Postnatal depletion, also known as PD, maternal depletion syndrome, or MDS, is a condition that affects mothers during and after pregnancy and involves symptoms such as fatigue, brain fog, and weight loss.
This condition was first identified by the Pan American Health Organization in 1987 and has remained a topic of active discussion in the world of women's health ever since.
During the 1980s and 1990s, postnatal depletion was a term used by doctors to categorize women who, due to multiple pregnancies occurring in rapid succession or inadequate nutrition, suffered a depletion of energy stores during pregnancy and breastfeeding that they struggled to regain.
Early researchers measured these energy stores by tracking the bodyweight of pregnant women. If a woman lost weight during or shortly after her pregnancy, she was identified as suffering from maternal depletion syndrome.
In the decades since postnatal depletion syndrome was identified as a medical condition, our understanding of what it means for a mother to be “depleted” has shifted and grown more inclusive.
According to Dr. Serrallach, these may include fatigue, memory loss, hormone imbalances, and more. Modern researchers recognize that a woman’s body weight is not the only indicator of her nutrition and wellness.
Doctors like Australian physician Dr. Oscar Serrallach describe postnatal depletion more holistically, giving the condition a flexible definition, including any negative symptoms and struggles many women face after giving birth.
Am I Experiencing Postnatal Depletion?
Suppose you are experiencing the symptoms identified by Dr. Serrallach, such as weight loss, low moods, poor nutrition, hormonal imbalance, and fatigue.
In that case, you may wonder if postnatal depletion could be to blame for post-baby struggles. It is always good to talk to your doctor about these symptoms. They can help you determine if postnatal depletion syndrome is to blame for your experiences. Then, they will help you develop a treatment plan to address your symptoms and recover as quickly as possible.
It’s important to remember that postnatal depletion syndrome takes many forms, and everyone is different. Experiencing fatigue, brain fog, lethargy, and other symptoms of postnatal depletion can be incredibly isolating and exhausting.
Reach out to your friends and family for help, and consider the following tools to help you cope and recover from PD or PD-like symptoms.
What Causes Postnatal Depletion?
The main cause of postnatal depletion is inadequate nutrition. While your baby is developing in the womb, an organ called the placenta mediates the exchange of nutrients between your body and your little one.
Developing babies require extensive energy and nutrients to grow at a healthy rate, and it is through the placenta your own body provides them with everything that they need.
Your body will automatically prioritize your baby's nutritional needs over your own during pregnancy. Suppose you have not altered your diet during pregnancy to ensure you’re consistently getting enough energy and nutrients for the both of you.
In that case, your own body will automatically forfeit what it needs to nourish your child.
When this happens, it may lead to postnatal depletion. To keep the growing baby healthy, a mother’s body will deplete its own nutrient and energy stores, even to the point of illness.
This depletion will catch up to you eventually and is what can cause fatigue and malaise.
Inadequate nutrition may occur if you are not consuming enough calories for yourself and your baby. Remember that women are advised to slightly increase their daily caloric intake while pregnant and breastfeeding to compensate for the energy they use to grow and nourish their baby.
However, getting enough calories does not guarantee proper nutrition. Make sure to eat a wide variety of food groups and follow your prenatal vitamin regime, to ensure that you and your little one are well-nourished.
Little Time Spent Between Pregnancies
Less time spent between pregnancies means less opportunity for your body to fully recover from the stress and changes associated with pregnancy and (if you breastfeed) lactation.
During pregnancy, your body experiences weight fluctuations, metabolic changes, and physical shifts. It will take time to fully recover after delivery before you feel like your old self – both physically and mentally.
Breastfeeding is a beneficial and globally recommended practice that helps you bond with your new baby and ensure that they get all the necessary nutrients to thrive. However, the practice of nursing is a big commitment.
Breastfeeding requires a lot of energy and extends the duration of your pregnancy and postpartum cycle. In fact, overlapping cycles, which means a new pregnancy beginning while you are still breastfeeding a previous child, were identified as early as the 1990s as a major risk factor for postnatal depletion.
This is because your body benefits from the time in between finishing breastfeeding your little one and beginning a new pregnancy.
During that period, your body returns to its typical hormonal cycles, ideal body weight, and restores any nutrients depleted by nourishing your little one. Shortening this window makes you more susceptible to postnatal depletion.
Brain Changes During Pregnancy
A woman’s brain changes significantly during pregnancy when she experiences a reduction in gray matter and restructuring of certain regions of her brain. Researchers believe that these alterations play a role in mother-child attachment and enhance caregiving behaviors.
This is a major change that occurs relatively quickly. Its side effects can include symptoms such as so-called “baby brain,” also known as post-pregnancy forgetfulness and brain fog.
The brain changes that occur during pregnancy have been found to stick around even six years after birth, suggesting that they are here to stay. It is likely that these changes in the brain also contribute to the cognitive symptoms of postnatal depletion syndrome.
Those symptoms include confusion, a feeling of detachment from your personality, and even what Dr. Serrallach describes as maternal “hyper-vigilance.” That hyper-vigilance might come from brain rewiring that helps women be more sensitive to their child's needs.
Unfortunately, it can also be incredibly draining for new moms and even cause stress and tension.
5 Tools To Help You Work Through Postnatal DepletionAdequate Food Intake
To address postnatal depletion, begin with the syndrome’s most common cause: maternal malnutrition. You can start protecting yourself even during your pregnancy against future postnatal depletion by consuming foods that will supply you with the required energy and nutrients.
During pregnancy, women with a typical bodyweight are instructed to follow a diet of 1,800 calories per day during the first trimester, 2,200 calories daily during the second trimester, and 2,400 calories daily during the third trimester.
Of course, your BMI and activity level will impact your metabolism, so talk to your doctor about a diet plan that will work best for your body.
After you’ve given birth, your nutrition needs will not immediately revert to pre-pregnancy. This is especially true if you choose to breastfeed.
The CDC recommends that breastfeeding women increase their daily caloric intake by about 330 to 400 calories while breastfeeding. This allows you to make enough milk to nourish your baby without getting into a caloric deficit.
If you do not nourish yourself sufficiently during pregnancy, your body will forgo the energy to supply your little one with what they need.
Note that this still constitutes a slight reduction in daily calories compared to the recommended intake during the third trimester, which, at 2,400 calories daily, sits about 600 calories above the average woman’s baseline.
However, you will still need to consume more food than you did pre-pregnancy to fulfill your nutritional needs.
Check Your Micronutrient Intake
Micronutrients, also known as vitamins and minerals, are substances that your body requires in minimal amounts in order to function. Don’t let the tiny dosage of these substances fool you. However, micronutrients are vital to your well-being and that of your child.
In women who suffer from maternal malnutrition, a lack of micronutrients can have acute and devastating effects, including worsening the symptoms of maternal depletion.
Micronutrients are varied, but some are particularly important during pregnancy. These include folic acid (vitamin B9), which is essential for the proper development of your little one’s brain and spinal development; zinc, which reduces the risk of preterm delivery; and iron, which can help reduce the risk of your child being delivered with low birth weight.
With the proper diet, it can be possible to avoid micronutrient deficiencies naturally. This requires including a wide variety of food groups and colors in your diet, such as dark leafy greens for folate along with iron and zinc-rich nuts, beans, and grains.
However, you and your doctor may decide that a prenatal vitamin is the most reliable source of micronutrients.
Consuming enough vitamins and minerals is essential to prevent postnatal depletion. If you are not getting enough of these vital materials through your diet or supplementation, your body will deplete its own stores to supply your child with whatever it can.
This can lead to postnatal depletion in the long term, so look out for yourself and your little one by bolstering your vitamin and mineral intake during pregnancy and beyond.
With fatigue being a major symptom of postnatal depletion, your first instinct might not be to hit the gym. But while intense exercise is certainly not recommended in the immediate postpartum period, staying active in whatever way feels good for you can help you beat the symptoms of postnatal depletion.
Exercising during the postpartum period has many benefits, including strengthening your abdomen, improving your sleep, and even helping to lift your mood. Exercising after delivery can begin in stages, and it’s important not to push yourself too hard.
Check out this guide to a mom-friendly workout for inspiration.
Dehydration is very common in postpartum women, especially those who choose to breastfeed.
This isn’t surprising: in order to produce enough milk for your growing baby, your body needs about sixteen cups of water every day. Compared to the eight cups you’re used to drinking while not pregnant, this can be a huge adjustment.
Staying hydrated is particularly important because dehydration can exacerbate the symptoms of postpartum depletion.
Dehydration causes fatigue, irritability, aches and discomfort, and digestive problems. It can also lead to slow healing and impede circulation. Drinking more fluids can have a marked effect and help you feel better every day, postpartum.
Water is always a great choice for hydration, but it isn’t always enough. Consider beverages with natural sources of electrolytes to replace micronutrients and help your body benefit from the fluids you’re drinking.
Coconut water, juices, or natural electrolyte drinks designed for nursing moms are all options that will help you maximize your fluid intake and feel your best.
Ask For Help
The lack of a reliable support system is a notable risk factor for postnatal depletion. It has long been recognized that mothers who are socially isolated, such as migrant populations and unemployed or single parents, face a much higher risk of developing postpartum depression than their socially-integrated peers.
Ideally, a woman with a strong support system can rely on her friends, family, and partner for assistance with child-rearing. Being able to delegate tasks to others ensures that you can have much-needed time for yourself.
Physician and postnatal depletion specialist Dr. Serrallach argues that a major contributing factor behind the rising prevalence of postnatal depletion is the lack of support for mothers in modern-day society.
If you have access to a support system, don’t be afraid to lean on them when you need to. Asking for help is always acceptable and can make a huge difference in the well-being of both you and your child.
Reach out to friends and family when you need it the most. If you lack a support system, consider joining a new mothers’ support group or bringing your baby to a playgroup to meet other new mothers.
The Struggles of Depletion Will Pass
Postpartum depletion can be frustrating, confusing, and isolating. This condition’s wide range of challenging symptoms can make it a dark cloud over the first few months or years with your new baby, which would otherwise be a joyful time.
Putting a name to this experience can be a helpful first step in addressing your symptoms and experience. Next, remember that you are not alone, although you may feel isolated and misunderstood.
In fact, Dr. Serrallach estimates that more than half of all mothers will experience some form of postnatal depletion. Motherhood in our modern society can be challenging, especially when your work or responsibilities do not allow you sufficient time to recover postpartum.
In addition, the increased prevalence of processed and fast food makes nutrient deficiencies more common. Altogether, postnatal depletion is becoming a greater threat to women everywhere.
This can be intimidating, but it is more important than ever to be aware of the risks and take your symptoms and needs seriously. Know that with support and patience, you will make it through PD.
With access to healthy, fresh foods, hydration, and emotional support, you can expect the symptoms of postnatal depletion to fade.
Of course, simply knowing that your symptoms are not forever is not enough. No mother should endure the exhaustion, brain fog, and discomfort of postnatal depletion.
Take action and enlist the help of your support network today to help you get the rest and recovery that you need. With the proper care and the tools above, you’ll be on your way to recovery and back to your old self in no time.
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Social exclusion, infant behavior, social isolation, and maternal expectations independently predict maternal depressive symptoms | Brain, and Behavior