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I have suffered from depression in the past, and after the birth of my first baby four years ago, I had a fairly serious bout for which I required medication. I gave up breastfeeding after only a few weeks because of sore nipples, and I was worried about the medication I was taking getting through my milk to my baby. I have been well for the last 18 months but am concerned about the possibility of baby blues. I really want to give breastfeeding a go this time. What have other mothers done to cope when facing the prospect of birth and potential depressive illness?
It is great that you are planning to breastfeed and looking at ways to get beyond the personal challenges that you might face.
There is a history of depressive illness and situational depression in my family too, so before I had my baby I looked for ways to combat this. I knew that a positive birthing experience could get me off to a good start when breastfeeding a new baby. I interviewed midwives and doulas and ensured that I knew, respected and, most of all, trusted those attending my birth and that they knew all of my choices around every aspect of birth.
I found out that breastfeeding can actually lower the chances of depression (because of all the feel-good hormones released when feeding) so I visited my local LLL group beforehand to get support in place for when it might be needed. The mothers were welcoming and relaxed. When faced with breastfeeding challenges, I remembered how friendly the Leaders had been. This gave me the confidence to ring them for support and information, which they very gladly gave and I wasn’t so nervous about attending meetings either. I discovered that there is a medical helpline which Leaders can ring and a book in the LLL library by Thomas W. Hale PhD, Medications and Mothers’ Milk that catalogs medications and which are compatible with breastfeeding, in the event that any need to be taken. This was a real reassurance.
I read several informative books including The Womanly Art of Breastfeeding (which has an especially supportive tone and can be easily dipped in to) and I got my partner to read The Baby Book by Dr. Sears. He gained a better idea of what to expect with birth and breastfeeding and was able to say supportive words to me rather than anything that I might perceive as undermining when I was feeling vulnerable. Once he knew more about breastfeeding, my partner turned out to be pretty good at trying to protect my birthing and babymoon space from anyone making unhelpful statements. I told close and trusted friends, who knew about breastfeeding, that I planned to breastfeed and would appreciate supportive comments from them when I was feeling particularly tired or low.
Finally, I was aware from being ill in the past how much diet and exercise can help in combating depression, so I ensured we had a freezer stocked with home-cooked nutritious meals (I asked for these from family and friends instead of gifts). I asked my partner to ensure we had a steady supply of avocados, bananas, oats, nuts and seeds, turkey slices and whole-grains, all of which are good sources of tryptophan, which builds serotonin (the happy hormone) in the brain. My partner would often leave me a “packed lunch” of a bowl of porridge (ready soaked), a big healthy sandwich and a big bowl of soup, hummus and crudités in the fridge before he went to work. These were all foods that I could eat one handed and with minimal effort, which was great when attending to the frequent breastfeeding needs of a newborn.
A dear friend bought me a wrap sling, which meant that I could get out of the house and go for long walks with my baby snuggled up to me, or even breastfeed in the sling. I walked almost daily, and it was a huge mood booster, especially on tired days when I didn’t feel like tackling more than a gentle walk.
A wise and lovely mother once told me that aside from specific challenges, breastfeeding always takes patience, determination, and support. It sounds as though you have the determination. I hope very much that you can gather some good sources of support. Be gentle and patient with yourself, as both you and your baby learn each other’s ways in the very early weeks of life together.
Johanna Rhys-Davies, Silsden, West Yorkshire, UK
I suffered with depression for years before having my little girl and so was aware I was high risk for postnatal depression. Because I was having fertility treatment I had to come off my antidepressants several months before falling pregnant. I was reasonably well at that time but I did some therapy along the lines of cognitive-behavioral therapy (CBT ) therapy and dialectical behavior therapy (DBT ), a form of psychotherapy, to make sure that, should my old anxieties and depression return, I had some tools that I could use to fight them.
I made lists of distraction techniques I could use in times of crisis. I saw a counselor weekly right up to and following the birth of my baby.
LLL became essential to me when I found them. My baby had a posterior tongue-tie diagnosed at six weeks. I was stressed, sleep-deprived, and was hating breastfeeding. I could feel myself slipping into depression. The prep I had done helped. I managed to stay rational, I talked it through with anyone who would listen, and I kept fighting for answers. It kept me off medication too.
It was still several weeks before I really felt close to my baby. Around four months she started sitting independently and got much more responsive when I tried to make her laugh. That’s when things really changed and my depression started to lift. But if the feeding hadn’t been sorted out it would have taken much longer. If breastfeeding hurts don’t suffer in silence. Leaders can help and an easy feeding journey will make bonding easier too.
If you do need to take medication, there are antidepressants that are safe while breastfeeding. It doesn’t have to mean the end of your journey.
I had depression after my first baby was born and, like you, didn’t end up breastfeeding. It was a dark time.
As the arrival of my second baby approached, I prepared for the same experience. We made practical arrangements: cooking lots in advance, warning people that my husband might not be able to continue with some commitments for a time, planning for friends to look after my toddler and, most importantly, telling people to be gentle with us!
But the best preparation was to find help BEFORE the baby arrived with breastfeeding so that instead of feeling overwhelmed, I knew where to get support. Breastfeeding made all the difference in keeping me from getting depressed again: the hormones, the ease of bonding (which I struggled with first time round), the fact I had to put my feet up to nurse and the support I got from LLL. Sure, things were tough, but that frightening black cloud stayed away.
Well done on preparing now and wishing you all the best!
Justine, Cambridge, UK
Depression is an awful illness and very different from baby blues, which are fleeting. I have had depression all my adult life and have taken the medication that works for me, Prozac, successfully through both my pregnancies and breastfeeding my children. My dose was changed by my doctor, so it was low when they were first born to reduce the chance of side effects, and then upped to reduce the chance of a major depressive relapse. Neither of my babies had any noticeable side effects. Health care professionals didn’t really seem to know much about possible risks so Medications in Mothers’ Milk was invaluable in making such decisions. My doctor did say to me that the risks of depression on the cognitive development of the child have to be balanced with the possible risks of medication.
I really struggled to get breastfeeding going and took six weeks before I had a pain-free feed, which I thought was my fault. Now I know I didn’t have the right support.
Second time round I was more relaxed, I knew where to ask for help if I needed it. My baby latched on and that was pretty much that! She will be two soon and despite having to take medication we have managed to keep a strong nursing relationship thanks to the right support and information. Can you get to an LLL meeting to start building up your own support network now? Best of luck,
Rhiannon Reid, Forfar, Scotland, UK
Many moms experience a depressed mood when they stop nursing, so it’s good to be prepared if there is a predisposition to clinical depression. Zoloft has a negligible milk transfer ratio. I recommend having practical support, not just people to give advice, but those who will be there to help you to get sleep, eat and do your chores.
Amy Rude, USA
Prepare ahead. Antidepressants don’t work for everyone. There are antidepressants that can be taken while breastfeeding. I read everything I could while I was pregnant about postpartum mood disorders. I found information from Katherine Kendall-Tackett to be very helpful: Depression In New Mothers. I wasn’t going to let something temporary ruin something as important as breastfeeding.
I really sympathize with your situation—it sounds so familiar! I had postnatal depression after my first baby was born, and was prescribed antidepressants when she was six weeks old. My doctor was supportive of breastfeeding, and not only checked that what she was prescribing was considered safe enough to take while breastfeeding, but also said, when I asked about giving up breastfeeding, that she didn’t think I should be making that decision in my depressed state. I went on to breastfeed for three years, coming off the antidepressants just before my daughter’s first birthday.
When I became pregnant again, I was determined, like you, to do everything possible to avoid the same problems. I spent time going over what happened the first time round, to try to work out the main triggers of my depression, and then my husband and I planned ways we might avoid them. For me, the triggers were a traumatic birth experience, a feeling of complete isolation and lack of support when we got home again, and that total loss of identity that can come with giving up a career and becoming a mother.
In preparation for my second child, I visualized the birth positively, asked a good friend to be my birthing companion (alongside my husband), and hired a postnatal doula for a few hours a week to give me the support I needed afterwards at home. If a traumatic birth was part of the problem for you, you may find that your midwife can talk you through your previous experience calmly.
Depression is a very personal thing, so perhaps your triggers were different, but by planning ahead you are giving yourself the best chance of avoiding problems, or being well prepared to deal with them. If you do need medication again, remember that many antidepressants are compatible with breastfeeding. Your doctor should respect your wishes on this and make sure he/she prescribes something safe.
Your little ones are lucky to have such a determined mama!
Fiona Lewis, Oxford, UK
Mother’s New Situation
My daughter is four months old and I am going back to work shortly. She still nurses all day and refuses a pacifier. I have tried to introduce a bottle, first with formula and then, when she rejected that, with my expressed milk but she would not take that either. I find pumping really difficult and do not think I’d have enough time to do it during my working day. It had been my intention to wean my daughter but it is clear to me that she is not ready to give up breastfeeding and I don’t want to stop either. I am wondering what other mothers who have found themselves in this situation have done? Can you please share your tips?
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