Breastfeeding and Women's Psychological Health

What about the emotional aspect of women's health? Where does breastfeeding fit in? Let's talk about mother-infant bonding, a somewhat controversial subject. Much is made about the way that breastfeeding facilitates this bonding, while at the same time it is clear that bottle-feeding mothers usually establish deep emotional bonds with their babies. This issue is difficult to study scientifically, but there is evidence of hormonal effects of breastfeeding which may predispose a mother to closer bonding with her infant. Combined with the automatic skin-to-skin contact and closeness afforded by breastfeeding (something which bottle-feeding mothers have to work to duplicate), this could result in improved bonding. An interesting sideline from a study in a developing country found that when breastfeeding rates were increased among mothers with a significant abandonment rate, fewer of these mothers abandoned their babies. Other studies have suggested that there may be a lower rate of child abuse in breastfeeding families considered to be at risk.

Another common psychological issue after birth is postpartum depression(PPD). The role of breastfeeding in this area is not clear, with some studies showing increased rates of PPD among breastfeeding mothers, others lower rates. The cause of PPD is unknown, and is probably due to a number of factors, including hormonal changes and lack of support in the new overwhelming role of motherhood. For some depressed mothers, their breastfeeding relationship takes on special importance. Sometimes, when antidepressant medications are deemed necessary, doctors are concerned about prescribing them for a breastfeeding mother. Antidepressants have been studied, and some have been demonstrated not to get to the baby or cause any symptoms. The small potential risk of the medication to the baby has to be weighed against the potential emotional devastation to an already depressed mother of having to wean her baby, as well as the known detrimental effects on infant emotional development when mother suffers from persistent depression.

Let's consider the situation of mothers who need to return to work. Is it worth it to breastfeed at all? Is it necessary to wean the baby when returning to work? Is pumping and storing mother's milk worth the effort? The answer to these questions is: yes, no and definitely. Even if a mother needs to return to work within weeks and will be unable to pump while at work, the baby benefits from the colostrum and early milk and mother gets the experience of the closeness and bonding. On return to work, a breastfeeding mother has three options: continue to breastfeed exclusively by nursing while at home and pumping her milk while at work; continue to nurse while at home and feed formula while at work; wean completely to formula. Clearly, any amount of continued breastfeeding would be preferable to weaning. Studies have shown that babies in day care whose mothers provide their milk have the fewest days out of day care and their mothers have the fewest missed days from work, while those who were breastfed and got some formula were sick more often. The mothers of completely formula-fed babies had the most days out of work to care for their sick babies.

Although pumping and storing may sound daunting and time-consuming, most mothers whose employers give breastfeeding support find that they work into an easy routine, and the work of pumping is worth it for the peace of mind of a healthier child and the continued bonding from breastfeeding on returning home. Increasing numbers of companies, in response to studies showing economic benefits, are instituting policies supportive of continued breastfeeding for their employees. Additionally, the cost of renting or even purchasing a pump is much lower than the cost of formula.