The Role of Inflammation in Postpartum Depression

And how breastfeeding decreases inflammation

The postpartum period is a transformative time for new mothers, marked by significant physical, hormonal, and emotional changes. Amidst these adjustments, many women experience postpartum depression (PPD), a condition that affects approximately 1 in 5 of mothers and even 1 in 10 fathers. Recent research has shed light on the potential role of chronic inflammation in the development of PPD and suggests that breastfeeding may offer protective benefits through its anti-inflammatory properties.​

Understanding Postpartum Inflammation and Depression

The postpartum period is a time of immense change. Not only are new mothers navigating the challenges of caring for a newborn, but their bodies are also undergoing significant physical and hormonal shifts. In the midst of these changes, the body can become susceptible to heightened inflammatory responses.

Recent scientific insights reveal a potential link between inflammation and postpartum depression. Chronic inflammation, a sustained immune response that can harm body tissues, has been implicated in numerous health conditions, from heart disease to diabetes. Recently, researchers have extended these findings to mental health, discovering that chronic inflammation may also play a role in depression.

It seems that the postpartum period, with all its physical and psychological stressors -such as sleep disturbances, physical recovery from childbirth, and psychological stress - might exacerbate this inflammatory response by elevating proinflammatory cytokine levels, potentially contributing to the development of postpartum depression.

Breastfeeding's Anti-Inflammatory Effects

So where does breastfeeding fit into this puzzle? Interestingly, breastfeeding is recognized as an anti-inflammatory process.

During lactation, the body releases oxytocin, commonly known as the 'feel good' or ‘love’ hormone. Not only does oxytocin promote bonding between mother and baby, but it also has anti-inflammatory properties. It reduces the levels of certain inflammatory markers in the body, potentially protecting against the onset of inflammation-induced depressive symptoms.

Additionally, the act of breastfeeding stimulates prolactin, commonly known as the milk making hormone. Prolactin in the breasts makes milk, but prolactin in the brain actually has anti-anxiety and anti-stress effects.

Moreover, the act of breastfeeding induces specific metabolic changes in the body that help further reduce systemic inflammation. In other words, successful and supported breastfeeding might offer some protection against postpartum depression by mitigating the body's inflammatory responses.

Dietary Considerations: Reducing Inflammation Through Nutrition

Emerging research highlights the impact of diet on inflammation and mood. Diets with high inflammatory potential such as including highly processed foods, oils high in omega-6 fatty acids, and added sugars - have been associated with an increased risk of inflammation and, therefore, PPD. In contrast, consuming anti-inflammatory foods - such as meats, eggs, fish and shellfish, full-fat dairy, fruits, vegetables, and omega-3 fatty acids - may help mitigate this risk. For breastfeeding mothers, maintaining a balanced and nourishing diet not only supports their own health but also enhances the vitamins, minerals, and healthy fats of breast milk for their infants. ​

Breastfeeding: Not a Cure-All, but a Piece of the Puzzle

It is important to emphasize that breastfeeding is not a panacea for postpartum depression. The relationship between these two is complex and is influenced by multiple factors - psychological, biological, and social. Breastfeeding can be challenging and stressful, especially without the right support, and this stress can also contribute to depressive symptoms. Difficulties such as latching problems, nipple pain, low milk supply, or receiving conflicting advice about breastfeeding can lead to frustration and feelings of inadequacy, potentially increasing the risk of depression. If postpartum depression is already occurring, breastfeeding will not cure it - seek professional support from your physician and a perinatal mental health trained counselor first then an IBCLC Lactation Consultant if you want to continue and feel able to provide human milk.

However, understanding the potential anti-inflammatory benefits of breastfeeding offers an additional lens through which to view the vital importance of lactation support from IBCLC Lactation Consultants. Providing comprehensive support for breastfeeding is not just about the baby's nutrition - it's also about protecting and promoting the mother's mental health.

When a mother is met with breastfeeding challenges and is able to overcome them or cope with them, she feels empowered and confident in her abilities. This is also beneficial for mental health.

In the face of these scientific insights, the call for more robust, accessible, and compassionate breastfeeding support becomes all the more urgent. Perinatal mood and anxiety disorders are the single most common complication of pregnancy and childbirth. By promoting successful breastfeeding from a preventative standpoint - during pregnancy, immediately after birth, and routinely throughout the first 6 months to 1 year - we might just be tackling postpartum depression on another front - by preventing breastfeeding problems and stress in the first place in addition to calming the flames of chronic and acute inflammation.

References:

Kendall-Tackett, K. (2007). A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. International Breastfeeding Journal, 2(1), 6. https://doi.org/10.1186/1746-4358-2-6

Groer, M. W., & Davis, M. W. (2006). Cytokines, infections, stress, and dysphoric moods in breastfeeders and formula feeders. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(5), 599-607. DOI: 10.1111/j.1552-6909.2006.00083.x

Corwin, E. J., Pajer, K., Paul, S., Lowe, N., Weber, M., & McCarthy, D. O. (2015). Bidirectional psychoneuroimmune interactions in the early postpartum period influence risk of postpartum depression. Brain, behavior, and immunity, 49, 86-93. DOI: 10.1016/j.bbi.2015.04.004

Torner L, Toschi N, Pohlinger A, Landgraf R, Neumann ID. Anxiolytic and anti-stress effects of brain prolactin: improved efficacy of antisense targeting of the prolactin receptor by molecular modeling. J Neurosci. 2001 May 1;21(9):3207-14. doi: 10.1523/JNEUROSCI.21-09-03207.2001.

Mezzacappa, E. S., Katkin, E. S., & Palmer, S. N. (2002). Breast-feeding and maternal health in online mothers. Annals of Behavioral Medicine, 24(4), 299-309. https://doi.org/10.1207/S15324796ABM2404_05

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