I was having a really good day, a great day, even.
And then all of a sudden I wasn’t.
I was sitting on the couch at my best friend’s house watching Mamma Mia and drinking a beer while my six-month-old son snored like a baby kitten on my lap. The night before I’d just finished breastfeeding for good, a moment I’d been looking forward to since I began my difficult breastfeeding journey. I was always a sub-par milk-maker, and my baby preferred bottle to boob. Charlie essentially had weaned himself, swatting away my nipple like a pesky mosquito, which made it even easier. I was delighted to have my breasts and some of my time to myself again.
Suddenly, just as Meryl was about to run up to the church on the top of Kalokairi, nausea roiled my stomach, my heart felt like someone was squeezing it in a meaty fist, sweat poured down the inside of my thighs, and it felt like ants were crawling up the back of my throat. I looked at my best friend with panic in my eyes.
“Is it because of Pierce Brosnan’s singing?” she asked. “I know. I feel it, too. It’s so bad.”
“I think I’m having a panic attack,” I gasped.
For the next couple of weeks, anxiety greeted me when I opened my eyes every morning. Throughout the day, I’d have stints of feeling OK — and then I’d be sunk by a piercing sadness, dread, and fear and guilt that I wasn’t being a good enough mom to my little boy.
I’m prone to anxiety, having dealt with it on and off since college. Before getting pregnant I weaned off Zoloft. But since giving birth I felt better than normal. I thought I’d been lucky enough to dodge the postpartum depression bullet.
But maybe I hadn’t. It seemed late to experience symptoms, but what else could it be? The only thing that changed was that I had quit breastfeeding.
Awake at three in the morning, paralyzed by insomnia and a roller coaster of exhausting thoughts, I googled anxiety, depression, and breastfeeding. I didn’t find much, mostly first-person blog posts and a lot of message boards with posts by other women who experienced similar symptoms after weaning. But I saw enough to realize this was a thing: Quitting breastfeeding can trigger anxiety and depression — but nobody seems to be talking about it in a real way. Although a handful of studies and papers have addressed the topic, they generally are few and far between.
I messaged my doctor. She wrote back quickly and efficiently: “Yes. You are right. Weaning can trigger anxiety.” That was all. We’d talked a lot about breastfeeding and how to keep my baby healthy and the fact that I would be weaning — but we were too focused on talking about the baby’s health to discuss my own issues.
I began talking to other women about it. One told me her body hurt so much after she weaned she thought she was dying. Her doctor essentially told her to suck it up and wait it out. Another said that nausea kept her out of work for an entire week. She couldn’t keep any food down and lost 15 pounds in two weeks.
My friend Shannon told me that even just quitting daytime feeds left her with feelings of nausea, anxiety, insomnia, and weepiness. “It’s like the hormonal roller coaster of newborn days, plus the physical symptoms of the first trimester.”
The thing that helped me the most was a personal essay from Joanna Goddard, the founder of the website Cup of Jo, titled, “The Hardest Two Months of My Life.” In it Goddard mentioned how hard it was for her to find good information about anxiety linked to quitting breastfeeding, and she detailed the depression and anxiety she experienced eight months after the birth of her first son.
“It came in waves. Sometimes I’d feel better, almost like myself again. Other times, I’d feel so overwhelmed with sadness and hopelessness that I’d feel like I couldn’t move or breathe...For six weeks — from late January to early March — life felt really, really dark. I couldn’t bear thinking about the future. Every day felt long and exhausting, and I couldn’t imagine making it through all the days ahead of me,” Goddard wrote.
I cried tears of real gratitude, nodding along with everything she wrote. I wasn’t losing my mind. This was something that happened to new mothers. But why?
The cause is hormonal, according to Flynn O’Neill, a nurse practitioner who has been practicing for more than a decade in Washington, D.C. at Bloom OB/GYN. She’s also the co-founder of Stork Childbirth Education, an organization that provides classes for new and expecting parents on a range of topics from childbirth to breastfeeding to child care.
“As you stop breastfeeding, your prolactin, which is the milk-maker hormone, starts to decrease naturally. This hormone not only produces milk, but it also produces a feeling of calm and well-being,” O’Neill says, adding that the other essential breastfeeding hormone, oxytocin, is needed for milk ejection, or let down.
“As women wean, the oxytocin stores start to go back to non-pregnant levels,” O’Neill says. “Oxytocin is known as the love hormone, so as it decreases you may feel sad, irritable or grumpy. Many women attribute this to fatigue, but the feeling is real and regulated by our hormones.”
There it was. That explained why I actually felt better postpartum than I did even before I got pregnant. It was like I was withdrawing from happy drugs.
Any history of anxiety or depression can also put women at a greater risk for both of those things when they wean, according to O’Neill. She added that weaning abruptly instead of tapering off can increase the problems.
Many women don’t get their periods while they’re breastfeeding. I didn’t. According to O’Neill, as your period resumes, your estrogen starts to return to normal, and many women start to feel better.
Most of the information I’ve gotten on my post-weaning anxiety has come from other moms, from talking to friends and mom message groups online. The common thread from everyone I’ve talked to is, “Why the hell didn’t anyone warn me?”
O’Neill believes the lack of research and information has to do with women underreporting their symptoms to their doctors. She encourages new moms to feel empowered to speak up.
“Mental-health care and coverage in our current healthcare system is poor, so that may contribute as well,” she adds.
Doctors also just don’t have much contact with new moms when they start weaning. Babies have a lot of check-ups. Moms don’t.
“When a woman weans they are no longer going to their ob-gyn on a regular basis. Many ob-gyns, including my office, screen women for potential depression twice during and after the pregnancy,” she says. “We have such a close connection to the mother right after delivery, but at the 6-12 month postpartum time, many women are too busy to come in for a visit since they are raising their children.”
The second reason that no one warned me has to do with mom shame. We all want to be good mothers, and these days “good” mothering has become so linked with breastfeeding that any small failure throughout the process brings on a tidal wave of guilt.
“Many women feel guilt or pressure to keep nursing, especially if the weaning is baby-led,” O’Neill adds. “With the constraints of work, raising kids, being a loving partner, and getting through the day, it is sometimes over a year that I see women return to take care of themselves and get their annual check-ups again.”
What it all shows is a systemic lack of support for women as they transition into motherhood. We are told how to care for a baby, but no one tells us how to take care of ourselves.
“In general, in America, there isn’t enough support out there for all of the transitions of new motherhood, and of course that includes when moms and babies wean,” says Lauren Smith Brody, author of The Fifth Trimester.
“There’s also a misconception that persists that if you’ve made it through the first blurry newborn weeks, you’re in the clear, but women experience perinatal mood and anxiety disorders months after giving birth — our need for support doesn’t magically abate,” Smith Brody says. “In fact the logistics of motherhood often get more complicated as the months go on.”
The answer isn’t rocket science. The answer, really, is just providing support for new mothers — comprehensive support, kind support, nonjudgmental support, support that doesn’t require playing phone-tag with your doctor and leaving dozens of frantic voicemails.
Doula, health educator, and author of Nurture, Erica Chidi Cohen likens it to tech support. It’s one of the things she tries to do on a regular basis. She stays in touch with her clients from LOOM, the Los Angeles-based reproductive empowerment center, throughout the breastfeeding process from start to finish.
“As a mother starts to wean, there has to be some support for them and an awareness of what can happen,” Chidi Cohen says. “I make sure they taper down the weaning process instead of complete extinction overnight. Coupling weaning with things to help manage cortisol levels, like massage and acupuncture, can help shore up the endocrine system.”
LOOM operates outside of the traditional healthcare system, but Chidi Cohen envisions a future when a pediatrician will actively help a mother as she transitions through the weaning process.
“They are seeing you more frequently than your ob-gyn,” Chidi-Cohen says. “And even though they’re a pediatrician, they can still assess for these things.”
Our family’s general practitioner, who is also Charlie’s pediatrician, has been great about helping me with my own health problems, from back pain to anxiety, when I go in for Charlie’s checkups. In fact, we switched to a family doctor expressly so I could be treated at the same time as Charlie. But even getting my healthcare provider to get me a therapist has required enough of a bureaucratic slog that I still haven’t gotten an appointment. Getting back on Zoloft was easy. That just took an e-mail.
Thankfully, I’ve been lucky. My anxiety dissipated as I started the drugs and got my period again. But not everyone is as lucky as I have been. I still see threads on mom groups where women talk about suffering for a year or longer after they quit breastfeeding. They have no hope that it ever will come to an end. I try to write back and tell them it will. I tell them to talk to their doctor and, if that doesn’t work, to try a new physician. I offer to chat on the phone or text late at night. But unfortunately, that’s just a small fraction of the support they actually need.
Jo Piazza is the author of the upcoming novel Charlotte Walsh Likes to Win.
Photos by Brittney Valdez.
