When things go well, breastfeeding can be a wonderful experience for both mum and baby; mum has no breast or nipple pain, and she enjoys the feeling of nourishing her baby so wholly and beautifully, and baby gets enough milk and peaceful time close to her mother. Breast milk is the perfect nutrition for babies, having multiple health benefits for mums and babies, as well as economic, environmental and life-style advantages. For all of these reasons, most mothers want to breastfeed their babies, at least for the recommended minimum time of 6 months and many times for much longer.
For many mums who are struggling with postnatal depression, breastfeeding can be a very healing experience. Mums feel proud of feeding their babies this way, and it can help with the bonding and attachment process, at the same time releasing some very calming hormones such as oxytocin.
However, breastfeeding is not always as easy as many mothers imagined it to be. Often, it can take 4-6 weeks for a new mum and her baby to master breastfeeding. And some challenges might occur along the way, that can make it a difficult and upsetting experience. The two most common challenges encountered are nipple pain and low milk supply. If mums do not get the right and timely support for these challenges, it can provoke a huge amount of anxiety and sadness in a mum, especially if breastfeeding was really important for her. This can bring about or worsen Postnatal Distress.
If you are facing a challenging breastfeeding experience, it is important to get support from your midwife, well-child nurse, peer breastfeeding support service or lactation consultant as soon as possible, before it affects your emotional well- being. Most of the breastfeeding challenges and issues can be resolved, if help is sought in the early days, just when the problem first emerges. If you are feeling too overwhelmed to seek help, try and ask your support person or a good friend to do this for you.
Your birthing centre or local hospital can provide you with a list of breastfeeding support venues and specialists in your area, many of them free of charge.
Some national resources:
https://lalecheleague.org.nz – Mother to mother support and lots of good info
https://www.nzlca.org.nz/find-a-lactation-consultant – Directory of private lactation consultants, most at some cost.
https://kellymom.com – Excellent, evidence-based website to look for information about different breastfeeding challenges.
Wonderful videos to watch for learning latch, positions and much more:
Breastfeeding and Perinatal Distress Resource
Click here to the link to our Breastfeeding and Perinatal Depression downloadable resource.
- Medications and Mothers’ Milk by Thomas Hale, RPh, PhD, world expert on this subject, is the best reference book and is updated every two years.
- The LactMed Database, a free online database maintained by the National Library of Medicine in the US, is a wonderful online resource for information on breastfeeding and medications. If your GP does not know about this resource, spread the word! They also have a free smartphone app that is very useful.
Things to consider
According to KELLYMOM.COM, when considering a medication (including herbal preparations) there are several factors to take into account:
- Do you need this medication/treatment right now, or is it something that you do not need or can easily postpone until your child is older?
- How old is your breastfeeding child? Are they healthy? Premature babies, newborns, and babies with health problems require somewhat more caution when it comes to the medications that the mother is taking; healthy older babies and toddlers are generally at a lesser risk since their bodies can metabolize medications more easily.
- How much breastmilk does your child get? A child who is getting smaller amounts of breastmilk (a newborn in the early days before mother’s milk volume naturally increases, a baby or child who is eating other foods in addition to breastmilk and breastfeeds less often, etc.) will also be getting less of any medication that passes into breastmilk.
- Is the medication in question one with a record of safely being given directly to babies and young children? The amount of the medication that passes into breastmilk will normally be significantly lower than that given directly to young children.
- Avoid medications known to affect milk production. Again, look at the websites above to find out if they do.
According to Harvard Medical School, antidepressants and anti-anxiety medications in general are considered to be relatively safe when breastfeeding, particularly SSRIs. Well documented studies on SSRIs suggest that the amounts of medicine to which the nursing baby is exposed is low, and that significant complications appear to be rare. Typically very low or minimal levels of these medicines have been detected in the infant blood.
If you have responded to a particular antidepressant in the past, it would be reasonable to consider using that antidepressant again. If you have been taking an antidepressant during the course of your pregnancy and have been doing well, it would be good to continue with that same antidepressant after delivery, as switching to another antidepressant may put you at increased risk for relapse.
All in all, in general the benefits of continuing or starting an antidepressant while breastfeeding usually exceed the very limited chance that the baby will be impacted in any way. The most important thing is your emotional well-being, and breastfeeding, if going well, is too precious to give up.
What if breastfeeding isn’t working?
If breastfeeding did not work well for you this time, please allow yourself to grieve and seek emotional support for your grief. Know this does not mean you are not a good mum or that you won’t be able to feed your next baby.
We need to understand that if a mother wanted to exclusively breastfeed and then ends up mixed feeding or formula feeding, she might suffer intense feelings of guilt, sadness, disappointment in herself, and grief. We need to acknowledge and support her through these feelings in a compassionate way.
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