图片来源：国际母乳会中国图片库（图文无关）
翻译：彭杨Penny
审核：Hetty，Daisy
每年的4月7日是世界卫生日，今年的主题是：一起来聊抑郁症。为庆祝世界卫生日的这一主题，世界母乳喂养行为联盟（WABA）与国际母乳会（LLLI）发表了关于母乳喂养与心理健康的联合声明。国际母乳会中国现发表此文的中译稿。
今年世界卫生日的主题是“一起来聊抑郁症”。根据世界卫生组织（WHO）报告，抑郁症是一个非常普遍的健康疾病，它影响所有国家中各个年龄各行各业的人们。抑郁症造成精神痛苦，使人们难以完成甚至是最简单的日常事务，有时还会摧毁与家人和朋友的关系。贫困、失业、失去爱人或婚姻破裂的生活变故、生理上的疾病或是酒精和药物带来的问题，都会提升患抑郁症的风险。
所有人都可能遭受抑郁症之苦，包括妈妈和孩子们在内。一位正在经历抑郁症的妈妈会发现照看她的宝宝更具挑战性。光是照顾孩子需要付出的体力就会让人精疲力竭，而这只会加剧抑郁症的影响。抑郁症可以通过适当的方法进行治疗，但是终极目标应当是通过长期的心理健康建设来预防抑郁症。
可持续发展目标（SDGs）以千年发展目标（MDGs）为基础，涵盖了包括生态、经济和公平等一系列议题。可持续发展目标（SDGs）促进全人类生理及心理健康，母乳喂养对此贡献卓著。
母乳喂养与心理健康的关连
对妈妈而言
分娩后，大约40-80%的新妈妈经历轻微并且短暂的情绪紊乱，然而当症状持续两周以上，13-19%发展成产后抑郁症。产后抑郁症主要的症状包括焦虑、内疚、绝望、过敏易怒、低能量、注意力不集中。最近的研究表明，母乳喂养可以保护妈妈们避免患上产后抑郁症。
相较于配方奶喂养的妈妈，母乳妈妈患上抑郁症的风险较低。抑郁中的妈妈也能从母乳喂养的行为中获益。可能起到降低风险作用的因素包括：
哺乳的激素
◆在母乳喂养过程中释放的催产素，对于妈妈而言有一种天然的镇静作用，并且能对抗压力。
◆负责乳汁生产的泌乳素，也保护着妈妈使其避免患上抑郁症。一项研究表明，降低的泌乳素水平是抑郁症的准确预测因素。
◆这两个激素的作用使得与抑郁相关的身体炎性反应下降。
睡眠
◆研究已经表明，事实上母乳妈妈比配方奶喂养或混合喂养的妈妈获得更多的睡眠。母婴睡得更久，普遍感觉更好。
对于宝宝而言
母乳喂养的宝宝得益于与妈妈频繁的交流。妈妈对乳房上的宝宝的看护与关注会在宝宝一生的心理健康上得以体现。一项研究表明，从出生到14岁9，母乳喂养到一岁的影响与心理健康有关系。在许多长期的母乳喂养研究里可以发现，这是一种剂量效应。母乳喂养的时间越长，积极效果越明显。
这个积极的影响深深扎根于良好的母婴亲密依附所带来的安全感中。如果妈妈们始终坚持通过用乳房给宝宝们安抚来回应其需求，那么就会产生非常牢固的依附。这就是最早的亲密关系，它会帮助宝宝对日后的生活压力有所准备。
研究者查看了宝宝的脑波模式来衡量抑郁症。他们发现妈妈患有抑郁症的母乳宝宝依然拥有正常的脑波模式。另一方面，配方奶宝宝则显示出了与抑郁症相关的异常脑波。母乳妈妈通过注视和触摸10，自然地与宝宝们互动更多，这是给予宝宝安全感的一种反应。
支持母乳妈妈：成功的关键
女性的社交网络对其健康相关的决定有着重要的影响。女性常常被那些和她们分享育儿经验的女性所吸引。当新妈妈遇到一些有经验的、能理解并认同她们的人，她们会更好地享受并且应对母亲这个身份。同伴支持可以担任这个角色，并且可以成为那些有着母乳喂养困惑与问题的妈妈们的救生索。
帮助妈妈们明白母乳喂养是如何进行的、了解早期出现问题的信号、知道需要时到何处求助，这些都能帮助妈妈避免抑郁症。创建“母乳喂养是正常的”的文化也为开始了养育之旅的新妈妈们提供了行为榜样。
包括国际母乳会在内的妈妈支持团体，在正常的母乳喂养以及问题解决方面都提供了榜样与精准的资讯。母乳妈妈们之间的分享与友谊也能提供一个充满支持的避风港。
一些妈妈和她们的孩子患抑郁症了，我们要接纳现实。但是，母乳喂养依然在保护这些母婴避免更严重的抑郁，同时提供着其他众所周知的益处。
总之， 母乳喂养带给世界更多的快乐和健康。让我们为每一位母亲及其宝宝构建一个“温暖的支持之链”，促进其心理健康，让每一段母乳喂养成为宝贵的经历。
This year, World Health Day focuses on thetheme of “Depression: Let’s Talk.” According to the World Health Organization(WHO)1: depression is a common mental disorder that affects people of all ages,from all walks of life, in all countries. Depression causes mental anguish andcan impact on people’s ability to carry out even the simplest everyday tasks,with sometimes devastating consequences for relationships with family andfriends. The risk of becoming depressed is increased by poverty, unemployment,life events such as the death of a loved one or a relationship break-up,physical illness and problems caused by alcohol and drug use.
Anyone can suffer from depression,including mothers and their children. A mother suffering from depression willfind it more challenging to care for her child2. Just the physical demands ofmotherhood can be exhausting, and this only adds to the impact of depression.Depression can be treated with proper therapy, however, the end goal should bethe prevention of depression through long-term promotion of mental health.
The Sustainable Development Goals(SDGs)3 build on the Millennium Development Goals (MDGs) and cover a rangeof issues including ecology, economy, and equity. The SDGs promote physical andpsychological wellbeing for all, and breastfeeding significantly contributes tothis.
Linking breastfeeding to MentalHealth
For Mothers
After childbirth, approximately 40–80% ofnew mothers experience mild and transient mood disturbance, while 13–19%develop postpartum depression when symptoms last over 2 weeks. Major symptomsof postpartum depression include anxiety, guilt, hopelessness, irritability,low energy, and loss of concentration. It was recently proposed thatbreastfeeding can protect mothers from postpartum depression.
Breastfeeding mothers are at lower risk ofdepression than formula-feeding mothers. Mothers who are depressed benefit fromthe act of breastfeeding as well. Factors that may be at work in this loweredrisk include:
The hormones of lactation
•The hormone oxytocin that is releasedduring breastfeeding has a natural calming effect on the mother, and offerssome protection against stress.
•The hormone prolactin, responsible formilk production, also seems to protect mothers against depression. One studyshowed decreased prolactin levels are accurate predictors of depression.
•Both of these hormones act to reduce thebody’s inflammatory response associated with depression.
Sleep
•Studies have shown that breastfeedingmothers actually get more sleep than mothers who formula-feed or combine thetwo. They sleep longer and generally feel better.
For Children
The child who is breastfed benefits fromfrequent contact with its mother. Her care and attention to the baby at herbreast is reflected in that baby’s lifelong mental health. One study showedthat the effect of breastfeeding for one year was associated with better mentalhealth through age 14.9 As is often seen in long-term studies ofbreastfeeding, it is dose-dependent. The longer a child breastfeeds, thegreater the positive effect.
This positive effect is rooted in the securitybrought about by good maternal-infant attachment. If mothers consistentlyrespond to their baby’s needs by offering the breast, a strong attachment canresult. It is that early attachment relationship that helps prepare for laterlife stresses.
Researchers looked at the brain wavepatterns of babies as a measure of depression. They found that infants who werebreastfed by depressed mothers still had normal brain wave patterns. On theother hand, formula-fed infants showed abnormal waves associated withdepression. Breastfeeding mothers naturally interact more with their babies— bylooking at them and touching them10 – a response which provides security forthose babies.
Supporting Breastfeeding Mothers: A Key to Success
Women’s social networks have a majorimpact on their health-related decisions. Women are often drawn to other womenwith whom they share life experiences, especially when those experiences relateto parenting. When new mothers have someone who can understand and identifywith their experiences, they can better enjoy and cope with motherhood. Peersupport can fulfill this role, and can become a lifeline for mothers withbreastfeeding questions and issues.
Helping mothers learn what makesbreastfeeding work, what signs may indicate a problem early on, and where toget help when needed may help ward off depression. Creating a culture in whichbreastfeeding is the norm provides role models for new mothers as they begintheir parenting journey.
Mother support groups, includingLa Leche League International, provide role models and accurateinformation for both normal breastfeeding as well as problem-solving. Thesharing and friendships that develop between breastfeeding mothers can alsoprovide a safe haven of support.
Some mothers and their children do getdepressed, that is an undeniable fact. However, breastfeeding can provide atleast some protection from depression, in addition to its manyother benefits.
In short, breastfeeding can make the worlda happier and healthier place, one mother and baby at a time. Let us build a“warm chain of support” for every mother and her baby to promote mental healthand helpensure a rewarding breastfeeding experience.
References:
1.http://www.who.int/campaigns/world-health-day/2017/campaign-essentials/en/
2.Neuroscience Shows Breastfeeding isNot Just Milk. KA Kendall-Tackett. 2017
3.http://www.un.org/sustainabledevelopment/sustainable-development-goals/
4.Oxytocin Mediates a Calming Effecton Postpartum Mood in Primiparous Mothers. Risa Niwayama,Shota Nishitani, Tsunehiko Takamura, et al. BreastfeedingMedicine. 2017; 12(2): 103-109.
5.Can Hormones in BreastfeedingProtect Against Postnatal Depression? Fiona Donaldson-Myles. British Journal ofMidwifery. February 2012; 20 (2): 88-93.
6.Lactation is Associated with anIncrease in Slow-Wave Sleep in Women. DM Blyton, CE Sullivan, N Edwards.Journal of Sleep Research. 2002; 11(4): 297-303.
7.Breastfeeding Increases SleepDuration of New Parents. T Doan, A Gardiner, CL Gay, and KA Lee.Journal of Perinatal & Neonatal Nursing. 2007; 21(3): 200-206.
8.The Effect of Feeding Method onSleep Duration, Maternal Well-being, and Postpartum Depression. KAKendall-Tackett, Z Cong, and TW Hale. Clinical Lactation. 2011; 2(2): 22-26.
9.The Long-term Effects ofBreastfeeding on Child and Adolescent Mental Health: A Pregnancy Cohort StudyFollowed for 14 Years. WH Oddy, GE Kendall, J Li, et al. Journal ofPediatrics. 2009; 156(4): 568-574.
10.Patterns ofBrain Electrical Activity in Infants of Depressed Mothers who Breastfeed andBottle Feed: The Mediating Role of Infant Temperament. Biological Psychology.2004; 67: 103-124
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