Most risk factors for postpartum depression focus solely on maternal factors: dropping hormone levels of estrogen and progesterone after birth, a history of depression, sleep deprivation, lack of support from a partner/family/friends, unplanned pregnancy, teen pregnancy, and substance abuse issues. If any of those apply in your situation, as much as it depends on you, seek help for those specific issues. For example, if you are sleep deprived (and what new parent isn’t?), attempt to get more sleep as best you can, find support or a support group, and seek professional help and medications if necessary. These all certainly help a tremendous amount.
However, not much attention is given to infant factors that can complicate the “4th trimester” with poor breastfeeding or bottle-feeding, or babies who are colicky, fussy, gassy, and frequently spitting up. For many moms, the birth did not go according to plan, and then sometimes feeding doesn’t go according to plan either! The baby can’t latch, or when they do it’s terribly painful (7/10 pain is seen at our office daily, and last week one mom said 12/10 pain!). These symptoms are sadly common, but not normal. Often, not much support is given except “wait it out”, or band-aids that don’t address the root cause of the feeding difficulties. In our experience, treating a tongue-tie and helping with infant feeding is a significant non-pharmacologic intervention that can help with postpartum stresses, and we see many struggling moms feeling more confident and in a better emotional state at their 1-week follow-up. It was also confirmed in Dr. Ghaheri’s studies (here and here) reporting increased maternal self-confidence scores with breastfeeding after tongue- and lip-tie release.These babies are given labels like “he’s a difficult baby” or “she’s just colicky” or “he’s just a GI baby,” meanwhile the parents and even the whole family are struggling because they are trying to feed a baby who spits everything up, is frustrated at the breast, or if bottle-feeding, falls asleep quickly and never finishes the bottle. Often, the reason the baby is crying or colicky is as simple as hunger (they’re not feeding well), and/or they are full of gas and uncomfortable. Also, just because a baby is gaining weight does not mean everything is ok. That’s setting a low bar: survival. We should be aiming much higher to help baby and mother (and father and siblings!) thrive.
Here is a typical intake form from our office that we see multiple times a day (this one is from yesterday). Each of these checkmarks is an issue the family is struggling with and often is related to tongue-tie and lip-tie issues. Notice the check at the bottom for feelings of hopelessness or depression. Anyone working with new moms needs to ask about how they are doing emotionally, as it is certainly relevant.
