breast milk

Psychological Distress in the Mother May Affect Levels of Immunoglobulins in Breast Milk

We have seen multiple studies which indicate that postpartum depression (PPD) interferes with breastfeeding.  Postpartum women who suffer from depression are less likely to breastfeed, and they typically breastfeed for a shorter duration than women who are not depressed.  A recent study looks at an entirely different question, asking whether postpartum stress affects the quality of the breast milk.  In this study, the researchers focused on levels of immunoglobulin A (IgA) in the breast milk.  (Immunoglobulins or antibodies are passed from the mother to the baby through the breast milk and help to confer immunity.)

Methadone and Breastfeeding

Up until 2001, the American Academy of Pediatrics (AAP) recommended that methadone was compatible with breastfeeding in women taking less than 20 mg per day.  Because most women on methadone maintenance therapy typically require 50 to 15o mg of methadone per day during pregnancy, this meant that most women on methadone were not able to breastfeed. However, the dose restriction for methadone was eliminated in 2001, a decision driven by several studies indicating that the levels of methadone secreted into human breast milk were relatively low.

SSRI Use Associated with Reduced Intention to Breastfeed

Given the potential health benefits of breastfeeding on both mother and baby, the U.S. Public Health Service for Healthy People 2010 set a goal to have 75% of mothers breastfeed in the early postpartum period and 50% of mothers to continue breastfeeding to 6 months by the year 2010 (US Dept of Health and Human Services 2000).  Groups of women who are less likely to breastfeed have been targeted in this effort.

Fish Oil and Postpartum Depression

One treatment that has recently received a great deal of interest lately is fish oil. There is some preliminary evidence to suggest that the omega-3 fatty acids contained in fish and fish oil, including eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have an antidepressant effect. It has been discovered that mothers selectively transfer DHA to their baby during pregnancy and through the breast milk to support neurological development in the developing child. Thus, child-bearing women may become depleted of DHA, and it has been hypothesized that DHA deficiency may make mothers more vulnerable to depression during the postpartum period.