Exercise help to relieve postnatal depression after the birth of a baby, called [postnatal or postpartum depression](https://nabtahealth.com/what-is-postnatal-depression/) ([PND](https://nabtahealth.com/glossary/pnd/)), is common. Thought to affect between 10 and 20% of new mothers, some of the main symptoms are frequent crying, a feeling of listlessness and tiredness, and an inability to fully bond with their baby. The reasons why some women are more susceptible to [PND](https://nabtahealth.com/glossary/pnd/) than others have not been fully established, but with many reporting that they had unrealistic expectations of what being a mother would feel like and others struggling with low self esteem due to an altered body shape, perhaps the high proportion of women diagnosed with [PND](https://nabtahealth.com/glossary/pnd/) is unsurprising. The vast array of physico-chemical and hormonal changes that occur during pregnancy and beyond probably play a role, however the exact mechanisms and contributing factors are still unclear. #### **The problem** Despite its high prevalence and the long-term health risks it poses, not just to the mother, but also her baby… despite the fact that it can impact a woman’s relationship with her husband, her friends and other family members… despite the fact that in its most severe form, it can [lead](https://nabtahealth.com/glossary/lead/) to suicidal thoughts… despite all of this, and more, current treatment options are limited to say the least. Postnatal health and weight management is important. Following pregnancy, many women are left with excess weight and reduced fitness, at a time when being fit and healthy is vital. The problem is that whilst this is widely known, there are no universal guidelines to support and instruct women on how to maximise their health and fitness post-childbirth. #### **So, can exercise help?** Let’s consider the literature first. There have been a significant number of studies demonstrating that regular exercise is beneficial for the general population. There have even been studies showing the importance of mothers-to-be maintaining a good level of overall fitness throughout their pregnancies. In the general population, physical activity has been shown to reduce stress, anxiety and depression; it has an important role in the promotion of good mental health. The National Institute for Health and Clinical Excellence (NICE) in the UK recommends that for adults with mild/moderate depression a structured group physical activity programme should form part of their ‘facilitated self-help’. The NICE guidelines on the management of [PND](https://nabtahealth.com/glossary/pnd/) make no specific mention of physical activity being used as an adjuvant tool, although they do refer people to the section of facilitated self help under the guidelines for clinical depression. An older version of the NICE guidelines did indicate that moderate exercise could benefit women with [PND](https://nabtahealth.com/glossary/pnd/), but newer versions seem to have removed this statement. Perhaps, this is unsurprising. Literature searches and meta analyses are fairly inconclusive. Data on the benefits of exercise for women struggling after childbirth is conflicting and positive associations are weak. There is a need for more robust, longer-term studies. Without the evidence to support it, few health institutes will be prepared to list the undertaking of physical activity as a viable treatment option. However, with many women reluctant to take antidepressants whilst breastfeeding and caring for a child, alternative approaches are required. It is, of course, important to consider both viewpoints. Not all women will want to exercise after the birth of their baby. Some will have childcare considerations, others will be adhering to breastfeeding and sleeping routines that minimise the opportunities for undertaking physical activity. The general fatigue that accompanies looking after a newborn can make it difficult to generate sufficient enthusiasm for exercising. It is certainly not a solution for everyone, but for some, it may be a good way of relieving some of the stress and anxiety they have after giving birth. #### **Personal Reflection** When I write articles, I do not always feel it is appropriate to share my personal feelings. This is not usually the medium for doing that; this is a place to present the facts, supported by the most recent published research. But, this is a topic I feel quite passionately about. I do believe exercise can improve a negative mindset, I am a great advocate of group exercise programmes and this is why. I never had clinically diagnosed [PND](https://nabtahealth.com/glossary/pnd/), but, like many women, I struggled after giving birth; I missed my independence and I found it a very socially isolating experience. In many ways, the second time round was easier, we knew what we were letting ourselves in for; life had changed significantly with our first baby. how much difference would another one really make (the absolute naivety of that statement is a topic for another time!)? What was difficult with round two, was that we had recently moved overseas; we moved when I was 12 weeks pregnant. And so, I found myself living in a different country, with no family, few meaningful friendships, a husband that worked, a toddler and a newborn. I still would not say I was depressed; I did not struggle in the way that some women do, but I was lonely and that can have a big impact on a person’s quality of life. I lived for the weekends, when my husband was home, but by then was too irritable and tired to make the most of it. Things changed hugely for me when I found a postnatal exercise class to join. I could take the baby and nobody minded if I had to stop part way through and breastfeed, but the main thing was, it was something for me; the focus being on me, and not on the baby. Sure, he got to come along, have a change of scene, stare at himself in a mirror and dribble over other baby’s toys; so you could say we both benefitted. I made friends, like-minded women, who were in a very similar position to me; I got fitter and felt better about my own body; I improved my energy levels and, ultimately, improved the relationship I had with my husband and my children. So, yes, I will take on board what the science says, I will not guarantee physical activity as the best and only way of relieving the symptoms of [PND](https://nabtahealth.com/glossary/pnd/). But, I will suggest that if you are struggling, find a type of exercise that works for you, with or without baby (there is no shame in having a break sometimes), and go for it. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#463f272a2a270628272432272e23272a322e6825292b) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “1 Guidance: Depression in Adults: Recognition and Management: Guidance.” NICE, [https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#step-2-recognised-depression-persistent-subthreshold-depressive-symptoms-or-mild-to-moderate](https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#step-2-recognised-depression-persistent-subthreshold-depressive-symptoms-or-mild-to-moderate). * “1 Recommendations: Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance: Guidance.” NICE, [https://www.nice.org.uk/guidance/cg192/chapter/1-Recommendations](https://www.nice.org.uk/guidance/cg192/chapter/1-Recommendations). * Carter, Tim, et al. “The Effectiveness of Exercise-Based Interventions for Preventing or Treating Postpartum Depression: a Systematic Review and Meta-Analysis.” _Archives of Womens Mental Health_, vol. 22, no. 1, Feb. 2019, pp. 37–53., doi:10.1007/s00737-018-0869-3. * Daley, Amanda J, et al. “The Effectiveness of Exercise as a Treatment for Postnatal Depression: Study Protocol.” _BMC Pregnancy and Childbirth_, vol. 12, no. 1, 9 June 2012, doi:10.1186/1471-2393-12-45. * Saligheh, Maryam, et al. “The Relationship between Postnatal Depression, [Sociodemographic](https://nabtahealth.com/glossary/sociodemographic/) Factors, Levels of Partner Support, and Levels of Physical Activity.” _Frontiers in Psychology_, vol. 5, 14 July 2014, doi:10.3389/fpsyg.2014.00597.
 #### What is maternal health and why is it so important? Pregnancy and childbirth are exciting, scary, life-changing events. They can be joyful experiences, and they can be fraught with anxiety, and physical and emotional challenges. Maternal health is about the wellbeing of women and their babies during pregnancy, childbirth, and the postnatal period. Women should feel comfortable and confident in the medical care and attention they receive each stage of their pregnancy journey. Lack of awareness about the potential complications associated with pregnancy and childbirth can [lead](https://nabtahealth.com/glossary/lead/) to devastating outcomes. Most maternal complications are preventable with prompt support by trained maternal health professionals. The goal for maternal health is always positive outcomes for both mother and baby. #### What are maternal health services? A pregnant woman will usually meet some or all the following skilled healthcare practitioners during and after her pregnancy: * Doctor or General Practitioner (GP): Provides basic pregnancy care. Doctors with added expertise may share pregnancy care with a hospital. * [Obstetrician](https://nabtahealth.com/glossary/obstetrician/): A doctor qualified in specialist antenatal and postnatal care for women and their babies. Obstetricians deliver babies and manage high-risk pregnancies and births. * Midwife: Medically trained to care for women during pregnancy, labour and after childbirth. Often a pregnant woman will be cared for by a team of midwives. * Doula: Some women choose a Doula as a companion for support during pregnancy and labour. A Doula is not a medically trained professional. * [Lactation](https://nabtahealth.com/glossary/lactation/) consultant: Helps mother and baby establish breastfeeding and overcome difficulties with latching, low milk supply, and sore nipples. * Maternal and child health nurses: Monitor the child’s development and growth from newborn until around 3.5 years old. #### Antenatal checks, tests, and screenings Routine antenatal checks and tests are an important part of a woman’s pregnancy care. As the pregnancy progresses, blood tests, urine samples and ultrasound scans are accompanied by scheduled check-ups to assess the mother’s health and wellbeing, and the baby’s development. Screening and scans during pregnancy typically include a full blood count, infectious disease screen, urine culture, dating scan, screens for genetic abnormalities, [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) screening, and Group B strep screen. It’s a personal choice to have all the antenatal tests. A mother’s healthcare team will recommend that she has all tests and scans as scheduled for a complete picture of her health and her baby’s development. The tests are also designed to pick up any medical problems and identify possible genetic conditions affecting the baby. This will enable the mother and her doctors to make informed decisions about further testing or actions. #### What are maternal health concerns during pregnancy? Major maternal health problems can [lead](https://nabtahealth.com/glossary/lead/) to serious illness or death for both mother and baby. Complications can include excessive blood loss during labour, infections, [anaemia](https://nabtahealth.com/glossary/anaemia/), high blood pressure ([hypertension](https://nabtahealth.com/glossary/hypertension/)), obstructed labour, and heart disease. Maternal mental health is also an important consideration. Pregnancy and childbirth are different for every woman. Access to the right healthcare before, during and after pregnancy will reduce the risk of complications. #### – Before pregnancy Medical history and pre-existing conditions: The healthcare team should be made aware of any medical conditions, medications, or family history that may affect the mother’s health, or the unborn baby’s health during pregnancy. #### – During pregnancy The mother should attend all recommended check-ups and screenings. The maternal health team will monitor and treat pregnancy-related health issues including [anaemia](https://nabtahealth.com/glossary/anaemia/), urinary tract infections, [hypertension](https://nabtahealth.com/glossary/hypertension/), [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/), mental health conditions, excess weight gain, infections, [hyperemesis gravidarum](https://nabtahealth.com/glossary/hyperemesis-gravidarum/) (severe and persistent vomiting). #### – After pregnancy The postpartum period usually refers to the first six weeks after childbirth. While there’s (understandably) lots of focus on the new arrival, postpartum health is just as important: * Physical recovery: Allow time for physical recovery from a vaginal birth or C-section. Mothers should prepare for perineal pain, vaginal bleeding (lochia) and uterine [contractions](https://nabtahealth.com/glossary/contraction/). * Postpartum or postnatal depression: Take care of emotional health. It’s normal to experience the ‘baby blues’ when hormones dip a few days after giving birth. Prolonged low moods and feelings of helplessness should be raised with the healthcare team. * Rest is best: Try to sleep or rest when the baby sleeps. Rest will help with recovery. * Eat regularly: Eat regular, healthy meals. What a mother eats, her baby eats. * Hydrate: Drink water, lots of it. Hydration will aid milk supply. * Feeding routines: Get support establishing feeding routines, whether breast-feeding or bottle-feeding. * Physical exertion: Avoid heavy lifting for the first 4 to 6 weeks after delivery and especially after a C-section. Exercise should be gentle walks with the baby. Try not to do any physically demanding activities (no running up and down the stairs and definitely no gym sessions!). * Vitamins: Continue taking antenatal vitamins #### What are postpartum complications? Postpartum complications to be aware of include mastitis, postnatal depression, excessive bleeding (hemorrhage) after giving birth, infection or sepsis, [hypertension](https://nabtahealth.com/glossary/hypertension/), pulmonary [embolism](https://nabtahealth.com/glossary/embolism/), cardiomyopathy, and cardiovascular disease. Postpartum mothers should be counselled to recognise the signs and symptoms of a problem. Contact a doctor at once at any sign of high fever, flu-like symptoms, a red and swollen breast, a headache that doesn’t improve with medication, chest pain, shortness of breath, seizures, bleeding through one maternity pad in an hour, and a red or swollen leg painful to touch. #### What happens at a postpartum check-up? Postpartum maternal checks are about the mother’s health. At your postpartum check-ups your doctor will check your abdomen, [vagina](https://nabtahealth.com/glossary/vagina/), [cervix](https://nabtahealth.com/glossary/cervix/), and [uterus](https://nabtahealth.com/glossary/uterus/) to make sure you are healing well. They will talk to you about when it is safe to have sex again and birth control (remember that even if you don’t have your periods while you breastfeed you can still become pregnant). And your doctor will also talk to you about your emotional health, whether you are getting enough rest, eating well and how you are bonding with your baby. Use these check-ups to raise any concerns you might have with your recovery and emotional wellbeing. #### Getting started with Nabta Health Nabta’s marketplace and resources are designed to support mothers at every stage of their maternal health journey. From at-home tests to prenatal courses; on-demand Doulas to hypnobirthing courses; maternity pads to nursing bras; prenatal yoga to postpartum care packages… Nabta’s team of healthcare and wellness experts has carefully selected products to meet a woman’s maternal health needs.
Lung Disease in Premature Infants, Premature infants are at risk for a variety of lung problems and diseases, in part because infants can survive birth at earlier ages than ever before. According to the New England Journal of Medicine, infants today “consistently” [survive birth at 23-26 weeks](https://nabtahealth.com/articles/your-pregnancy-week-23/)’ gestation. However, as a result, their lungs are less developed than a [full term](https://nabtahealth.com/glossary/full-term/) baby’s lungs, potentially leading to problems down the road. Here are a few conditions that premature babies may face both in the [neonatal](https://nabtahealth.com/glossary/neonatal/) intensive care unit (NICU) and after discharge. Respiratory distress syndrome (RDS) ----------------------------------- Premature babies often lack adequate surfactant, a special substance inside the lungs that makes it easier to breathe by preventing the lungs from collapsing. This condition, known as respiratory distress syndrome (RDS), is the most common lung problem affecting premature babies. Premature babies (usually those born before 36 weeks’ gestation) with RDS generally require treatment with surfactant immediately after birth. This medication coats their air sacs and enables them to breathe easier. Some babies with RDS require more intervention. They may need a temporary ventilator or continuous positive airway pressure (CPAP), which offers adequate airway pressure until their lungs mature and get stronger. Bronchopulmonary dysplasia (BPD) -------------------------------- Bronchopulmonary dysplasia can occur in premature infants who suffer from RDS. BPD is typically seen in premature infants born at or before 30 weeks gestation who need supplemental oxygen for a prolonged period of time. Infants with BPD have lung scarring and abnormal lung development. Fortunately, many babies outgrow BPD. However, others might need medications or lung treatments for years to come, including diuretics, inhaled steroids, and bronchodilators (a type of medicine that helps open up the lung passages to allow air to flow through more freely). According to the National Heart, Lung, and Blood Institute (NHLBI), between 5,000 and 10,000 new cases of BPD occur every year in the U.S. Apnea ----- Sometimes, premature babies have erratic breathing. In fact, even full-term healthy babies have moments when their breathing is uneven, referred to as periodic breathing. However, premature babies with infant apnea require close monitoring. The American Academy of Pediatrics ([AAP](https://www.aap.org/)) defines apnea as “an unexplained episode of cessation of breathing for twenty seconds or longer, or a shorter respiratory pause associated with bradycardia (low heart rate), cyanosis (blue color to the skin), pallor (paleness), and/or marked hypotonia (baby becomes floppy).” While in the NICU, the baby may require CPAP or even an infant form of caffeine to stimulate the baby to breathe regularly. Premature babies with infant apnea will oftentimes go home from the NICU unit with monitoring equipment. Sensors located in a special vest will detect and monitor both breathing and heart rate, and an alarm will sound if either of these fall below a safe range. Persistent pulmonary [hypertension](https://nabtahealth.com/glossary/hypertension/) of the newborn (PPHN) --------------------------------------------------------------------------------------------------------- Premature infants can have high blood pressure in their lungs called persistent pulmonary [hypertension](https://nabtahealth.com/glossary/hypertension/) of the newborn (PPHN). This condition most often occurs when babies aspirate [meconium](https://nabtahealth.com/glossary/meconium/) during labor. These infants are likely to require the use of mechanical ventilation until the condition resolves. They may require high-frequency ventilation, which is a specialized ventilator to help the lungs heal more quickly. They will also receive medication to help them breathe, including surfactant. PPHN can also occur in [full term](https://nabtahealth.com/glossary/full-term/) infants (approximately 2 per 1,000 babies) and is actually more common in [full term](https://nabtahealth.com/glossary/full-term/) infants than premature infants. Infections ---------- Lung infections can be dangerous for any baby but [premature infants](https://nabtahealth.com/articles/anemia-in-premature-infants/) are at a much higher risk of complications from either viral or bacterial causes. Respiratory syncytial virus (RSV) is the most common cause of viral lung infections in [premature babies](https://nabtahealth.com/articles/11-things-that-can-cause-preterm-labor/). (RSV) can infect anyone, but is a cause for concern in premature infants because their lungs are weaker. Treatment is usually just supportive, including oxygen and IV fluids. Viral infections can sometimes be complicated by bacterial pneumonia. Newborns with pneumonia will likely require supplemental oxygen until they get over the insult to their already fragile lungs. IV antibiotics are also used to combat the infection. Reviewed by Dr. Sara Connolly, December 2018 **Sources:** * American Lung Association * Understanding Bronchopulmonary Dysplasia (BPD). Baraldi, E., and Filippone, M * Chronic Disease after Premature Birth * N Eng J Med 2007:1946-55. Centers for Disease Control and Prevention * Respiratory syncytial virus (RSV). Committee on Fetus and Newborn * American Academy of Pediatrics * Apnea, sudden infant death syndrome, and home monitoring * Pediatrics * Apr 2003;111(4 Pt 1):914-7. March of Dimes * Common Conditions Treated in the NICU. Powered by Bundoo®
* The first step is to admit that you are feeling overwhelmed. * It’s important to involve your whole self (mind & body) in order to get the most effective results when overcoming overwhelm. * Tools and techniques you can use include breathing exercises, writing lists, and learning to say no. Yes, we’re still overwhelmed. No, we don’t just need to learn to relax. In our series of articles about career development and returning to work after maternity leave or a break, we explore the topic of how to deal with feeling overwhelmed. For more advice on how to get back into your career, sign up for a course with [Get Unstuck Career Coaching on the Nabta Health Women’s Shop](https://nabtahealth.com/product/back-to-work-online-career-coaching/). The 4 part ‘get back to work’ course includes a session on Using Emotional Intelligence as a Foundation for Career Development. By the end of the program, participants have the tools and confidence they need to approach job opportunities. Recognising overwhelm, and learning how to overcome feeling overwhelmed are crucial to tackling new challenges such as [work](https://www.getunstuckcareercoaching.com/post/getting-back-to-work-after-pregnancy), with confidence. #### Feeling constantly overwhelmed With everything that’s happened in the last year, the effects of the pandemic are still very real and will continue to affect us for some time. One of those effects is this feeling of constant overwhelm. Overwhelm of emotions, change, information, grief, and the unknown that is ultimately scraping away at our overall well-being. We mustn’t forget that our well-being is always important and just because time has passed since the beginning of the pandemic doesn’t mean that it’s gotten any easier to manage. We all know, rationally, the things we can do to help: eat healthier, exercise, get quality sleep. But it can be hard to do these things when you’re stuck in overwhelm. So, let’s look at some practical things you can start doing today that may help you get started. First of all, if you find yourself feeling this way a lot, you’re not alone. It can be difficult to admit but there are more of us feeling overwhelmed than not. Second, there are some things that you can try that might give you a little breathing room. You’ll notice that a couple of the things I mention below have to do with your body and I believe it’s important to involve your whole self (mind & body) in order to get the most effective results. #### How to overcome feeling overwhelmed ##### 1 **Breathe** More specifically, breathe in for 7 seconds and breathe out for 11 seconds. And repeat for at least 1 minute. You can also breathe in for 4 and out for 8, the idea is that you’re breathing out for a longer period of time than you’re breathing in. This method of breathing activates your parasympathetic nervous system, slows your heart rate down, and allows your body to slow down. I first learned about this technique during a hypnobirthing course I did when I was pregnant and have sworn by it ever since. ##### 2 **Make a list** Write it down using a pen and paper. Make a list of everything that is on your to-do list, everything that is causing the overwhelm. A great technique that I follow was created by [Ryder Carroll, the author, and creator of the Bullet Journal.](https://bulletjournal.com/pages/about) He says to create 3 columns and in the first one write down all the things that you’re currently working on, in the second column make a list of everything you should be working on, and in the third column list everything you want to be working on. Spend time on this exercise, don’t rush it. Each thing can be written down as a bullet point in short form. This method allows you to see your mental inventory. Then you want to look at this inventory you’ve created and ask yourself, for each bullet point, 1) Does this matter? (not just to you but maybe someone you care about) And 2) Is this vital? (to your housing, loans, job, etc.) Any point on your list that you answer with a “No” to both of these questions, can then come off your list. You should be left with only things that matter and/or are vital to you. “Everything else is a distraction,” says Carroll. He also mentions that it’s more beneficial to do this using a pen and paper so that you can be more mindful and present (rather than typing it on your phone or computer). ##### 3 **Learn to say “no”** And then keep practicing until it becomes a natural way for you to prioritize the tasks, people, and situations that you know won’t cause you unnecessary stress. Just like the mental inventory exercise above, notice what activities you’re doing that make you counter-productive and take up a lot of energy, which ones can you stop doing today? Next time someone asks for your help for example, instead of jumping in and saying yes, can you take a moment of reflection to ask yourself whether this is a priority or not? When you say yes to something that you know will stress you out and is not a priority, it’s like you’re saying yes to overwhelm too. What do you want to say yes to instead? How much of the overwhelm is caused by these situations? It can seem too obvious but when we’ve been practicing saying yes to almost every request, it can seem like it’s part of our identity but it’s not. You are always in control and are always at choice. Start with one thing today, and commit to practicing the exercise. Carve out at least 15 minutes today to get started and prioritize managing your overwhelm, instead of it managing you. To learn more about how to build your emotional strength and apply this in a work context, consider using a [career coach.](https://nabtahealth.com/product/back-to-work-online-career-coaching/) You’ll gain the tools you’ll need and you will develop self awareness and social awareness, self management skills and relationship management skills. Get Unstuck’s session on [Using Emotional Intelligence as a Foundation for Career Development](https://nabtahealth.com/product/back-to-work-online-career-coaching/) is a great one for learning practical techniques for building confidence when returning to work. Reviewed by the Nabta Editorial Team
* Postnatal depression is a condition that affects 1 in 10 women post birth. * It is normal to feel anxious and tearful for a couple of days after giving birth (baby blues). If these feelings do not go away or starts later, seek professional help as it may be postnatal depression. * Triggered by childbirth, postnatal depression is a condition that requires treatment and support. * Trying to manage by yourself is not only detrimental to your own mental wellbeing but can also affect the long term relationship between a mother and a child. Postnatal depression (or postpartum blues) is a condition that affects up to one in ten women after the birth of their baby. However, it is not a condition restricted to females and new dads are also susceptible to mental health difficulties in the weeks and months following a baby’s arrival. #### **Symptoms of postnatal depression** It is very common for new mothers to feel tearful, anxious and sad in the two weeks after having a baby; so common, in fact, that the so called ‘baby blues’ are considered to be entirely normal. However, if the feeling of sadness does not go away, or starts later on, you should speak to a healthcare professional. Postnatal depression is not a simple condition, with a simple set of symptoms. It varies significantly between people, both in terms of severity and the specific symptoms experienced. Some of the most frequently seen symptoms are: * Frequent crying * Lack of energy/tiredness * No longer enjoying things that used to give pleasure * Disturbed sleep patterns * Difficulty bonding with baby * Concentration problems * Loss of appetite/increased appetite * Feeling agitated, irritable and/or apathetic * A sense of guilt or hopelessness. It is important to remember that many of these symptoms are common in the weeks and months that follow a baby’s arrival. With a new baby, comes sleep deprivation, major lifestyle adjustment and the [reestablishment of familial roles](../dont-let-your-newborn-ruin-your-marriage), as husband and wife become daddy and mummy. However, if the feelings are prolonged, or you experience a number of them at any one time, it might be worth seeking help. Trying to manage by yourself is not only detrimental to your own mental wellbeing, but can also impact the longer-term relationship between you and your baby. #### **What causes postnatal depression?** There is no definitive answer to this question. Certainly, the surge in hormones after giving birth can play a role. However, the fact that new dads are also susceptible to the condition means that it cannot be solely attributed to fluctuating hormones. Whether it is entirely distinct from major depressive disorder, or a specific form of the condition, triggered by childbirth, is unclear. What is known is that certain people have a greater risk of developing postnatal depression. These include those with a history of mental health problems, those with a limited social support network, or poor relationship, and those who are experiencing stressful life events. #### **How should postnatal depression be managed and treated?** If you suspect you may be experiencing postnatal depression, the most important thing is to seek help and treatment promptly. Left unmanaged, postnatal depression can impact the relationship you have with your baby and your family. Having postnatal depression is nothing to be ashamed of and with the right help and support you can overcome it. There are various options for managing the condition, which your doctor can talk through with you. For mild cases, supported self-management might be possible. Taking the time to talk, rest, [exercise](https://nabtahealth.com/can-exercise-help-to-relieve-postnatal-depression/) and eat healthily and regularly can greatly improve a person’s emotional wellbeing. It can be difficult to factor in time for yourself when you have a newborn, but try to ask your partner and family for help; in most instances they will be pleased to be involved. If possible attend local support groups, talking to people who are in the same position and feeling a similar way can, in itself, be therapeutic. In some cases, treatment is required. This may come in the form of talking therapy, such as cognitive behavioural therapy (CBT) or antidepressants. CBT can be used to help a person think in a more positive way and to avoid thoughts that are unhelpful or unrealistic. New parents often place unreasonable demands on themselves, which can then [lead](https://nabtahealth.com/glossary/lead/) to feelings of guilt, failure and ultimately depression when these expectations are not met. Antidepressants are mood stabilisers, enabling those who take them to function normally. This approach is most likely to benefit those with a history of depressive episodes. Try using Nabta’s [Depression pack](https://nabtahealth.com/product/thoughtful-box-to-counter-depression/) to alleviate your symptoms. #### **Postpartum Psychosis** Postpartum psychosis is distinct from postnatal depression and fortunately, is very rare, affecting approximately 0.1% of new mums. It is a serious condition, requiring immediate medical assistance. Symptoms include delusions and hallucinations, as well as periods of mania and depressive episodes. It will usually require a hospital stay, but, with the right support, most women do make a full recovery. **Sources:** * Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. “Heterogeneity of Postpartum Depression: a Latent Class Analysis.” _The Lancet. Psychiatry_, vol. 2, no. 1, Jan. 2015, pp. 59–67., doi:10.1016/S2215-0366(14)00055-8. * Jones, I, and J Shakespeare. “Postnatal Depression.” _BMJ_, vol. 349, 14 Aug. 2014, p. g4500., doi:10.1136/bmj.g4500. * “Postnatal Depression.” _NHS_, [www.nhs.uk/conditions/post-natal-depression/](http://www.nhs.uk/conditions/post-natal-depression/).
After giving birth, there are a lot of things you expect to lose. Some, like excess weight, you may hope to shed rapidly; others, like a full night’s sleep, you may really struggle with. One thing you may not expect to lose though, is your hair. An estimated 40-50% of women experience greater-than-normal hair loss in the postpartum period, according to the American Pregnancy Association. Like many processes in your body, hair growth is influenced by hormones. Typically, at any one time your hormones will stimulate about 90% percent of your hair to grow, whilst 10% of your hair follicles go through a resting phase. This phase of inactivity usually lasts for about 2-3 months, after which, the resting follicles will fall and new hairs will grow in their place. Since you only lose a small fraction of hair at a time, the loss is usually not noticeable. Pregnancy, however, can change this normal cyclical pattern of growth and rest. The increased hormones in your body mean that your hair grows at a faster rate and remains in the resting phase longer than usual. This is why some women find their hair appears thicker and fuller during pregnancy. After you have given birth, hormone levels start to decline and the extra hair that did not fall out whilst you were pregnant, starts to shed in greater quantities than you would normally see. Whilst this is nature’s way of helping your hair growth to return to normal, and you are only shedding hair that would normally have been lost in the preceding months, seeing lots of hair come out at a time can, understandably, cause some concern. Signs of normal postpartum hair loss: * Noticing more hairs than usual in your hairbrush * Hair loss peaking at around four months after giving birth * Accelerated hair loss stopping by your baby’s first birthday. When to talk to your doctor: * If you have hair-free patches of scalp that are approximately 25 mm in size * If you feel the loss is excessive and not improving with time. In addition to following a [healthy diet](../which-foods-help-with-hair-loss), there are other steps you can take to reduce hair loss after pregnancy. These include avoiding extremely tight hairstyles that can accelerate hair loss, such as cornrows, braids, and hair rollers that are pulled too tightly. **Sources:** * American Academy of Dermatology * Hair Loss Common After Childbirth. American Pregnancy Association * Hair Loss & Pregnancy. KidsHealth Powered by Bundoo®
Postpartum depression (PPD) is commonly associated with new mothers, and support for women with PPD is readily available. However, emerging evidence suggests that 10 percent of new fathers also experience the “baby blues.” Postpartum depression in dads is more likely to occur if the dad has a history of depression or if he is feeling stressed in his marriage or about becoming a father. When a father has PPD, the whole family suffers. Why does PPD in dads go unrecognized so often? After the birth of a new child, mothers typically meet regularly with their OB-GYN and the child’s pediatrician. These opportunities allow mothers to talk about how they are feeling. However, fathers often return to work immediately or soon after a baby is born and do not have the opportunity to speak with medical professionals. Fathers also might not recognize that what they’re feeling is actually depression that would benefit from treatment. Media stories about PPD in fathers are rare, so many dads might not even be aware such a condition exists. Typical depressive symptoms are: depressed mood most of the day, decreased interest in activities including sex, changes in weight (gain or loss), changes in sleep (waking up during the night with difficulty falling back to sleep or sleeping more than usual), agitation, lethargy, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death. A father need not experience all of these symptoms to be considered depressed. Just as with moms, dads experiencing PPD need support. Informal support—from friends and family—is important, but if a father is experiencing symptoms of PPD for greater than two weeks, he should seek a doctor specializing in mood disorders, such as a psychiatrist, psychologist or mental health counselor, and schedule a check-up with his physician. Psychotherapy, or “talk therapy,” has been shown to be an effective treatment for depression. If symptoms and mood do not improve following treatment, a psychologist may advise dad to consult a psychiatrist for a medical consultation. Many patients report that the combination of talk therapy and medications, or “therapy through medication,” is beneficial in helping to improve their mood and return to their normal activities. Family therapy is another option for treatment of PPD. Family therapists teach couples communication strategies that can benefit the whole family. If you or your partner is experiencing symptoms of PPD, don’t wait to get help. Talk to someone you trust and get the support you deserve. Treatment is strongly recommended before the birth of the baby if there is a history of depression or marital issues or if dad feels stressed about fatherhood. Parents, take care of yourself so you are better able to care for your newborn. **Sources:** * Letourneu N, Tryphonopoulos PD, Duffett-Leger L, Stewart M, Benzies K, Dennis CL, Joschko J * Support intervention needs and preferences of fathers affected by postpartum depression. J perinat [Neonatal](https://nabtahealth.com/glossary/neonatal/) nurs * 2012; 26(1): 69-80. Ramchandani PG, Psychogiou L, Vlachos H, Iles J, Sethna V, Nesti, E, Lodder A * Paternal depression: an examination of its links with father, child and family functioning in the postnatal period. Depress Anxiety * 2011; 28(6): 471-7. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA * 2010; 303(19): 1961-9. Psychology Today * Find a Therapist. Powered by Bundoo®
After you have your baby, your doctor or midwife usually wants to see you in the office for a postpartum visit about six weeks after you deliver. However, a recent study that looked at moms who delivered in Maryland showed a pretty depressing statistic: only half of the women studied attended that postpartum check-up! While you may think this visit isn’t that important, there are many reasons it shouldn’t be skipped. At your postpartum visit, your provider will check your vital signs, including weight and blood pressure. If you had any issues with high blood pressure or [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) during your pregnancy, this is especially important. All providers should also screen for postpartum depression at the postpartum visit. Since postpartum depression affects approximately 15 percent of new moms, it is one of the most common complications of pregnancy. You do not need to suffer in silence if you have this; your doctor or midwife can discuss various treatment options—but they can’t help you if they don’t know about it. Your provider will also ask questions to make sure you are recovering appropriately from your delivery. They will want to make sure your bleeding is normal, there are no signs of infection, and that you are not in an abnormal amount of pain. They will also do an exam to make sure you’ve healed well and your [uterus](https://nabtahealth.com/glossary/uterus/) has returned to its normal size. Lastly, they will discuss having sex and make sure you are physically ready (though the green light from your doctor does not mean you have to yet if you don’t want to!). Discussing birth control is also a key component of the postpartum check-up, as you can get pregnant as soon as a few weeks after your delivery! A very high incidence of unintended pregnancies can be correlated to women not using birth control despite their desire to not conceive quite yet. If you are breastfeeding, your provider can make recommendations for options that will not interfere with this. If you’ve had any pregnancy complications, it is even more essential to keep this appointment. For example, women with [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) need a postpartum test to make sure it has resolved. These are also women who are at a much higher risk for developing Type 2 diabetes in their lifetime, so making sure they know this and have plans to be followed closely by their primary care provider can be discussed at this visit. So even if this is your third baby and you have no questions, it is still important for your overall health to make sure you get the preventive care you need. If you’ve missed your appointment and think you can wait until you are due for your annual, go ahead and give your doctor’s office a call. They will be happy to see you sooner! Get yourself [at-home postpartum physio](https://nabtahealth.com/product/at-home-postpartum-physio/) and get all the services you need. **Sources:** * Johns Hopkins Medicine * Fewer than half of women attend recommended doctors’ visits after childbirth. Powered by Bundoo®
Between the increase in flex-time at companies and a surge in the number of newly unemployed people setting themselves up as independent contractors, it’s never been easier to work from home. This can be especially appealing for parents, who are hoping to strike the [right balance between work and childcare](https://www.getunstuckcareercoaching.com/post/getting-back-to-work-after-pregnancy). Unfortunately, the reality of working from home can easily intrude on your grand vision of interrupted hours of productivity followed by calm lunches with your child. If you work from home and you’re looking to keep things sane, keep these tips in mind. 1\. Create a routine and stick to it (within reason)—This doesn’t necessarily mean working 9-5. One of the great benefits of working from home is setting your own hours. However, it’s still a good idea to have set “work hours.” The key here is to be realistic. You don’t need to commit yourself to a strenuous work schedule you can’t keep and only frustrate yourself in trying. When it comes to working at home, working smarter means working when your body and your parenting commitments are addressed. 2\. Set boundaries—Working from home can save you the interruptions from noisy co-workers and pointless meetings. However, it brings a new set of distractions, including noisy children and neighbors who stop by and may not understand the at-home work environment. It’s even possible your partner may ask you to perform extra tasks because you’ll be “at home.” You must set boundaries with your partner and children and enforce them whenever possible. From creating a sign that reads “Mom/Dad at Work” to asking your partner to keep from texting or calling unless it is an urgent matter, boundaries can and will help. 3\. Change the scenery—Because it can be tempting to finish chores or do other jobs around the house, it is important to embrace a change of scenery every once in a while. If you feel stuck in a rut, take your child out for a quick trip to regroup. Avoid distracting spots like a park or mall—these can work against your productivity. 4\. Be fair to yourself—One of the problems with working at home is not working enough but working too much. The lines can blur between office and home, and you may feel compelled to send one more e-mail or finish one more task on the to-do list. While these things have to happen sometimes, they can often wait. Prioritize. Ask yourself what tasks really must be completed “this minute” and what can truly wait while you spend some quality time with your family. **Sources:** * CNN * Work from Home Moms Face a Juggling Act Too. Parents * Master Being A Work-At-Home Mom. Parents * Work-at-Home-Success. Pew Research * Stay-at-Home Mothers on the Rise. USA Today * Working at Home: Family-Friendly? U.S * News & World Report * The Truth About Wannabe Work-at-Home Parents. Powered by Bundoo®
