Why Is Breastfeeding Important?
As per the recommendation of the WHO (World Health Organization), the baby should be breastfed from within the first hour of birth, and the infant should be exclusively breastfed for six months following birth. There are many short-term and long-term benefits associated with breastfeeding, both for the mother and the infant.
Breastfeeding mothers have a lower risk of obesity, reducing the risk for chronic conditions like hypertension, hyperlipidemia, cardiovascular diseases, and even cancer. Breastfeeding also has a psychoneuroimmunological effect on the mothers, which reduces the risk of anxiety. Studies also show that breastfeeding reduces the symptoms of depression.
Though breastfeeding has numerous benefits, the breastfeeding rate is still low in many countries. The perinatal period is between pregnancy and the first year after childbirth. This period is often linked to developing mental health conditions like anxiety and mood disorders. Women unable to breastfeed develop guilt; they feel inadequate, which leads to mental health conditions.
What Are Perinatal Mental Health Disorders?
Perinatal mental health is a collective term for mental health during the perinatal period, from pregnancy to one year after childbirth. These include a group of disorders called Perinatal Mood and Anxiety Disorders (PMADs).
These include:
Perinatal Depression:
Perinatal depression is depression experienced during pregnancy or after childbirth.
The symptoms of perinatal depression are
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Sleep disturbances.
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Mood swings.
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Excessive sadness.
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Withdrawn feeling.
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Anger.
Perinatal Anxiety:
Perinatal anxiety is the anxiety a woman develops during the perinatal period, the symptoms of which include:
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Sleeping difficulty.
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Restlessness.
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Racing thought.
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Agitation.
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Excessive worry.
Postpartum OCD (Obsessive Compulsive Disorder):
Postpartum OCD is one of the most misdiagnosed perinatal disorders.
The symptoms include:
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Obsessions (intrusive thoughts) are repetitive thoughts related to the baby.
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Compulsions mean the mother keeps on doing certain things again and again.
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Hypervigilant when it comes to protecting the infant.
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High anxiety.
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Often the mothers recognize that their thoughts are bizarre.
Postpartum Psychosis:
Postpartum psychosis is a condition that requires immediate medical attention. The mothers often fail to recognize that their thoughts are bizarre.
The symptoms include:
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Paranoia.
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Delusions (strange thoughts).
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Mood swings.
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Extreme irritation.
What Are the Mental Health Benefits of Breastfeeding?
Breastfeeding is one of the important risk factors associated with perinatal mental health disorders. Breastfeeding has been found to have a protective effect on maternal health.
1. Breastfeeding and Stress Response:
There is a strong relationship between breastfeeding and stress responses. Studies have shown that levels of certain hormones related to one’s mental health, like norepinephrine, ACTH (Adrenocorticotropic hormone), and cortisol levels, are reduced in lactating mothers.
Breastfeeding also reduces the activation of the HPA (hypothalamus-pituitary-adrenal) axis, a stress pathway in the brain. The activation of the HPA axis leads to decreased sleep and self-efficacy. Breastfeeding reduces HPA axis activation and limits glucocorticoid secretion, further reducing postpartum depression symptoms.
Breastfeeding hormones like prolactin and oxytocin promote a feeling of well-being and relaxation.
2. Improved Self-efficacy:
The more self-efficacy, the fewer the chances for postpartum depression. Breastfeeding mothers are found to have higher levels of self-efficacy and confidence level, which reduces the risk of postpartum depression.
Breastfeeding mothers are also found to have better mother-infant bonding when compared to non-breastfeeding mothers. A weakened mother-infant bonding is found in cases where the mother is depressed and in cases of non-breastfeed mothers. In such cases, the infant is less irritated and positively responds by showing more vocalization and physical contact with the mother. This further reduces the depression symptoms in the mother.
3. Sleep and Breastfeeding:
Breastfeeding affects the sleep-wake cycle of the infant and the mother. Getting proper sleep reduces the mother’s fatigue which further reduces the risk of depression. Studies showed that breastfed mothers slept 2.5 hours more than non-breastfed mothers after delivery.
Reduced nocturnal sleep has a great impact on the mother’s mental and physical health. Some studies also suggest an association between prolactin levels and deep sleep. Adequate sleep is not only important for a mother’s mental health but also ensures proper breastfeeding ability.
4. Early Breastfeeding Cessation:
Studies have shown that prenatal depression is linked to late initiation of breastfeeding and postnatal depression is linked to shorter breastfeeding duration. Postpartum depression and breastfeeding have a bidirectional relationship; that is, depression can lead to early breastfeeding cessation, and early breastfeeding cessation leads to postpartum depression.
What Are the Different Factors That Affect the Ability to Breastfeed?
The factors that affect one’s ability to breastfeed include:
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Psychological factors like anxiety, stress, and depression.
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Obesity disrupts proper milk flow due to adipose tissue deposition between the ducts in the breast.
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Diabetes delay lactogenesis due to reduced prolactin concentration.
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Thyroid issues affect hormonal levels, affecting the ability to lactate.
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Breast surgeries can change the anatomy of the mammary gland and affect the mother’s ability to lactate.
Apart from the above, social, personal, environmental, and cultural factors also affect one’s decision to breastfeed.
What Are the Challenges One Faces During Breastfeeding?
The main challenges one faces during breastfeeding are:
1. Pain:
The common challenge faced by breastfeeding mothers is severe nipple pain, which can lead to early breastfeeding cessation. Adequate support and education on proper positioning and lactation techniques can reduce the pain associated with breastfeeding. This pain can be distressing for the mother and affect her mental health.
2. Insufficient Milk Supply:
Hormonal or biological factors may result in an insufficient milk supply. This can lead to maternal mental health issues as the mother feels incapable of fulfilling the infant’s needs. The hungry and crying baby further adds to the stress.
Postnatal depression can also lead to insufficient milk supply in mothers.
Conclusion
Breastfeeding offers a lot of benefits to both the mother and the infant. It helps build a better mother-infant bond, increases the mother’s confidence levels, and reduces the risk of many chronic conditions, including the symptoms of postpartum depression. New mothers need individualized care, education, and support to breastfeed properly. Proper education on the same and a good support system can increase the breastfeeding rate among mothers, which further contributes to better maternal health.
