Postpartum depression (PPD) affects around 15 percent of the women who have recently given birth in the United States each year. Symptoms include loss of interest in baby or other activities previously enjoyed, changes in eating and sleeping habits, and more. Caring for a newborn baby can be challenging in the best of times - but can be especially difficult when mom has a postpartum mood disorder.
The research on the connections between infant feeding and postpartum depression are conflicting. Some resources conclude that breastfeeding is protective against postpartum mood disorders. But other research suggests these findings may not be accurate and the differences are due to other factors, not breastfeeding itself. Experts have also found that when a mom has PPD, her breastfeeding duration will be shorter.
A mother’s intentions for infant feeding can make a differenceIn a 2015 study, Borra and colleagues found that for women who did not have depression during pregnancy, breastfeeding decreased the risk of postpartum depression. And if she gave birth intending to breastfeed, she was less likely to show signs of PPD if she did go on to breastfeed. Interestingly, their study found rates of PPD were higher when a women was not planning to breastfeed but went on to breastfeed once the baby was born. To put that another way, if a mom was planning to bottle feed when she was pregnant, she may have a lower risk of PPD if she does, indeed, bottle feed rather than breastfeed. If you have symptoms of depression during or after a previous pregnancy, a history of depression or other mood disorders at another time in your life, or a family member who has been diagnosed with depression or other mental illness, your risk of PPD is increased. Knowing about this history and taking into account your own intentions for feeding can help you to make the best choice for you and your baby.
Switching from breastfeeding to bottle feeding
In some cases, switching from breastfeeding to bottle feeding can be an important part of treatment and healing when it comes to postpartum depression. Researchers have found that when a woman experiences breastfeeding difficulties - from a painful latch to cracked nipples, breast infections, low milk supply and more - she is at an increased risk of PPD (Brown Rance and Bennett, 2016). While some moms are able to find relief with breastfeeding support, others decide it’s best to switch to bottle feeding.
Potential causes of postpartum depression
The type of birth a mom has can impact not only feeding method, but postpartum depression risk as well. A recent study found that “epidurals, postpartum hemorrhage, postpartum surgery, and short labor duration increased depressive symptoms” (Kendall-Tackett, Cong & Hale, 2015) in addition to decreasing the initiation and continuation of breastfeeding.
Infant sleep - or more accurately mom’s sleep fragmentation with a newborn - is also a factor in PPD. Research shows that when a woman with PPD doesn’t get enough sleep, her symptoms are intensified. And that sleep can be hard to get if she is responsible for all of baby’s feedings at the breast. Other research adds to this, showing “mothers with depressive symptoms were at greater risk for both low breastfeeding intensity and adding cereal to infant formula at 2 months of age than were those without PPD” (Gaffney et al, 2014). The study goes on to suggest that this switch to bottles, especially with added cereal, is often done in an effort to help baby sleep longer so that perhaps mom can catch up on her sleep, too. Feeling more in control of feeding and sleep may be protective against worsening of PPD symptoms.
Other situations where bottle feeding may be protective against postpartum depression include when a mom has a past history of trauma or sexual abuse, especially if the abuse or trauma involved the woman’s breasts. If a woman has a history of body image issues, bottle feeding may be an option to explore.
Finally, if a woman is feeling pressured to breastfeed but she doesn’t really want to, bottle feeding may be best for the mother infant relationship. If mom resents the baby every time he is hungry, this isn’t good for anyone. Women who feel this way and decide to bottle feed instead say they feel a great deal of relief once the decision is made.
What you can do
Dealing with criticism about the choice to bottle feed can be difficult. When friends, relatives or even strangers question you about why you’re bottle feeding, it can be difficult to not feel judged as a “bad mother.” Your personal reasons for switching are not anyone else’s business. Knowing you are making the right choice for you and your baby should help you to feel good about the decision.
The interplay between infant feeding and postpartum depression is multifaceted and no true direct relationships can be found with confidence. While bottle feeding may not prevent PPD, it may be the right choice for some women. Whether choosing to bottle feed or breastfeed, get help with PPD. Counseling and medications can help you feel your best - not just as a mother but as a human being.
Brown, A., Rance, J., & Bennett, P. (2016). Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of advanced nursing, 72(2), 273-282.
Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Maternal and child health journal, 19(4), 897-907.
Gaffney, K. F., Kitsantas, P., Brito, A., & Swamidoss, C. S. (2014). Postpartum depression, infant feeding practices, and infant weight gain at six months of age. Journal of Pediatric Health Care, 28(1), 43-50.
Kendall-Tackett, K., Cong, Z., & Hale, T. W. (2015). Birth interventions related to lower rates of exclusive breastfeeding and increased risk of postpartum depression in a large sample. Clinical Lactation, 6(3), 87-97.
McCarter-Spaulding, D., & Horowitz, J. A. (2007). How does postpartum depression affect breastfeeding?. MCN: The American Journal of Maternal/Child Nursing, 32(1), 10-17.
Peleg, D., Maimon, N. A., Warsof, S., Larion, S., & Shachar, I. (2015). 787: Breast feeding and postpartum depression. American Journal of Obstetrics & Gynecology, 212(1), S381.
Pope, C. J., Mazmanian, D., Bédard, M., & Sharma, V. (2016). Breastfeeding and postpartum depression: Assessing the influence of breastfeeding intention and other risk factors. Journal of affective disorders, 200, 45-50.