Wednesday 21 April 2010

Postnatal depression and breastfeeding - the right answer?

Today I am speaking to staff at the Wexham hospital at Slough and have been asked to focus on breastfeeding and postnatal depression. In doing so I have collated some of the latest developments around the subject.

I breast fed Dominic and it remains one of my favourite experiences EVER! The closeness, the bond, the skin-against-skin, the ultimate maternal feeling. For those who have read my book the paragraph on page 52, when we were staying in a hotel when he was a few months old describes this:-

'As I sat curled up on the settee with Dominic suckling me I felt a wave of love for him which I had never really felt before. He was staring up at me, gulping away, then he suddenly stopped, caught my eye and smiled at me. Milk dribbled over both of us, but I did not care. He was my baby and I loved him. His smell. His feel. His smile.'

I persevered through all the disturbed nights, the painful infection of mastitis and only was forced to stop when I was hospitalised without him. I forever feel robbed of the natural ending of that bond and one of the many reasons I fight to get more Mother and Baby Units.

On the other hand I wonder did breast feeding contribute to my puerperal psychosis? In some ways I held onto the fact that I was the ONLY one who could feed Dominic so I had to be the one who did the night shifts; I could never have a true break so I became exhausted. I saw myself as invincible and no one else could help. I tried a breast pump - ooch!!! Breast feeding became the only thing in my increasing chaotic world that I could control and was my weapon to push away offers of help. There were many other stresses that added to my illness but I have to say this might be considered as one.

Then there is the 'guilt' because everyone tells you 'breast is best' so you carry on because with postnatal depression you feel you are a bad mother any way so if you stop, then it makes you even worse!

In contrast my sister had her first baby on 14th February and was very poorly physically. Claire also wanted to breast feed but for various reasons it could not happen. She too felt guilt. Yet here we are weeks later, Claire is brilliant; the rest of us can't wait to have baby Sophie and fight to have her overnight so that Claire gets a rest - well, that's our excuse! In all honesty we just love being with her - although of course we are giving Claire as much support as she wants.

My colleague Ann Girling, http://www.onthethreshold.co.uk/ with whom I am doing day workshops for Children's centres, also feels that breast feeding is wonderful but the most important thing for a baby is that it is fed and LOVED!

The wonderful Katherine Stone has some great stories on her blog about this - look at Breastfeeding & Postpartum Depression: What Should Moms Do?!
http://postpartumprogress.typepad.com/weblog/2009/05/breastfeeding-postpartum-depression-what-should-moms-do.html
I agree with her statement
'Women must support each other in their choices, including breastfeeding. We all travel down different roads.'

There are some wonderful handouts and short articles on Depression in New Mothers written by Dr. Kathleen Kendall-Tackett at http://uppitysciencechick.com/ppdhandouts.html

I was fascinated by the article here on Should Mothers Avoid Nighttime Breastfeeding to Decrease Their Risk of Depression?

The studies show that advising women to avoid nighttime breastfeeding to lessen the risk of depression is not medically sound. 'In fact, if women follow this advise, it may actually increase their risk of depression'.

I also think that this document by the New Hampshire Breastfeeding Task force is very useful -
2010 Breastfeeding-Friendly Approach to Depression in New Mothers: A Curriculum and Resource Guide for Health Care Professionals (Contains several screening scales and questionnaires)
http://www.breastfeedingmadesimple.com/ppd_curric_final_2009.pdf .

This has all the evidence based research and ideas for helping mothers.

Other useful websites are:
http://www.breastfeedingmadesimple.com/index-home.html

/http://www.breastfeeding.nhs.uk/

http://www.breastfeeding.com/

http://www.breastfeedingnetwork.org.uk/

http://www.laleche.org.uk/

http://www.abm.me.uk/

http://www.linkable.biz/

So yes, I do agree that breast is best, but it is a decision that cannot be taken in isolation and as Katherine says, we must be able to offer support to a mother and baby for what is 'best' for them. We all have a duty to make informed choices, sometimes which may be taken from us, but whatever the outcome to be surrounded by non-judgemental support.

Elaine Hanzak

www.hanzak.com

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