Tuesday, September 10, 2013

Postpartum Fatigue: Part 1

Today, we will start a new series of posts about postpartum fatigue. The newborn period is challenging and often parents’ fatigue is underemphasized because it is a normal part of having a new baby. Fatigue is also often overlooked by healthcare providers because it is seen as a normal stage that parents go through that resolves when the baby sleeps better. However, when you are the one experiencing the fatigue, it is extremely difficult to function through!

So what is fatigue? It’s defined as persistent exhaustion and lack of energy not easily relieved by sleep or rest. (Dunning 2013) It is “an overwhelming sense of exhaustion that is accompanied by a decreased capacity for physical and mental work at the individual’s usual level.” (Taylor 2010) You may be wondering what the difference is between fatigue and tiredness. Tiredness is relieved by resting whereas fatigue is a more persistent state that is not relieved by rest.

How common is postpartum fatigue? This differs by study but about 50-64% of women consider postpartum fatigue a significant symptom. Researchers reported in one study that nearly 70% of women had fatigue at 1-2 weeks postpartum compared to about 40% 12 weeks later. (Corwin 2007) Fatigue in fathers is common as well. One study found no significant difference in reported levels of fatigue among fathers and mothers, though mothers had more disrupted sleep, and less night sleep. Fathers, however, had less total sleep postpartum compared to mothers and less daytime sleep. (Gay 2004)
Several factors either contribute to or increase fatigue in the postpartum period. 

·       First time moms

·       Long labor or c-section

·       Increased postpartum blood loss

·       Maternal hormonal shifts

·       More depressive symptoms

·       Perceiving that your infant has a more difficult temperament

·       Less sleep or poor sleep quality (Even if it is the same amount of sleep as you received while pregnant, because of sleep disruption, you will feel less rested.)

·       Less social support

·       Poor diet and exercise

·       Persistent or high levels of infant crying (Mothers in one study reporting more infant crying than other mothers also had more fatigue. Crying can disrupt the mothers’ circadian rhythms and reduce chances to rest.)(Kurth 2011)
(Taylor 2010, Cooklin 2011, Kurth 2011)

Since infant night waking is normal, parents will inevitably have disturbed sleep in the postpartum period. It’s important to have tools to deal with the inevitable sleep deprivation and resulting fatigue. In our next post in this series, we’ll examine the effects of fatigue on parenting and then in the final post we will provide evidence-based tools to fight fatigue.

Dunning M, Seymour M, Cooklin A, Giallo R. Wide Awake Parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue. BMC Public Health. 2013;11(13): 26.

Taylor J, Johnson M. How women manage fatigue after childbirth. Midwifery. 2010;26(3): 367-75.
Corwin EJ, Arbour M. Postpartum fatigue and evidence-based interventions. MCN Am J Matern Child Nurs. 2007;32(4):215-20.

Gay CL, Lee KA, Lee SY. Sleep patterns and fatigue in new mothers and fathers. Biol Res Nurs. 2004;5(4):311-8.

Cooklin AR, Giallo R, Rose N. Parental fatigue and parenting practices during early childhood: an Australian community survey. Child Care Health Dev. 2012;38(5):654-64.
Kurth E, Kennedy HP, Spichiger E, Hösli I, Stutz EZ. Crying babies, tired mothers: what do we know? A systematic review. Midwifery. 2011;27(2):187-94.

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