April 4, 2009

Postpartum Depression: A father's comment -- strategy for relief

My job, as I see it, is to make a child’s life better if I can. The comment that this father emailed to me about a blog post gave me a glimpse into the first days of their lives as new parents. So I tried to break this situation down into problems that I could solve.

First, the wrist. This was my first target because it was the easiest. With sleep deprivation, small but persistent annoyances can appear as giant and impenetrable problems. They can be the spark that starts big fires. I brought the parents into my office and found the right kind of splint on my computer. I gave them the printout and told them to buy it that same day. Mom was to wear it all the time, except when showering or sleeping. The thick aluminum bar in the splint would prevent the wrist from flexing, allowing the tendons to heal on their own.

Then, the breastfeeding. The father said in his comment, “…we keep telling ourselves the benefits the baby will receive from breastfeeding will far out way [sic] a strictly formula diet.” Maybe it’s heresy, but breastfeeding may be best for the baby, but by how big a margin? Will one bottle of formula a day (maybe less than 10% of the baby's total nutrition) make a real difference? There's an interesting article on this from The Atlantic magazine, which poses this question. My priority is clear: what’s best for the baby? Breastfeeding dogma, which is powerful here in Berkeley, would have us believe that there is no other way. I saw an alternative path that I’ve used before.
  • First, I need to relieve some of the relentless pressure on this first-time mother. By giving her permission to feed the baby pumped breastmilk or even a couple of ounces of formula once a day, I might be able to absolve her of some of her performance anxiety. She’d worry less about the baby not getting enough and worry less about her own inadequacy. And skipping a direct feeding might give her a needed relief for her soreness.
  • Second, I needed to find a way for her to get help she could have confidence in. This would also take some pressure off.
  • Third, dad needed to be involved. He needed the opportunity to shoulder some of the burden his wife had been under alone. He also deserved an opportunity to step into his baby’s life.

Every night, they were to give the baby one bottle feeding. Dad would do this feeding by himself, so mom could sleep. True, it would be in the middle of the night. But dad would have this precious time for just him and his baby, in which he was meeting all the baby’s needs and the needs of his wife, too.

I saw this family again about a week later in the office, though I had called and spoken to them on the phone several times in the intervening week. Everything was better. They were still tired, but mom’s mood had brightened a lot and dad was now king of the night-time feeding. When I asked how things were going, mom told me a lot but when she was done, dad had a lot to add about the baby’s expressions and actions and feeding behavior and sleep pattern. He really knew.

Postpartum depression, and perhaps depression in general, seems sometimes to blind us to paths leading out of the dark places in which we sometimes find ourselves.

Next Post: Do 8-year-olds get depressed?

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Please let me know what you think. Do you know a child or situation like this?