Mental Health Care for Postpartum Depression During Lactation

Lactation management is particularly important in the context of postpartum depression because symptoms of depression can both contribute to and follow premature weaning. I have worked with many lactating parents coping with postpartum depression who sought mental health care only to be told by a prior care provider that treatment required them to stop nursing or expressing milk for their little one. This is rarely true, but many care providers—and the parents they seek to serve—don’t know this.

Primary care providers and mental health care providers can have culturally-based misconceptions about the “appropriate” duration of nursing, be uncomfortable with a parent nursing or pumping during a therapy session, be unaware of the importance of the nursing relationship to a dyad’s overall well-being, or be otherwise insufficiently knowledgeable about the evidence-based management of lactation in the context of psychotherapy.

Therefore, parents who deeply value breastfeeding, chestfeeding, and/or providing their expressed milk to their baby often struggle to find lactation-compatible mental health care. They can feel stuck between a rock and a hard place: treat their postpartum depression and grieve having to prematurely wean or continue providing their milk while enduring untreated postpartum depression.

My newly updated information sheet, Mental Health Care for Postpartum Depression During Lactation, reviews barriers to lactation-compatible mental health care for postpartum depression, how to research potential care providers, and treatment options. The vast majority of treatment options for postpartum depression, including most psychotropic medications, do not contraindicate lactation. And, parents deserve the opportunity to make informed decisions about their options.

Here’s an excerpt of questions that can be asked to evaluate a practitioner’s knowledge and support of lactation:

• How long do you think it is healthy for breastfeeding/chestfeeding to continue?

• How do you feel about a client nursing in your presence during a counseling session?

• What are your views on parenting behaviors that facilitate breastfeeding/chestfeeding, such as sleep sharing, baby wearing, and physical closeness in the parent-baby dyad?

• How do you protect and support lactation while providing mental health care?

• How often do you recommend weaning or the introduction of artificial substitutes for human milk in order to treat postpartum depression?

Cynthia Good

You can read the full information sheet for free here. I hope you find it helpful!

Cynthia

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