Breastfeeding & Postpartum Depression: What Should Moms Do?!

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Adrienne Griffin pointed out to me a recent article in the Atlantic called “The Case Against Breastfeeding”. I think the title goes a little far, as breastfeeding is of course just fine. The title should have read”The Case Against Acting Like Breastfeeding Is the Only Way to Be a Good Mom”. Author Hannah Rosin compares the medical literature on breastfeeding with the pop culture view on breastfeeding and finds out how much the two differ, after discussing her potential plans to stop breastfeeding her baby:

“One afternoon at the playground last summer, shortly after the birth of my third child, I made the mistake of idly musing about breast-feeding to a group of new mothers I’d just met. This time around, I said, I was considering cutting it off after a month or so. At this remark, the air of insta-friendship we had established cooled into an icy politeness, and the mothers shortly wandered away to chase little Emma or Liam onto the slide. Just to be perverse, over the next few weeks I tried this experiment again several more times. The reaction was always the same: circles were redrawn such that I ended up in the class of mom who, in a pinch, might feed her baby mashed-up Chicken McNuggets.”

This from a mom who didn’t suffer postpartum depression. Adrienne, the founder of Postpartum Support Virginia, pointed out that breastfeeding is often the #1 topic of discussion in some of the postpartum depression support groups in which she has been involved, as this issue often causes such pain for moms, especially those with postpartum depression or anxiety. Some moms want to breastfeed but can’t due to low supply, or because baby can’t suck, or perhaps because they’re on medication contraindicated in breastfeeding. Some moms refuse to get treated for postpartum depression or anxiety becausethey don’t want to be on medication while breastfeeding, all the while often unaware of the potential dangers of untreated postpartum depression for both mother and child. Some moms don’t want to breastfeed, whether they are or aren’t depressed, but do it while miserable to keep up with the Joneses. For other moms who are depressed, breastfeeding is the only thing that helps them feel close to their child and they continue on while getting treated at the same time. There is no one-size-fits all story around whether moms should or shouldn’t breastfeed.

It’s too bad the Atlantic article didn’t point out the effect the breastfeeding mystique has on women with postpartum depression and related illnesses. It would have been a great supporting point to her piece. If you read any of the stories on the Mother’s Day Rally for Mom’s Mental Health — such as this one from Sophie in the Moonlight — you can see how much moms are affected by the expectation that they will and should breastfeed if they truly love their babies. You can find another great story on the issue of breastfeeding and postpartum depression — A Mother Without A Breast –here, written by Lisa Sniderman. And still another great piece, which references the same Atlantic article, by Morra Aarons Mele on BlogHerabout the breastfeeding debate in general, with lots of comments from readers.

Interestingly enough, Therese Borchard just wrote about this very subject today on Beyond Blueafter receiving some negative comments on her post for the Mother’s Day Rally for Moms’ Mental Health, like this one:

Dear New Mothers,
Don’t make the same mistake this writer did. Learn the real facts about breastfeeding and depression medication. Know that there are options that can both treat your completely legitimate mental health needs and preserve your breastfeeding relationship. Know that your needs and your baby’s needs are not always in conflict. Breastfeeding need not be a soul-crushing, life-stealing endeavor. Indeed, you might find (as many do, as I do) that it is a life preserver, that it sustains and nurtures you and your baby through the good times and the bad.

Actually, the only thing new mothers need to know is that some moms can breastfeed and some moms can’t — for some it’s a life preserver and for some it’s an anchor –yet all can have loving, healthy relationships with their babies regardless.

I couldn’t breastfeed, even though I was being treated for my postpartum OCD. Breastfeeding exacerbated my anxiety, as I was constantly and consistently FREAKED OUT over how much milk my son was getting. My breast did not have ounce markings on it, and that was enough to cause me unrelenting worry. This was all made worse by the fact that the nurses in the hospital nursery chose to supplement him with formula to help his jaundice, without my knowledge, causing horrible nipple confusion and arefusal to latch on. For me, stopping breastfeeding in the end was onething, among others,that allowed me to calm down and focus on getting better while at the same time not being hystericalwhen it came tothe feeding of my child.

Women must support each other in their choices, including breastfeeding. We all travel down different roads.

More resources:

Which psychiatric medications are safe for breastfeeding?

Letting go of the guilt about not breastfeeding 

Photo credit: © Vladislav Gansovksy – Fotolia

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Tell Us What You Think

  1. I tried to BF my son. My milk never came in (never as in 3 weeks later it still wasn't in) and after a week he stopped even trying to nurse preferring the bottle that I had to use to supplement. I decided I was stressed out enough to bother with it since he would still be happy and healthy with a bottle.
    I didn't even try with my daughter for fear of the same issue. I didn't want to stress over it and make matter worse as I was bracing for another round of PPD.
    I agree that women need to support each other no matter their choice of food. I was told that it was impossible to not make milk (not true, I didn't and my mother didn't make milk), that it was impossible to for a baby to be allergic to it (not true as DH's cousin was allergic to breast milk…something his doctor confirmed at the Children's Hospital), that it was impossible that he didn't want to suck that that is must have been MY fault. Oh, what wonders THAT did for my PPD!
    Some women can't breastfeed. Period. There are many reasons why, but some can't. It isn't right to judge a woman by the way she feeds her children. The Mommy Wars really need to stop. We need to band together as women and support each other, not do everything we can to prove we are the better mommy.

  2. Not breastfeeding is not evil – but the pressure put on women whether or not they breastfeed is.
    Possibly the biggest problem with breastfeeding and PPD is the incredible lack of knowledge among pediatricians regarding the growth patterns of breastfed infants; about newborn growth/weight loss rates and growth patterns for older babies. Formula-fed babies' growth patterns seems to be the only norm that many pediatricians know. According to the CDC, only 31.4% of all babies are breastfed exclusively through 3 months in the U.S., and only a bit less than 12% are breastfed exclusively through 6 months. In other words, not enough data points exist in most pediatricians' practices about breastfed babies. Breastfed babies often have very different growth rates and this is all too often held against their mothers' breastfeeding capability – which is really, really, really not good for anyone's mental health (it also defies logic: obesity is a HUGE problem in the Western world and the WHO believes its beginnings go back to infancy – and yet doctors worry about completely healthy babies not gaining weight fast enough even while babies are actually bigger than ever before). So while there's huge pressure on women to breastfeed, there's very little real support that would make it a natural – and viable – experience. Unfortunately, lactation consultants and La Leche Leaders can only do so much against the pressure of worry over a baby's weight gain. And so breastfeeding gets held up to women as an ideal it's not possible for them to meet.

  3. God…your comment about your breast not having ounce markings on it really took me back. That was the hardest part for me. My baby wasn't gaining weight and I couldn't tell how MUCH she was eating. I remember going to a Mom and Me group at the hospital, primarily becasue they had a baby scale. I'd strip blair down to nothing (because I didn't even want a teeny amount of pee in the diaper to affecther weight), weigh her on the scale, dress her, nurse her, strip her again, then put her back on the scale to see how many ounces she ate.

  4. It's not just moms perpetuating the "Breast is Best" bs. I can't tell you how many moms I talk to that have had doctors and nurses make comments–about not taking medication because they should bf their baby instead etc. etc. etc. How uniformed for one thing, and completely ridiculous anyway. The BEST thing for baby is a happy mommy, and if that means she formula feeds or she breast feeds, YAY–and keep your nose the heck out of HER decision already. Like we moms aren't worried about enough as it is.

  5. Amen to Diane's "The BEST thing for baby is a happy mommy" – what a mom prefers to do should be up to that mom and only that mom. Others can provide guidance and support to help with the mom's decision, but to pressure her–whether intended or not–with "So, you're going to breastfeed, right?" as if that's your only choice…c'mon, how's the first-time mom going to feel? In court, that kind of question is referred to as "leading." Well, I object! As I wrote in my letter to new moms on Mother's Day, breast isn't always best. Certain things, like the mom's health, need to be taken into consideration. For me, my 7-day stay in the hospital after giving birth was such that I had to spend much of my time away (unfortunately) from my baby. My miserable experience at the hospital, separation from my baby, nipple confusion (because the hospital staff couldn't let my daughter starve while I was undergoing surgery and recovery), and my whole state of mind by the time I left the hospital prevented me from really catching on with the whole breastfeeding thing. Mothers are stressed out enough as it is without making them feel like failures right out of the starting gate with all these motherhood myths (e.g., breast is best, bonding at first sight). I wouldn’t be surprised if societal pressures are a contributing factor to the rates of PPD in this country. That, and the lack of support for the new mom.

  6. This right here is a topic that I feel is so neglected in the literature! I was able to take antidepressants and still breastfeed my child, BUT I think that my overwhelming stubbornness to give my baby nothing but breastmilk contributed to my PPD. I pumped exclusively for 2 months, every 3 hours, around the clock because my baby wouldn't latch. That alone drove me batty – forget adding the PPD stuff in there, too. I was just hammered from every side on the topic – convinced that breast was best. No one ever said, "Hey, it looks like this whole things is getting to be a bit much. Don't you think it would be better if the baby had a mama who wasn't stressed out and pissed off all the time rather than a mom who 'did the right thing' and exclusively breastfed her?" Shoot – next time around, if there are latching issues, I won't hesitate to use formula. I have no doubt that our nursing struggles and the tremendous amount of pressure I felt to breastfeed exacerbated my PPD.

  7. I think new moms are put under pressure to breastfeed even if they really don't want to. As a new mom you are made to feel like a failure if you don't breastfeed . I breastfed my first son only at the hospital and stopped when I got home and got the worst ppd I was so stressed out about not breastfeeding. My second son got severe jaundice because he wasn't getting enough milk from breastfeeding and I suffered severe anxiety during and after that process because I felt confused about my decision to breastfeed. I am not going to even attempt breatfeeding my new baby I am pregnant with. And by the way both my children are super close to me and they are extremely bright for bottlefed babies. Breatfeeding is not for everyone. It is truly about what is going to make baby and as mommy happy as stated in earlier comments. I think my ppd was made worse by the pressure I was put under about breatsfeeding.

  8. Breastfeeding is the only thing that has helped my PPOCD (at 20m pp I still have very violent intrusive thoughts). The only time I've never had them is when I am breastfeeding. I hate to think the condition I'd be in if I had given up on breastfeeding during one of my early hospitalisations. I'm proud of the fact that despite hospitalisation for postnatal psychosis, ppd and ppocd my 20month old daughter has never had anything but water or breastmilk to drink. And that's with me working full time since she was 8 weeks old. For us, breast *is* best.

  9. I have had really bad PPD after all three of my children and each time it went away once I stoped breastfeeding at 6 to 10 months. Has anyone ever heard of this before? I can't find ANY info about this ever happening to anyone else! The first time I did nothing to treat it. The second I took Zoloft which help me survive but I still had a really rough time even with it. The third time I tried every single natrual and selfhelp suggestion I could find and Still had an Awful time and had to get on Zoloft again to get through. But when I stop Breastfeeding the depression goes away everytime. And the third time Breastfeeding was great. No problems with ANYTHING other than Depression.

  10. I think that one of the things that is missing (informationally) from this piece is what kind of support women do/do not seek out to help them cope with not only PPD but also for breastfeeding HELP. Many of the comments on this thread mention legitimate concerns that CAN and ARE addressed in depth at La Leche meetings! I urge anyone who is having depression that is DIRECTLY RELATED to their breastfeeding to GO (not just call) to their local La Leche Group. If that group isn't working (perhaps it's run some zealot who makes you uncomfortable, for instance) then go to A DIFFERENT La Leche group. I assure you, there is a LOT of info out there that you SHOULD have been told about, but WEREN'T (in example, latching problems may be a sign of tongue tie. Get a second opinion from a tongue tie EXPERT! You can get the names of some at your meeting!)
    With my first child, I had a horrible experience where the La Leche person made me feel bad about supplementing (prescribed by the pediatrician). BUT my second child ALSO had a gaining issue, and in desperation, I reached out for help from La Leche again and OMG I cannot convey how happy I am that I did!
    Don't ignore depression…with a little bit of help, you may be able to have the BEST OF BOTH WORLDS… Help with PPD AND a breastfeeding relationship with your baby!
    In closing, sometimes moms think it's "all or nothing" with breastfeeding… NOT TRUE. SOME moms in my group only nurse in the morning and at night and supplement during the day. Some moms think ALL medications are dangerous- NOT TRUE! Check out this wonderful reference: Medication and Mother's Milk By Thomas Hale, MD.
    If you need help or have questions, talk to a local La Leche Leader, your doctor, or a lactation consultant. Even your local pharmacist may be able to answer your questions! (this is especially helpful at 1am and you can't sleep… call the 24 hour pharmacy! The pharmacist has tons of time to answer questions at that hour… this is really helpful!