September is Mental Health Awareness Month and a topic that is very close to our Lactation Consultant, Sioned. This week, Sioned discusses Post-partum depression and breastfeeding, its symptoms and its treatments.
Many mums are aware of having the baby blues around days 3-10 after birth and this often coincides with mother’s milk coming to volume. Not only do the hormones change, the pregnancy hormones drop and the breastmilk hormones surge. Those full heavy tender breasts ache, your baby struggles to latch because they are so full, the euphoria of the first few days of having made your baby, meeting him or her settles, you are discharged home responsible for this little wonderful person, and suddenly you have a feeling of being overwhelmed. t’s not what the books said or what you expected. This is a normal experience for many mums and with reassurance and support the next few days get better.
However, for some mums it doesn’t get better. Postnatal blues can and does develop into postnatal depression. For many mums in the UK they suffer in silence. 1 in 10 women are affected by postnatal depression, yet many hide or ignore their symptoms for fear of being perceived as bad mothers, weak and incapable of caring for their infant. Many mums struggle in darkness overwhelmed and panicked, not able to identify that they are unwell.
Midwives are now working with mums-to-be assessing their mental well-being to have earlier interventions if mum is feeling low, apprehensive or fearful of labour and parenting. They support mums who are experiencing low mood and depression to tailor their support and medication before baby is born to ensure that they can breastfeed and have support with parenting when baby arrives.
Signs and Symptoms
MIND UK is an information and support group and provides guidance for family, friends and mums who are experiencing mental ill health from baby blues, postnatal anxiety, depression and postpartum psychosis. For postnatal depression and low mood mums may show signs of:
- Being sad and low, tearful for no apparent reason, worthless, hopeless about the future, tired, unable to cope, irritable and angry, guilty, hostile or indifferent to your husband or partner
- From a mum perception you may behave with a loss of concentration, have disturbed sleep, find it hard to sleep – even when you have the opportunity, have a reduced appetite and feeling sick and nauseous, lack of interest in sex, have thoughts about death.
- Some of these symptoms, such as loss of sleep, tiredness, lack of concentration and libido are common for many mothers of infants but it is still useful to talk with your midwife, health visitor or doctor if you are experiencing these.
- Find out more here.
Getting treatment – Breastfeeding and Anti-Depressants
There are a variety of treatments available including Talking Treatments, Medication and a Combination of Both. Every person is unique and although it may seem scary, taking this first step to treatment, is your first step to getting better.
What I would like to focus on specifically is breastfeeding while taking anti-depressants. Your GP can find you the medication that makes it safe for you to continue to nurse and get better. For many mothers this is something that is going well and to stop may lead to feelings of guilt and sadness, adding to stress levels. There is no reason to stop breastfeeding your baby as a result of taking anti-depressant medication. For further information and support on breastfeeding and anti-depressants The Breastfeeding Network have great fact sheets to advise and inform you.
Advising a mum to stop breastfeeding in order to commence a certain medication should be seen as a last resort. Combining cognitive therapy, talking treatments and medication has been shown to be beneficial for both mums and infants.
Second Infants and Post-Natal Depression (PND)
Many mums are apprehensive about having another baby if they experienced PND last time. For some mums they will not be affected, whereas others will possibly experience PND again. With the right support mums who do have low mood, perinatal depression and PND will have an individualised package and can achieve their goals and expectations. Early intervention does help and having someone to talk to can make the next baby something to look forward to. The key is knowing that help is nearby if you do start to feel unwell.
There is no shame or guilt in experiencing low mood or depression. It does take time to recover but here are some tips that may help on a day to day basis:
Look After Yourself:
When you experience depression it is easy to forget your hygiene and for it not to be a priority – doing little things such as having a shower, getting out of bed, getting dressed whether you are staying in or going out can make a difference. Your appetite may be small and you may feel nauseous – so eat something small and often and try to steer away from the sugary foods which may affect your moods. Talk with family to help you with day to day family life and express how thankful you are that they can support you when things are tough.
Write a Diary
You may find writing a blog/diary useful or simply jotting down your thoughts before you try and sleep at night. This may help you to realise you have more good than bad days and keep track of your moods.
Be Kind to Yourself
We cannot be super mums and have babies that follow all the books we have read. For many mums these books are unrealistic so being a parent does mean learning new skills, having a go and adapting every day. Don’t beat yourself up and think you failed but see it as a learning curve and trying it again but from a different angle next time.
Chat and talk with your health visitor or a family nurse that is approachable.
PANDAS is a helpful support group for expecting and new mothers to get advice with pre and postnatal depression. You can contact the Helpline here 0843 28 98 401 to speak with a specialist volunteer who can offer advice and support from 9am-8pm. If you require urgent help call 999 for urgent medical assistance.
Postnatal depression is an illness and does need treatments as with any other sickness. You are not on your own, it does get better, you are a mum, a friend, a partner and can always seek support and help.