Breastfeeding and postpartum depression – case study

Uvod: Rojstvo otroka je življenjska izkušnja, ki običajno prinese veliko veselja in zadovoljstva. Nekatere otročnice pa so po porodu lahko nerazpoložene, nemirne, jokave, žalostne ali jezne. To je lahko nekaj povsem normalnega, lahko pa se iz tega razvijejo različne duševne stiske, med katere uvrščamo tudi poporodno depresijo. Med drugim so lahko duševne stiske povezane s težavami pri vzpostavljanju laktacije in dojenja oz. vzpostavljanju hranjenja novorojenca. Otročnico je treba podpreti pri izbiri načina hranjenja novorojenca, ki najbolj ustreza njej in njeni družini. Poporodno depresijo je treba zaznati in jo ustrezno zdraviti, saj lahko spregledana vodi v resne posledice za otročnico in otroka. Namen: Namen diplomskega dela je predstaviti izkušnjo doječe otročnice, ki se je v poporodnem obdobju soočila s poporodno depresijo. Avtorica se posveti uporabi antidepresivov v času dojenja in odnosu zdravstvenih delavcev med zdravljenjem. Metode dela: V prvem delu diplomskega dela je bila uporabljena deskriptivna metoda dela s pregledom strokovne literature v slovenskem in angleškem jeziku. V drugem, empiričnem delu raziskave smo uporabili kvalitativno metodo dela – predstavitev primera otročnice, ki se je v poporodnem obdobju soočila s poporodno depresijo. Izveden je bil polstrukturiran intervju, razdeljen na štiri sklope. Udeleženka je bila izbrana na socialnem omrežju Facebook, podpisala je soglasje za sodelovanje v raziskavi. Raziskava je bila odobrena iz strani katedre za babištvo. Rezultati: V raziskavi je sodelovala doječa otročnica, ki se je v poporodnem obdobju soočila s poporodno depresijo. Udeleženka v raziskavi povezuje negativne izkušnje z dojenjem s poporodno depresijo. Poudari, da sta ustrezna pomoč in podpora v tem obdobju ključnega pomena. Tudi avtorji v literaturi ugotavljajo, da težave pri dojenju lahko negativno vplivajo na počutje otročnice, zaradi neuspešnosti pri dojenju se lahko soočajo z občutki krivde in nemoči. Razprava in zaključek: Poporodne duševne stiske so resna stanja, ki prizadenejo veliko otročnic. Pri otročnicah z znaki poporodne depresije je več verjetnosti, da bodo otroka hranile manj pogosto in krajši čas, redkeje bojo dojile izključno. Uspešno dojenje lahko prekinejo tudi zaradi zdravljenja, ker zaradi nepoznavanja področja prihaja do predsodkov o uporabi antidepresivov v času dojenja. Rezultati predstavitve primera kažejo, da udeleženka v raziskavi ni dobila ustrezne podpore s strani zdravstvenih strokovnjakov. Pomembno je pravočasno prepoznavanje simptomov in ustrezno zdravljenje. Prav tako je pomembno otročnice ustrezno informirati o varnosti uporabe antidepresivov v času dojenja. Zdravstveni strokovnjaki, ki delujejo na področju obravnave otročnic imajo ključno vlogo pri prepoznavanju poporodne depresije. Zato morajo imeti ustrezna znanja in usposobljenost za obravnavo otročnice, pomembno je, da v obravnavo vključujejo duševno zdravje. Potrebna je prilagojena podpora ženskam s poporodno depresijo pri dojenju, da bi bile zadovoljne s hranjenjem dojenčka, hkrati pa jim je treba zagotoviti tudi ustrezno podporo na področju duševnega zdravja.Introduction: The birth of a child is supposed to be a joyful event. However, many women experience postpartum moodiness, restlessness, sadness or anger. This is completely normal, but various mental health distress, including postpartum depression can evolve from them. These mental health issues are often connected to difficulties with lactation, breastfeeding and establishing a feeding routine with a new-born. A neonatal mother needs support choosing her own way of feeding the new-born that suits herself and her family the most. Postnatal depression must be detected and treated properly. If left untreated, it can leave serious consequences both for the mother and the child. Purpose: The main purpose of the present BA thesis is to present experience of a breastfeeding woman facing postnatal depression. The author focuses on the use of antidepressants while breastfeeding, and on the attitude of medical workers during her treatment. Methods: The first part of this work uses the descriptive work method with an overview of literature both in Slovene and English language. The second, empiric part of the work uses the qualitative work method, presenting a case of a woman experiencing postnatal depression. The author carried out a semi-structured interview, divided in four sets of questions. The interviewee was chosen via Facebook and she also signed a consent to cooperate in the research. The research was approved by the midwifery department. Results: The study includes a breastfeeding woman facing postnatal depression, exposing trouble with breastfeeding as one of the main reasons for the development of postnatal depression. The woman also stresses the utmost importance of adequate help and support during the period. Various literature authors have also established that breast-feeding problems often negatively impact the mother and her well-being, due to unsuccessful breast-feeding they often face feelings of guilt and powerlessness. Discussion and conclusion: Postnatal emotional destress is a serious condition, experienced by a large number of women. Women with signs of postpartum depression are more likely to feed their child incorrectly, less often and for a shorter period of time, also making exclusive breastfeeding less present. Successful breastfeeding routine may be disturbed by treatment due to the lack of knowledge and prejudice regarding the use of antidepressants while breastfeeding. The case study results have shown that the research subject was not sufficiently supported by health care experts. It is of vital importance to recognize the symptoms and treat them adequately. Medical workers are crucial at recognising depression, making their suitable capacities and the state of being informed even more important. Therefore, they need to be appropriately qualified and able to treat the new mother as well as to focus on her mental health. Women with postpartum depression should receive adapted support with breast-feeding in order to feel satisfied also while breast-feeding their babies, and at the same time they should also receive sufficient support with regard to their mental healt