Seeking support for PMADs, or Perinatal Mood and Anxiety Disorders, doesn’t have to mean giving up breastfeeding or chestfeeding. 

Experts from The Motherhood Center, a leading maternal mental health care provider specializing in treatment for new and expecting mothers and birthing parents, and Amaris, a maternal care company dedicated to supporting parents and babies throughout their feeding journeys, share how evidence-based support can help you protect your mental health and honor your feeding goals. 

In this article, you’ll learn:

• Common misconceptions

• Compatible treatments

• Effects of untreated PMADs

• Balancing goals and care

• Meeting guilt with self-compassion

What are some of the most common concerns parents have about seeking mental health treatment while breastfeeding or chestfeeding?

THE MOTHERHOOD CENTER: Many parents worry that seeking mental health treatment—particularly medication—means they’ll have to stop breastfeeding or chestfeeding, or that treatment could negatively affect their baby. There is often confusion fueled by inconsistent guidance, online misinformation, and the pressure to feed “the right way.” Feeding already exists within a landscape of exhaustion, vulnerability, and self-doubt. Adding fear around mental health treatment can make parents feel as though they must choose between their well-being and their feeding goals, when in reality, support exists to honor both.

What mental health treatments are compatible with breastfeeding or chestfeeding?

AMARIS: As aforementioned, many parents mistakenly believe that seeking treatment must mean ending their breastfeeding or chestfeeding journeys, which may prevent them from seeking care. In reality, there are several treatment options for perinatal mood and anxiety disorders that are fully compatible with breastfeeding. While many medications used to treat PMADs pass into human milk, most have little to no effect on the nursing infant. Additionally, PMADs are typically treated through a combination of medication and therapy, such as talk therapy or cognitive-behavioral therapy, which are completely compatible with breastfeeding. 

When discussing treatment options with healthcare providers, we encourage parents to always share whether they are breastfeeding or planning to breastfeed, as this will be taken into account by providers when determining the most appropriate course of care.

Can untreated PMADs affect a parent’s feeding journey?

THE MOTHERHOOD CENTER: Untreated perinatal mood and anxiety disorders can significantly impact a parent’s emotional and physical capacity during an already demanding postpartum period. Feeding happens alongside sleep deprivation, hormonal shifts, and identity changes, factors that can overload the nervous system. When PMADs go untreated, parents may experience heightened anxiety, irritability, emotional reactivity, or shutdown, which can make feeding feel overwhelming, frustrating, or distressing rather than supportive. In many cases, addressing mental health concerns helps parents feel more regulated, confident, and supported, which can positively affect both feeding and bonding.

AMARIS: Research also shows that stress can affect hormones essential to breastfeeding or chestfeeding, potentially leading to delayed letdown and decreased milk production (Nagel et al., 2022). Overall, PMADs can make it more difficult for parents to care for themselves and their babies, which is why taking care of your own well-being is one of the most important ways to care for your infant.

How can you support your feeding goals while seeking care? 

THE MOTHERHOOD CENTER: We emphasize that seeking mental health treatment is an extension of caregiving, not a contradiction of it. “One-size-fits-all never really fits anyone” when it comes to feeding, and the same is true for mental health. Treatment is about responding to real needs in real bodies during a complex transition. Asking for support protects a parent’s capacity to show up, make informed decisions, and engage in their feeding journey in a way that feels manageable and empowering. It’s not about doing less, it’s about getting the right support at the right time.

AMARIS: The essentials are knowing your needs and speaking up for yourself. It’s important to recognize that trying to “push through” while struggling with your mental health is unsustainable. Seeking support is always the first step. Additionally, being open and clear with your healthcare provider about your feeding goals is key, as this information allows them to tailor a treatment plan that supports both your mental well-being and your breastfeeding or chestfeeding journey.

What do you say to parents who feel guilt or shame for needing mental health support during their feeding journey?

THE MOTHERHOOD CENTER: We remind them that feeding and mental health are deeply intertwined, and neither exists in a vacuum. There is no single “right” way to feed a baby, only what works best for the parent, the baby, and the family. Needing mental health support does not mean you’ve failed at feeding or parenting. It means you’re responding honestly to the realities of postpartum life. Guilt and shame often come from unrealistic expectations, not from truth. Support is not a sign of weakness; it’s a way to feel more grounded, informed, and connected during a vulnerable season.

AMARIS: Every journey is different. For some parents, breastfeeding can help alleviate symptoms of PMADs. In other cases, breastfeeding challenges, limited support, and the pressure to breastfeed can contribute to or worsen them.

There are situations in which a healthcare provider may not be able to create an effective treatment plan that is compatible with breastfeeding or chestfeeding. It’s important to remember that every feeding journey is unique and completely valid. Sometimes, using an alternative feeding method is necessary so a parent can heal and feel better—and that is okay.

FAQ

• What are Perinatal Mood and Anxiety Disorders?

• PMADs, or Perinatal Mood and Anxiety Disorders, refer to several mental health conditions that mothers and birthing people can face during pregnancy or after delivery, such as perinatal depression, perinatal anxiety, perinatal obsessive-compulsive disorder, perinatal post-traumatic stress disorder, and postpartum psychosis.

• Can you take medication for PMADs, such as postpartum depression, while breastfeeding?

• While some medications used to treat PMADs may pass into human milk, most are considered compatible with breastfeeding because they have little to no impact on the infant. Sharing your feeding goals with your healthcare provider helps them determine the safest and most appropriate care plan for you.

• Can PMADs, such as postpartum depression, affect breastfeeding?

• Untreated PMADs can make breastfeeding or chestfeeding feel overwhelming, frustrating, or distressing rather than supportive. However, with appropriate treatment, many parents may feel more regulated, confident, and supported, which can positively affect both feeding and bonding.

If you or someone you know is struggling during pregnancy or postpartum, The Motherhood Center offers a range of treatment options, from support groups to outpatient therapy and their unique Perinatal Day Program. Learn more at themotherhoodcenter.com or call 212-335-0034.