Editor's Note: Continuing our coverage and spotlight on Maternal Mental Health, Emerald Doulas IBCLC, Victoria Facelli, shares her thoughts about the intersection between infant feeding and mental health. If you're struggling with a PMAD and/or breastfeeding, please don't hesitate to reach out to us for help or support. 

Rarely does someone expect to develop a postpartum mood disorder, and often people are unprepared for how it affects their breastfeeding goals. Likewise, new parents are often ill-equipped for how their breastfeeding goals might impact their mental health. 

This is where things can get tricky...

For many people the pain, intensity and lack of sleep that accompany the early days of breastfeeding can lead to the development of a postpartum mood disorder. However, stopping breastfeeding before you are ready can be similarly difficult.

Many treatments for mood disorders include medication and longer stretches of sleep that can impede or even exclude breastfeeding all together. Many parents come to me during appointments with guilt and shame for choosing their mental health over breastfeeding.

“Breast is best” right? Except that it isn’t always best for everyone.

Do you know what is actually always best? A family's wellbeing.

There are a thousand little studies on the little benefits of breastfeeding; but, not a singe one of those benefits overrides the benefit of having present and healthy parents. We know that babies do not thrive without the love and care of their parents, but they can thrive without breastmilk.

If you are being faced with the choice between your mental health and wellbeing and breastfeeding, please hear this. 

I want you to chose your own wellbeing every time. 

That said, breastfeeding is an extremely important part for some mothers and the idea of closing that chapter completely is, itself, very traumatizing. In this case, I strongly encourage you to find a mental health provider, as well as an experiencing and compassionate lactation consultant, who can work together with you and your personal goals in mind. This team should be able to get you to pain free nursing, and help develop a plan that prioritizes your mental health. 

Finally, what can we all do to help make infant feeding a little less fraught for new moms? 

We can stop shaming people for how they feed their babies
Giving a side-eye for each bottle of formula or telling a new parent to "just stop breastfeeding because it is too much trouble" is not helpful and is actually harmful for us all. We can all work harder at assuming that every family is feeding their baby the right way for them. 

We can help people who are struggling with nursing find and connect into help.
Find a lactation consultant who understands the intersection of infant feeding and mental health, and work with them on a plan that meets the family's needs for sleep and recovery while keeping breastfeeding goals in mind. 

Make sure parents know where to go to discuss medications and breastfeeding.
Check-in with a qualified IBCLC or the Infant Risk Center Hotline (see below) to discuss your medications. Going on new medications to treat a mood disorder can feel scary. Most primary care physicians do not know fully understand which drugs are safe for breastfeeding and which ones are not.

Because of the ethics of testing Moms and babies, all medications ere on the side of "not safe", when most of them actually are. Any lactation consulting warm line should be able to look up the risk level for you, or you can go straight to the source and call the lab that does all of these tests. The Infant Risk Center at Texas Tech takes calls Monday – Friday, 8am – 5pm CT  and you can reach them at: (806) 352-2519.

As always, if you're struggling with a Perinatal Mood Disorder, please reach out to us for support. We offer a free PMAD Support Group twice a month in our office, have a compassionate, goal-centered lactation consultant here on-site, and  provide families across the Triangle with postpartum doula support as they recover from a mood disorder.