Parenting Resources

Parenting is one of life's most rewarding experiences but it can be extremely challenging as well. Fortunately, you don't have to tackle parenting all alone – there are many great resources available.

Post-Partum Mental Health

If you or someone you know are having thoughts of suicide or self-harm, or thoughts of harming others, get help right away by calling: Klinic 24-hour Crisis Line: (204) 786-8686 or toll free 1-888-322-3019. Manitoba Suicide Line: toll free 1-877-435-7170 (1-877-help170) (24 hours), website: http://www.reasontolive.ca/ Regional Health Authority crisis numbers: http://www.gov.mb.ca/healthyliving/mh/crisis.html Winnipeg: Crisis Response Centre at 817 Bannatyne Avenue. Open 24 hours. Rural: You can go to your local hospital.

Although there are many moments of joy in pregnancy and birth, the post-partum period can be difficult for many mothers and families. Difficulties can range from the common experience of ‘baby blues’, to post-partum depression or anxiety, to the more severe post-partum psychosis. It is important for mothers and their families to recognize that some changes in mood after having a baby are normal, and to be aware of how to connect with community supports when necessary, knowing that it is okay to do so.

What are postpartum mood disorders?

The first step is recognizing what post-partum mood disorders are and what they are not.

Baby blues is a normal and common phenomenon that happens to about 75% to 80% of women after giving birth, usually starting in the first week after delivery. Women may feel tearful, irritable, anxious, or overwhelmed by the responsibility that comes with caring for a new baby. Baby blues is thought to be connected with the hormonal changes that occur after birth. The baby blues are mild and time-limited – they go away on their own without treatment [i].

Post-partum depression (PPD) is also relatively common, experienced by 10% to 20% of women after giving birth [ii]. It usually occurs within the first month after birth, but it can appear anytime within the first year after birth. It lasts at least two weeks, and if left untreated it can last from three to 14 months[iii]. Symptoms of post-partum depression include: feeling depressed or sad; losing interest in things that would normally be enjoyed, including the baby; changes in weight or appetite; changes in sleep, including having trouble getting to sleep or staying asleep or sleeping too much; excessive fatigue or loss of energy; physical feelings of being slowed down, or excessive restlessness, jumpiness or edginess; feelings of worthlessness and excessive guilt; having a hard time concentrating and thinking clearly; and recurrent thoughts of death or suicide, including thoughts of self-harm or harming the baby.

The exact cause of PPD is not known, though it is believed that physical, hormonal, social, psychological, and emotional factors all play a role [iv]. PPD is treatable with counselling, supports, or medication; recovery is possible. PPD doesn’t mean you are a bad mom and it is important to remember it is not your fault. If you are concerned that you might be experiencing PPD, speak with your public health nurse, doctor or midwife as soon as you can.

Post-partum anxiety is experienced by between 4% and 15% of mothers after having a baby. It occurs when a new mom feels like she is worrying a lot—about the baby’s health or growth, her ability to care for the baby, or whether she can safely take the new baby out. She might experience racing thoughts, have a hard time sleeping (even if the baby is sleeping well), or feel edgy, irritable, restless, or keyed-up all the time. She may also feel panic, with shortness of breath, chest pain, or dizziness.

Post-partum obsessive compulsive disorder, is experienced as repetitive, unwanted, sometimes scary or upsetting thoughts or images (obsessions) along with behaviours (compulsions) to reduce anxiety the thoughts or images create, such as excessive cleaning or hand-washing.

Post-partum psychosis (PPP) is talked a lot about in the media and many mothers with milder PPD may worry they will develop it. However, it is quite rare. PPP occurs in about one to two out of every 1,000 births, or 0.1% to 0.2%. The onset of PPP is rapid, and usually occurs within the first four weeks after birth.

Symptoms of PPP include feeling detached from reality; seeing or hearing things that others don’t (called hallucinations); firmly believing in things that are not true (called delusions), such as feeling super-capable, invincible or on a sudden mission, or suddenly feeling unique or special; feeling very confused; behaving or talking in a very disorganized way; having extreme changes in mood or thinking patterns (difficulty concentrating, memory loss, disconnected thoughts); and having thoughts of death or suicide, including harming the baby or self[v]. Most mothers who have PPP do not harm themselves or anyone else[vi]. The new mother may notice these things herself or others may notice that her behaviour is unusual for her.

Risk factors for post-partum psychosis include having a personal or family history of bipolar disorder[vii].

Post-partum psychosis is a temporary, treatable, and very serious illness. If you think you or someone you love may have post-partum psychosis, don’t wait to get help – it is a medical emergency. Call a crisis number immediately. (Please see the list of helpful phone numbers in the text box at the top of this article.)

Barriers to seeking help

If you are currently experiencing post-partum mood disorders and are considering getting help, you might be feeling a wide range of emotions. Some of the reasons that women are reluctant to seek help for post-partum mood disorders include:

Shame and guilt. We get very strong messages from society that motherhood is something that must be done perfectly. There are many expectations that motherhood will be a joyous time. You might be reluctant to reach out for help because you feel it means you are a bad mom, don’t love your children, or are incapable or ungrateful. For women who feel pressure towards perfectionism, feeling not good enough can be very scary and can create shame. Also, PPD can affect the mother-baby relationship. Mothers may feel guilty about this since they are not feeling the same as other new mothers.

Women who have adopted a baby may have particularly complex feelings of guilt or shame for feeling the frustration and exhaustion that comes with being a new parent.

It is normal to feel many things when you have a new baby, and having these feelings does not mean that you are a bad mom. Remember that no one is perfect.

Misinformation. Many people wrongly assume that mental illness or post-partum mood disorders only happen in families of certain backgrounds.

In the five-year period (2001-2006), 1 in 4 Manitobans experienced a mental health problem or illness [viii]. Anyone can be affected, regardless of cultural or socio-economic background, or family status.

Judgements and stigma. In the past, mental health concerns were viewed as personal weaknesses. Stigmatizing attitudes and discrimination against people with mental health problems and illnesses still exists. This means that you might not want to share that you are experiencing mood disorders for fear of being judged by others. Some women may worry that if they admit to feeling down, they may be judged unfit to care for their children and that somehow their children may then be taken away from them.

We now know that mental health disorders are illnesses, just like illnesses that affect any other parts of our bodies. Remember that it is not your fault

Misconceptions about how to get better. Sometimes, people might suggest that one should just ‘tough it out’ or that someone can change depression by sheer will alone. While wanting to get better is helpful, it is not always enough. Some women may fear that medication might be ‘pushed’ on them—this fear may keep them from seeking appropriate professional help.

There are many paths to recovery, and each path is unique like the person travelling it. A treatment path may include counselling, medication, or other supports. It is important to know that you have the right to talk to a health care professional to help you decide on the most appropriate treatment for you.

Feeling isolated or unsupported. If a mother feels she has nowhere to turn or isn’t supported by family, friends or professionals, she may not turn to them when she is feeling most vulnerable. Know that your public health nurse is trained to help you with these feelings and can help and support you. You are not alone.

It is hard to ask for help. Depression, anxiety and other mood disorders make day-to-day living a challenge. Asking for help or going to appointments might feel even more overwhelming, especially in the post-partum period.

It is okay to feel unsure or scared about asking for help. Keep all appointments and ask a friend or family member to go with you.

Promoting positive mental health

Looking after your mental health during pregnancy and the post-partum period can help to prevent the development of and aid in recovery from post-partum mood disorders. These are tips that you can try that may help you feel better, and tips for families on providing support to a loved one who is experiencing a post-partum mood disorder.

Tips to help you take care of yourself [ix]:

• Stay physically active – it improves mood, gives you energy, and reduces stress.
• Sleep as regularly as you can, and take naps.
• Accept help when it is offered and ask for help when you need it.
• Take time for yourself, away from the baby every day.
• Spend time with your partner and/or your friends.
• Focus on short-term, rather than long-term goals.
• Every day, plan something to look forward to, like a walk, a chat with a friend, or a bath.
• Share your feelings.
• Know that it may take time and some work, but you can recover.
• Learn techniques to reduce stress and use them every day. You can find ways to reduce stress, like breathing and relaxation exercises at http://www.de-stress.ca/.

Tips for friends and family members of a loved one:

• Learn what you can do to be supportive as the mother works towards recovery.
• Educate yourself about post-partum mood disorders and how to help a mother recover.
• Help with practical tasks, like feeding or changing the baby, shopping, cooking or housework.
• Help her keep appointments with health care professionals and encourage her to continue with treatment.
• Just being there to listen, to spend time with her, and to offer encouragement and support can help too.
• Reassure her that she will get better [x].

Community Support

Many mothers also find that support groups are especially helpful. It can be incredibly comforting to know that there are other women who are having the same experience and who can relate to how you are feeling. The links below will provide more information for you and your loved ones.

Mood Disorders Association of Manitoba

Post-partum depression Canadian Mental Health Association

Post-partum depression Women’s Health Clinic: Coping with Change: A New Mother’s Guide

Treatment

Beyond these self-care tips and community supports, some mothers can begin to feel better with different types of treatments. Treatment for post-partum mood disorders may include counselling, medication, or a combination of both. Counselling can provide you with support as you are learning to cope with the stresses of having a new baby. Not all women need medication to get better. Women who are breastfeeding should be aware that some medications (including herbal or natural medications) will enter the breast milk. Research shows that some medications can be taken safely. It is important to talk to your health care provider whether medication is right for you.

Post-partum psychosis calls for immediate intervention which could include hospitalization. This can allow intensive treatment to begin, including medications or other therapies.

Help is available

If you or someone you love is experiencing post-partum mood disorders, don’t wait to get help—it is available. Contact your public health nurse, doctor or midwife, or call the mental health professionals in your area for information:

Public Health Offices: http://www.gov.mb.ca/health/publichealth/offices.html

Mental Health Services Contacts by region: http://www.gov.mb.ca/health/mh/crisis.html

Manitoba Farm and Rural Stress Line: toll-free at 1-866-367-3276, or email help@ruralsupport.ca

---

---

General Resources

• Adjusting to Your New Baby
  Tips to help you cope with your new baby and the changes in your life.
• Caring for Your New Baby
  Resource information to help you provide a healthy and nurturing environment for your child from birth to two years of age.
• Connecting With Your Child
  Learn about the importance of attachment in your relationship with your child and how it contributes to their healthy growth and development.
• CPR: Baby
• Enjoying TV & Computers With Your Child
• Families First Program
• Learning Through Play
• Let's Play
  A free parenting app that provides fun ideas for keeping babies and toddlers entertained and learning, especially during daily routines like commuting time, chores, bedtime, bath time, mealtime and shopping. The app allows parents to search activities by age (0-18 months, 18-36 months, and 3-5 years) and includes 'boredom busters' that can be used at anytime. Let's Play was developed by ZERO TO THREE, a nonprofit organization that focuses specifically on the healthy development of babies and toddlers.
• Infant Attachment
  Learn about what Infant Attachment is and how important it is to the healthy growth and development of your child.
• Making Connections
  Your First Two Years with Baby
• Manitoba Families of Multiples
• Multiple Births Canada – Twins? Triplets? Or more?
  Having multiples can be an exciting but challenging situation for any family. The Manitoba Families of Multiples (formerly known as the Winnipeg Parents of Twins and Triplets Organization) was formed in March 1966 by a group of five mothers of twins and triplets who were interested in meeting to discuss their common problems and to share solutions. All the member families have at least one set of twins, triplets, or higher order multiples such as quadruplets, and some even have two sets of multiples!
• Nobody's Perfect
  A parenting program for parents of children birth to age five.
• Parenting On Your Own Handbook
  Raising a child on your own has unique challenges. The Parenting on Your Own handbook features the many supportive resources available to you all in one place.
• Parenting Resource Information
  This link will take you to information that will help answer many of the questions you may have in raising your children.
• Parents Without Partners (PWP)
  PWP provides single parents and their children with an opportunity for enhancing personal growth, self-confidence and sensitivity towards others by offering an environment for support, friendship and the exchange of parenting techniques.
• Post-Partum Depression
  Signs and symptoms and what you can do.
• Raising & Caring for Your Child
• Resource Information for New Parents
  Follow this link for answers to some of the initial questions that you may have as a new parent.
• Sleep Strategies & Information
• Flood Stress Information
  When floods threaten individuals, families and communities, it's normal to experience strong emotions. The stress of losing a home or treasured possessions can take a serious toll.
• Temperament
  Understanding what temperament is; how knowing yours and your child's temperaments can help you parent more effectively.
• Understanding Your Child's Temperament
• Responding to stressful events: Taking care of ourselves, our families, and our communities
  Stressful events can cause fear, anxiety and distress as we worry about our own safety, and also about the well-being of our families and our communities. It is important for us to know and acknowledge that it is normal to feel this way, but that there are steps that we can take to feel better. Learn more about coping with stressful events by clicking on this link.
• The Canadian Father Involvement Initiative
• New Dad Manual
  Friendly, useful advice from other Dads on becoming a father and caring for your baby.

Community Programs

Parenting is one of life's most rewarding experiences but it can be extremely challenging as well. Fortunately, you don't have to tackle parenting all alone ? there are many great resources available. Maybe a drop-in centre works best for you and your family, or perhaps you feel more comfortable at a regularly scheduled group or class.

Depending on where you live in Manitoba, you may be able to access a range of programs at the community level. To find out more about the community-based services and programs for families in your area, try the CONTACT Community Information Online Search Tool and the other links below. If there are other programs or services you feel we should add to our Community Programs list, please let us know by emailing us at Contact Us with the details (type of program, location, phone number, hours of operation and cost).

• Child Care Online Search Tool
  A search tool parents can use to help identify the child care options available to them.
• CONTACT Community Information Online Search Tool
  This searchable list of programs and organizations throughout Manitoba is relevant to all parents – whether they have babies or teens – and provides information related to child health and education, as well as a variety of other useful topics. Manitoba Healthy Schools worked with CONTACT Community Information (a program of the Volunteer Manitoba) to develop this customized directory. CONTACT houses Manitoba's most comprehensive listing of province-wide community services, programs and organizations.
• Manitoba Community Parenting Resources
  The Manitoba CAPC Coalition is the collective of Manitoba programs funded through the CAPC (Community Action Program for Children) funding branch of the Public Health Agency of Canada. There are fourteen CAPC projects in Manitoba, all sharing the same goal: to enhance the well-being of children aged 0-6, living in conditions of risk. Click on this link for information on the fourteen locations ? seven within Winnipeg, seven outside Winnipeg ? including contact information, agency overview, programming and services offered, and much more. Topics and areas covered include child development, parenting skills, parent life skills, access to services and resources, youth development, Aboriginal culture, community development and knowledge of Fetal Alcohol Spectrum Disorder (FASD).
• Manitoba Schools, School Divisions, and Districts
  This link provides contact information for Manitoba schools, school divisions and districts, including maps, calendar dates and school board contacts.
• Nobody's Perfect Parenting Groups
  A parenting program for parents of children birth to age five. Nobody's Perfecting Parenting Groups are offered for free at various family centres and other organizations throughout the province of Manitoba. Child care and snacks are also provided.
• General Council of Winnipeg Community Centres
  The General Council of Winnipeg Community Centre's website includes over 60 City of Winnipeg Community Centres. Designed to be a resource for community centre volunteers as well as the public, you can check for your community centres' location, programming information, upcoming events, rental facilities and more.
• Winnipeg Parent Newsmagazine – Family Survival Guide
  The annual Winnipeg Parent's Family Survival Guide is a directory of everything family in and around Winnipeg. If you are looking for parenting support groups, community family centres, expectant parent and new baby information, preschool programs, camps, schools, family fun, party products and services, festivals, and more, click on the link above.
• Healthy Start for Mom and Me
  This neighbourhood-based adult education group is designed for expectant and new families with babies up to one year. The organization operates drop-in sessions in nine Winnipeg neighbourhood sites, and they provide other practical supports as well.

Separation & Divorce

Separation and divorce can be a time of confusion, sorrow and pain for all members of the family. Find resources here.

• Family Conciliation Services
  Works closely with the family law system. Family Conciliation Services offers conflict resolution services at no cost to families going through separation and divorce. It also provides qqq informational and educational programs free of charge.
• For the Sake of the Children: An Information/Education Program for Parents and Families
  Family Conciliation services offers the For the Sake of the Children program which will benefit all adults going through a separation or a divorce where children are involved. New court rules make program attendance a requirement for people who are requesting or responding to requests for custody, access or private guardianship. This free of charge program is also open to grandparents, other family members and interested people.
• Family Law Booklet
  Divorce, child access/custody, child support payments and child protection all fall under family law provisions.
• Moving On & Managing Your Money: An Information Guide for Domestic Violence Survivors
  When leaving a home where there is domestic violence, people are often faced with money problems. This Guide brings together a variety of information to help identify what steps to take and where to call as survivors get on their feet and manage their money.
• ManitobaParentZone.ca on Separation & Divorce and the Holiday Season
• Parenting On Your Own Handbook
  Raising a child on your own has unique challenges. The Parenting on Your Own handbook features the many supportive resources available to you all in one place.
• Klinic Crisis Line
• Canadian Mental Health Association: Separation & Divorce