Mothering a baby who has Down Syndrome

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My name is Gillian Phelan. I was invited by Doulacare Ireland to talk a little bit about my daughter Elliah who was born with Down Syndrome and my experience with all that comes with it, and also what we are doing to help her develop at as normal a rate as possible.

Firstly a little back story... Elliah is my first child, born thanks to IVF (after many failed attempts and surgeries) in October 2018. I had an excellent pregnancy up to 34 weeks when my placenta rather suddenly shut down leading to a real emergency c-section. A movie-worthy dramatic scene. But that’s a story for another time.

NICU baby special care

Baby had to be taken to Special Care because she was small (4lbs), but breathing on her own and otherwise doing pretty well. As soon as I saw her I said to myself that her eyes looked ‘Down Syndromey’... Tests went off and we waited and waited and waited... Every day the consultants were hopeful that the results would be back “tomorrow”, or “ by the end of the week”. There really was a doubt in our minds. Some of our nurses said they didn’t think she had it. Others were less sure. Her eyes were literally the only tell tale - she didn’t have any of the other signs on the checklist. It took 17 days for the diagnosis to come back from Crumlin - 10 minutes up the road from The Coombe where we were. It was confirmed that Elliah has Trisomy 21 - which means that she has a third copy of her 21st chromosome. Nobody knows why it happens, but in 1 out of 800 births it just does.

So we were told what is to be expected of our daughter, and quite honestly, from the get-go it seemed very limited. We were being told not to expect much. That there isn’t much hope that she be independent or have a fulfilling life in the usual sense. Well, I absolutely reject that. Their limitations, not ours. Putting a child in a box labeled ‘limited’ will only encourage them to be just that. This is not acceptable for me. Additional needs or not, each child develops at a different rate, and faces their own individual challenges.

mother and baby who has downs syndrome

Needless to say, once the initial settling in period had passed, we looked into alternative therapies to help ‘wake up’ her senses so to speak. Basically we were interested in anything that would help bridge the gap between herself and other babies of the same age. Our goal will always be that she be as close as possible to doing the things that her peers are doing. Whether that be sitting up unassisted, crawling, walking, talking and all those other key achievements down the line. We are linked up with St Michaels House in Ballymun now and everyone is great. They do a fantastic job, they really do. But relying on that one Physio or Speech therapist visit a month and going one morning a week to the pool just isn’t enough. Physical and mental development go hand in hand, and we have now found a set of daily stimulation exercises that work for us and are giving good results.

We travelled to France to meet with an ex Montessori teacher who has a 5 year old daughter with DS. She has become an alternative consultant on all things DS, and sees families to build a personalised program for their children. Her daughters name is Marie, and she is quite exceptional. Her speech and motor skills are pretty much those of an average child of her age. She is at the same level as all her friends and attending mainstream school without a Special Needs Assistant. Emmanuelle started out with her solid Montessori background and has done extensive research and training to complement that. She saw Elliah over 2 days and gave us a program to follow based on her particular strengths and weaknesses.

We were highly recommended to read Glenn Domans (horribly entitled) book ‘How smart is your baby?’ Domans research stretched over 40 years and he worked with thousands of children and their families - for the most part the babies and children in his studies had brain damage, not DS. Specific exercises and hyper-stimulation techniques are used to override the problem and wake up the affected senses. Now I’m not going to lie, some of this stuff is totally counter intuitive for the mother of a small baby, but his results really do speak for themselves. So after reading the book, and seeing Emmanuelle in France, we had a specially adapted exercise and stimulation plan for our baby.

baby special needs crawling mat

We have built her a crawling ramp to encourage as much movement on her tummy as possible. Children with DS tend to have issues with their muscle tone, so strengthening those all important neck and back muscles is vital.

We also had to ditch the traditional play mat which was not at all adapted to her needs. It has been replaced with a large gym mat - exactly like the ones we used to have in school (the navy blue yokes).

We also have a Dayvia light which is on constantly during her sessions. The very bright light is recommended for sensory stimulation of course, but also for helping with the distinction between day and night. Not to mention luminotherapy in our dark winter months.


Gillian & Elliah 4.jpg

The last ‘big’ thing we invested in after reading the research is an electromagnetic machine called an Earth Pulse. Designed to help athletes and Racehorses recuperate better, it emits a field adapted to the individuals needs so their rest is optimised and thus their performance enhanced. During their testing process they realised that all of the people partaking in the trial who had thyroid issues gradually stopped needing to take their medication. This is a key factor in DS. Our expert in France insists that ALL children with Down Syndrome have an issue with their thyroid. Even if a blood test says it’s functioning, ie producing satisfactory levels of thyroxin, there are no further tests done to check if that thyroxin is doing its job as it should in the cells. It really is one of those things where you believe it or you don’t. We thought that we have nothing to lose and a whole lot to gain. It’s been a few weeks now and Elliah is definitely more alert, more interested in her surroundings, more of a sparkle in her eye. She’s even sitting up in her highchair which is a big milestone and around the same time as an averagely developing baby.

Emmanuelle has been using the machine under Maries bed for a couple of years now and she insists that she started to see a difference in her capacities after a few weeks. Since we seem to have a similar timeline, I’m certainly inclined to agree.

It’s a lot. It’s very time consuming. But seeing Elliah improve every day is all the motivation I need

(I’ll have a shower when she’s 2 🤪) I’m also exclusively pumping which doesn’t help time-wise, but that’s my choice. It’s not a chore though. Elliah is not a burden. We feel as much love, and pride as any other parents. DS comes with the innate capacity to truly be oneself. To find joy in the simplest of things and to love without conditions or judgement. She is funny and sassy and an absolute ray of sunshine. I simply cannot imagine life without her smile.

Hopefully we are putting in place a foundation that will help our daughter be her best self and have more choices in her future. We will at least know that we gave it everything we had.

Well done if you’ve gotten to the end of this post 😂

What we wouldn’t do for our kids.

gillian 1.jpg

Postnatal Depression, when love doesn’t come as a thunderbolt.

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Postnatal Depression, when love doesn’t come as a thunderbolt.

I was 21, and diagnosed with Poly Cystic Ovarian Syndrome (PCOS), on a hot June day, in the consultants room, in a Cork hospital. One minute I was worrying about my parent's car being clamped, and the next minute I was being told,  if I was ever going to have kids, do it now in my early 20s. He closed the folder and stood up, as I sank into the chair. Fast forward to 23, going out with my husband, and about four weeks into the relationship, the clock now ticking so loudly, I sit him down and tell him. In September 2011, my daughter was born. Five years after my PCOS diagnosis. A greyness descended, initial happiness replaced with fears, thoughts, overwhelming feelings. My brain telling me that I’m not good enough for her. My husband was beaming, but my heart was breaking, because, after five years of hoping, wishing, endless sticks to wee on, I didn’t get that thunderbolt. I was in shock. 

I stayed in the hospital for four days, because I didn’t want to go home until I felt ‘right’ . That thunderbolt didn’t come. Over the following days and weeks, I lied to friends and family who were enamoured by her. I was staying awake all night, afraid, and dreading the moment she would need me again. Would she be better with someone else as her mammy? I envied my husband's love for her. I envied how happy he was. I loved her, but felt that I wasn’t enough for her. What if she didn’t like me? Friends kept telling me how lucky we were to have a happy, healthy baby. I didn’t feel lucky, I felt guilty, ashamed that I wasn’t enjoying the baby I had longed for. I was lucky to find a breastfeeding support group,  that allowed me to cry, talk openly, and not be judged. It became my lifeline. I found Kathy Kendall-Tackett's book, The Hidden Feelings of Motherhood, and it was eye opening, and reassuring. Dr Andrew Mayers from Bournemouth University, has done some interesting research about partners developing postpartum depression too.

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I had heard some myths about PND , and medication, and I had fears about asking for help. What if they take her off me? What if, what if, what if? I became numb, and comfortable in my numbness. I hit rock bottom in 2016, when my neighbour passed away suddenly. A few days later, at my doctor's for something else, I broke down. He gave me some options, and I chose a referral for counselling. It was amazing. A weight lifted. The shame and guilt could be put down. I could breathe. 

I now work as a postpartum Doula, with Doula Care Ireland. One client described me as “a wonderful calm presence amidst the chaos" .I am not a health care professional. I am not there to tell you what to do. I give you the information,  and allow you to make an informed choice that works for you and your family. There is no one magic cure for PND, but , with calm, clear, informative support you can begin your journey out of the greyness. I am continuously working on being the best version of myself, and it is a continuous process. Sometimes I see glimpses of how I felt, in my clients, and it reminds me that the process of being mentally well, is something we need to keep working on.



Written by one of our doulas Dee Burke. You can fins out more about Dee and the support she offers here https://www.doulacare.ie/dee-burke-1/


If you or someone you know is suffering with a postpartum mood disorder these resources may help


https://www.nurturecharity.org


http://www.pnd.ie


https://www.cuidiu.ie/httpwwwcuidiucomsupports_parenthood_postnatal


https://www.hse.ie/eng/services/list/4/mentalhealth/mother-and-infant-health/#Finally,%20support%20services%20for%20those%20with%20Poatnatal%20Depression


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VBAC Mothers are real!



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Hi I am here…a real life, breathing VBAC mum :) 

So many of our DoulaCare Ireland clients do not believe that VBAC’s actually happen in Ireland. Well as a doula I have supported them, as an antenatal educator I have taught parents about them and earlier this year I experienced a VBAC personally.

My beautiful baby daughter Kayla Rose (a bit of a social media celebrity now) arrived in a whirlwind on 25th March 2018. I had an intervention free VBAC, supported by my husband, doula and midwife (an obstetrician was there also but I have very vague memories of her as she was not my focus) 

As Kayla’s birthday starts to draw closer, I have started to write my birth story. I will upload it in two parts (its a long story even though the birth itself was fast) That will give you all a full run through of my VBAC.

Before labour began I was admitted to hospital at 38 weeks for polyhydraminos (too much amniotic fluid) and baby in an unstable lie. Kayla was lying diagonally across my tummy. This meant there was a high risk of cord prolapse if my waters released. So after weighing up all my options, the pros & cons I decided to stay in hospital. (see my pregnancy blogs and our social media posts during March 2018 for videos/updates etc) You can also look back through my weekly pregnancy blogs ;)

There was lots of talk about elective caesarean but I held firm that I would like to try for a VBAC. I was confident in my body’s ability to birth my baby. There was a lot of negotiation and I found being informed about my options really helped in these situations. I knew the benefits and risks and studies that were done around vaginal birth after caesarean and also repeat caesareans. I was never against caesarean. I knew it was one option and if that ended up being the case I was ok with it, once I was listened to. My main priority was always to have a safe birth BUT I also wanted to have a positive experience. I found having doula support a great advantage as I had someone that I could bounce my thoughts and feelings off, who was non-judgemental and impartial and made a great sounding board for me. They supported me as I mourned the birth I wanted (to labour at home before going into hospital), and help prepare me for my change in circumstances. The brain training techniques in the GentleBirth app also helped me keep my focus and stay calm as things changed for me.

During my pregnancy I did all I could to empower myself. I worked on my physical and mental health. Over the 9 months I worked on building a positive mindset. preparing my husband to be my advocate. I armed myself with great support, in the shape of my informed husband and my wonderful Doula. I took time for self care. I had regular reflexology, used aromatherapy, had shiatsu, realigned my pelvis with chiropractic treatments, listened to daily affirmations, GentleBirth tracks and had a vision board. I knew my VBAC wasn’t going to just land in my lap. I had to take ownership and prepare for it.

I stayed really positive and used my time on the antenatal ward to focus my mind and prepare my body. I went into spontaneous labour just as I was going to bed on the 24th of March. I did consent to having the CTG, even though I had originally felt I did not want it (more detail to come in my birth story) However I was clear that I chose my own position and moved with my body.

Kayla Rose entered the world at 4.17am, the night the clocks went forward. So my labour lasted less than 3 hours. She was 8lbs 2oz, at 38+6 gestation. 

kaylas birth 2.jpg


I escaped with only a small 1st degree tear and no abnormal blood loss. 

I did it!




Jen with baby kayla enjoying skin to skin,surrounded by love with (hubby paul taking the photo), midwife jo (rotunda) and doula mim.

Jen with baby kayla enjoying skin to skin,surrounded by love with (hubby paul taking the photo), midwife jo (rotunda) and doula mim.

It was such a high and I was so proud of myself. I haven’t really spoken about that high much. There was complications after, as Kayla was born with an undiagnosed cleft palate and Pierre Robin Sequence but that was not connected to our VBAC. My moment of euphoria only lasted a second before we realised something was wrong with our baby.

So after a bit of my story…. I experienced a VBAC in an Irish maternity hospital. Yes at times during my pregnancy I felt like there was a huge spotlight over my head. Yes I had to negotiate and be firm at times. Yes I had a wobble myself during labour, when I had a burning sensation across my scar but I did it. The evidence says many more woman can safely do it too. 

Preparing for a VBAC can definitely be a rollercoaster and support is crucial. Most people (including health care providers) just assumed I would be having a repeat Caesarean. I knew VBAC was safe, I was aware of the evidence and for me it was the option I hoped for.

There is a lot of misinformation out there about VBAC birth. You will hear care providers tell people that they can have a VBAC but only labour for so many hours as it is dangerous for the scar (not evidence based), or they cannot go over 40 weeks in case the scar ruptures (not evidence based), or because it has only been 2 years since their last baby their scar may be too weak (not evidence based)…you get the picture!!! So in order to have a successful VBAC you do need to prepare yourself. Below I have listed some of my top tips for anyone hoping for a VBAC.


What are my top tips?

Empower yourself with knowledge and the latest evidence.

Educate yourself and your partner so they are also aware and can advocate for you if needed.

Get yourself a Doula!

Take an independent childbirth class - a Cuidiu antenatal class or a GentleBirth workshop, or a VBAC specific workshop (also given by an independent provider).

Try to be under midwifery led care if possible.

Peer support is hugely helpful. The VBAC in Ireland Facebook group is a great support network of Mums who have tried for a VBAC, or are trying (LINK)

Don’t be afraid to ask questions at appointments (bring a notebook if it helps)

Know you have the right to decline any option of care once you understand the benefits and risks (a caesarean, a CTG trace, an induction and so on)

Remember to use BRAIN as a tool when discussing your options (both for you and your baby)

Example:

What are the BENEFITS of a repeat caesarean?

What are the RISKS of a repeat caesarean?

What are the ALTERNATIVES?

What does my gut INSTINCT say? Need more INFORMATION?

What happens if I do NOTHING for now and wait to make a decision?

Remember DoulaCare Ireland are here to support you through your VBAC. Ask us questions, gain information & support but above all, gain the skills to make informed decisions for your individual situation. 

I wish you luck on your journey. Whatever the outcome, what is important is that you have a positive experience - at the centre of that is making informed decisions and feeling supported. 



Doula Jen x



Some Further reading :

http://aimsireland.ie/vaginal-birth-after-caesarean-vbac/

https://www.hse.ie/eng/services/list/3/acutehospitals/hospitals/cavanmonaghan/maternity-services/consultant-led-care/maternityvaginalbirth%20aftercaesarean.pdf

https://www.rcm.org.uk/tags/vbac

https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf

https://evidencebasedbirth.com/topfive/

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How do I know my baby is getting enough milk?

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Baby breastfeeding

You will be learning together. Breastfeeding is a skill that can be learned, so take that time in the early days to relax and focus on getting to know your new baby. Your job is solely to cuddle and feed him, everyone around you needs to care for you! So snuggle up in bed, snooze, smell the top of his gorgeous head, cuddle, study his adorable face and tiny little finger nails. Savour every moment. Follow your instincts, you are his mam you will know if he is getting enough milk. Granted, you will be flooded with hormones and perhaps haven’t slept for a while so here are some basics to get you off to a great start! 

How does your baby appear? A baby who is getting enough milk will be alert and active during wakeful times. He will appear bright and healthy. He will have a good colour (not too jaundiced or pale) and have moist lips. He will be gradually growing in length and head circumference, your PHN & GP with keep track of this.

How often should my baby feed? A new born tummy is tiny, only the size of a marble. A full feed is 5-7mls (a tea spoon) this gradually increases to the size of a hens egg by one month old, about 80-150mls. Because they can only take in these tiny amounts, they need to feed often. Most new babies feed 10-12 times in 24 hours, some feed more! Follow your baby’s feeding cues. Don’t watch the clock thinking “It has only been an hour, he can’t be hungry again!” Those first few days and weeks are all about learning. Your baby has never breastfed before so he needs to find his rhythm (along with learning to breathe, smell, taste, see and process his new world) Offer encouragement and support as you both learn this new skill together!

How long should feeds last? A feed can last from 5-30 minutes on one side, once you can audibly hear your baby swallowing – he is still extracting milk from that breast. So leave him to work away! Once the rhythm slows to about one swallow every 7 sucks it is a good idea to switch sides. When he is finished that side you can change his nappy, wind him a little (most breastfed babies don’t suffer from much wind) and then offer the second breast. He may not be interested, take a small feed or sometimes feed on that side for 30 minutes again! Trust that your baby knows what he is doing. Relax and enjoy those new baby snuggles. 

mother and baby breastfeeding

What goes in must come out! If your baby is having lots of wet and dirty nappies then there must be milk going in to create it. You are looking for about 5 or 6 wet nappies per day and one dirty per day of life (ie one dirty on day one, two dirty nappies on day two and so on up to day 4) Your baby’s poo should change from the black sticky meconium to a greenish colour and then mustard colour by around day 5. Some breastfed babies have a poo after every feed!

Weight gain. Many new parents can become obsessed with their baby’s weight. Don’t worry too much about it, however it can be a good guide as to how your baby is doing. Weight loss of 5-10% is normal after birth. This can be higher if you had a lot of IV fluids during your labour and birth. You would be looking for your baby to regain his birth weight by about 2-3 weeks old. A rough guide is for your baby to gain about 5-7oz (or 150-220 grams) per week. Remember weight is just one part of the picture, it is not the sole focus. 

Remember breastfeeding can be tender for some in the early days but it should NEVER hurt. If nursing your baby is painful there is something wrong. Remember it is a skill that can be learned together so seek support. Ask your nurse to assist you, reach out to supports around you (listed below) or of course, have a Postpartum Doula by your side!

Doula Jen x

Jen Crawford

Co Owner & Founder of DoulaCare Ireland 

 

Further reading & helpful resources: 

http://kellymom.com/hot-topics/newborn-nursing/ Tips for the early days breastfeeding your baby. 

http://www.breastfeedinginc.ca/content.php?pagename=vid-reallygood Great video clip from Dr Jack Newman & IBCLC Edith Kernerman page ‘Breastfeeding Inc’. This clip shows what a good latch & drinking looking like. 

https://www.breastfeeding.ie/First-few-weeks/Guidelines-for-mothers/ Great chart with guidelines for first few weeks. 

 

Breastfeeding Supports:

Association of Lactation Consultants Ireland http://www.alcireland.ie/find-a-consultant/ 

Cuidiu, Irish Childbirth Trust http://www.cuidiu-ict.ie/supports_breastfeeding_counsellors

Le Leche League Ireland https://www.lalecheleagueireland.com/groups/

Friends of Breastfeeding http://www.friendsofbreastfeeding.ie/wp/support-2/

National HSE Breastfeeding support https://www.breastfeeding.ie/ 

 

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