Not many really want to talk about it, but postpartum depression is a real issue affecting 1 in 8 women in the U.S.
Postpartum depression is more severe and can last longer than the typical “baby blues” that many women and men experience after the birth of a child.
Combining the reality of a new normal with the challenges brought on by breastfeeding can intensify postpartum depression and make new moms feel worse.
In fact, research shows that breastfeeding moms who suffer from postpartum depression are more likely to stop nursing than breastfeeding mothers who do not have postpartum depression. For moms who really want to breastfeed, postpartum depression can feel like a major roadblock.
The team at Milk Drunk wants you to know it is possible to breastfeed with postpartum depression. In fact, there are numerous ways to deal with postpartum depression while still nursing your baby that can make you feel better.
Whether you’re currently pregnant or nursing, we’ll give you the information you need to empower you to make the best decisions for yourself and your baby.
What Does Postpartum Depression Look Like?
You’re tired, exhausted actually. You can’t think clearly, you feel sad, anxious, and overwhelmed. This experience is nothing like you thought it would be, and caring for your newborn seems impossible some days.
Is what you are experiencing just the “baby blues,” or is it something deeper?
While the baby blues is very common among new parents and caregivers, it typically consists of feelings of sadness, anxiety, and sleeplessness that are not experienced to a degree that interferes much with your day to day life, or for your ability to care for your baby. Additionally, the baby blues usually only last for a few weeks after your baby is born.
Parents with postpartum depression will experience these feelings, along with possible feelings of failure, insufficiency, and even guilt. These parents may even have thoughts of hurting themselves or their baby. Postpartum depression can last much longer than the baby blues.
If you think you are suffering from postpartum depression, it’s important to get help. You don’t have to feel this way or battle it alone; there are many resources available to help you cope.
How Does Postpartum Depression Affect Breastfeeding?
As previously mentioned, postpartum depression can make breastfeeding more of a challenge, but it doesn’t have to be this way.
It may be a mother’s goal to breastfeed her baby, but if she experiences difficulty with it (latch issues, supply problems, etc.) she may feel more depressed because of her postpartum depression diagnosis.
If it’s important to a mom to continue nursing, there are ways to help her cope with her postpartum depression that can help her feel better.
Can I Breastfeed While Taking Antidepressant Medications?
One of the most popular ways to treat postpartum depression is with the use of antidepressant medications. Normally, these would be prescribed for a specific period of time while the mother is suffering from postpartum depression.
However, is it safe for a breastfeeding mother to take antidepressants and still continue nursing?
Milk Drunk Mother Board expert Dr. Jane van Dis, board-certified OB/GYN, says yes:
“Patients with diagnosed mental health disorders should not be discouraged from breastfeeding, given that breastfeeding has important health outcomes for both mother and baby. 1 in 5 women suffer from perinatal mood and/or anxiety disorders at some point in the prenatal and postnatal time period.
Women who are taking antidepressants (most commonly SSRIs) in pregnancy should continue their antidepressants postpartum, as the postpartum period poses a higher risk for worsening or relapse of depression.
Women who have concerns about breastfeeding while taking antidepressants should individualize their medication choice, dose, and therapeutic goals with their ObGyn, mental health professional, family medicine physician or other treating provider.
Additionally, Dr. Jane showed us exactly what the Academy of Breastfeeding Medicine recommends:
Both psychological/cognitive behavioral therapy and antidepressant medication are recommended for women with moderate to severe symptoms or for whom there are current stressors or interpersonal issues that psychological therapy may help address. Maternal lactation status should not delay treatment.
An individualized risk–benefit analysis must be conducted in each situation and take into account the mother’s clinical history and response to treatment, the risks of untreated depression, the risks and benefits of breastfeeding, the benefits of treatment, the known and unknown risks of the medication to the infant, and the mother’s wishes.
If a mother has no history of antidepressant treatment, an antidepressant such as sertraline that has evidence of lower levels in human milk and infant serum and few side effects is an appropriate first choice. Sertraline has the best safety profile during lactation. The recommended starting dose is 25 mg for 5–7 days to avoid side effects, which then can be increased to 50 mg/day.
Formula Feeding & Combo Feeding
If your baby will be fed with formula only, the effect of antidepressants in breast milk won’t be an issue. However, if you plan to combination feed your baby (use breast milk and formula) the above guidelines for antidepressant use to treat postpartum depression would apply.
How To Treat and Ease Symptoms of Postpartum Depression
There are numerous methods of treating and easing the symptoms of postpartum depression, which is why it is so important to get help when you need it. A recent study suggests the following options for postpartum depression treatment.
Scheduling a therapy session is a great way to talk openly about how you feel and the challenges of motherhood. It’s also a valuable resource to learn new coping mechanisms.
Dr. Jane shared insight on some of the therapy options available:
- Interpersonal therapy. A time-limited and problem focused treatment for major depression which frames depression as a medical illness occurring “in a social context.” Most commonly women attend weekly or twice weekly sessions and evaluate their progress with the Beck or Edinburgh Depression scale.
- Cognitive behavioral therapy (CBT) which is based on the premise that perceptions and/or behaviors are directly linked to mood and CBT helps new mothers to modify or cease negative thinking and make behavioral changes that improve coping and reduce stress. Non-directive counseling has been shown to assist new mothers as well.
- Home visits by a nurse or mental health professional can also help women with PPD, receiving counseling sessions in the home. While home visits for postpartum care and/or postpartum mental health care aren’t widely used in the U.S. such visits are integrated into the healthcare system in many developed countries and have excellent outcomes data for both mother and infant.
- Telephone and virtual care. Due to COVID there has been a 300%+ increase in use of telebehavioral health platforms with good measurable outcomes.
Acupuncture and Massage
Acupuncture and massage or methods of helping relax the body and ease the mind. Although they haven’t been widely studied for the treatment of postpartum depression, they should be considered viable, non-harmful options as well.
As previously mentioned, antidepressants are definitely an option for a breastfeeding mother. Speak with your lactation consultant, primary health provider, or OB/GYN to see if there is a medication that would be a good fit for you.
Exercise & Yoga
Exercise is a great way to help handle stress and feelings of depression for practically everyone, postpartum women included. Exercising by walking your baby in a stroller, or taking a yoga class can help improve mood and depressive symptoms for postpartum women.
If you are physically limited, you can also consider meditation, which only requires solitude and reflection. There are many great meditation apps and books available to help you get started.
The best way to take care of your baby is to take care of yourself.
It can feel overwhelming and like you have no time to yourself when you have a newborn. Breastfeeding can also intensify these feelings, especially if your nurse throughout the night.
It’s crucial that new parents make time for themselves, away from their baby. Even if you only spend twenty to thirty minutes alone,it can help you destress and get a much needed break.
Getting the proper nutrition for your baby has been your main focus since your baby arrived, but what are you actually eating? Keeping your diet full of nutrient rich foods can help you feel mentally and emotionally balanced.
Avoid too much sugar, alcohol, and caffeine. Not only can these interfere with breastfeeding, they can make your depression feel worse.
Don’t go it alone! Local postpartum support groups (or lactation support groups) have been shown to improve mood and depressive symptoms for women generally, and for those with a diagnosis of PPD as well.
Low partner support is often correlated with increased risk of postpartum depression and peer support can be a way for mothers to connect if they have insufficient or absent partner or familial support.
Postpartum depression can feel crippling, and can sometimes hinder your breastfeeding goals.
The good news is, it doesn’t have to. You can get help to manage your depression and breastfeed at the same time, even if you use antidepressants.
If you’re struggling with postpartum depression or think you might be, talk about it. Get help and support from your friends, family, support groups, and of course, your team of online experts and fellow parents right here at Milk Drunk.