Diet & Postpartum Depression

Those early days of motherhood can be the headiest combination of bliss, immense pain, extreme joy, low mood, love, exhaustion and anxiety.  During your pregnancy, all eyes are on you and your health. People really seem to care how YOU feel, what YOU are eating, and if they can do anything for YOU. Once the baby is born, at a time when many women need the most support of all, unfortunately the attention often shifts to the baby. “Is the baby drinking enough? How’s his latch? Has she put on the right amount of weight? Is he sleeping ok?” Meanwhile, the mum can be left exhausted, anxious, and overwhelmed.

Postpartum Depression

Unfortunately for around 25% of new mums, these negative symptoms dominate, and they may be diagnosed with postpartum depression (PPD). (1, 2) 

The clinical presentation of PPD may include symptoms such as fatigue, agitation, decreased concentration, changes in sleep patterns and appetite, feelings of worthlessness, and even thoughts of death or suicide. (3) 

Factors that influence the likelihood of developing PPD are complex, but include genetics, as well as environmental, social, psychological and biological factors. (1) Unfortunately, many women fall through the cracks of the healthcare system and fail to get a diagnosis of PPD, thereby struggling through this difficult time alone. 

The Effect of Diet on the Development and Management of Postpartum Depression

Certain dietary patterns have been found to be protective in the development of PPD. (4) An overall ‘healthy’ dietary pattern, with greater seafood and fish consumption, polyunsaturated fatty acid intake, vitamin D, zinc, and possibly selenium, have all been shown to reduce the risk of developing PPD. (4) 

We also know that being diagnosed with depression prior to pregnancy increases the risk of developing PPD. (3) With this in mind, along with the knowledge we have of the protective effect of the Mediterranean-style dietary pattern on reducing depressive symptoms, it remains consistent that this pattern of eating in the perinatal period may be protective of the development, and useful as a treatment, of PPD. (4, 5)

The beneficial effects of healthier dietary patterns, characterised by higher intakes of fruits, vegetables, nuts, seeds, whole grains, legumes, herbs, spices, and seafood, are likely associated with the antioxidant and anti-inflammatory properties of the fruit, vegetables, and nuts, the neuroprotective properties found in the long-chain omega 3 fatty acids in seafood, and the B-group vitamins, essential for neuronal functioning, found in legumes and whole grains. (3)

Specific Nutrients and Postpartum Depression

Pregnancy and breastfeeding can really take its toll on women, depleting nutrients more rapidly than usual. In particular, omega 3 fatty acids, zinc, iron, folate, magnesium, and selenium are in high demand throughout this period, and these nutrients are also very important in mood regulation. (1, 2) 

Significant evidence exists to show that being deficient in vitamin D increases the risk of developing PPD. (4) Existing research shows that the body’s inflammatory response plays an important role in the relationship between vitamin D and PPD. (3) Vitamin D has been shown to reduce the inflammatory response in pregnant women who have been shown to have an elevated inflammatory response, and these changes are considered significant in the development of PPD. (4) 

Although a little under-researched, there is also a small amount of evidence to show that iron deficiency may contribute to the development of PPD. Iron deficiency has certainly been shown to be a risk factor in the development of clinical depression (non-postpartum), and it is believed that this may be due to its essential role in myelin formation, the cellular and oxidative processes of neurons, and neurotransmitter metabolism and function. (4)

Conclusion

There is substantial evidence to show that diet in the perinatal period, both during pregnancy and postnatally, may significantly reduce the likelihood of developing PPD, and may also reduce symptoms of existing PPD. Dietary modification therefore offers a promising alternative or adjunctive treatment to PPD, with extremely low risk for adverse side effects or complications. A diet high in fruits, vegetables, nuts, seeds, herbs, spices, seafood, whole grains and legumes should be recommended to women in the perinatal period to help reduce the risk of developing PPD.  

References

1. Mermer¹ M, Şanlıer N. Correlation between postpartum depression and omega-3, micronutrients. International Journal of Reproduction, Contraception, Obstetrics and Gynecology.;6(11):4738.

2. Lee D. How are Micronutrient Deficiencies Associated with Outcomes of Postpartum Anxiety and Depression in Women?. Proceedings of Student Research and Creative Inquiry Day. 2021 Apr 29;5.

3. Opie RS, Uldrich AC, Ball K. Maternal Postpartum Diet and Postpartum Depression: A Systematic Review. Maternal and child health journal. 2020 Aug;24(8):966-78.

4. Zhao XH, Zhang ZH. Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian Journal of Psychiatry. 2020 Aug 30:102353.

5. Jacka FN, O’Neil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M, Castle D, Dash S, Mihalopoulos C, Chatterton ML, Brazionis L. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’trial). BMC medicine. 2017 Dec;15(1):1-3.