Breastfeeding and Postnatal Depression (PND)
There is growing evidence that the experience of breastfeeding and postnatal depression could be inter-related.
Perinatal depression refers to depression that occurs during pregnancy or the postnatal period and affects 15–20 per cent of women in Australia.
Depression and anxiety during and after pregnancy are complex mental health issues beyond the scope of this page. If you or someone you know needs support, we have listed some Australian resources below.
Crisis support
If you need support, call one of the following numbers:
• Lifeline Australia – 13 11 14 (24/7)
• PANDA [Perinatal Anxiety and Depression Australia] National Helpline (Mon to Fri, 9am- 7.30pm AEST) 1300 726 306
What do we know about breastfeeding and PND?
Women who are breastfeeding and experiencing symptoms of PND might wonder if breastfeeding is having an impact on their mental health.
Women who have symptoms of PND and are breastfeeding might wonder if their mental health is having an impact on the breastfeeding.
Researchers in recent years have explored both these scenarios and results show some interesting data.
Women who breastfeed are less like to develop PND than women who do not initiate breastfeeding. There may be a hormonal factor in this as even partial breastfeeding offers some protection.
Women who have clear goals to establish breastfeeding and are meeting those goals are less likely to be experiencing symptoms of postnatal depression. Women who had intention to breastfeed but were unable to establish breastfeeding are 50% more likely to develop symptoms of PND.
Women who experience severe pain while establishing breastfeeding and develop negative feelings about feeding are more likely to have symptoms of PND at two months postpartum.
Women with symptoms of PND and are breastfeeding are more responsive to and interact more with their babies .
Women who are breastfeeding have fewer depressive symptoms.
Breastfeeding support is an important part of preventing and treating PND.
For women who have strong motivation to breastfeed and symptoms of PND, skilled support and effective management of breastfeeding challenges in the early days is even more important. IBCLC lactation consultants and peer support counselling both have an important role in supporting mothers to overcome issues around attachment and milk production in the early weeks of breastfeeding. Doctors, nurses and allied health professionals should all provide excellence in breastfeeding management and be aware of their influence of breastfeeding outcomes through their words and actions. Mothers with strong community and social support are more likely to overcome problems and achieve their breastfeeding goals. It must always be remembered than women never fail to breastfeed but society often fails to provide the support they need for success.
Breastfeeding and sleep
Women are often told they should introduce formula so they and their baby get more sleep. However, there is no research supporting this claim and growing evidence showing that breastfeeding improves maternal and infant sleep. Mothers are more likely to be exhausted by expectations their baby should be sleeping alone in another room. Room-sharing and breastsleeping can both reduce the time awake and improve sleep quality. Mothers should be supported to rest and nap during the day however their baby is fed. Understanding how infants sleep and how parents can work together to support the breastfed baby is important.
Medications and Breastfeeding
Breastfeeding women are often told they need to wean before taking medication. However most drugs prescribed for postnatal depression are safe to use in breastfeeding. Busy doctors who don’t recognise the importance of breastfeeding to their patients will often err on the side of caution or save time by not checking current recommendations. Mothers who have presented to a doctor with symptoms of depression or anxiety are not in the best state to question or challenge the advice and their support people are usually focused on getting the mother well. It should not be the patient’s responsibility to fact check medical advice however, when it comes to medications and breastfeeding, doing so can often save the breastfeeding relationship. If you are looking to fact check advice about breastfeeding and medications you are prescribed, services like the one provided by Senior Pharmacist Rodney Whyte at Monash Medical Centre in Melbourne are recognised experts in this field.
