PERINATAL MOOD AND ANXIETY DISORDERS (PMADs):

Postpartum depression is just the tip of a Titanic-sized iceberg

This presentation will assist the IBCLC in supporting mothers with perinatal mood and anxiety disorders (PMADs.)  PMADs include a spectrum of commonly-occuring mental health disorders.  About 20% of postpartum mothers experience depression, with rates climbing to 60% in some low social-economic status women and adolescent mothers.

However, lesser-known PMADs include perinatal panic disorder (up to 11% prevalence), perinatal obsessive-compulsive disorder (OCD) (also up to 11% prevalence), and perinatal post-traumatic stress disorder (PTSD) (up to 9% prevalence).  These often include very distressing intrusive or bizarre thoughts, behaviors, or flashbacks.

Perinatal bipolar disorder and postpartum psychosis are particularly dangerous due to severe depression, and reckless or bizarre behavior that can endanger mother and baby.  Women with bipolar disorder may have stopped medications during pregnancy and are experiencing mood instability.  They may also not realize they have bipolar disorder and require careful diagnosis, since twenty-two percent of depressed women postpartum have bipolar depression.   Postpartum psychosis is an emergency and occurs in 1 to 2 of every 1,000 deliveries.  This requires immediate hospitalization for safety, due to a 5% suicide rate and 4% infanticide rate.

The lactation consultant can be part of the safety net for postpartum mothers.  Although the IBCLC is not expected to diagnose psychiatric disorders, s/he can screen mothers, refer for services and act as an expert resource for the mother’s lactation journey.