Thursday, 18 August 2011

Sleep Deprivation Vs PND

I want to start by saying this is my experience, and by no means reflective of the norm, or reflecting on other experiences.

I was talking to some friends the other day about the change when you become a mother and also then as a second time mum, when you are trying to balance the needs of your first child with that of a baby.

The start of this is simple, most mums are now asked to complete a questionnaire in the weeks following birth, usually I think around eight weeks. It's usually the Edinburgh Scale (EPDS).

I'd also like to talk about my health visitor. I think she's amazing. Everyone really appreciates their midwife, but for me I was not only grateful for my midwife but also my health visitor- Charlotte. This may be a reflection of the investment where I live but probably just that fantastic people work for the NHS. Health visitors are clever, Charlotte came to see me before I gave birth to my first child. This is genius, see a woman before she becomes a mum really allows some one to assess how well you're coping with motherhood.

I had a really tough time breastfeeding, that in itself is a topic for another post, but by six weeks I was at my wits end, I was crying, anxious, it was horrible. Charlotte asked me to complete the EPDS, and I was at the high end of the scale. When it came to thinking about triggers, everything came down to my anxieties over Seren's response to breastfeeding. I took the decision to wean her onto formula, and in my case by ten weeks Seren was fully formula fed and I was on the low end of the EPDS. I wish it hadn't come to that, I wish I had been brave in earlier decisions and trusted my instincts a lot more. But it was what it was.

With the second pregnancy I was determined to learn from this experience, to write the first six weeks off. Knowing we were having twins meant I couldn't rely on previous experience, I was having two babies and Seren would have only just reached two, this was not going to be a walk in the park... well, actually, always good for getting a baby to sleep!

I took the decision on leaving hospital to stop breastfeeding. Many mums successfully breastfeed twins with young children, it just wasn't something I could do. I stressed too much and feeds took so long I couldn't expect Seren to keep herself entertained.

Surprisingly, life was amazing. We were amazing. We were managing to get out and about: the park; the Children's Centre; soft play; a week in Cardiff; we even spent the boys due date at Eureka! and I was so grateful that having no expectations meant it was easy to feel we were achieving little goals. Charlotte commented that if we had enjoyed Eureka! there was no chance of PND.
But by six weeks things started to change, going out was no longer as enjoyable for fear of where Tom's projectile vomit would land, we started to do lots more around the house- messy play, the weather wasn't bad so Seren did laps of the garden to rid excess energy.
At ten weeks Tom was admitted to hospital for six days and as we were transferred to Sheffield seeing Seb and Seren wasn't an option.
When we got out of hospital the focus was on Tom gaining weight but things were improving. We managed another trip to Cardiff.
After driving back from Cardiff, a 'normal' night of feeds with the boys, I had the boys check up. And this was accompanied by the questionnaire.  The check up didn't go so well. Tom was gaining an exceptional amount of weight, but then the health visitor commented that Seb wasn't doing so well weight gain wise. I burst into tears. After just getting Tom back on track I didn't think I could cope with Seb being ill. And then I did the questionnaire, and sure enough, on the high scale for PND.
As a positive, this was a trigger for getting the house on the market to move to Wales.
But with hindsight, I do wonder about the thought putting the thought of PND into my head. In the words of the BBC 'other options are available'.

Charlotte came round to see me a few weeks later. Things were fine, at 16 weeks the boys at decided to start sleeping for 13 hours a night. The house was tidy. I had been sleeping.

Charlotte looked at Seb's growth chart and commented that she wouldn't have mentioned the 'dip' in Seb's weight- this is of course, because she knows me, she knows that my biggest problem is that I am a control freak, that my biggest anxiety is the well being of my children. Nothing came of Seb's weight dip, it was just a glitch he went back to a 'normal' growth rate.
When completing the questionnaire, the boys were 14 weeks, therefore I had 14 weeks of sleep deprivation under my belt. And just because it is a factor, it was getting up to feed two babies, when they needed feeding it was more likely to be them acting as a tag team than in tandem.

And to cut to the chase, the point of this post, especially when talking to other mums:
I do wonder if more could be done to acknowledge the effects of sleep deprivation, whilst you can try to get extra support in the day nothing substitutes a good night's sleep.

Both my experiences, I would think would conclude I didn't suffer PND, but high levels of anxiety and sleep deprivation. I found both to be the most horrible experiences, especially when accompanied by the wonderfulness that are my children.

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