Tag: motherhood

Nursery settling: my experience of managing separation anxiety.

by Giulia Ciarapica, posted in mental health, Mother's Health, Parents life
Morning, blessed by the Sun, Spring walks.

Here we are in Spring, the season of transformation and re-birth. Things move fast in Spring. As the “wheel of life” increases in speed, we often come out from the slow cosy winter and suddenly we find projects waiting to start and changes to deal with. Just like seeds below the ground, they urge to come out and salute the sun. This spring for me came unexpectedly. Obviously I knew it was coming, but I found myself not waiting at the window for it. Probably because I knew that “painful” changes were going to happen in this period, so my subconscious was trying to believe that the time to face them would have never arrived. But instead, we got to the nursery settling week, the day on the calendar was right, no doubts and you know what? We made it! We managed to leave the cosy nest, to “re-dress” old and new social roles and bravely take off for new skies. I am going to share how I managed to deal with the separation anxiety and how it turned for us into an important step of transformation and growth, which is also mirroring within the nature around us right now.

When to start searching the right nursery?

Wellbeing at work cards box turned into toy.

I started being anxious about bringing my child at nursery long before she needed to go at it. She was only 4 months when my Londoner friends started highlighting that I should have found a nursery already as “they are all overbooked” otherwise ” you would struggle” to find one. That thought of having to do that was playing in my brain as background noise during all my walks, laundry hanging, morning coffees. It was like an annoying fly that doesn’t let you sleep during a wet night camping along the lake. It is just not going away. But I kept procrastinating that action because another voice inside me (plus the actual voice of my partner) was telling me that it was not time yet. It didn’t take long before I realised that the reason for procrastinating the nursery search had a name: fear. The fear of facing separation anxiety.

What I learnt from my experience is a good news for procrastinators: there is no right time to do it! There will be a time that is right for ourselves. Some people needs to move really in advance and to plan far ahead to benefit from the sense of security given by so much time to make possible changes. Other people, like me, benefits from the last minute pressure to complete actions.

Acknowledging that everyone has different timing and that this is okay will help feeling less guilty when comparing ourselves with other better time managing parents. It is true that London’s nurseries are very busy but it is also true that there is a lot of them available. There are many and in good variety in terms of method, type of premises, outdoor space available, timing availability, family run or big chains. So, what I suggest doing is that the first step is to start listening yourself and noticing what it is important for you. You could also name it, write it if needed. You could draw your ideal nursery, using such creative tools to connect with what it really matters to you. You could sit with your partner if you have one and make a list of the things that matter to you both. You could bring that list with you when starting making visits or screening the web for a good named and good located one that sounds good enough to be worthy a viewing.

The importance of asking

Acknowledging to ourself that we need help it can be tricky for some but also a truly relieving experience. Asking means being able to unload the weight that we put on our shoulders when we try doing everything by ourselves. It can heal the wound that made us being self-sufficient, realising that we are no longer that person that “either you make it by yourself or you die”, they are other paths available, you can be helped and this is okay.

So, I started being more receptive of informations around me regarding nurseries. Similarly to when I was pregnant and looking for a pram: I was spotting and following with the sight any strolling buggy from miles away and insistently sticking to it until lost in the horizon. Wheels, colours, height, comfortable handles, texture of the cover…and, obviously, cute babies in it. I am not sure how much parents were happy about that tired looking, weird pregnant woman staring at them. But I am sure most of them had been in the same place few months earlier so they understood.

I started spotting parents with children of similar ages and started conversation with them. In other words, I took any possible park cafe, neighbours chat, swimming pool and library visit to stay connected with my pears. I started asking, being curious and as soon as I met a like minded parent I asked for their nursery experiences and kept my ears open for responses.

This is how I found out about online tools to search and contact nurseries like for example ChildcareUK. I found the website and app useful as they list nurseries’ features in charts that make easy to spot the timing you need, lunch/not lunch provided, years range, Ofstead grade achieved etc. However, I found that it is not the only way. Also the Council website was a good help as a map is provided with all the nurseries available within the borough and the contact details. I suggest to use multiple online searching tools because the website might bias the nursery search based on its own listing features.

Asking can be an act of true connection and sharing when we do it with intention to actively listen the other person’s experience. It can bring inspiration, knowledge and a sense of “being in the same boat” that often relieves anxiety feelings. When we actively listen to other people’s experience we get an opportunity to listen to ourselves too: we can notice what it feels right for us and what it doesn’t and all this process of self scanning can take us to our choice. I also believe that it is an healthy exercise to remember to keep a distance from other’s stories and acknowledge that those stories are unique to them. We should avoid the risk of mirroring into other’s stories and absorbing fears, as well as too negative or positive experiences. How to do it involves acknowledging what belongs to them and what belongs to us and how this can be meaningful for us both when we pay value and respect for the experience that the other is sharing with us.

How psychotherapy can help the process

How often we listen friends and relative saying: ” I was crying more than my child when time came to leave her/him with the teachers and go”. Why it is so tough to manage those first separations? Why can it generate so much anxiety, worry or even stress? Even if we are happy with our decision and we trust the teachers, we liked their way of interacting with children, even if we sensed vibrations of kindness and serenity in the classes, we observed children being respected and valued, it is still extremely difficult to leave.

What I learnt, it is that the child that was panicking at the thought of that separation it wasn’t my child, it was actually me. The experience of “abandonment” of my child was resonating with my own personal experience, and probably with other experience related to abandonment. So I understood that it was my duty to acknowledge, embrace and give sense to that abandonment experience before I could be able to support my child. Psychotherapy led this process that created the conditions for being an emotional anchor for my child. This allowed me to be present and centred for her and with her, rather than lost into my own fears.

Positive mindset is key

My child’s back pack

I found helpful to set intentions. That is when yoga and mindfulness exercise can be a good help. Once we learnt what sits at the roots of our anxiety than it is time to truly embrace it, make room for it with empathy, love and acceptance. This can allow us to deal with our emotions so we become ready to be present and focused for our child. A good idea it is to include a set of intentions at the beginning or at the end of our yoga practice.

Allowing a space for stillness during the day it is a remarkably caring and wellbeing generating choice that we can make for ourselves. It is important to create the condition for us to feel relaxed, safe and undisturbed for a time of our choice. It can help to set a timer so we are reassured that that is the time we decided to allocate to meditation and we don’t risk our mind running away with fear of getting late to the next task. As we sit or lye down in a comfortable position, we bring our mind’s attention to breathing. Aligning our thoughts with the breathing movement will bring a feeling of decompression, the bless of a pause or a slow down from our inner chatting. Our thoughts will still run, the point is, allowing this without opposing, letting go the resistance and gently, kindly, bringing our mind back to breathing.

At the end of our breathing exercise we could allow some time to set our intention for the day. An example can be:

  • Take three deep breaths through your nose and exhale through your mouth, this will release tension
  • Add a few seconds of holding breath at the end every inhale, this will help you rooting your mind and feeling centred
  • Gently repeat to your-self “I will be emotionally present for my child and I will trust his/her own inner resources to make it without me”.

Nurturing feelings of trust

Once we are sure to have the elements required to trust the nursery we choose than it is a good help to establish trustful connections with people that work in it. I engaged with Claudia’s link teacher from the very beginnig, trying to establish a genuine connection with her. How did I do that? I have been honest. Honest with my feelings of the moment and the way I expressed them. I shared my fears as mother about to leave the child to someone for the first time. I asked about how nursery worked, and I made all the questions I felt I should. – I am still breastfeeding Claudia, do you think I should bring expressed milk?- or, – Do you do mostly teachers led activities or do you leave children playing independently?-, – How long have you worked in this nursery? Do you like the working environment?-. The teacher kindly complied with all my questions and responded with kindness and participation. Not just that, she taught me to acknowledge that I was leaving my child to a person that was a stranger until that moment and to recognise how this could make her feel lost and abandoned initially. She explained the process of settling, and how the child should become capable to gradually build trust within the adults that will look after him/her. This made such a huge difference.

So I learnt that if we nurture a feeling of trust towards the nursery staff, especially the teacher that will be linked to our child, we can make this process easier for them. It helped me to acknowledge with empathy that teachers are human too and that it is challenging for them too to manage settling. It can help to get into know them closer, to nurture a feeling of familiarity and to feel them less as strangers. Often nursery have pages on websites or a boards where teachers describe themselves: their professional background, their interests and hobbies. I found reading those made me feel closer to them as humans, that I was leaving my child to people I knew a bit more. It is helpful to nurture thoughts were we believe that such people can bring a positive input to our child lives. We can nurture trust in the fact that they will practice their profession in order to make them feel safe and loved while we are away. Teachers will perceive this and also our child will. This might create a positive cycle of trust. A safe net where our fears can be still listened but also dealt with, in a positive and mindful way.

Praising good achievements

If we made the right choice and followed the right steps, our personal right steps, things will start improving. We might observe our fears and worries will gradually settle and that leaving the child at nursery might actually become a positive experience. Our child tears will reduce, time by time and his/her ability to self-soothe and to trust the new adults in their life will improve. They will start making friends, socialising, playing, learning new skills and engaging in new activities that will enrich their range of thriving opportunities. I observed soon Claudia starting to sit at the table for eating more eagerly, or playing with a wider range of tools, objects, toys or even exploring new ways of playing. I noticed her motor skills improved at a faster pace. The learning of the routine was also hugely beneficial and engaging with such routines helped acquiring more structure at home as well. I found it is great to ackowledge such important goals, not just to observe them within ourselves but also to talk about them with partner, family, friends and, most importantly with Claudia. It is amazing how she can already understand that I congratulate with her, how she can understand the intention and the deep meaning of what I say, more than the single words.

Do I have enough milk? – Challenges of planning and starting breastfeeding and how to embrace it.

by Giulia Ciarapica, posted in Breastfeeding, Childbearing health, Mother's Health, Parents life

This is a topic I have been wanting to talk about for a while but never had the gut to sit and do it. I kept procrastinating and using the little space preciously reserved for writing for something else. Probably it has been an attempt to walk far from what it has been for me such a soft spot. A delicate topic for both my personal and professional experience. You don’t go and touch what hurts, do you? But if you do it with compassion and care, that is a touch that may heal.

I took this fast-proceeding Christmas time to finally do it, as my gift to myself and my daughter, as a celebration of the gift and privilege that I felt when I “received” the milk to be able to feed my daughter.  

My milk story 

Me and my one month old daughter breastfeeding at Tate Modern, London.

My milk story starts from a fear, a fear that originated long before I became pregnant with Claudia. Not sure exactly how and when it generated within myself the conviction that I wouldn’t have had milk, it could be a good session with my therapist to dig into. But somehow it did. When you are a child and you are told you have small breasts, you just believe it. Others’ spoken loudly (and not always polite) believes, comments and opinions are not kept a secret in small Italian village. And, when you are a child, other’s opinions easily become a truthful mirror to confront with, you just believe what you are told. You don’t have the maturity to take distance from other’s opinion, you may not have had a therapist or a very mindful parent to enlighten you about the fact that other’s opinions belong to them and find roots within their experience. Most times these speak more about them than about you. 

Anyhow, it happened that every time I would watch a relative, a friend or a patient breastfeeding it felt for me like a privilege, like a party I would have never been allowed to take part. I had this image of the grace of a serene face baby receiving the milk directly from his mother’s breast. The peaceful connection, the eye contact. The gesture of emotional and physical nourishment that a mother makes when offering the breast to her child. I would look with admiration while nurturing the fear that it would have never been that easy for me. 

Then time arrived for me when I became a mother myself, and the fear that looked so far away became a much closer threat. However, the physiologically induced effects of progesterone and prolactin came on my side: my breasts grew from the very beginning of the first trimester. I could observe, and welcome, my body gently expanding. A miracle. I was slower, heavier, sleepy all the time. It is like water element was prevailing within my body and permeating most my tissues. Yes, I knew breast tissue was growing. My breasts started becoming a different organ to the one they used to be, they were preparing for a different function. 

On a certain day, the miracle became real. I was around 22 weeks pregnant and I was having one of those relaxing hot showers after an intense day at work. Without thinking too much about what I was doing I had the instinct to express my nipple a little bit. I had no expectation or too conscious sense of what I was doing, it was more an instinctual gesture. I saw a little golden drop coming out slowly, without even pressing too much. An emotion grew within my heart, behind my sternum. I felt a surge of joy pervading my body and tears came out of my eyes, mixing with the hot water of the shower. – I can feed my baby – I told to myself. 

Few weeks after, Claudia was born, in the middle of the night, well before dawn, in the darkness of my bedroom, in the calm of my house. It finally came the time when I could experience her warm silky skin sliding against mine while crawling in search of my nipple. She looked like a little bird chick: eyes closed, open mouth, waving the head right to left, left to right, searching. Miracle, we didn’t even cut the cord yet but she knew exactly what she was doing. She was all instinct flowing; she didn’t need to know anything. The paramedics where still there as we were waiting for the placenta to come out. The gentle hands of my midwife helping me to latch her, as I asked for her to do it. And finally, the latch. That strong feeling of tightness. – you are so strong – I told her; I kept saying this to her since the labour started. That was the feeling she gave me, from the very first “real” labour contraction, I could feel her strength, her determination. 

I could finally practice on myself the latching techniques I used to teach to other women for all my midwifery life. Reason why it was not difficult to latch her from the very beginning. I knew how to hold her, how to positioner to help her to latch, how to foster her natural movements, just to make it easier, and to avoid her to chew my nipple as little as possible, but to latch deeply down on to the areola. 

What I couldn’t prevent or forecast was all the pain it came soon after. All the delicate parts of my body were hurting for several days. And it would hurt every time she would latch. And it would hurt a lot. I remember it being a lot even though a don’t remember the exact feeling. My species conservation hormonal mechanisms have already made me forget this. I remember one of my colleagues, also a breastfeeding mother of a 2-year-old and expert community midwife, coming home for my postnatal check and describing that feeling as being punched with a broken wooden stick. It was exactly that feeling. I regretted for having told to all my patients the midwifery book and guidelines’ story that the correct latch shouldn’t hurt. It is not like that for all women. As for most of the rest of the advice we give.

She also gave me another big tip that felt so true and mirrored so well what I was experiencing: – it is like your nipple skin is changing, it is scratching and nearly peeling off now but at the same time, it is regenerating to become something else. You will end up having no sensitivity when she latches-. It made so much sense. The evolution of my body, its metamorphosis that started the moment Claudia was conceived and implanted within my womb, was continuing. So, with the milk let down on day 3, my breast, as my colleague anticipated, reached soon the size of a summer melon, same consistency as well, to the point that I could not believe Claudia was able to latch to such a hard and tense surface, but she did. And the feeling of her emptying it, draining it, nearly completely, was the most relieving one, to the point that it compensated the needle scratch of the bite on my nipples. 

It was times of runs home from the laundrette where me and my partner were trying to clean the blood spots of my bed covers left from the labour to my house as my breasts were exploding and dripping everywhere while Claudia was doing the longest nap ever, probably helped by the white noise of the washing machines and the traffic. Times during which I was always wet, pads everywhere. Pads continuously to be changed, in my breasts, in my nickers. Never spent so much time between toilet, bed, sofa in all my life. But eventually the next evolutionary step miraculously happened. I choose to commit to breastfeeding on demand and managed to avoid any expressing of any sort, despite having to deal with a very strong flow that made Claudia choke and cry quite often, especially when she wanted to suckle for comfort and not for hunger. Thanks to that commitment, Claudia gradually managed to self-regulate the quantity of milk she needed so I could say forever goodbye to the breast pads in about within about 40-45 days. 

At the same time, I could pleasantly say goodbye to the nickers pads to. So, the summer ahead became much dryer, warmer. The element water rebalanced within my body and stopped being so prevalent. I could enjoy happily feeding my little one lying on fields, grass, river shores, beaches, benches, with my back rested on trees, back of the buggy, back of my partner. I mastered any imaginable reclined position with any possible position of the legs to save my back while allowing Claudia, and myself to feed comfortably. And I would never thank enough to the person that donated the breastfeeding pillow to that charity shop which sold it back to me for the most worthed £ 7,00 paid in my life. 

Breastfeeding in the Sun at Beckenham Place Park, London.

Now Claudia has past 7 months and I am watching the clock for her not needing me to feed her anymore and only relying on food. It is a pain and, as much as waking up 2,3 or sometimes even 4 times at night is hard, it will be much harder to lose that cuddle moment of a feed on the couch, light deemed, on a rainy and messy afternoon. Breastfeeding has been also this, a pause to the frantic days, to the moments where you don’t know what other play to invent, when your fantasy is gone off together with your sleep deprived brain. When you finished up all the good cards and you have no joker to play to make her happy and entertained. You sit, make a warm drink, if you manage, leave the phone as far as you cannot see it lightening up. You aren’t there for no one apart from her.

Antenatal preparation counts

One of the most common questions I received during my pregnancy with Claudia it has been: does it help being a midwife? Does it make it easier? The answer to this it is very complex to me and I had to shorten it and adjust it depending on the context and the person I was asked. But the point I want to make here is that knowledge really helps. As midwives we know physiology. Physiology means the process that happens in our bodies to make it function in a certain way. Knowing childbirth physiology, I believe it is why being a midwife it helps being a mother. On the other side, being a midwife means knowing the pathology, meaning all the possible things that may not go well. This generates fears and anxiety that such situations may materialize in our experience. But when we don’t let the fear to take over, and instead, we use the fear to guide us in picking up the cues that something could go wrong and make a change, that is when our pathology knowledge plays on our side. 

I believe that antenatal preparation must give this: an accessible knowledge of our mothering bodies, the mechanisms that make the lactation happens. This is why I would suggest picking up an antenatal class were they focus on developing self-awareness and trust in our bodies and mothering skills, which is essential for a healthy breastfeeding to establish. 

On the other side, I would avoid taking part in classes where it is reiterated how difficult breastfeeding will be, how challenging, how sleep deprived they will be, how bad sore nipple can be. 

Learning practical skills is also essential. As mentioned, knowing how holding and positioning baby to breast allowed me to make a smooth start. I think a good antenatal class should also aim to offer knowledge about how newborn physiology works, what can we do to help them digesting and sleeping well, how to sooth them, how to approach the crying baby. To me for example, being able to acknowledge a “physiological” cry due to blocked winds and being able to respond and soothe my baby effectively saved us from several unneeded hospital journeys. 

Holistic approach

I suggest that the choice of feeding our child it should be an act of real freedom. This to me means freeing ourselves from images and adjectives we acquired during all our life about how breastfeeding should or shouldn’t be. These are going to limit or affect our experience which is individual and personal. 

From the psychological point of view, how we feel about feeding our child finds roots within many aspects of our subconscious and is important we find a space where we can give room to these feelings, to talk about them, to process them without judgement. 

Physically, we need to create the conditions for the process to start and develop. This means taking care of all aspects that make our bodies healthy: nutrition, self-massage, breathing, relaxation, mindfulness exercises. All these activities help keeping stress levels at minimum and foster the correct hormonal release levels, essential to start lactation. 

Relationships are so important. It is important we connect to family members, friends, aunties, mothers, blood or life mothers, health professionals. We need to create a healthy community around us that can offer a support that is concrete, free of interests and judgement. And to be able to choose and nurture such relationships in a healthy way we need to nurture trust within ourselves. We need to nurture compassion for ourselves, curiosity of observing how our bodies are capable to change, to blossom, to become something we couldn’t believe they could. We need to learn giving ourselves trust, hope and love.