The Right Questions

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For some time now I’ve been planning a post centred around supporting loved ones with Post Natal Depression. If you’re a regular reader you’ll know that PND has played a big part in the lives of my family, close friends and me for the past two years. It’s something I’ve only spoken publicly about in the past few months and I find it easier to write than to speak about.

I now know what I need when I am at a low ebb. In my case it is usually help with the children and the opportunity for quiet reflection. To lick my wounds in private and to build up the strength to face the world again. Also anti-depressants and therapy featured heavily in my treatment, but for the purposes of this post I’m looking at what friends and family can do to help.

In researching this article I asked some of my readers and friends to share their experiences of depression with me and to tell me what they felt they needed in terms of support at their worst. What really struck me was how similar yet entirely different their replies are.

“I never really asked for practical help. If anyone had offered I would have put a front on that everything was fine and I was fine, even though I was beyond desperate.”

“I used to want to do everything as no one else did it the same as me or not to my high standards.”

“I would have loved someone to help with kids stuff like dinner times and even nursery runs as I really didn’t want to see or speak to other mums.”

“I felt better if someone took the kids and I got the cleaning done. It made me feel as if I had achieved something.”

“I’d have loved for people to have stopped by and offered to run the hoover around, or dropped a casserole off, but I couldn’t ask for those things for fear that people would think I wasn’t coping.”

“When people phoned I’d have liked them to ask after me and not just my new baby. I might not have been able to say anything, but it would have been nice to be asked.”

“What I wanted more than anything was company. Not to be alone with the babies. I didn’t actually want people to take them off my hands – but to come round and help me look after them, and help me to feel normal.”

“I just wanted to be left alone. I felt like there was never a moment for myself but I felt I couldn’t ask for help as I couldn’t bear the thought of people thinking (or knowing) that I wasn’t coping.”

“The worst thing for me was the feelings of isolation. I always needed to be around people whether it was friends, family or even strangers at a toddler group. I hated being at home alone.

I could fill pages and pages with quotes like these. Some women desperately need company and conversely others just want time alone. Some are silently crying out for help in the home and others can’t bear the thought of letting anyone else near the hoover. Some abhor the idea of unsolicited advice whilst others just want someone to take over and make everything okay.

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I have read and re-read this messages over and over, trying to digest them and to think of a way to coherently sum them up in to a neat article to solve everything. I hoped to narrow the stories down in to four easy-to-follow bullet points. These were my first three:
1) Listen with compassion and without judgement
2) Encourage professional help
3) Offer practical help.

I then got to point number four. Ask the right questions.

This, in my view, is absolutely the most crucial, key factor in supporting someone with depression. Without asking the right questions, nothing else matters. My previous three points are, well, pointless really.
Nothing else will work. You could run the risk of scaring the sufferer away or interfering, despite meaning well. If we don’t ask the right questions, we can’t possibly offer the right support.

In my previous life, before children, I spent thirteen years working in advertising. One of the first pieces of advice I was given was to ask open questions. They invite the other person to open up more and keep the conversation flowing.

Rather than this type of dead-end conversation….
You: Are you okay?
Them: “Yes thanks.”

It could be an idea to try something like this…
You: “So, is having a newborn what you thought it would be?”
or ” What is your favourite or least favourite thing so far about being a mummy? What has surprised you?” or “Is your partner enjoying being a new parent? What could they do differently to help more?”

You can see that questions like this encourage open dialogue. They offer the sufferer an opportunity to open up, if she is ready to.

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PND is so closely tied to a woman’s sense of worth as a mother.
Even the most well-meaning of comments can be twisted around in her mind to mean something else altogether. Mentioning that she is coping well, for example, can reinforce the fact that no-one understands what she is really going through. Offering to clean the house will probably leave her believing that you think her house is filthy and that she is a terrible mother. Offering to help with the children and bath time will cause horrible guilt and she will probably feel like a burden. Or, at least, this is how I felt in those situations. And the messages I’ve received show me I’m not alone in this.

This is why it is so, so hard to support someone who suffers with PND.

It is human nature to want to save people who are suffering with illness. We want to rush in and rescue, to take the pain away and to make it all better.
It is my style to offer practical advice or solutions to people in need. I’ll often turn up with a lasagne or offer to take kids to school or to clean the kitchen. It makes me feel like a better person to try to help others. In fact, I was told (rather bluntly, as it happens) by my therapist that this is, in fact a symptom of my own need to ask for help, but that’s another story.

My point being: sometimes these actions make us feel better, but not the intended recipient of our good deeds.

She might just want to sit in silence. She may want company. She may relish the idea of losing herself in the housework or baking whilst someone else watches the kids. Perhaps she wants to talk. But unless you ask the right questions, it’s simply impossible to tell.

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As the partner or close friend of someone with depression you will in all likelihood feel a combination of helplessness, anger, guilt, frustration and sadness. But it’s important to remember that depression is not personal. The fact that your loved one is not responding to your attempts to help them is no reflection on you. If you think about it, if G-d forbid you were supporting someone through cancer, you wouldn’t expect to be able to cure them by yourself. Depression is a shared responsibility, but not your sole responsibility. Professional help is out there and as the partner of someone with depression, it’s so important to seek out and to take the support that is available.

An old friend of mine, C, has supported his wife through post-natal and clinical depression for sixteen years. He gave me this advice:
” A depressed person ALWAYS sees one MASSIVE problem, but in reality problems are compound and are generally lots of little problems that if fixed (or managed) in turn, make the (not) massive problem simply crumble away.”

Please don’t ever imply that a depressed person can “pull themself together“. In my experience there is no statement more isolating or that further demonstrates a lack of understanding of what is going on. Depression is caused by a number of factors, with the main culprit being a chemical imbalance in the brain. There is nothing a depressed person would love more than the ability to “get a grip”. It’s just not that simple.

More than anything, my research has shown me that depressed people want to be listened to. Really, properly, listened to when they are ready to talk. Not with a view to offering solutions, not thinking about what to say next, just listening. My friend Sarah once sat with me whilst I sobbed. I spoke my darkest thoughts out loud and she just listened. She didn’t offer advice or try to fix me and I’ll be forever grateful for that. Sometimes shining light on darkness goes a long way towards chasing the shadows away.

I’m going to leave you with a passage from an incredible blog post by Andrew Lawes. You can find it in its entirety here, and follow him on Twitter @laweslaweslawes.

Try to imagine that depression is like being in a dark tunnel. The person with depression can’t see a thing, because everything is surrounded by darkness. Every sound is amplified, every fear is magnified. All they want to do is get out of the tunnel, but they can’t see where to go, they don’t know what to do. Your natural reaction is to lead them out of this dark tunnel, back to the light.

This is the WRONG approach.

You may think it makes sense, but for the person with depression, nothing makes sense. That’s the nature of the illness. They can’t be led out of the tunnel, because the fear is too great, the darkness is too dark. Trying to drag them out of this tunnel is more likely to make them curl up and hide than do any good.

What you need to do is be there for them. If they talk, just listen. Don’t talk, don’t give them opinions. Just really listen. Sit with them, let them talk. However upsetting or shocking what they say is, don’t give advice, just listen. When they finish, hug them, tell them you love them, and that however long it takes, you will be there until they find the strength to get better. You will never be able to lead someone out of the dark tunnel, all you can do is stay in the tunnel with them until they feel strong enough to lead themselves out.”


I’d just like to say a huge thank you to the women who shared their stories to make this post possible. I am so grateful for your bravery in sharing your darkest thoughts with a complete stranger.

I’d also like to clarify that I am not a medical professional. I have a list of support organisations here, if you’d like to talk to someone. Please do use it if you need to.

I Support You

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Since I started my blog back in January I’ve been planning a post on breastfeeding. It’s been floating around in my head all year, but until now it didn’t seem to be the right time.

My journey with breastfeeding was, I think, quite a big factor in my eventual post-natal depression. Or, more importantly, it wasn’t the feeding itself, but my attitude towards it, that contributed to a significant and steep decline towards a very dark place. Even sitting here and re-visiting some of the memories is causing me to breathe a bit faster and my heart to race.

I’d like to explain why I’m choosing now to share my experience with you. A few days ago one of my readers asked me whether I’d heard of the “I Support You” movement. In researching it I came across three amazing American blogs. Three women with very different stances and opinions on breast vs bottle-feeding are standing together to remind us that we all deserve support, no matter how we choose to feed our babies. It seems the stars have aligned and now is the time for me to get this off my chest (pun intended).

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I felt like whooping for joy when I read this:

From http://www.fearlessformulafeeder.com
“The I Support You movement is a respectful, empathetic, compassionate exchange between parents. We all feed our children differently, but we are all feeding with love, and in ways that work for our individual circumstances and family dynamics. I Support You is the first step in helping formula-feeding, breast-feeding, and combo-feeding parents to come together and lift each other up with kindness and understanding. We have chosen to announce this movement during World Breastfeeding Week, to honor the commitment of those who fight for better support for breastfeeding moms; we are inspired by this, but believe that by changing the focus to supporting all parents, we can truly provoke positive change without putting the needs of some mothers above the needs of others. The “I Support You” movement aims:

1) To bridge the gap between formula-feeding and breastfeeding parents by fostering friendships and interactions.

2) To dispel common myths and misperceptions about formula feeding and breastfeeding, by asking parents to share their stories, and really listening to the truth of their experiences.

3) To provide information and support to parents as they make decisions about how to feed their children.

4) To connect parents with local resources, mentors, and friends who are feeding their children in similar ways.”

Suzanne Barston, the author behind Fearless Formula Feeder is asking women to share their pictures and stories to encourage us to stand together in solidarity.

Read about the three amazing women behind this campaign here:

Fearless Formula Feeder
Mama By The Bay
I Am Not The Babysitter

My Story

My son was born two weeks late, by emergency c-section and weighed almost ten pounds. I was in hospital for several days afterwards, where he managed to latch on quite successfully but screamed pretty much all. the. time. Eventually, just before I went home, a midwife persuaded me to give him a bottle of formula. He calmed down immediately. Of course this made me feel incredibly guilty and like I’d traumatised my poor newborn by starving him in his early days. I felt my colostrum was not enough for such a large baby. I’ve since been told this is nonsense, but we all know there’s no reasoning with a hormonal woman who has just given birth.

I didn’t let this stop me from breastfeeding, though.

A day later I woke up with boobs like footballs, and over the next few weeks I managed to drop all but one of his formula feeds. I endured two horrific bouts of mastitis, which to this day is the worst illness I’ve ever suffered. The only real way out is to feed through the pain, so that’s what I did. I felt proud of myself. I felt that although I hadn’t managed a “normal” birth, there was still something that only I could do for my baby and that was to breastfeed him. Despite suffering through the agonies of mastitis I had persevered.

I can remember going to baby groups and clinics and feeding my son when he cried. When breastfeeding is successful, it is so wonderful. The closeness to your baby, even when it’s the middle of the night is so special.

When Monkey was four months old, he started losing interest. I couldn’t make him concentrate on breastfeeding and he wouldn’t feed from me anymore. He would inhale his late-night bottle of formula but ignore the breast. It seemed he has decided to stop and over the course of about ten days we made the switch to formula. I felt pangs of sadness, but they were lessened by the fact that almost as soon as he became a bottle-fed baby he started sleeping through the night. I felt I’d given breastfeeding my best shot but I wished I’d been able to continue it for a longer period.

All of the friends I’d made in my NCT ante-natal class continued to breastfeed for at least a year and I did feel disappointed with myself when I saw them, still nursing their babies as I bottle fed. So I resolved that when baby number two came along, I’d try harder.

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Two weeks under two years later, my daughter was born. This time I was prepared. I knew I’d be undergoing a c-section this time around and I knew this could mean difficulty in establishing breastfeeding. I made sure that the nurses knew that I wanted my daughter on my skin as soon as she was delivered. I even bought several feeding dresses, as I knew I’d be unable to wear trousers post-surgery so my feeding tops would be useless. I bought boxes of breast pads and nipple cream. I was ready.

I remember a nurse checking on me that first night. Madam was latched to my breast, albeit uncomfortably so all seemed well. The nurse ticked a box and disappeared. Sadly, I hadn’t realised (and no medical professional had pointed out) that all babies latch differently. It only takes a few feeds with an incorrectly positioned baby to cause horrible damage to your nipples. Once this happens it’s incredibly difficult to heal.

By the time I got home, both my nipples were horrifically damaged with gaping cuts on each side. Every time my daughter fed from me we would both be covered in blood. I can’t articulate how painful it was for me. I remember agonising shooting pains from my breasts to my armpits. I remember sweating, with every muscle in my body tensed. I used to sob whilst frantically kicking my legs in an attempt not to scream out in pain. I didn’t always succeed and used to feed her with tears streaming down my face.

My husband would help me to position the baby and then quickly disappear. I couldn’t understand it and felt like he was abandoning me when I needed him most. Turns out, he couldn’t bear to watch me suffer.

I enlisted the help of a lactation consultant who came to visit me at home. By the time she arrived, when my daughter was a week old, I’d corrected the latch and she was positioned perfectly. But it was too late. The damage was done. It’s impossible for nipples to heal when a baby is feeding from them for hours a day. I couldn’t express milk as that was so painful for me, too. Nipple shields offered no respite.

I endured ten days of unspeakable agony. I used to dread my baby crying, as I knew I’d have to feed her. I found it hard to look at her, as I felt that she was causing me such pain. Reading these words back, I feel sick. But that’s how it was for me. On day ten, my doctor called. He told me that it was okay to stop, really. He pointed out that he was not breastfed and managed to do pretty well for himself. He said that a happy mum is far more important than how much breast milk her baby gets.

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I was crushed, but I knew I had no option but to give up breast feeding. I felt such a failure and was utterly devastated. There began a quick decline in to what turned out to be a severe case of PND.

I realise now that I placed far, far too much emphasis on breast feeding. I’d imagined a wonderful, nurturing bond with my daughter, when in fact, my attempt to breastfeed her caused the opposite. It made me feel resentful towards her and that is something I still struggle to forgive myself for, two years on.

Whenever I saw a mother breastfeeding, I felt immense pangs of guilt. Bottle feeding such a small baby in public caused me more embarrassment than I used to feel breastfeeding my son in restaurants. I felt the need to explain what I’d been through to random strangers, to justify my decision to bottle feed her. I felt like I wasn’t good enough for my baby. Like a failure from the word-go.

Even at the time, I remember thinking that had one of my friends been through the same thing, I’d tell her not to be ridiculous. That she shouldn’t give herself such a hard time and that she should treat herself with more kindness. But sadly I wasn’t able to listen to my own advice.

This is why the second point in my Mummy Kindness Manifesto is:

‘I will feed my baby however suits me, my baby and my family. I will never judge another mother for how she chooses to feed her baby’

I think this is so incredibly important. We are our own harshest critics and we really need to pull together. Judgement helps nobody and we are all just doing our best, finding our way as we go.

“Never look down on anybody unless you’re helping them up.” ~Jesse Jackson

So I’m sharing this with you today, because I have been on both sides. I admit to have been slightly smug and judgey as a breastfeeder four years ago. I suppose I felt I’d earned the right. I also know the crushing disappointment at being unable to breastfeed a baby when you want to.

So I’d like to say this;
To the breastfeeding mums: I Support You
To the bottle feeding mums: I Support You
To the combo-feeding mums: I Support You

If you decide from the beginning that breastfeeding isn’t for you, I Support You.
If you want to stop breastfeeding, I Support You
If you breastfeed a three year old, I Support You
If you breastfeed in public, I Support You
If you pump, I Support You

If you feed your baby differently to me, I Support You
If you parent differently to me, I Support You.

Motherhood is hard. So hard. There need not be a divide between breast and bottle feeders. There need not be a divide between any of us. We can learn so much from each other’s stories. Let’s remember that what is right for you may not be right for someone else and respect one another’s choices.

You can follow the I Support You campaign via the Twitter hashtag #ISupportYou and also read lots more posts on this topic on the Fearless Formula Feeder’s Blog Hop here,

Our worth as mothers is not and should not be defined by whether or not we choose to breastfeed.

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Guest Post: The Princess. The Bump. Your Body.

Today I’m sharing a guest post from Karen Laing. Karen is a very well respected pre and post-natal exercise expert who blogs about health and fitness at www.alittlefitter.com. In addition to the blog, Karen teaches Pilates in Essex and London. Her specialism and passion is women’s health.
Karen writes for national publications and presents on health and fitness. She co-directs Fit School with husband Chris, a new fitness initiative which aims to educate through fitness.
Karen is mum to Isaac who is two and a half and is expecting another baby in January 2014.

I think this is such an important post. Every woman should read it so please do share it if it speaks to you.

Guest Post: The Princess. The Bump. Your Body.

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THERE has been much furore surrounding Princess Kate and her post-baby body since she emerged, glowing, from the Lindo Wing of St. Mary’s Hospital last week. In fact perhaps more media attention has focused on Kate’s body than on beautiful baby Prince George.

So; Newsflash! The female body takes time to recover after 9 months of growing a person and squeezing it out of a very small hole, or even out of the sun roof. But just how long? Weeks, months or years?

The doctor can sign you off as soon as six weeks post birth when initial recovery has taken place but a study published last year by Salford University, suggested it could take up to a year for women to recover both physically and mentally. Some experts suggest this may even be two years, since it takes this long for your abdominal muscles to fully return to their pre-pregnancy state. And then there’s breastfeeding – pregnancy hormones remain in your system for up to four months after you stop nursing your child.

So here’s a little guidance on how long it really takes for beautiful female bodies to recover after birth:

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Early days

In the early days after giving birth your body is in full recovery mode. You may have lost a lot of blood and fluids and you’ll definitely be short on sleep and energy. You’ll most likely be sore and swollen so now is the time to enjoy some confinement and TLC.

0-6 weeks

There’s a lot going on during the first six weeks of post natal recovery. Whilst your uterus is contracting (cause of the painful, cramping sensations you’ll be getting) the rest of your internal organs, which got squidged out of the way during pregnancy are returning to their rightful place. Your pelvis will be recovering and returning to it’s pre-labour state and your urethra, vagina and anus, which again will have moved slightly during pregnancy will be returning to their original homes. Any intense activity during this stage could hinder the healing process. Walking and gentle stretching is fine but definitely nothing bouncy.

You’ll also be bleeding heavily and may also be anaemic, so plenty of iron-rich foods and dark green vegetable to aid iron absorption are critical during this time.

You’ll be quite inflamed and possibly held together by stitches for a few weeks. You’ll need to keep them as clean as possible with salt baths and lavender or calendula compresses and drink plenty of fluids for breast milk and to flush out any nasties and minimize your risk of infection.

Some women get haemorrhoids, mastitis, back ache or other complications and all women will suffer with some degree of sleep deprivation so rest, recuperation and realism are the order of the day for the early weeks.

Up to 4 months post breastfeeding

Your pregnancy hormones, most noticeably relaxin stay in your body until up to four months after you finish breast feeding. This means any associated symptoms, such as reduced stability in your pelvis and joints, also linger for this amount of time. So high impact activities are best enjoyed with caution until you feel ready to go – experts disagree on this point but you know your body best and if you are at all at risk of or unsure of your pelvic floor stability, focus on this side of your training through Pilates or resistance training before you hit the tennis court.

You may also find that the extra ‘insurance’ fat that your body gained in the early days of pregnancy also sticks around until baby is weaned, this is because your clever body is still holding on fat stores vital for hormone and milk production. Fat is not just stubborn lumpy stuff with no purpose, it’s an organ in its own right, storing and generating hormones and of course energy.

Up to a year post birth

The University of Salford study, conducted by Dr Julie Wray, interviewed women during their first year post birth and concluded that women need a year to recover both physically and emotionally after child-birth. Her study found that women felt unsupported by medical services and very much left to get on with it. This is where social networks made through local health clinics or organisations such as the NCT offering Bumps and Babies groups can be a vital part of the healing process.

Relationships, personal self-worth, finances and health are all put through the mill in the first 12 months. It takes time to re-find your feet with a new member of your family.

Up to two years post birth

When you are pregnant, your growing baby forces your abdominal wall to stretch. The body responds by creating new muscle cells, or sarcomeres, literally lengthening your abdominals. According to health practitioner Paul Chek (author of How to Eat, Move and be Healthy) it can take up to two years for your abdominals to fully recover. Three big factors that can prevent this recovery, causing an abdominal distention are: Having two babies within two years (or falling pregnant within two years of the last pregnancy); gaining a large amount of weight during pregnancy; or a C-section (C-sections can cause internal scarring or adhesions which can add to abdominal distention).

Two years and beyond

Complications such as diastasis recti (split in the abdominal wall), adhesions, post stitches pain or pelvic floor dysfunction (such as prolapse) can cause problems well beyond two years.

So mummies, let’s lay off the ‘lose weight now,’ or, ‘get fit quick’ resolutions. You’ll know when you’re ready to get in shape or just get more energy, your local gym’s marketing team don’t.

This post isn’t intended to be a license to eat cake and ice cream forever, that won’t do much for your body either but do wear your physical changes like a badge of honour, enjoy the early years with your baby and be like the clever tortoise, not the media hungry hare.

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You can find more from Karen on her Facebook page here.