Tag: PPD

Homesick feeling while breastfeeding: DMER

- Julie Matheney

Dysphoric Milk Ejection Reflex (D-MER) During Breastfeeding

Dysphoric Milk Ejection Reflex (D-MER) is a condition that affects some breastfeeding mothers, characterized by negative emotions that occur just before or during milk letdown. Unlike postpartum depression or anxiety, D-MER is specifically linked to the physiological process of milk release. Understanding D-MER is important for providing support and effective management for affected mothers.

What is D-MER?

D-MER is a sudden and brief wave of negative emotions, such as sadness, anxiety, irritability, or even a sense of dread, that occurs just before the milk ejection reflex. These feelings typically last only a few minutes and resolve once milk flow begins.

Symptoms of D-MER

Symptoms of D-MER vary in intensity and nature but are generally negative and unpleasant. They can include:
- **Sadness or Despair**: Feeling profoundly sad or hopeless.
- **Anxiety or Panic**: Experiencing a sense of anxiety, panic, or nervousness.
- **Irritability or Anger**: Sudden feelings of irritability or anger.
- **Dread or Guilt**: A sense of dread or guilt with no apparent cause.
- **Emotional Numbness**: Feeling emotionally detached or numb.

Causes of D-MER

The exact cause of D-MER is not fully understood, but it is believed to be related to the hormonal changes that occur during breastfeeding:
- **Dopamine Regulation**: D-MER is thought to involve a rapid drop in dopamine, a neurotransmitter that helps regulate mood, which occurs to allow prolactin (the hormone responsible for milk production) to rise.
- **Hormonal Imbalance**: The sudden shift in hormone levels during milk letdown can trigger the dysphoric response.

Distinguishing D-MER from Other Conditions

D-MER is distinct from other emotional or psychological conditions like postpartum depression (PPD) or postpartum anxiety (PPA):
- **Timing**: D-MER is closely linked to the act of breastfeeding and the letdown reflex, whereas PPD and PPA are more constant and pervasive.
- **Duration**: The negative emotions in D-MER are short-lived, lasting only a few minutes during milk letdown.
- **Specificity**: D-MER symptoms are specifically triggered by breastfeeding, not by other activities or events.

Managing D-MER

While D-MER can be distressing, several strategies can help manage the condition:

1. **Education and Awareness**: Understanding that D-MER is a physiological response and not a reflection of your emotional state can provide reassurance. Knowing that it is a temporary and normal reaction can reduce anxiety about the condition.

2. **Support System**: Talk to a healthcare provider, lactation consultant, or support group about your experiences. Support from others who understand D-MER can be invaluable.

3. **Stress Reduction**: Engage in stress-reducing activities such as deep breathing exercises, meditation, or gentle physical activities like walking or yoga to help manage overall stress levels.

4. **Hydration and Nutrition**: Maintain a healthy diet and stay well-hydrated to support overall well-being and potentially mitigate some of the symptoms.

5. **Monitor and Track**: Keep a journal to track when D-MER symptoms occur, their intensity, and any possible triggers. This information can be helpful for discussing with your healthcare provider.

6. **Medications**: In some cases, medications that help regulate dopamine levels may be considered. Always discuss with a healthcare provider before starting any medication.

When to Seek Help

If D-MER symptoms are severe, persistent, or interfere significantly with your ability to breastfeed or care for your baby, it is important to seek professional help. A healthcare provider or mental health professional can offer guidance and treatment options tailored to your needs.

Conclusion

D-MER is a challenging but manageable condition that affects some breastfeeding mothers. By recognizing the symptoms, understanding the causes, and implementing effective management strategies, mothers can continue to breastfeed while minimizing the impact of D-MER. Support from healthcare professionals, lactation consultants, and peer groups can make a significant difference in navigating this experience.

Trauma informed postpartum care

- Julie Matheney

Giving birth is a profound experience that can impact a person both physically and emotionally. For individuals who have experienced trauma either before or during childbirth, receiving care from trauma-informed healthcare professionals (HCPs) is crucial for well-being and recovery.

Trauma-informed care is an approach that recognizes the widespread impact of trauma and emphasizes safety, trustworthiness, choice, collaboration, and empowerment in healthcare settings. It acknowledges the potential triggers and sensitivities that individuals with trauma histories may have

Why It's Important After Birth:

❤️Respecting Individual Experiences: It that every person's experience is unique and that past traumas can affect present health. It ensures that HCPs approach each patient with empathy, sensitivity, and understanding

  

❤️Reducing Triggers and Stress: Childbirth itself can be a triggering event for individuals with trauma histories. HCPs who are trauma-informed take proactive steps to create environments that minimize triggers and stressors, promoting a sense of safety and comfort

❤️Enhancing Communication: Trauma-informed care emphasizes clear and respectful communication. HCPs are trained to ask open-ended questions, listen actively, and validate patient experiences, fostering a collaborative and trusting relationship

❤️Supporting Emotional Health: Postpartum emotions can be intense and complex. Trauma-informed professionals are equipped to recognize signs of distress or post-traumatic stress and provide appropriate support and resources

❤️Promoting Recovery and Healing: By integrating trauma-informed practices, HCPs can contribute to the healing process and help individuals build resilience following childbirth-related trauma

Every person deserves to feel safe, supported, and respected in their healthcare journey, especially after childbirth

**How to Access Trauma-Informed Care:**

- **Ask Questions:** When seeking healthcare services after childbirth, inquire about the provider's approach to trauma and whether they have specific training or experience in trauma-informed care.

  

- **Advocate for Your Needs:** Share your trauma history and specific triggers with your healthcare provider. Open communication allows for tailored care that respects your boundaries and promotes your well-being.

- **Seek Support:** If you're unsure where to find trauma-informed care, reach out to local support groups, therapists specializing in trauma, or community organizations that can provide recommendations.

**Remember, You Deserve Compassionate Care:**

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This post aims to highlight the importance of trauma-informed care in the context of postpartum health and emphasizes the value of working with understanding and supportive healthcare professionals after childbirth.

Deep breathing and breastfeeding

- Julie Matheney

Put your oxygen mask on first. When there is an emergency on a plane, we are instructed to put our mask on first before helping others. This is also critical when caring for our babies. You’ve just gone through one of the most traumatic experiences your body could physical do: give birth to another human being. You’re healing a dinner plate sized wound on your uterus while sweating like a pig and not sleeping for more than a few hours at a time. There are so many physical, social, and emotional changes happening to you all at once it can be easy to just ignore all of them to focus your energy into your new tiny human.

Deep breathing is one of the easiest, most convenient tools to reduce stress, anxiety, and pain. And who doesn’t have all of those after the trauma of giving birth and dealing with all of the physical, social and emotional changes of bringing a tiny human into their life? Laying on your back, feet up against the wall and focusing on intentional breaths is one of the simplest ways to reset and promote balance in your body again 

Deep breathing:

❤️ Decreases stress, increases calm. Stress and anxiety makes your brain release cortisol, the “stress hormone”, which decreases oxytocin, your milk let down hormone. Deep breathing slows your heart rate, allowing more oxygen to enter the blood stream which relaxes your brain and lowers cortisol. This results in higher oxytocin and thus more milk

🧨Relieves pain through endorphin release which can help while you’re healing your lady bits (or those cracked nips)

💎Detoxifies the body by stimulating the lymphatic system. Carbon monoxide is released by breathing. 70% of the toxins in your body are cleared just by breathing

🚗Increases energy. More oxygen= better body functions and that improves stamina. Who doesn’t need that for 2am feedings?

🩺Lowers blood pressure. Relaxed muscles allows blood vessels to dialate, which improves circulation and lowers blood pressure

💊Fully oxygenated blood carries and absorbs nutrients and vitamins more efficiently, improving your immune system against viruses and bacteria. This also helps improve digestion! 

🤸‍♀️Supports good posture. When you breathe in, your lungs expand which pulls your diaphragm down and straightens your spine. You definitely need to lengthen your spine and release that neck tension from being hunched over while latching your baby

The risks of not addressing maternal mental health include:

✏️Poor infant growth, language and cognitive development 

✏️Poor gross and fine motor development

✏️Less efficient breastfeeding or weaning from breastfeeding earlier than desired

✏️Poor infant sleep and increased maternal stress. 

When considering antidepressant use during lactation, while most medications are considered safe for mom and baby, there is no “zero risk” option. However, the benefits of using a medication to help decrease depression and anxiety usually outweigh the risks acostares with taking a medication. If a mother has been on a certain med prior to breastfeeding and it worked well for her, it would be reasonable to resume that medication while breastfeeding. Sertraline (Zoloft) is a first-line drug for breastfeeding, due to documented low levels of exposure in breastfeeding babies and the very low number of adverse events described in case reports. Prozac is generally considered safe to take while breastfeeding; however, research shows that the average amount of the drug in breastmilk is higher than with other SSRIs. 

When taking any medication, you want to monitor for side effects both in you and the baby. Most common side effects when taking antidepressants are:

🥛 Changes in milk supply

🛌 Sedation/sleepiness in baby

Poor feeding or weight gain in baby

Antidepressants can work well to help you feel balanced again. Work closely with an IBCLC while starting antidepressants to help continue and feel supported in your breastfeeding journey

Weaning blues: why do I feel so emotional from weaning baby from the breast?

- Julie Matheney

If postpartum depression weren’t enough, it’s also possible to be depressed and have mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of postpartum depression. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moody, sad or even angry. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely to experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away once hormones stabilize. Some will also feel relieved and happy once it’s over and they can move on into the next stage of parenting. And that’s OK, too!!

If you are weaning and experiencing mood swings, you’re not alone! Remember, it takes at LEAST a full 40 days for those with an established milk supply to no longer see milk when they hand express or stimulate the breast. Your milk making cells are going through a cellular death called involution where they literally change from milk making cells back into breast fat cells. Some find it takes 1-3 period cycles after weaning for their hormones to reset and feel “back to baseline” which coincides with when this process is complete. It will get better!!

Some times being aware that this is a hormone shift and not something in your head is enough to bring peace in the process. Find your coping mechanisms. Reflect on your journey. There are herbs and supplements that can help in the process (set up a consultation to discuss which ones are right for you as they are NOT one size fits all). And if needed, seek professional counseling. 

Breastfeeding Grief

- Julie Matheney

Many times things don’t go as expected during labor and delivery and/or with breastfeeding. The loss of our expectation of what we thought would happen become the root of our grief and depression. It’s so easy to blame ourselves when things go wrong, even though our society is not set up to support postpartum families in any capacity, especially related to breastfeeding. This happens more than you think and I see it every day in my practice helping families in their breastfeeding journeys.

Grief is a spectrum that is different for everyone. You may not have even realized that the emotions you’re experiencing related to your breastfeeding journey not going as expected are in fact grief. Rage, anger, sadness, depression, anxiety, shame and guilt could all actually be stemmed from grief.

Different people need different ways to approach and process their grief. How do you start the grieving process? Recognition that you’re grieving the loss of an expectation is the first step. Realizing that you’re not the only one who is grieving their birth or breastfeeding story at this very moment can also normalize what you’re feeling. Give yourself permission and time to grieve. You may have a healthy, thriving baby. You may have really supportive family. You may have every resource available to you. That doesn’t negate your experience or the emotions you’re feeling.

Other steps to working through your postpartum and breastfeeding grief:
⭐️Avoid self blame
⭐️Surround yourself with people who will support you or who have gone through a similar experience
⭐️Talk to someone safe about what you’re experiencing. This may need to be a trained therapist
⭐️Find an IBCLC to help you reach your feeding goals. Schedule your consultation with me at www.lalactation.com
⭐️Hire a postpartum doula to help with baby and self care
⭐️Honor your story and the journey you’re on
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📷 @dionnachambers
🖊 @lalactation

Antidepressants and breastfeeding

- Julie Matheney

Put your oxygen mask on first. When there is an emergency on a plane, we are instructed to put our mask on first before helping others. This is also critical when caring for our children. Stress, depression, and anxiety can play major roles in how we care for our babies and for ourselves. Antidepressants are OK to take while breastfeeding. When maternal mental illness is not addressed, research shows this not only has a negative impact on the mother’s overall health, but can impact the baby as well.

The risks of not addressing maternal mental health include:
✏️Poor infant growth, language and cognitive development
✏️Poor gross and fine motor development
✏️Less efficient breastfeeding or weaning from breastfeeding earlier than desired
✏️Poor infant sleep and increased maternal stress.

When considering antidepressant use during lactation, while most medications are considered safe for mom and baby, there is no “zero risk” option. However, the benefits of using a medication to help decrease depression and anxiety usually outweigh the risks acostares with taking a medication. If a mother has been on a certain med prior to breastfeeding and it worked well for her, it would be reasonable to resume that medication while breastfeeding. Sertraline (Zoloft) is a first-line drug for breastfeeding, due to documented low levels of exposure in breastfeeding babies and the very low number of adverse events described in case reports. Prozac is generally considered safe to take while breastfeeding; however, research shows that the average amount of the drug in breastmilk is higher than with other SSRIs.

When taking any medication, you want to monitor for side effects both in you and the baby. Most common side effects when taking antidepressants are:
🥛 Changes in milk supply
🛌 Sedation/sleepiness in baby
Poor feeding or weight gain in baby

Antidepressants can work well to help you feel balanced again. Work closely with an IBCLC while starting antidepressants to help continue and feel supported in your breastfeeding journey

Depression with weaning

- Julie Matheney

Weaning blues. If postpartum depression weren’t enough, it’s also possible to have depression and mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle or love hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of post partum depression and aids in bonding with baby. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being, calmness and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moodiness, sadness or even anger. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away in a few weeks. Dropping no more than one feeding per week is a gentle way to wean and adjust to shifting hormones. People who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. Even for those who are ready to wean and doing so gradually, there may still be a sense of loss and sadness. Your breastfeeding relationship has been a major part of your parenting journey and it is understandable that you’ll feel a wide range of emotions.