[BabyFilter] Do you have any tips for dealing with (and surviving) post-partum insomnia?

July 10, 2007 7:02 AM

[BabyFilter] Do you have any tips for dealing with (and surviving) post-partum insomnia?

So our son is now 6 weeks old and, ironically, sleeping fairly well, if only at night (a total of 8-9 hours a day). The problem is that my girlfriend, who was sleeping fairly well for the first 4 & 1/2 weeks or so, has started suffering from bad insomnia.

She really hasn't had much success napping during the day, but earlier on she was sleeping a total of 5-6 hours a night. Now she's lucky if she gets 2-3 hours which is all she gets for the entire day.

We're doing 6 hour shifts at night (I do 9:30-3:30am and she does 3:30am-9:30) with the idea that each of us has a dedicated slot of 6 hours to sleep. During her time to sleep, though, she's really struggling to fall asleep, and then when she finally does she wakes up 2-3 hours later having to express and cannot fall back asleep afterwards.

We have a doula that has been coming in at night twice a week to cover night feedings and my GF has been sleeping well on those nights, so I'm pretty sure part of the issue is my GF has anticipatory stress of having to wake up for her shift which is affecting things...

So far we've talked to our midwife and my GF has tried taking Gravol, drinking "sleep tea", and drinking a small amount of red wine before bed and none of it has really helped.

It's not at the critical point yet, but we both know if this continues she may have to discontinue breast feeding to take a sedative - something we really want to avoid. I know we're not an extreme case but it's affecting both of us - I'm back at work now and it's very hard to leave my GF alone during the day knowing she's whacked out from lack of sleep.

Any suggestions from those that have been there before?

posted by theNonsuch to health & fitness (17 comments total)

Ambien saved my life. The insomnia is a really bad spiral that feeds on itself and can trigger or aggravate post-partum depression -- I remember all too well the rising anxiety of knowing that if it kept taking me longer and longer to fall asleep, I would be still awake by the time the baby needed feeding again, and I remember, too, that the four solid weeks of sleeping no more than an hour at a time was the darkest point of my life. I tried everything -- tea, OTC sleep aids, you name it. But it wasn't until I broke down and took my OB's recommendation for Ambien that I was finally able to get some relief. I don't know whether Ambien is a medication you can take while breastfeeding, but I can tell you that it was extremely helpful for dealing with the "prolonged sleep latency" issue I was having (essentially, when it takes too long to fall asleep), and the key part was that I was still able to get up and function when I needed to -- I could take the Ambien, fall asleep, and then wake up a few hours later to feed the baby, and fall asleep again. It was a really crucial intervention for me -- I think had I not been able to sleep, I would have had much more serious PPD.
posted by mothershock at 7:19 AM on July 10, 2007

Lunesta works, better than Ambien for me.

Also, could you switch shifts? 9:30 is pretty early to have to go to bed, especially in the summer with late sunsets, and waking up at 3:30 in the morning, long before it's light out, can be really unpleasant and disorienting. (That was my experience working the 4am shift in a bakery, anyway.)

If she took the first shift, she also wouldn't have to worry about waking up later on to do the feedings.
posted by footnote at 7:23 AM on July 10, 2007

footnote: the reason we decided that I'd take the first shift is mainly because my GF would have already spent the entire day with the baby and would be tired enough for a break, but you've got a good point.

I'll look into Lunesta and Ambien -- I've heard of the latter but not the former. My guess is both of those are not breast-feeding friendly, but if we get to the point where sleep is critical that's probably going to be the least of our worries...
posted by theNonsuch at 7:26 AM on July 10, 2007

I pretty much always end up recommending acupuncture in these threads, because it's worked on every pregnancy related issue I've had. I was really depleted, sleeping poorly if at all, when the baby was 3-5 weeks. The acupuncturist fixed me right up in about three sessions. She said that in traditional chinese medicine women who give birth are treated for hormone imbalances for up to three years!
posted by pomegranate at 7:34 AM on July 10, 2007

Speaking purely from my own experience - I too suffered insomnia for weeks after. My husband was a supportive player - as it sounds you are - and that helped greatly. It all got better with time, but those were some dark nights of the soul. Those early days and nights are long ones. Hang in there.

Looking back, though, I realized that the insomnia was a symptom of my post-partum depression and anxiety. There may be more things in your situation that need attention - I don't know your situation, obvs, but it's something to keep in mind.

What helped save my sanity a lot in those early days was being able to go out on my own for an hour or so every other day or as often as my husband could manage for us. Might help your girlfriend too - to clear the cobwebs and get some "me-time."
posted by lucyleaf at 7:40 AM on July 10, 2007

I would investigate the possibility of magnesium deficiency. An excellent, easy-to-read book on the subject of Mg deficiency is Dr. Carolyn Dean's "The Magnesium Miracle". It can be purchased on half.com for a paltry sum...
posted by msquare at 7:42 AM on July 10, 2007

A 6-week-old should be sleeping 15-16 hours per day. Sleeping 9 hours per day means you are keeping the baby incredibly sleep-deprived. Since the kid should be eating about 7-8 times per day, basically the child's entire day is either a) eating or b) sleeping. There is NO "up and playing" time left. So first of all, start putting the kid to bed after every feeding.

Now, about your own sleep. The kid should be sleeping in another room, not in your room. It's impossible to sleep with an infant next to you. Babies move, make noises, twitch, fuss, and you stay conscious of them the whole time. Get the baby someplace where you can hear it if it screams full volume - but only if it screams full volume. Once that is done, you should now be cutting out at least one night feeding. Just stop waking the kid up at night - when it wakes up on its own and screams, then you feed it, but not before. You'll quickly and easily get four and then five hour stretches at night. During the day, sure, wake the kid and cram food into it. But at night, no wakeups.
posted by jellicle at 7:48 AM on July 10, 2007

Seconding lucyleaf -- I, too, had insomnia as one of my symptoms of PPD. It hit me at six weeks to the day.
posted by The corpse in the library at 8:03 AM on July 10, 2007

I agree with jellicle. My boy is 8 weeks old and has slept midnight to 7-ish the past 4 nights. We do lots of feedings (BF) in the early evening and then put him down for the night between 11:30 and midnight. He lets us know when he's hungry and has been sleeping longer and longer stretches. You can adjust the times to fit your schedule but if the baby is over 12 pounds, then they are physically able to go for at least 6 hours without needing to eat. It may take a few nights but work on getting your little one used to going for longer stretches at night. Also, PPD can cause anxiety/insomia so have your GF talk to her DR if this persists. Good luck to both of you and enjoy these early days, they really fly by!!
posted by pearlybob at 8:24 AM on July 10, 2007

I've found Benadryl to be fairly effective at inducing sleep. As a drug, it has very few side-effects and interactions, the big one is that it makes you drowsy.
posted by plinth at 8:46 AM on July 10, 2007

jellicle - you're welcome to come over and tell my son that he should be sleeping more. :) Seriously though, it's easier said than done, especially right now in this heat. Our son doesn't sleep well unswaddled, but it's too hot to swaddle so there's not much we can do. Getting babies to sleep in the summer -- that should be another AskMeFi. :)
posted by theNonsuch at 8:47 AM on July 10, 2007

I agree with jellicle about the first part - your baby should be sleeping a LOT more (please talk with your Ped about this), but disagree on the other part.

I found that unless I had the baby in the co-sleeper or in the bed with me, sleeping was nearly impossible. Every sound on the monitor would rouse me, and I never slept deeply fearing that I would somehow miss him waking and he would scream and scream for a mommy who failed to come in. This was made worse when it actually happened - I put him to sleep in his crib and went to sleep in our bed and somehow didn't hear him howling and crying for (we think) about half an hour until his father finally heard him from downstairs and across the house where he was sleeping on the sofa. But I digress.

Get in the habit of letting the baby feed to sleep, then lay down with the baby. Co-sleep in the same bed, use a co-sleeper (sidecar), put baby in a moses basket (or even a padded laundry basket) on the floor, or in a crib nearby, but please do try to sleep when the baby sleeps.

Massage and acupuncture can also absolutely help.

Feel free to email me anytime if you want. Email is in my profile. (And congrats on the little one - the internet demands photos, you know. :-)
posted by anastasiav at 8:52 AM on July 10, 2007

but it's too hot to swaddle

Send someone out to the fabric store and buy cotton gauze. My son was born July 10th last year (hey, that's today!). We made him swadding-size blankets out of cotton gauze and/or lightweight linen and they worked like a charm.

The weird thing with babies is if they aren't getting enough sleep they then get overtired and refuse to sleep. But if you can get them to sleep just a bit more then they'll end up sleeping a lot more ... sleep begets sleep, my grandmother said, and she's right.
posted by anastasiav at 8:55 AM on July 10, 2007

This happened to me! At exactly 8 weeks post-partum. My OB said that if it lasted more than a week or so, I needed to come in and have my thyroid checked - post-partum thyroid problems are not uncommon.

Mine was terrible - not one minute of sleep for two nights in a row, plus several more nights before that with interrupted, limited sleep. I was a basket case.

My OB said Benadryl was fine and compatible with breastfeeding. I tried to "reset" myself with a really regimented routine in the evening - get ready for bed, brush teeth, take the Benadryl, wait 30 minutes, crawl in bed.

My husband kept an ear out for the baby, as I had earplugs in and an eyemask on. I also kept the ceiling fan running and the bedroom door closed.

It worked, I was fine after a few days of Benadryl. For me, I think it was the sudden change of my son sleeping through the night. Even though he had been waking only at 4 AM prior to that, as soon as he slept through the night, I started waking at all the times he used to nurse: midnight, 2:30 AM, etc. Or I would never fall asleep, thinking, "He's just going to wake up in 30 minutes anyway!"

Good luck!
posted by peep at 9:02 AM on July 10, 2007

Is she getting enough exercise? I had better luck getting back to sleep when I got an hour long walk with the baby in a carrier or stroller each day. Also, she can try Expecta (a non-fish oil omega 3 supplement) for a mood boost. Finally, I have found the BBC world service (broadcast on NPR during the night hours) to be very helpful in inducing sleep.

Unfortunately I have not come up with a good solution to this problem yet. My kid is 6 months old, her previously good sleeping habits are now somewhat random and crappy, and I still have trouble going back to sleep after feeding at night sometimes (but not every night). I have an underlying pre-existing mood disorder and have suffered from midnight waking problems for years so I'm not really a good data point for comparison.
posted by crazycanuck at 11:14 AM on July 10, 2007

From a friend whom I referred to this thread (she's a new mother suffering the same problem):

"ambien IS, i repeat IS, compatible with breastfeeding. much moreso than benadryl--antihistamines can wreak havoc with your supply. i took ambien one night and slept great, but i can't do that every night. it only seems to get really bad when i am REALLY sleep-deprived; then once i "re-set," i can sleep again. i don't know about lunesta, but i KNOW ambien is on kellymom's list of approved medications."
posted by Token Meme at 4:06 PM on July 11, 2007

My girlfriend just started going out for walks with the boy this week - she is just getting to the point in her healing where she can do this, so hopefully it will help at night. It definitely can't hurt.

Thanks for the cotton gauze tip -- I did some searching in town but couldn't find any, but I ended up buying a couple of those "Miracle Blankets" that seem to be light enough to use in the heat.

I spoke with our midwife yesterday and she recommended homeopathics, which we're going to look into. For now we're going to increase our night-time help to three times a week but we both would really like some kind of longer term solution... I'll ask about the Ambien, too.

Thanks to everyone for your support and advice! Keep it coming if you have any other ideas or comments.
posted by theNonsuch at 9:37 AM on July 12, 2007