Coping during COVID-19
Undoubtedly, this is a very difficult time to have a newborn! Even more so, if you have issues with breastfeeding or are uncertain about what is normal in the context of breastfeeding / lactation.
As you know, to stop the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the disease coronavirus disease 2019 (COVID-19), the National Government have announced a lockdown across South Africa, (though having a newborn may be socially isolating for many anyway).
To help cope with the uncertainty and resulting stress of this unprecedented global pandemic we have to find peace in the fact that we are doing our part to “flatten the curve” through:
- staying at home (social/physical distancing),
- keeping distance between ourselves and others when shopping,
- washing hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol,
- covering our mouths and nose with elbow or a tissue when coughing or sneezing and throwing away the used tissue &
- self-quarantining if experiencing any flu-like symptoms like fever, cough, etc.
Here are some tips to help you build mental strength to combat the stressful situation the whole globe is experiencing:
1. A sense of belonging, a sense of purpose is very, very important. Being socially together while being physically apart, social connection is going to keep our empathy strong and hold us together as humans. We all know the positive effect social support has on our ability to handle stuff in our everyday life, right? If you have a family member, you know to be isolated (alone) make (virtual) contact every single day!
Parents with new babies might feel like “they will never be alone again” which may also seem overwhelming ;-), but from experience I can tell you, these “baby” years pass all too quickly.
2. Manage your environment to minimize your exposure to what makes you anxious - like the news (an anxiety trigger). Chose only credible websites (e.g. https://www.who.int/emergencies/diseases/novel-coronavirus-2019, https://sacoronavirus.co.za/, https://www.cdc.gov/coronavirus/2019-ncov/) for a limited amount of time each day (maybe 2 x 30 minute periods per day). Do something uplifting at least once a day, like listening to music or going for a walk in your garden.
Music is a popular aid for relaxation. Some of the therapeutic properties of music: it reduces anxiety, decreases blood pressure, lowers stress hormones, alters perception of pain, enhances relax response, sets the tone / creates a calm atmosphere. Choose music in harmony of your body and mind.
Diet, apparently, also has an effect on mood. There is some evidence that deficiency or supplementation of nutrients can affect not only mood, but also behavioral patterns. Eat a healthy well-balanced meal at least once a day sitting down at a table with your family.
3. Structure your day (and include time for healthy distractions and (virtual) social connections). Routine is key to maintaining good mental health during lockdown. Stay close to your normal routine. Wake up and go to bed around the same time, eat meals, shower, adapt your exercise regimen, and get out of your pajamas! Do laundry as usual. Sticking to your normal routine keep you active and less likely to spiral, it will be easier to re-adjust to the outside world when it’s time to get back to work.
For parents with older kids who can keep themselves busy, doing one productive thing per day for you can lead to a more positive attitude. Tackle those long-avoided tasks, reorganize, or create what you have always wanted to.
Okay, but what if I have a newborn?! A newborn’s daily route may seem unpredictable but they basically need what they had in the womb, closeness, non-stop feeding, being held 24/7, etc. ;-). Think EASY. E=Eat (most of your time will go into building your breastfeeding relationship ;-). A=Activity (like bathing, diapering, cuddles, tummy-time etc.). S=Sleep (babe and you!!). Y=You time (very important to take care of yourself in order to have the strength/energy/stamina to take care of baby).
4. Being in lockdown limits parents access to a medical and practical support. Having to choose between taking baby for weight checks vs. the risk of exposing oneself and baby to a potentially deadly virus is tough. Use Telehealth as an option to talk to a Lactation Consultant (IBCLC) if you have any breastfeeding or lactation issues!
IBLCE (International Board of Lactation Consultant Examiners) in their Advisory Opinion dated 3 April 2020 stated, “Telehealth is an available option for IBCLCs provided it is permitted in a particular country of practice.” The HPCSA amended their original Telemedicine Guidelines during COVID-19 (dated 3 April 2020) stating, “Telehealth should preferably be practised in circumstances where there is an already established practitioner-patient relationship. Where such a relationship does not exist, practitioner may still consult using Telehealth provided that such consultations are done in the best clinical interest of patients.”
5. Having too much anxiety? Snapping at your loved ones? Feeling especially vulnerable? You may be in need of some conscious relaxation. Learn how to put your body into a relaxed state to help you (re)gain control. By learning how to consciously relax, we learn how to shut off anxiety.
Progressive relaxation is a method of teaching your body to relax. You will contract one group of muscles at a time while the rest relaxes.
With “Pavlovian conditioning” practice your relaxation with music or a trigger word. Let the person guiding you use a conditioning word (like sunshine or beach) throughout the guided progressive relaxation or use music as your trigger; so eventually your body will learn to relax when you hear the music or the trigger word.
Daily practice is encouraged (one or two 15 minutes practice sessions daily). The procedure consists of these steps:
Get comfortable, pillows as needed, no dogs barking, temperature comfortable
Focus attention on muscle group
Tense muscle group when partner says “tense” / “contract”
Maintain tension for 5-7 seconds
Release tension when partner says “relax”
Concentrate on relaxed muscle and discriminate differences in sensation from muscle tension and release (30 seconds)
Remember to breath in-2-3-4 and out-2-3-4 all the way through even during tensing the muscles (notice if you want to hold your breath)
Use the technique in each muscle group twice
- Try 10 sessions progressive relaxation over the next 2 weeks
- 1st session: focus on all 16 muscle groups, twice, 15 minutes daily practice
- 2nd and 3rd: sessions repeat as needed
- Session 4 and 5: reduce 16 muscle groups to 7 groups
- Session 6 and 7: muscle groups reduced to 4 groups
- Session 8: 4 muscle groups + recall (focus on muscle group and remember what tension felt like there, and releasing tension without ever actually tensing those muscles
- Session 9: recall and counting (release muscle while partner counts from 1 – 10)
- Session 10: counting only
- NOT ALL of the above ON 1 DAY!
The Breathing: The key is to breath easily and not work too hard
· Breathe through your nose and feel how your nostrils open. (Breathing through your nose is preferable because it moistens and warms the air but not necessary. You may breath through your mouth if that is your preference)
· As you breathe in feel how the lower part of your lungs expands and fill up with air. Also feel your lower ribs moving up and out
· Your partner could place his or her hands on your lower back - should feel their hands move as your breath “down your back”
· Then breathe out slow and long through a soft, relaxed mouth as though you are wearing a relatively expensive new lipstick. Feel the pressure subsiding. Out-breath sounds like a sigh or when you blow out a candle oh so gently as to make the most amount of smoke possible or blowing on soup
· The point is to breath the same volume of air in and out
· Count: In-two-three-four
· This breathing has a calming effect
· Rate is about 5 – 12 breaths / min
No one can predict with a 100% certainty what our future holds. Focusing on what we cannot control takes our attention and energy away from what we can control. Build your mental strength to combat this stressful unprecedented global pandemic by focusing on the things you can control: what you think, what you feel, what you do and say. All the best! Stay healthy! Wash your hands! And don’t touch your face!
Rogers PJ. A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function. Proc Nutr Soc. 2001;60:135–143