This subject is sadly neglected by the mainstream conversation on motherhood. We’re familiar with the dramatic stories of postpartum depression that the major media provide from time to time. This sporadic coverage of horrific events heightens awareness of severe postpartum depression, but it also obscures the more mundane reality of the many new mothers who are struggling with postpartum adjustment day in and day out. Postpartum depression is both so common and so taboo that many of my clients have simply referred to it as “postpartum”, a shorthand they expect me to understand instantly.
It’s beyond the scope of a blog to get into this topic in any great detail, but I want to provide a holistic perspective on postpartum mood care that might help any new mother to nurture herself and stay well. Here comes my disclaimer: if you suspect that you or someone you know is already depressed, do not wait! Get help immediately. These tips are not intended to diagnose or treat a medical condition.
The number one mistake that I see families make is waiting too long to get help, which disrupts the mother-baby dyad and other important relationships. This is precious time and you can’t get it back. A preventive and supportive approach for all mothers, regardless of their history or risk factors, makes a lot of sense. Here are some recommendations for all mothers:
1.Breastfeed! For as long as you are able, to the best of your ability. Breastfeeding is not a test of your quality or commitment as a mother. But its benefits are impossible to overstate, including a reduced risk of depression. If you are struggling to breastfeed, talk to a midwife or lactation consultant today. Time is your enemy. Most mothers become discouraged and have interrupted or stopped breastfeeding before they ever call anyone. Find your local La Leche League and connect with other nursing mothers before you give birth, if possible.
2. Enlist support. Reach out for the kind of help from family and friends that you want to have. This can be tough. Many mothers are disconnected from extended family and other mothers. We have smaller families, live apart, and don’t always see a community of strong, confident, healthy mothers. Even worse, the help we get sometimes isn’t help at all, but an added burden of trying to please others and keep on a happy face. The birth of each baby is also the birth of a mother, and the birth of a new family. The postpartum mothers needs recognition and validation of her accomplishment, whether it’s her first baby or her fourth. If you are friend or family to a new mother, remember that a newborn’s needs are usually being met by its parents. A new mother’s needs are usually being neglected by everyone. Spend your time and attention (and gifts) on the mama!
3. Evaluate the birth experience. This is so important. Mothers need to tell their birth stories, and they need to feel heard. Many birth stories are a mix of pride and disappointment, accomplishment and regret. Our society as a whole fails to adequately prepare families for birth. Very few births occur exactly as an expectant mother has imagined. The discordance between the ideal and the reality needs to be processed. This doesn’t mean that most births are “bad” experiences, but they are intense and dramatic events, and should be honored as such. Tell your birth story to a good listener and write it down. If the birth experience was traumatic in some way, acknowledge that and talk to a professional if the details continue to bother you. Many women simply try to move on because they have a newborn with 24-7 needs and feel guilty about their own needs.
4. Focus on nutrition. Don’t forget to eat and drink healthfully and regularly! A breastfeeding mother needs about 500 extra calories from high quality food sources. Postpartum women may want to increase their intake of complex carbohydrates, as this may temporarily alleviate the baby blues. Insure adequate intake of Vitamin B6 and Vitamin D, but don’t consume megadoses of any particular vitamin. Continuing a prenatal vitamin will cover most of your needs. Many, many women are Vitamin D deficient, which is independently associated with mood changes. If you are deficient, you may need more Vitamin D than your prenatal supplement provides.
5. Exercise, fresh air, and sunlight. Self-explanatory I hope. Physical activity releases endorphins and helps to modulate the neurotransmitter systems that are responsible for mood. Sunlight is necessary for Vitamin D production and may relieve seasonal mood changes. Sunlamps designed for seasonal use are drug-free and safe for new mothers. Getting outside or spending some brief time apart from your baby can be like hitting the refresh button on motherhood.
6. Aromatherapy, every day. Your new baby is the best aromatherapy, of course. Frequent close contact, preferably skin to skin, helps establish bonding and reinforces your baby’s brain template for successful breastfeeding. Postpartum mothers may also benefit from daily inhalation of essential oils. Dozens of oils have uplifting or relaxing qualities, but two really stand out for new mothers. Clary sage (Salvia sclarea) is balancing and regulating for women’s hormonal transitions and is my top choice for baby blues. Lavender (Lavandula angustifolia) is relaxing and sedating, with mild antidepressant activity. Buy only pure, undiluted essential oils, and avoid prepackaged blends. If you have an unpleasant response, try a different oil. Every woman is unique.
7. Try relaxing nervines. Nervines are herbal remedies that nourish the nervous system. Some are stimulating and some are sedating. Nervines that are compatible with breastfeeding include lemon balm (the “gladdening herb”), fresh milky oats, chamomile, lavender, and blue vervain. Passionflower may also be used, but is more sedating and should be reserved for bedtime. To make an herbal infusion, use any combination of the above as loose herb, which you can purchase from a local health food store. I prefer loose herb to prepackaged tea blends because it allows for individual customization. It also allows the hot water to fully penetrate and extract the benefits of the herbs. A standard infusion of an herb is 1 teaspoon of loose herb in 8 ounces of hot water, covered and left to steep for 10 to 15 minutes. Some herbs may require more plant material per cup of water. You can make your infusions a cup at a time with an inset strainer. Better yet, use a French press which easily separates the steeped herbs from the finished tea.
8. Motherwort stands alone. I would be remiss if I did not mention motherwort (Leonurus cardiaca), an herb with a longstanding reputation for soothing anxiety and calming mothers. Even though it is a mint family herb, motherwort is so bitter that most people prefer a tincture to a tea. Drop the specified amount of motherwort tincture into a few ounces of water that has just stopped boiling, and allow a few minutes for the alcohol to burn off. Chamomile tea makes a good base for the addition of tinctured herbs. Remember, herbs that may be safe to use postpartum are not always safe in pregnancy. Check with a professional before use.
In Part 2, I’ll share more specific nutritional and botanical options for at-risk mothers.