Breastfeeding problems can contribute to postpartum depression in a variety of different ways.
Often, we think of moms who are unable to breastfeed. But even those who successfully breastfeed can also find themselves suffering. Sometimes, breastfeeding dependency can make us blind to other problematic symptoms. Renee from This Anxious Mum shares her story about how her breastfeeding dependency led to sleep deprivation and other side effects. It became so important to her that she didn’t notice the bad shape her mental health was in.
This is Renee’s story.
I Drank the Crunchy Mum Koolaid – And It Made Me Self-Loathing
Of the many things I thought I’d cherish as a new mum, I NEVER counted on breastfeeding being one. I’d been firmly in the camp of “no thanks” for breastfeeding (especially extended breastfeeding, which I deemed “gross” and “only for hippie weirdos”) whilst pregnant, and I didn’t anticipate that changing.
Well, well well.
Nobody was more surprised than me when I became somewhat of a massive breastfeeding advocate. Of the many pivots my brain did in that short time between pregnancy and the fourth trimester ,this was perhaps the most significant in mine and my daughter’s life.
Despite being born at 32 weeks gestation and not mastering the sucking reflex until 34, I was able to maintain an exclusively breastfeeding relationship with my daughter for 10 months. The idea that I was the sole source of her nutrition was something that provided a great comfort to me, especially when I felt so utterly lacking in every other department.
I surrounded myself with other “breastfeeding buddies” and joined a multitude of breastfeeding support groups, eager to help new mums. I got in wars with other women over bottle vs breast and I openly judged anyone who, in my eyes was “depriving their child” through either their choice or inability not to breastfeed. I had a back pocket full of facts and sources about breastmilk and mother-child attachment.
“This is all that’s important,” I told myself of my breastfeeding dependency.
It didn’t matter that my little girl, Elliott, woke over 10+ times an evening to feed.
It didn’t matter that her own father couldn’t help her sleep and that she would only settle for me and my boobs.
It didn’t matter that I felt constantly “on call” and that the hyper vigilance was affecting any little sleep I was getting.
It didn’t matter to these women I surrounded myself with either because we were good mothers. And being a good mother meant being completely there for your child, day and night, even to the detriment of your own health.
I made snide comments to my husband about “those bottle-feeding families” how backward! Why would you willingly bottle feed when it’s so much extra washing up?! What about the maternal bond? Don’t they care?
As is common in these groups, I created a little toxic echo chamber for myself where I felt both safe and held as well as completely petrified of being shunned for any juxtaposing beliefs. I had (at least in my eyes) isolated myself from the majority of society, whose beliefs I openly and vocally deemed harmful.
Every day I was scrupulous about combing through my words, both written and verbal, to make sure I wouldn’t offend anyone and ultimately be thrown out of my friend group. I began to feel trapped in my parenting choices and completely alone.
As my daughter got older and more interested in things that challenged her fine motor skills, I found myself covered in tiny bruises in the stupidest of places after she had fed. She’d pinch, bite and slap me. I was no stranger to depression and anxiety, even before I had a child. I was convinced that I’d successfully shielded myself from postpartum depression, as though I was engaged in a game of hide and seek with mental illness, where I had a killer hiding spot.
Cracks began to form. Completely sleep deprived and emotionally depleted, I began self harming again, not even having the awareness to notice if my daughter was present. One evening I self harmed while holding my daughter. It was an unsafe environment and I needed help.
After my complete breakdown, I found myself in the local Mother and Baby Unit where I spent 5 long and emotional weeks. As well as engaging in therapy and using skills for myself alone, I also worked with an Occupational Therapist to help my relationship with my daughter, and things began to change.
My breast-obsessed, bottle refusing baby began to take a bottle of expressed milk. I told myself it was just a necessity now and that once I was better, I’d go back to being her everything, on call, always.
A large part of our breastfeeding relationship was feeding to sleep. I would feed my daughter for every nap and night sleep. Some nights she slept with my nipple in her mouth. And as much as I delighted in her little soft body and baby breath, I resented the loss of my bodily autonomy.
I had never intended to stop bed sharing, but a condition of staying a patient at the MBU is no “unsafe sleep.” My husband and I squeezed hands under the table when the admissions nurse mentioned this condition of admittance.
Surprisingly most of all to me, she took to a crib as though she’d been waiting for it, sick of sleeping next to someone. Changes seemed to take place slowly and then all at once. Four weeks into our stay, our baby seemed to turn into a little girl.
She ate finger foods like any other child her age and slept alone. I felt guilt, unlike anything I’d ever known. Our bed-sharing, breastfed baby, who refused solids, sleep and bottles were no longer, and it was my fault. I felt rejected and as though by partaking in these parenting practices, I was failing my daughter and her future development. The real struggles with this guilt and misplaced identity came after our hospital stay, on the day she turned 11 months old.
I began having migraines that couldn’t be helped by any painkillers I tried. Visiting the GP she prescribed a wafer type med that’d knock them out fast. One caveat being – I had to stop breastfeeding. I cried in my doctors’ office, I cried even more at home. Not because I felt I was depriving my daughter but because I felt I was depriving myself of something that I found comforting.
The truth is, my daughter hadn’t wanted to breastfeed for weeks and I was barely producing milk. She’d latch on if I initiated a feed but she’d lose interest within a minute or two, contented just to pinch the skin around my neck and make me self conscious. This loss, I realized, was all mine.
I held my little girl that night and breastfed her for the final time. I set up a self-timer and took photos of the “event” as though I was commemorating a loss. I woke the next morning fully anticipating a battle involving tears and tugging at the collar of my t-shirt.
There was nothing of the sort from my daughter, who was perfectly contented with her bottle and after all that worrying, the tears were all my own.
Renee is a maternal mental health blogger who believes in the healing power of words. When she isn’t writing she’s playing dinosaurs with her toddler.
Many women with postpartum depression report struggling to breastfeed, or at least feeling that extra pressure to do so.
It’s hard to know for certain whether breastfeeding problems cause postpartum depression symptoms or if symptoms of postpartum depression are making it difficult to breastfeed. It could be a combination of both.
Either way, breastfeeding takes some work. For a mother with postpartum depression, it’s just another aspect of motherhood that can contribute to more stress, added pressure, and self-doubt.
Here are some tips for mothers who are, or who might be, concerned about breastfeeding with postpartum depression.
Do Your Research
Don’t expect breastfeeding to come naturally to you and baby. Sometimes it does, but don’t expect it to. Breastfeeding may have come naturally to our ancestors hundreds of years ago when life was simpler, but if we want to be successful at it now, then we need to do some research.
The best time to do that research is while still pregnant, since the first few days of breastfeeding are the toughest. If you’ve enrolled in a birthing class, it’s likely they will cover breastfeeding as well. Don’t be afraid to ask as many questions as you can think of and take detailed notes. You never know which aspect of breastfeeding you might struggle with.
Being prepared for any breastfeeding setbacks can help you handle problems better if you end up suffering from postpartum depression.
If you’re already breastfeeding with postpartum depression, it’s never too late to research ways to improve your experience. There are plenty of resources available to help you.
A postpartum doula is a great option to consider if you’re worried about breastfeeding. They are trained to help mothers breastfeed successfully and can help you get enough rest and proper nutrition after giving birth, which is important for milk production.
Milkology – an online breastfeeding class that offers tons of information for all the different stages of breastfeeding.
KellyMom – the ultimate online breastfeeding resource. You can find articles about basically every single breastfeeding situation and/or question you could possibly have.
ABCKidsinc– a great collection of articles about all things breastfeeding. Includes common questions about health, diet, medications and products.
The Womanly Art of Breastfeeding – This book from the La Leche League is a breastfeeding bestseller for a reason. You can read it while pregnant and keep it on hand as a quick resource when and if situations arise.
Also known as Dysphoric Milk Ejection Reflex. D-MER is a newer breastfeeding condition that often gets confused as a symptom of postpartum depression. It is characterized by feelings of anxiety, sadness, panic, dread or loneliness that are brought on during letdown.
It is important to note that D-MER is NOT a symptom of postpartum depression, although it is triggered by a change in hormone levels. The “dysphoric” state that it causes is purely a physiological response to the sudden drop in dopamine levels required to increase milk-producing prolactin. In other words – a chemical imbalance.
Women with D-MER can also suffer from postpartum depression, which can add to the confusion and increase aversion to breastfeeding. Simply recognizing the unpleasant feelings as a physiological response, as opposed to a psychological condition, can make a huge difference.
Start Off Right
There is oneepic moment after you have a baby that opens the door for breastfeeding success. What you do in this moment will set the pace for your breastfeeding journey. I’m talking about when your milk comes in.
Up until your milk comes in, baby has just been “suckling” and they haven’t really been “feeding” on much other than colustrum (still super important, though). And then one morning, you wake up with boulders on your chest, pain up to your armpits and a soaked t-shirt and have more milk than you know what to do with.
The most important things to focus on when your milk comes in are:
It will be difficult to latch a baby onto an extremely full breast. The nipple can flatten or invert, and squeezing the breast to get it into baby’s mouth can be incredibly painful. Using breast shells was a lifesaver for me during engorgement.
With extremely full breasts, there is a lot of watery fore milk at the front, and the rich, fattier hind milk at the back of the breast. You want to make sure that baby is getting enough of the fattier hind milk before they get full. Otherwise, you can end up with greenish poops and red bums, along with other problems. The breast compression technique is the best way to ensure baby is getting the good stuff.
Clogged Milk Ducts
The name says it all and the last thing you want to end up with is a swollen, red clogged milk duct. If left untreated, it can lead to mastitis. Thankfully there are lots of easy remedies to help loosen up a blocked duct.
Regulating Milk Supply
It might be tempting to pump out all that extra milk, but the best thing you can do is just feed, feed, feed. Baby may go through a cluster feeding phase when your milk comes in so just lay in bed and feed baby all day long if you need to. Feeding on demand will help to regulate your milk supply so that your body will learn to produce exactly the right amount of milk for your baby’s needs.
Once you have an adequate supply of milk, you should start experimenting with different nursing positions. A football hold is great for managing those XL sized engorged breasts. Lying back can be helpful if you have a forceful letdown. Side-Lying is always a popular option for night feedings or to get through cluster feeding sessions. You can even try nursing with baby in a baby carrier.
Get Comfortable – find the most comfortable spot in your home to nurse baby and make sure everything you need are within arms reach. If you’re out in public, do whatever makes you most comfortable – whether it’s nursing with or without a nursing cover.
Cry it Out – crying is a way to release stress and built-up tension, not always a sign of despair.
Support vs. Pressure
Women with postpartum depression are extra sensitive to criticism, because they already feel like failures themselves. They often mistake breastfeeding support as pressure to breastfeed. I have heard many women with postpartum depression say they felt they would let their partner down if they could not breastfeed.
The truth is, your partner likely doesn’t care as much about breastfeeding as you do. They want what’s best for the baby, and if they’ve done as much research as you have, they also feel the pressure for breastfeeding to succeed. But they don’t feel the emotional urge like you do. They don’t understand what a total body experience it is.
What they do care about most, is you. They don’t want you to be miserable and in pain simply to breastfeeding. They will never think of you as a failure for not being able to breastfeed.
If they truly support you, then they will stand by you no matter what decision you make. And if your partner’s opinions about breastfeeding are causing you unwanted stress, it’s important to tell them, because they may not realize how much it’s affecting you.
Treatment Options While Breastfeeding
Talk to your doctor about your treatment options. I wasn’t given the option to take anti-depressants while I was breastfeeding, but I’ve heard that there are several safe options now. Prescription anti-depressants are not the only option, either.
Therapy is a great option for breastfeeding with postpartum depression. There are different types of therapy available, including cognitive behavior therapy, support groups or couples therapy.
There are several different herbs, supplements, vitamins and minerals that have been known to improve symptoms of depression.
Acupuncture has also been known to help with symptoms of postpartum depression, but make sure to indicate that you are also breastfeeding.
Don’t feel like treatment is out of the question for you if you are breastfeeding with postpartum depression, it’s important to know all your options.
Giving Up IS An Option
Choosing to stop breastfeeding will NOT make you a bad mother. Yes, we know that breast is best, and that there are so many benefits to breastfeeding. But at what cost?
When we weigh out the risks vs. the benefits, your mental health is one hundred times more important than the benefits of breastfeeding.
There are so many advanced options for formula feeding that your baby will never be at a disadvantage. In fact, they’ll grow up into junk food addicts just like every other kid. One day, you will watch your toddler eat dirt in the backyard and wonder why you ever stressed out about breastfeeding.
It’s alright to feel guilty for not breastfeeding, but there are so many other ways to bond with, and provide for, your baby. You will only be able to do those things if you focus on your mental health so that you can be there for them completely.
My own personal experience of breastfeeding with postpartum depression was actually a pleasant one. Knowing that my daughter needed me for her survival was what kept me going. As much as I despised doing it at the time, especially the night time feedings, I realize now that it’s what saved me from detaching from her completely.
No matter what your experience is like, or what choices you make for your baby, remember that your mental health and physical well-being are just as important as theirs.
Sleep training a newborn is all about establishing a good routine and developing the sleep habits that will become an important part of their lives. It’s about teaching them how the world works – when we sleep, when we eat and when we play – in order to be a functional human being. Sleep training a child is a long process, and the earlier they can learn, the easier it will be in the long run. By following a strict routine with a newborn, you may even be able to avoid sleep training in the future.
The goal of this sleep training guide is to:
Help your newborn baby identify the difference between day time and night time.
Establish a daily routine that focuses on healthy sleep habits.
Lay the foundation for stricter sleep training at a later age.
Help you predict what your baby needs and recognize the reason they are crying.
The reason why sleep training a newborn is so essential is because sleep at this age is instinctual and not something they have learned to fight (yet). This promotes a much more positive experience for both parent and baby. Remaining positive throughout the sleep training process is important to successful sleep training as the child gets older.
Here is a guide to sleep training a newborn (0-6 months), which includes routines to follow during the day, at nap time, bedtime and in the middle of the night.
Sleep Training in the Morning
Open the curtains
Let as much sunlight into your home as possible or sit by a sunny window. The point is to associate “daytime ” with brightness and noise.
Change baby out of their pajamas
It may seem like a tedious and unimportant task because many newborns stay in sleepers all day long. But the simple, routine, act of changing clothes in the morning will signal to your baby that it is time to start the day, and not just another one of their many wakeful periods.
Skin to skin contact
Several times a day, strip baby down to a diaper and lay them on your bare chest or cuddle next to them in bed. This is a great thing to do while nursing or bottle feeding baby as it can also keep them awake and stimulated so they will feed better.
If you’re a busy mother, or have other children to take care of and don’t have the time to lie in bed all day, then consider carrying baby around in a wrap-style baby carrier while shirtless.
A lot of effort should be put into those daytime feeding sessions. Feed baby as often as they want to during the day, whether it’s breast or bottle.
If you’re breastfeeding, now is the time to master the latch and try out different breastfeeding positions. Make sure to empty each breast even if it means feeding on the same side twice in a row. That will increase your supply and provide baby with more hind milk. Try using the breast compression technique to ensure baby is getting enough of the fattier hind milk and to help speed up the session.
Try your best NOT to let baby fall asleep during the feeding! Sucking is extremely soothing for a baby and it’s natural for them to drift off or get tired halfway through. If baby continues to fall asleep while nursing, they won’t get full enough and will wake up wanting more just a short while later.
Get a good burp
Different methods work for different kids but this is so, SO important. Try gentle bouncing or laying them on their tummy across your arm or leg instead of patting their back. Adding a little bit of pressure against their tummy with the palm of your hand, or holding their stomach against your rib cage as you bounce up and down can help to eliminate gas.
The number one reason why newborn babies cry after a feeding is because of gas. Often, babies will put their hands to their mouths or root around when they need to burp which can be confusing if they just finished nursing. For babies who are struggling with gas, try using colic tablets or essential oils to ease their tummies.
Get a good poop
This will usually happen on it’s own, so it’s really just a waiting game. You can try “pumping” their legs or holding them in a “sitting position” to get things moving along. The reason why you want to watch for this before putting baby down for a nap is so that they will be comfortable as they sleep and will have no reason to wake up before they’re ready to.
Newborn babies can poop frequently throughout the day (especially breastfed ones). Make sure to use a good bum balm to help avoid rashes with frequent changes. With time, you will learn how often and when they need to go. Their specific habits and routine usually remain constant as they grow older so this is just another way of getting to know your baby.
Talk or sing to baby, have tummy time and lots of skin to skin contact. A colorful play mat is a great tool to have for keeping young babies entertained. The environment should be stimulating and playful but not over-stimulating, so watch for cues that baby is done with a certain activity.
If you’re not sure exactly how to play with a newborn, then just take them around with you as you go about your day and talk to them while you do it. Babies don’t need a lot of entertainment at this age but they love to hear voices and watch faces.
Watch for signs of sleepiness
Throughout the day, keep an eye out for signs that they are ready to sleep. Some babies get very fussy, others may simply stare off in one direction and start the “slow blink.” As soon as you catch the hint that they are sleepy, prepare yourself to initiate the nap time routine.
Sleep Troubles? Watch Out for Signs of Sleep Apnea
Around 2 to 3 percent of children suffer from sleep apnea; infants can be affected too. Apnea means cessation of breathing, so a child who has sleep apnea can experience episodes in which they stop breathing for a few seconds during sleep. Read this guide to know more about sleep apnea in children.
Sleep apnea is a medical condition. If you notice your baby displaying any symptoms of sleep apnea, consult your doctor immediately. Sleep is essential to the growth and development of babies and older children, so anything that can disrupt your child’s sleep, especially a medical condition, should be taken seriously.
Sleep Training At Nap Time
Put baby to sleep in their bed
Wherever you want baby to sleep at night time is where you should put them for naps as well. It may be tempting to hold and rock that baby for the next 2 hours but the sooner you can get them accustomed to sleeping in their own bed, the better (don’t worry, you can get in lots of cuddles during “playtime”).
Try to avoid letting baby nap in a car seat, bouncer or swing, as this can develop bad habits as they get older. Remaining consistent about where they sleep will help them get used to their bedroom and learn not to fear it.
Make sure that baby’s room is as comfortable as possible. Try using a warm or cool mist humidifier to make sure that their room is set up with the right conditions for them to sleep.
Keep the curtains open
Daytime sleep needs to be different from night time sleep, so keep the room bright. If it’s a dark or cloudy day, then leave a light on while baby naps. Make sure that there is a significant difference in baby’s room during nap time versus at night.
It’s common to try to avoid any and all noise while baby is napping, but that will become something you need to keep up for years. Most newborns are deep sleepers (hence the term “sleeping like a baby”).
Play music in the background, use a sound machine or open a window to let in street noise. If you have older children, don’t shush them while baby naps. Basically, go about your regular every day activities. This will teach baby to nap despite life happening around them.
Some babies tend to startle in their sleep when they hear loud noises, such as a dog barking or a car horn. Swaddling can help keep the startle reflex from waking them up.
Wake baby up after 2 hours
… and start all over again. It might sound cruel to wake up a sleeping baby but wouldn’t you rather save that sleepiness for 3 am? Several smaller naps throughout the day work better than a few longer ones at the newborn age so that baby can eat more often.
Sleep Training at Bedtime
Make sure that baby has been up for at least 1 – 2 hours before bedtime
Even a 10 minute nap in the car can sustain a baby with enough energy to last all night. It will take some work to plan out baby’s nap times but it is much easier to put a sleepy baby to bed than it is to wrestle with an energetic one.
Dim the lights
The wakeful period before bedtime should be focused on darkness and quiet – different than the wakeful periods during the day. Dim the lights, close the curtains or install blackout blinds.
You still want to make sure baby gets a really good feed, burp and poop
*Ahem* this is your life now…
Tone down the playtime
In the hours before bedtime, choose less vigorous playtime for baby. Avoid swings and bouncy seats or over-stimulating toys. Talk in quieter voices and play soft background music. Try to avoid having the television on.
Bathing and massaging baby are a great way to wind down before bedtime. Opt for sleep-inducing essential oils and use calming bath products designed to help baby relax. Let baby have some time without a diaper on before that longer nighttime stretch. Make sure that playtime before bed is calming and soothing instead of stimulating.
Change baby’s clothes
This is the other part of the day when it’s important to change baby’s clothes to signal that it’s bedtime. It doesn’t really matter what you put baby to sleep in because it’s just the act of changing into pajamas that will create that routine habit.
Try NOT to feed baby right before bed
A feeding before bed is important to keep baby full but if you don’t want to nurse them to sleep every time they wake up, then you need to disassociate it with bedtime. Aim for a half hour before bedtime so that they don’t fall asleep while nursing. You can feed baby first, then gently bounce or dance around with them to get out all those gas bubbles. Or change them into their pajamas after the feeding.
Initiate the “BEDTIME ROUTINE“
This is the last thing you will do with baby before you put them to bed for the night. It can include a bedtime story or lullaby, turning on a projection nightlight, some gentle rocking or cuddling in a chair, or goodnight kisses and hugs from everyone in the family.
Over the years the bedtime routine will evolve as your child grows. But it should always include a calming activity that is reserved specifically for bedtime so as to give your baby the bedtime signal.
Put baby to bed when you see the early signs of sleepiness
It’s worth repeating here – put baby down when they are sleepy but not actually asleep. The younger the baby, the more they are acting on instincts and as long as all of their needs are met, they shouldn’t protest when you put them down.
If baby cries when you put them down…
Try feeding or burping again until they get drowsy. If baby falls asleep while nursing, just try to get them into bed as soon as possible afterwards. Try your best to remain positive about the process, or baby will sense your anxiety.
Once down for the night – DO NOT WAKE BABY UP TO EAT.
Newborns need to eat on a regular schedule, but because you have been pumping them full of food during the day, you can worry a little bit less about how much they are eating at night. They WILL wake up when they are hungry but it should be longer than 2 hour intervals. The older and bigger they get, the longer they will be able to go without a midnight snack.
Use a baby monitor to listen for when baby wakes up, and try to get to them as soon as possible. Try not to let baby cry for too long, as this will stimulate them more than necessary. Newborns will normally only wake up to feed so there is no point in letting them “cry it out.”
Sleep Training in the Middle of the Night
If and when baby wakes up in the middle of the night…
Do not turn on any lights
Keep the room as dark and quiet as possible. A soft nightlight or mood light offers just enough lighting for you to see what you’re doing but the idea is to help baby associate night time with darkness and quiet.
Keep baby dressed
Save the skin to skin contact for the daytime. If you swaddle baby then it’s up to you whether or not to unswaddle them, but the idea is not to disturb or stimulate baby any more than necessary.
Because you’re pumping them full of milk during the day, you don’t need to worry about how much they’re getting in the middle of the night. This is a great time to use the breast compression technique while breastfeeding. Most likely, baby will fall asleep during nursing. If they do, try to get them back into bed as quickly as possible.
Do not talk to or stimulate baby in any way
If you’re smooth enough – you might be able to convince baby that this is just a dream and that they aren’t really awake at all…
Only change a diaper if it’s poopy
If baby had enough poopy diapers during the day then the chances of a poopy diaper at night are slim (though they do happen). Good quality diapers can normally retain urine for an entire night’s sleep. If you find that baby is soaking right through them, try a different brand or move up a size. Some babies are prone to diaper rash, but skin can also become too sensitive with frequent changes. If you absolutely must change a diaper, use a warm wipe or washcloth and try to make it as quick as possible so you’re not overstimulating baby.
Get a good burp
But don’t try any fancy positions that might overstimulate baby unless they seem to be having a lot of trouble with gas.
Immediately return baby to crib
Don’t make a big deal out of night time wake ups. Try to make them as quick and quiet as possible and don’t take baby out of their room.
Continue this routine for all night time feedings until morning and then begin the daytime routine all over again.
By following a routine with your newborn throughout the day, you will be able to get them on a consistent schedule. This will help you to predict what they need and when, so that when they cry, you can rule out the common reasons. Having designated awake and nap times will also allow mom to get more rest and/or work done without having to constantly wonder when baby will be ready to eat or sleep. You could even try using an app to track baby’s sleep patterns. The routine will eventually become second nature to mom and baby, and will continue to change and evolve as baby grows. It will also help to reduce the stress and anxiety caused by sleep training at a later age.
Have you tried all these tips and your baby is STILL not sleeping through the night?
There could be something you’re missing. All babies are different, and there isn’t ONE plan that works for everyone. Don’t be afraid to seek help from an expert. Read my review of The Baby Sleep Site for more information.