Moved over to main website blog: Obstetric Cholestasis

Obstetric cholestasis

It has a number of names : Intrahepatic cholestasis of pregnancy (ICP), obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum.

What is it?

Obstetric cholestasis is a disorder that affects your liver during pregnancy. The main symptom is itching on the palm of your hands or soles of your feet. Another symptom is persistent itching of the skin (anywhere on the body) when there is no skin rash.

How common is it?

Takes from the RCOG : Obstetric cholestasis is uncommon. In the UK, it affects about 7 in 1000 women (less than 1%). Obstetric cholestasis is more common among women of Indian- Asian or Pakistani-Asian origin, with 15 in 1000 women (1.5%) affected.

Iching is a really common part of pregnancy, caused by the stretching of skin as your body accommodates your growing baby/babies. However, it can be one of the warning signs of cholestasis. It is important to flag any concerns with your care provider (midwife or obstetrician). They can preform a simple blood test to rule out any concerns of cholestasis. 

So what happens if you are diagnosed with obstetric cholestasis? 

Once diagnosed with obstetric cholestasis, you will be advised to be under the care of a consultant and have your baby in hospital with a neonatal unit (NICU). 

There is no cure for obstetric cholestasis but all symptoms generally disappear once your baby is born.

Most women will then have additional antenatal checks. This will include regular liver function tests, until you have had your baby. You will also be offered additional monitoring of your baby. Often this will involve extra ultrasound scans checking growth and measuring the amount of fluid around your baby.

When you are in labour, you will be offered continuous monitoring of your baby’s heart rate. There is some evidence that it is safer to birth your baby early if your symptoms are severe. You will have an opportunity to discuss the option of having labour induced after 37 weeks. 

Early induction (before term, 37 weeks) may carry an increased chance of having interventions such as assisted birth (forceps etc) or having a caesarean birth. It also carries an increased chance of your baby being admitted to the special care baby unit (SCBU) with complications of preterm birth. Your care provider or obstetrician will discuss what they feel is best for you and your baby in your individual situation so that you can make an informed choice.

Remember to take time to ask lots of questions. It can be helpful to have a notebook and pen ready to take notes as in unexpected situations it can be hard to take in all the medical information you are being told. 

Take time to weigh up all the pros and cons and understand each step before making your informed decision. 

Our doulas are an amazing support through this process - walking the journey with you - offering emotional and physical support. If you would like more information on how we can best support you pop us an email on info@doulacare.ie 

A Wonderful Partnership with Irish Life Health

Did you know DoulaCare Ireland have an exclusive partnership with Irish Life Health? 

At DoulaCare Ireland we offer true continuity of care and our focus is supporting families as they transition into parenthood. This is not always an easy journey, but it is one that can be fulfilling beyond words. We support women and their partners throughout pregnancy. We offer continuous support during labour and birth (home and hospital birth).  We will wipe your brow when hot, keep you calm and focused. We support your partner to feel in control offering them tips and tricks too. We stay by your side, after birth. We go to your home. We nurture you as you find your new normal We cook home cooked meals, catch up on laundry, keep the house running so as new parents our clients can slow down and enjoy those early days. We offer evidence based information. We are an independent support person, without the same emotional attachment a family member can have - meaning unbiased care. We pass on years of knowledge around pregnancy, birth and parenting. Helping our clients to make informed decisions about their care and that of their baby/babies.

We don’t want our clients to. drift through their pregnancy, unsure of their options and frightened of their birth.

We don’t want our clients to muddle through in a sleep deprived fog in those early weeks of parenting.

We want them to feel supported, heard and validated.

We want them to feel cared for, safe and confident.

We ensure our clients thrive in every aspect of this journey, not just survive! 

We chose to partner with Irish Life Health for their forward thinking and family centred plans. They have a huge focus on well being (physical, emotional and mental) which we felt sits with our own ethos. What makes Irish Life Health different to other insurers is that their support doesn’t end when you leave hospital. They know that becoming a parent is a life-changing journey that goes far beyond your hospital stay. Their benefits are there to support you emotionally and physically every step of the way.

Irish Life Health can help you access the support you need for whatever stage you’re at on your parenting journey. They have created an incredible Maternity and Parenting Path package. With DoulaCare Ireland you can now claim up to €200 off Birth Doula support plus up to 18 hours Postpartum Doula support in your home to set you up for success!* 

This is all available exclusively with DoulaCare Ireland. Irish Life Health only work with our Doula Agency.  Why choose Doulacare Ireland above an independent doula? 

Because DoulaCare Ireland are a professional national doula agency. 

• Our doulas are the only doulas in the country that are Garda vetted for their role. 

• All of our doulas carry insurance. 

• All of our doulas are trained by a reputable organisation. 

• All of our doulas attend a minimum of 3 CPD days per year.

• All of our doulas have access to mentorship & counselling sessions if required.

• All of our doulas have opportunity to debrief.

• All of our doulas sign up to a code of ethics.

• All of our doulas know their scope and practice within this at all times.

• All of our doulas are passionate and caring. 

• Mary and Jen are two of the most experienced doulas in their fields and bring that knowledge and support to our doulas and to our clients.

Our Doulacare Ireland national team

But there is more! Irish Life Health are offering their members support in many areas to ensure they have a positive parenting experience. You may be entitled to healthy meals delivered to your door with Gourmet Fuel. A midwife visit in your home. Access to the GentleBirth App https://www.gentlebirth.com A beautiful food hamper. Some home cleaning hours. Access to mental health supports with Nurture Health, another of our working partnerships. They are a nationwide counselling service specialising in the care of parents from fertility issues, conception, and pregnancy right through to postpartum and parenting. You can find out more on their website https://nurturehealth.ie/about-us/ You could have access to a Dietician or Nutritionist Consultation. You could have some Acupuncture sessions or take yoga or pilates classes and so much more!

We are delighted to be a part of this amazing care. We feel parents in Ireland are under so much pressure to get it all right when pregnant, partners are expected to know how to support a Mum during labour (without ever having been near a labour room before). We are expected to just  ‘bounce back’ to ‘normal life’ after having a baby. The big secret no one tells you is you will have to adjust to a new normal. This can take some time. With all of the outlines supports, parents can do this without feeling like they are losing control. Every pregnancy is unique. Every birth experience is unique. Everyone parents in their own way to meet the needs of their unique baby. Babies do not pop out with a manual. New parents have to find what works, one day at a time. Our doulas will be right there, offering encouragement and support every step of the way. 

Any questions?

Please give `Irish Life Health Customer Care team a call on 1890 714 444 or email heretohelp@irishlifehealth.ie to check your plan and see what you may be entitled to!

You can read more about some of these fantastic benefits here

https://www.irishlifehealth.ie/the-parenting-path/redeeming-maternity-benefits

https://www.irishlifehealth.ie/the-parenting-path/the-big-day

For direct enquiries about our benefits with Irish Life Health pop us an email irishlife.health@doulacare.ie or

info@doulacare.ie for general enquiries

*Each policy plan is unique so you can check with their customer care team if your policy is covered or you can make amendments to ensure it is included

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.

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.

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.

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.

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.

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Have you heard of Naming Ceremony?

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A Naming Ceremony is a celebration of family and life. This is a great way to bring your family and friends together. The Ceremony is written in conjunction with the parents and a Celebrant to create a personalised and meaningful occasion. It usually includes bestowing a name on your child and declarations of promises and commitments from the parents and guide parents and other important people in the child’s life.

Naming Ceremonies can be held in the home or at a venue of your choosing but not in a Church. They are also not officiated by a Priest but by a Celebrant. Although a Naming Ceremony is secular in its origin, it is entirely the personal choice of the parents as to whether any religious content, from any faith, is included. Having contact with your Celebrant is the best approach as you can use their experience to make the ceremony exactly how you have envisaged it. The Ceremony can be either relaxed or formal. You have total freedom to create a memorable experience for your family and loved ones.

Some parents like their other children in the ceremony. Their siblings can choose to write and say a reading or poem, or perhaps make their own commitments. They may want to make a promise to help look after their new sibling. As a family you may like to light unity candles or have a sand blending ceremony, the action of doing something like this as a family can be significant in bringing you all together.  

In the ceremony you can incorporate readings, poetry and music. The most important part is choosing the aspects that are special to you and your family.  Parents will declare their hopes and wishes for their child’s future and will share this experience with family and friends.  

Naming Ceremonies will include the bestowing of a name - this is where the child is named, perhaps giving the reasons for choosing that name, maybe it was an ancestral name or perhaps had an interesting history. This marks the very first time that a child is introduced to their community using their new given name

 Guide parents are chosen to make commitments to support and guide the child as they grow and they will make themselves available should the child ever need them for advice, care, guidance or help, this is similar to the role of God Parents.  Promises may be made by Guide parents, they can either answer questions asked by the celebrant during the ceremony, or they can prepare their own promises to your child - in doing this their role becomes even more personal to them. You will be surrounding your child with loving role models to nurture them and have a positive impact on their life. 

The duration of a Ceremony will depend on how many Ceremony enhancements, readings/poems you include, a Naming Ceremony usually last around 25-30 minutes

Some parents like to personalise the ceremony to include symbolic elements such as the lighting of unity candles, a sand blending ceremony, hand and foot prints as a keepsake or the planting of a tree (if the ceremony is being held in your home).

Naming ceremonies are not legally binding and do not have any legal status, although you may be presented with a record of the ceremony as a token of the day.

Naming ceremonies can also be tailored to welcome adoptive children and step-children into a new, extended family or relationship.

My name is Carol Colman and I am an accredited Celebrant with the Irish Institute of Celebrants. I am based in Dublin and I also cover surrounding counties.  I can be contacted through my website www.loveisallyouneed.ie ,on Facebook Carol Colman Family Celebrant or by email at carolcolman57@gmail.com.  I as a Celebrant will offer home consultation, alternatively you can choose to have contact through online platforms such as Skype, WhatsApp or other video call software, but if it’s possible, I would recommend meeting  person – but as a parent myself I fully understand how precious your time is with a new arrival or toddler.   

Throughout the process, I will discuss the options to personalise the ceremony and will get to know you so I can tailor a ceremony to suit your family needs.

I am an expert in creating bespoke celebrations that people love. I can help you by guiding you through what can be involved in the ceremony and also giving some ideas you may not yet have considered.

My Special Offer to anyone who quotes DoulaCare in their contact email to me is that they will receive their Ceremony for €200 (Usual price €250)

Here is some inspiration for things you may want to include:

• A book can be available at the celebration which guests are asked to sign or write a message and good wishes for the future for the child and the family.

• Guests could be asked to bring something small for the child, such as a letter or a flower, which is collected at the start of the ceremony.

• The celebrant can ask if any guests would like to say anything about the child after the ceremony.

• A video can be made with guests saying a message for your child at some point in the future.

• Creating a naming certificate with the details of the day and name which can be kept after the day for the child.

• Planting a tree either as part of the ceremony or after at your home. This can symbolise growing as family.

• A Sand Blending ritual can be a nice addition if there are other children in the family

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So Meghan Markle hired a Doula? What is that? Part 2

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 2.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas

In this blog we will focus on Postpartum Doula support.

In times past (and indeed today in many cultures around the world) parents were not sent home from hospital with a new baby and expected to know what to do and manage on their own. We would have had the support of families, neighbours, friends - minding us, feeding us, helping us adjust to the changes in our lives and allowing the new Mum to rest and recover from birth and support her during the first few weeks of life with a small baby. Today we are often lacking this support and just expected to cope. People do call in to visit but don’t think to bring a cooked meal for the Mum, let her rest, load the dishwasher or ask how she is doing. The focus is often on the baby and the Mum is just expected to get on with it. However, we are not hardwired to manage in this way. We need the support of others in those first few weeks and months and in lieu of support from our community the postpartum doula can step in and offer this support.

A Postpartum Doula begins work with their client as soon as they book in. For some, this is during pregnancy (the forward planners!) and for others this is after baby is born. If it is during pregnancy, your doula will help you to prepare for your new arrival and the huge shift your life will take. If it is after birth, your doula will slot right in to your new routine (even if you don’t think there is any form of routine) As with Birth Doula support, your Postpartum Doula comes with many layers of support. We help you to debrief and process your birth experience. We nurture you while you recover from birth and find your new normal. We help your older children adjust to having a new dynamic in the family. We support your partner, adjusting to their new role and debriefing their own experiences. We offer knowledge, encouragement, information and support every step of the way - as each new day brings new challenges. Above all, we help you to savour the good moments between the chaos :)

Knowledge: Doulas are information junkies. We love reading, attending study days and growing our knowledge base. In DoulaCare Ireland all our Doulas must attend at least three CPD days per year. - which ensures the building of knowledge as evidence changes and new research is undertaken. We also learn from every interaction, with each individual client. We bring that knowledge base to you when you come home with your new baby. No matter what comes up, with your recovery after birth or your babies needs - chances are we have seen it before (or we know who to call if not).

Encouragement: Anyone who has had a baby, knows that surreal feeling of being left in charge of this new tiny human. Many parents feel “they are not seriously letting me home alone with this baby? I don’t even know how to bath him or tell if he is hungry” Don’t fear. It is normal to feel that way. The truth is no parent has the answers. Babies don’t come out with an instruction manual. We all learn on the job! The great thing is, with your Postpartum Doula by your side - you have a calm presence helping you every step of the way. So nothing feels overwhelming. You and your baby learn together, with a helping hand from your Doula.

Information: To new parents this is invaluable. The number one question we get asked… “Is this normal?” Rest assured, your Doula will have all the latest evidence and research at hand to help you make informed decisions when the fog of parenting clouds your brain. It can be hard to process information when you are recovering from birth and haven’t slept more than an hour in 2 weeks. Your Doula will give you the information you need in bite sized chunks so you can fully process it as required. She would also be delighted to tuck you up in bed, with clean sheets, after a hot shower and home cooked meal - and after a nice nap it is easier to think more clearly and have perspective on the changes in your life!

Hands-on tips and tricks: A Postpartum Doula passes on all the parenting tips and tricks they have picked up through their training and working experience. They help you to simplify your daily life. Sometimes it’s a gentle suggestion on where to keep the changing table, that you hadn’t thought of (like having a second one in that corner downstairs to save you running up and down the stairs 20 times a day) Sometimes it is demonstrating different methods of helping baby to get wind up - which can be a tricky skill to master.

Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. In parenting, it can be helping them to figure out how to put a baby grow on baby (which way is up? Are these the arms? We all know how hard it can be to get a new baby dressed!) It can be explaining the hormonal rollercoaster women ride after giving birth and to expect highs and lows. It can be a listening ear for them to debrief or to gush about their beautiful new son or daughter. Sometimes it is offering gentle suggestions to help them adjust to their new role and see what part they can play in supporting their partner and adjusting to their own new role.

With DoulaCare Ireland you have a full team of support. Each client is matched with the perfect doula for their needs. In the bigger contracts (100+ hours) you will usually have two doulas offering support. You have the opportunity to meet both beforehand. Both doulas will know your parenting style and wishes. This means that if for any reason your doula needs to change your scheduled hours you have the option of your second doula covering so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

We know from neuroscience that our brains are not hardwired to manage on our own in those first few weeks of adjusting to life with a new baby. All so often when we arrive at a new Mums house, they disclose that they feel they are doing something wrong as they struggle to cope. So few of us talk about how hard it is, that many are left feeling not good enough. The postpartum doula steps in to fill the gap. We are there to build confidence and make those first few weeks a positive memory for years to come - in other words to help a family thrive and not just survive the early days of parenting

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Meghan Markle has hired a doula, what is that? Part 1

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So Meghan Markle has hired a doula and everyone is buzzing “what is a doula anyway?” Part 1.

There are two main types of doula. A Birth Doula and a Postpartum Doula. There are also Doulas who specialise in supporting families through loss and other niche areas

In this blog we will focus on Birth Doula support. 

A Birth Doula begins work with their client during pregnancy. Supporting them throughout pregnancy, labour and birth. We don’t clock out at 8pm. We are there by our clients side every step of the way. Offering continuity of care throughout pregnancy, labour, birth and postpartum. We then visit our clients at home, offering support with all those early parenting questions.. We offer knowledge, encouragement, information and hands on tips and tricks of the trade. 

Knowledge: We help our clients to understand their chosen place of birth (most commonly a hospital) policies.We compare the different hospitals policies, statistics and what the National Clinical Guidelines say. We also chat about International Guidelines and help our clients to make informed decisions about their care. We also cover the physical process of labour and birth and common things that come up. We can assist our clients to create their birth preferences for their unique journey. After baby arrives we share all the latest evidence on infant care, recovery after birth and anything else you’re wondering about too!

Encouragement: We build up our clients. A huge part of our role is to help our clients (the birthing mother and her partner) to feel confident. We are like their coach or cheerleader from the sidelines, reminding them of all the skills they have gained throughout their pregnancy and the strength they have within. This does not stop once baby arrives. We build you up again after birth and remind you of that strength and knowledge.

Information: Apart from the mentioned topics, doulas also answer any questions that happen to arise with each client. It may be they read an article online and wonder does that happen in Ireland? Or they are told they have a condition (such as gestational diabetes GD) and would like information to help them feel informed and confident on how best to manage it.

Hands on tips and tricks: Doulas are not afraid to get in there and help out. During pregnancy we show our clients different massages, counter pressure and comfort measure to help during labour. We teach these skills to the birth partner so they feel fully involved in the process. On the day of labour often doulas and partners work really well together - tagging in and out (counter pressure can be really tiring after a few hours!) This support continues on into parenting. From showing you how to change and dress a newborn (which is surprisingly tricky at first) to helping you find a comfortable position to feed in - your doula will be right there. 

Partners: Partners are often Doulas biggest champions! We help them to feel involved every step of the way. Partners often say things like “I didn’t know what to do to help my wife” or “I felt like a spare tool in a scary unknown setting” but with a Doula supporting them - they have a full tool kit to draw from. They also get encouragement and a helping hand along the way. After they become a Dad/Mam we are still there. Helping them to adjust to their new role and offering guidance on how best to support you.

With DoulaCare Ireland you have a full team of support. Each client is matched with two doulas. You have your primary doula and your back up doula. You have the opportunity to meet both. Both doulas will know your birth preferences and wishes. This means that if for any reason your doula needs to take a break (such as a long birth, where your doula may need to grab some sleep), you have the option of your back up doula joining you so you are never alone! Our co-owners Jen and Mary are always on hand too. We offer phone and email support to our clients and our doulas so no question is ever left unanswered.

In next weeks blog we will discuss Postpartum Doula support.

Until then… Doula Jen x

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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.

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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Moved over to main website blog:Adjusting to life with a toddler and a newborn

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Adjusting to life in the early days and weeks.

It is important to acknowledge that it will be hard at times, but it won't be impossible. It is all an adjustment but the love you will feel will make everything worthwhile. Of course as your Postpartum Doula I will assist you with adjustment and daily tasks. Here are my top tips on how to set yourself up for success and make each day easier.

• Cook extra portions of freezer friendly meals (like bolognaise/shepherds pie/fish bake etc) while you are pregnant or if baby is here then at the weekends so you've a good supply of nutritious food to see your family through week ahead. This is also something family and friends could do to help out.

• Shop online for now if a grocery shop seems unimaginable. 

• Buy preprepared fruit and veg as handy snacks to grab on the go.

• Don't be too proud to accept offers of help and don't be afraid to suggest chores (unload the dishwasher, hoover the stairs, clean the bathroom etc)

• Lower your expectations of how the house will look during the first few months. You've got a lot on your plate, and it doesn't really matter if the dusting doesn't get done or you have to wear un-ironed clothes for a few days, or years even.

• As soon as you can, try to get out for at least a short walk every day it's amazing what a boost it is to get out of doors. If that seems too epic right now, sit in the garden and play with your toddler.

• Take all offers of taking your toddler out for a while (once your toddler is happy of course!) Granny wants to take her out to the playground? Great, don’t feel guilty and try to go too - grab a nap with baby while you can :)

• Make your toddler aware from the very start that the baby is interested in her, is watching her and loves her. Say things like, "She's following your game with her eyes" and "She's very interested in what you're doing".

• Involve your toddler in games with the baby from the earliest days, and always tell your toddler how much you value her help with tasks such as handing you a nappy for the baby.

• Have a ‘special feeding box’ Fill the box with little toys and books, colours or activities for your toddler. This box only comes out while you are feeding the baby and is your toddlers special treat.

• Babywear. Using a sling gives you the ability to meet your newborns needs (to be warm, safe and close to you) while still playing, reading with or just spending quality time with your toddler. I would recommend attending a sling meet or get a sling consultant to your home to find the right sling for you.

• Take photos, because while the days seem endless right now, the weeks and months will fly past and you will appreciate the memories ☺

• Be gentle with yourself. No one is perfect. This is all learning on the job, take each day as it comes and remember you are doing your best and that is all anyone can do!

Enjoy the madness! Doula Jen x

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Things are not always as they seem on Social Media!

Things Are not Always as They Seem on Social

Media!

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Things aren’t always as they seem!

Social media like Facebook portrays an image of happiness and beauty. Everyone full of smiles, surrounded by friends and family, women with perfect make up, children looking sweet, even their house looks clean and decorated so beautifully in the background!

I have sat with so many parents who feel inferior and genuinely upset when they compare their life to their Facebook or Instagram friends (some of whom they may never have actually met in real life!) 

Well guess what? No one has a perfect life. Who do you know that told you about their toddler having a massive melt down on the floor of the super market?  It’s happened to us all! Now ask yourself this, have you ever seen them post a photo of said event? The probable answer is of course no. They may even have got through that hiccup in their day and gone on to post a video that evening of their little one singing a sing, full of smiles. This often leaves us all thinking “Look there is Sally’s little girl singing, she is so sweet. Why are my kids such terrors? I can’t even bring them to the shops to get milk and bread without a melt down!”

Social media is where people document their happy moments. It is well thought out before anyone posts a photo. They will find the clean corner of their house, hold the camera to its most flattering angle, nudge their partner to smile or do silly faces to coax a smile from their little ones. It is where we can look back and say “That was a brilliant day” or “Look how much my baby has grown since then!”

I encourage you all to enjoy social media, like Facebook and take inspiration from others. See another twin Mum getting out to a play group? Never thought you could? Maybe that was the photo you needed to see to give it a go ☺ 

Social media is a great way to stay connected to people, get peer support and find out about local resources. Remember to take off the rose tinted glasses and see behind the staged scenes of family photos. Reality is that there was probably shouting or bribery (or both) to get everyone in and smiling. If we capture that moment we can feel proud posting it, banking that moment in time for the future. 

So your life isn’t perfect, your kids are a pain in the backside most of the time, your house is a mess and your partner is a nightmare. Whose isn’t? Feel comfort in knowing we are all in the same boat ☺ Reach out to friends to chat. Go to peer support groups. Have a moan, then have a cup of tea and a biscuit, take a deep breath and enjoy the rest of your day.

Because even if your life isn’t perfect, you will never have this moment again. Your little ones will never be at this stage again. Sometimes the days can feel endless but the weeks disappear so quickly so savour every precious moment and breath through the hard ones.

Doula Jen xx

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What's the story with Kaylas Cleft?

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Anyone following my journey over the past year will know Kayla was born with a cleft palate (but not lip) Many people don’t quite understand what that means, and to be honest I struggled a bit at the beginning too! So I thought a blog would help :)

There are many different types of clefts and no two are the same. A baby can be born with a cleft lip, a cleft palate or both a cleft lip and cleft palate. Essentially what a cleft is, is a hole or gap in the area. 

The following stats are taken from (http://www.cleft.ie/?page_id=25) The incidence of cleft lip and/or palate in Ireland is between 1 in 700 and 1 in 1,000 births. Incidence of cleft palate occuring alone is about 1 in 2000 births. More than 70% of babies with cleft lip also have cleft palate. 

Parents who have a child born with a cleft, have a 5% chance of the next born also having a cleft (so a 1 in 20 chance). If a second child is born with a cleft, the likelihood increases further for any subsequent child. 

The chances of a parent who was born with a cleft having a cleft baby is approximately 7 in 100. So Kayla will have roughly a 7% chance of having a baby with a cleft (of course if she chooses to be a parent but we would love lots of grandchildren!). 

Types of Cleft Lip

• Forme fruste unilateral cleft lip
  A subtle cleft on one side of the upper lip, which may appear as a small indentation.

• Incomplete unilateral cleft lip
  A cleft on one side of the upper lip, which does not extend into the nose.

• Complete unilateral cleft lip
  A cleft on one side of the upper lip, which extends into the nose.

• Incomplete bilateral cleft lip
  Clefts on both sides of the upper lip, not extending to the nose.

• Complete bilateral cleft lip
  Clefts on both sides of the upper lip, extending into the nose.

Types of Cleft Palate

• Incomplete cleft palate
  A cleft in the back of the mouth in the soft palate.

• Complete cleft palate
  A cleft affecting the hard and soft parts of the palate. The mouth and nose cavities are exposed to each other.

• Submucous cleft palate
  A cleft involving the hard and/or soft palate, covered by the mucous membrane lining the roof of the mouth. May be difficult to visualize.

Kayla is linked in with the cleft team in Temple Street. They have been amazing. Big shout out to Jane the cleft nurse specialist who takes families under her wing and walks the journey with them. She gives us so much time to ask any questions we may have and checks in regularly to see how Kayla is doing.

In Ireland, the cleft teams grade the palate or lip cleft from 0-3. 0 being very mild and 3 the most sever. Kayla has a grade 3 cleft palate. She has a complete cleft palate, but instead of just being a gap or a hole Kayla is missing all of her palate (hard and soft)

Kayla also has a condition called Pierre Robin sequence (or syndrome) PRS for short. This is a condition in which babies are born with a smaller than normal lower jaw, a tongue that is small and bunched which often falls back in the throat, and difficulty breathing. It is present at birth but not always detected in pregnancy ultrasounds. Most babies with PRS have a U shaped cleft palate like Kayla. Again the team will grade PRS 0-3 and Kayla scored a 0, as luckily she does not have many issues with her airways. Kayla does well once she is on her side or raised. Another positive is that nature gave her a helping hand with a tight posterior and anterior tongue tie to hold her tongue in place, so her tongue does not flop back to block her airways (who would have thought it? A helpful tongue tie!!)

Other common issues in babies/children with PRS are problems with their eyes (Stickler Syndrome), problems with their inner ears and dental issues. Kayla will be under different teams for each and so far they have been wonderful.

Kayla will have her first surgery to create a soft palate when she is around 9 months. This will hopefully help with her speech development. She will most likely be 3 years old before her palate is completely closed but for now it seems the only long term issue she will have is a speech delay – which she will catch up on by the time she is 10 years or so. So while her first few years of life will be hard, with surgeries and hospital appointments it is something that won’t hold her back and she can put behind her!

I hope this blog helps to explain things a little? Please feel free to ask questions :)

Again thank you to everyone for the love and support since Kayla was born xx

If you or someone you know has a baby with a cleft or PRS these are helpful resources:

Websites:

http://www.cleft.ie/

https://www.clapa.com/

www.cleftlipandpalatebreastfeeding.com

https://www.breastfeeding.ie/Resources/Publications/ The booklet I co created "Breastfeeding and Expressing for your preterm or sick baby" has lots of information on getting off to a good start, maintaining your milk supply, storing milk, skin to skin and more. It is available free to download or order. All Irish maternity units should have copies also. 

The Australian Breastfeeding Association (ABA) has two booklets (both e-booklet -released during 2017 and hard copy)  The cleft breastfeeding booklet: https://goo.gl/ZnoFqc has information about breastfeeding - and expressed breast milk feeding, lactation aids, type of feeding methods including - cup/spoon/supply lines/ bottles/teats. As well as some of the experiences surrounding feeding from families.  The second booklet is all about expressing and storing breastmilk: https://goo.gl/ft7gDp. 

Facebook pages: 

cleft lip & palate association of ireland

Cleft Lip And Palate Association

Cleft Lip and Palate Breastfeeding Support Group

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