Following on from creating my Visual Birth Plan, you may have noticed that there were two plans which needed to be referred to separately, these being:
- Special Requirements – After birth care plan
- Breastfeeding Plan
After the Perinatal mental health meeting, it was noted that a plan needed to be created for my aftercare once Liberty is here to ensure that if I am showing any signs of either postnatal depression or postpartum psychosis, then I can get the support I need quickly. Also a plan would need to be created if I was to breastfeed following on from further research relating to the whole lamotrigine in breastmilk situation where I am able to still take my medication and how much transfer into my milk is kept to a minimum.
What is Postnatal depression?
Perinatal depression is depression experienced during pregnancy (known as ante or prenatal depression) or after childbirth (known as postnatal depression). Many people are aware of postnatal depression (PND).
What’s the difference between postnatal depression and the ‘baby blues?’
The ‘baby blues’ is a brief period of feeling emotional and tearful around three to 10 days after giving birth, which affects many new mothers. It’s natural to feel emotional and overwhelmed after experiencing childbirth and becoming a parent, especially as you’re likely to be coping with a lot of new demands on your time and attention, as well as getting little sleep. Although having the baby blues may be distressing, it’s important to be aware that it doesn’t last long – usually only a few days – and is generally quite manageable.
However, around 10–15 per cent of new mothers develop a much deeper and longer-term depression known as postnatal depression (PND). It usually develops within six weeks of giving birth and can come on gradually or all of a sudden. It can range from being relatively mild to very severe.
What is Postpartum psychosis?
Postpartum psychosis (PP) is a serious, but rare, diagnosis occurring in around one in 1,000 births. You’re likely to experience a mix of:
Symptoms usually start quite suddenly within a few weeks after giving birth.
For further information on perinatal mental health, spotting the signs, how to cope and how to treat, go to the Mind Website:
Aftercare Birth Plan
The aftercare birth plan stated that I was at a potential risk of a significant deterioration in my mental health. With this in mind there is a recommendation that I am going to be kept in Hospital for 5 days minimum to be monitored for signs of illness and to access additional support that I might need in the first few days. For the first 2 weeks, visitors will be restricted to close family and friends only and be at times in which we provide.
Having been given so much information about lamotrigine in breast milk from NHS guidance to drug company research, a member of my care team was tasked to try and find me a no BS answer to whether it was okay to breastfeed and guess what… I am no further toward with my decision. I have done my own research with help from one of work colleagues and personal friend who helped me connect with someone from the Breastfeeding Network. Looking at some of the resources that Milli Hill had provided in her book relating to this topic (page 216). I contacted the ‘drugs in Breast milk information service’ to get some advice from them. I then asked some of the health professionals supporting me during my pregnancy what their opinion was and they both said no as it is too complex and there is not enough evidence out there to give a concrete answer therefore falls down to me to decide. The last port of call for advice was at the antenatal breastfeeding workshop which is ran by the Harrogate Hospital’s Infant Feeding Coordinator.
Following all the research that I have received, it was noted that there had been reports of some adverse effects of babies that had mothers than we taking Lamotrigine. Some of these being irritability, poor feeding, weight gain or rashes and there had been one case of apnea. (apnea is a “pause in breathing of longer than 10 to 15 seconds). The research was based on a mother taking 200mg a day where I take 150mg. So in a nutshell it seems to be okay (I think) and I haven’t stopped taking it while I have been pregnant so she would have been getting some through the placenta. So I have decided… drum roll please ….I think the benefits outweigh the risks so I am going to do it!
So what is the plan?
I am going to breastfeed exclusively at the beginning. If Liberty was to show shows of being unwell then I would then express milk off prior to taking my daily dose (which I do midmorning) to cover if Liberty gets hungry when the dose hits its peak in my system. This is usually after 1-3 Hours of taking it.
What do you need for breastfeeding?
I attended the antenatal breastfeeding workshop to get some tips and advice on how to breastfeed and put my mind at ease as don’t really know very much after how to do it. It was also noted that there are many different support groups out there whether struggling with a night feed, a helpline is available or if you are any questions that you need answering, face to face groups are there to help along with contact numbers provided.
One of the questions in Milli’s book on page 280 ‘will it always be this hard/exhausing/boring/time-comsuming?’ and the answer was that breastfeeding a newborn was like a crash course in meditation. This was due to having to sit still for long periods of time. However once in a routine and when you get more confident then you will learn to maybe feed on the move or know when they will take longer between feeds.
Sitting still is so hard for me and I am literally the worst person to sit next to when watching a film. During my maternity leave, I am slowly learning to relax and have picked up a love for reading. This has helped settle me and enable me to sit still. #winning
I have created a comfortable space within Liberty’s nursery which I have set up for night feeding and have a number of comfortable sitting areas in the house which I have things within arm’s reach to occupy myself while she is feeding. I was gifted a thermal flask which I though was genius as I can enjoy my coffee at a suitable temperature for longer. I have also invested in a number of books from autobiographies to fluffy holiday reads and then stories relating to modern day society issues to try and expand my mind instead of watching HAYU channel all day every day. (however I will be watching this some of the time – only when Dave is at work)
As I had previously mentioned, I am taking 6 months off, a month before Liberty’s due date and 5 months after. I would love to be off for more than 6 months but need to get back into it but don’t want money to be an issue. According to the Maternity Policy at work, I am able to do a number of keep in touch days to help keep me in the loop and these days are be my choice. This is a genius idea for me as I hate not knowing what is going on so I have decided to plan some days in starting from 26th September (I have a course booked which I have been trying to get a place on for 2 years). I would then work a day every 2-3 weeks. This would reduce my anxiety as work has been the only consistency and been in the same job for 7 years!!! People think I am crazy but I know what I need to do! Yes I know I don’t know what it’s like to have a baby but I know how change affects me so doing this for my health! Being poorly won’t help Liberty in any way!
So that’s all the planning done for both Mental Health and Visual Birth Plan so come on Liberty, ready when you are #18DAYSTOGO