Debunking a Few Myths: Postpartum Depression, Breastfeeding & Sleep

Debunking a Few Myths: Postpartum Depression, Breastfeeding & Sleep

By Dr. Eileen Park

Depression in new mothers is relatively common, affecting 10-20% of new mothers worldwide.  Yet, it still remains poorly understood and there is much contradictory information on how it should be dealt with, especially with respect to breastfeeding.  The following are some common myths:

1.      Depression in new mothers is not serious.  Most women get the “baby blues”

Depression is not the same as the “baby blues”.  It is true that 50-80% of women experience the “baby blues” and this is often mild and resolves relatively quickly.  However, the symptoms of depression include moods of sadness, the inability to experience pleasure in normally pleasurable activities, sleep difficulties unrelated to infant care, fatigue, inability to concentrate, hopelessness, and even thoughts of death.  These symptoms must be present for at least 2 weeks to be clinically diagnosed with depression.  Post partum depression (PPD) may occur at any point within the first year of life and often does not resolve on its own without being properly addressed.  Note that the blues may be an early manifestation of depression and should not be ignored.

2.      Disrupted sleep is a risk factor for PPD so breastfeeding mothers are at increased risk.

Current programs for mothers with PPD recommend that mothers sleep in a separate room from the baby and the adult on duty and also pump or use formula for night time feedings in order to get more sleep.  However, research shows that breastfeeding mothers slept more than mothers who bottle-fed.  Moreover, breastfeeding mothers who bed shared got the most sleep in a 24 hour period when compared to those who did not bed share (Quillin & Glenn, 2004).  In another study, exclusively breastfeeding mothers slept approximately 40 minutes longer than mixed feeding mothers (Doan et al. 2007).  A more recent study confirmed that disrupted sleep was a major risk factor for PPD, but the factors related to disturbed sleep included previous sleep problems, depression, being a first-time mother, and NOT exclusively breastfeeding.  Therefore the authors concluded that mothers who were not exclusively breastfeeding had more disrupted sleep and a higher risk of depression (Dorheim et al. 2009).

3.      Breastfeeding is stressful and therefore can increase risk of depression.

Contrary to popular belief, the act of breastfeeding has been found to increase parasympathetic (restful) nervous system activity and decrease mothers’ perception of stress and depressive symptoms (Mezzacappa, 2004).  Breastfeeding has also been associated with decreased cortisol (a major stress hormone) levels (Heinrichs et al. 2001).  This is more likely to be true when there are no problems with the breastfeeding.  When breastfeeding is going well, it may be protective of maternal mood (Dennis & McQueen, 2009).  Fortunately, the majority of problems that lead to early weaning can be prevented with proper support and management especially in the first few days (Newman, 2006).  If you are experiencing difficulties with breastfeeding, please seek support.  Barefoot Health offers FREE Weekly Breastfeeding Drop In Sessions (click here).

4.      Mothers taking antidepressants cannot breastfeed.

Most anti-depressants are NOT contraindicated with breastfeeding and there is no need to stop breastfeeding.  For more information about breastfeeding and maternal medications, please see this handout written by Dr Jack Newman.

HANDOUT- Jack Newman

For information about a specific medication, an excellent resource is Tom Hale’s Medications and Mothers’ Milk.

Looking for more? Dr. Park recently appeared on Rogers Daytime for an in-depth discussion on postpartum depression.