Milk & Mind: How Lactation and Perinatal Mental Health Go Hand in Hand
By Jen Kost, MSW, LCSW, PMH-C
As a perinatal mental health therapist, I work with many new parents navigating the emotional rollercoaster of postpartum life. One of the most common and emotionally charged aspects of this transition is infant feeding. Whether a parent plans to breastfeed, chestfeed, pump, use donor milk, or formula feed, their feeding journey is deeply intertwined with their mental health.
Lactation struggles can contribute to postpartum mood and anxiety disorders (PMADs), while perinatal mental health challenges can impact milk supply, feeding behaviors, and a parent's overall experience. When lactation consultants and perinatal mental health professionals collaborate, we can provide more comprehensive support to families, ensuring both emotional well-being and successful feeding outcomes.
The Emotional Toll of Feeding Challenges
The early postpartum period is a time of intense physical recovery, hormonal shifts, and identity changes. Feeding an infant—often assumed to be a "natural" process—can quickly become a source of stress, frustration, and self-doubt when difficulties arise. Research shows that challenges such as low milk supply, latch issues, pain, and excessive infant weight loss are associated with an increased risk of postpartum depression and anxiety (Watkinson et al., 2021).
Many parents I work with express feelings of:
Guilt and shame—Believing they are failing their baby if feeding is difficult.
Anxiety and stress—Worrying about milk supply, weight gain, and feeding schedules.
Grief and loss—If their feeding journey does not go as planned.
Isolation—Avoiding social interactions due to difficulties or pressure to breastfeed.
Unmet feeding expectations are a major contributor to postpartum distress, with studies indicating that parents who planned to breastfeed but were unable to are at a significantly higher risk for postpartum depression (Borra et al., 2015).
How Lactation Support Can Improve Mental Health
Lactation consultants play a critical role not only in improving feeding outcomes but also in supporting perinatal mental health. By addressing feeding concerns early and providing compassionate, evidence-based guidance, lactation professionals help reduce stress and increase confidence in new parents. Key ways lactation support benefits mental health include:
Reducing stress and anxiety by addressing feeding concerns with practical solutions.
Improving self-efficacy—When parents receive support and encouragement, they feel more competent in their ability to feed their baby (Brown et al., 2016).
Providing emotional validation—Acknowledging the complexity of feeding decisions and reducing shame.
Encouraging flexibility—Helping parents understand that feeding is not "all or nothing" and that supplementing or combination feeding or simply doing what feels best for you can be a valid and healthy choice.
The Role of Mental Health in Lactation Success
While feeding challenges can negatively impact mental health, the reverse is also true—mental health conditions can impact lactation. Stress, anxiety, and depression can interfere with milk production due to the role of cortisol and other stress hormones in suppressing oxytocin, the hormone responsible for milk letdown (Hahn-Holbrook et al., 2013). Parents experiencing PMADs may also struggle with:
Low motivation or energy to continue breastfeeding/pumping.
Difficulty bonding with their baby, which can impact feeding cues and responsiveness.
Negative self-talk that contributes to feelings of inadequacy and guilt.
As a perinatal therapist, I support clients in:
Processing birth and feeding trauma that may contribute to anxiety or avoidance around feeding.
Challenging perfectionism and unrealistic expectations around breastfeeding and parenthood.
Developing coping strategies to manage anxiety, depression, and stress during feeding sessions.
Exploring options to prioritize both infant nutrition and parental mental well-being.
The Power of a Collaborative Approach
When lactation consultants and perinatal mental health professionals work together, we create a holistic, family-centered approach to care. A parent struggling with feeding issues may need emotional support just as much as practical solutions, and vice versa. By referring to and collaborating with each other, we can provide integrated support that acknowledges the emotional and physical aspects of infant feeding.
If you are a parent struggling with feeding challenges or feeling overwhelmed, know that you are not alone. Feeding your baby should not come at the expense of your mental health, and there is no one "right" way to nourish your child. Seeking support from both a lactation consultant and a perinatal mental health therapist can help you navigate this journey with greater confidence, flexibility, and emotional well-being.
Let’s normalize these conversations and ensure that parents receive the comprehensive care they deserve.
References
Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: The importance of understanding women's intentions. Maternal and Child Health Journal, 19(4), 897–907.
Brown, A., Rance, J., & Bennett, P. (2016). Understanding the relationship between breastfeeding and postnatal depression: The role of pain and physical difficulties. Journal of Advanced Nursing, 72(2), 273-282.
Hahn-Holbrook, J., Haselton, M. G., Dunkel Schetter, C., & Glynn, L. M. (2013). Does breastfeeding offer protection against maternal depressive symptomatology? Archives of Women's Mental Health, 16(5), 411-422.
Watkinson, M., Murray, L., & Cooper, P. J. (2021). Breastfeeding difficulties and maternal mental health: A systematic review. Journal of Affective Disorders, 281, 534-544.
