Postpartum Depression!! not to be ignored!

Hi everyone

This week I had the pleasure of attending the Grande Conference of the Association of Lactation of Quebec. Going to conferences is always so stimulating and fun. You not only get to meet colleagues but you get to listen to great speakers!!
The first day monday was on postpartum depression and the new paradigm. We had the pleasure of listening to an amazing speaker, Kathleen-Kendall Tackett. I learned so much on the subject. I thought it would be interesting to share with you some of the key elements.
Post-partum depression is sometimes not always talked about because of the stigma attached to it. Many mothers go untreated just because they do not get the appropriate help and first of all diagnoses. Breastfeeding also gets blamed easily with postpartum depression. Certain cultures say that 10-20% of mothers get postpartum depression but some people think that the numbers can actually be as high as 40-50%.
The old paradigm thought that the drop in estrogen and progesterone were some of the triggers for postpartum depression. Other risk factors identified were stress, pain, lack of sleep, inflammation, psychosocial trauma and a history of depression and anxiety.
The new paradigm and the latest research identified that the inflammation is actually the main trigger in postpartum depression and depression. Inflammation underlies all the other risk factors. It was found that the more inflammation you have in your plasma, the more depressed you may be. Normally, we can manage stress but when our system balance does not work you can not handle it and you start secreting some inflammatory components. You then add all the other possible triggers and your chances of having postpartum depression becomes very high!
The pro-inflammatory cytokines rise in the last trimester of pregnancy therefore mothers are at higher risk of depression in the last trimester. Moms that are showing signs of depression during pregnancy should be treated! It was shown that depression and anxiety increase the risk of preterm birth.
Breastfeeding is known to reduce these inflammatory cytokines because it has a calming effect on mothers and reduces stress and the stress response. It is key to help moms preserve their breastfeeding during these difficult period. Depression does change the way moms interact with their baby. It was also shown that depressed breastfeeding mothers touched, stroked and looked at babies more than depressed non-breastfeeding mothers. Breastfeeding is therefore good for mom and baby!!!
However if mom is experiencing breastfeeding difficulties and nipple pain, they were at higher risk of getting postpartum depression (38% versus 14%). This makes sense as it increases stress and inflammation therefore more at risk! So it is key to help mothers get out of breastfeeding pain and problems as quickly as possible. When the pain is gone ( i.e. inflammation is reduced ), the mood usually returns to normal.
She talked about the various treatment options for mothers . The traditional treatments such as antidepressants are sometimes necessary for a short course to get the mothers back on track. It should be noted that there is no contraindication to nursing with most of the antidepressants prescribed. Some alternative options such as omega 3 supplementation have been shown in many studies to help relieve depression. St- John’s wort is also an herb used to treat mild to moderate depression. It is important to mention to moms that there are alternatives when they decide which way to go when it comes to treating depression.
This was a quick summary but you can find a lot more information on her web sites. I am also including the abstract of her article that talks about it. If you would like the full article email me and I will forward it to you guys.
I hope you will pay attention to mothers around you and see if they are suffering from depression. Don’t be shy to get help if you are worried!!

International Breastfeeding Journal

Review Open Access

A new paradigm for depression in new mothers: the central role of

inflammation and how breastfeeding and anti-inflammatory

treatments protect maternal mental health

Kathleen Kendall-Tackett*

Address: Family Research Laboratory, 126 Horton Social Science Center, 20 College Road, University of New Hampshire, Durham, New

Hampshire, 03824, USA

Email: Kathleen Kendall-Tackett* –

* Corresponding author


Background: Research in the field of psychoneuroimmunology (PNI) has revealed that depression

is associated with inflammation manifested by increased levels of proinflammatory cytokines.

Discussion: The old paradigm described inflammation as simply one of many risk factors for

depression. The new paradigm is based on more recent research that has indicated that physical

and psychological stressors increase inflammation. These recent studies constitute an important

shift in the depression paradigm: inflammation is not simply a risk factor; it is the risk factor that

underlies all the others. Moreover, inflammation explains why psychosocial, behavioral and physical

risk factors increase the risk of depression. This is true for depression in general and for

postpartum depression in particular. Puerperal women are especially vulnerable to these effects

because their levels of proinflammatory cytokines significantly increase during the last trimester of

pregnancy – a time when they are also at high risk for depression. Moreover, common experiences

of new motherhood, such as sleep disturbance, postpartum pain, and past or current psychological

trauma, act as stressors that cause proinflammatory cytokine levels to rise. Breastfeeding has a

protective effect on maternal mental health because it attenuates stress and modulates the

inflammatory response. However, breastfeeding difficulties, such as nipple pain, can increase the

risk of depression and must be addressed promptly.

Conclusion: PNI research suggests two goals for the prevention and treatment of postpartum

depression: reducing maternal stress and reducing inflammation. Breastfeeding and exercise reduce

maternal stress and are protective of maternal mood. In addition, most current treatments for

depression are anti-inflammatory. These include long-chain omega-3 fatty acids, cognitive therapy,

St. John’s wort, and conventional antidepressants.

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