Being a new parent can bring a surge of unexpected feelings, not all of them good. Dionne Christian relives her own battle with post-natal depression – now called perinatal distress – and talks about how to get help.

Sipping a tepid cup of tea and staring at the biggest pile of washing I’d ever seen, I looked around the living room and wanted to disembowel those who wrote the poems in the “It’s a Girl!” greeting cards that surrounded me.

Just 19 days into new motherhood and I was falling apart. Rather than wanting to dance with butterflies and fairies, as the cards seemed to suggest I should, I imagined getting in my car and driving as far away as possible. Of course, I’d have to leave in my pyjamas because I hadn’t found time to shower and change for the day – or the one before that either.

Nothing had prepared me for the relentlessness of first-time motherhood and the unceasing feed-change-sleep cycle, which in our house went more like: attempt to breastfeed, only to have child refuse to latch and start to scream, give her a bottle and feel an all-consuming guilt about it; change, only to have child vomit (and scream) and need changing again; try to settle baby only to have her scream and scream and scream until she falls asleep around 25 minutes before, according to the midwives, it’s time to wake her and repeat the whole process.

Even when my newborn daughter was asleep, it was difficult for me to grab any myself because of my escalating anxiety about feeding her and why she cried so long and so often.

In the maternity ward, her crying was remarked on. One of the nurses said they were moving us to another room because she was disrupting the other babies and mothers with – and I quote – “all her noise, I’ve never heard anything like it”.

Expelled from an institution 36 hours into her life; it felt like a great start.

One nurse then helpfully suggested she was an “emotionally disturbed” child. You can imagine, as a new mother, having had three hours sleep in 72, the worry and anxiety that one careless comment created. Was my baby having problems feeding because she was disabled, disturbed or sick? (For the record, my daughter was a ventouse delivery and I suspect she had a pounding headache. Furthermore, if it’s right that what the mother eats alters the taste of breast milk, she may not have liked the spicy chicken curry the new mums were served for dinner the evening she was born.)

The midwives, the GP and the La Leche League woman I asked were unable to give me a straight or definite answer as to what was going on. Then again, one of the things I now realise is that caring for a baby is not an exact science and there is no “one size fits all” answer.

But family and some total strangers in the supermarket had plenty to say: I was told to stop breastfeeding and put her on a bottle because I wasn’t “a good cow”; to persevere with breastfeeding because “breast is best”; to let her cry, pick her up, wake her for feeds four hourly – no, three hourly – let her sleep, don’t forget to exercise and eat lots of healthy food, make time for my husband; maybe even express some milk and have a date night!

The completely contradictory suggestions overwhelmed me. I didn’t feel I could trust my instincts because I obviously didn’t have any. I started having panic attacks. I stopped eating. Nothing I did seemed to be right. What was I doing wrong and why did every other mother seem to have it down pat?

Although it felt as if I no longer had any control over my life, through the fog of tiredness and mounting despair, I realised I had a choice. I could struggle on and risk my sanity, and that of my husband and quite possibly my daughter’s safety, or I could fess up and ask for help.

The second option appealed more, so I referred myself – yes, you can self refer – to a psychiatrist specialising in maternal mental health. She calmly listened at length to my concerns, recommended a course of treatment which included medication and counselling, and, as a mother of three, shared some of her own thoughts with me.

These included taking some of the skills I’d learnt through working for 20-odd years and applying them to home. Not so much “scientific management” but basic stuff like “just as you would prepare for a meeting, prepare for each feed. Have everything you’ll need within reach – and don’t wear Helen Cherry pants that you don’t want baby to vomit on.”

She suggested turning to just one or two friends or support organisations, like Plunket, if I felt I needed advice but she added I should make sure whoever I sought help from shared my and my husband’s values, understood our lifestyle and what was important to us, and had no hidden agendas.

She also advised talking openly and honestly with the new parents in our newly formed coffee group, saying it might help others who could be encountering similar difficulties. To me, it didn’t seem as if anyone else was doing it tough but I decided there could be no harm in “sharing”.

Talk about opening the floodgates. As soon as I admitted how difficult I was finding things, so did around three-quarters of the coffee group, while the remaining members offered to help in whatever way they could.

From that point on, all of us discussed candidly the demands of caring for a newborn and things we wished we’d been told about: latching pain, growth spurts, how nailing jelly to a street was possibly easier than changing or bathing a wriggling newborn.

I am aware not everyone finds it as painless to bear their soul, particularly at coffee group. Other friends have talked about how competitive they found the whole scene, but I sometimes wonder if we mistakenly think mums (and dads) are bragging about their child’s progress when, in fact, they are simply trying to work out whether their bundle of joy is normal.

So this is a survival tale. It might not involve wildlife, extreme weather or hacking an arm off with a penknife. More Woman Vs Domestic than Man Vs Wild, if you like, but what I faced is being played out in thousands of New Zealand homes.

It’s one of the most common but least discussed mental health issues: postnatal depression – although, more recently, those working in the maternal mental health field have adopted the term perinatal distress (PND). They say this more accurately describes the range and spectrum of post-traumatic stress, anxiety and depression that some mothers – and fathers – experience during a pregnancy and after the birth of a baby.

Indeed, I don’t think I was depressed; just acutely anxious and ill-prepared.

Around 80 per cent of new mothers go through the “baby blues” in the days immediately following giving birth. Characterised by tearfulness, anxiety and low mood, these feelings usually peak three to five days after birth and are gone by 10 to 14 days as the body’s oestrogen levels balance out.

While it’s normal to feel anxious and tired after the birth of a baby, for most new mums and dads these feelings pass and they adjust to family life. But with perinatal distress, the anxiety and low mood linger and can intensify. Other emotions such as fear, continual sadness and/or recurrent and intrusive thoughts may appear – sometimes not until several months after baby’s birth.

Exact numbers are difficult to come by, but it’s thought 20 to 30 per cent of expectant and new mothers suffer a bout of depression or anxiety. Latest figures from the Antenatal and Postnatal Depression Association in Australia also indicate anywhere between 10-33 per cent of fathers face similar problems.

Yet there is no targeted awareness campaign, no TV advertisements – celebrity fronted or otherwise – and not a lot of discussion in antenatal classes about PND. Thankfully that may be about to change.

For years, community-based groups, often run by volunteers, have worked largely in isolation to support families with PND. In October, Wellington’s PND Support Group held a national conference bringing together dozens of people and organisations working in the sector.

Conference organiser Rosie Smith says the most moving moments were when keynote speakers, workshop presenters and a few “brave” delegates shared their personal stories of PND.

“There was a coming together in shared experiences and a passionate call for the voices and stories of New Zealand PND to be heard,” she says.

Because there was no national umbrella group for perinatal mental health/illness in New Zealand – and subsequently no focus for awareness and advocacy – in February the Perinatal Mental Health New Zealand Trust (PMHNZ) was born.

Smith is the trust’s inaugural chairperson and says its purpose is to lobby for more research into the condition and for government to put PND on policy agendas. For the organisations and groups working around the country, the PMHNZ Trust will act as a focal point and signpost for resources and information sharing.

With Mother’s Day fast approaching, those like myself who have lived through PND say it’s time to share stories and let other parents know they’re not alone. If there’s a wish list surrounding parenting, greater honesty about the emotions surrounding and experiences of having a newborn is at the top.

Mental Health Foundation CEO Judi Clements agrees parents need to tell it like it is, especially if there’s a chance a PND-related issue is developing.

“PND shouldn’t be Mother’s little secret. We know that we are all more vulnerable to mental illness at times in our lives where change is happening around us – leaving school, changing jobs, getting married, going overseas and, yes, having babies.”

There is widespread belief women are more frank than men about mental health issues but Clements believes PND tends to be something they are reluctant to discuss.

“Society tends to romanticise motherhood and, because of that, women are often reluctant to admit they are struggling with their feelings. It goes against the fantasy created around mothering.”

One of the happiest surprises of Clements’ working life was when EGG Maternity, who make and sell high-end maternity clothes, approached the foundation wanting to raise awareness of PND.

“I’ve worked in the mental health field for more than two decades in the United Kingdom and New Zealand. This was the first-time a private sector business came to us and said, ‘we’ve identified a need and want to do something’ because they were hearing, through their stores, about families living with PND.”

The collaboration led to a brochure which Clements says is the most requested of all those the Mental Health Foundation publish. In 2009, 32,548 copies were distributed.

Ruth and Andrew Holt agree wholeheartedly with the need to talk. Ruth also felt huge anxiety about feeding and caring for her newborn son, Isaac. Our experiences were similar in that she found it nearly impossible to sleep and rest because her mind whirred continually with thoughts about what she should be doing.

She had panic attacks, hot and cold sweats and struggled to bond with her son. None of the advice in the baby books about settling Isaac and getting him into a routine worked – and she found it contradictory from book to book, anyway – while life as she knew it seemed to have stopped completely.

She struggled on for six months until she finally collapsed. With her father visiting from England, Ruth found herself screaming uncontrollably when Isaac wouldn’t lie still during a nappy change.

“Dad rang my husband Andrew at work and told him to come home immediately.”

Andrew knew his wife was finding it tough, particularly as they had no family in Auckland. But like many new fathers, he felt torn between financially supporting his family and taking time off to help his wife.

When the breakdown came, Andrew told his employers and colleagues and found them supportive. But he counts himself as lucky; he’s well aware not every new dad has sympathetic employers.

Visits to doctors and referrals to a psychiatrist and cognitive behavioural therapy followed. Ruth was prescribed medication and joined a support group.

As Ruth points out, it’s a misconception that PND occurs among mothers whose children are difficult: “As babies go, Isaac was actually pretty good; the problem was my high levels of anxiety. The most perfect baby can still have a mum who develops PND.”

The Holts are expecting a second child later this year. The family is already putting in place plans to minimise the risk of a PND recurrence. Reflecting on what happened, Andrew Holt says he objects to the language used around PND.

“Expressions like the ‘baby blues’ are really fluffy and light; even the term ‘post-natal depression’ made it sound like something which would eventually resolve itself when the post-natal part of life is over and things return to normal.

“I think it trivialises what is a serious and potentially dangerous mental health condition with far-reaching consequences and I think we need to come right out and say, ‘it’s serious so don’t muck around. Get help as soon as you think something is wrong’.”

Of course, it raises the question of why, when it can be so difficult – but isn’t always – does anyone have kids? The mums and dads I spoke to have all had more children or are pregnant again.

As well as my amazing 6-year-old – now planning on becoming a princess vet – I’ve got a lively 20-month-old daughter and want to have a third child.

Parenting offers the chance to be a kid again and see the world with renewed interest and vigour through the eyes of your children; it prompts you to reconsider priorities and focus on new aspects of life. Having children and being involved with a greater range of community groups can make you feel more closely connected with people in the neighbourhood.

Like most things in life, PND passes and can leave you feeling stronger and surer in yourself. The key is discussing the issue and getting help quickly.

Find out more

For help or to learn more about PND click here.

For more information about the Perinatal Mental Health New Zealand Trust (PMHNZ) email pmhnztrust@gmail.com

By Dionne Christian

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The study, involving 10,000 mothers and their babies and in journal Archives of Disease in Childhood, says that may be because of the make-up of breast milk.

Or, it says, breastfeeding may lead to better mother-baby interaction.

Breastfeeding is already associated with other health benefits for babies, including lower rates of infection and less obesity in later life.

Researchers looked at the feeding habits of 10,037 mothers and their babies involved in a large study known as the Millennium Cohort Study.

Behaviour problems

The mothers were asked to assess problems in their children by the age of five, including anxiousness and clinginess, restlessness, and lying or stealing.

Only 6% of children who were breastfed showed signs of behaviour problems, compared with 16% of children who were formula-fed.

Mothers who breastfeed tend to be older, better educated, and from a higher socio-economic background, which may contribute towards fewer problems in their children’s behaviour.

But even after the researchers, from the Universities of Oxford, Essex, York and University College London, adjusted their figures to take that into account, they still found there was a 30% greater risk of behavioural problems among formula-fed children.

“Our results provide even more evidence for the benefits of breastfeeding,” said Maria Quigley of Oxford University, who led the research.

She said breast milk contained large quantities of a particular type of fatty acid, as well as growth factors and hormones, which were important for the development of the brain and nervous system.

But mothers who breastfeed also tend to interact with their children more, which could mean the babies learn more about acceptable ways of behaving.

Breastfed children also get ill less often, which may affect their behaviour.

Close interaction

“We just don’t know whether it is because of the constituents in breast milk, or the close interaction with the mum, or whether it is a knock-on effect of reduced illness in breastfed babies,” said Ms Quigley.

“But it does begin to look like we can add fewer behavioural problems as another potential benefit of breastfeeding.”

The Royal College of Midwives welcomed the findings and said they added to the evidence that breastfeeding was better for babies.

Janet Fyle from the RCM said it was vital women had enough help and support from midwives to help them keep breastfeeding.

But she said it was important not to over-emphasise the study’s results.

“We must not send a negative message to mothers that they have failed, or make then feel guilty because they bottle-fed their babies,” she said.

BBC

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Gluckman said it was the most important finding of his career and meant that, for the “first time ever”, there was a way of working out what a mother should eat.

George, a leading naturopath who specialises in fertility and maternal health, says she has treated hundreds of patients over 20 years on the basis that nutrition both before and during pregnancy can alter the baby’s makeup and affect its health later in life.

She says this was backed up over the years by scientific studies on animals, showing a mother’s diet can permanently alter the functioning of genes in her offspring. Gluckman and his colleagues have now shown this in humans, and George says he should be applauded for that.

But she says science is only proving what she and her colleagues around the world have been acting on for years, and wants mainstream medicine and the scientific community to collaborate with alternative practitioners to start putting the findings to immediate use for mothers and children at risk.

But George, a director of the Mother-Well Holistic Health centre in Auckland, who is on the board of Fertility New Zealand, has been shut out of scientific discussions.

She attended seminars on maternal health at the Liggins Institute at Auckland University, which Gluckman founded, and approached him afterwards to tell him about her work.

“I introduced myself and said we run the pre-conception health centre and have been doing it for many years and thought he would be interested in the practicalities of it, and seeing evidence of pre- conception health, but he just turned and walked away.”

Gluckman says he can’t be expected to engage with everybody who approaches him.

“I’m a busy person, I have a hundred people wanting to talk to me, I don’t know who the lady is, I just have to get on with my life,” he told the Star-Times.

He became angry when it was suggested that naturopaths like George were essentially preaching the same message as he is around maternal nutrition.

“I am not sure naturopaths have much to contribute to this matter,” he said by email. In a follow- up phone call, he said: “It’s not evidence-based science. Belief and knowledge are two different things – naturopathy has belief, but it doesn’t have robust scientific evidence supporting it. I’m not knocking them. The conclusion in this situation may perfectly be one I agree with, but it’s the process of how you reach it that matters.”

George says she would love to have the research funding that scientists receive.

“Our parents are telling us, because we have an ongoing relationship, how healthy their children are, that they reach milestones really well, they’re really bright, content, happy children.

“That’s where we’re at now, we’ve seen it for 20 years and now we want to actually show more scientifically how successful we’ve been.”

She could help Gluckman with his research by making her clients available for further study.

“It would be good to have more clinical research done and that’s where we come in, because we have the couples coming to us already. It’s almost as if, because I’m not in that camp, they won’t even look at it or acknowledge what is happening at the coal face.

“We’ve known all this historically, traditionally and from clinical evidence, and now science is proving what we’ve known.”

GLUCKMAN SAYS he is not in a position to provide a list of food that pregnant women should eat. “The media has chosen to make this a story about what mothers eat,” he says.

“We have no information on that as yet. The story is about the fact that the epigenetic state of the baby at birth determines its risk of developing obesity later in life. It so happens those epigenetic markers are associated with changes in mothers’ nutrition.

“People ask me what advice I would give now, given the information we have. That is no different to the information that has been out there for a while, which is to have a balanced, healthy diet. We can’t go more precise yet, because we don’t have the data. This gives us the first chance to get there.”

But George and her colleagues say valuable time will be lost waiting for more studies on suitable foods, when they already have that knowledge.

“Of course we can tell couples what they should be eating,” says Janette Roberts, a Sydney-based nutritionist and former pharmacist who co-authored The Natural Way to Better Babies.

She read about Gluckman’s discovery, and sent the story to her contacts. “I said, ‘I’ve only been saying this for 30 years’.”

Roberts says the Foresight group in the UK, for example, has been looking at the effects of modern diets, lifestyles and environments on reproductive health since the 1970s and has proven “quite conclusively” that the period before conception has an impact on the health of a child for its entire life, even more than what happens during pregnancy.

She and George talk of the importance of “pre-conception health” – in particular the three months prior to conception when the sperm and eggs are maturing – which means looking at the diet, lifestyle and environment of the father as well as the mother.

“We know that all of the refining and processing [of foods], the non- organic foods that are being stored, things cooked in trans fats, the deli meats – all of those have to go. My mantra is healthy food, grown on healthy soil – so fresh, in-season, organic if possible. It’s not rocket science.”

She also advocates supplements, so that couples have the required amounts of trace elements and vitamins to support healthy reproduction.

“What we do with our programme is get all the toxins out, and get an abundance of all the good things in.”

AT THIS point, a disclaimer: my wife and I went through George’s pre-conception programme prior to starting a course of IVF. My wife was a believer and wanted to get her body in the best possible shape to receive an embryo; I was a sceptic, but went along with it.

We did a “detox”, removing toxins from our systems, stuck to a simple diet of fresh, organic meat and produce, cut out alcohol and coffee, and took supplements such as fish oil capsules, antioxidants and multivitamins.

I was surprised by the results. I lost about 10kg quite quickly, but the most impressive thing was that tests showed the quality of my sperm had increased significantly. My wife attributes being able to carry our daughter, born last October, to full term and her excellent health to the hard work we did pre-conception.

My main misgiving was the cost. We spent hundreds of dollars a month on the supplements, although that was because of our fertility issues, and a basic pre- conception care programme is cheaper.

“We hate having to charge that kind of money,” says George. “The supplements are expensive and unfortunately they’re getting more expensive. Wouldn’t it be great if there was more recognition and a [government] subsidy?

“It’s the ultimate in preventive medicine. If couples are helped to have these essential nutrients, then it will save taxpayers a lot of money in the long run. First we have to be recognised.”

She says that recognition is slowly coming. Doctors used to tell her clients not to take any supplements or multivitamins, but now there is an acceptance of their importance, and the pharmaceutical giant Bayer has produced its own vitamin and mineral supplement, Elevit, which is proven to reduce the risk of neural tube defects like spina bifida.

“That’s an example of the medical profession finally acknowledging the importance of a multi and promoting it as ‘the one’ – when we have understood the use of multivitamin and mineral supplementation for many years,” George says.

She says GPs are referring patients to her, and she has a good working relationship with IVF providers.

Mary Birdsall, medical director of Fertility Associates Auckland, says many alternative health providers dispense “very sound advice” around the importance of good lifestyle to improve fertility and the health of the baby.

Birdsall says there is good evidence that optimising maternal weight pre-conception improves fertility and foetal wellbeing, as does quitting smoking, reducing caffeine and alcohol and taking folic acid and iodine.

The use of herbs is more controversial, Birdsall says. “They are medicines in their own right and sometimes may interact with western medicines in an unpredictable manner, so I wouldn’t recommend the use of both simultaneously.”

Roberts has turned to new technology to get her message to a younger audience. In conjunction with a Christchurch company, she has developed an interactive game that can be played via Facebook and teaches young people the importance of pre-conception health. It’s a “hard call” she says, because so many pregnancies are unplanned.

“High school students have no idea that their drug-taking, their alcohol, their cigarettes . . . will impact their fertility down the track and the health of the baby they might conceive years away.”

She has been working with schools in New South Wales and says natural health practitioners are gaining more recognition.

“We’ve been in the wilderness for a long time, and only now, with infertility rates going through the roof, are our recommendations being looked at more closely and with less scepticism.”

Rebekeh Paddy, a fellow naturopath and director of the Mother- Well clinic in Auckland, says she hopes Gluckman’s research will be a catalyst for getting information about maternal health to more parents and not be held up in further research.

“It’s great that science is proving it all, but it has to somehow be done at grassroots level and that’s really what Loula is doing. We’ve got such epidemics of obesity and gestational diabetes in New Zealand . . . sooner or later you’ve got to use the information you’ve got.”

For George, it’s about letting parents know there is support out there for them.

“So many couples come to me and say ‘Why weren’t we told about this before?’ It’s about educating people.” Have your say on diet and pregnancy: letters@star-times.co.nz

- Sunday Star Times

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The Government today revealed the 2011 Budget would include $54.5 million in extra money for services to help mothers and their babies.

More than $21 million of that would go toward WellChild services – which provides free health checks and support during the first five years of a baby’s life.

The additional funding would allow WellChild staff to pay 54,000 extra visits to around 18,000 mothers in the first two months of their baby’s life.

New mothers would receive an average of three extra Plunket visits.

Plunket chief executive Jenny Prince said the funding boost would make a lasting difference to New Zealand.

Not getting the right amount of support and attention in childhood led to problems later in life, she said.

“We need to concentrate effort on ensuring that families have the support they need to raise New Zealand’s future generations. Focusing on giving our children the best start in life is vital in helping us create a better society.

“This funding is targeted in the right places and will see a better return on government spending.”

Plunket had been campaigning for extra investment in under-fives for many years, Ms Prince said.

Health Minister Tony Ryall said the additional funding would ensure new mothers get the support they need.

“These three additional WellChild visits will ensure a smoother handover from midwives to WellChild providers.

“We all want the best possible services to protect the safety of mothers and babies.”

The other $33.2 million of the extra investment in the Budget 2011 would go towards a variety of maternity services, Mr Ryall said.

More than $18 million would go toward bringing maternity professionals together for clinical reviews of all births and increasing the number of midwives on hand in hospitals, he said.

A further $6 million is earmarked for parent information services and $6.8 million for health and social services for vulnerable mothers.

One-off funding of $2 million would ensure all DHB maternity data is collected nationally.

- NZHERALD STAFF

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A responsive mum will know when to soothe her baby
Being lavished with affection by your mum as a young child makes you better able to cope with the stresses and strains of adult life, say researchers.

Hugs, kisses and expressive declarations of love appear to rub off and foster emotional resilience.

The results are from nearly 500 people, from the US state of Rhode Island, who were studied as children and adults.

A secure mother-child bond may be key, the Journal of Epidemiology and Community Health reports.

But experts say it is important to know when to stop. Over-mothering can be intrusive and embarrassing, especially as children grow older.

High levels of motherly affection are likely to facilitate secure attachments and bonding, say the study authors, led by Dr Joanna Maselko.

This not only lowers distress but may also help a child to develop effective life, social, and coping skills, which will stand them in good stead as adults.

In the study, a psychologist rated the quality of interactions between the mothers and their eight-month-old children during a routine developmental check-up.

The psychologist judged how well the mother responded to her child’s emotions and needs, and gave her an “affection score” based on the warmth of the interaction.

Thirty years later, the researchers approached the children, who were now adults, and asked them to take part in a survey about their well-being and emotions.

The group was also asked whether they thought their mothers had been affectionate towards them, with responses ranging from “strongly agree” to “strongly disagree”.

The results revealed that children whose mothers gave them lots of affection handled all types of distress better.

In particular, the children of warm mothers were far better at dealing with anxiety than those of emotionally cold mothers.

The researchers said: “It is striking that a brief observation of level of maternal warmth in infancy is associated with distress in adult offspring 30 years later.”

They said the findings added to the growing evidence that early childhood helped set the stage for later life experiences, but said the influence of other factors, such as personality, upbringing and schooling, could not be ruled out.

Dr Terri Apter, a psychologist, writer and senior tutor at Newnham College, Cambridge, has studied the effects of mother-child relationships.

“What you really want is responsiveness as well as affection – a mother who is in sync with her baby,” she said.

“Babies are not born knowing how to regulate their emotions. They learn by being distressed and being soothed.

“And a responsive mum will pick up on cues that a child has had enough.”

A responsive mum will know not only when to give cuddles but also when to stop.

“If she is being responsive she will say: ‘You are a big 12-year-old and I guess it is embarrassing if I kiss and squeeze you like I did when you were a baby’. And she won’t make you feel bad about it,” added Dr Apter
BBC

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Aching Legs

It’s common to experience aching legs during pregnancy and it can be very uncomfortable and unpleasant. In most cases it’s caused by sluggish circulation through the veins, which makes your legs ache. The hormones produced when you’re pregnant relax the smooth muscle fibres in the wall of your blood vessels. Because of this relaxation, your circulation isn’t as good as it normally is.

As well as making your legs ache, it’s also the reason why your ankles are more likely to swell, you’re more likely to suffer from varicose veins and haemorrhoids (piles). As pregnancy progresses, aching legs are also made worse by the weight of the uterus constricting circulation even more. The problem is particularly bad if you’ve been immobile, for example sitting or standing for a while.

Aching legs can be eased by:

• Wearing support tights. They don’t look great, but they do wonders for your legs (and help varicose veins too). Ensure you get full support by putting them on properly – roll them upwards from your ankle.
• Moving your legs. If you’re standing up or sitting down for long periods, get the circulation flowing by exercising your calf muscles. Circle your ankles, flex them up and down or rise up and down on your tiptoes.
• Resting your legs when you need to. Try and elevate your legs, so they’re higher than your heart, by propping them up on pillows.
• Not crossing your legs when you’re sitting down, as crossing can reduce the circulation.

If the problem persists or gets worse, then it’s advisable to see a doctor or midwife. This is especially so if you start to experience swelling in one leg, pain on walking or moving the leg, tenderness and redness on one calf, breathlessness, chest pain, a terrible headache or high backache, as it could be caused by a blood clot or embolism (where a clot travels through your body). The risk of both these conditions is small, but the risk does increase slightly when you’re pregnant.

Varicose Veins

In the same way that the hormones produced when you’re pregnant relax the smooth muscle fibres in the wall of your blood vessels and cause aching legs, they can also cause varicose veins.

Another reason why varicose veins can develop is due to the pressure the growing uterus puts on the pelvic veins and the inferior vena cava – a vein on the right hand side of the body. This increases the blood pressure in the veins of the legs, which can cause varicose veins. The problem is exacerbated as the pregnancy progresses and the baby gets bigger. Other factors, such as a family history of varicose veins and being overweight, can also increase the risk. Estimates suggest that about 40% of pregnant women develop varicose veins.

By being aware of the risk of varicose veins it’s possible to reduce the chance of getting them or minimise the effects if you are affected. Some practical tips for aiding varicose veins include:

• Putting your feet and legs up whenever possible. Rest them up high on cushions or pillows, or lie on your left hand side with your feet up on pillows.
• Wearing support tights
• Not crossing your legs when you’re sitting down.
• Sleeping on your left side. If you’re worried about turning over in the night, you can wedge a pillow behind your back to keep you in place.
• Not standing up for long periods of time.

If you do have varicose veins, it doesn’t necessarily mean you’ll get stuck with them forever. Many people find that after giving birth, the problem gradually subsides in three to four months. However, if your veins are uncomfortable and problematic, it’s possible to have them surgically removed.

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During pregnancy you are likely to suffer from a number of ailments which can make it even tough for you to deal with pregnancy. But the two most important ones are aching legs and varicose veins. These can make your pregnancy a bit difficult. Due to the hormonal changes which may occur during pregnancy such a problem may occur when the circulation is not as smooth as in normal times.

Apart from the aching legs you are also likely to suffer from swelling of the ankles leading to varicose veins and haemorrhoids. Once the pregnancy time increases the aching legs problem will become even more acute because of the weight of the uterus and ultimately leading to more constriction of the circulation. The situation becomes graver when you have not done proper movements like exercise or walking, since sitting or standing for long hours can aggravate the situation.

If the problem persists for long it is quite advisable that you consult your doctor especially when you find it difficult to walk or there is swelling or pain in one of the legs.

Factors Responsible

Sometimes the pregnant lady may even suffer from tenderness and redness on one of the calf, breathlessness, chest pain, headache or backache. The basic reason for such situation is the blood clot or embolism.
Factors such as being overweight during pregnancy or because of family history of varicose veins can also increase the risk manifold. It is believed that as many as 40% of the women develop varicose veins. But the good news is that discomfort in the legs tends to disappear once the baby is delivered.

Preventive Actions

Pregnant women need to be extra careful and that’s why it is important that they should follow certain exercises so as to prevent the development of aching legs or varicose veins. They need to maintain a routine regime of exercises and stretching, yoga is said to be one of the best remedies in this regard. It is also an effective strategy to stay in good physical condition and a great form of relaxation. Doing yoga daily in the evening or early morning can greatly reduce your problem.

Apart from this, you should also drink plenty of fluids at regular intervals. You should also try not to stand for long hours. Give your feet enough of relaxation. Put them on the chair whenever you get a chance, you should also lie down and put your feet up. Try not to cross legs. It is good if you sleep on your left hand side at night time. But the best thing is that the problem will soon be over by over six months.

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But research shows the number of men battling the baby blues could equal that of women as they deal with the life-altering event.

Scavo used cannabis to deal with his depression but, in New Zealand, doctors are prescribing increasing numbers of anti-depressants.

Postnatal depression affects about 20 to 30 per cent of new mothers as they deal with hormonal changes, tiredness, changes in lifestyle and a lack of support, according to the Post Natal Distress Support Network Trust.

The latest figures from the Antenatal and Postnatal Depression Association in Australia show that, for men, the figure could be between 10 and 33 per cent.

Plunket clinical adviser Alison Hussey said men often experienced the symptoms as a result of supporting a partner with depression. The changing father’s role means that men are much more involved in their babies’ lives – but that can also spiral into a sense of isolation.

“They are juggling their wife’s emotions and needs, finances and adjusting to a new baby,” said Hussey.

She said new dads needed support as many were struggling with their new responsibilities and watching their partner go through the symptoms of depression.

Those symptoms include prolonged lowness, sadness or anger, tiredness and loss of enjoyment of life.

The Mental Health Foundation said those affected often isolated themselves and some had thoughts of self-harm or even harming their baby.

The number of men experiencing PND was previously thought to be about 10 per cent.

However, the change in figures could be because of an increase in awareness, said foundation spokesman Martin Street.

“There’s more willingness to admit it,” he said. Street credited campaigns such as Out of the Blue with spreading awareness of mental health.

Plunket runs fathers’ groups in some areas. For more visitwww.plunket.org.nz

Year long struggle

As a new father, Brendon Smith sank into depression while trying to cope with the needs of his partner and two babies.

He noticed the changes 10 years ago when his children were aged 6 months and 18 months, while watching their mother go through similar symptoms.

“Even though I’d heard the term postnatal depression, I didn’t really understand it,” he says. “I didn’t like going to work and I didn’t want to see my mates.”

The symptoms continued for about a year after Smith, who was 37, left his role in IT sales to become a stay-at-home dad. Smith has become a support worker for Father and Child, a trust set up by fathers for fathers.

By Abby Gillies | Email Abby

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Obese young children are vulnerable to bone fractures and more likely to develop osteoporosis in old age, according to new research seen exclusively by The Independent on Sunday.

Overweight children develop bigger skeletons in order to carry their extra weight. A study of 499 healthy six-year-old children – to be presented at the British Society for Rheumatology conference this week – found their bigger bones have 5 to 6 per cent lower bone density, because they lack enough minerals to make them strong. Higher rates of fractures in fat children had previously been linked to clumsiness and poor co-ordination.

The Medical Research Council (MRC) study suggests childhood obesity will increase the risk of osteoporosis, and debilitating hip and back fractures in old age, as 90 per cent of bone mass is acquired in childhood, directly affecting how strong bones are in later life.

The children are part of a much larger cohort being studied by MRC scientists at the Lifecourse Epidemiology Unit in Southampton, in an attempt to understand how lifestyle, diet and other environmental factors in pregnancy and childhood influence diseases of ageing, such as type 2 diabetes and heart disease.

Studies have already identified links between childhood obesity and asthma, and fractures and fizzy drinks.

Dr Zoe Cole, rheumatologist and researcher, said the findings made tackling childhood obesity even more urgent as the costs of osteoporosis are unaffordable. One in three British children are either overweight or obese.

Dr David Haslam, chairman of the National Obesity Forum, said: “We need the Government to stop their wishy-washy initiatives and to show some political will to prevent obesity in children and to improve management for those already overweight. Being overweight in childhood isn’t a death sentence, but children need help to lead healthier lives.”

Bone is living tissue that changes constantly, with bits of old bone being replaced by new. During childhood and adolescence, much more bone is deposited than withdrawn, so the skeleton grows in size, strength and density, a process that reaches its peak at the age of 30-35.

Fractures are most common in children and the elderly. Breaking a bone ultimately depends upon two factors: the strength of the bone and the forces applied to it.

Losing a lot of bone mass in later life can lead to osteoporosis which causes fractures in half of all women and one in five men over 50 in Britain.

Fractures in old age cost the UK £5.1bn (NZ$10.7bn) every year, according to the International Osteoporosis Foundation – a figure expected to rise as people live longer.

Hip fractures among the elderly are strongly associated with admissions to hospital and care homes, and even with early death.

Obesity costs the UK’s National Health Service and economy £20bn, according to the government research body Foresight.

Last week the national eating disorders charity Beat took the unexpected step of extending its services to people with obesity, reflecting a growing demand for psychological support from Britain’s increasingly obese population.

Dr Cole said: “Obesity in young children has major implications for many aspects of adult health. People are living longer, so if overweight children are starting off with poor bones, osteoporosis rates will rise regardless of current prevention strategies.

“If some children could revert to normal weight and near-normal bone density, then it would make an enormous difference to the bone health of the population as a whole.”

- INDEPENDENT

By Nina Lakhani

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The study of 300 children has shown for the first time that what a woman eats and drinks during her pregnancy can alter her child’s DNA.

That change can determine whether her child will grow up to be obese, and can even increase the risk of a child getting diabetes or heart disease later in life.

Professor Sir Peter Gluckman, of the Liggins Institute at the University of Auckland who aided the study, said: “For the first time ever, because of what we’ve done, we now have a way of working out what mother should eat.

“It confirms our suspicions that maternal nutrition does indeed influence the offspring’s risk of later obesity and disease.

“It’s a major breakthrough … It’s the biggest, most important finding I’ve made, as the result of 15 years’ work,” he said.

The study found there was an element in a woman’s diet, particularly during the first third of a pregnancy, that was of crucial importance.

But it was too soon to say what that was.

“If you are asking me to give you a specific nutritional recipe, what mothers should eat, I can’t do that yet,” Sir Peter said.

“I’d dearly love to, and I have my biases but I need to prove it.”

The international study was headed by the University of Southampton. Teams from New Zealand and Singapore also took part.

It revealed that change in DNA – called epigenetic change – could result in a child storing more fat, increasing the risk of obesity, diabetes or heart disease as an adult.

Of 300 children in the study, 25 per cent showed signs of a change in their DNA make-up caused by their mother’s diet during pregnancy.

Mothers who had a lower carbohydrate intake had children who had a change in their DNA and therefore had an increased risk of being obese.

There was also a 5kg difference in body fat between the children considered obese and the others.

Sir Peter said that was “a hell of a lot of difference”.

“At nine years of age – that’s an enormous percentage of body weight. And if you then see that going into adulthood, you can imagine how much difference in fat that would be.”

An important finding was that neither a mother’s weight nor the baby’s birth-weight made a difference.

A slim mother could give birth to a slim child whose DNA make-up had changed because of the food she ate. The effects would manifest themselves only years later.

But Sir Peter said a low carbohydrate intake alone had not been proved to be the reason for the DNA change.

“It could be there is something else that we didn’t measure,” he said. “But we haven’t proven which food it is.

“We do know for certain that the lower carbohydrate intake was the key factor.”

Sir Peter said researchers would next be looking at the food women ate – particularly the women whose children showed signs of a DNA change.

It was vital for moves to be made to help mothers, particularly new mothers, to look after themselves.

“The study demonstrates the importance of developmental factors before birth in the pathway to childhood obesity – and we already know that childhood obesity is an important predictor of later diabetes and heart disease,” he said.

“It does imply that attention to mothers’ health and nutritional status early in pregnancy is very important, to get the best for your baby.

“We have to start focusing more on the help of mothers … otherwise we will never tackle this epidemic completely.”

In 2009, an OECD report found 26.5 per cent of New Zealanders were obese. Obesity costs the health system about $500 million each year.

- additional reporting, NZPA

By Vaimoana Tapaleao | Email Vaimoana

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