By Kellie Scott, ABC Lifestyle
Post-weaning depression needs more research and awareness, experts say. (file image) Photo: Unsplash
Mariana is the first person in her family for four generations to breastfeed.
"In Mexico, everyone got pushed formula early on," the 36-year-old from Australia's Djilang/Geelong says.
"So for me, it was important to get to at least six months."
Mariana exceeded her goal, and just before her son turned two, she decided to stop.
"I was getting really touched out … we managed to go down to one night feed, then just stopped."
Weaning her son was easier than Mariana expected, but she wasn't prepared for how she would feel afterwards.
"I was just so sad all the time.
"I remember crying, asking, 'Why am I so sad?' We all thought it was delayed postpartum depression."
Mariana went hunting for information online, and came across post-weaning depression.
'Often mislabelled as late-onset postpartum depression'
Post-weaning depression, also sometimes referred to as weaning blues, is a "mental health concern that can arise when women are in the process of ceasing to breastfeed their babies", says Astrid S. Tiefholz.
She's a midwife, mental health nurse and international board certified lactation consultant with Karitane, a not-for-profit organisation offering parental support.
Unlike postnatal/postpartum anxiety and depression, post-weaning depression is not a clinical term, but is "a subset of postnatal depression", Tiefholz says.
It can be caused by psychological and physiological factors, says Nicole Highet, who has a background in clinical psychology and is the founder and executive director of the Centre of Perinatal Excellence (COPE).
A 2024 review of studies around the experience says it is often mislabelled as late-onset postpartum depression.
Fluctuations in hormones including prolactin, oxytocin and estrogen levels can all impact a breastfeeding caregiver's mood and wellbeing during the weaning process, says Tiefholz.
"Similar to many situations where there are hormonal changes going on in life, some women will experience those fluctuations quite intensely, and others will barely notice it at all."
Symptoms can be similar to those experienced during postnatal depression, she says, and include feelings of loss, emptiness, sadness, irritability, guilt, and even grief.
"That felt definitely like me," says Mariana of reading about others' experiences with post-weaning depression.
"It felt like everything was an effort, I had heaps of brain fog. I was just a really sad human."
The grief of breastfeeding coming to an end
How many women experience post-weaning depression is unknown.
"Post-weaning depression has been understudied to the point that even prevalence rates are unclear," Dr Highet says.
One of the studies included in the 2024 review was a project with more than 40,000 Norwegian women.
"It found that mums who stopped breastfeeding or were giving solid food or formula as well as breastfeeding had higher levels of anxiety and depression at six months after having their baby," Highet says.
"Women who had higher levels of anxiety and depression during pregnancy also had larger increases in these symptoms after weaning compared to those who didn't."
She says it's an area that needs more research.
Tiefholz says women with a history of mental health concerns will be at greater risk of post-weaning depression, as well as first-time mums, and those who wean earlier.
"The hormonal fluctuation will be less intense for a mum who has been feeding for three-plus years, compared to three months.
"If the decision to wean has not been something the mother was ready or comfortable to partake in, that can make it much harder as well."
Because weaning can also be about a change in the relationship, Tiefholz says, mums with children of any age can find it tough.
"Even with a three-and-a-half-year-old, that decision to cease feeding - and sometimes it's led by the child or mum, or sometimes a coproduction - it can still feel like a sense of loss.
"Particularly for women for whom this might be their one and only child, or their last child, there is sense of loss that 'This stage in my life is now over'."
Mariana was happy for breastfeeding her son to come to an end - especially knowing she would likely have the opportunity again with future children.
"I really wanted to get to the two years and almost got there, but it was time. I was just not enjoying it anymore."
She recently gave birth to a daughter, and says breastfeeding is "going well so far".
How to prevent and manage post-weaning depression
Dr Highet says it's important women are aware of the possibility of post-weaning depression so they know the signs.
Some strategies she suggests include weaning slowly rather than abruptly, speaking to a lactation consultant, calling the Australian Breastfeeding Association helpline and accessing professional support via a psychologist or psychiatrist with expertise in perinatal mental health.
"Prioritising self-care is also important as well as showing plenty of self-compassion."
Tiefholz says women can prepare by reflecting on how they have responded to other changes and life transitions in the past.
"How well did you navigate those changes - like finishing school, changing jobs, moving interstate - what was helpful and what's not been helpful [during those times]?
"Also doing a bit of inventory on how they have managed with other hormonal fluctuations; thinking about your menstrual history and mental health."
She says women should let people close to them know they are weaning, and how they can be best supported during that time.
"If you can just word people up: 'This [is] a change we are going through, and these are the things we do and don't need from you.'"
This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
- ABC
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