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After your baby is born, you may find that while you feel elated at your new addition, other feelings creep in. Your pregnancy hormones drop dramatically, so that almost buzzy happiness you felt in the third trimester has been replaced by confusion, sadness and exhaustion. This period of “baby blues” happens to nearly 80% of new mothers and usually passes after a week or so.

However, these emotions may progress, making you feel worried, anxious, and hopeless. The site of your baby may bring you to tears. You may feel like you have nothing to give him and resent his very presence. You may even stop trying to care for yourself, as if you have enough time for that anyhow. If this happens, you are one of the 15-23% of new mothers with postpartum depression. And while there are many risk factors, such as a history of depression, medical complications during pregnancy, prior drug use, and stress, no one can predict who will get and who won’t.

There is a recently discovered risk for postpartum depression that is almost universally overlooked. Not only is it common, moms are even told to expect it. It is painful breastfeeding.

In October of 2015, a study from the UK showed that women who experience pain during breastfeeding are at an increased risk for postpartum depression. Moreover, that depression can continue for over six months after they stop breastfeeding.

Although the study didn’t clarify why this happens, it is physiologically obvious. When a baby latches on correctly, mom has a pleasant sensation, which makes her brain secrete a hormone called oxytocin. Oxytocin is also called the love hormone. It literally fills mom with love and pushes the milk out of her breasts. When mom feels pain, oxytocin is replaced by cortisol, a stress hormone, filling her with anxiety and exhaustion, making her feel as if she’s in the middle of a war.

This is not a small finding, and its implications are monumental. We used to believe the converse was true–that mothers with depression are less likely to breastfeed. But armed with this new information, we can now protect mothers. We should never tell a mother to expect pain while nursing. If she already has depression her symptoms will get worse, and if she doesn’t have depression, she will be more likely to develop it as a result. We need to protect mothers from postpartum depression by educating them that painful nursing is something that should be minimized and best avoided. There are many options for fixing painful nursing. The worst advice you can give a mother is to nurse through the pain.

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