Parenting

BREASTFEEDING AND POSTPARTUM DEPRESSION

By Krystal Hoople RN, BScN, IBCLC

previously published in Birth Issues Spring 2012

Fiddle Leaf Photography

Fiddle Leaf Photography

As soon as we are pregnant we start making conscious decisions about the health of ourselves and our baby. We watch what we eat, stop poor lifestyle habits and drive slower, all because it is good for our baby. Along with wanting to do “the best” for our baby comes the decision of how we will feed our babe. We do the research and learn all the positive effects breastfeeding has for both of us. We quickly learn the cells, hormones and antibodies in breast milk protect babies from illness and that breastfeeding has also been shown to lower the risk of SIDS (sudden infant death syndrome). For mom, breastfeeding is linked to a lower risk of type 2 diabetes, breast and ovarian cancer and decreases the risk of postpartum depression (PPD) and can aid in a mom’s recovery from PPD. Did she just say breastfeeding can help with PPD?

Yes, breastfeeding can lower a woman’s risk of depression! A study review found that the rates of depression are lower in breastfeeding women than in non-breastfeeding women, and that formula feeding is a risk factor for depression1. A woman’s mental health is protected due to the hormones released and their ability to decrease stress hormones in a breastfeeding woman2. As reported by M. Altemus et al in a 1995 study, and stated in the newsletter for La Leche League International, New Beginnings, “The child’s suckling at the breast produces a special hormonal milieu for the mother. Prolactin, the milk-making hormone, appears to produce a special calmness in mothers. Breastfeeding mothers have been shown to have a less intense response to adrenaline”3. Oxytocin is an efficient anti-stress hormone. Research has shown, mothers who breastfed for more than seven weeks were calmer when their babies were six months old than mothers who did not breastfeed at all4.

Postpartum depression has triggers other than just the feeding method a mom chooses. There is thought to be a genetic vulnerability to developing postpartum depression. Rapid changes in the levels of reproductive hormones that occur after delivery are thought to be biological factors in the development of postpartum depression5. Also, the huge transition into parenting a newborn plays a role. This being said, breastfeeding moms are not immune to PPD. The good thing is breastfeeding can aid these moms in their recovery!

I breastfeed and still suffer from PPD, now what?

Keep Breastfeeding!

Do not let anyone convince you to stop breastfeeding! Abrupt weaning can cause mom’s hormone levels to change, which can cause the depression to intensify. Oxytocin, which is one of the hormones that is released while breastfeeding, is a powerful antidepressant. Many mothers who are experiencing postpartum blues follow recommendations to stop breastfeeding but will continue to have postpartum depression and some get even worse.

Breastfeeding also protects our babes from the negative effects of postpartum depression. Babies are protected as breastfeeding women tend to continue to touch and make eye contact with their babies more than depressed, non-breastfeeding women who are more likely to disengage from their babes. Emotionally, mothers benefit from breastfeeding by forming a stronger bond with their baby6.

Get the Breastfeeding Support You Deserve!

If you are having breastfeeding difficulties get support you need from family, friends or contact one of the following resources:

La Leche League Canada
Mother to mother information and support by phone & email.
Community Groups for pregnant and nursing mothers.
Website: http://www.LLLC.ca
Edmonton & Area Helpline: 780-478-0507

Lactation Consultants are International Board Certified Lactation Consultants (IBCLC). This means they are registered Lactation Consultants (RLC), who are required to keep current with breastfeeding information and must recertify every five years. They provide hands-on clinical support and are trained to work with all breastfeeding-related problems. In order to certify they must have many thousands of hours of practical hands-on training and must have completed many education credits to write the international exam in the first place. To find a local Lactation Consultant, checkout the Lactation Consultant directory in this issue or contact http://www.ilca.org for a worldwide search.

Breastfeeding Clinics are found in many hospitals. Most clinics are staffed by IBCLCs, though not always.

Nourish yourself with anti-depressant foods

To maintain a healthy physical and mental wellbeing, it is important to keep yourself nourished. Many foods are thought to have a positive effect on our mood. Here is a list of a few from Tom Servo’s article, Stay Happy by Eating the Right Foods7.

Water: As simple as may seem, water is one of the best natural antidepressants. Dehydration causes fatigue, which in turn, causes your body to not feel so great. People who don’t feel well physically have a tendency to not feel well mentally, as well. Drink at least one ounce of water per pound of body weight daily to help yourself feel less depressed.

Spinach: Spinach is a very good source of folic acid, which is very important for maintaining proper physical and mental health. A lack of folic acid causes the body to not produce enough serotonin. There’s a reason Popeye ate this stuff. Spinach is a great natural antidepressant.

Oranges: Oranges and other citrus fruits are packed with vitamin C, which is needed for your body to produce dopamine. It will also keep your red blood cell count high.

Red Peppers: Another excellent source of vitamin C. Red peppers actually contains more vitamin C than citrus fruit.

Wheat Bread: Whole wheat is another food that can act as a natural antidepressant. It’s loaded with complex carbohydrates that will help your body produce healthy amounts of serotonin. Try making a sandwich on whole wheat bread with spinach and red peppers, and then wash it down with a big glass of water and some orange juice, and you just got a dose of all five of these natural antidepressants in one meal.

Meet With Your Doctor

For severe cases of postpartum depression where you’re unable to care for yourself or your baby, antidepressants may be an option. Discuss these medication options with your doctor. Some women find antidepressants or other appropriate medications may help. Some antidepressants are safe to use during nursing; others may not be. One safe antidepressant is sertraline, which is sold under the trade name Zoloft. When nursing mothers take this drug, it is undetectable in their babies’ blood8.

Unfortunately, many doctors who recommend that women wean their babies before taking antidepressants do so because they don’t know about recent studies on the safety of particular drugs during breastfeeding. It is important your doctor is using an up-to-date reliable resource other than the regularly used CPS (Compendium of Pharmaceuticals and Specialties). Mother Risk is a Canadian resource developed by the Hospital for Sick Children in Toronto to provide expectant and nursing mothers with the most up-to-date drug and medical research for themselves and their baby. If you are unsure of the effects a medication will have on your breastfed babe, contact Mother Risk at http://www.MotherRisk.org or 1-877-439-2744.

If it is determined a mom would gain relief from antidepressant medication, the benefits of continuing to nurse far outweigh any risk the minimal amounts of the medication found in the breastmilk will have on a baby. Breastmilk is still the safest, purest and most nutritious form of nourishment in the first months of life9. As long as a nursing mom wants to continue breastfeeding, is comfortable doing so and her doctor sees no risk to the infant she can continue to nurse.

Understanding the effects breastfeeding has on you and your baby to prevent and aid in treatment of postpartum depression allows women to make informed decisions in a very emotional time. It allows you to gain the confidence to make the right choice for you and your babe.

“If I were to eliminate breastfeeding, I might have no hope of coming through this [post partum depression] nightmare. I was hanging onto the breastfeeding as my lifeline.”10 —Brooke Shields

Krystal Hoople is the wife of an amazing and supportive man, mom of three beautiful children, Registered Nurse, Certified Lactation Consultant and Childbirth Educator. She has a true passion for supporting expecting and new parents in their prenatal, birth and breastfeeding journey. She believes in increasing a woman’s confidence in her body to allow it to do what it naturally knows: birth and nourish a baby!

Notes:

1. C.L. Dennis and K. McQueen, “The Relationship Between Infant-Feeding Outcomes and Postpartum Depression: A qualitative systematic review,” Pediatrics 123, no. 4 (April 2009): e736-e751
2. M. Heinrichs et al., “Effects of Suckling on Hypothalamic-Pituitary-Adrenal Axis Responses to Psychosocial Stress in Postpartum Lactating Women,” Journal of Clinical Endocrinology & Metabolism 86, no. 10 (2001): 4798-4804.
3. A. Dermer, “A Well-Kept Secret Breastfeeding’s Benefits to Mothers,” New Beginnings July/August (2001): 124-127
4. S. J. Buckley, Gentle Birth, Gentle Mothering; A doctor’s guide to natural childbirth and gentle early parenting choices (Berkeley Ontario: Celestial Arts, 2009), 99-109
5. R. Dryden-Edwards, “What Are the Causes and Risk Factors For Postpartum Depression?,” accessed Nov 23, 2011, http://www.medicinenet.com
6. K. A. Kendall-Tackett, “Breastfeeding Beats the Blues,” Mothering: Inspiring natural families, Sept/Oct (2010): 60-68
7. T. Servo, “Stay Happy by Eating the Right Foods”, accessed Nov 23, 2011, http://voices.yahoo.com/5-foods-natural-antidepressants-3302574.html?cat=72
8. K. Higgins, The Nursing Mother’s Companion: 20th anniversary edition completely revised and updated (Boston: The Harvard Common Press, 2005), 149.
9. J. Newman, Dr. Jack Newman’s Guide to Breastfeeding (Toronto: Harper Collins, 2000), 189-191.
10. B. Shields, Down Came the Rain: My journey through postpartum depression (New York: Hyperion, 2005), 81.