Postpartum Bonding: The Foundation of Relationship

Inside your womb your baby’s every need was unconsciously met by you.  Cradled and protected inside you, your baby’s sense of touch, sight, smell and sound had been muffled.  In your perfect, climate controlled environment, your baby had never experienced significant discomforts of pain, cold or hunger. Following the birth, and in the weeks thereafter, you and your baby are learning how to live in the world together: how to communicate so you understand what your baby’s wants and needs are, and how to address them.  It’s a big task, and it takes time.

Matraea Mama & Babe

Ideally you create an environment where you are supported and freed-up only to take care of your baby.  Let go of daily chores and routines – they will be waiting for you when you and your baby are ready and able. Give yourself the space to follow the sage advice of “feeding on demand” as well as “sleeping when your baby sleeps.”  There are countless benefits to you emotionally and physically. Until your baby learns to adjust to your rhythm, it is best to surrender to theirs.

“Your baby is coming to you without a manual or the ability to tell you directly what she wants and needs. You will need
to learn your baby’s language and the best way to do that is to immerse yourself in the experience. The gentler you are on
yourself and the more time you take to just be with your baby the easier it will be.  It’s important to create space for this,
what we often call a babymoon or the fourth trimester." - Selina Boily RM

Initially, while adjusting to the unfamiliar outside environment, the baby will be most comforted being cradled in its mother’s arms. Mimicking the womb, they can hear the familiar rhythm of your heart, breath, and voice and so they are able to regulate their own temperature, heart rate and breath.  It is here in these spaces, that you learn to understand your baby’s communication, allowing you to respond quickly to your baby’s needs.  And most importantly, your baby learns to trust, knowing that when they experience hunger, pain, being cold or wet, or just want to be with you, that their parents will respond. They have learned--they are safe, they are loved.  It is the foundation of love and relationship.  It is that important. In fact, it makes all the difference in the world.

Nursing

Matraea Mama Nursing

Breastfeeding is one of those funny things that seems like it should be so natural and straightforward--place baby at breast, baby opens mouth, latches and eats.  Perfect.  And for many women that is exactly how it happens . But for some women it can be seriously challenging.  The combination of holding your brand new baby with one hand, placing her in just the right position, making sure that the nose and mouth are lined up with the nipple, that her mouth is open just right, that she isn't too high or low, that the tummy is tucked in against you and that your other hand holds your breast while bringing the baby to you rather than leaning into your baby (and that is all before the baby opens her mouth, latches and eats)--can be a lot like learning how to ride a bike for the first time. We know we are going to get it, it just takes a bit of time. (And we aren't even talking about sore nipples!!

 Typically during the first few days, while your baby is getting your colostrum, she will only one or two wet diapers per day. Once your milk comes in, usually on the third or fourth day after birth, your baby should begin to have 6-8 wet cloth diapers. It tends to be quite easy to tell if a cloth diaper is wet, but disposables can be a bit trickier.  Tip: look out for the yellow line in front--it will turn green once the diaper has been peed in. 

Most newborns will have at least two to five bowel movements every 24 hours for the first several months, although some babies will switch to less frequent but large bowel movements at about 6 weeks.  Baby's first poo is called meconium and tends to be black and thick--almost like tar.  As the baby gets more and more breastmilk, the dark sticky meconium is replaced by lighter, less sticky bowel movements that eventually turn mustard yellow in colour.  (Good thing about baby poo is that it generally doesn't smell!)

Babies can sleep a lot--sometimes 18-20 hours in a day. Their sleep is broken up every couple of hours by the need to eat and to have their diaper changed.  You should expect them to feed 8-12 times in a 24 hour period (every 2-3 hours) and that their feed would average about 15-20 minutes in length.  A baby that is sleepy and is hard to wake for feeds, should be assessed by your health care provider to make sure that she is getting enough milk and is not jaundiced.

Additional important signs that indicate your baby is receiving enough milk:

  • You can hear swallowing sounds as she is breastfeeding.
  • Your baby gains at least 4-7 ounces per week after the fourth day of life.
  • Your baby is alert and active, appears healthy, is pink with good tone, hydrated skin, and is growing in length and head circumference.
  • Your baby is content between feeds--not wanting to be feeding constantly, or when at the breast--not pulling off and crying.

Breastfeeding is much more than just nutrition. It is warmth, love, acceptance and trust all rolled into the simple act of feeding your child.  So if it doesn't work out the way you thought or wanted it to--perhaps you combine feed or choose to, for whatever the reason, formula feed--you are still giving a gift to your child.  Every time we hold and feed our baby, we are loving them. Understanding and appreciating that sometimes it can take time to learn how to breastfeed, and recognizing the signs of knowing when your baby is hungry and is getting enough to eat is part of becoming a mother. It is a journey, one feed at a time!

Because you don't put a Bandaid on your Perineum!

Childbirth has been compared to running a marathon.  Sometimes it is more like running several marathons in a row, and as a result, in the first few days following the birth we can be sore in places we never knew existed.  It is amazing how we use every part of our body to give birth--muscles in our arms, back, neck, face, hips, legs and of course, abdomen.  Possibly the most common discomfort experienced after childbirth is a sore bottom.  Epsom salts, and perineal herbs, made from herbs that have been used since ancient times, can both be used in a sitz bath to help with bruising or tearing that may have occurred.  We always recommend women put some pads that have been run under the tap in the freezer for after the birth (individually wrapped in saran wrap and then put in a ziplock makes the pads easier to use).  Pouring a small amount of Witch Hazel on the pad before use can also be quite soothing--especially if there are haemorrhoids involved. Many women will also take homeopathic Arnica to help with bruising and swelling.  For some women sitting can be quite painful and having a doughnut shaped pillow (or rolling up a towel) to sit on can be a lifesaver. A bruised tailbone can take quite a long time to heal and finding a comfortable way to sit becomes vitally important as we embark on the breastfeeding journey. And of course, taking the time to rest (and not doing too much around the house)--and sleep when your baby sleeps--allows you to recover much more quickly. 

Baby Blues

Matraea Postpartum

Sometimes after we have had our baby we feel as though we are on an emotional rollercoaster.  We can cry for no reason, feel very anxious, not sleep well even if we have the opportunity.  Sometimes we don't feel like eating, or going out.  We feel isolated and don't know how to ask for help.  Sometimes it take a long time to recognize how we feel.  These feelings can sometimes be easily explained: hormones and lack of sleep!

Commonly, this will get better after a couple of days, once our body has regulated itself and the postpartum hormone response has started to ease. We start feeling like ourselves again, still tired, but less anxious and that our ability to cope and adjust is intact.  However, if this is not the case, there are some helpful questions to ask yourself in determining if you may need more support during this vulnerable period.

The Edinburgh Postnatal Depression Scale was developed in 1987 as a way of addressing the most common complication of childbearing It includes a set of 10 screening questions that can indicate whether you have symptoms that are common in women suffering from depression and anxiety during pregnancy and in the first year following the birth of their baby. 

To complete this set of questions, you should select the response that comes closest to how you have felt in the past seven days.The total score is calculated by adding the numbers you select for each of the 10 items. 

Edinburgh Postnatal Depression Scale

  1. I have been able to laugh and see the funny side of things

    • As much as I always could               0
    • Not quite so much now                     1
    • Definitely not so much now             2
    • Not at all                                             3
  2. I have looked forward with enjoyment to things

    • As much as I ever did                        0
    • Rather less than I used to                 1
    • Definitely less than I used to            2
    • Hardly at all                                        3
  3. I have blamed myself unnecessarily when things went wrong

    • Yes, most of the time                         3
    • Yes, some of the time                         2
    • Not very often                                     1
    • No, never                                             0
  4. I have been anxious or worried for no good reason

    • No, not at all                                        0             
    • Hardly ever                                          1
    • Yes, sometimes                                    2
    • Yes, very often                                     3
  5. I have felt scared or panicky for no very good reason

    • Yes, quite a lot                                     3
    • Yes, sometimes                                    2
    • No, not much                                       1
    • No, not at all                                        0
  6. Things have been getting on top of me

    • Yes, most of the time I haven’t been able to cope at all    3
    • Yes, sometimes I haven’t been coping as well as usual     2
    • No, most of the time I have coped quite well                      1
    • No, I have been coping as well as ever                                 0
  7. I have been so unhappy that I have had difficulty sleeping

    • Yes, most of the time                          3
    • Yes, sometimes                                    2
    • Not very often                                      1
    • No, not at all                                        0
  8. I have felt sad or miserable

    • Yes, most of the time                         3
    • Yes, quite often                                   2
    • Not very often                                     1
    • No, not at all                                       0
  9. I have been so unhappy that I have been crying

    • Yes, most of the time                         3
    • Yes, quite often                                   2
    • Only occasionally                                1
    • No, never                                             0
  10. The thought of harming myself has occurred to me

    • Yes, quite often                                   3
    • Sometimes                                           2
    • Hardly ever                                          1
    • Never                                                    0

Your Score

Add up QUESTIONS 1­ through 10.

MAXIMUM SCORE: 30 | Possible Depression: 10 or greater. Consider making an appointment to talk to someone you are comfortable with as you may benefit from increase support if your score is over 10.

If you gave yourself a 2 or 3 for question 10 (suicidal thoughts or thoughts of self harm), please contact your health care provider as you need support. 

What It Means

Feeling overwhelmed or anxious during your pregnancy or after your baby is born is normal.  However,the degree to which you experience these emotions can sometimes indicate whether you need more support.  If you are not sure, it is best to ask.  Your partner, spouse, husband, family midwife, physician all care about you and will make time to listen.  Often when we seek support, we feel better. We realize we are not alone--many women share the experience of postpartum depression.  And with time and the right kind of support--most will move through it and return to a place of feeling good about themselves and their ability to cope with the changes in their lives.