A new study entitled “Bottle feeding simulates child loss: Postpartum depression and evolutionary medicine” published in the journal Medical Hypotheses suggests that bottle-feeding (with formula) and hospital practices/procedures that lead to intermittent separation between mothers and infants during the immediate postpartum period simulate (speaking in terms of evolutionary medicine) child loss and therefore increase a mother’s risk for postpartum depression.
The authors write, “For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by the micarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother’s decision to bottle feed [with formula] unknowingly simulates child loss. Consistent with this analysis, there is growing evidence that bottlefeeding is a significant risk factor for postpartum depression.”
The paper’s authors (who work in the Department of Psychology at the University of Albany/ State University of New York, Albany) recently completed a study of over 50 mothers recruited through local pediatric offices at their 4-6 weeks postpartum visit and evaluated them using the Edinburgh Postnatal Depression scale. They found that those who bottle fed their babies scored significantly higher on the scale than those who breastfed, even after they controlled for things such as age, education, income, and the mother’s relationship with her current partner.
The paper also cites four other studies that link bottle feeding [with formula] to an increased risk of postpartum depression and/or breastfeeding’s ability to decrease one’s risk for postpartum depression.
This is a fascinating article to me for a variety of reasons. First off, it is written by psychologists, not health care professionals and hence, takes a look at this very important topic from a completely different perspective.
Second, it is a study/analysis that focuses “not on the advantages of breastfeeding per se, but rather on the negative psychological consequences of the decision not to breastfeed.”
Thirdly, for mothers who cannot breastfeed (as related to the health of the baby or mother for example) or choose not to breastfeed, this article shows us how important it is as health care professionals to assess these mothers thorougly for signs and symptoms of postpartum depression as well as to educate these mothers and their loved ones about their potentially increased risk for postpartum depression so that they can obtain help and/or counseling if their “baby blues” turn into something more serious.
Forth, it is just yet another reason for me to continue to learn as much as I can about breastfeeding so that I can properly educate all my moms about the benefits of breastfeeding and the hazards of formula feeding. I look forward to future reserach on this topic.
After all, babies were BORN to BREASTFEED and if a mother and baby are healthy enough to do so it is important for all mothers to know that babies DESERVE breast milk and DESERVE to be breastfed! I dream of a world where ALL mothers who are willing and able to breastfeed get the support and encouragement and resources they need to do so!
Nursing Birth 
Very interesting.. I saw that the other day, but didn’t think of it from the perspective of keeping an eye on those that are higher risk.
I’m curious how many cases where women had trouble establishing or maintaining a breastfeeding relationship, and also had PPD, had an underlying cause such as hypothyroidism, which is a known contributing factor in both cases.
Amy @ EI, hmmmm, I don’t know!! That is a very interesting thought! You should totally email the authors!!
I had PPD and one of the things to get me through it was breastfeeding. I knew that I was the only one who could do that for my daughter and that she needed me. I felt really disconnected from everything, but that helped me bond with her. It’s irrational, but I felt like she liked everyone else better than me, but I was the only one who could give her those little “milk drunk” smiles. After a few months, the PPD got better and I continued to breastfeed my daughter until she was 2.
Saylor, thank you so much for sharing your story!! Most people dont realize how serious PPD is. I am so happy to hear that BF helped you through a very difficult time in your life! (And you’re right, there’s nothing like those little milk drunk smiles!)
My experience is that nursing went quite well in the hospital and became horrible once my milk came in! I understand the study, but honestly nursing made me more frustrated and upset than anything else I’ve ever experienced. I exclusively pump now, which is a great option for many moms! I mostly pump because formula is so pricey. You can know all the benefits of breastfeeding and still quit because it is hard and awful in the beginning for many, many women. Add that to the post partum hormones and my goodness those first couple weeks are not something I look back on fondly!
Michelle, looking into this study further I found that they do NOT mean bottle feeding with breastmilk, ONLY bottle feeding with formula. Although there are benefits to breastfeeding that are above and beyone pumping and feeding breastmilk, pumping and feeding breastmilk is PROFOUNDLY less hazardous and overall much much healthier for both moms and babies than fomula feeding. This study does not pertain to moms who pump breastmilk because you are still stimulating your breasts and hence the body does not “think” that there is no baby. Jus t a question for you, have you ever considered going to a La Leche League meeting??
Michelle, what you described was my EXACT situation with my son, my firstborn. I struggled SO MUCH with breastfeeding and had some really horrible recovery complications (had a c-section) and actually landed myself in the hospital one week postpartum. It was that moment that I said ENOUGH! I’ve had it! and switched to exclusively pumping. I, too, was adament that my son receive breastmilk. I just got to a point that I couldn’t physically do it (I mean, I was producing milk, but everything combined just made it all horrible). It felt good to let it go. However, in hindsight, I do wish I had reached out to LLL or something like that. I couldn’t keep up with demand and by 5 months or so I was supplementing with formula (which I HATED….it was expensive and I hated that we had to add to the breastmilk that I knew was the best). By 10 months, I was barely pumping anything and I finally stopped. So, for a almost 3 months, he exclusively had formula.
So, I agree with you that pumping can really work nicely in a tough situation, and I’m not sure how long you’ve been pumping but you may want to try again so that you can get all the way to a year without needing formula. And for what its worth, since my first child (the hard one!) I’ve had two babies who both nursed great….go figure!
I was told to try nursing again after a few weeks, but I had no interest. Bottlefeeeding was going so well (my daughter is 3 months by the way) and why would I go back to something that caused me so much pain and tears? As for LLL meetings, at that point I was done. The day I started pumping was the day I stopped crying. I didn’t want to go to a meeting and be judged for not wanting to put my baby back on the breast. For me, nursing went GREAT at the hospital and horrible once my milk came in fully. I think it would be nice to have an automatic home follow-up for breastfeeding moms a few days later. Breastfeeding with nurses and normal boobs is a lot different than nursing at home alone with engorged ones! I have supplemented because it took until 5 weeks to make enough for her, but I don’t have a problem with formula. I plan to pump until 6 months then dip into the freezer stash (300 oz saved so far) and use formula at that point. I very much understand that breastmilk is best, but I don’t want people to underestimate how hard it can be. I went into it thinking I could do it no matter what, and the pain and difficulty was a huge shock to me.
You’re likely sick of hearing from me, but I do want to say that I enjoy reading your blog. You helped inspire me to have a natural birth, and I was able to have a vaginal, med-free delivery. Thank you for the encouragement and information!
Michelle, I am NEVER sick of hearing from you or any of my readers! I love when people make comments and share their own personal experiences, both triumphs and tribulations!!
Sorry to but in, but I just wanted to say that I had a similar experience as you Michelle. Although, my breasts weren’t engorged, I had problems with breastfeeding with my first because of flat nipples and using the nipple shield. I pumped and gave her breast milk until 6 months. I noted things that maybe had went wrong on my part (I did consult LLL though) and was determined to change it when I had my second. I REALLY wanted a positive breastfeeding experience.
I refused to use the nipple shield this time. I sought the help of a lactation specialist and I latched my son on without it. I was ecstatic. Until both my nipples literally came off. I went to lactation specialists, but it just never got better. The ONLY thing I cried about after having my son was breast feeding. It was so hard, painful and emotionally draining on me to continue. So once again, I have been pumping and giving him a bottle. My nipples have finally grown back. But I still have the guilt. I hate that I feel like I have to explain to everyone my story when they don’t see my BF or that when I pull out a bottle I want to tell everyone that has breast milk in it instead of formula. There seems to be such a stigma against bottle feeding.
And like Michelle, this website helped give me tools I needed to have a unmedicated and fabulous birth with my second that I wanted with my first. Thanks nursingbirth!
I’m really surprised at how many women quickly give up on breastfeeding. I’m not trying to judge, but I’m curious if there are any stats on how long an average woman attempts it before giving up?
I don’t know how accurate any such stats would be. Women give up for *so* many reasons! I gave up because I felt on the verge of an emotional breakdown! I needed to let it be ok to stop trying. Other women half-heartedly give it a try and if it doesn’t come easily then they switch to formula….no emotional impact whatsoever….and those are just the extremes.
Good point Krista!
Wow. That is *really* interesting. I don’t know if I had PPD w/ my 1st — it wasn’t diagnosed, but looking back, it’s at least possible that I experienced it. I remember thinking similar to Saylor — seemed like my baby liked everyone better than me, and I felt like the world’s worst mother — all the “maternal instincts” that I expected to kick in and make motherhood dreamy never happened. BUT, I could breastfeed, and my son loved it. Five dear children and twelve years later, I can still particularly picture his gummy smiles as he’d pull off just to grin at me, my milk shooting all over his face!! I had never really thought of this before, but putting two and two together, I think I could have spiraled DEEP down if it hadn’t been for breastfeeding.
Very interesting! I love thinking about the evolutionary reasons behind things, and this hadn’t occurred to me.
I appreciate reading all these stories of breastfeeding difficulties and think it’s important to talk about them, for mutual support if nothing else. But I did want to write a different post, in case there are pregnant women out there reading this wondering about breastfeeding. When I was pregnant all I ever heard about breastfeeding were the negatives – it hurts, it was impossible, I couldn’t do it, it was a nightmare, and so on. I know women have those experiences, and that’s real and shouldn’t be minimized. On the other hand, pregnant women should also know sometimes it goes fairly smoothly and mothers have amazing experiences. I know I did. (I had oversupply and challenges related to this and sought the help of several lactation consultants, but because of their advice and my husband’s support, it all worked itself out.) Breastfeeding brought me great joy. My #1 piece of advice to pregnant-considering-breastfeeding moms is get a good book and read it while pregnant; it can really help you know what to expect and how to respond (and when to get help). . . When I breastfed my son, I was filled with such peace – in the beginning it was actual bliss. It really helped with the sleep deprivation and the hormones and the birth recovery; and when he was older, it helped me cope with the crying and continued non-sleeping, etc.
Erin, thank you! I completely agree, many mothers only hear the negatives, not just about breastfeeding but about labor and birth too!! We need to remind women that there are many MANY positives!
As so often happens with interpretation of breastfeeding studies, you are ignoring the fact that this study was observational. Yes, certain factors were controlled for; however, since it wasn’t a case where they took 100 women with PPD and forced half to breastfeed and half to formula feed, you have to look at the results with some perspective. One could easily take the opposite interpretation and say that the guilt inflicted on formula feeding women in our society (and by studies like these) can exacerbate PPD. It certainly did for me, and for many women I have interviewed for a book I am working on.
I am certainly not anti-breastfeeding; I think it is a wonderful thing. But there are cases where formula feeding is the best – or only – choice, and implying that formula feeding can cause PPD is just plain irresponsible, in my opinion. The LAST thing women struggling with PPD need is pressure to do anything. If they want to breastfeed, then great; however, it is often far more useful to get on antidepressant medications, which are not universally recommended for lactating women. There have been studies saying that the long-term effects on babies who’ve been exposed to antidepressants in breastmilk are negligible, but as my own pediatrician said, “none have proven this without a doubt.” If nursing is going to keep a woman from taking needed medication, then I do not think it is a healthy thing for baby or mother.
Just another opinion….
[…] In response to: New Study Hypothesizes Bottle-Feeding Simulates Child Loss Increasing a Mother’s Risk for PP Depre… […]
[…] Why Educating Our Patients is a Professional Responsibility and NOT About Guilt October 11, 2009 Filed under: Ramblings — NursingBirth @ 12:43 AM Tags: bottle feeding, breastfeeding, formula, guilt, mommy wars Yesterday I wrote a very long response to a comment left on my blog regarding a post I wrote entitled New Study Hypothesizes Bottle-Feeding Simulates Child Loss Increasing a Mother’s Risk for PP Depr…. […]
I am still breastfeeding my 15 month old and plan to continue until she self weans. If I change my mind, I plan to cross that bridge when I come to it. But I do want to say that I am so proud of all the women here that talk about breastfeeding being difficult but not giving up and switching to pumping. I just think that is so amazing. You women are so encouraging to me. I have heard more than a fair number of stories about women that couldn’t get through problems with nursing and so they just gave up and switched to formula. I am so inspired by the women like you that try pumping first. And even though some of you seem to minimalize by saying things like, “I know I only made it three months or six months or whatever.” Any amount you breastfeed is a wonderful thing. If you only try once, at least you tried and gave your baby something! I agree that breastfeeding got me through a really hard emotional time. I suffered a pretty rough placental delivery that resulted in a 9 day post partum hospital stay and 3 blood transfusions. I had specifically chosen a birth center to avoid complications and delivered the baby without any. But my placenta was tractioned 12 minutes after delivery and it was all downhill from there. It took me almost a year to work through my PPD. There were times when I was just broken and felt like the hospital should have just let me die. And those times, my daughter would just nurse and nurse for hours, sleeping soundly in my arms. Those moments made me realize that I was happy I survived the trauma. I am glad and sometimes surprised I made it through. I know that even women who try really hard don’t breastfeed for as long as they intend, but I have to give serious kudos to those of you that try. I consider breast milk through a bottle a form of breastfeeding and you women deserve respect for doing everything you could to breastfeed.
Clarissa Jarem, WOW I am so moved by your comment! What an ordeal you went through! I too hope that women reading stories about mothers who are successful at breastfeeding, despite difficulties, find them inspiring and motivating like you do. I know there are some mothers out there that take away a different “take home message” from those types of stories and my heart aches for them. You also write “Any amount you breastfeed is a wonderful thing.” I COMPLETELY AGREE! I try to celebrate any amount of time breastfeeding with the mothers I work with and meet in my everyday life. Thank you for sharing your story with us!