Does breastfeeding protect you from postpartum depression?

My wonderful friend Ellie Stoneley, a popular blogger based in the UK (and a Bruce Springsteen fanatic, which won this Jersey girl’s heart straight off), wrote a piece this week that has gotten love from both HuffPo and UNICEF. In essence, Ellie notes a recent study that found that PPD “is more than double in women who planned to breastfeed and then were unable to, whereas the women who planned to breastfeed and then did are 50% less likely to be affected.”

Ellie goes on to talk about how essential it proved to be that she prepared for breastfeeding, through classes and reading, before the birth of her lovely little sprite Hope, and how important postpartum support was. She advocates strongly that every woman, in every country, have ready access to ongoing support in the early weeks and months of her baby’s life, because, let’s all say it together: BREASTFEEDING MIGHT BE NATURAL, BUT IT AIN’T EASY.

Ellie’s piece resonated with me on a lot of levels, and I am so proud of her for advocating for something that ALL women and babies, of all socio-economic levels, everywhere, need and deserve.  But it also got me thinking that something continues to be missing from this conversation. (I can say this, knowing that Ellie will have my back!)

I’m going to copy-and-paste that UK study’s finding again here: PPD “is more than double in women who planned to breastfeed and then were unable to, whereas the women who planned to breastfeed and then did are 50% less likely to be affected.” As someone who struggled not with PPD, but with PPA (A is for Anxiety) with my first child, I don’t read this statement as “breastfeeding reduces the risk of postpartum issues”. I read it as “the anxiety that can come with breastfeeding issues INCREASES the likelihood of postpartum issues.” I guess it’s two sides of the same coin.

But for me, early postpartum support alone is not going to solve the problem. Nor is “compassionate support for women who had intended to breastfeed, but find themselves unable to” (although we could use more of that, too).

Here’s why: I took classes, read books, worked with a lactation consultant when I had issues early on, and all of those things together contributed to my eventual “success” in breastfeeding, despite a lot of pain and feelings of failure. I am one of the most privileged mothers on earth, because I have health insurance and gave birth in a hospital with LCs who visit your room, and had a pediatrician with an on-staff LC whom I could call at any time. My experience represents, bascially, the ideal that Ellie wants to see for every new mother.

But when I started to think about going back to work, that’s when my own personal choo-choo jumped the track. I knew how to breastfeed in that I had figured out how to establish a good supply, how to get my baby to latch, how to deal with engorgement and plugged ducts, how to do different holds, and so on. The early support was, therefore, successful. But the stress and strain of building up a freezer stash of milk, the total and complete unknown of how to do anything related to working and breastfeeding (this is why I’m writing a book about it, people!), the agony of thinking about leaving my perfect boy – I just kind of broke under the weight of THAT. I still knew how to breastfeed just fine. But it became my greatest burden. No longer did it feel like bonding time – it felt like I had to remain “exclusive” (my most hated term) and therefore I could be the ONLY way my baby was going to grow and, well, stay alive. Everything I had learned how to do also fell apart, in terms of usefulness, when I tried to imagine how I would pump at work on airplanes, in storage closets, while on conference calls, and, for God’s sake, in Nepal. Where were the LCs, the classes, the books, for this phase? Where was the supportive dialogue from the breastfeeding advocates? A paragraph in a standard breastfeeding book does not count as support.

And when I finally called that LC at my pedi’s office, a month back on the job and truly at the end of my emotional rope, here’s what happened:

Me: I can’t do this anymore. I can’t handle the pressure of breastfeeding. Now that I’m back at work it’s even harder and I feel like I’m breaking under the strain. I’m not sleeping, not eating, crying all the time. (NOTE: these are clear warning signs of postpartum issues – ones that any trained professional should be able to recognize)

LC: Well, it’s October, so you really, really need to keep exclusively breastfeeding him through flu season. So just hang in there until March.

Really? REALLY? What the f*$%@#* was I supposed to do with that “advice”? I remember hanging up the phone and just feeling…bleak. But you know what I DID do? I kept flipping breastfeeding until April, because that LC (and yes, I know that there are good and bad LCs and I’m not trying to paint them all with the same brush) made me feel like I’d be a piece of shit mother otherwise. And it damn near killed me. The minute I stopped, I was a better mother, wife, PERSON by about 6000%.

So…where is all of THAT? Where’s the understanding of what working women are going through to try to meet an ideal set for us that does not take into account what our days (and brains, and emotions) look like? Where’s the support for that? The how-tos? The legislation, the standard training of HR professionals and managers? Where’s the shift in “formula is evil” rhetoric to reflect that, for many working women, maintaining a full supply can be damn near impossible due to the demands of the job? Why is no one saying that formula can actually extend breastfeeding by taking some of the unbearable pressure off?

So, so, so many of us are in work situations that can push us over the cliff of anxiety, guilt, shame, and feeling like total failures when it comes to producing milk for our babies.

You know what I think, totally unscientifically, would have cut my risk of having postpartum issues? Being surrounded by professionals, resources, and popular culture and media messages that are up to speed on what breastfeeding is really like for a working mother. Being supported and trusted that I am the most qualified person to make decisions about what’s best for me and my family. Seeing and hearing more working women’s stories – warts and all. Seeing sustained commitments by businesses to help women make this work, at all levels, from HR to facilities to managers to co-workers.

This is not a niche issue. Consider these stats:

  • 49% of babies born in the US (or about 2 million a year) are still breastfeeding at 6 months
  • 57.3% of American women with infants are working

So let’s call that a million, give or take, working/breastfeeding women. A million!!!

This is the next frontier, my friends. I support you who are advocating and fighting for expert and compassionate support in the days and weeks after a baby is born. Now I’m asking you to broaden your sphere of interest to include the unique issues faced by working, breastfeeding mothers.

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3 thoughts on “Does breastfeeding protect you from postpartum depression?

  1. This post is right on. When a mother returns to work no one at work cares that you are trying to feed your baby. They want you to get the job done. It’s very hard for a mother to return and figure out how she is going to pump, prepare BM for her baby while she is gone and try to be as efficient and effective at work without feeling like a failure. My supply dropped drastically when I went back with Baby #1 and I am headed back to work next week with Baby #2. I look forward to reading your column as it is resourceful and makes us mothers feel a little more normal. Thank you!

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