getting ready for ppd - a "just in case" game plan

[mama_Agnieszka]

I'm pg with my third and had severe ppd with my first, less severe with my second. It's been three years since my second. I'm trying to anticipating potential trouble with mood - just in case. Of course, I'm also very *VERY* open to a good possibility that NOTHING will happen. But, I have to be realistic... So, I'm wondering, what do you all think I should try to have in place in case things go badly as they did with my first and second... I mean, I have psych doc and a counselor... and my dh is taking some time off... But I can't think of anything else I might need to help me...

One thing I thinking is, I had a really hard time with bfing both my girls and drove myself nuts (literally) with trying - pumping all hours of the night, stressing madly that it's not working, feeling terribly guilty for not making enough milk... So, I'm actually thinking - and please be gentle with me on this - that if I start to have trouble from the get go, like if my milk doesn't come (which is hardly did with both my girls, even with meds and herbs and constant pumping), I will not push myself as hard.

What would you do?

[APToddlerMama]

I agree. I wouldn't push myself too hard. A mentally healthy mama is much more important than a exclusively-breastfeeding-but-totally-stressed-to-the point-of-severe PPD mama. Sending positive vibes your way!

[njkarin]

I think it is a good idea to go easy on yourself. If you want to try breastfeeding, go for it. But if you need to supplement don't feel guilty. I put way to much pressure on myself the first time around and tried to force myself to enjoy it which just made matters worse. Plus I felt like I was poisoning my child if I gave him formula. This really added to my PPD issues. Once I gave up breastfeeding and realized my son would be fine, I was able to start the recovery process for myself. Next time I'll probably try to breastfeed but I'll be more open to supplementation. You need to do what is best for you too!

[Carlyle]

Have you read any of the threads about encapsulating or eating your placenta? I've heard it can work wonders for both ppd and breastfeeding supply. Good luck to you.

[sunfish21]

I would never want to push you to do something that you don't feel like you can do. That said, you could invest in a post-partum doula that could come to your house and assist with any breastfeeding concerns that you have. If you hadn't been going, Le Leche League is also a good place to get great information and support. Breastfeeding should not be as hard as it sounds like it was for you. Why were you pumping in the middle of the night? I am not familiar with what would cause milk to not come in. Did you start right away (like within one hour) of your babies being born? I would guess that you know that your milk works like supply and demand--the more you nurse your baby the more milk you make. You should do whatever you need to do--just trying to provide some assistance if you decide you want to give breastfeeding another shot.

There were serious concerns about PPD with me, given my history of severe depression in my past. Thankfully I did not have a bad time of it, but I had also come up with a plan to have in place. I was told that the hormones released by breastfeeding were beneficial to my mood and feelings of bonding with the baby. I had a counselor and a Dr. set up for meds....and also reminded close friends and family of "my" warning signs so that they knew if something looked bad.

Best wishes to you. I hope things go well for you!

[mama_Agnieszka]

Originally Posted by sunfish21

you could invest in a post-partum doula that could come to your house and assist with any breastfeeding concerns that you have.

My dp is taking a month off work - and that's about what we can afford... plus, I have access to my midwives for 6 weeks after birth. With both my girls, I had midwives to help, a very experienced consultant (she was the breastfeeding teacher for all nurses in Western canada at the time), and I went to a breastfeeding clinic for a good number of weeks. I was in touch with La Leche, too. In short, I exhausted the resources in our city.

Originally Posted by sunfish21

If you hadn't been going, Le Leche League is also a good place to get great information and support.

I'm hesitant because with both my girls, the La Leche ladies, very well meaning though they are, convinced me to keep giving it a try... It was on their advice that I was pumping every two hours at night... I'm not blaming anyone, though. I totally agreed and agree with what they were saying. I know that the more baby nurses, the more milk is supposed to "grow" and hat's the theory behind the pumping... my daughters would refuse to nurse because they weren't getting anything but the stimulation of nursing was what I was told would be required... So, the pumping was supposed to do that.

Originally Posted by sunfish21

Did you start right away (like within one hour) of your babies being born? I would guess that you know that your milk works like supply and demand--the more you nurse your baby the more milk you make.

I had both girls at home and I put them to the breast before they were even cleaned up...

And yes, again, that's why I pumped every two hours even when my girls wouldn't nurse, to increase supply. It didn't work with me, don't know why, no one has had an answer for me. I did get some milk, but very little (maybe 1 oz or less) per feeding... it's all an estimate but that's what the doc and consultant were able to figure out based on weighing my babies right after feeding... And that was on the highest dose of Motellium and while taking herb supplement.

Originally Posted by sunfish21

You should do whatever you need to do--just trying to provide some assistance if you decide you want to give breastfeeding another shot.

Thank you for that. I've read so many books and have talked to so many moms about their experiences... never mind the midwives with tons of experience and the consultants... and it was just so frustrating not to be able to find a reason and a solution... I do want to breastfeed and I am most definitely going to give it a good shot. I'm just trying to prep myself for the very real possibility that it may go as it did with my girls... which is, not so great... so that I'm not focusing on that and getting sad about the loss of that bonding opportunity, and instead, that I stay focused on loving up my babe...

Originally Posted by sunfish21

I was told that the hormones released by breastfeeding were beneficial to my mood and feelings of bonding with the baby.

It's funny, in a way, but that's one of the top reasons why I kept pushing myself... even as I got worse and worse over time... and over things not working out despite all that hard work and effort... In the end, I decided that holding my baby and loving every moment with her was far more beneficial to me and to her than my feeling like I'm a horrible, incapable, deficient mother...


Anyway, thanks for listening and taking the time to share your thoughts.

[APToddlerMama]

Originally Posted by sunfish21

I would never want to push you to do something that you don't feel like you can do. That said, you could invest in a post-partum doula that could come to your house and assist with any breastfeeding concerns that you have. If you hadn't been going, Le Leche League is also a good place to get great information and support. Breastfeeding should not be as hard as it sounds like it was for you. Why were you pumping in the middle of the night? I am not familiar with what would cause milk to not come in. Did you start right away (like within one hour) of your babies being born? I would guess that you know that your milk works like supply and demand--the more you nurse your baby the more milk you make. You should do whatever you need to do--just trying to provide some assistance if you decide you want to give breastfeeding another shot.

There were serious concerns about PPD with me, given my history of severe depression in my past. Thankfully I did not have a bad time of it, but I had also come up with a plan to have in place. I was told that the hormones released by breastfeeding were beneficial to my mood and feelings of bonding with the baby. I had a counselor and a Dr. set up for meds....and also reminded close friends and family of "my" warning signs so that they knew if something looked bad.

Best wishes to you. I hope things go well for you!

There are a lot of really good ideas in this post. I just wanted to comment though that it is a common misconception that "breastfeeding shouldn't be so hard" and it really doesn't hold true for many women. If you're one of those women who struggles, there is no reason to beat yourself up over it. I saw three different lactation consultants, as well as a speech therapist with experience in feeding issues, and still had a terribly difficult time breastfeeding. I was literally on the brink of going absolutely crazy from total lack of sleep trying to get breastfeeding going well and it really hurt my feelings when people commented that is is "supposed" to be natural, easy, etc. For me, it was anything but, even with tons of help and support. I also had to pump all night long too to get my supply up, which in hindsight was not so good for my mental health. If I struggle as much next time, I am definitely going to have to weigh the thought of partially supplementing versus my sanity. A friend of mine had low supply issues and when she finally weaned her son, he went from the 3rd percentile in weight to the 90th within a matter of weeks. The poor little guys was so hungry for months and months despite everything she was trying to do to make things work. Not saying this is at all related to your situation, just pointing out that even with support of doctors, LCs, etc, breastfeeding can be really difficult and it doesn't mean anyone is doing anything wrong.

[mama_Agnieszka]

Actually, APToddlerMama, everything you posted rings true for me... as well as your friend's story. Both my girls went hungry the whole time I tried and tried and actually did make myself sick...

Thanks for sharing your experience and thoughts!

[MamaArty]

How would you feel about donor milk? From what you've said, it sounds like trying to bf exclusively is going to be very hard on you, if not impossible. Would getting donor milk be a possibility, and would you be ok with that option? If you don't like needing to supplement with formula, that could be another option. At the same time, I do realize that getting donor milk can be very difficult to arrange, and that some people aren't comfortable with that route, so I am by no means wanting to make you feel awkward if you don't want to do that.

Besides the bfing issues, and I think you are very smart to realize you need to cut yourself a break with that, it sounds to me like you are as well prepared as possible. You already have all the resources in place.

Did you take antidepressants with either of your previous bouts? If so, perhaps starting a low dose shortly before or immediately after the birth could further help to stave off any recurring ppd.

[flapjack]

Honey, I don't think breastfeeding is the be-all and end-all. Yes, it's better, but formula is a perfectly safe and healthy alternative for the majority of children. Don't sweat it.

I'm sorry, I know this is MDC but my next words are going to be even more babycentre. Have you thought about how you're going to be looking after your self after the new baby? What things are important to you that you can't give up, that you're going to do with baby in tow? Is there anything that you want to do without baby?

I'm finding that exercise is really helping my mood, though I'm not pp yet. I'm hoping that the combination of fresh air and exercise continues to help me after baby is born.

[Carolyn R]

You've gotten lots of great replies...I just wanted to chime in and say good for you for being so proactive and thinking ahead.

I had really bad PPD with my fourth child, and if it taught me one thing, it was that a happy, healthy mom is the most important thing. If you can nurse, great; if it is impeding your health, by all means, explore other options.

I stuck with breastfeeding round the clock because I stubbornly felt like if I gave it up, I would somehow be less of a mom. Some days it felt like the only thing I was doing right. But looking back, I wonder if my recovery would've been faster had someone else had been able to feed the babe so I could've gotten a little more rest and had the freedom to attend counseling, etc.

This is just my story, but I tell it to you as a way of saying...release yourself from "shoulds" and "have to's"...trust your mom gut, and do what's best for YOU.

You will be in my thoughts and prayers...wishing you a calm and healthy journey.

[mama_Agnieszka]

Hi MamaArty,

Originally Posted by MamaArty

How would you feel about donor milk? From what you've said, it sounds like trying to bf exclusively is going to be very hard on you, if not impossible. Would getting donor milk be a possibility, and would you be ok with that option? If you don't like needing to supplement with formula, that could be another option. At the same time, I do realize that getting donor milk can be very difficult to arrange, and that some people aren't comfortable with that route, so I am by no means wanting to make you feel awkward if you don't want to do that.

Yes, I have done that with both my girls. With my first, I had an acquaintance who had her daughter literally one day before I had mine, and she had an abundance of milk... and was very kind to pump for me. So, I supplemented for a good number of months with her milk. It felt a bit risky - this was a person I did not know very well... but I did get to know her and we actually bonded over the experience...

With my second I actually approach a few women I knew who had babies right around my second daughter's birth, and they pumped for me ahead of time! And I supplement my second dd for a good few months... but not as long as my first, even though I had plenty of milk and people willing to help... It turned out that my 2nd dd has intolerances (to gluten and eggs) and it was just not something I could approach the helpful mamas about... I mean, they understood and they were willing to try cutting out some foods but I didn't push it at all. I mean, after all, these were women with their own families and babies!!!

So, I'm definitely open... though maybe a bit more cautious this time (my second dd lost a lot of weight because she wasn't digesting the donor milk). And the other trouble is that the women that I asked for help in the past either aren't having babies right now or are just too busy because they are on their third babies! So, it's a bit trickier right now. I have asked two mamas I know with babies (third babies in both cases) for whom nursing is going really well, if they were willing to pump for me... So far, I've not heard anything back. And I respect that. They've got their hands full!

What I'd love to have happen would be if I could nurse exclusively long enough for baby to be able to go straight to goat's milk... but I'm trying not to get attached to that idea.

Originally Posted by MamaArty

Besides the bfing issues, and I think you are very smart to realize you need to cut yourself a break with that, it sounds to me like you are as well prepared as possible. You already have all the resources in place.

Did you take antidepressants with either of your previous bouts? If so, perhaps starting a low dose shortly before or immediately after the birth could further help to stave off any recurring ppd.

Thanks.

And yes, I needed to be on antidepressants with my second - all through the pregnancy and afterward. I'm on a lower dose now and hoping that it will help. But it's no guarantee. With my second, the PPD was not as bad, granted, but I was still not %100. I really want to enjoy being with my new babe, to celebrate and to bond and to form a strong attachment, nursing or not. As I said earlier, my relationship with my first dd definitely suffered as a result of PPD...

Thanks again,
Agnieszka

[mama_Agnieszka]

Thanks, Flapjack... I appreciate your words... I agree that, in the end, the relationship and my ease of mind and health count for a lot more. Someone reminded me that if I'm suffering while I try to nurse I'm actually transferring those emotions to my baby with whatever little milk I have... so perhaps the stress level cancels out the positive aspects of breastfeeding. And I think that's probably true. A nursing mama isn't just a container of good food for baby - an emotional being, with positive or negative emotions, all of which the baby senses and is aware of...

Originally Posted by flapjack

I'm sorry, I know this is MDC but my next words are going to be even more babycentre. Have you thought about how you're going to be looking after your self after the new baby? What things are important to you that you can't give up, that you're going to do with baby in tow? Is there anything that you want to do without baby?

This is exactly the kind of thing I need to think of now. Playing piano is definitely up there on my list. And a gentle yoga class... My husband will be at home for a month so I'll have help with my two other children. And I'm looking into a postpartum doula, too... though I'm not sure if we can afford that. I definitely need to think of some more ideas...

Originally Posted by flapjack

I'm finding that exercise is really helping my mood, though I'm not pp yet. I'm hoping that the combination of fresh air and exercise continues to help me after baby is born.

I have this dream of taking up running next spring. It's not something I'll be able to do immediately pp, but eventually. I can definitely start with walking and eventually swimming. But, I did not find that exercise was helpful with my severe ppd... mainly because I was so "far gone" by the time I started to exercise that it just didn't have an effect. I know, sounds awful but it's true. I'd head out for a walk and just cry and cry and cry the whole walk through. I'm sure it did help somewhat - the physical activity always has a positive effect, right? But I sure didn't feel better.

[mama_Agnieszka]

Originally Posted by Carolyn R

I had really bad PPD with my fourth child, and if it taught me one thing, it was that a happy, healthy mom is the most important thing. If you can nurse, great; if it is impeding your health, by all means, explore other options.

I stuck with breastfeeding round the clock because I stubbornly felt like if I gave it up, I would somehow be less of a mom. Some days it felt like the only thing I was doing right. But looking back, I wonder if my recovery would've been faster had someone else had been able to feed the babe so I could've gotten a little more rest and had the freedom to attend counseling, etc.

Yup, exactly. That is what happened to me. I felt like if I gave up nursing, however little I was actually able to give, there wouldn't be any other way for me to bond and to be a good mother. But see, that already was, for me at least, a symptom of depression! I mean, why would a new mom feel this way?? But when you're in the middle of that, you don't see it that way. So, I refused to stop, mostly because I felt that I would be useless otherwise! And in my case, this thinking and the choice to keep pumping at night, going without sleep as a result, the stress and sense of failure most definitely were both a symptom of PPD and a cause for the disease getting worse instead of better. I could not make myself stop, like a reasonable person may have, until the psychiatrist at the Emergency at the hospital told me, either I stop and sleep through the night or he's going to admit me.

Originally Posted by Carolyn R

This is just my story, but I tell it to you as a way of saying...release yourself from "shoulds" and "have to's"...trust your mom gut, and do what's best for YOU.

You will be in my thoughts and prayers...wishing you a calm and healthy journey.

Thank you, Carolyn. I'm trying to trust and reminding myself constantly about what's really important.

[dinahx]

Doctors are doing a new protocol where you take meds in your last trimester. I have thought about doing something similar with an herbalist, I am also considering placenta capsules, but idk if there are extra considerations for someone who is rh- (my placenta will be +)

[flapjack]

dinahx, there's a company in the UK who make homeopathic preparations from placenta- called helios (www.helios.co.uk). It could be worth ringing the major homeopathics in the US to see if you can find something similar (I have no idea how you'd get a human placenta through customs.)