The Baby Blues: Depression & Breastfeeding

Is it baby blues?

Most women are hesitant to admit that the birth of their baby has been less than a totally joyful experience. The expectation in our culture is that new mothers will be happy with the birth of their child and totally in love with their new babies. In fact, the stress and fatigue that accompany the addition of a baby to a new family can leave many new mothers feeling “blue” in those early days and some new mothers to develop a full blown postpartum depression.

In the first few days after the birth of an infant there are many physiologic changes occurring in a new mother’s body. Levels of the hormones estrogen and progesterone drop after delivery and are replaced by higher levels of prolactin and oxytocin in women who are breastfeeding. A new mother may be recovering from major surgery, if she has had a cesarean section, as well as labor and delivery. New babies need attention and feeding around the clock, so sleep deprivation is the norm. It is very common for a new mother to develop a case of the “baby blues” in the first week after delivery as she makes the many adjustments. Feelings of tearfulness, forgetfulness, restlessness, and irritability lasting for three to five days are characteristic. This period is self-limited and usually self-correcting as the body recovers from delivery and the new mother starts to feel more comfortable in her mothering role.

It is important to distinguish this short period of “baby blues” from the much more serious cases of postpartum depression that can occur any time during the first year after birth. A mother who is experiencing postpartum depression has much more serious and long lasting symptoms. By definition, symptoms of sadness, despair, emptiness, low self-esteem, inappropriate guilt, social withdrawal, pessimism, sleep disturbance and/or abnormal fatigue lasting at least two weeks are signs of depression. It has been estimated that 10-20% of new mothers may experience an episode of postpartum depression in the year following the birth of their child.

Postpartum depression is a serious illness that should not be taken lightly. If left untreated it can last for years and cause harmful effects for both the mother and her children. When a new mother takes care of her own health needs, her baby benefits as well. If you, or a friend, are showing symptoms of depression it is important to seek care from a health care professional as soon as possible. Depression is a treatable disease, and receiving treatment for depression does not mean that a mother will have to stop breastfeeding her baby. A variety of treatment approaches are available depending on the severity of the depression and the mother’s response. Some of the newer antidepressant medications can be used for treatment of depression while a mother is breastfeeding.

Additional information about management of postpartum depression is available at The Academy of Breastfeeding Medicine website under their protocols section.

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