What you Need to Know About Breastfeeding and Parent Mental Health

Breastfeeding has important health benefits for babies and their parents. When all goes well, breastfeeding can have a positive impact on parents’ mental health by reducing rates of postpartum depression, increasing confidence, and facilitating parent-baby bonding. However, as many of us who have breastfed before know, it doesn’t always go well.

Breastfeeding is a learned behavior for both baby and parent that requires guidance, love and support. Not only that, but considerable work leave is required to establish and maintain a sustainable milk supply for a newborn. Fathers in the United States face an uphill battle over breastfeeding as they navigate parenthood without paid leave. Additionally, many parents have lost generations of breastfeeding knowledge and find themselves managing newborn responsibilities without the help of extended family or community networks.

If complications arise when trying to breastfeed, this can affect the mental health of the parents. In an article published in Advances in psychiatry and behavioral healthMy fellow researchers and I summarized different ways that breastfeeding complications and mental health can affect each other.

Pain and complications

Some parents encounter immense pain and difficulty in the first days and weeks of breastfeeding. Because a parent supplies breast milk every two to three hours to meet the feeding needs of a growing newborn, it can place a high level of physiological and emotional stress on the person experiencing that pain.

Some examples of breastfeeding complications are:

• Clogged milk ducts
• Thrush
• Breast swelling (engorgement)
• Fissures (cuts) in the nipples
• Mastitis (breast infection)

Complications are often related to the baby latching on to the breast and require the help of a lactation specialist, such as an International Board Certified Lactation Consultant (IBCLC). Having these complications can put the breastfeeding or breastfeeding parent at risk for higher levels of depression and anxiety.

Additionally, some parents experience a dysphoric milk ejection reflex or D-MER. D-MER is a condition that causes intense negative emotions during letdown or release of milk, whether breastfeeding, pumping, or expressing milk. These intense emotions resolve quickly once the milk flows and typically last between 30 seconds and two minutes. Research is ongoing and there are currently no treatments available. The important thing to remember with D-MER is that it is a reflex and not something the breastfeeding mother can control.

Milk supply

When breast milk comes back in during the first week after delivery, some parents experience intense engorgement (swelling of the breast tissue) and excess breast milk. Others have fewer milk-producing glands and worry that they are not producing enough breast milk to support their baby’s growth.

Both problems can lead to more sleep disruptions, anxiety, and obsessions. With an oversupply, parents have to work carefully to keep bloating and pain at bay, as well as reduce milk production without compromising long-term milk supply. This almost always requires working with a lactation professional.

With insufficient supply, parents can have intense anxiety, sometimes leading to obsessive-compulsive behaviors, regarding their baby’s weight and growth. Stress can impede the flow of breast milk, further aggravating the problem. Visiting the pediatrician can become a stressful experience weighing newborns, and parents often receive conflicting advice from health professionals about how to proceed with feeding.

Autonomy

An important theme that emerged from the research was the importance of parents having autonomy over their food choices. When parents had different intentions and expectations for their breastfeeding journey than they actually did, it put them at greater risk for postpartum depression. This included both the desire to breastfeed and the desire not to breastfeed.

Other psychiatric conditions

Current research overwhelmingly lacks studies on breastfeeding in parents with pre-existing mental health conditions, such as obsessive-compulsive disorder (OCD) and bipolar spectrum disorders. We don’t know the details of how those conditions affect parents’ infant feeding process and postpartum mental well-being. Sleep disruption is a known trigger for people with Bipolar spectrum disorders and postpartum depressionmaking breastfeeding on demand during the night a potential challenge. It is important that all members of a person’s care team are informed to help the family make appropriate risk decisions and have support at home when the baby arrives.

Feed the baby and care for yourself

So how can you and your partner best prepare for feeding your new baby while taking care of yourselves? This question is especially important for those, like me, who have pre-existing mental health issues.

Education is a great place to start. Take a breastfeeding course with your partner. Read a little about vetted resources like mom kelly and La Leche League.

Know all your options and discuss them with your care team before you conceive or during pregnancy. Talk to your mental health provider about your wishes to breastfeed or not. Talk to your pregnancy care team about your mental health concerns.

Build your support network. Compassionate support from other parents who have been there can lift your spirits on a difficult day. Look for local parenting groups in your community or find support online with International postpartum support. Having support at home from a family member, postpartum doula, or visiting nurse after your baby arrives can also be beneficial in supporting your feeding goals and well-being.

Find the experts. Use a resource like The Breastfeeding Network to find a local team of nutrition experts who are knowledgeable in mental health care. Use the Anxiety and Depression Association of America’s provider search tool. Postpartum Support International also offers a national supplier directory of professionals specialized in perinatal mental health.

Be kind to yourself. Things don’t always go as planned and that’s okay. Give yourself a lot of grace. Speak up when you’re worried or overwhelmed. Be open to receiving help. There are many ways to be a loving father.

Sources):

1. Thompson, L., Leistikow, N., Smith, M., & Standeven, L. (2024). The relationship between infant feeding and maternal mental health: clinical vignette. Advances in Psychiatry and Behavioral Health, 4, 135-145. https://doi.org/10.1016/j.ypsc.2024.05.005
2. Perry, A., Gordon-Smith, K., Lewis, K.J.S., Di Florio, A., Craddock, N., Jones, L., & Jones, I. (2024). Perinatal sleep disruption and postpartum psychosis in bipolar disorder: findings from the UK BDRN pregnancy study. Journal of Affective Disorders, 346, 21-27. https://doi.org/10.1016/j.jad.2023.11.005
3. Leistikow, N., Smith, M. (2024). The role of sleep protection in the prevention and treatment of postpartum depression. Perinatology Seminars, 48. https://doi.org/10.1016/j.simperi.2024.151947