Breastfeeding and Postpartum Depression

The relationship between breastfeeding and postpartum depression (PPD) is complicated. Years of research on breastfeeding and maternal mental health have mixed and often conflicting results. While the connection between PPD and breastfeeding is not fully understood, science shows there is a relationship.^1,2

What is postpartum depression?

Postpartum depression or PPD is a mental health condition that can affect mood, behavior, and physical health. PPD is common. Up to 20 percent of women are impacted.^1,3

Common symptoms of PPD include:^1,3

• Low mood
• Feelings of sadness
• Hopelessness
• Guilt
• Shame
• Worthlessness
• Extreme fatigue

Symptoms of PPD typically start within a few weeks of giving birth. These symptoms can develop during pregnancy or up to a year after giving birth.^1,3

Feeling a wide range of strong emotions and mood shifts is common after having a child. This is sometimes called the "baby blues." Baby blues symptoms usually get better within a few weeks. In contrast, PPD symptoms last longer and are more intense.^1,3

How does postpartum depression affect people?

Someone with PPD might not feel connected to their baby. They might not feel love for their baby. They may have a sense of ambivalence or disconnect to their child. Some people have thoughts of hurting themselves or their baby.¹

Mom and baby's physical health can be affected. PPD is linked to:⁴

• Poorer sleep quality
• Increased health concerns
• Increased chance of infant death

Breastfeeding and postpartum depression

The relationship between breastfeeding and PPD is complex. The connection is not fully understood by science because the results of research are mixed. To add to the difficulty of understanding the link, past studies may have had bias in terms of:^2,5,6

• Education
• Race
• Income

We know that there is an intertwined relationship between breastfeeding and PPD. According to the US Centers for Disease Control and Prevention, the direction of the relationship between breastfeeding and PPD is unclear. Does breastfeeding help protect against PPD? Or does it increase the likelihood of developing PPD? Does PPD impact breastfeeding?⁵

The relationship isn't completely clear

How breastfeeding and PPD are connected is difficult to determine because of many variables in a person's life. Some factors that can play a role are:^2,5,7

• Prior depression history
• Employment
• Relationship status
• External support systems
• Whether the pregnancy was planned

Finding a clear relationship between PPD and breastfeeding is challenging. Women with depression might have trouble starting or continuing to breastfeed. Or it may be that women who have problems breastfeeding develop depression.⁷

Can nursing affect the risk of depression?

Some studies show that breastfeeding can help protect against PPD. Breastfeeding promotes the release of hormones like oxytocin. Oxytocin can have a positive impact on mood and stress levels. This could be part of the reason why people who breastfeed are more likely to report:^1,2

• Less anxiety
• A good mood
• Increased calmness

While past research may be conflicted, there are a few clear trends. Experts agree that women who breastfeed exclusively are at lower risk of developing significant PPD.^4,6

One large study looked at tens of thousands of women. The study took into account many things that could affect the relationship between PPD and breastfeeding. This study found that women who breastfed had a much lower PPD risk than those who did not. It also found that the longer women breastfed, the more their risk of PPD decreased.⁶

Difficulty breastfeeding

Some women may want to breastfeed but are not able to. Challenges that prevent breastfeeding include:^1,2

• Low milk supply
• Pain while breastfeeding
• Problems with latching
• Infant health conditions
• Mother's health condition or medicines

Breastfeeding challenges may lead to frustration or stress. And these feelings could make PPD symptoms worse. Some research suggests these challenges might be a risk factor for developing PPD.¹

Pressure from society and the idea that breastfeeding is the best way to feed a child may also affect a mother’s mental health. Some women may feel ashamed if they cannot or choose not to breastfeed. That stigma may harm a mother's overall mental health.²

How might postpartum impact nursing?

Some research shows that PPD can impact the decision to start breastfeeding. Women with PPD may be less likely to try breastfeeding. Studies also show that PPD can lead women to stop breastfeeding earlier.⁶

Everyone’s experience with breastfeeding is different. Some new moms with PPD may have difficulty with breastfeeding. Others may not have challenges and so have a better experience.^2,5

Support makes a difference

The decision to breastfeed is personal. Some women may not have the choice. Doctors, therapists, and lactation consultants can help new moms address depression and breastfeeding.^2,5

If you think you or a loved one may be experiencing postpartum depression, contact your doctor right away. If you have thoughts of hurting yourself or dying, contact the Suicide and Crisis Lifeline by calling or texting 988.