Postpartum Insomnia: The Connection Between Breastfeeding & Sleep Disturbances

For women, the postpartum phase—often referred to as the “fourth trimester”—is a period of profound physical and psychological transformation. The joy of welcoming a new life is often accompanied by myriad challenges, including hormonal shifts, physical recovery from childbirth, and the demands of caring for a newborn.

Sleep disturbances are a common issue during this period. Studies have shown that approximately 57.7% of women experience sleep problems in the first seven weeks of the postpartum period. One of the most prevalent sleep disturbances experienced is postpartum insomnia, a condition that can significantly impact the health and wellbeing of new mothers.

What is Postpartum Insomnia?

Despite having the opportunity to sleep, postpartum insomnia is characterized by difficulty falling or staying asleep. For new mothers who are already juggling the responsibilities of raising a newborn, this condition can be especially difficult. Insomnia can lead to fatigue, mood changes, difficulty concentrating, and even an increased risk of postpartum depression.

Poor sleep quality can also affect the quality of the nursing experience and milk production for mothers who are nursing their babies. During this taxing time, getting enough sleep is essential to preserving your best physical and mental health. 

Causes of Postpartum Insomnia

Many things can lead to postpartum insomnia. These are a few of the most typical reasons:

Hormonal Changes

The immediate postpartum period is characterized by drastic hormonal changes. Levels of hormones such as progesterone, estrogen, and cortisol fluctuate significantly after childbirth, which can disrupt sleep patterns. For instance, the sudden drop in progesterone, a hormone that promotes sleep, can lead to insomnia.

Physical Discomfort

Childbirth is a physically demanding process, and recovery can involve pain and discomfort. Insomnia can result from new mothers’ inability to find a comfortable sleeping position due to discomfort from episiotomy stitches, hemorrhoids, or breastfeeding issues.

Anxiety and Stress

The responsibilities of caring for a newborn can bring about significant anxiety and stress, which are well-known contributors to insomnia. New mothers may experience “hypervigilance,” where they are extremely alert to their baby’s needs, making it difficult to relax and fall asleep.

Breastfeeding Schedule

A mother’s sleep schedule may be disturbed by the necessity of feeding a newborn every few hours. This can lead to fragmented sleep and difficulty falling back asleep after nighttime feedings.

Postpartum Depression

Postpartum depression is a severe mental health condition that affects around one in seven or 15%, of all mothers. Insomnia is one of the symptoms associated with postpartum depression. It’s important to seek help if you’re experiencing feelings of extreme sadness, low energy, changes in eating or sleeping habits, or thoughts of harming yourself or your baby.

Lifestyle Factors

Other lifestyle factors can also contribute to postpartum insomnia. These include consuming caffeine, a lack of physical activity, and exposure to screens or other bright lights before bedtime.

Finding practical ways to manage and treat postpartum insomnia can be aided by understanding these causes.

Management and Treatment of Postpartum Insomnia

Addressing postpartum insomnia often involves a multi-faceted approach that combines both medical and behavioral strategies. The following are some of the most popular techniques for controlling and treating this illness:

Medical Treatments

Certain medications may be recommended by a healthcare provider based on the severity of insomnia. This could involve prescription drugs, over-the-counter sleep aids, or natural supplements like melatonin. But before beginning any medication regimen, especially for nursing mothers, it is important to see a doctor because some medications can be transferred to the baby through breast milk.

Cognitive-Behavioral Therapy for Insomnia (CBT-I)

This program is structured to help you recognize and replace sleep-inducing or worsening thoughts and behaviors with sleep-promoting habits. CBT-I, as opposed to sleeping medications, assists you in resolving the root causes of your sleep issues.

Sleep Hygiene Education

The term “sleep hygiene” describes routines and behaviors that help one sleep soundly on a regular basis. This could involve creating a comfortable sleep environment, establishing a regular sleep schedule, limiting exposure to screens before bed, and avoiding caffeine and heavy meals in the evening.

Relaxation Techniques

Methods such as deep breathing, progressive muscle relaxation, yoga, and mindfulness meditation can help reduce anxiety and promote a sense of calm, making it easier to fall asleep and stay asleep.

Physical Activity

Frequent exercise can help lower anxiety and enhance the quality of sleep. Nonetheless, it is crucial to steer clear of strenuous exercise right before bed because it could disrupt your sleep.

Professional Support

If you have tried these strategies and your insomnia still does not go away, you should consider getting professional help. Psychotherapy and counseling are two more methods and treatments that a mental health professional can offer to treat insomnia. 

What is the average duration of post-weaning insomnia?

The duration of post-weaning insomnia can vary widely among individuals. It’s important to note that sleep doesn’t just return to normal immediately after discontinuing night feeds.

Sudden drops in prolactin from weaning can cause sleeplessness. This is a natural part of your body adjusting to the hormonal shift that happens when breastfeeding ends. Some women may experience insomnia only for a few weeks after weaning, while others may continue to have sleep disturbances for several months or longer.

Moreover, post-weaning depression can also contribute to sleep disruptions. This condition is thought to be the result of a subsequent drop in hormone levels and can occur during or after breastfeeding cessation. It is important to get professional help if you are experiencing symptoms of depression after weaning.

Navigating Post-Weaning Insomnia

Sleep deprivation can often feel like an inevitable part of the child-weaning process for many mothers. However, if persistent insomnia arises, it’s important to recognize that this goes beyond normal sleep disruptions and can pose significant health and emotional risks.

Dealing with post-weaning insomnia can be challenging, but it’s essential to remember that this condition is treatable. If lifestyle modifications and non-pharmacological strategies don’t help, don’t hesitate to seek professional advice. Medical treatments are available that can significantly improve sleep quality and duration.

Medications such as low-dose antidepressants, like Trazodone, or non-benzodiazepine sleep aids, like Zolpidem, can be effective. However, due to potential side effects and the risk of dependence, these should only be used under the close supervision of a healthcare provider.

For breastfeeding mothers considering medication, it’s crucial to communicate with your healthcare provider. They can direct you to safe options that reduce any potential risks to your baby. Prescription medications, such as Zaleplon and Ramelteon, are thought to be relatively safe to use while breastfeeding.

Always remember, while post-weaning insomnia can be a challenging hurdle, it doesn’t have to define your postpartum journey. With the right support and treatment strategies, you can navigate this phase successfully and regain restful nights of sleep.