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San Diego, CA 92123-4282
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Article Review Sheila Weibert, WHNP, IBCLC
Postpartum Stress: Current Concepts and the Possible Protective Role in Breastfeeding, Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN), Vol. 31, Number 1 July/ August 2002
This article is a review of the literature relating to postpartum stress and research on a possible protective effect of breastfeeding on reducing postpartum stress. A limited number of animal and human studies were reviewed comparing different stress responses. The stress categories during the postpartum period were physical, intrapersonal, and interpersonal.
There are a wide variety of physical symptoms in the postpartum time. In the physical category, fatigue consistently increases stress in breastfeeding, self-care, mothering and infant care. On average, the amount of sleep in a 24-hour period during the 4th week postpartum is 7.5 hours, with only 6.15 hours during the night. Sleep depravation may continue for some women for months, causing acute and cumulative problems. Other physical stressors include sexual concerns, poor appetite, breast symptoms, constipation, hemorrhoids, and hand numbness and tingling.
The development of maternal identity (maternal role) is in the intrapersonal category. Interpersonal relates to the
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interaction between the mother and others. High levels of maternal role stress at one month postpartum showed a decreased maternal sensitivity to infant cues at 4 months postpartum. The woman's weight in the postpartum period is another intrapersonal stress. Daily stress, self-esteem, and child care stress were predictors of postpartum depression in the intrapersonal stress category. The majority of mothers have concerns about their ability to meet the needs of the family, the infant, and to find time for themselves. Cultural expectations may be an interpersonal stressor for postpartum women also. This can lead to overload, role transition problems, guilt and depression. An endocrine and immune state occurs in lactating mothers promoting calmness and nurturing behavior, reducing maternal reactivity to the environment, enhancing quantity and quality of milk, and enhancing immune function. The anti-stress nature of lactation is partially due to the hormone oxytocin. In human mothers this hormone has been found to be amnesic, reducing anxiety and producing sedation.
Though there is minimal research on the reactivity to stressors in breastfeeding mothers, there is a diminished response to stress in women who are lactating. This protection appears to be neuroendocrinologically associated with breastfeeding. This evidenced based research article shows breastfeeding has a calming effect on mothers, resulting in less reactivity to stressors in the postpartum period.
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