Postpartum depression is a serious illness that can be debilitating and even life threatening. Most women and men are completely in the dark about how it happens and how to prevent such an episode. We are going to go into some detail about postpartum depression and steps that the whole family can take to both prevent and recover from an episode.  

There are 2 main causes of postpartum depression, both of which are heightened by a lack of sleep:

Chemical Imbalance

Some people develop an imbalance of chemicals in the brain through any of the following means:

  • Not getting a minimum of 8 consecutive hours of sleep.
  • Hormonal changes.
  • Vitamin/Mineral deficiency.
  • Genetic mutation.
  • Unexplained inability of the body to produce specific neurotransmitters properly. 

Note: Those with severe forms often require regular sleep (minimum 8 consecutives hours per day), regular monitoring by doctors, supplements and even long-term use of medication. For such people, staying on medication during and post pregnancy may be the only option and their doctors will often completely advise against breastfeeding altogether.

Burnout

A burnout is a form of depression caused by putting a lot of energy into something and not feeling like you are getting enough positive energy back. Although most people associate this type of depression with the workforce, it is extremely common amongst mothers with young infants for the following reasons:

  • The constant feeding means women are not getting enough consecutive hours of sleep.
  • The reality that all the baby does the first couple of months is eat, sleep and soil themselves can seem like an endless tunnel.
  • There is an unrealistic expectation that breastfeeding will be easy because it's "natural" and lots of bullying against those that are forced to switch to formula. 
  • The constant criticism from other people who think they are helping but actually are not.

Prevention Plan

We have put together a postpartum depression prevention plan. We recommend doing as much planning as you can during the pregnancy to speed up recovery time if an episode occurs. If you are interested in courses, take them while you are pregnant and have the time.

Note: If a mother has ever experienced a depressive episode in their life, we recommend planning for the worst. This means that breastfeeding may have to be sacrificed entirely for the health of the mother. 

Prenatal Supplements, Vitamin D & DHA

A mother should continue taking her prenatal supplements, vitamin D and DHA for the following reasons:

  • All the blood loss during delivery and postpartum can affect hemoglobin levels leading to anemia. This means less energy, feeling even more tired and a weaker immune system. Continuing to take prenatal supplements will ensure the mother is getting the appropriate vitamins to produce hemoglobin (i.e. iron, B12 and folic acid).
  • Lack of sunlight for the mother can lead to vitamin D deficiency. Similar to low hemoglobin, this will lead to less energy, feeling even more tired and a weaker immune system.
  • The non-stop care of a newborn and lack of sleep lead to poor eating habits. We recommend that breastfeeding mothers continue to take supplements to ensure the baby is getting the appropriate nutrients to develop properly.

Choose a lactation consultant ahead of time

  • Choose a lactation consultant before the baby is born. Try to find one that can book appointments quickly.
  • If there are any issues (e.g. latch problems, bleeding nipples, infection, lack of weight gain) contact the lactation consultant right away. 

Note: Some lactation consultants will do everything they can to avoid formula feeding; they may even bully you. If you or your spouse feel that you have tried everything and that it is affecting your sanity, it is probably a good idea to switch/combine formula.

Choose bottles ahead of time

  • Unless a doctor has completely advised against breastfeeding we recommend choosing bottles that best resemble the mother's nipples to avoid nipple confusion.
  • Reflux in babies is caused by the lower esophageal sphincter (LES) not closing properly allowing fluid to travel back up the esophagus. This is quite common in babies under 6 months and can affect both the comfort and weight gain of a baby. For this reason, we recommend choosing bottles that minimize bubbles/colic ahead of time.

Choose an infant formula as a backup ahead of time

  • Choose a formula during the pregnancy. If it is a formula that takes time to order (e.g. Top-Rated in the World Hipp Formula) or if the mother has already suffered from depression in her life, order in advance.
  • Aim for a lactose based formula, the primary ingredient in breast milk. Non-lactose based formulas tend to be sweetened with glucose syrup or another type of sugar which can lead to an increased chance of digestive issues, obesity later in life and tooth decay when the teeth come in.

Probiotics

We recommend having probiotics on hand for the following reasons:

  • Probiotics are a great way to build up the immune system of the baby, especially if a mother cannot breastfeed and is therefore unable to provide colostrum.
  • If a child requires antibiotics or has gastroenteritis, administering probiotics will ensure the baby rebuilds their good bacteria preventing future illnesses.

Limit visitors and assign tasks ahead of time

  • Limit visitors to family or close friends that can help you with specified non-baby related tasks (e.g. cooking, cleaning, groceries) and inform them in advance.
  • Try to delay less task-oriented out-of-town visitors by at least a couple of weeks until the baby is successfully gaining weight and the parents feel they have bonded with the baby. Have them stay at someone else's house.
  • To avoid arguments, inform people during the pregnancy that visitors will be limited the first couple of months.
  • Avoid anyone with a sick family member in their house.
  • Avoid young children. 

Have the baby sleep in their own room

We recommend having the baby sleep in their own room from the day they are brought home for the following reasons:

  • Mothers are so in tune to their baby's cry that, being in the same room, they will wake to every stir and whimper and never get any quality sleep. 
  • Babies wake often and fall back asleep. Filtering out the quieter cries means they will learn to self-soothe.
  • Babies get used to habits from the day they are brought home. This means that if all they've ever known is sleeping in their own crib in their room at night, they will never have to be sleep trained.

Organize shift work

To recover from any depressive episode, an individual requires a minimum of 8 consecutive hours of sleep each day for an extended period of time. Here are steps to take to make sure the mother gets the required sleep:

  • During the pregnancy, choose a backup person to take over all-baby related tasks during the mother's sleep shift (e.g. spouse, close family member, night nanny).
  • Choose a shift, the same time each day, of at least 8 consecutive hours when all the mother's duties will be taken over (e.g. feeding, diaper changes).

Seeking medical care

  • Speak with your gynecologist ahead of time to find out which doctor you should contact in case you start experiencing signs of depression.
  • If you are the spouse and the mother shows any signs of suicidal thoughts, bring her to the hospital and do not leave her alone with the baby.
  • Trust your doctor's judgement and don't feel guilty if your doctor recommends that you stop breastfeeding and that you go on medication.

Note: The spouse is often better at predicting when a depressive episode is about to happen than the mother. We recommend mothers to trust their spouse's advice when it's time to get external help.

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