Baby

Can weaning your baby cause maternal depression?

A year into nursing my third son, I went to feed him for the millionth time and the strangest thing happened: I was overcome with the almost nauseatingly strong urge to not. I knew it was time to begin the weaning process, just as I’d done before with my other two babies.

It took a few weeks to fully wean him, using the same gradual approach I’d taken with his big brothers, all around the 14-month mark. I expected a smooth transition into toddlerhood and looked forward to a life without another human attached to me. But the onslaught of physical and emotional changes that soon followed was overwhelming and all-consuming. I developed seemingly random symptoms I’d never experienced before: debilitating headaches, mood swings, sadness, anxiety and lethargy—it felt like PMS with a side of the flu. It was more intense than the first months of pregnancy had been.

After some passive attempts to google my symptoms and find someone who could relate online, I realized I was dealing with one of the least discussed but more difficult parts of postpartum life: an intense reaction to weaning. I can describe it only as the “weaning fog.” My always reliable social media mom groups, and even some deeper research, produced little advice and very few articles on the weaning fog. Of course, I found information on the basics of weaning: preventing engorgement and finding alternative ways to continue bonding with the baby. But this wasn’t what I was experiencing. I took pregnancy tests (negative), visited my doctor (“It’s a phase”) and talked to other moms (huge variety of experiences). I was frustrated and I needed to know why I was feeling like garbage.

My husband and I now refer to what happened to me as the “dark side” of weaning.

Let’s start with the facts: Research does not, technically, show that postpartum depression or anxiety surges at this time. But that’s because mothers aren’t specifically screened for depression during weaning, as it’s usually a temporary phase and everyone weans at different times—it could be three months postpartum or three years postpartum. High-quality research simply does not exist yet. However, plenty of women report feeling the effects of the hormonal changes that occur during weaning.

Reproductive psychiatrist Alexandra Sacks, author of What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood and the host of the Motherhood Sessions podcast, explains it this way: “Some women are more sensitive to hormonal shifts than others; some have more dramatic mood changes around periods, during pregnancy, postpartum and around weaning, but these are individual sensitivities—so some people feel better, and some feel worse.” Others don’t notice any mood changes at all.

A decline in oxytocin, the bonding hormone stimulated by breastfeeding, may lead to some women feeling low, says Sacks. She also explains that some women feel better after weaning if they had found breastfeeding to be stressful or disruptive to their own sleep (which may increase stress hormones).

When you stop breastfeeding, prolactin (the milk-production hormone) drops off, estrogen shoots back up, and all of it sent me into a PMSing, semi-permanent state of terribleness.

Verinder Sharma, a professor of psychiatry with a cross appointment to the Department of Obstetrics and Gynecology at the University of Western Ontario, confirms that the prolactin decrease is the issue, but it’s not the whole story: What matters is how the prolactin affects other changes in the brain and results in depression—or even mania.

Sharma says to look for a “clustering of symptoms.” Some women may experience comparatively simple hormone changes with weaning, while others might be plunged into a full-blown postpartum depression. I sure had a cluster of symptoms, but I didn’t feel they were depression-like. It felt more physical for me.

“We make a distinction between symptoms and syndromes,” says Sharma. For women, all “reproductive events” related to hormonal changes—this can include pregnancy and postpartum, as well as monthly PMS, menopause, and when you’re getting your period for the very first time—increase the risk of psychiatric problems, he says. For example, bipolar disorder mania is extremely affected by hormonal changes—one in three women with bipolar disorder will experience an onset within a year of starting puberty or getting their first period. It’s also the mental disorder most exacerbated by childbirth, according to Sharma.


mother breastfeeding her baby sitting on some steps
How to stop breastfeeding
In the 18th century, doctors and psychiatrists did, in fact, distinguish between postpartum disorders and the “lactational period,” but in contemporary studies, they haven’t done this. Sharma says we are still evaluating men and women too similarly and that a paradigm shift needs to take place for us to more holistically consider a woman’s hormones in relation to her mental health. “That change should reflect the heightened risk around the time of reproductive events,” including during weaning, says Sharma. Due to the lack of research in this area, Sharma says there are no concrete numbers on how many women experience depression or other mental disorders during weaning. He thinks screenings for mood disorders during weaning should be as commonplace as mental health assessments during the early postpartum period. Ideally, doctors should be considering and connecting potential changes at each major hormonal shift in a woman’s life.

While my so-called weaning fog was nothing like bipolar mania, I’m certain it was affected by the soup of hormones flowing from my pituitary gland and swirling throughout my body. In addition to this hormonal chaos—or maybe because of it—I was also feeling a little sad that breastfeeding was over, while simultaneously feeling glad that we had stopped. After nursing three babies, I felt a sense of nostalgia and freedom at the same time. It’s that classic push-pull feeling of parenthood: Looking forward yet yearning for the past, too.

Mourning the breastfeeding period and feeling a sense of grief or loss is common. Catie Agave*, a 36-year-old mom in Toronto, felt it intensely, since she knew she was most likely going to have only one child. “The journey was ending for us, so that brought on sadness as well,” she says. While she weaned her three-year-old gradually, she started to feel foggy within two weeks of completely weaning.

“I wasn’t prepared for the change,” she says. “I didn’t feel like myself. I was more exhausted even though he was finally sleeping more. By week three or four, I had a lack of interest in daily activities, which is difficult when you have a child of that age.” She kept her feelings to herself at first, and then did some googling, but she found very few research-based articles and a lack of support, even in her usual go-tos: her Facebook mom groups and breastfeeding forums. “Nobody talks about it.”

“There are a lot of people talking about postpartum depression,” she says. “And reading their symptoms, I thought, yeah, this is what I have—this is depression. But nobody ever said you can have postpartum depression from weaning, too. I was very sad, and it lasted for a long time. I couldn’t find anyone else going through that,” she says. “It was a scary experience.”

Agave says she was hesitant to talk to her doctor because she assumed postpartum depression (PPD) was for moms of infants, not moms of toddlers or preschoolers, and she worried she’d be judged for her choice to practise extended breastfeeding. She credits her sister with encouraging her to see a doctor, in spite of her fears. “The doctor was supportive and mentioned postpartum depression can happen up until three years,” she says.

Sacks is working to popularize the term “matrescence,” originally coined by an anthropologist in the 1970s, as a better way to describe and fully capture the ongoing transitions of motherhood over time, even if your baby is now growing into a toddler. “It’s a helpful framing of new motherhood as a developmental phase, like ‘adolescence’—it’s not a coincidence that the words sound similar,” she says. “Both matrescence and adolescence describe shifts that are challenging because they involve changes in so many parts of life, ranging from the physical, hormonal, social, emotional and all the rest.” Adolescence is a gradual process—it isn’t instant in the way motherhood can be divided into pre-baby and post-baby life. But we need to be forgiving of ourselves, and to acknowledge that it might take time to adjust to all the shifts and challenges happening at once. Your body, your brain chemistry and your identity are all changing. Whether it’s a few months after birth or three years later, women shouldn’t feel ashamed if they experience the weaning fog, like me, or true depression symptoms, like Agave. We all have our own recovery period.

Sacks encourages moms to remember that the end of breastfeeding doesn’t mean your baby needs you any less.

Agave, who had struggled with anxiety in the past—but never depression—was ultimately referred to a treatment program where she improved through cognitive behavioural therapy (CBT). She was relieved to know CBT was an option, in addition to taking prescription medications, such as antidepressants. (She was prescribed an SNRI but chose to focus on CBT treatment instead.) “Eventually, my hormones regulated and the feeling of depression significantly decreased, but to this day, the anxiety piece is still there. I think a lot of it is the stress of being a mom.”

Around the time I was preparing to pursue professional help, my own symptoms eased up, around two months after they began. I found myself reflecting back on the previous two months, asking, “What just happened?” It had felt like the flu, mixed with mild depression, combined with all those yo-yo-ing feelings about my relationship with my baby. I felt so thankful to feel “normal,” or like myself, again.

Batya Grundland, a family physician with an emphasis in obstetrics and women’s health in Toronto, and the former head of maternal care at Women’s College Hospital Family Practice, says gradual versus cold-turkey weaning can play a part in the intensity of hormonal changes. She believes weaning is unlikely to be the sole cause; rather, it’s a complex puzzle with multiple additional factors happening all at once.

“The tricky thing is that it would be hard to associate symptoms only with weaning,” she says. For many mothers, reductions to the nursing schedule often coincide with a return to full-time or part-time work. Some women will also experience the return of their period, with ovulation and menstrual cycles beginning to regulate again during the same time frame.

“It could make sense that [weaning moms] describe feeling pregnant. With the prolactin and estrogen changes, you could feel a whole bunch of things,” says Grundland. Not only are hormones changing drastically during this phase, but women may also be spending long days away from their babies, weaning by necessity (or attempting to pump at work), juggling full-time employment, adjusting to the work/daycare dash, not sleeping enough at night and forgetting to take care of themselves in all of this.

“Moms are so busy—they need to be reminded that self-care is important, and we need to figure out ways to better support mothers,” says Sacks. She nudges parents to ask themselves how much they’ve slept and when they ate their last real meal. Do you have time to simply go to the bathroom and brush your teeth alone? Have you had time to yourself not engaged in childcare? Sacks says moms need to reconnect to who they are outside of parenting—like seeing friends, spending time with a romantic partner or pursuing non-child-related interests. “If you cut out the majority of activities that were essential to your routine before having a baby, you may feel disconnected from your identity.”

Both Sacks and Grundland also recommend seeking help if temporary feelings of sadness become long-term or interfere with daily activities, but they agree that some sadness can be normal for some individuals. Most women can expect to feel physical and emotional changes for about four to six weeks, says Grundland.

My journey through the weaning fog, and my version of self-care during the recovery period, meant seeking out meals with multiple food groups, a simple thing that had fallen off the priority list when I was caring for a colicky baby and keeping my other two toddlers alive and happy. I distinctly recall a three-course lunch I bought for myself, including a rack of ribs, that reminded me how to enjoy other things again, as a separate human from my baby. I had forgotten that I needed to eat real food, too.

The end of breastfeeding doesn’t mean your baby needs you any less, emotionally, says Sacks. It’s like every other bittersweet aspect of parenting: “You feel a sense of longing when you see clothes your child no longer fits into, but you’re happy they’re growing. A baby is able to eat [solid] foods, but the ‘baby phase’ is now behind you. You can want two things at once.”

I wanted to be the selfless, amazing super mom, but to also feel zero guilt treating myself to that rack of ribs—alone—instead of nursing a baby for the fourth time that day. I wanted to feel even-keeled and clear-headed again, yet still bond with my baby in the ways breastfeeding had magically provided. In the end, the months-long weaning fog was just another example of the bizarre and unexpected, yet temporary, phases in my first few years of motherhood.

Read more:
‘You’re STILL nursing?!’ and other things to never say to a mom who breastfeeds her toddler
Why did no one tell me how hard it is to stop breastfeeding? 

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