Friday, May 23, 2014

Nursing my babies: Can it help prevent Postpartum Depression?

Written by Susan Bordon, LCSW

By all accounts, I should have had Postpartum Depression. All the risks were there.  Family History of depression? Check. Pain during pregnancy? Check. Traumatic pregnancy/birth? Check. Breastfeeding issues? Check. Baby who wouldn’t sleep? Check. If I had all of the risks associated with PPD, why was I able to escape the Fourth Trimester somewhat unscathed, while so many other moms suffer in silence from PPD/Anxiety? After hearing new research presented by Dr. Kathleen Kendall Tackett, Ph.D., IBCLC FAPA, my answer is: Breastfeeding. All this time I thought that I was breastfeeding my babies as a gift for their future wellness, a completely selfless act of love between me and my child and bonding us in a way that is unexplainable. All of that is still true, but who knew throughout my babies’ first year I was also shielding myself from developing Postpartum Depression/Anxiety?

Now, I must preface this by saying there is no judgment here if you are unable or make the choice not to breastfeed. I have complete trust that every mother they breastfeed, bottle feed or use some combination is making the best choice for themselves and their little one at that time. For me, if I am honest, with my first child, my choice to continue exclusively breastfeeding had more to do with fear of the wrath of my own Le Leche League Leader mother than nourishing my child.  Research in the field of Psychoneuroimmunology presented by Dr. Kendall Tackett at the recent Breastfeed LA conference suggests that breastfeeding is not only protective for baby, but can also be hugely protective against the development of PPD/Anxiety in the mother.   

PPD/Anxiety affects 1 in 8-10 women who give birth, making it the leading complication of childbirth, and still women often suffer in silence. While PPD/Anxiety can affect any mother, regardless of her history, there are risk factors, as I mentioned above.  A well-meaning psychiatrist recently told me “the first thing I do when a women is suffering from PPD is get her off breastfeeding. She needs sleep!” This old news pervasive way of thinking is completely out of sync with new data that states that when thinking about PPD, all roads lead back to inflammation. You know those risk factors I mentioned: pain, stress, history of familial mood disorders, sleep issues, trauma? They all cause an inflammatory response in your body. Women that experience PPD have a high inflammatory response. Guess what has anti-inflammatory effects? Breastfeeding!

Now from a practical standpoint, ok I get it, reduce maternal stress causing inflammation and decrease chances of PPD. Well, I don’t know about you, but predispositions aside, having a newborn is stressful. That is like telling me to get more sleep and I will feel better. Thanks. I know. I have always heard from my slightly smug well-rested formula feeding friends that formula fed babies sleep longer. According to a study by Doan et al. J. Perinat Neonat Nars 2007, exclusively breastfeeding mothers are getting 40 minutes more sleep than formula or mixed feeding mothers. Even though EBF babies were having more frequent awakenings, the EBF mother was able to fall back into deeper more quality sleep quicker than the formula or mixed feeding mother. Because these mothers were getting slightly better sleep, they also had decreased inflammation. So, while some might advocate giving up breastfeeding to protect sleep, that treatment may backfire, increasing inflammation and the chances of developing PPD.

From a treatment standpoint, the take away from this conference for me was that in order to treat the Depression, we must treat the inflammation first. Chronic pain can lead to depression. If the pain during breastfeeding is causing the inflammation, then let’s see if we can fix that with a lactation consultant and reduce the inflammation. Known treatments that reduce inflammation are exercise, anti-inflammatory nutritional supplements such as St. John’s Wort and EHA/DHA, and, you guessed it, breastfeeding. Breastfeeding diminishes stress and protects maternal mood. In fact, all treatments for depression are anti-inflammatory and almost all are compatible with breastfeeding.

So, thanks, mom, for instilling in me an often dysfunctional fear of parental disappointment, and encouraging me to nurse those kiddos. All in all, I am adding this to the list of reasons why I am pretty convinced that boobs are absolutely the brains behind this operation.