Life
The importance of breastfeeding — for both baby and mama's health — is well-known. Much of what happens to a breastfeeding woman's body during the period where she's lactating has positive effects in the long run: Women who breastfeed for longer have lower risks of cardiovascular disease, diabetes, high cholesterol and hypertension, for example. But when it comes to the relationship between breastfeeding and maternal mental health, things become a bit murkier — not only because there's less research on the subject, but because of the societal pressures about breastfeeding and its complicated relationship with "ideal" motherhood. The mental health effects of breastfeeding are linked in a surprising way with social pressure, and it's an important feminist issue.
The relationship between breastfeeding and mental health medications, in particular, is a complex one. Most doctors recommend against breastfeeding while on antidepressants or antipsychotics, because clinical drugs aren't tested on pregnant women or new mothers, and because the medications themselves can pass to the babies through milk. (Under medical supervision, women with mental illness can take medications while breastfeeding, but it has to be carefully monitored.)
Aside from that certainty, however, there are more complex issues — like a link between not breastfeeding and depression that goes beyond biology into culture and motherhood itself.
What's Happening Behind The Scenes?
Women are overwhelmingly told that breastfeeding is their "natural" duty to their kids, for many of the health benefits outlined above. It can seem as if this has been the norm for a very long time: witness Renaissance paintings of the breastfeeding Virgin Mary. And yet it's easy to forget that, for the early part of the 20th century, the advent of safe, nutritious formulas made breastfeeding unfashionable, and it only started regaining ground in the 1970s as doctors and the natural birth movement started to advocate for it again — and this gave rise to the hugely problematic "ideal" mother. Staff Writer Emily Wax-Thibodeaux wrote in the Washington Post in 2014 about her experience with what she jokingly called "breast-feeding nazis," who insisted that she needed to breastfeed her infant son despite the fact that, after having a double mastectomy, that was actually impossible. While breastfeeding does provide benefits to kids and parents, the impact of feeling like a 'failure' if breastfeeding isn't feasible, for whatever reason, seems to have a crushing effect on women's mental health.
Social pressure can cause this shame that can ultimately lead to mental health issues, but psychology itself may also play a role. "A mother's pre-natal mental state, pregnancy and birth experience can all result in stress and trauma — all of which can influence how a mother feels about breastfeeding," notes Shereen Fisher, chief executive of the Breastfeeding Network, in an article on their website. The researchers behind the 2014 study also note that other elements, like the mothers' personalities, might have played a role in how likely they were to develop depression.
Another possible factor is biological. Breastfeeding appears to help women cope with stress factors a little better, and seems to produce better metabolic responses to pressure and worry; a study of breastfeeding mothers in 2015 found that they had lower cortisol levels (the stress hormone) in their saliva up to six months postpartum than non-breastfeeding mothers. But a theory advanced in the International Breastfeeding Journal in 2007 went further. It suggested that there's a link between breastfeeding's role in reducing inflammation levels and depression. The reasoning is that depressive disorders are associated with increased levels of bodily inflammation, and that inflammatory symptoms may actually help cause mood disorders. When women breastfeed, their inflammation levels naturally drop, which may contribute to better mood outcomes.
Understanding the biological and societal factors behind the link between depression and difficulty breastfeeding is a big deal — and a feminist issue. Women's bodies and women's issues garner a significant portion of medical attention, but the wider picture needs to be understood too: that breastfeeding and its place as the "ultra-maternal" mode du jour are another way of policing women's bodies and making parts of female experience ultimately less-than by putting them up for public debate. The implications for women's mental health are serious and need to be explored more deeply, and women who are struggling need to be given more professional support.