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  • Writer's pictureEleanor Campbell

How does breastfeeding affect my mental health?

When we think of the ways women are affected by pregnancy and birth, we often focus on the obvious. Stretch marks, stitches and pelvic floors. We don’t generally hold perinatal mental health in the same place in our heads, even though mental illnesses are the most common complications of pregnancy and the first year.

Despite the progress being made around de-stigmatising and normalising depression and anxiety disorders, we don’t talk about risk factors or prevention as often as we tell women to do their pelvic floor exercises.

One factor we know has a significant impact on maternal mental health is breastfeeding. It isn’t a simple input=output scenario though, there’s a complex picture to unpick.

Multiple studies have demonstrated that meeting your own breastfeeding goals increases self-efficacy, feelings of calm and positive mood. This makes sense because having and caring for a baby is hugely stressful, and sustained high cortisol levels are a big risk factor for psychiatric disorders. But oxytocin, (a primary lactation hormone) reduces the impact that cortisol (a stress hormone) has on the body, giving a significant protective effect.

There is a flip side though. Those with pre-existing depression or anxiety are less likely to initiate breastfeeding, and more likely to stop before they wanted to. Interestingly, within this group, those who did breastfeed showed a significant decrease in depressive symptoms.

The other affected group is those who did not have a history of depression, who intended to breastfeed but did not. This is key, because these women have spent their pregnancy being educated about the value of breastfeeding. The vast majority of babies in the UK will have some formula by the time they reach six months, but women describe feeling pressure to breastfeed, both internally and from society more broadly. Those who have made a choice to breastfeed but are unable to, experience devastating consequences – a much bigger negative effect on mental health than simply choosing to formula feed from the outset.

It has frequently been said that women don’t breastfeed, societies do. This is because our environment strongly affects our ability to breastfeed. If our support network – family, friends, healthcare professionals – lack knowledge, they are unlikely to be able to provide meaningful support in navigating common issues that occur.

I frequently see families where multiple hurdles have been created by lack of experience, knowledge and education in their support network. They leap these hurdles as best they can – tall and small, many and few. So many mothers are tripped up by this environment. These women internalise blame and guilt for the situation they had little control over. Debriefing can be a very powerful tool in helping families come to terms with outcomes that diverged from their original goals. Validating negative emotions like grief and sadness rather than waving them away with phrases like “fed is best” is key. We understand that if someone walks away without a scratch from a high-speed car crash that they are likely to experience trauma, and need time to process it, we don’t simply tell them “you’re fine, it doesn’t matter”.

The ability to exercise our choices as individuals matters, an effective support network matters, counselling and validating women’s feelings matters. The absence of any of these are risk factors for postnatal mental health, and it’s time we get to work.

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