The arrival of a little bundle of joy brings heart-stealing smiles along with many opinions and advice about breastfeeding. Undoubtedly, nursing creates a physical and emotional attachment between mother and baby. It strengthens babies’ immune systems, and for moms, can reduce the risk of disease and bring joy and fulfillment.

But not always.

For some mothers, breastfeeding is extremely painful. Others cannot supply enough milk, which can lead to extreme feelings of guilt. Breastfeeding and anxiety often go hand in hand as infants on breast milk require frequent feedings. The resulting lack of sleep causes stress, which can reduce mom’s milk supply, creating a vicious cycle. 

“Feeding and sleep deprivation — which, of course, are connected — are two of the biggest triggers for moms’ anxiety and mood disturbances,” says Dr. Pooja Lakshmin, a psychiatrist specializing in women’s mental health, in The New York Times

Depression and breastfeeding

Does nursing reduce the risk of postpartum depression (PPD)? For most new mothers the answer is yes. Yet those who have a negative breastfeeding experience are actually at greater risk for PPD. 

Another mental health issue, but one rarely discussed, is post-weaning depression. Once baby moves to the bottle, sadness is common as the feel-good hormones released while breastfeeding drop significantly. 

For post-weaning depression and PPD, antidepressants are often prescribed. But what if you are breastfeeding? Some medications like Sertraline (Zoloft) are safe according to the Mayo Clinic. Others like Alprazolam (Xanax) taken while breastfeeding are considered harmful to both mother and baby.

Medications and nursing moms

Other medication issues complicate breastfeeding. Post childbirth, opioid-based pain medications like Percocet are acceptable before lactation begins. Yet taking Percocet while breastfeeding can be dangerous for baby. For guidance on medication safety while nursing, be sure to check with your health care provider.

An informed choice

August is National Breastfeeding Month which is dedicated to helping mothers achieve their breastfeeding goals. Recently, the American Academy of Pediatrics updated their recommendations, encouraging mothers to breastfeed for two years or more. Still, the decision about how long and whether to supplement with formula is a very personal one. It depends on a multitude of factors, not the least of which is mom’s mental health. 

“I worry that the lack of centering of mothers’ mental health continues to reinforce a narrative that in order to be ‘good’ moms, women must sacrifice their own emotional and mental well-being for the sake of their families, when, in fact, the data supports the opposite. Prioritizing moms’ mental health positively impacts the whole family,” says Dr. Lakshmin.

Here are a few resources to guide parents in their decisions regarding breastfeeding.