depression and breastfeeding

[lbrowne]

More women become depressed while their children are babies than at any other time in life (Clin Pharmacokinet 1994 Oct;27(4):270-89). With the surging tide of postpartum hormones, mounting sleep deprivation, persistent noise, shifting body image, the change of life structure, and the loss of control of one's own time, this depression is not surprising -- even with a brand-new bundle of joy in the home.

For a nursing mother, making the decision to take medicine to treat this depression is tricky. We know some medicines are not safe to take when nursing; others are okay. For most medicines, there is not enough known to do better than make an educated guess. Most of the antidepressants fall into this last category.

Since most medications of any kind taken by the mother do show up in the breast milk, my rule of thumb is that, all other things being equal, it is better for a nursing mom not to take a medicine that is not clearly okay to prescribe for the baby.

In the case of depression, all other things are not equal.

Solid evidence is mounting that maternal depression is not good for babies' development. A study released just last month looked at 225 four-month-old infants, and their responses to the voices of depressed and non-depressed women. Babies do not learn as well when they are listening to the flatter, less melodic voices of depressed women. Adults' perky, high-pitched baby talk sets the stage for intellectual development (Child Development 1999;70:560-570).

Depressed mothers deserve treatment, both for their babies' sakes, and so that the mothers do not miss out on enjoying one of life's unrepeatable joys -- the all-too-brief babyhood of each child.

It’s best to treat the depression with sleep, exercise, bright light, upbeat music, and healthy food. Exercise is particularly difficult in the postpartum period -- both time and energy are often lacking. But exercise has been proven to help specifically with postpartum depression (J Sports Med Phys Fitness 1997 Dec;37(4):287-91). Cooperation and commitment will be needed from family and friends to guard Mom's sleep and to free her up for daily aerobic exercise -- outside if possible (Prev Med 1999 Jan;28(1):75-85). An hour of aerobic exercise daily can be as powerful as even the strongest antidepressant medications. Even 10 minutes a day can make a noticeable difference.

Anaerobic exercise, while effective at treating depression, creates lactic acid that causes sore muscles. This lactic acid gets into the breast milk. It doesn't taste good and leads to fussier babies -- which in turn increases the risk of depressed moms (Pediatrics 1992 Jun;89(6 Pt 2):1245-7). I also wonder whether depression itself may alter breast milk, giving another good reason to treat.

Even an hour of quiet rest with no responsibilities can significantly improve the depressed symptoms (J Sports Med Phys Fitness 1997 Dec;37(4):287-91). If treating the depression without medicines isn't satisfactory, I am in favor of using antidepressant medicines.

Rest of article here, including discusion of specific meds: http://www.drgreene.org/body.cfm?xyz...detail&ref=560

A good reminder to exercise. Even if you don't feel up to it, it can possibly help as much as meds would! Not to forget, eating right and getting enough sleep.

Postpartum depression (PPD) is quite common after a baby's birth. It can range from the mild(er) "baby blues" which affect between 50 and 80 percent of all mothers, to psychosis. In general, over 10 percent of mothers experience some level of postpartum adjustment problems. When these problems begin to interfere with a mother's ability to take care of her baby and her daily tasks, it is time to seek professional help. The entire family is affected when a mother is depressed. It takes a toll on everyone, especially the baby, who may also begin to show signs of depression, keeping his chin down on his chest and avoiding eye contact.

Breastfeeding may decrease the rate of PPD, or lessen its impact. A 1994 study by Astbury, published in an Australian medical journal found the rates of PPD to be lower in women who had nursed their babies.

http://parenting.ivillage.com/newbor...,,3x1b,00.html

~ Linda

[zencyn]

THis is a good article. And I STRONGLY encourage any mother to go seek help if you think you may have post-partum depression. I have a long history of depression and I have been off and on meds for a long time. I stayed on low doses of meds while I was pregnant and nursing my first two children. I was off my meds when I got pregnent with my third and refuse to go back on my meds. By the time my baby was 4 months old I was a basket case and I was starting to go off the deepend. I know exercise can help depression, but I think there's only so much it can do. When you're that depressed it feels like too much effort to do anything much less exercise and take care of yourself.

Nursing did not go well with my third baby. I deeply regret that I did not seek help early. And I truly believe she was such a fussy baby due to my depression and this really saddens me - I totally quit nursing when she was almost 5 months and am now on 3 meds. I mentally feel like another person, but I am still sad and guilty about having to quit nursing.

And it's true, the whole family is affected. A little part of me is a little mad at my DH for not insisting I get help, but I don't know how realistic that is.

So, take it from me, PLEASE get help if you think you need it and don't put it off. I do wish I had been exercising and taking better care of myself while I was pregnent, I think that could have prevented a lot of it.