Postnatal Depression and Baby Massage
Postnatal depression can affect one in ten women after the birth of their child. The arrival of a new born baby should be a happy occasion but for women suffering from depression it can be a stressful lonely period. I intend to briefly explain some of the causes, symptoms and treatment methods. Most importantly, is there any evidence to suggest that baby massage classes can help mums on the road to recovery.
There are three recognised mood disorders in the postpartum period.
At one end of the spectrum is ???baby blues??™, affecting about 80 per cent of new mothers, almost expected by all mothers. It usually occurs between the third and tenth day after birth. Symptoms include tearfulness, anxiety, mood fluctuations and irritability.
At the other end of the spectrum is postnatal psychosis. This affects one in 500 mothers, usually in the first 3 to 4 weeks after delivery. Postnatal psychosis is a serious condition. The mother herself may be unaware she is ill, as her grasp on reality is affected. Symptoms include severe mood disturbance, insomnia, and inappropriate responses to the baby. There is risk to the life of both mother and baby if the problem is not recognised and treated.
Between the ???blues??™ and psychosis lies postnatal depression (PND). More than 10 per cent of women develop postnatal depression. Many women do not know that postnatal depression can occur unexpectedly after delivery and typically blame themselves, their partners or their baby for the way they feel. Some try hard to ???snap out of it??™ without understanding that women with PND have little control over the way they are feeling.
Symptoms of PND
??? Sleep disturbance unrelated to baby??™s sleep needs.
??? Appetite disturbances – eating too much or not at all.
??? Crying for no reason.
??? Inability to cope ??“ doing daily chores and caring for the baby.
??? Irritability ??“ snapping at her partner or children.
??? Anxiety ??“ feeling panicky without cause.
??? Fear of being alone ??“ feeling something will go wrong with the baby if she is left alone or inability to cope.
??? Loss of concentration or memory ??“ can??™t concentrate on simple tasks, organising herself and family has become difficult.
??? Feeling guilty or Inadequate
??? Loss of confidence and self-esteem ??“ she may be worrying about going back to work and no longer sure if she can do the job.
??? Postnatal depression occurs in all cultures and all socio-economic classes, and can happen to child-bearing women of all ages.
??? Postnatal depression has been around for a long time.
??? Mild, moderate, or severe symptoms can begin during pregnancy (antenatal depression), suddenly after birth, or gradually in the weeks or months following delivery. Symptoms can emerge at any time during the first year after birth, but most cases have their onset within the first 4 months.
??? Postnatal depression can happen after miscarriage, stillbirth, normal delivery, or Caesarean delivery.
??? Postnatal depression happens mostly after a first baby, but can occur after any other pregnancy.
??? Postnatal depression has a 50 per cent chance of recurrence with a subsequent pregnancy. If a woman becomes pregnant again before recovering from postnatal depression, the condition will continue through the pregnancy and may worsen.
What causes depression
There a three area to look at when looking for the cause which is biological, social and psychological.
??? Genetic predisposition to depression.
??? Sudden changes in pregnancy hormones following delivery (There is a decrease in progesterone and estrogens immediately after the birth).
??? The mother is not getting enough nutrition and sleep deprivation.
??? Difficult or complicated pregnancy or childbirth experiences.
??? A history of pre-menstrual tension.
??? Previous experience of postnatal depression, or family/personal history of other mental health conditions.
??? Breastfeeding difficulties.
??? Infertility and use of in-vitro fertilisation (IVF) for conception.
??? A difficult or traumatic birth (including unexpected interventions, e.g. emergency Caesarean section).
??? A traumatic or abusive childhood (particularly sexual abuse).
??? Unrealistic expectations of motherhood and of herself.
??? Certain personality types (perfectionist or controlling).
??? Limited social and emotional skills (difficulties in effectively communicating).
??? Problematic or unresolved relationship issues with own mother.
??? Past unresolved issues of grief and loss such as previous miscarriage.
??? Lack of family and community support.
??? Difficult relationship with partner ??” removed emotionally, works long hours or travels.
??? Intrusive or difficult family relationships.
??? Social isolation and lack of transport.
??? Financial hardship.
??? Lack of close friends, particularly families with children.
??? Being a younger or older age.
??? Stressful life events such as a death in the family or job loss.
Treatment of PND
??? Joining a support group can help by talking about your experiences and feelings with others. It can help you see that you are not on your own and that others are going through the same problems.
??? Get support from your husband and family. This can be difficult if your husband doesn??™t understand what is wrong and what you are going through. Educating him and your family on what you are going through and getting their support will help.
??? Have time for yourself during the day ??“ ask a family or a friend to baby-sit whilst you have time to relax and do your own thing. This could be catching up with a friend, reading a book or relaxing in the bath.
??? If recommended by the doctor antidepressants to help lift your mood although you should allow follow your doctor??™s advice.
??? Speak to a counsellor or cognitive therapist ??“ sometimes just talking to someone can help you question your own assumptions and beliefs which can help you deal with your thoughts.
Baby Massage as a Treatment
Women with PND can improve the relationship with their babies if they give them gentle massages, research has found. PND not only harms the sufferer, but can severely affect the bonding process between mother and child. This can subsequently harm the future development of the infant, leading to behavioural problems. But a small study which compared women with PND who massaged their child and those who did not, found tangible benefits after only a few sessions. Dr Vivette Glover, an expert in child stress from Queen Charlottes Hospital in London carried out the study.
The full research was published in the ???Journal of Affective Disorder??™, March 2001, ???Infant massage improves mother-infant interaction for mothers with postnatal depression??™. Thirty four women with PND were involved with this experiment. One group had five weekly lessons of baby massage and the other group attended a support group for five weeks. The results found that those women who went to the baby massage classes had a higher increase in mother baby interaction. Also, they felt happier as their mood increased to feeling more content and happy.
???Complementary Therapies in clinical Practice??™, Aug 2006, Vol 12 Issue 3 published a study on the effect of baby massage on the mother??™s mood state. The results shown that baby massage positively affects the mood of the mother and should be recommended by health care professions to new mothers.
Touch is the most developed of the senses at birth and the prime means of communication with a new born child. It plays a significant role in the parent and child relationship. It enhances the bonding with the mother and father. There are many benefits of massaging your baby, but more so for a mother with PND. She would be able to gain her confidence back in handling her baby; the techniques show the mother how to relax with her child and how to connect as a mother. The mother is more observant and able to pick up cues which are guided by her child i.e. if they are hungry or tired. Research has already proven that it improve the mother child interaction and positively increases the mother??™s mood. The mother also has the support of the massage class group and instructor. These are all reason why a mother with PND should attend baby massage classes. We have to remember though that it could be very hard for a mother with low self esteem and confidence to join a class or to admit that she needs help. We therefore need to give extra support and encouragement if someone with PND wants to join a session.
Research is still ongoing but, I believe that we should encourage all mothers with PND to attend classes for support from other mums and to embrace the positive effects of baby massage on the mother and her child.
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