Motherhood has been…. different from what I expected to be. Actually, no, I am different from what I expected. I never expected that I would spend the first year and a half of my first son’s life struggling with, and denying that I had, postpartum depression. I have briefly written before that I struggled in the beginning with a difficult birth, difficulty breastfeeding and difficulty with a baby who needed me all the time. I was more than just overwhelmed and exhausted. I was terrified. Like, all the time. Terrified of not doing the right things for this tiny, fragile little baby that I loved so much. And angry. So, so angry. It’s strange to think that motherhood could inspire feelings like rage, but it did for me. My inner fear, anxiety and insecurity manifested outwardly as intense, quiet rage. At the end of the day I would feel exhausted just from being mad and anxious. I have finally been in real treatment for about three months and it already feels like a lifetime ago that I spent so much of my time feeling such rage. Since May is National Maternal Depression Awareness Month, I thought it would be appropriate to share with you some important information I have gathered and learned during my own journey through postpartum depression and anxiety.
One of the guiding principles of BWI is that the practice of babywearing is beneficial for both children and caregivers. It has been pretty well established through empirical evidence that babywearing and kangaroo care has many physiological, cognitive and emotional benefits for babies. But what about caregivers, especially those suffering from postpartum mood disorders (“PPMD”)? PPMD, often referred to simply as postpartum depression (PPD), postpartum mental illness (PPMI), or perinatal mood or anxiety disorders (PMAD), actually includes a range of mood disorders such as postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder, postpartum post-traumatic stress disorder, postpartum bipolar mood disorder or postpartum psychosis and affects as many as 15 to 20% of mothers and 10% of fathers.
So where does babywearing enter in all of this? Can wearing your children alleviate symptoms and/or prevent PPMD? Unfortunately no research been done on babywearing specifically as a treatment for postpartum mood disorders, however, we do know that there is a growing body of evidence to support that kangaroo care, also known as skin-to-skin, has a positive effect on postpartum depressive symptoms.
Before we get there, let’s first discuss the science behind PPMD. PPD differs from regular clinical depression mainly by the fact that the onset of symptoms are clearly due to the recent birth of a child, generally anytime between 4 weeks to 6 months postpartum (although some specialists will expand the onset period up to two years postpartum). The other major difference between those suffering from clinical mood disorders without postpartum onset and those suffering from PPMD is a baby. Having a baby is an enormous life transition, whether it is your first child or your fifth, and a cause for extreme stress all on its own.
“What makes postpartum depression different from other forms of depression is that it occurs in the setting of responsibility for a new life-with a person who is completely dependent, and brings his or her unique qualities to the relationship. To fully hold the mother’s experience, it is important to recognize the baby’s contribution. For example, when a baby is born with difficulties settling to sleep, or is not naturally cuddly, it will have significant impact on the mother’s emotional experience. Sleep deprivation and feelings of inadequacy may compound an existing depression. In turn, the mother’s state of mind, particularly if she is preoccupied with her own distress, may impair her ability to help the baby to contain and manage his experience.” (Gould)
It is believed that PPD and other postpartum mental illnesses are caused, at least in part by, drastic hormonal shifts that affect the oxytocin levels in a your brain. Without getting too technical, oxytocin is a hormone that works in two ways to fight depressive symptoms. First, it inhibits the release of stress hormones responsible for the “fight or flight” response, and it also increases feelings of calmness, attachment and pleasure. Oxytocin, dubbed the “love hormone,” facilitates the feelings of attachment and bonding between primary caregiver and baby. Oxytocin is also the hormone responsible for labor contractions and the let down reflex in breastfeeding. It has also been revealed that mothers experiencing PPMD have lower levels of… you guessed it, oxytocin.
Curing PPMD and other forms of clinical depression may not be as simple as synthesizing oxytocin and administering it as a pharmaceutical intervention. Studies have been conducted in which synthetic oxytocin was inhaled as a nasal spray, and while it did produce positive results (like reduced stress, anxiety and cortisol levels in men) it also had mixed outcomes, including possible aggressive and hostile behaviors. Other pharmaceutical interventions such as antidepressant/anti-anxiety medications have a relatively high success rate on PPMD, but the effects on infants for mothers who are breastfeeding, while generally thought to be safe for certain medications, still needs more study. Not to mention the cost of such medications can sometimes be prohibitive, especially to those who lack adequate insurance coverage. Psychotherapy has also proven to be an effective, non-pharmaceutical intervention for PPMD but, again, the costs of such treatment can and do keep many from seeking treatment.
In the aforementioned studies on kangaroo care, it was found that the prolonged skin-to-skin contact increases the secretion of oxytocin, which in turn lessens the severity of or even prevents postpartum depression. Kangaroo care is different from babywearing in that it specifically requires baby’s skin to be in direct contact with mother’s bare chest for a prolonged period of time. This can certainly be accomplished while wearing baby in a sling, but most of the time such activity isn’t practical past the newborn stage when depression symptoms may begin to manifest. Parents (and babies) are wearing clothes and are being held in different positions than just tummy to tummy, especially older babies. However, there is also plenty of research to suggest contact need not be so specific to encourage those love hormones to flow freely.
Cuddling, hugging, kissing and even just gazing into someone’s eyes can facilitate the flow of oxytocin.
The research of Dr. Tiffany Field indicates that mothers who practice infant massage on their babies experience reduced depression and anxiety levels. Some recent research has even suggested that any recent contact with infants can reduce postpartum anxiety symptoms. In fact, adults and children of all ages benefit from the power of physical touch. In laboratory studies by Dr. Kathleen C. Light of the University of North Carolina at Chapel Hill, mothers and infants who have frequent and warm contact with each other produce higher levels of oxytocin in their blood as do couples who talk about happy memories while holding hands. Light suggests that anything that inspires a sense of support and bonding can activate the system in your brain that releases oxytocin in your bloodstream.
Caregivers, especially mothers, who are suffering from PPMD and who may also be having difficulties bonding with their babies, can use soft baby carriers to encourage more physical contact. The oxytocin released from frequent close contact would, in theory, increase feelings of maternal attachment and decrease feelings of depression and anxiety in mothers and babies. Of course babywearing will also help these mothers attend to the self-care needed to help combat PPMD while simultaneously caring for their children. Wearing your baby while you prepare and eat meals or attend to personal hygiene keeps them calm and it may in fact also be keeping you calm. You can even take a shower using a water sling if you needed to. This is no small thing in the treatment of depression.
In an interview with Babyology blogger, Dr. Koa Whittingham, University of Queensland parenting researcher and clinical and developmental psychologist states:
“…babywearing is a convenient way to give generous physical contact to baby…Babywearing enables her [the mother] to pursue her own interests, passions and pleasures. It also makes regular physical exercise and social activities easier to pursue. This is not trivial … In fact, deliberately cultivating a rewarding lifestyle is an evidence-based treatment for depression… Babywearing can play an important role in building a rewarding lifestyle to prevent or to overcome postnatal depression.”
Babywearing can also make it easier to combat isolation, which can precipitate and exacerbate depressive symptoms. Strap your baby on and go for a walk around the neighborhood or run to the grocery store. Better yet, go to a sling meet, find other caregivers who also wear their babies and begin building your village. The likelihood that you will meet someone who is going through the same thing you are is 1 in 5.
So that’s it then, right? Babywearing is an effective treatment for PPMD? Not necessarily. More research is needed to determine whether babywearing can directly improve PPMD and related disorders. Beth L. Mah, Ph.D., of the Mothers and Babies Research Centre at the Hunter Medical Research Institute in Australia who published a review of 50 studies on postpartum depression and oxytocin (OT) in the Harvard Review of Psychiatry states: “I’m not sure that we know OT is associated with decreased PND [postnatal depression, another term for PPD]. There is very little literature on OT and depression generally, let alone in PND. OT improves sensitive care giving but we don’t have enough evidence to use it in PND.” In response to a 2011 study linking lower levels of oxytocin in women at the end of their pregnancy with an increased risk for postpartum depression, Dr. Salih Yasin, of University of Miami Miller School of Medicine, stressed that even if the link is confirmed with further study, oxytocin isn’t the only factor affecting postpartum mood disorders. Dr. Yasin states, “Postpartum depression has so many factors. Some of it has to do with socioeconomic status, the stress levels, the family history, previous depressive symptoms, the presence or absence of other medical conditions.”
In a survey of healthcare providers and mothers in Northern Ireland by babywearing consultant Aimee Gourley, one respondent stated:
“I think it is difficult to separate babywearing from other interventions in terms of the benefits specific to PND. I would be hesitant in making a definite association, but in the context of it increasing the bond, aiding breastfeeding, enabling some mothers to actually get out and about, and helping a baby become more content (which eases mother’s anxiety) then I strongly am in favour. However I couldn’t make the statement to a mother that it ‘reduces the risk of PND’.”
That said, anecdotal evidence strongly suggests babywearing has a positive effect on postnatal depression. In Ms. Gourley’s survey of mothers discussed above, respondents who experienced PPMD claimed babywearing benefited their postpartum mental health by way of bonding, improving breastfeeding or coming to terms with the end of breastfeeding, stress reduction, reduction in anxiety, increasing calmness, and coming to terms with a difficult birth. A few other BWI volunteers added their personal experiences:
“Wearing helped me bond with my boy when I felt no connection with him. I would wear him and go for a walk and snuggles plus nature made a HUGE difference. Even now when I struggle with postpartum rage, wearing him helps me feel that love again” – Ashley L.
“Babywearing allowed me to keep up with housework, something that was really crucial for me while struggling with PPD. Attending BWI meetings also introduced me to a network of parents that helped me feel less alone and isolated as a new mom.” -Maddie H.
“I wished I had gone to a BWI meeting when I was pregnant. My husband and I had received Bjorn and Infantino SSCs as baby shower gifts and we figured they would be fine. But then my daughter turned out to be a fussy baby with congenital hip dysplasia who needed to be held in order to sleep, and those two carriers weren’t compatible with her Pavlik harness. I had no friends with children, and my daughter wasn’t good in the car, so I didn’t have visitors to come over and didn’t dare go out. I developed severe PPD/PPA, to the point where I was hospitalized for a week. When I finally started responding to medication and therapy, I joined my local BWI chapter, made friends, and gained confidence in my parenting skills. I can say that my best mom friends came from either babywearing or breastfeeding groups. Babywearing helped me bond with my daughter and be able to get out for walks, grocery shopping, and events. If my husband and I were to have a second child, I would start wrapping and using ring slings from day one, as with my daughter I mainly used SSCs – but if I had learned to wrap when she was little, my PPD may not have been so severe.” -Sarah Beth L.
“It was hard to accept my midwife’s recommendation that I go on medication for postpartum depression and anxiety. As i struggled with that and a colicky newborn, babywearing was one area of parenting where i felt some confidence. I worried i was failing as a mom, but when i put my daughter in our sling, she was calmer (and so was I), so i must be doing something right! She was close and I had free hands for self-care like eating, drinking, or brushing my hair. Babywearing meetings were a place i could go and feel “normal.” i never worried that i would be judged as an anxious new mom. Both the physical act of babywearing and the community i found in my local group help me through one of the hardest times in my life,” Tamara A.
This post is not meant to promote babywearing as the only treatment for PPMD. If you think you may be experiencing any of the symptoms of PPMD (see Postpartum.net for an extensive list of symptoms), please talk to your physician, midwife or other health care provider about your treatment options, which may include medication and talk therapy. There is also no one size fits all treatment for PPMD. I truly believe that there is a carrier out there to meet the needs of every caregiver if they wish, but when it comes to depression, babywearing may not be the answer for you. Sometimes, at the end of the day when you are feeling utterly “touched out” from caring for your child, wearing your baby may be the last thing you want to do. If babywearing would only overwhelm or further aggravate your symptoms, don’t do it. Have someone else wear your baby while you take a shower.
Several weeks ago, I spent an afternoon running an errand with my family at our local discount warehouse store. We had checked out and sat down in the food court to have a quick lunch before going home and putting the kids down for a nap. I had my youngest in a baby carrier while my toddler sat next to my husband on the bench seat, eating his slice of pizza and pointing at all the things around him that he knew the words for. (When did my little boy get to be so big?!) The baby stirred on my chest, ready for his lunch too, so I discreetly nursed him in my carrier while his big brother continued to giggle, chatter and wave at passersby. After a few minutes I realized my baby had fallen asleep against by breast, content and full. I looked down at him, feeling warmth instead of the panic I had felt so frequently lately. I looked at my older son with his little teeth and cheesy pizza smile sitting like a big boy at the table and felt feelings of calm instead of irritable. I looked at my husband, the loving father of my children and supportive partner in what I can only imagine was a difficult year for and a half for him as well. I looked at my family and I drank it that moment.
Parenting is a long and difficult slog. The rewarding moments can be few and far between which is especially difficult when you are battling mental illness. For me, babywearing gives an opportunity for those moments to happen. I can take my active toddler to the zoo or the science museum to play and be stimulated while I carry his baby brother on my chest or back. When that same toddler comes to you after his thirtieth tantrum of the day and hands you the carrier and requests to be held, you comply, even if he wants down ten seconds later. The past two years in my parenthood journey are largely hazy due to my untreated depression and anxiety but in my phone are hundreds of grainy photos of me wearing my boys. Somewhere in between the rage and anxiety, there were moments of contentment and joy and I know this because I had the presence of mind to snap of a photo of it so I could remind myself of why I do what I do and why I wear my children.
Do you have experience with postpartum mood disorder? Did babywearing help you cope or recover? Share your story in the comments below.
Laura Vitanova is a Volunteer Babywearing Educator for the Wichita, Kansas chapter of BWI, paralegal and mother to two sweet and active boys.
Azar, Beth. “The postpartum cuddles: Inspired by hormones?” Monitor on Psychology 33.9 (2002): 54. Retrieved from http://www.apa.org/monitor/oct02/postpartum.aspx
Badr, H. A., & Zauszniewski, J. A. (2017). Kangaroo care and postpartum depression: The role of oxytocin. International Journal of Nursing Sciences,4(2), 179-183. doi:10.1016/j.ijnss.2017.01.001
Balding, A. (2016, November 14). Babywearing plays a role in postnatal depression prevention and recovery. Retrieved from http://babyology.com.au/health/babywearing-plays-role-postnatal-depression-prevention-recovery.html
Blois, Maria. (2007) Hold Me Close: Encouraging Essential Mother/Baby Physical Contact [Excerpt]. “Birth: Care of Infant and Mother: Time Sensitive Issues.” In W. Gordon and J. Trafton (Eds). Best Practices in the Behavioral Management of Health from Preconception to Adolescence (pp. 108-132). Los Altos: Institute for Disease Management.
Chapman, C. J., LCSW. (2015, May 24). #NoFlawsOnlyHuman. Retrieved May 10, 2017, from https://babywearinginternational.org/2015/01/26/noflawsonlyhuman/
Cuddling – The best cure for depression and anxiety. (n.d.). Retrieved May 10, 2017, from http://3news.com/cuddling-the-best-cure-for-depression-and-anxiety/
Donvito, T. (2017, April 3). Could Oxytocin Treat Postpartum Depression? Retrieved from https://www.fitpregnancy.com/parenting/postnatal-health/could-oxytocin-treat-postpartum-depression
Gardner, A. (2011, May 11). Fitness, Nutrition, Tools, News, Health Magazine. Retrieved from http://www.health.com/pregnancy/oxytocin-postpartum-depression
Geisler, R. (2016, July 07). Cuddling Does Kids (and Parents) Good. Retrieved from http://www.chla.org/blog/rn-remedies/cuddling-does-kids-and-parents-good
Gould, C. M. (2012, May 09). Postpartum Depression Rx Links Mother’s Day and Children’s Mental Health Month [Web log post]. Retrieved from http://claudiamgoldmd.blogspot.com/2012/05/postpartum-depression-rx-links-mothers.html
Gourley, A. (2015, May 9). The Impact of Babywearing on Postnatal Mental Health: Mothers’ Voices. Retrieved from https://aimeegourleyni.com/2015/05/09/the-impact-of-babywearing-on-postnatal-mental-health-health-care-providers-voices/
Gutierez, D. (2016, May 20). The power of natural oxytocin and why cuddling can boost your immune system. Retrieved from http://www.naturalnews.com/054082_oxytocin_cuddling_immune_system_boost.html
Hillin, T. (2015, February 17). Snuggle science: Why cuddling is good for your health. Retrieved from http://fusion.kinja.com/snuggle-science-why-cuddling-is-good-for-your-health-1793845393
Slingdad Ben. (2014, October 10). How Babywearing helped me through Post natal Depression. Retrieved from http://slingdads.co.uk/content/2014/10/10/how-babywearing-helped-me-through-post-natal-depression/
Kim, S., Soeken, T. A., Cromer, S. J., Martinez, S. R., Hardy, L. R., & Strathearn, L. (2014). Oxytocin and postpartum depression: Delivering on what’s known and what’s not. Brain Research,1580, 219-232. doi:10.1016/j.brainres.2013.11.009
Kleiman, K. (2012, December 12). Is Postpartum Depression Different from “Regular” Depression. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/isnt-what-i-expected/201212/is-postpartum-depression-different-regular-depression
Knowles, R. (2015, Jan. 25). “How Babywearing can Help with Postnatal Depression.” Sheffield Sling Surgery – Consultancy and Library. Retrieved from https://sheffieldslingsurgery.wordpress.com/2015/01/14/babywearing-pnd/
Knowles, R. (2016 Oct. 12) “Post Natal Depression • Sheffield Sling Surgery.” Sheffield Sling Surgery. Retrieved from http://www.sheffieldslingsurgery.co.uk/2015/03/23/post-natal-depression
Knowles, R. (2016 Oct 28). “Post Natal Depression and Babywearing.” Sheffield Sling Surgery. Retrieved from http://www.sheffieldslingsurgery.co.uk/2014/06/01/post-natal-d
Lonstein, J. S. (2007). Regulation of anxiety during the postpartum period [Abstract]. Frontiers in Neuroendocrinology,28(2-3), 115-141. doi:10.1016/j.yfrne.2007.05.002
Mah, B. L. (2016). Oxytocin, Postnatal Depression, and Parenting [Abstract]. Harvard Review of Psychiatry,24(1), 1-13. doi:10.1097/hrp.0000000000000093
Mosher, D. (2016 Nov. 15). “Holding a baby can make you feel bodaciously high – and it’s a scientific mystery.” Retrieved from http://www.businessinsider.com/baby-bonding-oxytocin-opioids-euphoria-2016-10
Nonacs, R. (2016, July 13). Maternal Depression and Its Effects on the Child: What is the Role of Oxytocin. Retrieved from https://womensmentalhealth.org/posts/maternal-depression-effects-child-role-oxytocin/
Nonacs, R. (2016, August 09). “Postpartum Depression and Bonding Difficulties: Different but Interrelated Problems.” Retrieved from https://womensmentalhealth.org/posts/postpartum-depression-bonding-difficulties-separate-interrelated-problems
Norman, R. (2017, April 24). Why Cuddling Is Good For Kids’ Brains. Retrieved from http://amotherfarfromhome.com/cuddling-benefits-childrens-brains/
O’Connor, S. (2012, February 29). Can Cuddling Cure Depression? Retrieved from http://www.prevention.com/mind-body/emotional-health/oxytocin-help-depression
Pearson, Catherine. (2015, October 23). “The Incredible Benefits Of Simply Holding Your Baby Close.” The Huffington Post. Retrieved from http://www.huffingtonpost.com/entry/the-incredible-benefits-of-simply-holding-your-baby-close_us_5626700fe4b08589ef491176
Reynolds-Miller, R. L. (2016). Potential Therapeutic Benefits of Babywearing. Creative Nursing,22(1), 17-23. doi:10.1891/1078-4522.214.171.124
Science Says Cuddling Helps Curb Depression And Anxiety, Here’s Why. (n.d.). Retrieved May 10, 2017, from http://www.lifehack.org/377685/science-says-cuddling-helps-curb-depression-and-anxiety-heres-why
Science Dr. Mom. (2016, November 29). The Neuroscience of Babywearing. Retrieved from https://sciencedrmom.com/2016/10/06/the-neuroscience-of-babywearing/
Shen, Helen. (2015, June 24). “New Oxytocin Neuroscience Counters “Cuddle Hormone” Claims.” Retreived from https://www.scientificamerican.com/article/new-oxytocin-neuroscience-counters-cuddle-hormone-claims/
Trafton, J. A., & Gordon, W. P. (2007). Best practices in the behavioral management of chronic disease. Los Altos, CA: Institute for Brain Potential.
Wein, H., PhD (Ed.). (2007, February). The Power of Love Hugs and Cuddles Have Long-Term Effects. Retrieved May 10, 2017, from https://newsinhealth.nih.gov/2007/february/docs/01features_01.htm
Williams, A. (2015, May 15). Babywearing (probably) Saved Me. Retrieved May 10, 2017, from https://babywearinginternational.org/2015/04/20/babywearing-probably-saved-me/
Wyser, C. (2015, August 3). Postpartum depression and Infant Bonding. Retrieved May 11, 2017, from https://sites.williams.edu/les4/uncategorized/postpartum-depression-and-infant-bonding/