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Postpartum Depression and Breastfeeding: Navigating the Complex Journey

The postpartum period, even in the best of circumstances, is a challenging time for new parents. For many mothers, this period can feel like an emotional rollercoaster as they navigate the demands of a newborn, adjust to physical changes, and attempt to heal from childbirth. Amidst these demands, postpartum depression (PPD) can develop, adding a layer of difficulty that can impact both mental health and the breastfeeding journey. For some, breastfeeding provides a bonding experience; for others, it adds stress and physical discomfort. When combined with PPD, breastfeeding challenges can be amplified.

Understanding Postpartum Depression

Postpartum depression is not simply the “baby blues,” a common experience for many women due to rapid hormonal changes, exhaustion, and the overall adjustment to new parenthood. While baby blues generally last a few days to two weeks, postpartum depression is a more serious, long-lasting condition that can affect a woman anytime within the first year after birth. For some, PPD can even extend up to two years postpartum, impacting daily functioning, relationships, and parenting.

Research indicates that 9-16% of new mothers experience significant postpartum depression. It doesn’t discriminate—mothers in healthy relationships, single mothers, mothers of one or multiple babies, and even fathers can experience postpartum depression. PPD can present with a wide range of symptoms, including feelings of sadness, hopelessness, anxiety, irritability, and difficulty bonding with the baby.

The Connection Between Birth Plans and Postpartum Depression

A birth plan is often a mother’s vision for how she hopes labor and delivery will go. It’s filled with preferences for pain management, birthing positions, support persons, and more. However, childbirth is inherently unpredictable, and for some mothers, the experience may end up far from what they had imagined. When birth plans don’t unfold as expected—especially when interventions or surgical procedures are necessary—the gap between expectation and reality can lead to feelings of disappointment, frustration, or guilt. For some, this sense of lost control or failure can contribute to the onset of PPD.

When we attach our sense of worth, strength, or competence to our birth experience, it can feel devastating when things don’t go as planned. For mothers who experience challenging deliveries or unexpected medical interventions, adjusting to the reality of postpartum recovery and caretaking can be particularly overwhelming. It’s important to remember that the safety of both mother and baby is paramount and that PPD is a common response to these intense experiences.

The Impact of Postpartum Depression on Breastfeeding

While breastfeeding is widely acknowledged as the healthiest choice for newborns due to the immune benefits, nutritional value, and bonding experience it offers, PPD can interfere with a mother’s ability to initiate and sustain breastfeeding. Some specific ways PPD can impact breastfeeding include:

  1. Reduced Desire to Breastfeed: Postpartum depression can dampen a mother’s motivation to breastfeed, often because of low energy, lack of interest, or feelings of detachment from the baby.

  2. Difficulty with Milk Production: Depression can trigger the release of stress hormones like cortisol, which may interfere with milk production. Additionally, insufficient sleep and poor nutrition, often associated with PPD, can further affect milk supply.

  3. Increased Pain and Discomfort: Some studies suggest that mothers with PPD are more likely to experience pain or discomfort while breastfeeding. Pain, in turn, can exacerbate feelings of anxiety or frustration, leading some mothers to give up breastfeeding sooner than they had planned.

  4. Challenge with Perseverance: Breastfeeding can come with a learning curve, from latching difficulties to managing feeding schedules. For mothers with PPD, the added stress may make it difficult to continue breastfeeding, even if they were initially committed to it.

For mothers experiencing PPD, the physical and emotional demands of breastfeeding can feel insurmountable. But with proper support, many mothers can navigate these challenges and successfully breastfeed.

Support and Resources for Managing PPD and Breastfeeding

If you’re struggling with PPD and find breastfeeding difficult, know that there are options and resources available to support you. Seeking help doesn’t mean you’re failing—it’s a step toward taking care of yourself and your baby. Here are some ways to find support:

  1. Consult a Lactation Consultant: Latching issues are among the most common causes of breastfeeding pain. A lactation consultant can help you and your baby find a comfortable and effective way to latch. Many hospitals and clinics offer lactation consultations, and there are also virtual options available.

  2. Hire a Postpartum Doula: A postpartum doula can offer practical support for you and your family, helping with baby care, light household tasks, and emotional support. This extra help can reduce stress, giving you more time to focus on bonding with your baby.

  3. Attend La Leche League International (LLLI) Meetings: LLLI is a global organization that offers mother-to-mother breastfeeding support. These meetings provide a space to learn, share experiences, and find community with other new mothers.

  4. Talk to Your Healthcare Provider: Your doctor or midwife can provide medical support and may also recommend counseling, support groups, or, in some cases, medication to help manage PPD.

  5. Explore New Mother Support Groups: Many communities offer support groups specifically for new mothers. These groups provide a safe place to discuss the challenges of early motherhood and receive emotional support from others experiencing similar challenges.

  6. Make Time for Self-Care: Exercise, sunlight, and fresh air are proven mood boosters. If possible, set aside a little time each day for a walk or gentle activity. Simple relaxation techniques, such as deep breathing or mindfulness, can also help manage stress.

  7. Allow Yourself to Accept Help: Family members, partners, and friends are often eager to help but may not know how. Let them know what you need—whether it’s watching the baby for an hour, preparing a meal, or just offering companionship.

When to Seek Professional Help

If these strategies don’t alleviate symptoms within a couple of weeks, or if your depression feels intense or persistent, consider reaching out to a mental health professional. Therapy, support groups, and medication can all play a role in managing postpartum depression.

Some women may hesitate to consider medication due to concerns about breastfeeding. However, according to Dr. Jack Newman, a leading breastfeeding expert, there are several medications that are generally considered safe for breastfeeding mothers, including:

  • Zoloft (sertraline)
  • Paxil (paroxetine)
  • Prozac (fluoxetine)
  • Tricyclic antidepressants
  • Lithium (with close monitoring)

Discuss your options with a healthcare provider, who can help you weigh the benefits and potential risks. The goal is to support both your mental health and your baby’s well-being.

When Breastfeeding Isn’t Right for You

While breastfeeding is widely regarded as the best choice for infant nutrition, it’s also a deeply personal decision, and every mother’s situation is unique. If PPD or other factors make breastfeeding feel impossible or unmanageable, remember that there are alternatives that still provide the nutrients and care your baby needs. Babies can grow and thrive on formula, and many parents find that a bottle-feeding routine provides flexibility and support for their family’s needs.

Avoid allowing guilt or societal pressure to determine your choices. Your health and mental well-being are essential, and a healthy, happy baby comes from a well-cared-for parent. If breastfeeding doesn’t feel right for you, know that it’s okay to choose another path.

Final Thoughts: Seeking Light Amidst the Challenges

The postpartum period is often filled with both joy and hardship. If postpartum depression enters the picture, it’s crucial to remember that you are not alone. PPD affects many mothers and can impact breastfeeding and bonding. However, with support, resources, and self-compassion, you can find your way through this challenging time.

Whether you choose to breastfeed, pump, formula-feed, or use a combination of methods, the best choice is the one that supports both you and your baby. Embrace the resources available to you, allow loved ones to support you, and prioritize your mental health.

1 Diane Wiessinger, Diana West, and Teresa Pitman. The Womanly Art of Breastfeeding. (Ballantine Books, NY, 2010), 415.

2 Jack Newman, M.D. and Teresa Pitman. The Ultimate Breastfeeding Book of Answers. (Three Rivers Press, NY, 2006), 193-196.

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