I always knew I wanted to breastfeed when I had children and my stubborn desire to do so was the only way I was successful. Breastfeeding with my son had a very difficult start, as I've mentioned in a previous post, and I could easily have switched to formula if it hadn't been for my excessive determination. My success at breastfeeding has been such a positive in what has been a difficult year, heightened when a health visitor (who has the role of breastfeeding specialist), told her trainees just how impressed she was with me, that it was an extraordinary feat for me to be exclusively breastfeeding after the complications I experienced during the birth.
So the fact that I have breastfed my son for over a year, is something I am immensely proud of.
I am one of the least judgemental people, I do not intend on telling anyone what they should or should not do in any area of their own lives. I believe every mother can make their own decisions in whether or not they choose to breastfeed, it is a very personal choice that should suit each individual mother. My initial and ongoing experience of breastfeeding was, at times, incredibly stressful and I could go as far as to say a contribution to my postnatal depression, it was definitely a factor involved in my sleepless nights and it was the reason I could not go out socially in the evenings for a very long time.
So if I start from the beginning. My first attempt at nursing my son was when he was literally minutes old. The health professionals had delivered my baby, stitched me up and dealt with the first massive haemorrhage I had. After all that drama they left the room and let us have our first experience as a family of 3 and I decided to take an inexperienced shot at nursing. I had not a clue what I was doing and just placed my son near my boob and hoped he would figure it out. To my amazement he did! I had no way of knowing whether he was getting anything but he seemed to be doing the right action. It was during this feed though that I felt a pressure, not dissimilar to the pressure I had experienced during labour. It was another haemorrhage, enough to take me over the edge, a significant loss of blood that I would require blood transfusions and to drop my blood pressure so low I was on flat bed rest for over 24 hours having my observations taken every 15 minutes.
In hospital I got absolutely no guidance with breastfeeding, I had no idea if my son was getting the good stuff or not. I was not told in hospital that my experience would be affecting my milk supply. Being on the high dependency unit their focus was me not my newborn. They were even encouraging me to allow them to top him up with formula so I could get some much needed rest. I refused.
A few days at home and I was getting upset because my son was asking to feed ALL the time day and night, he was very frustrated and I was feeling very sore. I very nearly caved, holding a bottle of prepared formula, but I did not give it to him. The Midwives at my 10 day check felt his feeding was excessive and suggested some expert advice. We went to the breastfeeding clinic and spent 1 hour being hysterical. They were doing their best to help, trying to teach me how to get him to latch properly, explaining he was not feeding because he was not taking long enough sucks but lots of little ones. On reflection this is probably because I wasn't producing enough for him (which is actually very unusual and something mothers believe is happening when it is not). However shortly after that my milk supply did come in and nursing began to work well.
I gained so much confidence, I picked subtle tops and nursed in public regularly. I only ever had one negative experience in public and even then it was only a look and not a nasty comment. My son, after an initial drop in weight, has gained weight really well. He started on the 75th centile, dropped to the 50th and then gradually worked his way up to the 91st centile!! The health visitors are happy with him.
My son took to breastfeeding so well that he refused milk in any other way. For months and months we tried to get him to take expressed milk and even formula from almost every brand of bottle in existence. We never really succeeded. I missed out on many social events including a friends wedding for this reason. I never got any me time.
Night time and a serious sleep deprivation, regular night feeds, my partner not being able to help with this, and comfort feeding (it took me a fair while to realise the difference). Breastfeeding was one of several factors that led to a "bad sleeper".
Then there was the agony of mastitis. A blocked milk duct. My first experience of this was over the Christmas period. Red, hot, solid, tearfully painful boob, high temperatures and feeling rough, just what I wanted at Christmas time when the GP surgeries are closed. Nursing on that boob (which is encouraged) was excruciating and eventually I had to get an out of hours appointment on a bank holiday, down at the hospital for antibiotics. Fortunately I never got it like that again, I recognised the signs early, and on 2 future occasions self managed the problem.
When I was diagnosed with PND, I was prescribed antidepressants. This, I was told, had a risk of side effects to my son due to being breastfed. My GP encouraged me to stop breastfeeding. I refused to stop and so I refused to take them initially due to the risks to my little boy. Once my son was feeding less frequently I started on a very small dose but continued to refuse to up my dose as prescribed. My GP clearly felt I needed to up my dose for my recovery but breastfeeding meant that morally I couldn't, I was putting my son first.
Much of what I have written seems negative and not great for selling the benefits of breastfeeding, plus I have already suggested that my choice contributed to my post natal depression so why did I continue feeding for over a year? Because I LOVED breastfeeding! Despite all the significant hurdles we had to get over, I would not go back and change my decision. Stopping breastfeeding would have been more of a contributory factor in my PND than continuing. During a year that I was feeling like a failing mother, my success at breastfeeding my son was something I was most proud of. Many mothers with PND report a lack of bond with their baby, this was far from how I felt, breastfeeding gave us the most amazing bond, I loved our closeness, I loved knowing I was giving him a great start in life in terms of nutrition, immunity and all the other many benefits of nursing. My health visitor confirmed my suspicions and reluctance to stop by citing research that showed depression worsens in those women who cease nursing before they feel ready.
Before I had my son I decided I wanted to aim to breastfeed for 6 months, 1 year later and I now feel ready to switch my son onto cows milk. I knew with my son that this would be challenging based on our bottle experience but we have slowly been introducing cows milk since 10 months under the guidance of my health visitor to ease the transition once I chose to make it. Today is the 4th day that I have not breastfed. It is a bittersweet feeling. I already miss it, especially our bedtime routine and actually having boobs. But I was ready, my decision has not affected my mood, I was able to attend my best friends 30th birthday night out and now I can up my antidepressant medication to the dosage my GP has recommended without any worries that they will affect my son. I can take the next step in my recovery.
Showing posts with label Sertraline. Show all posts
Showing posts with label Sertraline. Show all posts
Sunday, 27 November 2016
Monday, 17 October 2016
A surprising amount of normality
6 weeks into my Sertraline prescription and after my first talking therapy session, I could feel that I was starting to return to my old self.
Lets start with some background to my personality.
Since a nipper I have been non-stop active, fun loving, consciencous, caring and happy, but I have had some dips in my mood in the past, none of which required any kind of intervention though.
I've always been shy, when I was a youngster I was ridiculously timid. I recall a parents evening at the start of secondary school when my history teacher begged me, in front of my parents, to speak more in class. I am fairly certain that is an unusual request for a teacher to make.
I have never had much self confidence and I have always set my standards too high, never been satisfied with my own personal achievements. An example being my GCSE results day. I got 6 A's, 5 B's and a C. I was absolutely mortified by my C. Rather than being proud of my A's and B's, I was heartbroken by my C in Spanish. There is nothing bad about getting a C I'd like to add but I had worked so hard and to me I had failed myself. My Spanish ended up getting re-marked and was upped to a B but by then I had experienced total disappointment.
I know I should be proud of my achievements, I worked so very hard to get to where I am. I think the school systems are partly to blame (I "failed" my 11+ when it was expected I would pass, and then passed my 12+, I went off a grammar school where I was made to feel anything lower than a B wasn't good enough only to get a C in Spanish when I had been predicted an A, then at A level I got BBCD and was the only person out of all my friends not to get into university that year. I spent a year at home, whilst everyone else enjoyed uni life, and resat my exams) but my opinions on school assessment is another topic entirely. The point is, I set my standards high even at a young age and achieving didn't come easily to me. It wasnt until I was a sucessfully qualified 22 year old Physiotherapist, working with so many different people, patients and colleagues, from so many different backgrounds, and I was able to see that I was making a positive difference in their lives, that my self esteem began to improve. And over the 7 years since qualifying, I gradually became a much stronger person.
So back to the main point of this post. I didn't have a masses of confidence before I had post natal depression but the confidence I did have, had been built up over years of work , and so this monster had taken what confidence I had. I have had 11 months of feeling almost reclusive, with most conversation being no more complex than 'I think it's snack time' or 'have you done a poo? ' So I pleasantly surprised myself on a work course in London last week.
I have never been fazed when it comes to travelling so the trip alone to London did not daunt me one bit, but once in London my apprehensive, polite, introvert self took over again. It was rush hour and I missed the first 2 tubes for the sole reason that, unlike everyone else in Baker Street station, I didn't confidently and forcefully push my way onto a train that had not a single inch of space left on it, and I was left behind each time.
Eventually making it to London Bridge and into my course room, something unusual yet distantly familiar happened, I found myself chatting to the other strangers in the room, mostly health professionals, all with a neurological interest. I immediately saw some of that bygone confidence and my true identity making a reappearance. It wasn't until that point that I realised how long it's been since I saw this person and quite how much I've missed them!
The day continued in this way. We had to do a role play type task, my idea of a nightmare, but at the end of the task, the course leader asked for some feedback and to my astonishment I was the first person in the group to volunteer my opinion and to top it off, I got a laugh from the group! My history teacher would have been so proud.
Don't get me wrong, it wasn't a total transformation from the PND me to the old me, I had my moments, like when I couldn't figure out how the hot water jug worked and eventually, timidly and in embarrassment asked someone to help me. But the old me was definitely reminding me every so often that they are still there and to me this brought hope and a monumental, positive step in my recovery.
I got home from London and received big cuddles from my son, it had been a long day away from him, the longest so far, and I had really missed him but I had also enjoyed my day. I had used my grey matter, been involved in intellectual conversation with actual adults and it had allowed me to rediscover my own identity. Today I was me and not just E's mummy.
As I write this I'm watching my little boy, who is 3 weeks from his first birthday, pulling himself up to stand and waving at me and I finally feel proud of myself. It's been a tough journey these last 11 months, with big highs and lows but my son is a handsome, well behaved, albeit cheeky, intelligent little man and I played a massive role in that, I am truly seeing that now. Returning to work in 3 weeks time will be tough but stricking the right balance between being me and being E's mummy, I feel, will bring me back to that cheerful, confident person I was a year ago. Normality.
Lets start with some background to my personality.
Since a nipper I have been non-stop active, fun loving, consciencous, caring and happy, but I have had some dips in my mood in the past, none of which required any kind of intervention though.
I've always been shy, when I was a youngster I was ridiculously timid. I recall a parents evening at the start of secondary school when my history teacher begged me, in front of my parents, to speak more in class. I am fairly certain that is an unusual request for a teacher to make.
I have never had much self confidence and I have always set my standards too high, never been satisfied with my own personal achievements. An example being my GCSE results day. I got 6 A's, 5 B's and a C. I was absolutely mortified by my C. Rather than being proud of my A's and B's, I was heartbroken by my C in Spanish. There is nothing bad about getting a C I'd like to add but I had worked so hard and to me I had failed myself. My Spanish ended up getting re-marked and was upped to a B but by then I had experienced total disappointment.
I know I should be proud of my achievements, I worked so very hard to get to where I am. I think the school systems are partly to blame (I "failed" my 11+ when it was expected I would pass, and then passed my 12+, I went off a grammar school where I was made to feel anything lower than a B wasn't good enough only to get a C in Spanish when I had been predicted an A, then at A level I got BBCD and was the only person out of all my friends not to get into university that year. I spent a year at home, whilst everyone else enjoyed uni life, and resat my exams) but my opinions on school assessment is another topic entirely. The point is, I set my standards high even at a young age and achieving didn't come easily to me. It wasnt until I was a sucessfully qualified 22 year old Physiotherapist, working with so many different people, patients and colleagues, from so many different backgrounds, and I was able to see that I was making a positive difference in their lives, that my self esteem began to improve. And over the 7 years since qualifying, I gradually became a much stronger person.
So back to the main point of this post. I didn't have a masses of confidence before I had post natal depression but the confidence I did have, had been built up over years of work , and so this monster had taken what confidence I had. I have had 11 months of feeling almost reclusive, with most conversation being no more complex than 'I think it's snack time' or 'have you done a poo? ' So I pleasantly surprised myself on a work course in London last week.
I have never been fazed when it comes to travelling so the trip alone to London did not daunt me one bit, but once in London my apprehensive, polite, introvert self took over again. It was rush hour and I missed the first 2 tubes for the sole reason that, unlike everyone else in Baker Street station, I didn't confidently and forcefully push my way onto a train that had not a single inch of space left on it, and I was left behind each time.
Eventually making it to London Bridge and into my course room, something unusual yet distantly familiar happened, I found myself chatting to the other strangers in the room, mostly health professionals, all with a neurological interest. I immediately saw some of that bygone confidence and my true identity making a reappearance. It wasn't until that point that I realised how long it's been since I saw this person and quite how much I've missed them!
The day continued in this way. We had to do a role play type task, my idea of a nightmare, but at the end of the task, the course leader asked for some feedback and to my astonishment I was the first person in the group to volunteer my opinion and to top it off, I got a laugh from the group! My history teacher would have been so proud.
Don't get me wrong, it wasn't a total transformation from the PND me to the old me, I had my moments, like when I couldn't figure out how the hot water jug worked and eventually, timidly and in embarrassment asked someone to help me. But the old me was definitely reminding me every so often that they are still there and to me this brought hope and a monumental, positive step in my recovery.
I got home from London and received big cuddles from my son, it had been a long day away from him, the longest so far, and I had really missed him but I had also enjoyed my day. I had used my grey matter, been involved in intellectual conversation with actual adults and it had allowed me to rediscover my own identity. Today I was me and not just E's mummy.
As I write this I'm watching my little boy, who is 3 weeks from his first birthday, pulling himself up to stand and waving at me and I finally feel proud of myself. It's been a tough journey these last 11 months, with big highs and lows but my son is a handsome, well behaved, albeit cheeky, intelligent little man and I played a massive role in that, I am truly seeing that now. Returning to work in 3 weeks time will be tough but stricking the right balance between being me and being E's mummy, I feel, will bring me back to that cheerful, confident person I was a year ago. Normality.
Thursday, 6 October 2016
Starting on antidepressants
When my GP diagnosed me with Postnatal Depression her first recommendation was that I start on an antidepressant, Sertraline was her antidepressant of choice. At the time she did not give me any other treatment options. In her words, she felt I needed to be 'more stable' before I would respond well to any other input.
I was very reluctant to start on antidepressants, in fact I went against her professional recommendation initially and didn't take them. This was not just my own selfish reluctance, I was also aware that it can pass into the breastmilk. It was my GPs opinion that the risks outweighed the benefits to my bubba (minimal risk of side effects to my baby verses a mum who was coping better). But she did also encourage me to cease breastfeeding. I went home and read some online research and still wasn't reassured.
4 weeks later when I met with my new health visitor I explained why I hadn't started on the Sertraline and how I wanted some other treatment options. She listened. It was explained to me that I was starting on a very low dose (50mg) and that the risks to my little man really were small especially as he only has two feeds a day from me now. She also disagreed that I should cease breastfeeding, and cited some research that concluded mood is lowered further in mothers who stop breastfeeding but are not ready to, but she wanted further treatment alongside the medication if I agreed to take it. She suggested Talking Therapy and input from their team to improve my son's sleep.
So I started taking 50mg of Sertraline (that was 5 weeks ago). I read all the possible side effects and I expected the first couple of weeks to be unpleasant but I barely noticed a difference. I felt slightly foggy and a marginally more sleepy for the first week and my appetite reduced a little but otherwise I was well. These minimal effect cleared after a week.
After 3 or so weeks I noticed that I was nowhere near as tearful as I had been and I was not taking absolutely everything to heart anymore. The medication was having a positive effect and, more importantly to me, didn't seem to be having any negative effects on my son. I was, however, also getting more sleep as the nursery nurses input had resulted in my son sleeping through the night. So my mood improvements were likely due to both these factors.
4 weeks into antidepressant treatment I had a review with my GP. She was pleased with my improvements and felt I was more positive. She still felt my confidence was down and that I would benefit from upping my Sertraline dose to 100mg. Again, she was unable to guarantee no side effects to my son. Again I have declined to follow her advice. I explained my trepidation and I compromised. My son is almost 11 months and I've always said that I want to breastfeed for 1 year. Over the next month I will begin to wean my bubba into cows milk and once he is fully weaned, if I still need to, I will up my dose.
I have some big changes happening over the coming month including returning to work, and I feel this may be a helpful step with regards to my well being. So we agreed to review how I was managing in 6 weeks time. So I will blog again in a few weeks to update.
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