According to the Academy of Breastfeeding Medicine, postpartum depression (PPD) and sometimes referred to as pregnancy-related mood disorder, is one of the most common and serious postpartum conditions, affecting 10–20% of mothers within the first year of childbirth. Studies have found that up to 50% of women with PPD are undiagnosed. Risk factors include a prior history of depression (approximately 25–30% risk of recurrence), including PPD, and depression during pregnancy.
Other risk factors include recent stressful life events, lack of social support, unintended pregnancy, and women who are economically stressed, disadvantaged, or low income. Moreover, studies of economically disadvantaged families have shown that approximately 25% of women will have ongoing depressive symptoms that last well beyond the initial postpartum year.
‘‘Postpartum blues’’ is a condition characterized by emotional changes, insomnia, appetite loss, and feelings of being overwhelmed that can affect 30–80% of women. It is a transient condition that usually peaks on postpartum Day 5 and resolves by Day 10. Unlike PPD, postpartum blues does not adversely affect infant care.
“Postpartum depression’’ is a major depressive episode that impairs social and occupational functioning. Symptoms cause significant distress and care of the mother and infant are disrupted. There are often strong feelings of disinterest and detachment. If untreated, symptoms may persist beyond 14 days and can last several months to a year.
‘‘Postpartum psychosis’’ is a psychiatric emergency and is characterized by paranoia, hallucinations, delusions, and suicidal ideation.
Treatment approaches include nonpharmacological therapies such as interpersonal psychotherapy or cognitive behavioral therapy, pharmacological therapies, or a combination of both. Antidepressant medications are one of the most commonly prescribed pharmacologic treatments of PPD. The mother and her provider should work together to make an individually tailored choice.
Breastfeeding mothers may be concerned about continuing and/or starting medication for PPD. Some providers are reluctant to prescribe for lactating mothers due to lack of information about antidepressants and breastfeeding. Studies have shown medication use is safe for the breastfeeding mother and infant. The risks of untreated depression, and the benefits of treatment must be fully considered when making treatment decisions.
Please talk to your healthcare provider, mental health professional, or lactation consultant, if you are experiencing any of these symptoms. Further resources available at Aspen Valley Hospital-Aspen Birth Center 970.544.1130
Heather Knott, RN-IBCLC
ABC Latctaion Services 970.544.1251