Karen Klusmann RN IBCLC wrote:
<I have a mom that is 12 days post partum. All is going well with
breastfeeding and recuperating from her delivery, except for the fact she
can't sleep. Says that she is just anxious about everything. She knows
that she needs to relax and sleep, but she watches the clock and worries
that she has to get to sleep fast since the baby will wake for another
feeding>
Hi Karen
Alarm bells are going off for me here. I think it would be worth doing some
screening for postpartum depression for this mom. The difficulty sleeping
due to anxiety and having a "racing mind" are one of the major symptoms.
Below is the Edinburgh scale and some questions you could ask that will help
both her and you determine if it could be PPD. If so please have her call
her doctor. I am a Doula and Social Worker and I run a support program for
women with PPD so please feel free to email me privately if you want more
info on how to help this mom if she does have postpartum depression (hope
not, but sounds like it is worth looking into).
___________________________________________________________________________
Corrine Mahar-Sylvestre
Quinte Doula Service
Postpartum Support Program of Quinte
[log in to unmask]
"Perhaps we share stories in much the same spirit that explorers share maps,
hoping to speed each others journey, but knowing the journey we make will be
our own"
Gloria Steinem on motherhood
Preliminary Screening for Postpartum Depression (PPD)
------------------------------------------------------------------------
To physicians and other healthcare practitioners:
Please take a minute to ask your patients a few questions about how they are
feeling emotionally.
1. Have you had PPD before?
2. Do you have a history of depression?
3. Are you sleeping OK when your baby sleeps?
4. Any changes in your appetite?
5. Are you experiencing anxiety or panic?
6. Are you afraid to be alone with your baby?
7. Do you feel more irritable or angry than usual?
8. Are you worried about the way you feel right now?
9. What worries you the most?
10. Are you afraid you might loose control?
11. Are you afraid of the thoughts you are having?
12. Do you wonder if you are a bad mother?
13. Do you ever have thoughts about hurting yourself?
14. Do you find it hard to make decisions?
15. Does your partner know how you are feeling?
16. How do you feel about taking medication if it helps you feel better?
17. Are there other stressfull events that are impacting the way you feel?
18. Is there anything you are afraid to tell me, but think I should know?
(c) 1998 The Postpartum Stress Centre
Postpartum Mood Scale (Edinburgh Depression Scale)
------------------------------------------------------------------------
Many women become sad, anxious or depressed after having a baby. For some
women these feelings last only a few days, while for others they can
continue for weeks to months. As you have recently had a baby, we would like
to know
how you are feeling. Please take the time to answer a few questions even if
you are not feeling particularly sad. Underline the answer which comes
closest to how you have felt in the PAST 14 DAYS, not just how you feel
today.
Here is an example already completed:
I have felt happy:
Yes, all of the time.
Yes, most of the time.
No, not very often.
No, not at all.
This would mean: "I have felt happy most of the time" during the past 2
weeks. Please complete the other questions in the same way.
In the past two weeks:
1) I have been able to laugh and see the funny side of things:
a. As much as I always could
b. Not quite so much now
c. Definitely not so much now
d. Not at all
2) I have looked forward with enjoyment to things:
a. As much as I ever did
b. Rather less that I used to
c. Definitely less than I used to
d. Hardly at all
3) I have blamed myself unnecessarily when things went wrong:
a. Yes, most of the time
b. Yes, some of the time
c. No, not very often
d. No, not ever
4) I have been anxious and worried for no good reason:
a. No, not at all
b. Hardly ever
c. Yes, sometimes
d. Yes, very often
5) I have felt scared or panicky for no good reason:
a. Yes, quite a lot
b. Yes, sometimes
c. No, not much
d. No, not at all
6) Things have been getting on top of me:
a. Yes, most of the time I haven't been able to cope at all
b. Yes, sometimes I haven't been coping as well as usual
c. No, most of the time, I have coped quite well
d. No, I have been coping as well as ever
7) I have been so unhappy that I have been having difficulty sleeping:
a. Yes, most of the time
b. Yes, sometimes
c. Not very often
d. No, not at all
8) I have felt sad or miserable:
a. Yes, most of the time
b. Yes, quite often
c. Not very often
d. No, not at all
9) I have been so unhappy that I have been crying:
a. Yes, most of the time
b. Yes, quite often
c. Only occasionally
d. No, never
10) The thought of harming myself has occurred to me:
a. Yes, quite often
b. Sometimes
c. Hardly ever
d. Never
Key: 1a = 0 2a = 0 3a = 3 4a = 0
1b = 1 2b = 1 3b = 2 4b = 1
1c= 2 2c = 2 3c = 1 4c = 2
1d= 3 2d = 3 3d = 0 4d = 3
5a = 3 6a = 3 7a = 3 8a = 3
5b = 2 6b = 2 7b = 2 8b = 2
5c = 1 6c = 1 7c = 1 8c = 1
5d = 0 6d = 0 7d = 0 8d = 0
9a = 3 10a = 3
9b = 2 10b = 2
9c = 1 10c = 1
9d = 0 10d = 0
12.5 and above: probably depressed. Be concerned and refer >9
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