Research question re PND and breastfeeding. Tiktok? Mears? Any contributions please.

[moondog]

In a (Heatlh) Trust presentation today hearing about PND. HV giving it said 9in regretful tone and said it was not info they would share with new mothers) that incidence of PND higher amongst women breastfeeding. but gave no references. Is this so??

[HeinzSight]

I had PND after all of my pregnancies and this contributed each time to me giving up/feeling unable to BF, yet, strangely, the only time I felt calm was when I was BF, so I really should have tried to continue, but I was in a terrible place.

Am pregnant with No4 and will desperately try again to BF.

[gabygirl]

I can't understand why breastfeeding PER SE would be linked to poorer psychological outcomes, given that it's the biological norm and (as someone else has pointed out) is linked to higher serotonin levels, also high levels of prolactin and oxytocin ('mothers little helpers').

HOWEVER

When you take into account that most people's expectations of parenthood are shaped by the fact they live in a bottlefeeding culture, and when you know how many women are hindered from normal breastfeeding by the care they get during and after birth..... plus the fact that life is made so difficult for many breastfeeding mothers by dint of the fact they live in a society where breastfeeding is acceptable only if it's invisible....

Well - it makes perfect sense that PND should be higher in women who are breastfeeding.

[Grendle]

There doesn't seem to be any clearcut answer on this one from a research point of view. Some studies have shown that where bf goes well, the risk of depression is reduced.

This recent large review:

www.ahrq.gov/clinic/tp/brfouttp.htm#Report

concluded

"For postpartum depression, studies of moderate quality reported an association between not breastfeeding or short duration of breastfeeding and postpartum depression. It is plausible that postpartum depression led to early cessation of breastfeeding, as opposed to breastfeeding altering the risk of depression. Both effects might occur concurrently. Additional factors that may have a bearing on both postpartum depression and the decision to initiate or terminate breastfeeding should be sought. Documentation of baseline mental health status before the initiation of breastfeeding and detailed recording of breastfeeding data will improve the quality of the studies and help understand the nature of the association."

[galen]

Well I have been really interested in this recently. Some one ( who has a PHD and knows a lot about brain biochemistry )told me that serotonin levels are higher in breastfeeding women. Don't know where she got that, would love to find a link to some research or something.... from my own point of view - Ds1 was BF for about 3 months. No PND. Found it totally overwhelming and exhaustiing having a baby - but no PND ( if only I'd known then how easy one was compared to 6 lOL)
DD1 - mild PND. She was BF for about 2 months. PND mild, never medicated. DD2 - BF for about 5 weeks - no PND.
DD3 - BF for 1 week. Bad PND - on antidepressants. But I did have a bad birth with her - lots of intervention, in hospital for 3 days which I HATED - exhausted by the time I got home and just threw the towel in on BF. Didn't feel especially bad about giving up BF - so not really due to that.
DD4 - no PND. BF for 2 years! Exclusively for 6 months then baby led weaning - so she still fed a LOT for about 15 months! Really exhausted due to lack of sleep - but definately no PND. THink the BF definately helped - but also did a lot of AP type stuff like babywearing and co-sleeping which I'm convinced had a positive effect on my mood.
DS2 BF exclusively till 7 months - tried baby led weaning but very interested. Now on purees at 8 months cause I need him to slep more. Has had some bottles of formula recently. Was thinking of weaning him but the less I breasfed the more I could feel my mood dipping. This could be realted though to really nt wanting to stop BF so was very upset about the thought of giving up. Now decided to try and BF a bit longer so trying to boost my supply again - and mod improved - but again could be due to I feel relieved at not stoping BF.
So not really conclusive! I was worried about getting PND again after DD3 but I do feel a lot of how we parented DD4 helped to ward it off - may be more than that involved though!

[Pixiefish]

Moony- if you see this- have tried to email you but they bounce back. Could you email me thepixiefish @ Yahoo dot co dot uk

without spaces etc

[notcitrus]

I did some research on WebofScience which suggested bf associated with lower PND risk, but could be because bf links with higher income/support levels.

I'm sure GPs and midwives told me bf likely to reduce PND - experience so far is a great high when bf is working, and satisfaction that Squirmy is thriving on my milk, which so far is staving off the SAD I normally get this time of year (and PND/psychosis run in the family). My antidepressants are ancient ones known to be compatible with bf, so if I need them I know they're there.

Was also told, which makes sense, that even if you get PND, if you've been depressed before you'relikely to copebetter because you know how to recogniseanddeal with it anddon'tjust beatyourself up.

Friends who are mums have been telling me that the difference between PND and bloody exhaustion is almost nil... that may be a factor?

[Candlewax]

With my first I unsuccessfully breast fed and was made to feel a failure by my family but I kept at it but weaned early and I had no PND.

With my second, I breastfed like mad and was very successful but I was also suffering from PND and did not realise until my ds was nearly a year old and by then I was almost suicidal.

[MoonlightMcKenzie]

It wouldn't surprise me. BF support is VERY depressing.

[gigglewitch]

I bf all three of mine, 10mo each for boys and 17mo for DD. Had milder pnd (not "diagnosed") with ds1, depression from 24wks pg with ds2 [traumatic pg] with medication until he was 12mo, and severe pnd after dd for which i'm still being treated, 2.7yrs on
Also am a pro-pro-breastfeeding mum and when they said at one point i should give up bf to get stronger meds I was pretty much suicidal as bfing was the only thing I was enjoying.
I think there's a big link to having suffered from depression before pg, also to hormonal mood variation - controllable but significant episodes of low mood are a monthly thing for me m'afraid. should've namechanged actually as you're getting all my darkest secrets here.
I find the whole area of great interest though, am off to peruse the links

[CorpseBrideOfJohnCusack]

well with me I'm pretty sure the worst bits of PND - the proper onset if you will - coincided with the return of periods. BF DD for 10 months (until she refused) and periods back at 7 months. BF DS for 14 months (until he TOO refused to do it anymore) and periods back at 10 months.

so some sort of hormonal connection. Dunno if it would have come earlier if I'd FF and therefore periods came back earlier - impossible to tell

citations essential I'd say

[FAQ]

another anectdotal here - BF DS1 for 14 months, a few hiccups in the early days, but nothing that wasn't insurmountable (apart from getting him to take expressed milk from a bottle ) - I had horrendous PND and really struggled to bond with him (something I think that still affects us both today sometimes- and he's just turned 8 )

DS2 was bottlefed (horrendous birth though) - did have PND - but nothing like as bad as with DS1

DS3 - BF for 3 weeks, mixfed until 4 months, then FF - (fantastic birth) not sure if I had PND - when he was 9 months old I definitely had depression - but not sure wheter I can link it to being PND or not.

[VeniVidiVickiQV]

if you fancy some anecdotal....

i b/fed DD without hitch for 6 months and was fine. Fairly difficult much intervened natural delivery.

DS - more normal delivery but hospitalised with PE. B/feeding more difficult - had thrush and mastitis for first 8 weeks. b/fed for 2.4 years. Had PND diagnosed when he was 7 months.

[crokky]

I bf DS excl 6 months, then til 12.5 months with solids. DD is 6.5 months - I did 6 excl and now she's on solids with BF.

I haven't got PND, but I would definitely say that the hormones that breasfeeding produces make me very very anxious. As soon as I stopped BF DS, I felt totally different. Now I am BF DD, I feel very anxious all over again. In a way, I'm looking forward to stopping so that I feel better in general. However, I love feeding her and cuddling her and I never ration the boob. So it's a bit difficult!

Hormones affect different people in different way. eg pg hormones make some people end up with hyperemesis and other people feeling on top of the world. Has wildly different effects. Perhaps same for BF hormones.

Also my mum had PND whilst she bf me (til 9 months). When she stopped BF, this magically disappeared.

Anyway, a bit silly to link them pubically as people respond differently to hormones.

[moondog]

Thank you all and Tiktok.

Yes, I was thinkning along these lines myself. I thought it off to be saying this stuff with no citations in a hospital that is striving for Baby Friendly status, largely due to work of lactation cosultant Sharon Breward (now MBE for heroic services to breastfeeding)

[expatinscotland]

i didn't bf dd1 and had PND.

i bf dd2 and had PND.

it made no difference.

[waitingtobloom]

I have had pnd twice and breastfed twice - I was only wondering earlier if I would have escaped it if I hadnt breastfed. Saying that I am so pro breastfeeding that not being able to breastfeed would prbbably depress me!

Perhaps there is a link for women who react depressively or extremely to hormones. Would be interesting to see the links with pmt, hyperemesis, pcos - that sort of thing. Personally I react badly to hormones in pregnancy - am sick for the whole 9 months and then depressed afterwards (still want more though lol).

What I also found was that although my pnd went away last time after 9 months it came back horribly so for about 2 - 3 weeks when DS weaned at about 15 months. I was ready to wean and he self weaned and was really happy so dont think it was psychological. I then also found for a while that I got mildly depressed just before each period which i hadnt before.

I definitely think a bad experience/need to stop breastfeeding can lead to depression but I had easy breastfeeding experiences with few problems apart from tiredness from the frequent feeding and mastitis - nothing that would have made me depressed.

It could also be that women who suffer from problems breastfeeding also suffer from problems in the rest of their lives which contribute to the bf problems (eg lack of support) and its these problems which exacerbate things.

THere are some links on Kelly mom - one saying it reduces pnd but 1994 study.

Really interesing.

xx

[TheFallenMadonna]

Second link pretty old too TBH.

[TheFallenMadonna]

I wasn't vouching for it tiktok. I merely did a quick search and came up with two studies with contrasting results. It wasn't offered as a comprehensive literature review.

[tiktok]

TFM, I was referring to your first link when I said it was old.

[tiktok]

TFM - an o....l....d study, and from the abstract, riddled with holes.

moondog - the HV should not say things like that without a citation.

The last time I looked at this issue, I came to the conclusion that no one has any evidence to be dogmatic about feeding and PND either way.

It may be true that women who bf have more incidence of PND - but if we define bf as 'ever putting baby to breast', then as most women who bf stop long before the 6 ms excl. bf recommendation, let alone long before any 'natural' age, then all we could say is that 'unphysiologically short terms of bf are associated with an increased incidence of PND.'

OTOH it may be true that as bf for many women in the UK is an unrewarding, socially-excluding and counter-cultural phenomenon, it might be linked an inc risk of PND for those reasons.

This is speculation, I stress - would have to read more recent texts to be more confident.

No idea if the HV is right anyway...

[TheFallenMadonna]

This gives a differnt view I think.

[moondog]

Also interesting. Have spent summer in Bangladesh (dh works there) and it is of course the place where formula companies are doing some staggeringly immoral things.

[TotalChaos]

you may find this of interest

journals.cambridge.org/action/displayAbstract?fromPage=online&aid=1828380

[flourybaps]

I had (still recovering from) PND, on reflection I think guilt at failed attempt to breastfeed and traumatic delivery definately contributed.

Interestingly though, and sorry I cant back this up with any research, I had some CBT to help deal with the PND and the hv did say that people who had 'difficult relationships' with their own mothers were also much more likely to get PND.

[moondog]

Interesting