Pregnancy and delivery changes a woman forever – beyond physical changes, it also changes one mentally and emotionally. At a time when the new arrival takes priority over everything else, many women find themselves sacrificing their own practical and self-care needs in favour of the baby’s nutrition and safety. It is important to remember that postpartum care for yourself is critical so that you can be your best self as you bond with and care for your infant. Understanding the postpartum periodThe postpartum period encompasses the first 6 weeks after giving birth. This period, often dubbed as the fourth trimester, is a time when your body begins to heal and adjust to not being pregnant. It is described as a period of significant transition characterised by changes in self-identity, the redefinition of relationships, opportunities for personal growth and alterations to sexual behaviour as women adjust to the ‘new normal’. In short, there is definitely a lot going on!  There are many factors that come into play in your postpartum recovery journey. These include whether you’ve just had your first child or your third, vaginal or C-section delivery, if you had gestational diabetes or if your baby was born preterm. Nevertheless, there are some general changes in your body and mind that you can expect.  Changes to your bodyExpect some soreness in your vagina if you had a vaginal delivery. This would be accompanied by some bleeding over the first week. Bleeding is likely to gradually change to light-coloured discharge that may continue for about 6 weeks. You would also feel contraction-like sensations as your uterus is contracting back to its pre-pregnancy size.If you had delivered via C-section, you will experience pain at the site of incision. Movement is likely to be difficult. For example, you may have trouble getting in and out of bed. However, you are advised to move around to avoid blood clots from developing. Mood changesIt is common to feel sad during the first few days after delivery. You may also feel irritable, moody, anxious, may have difficulty concentrating or even experience sleep problems. As your hormone levels are changing during this period, with oestrogen and progesterone levels dropping off and prolactin and oxytocin levels rising and falling as your baby nurses, it is normal to experience a case of baby blues. These feelings typically peak on the third or fourth day and subside within 2 weeks. Do seek help if you find yourself experiencing severe mood swings, loss of appetite and overwhelming fatigue as these may be symptoms of postpartum depression. How can you care for yourself?Your body has done a lot of work throughout your pregnancy and continues to as you care for your newborn. It’s important that you also care for yourself and get the support that you need to cope during the intense postpartum period. Ask for and accept help from your partner, family and friends. There are many remedies you can try to ease discomfort and pain, including pain medications. Talk to your doctor to know what is safe to take, especially if you are breastfeeding. It’s okay to feel uncomfortable about your postpartum body but remember to be gentle on yourself and set realistic weight loss expectations. Plan small trips to get out of the house from time to time for a change in environment It’s normal to feel like you have no idea what you are doing in the early days. As you spend more time with your baby, you’ll be able to figure out what your baby needs and wants. The postpartum period is overwhelming. You may experience a range of conflicting and contrasting emotions, including intense feelings of joy and love as well as guilt and lack of control. Be gentle on yourself. Accept that your life has changed and while the transitioning phase may be hard, it will get better.   References Healthline. Your Guide to Postpartum Recovery. Available at: https://www.healthline.com/health/postpartum-recovery-timeline Accessed 10 November 2021. Finlayson K, et al. PLoSOne 2020;15(4):e0231415. MSD Manual Consumer Version. Overview of the Postdelivery (Postpartum) Period. Available at: https://www.msdmanuals.com/home/women-s-health-issues/postdelivery-period/overview-of-the-postdelivery-postpartum-period Accessed 10 November 2021. 

There is a misconception that a snoring baby is one who is in deep, restful slumber. While often times snoring is due to mucus in the nostrils, in rare cases, it can be a sign of a more serious problem such as sleep apnoea. What does normal sleep look like?Sleep patterns of infants vary with age. In their first month of life, a newborn sleeps up to 20 hours a day. This gradually reduces to about 11 hours by the time they are 2 years old. It is normal for an infant to have short pauses in breathing followed by rapid breathing during sleep, however, this should not be seen with colour changes or loud, noisy breathing. When snoring is harmlessIn most cases, babies who snore simply have blocked noses. This is because the nasal passages of infants are very small, so even a tiny bit of dryness or extra mucus in their noses can make them snore or have noisy breathing. A stuffy nose can usually be cleared up using a simple home remedy of saline drops or may not need any treatment at all. If the loud breathing or snoring does not resolve over a short period of time, it may be an indication of other underlying issues, requiring the attention of a paediatrician. Infant sleep apnoeaPersistent snoring in babies may indicate the presence of a sleep-related breathing disorder called infant sleep apnoea. This is a condition where there is a pause or reduction in breathing when an infant sleeps. Infant sleep apnoea may be central, obstructive or mixed. Snoring is more commonly associated with obstructive sleep apnoea. SymptomsThe following are some signs of the presence of infant sleep apnoea: Prolonged pauses in breathing lasting 20 seconds or longer A breathing pattern of repeated pauses, gasping for breath or choking Persistent snoring Difficulty breathing while taking naps during the day Risk factorsPremature babies are more likely to have infant sleep apnoea than those born full-term. The risk is more pronounced during the first months after birth in infants with lower birth weight. Apart from that, a variety of medical conditions can cause infant sleep apnoea or make it worse, including acid reflux, anaemia, infection and lung disease. Infants with underdeveloped facial features, such as a small chin or jaw, having a large tongue, tonsils or adenoids or those with a floppy airway due to a softening of the voice box (larynx) are also at risk. Seeking interventionUnresolved sleep apnoea is of concern as it may affect growth and development and lead to long term physical and behavioural issues. So, if you are concerned about your baby’s consistent snoring, it’s best consult a paediatrician to get it checked. Taking a quick recording of the snoring and playing it for the paediatrician would be helpful to determine if there’s anything of concern going on. A sleep study may be recommended to monitor breathing during sleep, which can detect and identify any problems. In most cases, infant sleep apnoea resolves as the child grows and matures. Studies have also found breastfeeding to be protective against snoring. In other cases where there are other underlying medical conditions, treatment with medications or surgery may be necessary depending on the nature of the problem.   References Hong H, et al. Am J Respir Crit Care Med 2018;198:15-16. American Academy of Sleep Medicine. Sleep Education. Infant Sleep Apnea. Available at: https://sleepeducation.org/sleep-disorders/infant-sleep-apnea. Accessed 13 August 2021. Healthline. Why Is My Newborn Snoring? Available at: https://www.healthline.com/health/parenting/newborn-snoring. Accessed 13 August 2021. Bonuck K, et al. Pediatrics 2012;129(4):e857-e865. Katila M, et al. Acta Paediatr 2019;108(9):1686-1694.

The last thing any mother wants to think about is returning back to work, away from their child for an extended period of time because separation anxiety is inevitable. With so many emotions, how do you prepare for a smooth transition back to work? After an extended maternity leave or even a prolonged period of Work-From-Home due to the pandemic, mothers often struggle to create new routines balancing both motherhood and the rigours of work. The good news is, you do not have to take this journey alone. Join us in this Nectar Circle as Dr Yeow May Tan, a Clinical Psychologist from Annabelle Psychology, shares some tips on how mothers can go back into the workforce while managing their baby. About the Speaker Dr Yeow May Tan is a Clinical Psychologist in Singapore accredited by the Australian Health Practitioner Regulation Agency (AHPRA).She has clinical experience providing individual and group therapy to persons struggling with Personality Disorders, Mood and Anxiety issues, adjustment, psychosis and trauma related problems, and individuals experiencing stress, interpersonal and familial difficulties, self-harm and existential issues. Over her years of practice, she developed a strong appreciation for the value of utilising dynamic and interpersonal approaches, as these address underlying issues that often manifest as problematic psychological symptoms. Dr Tan believes that psychotherapy is a collaborative and dynamic process that allows for greater self-understanding in navigating distress and difficulties.In addition to her clinical work, Dr Tan has coordinated research studies across several international sites and presented in several symposiums and conferences.Dr Tan is also a working mother herself and she has a bunch of experience in striking the perfect balance between her mommy duties and work. Related resources:  Key takeaway slides