Post Partum Depression
It’s world Breastfeeding week (August 1-6, 2016) and August is Breastfeeding Awareness month.
Some of you are pretty sick of me posting breastfeeding memes and articles on the facebook page and have expressed your displeasure at what you perceive as my “bullying” mamas to breastfeed, and shaming those who have chosen not to breastfeed. I am a breastfeeding advocate to my heart, that I cannot deny. But my passion for women to breastfeed their babies stems from the unequivocal benefits that occur to both mamas and babies when breastfeeding occurs.
When babies breastfeed, they receive cells, hormones, and antibodies in breastmilk which protect them from illness. This protection is unique and changes to meet a baby’s needs as he/she grows. Until a baby receives all of his/her immunizations, they will receive protection via their mama’s antigens via breastmilk. Breastfeeding has also been linked to reduced risks of:
- Childhood leukemia
- Childhood obesity
- Ear infections
- Eczema (atopic dermatitis)
- Diarrhea and vomiting
- Lower respiratory infections
- Necrotizing enterocolitis, a disease that affects the gastrointestinal tract in pre-term infants
- Sudden infant death syndrome (SIDS)
- Type 2 diabetes
Likewise, mamas who breastfeed typically (but not always) lose their pregnancy weight faster. Mamas who breastfeed will have reduced uterine bleeding post partum due to the oxytocin released and the increased uterine contractions, and their uteri return to pre-pregnancy size and position sooner than in mamas who do not breastfeed. Breastfeeding also leads to increased bonding between mamas and their infants as they are very close, skin to skin and at times gazing eye to eye. This closeness promotes a sense of safety and security in infants enabling them to feel soothed and less fussy. According to La Leche League, moms who breastfeed sleep more, are less likely to miss work due to illness save money and are at lower risk of several diseases and forms of cancer. Breastfeeding has also been linked to reduced rates of post partum depression and reduced severity in post partum depressive symptoms.
Still, I get it. Many women will not breastfeed their babies, either because they were not able to breastfeed or because they simply did not want to. That is okay. How a woman chooses to feed her child is a very personal decision. But as a clinician and women’s health educator, I would be remiss if I didn’t provide you with the most up to date information and resources so that you can make wise health care choices for yourself and your family and live the healthiest lifestyle possible.
I’m currently working towards the IBCLC credential to become an international board certified lactation consultant. In my training, the most common issue that I see is women not having the support that they need for breastfeeding success. Breastfeeding is natural, but not always easy. Sometimes all a mama needs is guidance and support. You’d be amazed at how simply changing a baby’s position (so that the angle at which their little mouth approaches the breast) will dramatically reduce breastfeeding pain and cracking nipples. Likewise many mamas don’t believe that they are making enough breastmilk to feed their babies and stop thinking that they aren’t feeding their babies enough. Mamas can be reassured their babies are getting enough to eat when they note nursing weights increased after breastfeeding. Additionally, if a baby is healthy, happy and gaining weight appropriately, then a mama can rest assured that she is making a sufficient amount of breastmilk.
While there are numerous books and articles available to guide a new mama on her breastfeeding journey, I am a staunch proponent of breastfeeding consultations (and hence my training!). When a mama is before me, I can see how she holds the baby, how the baby is behaving, how the baby is latching to the breast….And then it is often easy to see the possible obstacles to successful, pain-free breastfeeding and to correct them. Sometimes babies need to more inline with Mamas’ chests and resting babies on a pillow or two makes breastfeeding easier. Sometimes having mama lay on her side and nurse is helpful. And if a mama is having nipple soreness, cracking or has inverted nipples, a nipple shield may prove invaluable to her breastfeeding success.
Mamas, in a perfect world, all mamas would breastfeed their babies. I do believe that many more mamas here in the US would breastfeed or breastfeed longer if their efforts were more accepted and supported. We’re getting there. More businesses are providing areas in which mamas can nurse their babies. Employers are providing areas where mamas can either nurse or pump breastmilk. Many hospitals are obtaining the Baby Friendly designation, a designation that states the hospital is committed to exclusive breastfeeding as the most beneficial infant nutrition and all hospital staff is trained and dedicated to this initiative. NO FORMULA IS PROVIDED IN THE HOSPITAL AND NO FORMULA SAMPLES ARE GIVEN TO MAMAS! Finally, more and more birth workers (like me) are boning up on their breastfeeding skills and making themselves available to help and support mamas. Look for these Breastfeeding Consultants and supports in your area:
Peer Breastfeeding Counselors
Labor and Delivery Nurses.
It is my mission to help every mama who wants to and is physically able, to have a healthy baby. It is also my mission to help and support her to love and a raise that baby. Breastfeeding is quite possibly the best way for an infant to start out in life. While I know that is is not easy, if a mama wants to breastfeed, I’m here to do everything that I can to help. If you can’t reach one of the above supports, I can assist you. Simply send an e-mail to firstname.lastname@example.org and we’ll schedule a time to talk and see what you need.
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August kicks off National Breastfeeding Awareness Month here in the US. Officially designated on August 6, 2011 by the United States Breastfeeding Committee (USBC), the month of educational and promotional activities is designed to raise awareness of the benefits of breastfeeding-physiologically for mamas, developmentally for babies, emotionally for both and economically for families. Here is the full proclamation. Breastfeeding has been reported to have the following benefits. In Babies
- Breast milk is widely acknowledged as the most complete form of nutrition for infants, with a range of benefits for infants’ health, growth, immunity and development. (Healthy People 2010, Centers for Disease Control and Prevention, Atlanta, Georgia)
- Breast-fed children are more resistant to disease and infection early in life than formula-fed children. Many studies show that breastfeeding strengthens the immune system. During nursing, the mother passes antibodies to the child, which help the child resist diseases and help improve the normal immune response to certain vaccines. Breast-fed children are less likely to contract a number of diseases later in life, including juvenile diabetes, multiple sclerosis, heart disease, and cancer before the age of 15
- Breastfed babies are less likely to be obese as adults
- Breastfeeding has been shown to reduce the likelihood of ear infections, and to prevent recurrent ear infections. Ear infections are a major reason that infants take multiple courses of antibiotics.
- Researchers have observed a decrease in the probability of Sudden Infant Death Syndrome (SIDS) in breast-fed infants.
- Another apparent benefit from breastfeeding may be protection from allergies. Eczema, an allergic reaction, is significantly rarer in breast-fed babies. A review of 132 studies on allergy and breastfeeding concluded that breastfeeding appears to help protect children from developing allergies, and that the effect seems to be particularly strong among children whose parents have allergies.
- Breastfeeding helps a woman to lose weight after birth.
- Breastfeeding releases a hormone in the mother (oxytocin) that causes the uterus to return to its normal size more quickly.
- When a woman gives birth and proceeds to nurse her baby, she protects herself from becoming pregnant again too soon, a form of birth control found to be 98 percent effective — more effective than a diaphragm or condom. Scientists believe this process prevents more births worldwide than all forms of contraception combined. In Africa, breastfeeding prevents an estimated average of four births per woman, and in Bangladesh it prevents an estimated average of 6.5 births per woman.
- Breastfeeding appears to reduce the mother’s risk of developing osteoporosis in later years. Although mothers experience bone-mineral loss during breastfeeding, their mineral density is replenished and even increased after lactation.
- Diabetic women improve their health by breastfeeding. Not only do nursing infants have increased protection from juvenile diabetes, the amount of insulin that the mother requires postpartum goes down.
- Women who lactate for a total of two or more years reduce their chances of developing breast cancer by 24 percent.
- Women who breastfeed their children have been shown to be less likely to develop uterine, endometrial or ovarian cancer.
- The emotional health of the mother may be enhanced by the relationship she develops with her infant during breastfeeding, resulting in fewer feelings of anxiety and a stronger sense of connection with her baby. Breastfeeding has also been shown to reduce the incidence of post partum depression in mamas. (See our posts on Breastfeeding and Post Partum Depression!)
August 1-7, 2014 is also World Breastfeeding Week. Coordinated by the World Alliance for Breastfeeding Action (WABA), the theme for this year’s week of awareness is to impress upon everyone importance of increasing and sustaining the protection, promotion and support of breastfeeding. Breastfeeding is one of the methods advocated in the Millennium Development Goals, developed in 1990 by the United Nations and affiliated governments to help fight poverty and promote healthy and sustainable development in a comprehensive way by 2015.
According to the WABA breastfeeding and the Millennium Develoment Goals are intricately linked, “The Millennium Development Goals (MDGs) are meant to be achieved by 2015 – next year! Although much progress has taken place, there is still a lot of “unfinished business”. Here are some examples: Poverty has gone down, but 1 in 8 people still go to bed hungry. Undernutrition affects about a quarter of all children globally. Overweight, the other form of malnutrition is becoming more common too. In the last 2 decades, child mortality has decreased by about 40%, but still almost 7 million children under five die each year, mainly from preventable diseases. As the overall rate of under-five mortality has declined, the proportion of neonatal deaths (during the first month of life) comprises an increasing proportion of all child deaths. Globally, maternal mortality has declined from 400 per 100,000 live births in 1990 to 210 in 2010, but fewer than half of women deliver in baby-friendly maternities. By protecting, promoting and supporting breastfeeding, YOU can contribute to each of the MDGs in a substantial way. Exclusive breastfeeding and adequate complementary feeding are key interventions for improving child survival, potentially saving about 20% of children under five. Let’s review how the UN’s Scientific Committee on Nutrition illustrated how breastfeeding is linked to each of the Millennium Development Goals.” So breastfeeding can go a long way to not only benefitting the health of mamas and babies individually, but help reduce poverty, malnutrition and infant and child mortality globally. If you are considering breastfeeding and want more information, the links in this post are from some of the best resources globally, especially if you want to take on an advocacy role. If you want more specific personal information on breastfeeding, I suggest you contact your local La Leche League. These folks really know breastfeeding!! They offer a plethora of information on their website, have many books on breastfeeding available for purchase and do phone and often in person consultations. You can also check with your healthcare provider and local hospital for referrals to lactation consultants who can assist with breastfeeding. Do you have more questions? Join Bedrest Coach Darline Turner for a one hour Q & A session during the Free Third Thursday Teleseminar, August 21, 2014, 1:00-2:00pm ET. She will field any and all questions relating to bedrest, pregnancy and post partum. You can join the conversation live or submit your questions up to 24 hours before via e-mail at email@example.com. Join our interactive bed rest community on Facebook and chat with mamas globally on all things bed rest! Finally, Get your copy of the e-book From Mamas: The Essential Guide to Surviving Bedrest! This guide will help you not only survive bedrest, but THRIVE on bedrest! Order your copy now on Amazon.com Other Resources: Natural Resources Defense Council 101 Reasons to Breastfeed Your Child
Today we finish up the series presented by Kathy Morelli, LPC on hormones and mood disorders. Once again I’d like to thank Kathy for such a well written and informative series. I am also very grateful that she allowed me to share the series with Mamas on Bedrest.
The final installment of the series is Post Partum: How Women’s Brain Biology, Hormones and Mood Relate!
“After giving birth, a woman’s hormone levels drastically plummet. The literature says within one to five days after birth, estrogen levels drop to the level of a normal menstrual cycle. A woman’s body needs time to adapt to all of the physical changes. Remember that estrogen precedes serotonin, the mood stabilizer, in the brain. And a steep drop in progesterone has a depressive effect as well. There’s a big chance for dysregulation in the brain-gland feedback loop (Sichel and Driscoll, 1999).”
“Other hormones that come into play postpartum and have an effect on the HPA and mood are prolactin and oxytocin. Prolactin is produced in the pituitary gland and is the milk-producing hormone. Prolactin levels rise during pregnancy and while breastfeeding. Some studies indicate prolactin is protective of postpartum depression, but others indicate prolactin causes vigilance, appropriate to a protective mother, but this feeling can morph into anxiety and irritability. The presence of prolactin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).”
“Oxytocin is another neuro-hormone with a big effect on mood and happiness. Oxytocin is synthesized in the hypothalamus and released by the pituitary gland. Oxytocin is secreted during breastfeeding. Research has shown that oxytocin induces feelings of calm and bonding (Donaldson-Myers, 2012). And the presence of oxytocin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).”
Women’s hormonal levels go from such highs at the end of pregnancy and then plummet to such lows with labor and delivery it’s a wonder that not all women become depressed. Kathy shares that
“85% of women suffer from the baby blues and 20% suffer from a form of postpartum mood disorders”
so clearly these hormonal fluctuations are indeed significant. And let’s not forget that Mamas on Bedrest are at an even greater risk of perinatal mood disorders because of bed rest, so these numbers may not reflect the full scope of perinatal mood disorders.
So much more research is being done on hormones, mood disorders and the lifestages of women. When considering the mental health of post partum women, we also have to take into account their support system, their ability to take time to rest and recover from pregnancy (and bed rest!) labor and delivery, the family situation and interpersonal relationships. All these factors-along with the “pre-wiring” in a woman’s genetic make up will determine how well a woman fares emotionally after pregnancy. Mamas, Take this information, think it over and use it as a catalyst to take exquisite care of yourselves! A woman’s body is designed to do extraordinary things-not the least of which is create new life-but that feat is not without its consequences. In order to be able to successfully reproduce, mamas must take exceptional care of themselves-eat nurtritious meals, drink plenty of water, rest, regular exercise, safe secure home and financial security. Mamas, self care is not a luxury-IT IS A MUST if you want good health for yourself, your baby and your family!