Do I have PND or am I just starving?

[Rapples]

Asking here because, to be frank, if I contact my HV or GP they'll 100% say it's PND because they just adore diagnosing it and I'd like to get a more balanced perspective. They'll also just suggest we stop breastfeeding because that's their fix for everything and I don't want to stop - it's what we want to do.

I have an emotionally unhealthy relationship with food, I always have. Food makes me happy and I don't think I really feel hunger in a traditional sense, just cravings. For example, if I want to eat a steak then I'd genuinely rather not eat than have something else. If I do eat something else, I'll feel just as "hungry" afterwards - I could eat something else until it hurts and the "hunger" would still be there and just as strong. I'm a healthy weight and have tended to eat a balanced diet, but definitely not a good emotional attachment to food. If I celebrate something, I celebrate with food. If I'm sad or hurt or tired, I get the most overwhelming urge to eat (my stomach physically aches and I get dizzy) - but, again, only the specific food that I want.

During my pregnancy, I had HG. DD is a month old now and I weigh over 10kg less than when she was conceived. DD is EBF and has suspected allergies so, because she wasn't gaining weight from being sick, the GP advised that I cut out certain foods. The vomiting has stopped and she's now back on track weight-wise. I have a crazy over supply of milk and I'm expressing twice as much as she needs.

But I feel so sad - and my stomach hurts and I feel dizzy. But, I can't eat any of the foods that I want to eat, so even if I eat, I'm still "hungry". I can't see much point in eating at all. So, I can't determine if this is PND or just my issues with food combined with a lack of sleep and burning a bunch of calories when breastfeeding. I'm missing the majority of PND symptoms (I'm not struggling to bond with DD and I adore her, no insomnia, no panic attacks, no thoughts of harming myself or DD etc) - just intense sadness and hunger.

Anyone have PND or emotional issues with food who can relate to any of this? Or is this just normal hunger from breastfeeding and not eating enough?

I can't say but my DD was 10lb 6oz born and by the time she was 16 months and started her on bottles she drank 10z bottle in one go quickly.

I was bloody starving whilst breastfeeding, ate loads and lost weight.

If you have an over supply of milk can you stop expressing it and let your supply dwindle?

Kelly Mom is a great breastfeeding resource and will teach you how to reduce your supply

I used to just express enough to take the pain out of being engorged.

I'm only expressing because it hurts and I got mastitis - I'm not draining them at all but my supply is just going up and up at the moment.

Massive oversupply here. I was 57kg at 5’7” when I conceived, 67kg at nine months pregnant, 59kg with a 2-week-old and 54kg when she was 4 months old. My milk came out like a tap and I could not keep any weight on, despite eating two dinners and midnight ice cream. For some of us, breastfeeding uses up an insane amount of calories.

Btw I rang La Leche League (hv seemed clueless when it came to wanting to reduce supply), and they said to only feed from one side over a 2-hour period, then swap to the other boob over the next two hours.

Literally just take the minimum out off to relieve the pain.

It's tough been there with mastitis and incredibly painful engorgement.

I breastfed an allergy baby/child until he was 20 months old. It's so hard to cut out all the things you usually eat, it's like no other 'diet' because the person you love most in the world is relying on you not to stray from the plan and will be horribly affected if you do, so you don't.

Have you tried eating completely new foods that you brain doesn't know and maybe your cravings might change? I don't know, I've no advice really. But I think I know how you feel because I've been somewhere similar and it can feel miserable at times.

What foods are you craving?

It could indicate nutrients you're missing out on as part of the exclusion diet they've told you to follow.

It does sound like this could be connected with your eating problems. Can you try some of those nutritional drinks to help ensure you are getting all the calories and nutrients you need.

Is this something a therapist could help with?
Physiologically if you're hungry and eat any reasonable, well balanced meal you 'should' feel full and satisfied, you don't because you didn't get to eat what you wanted to, do you have any idea why this is? How long it's been going on?

You might need some therapy to get out of your mind and into your body to pick up real hungry and full cues again.

If this was a new issue I'd be thinking maybe you're deficient in something your body needs and you're craving that but that's not what this is by your description unless...you haven't been eating well/balanced for years and your body is craving something in which case your GP might be able to help/check you levels of everything

It sounds like it's not related to breastfeeding/post partum at all but is an issue you've had for years that is now been exacerbated because you can't engage in your usual way of coping with it

Another one who was starving throughout the first year of breastfeeding and, with DS1, lost so much weight that the HV asked gently if I was eating ‘normally AND treats’ and on being told I was out eating DH and having at least a chocolate bar a day suggested it was ‘time to deploy a second chocolate bar’. So yes, you may well be hungry.

In my experience the majority of PND cases are situational e.g lack of sleep, lack of support (often from male partners but also from wider family), money worries, lack of tasty nutritional food.

Unfortunately there is no prescription for a post natal doula, a wet nurse, a husband who is fully invested or a fantastic best friend who isn’t working. So most women go on anti depressants rather than get the help the actually need.

Makes me quite angry actually.

This is good advice.

I cut out dairy. I found some solutions. E.g flapjack recipe made with oil.

What have you cut out and what are you craving? There might be some alternatives?

Clearly there's a long term problem but it seems like a mountain to climb on top of everything else so maybe the short term fixes to cover the cravings but a longer term plan to address the food cravings?

I m not at all qualified but the compulsion element of your relationship with food could be a type of OCD? Which is very treatable I think. It is likely it would be exacerbated by post partum and food elimination/lack of sleep? The body and mind are so linked arnt they! Its probably not beyond the realms for your body to be experiencing anxiety symptoms as a 'hunger pain'' in the same way stress can give you IBS or a head ache. Especially if you associate eating with emotions ... obviously I could be very wrong!!!!

Thanks everyone.

I shouldn't be nutritionally deficient because I'm taking multivitamins and ferrous sulphate because I was anaemic during the pregnancy (because of the HG). The cravings don't really correlate with any vitamin or mineral and are pretty varied.

I have always been this way, for as long as I can remember. DM is an amazing cook and always expressed love through food. Special occasions and celebrations always centred around food and, if we were sad or hurting or needed support, she'd provide food. I definitely need therapy for it but a) it's not usually a problem because I just eat the food I want - if it's high in calories or unhealthy then I just eat less, b) I just don't have the money to prioritise that right now, and c) food brings me so much joy that I'm somewhat scared of losing it if I lose that attachment.

I'm relieved that there seems to be agreement that this isn't PND and is just my personal issues with food and genuine hunger. I probably haven't been eating enough but I'm very concerned about gaining weight - I don't do well on diets (for obvious reasons) so would struggle to lose what I put on. I'm also awaiting surgery but they won't perform it if my BMI is above 25, and I'm just personally miserable if I gain weight - I'm a small frame so I don't carry excess weight well even if I'm in the healthy weight bracket.

What is it you want to eat and can't? What is she allergic to? Posters can help with practical suggestions if you can answer these questions.

Have you got a big freezer? Bag the extra milk and save it for bottle feeds later. You can store bm for up to 6 months in a chest freezer. I had an oversupply with my son and froze loads for when I stopped pumping. Made life so much easier!!

I think this is related to your issues with food but also the fact that you had HG. I had HG and it is hell and I know for a fact that during your pregnancy you just dream of being able to eat a normal meal once the baby is here. Now that the baby is here and you have the dietary restrictions, there's no wonder your sad!

I think it's up to you wether you feel you can push through the sadness. Like your pregnancy there will be an end to breastfeeding. Is there any things like an allergy friendly milkshake that you can drink to bulk up your calories. In my newborn phase I literally just viewed food as fuel and just ate even if I wasn't hungry to keep up with the calorie intake.

You could give up breastfeeding which is sad but I can assure you it will be fine. I also pushed through with breastfeeding and didn't sleep for almost a week. I think because I felt like I couldn't be pregnant properly that I wanted to succeed at breastfeeding. I ended up combi feeding which I don't think will be an option for you unfortunately.

I think you do have the option to try anti depressants as after all they probably will boost your mood but then you have to think about the side effects (it can be quite rough when you first start them) and then you will have to wean off them too.

I don't think you have pnd, recovering from a HG pregnancy is rough but if you want to persevere with the bf then just keep telling yourself there will be an end in sight. Maybe give yourself a goal of getting to six months etc.

My dd has the same relationship with food that you describe

I have no advice -it's bloody hard when she's craving something that she can't access for whatever reason so just wanted to say that I totally sympathise with the food restrictions

I don't know about allergy breast feeding but could you possible switch to stored milk for a few days to allow you to occasionally eat something you crave

I did this when breast feeding and had an event when I wanted to let my hair down and have a few too many drinks and it seemed to work -I used my frozen supply and just expressed and dumped the milk for a couple of days

This all sounds normal, OP.

Celebrations and family occasions often centre around food: Christmas, BBQs, Sunday roasts, ice creams on the beach, etc.

This is not unhealthy, it's totally normal and has been for as long as humans existed in societies. Feasts, etc, at celebrations.

An unhealthy relationship with food is when you cannot control the urge to eat when there is no celebration or reason to feast, and you are full already. It's about moderating your appetite back to normal portions if you need to, on "normal" days.

There may be more backstory but from your post your DM's behaviour around food was completely normal.

Based on your posts you are hungry because you are breastfeeding so your body requires more calories than normal. So eat how much you need to, and enjoy it. No need for all of this angst about it.

Your supply is going up because you are pumping. Just feed her and it will settle down.

You cannot obsess or worry about weight gain while breastfeeding. I gained weight during this period having gained little during pregnancy due to sickness. The weight and hunger adjusted when I stopped feeding. Your whole metabolism is altered- try to listen to your body and eat in a way that feels natural. If you are under eating no wonder you have cravings.

Good luck, none of this is easy. Also surely your surgeon will take into account you are post partum and feeding?

Multivitamins do not contain everything, so you could still be missing out on something - such as protein if you've cut out all dairy, magnesium, sulfur if it's eggs, etc. If you've also cut out meats or wheat/oats/barley/rye + soya and not found suitable alternatives, there's so many things other than what's in a standard multivitamin + iron that you could be needing. Plus there's the mouthfeel, satiation, dehydration and the sense of not being able to have something.

Listening to my cravings and working out what they actually mean has been incredibly useful to me in not engaging in dysfunctional eating, especially when I'm now also constrained by necessary dietary restrictions.

It could be really, really helpful to say what cravings you've had and what you've been told to avoid.

I can't have wheat or milk. Unfortunately, they stay in the system for a long time (up to three weeks) after consumption so, unlike things like alcohol and caffeine, I can't have some and feed DD from the freezer stash.

I've been craving a whole range of things - most recently pizza and an ice cream sundae from the cafe at the end of my road. I wanted this specific pasta dish I make with leeks. My homemade soda bread, quavers, a Terry's chocolate orange, sweet and sour chicken balls from my local Chinese etc. I really want feta! Just a bunch of stuff. I've tried a few free-from alternatives and found the sweet stuff is really good (I honestly can't tell the difference with the Gu free-from desserts, coconut ice cream is great etc). Savoury alternatives that I've tried are gross! The pizza I ordered was unbearable - like mustardy melted plastic for cheese. Gluten-free flour alternatives make everything so dry and crumbly.

@nameisnotimportant You're spot on. I was desperate for the HG to end - I was so unwell, I weighed less at full-term than at conception. I just wanted to be able to eat and drink again.