At least one in 7 women in Ireland is thought to experience postnatal depression (PND) after they have a baby. But the true figure could be even higher, as many women don't ask for help or tell others how they're feeling. PND isn't the same as the baby blues. Thought to be caused by sudden changes in hormone levels, the baby blues is when you feel emotional during the first week or 2 after giving birth. Having the baby blues is so common, it's considered normal (up to 85% of mothers are believed to be affected). With the baby blues you may feel weepy, anxious, tense and generally a bit down from around the third day after giving birth. PND on the other hand is less common and usually starts during the first month after childbirth (though it can be triggered several months later). The symptoms - many of which are similar to those of ordinary depression - last longer than the baby blues. But there are ways to treat PND successfully (no treatment is usually recommended for the baby blues). Symptoms associated with PND Low mood or mood swings Feelings of sadness or despair Crying a lot Feelings of worthlessness, hopelessness or guilt Loss of interest in everything, an inability to feel pleasure or enjoyment Feelings of anxiety, irritability or anger Inability to sleep properly Loss of appetite or increased appetite (comfort eating) Low energy, feelings of exhaustion Lack of confidence in looking after your baby Lack of interest in sex or your partner Alarming thoughts (e.g. harming your baby or suicide) Poor concentration, feelings of confusion These symptoms may start so gradually that some mothers may not realise they have PND. And not only women are affected. According to the NHS, research has found up to one in 25 new fathers also become depressed after their partner has a baby. What causes PND? Experts aren't really clear about what causes PND, but several things have been linked to it, including a history of mental health issues (including depression during pregnancy), having close relatives who had PND, recent high-stress events, health problems caused by pregnancy or childbirth, unplanned pregnancy, relationship or financial problems and a lack friends and family close by who can offer support. But even if none of these things apply to you, you may still experience PND, as having a baby is a major life-changing event and can be tiring and stressful to say the least. There again sometimes there is no obvious cause. What should you do if you think you're experiencing PND? Experts suggest PND symptoms should improve within 3 to 6 months without any help or treatment. But if you do seek help you'll not only help yourself to recover more quickly, you could also improve your relationship with your partner and your family, as well as your baby. It's also important to remember that admitting you're feeling depressed isn't a sign of weakness and it can happen to anyone. Your GP or health visitor can suggest ways to help you feel better. The type of treatment you may be offered will depend on a number of things, including what symptoms you have (and how severe they are), whether you've had depression or other mental health problems before and what type of treatment you'd prefer. These include the following: Psychological treatments Counselling has been shown to be an effective treatment for PND. Cognitive behavioural therapy (CBT) is often recommended, as well as other therapies such as interpersonal therapy and psychodynamic psychotherapy. Your GP or health visitor may also recommend a self-help course, such as one based on the same principles as CBT. Antidepressants If your symptoms are moderate or severe your GP may recommend taking antidepressants. There are several types of antidepressant medicines you could take, so if one isn't suitable your GP can prescribe another. Speak to your doctor about any concerns you may have about taking antidepressants while breastfeeding, as some antidepressants are more suitable than others for breastfeeding mothers. Self help Talking about your feelings with your partner, friends and family members may help, and you may find others will offer lots of practical help that could make a big difference. Try to rest as much as possible - don't worry about things like housework and get lots of sleep. Eating a healthy diet can support your mind and body during challenging times too. And while you may not feel like doing much exercise, regular gentle activity could help boost your mood. It's also a good idea to get out and about with your baby and mix with other new mothers (your health visitor will suggest local groups you can join). Article reproduced with the kind permission of CABA, the organisation providing lifelong support to ICAEW members, ACA students and their close family around the world.

Jul 08, 2019

Pregnancy can be exciting, it can be daunting - or both! It's your personal journey and no two pregnancies are the same. As Nutritionists we give you our professional and personal interpretation of the information out there to help make your pregnancy as healthy as possible. It would be of no surprise that the message is simple - eat a varied diet, and as healthily as you can within your budget. It shouldn't really be that different to how you think you should eat when you're not pregnant, but this time it's not about you - you're doing it for someone else. I don't think we'd be alone if we said we want to give babies the best start they can have in life, and eating a healthy diet ourselves is a good place to start. Including carbohydrates (bread, pasta, rice, potatoes), protein (fish, red meat, eggs, dairy, beans, lentils, legumes), and good fats (fish, avocado, nuts, seeds), plus 5-a-day in a variety of colours each day. No to nausea On that note, we really don't need to eat for two - nausea/morning sickness can certainly make you want to eat more and frequently. For many the nausea is worse when blood sugar levels are low so every two hours graze on something. A quick and easy favourite is bircher muesli  (the recipe for this can be found at the bottom of this blog) which can be made in bulk in advance and kept in a fridge or taken to work and eaten every couple of hours. For some women ginger biscuits worked, but for others ginger had no effect. Other snacks include: Natural yogurt/glass of milk + piece fruit/dried fruit Healthy cereal (e.g. Lizi's granola) Houmous with raw vegetables (carrots, celery, peppers) Energy boost It's not uncommon for women to feel extremely tired particularly in the first and third trimesters of pregnancy. Getting rest where you can, being even more organised and planning ahead does help especially when it comes to meal times when the last thing you want to do is cook! Getting other people involved to help cook with/for you, and batch cooking can be a real life saver. On a specific nutrition level here's our suggestions to improve your energy: Iron Often one of the first symptoms in pregnancy is tiredness - there's a lot of growing going on. Perhaps not initially, but certainly towards the end of pregnancy many women will become iron deficient and anaemic. Foods high in iron include: Red meat (it is recommended to eat red meat up to twice per week) Green leafy vegetables (spinach, kale, rocket) Dried apricots Nuts Also remembering some foods reduce the absorption of iron - those being phytates (grains found in bread, rice, pasta) and black tea, so try to consume these away from high iron foods. If you take an iron supplement best take this away from phytates and black tea, plus take the supplement with some vitamin C to enhance the absorption of iron. Some iron supplements can make you constipated so try where you can to stay well hydrated and include a variety of vegetables and to some extent fruit to improve your daily fibre intake. Vitamin B12 If you are vegetarian certainly B12 should be taken daily. B12 is involved in red blood cell formation and when reduced you may feel more fatigued/anaemic. Healthy baby Folic acid It's the first vitamin most people may think about when pregnant. Taking 400mcg folic acid daily during the time you are trying to conceive and up until at least the 12th week of pregnancy is advised by the HSE. If you haven't taken folic acid prior to pregnancy start taking it as soon as you know you are pregnant. Folic acid can help to reduce the incidence of neural tube defects including spina bifida. Vitamin D A relatively new entry into the pregnancy recommendations but nonetheless important is vitamin D - the sunshine vitamin. As Nutritionists we'd love to say you can get all your vitamin D from the sun but let's face it, in Ireland the sun doesn't shine often enough. Recommended guidelines are 10mcg of vitamin D per day. It's recommended because vitamin D is like a key allowing calcium into bones without it the calcium struggles to enter bones (and during pregnancy there is a lot of bone creation going on). You can absorb vitamin D from oily fish and eggs but the quantity is insufficient. Calcium Essential for growing bones and teeth, calcium can be found in dairy (milk, yogurt, cheese - but not soft cheese e.g. camembert, brie or blue cheese - these are OK if they have been cooked. Cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta are all OK to eat during pregnancy). Calcium can also be found in green leafy vegetables, tofu, dairy alternative drinks are often fortified, tahini (used to make houmous), fish where you also eat the bones (tinned salmon, sardines). Omega-3 There are some interesting studies relating to omega-3 (fish/flaxseed oil) and baby brain development. As nutritionists many of us have taken omega-3 during pregnancy, the only caution being not cod liver oil, and also not choosing the cheapest fish oil as the filtration process to remove heavy metals may not be as effective. Cautions There's also caution with the following foods during pregnancy. Caffeine (found in coffee, tea, green tea, chocolate) in high amounts has in some studies resulted in babies with a lower birth weight. Cold and flu remedies may also contain caffeine and you should consult your GP before taking one of these during pregnancy. Although caffeine may appear to be your friend to help you get through the day when the baby is born, breastfed babies are often restless following mum's cup of coffee Soft cheeses (see above in calcium) Raw/partially cooked eggs due to the risk of salmonella (unless they're produced under the British Lion Code of Practice - these eggs have a red lion logo stamped on the shell) Pâté may contain listeria Peanuts are now considered safe to eat during pregnancy, unless you have an allergy to them Raw or undercooked meat due to toxoplasmosis (infection found in undercooked meat, and cat poo). Salami, prosciutto, pepperoni and chorizo are not cooked and may contain the parasite causing the infection Game may contain higher amounts of lead (heavy metal) from the lead pellets Ice-cream is acceptable to eat as long as the milk and eggs have been pasteurised Cod liver oil supplements are specifically from the cod's liver which is high in vitamin A and toxic to babies Limit tuna to 2 steaks/4 cans per week due to the higher levels of mercury found in tuna than many other fish Sushi is OK to eat when pregnant as long as the raw fish has been frozen first On a final note, if you are unsure if your diet is sufficient to provide all the nutrient requirements for the next few months it would be wise to take a daily pregnancy supplement - that way you are covering all the bases and topping up on all the good work you are doing. Bircher muesli recipe Ingredients 50g rolled porridge oats 1tbsp flaxseed / handful of mixed nuts (chopped) 1tbsp chia seeds 1tbsp dried fruit 1 apple (grated) 1/2 tsp cinnamon (optional) 1/2 tsp nutmeg (optional) 120ml milk or dairy alternative (almond/oat/coconut) Method Combine and mix all ingredients in an air tight container and leave in fridge overnight. Add/subtract milk according to the preferred consistency. Written by: The Natural Alternative Health & Wellbeing Ltd The Natural Alternative Health & Wellbeing Ltd was founded in 2006 by Anjanette Fraser whose previous career was in Corporate Finance at PricewaterhouseCoopers, London. With a previous career in finance and studying a MSc in Nutritional Medicine, Anjanette translates the latest scientific research into an easier to understand format to improve employee health, and making healthcare more accessible by bringing Nutrition health professionals into the workplace. Article reproduced with the kind permission of CABA, the organisation providing lifelong support to ICAEW members, ACA students and their close family around the world.

Jun 11, 2019