Friday, August 18, 2017

Breastfeeding and Postpartum Mood Disorders: Milk, Tears, and Hope


While many women experience mood changes during or after the birth of a child, 15 to 20 percent of women experience significant symptoms of postpartum depression and anxiety. This World Breastfeeding Week, UCSD and SDCBC mini-seminar discussed how to treat a women suffering from perinatal mood and anxiety disorders (PMADs) and help her with her breastfeeding goals.

Many healthcare providers have not received adequate refining in how to recognize, screen for PMADs, and refer mothers for help. This is unfortunate because “recent research has confirmed that the optimum development of an infants social and emotional health hinges on the responses of and relationships with their caregivers, often the mother,” according to Bethany Warren, licensed clinical social worker and the president of Postpartum Health Alliance.

There are effective and well-researched treatment options that can prevent worsening of symptoms and help women fully recover. “New moms are going through an identity shift, and our goal is to help them recognize their expectation, reducing the perfectionism and comparison, manage the anger, and resolve the conflict and grief,” explained My Hanh Nguyen, a psychiatric-mental health nurse practitioner of UCSD Dept. of Psychiatry. “Not all expectations happen and that’s okay.” Common strategies including interpersonal psychotherapy, cognitive behavioral therapy, mindfulness, support groups, and of course, medication.

Because of the possibility of exposing the baby to medication through the breastmilk, many are hesitate to treat breastfeeding moms with drugs. However, as Jason Sauberan, Doctor of Pharmacy of Sharp Mary Birch, pointed out, “we don’t want the drug to hurt the baby, but we don’t want to tell moms that you cannot be treated while breastfeeding, either.” The important thing is to help medicated moms reach their breastfeeding goals by understanding the physiochemical drug properties and milk transfer, judging infant risk and making the right decision. This is crucial because breastfeeding has a protective role for both mother and infant.

When supporting a breastfeeding mother with postpartum depression or anxiety, clinicians need to employ messages to all mothers experiencing the symptoms, “You’re not alone. You’re not to blame. With help, you will be well.” When identifying the mom at risk, “the most important aspect of assessment is to listen to the women’s story,” said SDCBC’s Rose deVinge-Jackiewicz, RN, MPH, IBCLC, “Her story is unique to her.” Moms need to be heard, clarified, validated and categorized. “Sometimes, even what you see tells a lot,” deVinge-Jackiewicz told the seminar attendees. Is the mom holding her baby? How’s she interacting with her husband, boy friend or in-laws?

To understand what’s PMADs really like, Jessica Furland, clinical social worker of UCSD recommended three documentaries: The Dark Side of the Full Moon, When the Bough Breaks and The Emily Effect. Each of the documentary delves into the unseen world of maternal metal health in the U.S, brings attention to this public health issue and illustrates the lack of awareness and appropriate treatment options for postpartum mood disorders by looking into a woman’s journey to recovery.

*This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

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