POSTNATAL DEPLETION - EVEN 10 YEARS LATER
If you have had a baby - you HAVE to read this! Best article I have ever read that examines the postnatal condition. All you mama's out there - this is why is should be Mothers Day - everyday!
POSTNATAL DEPLETION - EVEN 10 YEARS LATER
Consider this: If you’ve had a child within the last decade, you might still be suffering some consequences—lethargy, memory disturbances, and poor energy levels, among other symptoms. And according to Dr. Oscar Serrallach, a family practitioner in rural Australia, it’s not just because being a parent is hard—physically, the process of growing a baby exacts a significant toll. The placenta passes nearly 7 grams of fat a day to the growing baby at the end of the pregnancy term, while also tapping into the mom’s “iron, zinc, Vitamin B12, Vitamin B9, iodine, and selenium stores—along with omega 3 fats like DHA and specific amino acids from proteins.” On average, a mom’s brain shrinks 5% in the prenatal period, as it supports the growth of the baby (much of the brain is fat) and is re-engineered for parenthood. He has spent the majority of his career witnessing this syndrome, which he calls Postnatal Depletion, first-hand, watching as women fail—hormonally, nutritionally, and emotionally—to get back on their feet after the baby comes. Dr. Serrallach first became tuned in to it when he encountered a patient named Susan, a mother of five children, who was so emaciated and depleted that she “was visibly running on empty.” After an extensive visit where he ran bloodwork, and proposed nutritional and emotional counseling, she looked at the clock and bolted. And he didn’t see her again: Until she turned up in the emergency room with pneumonia so evolved that she needed intravenous antibiotics. She spent less than a day, before checking herself out against his orders. That image stuck with him—of a woman ripping out an IV to rush back to her family—and its representation of a mother sublimating all of her own needs to serve her children. Part of the brain shrinkage mentioned above, Dr. Serrallach explains, is reprogramming: “It supports the creation of ‘baby radar,’ where mothers become intuitively aware of their child’s needs, if they are cold or hungry, or if they cry at night.” This hyper-vigilance becomes dangerous for the mother when she, in turn, is not supported. When his own wife had their third child he observed that she too was totally destroyed, and unable to get back to “feeling like herself.” Sound familiar? All the moms at goop think we have it. “There is plenty of prenatal support,” he explains, “but as soon as a baby is born, the whole focus goes to the baby. There’s very little focus on the mother. The mother disappears into the shadows of her role.” As in all things, knowledge is power: Below, Dr. Serrallach outlines exactly what you need to do to shake the brain fog, regain your energy, and get back on your feet.
Can you take us through what happens to a mom physiologically and emotionally as the baby grows?
What is happening in our society is that many mothers-to-be are already depleted leading up to the conception and pregnancy time. Nature’s design is that the developing fetus will take all that it requires from its mother. The go between to ensure that this happens safely is the placenta. The placenta is unique in humans in terms of how extensively the finger like projections of the placenta reach into the womb lining, thus creating a massive surface area. The reason for this lies in the fetal brain and its huge requirement for energy and fat (in the form of specific fatty acids such as DHA). Toward the end of the pregnancy, up to 7 grams of fat pass across the placenta each day to feed and build the baby (much higher than any other animal). Also, 60% of the total energy that goes to the baby via the placenta is to feed the brain (other primates, including gorillas, have a figure of around 20%).
The placenta serves two masters: the growing baby AND the mother. During the pregnancy, the mother supplies everything that the growing baby needs, hence why so many mothers become low in iron, zinc, Vitamin B12, Vitamin B9, iodine, and selenium. They also have much lower reserves in important omega 3 fats like DHA and specific amino acids from proteins. The placenta also tunes the mother to the baby, and the baby to the mother. This is no accident. The placenta develops at the same time as the fetal hypothalamus (a hormone producing gland in the baby’s brain) and the hormones produced by the placenta look very similar to the hypothalamic hormones—again no accident. A beautiful example of this occurs during birth. What causes labor pains (contractions of the uterus) is oxytocin, which is also known as the “love hormone.” As the baby is squeezed through the birth canal, its hypothalamus produces oxytocin which ends up in the mother’s blood stream, causing more contractions. It is as if the baby is assisting the mother in its own birth. Once the baby is born, there are huge amounts of oxytocin in both the mother and the baby, literally creating this love fest they call the “baby bubble.” This needs to be encouraged and respected, and caregivers and fathers need to be aware of the importance of this time post-birth, when the bond between mother and baby is established. Breastfeeding then keeps this bond strong. This is nature’s design, so the further we drift away from this in terms of interventions such as caesarian surgery, and opting not to breastfeed, the more we can expect the “cascade-like” flow on of “compromises” in the postpartum period and beyond, for mother and baby.
Part of the job of the placenta is to reprogram the mother. It’s as though she gets a “software upgrade,” with some parts of the brain being reinforced and other parts of the brain being lessened. The average brain shrinkage during pregnancy is about 5%, but it is not so much the brain getting smaller, but rather being modified to acquire the skills to become a mother. This is not discussed or respected enough in our society, and I feel mothers need much support and acknowledgement for this new phase of life. Part of this upgrade is the acquisition of the “baby radar,” where mothers become intuitively aware of their child’s needs, if they are cold or hungry, or if they cry at night. This hyper vigilance is obviously vital for the survival of the child but if living in an unsupportive society, it can lead to sleep problems, self doubt, insecurity, and feelings of unworthiness. An extreme example of how this can work to the mother’s detriment is the mother who “discharged” herself from hospital with pneumonia because she needed to get back to her children—without any external support, her upgraded program told her to take care of her children even if it means sacrificing her own health.
You’ve identified a syndrome in mothers, which you call Postnatal Depletion—what is it exactly?
It is the common phenomenon of fatigue and exhaustion combined with a feeling of “baby brain.” Baby Brain is a term that encompasses the symptoms of poor concentration, poor memory, and emotional lability. Emotional lability is where one’s emotions change up and down much more easily than they would have in the past, e.g. “crying for no reason.” There is often a feeling of isolation, vulnerability, and of not feeling “good enough.” It is experienced by many mothers, and is an understandable and at times predictable outcome associated with the extremely demanding task of being a mother from the perspective of both childbearing and child raising.
Along with these features, I have identified a typical associated biochemical “fingerprint” that is partly the cause of and partly the result of postnatal depletion.
How many women do you believe it affects? And for how long?
I suspect up to 50% of mothers will have some degree of postnatal depletion—possibly more, but because of the focus of our clinic I would have a slanted view. I don’t tend to have mothers seeking my helping who are feeling “amazing.”
Postnatal depletion, I feel, can affect mothers from birth until the time the child is 7 years of age (possibly longer). There is a lot of overlap between postnatal depletion and depression in terms of symptoms and biochemical findings. For some women postnatal depression occurs at the severe end of the spectrum of postnatal depletion.
In Australia, the peak incidence of postnatal depression is four years after the child is born, not in the first 6 months which was previously thought to be the time of highest incidence of depression. This shows that postnatal depression is an accumulation of factors from the pregnancy, delivery, and post childbirth. This is also the case for postnatal depletion though many mothers with depletion don’t experience depression and it is possible to have postnatal depression without the depletion.
What are its symptoms?
- Fatigue and exhaustion.
- Tired on waking.
- Falling asleep unintentionally.
- Hyper-vigilance (a feeling that the “radar” is constantly on), which is often associated with anxiety or a sense of unease. I often hear the words “tired and wired” describing how mothers feel.
- Sense of guilt and shame around the role of being a mother and loss of self esteem. This is often associated with a sense of isolation and apprehension and sometimes even fear about socializing or leaving the house.
- Frustration, overwhelm, and a sense of not coping. I often hear mothers say: “There is no time for me.”
- As mentioned, brain fog or “baby brain.”
- Loss of libido.
What are its causes?
It is multifactorial.
We live in a society of continual ongoing stress and we literally don’t know how to relax or switch off. This has profound effects on hormones, immune function, brain structure, and gut health.
Woman are having babies later in life. In Australia the average age for a mother having her first baby is 30.9 years.
Women tend to be in a depleted state going into motherhood with careers, demanding social schedules, and the chronic sleep deprivation as the norm in our society.
As a society we tend not to allow mothers to fully recover after childbirth before getting pregnant again. It is not uncommon to see the phenomenon of a mother giving birth to two children from separate pregnancies in the same calendar year. Also with assisted reproduction we are seeing higher rates of twins which will obviously exacerbate any depletion.
Sleep deprivation of having a newborn with some research suggesting that in the first year the average sleep debt is 700 hours! Reduced family and societal support is very common.
Our food is becoming increasingly nutrient poor. We are in many cases having “2 mouthfuls of food for 1 mouthful of nutrition.”
Though poorly studied, there are specific aspects of the 21st-century lifestyle that are contributory to postnatal depletion. This includes environmental pollutants such as air pollution, heavy metals, chlorinated water, and “electrosmog” to name a few.
There is a perceived notion that the mother has to be “everything” and as result many mothers suffer in silence and are not receiving education, information, or support. Multi-generational support groups for mothers have been part of indigenous cultures for millennium though they are sadly absent in our post-industrial culture.
The phenomenon of inter-generational epigenetic changes in the expression of our genetics is very complex but explains in part the higher rate of allergic disease and autoimmune disease that we are seeing in our society. In short we cannot do the same as what our parents or grandparents did and expect the same level of health. We literally have to “up our game” just to experience the same level of health as our parents, let alone experience better health.
Where should women start in terms of starting to feel like themselves again?
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