“At the beginning of your world, I was part of you.
Made of the same luminous fabric, flesh of your flesh,
of our father and mother’s being.
As we grew, we were separated but united. I fed you, breathed for you,
became a pathway for the flushing currents of our mother’s blood.
As you slept, I was your cradle and your guard;
when you awoke I was your companion.
Together for that last day I leashed you the very limits of our linking line before
releasing you to the touch of others – lovers, yes – but surely none will hold
you as nearly, as sweetly or as softly as I did.
As our connection was severed you wept for me once, then were gone.
Carry me deep in your heart as you bury me in the soil of our home,
for I am the earth of your making.”

—Kate Alice 2002

One of the decisions home birth families will have to make is how they will treat the placenta. Throughout history the placenta has been treated with varying degrees of respect and ceremony and is considered sacred by many. While most hospital births include the quick disposal of the placenta with any other medical waste, many home birth whānau often like to treat the placenta with a bit more respect. It is the organ that is responsible for nourishing and protecting your baby during pregnancy, after all! Until recently in New Zealand history there was no accommodation made for more ritualistic or traditional placenta treatments. However, it is now acknowledged that the placenta is considered precious by many, and is to be respected. Traditional Māori practice is to bury the placenta and return it to the land. This is because the earth mother, Papatūānuku, birthed all living things and the land is her placenta or whenua. When we bury the whenua, we return it to its place of birth. The Māori of New Zealand are Tangata Whenua, people of the land and so the word whenua means placenta, but also land.

Whenua burial
Burying a placenta can occur in many different ways. This practice reinforces the relationship between the newborn child and the land of their birth. Some people weave, form, or create an Ipu whenua, which is a vessel that is used to bury the placenta in. Others return the placenta straight into the earth. It is common to bury the placenta beneath a special tree or in a special place so that baby can be remembered through their connection to the earth.

The iho or pito (different parts of the umbilical cord) can often be buried in a different place, traditionally it is placed in the hole of a tree trunk or a cliff face. The pito is the portion that is close to the baby and falls off after it has been tied. The iho is the central part and the rauru is the part that is closest to the placenta. Some tribes have customary places where all pito are buried at the corner of a boundary.

It is important to bury the placenta deep and well wrapped in biodegradable materials, to protect the tree and prevent animals scavenging. Often a placenta is buried on tribal land so that the baby always has a home-place to return to. Many people consider storing their placenta in the freezer before burial; however this mixing of sacred pregnancy with our food is not considered appropriate in Māori culture.

Placenta burial can be as simple or as ritualised as each whānau prefers. Traditionally a karakia of new life or ‘oho rangi’ was performed when the baby is separated from the whenua. Other traditions include a tohi ceremony which is a water blessing for the baby. People who are not from Māori culture may choose to bury their placenta and this can take any form that feels right to them.

Lotus Birth
Lotus birth is when the placenta is not cut away from the baby. Instead, the placenta naturally shrivels and falls off the baby, which happens anywhere from 3 to 10 days after birth. This is considered to be a more natural and physiological process allowing the baby to be separated from the mother gently. There is also a physiological benefit of baby receiving their full quota of blood which is often denied them with hasty cord clamping. During a lotus birth the placenta is often salted and wrapped and carried with baby until it is ready to fall away naturally. Though there are many levels of lotus birth and a physiological 4th stage where the placenta is birthed naturally and not clamped for several hours is considered a lotus birth also.

Placentophagy
It is common knowledge that most other mammals will eat the placenta when they give birth, this is to protect the newborn from predators but also to provide essential nutrients to the mother. Nothing is wasted. In traditional Chinese medicine the placenta was cooked and dried and ground into a powder to create maternal supplements. The hormones in the placenta and the nutrients are said to help prevent postpartum haemorrhage, postnatal depression and to aid in milk supply. Despite a cultural squeamishness from the uninitiated, placentophagy is gaining popularity and it is now common to find people who will encapsulate your placenta for you after birth.

Home Birth Aotearoa advocates for exclusive breastfeeding where possible for all babies.   Successful establishment of breastfeeding has a significant impact on the breastfeeding and bonding for mother and child and birthing at home gives you an excellent opportunity to naturally establish breastfeeding in a comfortable and familiar environment.

Experts say that breastmilk is the natural food for your baby, as breastmilk is uniquely suited to your baby’s requirements. Even though companies that make baby formula make every effort to closely resemble breastmilk, formula will never precisely match breastmilk. Additionally, as your baby grows older and takes fewer feeds, breastmilk adjusts to your baby’s nutritional requirements. For the first six months of life, your baby receives all the nutrients they require exclusively from breastmilk. Your baby’s digestive system easily digests and absorbs breastmilk. If you only give your baby breastmilk and no solids, water, or other liquids, this is referred to as exclusive breastfeeding, and your baby will grow and develop properly.

The health and well being benefits of breastfeeding are significant and lifelong. Your baby’s immune system is strengthened by colostrum, which also promotes their growth and development. Colostrum and fully developed breastmilk both contain antibodies, healthy bacteria, and other components that lower your baby’s risk of infections and certain illnesses. Babies who are breastfed have a reduced risk of sudden unexpected death in infancy (SUDI), including sudden infant death syndrome (SIDS) and fatal sleeping accidents.

Breastfeeding is also good for mothers, not only is it convenient, free, helps with bonding, it has some health benefits. Breastfeeding mothers sleep cycles are more in tune with their babies’ cycles and they tend to fall back to sleep more easily compared to formula-feeding mothers. Also breastfeeding can assist some women in losing weight after giving birth. The longer you breastfeed the better it is for your health , as it reduces your risk of breast and ovarian cancer, osteoporosis, type 2 diabetes, and high blood pressure.

INITIATING BREASTFEEDING
Most people believe that babies need help to breastfeed, however, a healthy term baby, born by normal vaginal delivery without any medication, can decide for themselves when they are ready to take their first feed. It has been found that infants are 8 times more likely to breastfeed spontaneously if they spend more than 50 minutes in skin to skin contact with their mother immediately after birth.

If the baby is placed on their mother’s abdomen and left for at least 60 minutes, they will begin a 5 part sequence:

1. For the first 30 minutes (approximately) they will rest and peer up at their mother.

2. Between roughly 30 – 40 minutes, the baby will start lip smacking and mouthing their fingers, followed by an outpouring of saliva onto their chin.

3. He or she will then begin to inch forward up the mother’s abdomen, pushing strongly with their legs, as they move upwards, they will often turns their head from side to side.

4. When they reach mother’s sternum, they will bounce their head (head bobbing) into her chest.

5. As they come close to the nipple, they open their mouth widely and after several attempts, attach to the breast perfectly. Babies who attach in this way have fewer problems with breastfeeding.

The baby uses the smell of amniotic fluid on their hands to make a connection with an oily substance secreted on the areola to guide their way. If the breasts are washed it will interfere with this sequence of events.

This natural sequence of events also helps the mother. The baby pushing their feet on her abdomen may help the expulsion of the placenta. The stimulation and suckling of the breast helps to release a surge of the hormone oxytocin which helps contract the uterus thereby expelling the placenta and closes off many blood vessels thereby reducing bleeding. The suckling also results in the production of the hormone prolactin, enabling further milk production. The act of skin to skin contact also enhances the bond between mother and baby.

Getting a good latch
Ensuring that the baby is latched correctly and comfortably is the most important aspect of breastfeeding, as this ensures that baby is effectively taking milk from the breast, and that breastfeeding is comfortable for mum. A wide open mouth, with babies nose to the nipple should ensure a good latch. Trust your baby and your own instincts when latching.

Hunger Cues
If we consider the baby’s reflexes and behavioural sates, we can consider the best times to offer breastfeeds and how to stimulate the baby’s interest in breastfeeding.

As mentioned earlier, initially after birth, the baby is in an alert and responsive state and is likely to make a successful first attempt at breastfeeding. If the baby has an early successful feed it has been found that the mother is more likely to breastfeed for longer; if that feed is delayed it is less likely to be successful. Therefore, the optimal time for the first breastfeed is the first 30 minutes to 1 hour after birth. It is not necessary or helpful to try to force the baby to feed, but to recognise rooting and other signs that the baby is ready to feed.

After this initial period of alertness, many babies enter a long state of quiet sleep where they become difficult to rouse for feeding. It is thought that this nature’s way of allowing the mother to rest after the exhaustion of labour and the baby following the stress of being born.

Observe your baby for periods of REM sleep when they can most easily be awakened and thus encouraged into breastfeeding through stimulation through skin to skin contact. You may also observe them stirring and making hand to mouth movements showing that they may be ready for another feed. Crying is a late indication of hunger and the baby’s movements are likely to be disorganised so they cannot feed effectively and may fall asleep before much milk transfer has taken place. Forcing a baby to breastfeed will often result in breast refusal. The mother and baby need to remain in close contact after birth, rather than the baby being removed to a separate room.

BREASTFEEDING TIMEFRAME

Immediately after baby is born:

• Request skin-to-skin contact with your baby as soon as possible after he or she has been born.   If you are unable to do this yourself, ask that baby has skin-to-skin contact with your partner.
• Nipple tenderness is normal for some women.  Intense pain is NOT. Seek skilled help early to prevent damage to your nipples. A lactation consultant, La Leche League Leader or Peer Counsellor has those skills. Please also see the links at the bottom of this section for where to go for more help.
• Day 1: baby will have around ½ teaspoon of colostrum (the early, yellow/gold milk) each feed, around one wet nappy and sticky green-black poo.
• Day 2: Approximately 1 teaspoon of colostrum each feed, around 2 wet nappies and soft green-black poos.
• Day 3: breastmilk is starting to increase, around 3 wet nappies and poos are becoming greenish-brown and less sticky.
• Day 4: 4 wet nappies and poos becoming a lighter green-brown or may have changed to a mustard-yellow and can be ‘seedy’ or watery.
• Day 5: breast milk supply increases, around 5 wet nappies and poo mostly mustard-yellow, soft or liquid and 3-4 times every 24 hours.
• Day 6: onward, 6-8 clear wet nappies and about 4 poos or more is all normal in 24 hours.

The first few days and weeks

• Expect to spend lots of time sitting down, feeding your baby!! It is normal for newborns to need around 12 feeds in 24 hours. You and your baby are working hard to get the right amount of milk.
• It can take 6-8 weeks for the breastfeeding ‘dance’ between mum and bay to find its rhythm. Each baby/mother pair is unique with different patterns, so try not to compare yourself or your baby to others. Just like adults, all babies have different eating patterns.
• There are usually lots of questions, from both parents, so your breastfeeding support network is very important at this time.
• Accept all offers of help from friends and family – you deserve it!
• You may like to check out local support groups, where you will meet mums with babies of all ages, with similar questions and experiences.
• Going out with your breastfed baby is easy. You have baby’s food ready to go, at the right temperature, in sustainable and attractive packaging!
• Have your nappy bag packed ready at the door – nappies, wipes, perhaps a baby sling and a change of clothes are really all you need.
• If your baby is hungry while you are out, feel free to breastfed him/her wherever you feel comfortable.

After the first few weeks:

• From around 6 weeks, some mums find they have lost that ‘full’ feeling in their breasts and start to question whether they have enough milk. What is actually happening is that your milk supply is starting to match the needs of your baby – clever you!
• Solid foods can be introduced at around 6 months, with breastfeeding still forming a significant part of baby’s diet until around 12 months old. The World Health Organization recommends that babies continue to receive breastmilk for 2 years, or more, as long as mother and child wish.
• Returning to work – explore childcare options that are going to be compatible with your family needs and supportive of caring for a breastfed baby. You don’t have to stop breastfeeding just because you go back to work.

 Although breastfeeding has many advantages, it can be difficult to master. It may be helpful to know that you can overcome the majority of breastfeeding challenges with the proper support. If you decide not to breastfeed, infant formulas provide sufficient nutrition for your baby. And just because you may need to supplement breastmilk with formula doesn’t mean you have to stop breastfeeding entirely or forever.

Sore nipples
The most frequent cause of sore or damaged nipples is from your baby not correctly attaching to your breast. When your baby first attaches to the breast, you might experience some tenderness in the first few days or weeks of breastfeeding, but this should subside as the milk begins to flow. Breastfeeding should not be painful. The first thing to do when you have sore nipples is to check your baby has a good latch. If you’ve checked your baby’s attachment and you still have sore nipples, don’t give up just yet there are other things you can attempt.

Feed your baby when they first begin to show hunger cues, a relaxed baby will be more gentle on your nipples that one crying from hunger. Damaged nipples hurt the most before milk begins to flow, and the pain typically goes away once the milk starts flowing, so try to initiate your let-down prior to attaching to the breast. Try admiring your sleeping baby, taking slow and deep breaths, remembering a sweet moment, while massaging your breast and softly rolling your nipple between your fingers to induce a let-down. Breastfeed on the side that is less painful first. If you need to remove your baby from the breast, first break the suction by placing your little finger between the gums in the corner of your baby’s mouth. Remove your baby from the breast gently.

At the conclusion of each feed, inspect your nipples for visible signs of damage, they may appear compressed or have cracks. You can hand-express a few drips of your own breastmilk and distribute it over your nipple, also allow your nipples to air dry after breastfeeding. You can try applying a purified lanolin ointment. Avoid using shampoos and soaps on your nipples. Even if you’re finding it too painful to feed your baby and you’re waiting to get help, you still need to keep your milk moving by expressing it. If you don’t take the milk out regularly, your breasts might become engorged and you’ll be at risk of mastitis. Not emptying milk regularly will also reduce your milk supply. Feed your milk to your baby by cup or spoon until your nipples feel better. Babies suck differently on breasts, so if you can, avoid using teats, bottles or dummies. If the soreness doesn’t get better each day, it’s worth talking to your midwife a lactation consultant.

Blocked milk duct
If you notice a painful lump in your breast but otherwise feel fine, you may have a clogged milk duct. Try these remedies right away to help resolve the issue. Take a warm shower or apply a warm heat pack in a soft fabric and place it against your breast for a few minutes. and massage the breast to try break up the lump so it can work its way out. When breastfeeding, remove your bra and offer the breast that is affected first and feed frequently to drain the breast. While baby is feeding, using the flat part of your finger gently massage the lump towards the nipple.

Examine and ensure your baby has a good latch and change your baby’s feeding positions to ensure that your breast drains properly. If feeding does not remove the blockage, attempt expressing by hand, you may find this easier while showering. Continue trying to clear the blockage as it may lead to mastitis.

Mastitis
Mastitis is an inflammation of the breast and can be triggered by an uncleared blocked milk duct. Mastitis may be present if your breast is showing signs of inflammation, hot, sore, swollen, or some discolouration. The discoloration on pale skin may be rosy or scarlet, or it may have shiny, silvery lines. Discoloration may be difficult to see on darker flesh, but your breast will be sore and warm. Symptoms of mastitis include fever, headache, muscular soreness, and chills. If you think you have mastitis, follow the same steps as for a blocked milk duct. If your symptoms don’t improve, you might have an infection. Consult your midwife or doctor without delay. Antibiotics will almost certainly be given to assist with both the inflammation and the infection.

It is important to continue breastfeeding until your symptoms have resolved, as stopping increases the chance of getting a breast abscess. Attempt to drain as much of the afflicted breast as feasible. If you are too unwell to breastfeed or if your baby refuses to feed, express your milk as it is important to drain the affected breast as much as possible, the breastmilk is still safe for your baby to consume. Mastitis can make you feel very sick, you may need someone to look after you and your baby, you need to rest as much as possible, eat well and drink plenty of water. Talk to your midwife or doctor if your symptoms don’t improve after a few days of treatment. If mastitis isn’t treated quickly, a breast abscess can form.

Low breastmilk production
If given the proper knowledge, assistance, and care, most mothers can breastfeed and make enough milk for their babies. However, many mums are still concerned that they are not producing enough breastmilk. Looking at your baby’s nappies and growth is the best method to determine what’s going on with your milk production and whether your baby is receiving enough milk. Your midwife will monitor these during postnatal visits. It is common for babies to lose some weight during their first week of life. Following this, your baby may not be receiving enough milk if they aren’t gaining weight or they are urinating and passing bowel motions less than expected. If your baby cries after feeds, it can be for a variety of reasons. It is not always an indication that they are still hungry.  They may be stating they are tired, no longer want to feed or they have a sore tummy.

Offer more breastfeeds to boost milk production. Your breasts receive a signal to produce more milk each time your baby drinks some of your milk. Therefore, nursing a few more times per day will boost your production. To begin with, try to breastfeed 8–12 times per 24 hours. If you are presently breastfeeding your baby every three to four hours, in between some of these feeds you may be able to work in an additional short top up feed. Again, if your baby does not settle after a feed, give them a ‘top-up’ feed. You’ll have more milk in 20-30 minutes, even if your baby has emptied your breasts. Because your prolactin levels are greater at night, feeding more frequently at night may boost your milk production. Wake your baby to feed, particularly if they sleep for extended periods of time or are usually sleepy and refuse frequent feeds. After each breastfeed or while your infant is asleep, express. This will empty your breasts and help with increasing your supply.

Furthermore, having lots of skin-to-skin contact with your baby can boost your milk production by stimulating prolactin and oxytocin. Both of these hormones aid in the production and discharge of breastfeeding. Having your baby on your chest in a nappy and taking off your top and bra will allow you to have skin-to-skin contact while breastfeeding. Put a blanket around yourself if it’s cold to stay warm. Make yourself comfy and unwind, your milk production will be improved while breastfeeding if you are more at ease. Ensure that your bed or chair is comfy and attempt to eliminate distractions .You’re more likely to produce milk if you’re well-rested and healthy. So, make sure you have a bottle of water on hand, breastfeeding can dehydrate you, eat healthily and keep moving. Rest or attempt to get some shut-eye when your baby is sleeping and take up any help offered by family and friends.

Breastmilk oversupply
Overproduction of breastmilk occurs when you produce more milk than what your baby requires. An oversupply of breastmilk is typical in the first few weeks after birth. However, it’s comforting to know that your supply will typically level off. After breastfeeding, you might also observe that your breasts feel lumpy and tight and seem to fill up rapidly. Your baby may be experiencing an oversupply of breastmilk if they experience any of the following symptoms: wind, stomach aches, excessive weeing, green frothy poop, frequent crying, coughing or gagging due to the fast flow of your milk. You might also notice that your breasts seem to fill quickly or feel lumpy and tight after breastfeeding.

Oversupply can be addressed by feeding your baby when you notice their hunger cues so that you can meet their needs. Your baby can latch to and drain from your breast more easily if you offer the breast early. However, you might want to wake your infant to feed if the excess is making you extremely uncomfortable. Let your baby feed from one breast for as long as possible, before offering the other side, try to make sure the first breast feels completely emptied. Double-check your posture and technique and use gravity to help slow down your milk flow. If your breasts are painful, you should express a small amount of milk. However, overexpressing will result in the production of more milk, so make sure you only express enough to ease any pain or soreness.To soften the area of the breast where your baby will latch, apply reverse pressure, this will help the baby latch more easily.

Breast engorgement
Breast engorgement is when milk and other fluids accumulate in your breasts, causing them to swell and become painful. The first week following birth is the time when breast engorgement is most likely to occur. However, it can also occur at other periods, such as when a feed is delayed or missed. Engorgement of the breasts can be very painful and breastfeeding may also hurt. You may feel as though your breasts are much heavier and warmer than normal. The best method to deal with breast engorgement is to feed your baby more frequently and pay attention to your baby’s early hunger cues. If your breasts are engorged for more than 1-2 days, especially in the early days of breastfeeding, talk with your midwife, lactation consultant or a breastfeeding counsellor.

Other things to help you get some relief from breast engorgement you can try are, ensuring you wear a crop top or bra that is not too snug; rather, wear one that fits well and is supportive and before starting to breastfeed, fully remove your bra. Before beginning the feed, warm your breasts with a warm cloth for a few minutes before breastfeeding. This can help your let-down. You can also attempt reverse pressure softening or hand-expressing a small amount of milk. Your baby may be able to attach more easily and get a good latch as a result. Switch up your breastfeeding positions. You could, for instance, attempt the football hold at one feed and the cradle hold at the next and massage your breast gently while breastfeeding. To reduce pain and swelling after breastfeeding, apply an ice compress or a bag of frozen peas covered in cloth to your breast. Some mums find it helpful to cover their breasts with chilled cabbage leaves.

We often hear stories of how new parents form these instantaneous, intense, and magical bonds with their babies at the time of birth. However, the reality is that while most infants are ready to bond immediately, this doesn’t always happen for parents. When that bond between the parent and their baby takes longer to establish, new parents may experience feelings of guilt and shame. It’s not uncommon to find that it takes time to develop a relationship and bonding with your baby may take days, weeks, or even months.

For many parents, bonding results from everyday caregiving. It may not be until your baby begins to smile that you feel those warm fuzzies and you may not even have realised those feelings were developing until that moment. Bonding is a process, not something that takes place within minutes and not something that has to be limited to happening within a certain time period after birth. Read on to learn why forming a bond with baby is important, how that bond might form and what you can do to help things along.

The importance of bonding with baby
Bonding with your infant is essential. It aids in the release of hormones and chemicals in the brain that promote rapid brain development. Additionally, bonding fosters the growth of your baby’s body, your baby’s sense of security and self-esteem and coping mechanisms for emotional distress. Your child gains the confidence to explore, grow, and be creative and independent thanks to this. A child may experience anxiety or distress if they don’t feel confident that their parent will always be responsive, accessible, and protective. They may even become clingy or afraid of their surroundings if there isn’t a strong bond in place. In the long run, this may make them avoidant in an effort to live life without the help or affection of others. Without a strong connection, a child may not have trust in their parent’s ability to be available, responsive, and protective, which could result in feelings of anxiety or distress. They might even become overly attached or afraid of their surroundings. In an effort to survive life without the help or love of others, they may eventually develop avoidance behaviours.

Responding to your baby
Bonding should happen naturally as you care for your baby and meet their needs. You cannot spoil a baby. Babies need a lot of care and attention and are too young to sort out their own problems, so you will not be creating bad habits by responding to your baby’s needs. These basic activities include things such as, changing their nappy, feeding, providing warmth, interacting with them and giving them affection. Responding to what they want and need builds their trust in you and helps them feel confident.

Mothers are biologically programmed to react when they hear their baby crying, and when you are unable to respond to your baby immediately you may feel anxious. If you know that your baby is safe, try using your voice to reassure them until you are able to go to them and gently soothe and comfort them. Your baby will quickly learn the difference between your touches if you and your partner frequently hold and have contact with your baby. Both breastfeeding and bottle feeding are natural opportunities for bonding. Holding your infant against your skin while feeding or rocking him or her allows you both to experience skin-to-skin contact with your baby.

Delayed Bonding
Bonding can be delayed for a variety of causes. Because a baby’s face is his or her main mode of communication, it plays an important role in bonding and attachment. Parents may envision their infant as having certain physical characteristics. When you meet your baby at birth reality might require you to adjust your mental image. Hormones can also impact bonding, when mothers’ hormones are raging or they suffer from postpartum depression, it can be difficult for them to connect with their infants.

If your birth was lengthy, challenging or traumatic, it may take you more time to heal and detract from or delay the bonding process. Bonding can be delayed if your baby has serious, unexpected health issues and require them to be in an intensive care unit. You may feel overwhelmed and disconnected in such an environment. You can still bond by interacting with them, by observing, touching, and chatting with them. They will soon respond to your words and touch and recognise you. You can hold them when they’re ready, and the hospital personnel will assist you.

WAYS TO BOND WITH YOUR BABY

Make the most of feeding time.
Breastfeeding is a good opportunity for skin-to-skin contact as well as reading your baby’s facial expressions and body language. If you’re unable to breastfeed, use bottle feedings as a chance to bond in the same way. Whether you are bottle feeding or breastfeeding, make an effort to concentrate on the job at hand and Increase attachment by making eye contact and smiling while holding and feeding.

Talk to your baby
Even though it may seem silly, your baby enjoys hearing your voice. As often as you can, speak to your baby in calming, comforting tones. You could talk about your actions while changing nappies, bathing, getting dressed, or share stories. Your baby will benefit from learning to identify the sound of your voice this way. It will also aid in your baby’s future linguistic acquisition.

Play with your baby
To begin with your baby won’t be giving you much in the way of interactions. But it’s never too early to begin play activities. Reading and singing both count, or try playing peek-a-boo or blowing kisses. Your baby will probably enjoy the rhythm and tones of music. Soothing music can help both of you feel calmer, and your newborn won’t mind if you forget the words to songs. Look your newborn in the eyes as you speak, sing, and make exaggerated or silly facial expressions. This teaches your baby the relationship between words and emotions. When baby starts becoming vocal, mimic their sound and after mimicking your baby’s noises or signals, wait for a reaction before proceeding to have a two way conversation.

Wear your baby
When properly used, slings, wraps, carriers allow you to remain close to your little one. Babywearing can be a great way for you get chores done when baby is awake or wanting to be close to you.  Also, you can get outside and go places a pushchair can’t and they are great for shopping trips. Baby can experience the world through your eyes.

Sleep near your baby
At birth, a newborn baby has a strong and distinct sense of smell, which enables your baby to recognise your presence from a distance. Allowing your baby to sleep in your room in a bassinet that you can connect to your bed or have close to your bed will keep them close to you, allowing you two to bond throughout the night. It is also convenient for night time feeds and resettling them to sleep.

Learn how to respond to your baby
Learn to interpret your baby’s cues and signals and communicate with him or her. Your baby’s cries are their own language, and learning to interpret them will help you know when they need to be fed, changed, or simply kissed. Even if you have no idea what they need/want, your responsiveness will deem you trustworthy in their eyes.

Facilitate touch with your baby
Infant massage is a traditional technique that strengthens your relationship with your child while calming her muscles, boosting circulation, and lowering tension for you both. Additionally, a 15-minute massage or a bath before bed will promote faster and deeper sleep for your infant. Bonding occurs when parents make different kinds of contact with their baby, so hold, touch and cuddle your infant frequently.

Don’t Forget About You
You have an infant who relies on you at all hours of the day, it’s easy to become exhausted and touched out. It is critical to make time for yourself. If you need a break and want to relax, allow your spouse, whānau member or a friend to help, even if only for an hour. In the end, everyone will be happy. Finally, keep in mind that returning to work will not damage your relationship. Continue to spend as much time as possible with your infant, even if it means putting off the housework.

Let’s be honest, it can be challenging to give so much in those first days and weeks and not get much engagement from your baby in return. However as your baby develops and matures, they’ll begin to establish eye contact, smile, and give you encouraging coos and giggles—and your attachment will grow. At the end of the day, don’t forget to be kind to yourself. Whatever your route to parenting, you’ve just gone through a change that can be overwhelming. If it takes some time for you to adapt, don’t feel bad or ashamed about it. The most crucial element of bonding is lovingly and tenderly attending to your baby’s needs.

FATHERS BONDING WITH BABY

Fathers nowadays spend more time with their children than previous generations. Although fathers frequently desire closer contact with their baby, bonding often happens on a different schedule, in part because dads don’t have the same access to their baby as many mothers do through breastfeeding and also, they may have limited time due to work commitments. A father’s relationship with their child is different to that of a mother, they often engage in more special activities with their baby.

Early bonding activities include:

• burp and settle baby after a feed
• bottle feed of expressed breast milk once breastfeeding is well established
• cuddle, change, and bathe baby
• read or sing to baby
• mirror baby’s movements and mimic baby’s cooing and other vocalizations
• babywear during routine activities
• let baby touch dad’s face
• share the night shift

Maternal gatekeeping occurs when a mother’s protectiveness discourages and limits her partner’s interactions with the baby. When a mother’s protectiveness discourages and limits her partner’s interactions with their baby, this is known as maternal gatekeeping. While a mother wants to keep her baby safe, failing to open the gate sufficiently will jeopardise her partner’s relationship with the baby and it is also likely to harm the couple’s relationship. Maternal gatekeeping can have a negative impact on their partner’s commitment to both them and the baby or a mother may find nurturing behaviour in her partner that she has never seen before if she opens the maternal gate.

When the baby is small, there is always a maternal gate; the issue is whether it is open or closed. When the mother is peering over her partner’s shoulder while he is doing things with the baby, always criticising his handling of the baby, giving him unasked-for instructions rather than letting him figure it out on his own, and complaining or making jokes to others about how inept he is with the baby or that he doesn’t know things indicates a closed maternal gate. If the father is not allowed to engage with the baby or does not take advantage of chances to do so, the baby’s ability to form a secure attachment to their father is limited, as is the father’s ability to enjoy and even like the baby. This may have an effect on his dedication to both the baby and his relationship with his partner.

Maternal gatekeeping is frequently done by well-intentioned mothers who are unaware of their actions. And because she isn’t aware of what she is doing, if he brings it up, she may dismiss it or assume he is criticising her. Mum can open the maternal gate by allowing her partner to care for the baby without hovering over them and without providing detailed instructions. She can talk through ideas and decisions regarding the baby with her partner, valuing his thoughts and opinions. Also, she can allow time for bonding, by making activities such as bath time, bedtime, and walks, dad and baby time. Share the “chores” like changing nappies, doing laundry, and getting up in the middle of the night and recognising the effort he puts in. A close connection between two parents and their child is preferable to one. Parents working as a true team benefits the entire family.

Baby sleep is often a controversial topic, mostly due to misleading information about sleep training or articles containing unrealistic expectations about baby behaviour. People often ask how your baby is sleeping and offer their unsolicited advice and it often leaves parents feeling judged and questioning themselves. Babies are restless and unreliable sleepers who need to feed every few hours, therefore they are expected to wake numerous times during the night. Babies are not born with a circadian rhythm, and they are unaware that people sleep at night, and their sleep patterns can vary greatly. It is not until they are four months old that babies will know the difference between day and night. This period of severely disrupted sleep while caring for an infant is exhausting and challenging for parents and can have a significant impact on the health and wellbeing of your whānau. Just try to sleep or rest when your baby does and ask whānau and friends for support if needed.

Knowing what constitutes as biologically normal sleep for babies can help parents negotiate the wealth of conflicting information and distinguish fact from opinion. It’s essential to keep in mind that infants follow their own biological rhythms and are not aware of what their parents are reading or being told. A baby’s day-night pattern of wakefulness and sleep can often take several months to develop. Many parents simply want reassurance that their infant is healthy during this period and that their baby’s sleep patterns are developing normally. It may not be the baby who is an issue when we are unhappy with our baby’s sleep habits, but rather our expectations concerning babies needs and how babies ‘should’ sleep.

Newborns have sleep cycles and just like adults they are made up of various stages and depths of sleep. Babies’ sleep cycles are short, approximately 45 minutes long and young babies may only sleep through one of these at a time or they may sleep through more. These sleep cycles can be broken into stages. At the beginning of the sleep cycle baby is drowsy, then moves into stage 2, light sleep. While your baby is in a light sleep, they naturally make noises and stir as their brain activity changes. You may notice that their breathing is irregular, they may twitch, smile, or make sucking movements with their mouth. When they are in a light sleep, they wake easily. In comparison, when they are in a deep sleep, stages 3 and 4, they barely move, and their breathing is deep and regular. They are less inclined to awaken while sleeping deeply. Baby will then move back from stage 4, to 3, then 2 and then to REM, For some babies, these natural stirrings during REM may lead to them waking fully, and for other babies they move more into another sleep cycle.

• Stage One – drowsiness, is the lightest stage of sleep. Your baby’s eyes droop and may open and close.
• Stage Two – light sleep, is the first “true” sleep stage. Your baby moves and may startle or jump with sounds.
• Stage Three – deep sleep, is the deeper, more restorative part of the sleep cycle, important for growth and development. Your baby is quiet and does not move.
• Stage Four – very deep sleep, is the stage where the brain is consolidating information and storing memories. Your baby is quiet and does not move, and usually remains asleep through loud noises.
• REM (rapid eye movement sleep), this is a light sleep when dreams occur and the eyes move rapidly back and forth. REM sleep makes up half of babies sleep each day.

Just as with feeding, babies exhibit signs and cues when they are ready for a change. It can be challenging to interpret the signals, as we may mistakenly think baby is hungry or unsettled when they are actually tired. You might be able to determine what they need by pausing and observing their cues. Some babies need you to stay with them to help them settle, while others may settle without support. Every baby is different and sometimes they may need you more than usual. Be kind to yourself as it takes time to learn about sleep and what works best for you and your baby.

The signs that may tell you baby is ready for sleep include:

• Yawning
• Grizzling or fussing
• Jerky movements or arching backwards
• Clenched fists or sucking fists
• Looking away or losing interest in toys or people
• Eye rubbing
• Startling easily
• Frowning, fixed stare or staring into space
• Crying (a late sign)

If you notice tired signs or cues you might like to respond by:

• Cuddling or rocking baby calmly
• Patting, stroking, or talking to your baby quietly
• Swaddling baby safely
• Singing oriori or lullabies
• Putting babies in their baby bed while they are drowsy

Safe sleep

In New Zealand, between 40 and 60 babies die of SUDI each year. SUDI stands for sudden unexpected death in infancy and includes fatal fatalities from accidents during sleep, often suffocation and also sudden infant death syndrome (SIDS), where no cause of death can be found. 80% of cases happen before babies are five months old and many of these deaths could be prevented by using safe sleep practices and ensuring your baby’s bed and sleeping space are safe for them. While it’s frightening for new parents to think about, it’s important to know the facts, and to know what you can do to reduce the risk for your baby. Make every sleep a safe sleep.

Babies spend a lot of time sleeping and there are plenty of things you can do to keep your baby safe while they sleep. The main risk factors for SUDI are unsafe bed-sharing, baby being exposed to tobacco smoke during pregnancy or after birth, and the position of your baby when sleeping.

The risk is greater if:

• babies sleep on their sides, the SUDI risk is double.
• babies sleep on their front, the SUDI risks are six times higher.
• you share a bed with your baby in an unsafe way
• baby is put down to sleep on a soft surface
• baby is put down to sleep with loose or fluffy clothing, bedding, or soft toys
• baby sleeps with their face or head covered
• baby gets overheated.

The four key steps for making sure your baby has a safe sleep spell PEPE.

P – Place baby in their own baby bed in the same room as you
For every sleep, place your baby in their own safe sleep space, such as a bassinet, cot, a wahakura (woven flax bassinet) or Pēpi-pod, including when visiting friends and whānau and in the same room as you for at least the first six months. The bed should have a firm and flat mattress so your baby’s airway is open when lying flat on their back; there should be no gaps between the bed frame and the mattress where your baby could become trapped or wedged; and there should be nothing in the bed that could cover your baby’s face, lift their head, or choke them, such as pillows, loose bedding, bumper mats, toys, bibs, headbands, and necklaces. 

If you choose to bed share with your baby, avoid placing your baby directly in the bed with an adult or a child who might roll over and unintentionally smother them, put them in their own baby bed beside you. It is important that parents are responsive to their baby’s needs, and they are not extremely tired, and they are free from drugs and alcohol. If you don’t have a baby bed, talk to your midwife, doctor, or Well Child nurse to see what help may be available in your area. If you’re on a low income, you might be able to get assistance from Work and Income.

E – Eliminate smoking in pregnancy
Eliminate smoking during pregnancy, and protect baby with a smokefree whānau, home and car. There is a strong correlation between smoking during pregnancy and SUDI. A healthy baby’s breathing is protected by an inbuilt ‘wake up’ response. Smoking seriously impairs this response in babies, particularly during pregnancy. Compared to infants who have been subjected to cigarette smoke, infants from smoke-free pregnancies have stronger lungs and an increased drive to breathe. Since babies have small bodies and lungs and breathe faster than adults, they are more vulnerable to the impacts of smoke. Tobacco smoke exposure after birth raises the chance of SUDI. Smoke-free environments are ideal for baby both before and after birth.

If you want to give up smoking:

• call the free Quitline on 0800 778 778 or text 4006
• check out the Quitline/Me Mutu website
• ask your midwife or family doctor about support services near you

P – Position baby flat on their back to sleep.
Put your baby to sleep on their back, with their feet near the end of their bed so they can’t wriggle down. Keep their face clear of bedding or anything else, their bed should be free from toys or other objects they can suffocate on. When your baby is asleep on their back, their airway is clear and open and this helps them breathe easier.
If you’re worried about your baby developing a flat head, turn their head to alternate sides with each sleep.

When awake they can be on their front for tummy time and upright for cuddles and hugs. You may also be concerned they will choke on their own vomit, Babies gag and swallow in all sleeping positions – that’s how they protect the airway. The risk of choking on vomit is lower in this position because the gagging reflexes are stronger and it is simpler for babies to maintain a safe airway.

E – Encourage and support breastfeeding.
If possible, breastfeed your baby or support mum to breastfeed. The antibodies and nutrients in breastmilk help baby stay strong and healthy. When a baby is unwell, their breathing may be under stress, which can make it harder for them to wake up normally. A robust immune system lowers the chance of SUDI and assists in protecting your baby against infections. At around 2-3 months old, breastfed infants may rouse from sleep more easily. The two to four month period is when infants is most at danger of SUDI. It is thought that breastfeeding lowers this risk.

Having a baby is a life-changing event, and the transition to life with a newborn can be both joyful and stressful for whānau, especially in the first few weeks and months. It is perfectly normal to have the ‘baby blues’ days where you feel down, sad and tearful, looking after a newborn 24/7 can be difficult at times. These feelings often last a few hours to a few days and whānau support at this time really helps,

On the other hand, mothers who are experiencing long periods of low mood, frequent tearfulness, lack of interest in activities, feeling tired and being unable to sleep, and lack of appetite, may be suffering from postnatal depression, a debilitating illness that can taint the experience of motherhood, interfere with the development of the mother-baby bond, and place an enormous strain on adult relationships.

After giving birth, women are more likely than at any other point in their lives to suffer from mental health issues such as anxiety and depression. Their partners may also struggle to adjust to having a newborn. Postnatal depression affects 10–20% of people who have recently given birth and can happen any time during pregnancy or up to a year after your baby is born. Postnatal depression may arise at any given time during the first year after birth. It can appear suddenly, range from mild to severe, and affect mothers with their first, second, or subsequent baby. Early diagnosis and therapy can reduce its severity and you can access a variety of support services. Remember it is treatable and and you will get better with the right support and some time.  

CAUSES

Although no one knows what causes the illness and anyone who gives birth is vulnerable, it appears there are certain factors that may increase the chances of developing it. Even so, postnatal depression can develop in the absence of any of these stressors, there’s no simple reason why some women are affected by postnatal depression and some aren’t. Being a single parent, having little support and getting very little sleep and being under financial stress may increase the risk of postnatal depression. However, people with lots of whānau and social support, who are in a stable relationship and are financially secure, can and do also experience postnatal depression. In either case, it doesn’t mean your brain is broken, It just means you need some help.

Postnatal depression is more common if you:

• have anxiety or depression during pregnancy
• have suffered from depression or other mental health problem(s) in the past 
• have a family history of depression  
• hormonal problems
• have limited support from your partner, whānau or other social support
• have relationship difficulties and conflict
• have been through something stressful like a bereavement, an illness, or a natural disaster 
• are stressed about your housing and finances
• the birth not meeting your expectations or experiencing birth complications, such as planned home birth transferred to hospital, an unplanned caesarean delivery, leading to experiencing birth trauma
• an experience where healthcare workers were not listening to you or taking your wishes sufficiently into account, feeling or not gaining your consent
• a baby with health problems, including birth injuries
• a baby that is fussy and unsettled or has problems feeding

SYMPTOMS

Each woman’s experience of postnatal depression is different. The symptoms of postnatal depression are the same as those of depression, and while any mother with a baby will likely experience some of these symptoms at some point, postnatal depression occurs when these feelings have been present and persistent for at least a two weeks. These may change over time and are easily overlooked by others because many mothers spend a significant portion of the day ‘alone’ with their pēpi.

Postnatal depression can have an effect on how women feel about and care for their pēpi and other tamariki. If a woman or her whānau notice that they are experiencing any of these feelings and particularly if they are persistent, speak with their midwife or doctor so that they can get the support that they need. Understanding that these are typical symptoms of postnatal depression and not an indication of being a bad parent is the first step towards recovery.

Feeling depressed
People might experience feelings of sadness, emptiness, despair or they may feel no emotions at all. For no apparent cause, they may be tearful and feel whākamamae, emotional pain or distress that is difficult to describe. Feeling wainuku, really low or down in the dumps can be worse at certain times of the day. Some people feel sad or low all the time, while others have periods where they feel better for a day or two and these are followed by poor days.

Loss of self confidence
Negative emotions are also common, such as feelings of inadequacy, especially as a mother, worthlessness, whakamā (shame) or excessive guilt.  These feelings can lead to a loss of self-confidence, where they doubt their ability to care for their child or believe they are a bad parent and they may also fail to take care of themself or care how they look. It’s also common to have exaggerated negative thoughts about individuals, especially those closest to them. The mother may experience these negative feelings of if she is unable to establish a routine or determine what her child needs and is having difficulty keeping up with everything and is becoming stressed and overwhelmed.  She may become resentful and find it hard to love the baby, which increases her sense of guilt, eeven though she has really looked forward to motherhood. 

Loss of interest and enjoyment
Women may find they are no longer interested in or appreciate the things or activities that used to make them happy.  As a result, they may feel a loss of joy or satisfaction or experience a lack of pleasure, feeling numb and empty, or having no emotions at all.

Feeling irritable or angry
Some people believe that this is the most obvious indication that something is wrong following childbirth. It can exacerbate the frustrations of caring for a small baby and can cause harm to other relationships. It becomes normal for mothers to feel angry (pukuriri) and irritable (hōhā) and have no idea why. These feelings may be directed at those around her, such as her spouse, children, or other whānau members, who may be unaware of what is going on.

Feeling anxious 
This involves excessive worry or fear, frequently regarding their baby. The mother may be obsessed with the baby’s health and concerned that the baby will come to harm if left alone, therefore they have a constant need to check on the baby constantly, so they get that reassurance that they are fine. They may feel overly anxious and focused on how hard it is to cope with ‘baby problems’ like colic or reflux and although they are looking for help, they feel it isn’t enough. They may experience panic attacks, which are sudden physical episodes of extreme fear and anxiety. The physical symptoms may be headaches, stomach pains, heart palpitations or a racing heart, which can make the mother feel like she is going to have a heart attack or a stroke, feel shaky or find it difficult to breathe.

Cognitive Difficulties
People with postnatal depression may have a deceased ability to think clearly. This may include difficulty in concentrating, making simple everyday decisions, or have memory difficulties. This makes it difficult to multitask and to think ahead which, in turn makes looking after yourself, your baby and completing other necessary tasks a major challenge.

Sleep disturbance
The most frequent change involves reduced sleep, but also includes difficulty falling asleep, disturbed sleep, and/or waking up early and being unable to fall back asleep. While it is normal for new parents to have their sleep disrupted by a waking baby, people suffering from postnatal depression, regardless of how tired they are, frequently find themselves waking before their baby or waking very early in the morning and/or unable to fall asleep even after they have fed.

Change in appetite

Women may develop a poor or excessive appetite. It is natural for most postpartum women to have an increase in appetite to keep up with their energy needs. However, depression is often associated with a decrease in appetite, where women have no desire to eat, resulting in weight loss. On the other hand some women will have increased appetite, often without taking any pleasure in eating. They may eat for comfort and then feel bad about putting on weight.

Low Energy and fatigue 
Having little or no energy may make the smallest and simplest things feel impossible. This makes caring for a baby more difficult and women may begin to feel as if they just can’t cope with anything, even basic housework or getting dressed may seem like a mammoth task. If observed by others for significant periods of time they would notice a lack of energy, low motivation and a slowness or loss of vitality about the person. Physical sluggishness or restlessness, is frequently associated with severe postnatal depression. Mothers might sit still for long stretches of time and their movements, speech, and responses are very slow, or they might appear agitated and be unable to remain still and pace back and forth or wring their hands.

Delayed bonding
It is possible that the mother will be unable to react to her baby’s need for love and affection. This is a serious worry because emotional availability during the first six months of life is critical to the baby’s overall health and future development.

Social withdrawal
These emotions associated with postnatal depression can lead to whakamā or shame, and some people may be too embarrassed to ask for assistance or share how they’re feeling. This may lead to the mother not feel connected to or wanting to engage with others and she may withdraw or isolate herself from her whānau and friends.

Morbid Thoughts
The mother may be particularly fearful that her baby will somehow be harmed or that she and/or her partner were to die, the baby would be left uncared for. Alternatively, she may be afraid to be left alone with her baby as she has had negative thoughts around or considered harming herself or her baby. The mother might believe her baby would be better off or safer without her, that the only solution to her issues is suicide. This needs to be treated very seriously, and urgent assistance should be sought.

TREATMENT AND SUPPORT

Naturally, you may be preoccupied with caring for your baby. Keep in mind that your own health is just as important. Exercise and a healthy diet, rest, enjoyable hobbies, and connecting with others are all crucial for our physical, emotional and mental wellbeing. Treatment for postnatal depression can include a variety of approaches, each of which can be customised to your personal needs.  Your doctor will suggest a combination of treatment options that are right for you. Try to collaborate with them to determine what isn’t working for you and come up with a solution that will help you recover. If you’re pregnant and have a history of depression or another mental illness, you should consider the assistance or support you might require after your baby is born. You could ask others to be prepared to assist you, or you could inform people about what to watch for so that you can get help as soon as possible.

Self Care
Excellent nutrition, plenty of sleep, and regular exercise are excellent places to start when it comes to taking care of oneself. A genuine difference can be made by eating regular nutritional meals, if you have trouble digesting large meals, consider eating small meals more frequently. About ten tall cups of water per day are advised to keep you hydrated. Since postnatal depression sufferers frequently experience sleep disturbances, it’s even more crucial to make time to unwind, rest, and sleep whenever you can. Doing some light exercise is an excellent way to relieve stress and feel better.  Try going for a walk, getting some fresh air in the garden, doing some yoga or deep belly breathing.

When you have depression, it can be hard to find the energy or motivation to look after yourself. Be reasonable with your expectations of yourself; try to embrace each day as it comes and recognise that you will have good and bad days. It doesn’t matter if you don’t complete everything on your to-do list, so try not to overwhelm yourself with household chores or other work. Start small, return a text message, open a window, close your eyes and listen to the birds singing. Slowly build up to bigger things and try to notice what makes you feel better. Make a list of things that feel good and keep it on your phone, in your diary or on the fridge. When you’re struggling, check your list and pick one thing you can do right now that might help. Plan an activity for the day or the week ahead and commit to it. Read and learn more about postpartum depression to better comprehend why you’re feeling the way you do. Try writing down how you’re feeling to track your mood, and monitor your anxiety level. 

Professional Support
If you are struggling with your mental wellbeing and need more support, help is available for you. Talk to a medical professional, this may be your GP or Māori health provider, your midwife, or Well Child nurse, they should know what support services are available in your area. Your doctor will be able talk to you about treatment, which may include taking medicine or a referral to counselling. It’s essential that you get the treatment you require to recover. If you do not receive assistance the first time you ask, try again or seek someone else who will listen. You may be able to access postnatal depression support groups, community mental health services, home help and counselling from appropriately trained professionals. It’s also beneficial for your partner and other support people to understand what to do if they are concerned about you and to get advice on how to best support you. These conditions are treatable and manageable, if one option isn’t working, try another, until you find a combination of tools and strategies that works best for you.

Helplines with trained professionals

• Call or text 1737 to speak to a trained counsellor.
• Call Plunketline 0800 933 922.
• Call Depression Helpline 0800 111 757.
• Further information www.mentalhealth.org.nz

Talking Therapy
Supportive counselling or talking therapy can be very beneficial and is just as successful as antidepressant medication in treating milder forms of postnatal depression.  Postnatal depression can often be treated successfully with talking treatments like acceptance and commitment therapy (ACT) or cognitive behaviour therapy (CBT). It gives you (and your whānau, if you choose) a supportive, judgement-free place to better understand your experience, thoughts, emotions, and behaviours. There are therapists out there who can offer this in accordance with your cultural practises and views. You will gain knowledge of techniques and skills that have been proven useful for assisting with emotional regulation and parenthood transition.

Medication
Your doctor may prescribe medication and provide other strategies for managing your wellbeing. It is very important that you don’t suddenly stop taking medication without your doctor’s advice. There are medications that can be taken when you are breastfeeding. If the depression is severe, or has gone on for a long time, antidepressant medication can be used safely while breastfeeding. Medication is not an effective treatment for everyone, however for about 60% of women with moderate to severe postpartum depression and women usually begin to feel better within a few weeks of taking it. There is no foolproof way to predict which medication will be effective for and well tolerated by any one person; finding the correct medication may require some trial and error. It is very important that you don’t suddenly stop taking medication without your doctor’s advice.

The use of medication depends on several factors:

• How unwell you are
• Whether you agree
• What has already been tried

Complementary Therapies
Generally, therapies and treatments that vary from and that could be used to assist and complement conventional western medicine are referred to as complementary therapies. These might include hypnosis, yoga, meditation, calming techniques, massage, mirimiri, and aromatherapy. All of these have been demonstrated to lessen emotional distress to some extent and may improve your life and help you get and stay healthy. You should always talk to your doctor before taking any supplement, herbal remedy, or medicinal preparation to ensure that it is safe and won’t negatively impact your health, such as by interfering with any other medicines you are taking.

Peer Support
Postnatal depression is quite common. Connecting with others who have gone through it can be extremely beneficial and can help you feel less alone. You may connect in person or even online, and you could probably enjoy connecting with people who share your background, age, ethnicity, sexual orientation, and so on. It is often beneficial to see how others have healed and that there is hope for the future. Many people find support groups where you can connect you with others who have similar experiences, are a key part to improving their wellbeing.

Wellbeing Plan
You can discuss with your health provider and together develop a written plan, to follow and help you feel in control if challenging feelings return. Using your own words, your wellbing plan should outline your symptoms or signs to look out for, potential triggers that may cause these, and things that can be helpful. Your plan can also provide contact information for support groups, hotlines, and other resources. It should also specify what you wish to happen if you require professional help. Much like during childbirth, you must ensure that those around you, including your partner, whānau, friends, and any healthcare providers, are aware of your wellness plan and are prepared if you become unwell again.

Family/whānau support
Whānau and friends want to help, yet they may be unsure how they can help exactly. It’s good to accept offers of support that you feel comfortable with. Also, you can determine how much help you require and how involved you want whānau and friends to be. They can help with small everyday chores, preparing meals, vacuum, do laundry or even watch baby while you shower or do something for yourself. If there are specific things that would help you, try asking for them. You could say: “It would be really helpful if you took the other kids out for a bit, so I can have a nap”. Also talk with your whānau and friends, you may be surprised by who had the same feelings as you when they had new babies.  

Remember that seeing you in such a low state may be challenging and distressing for family/whānau and friends, and they may need to:

• seek support for themselves from friends, family/whānau and/or counsellors
• learn more about postnatal depression
• get help with understanding what is happening to you
• learn to set boundaries for their own wellbeing
• learn to manage their own stress

Friends and whānau can practise using language that can help you feel supported:                                                                                                                                      

• “You are not alone in this. I’m here for you.”
• “You may not believe it now, but the way you’re feeling will change.”
• “I may not be able to understand exactly how you feel, but I care about you and want to help.”
• “You are important to me. Your life is important to me.”

Bonding With Baby
Men nowadays spend more time with their children than previous generations. Although fathers frequently desire closer contact with their baby, bonding often happens on a different schedule, in part because dads don’t have the same access to their baby as many mothers do through breastfeeding and also they may have limited time due to work commitments. A fathers relationship with their child is different to that of a mother, they often engage in more special activities with their baby.

Early bonding activities include:

• participating in the labour and birth
• burping and settling baby after a feed
• putting baby to bed and nappy changes
• reading or singing to baby
• giving the baby a bath
• mirroring baby’s movements and mimicking baby’s cooing and other
• vocalizations
• babywearing during routine activities
• letting baby touch dad’s face

Supporting your breastfeeding partner
If your partner is learning to breastfeed, your excitement, support, and faith in her can go a long way. You can attend in-person or online breastfeeding education courses together. Learn why breastfeeding is beneficial, how breastfeeding works, how to manage breastfeeding issues, and how to get help for your partner if necessary. Find practical ways to help out with your baby and take on additional housework. Your help and encouragement may increase your partner’s likelihood of continuing to breastfeed for longer.

Breastmilk is a nutritious, natural, free and convenient food that provides protection against infection and disease. Most newborns feed 8-12 times in a 24 hour period with feeds lasting anywhere from 10mins to an hour. Common breastfeeding problems that your spouse might experience include blocked milk ducts, mastitis, low or excessive milk supply, breast engorgement, sore nipples, and nipple infections. Learning to breastfeed requires time, practice, and patience. Most breastfeeding mothers can overcome breastfeeding challenges and produce all the milk their baby requires with the right support.

It’s a big responsibility to take care of a newborn, and as parent you also need to take care of yourselves. This includes maintaining a healthy diet, engaging in physical activity, having enough rest, and accepting assistance from others. It is important to consider practical ways to care for your partner while breastfeeding, such as bringing a glass of water, healthy snacks or an extra pillow, as well as bringing your baby to your partner’s bed for feedings at night and putting him or her back to sleep. Taking on extra housework, being understanding if your partner doesn’t feel like being intimate with you, and letting your partner know how much you appreciate their breastfeeding efforts and achievements.

Even if you are not breastfeeding, it is still essential for you to spend time with and be close to your baby. To achieve this, you can carry your baby in a sling or baby carrier, cuddle skin-to-skin, bathe or massage your baby, burp your baby or change your baby’s nappy after a feed, take your baby for a walk or play gently with your baby in between feeds.

Supporting your partner with postnatal depression
Your partner needs to know that you are there for her and that you can take care of the baby. This is crucial to her recovery. You’ll need to step up and fill in the gaps. Support her by, allowing her to talk; reassure her, locate a health professional with whom she can speak, reduce pressure by handling more of the baby-care and housework yourself, and, if possible, bring in assistance, such as whānau and friends.

Postnatal depression also impacts your baby. A newborn requires frequent face-to-face contact. An infant’s brain is stimulated by being stared at, interacted with, and played with.  It will be challenging, if not impossible, for a depressed mother to offer her baby the amount of attention and eye contact that a baby requires. The baby’s connection to the mother may be hampered by the mother’s depression. If no one steps up to cover the void left by her depression, the baby’s development will be hampered and will have a long-term effect on the child’s emotional and intellectual growth. In order to make up for this, the father (or another person) will need to be present to assist with daily parenting duties and take on more of the nurturing role with baby.

You might feel resentful about having to do so much more housework while your partner seems to be doing nothing because they have postnatal depression. It’s normal to feel irritated. But remember this is an illness and not her fault and not something she chooses. With the extra responsibilities, you need to be mindful of looking after yourself. It may be beneficial to reduce your outside obligations. Maintaining contact with your whānau is essential. You two should not isolate yourselves from the people you need support from. Find someone to speak to if your partner is depressed and you’re having trouble and need support. The majority of the services available to her are also available to you.

Depression in dads
Postnatal depression can also affect men. Depression rates in the general community are between 2 and 3 percent, but they are roughly double that for new dads. A father is more likely to experience depression if his partner has postnatal depression. For fathers, feeling extremely down, failing to enjoy anything, having trouble concentrating, having a poor appetite, worrying at night, and having trouble sleeping, and using alcohol or other drugs more frequently are all signs that something is wrong.

Having a child can be a significant adjustment and challenge for new fathers, especially if the pregnancy was unplanned or if they did not feel equipped to be a father. It can be physically and emotionally exhausting, balancing the demands of work, fatherhood, and other responsibilities. Some men feel obligated to make more if their partner is not employed. So, it’s not surprising some new dads get depression.

If you believe you are depressed, you should not ignore your emotions. Talk about it with a friend or family member who will listen and don’t let yourself become isolated. If needed seek professional assistance, contact your doctor, or speak with your Well Child Tamariki Ora nurse. Also, you can call or text NEED TO TALK on 1737. If you accept something is wrong and seek assistance, your recovery from depression is likely to be faster. The sooner you start dealing with it, the faster and simpler it will be to escape from it. What doesn’t work as a treatment for depression is abusing alcohol or other drugs, drowning yourself in work, and withdrawing from your partner, friends and whānau.

Sex during and after pregnancy
Pregnancy, birth, motherhood, and fatherhood can all significantly affect a couple’s sexual life. The way a woman thinks about sex during pregnancy is greatly influenced by hormones, and some men may become less interested in sex as the pregnancy goes on and after the baby is born. Every individual is unique, as are every couple. However, all couples’ relationships, including their sexual lives, alter as a result of being pregnant and then having children.

Couples might avoid talking about personal matters, and women might be reluctant to mention that they still bleed for four to six weeks after giving birth or that they experience discomfort when urinating. She might have had breast sensitivity or sutures. Given what her body has been through, she might be concerned about how having sex will feel. Talking about these private matters with our companion helps us develop a sense of intimacy with them, which can eventually lead to physical intimacy.

Women’s bodies typically need about six weeks to fully heal after giving birth. Every woman, is unique and it may be much longer until she feels emotionally and physically ready to have sex and you shouldn’t expect her to engage in sexual activity that she doesn’t find enjoyable. Due to fatigue, constant busyness, and feeling so focused on the infant, couples engage in sexual activity less frequently than they did before the baby. This can cause changes in both parents’ lives, such as feeling “touched-out” and not wanting to be touched by their partner and sex is most likely off the menu if one or both parents are depressed.

Couples can learn and do things to get their sex life going again, such as talking about their feelings and asking her how the other feels about it. Listening is as essential as talking when communicating, so ask your partner about how their life has changed and how they feel about sex. Talking about sex isn’t about making her feel bad, playing the victim, or attempting to talk her into it. It can be as easy as bringing up the subject, or it can be as complex as discussing your feelings and asking her how she feels about it. Good communication can help them feel closer and more understood resulting in a more intimate connection. If talking about it doesn’t help, locate a friend or family member who has been through it to talk to.

​When you resume sexual activity, don’t assume that because your partner has recently given birth or is breastfeeding, she can’t become pregnant again. Both of you are responsible for birth prevention if that is what you both choose.​

In New Zealand, eligible children receive free health care. It is critical to enrol your child as soon as feasible so that they can access these health services as needed. The enrolment form will be provided by your midwife, and they will assist you in enrolling your infant in with a general practice, your local Well Child Tamariki Ora program, and your Community Oral Health programme.

Your care will be transferred from your midwife to a Well Child Tamariki Ora provider of your choice, 4 to 6 weeks after the birth of your child. Your midwife will inform you about Well Child Tamariki Ora services in your region, some areas also have Kaupapa Māori and Pasifika services. It is entirely up to you which one you register with.

Children get regular health checks via a Well Child Tamariki Ora service up to the age of 5 years. Well Child Tamariki Ora nurses have received special training in assisting parents and carers in caring for babies and preschoolers. The nurse will examine your child’s health, growth and development and will ask you questions about your child’s home and whānau life. If additional services are required, the nurse can refer you to them. There may also be times when you and your baby will be seen by a general practitioner for a Well Child assessment and immunisations.

The nurse may be employed by a range of organisations including:
• Plunket
• a Māori Well Child Tamariki Ora provider
• a Pacific Well Child Tamariki Ora provider
• a general practice team
• a public health service

The free Well Child Tamariki Ora visits cover:
• child growth and development
• family health and wellbeing
• immunisation information
• oral health (teeth and gum) checks
• early childhood education
• vision (sight) and hearing
• health and development checks for learning well at school.

There are usually 8 checks, at:
• 4-6 weeks
• 8-10 weeks
• 3-4 months
• 5-7 months
• 9-12 months
• 15-18 months
• 4 years old (B4 School Check) – includes hearing and vision screening.

You are the most familiar with your little one. If you have any worries about your child’s health, hearing, vision, development, or learning, speak with your family doctor or schedule an appointment with your Well Child Tamariki Ora service.