Postpartum Anxiety And Breastfeeding

Introduction

Women are more likely to experience anxiety compared to men. In the US, 18.1% of adults suffer from anxiety. Women are 60% more likely to suffer from anxiety compared to males at some point in their life. Furthermore, between 7–10% of pregnant women in wealthy nations and 25% of pregnant women in poor nations feel anxiety. Additionally, approximately 16 per cent of German women who were tracked from 10–12 weeks of pregnancy to 16 months after giving birth reported feeling anxious throughout this period. While the relatively low prevalence of anxiety during pregnancy may imply that anxiety is uncommon, it still needs to be addressed. We need to learn more about if and how anxiety affects mother and child health during pregnancy and the postpartum period.

Postpartum anxiety is a type of anxiety that affects some women after giving birth. It can manifest as a range of feelings and symptoms that can impact the mother's emotional and physical well-being. It is essential to recognise the signs and seek appropriate support and treatment. Postpartum anxiety and breastfeeding are closely intertwined experiences for many new mothers. It refers to the anxiety that a woman may experience following childbirth. It is distinct from the more commonly discussed postpartum depression, although the two conditions can coexist. 

Signs and symptoms

• Excessive Worry: Constant and intrusive worries about the baby's health, safety, or well-being, as well as other concerns such as finances or relationship issues
• Fear of Harm: Intense fear that harm will come to the baby or oneself, often manifesting in obsessive behaviours like checking on the baby frequently
• Panic Attacks: Sudden, intense episodes of fear or panic, which can include symptoms such as  racing heart, sweating, dizziness, or shortness of breath
• Sleep Disturbances: Difficulty sleeping, staying asleep, or resting, even when the baby is sleeping
• Changes in Appetite: Changes in eating habits, which may include a lack of appetite or overeating
• Irritability and Restlessness: Increased irritability, restlessness, or feeling on edge
• Physical Symptoms: Muscle tension, headaches, nausea, or other physical symptoms associated with anxiety

Risk factors

• Previous Anxiety: A history of anxiety or mood disorders can increase the risk of postpartum anxiety
• Hormonal Changes: The hormonal shifts that occur after childbirth can contribute to anxiety
• Stressful Life Events: Major life changes or stressful events such as a difficult birth, health problems, or a lack of support can increase risk
• Sleep Deprivation: Lack of sleep, common for new mothers, can exacerbate anxiety

How postpartum anxiety can interact with breastfeeding

Anxiety and Stress Levels: Postpartum anxiety can increase stress levels in a new mother. Elevated stress can impact breastfeeding, as it might affect the mother's ability to relax and produce milk

Latching Difficulties: Anxiety can sometimes make it harder for a mother to establish an effective latch with her baby. The stress and worry about whether the baby is getting enough milk can create a cycle of increased anxiety

Concerns About Milk Supply: Mothers with postpartum anxiety may worry excessively about their milk supply, which could lead to more stress and anxiety

Support Systems: Women experiencing postpartum anxiety may benefit from increased support in their breastfeeding journey. This could include help from lactation consultants, healthcare professionals, or support groups

Impact on Baby: A mother's anxiety can potentially impact the baby indirectly through breastfeeding if the baby senses the mother's stress or if the feeding experience is affected

Seeking Help: If a new mother is experiencing significant anxiety that is interfering with breastfeeding or her overall well-being, it's important to seek professional help. Therapies such as cognitive-behavioural therapy (CBT) or counselling may help manage anxiety, and in some cases, medication may be prescribed. It's crucial to discuss any medication with a healthcare provider, especially during the breastfeeding phase

Mindfulness and Relaxation Techniques: Engaging in relaxation practices such as deep breathing, meditation, or yoga can help manage anxiety and make breastfeeding more comfortable

Education and Support: Gaining knowledge about breastfeeding and connecting with others in similar situations can help alleviate anxiety. Breastfeeding support groups can be particularly beneficial

Prevention

There are situations when there is nothing you can do to stop postpartum anxiety. You didn't do anything to trigger it, so it's not your fault. Speak with someone when you are pregnant if you have a history of anxiety or depression or if you are aware of certain triggers from the past. The intensity of your worried thoughts during the postpartum period can be lessened by speaking with a counsellor and practising coping mechanisms prior to the birth of your child.

Treatment and support

• Professional Help: Speaking with a healthcare provider for an assessment and recommendation is essential. A mental health professional may suggest therapy such as cognitive-behavioral therapy (CBT)
• Support Network: Building a support network can help manage anxiety. Friends, family, and support groups can offer emotional support and practical help
• Self-Care: Prioritising self-care, including rest, nutrition, and gentle exercise, can improve emotional and physical well-being
• Mindfulness and Relaxation: Practices such as mindfulness, meditation, deep breathing exercises, and yoga can help in managing anxiety
• Medication: In some cases, medication may be recommended to manage symptoms. Any medication should be discussed with a healthcare provider, particularly if breastfeeding

Types of medication include

For postpartum anxiety and depression, selective serotonin reuptake inhibitors, or SSRIs, are the most prescribed and extensively studied drugs. SSRIs function by raising serotonin levels in the brain. Serotonin is reabsorbed by the nerve cells after serving as a messenger between them. Serotonin acts as a hormone which helps in regulating body temperature, sleep or hunger. Reduced amounts of serotonin can cause anxiety. (Seems too much for non-medical readers?)

Like SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) function by raising specific neurotransmitters in your brain. Anxiety can also be treated with other drugs, such as norepinephrine and dopamine reuptake inhibitors (NDRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs). However, due to their minimal adverse effects, SSRIs are the recommended treatment.

Every drug has the potential to cause negative consequences. Therefore, you may need to discuss the advantages and disadvantages of using medication to treat your anxiety with your doctor before starting. Tell your doctor if you are nursing or intend to start nursing so they can administer a treatment that is suitable for nursing.

Summary 

Any type of postpartum anxiety illness could be harmful to the ?. Numerous moms suffered from multiple anxiety disorders, frequently co-occurring with postpartum depression. The majority of studies conducted so far have concentrated on the prevalence rates of postpartum anxiety disorders; there is little data regarding the clinical and subclinical symptomatology of these illnesses or how they affect the mother-child bond. Thus It's important to seek help if you are experiencing postpartum anxiety. Early intervention and support can make a significant difference in managing symptoms and improving the quality of life for you and your baby. If you or someone you know is in immediate danger, such as experiencing suicidal thoughts or harming the baby, seek emergency help right away. It is recommended to seek advice from healthcare professionals such as a doctor, a midwife, or a lactation consultant. They can provide personalised guidance and support.