Postnatal mental health issues (dad guilt)

[Davedxy]

Hello Mumsnet,

I'm looking for some advice from other mums as I am at a loss as to how to further help my partner.

I'm father to the most beautiful daughter who is 11 months old. She is very intelligent and seemingly ahead of her peers in many areas, and I give all the credit to my partner who invests an incredible amount of time and effort into her. I'm very proud of them both.

But my daughter's sleep is like nothing I ever imagined was possible. My partner is of the opinion that it must be reflux because she cannot make any other sense of why she would be so disturbed in her sleep. Sometimes she will shout/cry four or five times an hour and will only be pacified by being breastfed. We have tried all manner of alternatives to get her back to sleep but nothing works, and in fact just makes it worse. On the nights my partner has just tried to ignore the crying and screaming, even after falling back asleep after an hour and a half, she will be disturbed again 20 minutes later.

Last night was one of those nights where my partner let her cry, or should I say tried to appease her in every way but breastfeeding. Our daughter woke again 30 minutes after falling asleep and my partner breastfed her, as by that point she had been awake for two hours.

When I remarked that it had been a rough night (we sleep in separate rooms as my partner and daughter currently co-sleep to theoretically minimise the disruption of having to get out of bed every time), my partner said that although she didn't really mean it, the thought "I'd rather kill myself than be in this situation" had crossed her mind during the night.

I was already concerned about my partner's wellbeing but this has obviously been very upsetting to hear. I know she's completely withdrawn socially as of late, and only goes out for the sake of our daughter. She doesn't want to pursue any personal interests or do anything for herself, despite me insisting I'll have our daughter for a few hours so she can do whatever she wants. She will just spend any 'free time' she has getting on top of meal prepping or cleaning for when I'm back at work. I'm also aware that she is incredibly more anxious and panicked about small things than she was prior to our daughter.

It's clear to me at least that she is suffering with some kind of postnatal mental health struggles, but I don't know how to help. She's been to the GP and they gave her a referral to local mental health services, but the waiting list is forever, and to be honest the biggest contributing factor is the chronic sleep deprivation. When I've tried to settle our daughter, she cries and screams and my partner then gets very upset herself. My partner also finds that she can't sleep during the day anymore as she ends up waking up every five minutes herself if she tries to nap.

I'm sorry this is so long and there's a lot I've probably missed, but hopefully it's enough for readers to get the jist. Any advice on how to mitigate the dad guilt with some practical advice is appreciated.

Thank you, Dave.

Hi

I am going to chat to my daughter about this. She breastfed her first child, a girl, until past 1 year old. I was about demented with the situation (I breastfed non of my kids). The baby did have reflux and in time she was on treatment for it. I don't know if medication has been considered.
Or would it be an option for you to offer your daughter a bottle of expressed milk some night.
I will come back to this.

I've had similar experiences to you, with a phase where dd just kept waking up. It is exhausting. I spoke to health visitor when she was 11 months, and she suggested not changing things, as dd was about to start nursery and that would change things anyway. Dd is now 15 months and sleeps so much better, I still bf her back to sleep when needed, as fastest way to get her to sleep. It also feels so natural and relaxes me to so I get back to sleep. DP now gives her a bottle of cows milk at her first wake up , if there is one, but if it gets after 3 or 4am I feed her as she'll be less tired and so harder to get her back to sleep .

I did see this article when dd sleep was worst a 8m, and it gave me hope. And she has definitely got better the last two months.

sarahockwell-smith.com/2017/07/24/the-rollercoaster-of-real-baby-sleep/

I’d suggest expressing milk so that you can be more involved - a little after each feed will make enough for a bedtime feed. You do the feed. Do this for a couple of weeks and give your partner time to have a real break. You are a career too. As baby will be on solids now,
the need for bf milk is decreasing, you can ditch the nighttime feed offer water and you need to take baby at weekends to give your partner a break. If you have relatives nearby could you take baby there or send partner off to a hotel or some where to have a spa treatment and early night? You could build up enough for a late night bottle with bf and have enough bf for breakfast so she can have a total break easily from 8pm - 10am Doesn’t sound much but if you and baby can clear off at 7pm or partner can go to a local hotel it’s a start. Although you work, you need to physically be involved more

Thank you for the replies.

Regarding treatment for reflux, my daughter has been on omeprazole but it had no effect. Gavisgon was also trialled but it caused constipation which made things even worse, as then day time mood/sleep were also affected. We have been back to the GP and insisted on something further (investigation if treatment is ineffective) from the paediatric department but have been met with a brick wall.

Expressed milk, we have tried this on and off throughout and it's always caused the same reaction - screaming as soon as she realises it's something plastic in her mouth rather than flesh. She won't, in her confused sleepy state, even let herself get to a point where she realises it'll deliver milk. It probably doesn't help that she has never really taken to a bottle; the last time my partner did go out and do something for herself and left me with our daughter for around six hours, she went on hunger strike rather than take from the bottle. She would now drink from a cup but my daughter is too 'asleep' still to sit up and try to drink.

This is so hard to read as I can understand the emotional challenge your partner is going through.

I know it's hard to get a baby to take a bottle especially one who's been having breast milk for so long but it can be done. Your partner can either express or you can try comfort milk for your baby. Try giving the bottle to her on the day when she is hungry, also do not give in to the breast even when she is unsettled.

For the nights, she needs to try give up the milk as she's 11 months now and should be ready to go through the night without milk. I would try to give her a well balanced meal in the evening as late as possible and then maybe a dream feed of comfort milk around 11-12pm (whatever works for your little one) this should help her sleep through the night.

How are her naps in the day? She should be having around 2 naps a day, maybe try dropping to one if is possible.

In regards to your wife's mental health, she needs to make a doctors appointment, maybe go with her so you can talk about her symptoms and maybe they can prescribe her something to help with her low moods.

Please try to take over the night feeds when you don't have work and give your wife some rest. I know it's hard as baby doesn't settle but it will take a couple of weeks of hard work to get her on the bottle and she may settle after this.

Thank you aluvss.

We have tried expressed milk throughout her life as she was on occasions, left with a relative (who is no longer with us) prior to six months old. Even with my partner not around and thus no option of being breastfed, my daughter would not take the bottle and would eventually hold her mouth closed and try to turn away if there was persistence. As I say, on an occasion where my partner was out of the house for six hours and my daughter is was very evidently hungry and upset, she still refused. She drinks water out of a cup all day long now, but during the night is a very different story.

She is fed usually an hour before bed, i.e. immediately prior to her bedtime routine. Having experimented with food types/timings, we've noticed it's not made any difference to the night. This is why it's suspected that the issue is reflux because there's no reason to suspect she is seeking breast milk to satisfy hunger, and rather to ease the burning sensation.

Her naps in the day are fine. She sleeps two and a half to three hours, split over two naps, but these are in the pram where she is inclined. We don't get the same issue in the day and again, is why it's believed the night time issue is discomfort. From what my partner tells me, she is definitely not ready to drop to one nap yet as she has had episodes of overtiredness if my partner has been out with her and not managed to get her to sleep after her usual amount of time awake.

My partner has been to the GP already and explained the situation. She doesn't wish to take antidepressants as she says she's not of general low mood, only disheartened about our circumstances.

I really do offer to go and settle our daughter or to spend the night with her when I have a few days off together, but my partner cannot tolerate her level of distress due to the belief she is uncomfortable and that it is not fair to therefore withhold what provides her with comfort. We did previously try some crying methods as we thought she had become reliant on breastfeeding to get back to sleep, but when it didn't work my partner really beat herself up that she'd left her in such a state to see no improvement. As such she now gets very anxious about her crying for too long.

I would call the Health Visitor and ask for some help with your daughter's sleep issues. Chronic sleep deprivation is the worst.

I also apologise to all as I'm cognizant that it seems I've asked for an impossible answer. I posted yesterday out of desperation as none of my friends/colleagues with children have experienced anything like this and I had no idea where else to seek similar experiences. I just feel terribly guilty that I can't seem to share the burden.

Thank you Alice, I will definitely suggest that. I don't know if the thought has crossed my partner's mind as we worked our way through various methods within a sleep book, to no avail, and so perhaps she hasn't thought that the health visitor would have any new suggestions.

Have you thought about hiring a sleep consultant?

sounds like you need one

also a cleaner?

also nursery? Your wife is absolutely shattered and the sleep disturbances are impacting her enormously

have you tried a dummy?

do you wedge the cot up? By putting a few books under the mattress

give the child a yoghurt pouch prior to bedtime to nuetralise her tummy acid

is your wife eating something that is irritating your child? Like spicy foods etc I think (but not 100pc) foods mum eats can affect baby via breast milk

Also I’m doubting reflux because omeprozol are absolutely brilliant (having took them myself) so I know they do actually solve reflux

To Quitelikeit,

The woman who conducts the swimming class my partner goes to is a sleep consultant, this is who she borrowed the book I previously referred to from. After the methods within failed, the woman advised us to see the GP as she felt there may be something underlying. This is when we've asked for some kind of investigation; the GP did refer to paediatrics for advice but it is them who have stonewalled us.

I will look into a cleaner (although just for the record, I do also help when I'm around if I'm not looking after my daughter).

Admittedly I don't think we've ever looked into nursery and automatically assumed it would be outside of our budget based on comments from other people about the extortionate cost. We did also have childcare in the form of a relative which is another reason probably why, but that's no longer an option so it may be worth seeing what "extortionate" actually equates to in monetary terms and assess.

A dummy is an absolute no-no, always has been even since our daughter was only a couple of months old (we waited till after breastfeeding had been established as recommended, but she never kept it in her mouth).

We tried wedging the mattress, which she ended up wriggling down, and tilting the whole cot. In comparison to how inclined she is in the pram when she naps, it seems no where near enough and we didn't notice a difference with what we felt was reasonably safe.

Definite yes to the yoghurt (because it's her favourite food), but again the issue persists regardless. I don't know if the fact it's not a dairy yoghurt would make it less likely to help but either way.

And my partner is very careful with her diet due to allergies (and generally being mindful of what she eats, our daughter eats). So no spices, caffeine, alcohol, allergens of course, and she has trialled cutting out is it FODMAP foods in case something unusual is the culprit.

My partner has changed her mind a million times as to what she thinks is causing the problem, and I've supported her to make the amendments necessary to eliminate the assumed issue at any one time. I think settling on it being reflux is due to the irregularity of her disturbances, in that she's not just unsettled at the end of a sleep cycle, and she told me the other day that she's noticed our daughter will often cough, swallow and pull a face that you would if you'd had a "sick burp", every so often in the day. In addition, my daughter absolutely hates being lay flat during the day and will cling on for dear life if she realises you're about to put her down on her changing mat, etc. I don't know if it's related but it would feed into the reflux theory.

I always found that books were no substitute for chatting the issue through with an actual human being, even if the suggestions are the same! This type of thing is literally what health visitors are there for.

I would let your child sleep in the pram for a test night to see if it stops the crying. I think your wife is truly exhausted

Also this will pass.

Your wife needs to make a decision re the BF though. And needs to stick to it either way.

Here you can get up when baby cries and she will know you have no boob.

it will be very hard at first. But she will get the message after a few days

you should go to bed for a couple of hours first then be prepared to have a hell of a night

I have been there, first because of silent reflux and then due to teething. Broken nights are a disaster and regardless what DH helped, I felt exhausted and mentally drained.
It was part of my PND, not the sole reason but factored heavily into it.

Like your wife I restricted my diet a lot, we found that food like dairy, citrus, spices, caffein and anything fizzy would make it worse. Interestingly DD had no dairy issues at all when we weaned her.
What helped DD was me drinking nursing/breastfeeding tea. Normally designed to imporve the milk flow, it also helps with reflux.

We tilted the cot, quite severely but it was the only way to get her to sleep. We checked the cot daily to ensure it didn't slip or changed, the usual things you can buy to lift the legs weren't enough, we had 2x 500 page hardback books under each leg.

Like your DD, mine was a bottle refuser. We found out she couldn't stomach any previously frozen milk and I didn't express enough for a full bottle. When we stopped bf we went straight to a free flow Doidy cup, it comes out fast so DD realised it was milk and not water and drunk. It could make a mess but we managed 8 months with it. I wonder often if it was the bottle or the sucking which caused discomfort, she never drunk out of these no-spill bottles either.

If she already was on reflux medication I would stress the GP again, a nearly 1 year old shouldn't wake up screaming each night. Can you go private ?

If it’s reflux you need to be back at the GPs requesting omeprazole or another PPI medication; how long did you try it for, it can take up to 8 weeks to be effective. Gaviscon will Help but invariably needs to be prescribed with lactulose.
Prop the cot significantly. There are ways to stop the child sliding. A towel between the mattress and fitted sheet gives more friction.
I know you said no to a dummy but it’s reflux recommended by a number of the consultants we saw.
Check food stuffs and Calpol etc for being sugar free. The sugar substitute oils of a reflux trigger.
Remember most children grow out of reflux around 12-18 months and weaning helps.
We had two under 1s at once with severe reflux. One vomiting, one silent. I had to make myself the expert in order to pass a gate keeping GP and access services. We now have one reflux free and one still being treated 4 years on.
Good luck.