We know that up to 20% of women are affected by mental illness either during pregnancy or in the 12 months after giving birth. These can include anxiety and depression, postpartum psychosis and post-traumatic stress disorder (PTSD) resulting from birth trauma or caring for an ill baby. Any of these can have a profound affect on breastfeeding and it is so important that families can access support at this difficult time.
Levels of care and support for women affected by perinatal mental illness vary across the UK – there are areas where there are great support networks in place and others where there is nothing. Find more information on how you can access NHS mental health services here.
At the Breastfeeding Network we are in contact with, and support thousands of new mums every year. We work in a mother-centred way and are committed to supporting mothers however they feed their babies.
We know that around 15% of the contacts our Drugs in Breastmilk information service receives are related to mental health issues. Many mums tell us they have been told to stop breastfeeding in order to take anti-depressant medication, but the evidence shows this is unnecessary in many cases, and there should be careful consideration of the impact that stopping breastfeeding before the mum is ready might have on the mum’s mental health.
There is evidence that breastfeeding can have a preventative effect on mental illness developing. A large scale research study published in 2014 showed that mothers who planned to breastfeed and who actually went on to breastfeed were around 50% less likely to become depressed that mothers who had not planned to, and who did not, breastfeed. Mothers who planned to breastfeed but who did not go on to breastfeed were over twice as likely to become depressed as mothers who had not planned to, and who did not breastfeed.
Research also shows that more than 3 in 5 women stopped breastfeeding earlier than they wanted to. This shows the importance of providing good quality breastfeeding support and evidence based information on the safety of anti-depressant medication for mums who do want to breastfeed.
We have detailed, evidence based, information sheets on anxiety and breastfeeding, feeling depressed and breastfeeding, feeling anxious and breastfeeding, OCD and breastfeeding, Bipolar disorder and breastfeeding and postnatal depression treatments and breastfeeding. These are written by our qualified and highly experienced pharmacists and can be downloaded or printed out to discuss with your midwife, health visitor or GP.
You can call the National Breastfeeding Helpline which is open 365 days a year on 0300 100 0212 to talk to a trained volunteer, who is also a mum who has breastfed. The helpline also welcomes calls from partners, family members and friends.
The ‘Saving Lives Improving Mothers’ Care 2023’ report tells us “Deaths from mental health-related causes as a whole account for nearly 40% of deaths occurring between six weeks and a year after the end of pregnancy with maternal suicide remaining the leading cause of direct deaths in this period.”
This is a scary statistic, but highlights the need to talk about it – even though it is an uncomfortable topic. It is important that we know when to ask for help, and where to get it.
Here are some sources of support if you are worried about perinatal mental illness – in yourself or someone around you:
ASSOCIATION FOR POSTNATAL ILLNESS
Perinatal Mental Health Partnership
Action on Postpartum Psychosis
NHS Accessing Mental Health Services
Northern Ireland only, Lifeline – phone 0808 808 8000 or access
Local NHS urgent mental health helpline (England only)
If you are on Twitter, search for #PNDChat, #PNDHour and #birthtraumachat to find a supportive community organised by @PNDandMe http://pndandme.co.uk/
Resources for Volunteers and Professionals
During pregnancy and the year after birth (the ‘perinatal period’), women can be affected by a range of mental health problems. These can be devastating and have a significant impact on women and their families at an important life stage. It is important that any professionals and volunteers working with women during the perinatal period – whatever their primary role – understand the risks of perinatal mental health problems; how to identify symptoms or risk factors and respond appropriately. This is particularly important for professionals and volunteers who support infant feeding, who work with women – building trusting relationships and providing emotional support – at some of their most vulnerable moments.
This competency framework sets out the knowledge, skills and support that professionals and volunteers who support infant feeding should develop around perinatal and infant mental health, including:
- Understanding perinatal and infant mental health and their relationship with infant feeding.
- Understanding how to empower individual women to make and achieve the feeding choices that are best for them (taking account of their mental health).
- The ability to support women – wherever they are in their feeding journey – in a way that protects and promotes their, and their babies’ mental health.
The framework describes competencies for practitioners to work towards. It does not specify the nature of training and development opportunities required to deliver these competencies. These will vary depending on the professionals’ prior experience and skills, the nature of their role and the context in which they work. We hope it will provide a useful tool to support commissioner and provider organisations, trainers, managers, professionals and volunteers themselves to consider what more might be done through infant feeding services to support the mental health of new mothers and their babies.
The Breastfeeding Network has been pleased to work with the Maternal Mental Health Alliance (Mums and Babies in Mind Project), Association of Breastfeeding Mothers, NHS Foundation Trust for Central and North West London, NCT, Lactation Consultants of Great Britain, Manorgardens and Swansea University in the development of this framework.