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Postpartum Depression & Its Impact on Breastfeeding and Infant Growth

by Dr. Pooja Saini
Depression

What is Postpartum Depression?

The incidence of postpartum depression among women has increased these days. It is a serious mental problem that affects the women who have recently given birth. The symptoms of postpartum depression reach its maximum intensity in the first six months. These symptoms can further be prolonged until the end of the first postpartum year.

Such a depression not only affects the mother, but it has negative effects on the infant’s health too. Postpartum depression is characterized by low mood in new mothers, accompanied by feelings of worthlessness and sadness. Depressed mothers are less willing to continue breastfeeding because they are less confident about their ability to breastfeed as compared to mothers who are not depressed.

Symptoms of Postpartum Depression

Depression

The prevalence of postpartum depression is between 5 and 60.8% worldwide, reports a study. Different women experience different symptoms. The common symptoms of postpartum depression are:

  • Mood swings.
  • Sleep disorders or inability to sleep.
  • Changes in appetite.
  • Fear of injury.
  • Serious concerns about the baby.
  • Crying and sadness.
  • Difficulty in concentrating.
  • Sense of doubt.
  • Lack of interest in daily activities.
  • Thoughts of suicide and death.

These symptoms can further have a negative effect on the family health. Therefore, it is advised that susceptible women need to be identified before delivery so that they can receive proper care measures.

Risk Factors for Postpartum Depression

There are four major types of risk factors:

Psychological factors

Women with a previous history of depression and anxiety disorders are at a higher risk of postpartum depression. Such women are more susceptible to hormonal changes.

A history of moderate to severe premenstrual syndrome also affects the onset of postpartum depression. Fluctuations in serotonin, could trigger PMS symptoms. It further causes a drop in the level of tryptophan and induces postpartum major depression.

Obstetric Risk Factors

Studies have found that the risk of depression increases in women with more than 2 children due to the higher psychological burden. Other risk factors include emergency cesarean section and hospitalization during pregnancy.

Besides this, postpartum complications like umbilical cord prolapse and obstetric hemorrhages are also responsible for postpartum depression.

An interesting study found that mothers who give birth to low birth weight infants, less than 1.5 kilograms, are 4-18 times at risk for postpartum depression as compared to others.

Biological Factors

Age is a risk factor for postpartum depression. The risk of depression decreases with increasing age. In other words, young age during pregnancy increases the risk of depression. Gestational diabetes or glucose metabolism disorders also increases the risk.

Social Factors

Social factors that may lead to depression include financial support, emotional support and intelligence support.

Impact on Infant Growth and Development

Breastfeeding posture

Postpartum depression also affects infant’s growth and development. Let’s discuss the major effects:

Cognitive Development

Scientific studies have reported that maternal postpartum depression has a negative effect on the growth and development of the infant. Mother’s postpartum depression and anxiety influences the child’s mental development.

Such children are at a higher risk of impaired language acquisition at 12 months of age. Maternal postpartum distress delays the socio-emotional and cognitive development during the first year of life.

Depressed mothers are less infant-focused. As a result, mother’s speech and playtime with the infant is reduced. This may affect the speech and the learning process of the infant and may result in the delayed cognitive development.

Infant Growth and Development

Postpartum maternal stress and depression are associated with poor infant growth and development outcomes. Because there is a lack of interest in the daily activities, such mothers may come across more breastfeeding problems.

One reason for poor growth outcomes in infants could be an early cessation of exclusive breastfeeding. Depressed mothers are emotionally unavailable to their babies, which may be identified as a key factor in infant under-nutrition.

It is very well-known that breast milk is the best for infants, and it is loaded with an array of nutrients and bioactive compounds that are necessary for the physical as well as cognitive growth of the infant.

Studies have indicated that maternal mood may affect the infant feeding practices, and this can reduce the overall breastfeeding duration. Such a decrease may lead to an increase in the use of formula feeds or other kitchen feeds.

Hence, early intervention addressing maternal feeding attitudes may improve the extent of breastfeeding as well as overall physical growth and development in the infant.

Infant Mortality and Morbidity

Research-based studies have found that maternal depression after childbirth is associated with increased risk of mortality in children up to 5 years of age.

Postnatal period is a critical period for infant survival. This is the phase where mother-child bonding is formed. Because of depression mother may not be able to provide good quality care and nurturance to her little one.

Postpartum maternal depression could lead to poor mother-infant interaction and poor adherence to child survival interventions like childhood immunizations, good hygiene behaviors, safe food preparation of food and storage. Lack of prompt care seeking for childhood illnesses may lead to mortality.

Exclusive breastfeeding protects the infant against various illnesses and infections. Depressed mothers do not breastfeed their little ones regularly, which may make the infants more prone to infections.

Emotional and Social Behavior

Scientific studies have reported negative effects of being raised by a depressive mother on the infants. Such children have an increased risk of developing depression and psychiatric disorders.

Maternal depression reduces the ability of the infant to regulate his or her negative emotions. Emotional regulation serves an important role in the development of behavioral control.

Poor regulation is linked to greater expression of negative emotions. Postpartum depression affects the mother-child interaction, which makes the child less sociable. Such a behavioral disturbance continues way beyond infancy, up to the pre-school age.

Stress Management

Studies have observed that infants of depressed mothers have lesser ability to manage stress as adults as compared to infants who did not have depressed mothers.

Postpartum maternal depression interferes with the mother’s capacity to care for the infant. Such children exhibit poor neuropsychological and emotional skills across childhood and up to adolescence.

Depressed mothers cannot promote a growth-promoting environment for their little one. This affects the ability of the infant to manage psychological stress, regulate negative emotions and handle social processes. Therefore, maternal postpartum depression is a risk factor and it can disrupt physiological and social-emotional growth.

Infants’ response to stress is susceptible to the mother’s negative mood. The level of stress hormones is higher in children of depressed and anxious mothers. This causes lifelong disruptions to the stress response after exposure to maternal negative mood.

Role of Diet and Nutrition in Postpartum Depression

Foods

Foods

Lifestyle factors also contribute to postpartum depression. Lifestyle factors like irregular sleep pattern, food intake, exercise and physical activity may affect postpartum depression.

A nutritious and wholesome diet loaded vegetables, fruits, legumes, seafood, olive oil, may reduce the risk of depression by 50% in mother post-delivery, reports a study.

Serotonin is a happy hormone that induces a feeling of happiness and overall well-being. Vitamin B6 is required for the production of serotonin. A diet low in vitamin B6 may interfere with the production of this B-complex vitamin and increase the risk of depression.

An interesting study found that high intake of docosahexaenoic acid and seafood consumption is linked to decreased risk of maternal depression.

Among the micronutrients, lower intake of selenium and zinc is associated with incidence of postpartum depression. Zinc influences the serotonin uptake and acts as an anti-depressant. A deficiency of selenium develops thyroid dysfunction and causes postpartum depression.

Ayurveda for Postpartum Depression

Shirodhara

There are several ayurvedic therapies, which can help women suffering from Postpartum depression. These therapies are non-invasive and safer than allopathic medicines. Here is a list of these therapies, which you can read for more details:

  1. Shirodhara
  2. Ayurvedic Full Body Massage – Abhyanga
  3. Shiro Abhyanga (Indian Head Massage)

In addition to these therapies, ayurvedic treatment is also available for the management of Postpartum depression. You can consult ayurvedic practitioner for more details.

Summary

Maternal postpartum depression doesn’t just have a negative effect on the mother’s health, but it also affects the infant’s physical growth and development, cognition, social and emotional behavior and the way he/ she manages stress.

Identifying depression through early assessment and a proper treatment can improve the quality of life of the mother as well as the entire family.

Pregnant women should pay special attention towards her diet, nutrition, physical activity and sleep pattern. Erratic lifestyle patterns can also push a woman towards depression.

Healthy eating and healthy living can protect the pregnant and lactating women against depression and anxiety.

References

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