If the going gets tough

If the going gets tough

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Many parents say that being a parent is the toughest job they have ever had. We know that having a new baby increases the risk for experiencing stress, anxiety and postnatal depression (PND) in new parents.  

Up to one in every seven new mums in Australia can experience PND, and about half of their partners.   

If you feel that you or your partner may be suffering depression, anxiety or stress, make sure that you talk to each other and to friends and family. The start of PND may be gradual and many people experience it without realising it.   

If you think that it’s not something that you can handle on your own, or with your partner and family, seek professional support. Don’t let things go on for too long.   

Getting advice and information for yourself and your partner is a positive action. Beyondblue have some great resources on emotional health and wellbeing.  

Some facts about postnatal depression (PND)

  • During the first week after birth, up to 80% of new mothers will get the ‘baby blues‘. That means you may feel quite sensitive, teary, have mood swings, feel irritable or anxious. This happens because your body is withdrawing from the placental hormones.   
  • These symptoms usually peak 3 to 5 days after delivery and go away in about two weeks. If your low mood lasts more than two weeks you may be having something more than the baby blues. It could be postnatal anxiety or postnatal depression. It is important for you to talk to your GP or Child Health Nurse as soon as possible.   
  • Anxiety occurs in about one in five women after birth and postnatal depression occurs in 16% of women.  
  • It is also very common to experience postnatal anxiety and postnatal depression at the same time. In fact, in up to 50% of cases these two conditions co-occur.  

Symptoms of PND

There are many ways to treat postnatal depression, but the first step is to know the signs and symptoms and find help. Common symptoms include:

  • Feelings of sadness, anger, tiredness, anxiety, panic and low self-esteem 
  • Sleep problems, low energy, changes in eating habits, lack of interest in everyday activities  
  • Difficulty concentrating or making decisions 
  • Thoughts of running away or hurting your baby   

Not everyone with postnatal depression will experience all these symptoms. If you have been experiencing any of these symptoms for more than a few days, it is best to speak to your doctor.  

Every parent needs to look after themselves whether or not they are experiencing stress, anxiety, or depression.  

Factors contributing to PND

The exact causes of PND are still not known. Some contributing factors might include: 

  • Physical changes: Even an easy birth has major effects on the female body. The sudden drop in pregnancy hormones affects brain chemicals. Broken sleep and exhaustion can also contribute to depression. 
  • Emotional changes: Adjusting to parenthood can be hard. New parents have to deal with the constant demands of a baby, broken sleep, changes in the relationship with their partner, and often the loss of independence.  
  • Social changes: Society puts lots of demands and expectations on new parents, which they may feel they need to live up to. You may find yourself less able to keep up contact with friends and workmates.   

It’s OK to get support

“It takes a village to raise a child”.  Don’t be afraid to ask for help and support in taking care of a new baby and yourself. Identify who you can call on for advice and support, like friends and extended family members and discuss any feelings you may be experiencing with them sooner rather than later.    

Plan for how you can deal with busy times in the household such as meal times, bath and bedtimes, appointments, chores, work times and time out for yourself.  

Make yourself familiar with the places in the community where help might be found, like parent groups, community, child, and parent centres, your local child health professionals or other groups where you will find like-minded people.       

Getting symptoms of depression and anxiety under control can improve your quality of life, overall experience of parenthood and relationship with your new baby. Don’t hesitate to seek help.  

Want to know more?

The Raising Children Network – New mums: the first weeks 

Raising Children Network – Parents: looking after yourself 

Raising Children Network – Grown ups: looking after yourself videos 

Department of Health – Emotional health for new parents 

KEMH – Common emotional problems 

Post Antenatal Depression Association (PANDA): 1300 726 306  

Contact your local child health nurse: 1800 022 222

How newborns sleep

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Sleep is necessary for all of us. It helps our brains and bodies to develop, restore and repair. That’s why growing babies need so much sleep.  

Sleep range

11.8 to 20.5 hours out of 24, although most babies sleep about 15 to 18 hours.

Sleep patterns

Most babies sleep for a one to three hour block.

Awake patterns

Usually tired after one to one and a half hours of awake time. 

Sleep cycles

When we sleep we go through a series of sleep-wake cycles. We become drowsy, fall asleep, move into a deep sleep and then back into light sleep again. This is called a sleep cycle.  

Your baby will start with short sleep cycles of 15 to 20 minutes, but over time these will get longer.  

Within these sleep cycles there are two types of sleep:  

  • REM (rapid eye movement) is light sleep, usually after midnight. 
  • Non-REM is deep sleep, usually before midnight. 

REM sleep is very important for your baby’s brain development and learning.  

Your baby will spend 50% to 75% of their sleep in REM. As your baby sleeps their brain is sorting out what has happened during the day. It orders memories and stores them in the right parts of the brain so the information can be remembered. Your baby can be easily woken during REM sleep.  

When your baby is in deep non-REM sleep, they will lie quite still, breathe deeply and be difficult to wake. If woken they may be upset or confused. 

The key to longer sleeps is to help your baby link their sleep cycles. 

By helping your baby to self-soothe and settle they will learn to link their sleep cycles for longer periods of time. When we repeat routines of soothing and resettling, babies begin to learn that these are signs to sleep.   

A baby’s daily routine of feeding and sleep will mature over time. Babies have different abilities to settle themselves so you will need to get to know what help your baby might need to link their sleep cycles.    

Melatonin is the hormone that makes us tired and helps us to differentiate night and day, as the sun goes down we begin to produce melatonin. The release of melatonin is regulated by our circadian rhythm, the cycle that our body becomes accustomed to for our day and night routine. So maintaining the quiet, darkened space for your baby to sleep helps them maintain this rhythm.  

Newborn sleep routines

As your baby grows, sleep patterns will change. From stage to stage, you will adapt and find ways to help your baby settle. There is no quick fix, but in time your baby will develop the ability to self-soothe.  

Up to six months of age, most babies wake two to three times a night for a feed. Breastfed babies may wake more often.  

Sleeping patterns often change at the same time as major milestones. Babies are growing and learning fast in their first year. This influences their sleep and waking. When your baby starts to roll over, crawl or has a growth spurt you may notice a change in their sleep routine.  

A return to night waking after periods of sleeping through the night is normal. This is usually linked with a leap in brain development and processing new things they have learnt. Teething and illness or a change in the sleeping environment will also affect their sleep.  

Average Sleep Patterns

The average sleep patterns from newborn to four years of age is represented in our sleep chart: Average Sleep by Age.

Want to know more?

Raising Children Network – About newborn sleep 

Raising Children Network – About sleep

Frequently asked questions

How much will my baby sleep?

The amount of sleep that babies need varies from child to child. The amount will decrease over the first three months and then stabilise during their first 12 months. 

My baby doesn’t sleep at night!

Don’t worry, your baby will quickly learn to respond to the patterns of light and dark, night and day rhythms. Some babies need more help than others. 

A 6- to 12 month old baby may wake repeatedly at night. This is due to a number of factors and is quite normal. Mainly they are overcoming their anxiety of being separated from you, and are learning to become more independent.  

When will my baby have a sleep routine?

It may take up to 14 weeks – as their brain develops – for babies to start a pattern of responding to changes in night and day rhythms. You will help them to develop a routine with soothing, settling and sleep cues. 

Your baby’s routine may be affected by factors in their environment. The Raising Children Network has further information on light and noise at sleeptime. 

The act of going to sleep is one of your baby’s first experiences of being apart from you. Considering this, it’s easier to understand if they are wakeful. This is a normal developmental stage. Your consistent responsiveness will make your child feel secure and trusting – you are not ‘spoiling’ your child. 

Settling your baby to sleep

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Being able to settle off to sleep is a learned skill for most babies. Our job as parents is to help our baby to make a smooth transition.  

There will be crying and fussing while they are learning. Your baby needs you to respond for comfort and reassurance so that they feel secure and loved. 

Settling into rhythms

At about four months of age, babies begin to establish their awake and asleep rhythms. This is the time to begin to establish day/night bedtime routines. 

Crying is to be expected and distressed crying can occur for several hours a day. It will often peak when your baby is about six weeks old but usually lessens after this time.   

It takes time for you to get to know the different cries and your baby’s individual body language.

All babies cry

No one response fits all types of cries. Try and observe your baby’s body language and listen to the cries to work out which response will work best for you. 

Holding a crying baby over your shoulder for a prolonged period can be hard work. It is very loud and can add to your own stress levels.  

  • Place pressure on your baby’s abdomen by laying him/her across your knees, or along your forearm. 
  • Slow your own breathing down-this sometimes helps to settle a distressed baby and helps you remain calm as you learn about what your baby needs  
  • Try the “C” position. Hold your baby upright. Face them outwards so the back of his or her head lies against your chest. Draw baby’s knees up to his/her abdomen so he is in the foetal position. 
  • A change of scenery can help – head out into the garden. 
  • Use a baby sling. Ensure baby’s face is not covered or buried in sling. 
  • Pat or rock baby (ensure slow and rhythmic movement). 
  • Hold baby upright for a short period of time following a feed. 
  • Massage with circular motion, clockwise on baby’s back or abdomen.  
  • Take baby for a walk in the pram. 
  • Cuddle baby: try skin-to-skin contact or lay down with baby. 
  • Sing to baby: rhythmic nursery rhymes, songs or stories . 

Believe in yourself and trust your own judgement – all babies cry.   

Waking up

Waking regularly during day and night sleeps is common. This may be a sign that your baby does not know how to settle without you. 

You can also try a consistent gentle touch, rocking the cot or singing a lullaby or putting on their regular going to sleep music. 

Research shows that babies about four months old who are placed in a cot while drowsy are better able to self-soothe both at the beginning and between sleep cycles. 

Some babies need more adult support to calm and settle. It is normal for your baby to need a number of attempts to settle depending on their age, health and level of tiredness. 

“Controlled crying”

You may have heard of “controlled crying” or “controlled comforting” as a way to change how babies settle. This can mean different things to different people.

At Ngala we promote gentle settling and we do not agree with leaving babies to cry themselves to sleep.  

Babies are sensitive to the nurturing they receive from caregivers. Newborns as young as six weeks of age become distressed if their relationships with caregivers are non-responsive. 

Responding to a crying baby makes them feel secure. It is important to support babies as they learn to self-settle to sleep. 

Want to know more?

Raising Children Network –Newborn sleep 

Raising Children Network – Patting and settling technique to help babies sleep 

Pregnancy, Birth and Baby – Sleep and settling

Frequently asked questions

My baby wakes up after being put in the cot. How do I get my baby back to sleep?

If your baby falls asleep being rocked in the comfort of your arms, close to your heartbeat and then wakes up in bed alone, it’s probably a bit of a shock.  

When your baby falls asleep in your arms or during a feed, aim to wake them just enough so that they are aware of their surroundings as they go off to sleep; maybe check their nappy. This will help to reduce the anxiety of waking in a strange place. 

If your baby wakes frequently or soon after you try to put them down, you may need to look at the following: 

  • How long have they been awake? 
  • What are you doing to help them get to sleep? 
  • What could you do less of to get your baby to sleep? 

Safe sleeping

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The safest place for a baby to sleep is in the same room as an adult caregiver on their own sleep surface for the first six to 12 months. This helps with night-time bonding and allows you to respond quickly to your baby.

Co-sleeping

Research has shown that sharing a sleep surface can increase the risk of Sudden Infant Death Syndrome (SIDS). A shared sleep surface can be either a bed, lounge chair, bean bag or on a parent’s chest.  

Ngala follows the Red Nose recommendations.

The Red Nose recommendations give the following advice to keep your baby safe while sleeping: 

  • Sleep baby on their back  
  • Keep baby’s head and face uncovered 
  • Keep baby smoke-free before and after birth 
  • Safe sleeping environment night and day 
  • Sleep baby in their own safe sleeping place in the same room as an adult caregiver for the first six to 12 months 
  • Breastfeed if you can 

Swaddling or wrapping

Babies who find it difficult to keep their bodies still for sleep may need more holding than others. Some babies may need a firm embrace or wrapping to reduce arm and leg movements and back arching.

In general, it has been found that wrapped babies wake less and sleep longer. The benefits of wrapping are particularly obvious for pre-term babies. Wrapping is not recommended when the baby begins to turn or roll. 

The Raising Children Network has tips for dressing your baby for bed and a video on wrapping a newborn.  

Want to know more?

Raising Children Network – Safe sleeping: 11 tips 

Raising Children Network – Wrapping a baby – in pictures 

Red Nose – Safe sleeping 

Tired signs and cues

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Your newborn baby may be tired after just one hour of being awake. Generally, babies under three months of age will be awake for only one to one and a half hours at a time. 

Common signs of tiredness

There are many signs you can looks for that might mean your baby is getting tired. These include:

  • grizzling 
  • low repetitive tone 
  • disengaging 
  • clenched fists 
  • yawning
  • rubbing eyes or ears 
  • change of face skin colour 
  • arching back 
  • jerky movements 
  • having difficulty focusing or going cross-eyed 
  • sucking fingers as a way of self soothing to sleep 

How babies express their needs

Your baby will signal to you that they: 

  • want affection from a caregiver (engagement cues) or 
  • have had enough of a situation (disengagement cues). 
When your baby wants to ‘engage’ with you they may:  
  • reach out to you 
  • make eye contact 
  • be still or smoothly move their arms and legs 
  • smile 
  • have their hands open 
  • cry 
When a baby is tired and wants to ‘disengage’ they may:  
  • be irritable
  • turn their head away 
  • cough  
  • arch their back 
  • move jerkily 
  • yawn 
  • breathe faster
  • frown 
  • hiccup 
  • stick out their tongue 
  • show a change in facial skin colour 

Your baby may give mixed cues when they are stressed or tired. The main thing is to be sensitive to their needs. You will gradually learn what most of their cues mean, and will be able to respond promptly and sensitively to meet their needs. 

Want to know more? 

Raising Children Network – Tired signs in babies and toddlers 

Raising Children Network – Baby and toddler cues in pictures 

Pregnancy, Birth and Baby – Sleep and settling your baby    

Frequently Asked Questions

How do I know when my baby is tired?

When your baby becomes tense, frowns and clenches their fists after being calm and content, they are showing tired signs. This will progress to a grizzle and cry. 

You may also notice that your baby is not keen on feeding when they are tired. They may also disengage from your attempts to have eye contact or chat. 

When you see these signs within an hour of your baby’s wake time, it is time to settle your baby. 

Sleep and growing brains

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At birth a full term baby’s brain weighs about 400 grams and has around 100 billion brain cells.  

The brain develops in a particular order; the brain stem is the least complex and develops first and is fairly mature at birth. The brain stem controls basic functions such as heart rate, temperature, sucking and digestion. The limbic system matures next, which is responsible for sleep, appetite, emotions and the ability to form attachment.  

By the time they are 3 years of age the brain weighs 1100 grams! The increase is size and weight can be attributed to the connections that are forming in the brain and good nutrition.  

New connections

Every experience your baby has is new and is forming a new connection in the brain. It is exhausting which is why your new baby needs so much sleep. When babies sleep they rehearse their new learnt skills. 

All those nappy changes and feeds provide a wonderful opportunity to form connections in the brain. Much of what a baby needs for brain development occurs within relationships with other people.  

  • Talk to your baby while you feed.  
  • Chat and ask questions when you change a nappy.  
  • Talk about what you are doing- while it might feel awkward at first you will get better at it and enjoy the response you get from your baby. 

REM sleep and brain development

Sleep is important for healthy brain development and creativity. Sleep helps the brain to form patterns and lays down memories from and about experiences. Sleep improves motor and perceptual skills. 

Over the last ten years researchers have tried to provide insight about the developmental functions of sleep. During the late foetal stage and early weeks after birth, there is a high percentage of REM sleep. This is a critical period in brain growth, function and maturing. During REM sleep, experiences and activities are consolidated in the brain. 

Circadian rhythms are those natural signals in our bodies that tell us when to eat and sleep. Circadian rhythms are not developed in babies until they are four to six months old. As a result, babies can become hungry or tired at any time of the day or night. With regular and repeated cues from an adult, babies learn to understand the experience and begin to form a feed, play, sleep pattern. 

Babies encode memories during REM sleep. Their memories are the ones formed through the senses. They include the sound of their parents’ voice and smell, the sounds of home, the warm sensation of being cuddled and repetitive experiences of being responded to when they cry. 

Researchers suggest that by day ten, your baby can remember the way you smell. At one month they can remember when they are fed and come to expect to be fed at that time. 

What can parents do?

  • Tune in to baby’s tired signs to avoid overstimulation and help them sleep. 
  • Help to resettle to sleep if they wake after a short sleep cycle. 
  • Warm and responsive parenting helps babies feel safe and calm. This helps to form positive memories through their senses and daily experiences while they sleep. 
  • Babies also learn routine by regular cues from parents in the way they are settled to sleep. Pat, rock and stroke your baby to calm them. Stop calming them when they are quiet but still awake so they learn to fall asleep during this calm state by themselves. 
  • Keep the light dim during sleep times as the sleep hormone melatonin level is dependent on the amount of light. Keep household noises normal as babies become familiar with these sounds and it helps them to feel secure. 

Want to know more?

The Royal Children’s Hospital Melbourne – Brain Builder

You and your partner

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The arrival of children can be a big challenge, impacting relationships as it introduces significant changes into your day-to-day emotional and physical life.  

Each partner has their own expectations and assumptions about the impact a child will have and how it will affect them during the early stages of parenthood.

Keeping up communication

Expectant parents benefit from communicating these feelings and expectations during their pregnancy and start the transformation from partnership to parenting. 

Commitment to your relationship is important. Understanding feelings and sharing them with your partner is crucial for the health of relationships. Being sensitive to each other’s emotions and feelings is key to understanding each other. 

Most fathers have very clear picture of their roles and responsibility as a provider, protector and lover. A new role, involving paying close attention to your partner’s emotions, will allow you to respond with empathy.  

If you understand each other’s emotions it will be much easier to learn new skills about being parents. Together, it is easier to be aware of and solve some of the more complex issues that can arise like anxiety and post-natal depression.

Maternal emotional and physical changes during pregnancy and following child birth impacts the nature of intimacy and relationships. Both parents’ awareness and openness to discuss the topic will reduce the parental stresses in these important early stages. 

Things to remember

  • Keep communication open and work together to develop a new pattern of time together. 
  • Both parents need to take care of themselves while the family’s focus is on caring for their baby. Planning is important for taking time out for yourself or with your partner.  
  • New parents need to have space to welcome their baby into their lives and an opportunity to establish the healthy dynamics in their relationship.  
  • Enjoy the support of grandparents and extended family. 

Want to know more?

Pregnancy, birth and baby – Post natal depression 

Partners to parents  

The Raising Children Network – Grown ups 

Beyond Blue – Pregnancy and new parents 

Relationship services

Staying connected

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While you are adjusting to being parents (particularly for the first time), you may find yourself feeling isolated from the people and activities that have made up your social lives.  

Changes for new parents

Often you have left work and may miss the connection to friends in the workplace. Apart from feeling a little tired in the early weeks, just being with your baby and establishing a routine can mean some of your usual activities are not possible.  

Many new parents keep in contact with family and friends by social media, text and phone. However, if you have a partner who goes back to work, the connections with “real people” may be limited. 

During the first weeks, there may have been visits from friends to celebrate the baby’s arrival. In the weeks and months following, it may be just grandparents and one or two close friends who visit. It is time to think about doing something active to ensure you do not feel isolated or bored.  

Ideas to connect with others

  • Join a new parents group run by your local child health nurse to meet other new parents from your area. 
  • Invite another parent who you would like to get to know to visit your home. 
  • Join a local playgroup or other activities at your local library or Child and Parent Centre.  
  • Find a parent and baby exercise or dance class. 
  • Walk to the park or local shop. The fresh air is good for you and the baby.  
  • You might start or join a pram walking group to substitute for those gym sessions you used to attend. 
  • If you’re craving a movie out, some cinemas also have parent and baby sessions.  
  • Ask grandparents or your partner to mind the baby while you catch up with someone for a coffee.  
  • Invite friends for a ‘bring and share meal’ so that you can catch up without too much preparation.  
  • Join an online forum and chat with other parents. 
  • Check local websites to find other groups like Buggy Buddys.  
  • Take up a new hobby that you can do at home that you have not had time to do when you were working. 
  • Talk to you child health nurse or visit the community centre to find out whats happening around your area.   

Want to know more?

Playgroup WA 

Perth and Districts Multiple Births Association  

Australian Breastfeeding Association – Local breastfeeding groups

 

Sex and intimacy

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Parenting can put a lot of pressure on your relationship, including your sex life. One of the most difficult challenges parents face is learning how to make room for their own relationship once baby has arrived.  

The most important part is to keep communicating with each other. Many couples find that their sexual relationship changes after the birth of their child. Try to find ways to stay connected, intimate and friendly that work for both of you.   

Your relationship with your partner

Couples often talk about feeling closer in the days after the baby has arrived, when they are feeling excited and joyful about their new baby. After a period of time, usually within the first months, this can change. Many couples feel more stress from interrupted sleep, more housework, financial and work pressures.  

Each partner feels both their own stresses and the stresses on the family as a whole. Sometimes, this can lead to increased conflict, relationship problems, and poor mental health.  

Some new parents who are in paid work find themselves working more or getting home from work later in the day. This may be to avoid the housework and potential conflict with their partner but is unlikely to resolve the issues and could make them worse.  

A more positive step is to have a talk with your partner at the earliest signs of stress. Discuss how you can work together to better manage these normal changes. 

Will I ever have sex again?

Although many men talk about having less sex after the birth, there may also be an underlying need for affection and closeness with their partner. Some parents may struggle with this issue after they have a new baby.  

Some normal and expected changes
  • Physical changes to your partner’s body. 
  • Changes in the way that you and your partner now view your sex life.  
  • Your partner may be feeling and expressing that she is “all touched out”, especially if breastfeeding, handling and settling the baby. 
  • You may be unsure about your partner’s breast changes, and their role in breastfeeding. Breast changes may also affect sexual intimacy. 
  • Postnatal Depression (PND) – research has shown that there may be a major decrease in sexual interest when a person has depression and/or is using anti-depressant medication.  

Many couples report these are difficult issues to discuss. It can be useful to seek counselling or other professional help. This will give you a neutral and safe place to talk openly. 

It can be helpful to learn a little more about safe and comfortable sex after both vaginal and caesarean birth and talking about this with your partner. 

Want to know more?

Raising Children Network – Good relationships and how to build them 

Pregnancy, birth and baby – Sex and relationships 

Further information regarding physiotherapy after childbirth, your caesarean birth and recovery and caring for your perineum can be found on Women and Newborn Health Service, King Edward Memorial Hospital

Recommendations for physical activity

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Physical activity of moderate intensity is recommended on most days throughout pregnancy, for at least 30 minutes. An activity is moderate intensity if it increases your breathing and heart rate, but not so much that you can’t talk comfortably.

Moderate intensity activities

  • Brisk walking 
  • Cycling 
  • Swimming 
  • Aqua aerobics 
  • Dancing 
  • Pilates 
  • Low-impact aerobics 

You can continue to perform moderate intensity exercise throughout the last three months of pregnancy. However, no more than three sessions per week of intense exercise is recommended. If you have high blood pressure or other medical conditions, check with your health professional before exercising. 

If you were regularly active before pregnancy, you can usually continue that level of exercise. Check with your doctor and follow the advice given about what is safe when exercising in pregnancy. You may need to change the type, duration and intensity of the activity. 

Starting off slowly

If you were inactive or sedentary before becoming pregnant, it is best to start off slowly, for example, 15 minutes of activity about three times per week. Once you are used to this, gradually increase to 30 minutes per session then increase the frequency. Check with your doctor before you start a new exercise program. 

If you find it hard to exercise for 30 minutes, try breaking up the session into three ten-minute sessions. This can be helpful when you are starting a new program or as your pregnancy progresses. Combine moderate intensity exercises with lower intensity activities which could include: 

  • Pelvic floor muscle exercises – these are important to help control your muscles during labour and avoid problems such as haemorrhoids or a leaky bladder. See pelvic floor exercises. 
  • Take the stairs instead of the lift or elevator.
  • Park further away from your destination and walk the rest of the way. 
  • Walk to see the neighbour or a friend instead of calling. 
  • Walk or ride when you just need to make a short trip to the shop or post box. 
  • If you are feeling short of breath or light-headed you are pushing yourself too hard.  

The aim of staying physically active during pregnancy is to get your blood pumping and muscles working enough to get toned and release endorphins. Exercise shouldn’t cause body aches and pains so if you are experiencing issues, talk to your doctor. 

Want to know more?

Sports Medicine Australia – Exercise during pregnancy 

Better Health Channel – Pregnancy and exercise 

Pregnancy, Birth and Baby – Exercising during pregnancy