Your baby finally has arrived and it is a time of pure bliss. The snuggles, the coos, the bonding…it has all become so real. But there is something inside of you that just isn’t right. You are emotionally and physically drained from the hours of labor. The sleep deprivation starts to kick in because your little one can’t tell the difference between night and day. If you are breastfeeding, the nipple pain you are experiencing hurts so bad that you may even shed some tears. The feedings and diaper changes are around the clock. Becoming a new mother can be hard at first. As many as 1 in 5 new mothers will suffer from severe depression or anxiety after giving birth, and a woman is significantly more likely to suffer from one of these conditions during her first year as a mother than at any other time in her life.1
The Hormones
There are many factors that can contribute towards postpartum depression. First, the hormonal roller coaster after giving birth is one that no one can prepare you for. The Estrogen levels during pregnancy are approximately 100 times what they are during your period.2 After giving birth, estrogen levels decrease dramatically (especially within the first 24 hours). The levels drop even further if you are breast feeding and you may even experience hot flashes and vaginal dryness. Dr. Allison Hill, a board-certified OB/GYN in Los Angeles compares breast feeding hormones to that of a woman in menopause when she explains the hormonal shift after pregnancy to her patients.2
The levels of progesterone increase as well when you are pregnant and don’t actually return to normal until your normal menstrual cycle returns. You can expect your period to return about 6-8 weeks after birth if you are not breastfeeding. If you are breastfeeding your period won’t return as quickly. For some women, they might not have their period the entire time they breast feed.
The hormone called prolactin increases up to 20 times more than pre-pregnancy levels and remains high until breastfeeding ends.2 This hormone helps the breast glands to produce milk for breastfeeding. Prolactin levels fluctuate during the day and are the highest at night and times of stress.
You may even notice that when your baby is crying, you will experience milk discharge or milk letdown. The letdown reflex is due to the Oxytocin which helps you relax and helped with the pain during labor. The hormone is known as the “bonding hormone” and during the first weeks of lactation, is still being tailored to respond to the sensation of your baby nursing.2 Frequent nursing will fix this.
So what can you do while your body is trying to adjust its hormones after giving birth? A healthy body regulates hormones more efficiently. By working to replenish the nutritional losses that are a part pregnancy, delivery and lactation as well as reducing the exposures to toxic elements that you have control over, you can reduce your risk of experiencing periods of postpartum depression. Reducing your exposure to the following chemicals is a big step toward optimizing your health and hormone regulations.
- Use only organic based whole foods when you can. Buy hormone free meats products where possible. If you can’t buy organic, wash your food well to rid the pesticides.
- Avoid all pesticides, herbicides, and fungicides use around your home.
- Have a good reverse osmosis water filter for your source of water.
- Avoid plastic goods. Use glass or ceramics whenever possible to store food.
- Do not microwave food in plastic containers, and especially avoid the use of plastic wrap to cover food for microwaving.
- Don’t use fabric softeners as it puts petrochemicals right on your skin.
- Use a simple laundry, dish detergent and home cleaners with less chemicals.
- Use organic soaps and toothpastes. Avoid fluoride.
- Avoid blue cohosh, vitex, saw palmetto berry, lavender, tea tree oil, licorice, hops, rhodiola rose root, black cohosh, dong quai, red clover blossom and motherwort leaf as they all increase levels of estrogen.
- Strictly avoid soy
The Physical Changes
Hormones aren’t always to blame though. There is a lot of pressure on moms “bouncing back” after pregnancy and returning to pre-pregnancy weight right away. Women are advised to gain an average of about 25 lbs during pregnancy. This recommendation is based on the BMI (body mass index) of the woman at the time when she finds out she is pregnant. Overweight women are advised to not gain as much for the health of themselves and their infants. This hasn’t always been the guideline though. In the 1930’s excessive weight gain was seen as a possible sign of swelling or impending high blood pressure. In an effort to prevent this, it was recommended that weight gain should not exceed 15 pounds during pregnancy3. This was also considered good for “preservation of figure”.
Many women are unhappy with their post pregnancy body due to the presence of stretch marks, a belly bulge, wider hips, and breast changes. A TODAY Moms survey of 3,000 new moms found that almost two-thirds of women say they worry their partner doesn’t like their body4. We live in a society of judgement and a culture that expects women to maintain their physique.
It is important for new moms that are feeling the pressure of returning to their postpartum bodies to accept the fact that it took around 40 weeks for the body to make a human and prepare for delivery, so in turn, it will take time for the body to return back to what you are used to. It may not even happen though. Depending on if you are planning to have more children or if you have just had your third, each and every pregnancy is different.
It is no longer only your body. You have shared your body with the tiny humans you have created. Your body has nurtured them and will continue to do so, physically and mentally, for the rest of your life.
Returning to exercise isn’t always easy. Waiting 6-8 weeks after delivery is typically recommended. However, if you had a C-section, you may not be able to recover as quickly. For some, it can take months to recover and although your doctor may “clear you for exercise” be certain that this means light and gentle exercise. Getting outside and going on a walk with your new baby is probably one of the best exercise you can get for your body and your mind. Try to change up the scenery too. You can wear your baby in a front carrier facing inward as early as you want. This allows you to go on walks where there may not be a stroller path. Be careful though if you choose to hike where there may be tree roots or rocks you could trip on. See your carrier instructions for different ways to wear your baby.
Dieting isn’t recommended right away after giving birth. Your body needs calories and nutrients to feed your baby and for the healing process to begin. This is true especially if you are nursing because your body can burn up to 500 calories a day just by making milk for your baby! A diet high in protein and healthy fats will supply you with enough energy to take care of your baby while the extra weight you gained during pregnancy can come off. Keep healthy snacks around like nuts, guacamole, peanut butter with celery, vegetables and hummus, etc. Drink lots of water and be sure to measure it if you aren’t sure if you’re getting enough. Drinking 2-3 quarts of water is recommended and it will keep you hydrated if you are nursing.
Breastfeeding
“If breastfeeding is so natural, how hard can it be?”
The number one topic of discussion in some of the postpartum depression support groups that mother and founder of Postpartum Support Virginia, Adrienne Griffin, has been involved in is breastfeeding.5 For some women, breastfeeding exacerbates their anxiety because they are experiencing too much pain, worried their baby isn’t getting enough, worried they aren’t going to be able to maintain their supply, or just concerned about what others would think if they stopped. The rate has been shown to be as high as 92% of mothers reporting breastfeeding challenges during their first week postpartum.6 Pain is very common when a new mother starts nursing. Let’s face it, they don’t make nipple cream for nothing. The soreness does go away as both you and your baby learn how to nurse together. Although breastfeeding is instinctive , there is a learning curve when it comes to breastfeeding and it may take weeks before you and your baby master the skill. This learning process involves multiple times a day (every 2-3 hours in fact) of attempting the latch, finding a comfortable position to hold the baby, make sure they are swallowing, switching breasts, etc. Remember, we are born with the innate ability to find the breast and feed.
If you are having trouble, do not wait until you cannot take the pain anymore. Reach out to a professional such as your OB/GYN, a La Leche League leader, postpartum doula or midwife, or even a parent for help.
New mothers are returning to work after giving birth sooner than ever. The U.S. is the only major country on the globe that offers no paid time off for new mothers, placing a terrible burden on these women, their families and the country. A CDC report shows that only 10 percent of mothers who work full-time are still breastfeeding their baby at 6 months!7 Some things you can do before returning to work to make sure your baby can get the benefits of breastmilk for as long as possible:
- Get a hands free double breast pump. This type of pump is the most time-saving and you also have the freedom to still do work with both hands free. Talk to your insurance company for what specific types of breastfeeding equipment are covered under your plan. If you travel a lot for work, purchase a battery for your pump.
- Purchase a travel friendly cooler and ice pack to keep the milk you pump fresh. (Expressed milk can stay good for up to 8 hours if you don’t have a cooler on hand.)
- Be sure you speak to your boss or department at work to set up a time and place for you to pump while at work to maintain your supply during missed feedings while you are apart from your baby.
- Pump and store before returning to work. Pick a couple times a day to pump after feeding your baby. Store this milk in the freezer so you have a nice stash before returning to work. Date the bags. Frozen breastmilk is good for 3-6 months. Once thawed, be sure the baby consumes it within 24 hours.
Find Out What You are Missing
You may have been deficient in Vitamin D during pregnancy and never knew it if you weren’t tested. Most nurses and OB/GYN doctors only ask if you have been taking a pre-natal vitamin. However, most pre-natal vitamins do not have enough Vitamin D in them to achieve optimal status at serum levels. A recent study published in the journal Archives of Women’s Mental Health suggests that low vitamin D levels in mothers during pregnancy increases the risk for postnatal depressive symptoms.8 Vitamin D supplementation is a low-cost and safe intervention for all pregnant women.
Is your HDL Cholesterol high enough? Cholesterol also happens to be a precursor to sex hormones and vital for vitamin D physiology. In a well-known study published by the Journal of Psychiatric Research, the authors found that postnatal participants with depressive symptoms had lower serum HDL concentrations.9 This type of cholesterol can be raised by taking a supplement rich in Omega-3 such as Fish Oil. Dietary intake of avocado, nuts, fish, olive oil, coconut oil are all good options.
Vitamin D and HDL Cholesterol levels are just two of many missing links that may be contributing towards depressive symptoms after giving birth. You are experiencing all sorts of feelings at once in this time in your life. Whether you are a new mother or considered a veteran, every child is different and you will face different obstacles to overcome. So take the guesswork out of your health. See an experienced nutritionist that will test a comprehensive panel in the blood and check your toxic element status so you can be sure you are doing everything you can for you and your baby. There are safe, natural treatment options for depressive disorders and anxiety. Most supplements are safe to take during and after pregnancy, even if you are nursing. By testing first, you won’t fill your valuable time reading labels or taking supplements by trial and error. Your nutritionist will tailor a detailed program for you to follow that can optimize levels in the blood to avoid and/or improve depressive disorders. Depression should not be taken lightly. It is not just you who will be affected; you now have a baby who relies on you for care and comfort. Don’t be afraid to reach out for help during these tough times. You want to cherish these moments that only will last so long.
But, you can do more when it comes to prevention. Just as we have been recommending for many years annual or semi-annual blood tests can catch problems before they become full blown crisis. It’s just as important for a woman to get tested prior to conception, during pregnancy and post partum to identify nutritional imbalances and toxicities that could affect the outcome of each state of fertility. Contact our office for further details because it is never too early in life to work toward prevention.
References:
1. Gregorie, Carolyn. Postpartum Depression Is Fundamentally Different From Other Mood Disorders. Huffington Post. 1/27/2017
2. Revelant, Julie. Your pregnancy hormones, explained. Fox News Health. May 30, 2012.
3. Miller, Debbie. Pregnancy Weight Gain Guidelines in the US – a Historical Overview. Marian University Nursing. May 2010.
4. Dube, Rebecca. ‘Love my kids, hate my body’: Real moms speak out on body image after babies. TODAY. February 12, 2013.
5. Stone, Katherine. Breastfeeding & Postpartum Depression: What Should Moms Do?! Postpartum Progress. May 13, 2009. http://www.postpartumprogress.com/breastfeeding-postpartum-depression-what-should-moms-do
6. Wagner, E., et al. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics 2013; 132(4):e865-75.
7. Kam, Katherine. Why women don’t nurse longer. Parenting. http://www.parenting.com/article/moms-right-to-breastfeed.
8. Hunter, Will. Low vitamin D status during pregnancy may increase risk for symptoms of postpartum depression. Vitamin D Council. April 2014.
9. 9. Teofilo, Marcella Martins Alves, et al. HDL-cholesterol concentrations are inversely associated with Edinburgh Postnatal Depression Scale scores during pregnancy: Results from a Brazilian cohort study. Journal of Psychiatric Research. Volume 58. November 2014, Pages 181–188
