Feeling sad, even depressed, during or after weaning? You’re probably not alone.
Hormonal changes at weaning, coupled with the loss of the breastfeeding relationship, theoretically may heighten the risk of feelings of sadness, even leading to depression in some women.
While there is no research examining exactly this question, it is “certainly plausible that losing [these hormones] is going to make people feel physically bad, independent of any cognitive sadness they’re experiencing,” says Dr. Alison Stuebe, assistant professor of maternal and child health at the University of North Carolina.
Two key hormones of breastfeeding, prolactin and oxytocin, both affect mood. Prolactin is a calming hormone, and oxytocin both calms and instills a feeling of closeness (hence its nickname “the love hormone”). Theoretically, reductions in the levels of these hormones, especially when weaning is abrupt, may contribute to mood changes in some women.
One hypothesis, explained in this article, suggests that shared hormonal mechanisms may contribute to both breastfeeding problems and mood disorders. And some women, even those for whom breastfeeding has gone well and is ending in a satisfactory way, feel sadness at the loss of this relationship.
What can you do? If possible, wean gradually to avoid a “crash” in your hormone levels. If this isn’t possible or doesn’t work (even mothers who wean gradually may experience these feelings), check out this page of comfort measures for moms during weaning. If possible, consider doing some skin-to-skin or extra snuggling time with your child – this kind of closeness can raise your prolactin and oxytocin levels even if you aren’t nursing.
And if you are concerned that your mood may be depressive or otherwise troubling, be sure to seek help from a health care provider.
If so, you might be wondering how to prepare, both logistically and emotionally, to give yourself the best odds of having the outcome you want. The VBAC rate has fallen dramatically in recent years, making preparation and planning very important.
So we assembled this list of steps you can take in preparing for a VBAC. Consider it a starting point, and feel free to add to it in the comments!
Choose providers carefully, and don’t be afraid to shop around. Probably the most important decision you’ll need to make is your choice of provider. Obstetrical and midwifery practices can have widely varying VBAC success rates, so it’s important to shop around. This might lead you to change providers, which you can do even in the final weeks of pregnancy. You may feel uncomfortable switching practices or shopping around, but a provider’s VBAC history is the factor most likely to determine a birth outcome. Concerned about having to drive a little longer to get to the hospital? One mom we know puts it this way: Would you drive an extra 15 minutes to get to a good hairdresser? (And in a true emergency you’ll end up at the closest hospital anyway).
How should you judge the best place for a trial of labor? Look at the practices’ VBAC rates, including the number of women who have had a trial of labor and the percentage of those labors which ended in VBACs. If this isn’t available online, call and ask the practice for their rates in the last year or two. If they are unwilling to share this, consider that important information. Also check the hospital’s rates, which are more likely available online, but understand that most hospitals host several practices, so this number is a combination of the practices’ rates. When interviewing providers, try to learn as much as possible about practices’ VBAC policies: How long can you go “post dates” and still try for a VBAC? What kind of monitoring do they do? Can you labor in water? If you end up with a CBAC, can your doula be present in the operating room? What do they think makes someone a “good candidate” for a trial of labor? In your search, remember that, while there are many wonderful obstetricians, certified nurse midwives in general have lower cesarean rates.
An important tool in researching your options is the International Cesarean Awareness Network (ICAN) website’s VBAC policy database. ICAN members contacted every maternity hospital in the U.S. to determine which had bans on VBAC – both outright and “de facto” (those without an official policy but in which no practice would attend a VBAC) – and found that roughly half of all hospitals do not allow a trial of labor. So you may want to begin here in your research.
Hire a doula. Labors with the trained support of a doula are less likely to send in cesarean births, so be sure to have a doula or other trained labor support person present. When looking for a doula, try to find one who has experience with VBAC labors and who is knowledgeable about providers’ VBAC practices and policies. If you can’t afford one, see our post on ways of finding good labor support when a doula isn’t in the budget.
Get peer support from other mothers who are in your position. Even when mothers get great support from their providers and partners, it can be isolating to try for a VBAC and it’s often very powerful to have peer support from people who understand how you feel. ICAN is one such organization, and you can find a group here. If there isn’t a group near you, you can find support in their closed Facebook page, and the forums of a number of other websites. You may also want to read VBAC birth stories, and there are many on the ICAN website.
Learn non-medication based methods of reducing discomfort in labor. As with birth generally, the longer you can relieve pain without using medication during a trial of labor, the better your chances of having a vaginal birth. That’s because medication-based means of pain relief often trigger a “cascade of interventions” which leads to a cesarean. So learn about ways of relieving pain, such as movement, deep relaxation, partner massage, visualization, breathing, water, and others. Of course, it’s definitely possible to have a VBAC with medication, so if your labor ends up going in that direction all is not lost!
Learn about fetal positioning. If your cesarean birth was due at least in part to fetal positioning (having a posterior or “sunnyside up” baby), learn more about that topic and choose providers (including doulas) who are skilled at helping babies settle into optimal position for vaginal birth, including during labor. The Spinning Babies website and chiropractic care from someone trained in Webster’s Technique can be helpful. Be sure to listen to our podcast on posterior babies and what can be done to change their positions, including the “belly lift” and “sifting” with a rebozo.
Prepare for the possibility of another cesarean birth. Even moms who are completely focused on having a VBAC need to have a back-up plan they’re comfortable with. Explore the possibility of family-centered cesarean, which may include options such as doing skin-to-skin and/or breastfeeding in the operating room, having your arms free to touch the baby, a slower birth through the incision, lowering the drape so you can see the baby being born (if you want), and other less frequently used practices. Meet with the obstetrician who would be performing the cesarean to work out your backup plan. And you may want to listen to our podcast on family-centered cesarean.
Work on processing past experience. If the prior cesarean was traumatic and strong feelings are affecting emotional preparation for your next birth, do the hard work of processing it. EMDR and other therapies can be very useful for this. Discuss your prior experience with your providers and briefly explain it in your birth plan. Other emotional preparation, such as visualizing a repeat cesarean or peering into the OR, may be useful. You may also want to read our post on getting help for traumatic birth experiences or listen to our podcast on traumatic birth.
Stay active. Exercising reduces your risk of gestational diabetes and having a large baby, both of which can affect your chances of having a VBAC. You’ll also be in better shape for the workout that is labor and birth.
Finally, you may want to listen to Motherlove’s podcast on VBAC – an interview with he president of ICAN.
Charlie spoke about how few moms have paid parental leave, how much leave moms actually take, the health and economic costs of our current policy, how current policy affects the role of partners, and what Moms Rising is doing to advocate for better policies.
Whatever you call it, if you’re pregnant and want a more satisfying cesarean experience should one be necessary, you’ll want to learn more about it.
In this podcast interview we talked with Robin Elise Weiss, author, childbirth and postpartum educator, certified doula, doula trainer, and lactation counselor. Robin is the Pregnancy and Childbirth expert on About.com and is the author of numerous books, including The About.com Guides to Having a Baby and Baby Care, The Everything New Mother’s guides to The First Year, Pregnancy Fitness, and Getting Pregnant.
We discussed what a family-centered cesarean looks like, what it means to moms and for birth outcomes, how moms can advocate for a family-centered cesarean, and whether this new trend will harm efforts to reduce the historic high cesarean rates of recent years.
It’s a common scenario for babies whose moms have returned to work, babies who are too busy or distracted to eat during the day, and teething babies. And it has a name: reverse cycling.
Why does reverse cycling happen? There is usually a reason. Babies want food, comfort, or both at night, often because they aren’t getting as much as they want or need during the day.
A typical case is a baby who doesn’t like to take a bottle at day care, who “sips” enough during the day to make it the reunion with her mom at the end of the workday – when the all night feast starts. Or a baby who is adjusting to having less frequent contact with his mom during the day now that she’s gone back to work, and so wants more comforting at night. Occasionally, it’s the mom who is so busy juggling multiple kids during the day that feedings are not frequent enough, or not long enough.
So if your baby is reverse cycling, what can you do?
First, identify a possible reason why he has adopted this pattern. Is he not eating enough during the day? Too distracted to eat much during waking hours?
Then, address look for ways to address her needs. Our favorite resource page is at kellymom.com, where you’ll find lots of tips for different situations. You’ll also find some tips for making reverse cycling work (and why some moms even encourage it) on this page. You may also want to check out our podcast interview with Nancy Mohrbacher on night nursing.
And whatever you decide to do, take heart in the knowledge that this pattern will pass in time!
There are all kinds of ways of indicating that you’d would like some privacy, but we thought we’d share several free door hangers you can print out, cut out, and post!
Texas WIC program: Breastmilk – Every Ounce Counts
New Mexico Breastfeeding Task Force: Doorhanger includes information about state law on pumping at work
Bellabama: Uses the International Breastfeeding Symbol
These doorhangers from a company local to us are not free, but we love them!
And check out these hilarious ones (not printable, but worth a look!).
There are many remedies for breast engorgement, ranging from massage, to cold packs, to cabbage.
But did you know that herbs – in the form of a poultice – can also help reduce swelling and inflammation associated with engorgement?
What’s a poultice? It’s an age-old way of treating soreness and inflammation, using moist herbs applied directly to the skin, usually held in place with a cloth.
Herbs that work well in a breast compress are anti-inflammatory and reduce swelling (comfrey, chamomile, calendula, lavender), increase lymph circulation and drainage (cleavers, burdock root, yarrow), and draw out infection (slippery elm, marshmallow root). Mullein leaf relieves pain.
To prepare, pour boiling water over the herbs and steep for 10-15 minutes. When cool enough to touch, apply herbs as a poultice directly to skin. You can also dip a cotton cloth in the warm infusion, wring it out and wrap around the breast and under the armpit. Keep the poultice on until it cools. Reapply throughout the day. If infection is present, a clean poultice or cloth should be used every time.
For a comprehensive discussion of engorgement, including prevention, treatment, and when to seek help, see this page on Kellymom.com.
Image credit: Chamomile, Wikimedia Commons
But there’s good news: the scent of herbs may help lift your spirits. Scents can be powerful mood changers, stimulating many regions of the brain and influencing emotional, immune, and hormonal functions.
The essential oils of a number of herbs can be helpful at this time of year. You’ll find them in lotions, bath salts, and massage oils. You can use them in an aromatherapy diffuser or vaporizer. Or you can create a quick steam inhalation bath by putting two drops of oil in a tub of hot water and leaning over it while covering your head with a towel (*Kathryn – are all of the oils below safe to inhale in these small amounts?). Just remember that essential oils generally shouldn’t be applied to the skin in undiluted form.
Here are a few of our favorite scents to lift the spirits in winter:
Citrus fruits (lemon, orange, grapefruit) have invigorating scents which many people find energizing. Research has even found that they can reduce stress and improve mood. Other energizing scents include basil, ginger, lemongrass, juniper, mint, sage, and thyme.
Lavender is a familiar, clean and crisp scent. It’s traditionally used to relieve headaches, depression, exhaustion, and to promote relaxation and sleep. You’ll find the herb and scent used in many herbal body care products, sachets and sleep pillows. Other soothing and relaxing herbs include: chamomile, elder, hops, jasmine, rose, and valerian.
Pine. When you’re stuck indoors, the scent of pine can bring your mind right back outside. Pine has been used traditionally for many purposes, including stress reduction, pain relief, and for strengthening concentration. Research suggests that it’s an effective mood-elevator.
Rosemary is another energizing scent to lift late winter spirits. It’s used for stress, anxiety, depression, and even strengthening brain function. Its strong scent may also be useful as a decongestant for winter colds.
In this podcast interview, Kathi Barber, author of The Black Woman’s Guide to Breastfeeding and Lactation Management: Strategies for Working with African American Moms, discusses the history of breastfeeding in the black community, from a strong African breastfeeding tradition, through slavery and wet nursing, to the present day. She also provides guidance for breastfeeding support people working with African American mothers.
These are common concerns during breastfeeding, and they’re perennial hot topics at breastfeeding and new mom support groups. Of course, there are many books that cover these issues, too.
But what if you want quick, reliable information from a trusted source in your purse and on your nightstand any time of day or night?
Nancy Mohrbacher, author of many of the best books on breastfeeding money can buy, like Breastfeeding Made Simple, Breastfeeding Answers Made Simple, and Breastfeeding Solutions, has produced a new app for iPhone and Android devices that covers all the basics. We spoke with Nancy last year in a podcast interview about night nursing.
Based on her book Breastfeeding Solutions, this app providing straightforward solutions to the 30 most common breastfeeding problems, from birth to weaning. There is a “Solutions” section to help you pinpoint a problem’s cause, and for for answers to common concerns there is a comprehensive “Articles” section. It’s ad free and not sponsored by a formula or other company. Its creator is a board certified lactation consultant and is one of the most knowledgeable individuals on breastfeeding on the planet.
The Breastfeeding Solutions app sells for $6.99 and we think it’s one of the best investments you could make to ensure that you meet your breastfeeding goals. You can find it at the iTunes and Amazon (for Android) and Google Play stores.
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