You’ve heard breastfeeding will leave you a train wreck, but you’ve also heard the hormones are supposed to help with mental health. The truth, as usual, lies somewhere in between.
During prenatal visits, I ask expecting parents what their vision is for feeding their baby. What would an ideal scenario look like for them? The response often goes like this: “I want to try, but I’m okay with whatever happens. I don’t want to destroy my mental health over it.”
Everyone has heard a horror story of a friend who got chewed up and spit out by breastfeeding (specifically nursing, or directly latching to the breast) and either quit altogether or ended up exclusively pumping and bottle feeding. This friend wanted it so badly, she gritted out one complication after another and ultimately was overwhelmed into depression.
First, I’d like to say this friend most likely was not working with a lactation consultant. We’re here to spot those complications early before they get too complicated. Second, this story is far too common and makes me very, very sad. And angry.
Seriously. Pregnant parents have more than 10 provider visits before birth, during which the importance of breastfeeding is emphasized. A box is checked around week 28 (“plans to breastfeed”) and that’s the end of it. No one tells you that if you have a history of loss, or a mood disorder, or fertility issues, or any host of other risk factors that you are more likely to give up breastfeeding early. No one teaches you anything about how to hold a baby to breastfeed, how breastfed babies behave, that it shouldn’t hurt, or how milk supply works.
Instead, we wait for you to have the baby and then cram everything in during your 24-hour stay in the postpartum unit–along with all the other newborn care you need to learn that day.
Are we really surprised that our new parents are completely blindsided and overwhelmed by breastfeeding?
A bi-directional relationship
Yes, healthy, successful breastfeeding protects a mother’s mental health. This is 100% true. The primary hormones of lactation act as agonists of stress hormones–regular doses of oxytocin suppress cortisol and have a soothing, reassuring effect. Research shows that breastfeeding moms have less depression and anxiety. Wonderful.
The trick is getting to the healthy, successful breastfeeding. The barriers to this are the subject of another post, so suffice it to say here that not everyone will reach this goal. And for most, it will take at least a few weeks.
So this is the rub: a mom who already feels depressed or anxious in pregnancy is more likely to give up in those early weeks, and therefore least likely to reap the protective benefits that she needs more than the healthy mother. In fact, the mother who was depressed or anxious before she had the baby is more likely to become more depressed and anxious if breastfeeding fails.
How do you like dem apples? You don’t. They’re rotten.
How to protect breastfeeding and your happiness
One reason we choose to breastfeed is that it is supposed to feel good! And feeling good is not just for you. We know that mothers who are depressed are less attuned and less responsive to their infants. They have a harder time bonding, and as a result, the baby has less interaction and attention from this primary parent.
This is not to make you feel guilty if you don’t feel well, but to emphasize that your well being directly impacts your baby’s. Taking care of yourself is taking care of your baby.
So this is quite a thicket we find ourselves in, where breastfeeding reduces stress and supports bonding, but can be imperiled by anxiety and depression. Take heart–there are concrete and manageable steps to improve your chances of having both successful breastfeeding and emotional wellness.
- You know what I’m going to say: establish care with a lactation consultant while you are still pregnant. You can get all of this when you do. If breastfeeding is important to you, don’t wait until you need help to look for it. Set it up ahead of time so it’s available immediately.
- Screen yourself. In my practice I use the Edinburgh Postnatal Depression Scale, which can be found online and self administered. A score of 7 or above shows that you may not be feeling your best, and above 14, you’re really struggling. Elevated scores in pregnancy are strong predictors of mood disorders postpartum. Feelings of anxiety and overwhelm will almost certainly be higher once the baby is here, so getting treatment before his arrival is critical.
- Find a therapist. If you are currently having symptoms of a mood disorder, or have a history of one, it’s a good idea to have a mental health professional on board for the transition to life with a baby. Just like your LC, they will be there when you need them. Postpartum Support International has a directory of providers certified in perinatal mental health.
- Consider medication. Studies show women who were taking medication for depression breastfed longer than moms who were untreated. Most medications for these disorders are safe to take while pregnant and breastfeeding–many have been studied extensively and have shown no harm to babies. Your obstetrician should be able to guide you, and you can call Infant Risk to get safety information on any maternal medication at 1-806-352-2519.
Smaller steps to get started
As many as 1 in 7 mothers and 1 in 10 partners experience depression during pregnancy and the first year after birth. In fact, it is the most common complication of normal childbirth.
Reach out if you think you may have risk factors. I will share a list with you, and you may be surprised at how many events are associated with mental health challenges. Knowing them ahead of time will help you build a strong self-care plan.
If you aren’t sure how you’re feeling and don’t know where to start, please email me. I will send you a check list of symptoms that can act as an emotional weathervane to help you orient. Refer to my resource page for a starting list of local mental health resources.
Prevention and healing start with awareness. You don’t have to go into this blindly. You deserve to feel good as you transition to life with a new baby, and with the right support, you can.
all images source: U.S. Breastfeeding Coalition