Sure, breastfeeding is great and all….but when it isn’t going well, it can absolutely SUCK for your postpartum mental health!
Perinatal Mood and Anxiety Disorders (aka PMADS) is strongly related to often uncontrollable hormonal factors. Difficulties with infant feeding are common and can greatly impact mental health.
There are several other diagnoses that quality as “PMADS”, which can be given during pregnancy and/or within the first 12 months of your baby’s life. (these include: Postpartum Depression, Anxiety, OCD, PTSD, Bipolar, and Psychosis).
Statistically, 20% of new parents experience postpartum mental health issues. This is already a significant number. However, these are just REPORTED cases. Due to underreporting and lack of frequent postpartum care and screening, it is thought that as many as 70% of new parents experience some form of PMADS in the first year of their baby’s life. It affects women of all ages, income level, and race: it does not discriminate.
Many women experience mood changes during this time- due to hormonal shifts, sleep deprivation, and overall life adjustments. No matter how “normal and common” these mood changes may be, it does not mean that you should be experiencing them all alone. Never hesitate to reach out for support, discuss feelings with your doctor, midwife, lactation consultant, nurses, friends, and family.
When breastfeeding is going well, it is hugely protective against postpartum mood disorders. The hormone surges are so beneficial, as is the confidence and sense of achievement you can get from providing direct nutrition to your baby.
However, when it isn’t going well, breastfeeding can be incredibly detrimental to your mental health. Stress, fear, anger, and pain work to further impact breastfeeding, making your journey that much more difficult.
There are a few risk factors for breastfeeding issues, but many of them are unpredictable.
Breastfeeding is very inconsistent, and your baby’s needs will be different at every feed. There is a certain amount of “letting go” that needs to occur (which is INCREDIBLY difficult: biology and hormones make you more alert, more aware, and more concerned for any and every potential issue regarding your baby’s health).
If you are a Type A perfectionist who must have a schedule, and a visual or numerical measurement of “success”, both a lactation consultant and a mental health professional will be incredibly valuable in your postpartum journey. (nothing against Type A perfectionists: I’m in this category myself! Anecdotally, in my practice, parents who have perfectionist and analytical tendencies often are at the most risk for PMADS).
Yes, breastmilk is pretty cool. It is a living fluid and is constantly changing. It is really fascinating, and I always look forward to new research on it.
There are about a million other factors involved that will influence your child’s overall health and future success.
I’m going to be bold and postulate that a lack of breastfeeding has never been the reason for anyone’s rejection from Harvard University (it’s likely a lack of money, family connections, and private school that prevent people from Ivy League acceptance). IQ points are influenced by many other lifestyle and socioeconomic factors: breastmilk alone has not been found to directly affect intelligence.
Breastfeeding is often a very privileged undertaking.
Not only do you need a shit-tonne of TIME to do it, but you often need support (someone to help the household financially, as well as with cleaning, cooking, and care of other kids). Sometimes, you require access to tools such as breast pumps or additional health care professionals for issues such as tongue-tie, low milk supply, nipple pain, and mastitis.
It is unfair that our society guilts parents (ahem, women and mothers) into believing that their child’s academic achievements, future weight, health status, and disease diagnoses can be attributed solely to their feeding choices during their baby’s first 6 months of life. Let’s stop blaming and shaming mothers for the failures of society, capitalism, governments, and health systems.
Your parenting goals are important, and, as an IBCLC, I want to help you achieve them. Guilt, shame, and misinformation should not play into your infant feeding decisions.
If breastfeeding is a constant struggle, and you are unable to access additional support or professional help, please keep the above information in mind. Do not be hard on yourself or beat yourself up. You are not dooming your child to a life of disease if you choose to not breastfeed. Sometimes, choosing to not breastfeed is the healthiest option for parent and child.
What do Breastfeeding Apps have to do with it?
There is no question: we loooove numbers, charts, and measurable indicators of our success. Tracking feeding times, amounts, weights, and diaper output can be useful in monitoring trends in your baby’s feeding habits.
This can be a slippery slope, however. <h4>Tracking every aspect of feeding can become a big time-waster, and can frankly lead to obsessive behaviors.</h4>
If you are exclusively breastfeeding, feeding durations can vary quite a lot and tracking them may not be all that useful. For example, some feeds might last 10min, others 30min: no baby feeds for exactly 20min every 2h around the clock. The same goes if you are pumping. Pump output can be drastically different from what your baby would get during a breastfeed and thus isn’t often a great indicator of milk supply. Having a general idea of how much you usually pump in a day is fine, but tracking the exact amount of every session is not necessary.
Things that I think are important to be aware of are: your baby’s daily diaper output (general number of poops and pees), how many feeds your baby had on one day (if breastfeeding, you should aim for around 10-12 feeding sessions per 24h), and which side you last fed on (to avoid the dreaded lop-sidedness!). these things can be tracked on an app, or just a piece of paper tbh.
These apps can be very useful for some things and very damaging for others. If tracking every aspect of your baby’s feeding behaviors starts taking up a lot of your time, or if you find yourself obsessing over all of these numbers, it may be a good time to call an IBCLC for some support!
DMER: Dysphoric Milk Ejection Reflex
Lactation consultants and breastfeeding advocates often speak about the overwhelming feelings of love, relaxation, and joy that breastfeeding can bring. This is due to the surges of oxytocin that happen during skin to skin time, from the nipple stimulation that occurs with feeding, with the let-down reflex, and the peaceful bonding time that is happening during feeding times.
While this is a great way to promote breastfeeding, where does it leave women who don’t feel these emotions during feeding? What about those who actually feel depressed or anxious during feeding times, even when breastfeeding is “going well” (milk supply is decent, latch is on-point, baby is gaining weight).
Dysphoric Milk Ejection Reflex is a physiological reaction to milk release which has primarily psychological effects. It is defined as a sudden feeling of sadness, anxiety, restlessness or other negative feelings just before milk ejection occurs, and lasting no more than a few minutes each time. It IS a reflex, controlled by hormones, and cannot be controlled by the mother.
Research has shown that inappropriate dopamine activity at the time of the milk ejection reflex is the cause of D-MER and that severe cases can and should be treated.
If you are having any of the above experiences, make sure to discuss them with your doctor or midwife.
How I Can Help
An initial home visit with me comes with continued email and text support for the duration of your postpartum journey: how amazing would it be to have a lactation consultant at your fingertips? My goal is actually NOT to make you breastfeed at all costs. My goal is to guide you through your postpartum journey, helping you to make the healthiest and most practical choices for you and your family.
I can help you with your infant feeding concerns, and point you in the direction of other beneficial mental health professionals. It really DOES take a village!
For more information, there are several helpful links on the SOGC website, which can be found here:
SOGC Postpartum Mental Health
BC Perinatal Services Best Practice Guide for PMADS
Postpartum Support International is another notable resource for information and help.
Postpartum Support International
Contact me today for more information!
Link in Bio!