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BREASTFEEDING AND DEPRESSION
Why Do New Moms Feel Sad?
A new mom walks into my office at four days postpartum and within minutes, sometimes within seconds, she bursts into tears. She says, “I don’t know why I’m crying.” I reassure her that almost everyone cries around four days after they’ve had a baby. You have dramatic hormone fluctuations, sleep deprivation, and the powerful emotional effect this new little person has on you.
You may have immediately fallen in love with your new baby, and everyone knows how emotional falling in love can be. Or falling in love may be taking some time, and you are worried and asking yourself, “Is something wrong with me that I’m not falling in love with my new baby? “
The answer to that is yes, it can take time for some moms to feel that deep connection with their new baby, and no, nothing is wrong with you if that is the case.
On top of that, your milk has probably come in, and your breasts may feel like rocks. If it hasn’t come in, then you may be worried about that.
If you are in my office, something is probably not going well with breastfeeding, and you are worried about that.
It is the perfect storm.
You almost certainly have a case of the baby blues. Everyone has heard about these. The baby blues are common. Some sources believe baby blues happen to over 50%, possibly as high as 80%, of new moms. Baby blues usually make their first appearance around four days after your baby arrives, and they should be gone by two weeks at the lastest.
Have a good cry. Some people say to do it in the shower. I say, do it wherever you want to.
If your baby is two weeks old and you are still crying at what feels like nothing, you may have something more serious going on.
Postpartum depression (PPD), while not as common as the baby blues, still happens to 10-20% of new moms. PPD is usually defined as depression that occurs within the first four weeks of giving birth to a new baby. However, some sources identify PPD as depression that happens in the first year after having a baby.
Post-partum depression (PPD) can be a temporary thing, or it can be a very prolonged and even debilitating condition.
If you are breastfeeding, you will want to have some reliable information and facts about breastfeeding and depression, to help you make the right decisions about how to manage both the breastfeeding and the depression.
Fortunately, there has been an increase in awareness about PPD in recent years, which is a good thing.
Screening for PPD
The positive effect of the increased awareness about PPD is that health care providers, hospitals, and birth centers are making it part of their discharge teaching and health care providers are doing PPD screening at women’s post-partum check-ups. Some providers are even making therapists part of their team.
Just as depression in the general population is, PPD is on a spectrum.
How Will Depression Affect Breastfeeding?
The number of depressed moms is significant. Some depressed women will become pregnant, and this will continue throughout pregnancy and birth. PPD occurs in approximately 10-20% of women. Women who have had suffered depression before are at higher risk for having PPD.
A mom may wonder if having PPD, or depression that has been a long-term issue for her will mean that she can’t breastfeed.
It is clear that breastfeeding and depression must be addressed.
Symptoms of PPD
The first step is realizing that you have moved past a run of the mill case of the baby blues and are experiencing PPD. Fortunately, there is less stigma attached to the word “depression” and women are encouraged to get help if they are having a case of PPD. More hospitals and birth center are sending moms home with the screening test, known as the Edinburgh Postnatal Depression Scale. If yours did not, you can find it here.
- Continued crying
- Sleep issues – too much or inability to sleep at all
- Difficulty concentrating
- Having no interest in things you normally enjoy
- Withdrawing from family and friends
- Issues with being able to care for your baby
- No emotional attachment to your baby
- Anger or rage
- Wanting to harm yourself
- Wanting to harm your baby
You may simply feel like you are “not yourself” or that things aren’t right. It is essential for the people around you to be aware of symptoms of PPD because some moms are not going to recognize it in themselves. Your support people should contact your provider if you are not receptive to what they have to say or if you don’t call your provider or someone else who can lead you to help.
Treatment for Depression
There is safe treatment for both depression that has always been an ongoing problem, as well as for PPD. While there are medications that can be used for depression when breastfeeding, there are also non-medical treatments that can be used before meds, or in combination with meds.
- Support groups
- Omega 3 fatty acids
- Light Therapy https://www.infantrisk.com/content/bright-light-therapy-depression
While recommending specific medications is outside of my scope of practice, I can say that there are antidepressants that you can take if you are breastfeeding. While no drug is entirely safe when breastfeeding, there are risks to an infant with a depressed mother as well as risks to not breastfeeding.
To get the latest information on meds and breastfeeding look at, or better yet, call the Infant Risk Center https://www.infantrisk.com/
If you have the app, MommyMeds, you can check that. If you don’t have it, get it. It has information for all kinds of medications.
It’s also important to keep in mind that breastfeeding has been shown to result in a decreased incidence of depression, and is yet another reason to seek breastfeeding help if you are struggling with it.
One last thought
Breastfeeding is an important consideration if you are experiencing depression after having your baby. It is possible to continue breastfeeding, and in most cases, it is preferable. It is also a topic that the media often presents when there is a sensationalized case about it. It is something that happens to a lot of moms though.
What kind of concerns do you have about breastfeeding and depression? You can share questions and concerns in the comment section.
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BREASTFEEDING AND DEPRESSION
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.