The period after delivery is often considered the “fourth trimester”, lasting between 30 days and three months. There are a number of changes that occur in a woman’s body during this time including many hormones fluctuations, including estrogen levels dropping approximately 300%. This hormonal shift generally takes an average of 10 days to balance out.  With the hormone changes that occur post-pregnancy coupled with sleep deprivation, adapting to the demands of a newborn, and so many other requirements, it is normal for a new mom or even a seasoned mom to have multiple changes in mood over the course of a day. After the much anticipated arrival of the new baby and the excitement of birth, it may come as a surprise for new moms to experience emotions such as sadness and anxiety.

Here are five general recommendations for treating low mood after delivery:

1.    Maintain Excellent Nutrition

Eating right is key during this time for both postpartum depression (PPD) and baby blues.

• Support your “happy hormones” – Choose foods high in tryptophan and tyrosine as these amino acids are important building blocks for serotonin and dopamine (our “happy hormones”). Examples of foods rich in these amino acid rich include: meat, fish, eggs, some dairy options (preferably organic full fat options), oats, fermented soy, nuts and seeds, seaweed, and of course lots of vegetables!
• Supplement your vitamin B, vitamin D, and fatty acid intake – Staying on a professional quality prenatal vitamin with all of the B vitamins especially a good dose of vitamin B6 and iron (for most women) provides all of the required minerals and vitamins essential for energy but also hormone and neurotransmitter production. Essential fatty acids like those found in fish oil are known to prevent and treat mild to moderate depression. Supplementing with vitamin D3 has been linked to improving mood and for maintaining immune health; it may be a good idea to have your blood vitamin D levels tested to make sure you are in the optimal range.
• Stabilize your blood sugar levels to prevent variability in mood – Having a small meal that includes protein and fiber every two hours during the day can help prevent changes in mood.
• Monitor your iron levels – Have your healthcare provider rule out and correct iron deficiency or anemia prior to pregnancy when possible and continue to monitor it postpartum. Iron levels become depleted when women lose blood during and after delivery. Ferritin is a blood measurement of stored iron and is usually depleted before true anemia occurs (hemoglobin level is measured below normal range). Hemoglobin normally decreases during pregnancy as blood volume increases almost 50% – when this occurs it is not necessarily anemia. After delivery, it can take 4-6 months for hemoglobin to return to pregnancy levels. Other measurements your healthcare provider may obtain to assess iron status include serum iron, TIBC (total iron binding capacity) and transferrin saturation. (See more on the importance of iron for your baby here.)

2.    Remain Hydrated

Insufficient hydration leads to lowered blood volume which can lead to lower mood. It is important to increase your intake of fluids while you are breastfeeding; aim for 2-3 liters of water each day. Pay attention to your thirst and have water accessible so grabbing a quick drink is easy and doesn’t take up too much of your time – having a glass of water each time you sit down to breastfeed can be a helpful reminder. Herbal teas throughout the day also count as fluid repletion. Many teas and herbs are not considered safe while pregnant (and breastfeeding) – download the lists here.

3.    Light Exercise – Getting Fresh Air

Daily exercise might be the last thing on your mind during this time however it may also be the best way to elevate your mood. Exercising outside in fresh air has been well studied for its effects on mood. In fact, 20 minutes of brisk exercise releases serotonin (our “happy hormone”) similar to the effects that Prozac has on our brains. Having an exercise routine in place before and during pregnancy can help make it easier to continue exercising after delivery – and exercise increases strength and stamina for labor preparation.

Joining a group can be a great way to stay motivated and make new connections especially with other new moms. If you prefer to exercise indoors, that’s okay too, you will still benefit from increased endorphins and mood enhancing neurotransmitters. Mommy & me yoga classes can be a nice way of getting you out of the house. Yoga is gentle and can help rebuild much needed core and pelvic floor strength after birth!

Most new moms can start their regular exercise routine after six weeks postpartum but you should consult your healthcare practitioner about when the best time to start exercising is for you. Click here to find out more about exercise (and sex) postpartum, including after a c-section.

4.    Resting

Sleep is important for so many factors including mood stabilization. Calm Baby Sleep Routine could help provide you with a routine and the ability to get more rest — without stressing about tears, and it’s gentle enough that most parents should be able to start right away. If you’re expressing milk with a breast pump or bottle feeding and it is available, consider trading off with your partner for some of the night or early morning feeds to allow you to get more continuous hours of sleep. Alternatively, have your child sleep in a bassinet in your room for easier feeding without too much interruption; having baby sleep in bed with you may be an option if your healthcare provider is okay with it. Having a nap while your baby naps during the day may not always be possible but even a 10 or 20 minute nap will help increase the amount of rest you get in a day. Try not to overdo it; most chores can be left for another day or for a family member to help out with.

5.    Other Considerations

There are many options available, below are a few ideas to consider.

• Look into B12 or IV therapy – Consult your naturopath or other healthcare provider about whether you would benefit from B12 or IV therapy. These concentrated nutrients bypass the digestive system and give a boost of energy by saturating the tissue and supporting the adrenal glands. IV therapy is generally considered safe while breastfeeding. (Find out more about these options here.)
• Keep a journal for you (not just for your baby) – Writing down how you are feeling may be a good way to express difficult emotions and provide an opportunity for you to reflect on a consistent basis. It might also add some perspective for what you’re going through and makes a nice keepsake.
• Keep Bach Rescue Remedy spray or drops on hand – These natural products provide a calming essence for many people especially when dealing with acute stress. (See posts linked here to learn more here.)
• Monitor and support your thyroid gland as needed – Having your healthcare provider assess your thyroid function is a good idea as the thyroid gland is important for numerous metabolic functions in your body. Thyroid hormones can fluctuate during pregnancy and the postpartum period and these swings may play a role in mood and energy.
• Ask about placenta encapsulation – Placenta encapsulation may be a consideration. Discuss this option with your midwife or naturopath. (Read more about our team’s experiences with placenta encapsulation here.)
• Organize support before your baby is born – Asking for help is a good thing, don’t be afraid to ask for it! Most people are willing to help out (especially friends and family) but they need to know what you need help with. Consider asking for help planning and making healthy meals (freezer or fresh), doing laundry, looking after older children (organizing play dates) or assisting with any number of items important to you. Let your friends and family know ahead of time that you are not sure what you will require help with after your baby is born but having reliable people on standby can make daily chores more manageable. It is particularly important to communicate with your partner. They may not be able to anticipate your needs like you would prefer them to and most likely they are feeling a bit helpless so would appreciate some loving guidance!

I have many posts discussing low mood, “baby blues”, postpartum depression (PPD) and postpartum psychosis (see them here). Discuss how you feel physically and emotionally postpartum with your healthcare provider.