Kim

Postpartum Depression Epidemic Affects More than Just Mom February 2008 Scientific American Mind By Katja Gaschler The psychologist smiles at Manuela, a new mother in her late thirties. “Please play with your baby for two minutes,” the therapist instructs her and then leaves the room. Two video cameras film Manuela (which is not her real name) and her threemonth-old daughter. In the next room, a split-screen monitor shows the mother’s profile on the left and her infant in a baby chair on the right. At first, Manuela appears to be at a loss for what to do. Then, her face noticeably stiff, she begins to talk softly to her baby. Her baby fidgets, briefly makes eye contact and then turns away. Manuela eventually stops talking and stares into the distance, unsure again how to act. She absentmindedly strokes her baby’s foot with one hand. The psychologist knocks on the door; the videotaping is over. The new mother is now on the verge of tears. Manuela is undergoing therapy at the Clinic for General Psychiatry in Heidelberg, Germany, for postpartum depression, an ailment that has strained her relationship with her baby. Although the vast majority of mothers experience periods of crying and irritability along with concentration lapses and exhaustion, these so-called baby blues disappear within a few hours or days of delivery. But 10 to 20 percent of women in the U.S. develop, in the first year after childbirth, the more disabling despair that afflicts Manuela. These mothers succumb to a deep sadness that, if untreated, may persist for months to years. Manuela frequently feels exhausted and emotionally empty. When her baby cries, she sometimes wants to flee or hide. She is wracked with guilt because she cannot show love to her daughter. Mothers with symptoms of postpartum depression [see box on page 70] are often overwhelmed by the feeling that they might harm their babies. Although they rarely cause any outright harm, depressed mothers may have difficulty caring for their infants—and that fact can heighten their distress. These emotional problems plague women worldwide. A 2006 review of 143 studies in 40 countries documents that postpartum depression is especially common in Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea, with prevalence rates as high as 60 percent in some countries. The causes of the disorder are not fully known, but the dramatic hormonal fluctuations that occur after delivery may contribute to it in susceptible women. A bout of previous depression is a huge risk factor for the postpartum variety, new research shows. Whatever its cause, depression can weaken the nascent bond between a mother and her child, studies suggest, and thereby make a toddler more passive, insecure and socially inhibited—although a child’s intellectual development usually remains unimpaired. Thus, in addition to treating the mother’s depression, psychologists and psychiatrists increasingly focus on strengthening the relationship between the mother and her child— for example, by using a video camera to record and analyze their interactions. “We need to change the unfavorable behavioral patterns that develop between mother and child during depression,” says University of Heidelberg psychologist Corinna Reck.

Sleep Deprivation Worsens Postpartum Depression December 12, 2008 Posted by Katherine Stone/Postpartum Progress

I don't know. I think I'd put this in the category of "Did they really need to spend money on research to figure this out??" I suppose I shouldn't be a pain in the butt about it, but it feels obvious. Anyway, ignore me and read on: "A study published in the current issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing shows that depression symptoms worsen in PPD patients when their quality of sleep declines. Sleep deprivation can hamper a mother's ability to care for her infant, as judgment and concentration decline. Sleep-deprived mothers also may inadvertently compromise their infants' sleep quality because infants often adopt their mothers' circadian sleep rhythms. All new mothers experience some sleep loss following childbirth, as their estrogen and progesterone hormone levels plunge. They typically spend 20 percent more of the day awake than average during the first six weeks postpartum. Postpartum women wake more frequently and have less dream sleep than non-postpartum women, with women in their first month postpartum spending only 81 percent of their time in bed actually sleeping. Neurotransmitters that influence sleep quality also affect mood, raising sleep-deprived mothers' risk for depression ... Study author Bobbie Posmontier of Drexel University compared sleep patterns of 46 postpartum women, half with symptoms of PPD and half without. Sleep patterns were monitored for seven consecutive days. Results showed that mothers suffering from PPD took longer to fall asleep and slept for shorter periods. The worse their sleep quality, the worse their depression. Posmontier recommends clinicians treating women for PPD to address the importance of adequate sleep. 'Mothers can develop a plan to have other family members help care for the baby at night,' she said. 'They also should practice good sleep hygiene. That includes going to bed at the same time every night, avoiding naps and steering clear of caffeine, exercise, nicotine and alcohol within four hours of bedtime.'" I completely agree with the issue of sleep management for any new mom, but especially those moms who have a perinatal mood or anxiety disorder. My husband and I had a plan: I stayed up with the baby two nights in a row, and he stayed up with the baby the next two nights while I slept in a room without the monitor. And yes, he had a job to go to in the morning. But he sacrificed so that our whole family could be healthy as soon as possible. Let me tell you, a full night's sleep does a lot for your ability to cope. Husbands out there: You can balk now if you want to, and not stay up to help with the baby. But if you do, you may pay for it later with a completely incapacitated wife. Remember, the vow reads "in sickness and in health."

BABY BATH Preparing Your Baby's Bath • •

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Plan for your baby's bath. Get everything ready before you start the bath. This makes bathing your baby easier and safer. If you can, turn down your water heater to 120 degrees. Babies can get scalded easily. Fill the sink or tub you're going to bathe your baby in with warm water. Always test the water with your wrist or elbow. The water should be comfortably warm, not hot. Make sure you have everything you need for the bath. You can keep mild soap, cotton balls and a clean diaper in a shoebox or other container. Then you can bring the box in with the towel and washcloth to the room where you bathe your baby. When everything is ready, get your baby. If you forget an item, you will have to carry your baby with you. This is hard to do when the baby is wet and slippery. Never leave your baby alone in water. It's best not to answer the phone or the doorbell during your baby's bath. If you do, pick up your baby and carry her with you. If your spouse, relatives or friends call you often, let them know when your baby's bath time is. Tell them you won't take phone calls at that time.

Bathing Your Baby Your baby needs sponge baths at first. Give your baby a sponge bath until her umbilical cord or his circumcision, if any, is healed. After that, your baby can have a tub bath. Fill a bowl or basin with warm water: Use your wrist or elbow to check the water to make sure it is just the right temperature. Be sure the water is not too cold or too hot. Very hot water can be dangerous. Take the bowl of warm water and a soft washcloth to the place where you are going to bathe your baby. Pick a place for bathing that is warm and not drafty. You don't want your baby to get chilled. You can put your baby on a bath towel in her crib or any other flat surface. If you put your baby on a table, make sure she cannot roll off. Do not leave your baby alone, not even for a few seconds. Take your baby's clothes off. Put the washcloth in the warm water and squeeze it out until it is just damp. Use the washcloth to gently wipe your baby all over. Wipe her head and neck, behind her ears, and between her fingers and toes. Your newborn does not need to have a bath every day. Just clean her face, neck and diaper area whenever they are dirty.

Be Gentle When Bathing Your Baby •

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You can use your bathtub, kitchen sink or a plastic baby tub. Use something to line the tub to keep your baby from slipping. If you use a foam liner for a tub, it needs to be dried out after each use. This prevents the growth of germs. Or you can line the tub with a bath towel. Be sure to wash and dry it after each use. Use a clean, damp washcloth, without soap, to wash her face. Gently wash the outside and back of each ear and wash and dry under her neck. Don't use bubble bath or detergents in the bathwater since these may cause rashes. Use damp cotton balls or cotton pads to gently wipe your baby's eyes before you put her in the tub. Be sure to support your baby's head when she is in the tub. Wash your baby's hair and scalp very gently, using soap or a baby shampoo. Do this only once or twice a week. Rinse with a damp cloth. Make sure that soapsuds don't get into her eyes. Wash her body, starting with the chest. After washing with a soapy washcloth, rinse the washcloth and rinse her off. Pat your baby dry with a bath towel. Always keep her covered and warm when she is wet.

Health Teaching About Baby Bath Submitted by: GARCIA, Kimberly A. Course/yr/Sec: BSN III-A Submitted to: Ms. Aimee Agorilla