[Editor’s Note: My longtime readers are aware that, for me, quitting breastfeeding was helpful in my recovery from postpartum OCD. I was so anxious about breastfeeding, and so sleep-deprived, that in the end I think it helped to switch to a bottle. BUT, many moms do not feel the way I do. In fact there are a lot of moms who feel very strongly about continuing to breastfeed and who say it’s the only thing that makes them feel good during PPD. So I asked an expert, Annie of PhD in Parenting, to share the best ways to make sure you get enough sleep to help you recover from postpartum depression or anxiety while continuing to breastfeed. She had lots of great input, so I’ve broken her guest post into two parts. (Check out Part Two here.) I hope you find his helpful! -Katherine

Sleep Management, Breastfeeding & Postpartum Depression -postpartumprogress.com

Being a new mother can be overwhelming. You don’t get enough sleep. Breastfeeding can be difficult. Some babies seem to cry and cry and cry and you don’t know why. This can be incredibly trying for any new mom, but it can be debilitating and dangerous for a mom with postpartum depression (PPD).

What does the research say?

There is research that indicates that mothers with PPD who do not get enough sleep are at greater risk for more severe depression.  According to an article by April Hirschberg, MD on the Women’s Mental Health website:

Women with PPD had poorer sleep quality and lower sleep efficiency than women without PPD.  ….  Poor sleep quality significantly predicted increased PPD symptom severity.

The authors conclude that clinicians must address measures to improve sleep quality in depressed mothers in order to decrease the severity of depressive symptoms. Furthermore, researchers must develop interventions which facilitate better sleep quality in women with postpartum depression.

There is also research that demonstrates a link between weaning and depression. However, according to an article by Alison Stuebe, MD, MSc on the Academy of Breastfeeding Medicine’s blog the cause of that link is unclear.

There’s considerable data showing that moms who are successfully breastfeeding are less likely to be depressed than those who are not. It’s far from clear, however, whether depression causes weaning or weaning causes depression.

To complicate matters even more, there is also research that shows that mothers who are not exclusively breastfeeding have poorer sleep quality, but a mother who is being woken constantly during the night by a newborn baby may laugh at that research. I certainly would have in the early days with my first child, even though I later enjoyed the benefits of breastfeeding hormones as a sleep aid.

I don’t want this article (or the comment section) to turn into a debate on whether or when it is a good idea to switch from breastfeeding to bottle feeding if you are experiencing PPD. I know some mothers who suffered from PPD that felt incredible relief when they decided to stop breastfeeding, while others found their depression worsened. The decision to breastfeed or not is a very personal one and it is critical to recognize that breastfeeding is more important to some mothers than it is to others (whether that is biologically, intellectually, or emotionally determined).

When it comes to PPD and sleep advice that is incredibly important to remember. Yes, sleep is important in helping mothers to manage and overcome PPD. But if being able to breastfeed is also incredibly important to them (and to their mental health) and if the mother is breastfeeding successfully, then the sleep advice needs to be compatible with maintaining a healthy milk supply. Bad sleep advice could cause the mother’s milk supply to plummet and unnecessarily compromise her ability to breastfeed her baby.

Note: Although it is not the topic of today’s post, I want to note that it is possible to breastfeed and take medication for postpartum depression. For more information see: Which Psychiatric Medications are Safe During Breastfeeding?

The Importance of breastfeeding frequency

According to kellymom.com’s tips on breastfeeding your newborn, frequency is incredibly important.

Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10 – 12 times per day (24 hours). You CAN’T nurse too often; you CAN nurse too little.

This can mean different things for different babies, which is why listening to their cues is so important. My son nursed every two to three hours around the clock. My daughter nursed more frequently than that during the day (at least once per hour when she wasn’t napping), but slept longer at night (usually got a 4 to 5 hour stretch in).

In the past, Katherine has talked about her family’s two nights on, two nights off approach. She wrote:

My doctor at Emory believes sleep management is extremely important. My husband and I had a “2-nights-on, 2-nights-off” plan. I knew that soon I would get two full nights of rest, and that went a long, long way in helping me to try and keep it together and to recover from PPD. Sleep deprivation is a form of torture, after all.

She also expressed agreement with a Huffington Post article that suggested a different approach, based on a similar idea:

Split nighttime baby duty so you each get at least one five-hour uninterrupted block of sleep. One of you is “on” from 8:00 p.m. to 1:00 a.m., and the other from 1:00 a.m. to 6:00 a.m. (adjust these figures to your family’s schedule). When you are “off duty,” sleep in a separate area, and try earplugs, a fan, or a white-noise machine. The on-duty parent can sleep, too, but he or she will be the one who has to wake up to respond to and feed the baby.

While these tactics may work for a formula fed baby, it could be incredibly detrimental to a breastfeeding mom’s milk supply, especially if they become a permanent solution rather than a one-time “catch up on my sleep” tactic.

How to combine breastfeeding frequently with good sleep

So, if you need more sleep but want to keep breastfeeding and don’t want to compromise your milk supply, what can you do? Start by implementing general practices that help promote good infant sleep. But beyond that, there are other things you can do to help protect your milk supply and get more sleep.

Here’s part two with Annie’s tips on how to do just that!

Annie has been blogging about parenting, feminism and social change at PhD in Parenting since May 2008. She is a social, political and consumer advocate on issues of importance to parents, women, children and the earth. She regularly uses her blog as a platform to create awareness and to advocate for change, shedding light on positions, policies and actions that threaten the rights and well-being of parents and their children.