considering mum and baby unit - please help

[narmada]

hi everyone, am hoping for some advice.

i have a new son aged 7 weeks, and a daughter aged 2.5. my son has reflux which means he has been unsettled and cried a lot since birth. he needs to be held for all daytime naps and/ or paced around the house to prevent screaming. he is on meds and we are awaiting paed appointment.

i have been feeling totally unable to cope and just want to run away. currently my partner is doing every night shift with the baby, my 70 year old (but fit and active) mum sleeps in with my DD and is basically caring for her. i have been staying at a local hotel on the advice of local mental health team, who are heavily involved with us. they presented this as an alternative to going into acute care because i felt totally unable to stay at home and was saying i needed to get away and couldn't cope at home, the idea being to give me some space for a few days and chance to rest.

i am on citalopram but having horible anxiety and panic symptoms,which i know are normal on this med,am on zopiclone at night to help me sleep but averaging about 5 hours before waking up totally unable to get back to sleep in a state of sheer panic.

by going to the hotel i feel i am becoming less and less involved with my kids each day - i can't wait to escape in the evening, but in the morning i semi-dread coming home and am feeling less able to cope as the days go by.

last week i was pleading for inpatient treatment of some kind but don't want to go into local psych ward as nightmarish mixed sex place and my kids won't be allowed to visit and i fear i would never come out. i would just spiral lower and lower and how would it help me feel i copuld cope with the kids? in any case they wouldn't admit me as say i am basically not ill enough as not suicidal or psychotic. there are no local nhs mum and baby units - the local one has closed. and again they say they will not refer out of area because am not ill enough.

i keep thinking it is for the best to go to a private mum and baby unit and pay. it would wipe out all our savings, meant for a house, but i feel the alternative is our family falling completely apart. my mum and partner cannot look after the two kids forever on their own and i am worried they will both collapse from sheer exhaustion and then where would we be? i am also puttying myself under real pressure to get better quickly because they are dealing with the burden of everything at home.

does anyone have similar experience or any thoughts? please?

sorry if this is a bit rambly and long but unsurprisingly finding it hard to concentrate at the mo.

Oh yes, Leonie, I really sympathise with the 'I wish they would sleep somewhere, anywhere, other than on me' thing. We bought everything on the market for DD, nothing, absolutely nothing made her sleep more than about 7 hours in 24, and that was in 45 minute bursts. DS at least shows a bit more promise. And he is just dropping off in his swing now, which is nothing short of a miracle in my book.

So glad the swing seems to be helping, even if you get half an hour of respite it is worth it. Made me smile as DH went out and bought a rocking chair in our hour of desperation and we spent months rocking away where DS2 would at least be quiet, I found it soothing too! Wish we had thought of a swing though...you know what though, am sure it doesn't seem like it now but this patch really will be over in the not too distant future and you will be congratulating yourself for surving it.

I have been feeling brighter day by day, emlim, thanks. Sleep is still an issue as I am still waking early and often unable to get back to sleep, but my mood seems to be on the up.

The swing is a total lifesaver. I would say it has done as much as the meds for my mood - sounds ridiculous but it's true. DS will sleep in it for (ssshhh, whisper it now) longer than 30 minutes. I can do things like lift DD out of cotbed again, and even play with her occasionally. AND because i am not schlepping round the house with him in a sling, my poor back and pelvis is getting a break - I had SPD in pregnancy so the constant pacing/ carrying was really not helping at all.

We have his paed appt on Thurssday and I hope they're going to put DS on some easy-to-administer form of omeprazole - we had Losec MUPS (don't know if you had that) and it was impossible to get into him. But it is supposed to be the gold standard reflux treatment so let's hope the consultant agrees.

Was wondering how it went with the Paed today? Hope it was helpful and you continue to feel more positive about everything.

Hi emlim, thanks for checking back! The paed was a bit uninspiring to be honest... we made the mistake (!) of saying DS seemed marginally better on his current meds and so she then said brightly 'let's keep him on them, then'. Not what I was hoping for as he is still a long way from being a settled happy baby. While we were there, she also told us that she wanted to do some extra blood tests and a chromosome analysis 'to check nothing was being missed' as DS has poor muscle tone in arms and neck especially, apparently. We asked her to elaborate and she said she wanted to rule out systemic neuromuscular problems but that she was hopeful the little things she had noticed were just a marker of something benign -e.g., he is just at the lower end of the 'normal' scale. I wish I could say different but the visit did not provide the reassurance and positivity we were hoping for .

I have come off the citalopram and am just on the mirtazapine now - so as expected I have kind of had a bit of a step backward, mood wise. Sleep is still all over the place. But am still managing to get through the days, so that is good. AND I have done some Christmas shopping. Big achievement.

Sorry that your paed appointment didn't go that well today narmada, it must be a bit worrying for you about further tests but I expect that they are just being cautious. It's difficult when you look forward to an appointment and then it doesn't give you what you were hoping for. Will there be a further appointment?

Well done with your Christmas shopping - I haven't done much, though I did make mince pies today which I have never done before. Must be something about being a mum!

Sorry to hear the Paed appointment wasn't as positive as you had hoped and now there is a new potential issue, how long til you get the results?

It is still hard even if the extreme feeling of not coping has lifted somewhat, however you are feeling you still have a really challenging baby to deal with, getting out to do the Xmas shopping though I am impressed!

To be honest we didn't find the Paed opinion that helpful either, the major concern for us was DS's poor weight gain (went from 91st to 9th centile) so we had to persevere with the gaviscon stuff that solidified the milk into a jelly like substance-was an absolute nightmare to get in though. The first breakthrough for us was starting solids. I Don't advocate this as we started very early I know against current thinking-at 14 weeks -we were desperate, basically formula thickend with baby rice and the difference was immediate. Milk stayed down and he screamed less and quickly went back towards the 91st centile. I sometimes feel guilty that we did this so early but justify it to myself that he was a big boy who physically was well developed, born two weeks late, crawled at 5 months, walked at 9 and was very very hungry!

The second breakthrough was getting myself sorted out, on meds, regular help with children to give me a break and so on.

Sorry I am rambling on with my own story which is probably no help to you but I did want to say that DS2 is a delightful 3 year old now and far easier at this age than his brother was. He has some vocal cord issues from the reflux so has a very husky voice but other than that we have all come out the other side relatively well adjusted, so hang on in there it really will pass and get easier.

Hi Emlim,

I think the results can take a while to come through - the chromosome analysis at least. We have pushed it out of our minds for now...

DS is very on-and off. Yesterday was foul, he was really cranky and sleepy and cried loads. Today he is right as rain and hardly a peep out of him. For which I am grateful!

I think a lot of people are disappointed with the approach of paeds, but I guess they are just doing their jobs. Interesting to hear your weaning story - our fella is hungry too, which causes probs as large liquid consumption= more refluxing and more problems! I don't think we'll be waiting till 26 weeks :)

Really nice to hear your story had apositive outcome. I know (hope, let's not think about the chromosome stuff....) that he will be fine in the longrun and so will we both be as parents.

Oh my goodness, sleep has really gone out the window now. Last night I was on the nightshift and I didn't drop off until half five in the morning when I slept really fitfully and had these wierd, wierd dreams and then my son woke me up at seven. Whether it's some sort of withdrawal effect from stoppung the citalopram, or just because the mirtazapine is no longer sedating me I do not know. The vicious circle of no sleep equals anxiety and depression has started again :(. Have been on to my CAMH team to ask their advice as I am away from home at my parents for Christmas, all of shoehorned into a tiny house too small for all of us, which is really not helping too much.

My DD has decided in the last few days to give up her afternoon nap (I know, I know, we are lucky she had it for so long) and has also today developed a stinking cold.

I feel so fed up. I just want to enjoy christmas with my beautiful kids and partner :( . They are all so visibly disappointed as I think they thought I was 'fixed' now.

Hi Narmada, I have nothing useful to add but have followed your thread, as a PND sufferer years ago and I remember the nightmare anxiety (and I didn't even have a baby with reflux problems) and insomnia. I know how debiliating the anxiety/insomnia is. I think you are doing so well. Insomnia makes everything seem 10 times worse. I would just like to wish you a happy Christmas and hang on in there, it WILL all get better and just hang onto the fact that this will pass and one day you will look back and be so proud of yourself for getting through this.

strawberry thanks so much for your post, and your support. It means a lot. Had a decentish sleep last night aided by Zopiclone again - not really what I wanted but I think I need it in the short-term again while my main meds are sorted out ...

I know this Christmas will probably be rough for you, but hold onto the fact that your baby will turn into a beautiful little boy and you have many fun Christmases to look forward to with him and your daughter and your DH

Thanks again strawberry. Merry Christmas to you too.

Hi Narmada
How are things going and how was Christmas?

Hi Strawberry, thanks for checking back. Christmas itself was ok actually, we were up at my mums. Things have been really tough since we came back down here - I am having a hard time sleeping, DS has a horrible cough/cold/diarrhea bug causing food refusal.... just generally sh*t. We are still waiting for some tests/ results on DS, so that is stressing both me and DP out although trying not to think about it.

Now on a higher dose of mirtazapine, so hoping that will kick in soon.

I think I was on Mirtazapine at one point and I seem to remember I couldn't stay awake on it, so much so that i had to pack it in and go back to Lustral. Be good if it has that effect on you .
Seriously though all you can do is take one day at a time, and accept any and all support offered.

narmada - hope you're coping, it's so incredibly hard in the beginning. I have no doubt this will all pass and in some months you will look back with amazement at how tough it was and relief that you got through it. I'm so glad you have family around to help you.

I've been through a lot of what you're going through. Don't be so hard on yourself. You're doing the best you can on very little sleep and facing some real challenges.

On the reflux front, I really really recommend trying an anti-reflux formula. I was at my wits end (but seriously) with my son's reflux when I switched to Enfamil A.R. formula. It was the breakthrough moment for us, he suddenly stopped screaming during feeds and took a load more. You can buy the formula from Boots or other pharmacies, but it's one you have to order. You don't need a script for it. You do need variable flow teats and you have to mix it up cold, then warm it up. It contains rice starch which thickens while it's being digested.

Wishing you lots of strength.

Thanks casseopeia, that is really kind of you. Unfortunately we have already tried the thickened formulas to no avail. Makes not a jot of difference! But I know it does for a lot of people/ babies. Thanks fo your support.

Strawberry, yes, one day at a time is definitely the way forward. 30 mg mirtazapine is not in itself enough to knock me out, so I am thinking that I need to adddress the insomnia behaviourally. E.g., address those stubborn thoughts that keep me awake, and my fear of not being able to sleep.

Well, after a shocking few days culminating in another kind of mini-crisis last thursday, I am now back on sertraline in addition to mirtazapine. I am really hesitant to be on an SSRI again, as the commencement effects with the last batch were totally and utterly horrrendous. However, I think I just need to tough it out this time and wait for those effects to settle. And hopefully the sertraline will be a little different to the citalopram - e.g., less ramped-up anxiety. I bloody hope so.

Good luck Narmada, I was on sertraline years ago, hopefully you'll be ok this time.

thanks strawberry. have been on sertraline before in past as well. so far day 4 and not too bad yet. with the citalopram by this stage i was starting to climb the walls i think.