A recent research article, posted by The Postpartum Stress Center on Facebook, looks into the relationship between postpartum depression and breastfeeding.
The findings? Women who breastfeed are less likely to experience postpartum depression.
Here’s what The Postpartum Stress Center had to say about the study on Facebook:
“Uh-oh. Here we go… research shows reciprocal relationship between PPD and breastfeeding. Women who breastfeed were more likely to have PPD and women with PPD were less likely to breastfeed. Now, that being said – this is NOT what I see in my clinical practice. In fact, we see more evidence of women feeling BETTER when they stop breastfeeding. For a number of reasons that vary from woman to woman. This is why it continues to be important that we read the studies, but not jump to conclusions that may not relate to each individual woman.”
Here’s my reaction:
- Small study – only 137 women
- Mentions employed mothers who were formula feeding but the abstract makes no mention of employed breastfeeding/pumping mothers.
As a blogger focused primarily on Postpartum Mood Disorders and emotional health for moms, this study raises my hackles.
I’ve blogged about the whole breastfeeding v. not-breastfeeding thing during a Postpartum Mood & Anxiety Disorder thing before – several times- and each time, I conclude the same thing.
YOU have to do what is BEST FOR YOU. It doesn’t matter what anyone else says, it doesn’t matter what the research says, it doesn’t matter what is best for baby food-wise. What matters here, the most, is that you are addressing your needs, healing, and doing so in a manner which alleviates the most stress and anxiety for you.
Your motherhood journey is just that – yours.
The only thing which matters is that you, your baby, and your family, are thriving. If your path includes breastfeeding, great. If it doesn’t, that’s great too. When you struggle with a mental illness, your emotional health absolutely comes before everything else –at least in my book it does.
If you wanted to breastfeed but find it’s too stressful because of your Postpartum Mood & Anxiety Disorder, talk it over with your care-provider. Let them help you make your decision but don’t let them pressure you into continuing simply because the research claims breastfeeding is “protective” against PPD. Guess what? You’re already struggling. So unless breastfeeding is the ONE thing to which you’re clinging and the ONE thing which helps you heal, helps you feel like you matter, it’s OKAY to stop.
It’s okay to use formula.
Frankly, it’s sad we have to give ourselves permission not to breastfeed in this day and age. Moms use formula for a variety of reasons –as long as baby is growing, healthy, happy, and loved, it shouldn’t matter what form of nutrition is used.
So go. Do what feels best for you, for your family, and for your sanity –and don’t let anyone judge you for it.
In a new study appearing in the Journal of Pediatrics, researchers discovered a tie between Postpartum Depression and domestic violence. The study, Postpartum Depression and Intimate Partner Violence in Urban Mothers: Co-Occurrence and Child Healthcare Utilization, focused on urban mothers and screened for both Postpartum Depression and domestic violence during pediatric visits for children.
Of those screening positive for Postpartum Depression, 7% also screened positive for “intimate partner violence” according to the researchers. Also according to the study, 60% of those who screened positive for intimate partner violence also screened positive for Postpartum Depression. an interesting side note is that mothers screening positive for Postpartum Depression in this study were more likely to take their children to the Emergency room. Perhaps this is related to the higher level of anxiety and worry we experience during a Postpartum Mood & Anxiety Disorder.
The most important thing to keep in mind as a result of this study is that the researchers did not definitively determine cause/correlation between Postpartum Depression and intimate partner violence. When you’re in an abusive relationship, it can be difficult to leave for many reasons. It may cause depression or you may “allow” the abuse for longer if you are already depressed. It’s a very fine and exhausting line on which to find yourself teetering.
There is always help and hope available though.
For those with Postpartum Depression, visit Postpartum Support International’s website to find a coordinator near you.Or call the warmline at 1-800-944-4PPD.
If you’re in an abusive relationship, you can find help throughout the United States through The Hotline.
You’re not alone, there is help, and there is hope.
From time to time, I’m contacted by Graduate students and researchers asking me to share their work in the realm of Postpartum Mood & Anxiety Disorders.
If you have given birth within the past two years and feel up to completely a relatively painless survey (I’m told 10 minutes or less), I know the researcher would really appreciate it. She’s part of a class project at Emory University in Atlanta.
A quick note from the grad student: “All information is anonymous and will be kept confidentially. We really appreciate your help in learning more about postpartum.”
Thank you for sharing your experience!
(Also – please pass this on to anyone you think may be willing to also complete the survey or knows someone who would be willing to do so!)
All across the globe, there are Researchers dedicating their lives to exploring all aspects of Postpartum Mood Disorders. Many of these researchers work in clinics, some are purely academic, and others review the research of others and present a compilation to conclude results.
Clinicians (for our purposes here) are trained in a variety of professions from therapists to psychiatrists to psychologists. These are the professionals on the front line. Some may be trained specifically in Postpartum Mood & Anxiety Disorders while others may be largely unware of the nuances of these conditions.
Medical Professionals often see Postpartum Women prior to a Clinician is involved. These are General Pracitioners, Family Practice doctors, Pediatricians, Obstetricians, Midwives in some areas, ER doctors, nurses, etc. These professionals again, may or may not have additional specific training in Postpartum Mood & Anxiety Disorders yet it is highly unlikely they are familiar at all with the nuances involved.
Peer Support Advocates are in the trenches. These may be made up of survivors, passionate and informed Clinicians, nurses, pediatricians, IBCLC’s, doulas, and a number of other people various walks of life. They become Peer Support Advocates for various reasons but largely due to personal experience from either a lived experience or the experience of a loved one.
Struggling Patients are in the thick of a Postpartum Mood & Anxiety Disorder, often navigating the system for the very first time. Many of them have never had a mental illness before giving birth or pregnancy. They are not familiar with their rights, the issue of medication, diagnosis, follow-through, or where to turn for help. They are filled with guilt, shame, and fear. These families and patients are often afraid to speak up and reach out for help. But their voices are increasing. Yet they are still echoing into an empty cavern as they scream out for the help they so desperately need.
Peer Support Advocates often are the first to hear the cry of the struggling patients. We work with them to find knowledgeable support in their locale. While the possibility of connecting these patients with knowledgeable or compassionate care is increasing, often times, we find ourselves up against a brick wall riddled with barriers to treatment. The biggest barrier is lack of knowledgeable local referrals. Primary referral in many areas is often to an uninformed or untrained Medical Professional.
An uninformed Medical Professional may do more harm than good with a Postpartum patient. He or she may erroneously take the DSM guidelines to heart, refusing to acknowledge a Postpartum Mood Disorder if the patient had her baby more than four weeks prior to presenting with symptoms. Nevermind that the APA itself admonishes the usage of the DSM in such a manner. If the non-mental health trained Medical Professional is informed, then the patient may find herself ushered higher up the ladder into the office of a professional Clinician trained to deal with psychiatric illness and disorders.
Clinicians are not always trained in Postpartum Mood & Anxiety Disorders. Therefore, it’s important for the patient to know what questions to ask when making an appointment with a specialist in the psychiatric field when seeking help for a PMAD. Questions like “Have you been trained in Perinatal Mood Disorders?” or “By whom have you been trained?” or “How long has it been since you were trained?” or “What is your approach to treating PMADs?” are all excellent questions someone who has been trained in Perinatal Mood Disorders would be comfortable in answering. A good clinician will answer honestly that he/she has not been trained but is willing to learn. He/She should offer her viewpoint on treatment and not force you into accepting their way or the highway. A good (and informed) clinician will also keep up with the latest research regarding PMADs.
Researchers are often not in the field with patients. On rare occasion they are clinicians themselves. Many are academic researchers. These researchers study everything from epidmeology to treatment to type of Perintal Mood Disorder, to risk factors, to contributing factors, birth trauma, etc. The issue with Researchers comes in when their research is manipulated, funded by Pharmaceutical companies, involves retro-data, a small data group, or a limited field in which some factors are not viable simply because the size of the group or source of the group is inherently flawed or for some other various reason. This is not to say that all research should be thrown out the window. It shouldn’t be at all. BUT it is important to be able to distill the research with a keen eye and apply some common sense to the outcome.
This is where Clinicians, Medical Professionals, and Peer Suppport Advocates come into play. Anyone trained or in contact with experts in the field of Perinatal Mood Disorders will be able to help you recover. Even those not well-trained but well-meaning and open-minded will be able to help you. If your Clinician, Medical Professional and Peer Support Advocate is willing to help formulate (or find) help which fits your personal lifestyle and belief system, your chances of recovery increase. But if you have a Clinician, Medical Professional or Peer Support Advocate who is closed off to certain avenues of treatment due to a certain aspect of your own life such as breastfeeding, other children, pregnancy, etc, then you may want to continue looking for help elsewhere.
In light of the new guidelines in the DSM-5 which will keep the Postpartun Depression Identifier at 4 weeks, we need to work to get those involved in care for Postpartum Women struggling with disorders talking with each other instead of at each other or indirectly with each other via research, peer support survivors, and trainers, etc. But how do we do this?
How do we get the researcher to share with the Clinician their goals, interests, and conclusions? How do we then get the Clincian to spark interest in the Medical non-specialist Practioner to learn about Perinatal Mood & Anxiety Disorders? Then how do we plug in the Peer Advocate and the patient? How do we open the discussion between Professional, Peer Advocate, and patient? How do we keep the communication going once it’s started? What will it take? How many more tragedies must we endure before everyone involved is ready to talk and on the same page?
Enough is enough. We need to stop talking at each other, around each other, to each other and instead talk WITH each other. Until we do, innocent women, children, and families will continue to struggle, suffer, and possibly even die. I am not willing to let that happen. Are you?
Speak up. Say something. EVERY Word makes a difference. Every.Word.
I had a friend of mine contact me today asking if I’d spread the word she’s in need of some research about Postpartum Depression & Domestic Violence victims for a current project. She is specifically “looking for research that demonstrates victims of domestic violence are at a greater risk of developing perinatal depression and also for research that demonstrates a history of sexual assault being a risk factor.”
Please direct any links, research, further questions you have to firstname.lastname@example.org.
Thanks wonderful readers!
Something is afoot.
Something strange, disturbing, and downright irresponsible.
Sadly, I am not surprised at this recent development given what a hot topic Postpartum Mood Disorders has become of late in relation to recently (passed!) legislation and the courage of more and more mothers speaking out about their own difficult experiences after the birth of a child.
More and more, I have been receiving very odd links in my Google Alerts for several Postpartum Mood Disorder related search terms. These links lead to websites that have absolutely nothing to do with anything maternal, postpartum, baby, family, or any other related topics. And the information included therein is anything but accurate or reliable.
Even worse, I’ve been seeing a lot of new websites crop up with blanket promises of “Curing” postpartum depression for one low price. (One website even includes a friends and family “coupon” which cuts the price in half just for you!)
My stomach has been churning at the very thought of at-risk women and well-meaning family members finding these sites.
Oh yes, ladies and gentleman, I’m talking about the spammification of Postpartum Mood Disorders.
I can tell the difference between a reliable website and an unreliable website.
Women who blog with me, survivors, experts, and others intimately familiar with the topic can tell the difference.
But what about women and families currently being tossed about on the big nasty Postpartum Sea? Can THEY tell the difference or will they fall prey to these deceptive tactics masquerading as effective life preservers in a hopelessly churlish sea?
Spamming is a disgusting and contemptuous act which has been going on for years. Many of our in-boxes sit full of spam. Some of it makes it through from the spam folder into our in-box making it seem even more reliable. And if one of these links were to make it into the in-box of an at-risk woman or a well-meaning but uninformed family member of a woman struggling with a Postpartum Mood Disorder, the results may prove ghastly.
So what are we to do?
How do we get educated and knowledgeable when it comes to dissecting the authority and reliability of a website?
There are a few steps you can take.
First, is the site’s URL address directly related to the topic you’ve researched?
Chances are that if you’ve researched Postpartum Mood Disorders or Depression and end up on a website for air conditioners, furniture, auto repair, or turf builder, you’re not at a reputable website.
Second, let’s say that the website you’re at DOES correlate to the topic you’ve researched and the word postpartum is in the URL address. That’s gotta be good, right? Well, yes, and no.
Does this website link to known organizations specializing in helping women with this issue? (Think Postpartum Support International) What’s their google page rank? Are they HON Code certified? (Think Postpartum Progress) What’s the story behind the person who put the website together? Are they clear about their training? Do they let you know they’re a Mom/peer supporter, a doctor, provide confirmable evidence of education/degrees/certifications? Can you find anything about them elsewhere? Have other bloggers or websites linked to them and endorsed them or mentioned them? Or are they only published at their specific website and other unreliable websites? (I don’t have a high Google Page Rank or an HONcode certification but I am working to improve my page rank and also toward an HONcode certification as well. I also over-research everything I put up here which is why sometimes I’m a little behind on posting about a hot topic. I’d rather get it right than have it up as soon as it happens)
Third – is the website trying to sell you something? Does the website promise a cure? Are they dismissive of an entire approach to treating Postpartum Mood Disorders?
If the website is really trying to get you to buy something without describing in detail what it is, you need to be wary. There is no one size fits all treatment. There is NO overnight cure for Postpartum Mood Disorders. Just as with all women, all pregnancies, and all deliveries, there are many different types of Postpartum Mood Disorders and they are rooted in different issues dependent on the history of the woman, the type of birth she experienced, her thyroid levels, anemia levels, etc. There are SO many different layers to uncover when it comes to a Postpartum Mood Disorder. It is dangerous to buy into a one size fits all approach. Just as labor is a fluid process subject to change at any moment given any circumstances, so is postpartum recovery. We all approach life with our own individualized chemistry and baggage. Matching sets don’t commonly occur out here in the real world.
The practice of Quackery has been around for eons and will unfortunately continue to exist as long as people are willing to grasp at any answers that may save them from their current condition. That being said, there are legitimate complementary treatments and alternative approaches available for treating postpartum mood disorders. Anyone worth their salt in dedication to helping women with Postpartum Mood Disorder will be open to supporting whatever path you choose to take toward wellness regardless of what type of methods you choose. In the same vein, anyone worth their salt will also strongly encourage you to work with medical professionals as you work toward wellness. Anyone worth their salt will also openly share their training, education, and base of knowledge with you as well. There should be no hidden cloak, no Wizard of Oz mumbo jumbo going on during your journey to wellness with a good provider.
Here are a couple additional links that may help you navigate your way through the 102,000 results you’ll get via Google in .20 seconds for Postpartum Mood Disorders:
What can you do if you fall victim to one of these websites? First, you can file with the FTC. And if you’ve lost money and care to pursue legal action, you are entitled to do so under something called the Lanham Act. You can also contact the Better Business Bureau’s Online department by clicking here. You can also click here for seven tips on how to keep your email address from getting added to the growing number of spam lists out there.
As more and more voices speak up about their experience with Postpartum Depression, more and more Snake Oil salesmen will crop up to take advantage of the growing searches occurring on the Internet for information. It’s sad and blasphemously tragic but such has been the way for ages with many medical conditions.
Bottom line: If in doubt, throw it OUT. That phrase is handy in the restaurant industry and certainly handy here too. If a link promises too much too fast or reeks of a foul distrusting odor, throw it out.
Tread carefully. Think it through. Talk to a professional. Take care of you.
Tomorrow we’ll be sharing tips on how to tell a good doctor/therapist from a bad doctor/therapist.
Have any tips or insights to share on this? Email me at ppdacceptance(@)gmail.com.
Be sure to check back to see if your tips/experiences were included!
Doctoral candidate Kristi Marshall at Trevecca Nazarene University in Nashville, TN, is studying postpartum depression in new mothers. She is currently seeking 18-40 year old women who are within 1 year of giving birth. A postpartum depression diagnosis is not necessary for participation. Kristi hopes this research will contribute to the understanding and treatment of postpartum mood disorders.
The questionnaires for this study will take about 10 minutes to complete. If you submit your email address you will be entered to win one of several $20 gift cards. You will be eligible if you complete the entire survey by December 31, 2009.
If you have any questions before participating, please contact Kristi at kmarshallcounseling(@)gmail(dot)com.
The questionnaires, with a consent form and instructions, can be accessed by clicking on the following link: Postpartum depression, attachment style and the mother-daughter relationship.
Please feel free to forward this information to other women who might be willing to participate!
While the title itself raises eyebrows, the researchers themselves state that they were unable to conclude if the results were because of medication or the underlying depression. Also important to keep in mind is that this research is based on women who had prescriptions filled for SSRIs but does not appear to have checked to see if these women actually took the medication. Instead, they rely on data from a national registry.
“Pedersen and colleagues analyzed national registry data on more than 493,000 births in Denmark from 1996 to 2003. The data included prescriptions filled by mothers-to-be as well as the medical status of their babies at birth.”
And directly from the study:
Our results, however, depend on a correlation between redemptions of prescriptions and drug use. Non-compliance might be a problem for this type of exposure definition and could mask true associations if some of the “exposed” were in fact unexposed.
The most interesting piece to come out of this research is that of the studied SSRI’s, Paxil appeared to have the least risk of septal heart defects. I find this very interesting considering that Paxil is the only SSRI to currently carry a heart defect specific warning.
As with all studies and research, you should always examine all sides and aspects and educate yourself rather than relying on the word of others when making your final decision. Ask yourself if the person presenting the information has your best interest at heart or is merely trying to frighten you with inflated facts and figures. (Click here to read a previous post full of tips on how to find solid medical advice on the web.)
Dr. Shoshana Bennett, author of “Pregnant on Prozac” released this statement regarding this research:
Finally, treatment for the serious and potentially life-threatening illness of prenatal depression (for both mom and therefore baby) is being formally discussed. Fifteen percent of clinically depressed pregnant women try to take their lives – a bit more risky for the baby than mom taking an antidepressant, wouldn’t you say? If the pregnant woman can be non-depressed without a medication, that’s optimal. Some form(s) of treatment, however is essential. If natural and alternative approaches to wellness are not enough, it is regarded by those in the know to be safer for her (and her developing baby) to take an antidepressant than to remain depressed. Depression itself – it is quite clear from the research – crosses the placenta and alters the uterine environment causing negative consequences to the baby. In the latest research there appears to be low (0.9%) chance of a septal heart defect in babies whose mothers had taken certain antidepressants. However, what fear-mongers do not report, is that the researchers themselves could not be sure whether it’s the antidepressant or the underlying depression itself that caused the defect. Women need all relevant information and education about options for treatment during pregnancy so they can make the best decision for themselves and their family. Watch out for alarmists who are not interested in actual data – they are simply invested in promoting fear in women who are at their most vulnerable.
Shoshana Bennett, Ph.D.
Increased risk was determined by “redemption” of more than one SSRI prescription. Those who redeemed more than one prescription had infants with a higher percentage of septal heart defects. But again this begets the question of whether or not this result lay with the SSRI or the underlying depression/mental illness/stress the mother may have been experiencing in order to receive said prescription.
Bottom line here: Don’t think for a second that becoming a Mom starts at birth. It starts at conception. And we owe ourselves AND our infants the best start possible. This means researching by asking questions and seeking out solid answers. It means finding physicians who will be your co-pilot instead of an uncooperative Auto-Pilot unaware of the pot-holes facing them. It means putting together the best support you can with what you have access to at the time. I happen to agree that a SSRI free pregnancy is absolutely optimal. I also think you should run (not walk) out of any doctor’s office if said doctor is quicker with the script pad than the warm shoulder. But we have to remember that every situation is different. Every person is different and every pregnancy is different. And sometimes we may just have to take medication. It doesn’t make you weaker, it doesn’t make you stupid, and it doesn’t make you a bad mom. And above all, remember that the decision to take or not to take a SSRI during pregnancy is your decision. Make it with an empowered spirit, stick to it, and don’t look back.