Dealing with change as an expectant or new parent

Family Links is a national charity dedicated to empowering children, parents, families and schools to be emotionally healthy.  We were honoured to have them as Oak sponsors of our event in Manchester in October 2016. This is their third post for our blog series, and has been written for Growing Families by their Training Lead, Rowan Smith.

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Change, in its many guises, is inevitable and unavoidable. It happens all the time throughout our lives, whether it’s major or minor; positive or negative; planned or unexpected. However, parents going through pregnancy and looking after infants could be experiencing the most intensified period of change of their lives, and it’s important to be prepared and equipped with the right skills to cope with these changes.

The changes expectant and new parents can experience are varied and can happen on physical, emotional and social levels. The most obvious external change during pregnancy can be the mother’s bump, but pregnant women may also experience other changes that are less noticeable to other people, such as fatigue, sickness and raised body temperature, amongst others.

For both mothers and partners, emotional changes may occur during this time such as feeling stressed or anxious, feeling more maternal/paternal, and positive or negative feelings around body image. Social changes may also occur, such as possibly wanting to go out less frequently, which may be linked to some of the physical changes mothers can experience. Pregnant mothers may also notice an increase or decrease in their sex drive during different stages of pregnancy. These are just some examples of things that expectant parents may go through, and changes are likely to be different for every parent.

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Once the baby arrives there are also lots of other changes to consider. The way parents perceive themselves can alter as they as they have a new role as a mother or father, in addition to being a couple or a single person. There are also very practical considerations to be made around how extra jobs will be shared when the baby has arrived, in addition to pre-existing jobs around the household. A significant change for couples may be that as parents, two different sets of morals and codes of living are converging as you begin to raise a child together. It’s important for couples to discuss and agree how to bring up their child before the baby arrives, so that decisions aren’t being made when emotions are running high.

When it comes to preparing for these varied, significant and different changes, the most important thing is to plan and if you’re in a couple, to plan and communicate. Think about what might happen if a certain change does occur, and prepare for what you might do in that situation. For instance, an expectant mother might want to consider whether she’s going to breastfeed or not and what this might be like, while a couple might want to discuss the options around feeding; who will feed the baby when, and what are the practicalities of doing this? If expectant parents plan around how they might manage changes and different situations, it may be easier to refer back to what you decided together before the change occurred. This can be more helpful to parents and couples than making decisions in the heat of the moment, or when the baby is crying and you might be tired or stressed.

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For parents it can also be important to not underestimate that the little changes can be really hard. Infants change so quickly that it might feel like as soon as you’ve gotten to grips with the stage your baby is at, they’ve already moved onto the next stage. There may be a parallel between excitement for the new stage your baby has reached, but also a genuine need to mourn the stage they’ve left behind.

Practitioners working with new and expectant parents can offer support in preparing mothers and fathers for change. It’s often an issue of “you don’t know what you don’t know”, so for practitioners to open up the conversation can be very important, so parents can think about what is coming and how they might deal with it. For example, practitioners can pose hypothetical questions such as: “How are you going to manage getting the food shopping in when the baby arrives?” or: “How will you decide who soothes or feeds the baby when they wake in the night?” This allows expectant parents to discuss and think about dealing with different aspects of being parents that they might not have thought about otherwise.

Opening up conversations around these practical, emotional, social and physical changes that many parents experience can really help and support mothers and fathers in preparing for when their baby arrives. Practitioners can also offer guidance and ease worries by normalising the different changes that parents might encounter, so that when it does come they can look back to what they decided and discussed before, and know that other parents also experience the change that is happening to them.

By planning, discussing and making decisions about how to cope with different aspects of pregnancy and looking after a new baby, parents can be better prepared and more confident to deal with the changes that a new baby can bring.

 

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Rowan Smith
Training Lead
Family Links
November 2016

A day in the life of a human rights centred midwife

We are so proud to have Birthrights as one of our sponsors for “Growing Families: Facts Fiction and Other Stuff” in Manchester on Thursday 6th October.  Here their trustee, Simon Mehigan, writes for us about what makes a human rights centred midwife.  The image at the top of this piece is the “heart values” word cloud from the #MatExp campaign, put together by Growing Families team member Emma Jane Sasaru.

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Today started as many of my days do with me going straight into a meeting, no time to grab a drink or check my emails. The meeting was discussing how we improve services for women accessing early pregnancy and gynaecology. By redesigning our estate we can improve the journey for these women. How does that relate to their human rights? Well, ensuring women are cared for in an area that’s private and appropriately staffed with skilled nurses and medical staff means women that are suffering a miscarriage or early complications in pregnancy are appropriately cared for and supported. Midwives working in a hospital setting often don’t have any dealings with women below 20 weeks so its important that I make sure that the way in which these women are cared for compliments the midwifery care they receive and promotes the ethos of women centred care. If the care we give is based on the needs and wishes of individual women then we will be meeting their human rights.

Walking round the maternity unit I meet one of our new consultant midwives who talks to me about a women she has been caring for. This woman is very keen to have a vaginal birth but is being discouraged by some of the medical staff who have concerns about her risks. Midwives and obstetricians have an obligation to talk to women about any risk factors they may have. Unfortunately every Dr this woman has met has felt the need to reiterate this woman’s risks factors. As she clearly states “I know the risks, I’ve been told them, I’ve researched them, I just want the best chance to have a good birth experience”. The skill to being a woman centred midwife or doctor is to speak to women on an equal footing. To remove the power dynamic that is so often present in the relationship between health professionals and those they care for is one of the fundamental steps in building a trusting relationship. Trust is, I feel, one of the building blocks of a human rights based relationship with those we care for.

I meet a young woman who has recently given birth to her 1st child but is still here 6 days later. The baby has been under the care of the neonatologists. This intelligent woman has become a mother and has experienced first hand how the “just in case” approach and “Dr knows best” has led her to stay in hospital all this time. She’s a health professional and the work part of her has made her question the doctors, she doesn’t feel the treatment and the investigations her baby has had were necessary, but now she’s a mum and the very rational, logical, evidence based approach she uses every day at work has become clouded by the emotions that come with being a mother combined with all the changes taking place in her body following birth. We talk through how she feels, she comments on how the care she received was great until the baby was born and then it all “got out of control”. She has been told she can go home today so we agree that she will write to me, detailing her experiences as a mum and as a health professional. I can then use that to help me challenge some of the policies, procedures and behaviours that exist in the organisation that don’t support a culture of respecting the human rights of mothers and babies.

My afternoon is spent trying to support the managers in staffing the unit safely, rewriting a job advert for midwives focusing on attracting candidates that believe in women centred care and the role the midwife plays in facilitating choice and helping women and their families to have a positive birth experience. I then respond to a complaint from a woman who feels she wasn’t listened to when she was in pain, didn’t have her wishes respected or her beliefs.

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New book by Birthrights Chief Executive Rebecca Schiller

All of the above makes my day sound pretty depressing but actually it’s full of positive stuff. I see midwives and doctors supporting women, being kind, communicating well and appropriately. I see staff members supporting each other with guidance and tips on how to manage particular situations and I see many, many happy faces of women, their partners and their families who have recently met the latest arrival to their family.

I haven’t laid a hand on a pregnant woman’s abdomen, or caught a baby as its mother pushes it out or helped a new dad figure out how to put a nappy on his new child. That doesn’t make me any less of a midwife nor does it mean I’ve not been able to act in a way that promotes the human rights of childbearing women.

What makes a “human rights centred midwife”?

Kindness, compassion, consideration, respect, honesty and a fundamental belief in a woman’s right to choice.

You know what’s interesting? You could take out “human rights centred” because these are all the qualities that make a great midwife and having spent 22 years working in maternity services the overwhelming majority of midwives I have met have all those qualities. Unfortunately sometimes the services they work in, the culture of the organisation in which they are employed doesn’t support them in demonstrating all these qualities. Fear of litigation, of not following guidelines or of being labelled a “maverick” midwife by supporting choices women make that might not be the norm, make some midwives act towards women in a way that they don’t fell comfortable with. This makes some midwives move on, some leave the profession all together and some give in, become part of the culture.

My words of wisdom…..

Be brave, be strong…….be a midwife…..

 

Simon Mehigan – Birthrights Trustee
Deputy Director of Midwifery
Chelsea and Westminster Hospitals NHS Foundation Trust

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www.birthrights.org.uk

Trust Your Instincts

We are very proud to have eRedbook as one of four Oak sponsors for our event in Manchester on Thursday 6th October. In this blog piece they have interviewed one of the mums using eRedbook, Daniela Tanneberger, about being a mother, the difference between having your first and second child, and how the eRedbook helps her to manage her new baby’s health.

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Daniela, mother to eight-year-old son Robin and three-month old daughter Emma, lives in Chessington. She’s originally from Germany and moved to the UK in 2015. As part of the London field test, her midwife told her about the eRedbook and she registered an account.

How was it for you to give birth in the UK, compared to your experience in Germany where you had your son?

I found the care system in the UK very different from the system in Germany, although I quickly adjusted. You get fewer check-ups and ultrasounds in the UK, but at the same time I’m not sure if all those appointments in Germany were really needed. Here you get a phone number and they tell you to call if something’s wrong, but you don’t really want to call. Once I did phone the maternity ward to rebook an appointment and was told by someone who sounded really annoyed that I should dial a different number. I was ready to tell them “Hey, I’m the pregnant lady, it should be me that’s emotional!” I was lucky that it was my second pregnancy and I was more comfortable.

Was pregnancy easier the second time around?

The second time was more relaxed. I knew what I had to buy, I didn’t waste time looking up the best buggy or buy stuff that I didn’t need. With my son it took me three months to find out that he liked the sound of the hairdryer as white noise. With my daughter I used the hairdryer straight away: she loves the sound as well and I use it to dry her off after a bath.

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You are currently using the eRedbook to keep track of your baby’s health. What were your reasons for registering?

I use technology on a daily basis but I wouldn’t say I’m really into it – I’m not interested in the latest tablets or fitness gadgets. However, when my midwife told me about the eRedbook, I was immediately interested. The reason was that I travel all the time and I always lose paper documents. It’s much easier to have everything available online.

Would you recommend the eRedbook to other parents?

Yes, I definitely recommend the eRedbook to new parents, I absolutely love it. I’m terrible with paperwork, so I appreciate that I can log in to my daughter’s information now at all times.

The other day I spoke to my doctor and he complained that people are always late at appointments because they leave their red book at home and need to go back to get it. I told him that there’s no reason to be late as they can use the eRedbook with their smartphone. We all know how difficult it can be to get everything ready when you go to a doctor’s appointment; carrying the baby while scrambling to get the changing bag, dummy, car seat, etc. The eRedbook just makes it much easier.

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What other advice do you have for new parents?

Trust your instincts. The guidance you receive sometimes seems really strict: ‘don’t use a dummy’, ‘do not co-sleep’, ‘do not spoil your baby’, etc. The truth is that it can be hard to maintain a strict routine, especially when you’re breastfeeding and your baby feeds on demand, and when your baby is not well it can be very comforting to let them sleep with you. You will get a lot of advice from family members and everyone means well, but different generations do different things. So trust your instincts and do what feels right to you.

 

Maddie Kortenaar interviewing Daniela Tanneberger
eRedbook
September 2016

Connecting Through Babywearing

Jenny Neill of Connect Emotional Education is kindly sponsoring our breakout session on Babywearing, and has written for us here about why babywearing means so much to her.

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When I found out about the Growing Families conference I knew that I had to be involved.  I have always worked with children (as a teacher) and in the last five years I have  worked more closely with parents too, culminating in me setting up my own business ‘Connect Emotional Education’ this year where I provide 1:1 support and parent workshops in the area of emotional wellbeing of children and teenagers.

I’m really happy to be sponsoring the Babywearing breakout session.  Babywearing has been important in my parenting journey and I am a trained babywearing peer supporter which means I help other parents in my local area to find out about babywearing.  I love introducing new parents to this simple way of meeting their babies’ needs that has a myriad of other benefits too.

Before I became a parent I had learned, as I did further study in Emotional Education, about the evolutionary theories about babies’ attachment to their parents.  It made total sense that a baby who had spent time growing inside their mother would notice a sudden change once they had been born and that this was down, in part, to the fact that this was something that had been a definite advantage in the days when we lived in caves and had very real physical threats.

For a few years I worked as a Baby Sensory teacher and this gave me a great insight into baby development and I was also lucky to be working in Sheffield, which some call ‘The Sling City’ due to its’ large numbers of babywearers and babywearing support sessions.  I would watch lots of parents come to my classes with their babies wrapped up in various slings and carriers and I saw, first hand, how these babies looked content and settled.  NB – there’ll probably be a time when your baby is looking far from content and settled and you will hope that nobody sees you as you feel sure you are the worst advert for babywearing ever – this happens!  I was convinced by what I saw and decided it was something that I wanted to do with my baby when he came along.

So I did and at nearly three years old we are carrying still, for shorter periods of time and on my back now as wearing evolves as your little one gets older.  I don’t know how long we’ll enjoy this but it’s so much easier that carrying in arms at this age – toddlers are heavy!

 

Neuroscience

A lot of the work that I do with older children and teenagers involves understanding the reptile and mammal parts of the brain so I’m going to start there.  Babies’ brains are not finished at birth and will continue to grow and be shaped by their experiences in the first years of life.  The lower (reptile) parts of their brain are quite well developed as these deal with survival aspects like breathing, feeding,  getting rid of waste and sounding the alert (through crying) if they’re in pain, discomfort or hungry.  The upper parts of the brain (those associated with mammals and humans in particular) are not very developed at all which is why when I look at this picture of my son from when he was about six weeks old I’m left thinking, “Where is the rest of his head?!”

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These upper parts of the brain develop rapidly throughout the first three years of life (which is why you might have heard about various organisations supporting parents and children during the first 1000 days).  Part of our role as parents is to provide nurturing experiences for our babies so that their brains develop and grow.  They are learning about themselves and the world in every interaction so these need to be positive (or challenges dealt with in a positive way).  When they have positive interactions pathways in their brain are strengthened.  Being close to a loving parent also helps to calm baby and send lots of chemicals whizzing through their brain and body.  Oxcytocin is particularly important, sometimes called the ‘cuddle chemical’, and it’s released through touch, sucking and warmth.  Touch and providing warmth can be achieved through holding baby (something that we instinctively do); babywearing using slings and carriers can be used to make this easier – even small babies get heavy after a while! Having your hands free to do other things is also a benefit (particularly if you have other children to look after as well).

If you want to find out more I have included some book recommendations at the bottom of this post.

 

Security

“Having that extra contact is wonderful. I think it makes them feel more secure.  I love the closeness.” – Lisa, mum of three

“One of my favourite things was carrying her in our sling.  I loved having the intimacy and whispering in her ears; being able to respond and have that degree of closeness to her was truly magical.” – Ben, dad of three, slingdads.co.uk

 As I briefly mentioned before, the world can be a new and confusing place for babies when they arrive. As they get older their understanding of the world increases but so does their awareness and this can lead them to need more security.  Wearing babies and toddlers can help them feel secure by keeping them physically close but also by having them close to you they can be included more in daily life and it’s easier to reassure them or explain what is happening as you move around.

Babies have a lot of things going on that they can’t understand and the main means they have of communicating is crying.  Laura, mum of two, sent this picture with the caption, ‘early evening walks in the ‘colic hours’ … relaxed and contented baby and mummy!’ There are various theories about what colic is but, when it occurs, a baby’s main method of communicating about their pain is through crying.  Parents will try anything and everything to help and it’s often reported that holding or wearing baby in an upright position can help.  Laura elaborates, “my son had horrendous colic.  My daughter (in the picture) didn’t but had some unsettled evenings that reminded me of my son’s colic and taking her out in the wrap was brilliant! I wish I’d have tried it first time round!”

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Adam, babywearing blogger, talks about the benefits of wearing his son close, “what I love about baby wearing is the closeness, the bonding we have enjoyed from birth to toddler.  Babies love it in the sling.  It calms them down.”

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Security for parents

I read the quote, “making the decision to have a child is momentous.  It is to decide forever to have your heart go walking around outside your body,” and it’s what I think of when I think about that time after birth.  I had been very anxious during pregnancy and was desperate for my baby to arrive safely then, as soon as he did, I was unnerved by not always being able to reach down and touch him as I had when he was a wriggly bump.  It’s not quite as simple of that but I can definitely understand the comments of two mums that I spoke to recently:

“I found babywearing hugely helpful. I suffered from PND and anxiety but could feel the pressure lift and my anxiety drop when I wore baby. By keeping her close it made me feel calmer.” – Rebecca, mum of one

“I have felt panicked when separated from both sons as infants.  Holding them close in a sling meant we felt connected.  I could feel their movements and hear their breathing.” – Natalie, mum of two

It’s a natural instinct to want to keep our babies close and meeting their needs as they grow is important too. Claire, from Honeybee Mama, sums it up when she says, “Now I can meet my son’s needs whilst still getting on with other stuff. So apart from the beautiful early days where all you want to do is hold them, slings are great for your sanity as your children grow.”

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Seeing the world through the eyes of your baby. Living in the moment.

Becoming a parent involves a big change, a really big change; in pace, priorities an perspective.  One thing that I hadn’t considered until a friend pointed it out was that connecting with your baby through babywearing could have the following impact on us as parents.

“For me, it took an actual baby looking at the world with such awe to make me truly look deeply at what was around me and be taken aback by it all.”  – Tracy G. Cassels, author of My Unexpected Consequence of Babywearing.

When you’re walking along wearing your little one it’s almost impossible to stop yourself from talking to them, pointing out things that you see along the way or around.  As they grow this inevitably involves stopping to touch leaves on trees, post letters, talk to people you see and your child can be more closely involved in these things when you wear them so it’s great for communication and so you roll along in a circle of communicating and connecting leading to more communicating and so on.

For a more in-depth discussion please see http://evolutionaryparenting.com/my-unexpected-consequence-of-babywearing/

This picture is of me wearing my son at around 8 months old.  We were on a very windy beach in Scotland and I remember his exhilaration at the wind in his face.  Being in the sling meant that I could get the balance right between letting him experience this new sensation but sheltering him from the wind when it started to get too much.

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Carry on wearing

Babywearing could be called baby, toddler and pre-schooler wearing (but it’s not a very snappy title).  I love a bit of myth-busting and it’s often thought that babies are too heavy to wear after a certain point.  It’s not true and may be down to finding the right sling or carrier for the next step on your babywearing journey.  I find it so much easier to carry my nearly three year old on my back in a carrier than I do to pick him up and carry him in my arms.  He walks about 90% of the time because he’s an active toddler but there are times when he’s too tired to walk or he’s fallen or another reason and then carrying him comes into its’ own again.  I spoke to two other parents about their experiences of carrying their older babies and children.  Louise, mum of one, spoke about the conscious effort she made to wear her son when she returned to work.  “I returned to work and our son was being cared for by my husband.  I felt that I would miss out on loads (of experiences and opportunities for connection) so continuing to carry at this time (10 months until now at 22 months) has really helped to keep us connected. Now he’s at nursery part time and I sling him there and back so we can have one on one time to talk about the day and ensure he is comforted during this transitional time.”

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Photo credit: Ellie Thouret

Ellie, sling consultant at Peekaboo Slings, said, “(when my son was 2 ½) I began carrying him home in a sling, pushing the babies in the buggy … this gave us the chance to talk while the babies were soothed by movement. He’d tell me about his day and I’d feel us reconnecting, finding our way through our new normal.” For more insight into this see http://peekabooslings.co.uk/why-i-carry-my-big-kid

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Photo credit: Ellie Thouret

I’m looking forward to the Growing Families conference, if you are attending and are interested in finding out more about babywearing you can attend the breakout session run by Victoria Ward from School of Babywearing.  There will also be a pop up sling library run by Ellie Thouret of Peekaboo Slings.  I hope the new parents attending will be inspired to have a go at babywearing – search for your local sling library or babywearing meet if you want to find out more information after the event or you can ask lots of questions at the event.  I love this quote which sums up the benefits of babywearing, both emotional and practical:

Babywearing can soothe our children, help us become a flexible ‘all-terrain’ family. Really it’s almost close to a super-power from something that’s a simple as a piece of fabric. Something that feels so instinctual and so good.” – Daniel Nisbet

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Books I love if you want more information on neuroscience and its’ implications for parenting

What Every Parent Needs To Know – Margot Sunderland

The Hormone of Closeness – Kerstin Uvnäs Moberg

Kiss Me! – Carlos González

Baby Calm – Sarah Ockwell-Smith

Why Love Matters – Sue Gerhardt

Baby Bliss – Dr Harvey Karp

Brain Insights cards (Love Your Baby, Fun While I’m One etc) – Deborah McNelis

 

Jenny Neill
2016
Connect Emotional Education

http://connectemotionaleducation.weebly.com/

https://www.facebook.com/Connect-Emotional-Education-637889949648340

https://twitter.com/jenconnectemed

Families and Mental Health

Our thanks to Mary Nolan for writing for us on the subject of families and mental health.  Mary is one of our main session speakers at the Growing Families: Facts, Fiction and Other Stuff event in Manchester this October, and will be delivering the section on Understanding Baby, in conjunction with Helen Ball of the Durham University Parent-Infant Sleep Lab.  This is her second blog post for us, her first being “All Change! Some totally new parenting advice is about to arrive!”

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I’ve just finished reading a fascinating book about what it was like for children in the nineteenth century. Some of the facts and figures quoted were startling. At the start of the century, about one baby in four died before reaching his or her first birthday and another one in four died before they reached the age of 15. Across Europe, enormous efforts were made to identify the cause of infant deaths and governments became increasingly involved in trying to protect children through such measures as limiting the hours they worked in factories and mines, introducing compulsory primary education, improving sanitation and reducing overcrowding in urban housing.

Such measures were largely successful and today, being born and being a baby, toddler and child, aren’t anywhere near as hazardous as they were two hundred years ago.

However, there are new hazards – or, at least, there are hazards that we’re now much more aware of because we don’t have to spend so much time worrying about our children’s physical health (not that we don’t still worry about this, of course!)

A survey carried out by Action for Children last year found that parents worry more about their children’s mental health than any other health issue, including diet, weight and serious illnesses such as cancer. The Chief Executive advised that, ‘Spending time and money preventing a problem rather than repairing the damage is the right and logical thing to do’. I could not agree with him more.

The best way to support children’s mental health is by supporting their parents’ and by being clear about the value and importance of families, however the family is constructed. Families may be constructed in different ways in the 21st century just as they were in earlier centuries.  (Until I read the book I mentioned at the start of this blog, I thought that 19th century families always consisted of a father and a mother and a (large) number of children. This is not true. A lot of children were brought up by relatives other than their parents because one or both parents had died; there were a lot of single-parent families, and probably as many families combining children from different marriages as there are today.) The key to successful families lies not in who the family members are but in how they relate to each other.

Let me share with you an example of the transformative power of a family. A couple I know very well had three children whom they raised to adulthood and saw happily settled with partners and families of their own. Now in their fifties, this couple decided to adopt five siblings, three girls (including twins) and two boys, whose own parents were unable to care for them owing to longstanding and deeply ingrained problems with drug abuse. The children were aged from a few months to five. The first thing I want to do is to honour this amazing couple who, not in the first flush of youth, had the courage to take on such a commitment.

The baby they adopted needed the usual amount of attention babies need (i.e. a lot!) but the other children needed even more attention to help them settle in their new home and with their adoptive parents. Let the camera roll and ten years later, these children, now aged 10 to 15, are the happiest, most sociable, fun-loving kids you could ever hope to meet. I had the privilege of being at a social event with them recently and enjoyed lovely conversations with the oldest girl about her ambition to become a child psychologist; with the middle children about football, mobile phones and dancing, and the youngest boy about how to manage bulls (they live on a farm)!

This is a story of tragedy and joy. The birth parents have lost the care of their children and remain poorly and in receipt of mental health services. That is a tragedy. The adoptive parents have given five highly vulnerable children a family that has enabled them to thrive and to realise their innate potential to be happy young people who will make a contribution to the European country of which they are citizens. That is a cause for joy.

This isn’t a plea for more adoptions; the outcomes are not always as successful as the example described here. But it is a plea for supporting families because they are so important in shaping the adults we become.

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So my wish list for children’s mental health would first and foremost, prioritise parents’ mental health because that, maybe more than anything else, impacts on children’s wellbeing. Children of depressed parents have a 50% risk of developing depression themselves before the age of 20 according to the Mental Health Foundation. I think preparation for parenthood education should include opportunities for mothers and fathers-to-be to explore their personal strategies for maintaining good mental health and learn some new strategies, such as relaxation and mindfulness skills.

Next, I’d make sure that families have enough to live on. The single most critical risk factor that predicts later mental health and behavioural problems in children is poverty. The research tells us that poverty threatens parents’ positive interactions with their children and makes it more likely that negative and punitive relationships develop.

Thirdly, I’d take some simple measures to support pregnant women who have a history of mental illness or are suffering with antenatal depression. I’d use a buddying system whereby a trained, sensitive, empathic professional, or lay person, visits the mother regularly throughout her pregnancy, supports her at the birth if she so wishes, and continues to visit for as long as the mother wants after the birth. The ‘service’ would be simple friendship with an opportunity for the mother to talk about her feelings and to think about her relationship with her baby.

And finally (but only after all of the above had been put in place) I’d ensure adequate funding of parent-infant mental health services (of which we have only a few in this country), and of children and adolescent mental health services.

But to reiterate: offering support and education at the earliest possible moment – and that probably means educating young people in schools about positive mental health well before they become parents – is surely the way forward.  We should certainly be ‘intervening’ in pregnancy with information, education and support. So if you’re pregnant right now (congratulations!) and are looking for antenatal classes, do ask whether the curriculum includes positive mental health strategies for parents and babies. You might feel that you really don’t need this kind of input, but you never know and what you learn will still be very useful if ever you find yourself supporting friends and family members in the future.

 

Mary Nolan
September 2016

What should new parents expect?!

Sally Hogg is a mother who works in children’s policy, research and practice, and has done extensive work on the subject of excessive crying in infants.  She is now the lead for the Mums and Babies in Mind Project, from the Maternal Mental Health Alliance.  Our thanks to Sally for her support for Growing Families: Facts, Fiction and Other Stuff.  Here she discusses parental expectations and the realities of new parenthood.

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I often need to go to bed quite early and nearly always fall asleep as soon as my head hits the pillow. In the morning, I am ready to get up as soon as my alarm goes off (although I have a toddler, so don’t need an alarm these days!).

My husband, on the other hand, needs time to relax and ‘switch-off’ before he can sleep. And in the morning, he has multiple ‘snoozes’ before he’s ready to face the world.

When it comes to food, I need a good breakfast early on, but then can go without food until lunchtime. My husband likes a later breakfast, but needs to eat and drink regularly or else he gets ‘hangry’.

You may be wondering why am I writing all this in a parenting blog.

Good question.

I want to illustrate how people can be really different, even in some very basic ways. We have different characteristics and constitutions. It’s part of how we are made.

And babies are just little people. So they are all different too.

This may seem obvious, but I think it is such an important point for expectant and new parents to keep in mind.

The parenting books, public opinion, and sadly some professional advice too, can lead us to believe that all babies should be the same, that they will have similar sleeping and feeding patterns, and that there are simple rules and routines that we as parents can, and should, follow, to get our babies to behave in the expected way.

Not enough recognition is given to the fact that every baby, every parent, and every situation is different. Ok, so the 10-point plan in the baby book MAY have helped the author’s baby to sleep. That doesn’t mean it will work for Joe and Joanne Blogs and their baby.

Parenting isn’t about sticking to someone else’s 10-point plan. It’s about getting to know your baby and their likes and dislikes, strengths and struggles, and finding a way through that works for all of you.

I heard some wonderful advice recently; One mum asked another at what age she stopped feeding her baby at night. Her answer,

“We just gave him what we needed, and when he stopped needing it, we stopped giving it to him.”

Simple.

If parents expect their baby to feed, sleep, cry and behave like other babies (whatever that actually means), then it’s more likely that they will feel something is going ‘wrong’ in the first few months when their baby doesn’t match these expectations. They may start to believe that they, as parents, are doing something ‘wrong’ because their baby struggles to sleep, for example, or that there is something ‘wrong’ with their babies because they cry or feed more than others. This line of thinking leads parents to beat themselves up; to get stressed, or to try and find endless cures or solutions to ‘problems’, rather than settling in to find the best way to parent the wonderful, unique baby who has joined them.

There are lots of examples of how, when parents expect that they, and their babies, will have a textbook experience, the reality can be really difficult.

We know, for example, that postnatal depression is more prevalent among mums who plan to breastfeed and then don’t, compared to both those who don’t plan to at all, or those who plan to and do so. It’s really hard when we struggle to be the parent we expected ourselves to be.

We also know that the expectation is that parenting will be a magical time. And the (misplaced) belief that everyone else feels that way, makes it hard for the 20% of mums with mental health problems to talk about their feelings and seek help.

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Conversely, we know that when we prepare parents for the fact that things might get difficult, it can make a big difference. The NSPCC found that showing parents a 10 minute film explaining the reality of how much babies can cry, and how stressful this can be for parents, had a significant and prolonged effect on parents’ confidence, their ability to talk to others about problems, and their use of different soothing techniques.

And when midwives and health visitors spend just 10 minutes helping new parents get to know their baby and understand his or her unique characteristics, and how easy (or not) he or she find it to stop crying, or get to sleep (using an approach called the NBO), this helps parents to feel closer to their baby and more confident as a parent, and reduces the incidence of postnatal depression.

I don’t want to suggest that parents-to-be should expect to parenting to be difficult, breastfeeding hard, or babies to cry a lot. But they need to be prepared that they may experience these things, and that if they do, it doesn’t mean there is anything wrong with them or their baby. It’s part of the normal rollercoaster of parenting, and there’s a lot of support out there to help.

If I had to tell parents what to expect when they have a baby, I’d tell them to prepare to meet your own fantastic, individual little person. And don’t expect anything to be like you read in the books.

 

Sally Hogg
September 2016

All Change! Some totally new parenting advice is about to arrive!

Our thanks to Mary Nolan for writing for us on the subject of parenting advice, confusion and consistency.  Mary is one of our main session speakers at the Growing Families: Facts, Fiction and Other Stuff event in Manchester this October, and will be delivering the section on Understanding Baby, in conjunction with Helen Ball of the Durham University Parent-Infant Sleep Lab.

Mary trained as a nurse in the 1970s and then as a childbirth educator with the NCT. She has worked with parents across the UK and has trained educators in Australia, New Zealand, Ireland, Belgium and Germany. She has published several books including, ‘Antenatal Education: A Dynamic Approach’, ‘Home Birth: The Politics of Difficult Choices’, and chapters in ‘Essential Midwifery Practice: Intrapartum Care’ edited by Denis Walsh and Soo Downe. Her PhD examined the impact of antenatal education on women’s choices around pain management in labour and her research into women’s and men’s experience of early labour, what women want from antenatal classes, and health visitors’ engagement with new fathers has been published in peer-reviewed academic and professional journals.

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My father is 88 years old – a truly splendid octogenarian who maintains a keen interest in a world which he sometimes finds confusing. He is not slow to remind us – with a twinkle in his eye – that advice is like fashion; it comes and goes and if you hang onto what you wore/were told in the 50s/80s/00s, you’ll eventually find yourself ‘on trend’ and doing ‘the right thing’ again after being out of fashion and doing ‘the wrong thing’ for a couple of decades!

He’s particularly keen to point out that the parenting my mother considered appropriate – three meals a day (sitting at the family table) and only water and fruit in between, and bed-time before 8pm are now being advocated again. (Along with real butter which my Dad loves!)

It’s hard today being a mother or a father or a kinship carer or anyone who has charge of children and wants to do the best they can to ensure they are physically, emotionally, socially and spiritually healthy. And people like myself, who are in the business of parent education and research, don’t always make life easier – although we are totally committed to finding the very best evidence to give to parents and co-parents.

Helping out at a playgroup the other day, I was startled to hear two young mothers (mid to late twenties) talking about what kind of milk to give their babies. The babies in question were adorable little girls of around 4-6 months of age. The babies were sitting in their pushchairs smiling amiably at each other and occasionally demanding some attention from their moms which was very willingly given. I presumed that the mothers were discussing breast milk v formula, or different kinds of formula. Not so. The mothers were discussing when to give cow’s milk and whether it should be full fat or semi-skimmed. The conclusion they came to was that it was all right to change from formula (which both babies were receiving) to full fat cow’s milk at 6 months of age. The World Health Organisation and the Department of Health recommendation is not to give cow’s milk before a year at the earliest. It’s one of the few recommendations that has been consistent over quite a long period of time.

These were clearly devoted and conscientious mothers with healthy and happy babies. So how could they have got hold of such wrong information?

It’s not just mothers, of course, who are victims of the confusion that inevitably arises when health information changes from one week to the next, or is transmitted in a confused way or is different according to which health professional you speak to. Health professionals are confused as well. While leading a seminar recently for a bright and dedicated group of student midwives, I found myself in a debate with one young and ardent student about whether caesarean section was as ‘good’ as vaginal birth. I mounted the usual (and, to my mind, correct) argument that caesarean can be a life-saving operation for some mothers and babies and that we are fortunate to have easy access to it, but that vaginal birth has many advantages that may affect the new baby for the whole of their life. I therefore suggested  that it is the midwife’s role to support women and their birth companions physically and emotionally to have a straightforward vaginal birth whenever possible. The student quite definitely did not agree with me and felt that vaginal and surgical birth should be presented as equal options.

You might be thinking now that I have made these two stories up for the sake of this Blog – but, actually, I haven’t. Both are true and both incidents occurred in the last month.

Rachel Law

Research into health promotion is very clear that conflicting and inconsistent advice leads (who would have guessed?) to conflicted and inconsistent parenting. And that inconsistent parenting doesn’t help young children to feel secure and ‘get a grip’ on the world. The baby and toddler are busy developing a template for life. Their fast-growing brains are trying to sort out which behaviours lead to which responses. As humans, we all need to feel pretty certain that our actions will have predictable outcomes if we are to function effectively on a day-to-day basis and avoid becoming anxious and indecisive. As a very young child, I need to know, for example, that food arrives at certain times and that eating it makes me feel content; that smiling at dad and reaching out to him elicits a warm playful response, and that pulling grandma’s hair hard makes her sad. I need my mom and dad, or whoever is looking after me, to do things in ways that I come to recognise as ‘how things are done in our family’. If mom and dad are continually changing the way in which they look after me because the advice they are receiving is always changing, that’s not particularly good for me as the little person on the receiving end of that inconsistent parenting.

For me as a birth and parent educator, and an academic who’s interested in how to transmit accurate health and child care messages, the age of social media is challenging. Twitter and Facebook can function rather like a game of Chinese whispers with a message starting out as one thing and becoming something very different by the time it reaches the hundredth or the thousandth or the ten-thousandth recipient. For parents and co-parents, trying as hard as they can to be not just ‘good-enough’ parents, but excellent parents, ever changing advice is a nightmare.

It’s a conundrum. So what advice would I give about advice???!! I think exactly the same as I would have given when I first started practising as a parent educator about 30 years ago. Choose one person who you have reason to believe knows what s/he’s talking about and understands the way in which you want to parent, or one website that has been recommended to you by a health professional, or one book that is authoritative (the reliable ones generally have reference lists so you can check the research on which they’re based) and stick with that person or information source. As a very wise friend once said to me (rather shockingly, I thought at the time), ‘Even better than loving your children is being consistent’.

 

Mary Nolan
August 2016