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Archive for the ‘Postpartum Depression’ Category

I am not a food blog. Yet during pregnancy and the postpartum months food plays a very important role, both in providing nutrients where they’ve been lost and in boosting energy, milk production, and very importantly, mood! I’ve put together here a collection of my favorite go-to recipes that I bring to mothers post-birth, when some feeding of the soul and body are needed.

(They are also family-taste-tested, my kids eat most of them too! 

And that’s not a small feat.)

And I apologize in advance for my feeble attempts at food photography….

THE SUPER YUMMY SMOOTHIE

Now, I’ve always loved smoothies, after a brief and terribly random stint as a dishwasher for a vegan resturaunt while a University of Alaska freshman. At that time I had no idea what vegan eating was, much less healthy eating, as I was your average teenager! But a hungry student supporting herself through university on scholarships will eat what comes her way, and the free smoothie lunch I was given was a revelation.

After moving to Israel where fresh fruit is abundant, I began freezing kilos of fresh chopped fruit when it is in season, and these frozen ‘ice cream’ smoothies helped air-condition my body during the summer months. At any time of the year you may find in my freezer great quantities of banannas, strawberries, peaches, apricots, dates, plums and shesek (loquat, apparently, in English).

Since Asher’s birth I’ve learned more about nutrition and breastfeeding, and have been packing my smoothies out with extra ingredients: ground flax seeds (rich in mood boosting Omega 3) almond butter (excellent for boosting lactation) and date syrup or black strap molasses (iron). Often there will be pumpkin seeds (magnesium, potassium and more Omega 3) and lately, I’ve gotten brave and started adding green leafy veg (iron! salad!) to my smoothies. This video showed me how to do it: How to make a green smoothie

Sharing with nearby toddler optional

  • a handful of one kind of green, such as chopped kale, spinach, lettuce, coriander, beet greens
  • a soft fruit, such as half a papaya, half a mango, 5-6 strawberries, peaches, or any other frozen berries
  • 1 frozen bannana (if it is frozen it adds that smooth, ice-cream like quality to your smoothie, and ensures it’s chilled and tasty.)
  • sweetener: 1 or two chopped dates, or 1 TBS date syrup (silan), or 1 TBS honey or blackstrap molasses
  • 1 tablespoon almond butter or raw tehina (ground sesame)
  • nuts or seeds, such as pumpkin seeds, chopped almonds or brazil nuts
  • 1 teaspoon milled flax seeds (“subin pashdan” in Hebrew) which is actually really cheep to buy. The one in my cupboard cost 7 NIS, and I’ve been adding it liberally to smoothies and breads for a few months already.
  • 1 cup of water. You can use fruit juice or part yogurt if you prefer, but it already tastes good so it’s up to you!

Blend, pulsing first until the frozen banana is broken up, and then allow to run for 30 seconds on low, until a smooth consistency is attained. Taste, and adjust if needed.

Feel free to share part of your smoothie with your children or other visiting mothers, but make sure you eat plenty of it yourself! Enjoy with the knowledge that you’re feeding your body well.

ROASTED BEET AND ROOT VEG SOUP

This last winter I discovered that not only are beets full of beta-carotene and iron, but their greens are even more so! So now I know what to do with all those leaves that Israeli beets often come still connected to: In this recipe you roast the vegetables which brings out the richness of their flavor, and then add the greens to the soup just before blending. Tada!! You have a rich, tasty, full of pro-lactogenic vitamins, and is a hearty, filling soup for any new mama. I often bring this soup to mothers a day or two after birth and they swear there has never been a tastier soup.

preheat oven to a high temperature, about 250 celsius (just under 500 Fahrenheit)

chop and toss together on a baking sheet: 

  • 1-2 beets (also add if you want: turnips, kohlrabi, etc)
  • 2 potatoes
  • 1 onion
  • 2 carrots or sweet potatoes 
  • 1/2 cup celery or fennel 
  • 3 cloves of garlic, still in their skins
  • 1 teaspoon of coarse sea salt, pepper to taste
  • 2 tablespoons olive oil
  • Beet green, or a big handful of some other iron-rich leafy green like spinach

Roast for 30 min, or until nice and golden, softened and smelling wonderful. Tip into a cooking pot, making sure you squeeze the roasted garlic cloves out of their skin first. Fragrant and yummy already! Add:

  • Hot water to cover
  • 2 cubes of beef stock, or vegetable stock
  • 2 tablespoons tomato paste
  • 1 teaspoon brown sugar
  • 1 bay leaf
  • the washed, chopped beet greens, around 1 cup (or any other dark green leafy vegetable)
  • optional: 1 can chopped tomatoes or 2 fresh chopped toms

Heat to boiling. Taste and adjust seasoning. Remove the bay leaf, and blend with a hand blender. You can leave a few chunky bits for texture, if you desire. Serve with crusty dark bread and a dollop of yogurt. *


BREAKFAST COOKIES

Okay, so every now and again (or, often) a mother doesn’t have time to warm up a bowl of soup. Or sit down and make a proper breakfast for herself. These breakfast cookies are packed with goodness, it’s like a healthy granola in your hand. I’ve added oats and flax for boosting milk production.  The up side of these cookies is that they don’t taste like cardboard – they are YUM. Especially if you add a handful of dark chocolate chips….

Mix together:

  • 2 c. oats
  • 1 1/4 c. whole wheat flour
  • 1 c. white flour
  • 1 c. cereal (whatever you have on hand, from corn flakes to grape nuts )
  • 1/2 c. wheat germ
  • 1/4 c. ground flax seed
  • 1 1/2 tsp. baking soda
  • 1 tsp. baking powder
  • 1 tsp. cinnamon
  • 1/2 c. of seeds: sunflour, pumpkin, sesame, flax – whatever you have 
With a hand mixer, in a separate bowl, blend:
  • 1 cup butter
  • 1/2 cup applesauce
  • 1/3 cup raw tehina or peanut butter
  • 2 eggs
  • 1/2 c. brown sugar
  • 1/2 c. white sugar (can be replaced with molasses or agave nectar)
  • 1 TBS vanilla
  • 1/2 c. chopped almonds
  • 1 c. raisins or dried cranberries
  • 1 c. dates  (Or use dark chocolate chips if you want/need them!)

Preheat oven to 350f/180c. Line baking pans with baking paper or lightly grease. Combine dry ingredients. Beat butter, eggs, sugars and vanilla. Add dry ingredients, mix until blended. Mix in almonds, raisins or cranberries and dates. Shape into balls and flatten on cookie sheets. Bake 13/15 minutes, until lightly golden.

And lastly, some link love to some tasty, healthy, give-able recipes I’ve used and fallen in love with this year:

The Yummiest Easiest Roast Veg Soup Ever (my name for it) By JCasa

A Famous Plum Tart  from The Kitchn

Chorizo and Chickpea Soup from Claudia at Aux Petit Oiseaux

Swiss Chard and Sweet Potato Gratin from Smitten Kitchen (In Israel, “margold” stalks are sweet and don’t need removing.)

Black Bean and Pumpkin Soup** from The Kitchn

Mediterranean Chickpea Salad  from Cooking With My Kid

Whole Wheat Banana Bread by Creative Jewish Mom

Simple Crustless Spinach Quiche  by Kahakai Kitchen (iron and protein, good warm or eaten cold with one hand…)

Maklooba the ultimate dinner to bring over! From the Middle Eastern Food Blog

Please if you have any more recipes that you love for breastfeeding and post-birth, do share! x

*As always, the color of beets passes through the system, so do not be alarmed at the color of your child’s next diaper change.

** Yes there are a lot of bean recipes in this list. If beans make you very gassy, they may make your child gassy too, and often they are on the ‘avoid’ list for breastfeeding mothers. But cutting them out completely deprives you both of a very use-able, healthy, inexpensive protein, and so the BETTER rule of thumb is to include beans, but to do so with moderation. Do not over do it, but eat beans regularly so that your system, and hence your baby’s system, tolerates them normally.

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My husband is an animator:

Hence the very cartoon-y quality of his illustrations! 

Dear Husband, Partner, Boyfriend.

My wife asked me to write some advice for you, as someone who’s been a partner of a woman suffering post natal depression.

As if I know what I’m talking about. I may not be a certified professional expert source, but I have lived it.

Frankly, I’d like to just look you in the eye and say I know how bad it is. And I’m sorry. But: it really will get better. Your woman will return to you.

When I think back on that period of our life six years ago, my mind settles on one image: a snapshot of emotions taken over a bleak Christmas holiday. One night, out of frustration with this passive, dark creature that my wife had become, I vented my feelings. I knew I needed to be the support, the calm centre, a touchstone for her to hold on to- but I was tired. And I had had enough. Later I found her upstairs, cutting small slashes into her forearm with my craft knife.

I won’t forget that. You don’t really prepare for moments like that in a relationship, do you? You start in a rush of excitement and coiled potential, which plays out hopefully in a full and rich partnership. But- and here is where I will sound selfish- You will feel betrayed and abandoned by a partner with depression. You will be amazed that you, a pretty decent guy, are not able to fix this.

Hmmm…. where is the ‘reset’ button?

1.You can not fix her.

Face it. As a man, in an argument, your overriding need for process and parameters and a clear bottom line means that you think you can and must fix things now. I’m talking to the average guy; guys like me. If you’re a superstar listener and a rock solid support you’ll be fine. But for the rest of you: You can’t fix her. She is fighting with thoughts that make no sense, overwhelming dread, numbness. This cannot be fixed by what you say.  It will be healed over time. Resist the temptation to take control and straighten her thoughts out for her.

2.Carry her burden.

I felt that Sarah really withdrew from me when she sensed my own withdrawal, my frustration with the months of waiting for her to be well- for her spark of vitality to return. She felt judged, another layer of failure to add to the tomb of thought she was struggling to climb out of. Depression is exhausting. Fighting it is a battle that needs reinforcements and nourishment. What can you do to stand beside her, carry her burden, like the strong ox that you are? You can take the kids off her hands. You can cook dinner. You can sit and read next to her. You can find the youtube video of that comedian that she likes. You can take her out, and not talk about ‘it’. You can let her lie in. You show her that you stand next to her, with her, carry the burden that she is carrying.

3. Don’t judge her.

This is vital. She will do, say things that will make you feel like trash and the relationship feel like a sinking ship. The house will be empty of her life giving charisma. You, feeling tired and hassled, frustrated, will start to compare her to other, maybe fictional, women and she will not match up well. No. That route is the wrong one. Don’t judge her. Forgo judgment completely. It’s a tough route to walk, but you can do it and she needs you to. It is not a case of seeing her at her worst.  It’s more a case that she is not herself at all. But she will be back.

Date night brownie points?! Kerching!

4. Surprise her.

The pattern of the days for someone with PND can be overwhelmingly repetitive and void of joy. You might be tempted to hunker down and wait, allowing that pattern to stay the same until its finished and the stormclouds have moved on. Actually, this is the perfect time to surprise her and keep her on her toes. You are reminding her that the day can be something that brings life and new things, however small.  A note in the cutlery drawer, maybe. Or bigger surprises: That Christmas I mentioned earlier was followed by a three day trip to a bed and breakfast on a welsh beach. Sarah and I had for those three days a beautiful respite from the illness, discovering a new place together. That memory is much more powerful than the bad ones.

5. This time, read the manual.

I don’t read the manual, do you? I prefer my expensive purchases assembled by instinct and impatience rather than thoughtful absorption of the instructions. If you are this type, then I suggest that you do read the manual on PND. Find out how it makes other mothers feel, and you’ll realize that this isn’t the great unknown after all. Talk to your family doctor. Speak to the health care professionals who are working with her. Look at online resources, especially those written from a dad’s perspective.

 6. Take care of yourself.

When she returns, she’ll be wanting to find that you are the same guy you were. You must recognize that this thing that has touched your family is really, really tough. And you can’t carry the load of it all on your shoulders. You are part of the healing, as are the right doctor, the right meds, and healthy food, and walks in the park. Youneed to be well- that means sharing your burden with a good friend, keeping physically active, it means finding some time each week for yourself. If that means dropping the baby off at grandmas, and going fishing (whatever that is), then it must be done as part the plan for recovery. Do it to come back ready to share her burden again. Recognize the cracks of stress in your life, and back away from high pressure work, deadlines, business, drinking hard, or all-consuming hobbies that take you away from home. This is necessary, to realize that this period is a time for saving your strength. This storm will soon pass, and you’ll both emerge stronger.

I failed at most of these things. I learned slow, and with difficulty, but we are through. Sarah is entirely, utterly different now. She returned, as your partner will. Together, you’ll have some scars that a lot of relationships don’t experience. And you can be proud of them. You’re stronger than you were before.

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Hello again, long time no see! I’m finally, finally coming back to this space.

It has taken me a long time to get my head around this blog post, because the topic is postnatal depression. There’s a lot of fear to overcome when admitting to having suffered from such an experience: the question of whether publicly discussing my illness will de-legitimize my abilities as a doula was a huge one. In the end I’ve decided that if it does stop a few prospective mothers from hiring me, that’s not too high a price to pay in order to reach those that are struggling and really do need help. So, if you’ve googled this topic because you or a loved one of yours is suffering and you’re trying to understand why and how to help, this post is for you. And from the bottom of my heart I am cheering you on, having walked through the fire and come out stronger.

I suffered from severe clinical postnatal depression after the birth of my second child. Therefore for this third birth we planned meticulously. One of the steps I took was to dedicate the entire first year of my son’s life to lying low, and I planned a whole year of maternity leave (ha, being self employed of course, the pay is symbolic!) and focus on my health and stability. I am happy to say that this time things have gone well and I’m very thankful that there was no repeat experience of last time, even though my psychiatrist said that I had a 98% chance of the illness coming back as bad, or worse. And here I am standing in the 2%! There were some tricky times a few months in ,where I was close to sliding into that hole, but thankfully we pulled through and I’ve grown stronger and stronger, and in the end I’ve returned to the birthing world earlier than I had planned, and I’m well. Thank God, I’m well!

A list of self-care steps we took when facing this third pregnancy and birth will be published shortly. 

Here’s a myth about PND* that I’d like to bust: Post Natal Depression doesn’t necessarily go hand in hand with sadness.

Now that he's crawling, the game changes! Look out, big brother's Lego...

Before it happened to me, after my second birth, I have to be honest, I didn’t really believe in depression, full stop. I was in that snap-out-it, pull-yourself-up-by-your-own-bootstraps, just-pray-harder category.  PND sneaked up on me when I was in a time of my life when I thought I had no reason to be struggling! I was (am) married to a handsome, talented man, my children are healthy and cute, I loved my home, and my work as a doula is so satisfying. I’ve had a safe childhood and never self harmed or suffered from mental illness or trauma in my past. Just because circumstantial and historical issues place you in the risk category for PND, doesn’t mean that you must be already off your rocker to have intrusive thoughts. I didn’t have all the classic signs one thinks of with depression: I wasn’t crying all the time, my house was spotless (too tidy) my children and myself were well dressed, and I smiled. A lot. What I didn’t realize is that there are a host of other risk factors and symptoms. PND is sneaky. I got blindsided.

By the time it was diagnosed in 2006, my daughter was seven months old. I was unable to leave the house to attend functions, because of panic attacks that would start three hours before an event and last for three more after we returned home – not worth the effort. I couldn’t drive our car, because I couldn’t concentrate on all the visual input and decision proccesses it takes to drive (too fast, dangerous corners, urges to crash into walls.) I often couldn’t make dinner for my children, because I couldn’t decide what to make, or focus long enough to make anything. I couldn’t concentrate to watch a movie or read a book . I was terrified of taking a shower (have you ever thought of how many steps it takes to complete that task?) and at one point went three weeks without washing my hair. Speaking of hair, one night at 2am I used the kitchen scissors to cut it all off. A few years later when Brittany Spears did the same thing just after the birth of her second child, I was like, hey! She’s copying me!

Sleep. Disturbed sleep patterns always accompany PND. While I mastered the motherly art of falling asleep in the instant after finishing a breastfeeding session, I would awaken 20 times a night to check the kids blankets/windows/oven/I have no idea what else. I was obsessive compulsive about the cleanliness of my own home, and could not sit still and chat to a guest (my health visitor) if there was a piece of lint on the carpet across the room, I would have to pick it up immediately. If I couldn’t feed my family, at least the home would be clean.

Among the worst things that happened (and the hardest to admit): I was perscribed co-codimal for a breast abcess and recurrent deep tissue pain, and was introduced into the world of abusing prescription drugs. I bought a bottle of vodka and hid it. (All this from a woman who had never been drunk, never smoked a cigarette, never abused anything!) I was self harming on a regular basis. I felt like if I cut myself and drew blood, that would satisfy the terrifyingly painful urge in my chest to harm my children, to kill myself. It was only a little blood. My children never saw, there was no ‘real’ injury. I had to plan how I would get myself and my baby away from my balcony, where the cement walkway below looked so terribly inviting.

Even more terrifying than that, I felt like I’d lost God. My sense of the divine was gone, like heaven became cement, there was no one looking and no one hearing. Right and wrong, good and evil were all mixed up and I didn’t know who to believe anymore. I felt like I was to blame, and at the same time, that it was so unfair that the one time when I needed help most in my entire life, that I was abandoned. Desolate. Afraid of life, afraid of the world I’d brought my kids into.

I was hospitalized in a Mother and Baby Mental Health Unit for nine weeks. I tried seven different antidepressants and other drugs before we found something that finally, finally, helped me feel like ‘me’ again.

Recovery took years. Hence the age gaps: Ana and Noah are 22 months apart – and then there are five and a half years until Asher.

Ana 5, Noah 7, Asher 5 months. Aren't they lovely!?

The first glimmer of hope that spoke to me came from a nurse in the Mother and Baby Unit of my local mental health unit. Being a naturally smiley person, people were often surprised that I was one of the patients. Well, I certainly wasn’t going to erase the smile and look glum, just to fit their expectations. I still struck up conversations with staff, just to be polite. Trying to be friendly, I asked her how working on the Mother and Baby Unit was different from the other mental health wards she’d worked on over the years, and why she chose this unit in particular. (I was a very articulate kind of patient.) Her answer has echoed in my mind all this time. She said,

“I like to work in this ward because mothers suffering from PND get better.

They recover, they go home.

Not like the patients in the regular mental health wards.

And like that, a ray of hope peirced my darkness. We get better. It is a mental illness with a very high recovery rate; I was going to recover.

I did recover.

The following are very painful lessons I’ve learned:

1. Children are scarred for life if their mother didn’t love them enough to stay around and chose to kill herself. No one recovers from that kind of hurt.

2. Children are resilient. They love their mama, they forgive their mama, they need you.

3. “If I confess what I’m feeling then ‘They’ will take my children away from me” – that fear is false. Health professionals want to help you heal and the end goal is to keep the family together. If you have these thoughts, someone needs to know so that they can heal the source of those thoughts.

4. While it does not happen to everyone, it happens to enough women so that you can know that you are not alone! And those thoughts and feelings that make you feel alone have been felt exactly the same way by so many others. This helped me understand that the awful thoughts and urges must not be true or from me; they belong to the illness. Find a support group – there are some excellent online ones, including the mothers at Postpartum Progress. So many of us do get better.

5. It is an illness. It passes. You do emerge again, changed perhaps, but truely you. I am far more me, honestly, after the re-building of my spirit.

6. So many women are scared of taking medication, whether because of the very real stigma surrounding depression (I personally have spent years avoiding writing this post) or because they are worried about taking something that might be addictive. At some point the benifits start outweighing the cons. Getting well is so very worth it.

7. Breastfeeding – is it a benefit or does it cause more hormonal upheaval? There is a lot of debate about this one, in both directions. For me, I finally needed help myself if I were to remain alive for my daughter. Yes, breastmilk is magic juice and I loved giving it to her, but she needed her Mama living, attached, loving her.

8. It is important to keep looking your kids in the eyes, hug them, and tell them you love them. Daily.

9. For a simple, preliminary online test for PND try the Edinburgh Postnatal Depression Scale.

10. There are survivors who are on call daily, and would like to talk to you. If you live in Israel, phone NITZA, the Israel Center for Maternal Health at 02-5332810, or email them at nitzappd@013.net

11. Dads and family members need help too! It is totally bewildering to see your wife turn into someone you don’t recognize. My husband has written a post about what he would like to say to any dad whose loved one is suffering, which I will post next week.

I am on the other side, a stronger, more humble woman; more appreciative of life than before.

Baby wearing: ticks the bonding box as well as providing exercise! *phew*

*otherwise known as PPD. Since I suffered the illness when I lived in the UK, I refer to it as PND in this article.

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