Mental Health and Breastfeeding
Okay, long and serious blog post ahead. BUT, super important! Read on. Maybe you’ve heard of “baby blues” or post-partum depression (PPD). Maternal mental health concerns can begin long before your baby arrives and continue past the early weeks. Along with anxiety and depression, mood disorders include obsessive symptoms, bipolar mood disorder, post-traumatic stress disorder and postnatal psychosis. Together, these are called perinatal mood and anxiety disorders, PMAD for short. These conditions can be present prior to conception, can occur during pregnancy and can turn up post-partum. Evidence suggests that if a woman has a mood disorder prior to delivery, her risk of PPD after the birth of her baby is higher.
You may be asking, “How does this affect breastfeeding?” The downside is that women with mood disorders have an increased risk of low milk production. This is a complex phenomenon, however; one of the factors that contributes to this is a disruption in oxytocin, the hormone that is responsible for your milk ejection reflex. If your milk cannot easily leave your breasts, your baby drinks less milk, and this leads to less overall milk production. Talk about a let down! It can be difficult to connect with your baby when you are struggling with your own mental health. The stress of taking care of an infant and attempting to care for yourself plus anyone else in your household, and the home itself, can take a big toll and can all interfere with your milk-making awesomeness.
Maybe reading this feels very heavy, overwhelming or even hopeless. It is not! There is hope! It is possible for you to gain a foothold on your mental health and have a successful breastfeeding relationship with your baby. The most important first step if you are noticing signs of a mood disorder is to seek help. Talk to someone. A friend, trusted healthcare provider, counsellor, therapist, anyone that you feel comfortable sharing your feelings with. Do not ignore how you are feeling. Acknowledge and validate that something is not right within you. Don’t know who to talk to? Volunteers are available 24/7 from Postpartum Support International. They can connect you with resources and online support groups specific to your needs and location. Click here to learn more.
Maybe you are not sure if you should seek help. Here is a quick questionnaire that you can complete on your own. When you are finished, you will see your score and an indication of what it could mean. A score above 10 indicates that you may be depressed or anxious. Take this information to your health care provider for support. This questionnaire can be used prenatally and postnatally and can be used to assess for anxiety and depression in fathers too. Yes, fathers can experience PMAD as well. This can have a big impact on maternal mental health and interfere with bonding and breastfeeding. If your partner is struggling with mental health, encourage them to seek support. You can find an excellent therapist who specializes in mental health for males here.
There are strategies that you can use to help manage the symptoms associated with anxiety and depression and improve coping skills. These include spending time (even as little as 3 minutes a day!) in self-reflection and allowing yourself to sit and feel your emotions, meditation, journaling, breathing, and grounding techniques. Visit this website to learn more about grounding techniques. Art therapy and music therapy can be helpful in channeling and re-directing strong emotions. A therapist can provide psychotherapy and suggest cognitive techniques and behavior modifications for managing stress. Regular exercise has been shown to help reduce symptoms of anxiety and depression. Sleep may be difficult with an infant. Attempt to sleep or rest when your baby is sleeping. It takes a village! Look to your community for support. Who are your people? Create a network of helpers to call on when life is overwhelming. It is OK to ask for help. Eat a healthy, balanced diet and drink plenty of water (which you will want to do anyhow as a breastfeeding parent!). Ask people to do your laundry, dishes and prepare meals, or anything else that you would find helpful so that you can maximize your time with your baby and have time for yourself.
Depending on your mood disorder, treatment interventions and coping strategies will be different. It is important to be honest and open with your healthcare provider so effective treatment can be started. You may require medication. Many medications that are regularly prescribed for mood disorders are generally safe to take while pregnant and breastfeeding. If you and your healthcare provider are not sure if a certain medication is safe, there are excellent resources that contain all the information you need to make an informed decision. Two resources are Lactmed and Dr. Thomas Hale's Medications and Mother's Milk. Refer your healthcare provider to these sources. Simply not knowing whether a medication is safe during pregnancy or lactation is not a good reason to advise against it, or worse, to advise a mother not to provide milk for her baby.
Caring for yourself and your mental health is part of caring for your baby. If you are struggling with breastfeeding, talk to your local International Board Certified Lactation Consultant (IBCLC). One of the responsibilities of an IBCLC is taking account of your mental health and working with you to find solutions that will achieve your goals, as well as connecting you with the resources you need. With good support, you can enjoy a successful and fulfilling breastfeeding relationship with your baby!