Maternity Insurance|Maternity Care|Postpartum Care

What kinds of head shape deformities are seen in infants?

Deformational plagiocephaly (Often known as flat head syndrome) is an abnormal shape of a baby's head caused by external forces. The baby's head may appear to be misshapen or asymmetrical immediately after birth, or the abnormal shape may become noticeable n the first few months of life. Parents and carers are often the first ones to notice the unusual shape of the head and usually bring it to the attention of the GP or health visitor during a regular check up. Head shape abnormalities are usually more noticeable at bath time when a baby's hair is wet and in babies with little hair.

Deformational brachycephaly is when the entire back of the baby's head is flat (central flattening) and the head is very wide. The forehead is often bossed or prominent on both sides, and the height of the head is very high. Often, babies with this problem have a history of excessive time in carriers and car seats,or suffer from medical conditions that do not allow the baby to be placed on the tummy. Treatment through orthotic management attempts to correct the disproportion of the head shape and the associated deformities.

Asymmetrical brachycephaly is a common type of brachycephaly where the head is excessively wide and is also asymmetrical. Treatment through orthotic management focuses on improving both symmetry and the proportions of the baby's head.

Deformational scaphocephaly is characterised by a long and narrow head shape, sometimes caused by consistent positioning of the baby on his or her side. Like symmetrical brachycephaly, scaphocephaly is mainly a deformity of proportion, although the elongated shape can also produce abnormal frontal and posterior changes in the head.

Premature babies are particularly prone to scaphocephaly, because a side-lying position is often used in the neonatal intensive care unit (NICU) for easy access to monitors and other equipment. Treatment through orthotic management focuses on normalising the proportion and overall shape of the head.

Craniosynostosis is caused by the suture between the plates of the baby's head fusing together prematurely, and can occur at any of the sutures between the 5 plates of the baby's skull. The area that has fused does not grow at the same rate as the rest of the skull which can cause pressure to the brain. This is a rare condition affecting only 1 in 2500-3000 births. Treatment of craniosynostosis is surgery to remove the section of fused skull and allow normal development. This is usually performed by a neurosurgeon or a craniofacial surgeon.

What causes deformational plagiocephaly?

There are several causes of deformational plagiocephaly, and some of them occur before the baby is born. Restricted space inside the mother's womb can create excessive contact in certain areas of the baby's head. This is often the cause of deformation in babies positioned in a breach position, cramped in utero due to multiple foetuses, or in babies who spend excessive time with the head confined in the birth canal. Suction or vacuum instruments can also create forces that can deform the newborn skull, which is soft and pliable. After birth, the skulls of premature babies are particularly susceptible to deformation because they are thinner and more fragile than those of full term babies.

The skull is made up of several plates with fibrous sutures between them. This allows the skull plates to slide over each other to ease the passage of the baby's head through the birth canal. Usually, the head becomes more symmetrical and better proportioned within 6 weeks of birth if the deforming forces are no longer present. However, the flattened area may not resolve if the baby's head continuously rests in the same position. This is particularly problematic if the baby has neck tightness at birth (torticollis).

Are there other causes of head shape deformities?

Another leading cause of abnormal head shape in young babies is neck tightness caused by congenital muscular torticollis or neck trunk muscle imbalance. Torticollis is usually caused by an imbalance in the sternocleidomastoid and other neck muscles, which prevents the full range of motion in the neck. It is estimated that about 85% of the babies with deformational plagiocephaly also have some kind of neck issue.

Typically, the head of the baby with torticollis is tipped to one side and rotated to the opposite shoulder, causing the head to consistently rest in the same position. This constant pressure to the same side of the head causes flattening. Torticollis can also pull abnormally on the base of the skull and cause the ear on the same side of the flattening to be pushed forward. In severe cases, the forehead can also be pushed forward on the same side, the facial features including the eyes, cheeks, and the jaw may not be symmetrical.

Another postnatal cause of abnormal head shapes occurs when the back of the baby's head rests for prolonged periods of time against a hard surface like a car seat, bouncy chair, swing or push chair.

Before 1996, babies were put to sleep on their tummies, which varied the amount of force on the back of the head. Since the "reduce the risk" advice from the FSID (Foundation for the Study of Infants Death) as an effort to end the sudden infant death syndrome (SIDS), babies now spend all night on their backs until they are able to roll and reposition themselves.Unfortunately, the combination of the equipment we use to carry and position our babies during the day and placing them to sleep on their backs all night has led to an increase in head shape deformities. It is very encouraging that the incidence of SIDS has reduced by 40% following the introduction of "back to bed".

The best way to reduce the potential for the head shape problems is to increase the time your baby spends on his or her tummy during the day while awake and supervised.

There are some great things about the confinement phase of life. You get to bond with your new baby and watch as they start to grow from a tiny creature with little hair to a wiggling, demanding baby who looks around and seems to connect with others. This is an amazing time of life for all women, but not everyone receives the care they need and deserve during this time.

This brings the question of what happens if your confinement needs are not cared for and looked after diligently. Not all women are able to afford confinement nurses and some may not have relatives or friends willing and able to look after them after having a baby. Other women may simply believe they are just fine to return to their normal daily duties and neglect to take care of themselves by chance.

Whether it is by choice or necessity, there are some very serious consequences for neglecting your personal needs during the postpartum periods.

Infections

Your body is at serious risk of infection after having a baby. If you had a vaginal birth, you have rips, tears and stitches which can become infected if they are not properly cared for and rested. If you have a cesarean section, then you have a wound on your stomach which can easily become infected as well.

These infections can interfere with the healing of these pregnancy related wounds and may spread to other parts of the body if not properly treated. Infections in these sensitive areas of the body can be quite painful and uncomfortable.

Usually, these infections occur when the wounds are not kept clean and sanitary. It can also occur if too much physical activity is carried out too soon after having a baby. Your body needs a lot of rest to allow these wounds to heal properly.

Torn Stitches

If you start moving around, climbing stairs, and lifting heavy objects (other children included) too soon after giving birth, you can actually tear the stitches that are holding your pregnancy wounds together. This is painful and will make your postpartum recover take even longer.

You never get ahead by jumping back into normal daily routines after having a baby! It will be much faster in the long run to allow the body to heal and then start gradually adding daily activities into your life again.

Every woman needs at least six weeks of recovery time after having a baby. If you have a c-section, then chances are you need even more time before you completely out of the postpartum period. This is why it is so important to look after your health needs and take care of yourself after having a baby.

If you don't have family and friends around who can help with other children and household duties while you rest and bond with your baby, it is important to bring a postpartum nurse on board. They will make the confinement period more enjoyable and ensure that all of your health needs are looked after. If you aren't sure if you should be doing something or aren't sure if it's too soon to start moving around more, they can help you decide the safest course of action so you don't get infected or rip out your stitches.
If you have a c-section it is even more important to get this help!

In society and in the media you are going to find many answers to why somebody sufferers from postpartum depression. There will be answers such as lack of money, a traumatic birth, lack of sleep, not being able to breastfeed, a relationship break up. There are millions of so called 'reasons' why somebody suffers from postpartum depression.

But here's an interesting thought. Why is it that not everyone who goes through these challenges suffers from postpartum depression? Why is it that some people can handle these events with minimal fuss, but others get depressed? Is it really about the event, or is it something else?

Consider for a moment what your reaction would be if a spider was to crawl down the wall beside where you were sitting. Would you simply get up, grab a glass jar and take it outside, or would you freak out and run a mile because you are terrified of spiders?

If it were the latter and you feel an enormous amount of fear, you would also be feeling the chemical of adrenaline rushing through your body. But this doesn't happen to everyone who encounters spiders does it? It only happens to those that are scared of spiders. What makes you scared of spiders? Is it the spider, or is it what you believe about spiders?

Not everyone holds the same beliefs about spiders, so their reactions to a spider crawling down the wall beside them are different too. Similarly not everyone experiences the chemical of adrenaline when it comes to spiders either, because their beliefs are not creating that fear and hence the chemical response to occur.

Now let's apply this same analogy to your postpartum depression. What if the cause of your depression is not all of these troublesome events in your life? What if it's your beliefs that are causing your depression too, just like it causes you to freak out over a spider? Sure there is the chemical imbalance in the brain that is present with depression that we need to consider, but what if it is your beliefs about life that are triggering that chemical reaction to occur, just like with the spider?

This would definitely explain why one person becomes depressed about certain life events where another does not. They each perceive that situation differently.

The truth is that any type of stress never occurs because of an event. It is because of how we perceive that event and what we perceive that event to mean about ourselves. There is always a self-worth component to all stress related disorders.

As we have been raised, we have been taught to view the world in certain ways and we hold beliefs and expectations about how life is 'supposed to go'. We learn this predominantly from our parents or primary care givers, but also from other family, culture, religion, media, education, peers and other major influences in our lives. In this 'get your life right' world, we are also taught that our self-worth is dependent on what we do, are and have, so if we are not living up to these expectations then we are taught that we are not as worthy as we could be. We learnt to rate our self-worth as being more or less and we attach it to what we believe is the 'right path for our lives.

Somebody with postpartum depression believes that their worth has diminished to the point of being a complete failure and they feel like they just could not be bothered trying anymore. This is because they have perceived the events in their life to be reflective of their self-worth. They have attached their self-worth to how their life unfolds.

The answers to stopping postpartum depression, or any stress related disorder, is to change the way you view your life and to learn an accurate view of your self-worth. Understanding why you are worthy just the way you are is learning how to stop attaching your worth to getting life to go 'right', will result in the demise of your depression.

All stress is a conflict between belief (what you are thinking) and reality (what is actually happening and the correct perception of the situation). We hold onto the beliefs that are ingrained to us from childhood and when they do not match what we are experiencing, we find that we are stressed, depressed or anxious.

There is a distinct mind-body connection between what we think and how we feel, so it makes complete sense that the way to stop postpartum depression is to change the way you are viewing the challenges that arise as a mom. Why do you think therapists can be very useful in postpartum depression treatment. They aren't treating the chemical imbalance, they are treating the beliefs behind the chemical imbalance.

The reality is that there are going to be loads of ups and downs that occur in motherhood, just like there is in other aspects of our life. It won't be any of those down times that cause you to feel depressed, it will be your perception of these events and if you don't correct your mindset that is responsible for this perception, then you are likely to do depression over and over and over again, every time life doesn't go to plan.

So how do you change? The same way you learnt to hold this unproductive mindset to begin with. It was through continual exposure to your environment that taught and reinforced the very beliefs that are causing your depression right now, so it will be through this same repetition that you will be able to change the way you view life now.

Your thoughts are the answers to your postpartum depression recovery and when you get that and start actively and consciously changing your current thinking to be in alignment with reality (of life and self-worth), then you will overcome your postpartum depression and become the Happy Mum you want to be.

Change your mind and you change everything.

Pregnancy is a very precious thing especially for women who don't have a child yet. They take care of themselves because they know that a new life is starting to grow inside their womb. Carrying a baby for almost nine months is not an easy thing to do.

There are many things to consider because the health of the baby will also depend on that of the mother. However, certain things may be inevitable sometimes. Preeclampsia is one of the conditions a woman may suffer that can lead to a very difficult delivery.

It is a condition in which there is a constant increase in the blood pressure of the pregnant woman. Many people believe that this can only occur within the full course of pregnancy that last for nine months and the only cure is the baby's delivery.

Yet, a full blown mother can also experience high blood pressure postpartum.

Postpartum preeclampsia often starts 6 weeks after the birth of the baby and this often occurs to those women who did not suffer this condition when they are still pregnant. But in some cases it may also occur to those who already undergone this condition when they are still pregnant.

A woman with high blood pressure postpartum may experience headache, blurred vision, photosensitivity, decreased urine production, and low platelet level or blood clotting cells. In severe cases, it includes infection and multiple organ failure.

Hypertension is a very common condition suffered especially by aging people. But this can also be a significant condition that must be guarded when it comes to pregnancy. Not all women may undergo this process but a constant monitoring and prevention could be of great help. High blood pressure postpartum can endanger both the life of the mother and her baby.

But to those who are already suffering this condition, an immediate cure must be taken into consideration. The patient may take certain kinds of medications to manage this problem. Such medicines may include beta blockers and calcium channel blockers, which can help in the proper circulation of blood and lessens vasoconstriction. Anti seizures are also given because most probably preeclamptic women may experience seizure.

Steroids are also given as anti inflammatory drugs because of the swelling brought about by this certain disease process.

Life is a very valuable thing that each of us must give proper care. Raising a child is not that easy. But giving birth is more difficult because the mother's life is also placed in danger within the giving birth process. Thus, pregnant women should always conduct regular check-up to monitor any occurrence of high blood pressure postpartum.

LIFE AFTER BIRTH: THE FIRST 6 WEEKS

Life after birth can be chaotic, especially if this is your first baby. Taking care of your newborn is hard work and won't be much fun until he or she develops a personality. In case you didn't know, a newborn doesn't laugh or smile, it can't play or even hold its own head up without a supporting hand. All it can do is eat, sleep, dirty diapers, pass gas, throw up and cry. Despite all of this, you will - believe it or not - love your little tot more than anything else in the world. Moreover, you will learn a lot about yourself and your partner as you both navigate through these initial days of parenthood.

Sex (or lack thereof)

You should know that sex is off-limits for at least 6 weeks after your partner gives birth. Don't forget that she just delivered a fair-sized human through a very tiny birth canal and her body will need time to heal. Your gal's doctor will ask to see her about six weeks after delivery for a full physical and emotional post-baby follow-up. At this visit, the doctor will check to see how her wounds are healing. If everything is good, your partner will get the green light for sex. However, this doesn't mean that she will be as keen and eager to get back into the game. She'll likely be tired from the whole pregnancy ordeal and from the added responsibilities of caring for a newborn. Help out as much as possible and be patient. Her interest in sex will return...just don't push her too hard.

Sleep (or lack thereof)

The good news is that babies need a lot of sleep - about 15-16 hours a day. Unfortunately, newborns don't have regular sleep patterns and don't sleep for long hours at a time. This means that you won't have regular sleep patterns either. Get used to napping throughout the day. And if that doesn't work for you, then get used to sleep deprivation. You and your partner may feel like you are losing your minds as you quickly realize how cranky and dysfunctional you can be after several nights of disrupted sleep. Hang in there. After about 8 or 10 weeks, your baby will start to sleep through the night (approximately five consecutive hours) and your sleep-deprived, zombie-like state will be a thing of the past.

You may with to alternate night shifts to maximize the amount of uninterrupted sleep each partner gets. There really is no need for both of you to get up every time the baby needs to be fed, coddled or changed.

Caring for Your Tiny Tot

After your shopping spree for nursery items, layettes and strollers, you may have thought that you were fully ready for your baby. While these purchases were necessary, they are only a small part of what you need to survive postnatal care. There will be many new and strange things for you and your partner to learn. The ins-and-outs of feeding, bathing, diapering and umbilical cord care are in no way intuitive. Don't get scared or discouraged by your new-found incompetence. Chances are that your partner is also incompetent in this area. It's okay to make mistakes; every new parent does. The good news is that the parental learning curve is steep. You and your partner will quickly develop the skills needed to care for your tot. To give you a helping hand, here is are a few pointers on baby care basics:

Feeding

The first step is to decide your method of feeding - breast milk or formula? There are many benefits of breastfeeding, including nutritional and emotional advantages. Breast milk is a complete food source that contains hormones and disease-fighting compounds that are absent in formula. Nursing also helps build a special bond between mother and baby. Studies show that babies thrive on the skin-to-skin contact, cuddling and holding that occurs during breastfeeding. However, there are a variety of reasons why many women do not nurse. They may not be able to produce enough milk or they may have to return to work soon after birth and are not available to nurse the baby throughout the day. Whatever the reason, your gal should not feel guilty or uncomfortable with deciding to bottle-feed. There are many excellent formulas available which are highly nutritious. Speak with your partner's physician or pediatrician about recommended formulas.

Regardless of your method of feeding, you should know that most newborns eat about 8 times a day (approximately every two to three hours). However, you shouldn't try to set scheduled eating times during the first few weeks after birth. Let your baby eat whenever he or she seems hungry.

Bathing

Because your baby's umbilical cord will need to heal, it is very important that you keep it dry to prevent infection. After about two weeks, the gross looking stump (i.e., remnants of the umbilical cord) will fall off and your baby will be left with a cute little belly button. In the meantime, take extra care not to wet the umbilical cord during bathing. The best way to do this is to give your tot sponge baths until the cord heals.

To give a sponge bath, you will need a stable surface, a soft washcloth and lukewarm water. Make sure that you test the water temperature before applying the cloth to your baby to prevent scalding him or her. Your elbow or the inner part of your wrist is a good place to test water temperature. Your hand is not a good guide since it is not very sensitive enough to tell how hot or cold the water really is. Now you can begin wiping your baby gently with the moistened washcloth. Begin by wiping your baby's eyes (from inside to outside), ears and under arms. Then you can move onto legs and genitalia. When washing the bottom, make sure you wipe from front to back to avoid bringing any feces near the genitals. If you have had your baby boy circumcised, then you will want to speak with your pediatrician about caring for the penis while it heals.

The most important thing to remember when bathing your baby is to NEVER leave him or her along - not even for a second. Babies squirm around a lot, so you should always keep your eyes and one hand on your little one during bath time. The same rule applies when you are changing your baby's diaper.

Changing Diapers

Don't avoid this responsibility because it you have never changed a diaper before. Because babies pee and poop so often, you will spend a lot of time changing diapers. Take advantage of this precious time with junior. You may also have to develop silly and immature techniques to comfort your baby if he/she does not enjoy the diapering process. As ridiculous as you may feel, this is actually an important part of establishing a parent-tot bond.

While it may be dirty work, diapering is not rocket science. For easy to follow instructions, make sure to read our article on How to Change a Diaper at http://www.thefunkystork.com.

Caring for Yourself and Your Partner
As flighty and silly as it might sound, self-care is important. Neither you nor your partner is doing your tot any good by neglecting yourselves. Try a shift-work system where you schedule an hour or two during the day where one parent will care for the baby alone. This way, the other parent can practice self-care - taking a long, warm bath, going for a run, doing yoga, reading or just going for coffee with a friend.

You will find that self-care will also help maintain civility in your relationship with your partner. By making time to do something for yourself, you will find that you won't feel as overwhelmed by your initiation to parenthood. And don't forget that this rule also applies to your partner. In fact, she will likely need more time for self-care than you since she will also be recovering from both 40 weeks of pregnancy and hours of childbirth. Also be aware that your partner is particularly vulnerable to postpartum depression during the first weeks after birth.

Postpartum depression, which is a more serious case of the baby blues, can begin as early as a few days after delivery. Experts don't know the real cause of postpartum depression, but they suspect that it has something to do with changes hormonal levels. Stress, disturbed sleeping patterns and changes in daily routine can all contribute to postpartum depression. Signs and symptoms include restlessness, irritability, changes in appetite, sadness and anxiety. If your partner is experiencing any of these symptoms or if you sense that something isn't right with the way your partner is behaving, you should consult your physician immediately. Untreated, postpartum depression can develop into postpartum psychosis, which is a serious mental illness that requires medical intervention. Both you and your partner should take her postnatal psychological state very seriously.

On a lighter note, you and your partner make an extra effort to keep the romance in your relationship. While your baby will require a lot of your time and attention, he or she will also be taking a lot of naps. Nap-time may be the perfect (and only) time for your and your partner to romance each other. Snuggle, watch a movie, make dinner or enjoy a glass of wine together. Whatever you decide to do, take a minute to set the mood with candles and relaxing music.

Another important factor to consider is how involved you want your parents or partner's parents to be. Parental intervention can add some seriously unneeded stress to the situation and unnecessary strain on your relationship. That said, you shouldn't reject offers to help. Being a new parent is not going to be easy and you will need all the help that you can get. Just remember to set limits and don't be afraid to tell your relatives what you need (and don't need). The last thing you want is to have one overbearing relatives overstepping their boundaries and overstaying their welcome.

Now What?

Things change after about 6 weeks of caring for your newborn. You and your partner will be different people, your relationship will be redefined and your tot will begin to act more like a baby than a squirmy alien. Life will get easier from here on out. Your tot will become a toddler and will begin roaming around the house. Make sure you are prepared for junior's curiosity by baby-proofing your home early.

It is common to confuse simple "baby blues" with postpartum depression, but it happens all the time. Baby blues are very common, and happen when the mother feels conflicting feelings where she is happy that the baby has arrived and at the same time is very sad as well; this happens, even though everyone around is celebrating the new arrival.

Baby blues usually happen around 24 hours after childbirth and are characterized by feeling empty, sad and upset. One can have disturbed sleep, have difficulty sleeping at all, experience extreme crying spells, and can be exceptionally emotional with the baby blues.

Symptoms are at their worst between three to five days after the baby is born and can last up to two weeks.

However, postpartum depression is different. It lasts much longer than baby blues do, from six months to a year. Postpartum depression is also much more intense than baby blues are.

Baby blues are very common and do not interfere with the mothers' ability to take care of the baby or to go about normal daily life. However, postpartum depression can be extremely crippling and can stop normal life.

The depression itself can leave a woman emotionally fatigued and physically drained.

Following are some of the symptoms of postpartum depression, and should be watched out for:

* Having extreme mood swings and emotional fluctuations
* Being unable to sleep
* Being unable to enjoy your new baby
* Being unable to enjoy activities you did previously
* Being very fatigued
* Having fluctuations in appetite
* Feeling inadequate as a parent and spouse
* Having negative thoughts about yourself, and/or the baby
* Being suicidal, and/or thinking of harming the baby

There are times as well when postpartum depression can be severe enough that it can become postpartum psychosis. With postpartum psychosis, a new mother may become delusional, may become severely depressed, or may even start hallucinating.

Health centers in Edinburgh and Livingston have developed what is called the Edinburgh Postnatal Depression Scale; also called the "postpartum depression scale," this scale helps to detect possible postpartum depression in mothers.

If you or your health care provider suspects that you may be suffering from postpartum depression, you will be asked some questions from the scale, such as how long you have had the depression, how intense it is, any previous history of depression you have had, any substance abuse problems you have had, any marital problems you may be having, or any other discord or form of stress you may be experiencing now, so that conclusions can be drawn.

You will also be asked to take what is called a "postpartum depression scale test."

The latter is a questionnaire that has 10 statements, each with four possible answers. If you are asked to take this test, you will be asked to identify what you have felt in the past week, that just previous to the time you take the test.

If your score is higher than 92%, it is likely that you are severely depressed. Ideally, this test should be taken between six to eight weeks after you have given birth, and it should be completed by you (or the mother who has given birth, as applicable) without first discussing answers with anyone.

In addition to the Edinburgh Postnatal Depression Scale, there is also the PPD Screening Scale Test. This scale test has 35 items on it that you grade from a scale, ranging from "strongly disagree" to "strongly agree."

After the test is taken, the physician should be consulted so that proper decisions and treatment can be discussed and applied.

Upon successful graduation from a Yoga teacher training course, many new Yoga teachers feel they still need some direction. After spending five months, up to years, with a Master Yoga teacher, Swami, or Guru, the new Yoga teacher has left the nest, but where should he or she go from there?

Let's look at an organized way for new Yoga teachers to expand their knowledge, while pursuing their passion. After all, Yoga instructors cannot share the same interests all the time. With so many forms of Yoga, and a multitude of aspects to choose from, "the sky is the limit."

Are you interested in Office Yoga, Prenatal or Postnatal Yoga, Chair Yoga, Yoga Therapy, Yoga for Stress Disorders, teaching Yoga to children, or another Yoga teaching path? There are many directions to specialize in, and it is best to keep the list small.

This brings up the first step in finding your direction: Write a list of goals, interests, and objectives, for teaching Yoga. There is something very powerful about "etching ideas into the subconscious mind," with a pen and paper.

If you decide to enter deadline dates, for short-term goals, you might be shocked at the number of goals, which reach fruition. When you put ideas into writing, and take action, the success rate does go up.

Avoid procrastination, and do not allow excuses to run your life. This is a pitfall on a goal-setting path. I guarantee that you will run into obstacles. Nobody has a life without them; however, look at each one as a stimulating challenge.

Do not waste time on blaming anybody, or anything; this will make you stronger as you journey toward becoming a better Yoga teacher. This will also guide you in the right direction to meet the needs of your students.

Organize your list of goals by priority. Which goals are more urgent? Decide by projected deadlines - in measurements of days, weeks, months, and years. This will help you to avoid wasting time on long-term goals, when you have a serious deadline facing you this week.

It is human nature to try to avoid the tough projects. Yet, you are best off to tackle the difficult projects first. Once you have taken care of the toughest chores, a heavy burden has been lifted from your mind and you can think clearly.

Get rid of all distractions for optimum use of your time. For example: Cell phones, television, time wasting chatter, and Email must wait if you are in the middle of an important project or your studies. You do not have to live the lifestyle of a Spartan, but there are some times when the "technological toys" get in the way of real progress.

Lastly, reward yourself with quality time, when you have finished a project. Make sure that you take the time to enjoy your family, friends, and quality relationships. You are a Yoga teacher, who teaches the art of living, and you should also enjoy a balanced life.

© Copyright 2007 - Paul Jerard / Aura Publications

Can postpartum depression become so invasive as to cause a mother to kill her children? Since this very rarely happens, many scoff at the prospect. Interestingly enough, postpartum psychosis was first recognized as a disorder as far back as 1850. According to Pregnancy Infonet, (2007), studies on the rates of the disorder have shown that the number of women experiencing postpartum psychosis hasn't changed since the mid 1800s. Expert psychologists, psychiatrists, and behavioral scientists are discovering that postpartum depression can, if not treated promptly and properly over an extended period of time most definitely can escalate to psychosis. Doctor statements and evaluations, insufficient treatment, and failed suicides are things that must be considered in determining Andrea Yates mental defect at the time of her crime.

It has been argued that due to some of Yates' logical and thought out actions that these prove she was sane at the time of the incident. The fact that, on two occasions she refused medication and on another occasion she stopped taking her medication. The fact that she had done a "practice run" of filling up the bathtub and, individually tracked her children down and drug them to their death are all arguments that are being touted as evidence that she had full knowledge of what she was doing.

To understand the concept of Postpartum depression and Postpartum psychosis, one must first realize that the two illnesses are not synonymous. Postpartum depression is described as something that can start at anytime within one year of birth. There is usually sadness, common after such an ordeal as birth, and of course a loss of energy, also a common thing after giving birth. Sometimes there will be a bout with the inability to concentrate, especially for first time mothers and along with that, anxiety about motherhood. All these are symptoms of postpartum depression. Not every woman experiences these and some may experience only a few of them. However, these symptoms are quite different than those of postpartum psychosis. Catherine Roca, (April, 2005)

Dr. Dan Williams, Psy.D., PA-C, "Peace and Healing", (2006), describes post partum psychosis as "very rare". He goes on to say that "It is characterized by homicidal and suicidal impulses, hallucinations, delusions, disorganized and bizarre thinking." Dr. Williams goes on to further describe some of the consistent characteristics of one who suffers postpartum psychosis.

"The dilemma is that these individuals usually refuse treatment. This is a medical emergency situation. If post-partum psychosis is suspected, families need to call 911 as emergency intervention is necessary. Medication most likely will be prescribed. The ultimate goal is to keep the baby and mother safe." "Peace and Healing", (2006)

Yates was first diagnosed July 21, 1999 as having severe major depression by Eileen Starbranch, MD. This diagnoses, came after her attempted suicides. During her week stay at Methodist Hospital Psychiatric Unit, she was diagnosed as having severe major depressive disorder, recurrent with psychotic features. Additional problems diagnosed were social withdrawal and minimal verbal communications. It was during this psychological evaluation that Andrea Yates admitted to having thoughts of hurting herself or someone else.

Eileen Starbranch, MD, Court TV, Psychiatric Evaluation July (1999) On August 5, 1999, Dr. Starbranch along with Dr. Arturo Rics, M.D., had a consultation regarding continued care of Andrea. The findings of this consultation revealed that the onset of her depression began about six week prior along with symptoms of psychosis. Much of the documentation that was reviewed by both physicians indicated that Andrea remained reclusive, guarded and still had a persistent, depressed mood. Eventually Andrea did respond to some degree to her medication but was warned by Dr. Starbranch not to have another child as this could bring on another psychotic episode.

Dr. Arturo Rics, M.D., Dr. Starbranch, MD, Methodist Hospital Psychiatric Center July (1999) Another psychiatrist, Dr. Melissa R. Ferguson, former medical director of psychiatric services at the Harris County Jail, gave testimony that in her opinion, Yates was suffering from psychosis. According to Dr. Ferguson, Yates told her she believed that the cartoon characters on television were telling her how bad she was for giving her children "too much candy and cereal". Ferguson also testified that she believed that Andrea was incapable of understanding the consequences of what she did. Dr. Milissa, Former Director, Harris County Jail.

Andrea Yates had all the classic symptoms of post partum psychosis. Even though medication was administered, there was little supervision to ensure that she followed doctor's orders. Her hospital stays were short and therefore not effective in a medically supervised environment assuring that at best the possibility of her harming herself or others was sufficiently minimized.

There is absolutely do doubt in anyone's mind that Andrea Yates did in fact drown her children in a bathtub. There is no doubt that the "how" was too horrible to fathom. Because of the rarity of this condition and its horrendous results if not treated, many Americans, particular women, will judge women like Andrea Yates without compassion for the suffer or the effort to learn and understand the illness. What those individuals should realize is that by understanding this catastrophic illness, it in no way condones the actions done as a result of that illness.

In conclusion, the state of Texas is to be applauded in its efforts to recognize this rare, yet debilitating and extremely dangerous illness. The Andrea Yates bill became affective September 3, 2003 and it states the following:

"Postpartum depression (PPD) is a serious disorder, each year affecting 10% to 15% of women who have delivered children. This disorder, despite its high prevalence, often goes undetected and untreated. In an attempt to address this public health problem, the State of Texas has enacted legislation, House Bill 341 (also known as the "Andrea Yates Bill"), which went into effect on September 1, 2003. This law requires healthcare providers who treat pregnant women to provide them with resource information regarding counseling for postpartum depression and other emotional traumas associated with pregnancy and parenting."
Blue Corss/Blue Shield of TexasPostpartum Depression and House Bill 341

References:

BlueCross BlueShield of Texas; Postpartum Depression and House Bill 341

(2007) Retrieved on September 9, 2007 from the World Wide Web:
http://www.bcbstx.com/provider/postpartum.htm

Ferguson, Dr. Melissa R. Former

Medical Director of Psychiatric Services at the Harris County Jail. Retrieved on September 8, 2007
from the World Wide Web: http://crime.about.com/b/a/257021.htm

Roca, Catherine , Chief, Women's Programs, (2005) Depression During and After Pregnancy

National Institute of Mental Health, (April 2005). Retrieved on September 7, 2007 from the World
Wide Web: [http://www.4woman.gov/faq/postpartum.htm#5]

The Pregnancy-Info Team, Postpartum Psychosis (2007) Retrieved on September 7, 2007 from the World Wide Web:
http://www.pregnancy-info.net/postpartum_psychosis.html

Starbranch, Eileen, M.D. Court TV

Retrieved on September 9, 2007 from the World Wide Web:
http://www.courttv.com/trials/yates/docs/gifs/psychiatric6.gif

Williams, Dan Psy.D., PA-C, (2006) Peace and Healing.

Retrieved on September 7, 2007 from the World Wide Web:
http://www.peaceandhealing.com/psychosis/postpartum.asp

We cannot overemphasize the delicate condition that most women experience during pregnancy. In fact, as a pregnant woman, you are encouraged to seek prenatal and postnatal care to make this difficult stage in your life more bearable. Health care providers encourage you to perform regular exercises that are suitable to your condition. These exercises are expected to make you better fit during the entire nine- month period and lessen difficult moments during your labor and childbirth.

Have you ever thought about practicing yoga during pregnancy? Did you know that nowadays, more and more pregnant women resort to yoga to prepare them for the painful moment of childbirth, and even the challenging world of motherhood?

Being pregnant will of course not allow you just to perform the regular routines that require strenuous postures which may pose complications to your delicate condition. You shall not be allowed to do back bending; balancing poses on one leg, camel, handstands and headstands as well as upward bow, to ensure the safety of both you and your baby.

Breathing techniques used during yoga exercises provide oxygen to your whole body. This gives benefit to the fetus because of the pumping in of the charged blood. In addition, the breathing exercises result to the soothing of muscle tension and muscle cramps which are always normally experienced during pregnancy.

In terms of physical fitness, the mild yogic exercises allowed for pregnant women like you will help maintain your muscle tone. These muscle tones are particularly for the back and the pelvis, the body parts that take on the most pressure during the nine-month period of pregnancy and one year thereafter.

On the other hand, yogic sleep calms the mind and body and to some extent prevents the trauma during childbirth. Stretching and gentle toning exercises modified specifically for you can really work wonderfully to prepare your body not only for delivering your baby but for caring as well. Prenatal and postnatal depressions are common problems of would-be mothers like you. But practicing yoga exercises calms and relaxes the mind and allows your worries and fears to vanish. The peace within you descends to your child and this makes childbirth bearable.

Generally speaking, the great benefits you can acquire with the practice of yoga during pregnancy cannot be outweighed by the risks other people may think about. To avoid any risk and enjoy the full benefits of a peaceful and enjoyable journey to motherhood, you have the responsibility of checking it out first with your doctor if you are in the right condition to practice yoga.

Because different people have different strengths and weaknesses, what is usually good to one may not be good for you. You have to carefully check with your yoga teacher which exercises are allowed during each stage of pregnancy. You should also be able to share with him if you have certain conditions that may prevent you from doing certain positions or exercises. But most of all, you should be very conscious about the effects of each activity to you as you go along to ensure that you and your baby are protected from harm.

A nurse practitioner is an advanced degree nurse who has completed a Master's or a Doctoral degree. They have received additional training and education and have specialized in such areas as adult care, gynecology, obstetrics or family practice. In the United States in order to perform nursing jobs one must have passed national board certification. Not only can they apply for nurse practitioner jobs, they can seek seek positions in occupational therapy, physician assistant, travel nursing, physical therapy and speech pathology.

A nurse practitioner works independently from a physician in some parts of the United States. Their job can include diagnosing, evaluating and treating chronic and acute disease and illness such as high blood pressure, conducting physical exams and performing, ordering and interpreting lab test, x-rays and EKG's. They can prescribe rehabilitative treatments and drugs for acute illness, this can vary by state. They provide prenatal care, well-child care, assist in surgeries and counsel patients.

One must complete the training to become a registered nurse first and then complete graduate-level nursing courses. They must then pass a national board certification in their specialty. An associate degree in nursing, or ADN, is offered through community colleges and takes 2 to 3 years to complete. A bachelor of science degree in nursing, or BSN, is offered through colleges and universities and takes 4 to 5 years. Then they must complete a masters degree. The nurse practitioner degree program began in 1965 due to a prediction of a shortage of physicians. The nurse practitioner can commands a higher salary than a nurse and is in great demand.

With a position in a women's health clinic, a nurse practitioner can provide women's wellness care. This includes counseling on birth control, sexually transmitted diseases and providing breast and pelvic exams. Some practitioners get further training to become nurse midwives. A certified nurse midwife can provide prenatal and postnatal care as well as assist in uncomplicated pregnancies through labor and delivery.

In primary care, they can work with both pediatric and adult patients. They can provide preventative care and check-ups and treat minor emergencies as well as treat patients with acute illnesses. They can practice in a private practice in a setting known as nurse-managed health centers. These centers employ only nurse practitioners rather than doctors or physicians' assistants to provide primary care. These centers are often located in underserved areas and will typically provide mental health care as well as physical care.

Geriatric clinics are settings where nurses are also employed. They provide care for older adults in managing chronic conditions such as arthritis, hypertension and diabetes. This type of health care involves case management and coordinating care.

Another setting for a nurse practitioner to work is a hospital. There they can diagnose patients, order medications and tests and help to determine discharge dates. In teaching hospitals acute care nurses are often involved in teaching new doctors in their first years of residency.

In mental healthcare a nurse can work with outpatients, inpatients or partial hospitalization settings. They can diagnose patients and prescribe medication. Complying with a medication regimen can often be problematic with these patients so a nurse practitioner can provide patient teaching to teach about side effects and how to use self-help tools to manage symptoms as well as finding support through their communities.

What is postpartum depression?

Postpartum depression (PPD) also called postnatal depression is a form of clinical depression that affects some women after they have delivered a child. The exact cause of this condition is not known however some research says that since the hormone levels change during and after pregnancy this imbalance of hormonal level in woman's body causes chemical changes in the brain that play a part in developing depression.

Post partum depression can be treated by talk therapy and medicine (antidepressant).

Why do women get affected by it?

Giving birth to baby is a tough job. The rapid gush of hormones in that period creates a state of imbalance in the body for a while. And this imbalance can last from a few days to months, which maybe a cause for postpartum depression.

However giving birth is also one of the most beautiful feeling a woman can ever experience. From the moment a woman has given birth she feels sheer joy and happiness, fulfillment, achievement, thankfulness. But with all these positive qualities come along anxiety, fear, uncertainty, responsibility and sometimes depression.

Simple steps to treat your depression yourself:-

• Be pro active not reactive

Once you get pregnant you want to gather all the information regarding your baby's development, what to eat what not to, what's good for the baby's health, what's the sex of the baby etc. Side by side do make it a point to study the topic of postpartum depression.

• Do not live in denial

Even if you are having a very smooth pregnancy and everything's fine, do not guarantee yourself that you cannot get depression.

Even the happiest of pregnant women do get some form of depression either they get mood swings also called Baby Blues or PPD or in very rare cases Postpartum psychosis.

• We fear the unknown

You delivered a baby a week ago. You are exhausted. You are not getting enough sleep you don't even know who this new person is? You hate your body. You hate the people around you. You don't have much interest in this baby. You just want to run away some place. In short there is nothing you feel good about. You have PPD!

You try to pretend that you don't know what's wrong however your subconscious tells you that there is something wrong with you and this is not normal. Once you know it that you have PPD, you have treated this illness 50%.

• Remember all your baby needs is you

You want to sleep for a stretch of 6 hours; you want to watch a movie alone or with your partner. Maybe all you want is some peace and quiet. Yes you can do all this but stock it up for some time later because rite now the most important thing in your life is your baby.

Remember this is tiny person you anxiously waited for 9 months. You worked so hard to make everything perfect for your baby.

Finally your baby is here. Your baby wants to be close to you, she wants your touch. She wants your body warmth; she wants your breast she simply wants to be near you. You are your baby's main life support.

You have to tell all this to yourself. Forget the world. Right now it's just you and the baby.

• Have faith in yourself

Do not jeopardize yourself in the process of child care. Go easy. Sleep when the baby sleeps even if it's for 15 minutes. Talk to your partner or any friend. Make plans for your baby.

Try to indulge yourself totally in motherhood. Yes this absolutely works.

Keep reassuring yourself that everything will be fine. Think positive. Do not let those irrational feelings take over you.

Taking antidepressant drugs is not a very good idea especially for a breastfeeding mother because the drug can get into in the milk.

Remember Postpartum depression is not a disease or illness it's just some bad vibes that hover over you when you have been blessed with the most beautiful gift. A baby!

Every mother feels the indescribable joy of holding her newborn child in her arms. But amidst all that, she may sometimes have to endure an unbearable animosity towards the child, which can even get the better of her and her relationship with the child.

This is no ordinary problem. It is an illness that not only will affect her, but also, the innocent child. In worst cases, it can lead to death.

We are referring to Post Natal Depression.

Post Natal Depression can be considered a syndrome that attacks some women out there the moment they have given birth.

Yes, life after the birth of your child is not necessarily a fairy tale like what you would see on television dramas or movies. You may not be battling with the physical pain that much, but you would definitely be battling with your emotional roller coasters the most.

Your mentality of everything that surrounds you will change for the worse, in such a way that you would have thoughts of negative happenings that apparently have not taken place at all, and would even go against others around you without any rhyme or reason. Most of all, you would develop negative perceptions and hatred for your own baby.

If you are one of those women who are going through these darkest after-birth moments, you need help!

But do not fret! It may seem like an illness that is beyond control, but it can actually be cured and overcome if you try your best to.

Ladies, let us share with you on what you can do to fight the battle. This information, too, would be useful for any of you whose friends or loved ones are facing Post Natal Depression, because in times like this, you could be the one they need the most.

1. Family support is the key factor that can keep her going despite her post-natal ordeals. Family members should never leave her unattended. You can take turns among yourselves to take care of her. Most importantly, understand that what she is going through will not last forever. Hence, you should be tolerant of her and not be too pushy for that period of time, and always remind her that the illness will gradually fade away.

2. Seek advice from doctors or professionals. They would be able to prescribe the most appropriate medications and provide further therapies that can help improve the situation.

3. Besides doctors, counselors can play a part for you too. Since Post Natal Depression highly involves conflict of emotions and downfall in terms of your self-esteem, counselors would be able to advise you on how such illness can be tackled in a more proper way. Family members can also get help from these professionals on how they can show their support towards the victims of this illness.

4. Instill some self-belief and self-confidence in you. Have faith that the illness will go away as long as you stay unwearied and strong. Yes, it is tough to pull it through, but if you can overcome that unbearable pain of bringing your child to life, why would you not be able to overcome this one?

5. Avoid consuming pills because they will exacerbate the depression in you rather than reducing it. You should especially avoid them during that point in time when you had just given birth to your child. Remember that pills are not the easy way out for you. As mentioned earlier on, seek advice from doctors with regards to the prescription of medications if you really need a form of medication for yourself.

Mothers and mothers-to-be, Post Natal Depression cannot be taken for granted, but it can be remedied. After all, it is only temporary.

To the families and friends of these victims, always shower them with your love and care, and perhaps the illness can fade away sooner than you expect.

Motherhood can be the most unforgettable if you know how to control your emotions and your mind. Think about your child who has got nothing to do with what you have to endure.

And think about those women who have been there done that. If those women could fight and surpass the illness, so could you.

Hope that all of you will be able to enjoy motherhood to the fullest!

Perinatal Depressive Disorders

Feeling Blue Before and After Baby Comes?

Motherhood is often glorified as a time of happiness and fulfillment, but for a significant proportion of women, their experience is clouded by less rosy emotions which they experience throughout the nine months, and even after the baby is born. Perinatal depressive disorders are common and can have significant impact on the pregnancy and well-being of both mother and baby.

A Common Condition

Perinatal disorder is a range of mood disorders that can affect a woman during and after pregnancy, between 15 and 20 percent of all women experience some form of perinatal depression. A common perinatal depressive disorder is postpartum depression, which can affect as many as two in 10 women following childbirth. Its cause is usually genetically-linked or can be due to other factors such as difficult social circumstances, pervasive stress or poor social support. The most common symptoms include feeling overwhelmed, irritability, feeling weepy and crying. Fortunately, these symptoms usually resolve within two weeks of delivery. Whilst women benefit from a supportive and understanding environment, professional help is often required to manage baby blues.

The Telltale Signs

Symptoms of perinatal depression may include feelings of sadness, emptiness or a feeling of detached emotions, difficulty in experiencing pleasure, decreased sense of enjoyment, decreased motivation, a sense of guilt or loss of hope. Some women report poor concentration and slowed thinking. A small minority of women may also experience suicidal or infanticidal thoughts. Women who suffer from depression during their pregnancy have an increased risk of obstetric complications, including premature labour. Postnatal depression is associated with disturbances in bonding and attachment, which can have negative effects on the child's development.

How To Deal

Perinatal disorder is treatable and there are a few treatment options available. A woman who suspects that she may be experiencing symptoms of perinatal depression during or after her pregnancy should seek professional help or consult a doctor early. During the consultation, doctors would typically ask about any history of mood disorders or family history of perinatal depression.

Two common types of treatment are psychotherapy and medication. The type of treatment will depend on the severity of the depression. Whilst medication is used cautiously in pregnant and breastfeeding women, the risks of untreated depression are always weighed against the risks of medication. The earlier treatment is initiated, the better the prognosis. The spouse and family members of the mother experiencing perinatal depression can also provide valuable support by making themselves available to listen, understand and provide practical support. As for the mother herself, parenting classes also provide valuable information on coping strategies, apart from seeking professional help.

The strength and ubiquity of the 'breast is best' message in New Zealand means there is greater awareness than ever of the benefits of breastfeeding, increasingly advocated as the risks of formula feeding.

However, women remain unsupported in their choice to breastfeed, from work policies and a lack of timely information and support, to family attitudes and perceptions of a "good baby" as one which sleeps through the night and therefore requires slowly digested formula to do so.

The conflict between the lactating and revered sexual breast in Western society means that while the media is awash with images of 'boobs', public breastfeeding is taboo. A 2009 study found that 36 per cent of Australians said breastfeeding was unacceptable in a cafe or at work. Jennifer James of RMIT University, which conducted the study, said "Part of the issue why young mothers wean their babies too early is societal pressure and isolation from other mothers experiencing the same difficulties."

The result is that many women do not establish breastfeeding, the trauma of which is then compounded by the censure faced when bottle feeding.

In recognition of the experiences of these mothers, Christchurch based counsellor Karen Holmes, is launching a counselling service specifically for "unvalidated grief" around women's breastfeeding experiences.

Holmes explains: "This is something which is just never talked about, but for many women giving up breastfeeding is a very real loss which impacts their lives. It may never be acknowledged as grief - not by others and not even by themselves." This grief therefore expresses itself in other ways, for example through anger at breastfeeding mothers or feelings of resentment at being let down by the health system.

Holmes offers counselling to those impacted by infant feeding grief, trauma or related concerns, including mothers and those who find themselves with issues in their work with mothers. Counselling could be historical, for example with grandmothers, as well as for contemporary issues. In addition to grief from not establishing breastfeeding, it can also arise when a child weans unexpectedly.

Mother of three, Charlotte, comments: "I breastfed my eldest for 23 months. I couldn't breastfeed my middle son and I had to bottle feed, it caused me a lot of negative psychological stress for a while, and I got it into my head that he didn't love me. My third son I breastfed for just over 6 months, then he decided he wasn't interested anymore and preferred food and a bottle. This was a bit of a shock at first."

Infant feeding issues may also arise in pregnancy. For example, one mother who had an eating disorder when younger, had recurring nightmares throughout her pregnancy that she would be unable to feed her baby.

University of Albany evolutionary psychologist Gordon Gallup believes the grief a mother may experience also operates at the level of biology, commenting: "For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother's decision to bottle feed unknowingly simulates child loss."

A study of 50 mothers conducted by Gallop showed that those who bottle fed scored significantly higher for postnatal depression than breastfeeders.

Feelings of loss at not breastfeeding may be compounded by guilt, and also rejection by having felt undermined by questions when attempts at breastfeeding were underway.

Holmes spent ten years as a La Leche League (LLL) leader and observed that much of the meetings were devoted to discussions about addressing challenges from others toward breastfeeding women. For example "are you sure you've got enough milk", "that baby's got you wrapped around it's little finger", and assumptions about the duration of breastfeeding and the need for supplementation from formula.

Anthropologist Sheila Kitzinger in Ourselves as Mothers (1992) stresses the importance of self-belief when she writes: "The firm expectation that (women from traditional cultures) will breastfeed successfully is much more important for a mother than any specific breastfeeding practices... women can breastfeed under apparently impossible conditions if they are convinced that they will be able to do so."

Breast vs Bottle Polarisation

The polarisation of breast versus bottle hurts mothers and the women at the frontline of breastfeeding promotion. Holmes comments: "There appears to be this big division between breast and bottle feeding, but there are multi-causal factors with infant feeding in Western culture today including historical, cultural, familial and political. In a culture that often wants to point the finger in one direction, in reality it serves no one to do this. I believe we need an honest look at where we are to acknowledge that the two camps have much in common."

Holmes continues: "I think we need to appreciate that all women go through the same ringer when making decisions about feeding their babies - a successfully breastfeeding mother could have had endless struggle, undermining and interference to get to that point, just like a formula feeding mother. But yes, the breastfeeding mother's trauma may be alleviated by her eventual success."

Holmes herself experienced problems breastfeeding so knows first hand what women may go through. Holmes said she wanted to breastfeed her now grown-up daughter for economic reasons and because "it gave me an excuse to be close to my baby", a poignant testament to the independence expected between mothers and infants in Western society.

During the first few days of her daughter's life, and having difficulty feeding, Holmes was "constantly questioned" as to whether her baby was getting enough breastmilk and was "eventually worn down", and gave her baby formula. She then overheard someone saying of her "they just don't try very hard these days do they". However Holmes persevered, and with help from an LLL breastfeeding counsellor regarding positioning of the baby, she went on to breastfeed until her daughter was three years old.

The breast versus bottle debate has lead to an emphasis on breast pumps, by viewing breastfeeding through a bottle feeding lens and equating breastfeeding with breastmilk. However the use of breast pumps are linked to a decrease in milk supply and therefore negatively affect breastfeeding outcomes.

Carol Bartle, coordinator of the Canterbury Breastfeeding Advocacy Service, comments "Breast pump marketing implies that all women need a breast pump to breastfeed, and the only pressing issue is finding out "which pump is right for you". However seductive the pump marketing messages are, with their impressions of the modern mother's need to get away from her baby, fathers' need to give bottles, and images of attractive women with their backpack and pump, the reality of pumping is that of a complex and time consuming practice that is hard to maintain. I have yet to meet a woman who enjoys pumping but have known hundreds who love to breastfeed once they have established breastfeeding".

Bartle, who has 30 years' experience working in neonatal intensive care, where women try and establish their milk supplies using breast pumps, continues: "Many pumps are inefficient and do not remove milk effectively enough to maintain milk supply. Women who give breastmilk to their babies in bottles, and do not put their baby to the breast at all, are at the highest risk of serious milk supply problems."

This observation is confirmed by a 2009 study from Stanford University School of Medicine, California, which found that "pump suction alone often fails to remove a significant fraction of milk as more can be expressed using manual techniques". So to ensure pumping is done effectively, and the milk supply is maintained, pumping needs to be done in combination with hand massage techniques. Something few women are aware of.

Barriers to breastfeeding

It is very clear that women should not take sole responsibility for their breastfeeding experiences. Holmes identifies that grief issues "depend on self-image and expectations", so that when women are given unrealistic ideas of breastfeeding and at the same time undermined on the way to achieving breastfeeding, the grief and sense of failure can be significant.

New Zealand's National Breastfeeding Advisory Committee (NBAC) in its 2008-2012 national plan for breastfeeding detailed a list of 13 Social and environmental barriers to breastfeeding. These included the perception that artificial feeding enhances the father's opportunities to bond with the infant, attitudes that make breastfeeding embarrassing or uncomfortable for the woman, societal expectations about the acceptable duration of breastfeeding, a culture that portrays bottle-feeding as normal, and returning to work, by choice or through financial necessity.

The World Health Organization (WHO) says that "virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large".

These sentiments are reinforced by the pro-formula backlash, for example the book Bottle Babies by Adelia Ferguson (1998), which catalogues letters from bottle feeding mums - many of which are a testament to a fundamental lack of support around their breastfeeding experiences.

Holmes comments: "Many bottle feeding mums feel extremely traumatised by their persistent efforts to breastfeed to the point where they will not ever try again with subsequent babies. Sadly much of this experience is due to inaccurate breastfeeding information. However, there are successful breastfeeding experiences after some extreme circumstances. This is done knowing how breastfeeding works and that others have done it successfully."

In 2008, the UK's Scientific Advisory Committee on Nutrition said of the latest Infant Feeding Survey in 2005 that "The reasons mothers gave for abandoning breastfeeding suggest that relatively few mothers truly chose not to breastfeed. Three-quarters of breastfeeding mothers... said they would have preferred to breastfeed for longer had they been able. These findings suggest that most women who start to breastfeed are committed to it but stop because they encounter problems and find that skilled support is not readily available."

In recognition of this, the Canterbury Breastfeeding Advocacy Service provides not just information about breastfeeding but practical support in the form of networks between health care professionals, local groups and mothers. Bartle comments "We are trying to shift the culture to one that supports and protects breastfeeding women, rather than just promoting breastfeeding without support structures in place to really make a difference. For example, I have just been working with a mother who said that the most useful assistance she could have received while trying to establish her preterm baby on the breast after going home from the hospital, was home help."

Meanwhile, commenting on the national situation in New Zealand, outgoing LLLNZ Director Barbara Sturmfels, says: "Legislative changes to improve conditions for breastfeeding mothers in the paid workforce, a public advertising campaign to promote breastfeeding in public, and support for the implementation of UNICEF's Baby Friendly Initiative in New Zealand are some of the ways that the government is seeking improvements in breastfeeding rates through institutional and societal change."

Many problems need not prohibit breastfeeding were they seen as part of the breastfeeding journey and if consistent support and information were on hand in the crucial first days and weeks. Denise Digman in Breastfeeding in New Zealand: Practice, Problems and Policy (1998), says the medicalisation of breastfeeding has detracted from "perceiving the range of physical sensations and difficulties experienced while breastfeeding as part of the normal spectrum of events". This is echoed by NBAC which talks of "insufficient knowledge about the normal course of breastfeeding, including common problems and the solutions".

Holmes gives an example from her own life to illustrate this point: "In her first weeks, my youngest daughter was putting on very little weight and this was of concern to the Plunket nurse. I explored what factor might be creating the problem and discovered a cowsmilk intolerance. As soon as this was eliminated from my diet her weight gain improved. Without this knowledge, this could have turned into a safety issue."

New Zealand's breastfeeding rates compare favorably with those of other developed nations. Different countries measure the rates in different ways and for different years, but for a broad comparison, rates for exclusive breastfeeding are: New Zealand 2008 16% at 8 months; Canada 2008 14.4% at 6 months, Australia 2007 14% at 6 months, USA 2006 13.6% at 6 months, UK 2005 less than 1% at 6 months.

However seen globally, it is clear the impact Western values may have on breastfeeding. WHO recommends that infants be exclusively breastfed for the first six months and for breastfeeding to continue "up to two years of age or beyond".

The top 5 countries for exclusive breastfeeding at 6 months (Unicef 2008) are Rwanda 88%, Kiribati 80%, Sri Lanka 76%, Solomon Islands 74%, and Peru 69%. At aged 20-23 months, Sri Lanka, Burkina Faso, Ethiopia, Bangladesh and Nepal all had breastfeeding rates of over 80%, with Nepal at 95%.

In New Zealand, rates for Maori and young mothers are much lower than average, and Maori currently have the lowest exclusive breastfeeding rates in the country. This is also a hallmark of Western society: As Glover et al explain in Maori Women and Breasfeeding (2008) "Beliefs and practices introduced to Maori by European immigrants to New Zealand have supplanted Maori infant feeding practices". The report therefore recommends that "promotion of breastfeeding to Maori should focus on re-establishing breastfeeding as a tikanga (right cultural practice)".

As well as Karen Holmes new counselling service, Christchurch is fortunate in having the Young Parents' Breastfeeding Group Whangai U "Matua Puhou". Headed by public health advocate and breastfeeding peer counselling administrator Susan Procter, the group has over 20 regular members and meets regularly to support breastfeeding families where the mother is aged under 25.

Procter comments: "The impact the group has had is enormous, both in terms of breastfeeding success and also in giving several of the mums a passion and motivation to apply to enter the health care professions to advocate for breastfeeding and to support other young mothers."

Breastfeeding as Patriarchy

A further irony of the breastfeeding debate is that when a mother does successfully breastfeed, she is likely to be censured if she continues past an arbitrary cut off point of a few weeks or months.

Part of the problem is that motherhood, the archetypal female domain, is accused of becoming a patriarchy with male values overlaid upon it. For example the reverence of science over instinct, of experts over the mother's voice, and of consumer products over the mother's body. This is particularly relevant with the medicalisation of birth, with the rising number of cesarean sections impacting negatively on the establishment of breastfeeding.

Dr Truby King is a controversial example of the mothers' expert, having founded New Zealand's Plunket Society in 1907 "to help the mothers and save the babies" and the Karitane Product Society (KPS) in 1927, which consolidated King's production of infant formula.

Linda Bryder says of King in A Voice for Mothers (2003) "The diagnosis of the problem and the solutions put forward were the same everywhere: mothers were ignorant of the correct methods of child-rearing and needed to be educated". Meanwhile Sheila Kitzinger claims that King "Destroyed women's confidence in breastfeeding and made loving mothers feel inadequate and guilty."

One hundred years later, that charge was still being leveled at Plunket for the promotion of scheduled feeding, based on the digestion time required for formula, rather than for quickly digested breastmilk. The emphasis has shifted recently with Plunket advising that "your baby may wake wanting frequent feeds. For breastfed babies these feeds are important to help establish and maintain breastfeeding". However the organisation remains out of step with international WHO guidelines by recommending breastfeeding only "until they are at least 1 year or older".

Plunket's controversial partnering of breastfeeding promotion with corporate interest through King's formula production, continues today with Wattie's sponsorship of Plunket. Wattie's promotes Nurturebaby formula and markets "Stage 1" baby foods for "4-6 months onwards", in conflict with WHO's recommendation of "exclusive breastfeeding for 6 months" and Plunket's recommendation of "breastfeeding exclusively until around 6 months". The Plunket logo appears on the packaging of Wattie's Stage 1 foods, giving the perception that Plunket endorses feeding solids at 4 months, despite the clear conflict with Plunket's own policy. The presence of the Plunket logo also gives the impression that Plunket is endorsing that particular brand of baby foods above both competitive brands and baby food prepared at home.

The patriarchal legacy remains a tangible presence for women, their partners and families today. Holmes comments: "Progressively, women were told that their instincts, their feelings and everything else they may have previously believed were wrong and they needed to listen only to the experts if they wanted their babies to live. This creates internal conflicts which may become problematic, especially the thought that something must be wrong with a woman as mother."

Holmes continues "It is with this that I want to work, for example validating grief, feelings, impacts. Helping women to understand what creates these conflicts and giving them permission to feel what they feel. I would hope also that in doing this women may regain a sense of their own wisdom and feel empowered to make informed choices."

Holmes stresses that the understanding and support of fathers is a crucial part of this process. Holmes comments: "Breastfeeding is a human issue, not a women's issue. Men have a valuable and active role in supporting women to breastfeed and in protecting it." This is reinforced by Sturmfels who says "Informed and skilful mother-to-mother support can really make a difference. A new mum needs the love and support of her partner and family."

Holmes concludes: "What is most important is that all mothers are honored in their experiences around infant feeding. That mothers feel supported, valued and confident in their own ability as a mother."

Congratulations on becoming a mum!

Months of pregnancy followed by labour have taken its toll on your body and it will take time to recover from all the events of the last 9 months. There is no rush to push your body to its limits right away; however it is time to gradually regain your strength and fitness.

1. During pregnancy your body adapts to accommodate your growing baby. You have a piece of soft tissue called the linea alba which attaches itself to the pubis symphesis (centre of the pubic bone) and the xyphoid process (the bony bit at the bottom of the sternum between the top of the rib cage). Its purpose is the connection of other muscles around the abdominals. As you grow during pregnancy this tissue can separate and the abdominal muscles spread away from each other. This is a perfectly natural thing to happen. However, before you anticipate exercising after giving birth you must wait until this tissue has returned almost to its original form. It is therefore import that you get clearance from your GP before starting a training programme. If you delivered your baby via caesarean section then you will take a little longer to heal. Also the remaining scar tissue in the muscles renders them slightly inactive and they will take time to start working properly again. It's important to communicate with your GP/obstetrician who will be able to advise you when you have recovered sufficiently from the surgery to begin an exercise programme.

2. It should be noted that for a few weeks after giving birth hormones are still racing around your body. There are still residual amounts of relaxin in your body. This hormone is released during pregnancy to allow soft tissues to become more elastic to allow extra space for the baby. Because of this, for a short while after birth you need to take care when stretching to avoid injury by stretching too much.

3. Are you breast feeding? If so then it is advisable to plan your workouts around feeding times. Some research suggests that if a mum breastfeeds straight after very rigorous exercise, her milk may contain high levels of lactic acid that can temporarily affect its taste. However, this only applies to truly strenuous exercise.

4. Once you are ready to start getting back into shape, take care which exercises you choose to begin with. The pelvic floor has been put through a lot of strain during labour which can cause stress incontinence, however the good news is that you can start pelvic floor exercises almost immediately after giving birth.

5. The core muscles have also been put through a lot of strain during pregnancy and labour. These muscles need activating to get them firing properly and help improve posture. This will help with any lower back pain too. Try this simple reverse breathing exercise to get them working again:

- Place yourself on the floor on your hands and knees.
- As you take a deep breath in push your belly towards the floor and hold for a couple of seconds.
- As you breathe out slowly, pull your belly in towards your spine as tight as you can. Breathe out as far as possible and again hold for a couple of seconds.
- Repeat the exercise.
- Make sure you take long slow deep breaths; you may even feel the pelvic floor lift as you breathe out.

As you improve you can make this exercise more challenging by extending out your arm and/or opposite leg. This places more tension on the core to stabilise.

6. Progress at a steady pace. After your 6 week check up, don't try and run a marathon the next day (unless you are Paula Radcliffe!). Start working at around 5 out of 10 (10 being maximum effort) and after a couple of weeks increase to 6 out of 10 and take care with high impact exercises. When your lochia (post natal bleeding) has stopped you could try swimming, although it's best to wait for at least 6 weeks to avoid infection.

7. Finally, eat good quality fresh organic food and drink plenty of water, which will be good for you and the baby if you are breastfeeding.

So here's to your good health and wellbeing. Good luck!

New mothers sometimes experience "postpartum blues." This is understandable. Pregnancy and birth are very dramatic events for your body - both physically and emotionally. So, it's common to feel a little weepy, irritable or moody in the first few days after birth.

If you eat well, supplement your diet with high quality whole food supplements (especially omega-3 oils and B vitamins) and get enough rest, mild cases should pass quickly.

But, if "the blues" continue for more than just a few days, or if you're feeling really depressed and down, please don't try to tough it out. Get professional help. Ask your midwife or doctor to connect you with someone who can give you appropriate counseling.

Here are some tips that can help prevent or ease the symptoms of postpartum depression:

1. Ask for help after the birth. Here are some things friends and family could do for you during the first few weeks that might work better than giving the traditional baby shower gifts. They can:

Bring you a complete dinner (hot and ready to serve);

Volunteer to do your laundry;

Take care of your house cleaning;

And/or entertain older children with a day of play.

2. Get yourself out of the house - if only onto the deck or front steps - for at least a few minutes each day. Set up a lawn chair, wrap up yourself and your baby in a blanket and take a break. Set aside this time for you and baby.

3. Take it easy. Play with your baby. Visit with friends and family. Listen to relaxing music. Watch some old "feel good" DVD's. Get someone to take you and baby for a long ride in the car. Baby will probably fall right off to sleep and you'll get a chance to shut your eyes and relax for a few moments too.

4. And most importantly, eat really well and get yourself on a complete whole food nutritional program including pure omega-3 oils with EPA and DHA. I've seen high quality whole food supplements, combined with wholesome eating, consistently succeed in overcoming postpartum depression.

This is a special time for both you and your baby. It's important to relax and enjoy it. And remember, if your depression continues for more than a few days, please don't be afraid or ashamed to ask for help. Support is only a phone call away at the National Post Partum Depression Hotline 1-800-PPD-MOMS (773-6667).

Raising a kangaroo at home isn't something that you can take lightly. In order for you to become an effective pet owner to this exotic animal, you have to prepare yourself through research and studying. Knowing important details about your pet is vital as this will help you deal with it effectively.

Learning about raising a kangaroo basically starts with knowing the background of your exotic animal. Kangaroos are considered as amazing members of the Australian fauna. They are marsupials that are closely related to wallabies, Quokka, wallaroos, and pademelons. All in all, there are around 63 different species of the Macropodidae family in the wild today. Kangaroos are endemic to the lands of Australia. However, some members of this family specifically the smaller marcopods have also been found in New Guinea. They thrive on the landscape of Australia. They're not farmed. Instead, they're sought because of their meat. This animal has become a national symbol for Australia and is often observed on the Australian Coat of Arms, the country's currency, and on the tail of its national airline called the Qantas.

Males are referred to as kacks or bucks while females are called jills or does. The young ones or the babies on the other hand are called joeys. Among the different types of species existing today, red kangaroos are the largest ones. In fact, they are the largest surviving marsupial on the face of the planet. They thrive in the arid and semi-arid regions that are located at the center of the continent. The Eastern Grey Kangaroo on the other hand, which is another famous species, is commonly seen in the fertile eastern region of Australia. The Western Grey Kangaroo, which is also another species is a native of Western Australia and Southern Australia as well as of the Darling River basin.

Let's discuss some cool facts about these types of exotic animals. These animals are equipped with large feet and strong hind legs. Their physical adaptation helps them to leap. They have a muscular tail, which functions just like a tripod leg. Their tails come in handy for balance. The most unique feature of these exotic animals would be their marsupium or stomach pouch. This is physical characteristic that's common to all marsupials. The pouch is used to serve as a home for joeys during their postnatal development.

Kangaroos hop for locomotion. They can hop at speeds that average at 70 km/h especially when they're looking for food and water and when they're running away from predators. Their most common predators include goannas, feral cats, foxes, and wedge-tailed eagles. These animals usually live around for 4 to 6 years. Their diet varies depending on their species. In general, they are known as herbivores. They love feeding on a wide variety of grasses, hypogeal fungi, and shrubs. They are known to be both crepuscular and nocturnal. This means that they are most active during the night and by twilight.

Depending on where you live, there are a number of fascinating names for them. Here in the U.S. we refer to them as mutts, Heinz 57, Sooners, mongrels, hounds, and tykes. In Hawaii, they are known as Poi Dogs. Country folks in the South, call them feists or curs.

In Newfoundland you will hear the term a Cracky. In the Bahamas and nearby islands, they are called Potcakes. Jump over to South Africa and you will hear the people refer to them as a Pavement Special. Our Australian friends call theirs Bitzers.

No matter what they are called, for many dog owners, they are the only real dogs. To them, the more breeds in the mix, the better!

So, what are the advantages and disadvantages of a mutt? Let's start with the advantages. The fact they are less likely to be stolen is a good one! There is often a lower incident of genetic defects, as there is a larger gene pool. It's a fact, the bigger the gene pool, the less likely the odds of combining two defective genes. That is a plus for many less discriminating, yet adoring dog lovers.

Additional advantages are mutts are less expensive to purchase. Let's face it; sometimes they are free for the taking! Usually, they are also less expensive in the upkeep department as they require few, to no visits to a groomer for a fancy hairdo.

It is also a fact, mutts tend to have a higher than average natural longevity compared to pedigrees. Cars are not counted in the equation! The reason for this as studies have shown, may be mutt mothers are normally excellent moms compared to their pedigreed cousins. It's true. Documentation in many countries show, they normally provide better care, as well as more and a higher quality of milk. Because of that, infant mortality in mutt litters is noticeably lower than with purebred-bred litters. Between a diluted gene pool, and quality postnatal care, it appears a mutt pup has the advantage a healthier start and possibly a longer life.

Finally, whenever you look into their eyes, there is the sense you did the right thing. They may not be the cutest, fluffiest, most handsome, or prettiest dog in the dog park, but they are forever grateful, that you saw their "inner beauty."

So, what are the disadvantages? The disadvantages are few. Granted, you won't find a mutt participating in the AKC/Eukanuba or Westminster Dog Show, even though Eukanuba doesn't seem to mind too much that mutts are customers. Nor, will you see them at most AKC events...although that is changing a little with their AKC Partners Program.

The only other disadvantages of owning a mutt are you will never really be sure how big they will get, or what their temperament will be. Not that there is any guarantee with a pedigreed dog! Nonetheless, responsible breeders do have a general idea of the likely size and temperament of the offspring of their mating pairs.

If sharing your life, love and home with a blue-blooded pedigree is imperative to you, than this article won't make a difference.

However, if you are less discerning about your image and want to share your life, love and home with a wonderful pet, consider adopting or rescuing a mutt. At a local shelter or rescue, the perfect companion and new best friend is anxiously waiting just for you. Save a mutt's life!

I admit, while not a medical term, new baby painful wrist and hand syndrome accurately describes what so many new mums, including me, have all experienced. Medically, it's referred to as tendonitis or carpal tunnel syndrome and is common among new mums. Carpal tunnel or wrist tendonitis is irritation and inflammation of the tendons of the wrist. Pain is the main symptom and there can also be swelling of the local area. The tendons get inflamed through repetitive motion such as picking up the baby and holding the baby in position while breastfeeding.

In my case, for example, sharp pain would shoot from my right thumb up my arm whenever I picked up my daughter. The pain was so intense it would make me cry out loud. In the same way you pull your hand away when you burn yourself, I began to fear dropping my baby as a reflex reaction to the pain. I purchased a wrist brace but found it way too uncomfortable so I developed a particularly ungraceful way of picking up my daughter by leaning in really close to her and scooping her up with my forearms. Using this technique I could avoid opening my hands to pick her up in the usual way under her arms. It looked really strange but it worked until I found time between feedings, exhaustion and new mum anxiety to schedule an acupuncture treatment.

In my own business as an acupuncturist, I had treated many cases of tendonitis and carpal syndrome. Some were new mums, some were athletes, one was a drummer, and most were office workers spending hours on the computer. Whatever the cause of the pain, acupuncture helped all of them, quickly and effectively. So naturally I turned to acupuncture when I needed it. Since it's really difficult to do acupuncture on yourself, I turned to a colleague for help. After the first treatment, the pain was much better and by the third treatment, the pain was significantly reduced and much less frequent. A couple more treatments were all that was needed to get rid of the pain.

What are the usual options for these painful wrists? A doctor will most likely prescribe steroidal anti-inflammatory medication such as prednisolone or a cortisone injection directly into the wrist. While these can help, many prescription medications are not advisable for the mum who is breastfeeding as they can seep into the breast milk.

This makes acupuncture a great alternative as it has no side effects. And a 2009 clinical trial published in the Clinical Journal of Pain concluded that short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate carpal tunnel syndrome 1.

References:
1. Yang CP, Hsieh CL, et al., Clinical Journal of Pain, 2009 May; 25(4): 327-33 Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial

Palmers stretch mark cream is a very popular beauty product. It is also common among expectant and postnatal mothers. Being an anti-stretch mark cream, Palmer has won the hearts of ladies all over the world. It is possibly the most loved product in regard to the removal of skin dermal scarring. Have you ever bought this cream? It's essentially ingredient is cocoa butter and that is why most of you know it. Palmer has a soft balmy feel, enticing scent and offers easy application.

While some creams are too expensive, this one is cheap and effective. As some of you may know, anti-stretch mark balms should do a little more than keep the skin moisturized. Fortunately, you will not be disappointed in Palmer's stretch mark cream. It has what it takes to reduce all types of skin silvery stripes that often form on the belly skin during and after pregnancy. Reducing means fading the marks so that they can become less visible to the eye.

For that to happen, the creams one uses must penetrate the skin so that it can reach the dermis layer. This is usually the central layer that become scarred when a woman loses weight quickly or when her belly stretches during pregnancy. Now you may be wondering how Palmers stretch mark cream works. It has an ingredient called shea butter, known to facilitate penetration of the balm itself. Shea butter added to the cocoa butter enhances the soft texture of the skin.

These two types of butters are not the only ingredients to expect. Palmers has essential additives such as hydrolyzed elastin and collagen, which are both essential elements of your skin. The combination of the two really does something to improve the appearance of your skin. The fact the two are dermatologically tested means that you can actually use the products without fear. There are other countless users of the product worldwide who are happy about it.

This cocoa butter balm is clinically secure and its job is to prevent further development of stretch marks. Even so, your patience is necessary, especially if you are looking to eliminate already established blemishes. You have to allow the item work gradually rather than expect it to give you accurate results right away. Women that have used this product before show mixed emotions.

For instance, some are so happy and satisfied with it while others are partly positive about it. See, everyone's skin is different plus the fact that a few ladies' scarring is genetic. Such ladies always have a bigger share whether they are expecting babies or not. There are some ladies who claim that this product simply fades the color of the blemishes and ends the itchy feeling.

Whatever their claims about Palmers may be, the fact is it contains cocoa butter, a unanimously acceptable anti stretch mark ingredient. Besides, even the owners of the product do not give any guarantee that it would work for all ladies. However, it cautions that irregular use of Palmers stretch mark cream is not okay. It shows your skin is not getting consistent attention.