Postpartum Depression

Postpartum depression (PPD) is a serious problem experienced by as many as 4 in 5 mothers within a few days after giving birth, and in some, continues past the first weeks. While “baby blues” can be described as trouble sleeping and anxiety, tearfulness, and dysphoria, PPD is much more severe, causing disturbances in eating habits, self care and hygiene, and even troubling thoughts and/or actions.

Some are more at risk than others to develop postpartum depression. These risks include, but are not limited to (no particular order):

  • Prenatal depression – Depression during pregnancy may be the strongest predictor for later suffering from PPD

  • Prenatal anxiety
  • History of previous depression and / or anxiety
  • Presence of maternity blues aka “Baby Blues”
  • Recent stressful life events
  • Inadequate social supports
  • Poor marital relationship
  • Low self-esteem
  • Childcare stress
  • Difficult infant temperament
  • Single marital status
  • Unplanned or unwanted pregnancy
  • Lower socioeconomic status
  • Breastfeeding and Postpartum Depression
  • Prenatal depression – Depression during pregnancy may be the strongest predictor for later suffering from PPD
  • Prenatal anxiety
  • History of previous depression and / or anxiety
  • Presence of maternity blues aka “Baby Blues”
  • Recent stressful life events
  • Inadequate social supports
  • Poor marital relationship
  • Low self-esteem
  • Childcare stress
  • Difficult infant temperament
  • Single marital status
  • Unplanned or unwanted pregnancy
  • Lower socioeconomic status
  • Not initiating breastfeeding
  • Breastfeeding and Postpartum Depression

In regard to breastfeeding, there is certainly a relationship between the two, and that connection goes both ways. Symptoms and reactions of PPD can make it harder to be attentive, both mentally and physically, having overall less initiation rates and stopping earlier than average. Many mothers report or exhibit lower confidence levels at their ability to breastfeed, which may be exacerbated by their depressive state. 

The other side to this is not breastfeeding can cause PPD, as well as worsen existing PPD. When scored on the depression scale, those who had longer durations of breastfeeding repeatedly scored better, and did so sooner, as opposed to the counter statuses. In other words, it is important for the mother to have support to breastfeed for her mental health and early identification of PPD and risk factors can make interventions more effective.

So, what is it about breastfeeding that helps so much with managing and reducing PPD risks?

Hormones

Specifically oxytocin and prolactin, these two are responsible for making milk and positive response to the baby. There is a neuro effect these contribute to, promoting bonding, mood-enhancements, and nurturing tendencies.

Cortisol levels, a stress hormone, lower and are more controlled when these two hormones are in circulation, as well as promoting more effective and restful sleep. (Even if we are getting considerably less amounts of it!)

Mother-Infant Interaction

While this sounds self-explanatory, it is worth elaborating on. Less time making bottles and decreased risk of health issues leads to more time to just love on their baby. In a study conducted to examine lactation and PPD connections, more mothers reported stroking/cuddling their baby when breastfeeding. That physical connection and downtime could very well make the difference needed for a mother who is struggling.

Treatment

Therapy

Family and general practice therapists and counselors are great options to discuss thoughts and concerns. Having a judgement-free outlet or sounding board can work wonders on the psyche, as well as having a professional gateway to other resources, as needed. A therapist can also help navigate additional options, such as medication and family mediation.

Medication

Many mothers worry about medication while breastfeeding, but there are options! Discuss with a primary care physician about breastfeeding-friendly antidepressants and anxiety medications. Probiotics may also be a favorable choice to compliment mental health measures. 

Nutrition and Exercise

Not to underestimate the power of a healthy body, physically, find ways to get more variety of fruits, vegetables, healthy fats and proteins, as well as making an effort to do something as simple as a 10 minute walk outside. Being stuck in the house with a newborn will wreak havoc on anyone’s mental health, and eating poorly will not help. Seek support where able to get healthier options into the daily routine where possible!

In conclusion

There is still a lot to study, and many variables to account for when talking about depression and breastfeeding, individually and combined. However, its important to reach out for both mental health assistance, as well as for breastfeeding. Feeling insufficient, not confident, embarrassed, and even perhaps that your problem isn’t as severe as another’s, are all normal and common feelings, but its paramount to know to ask for help anyway and know your resources! (See also 5 Things Your LC Wants You to Know)

Mental Health Resources
Postpartum Support International
PSI Helpline: 1-800-944-4773 #1 En Espanol or #2 English
OR TEXT:
English: 503-894-9453 Español: 971-420-0294
https://www.postpartum.net/

Substance Abuse and Mental Health Services Administration (SAMHSA)
1-800-662-HELP (4357)
https://www.samhsa.gov/find-help/national-helpline

More at:
https://www.cdc.gov/reproductivehealth/depression/resources.htm

Research Resources

https://womensmentalhealth.org/posts/postpartum-depression-who-is-at-risk/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842365/

O’Hara M. W., McCabe J. E. Postpartum depression: current status and future directions. Annual Review of Clinical Psychology. 2013;9:379–407. doi: 10.1146/annurev-clinpsy-050212-185612.

Beck CT. Predictors of Postpartum Depression: An Update. Nurs Research. 2001 Sep/Oct;50(5):275-285. Dennis CL. Psychosocial and psychological interventions for prevention of postnatal depression: systematic review. BMJ. 2005 July 2;331(7507).

Wisner KL, Perel JM, Peindl KS, Hanusa BH, Piontek CM, Findling RL. Prevention of postpartum depression: a pilot randomized clinical trial. Am J Psychiatry. 2004 Jul;161(7):1290-2.

Ashley Georgakopoulos
Ashley Georgakopoulos

About the Author

Ashley is an International Board Certified Lactation Consultant (IBCLC) that specializes in the clinical management of breastfeeding and an expert in the field of lactation. Ashley is from Knoxville, TN, and is a mother who has dealt with the obstacles and joys of breastfeeding. As the owner of Genesis Lactation, she educates families, connects them to resources, and helps the next generation be as healthy as possible: nutritionally and sustainably

Read more blogs by Ashley!

All content published on the Motif Medical site is credited for information purposes only. This information should not substitute as medical advice, diagnosis, or treatment. Always consult your doctor or qualified health professional with any questions regarding the health of you or your baby.