Journal of Personal Science: Omega-3, Nursing a Baby and Postpartum Depression (Part 1 of 2)

by Allan Folz

My wife had moderately severe postpartum depression (PPD) after the birth of our first child, a boy, in 2004. The depression lifted at the same time the nursing stopped, when he was about two years old. The pregnancy itself was without major or even minor problems so the depression was a big surprise. It was frustrating because nothing we did to alleviate it actually helped.

With our second child, born in 2007, for the whole pregnancy we were worried she would experience it again. Thankfully she did not. There were a couple of differences between the two pregnancies. Our first baby was a boy and born with a complication during delivery. The placenta did not release. This caused to be transferred to a hospital, as it was a home birth. At the hospital she was given two units of whole blood. Our second baby was a girl, also born at home, and this time with no issues.

Her third pregnancy was in 2010 and this is where the story begins.

A couple months before she became pregnant, I had discovered paleo dieting following a link to Richard Nikoley’s blog. I read about his experience and followed links to other sites in the paleosphere. The diet, the rationale behind it, and the numerous reports of other people having their health remarkably improved by it really resonated with me, so we adopted a lower-carb, paleo-style diet.

We didn’t have health problems that we were trying to correct for ourselves or a particular need to lose weight, outside of a few pounds for my wife relative to how much she weighed prior to her first pregnancy some six years before. However, I’ve always had an interest in health, medicine, and how the body functions. I even considered becoming an M.D. back in my undergrad days and minored in biology alongside my major in electrical engineering. I have a strong skepticism towards experts and what is the conventional wisdom in mainstream media sources. I think that’s why I almost immediately found Seth’s blog so intriguing, he questions the conventional wisdom and pushes people to take personal responsibility over their health and well-being. So, we were on a low to moderate carb diet, but weren’t fanatical about it. I remember that after my wife’s first visit with her midwives they were concerned by the ketones in her urine and strongly suggested she start eating more complex carbs. She followed their advice to be conservative. We were also supplementing Vitamin D and a little fish oil (a Mega-EPA omega-3 supplement). She was averaging 5K IU of Vitamin D a day, but only about one, 1 gram capsule once or twice a week of the fish oil. All in all, not much fish oil as I wasn’t sure how much was really necessary for people otherwise eating traditionally healthy, home-cooked meals, and I’m very skeptical of the diet supplement industry.

Late in the third trimester she started experiencing some moodiness. By itself, it probably would not have seemed atypical for a woman in her third trimester, but with my wife’s history we were far more sensitive to it and quick to take notice. Paying close attention (and long before discovering Seth’s blogging on self-experimentation), I eventually realized the moodiness happened when we’d skipped taking fish oils mid-week. If she didn’t take any mid-week, by Saturday it was very noticeable that her mood was on the short-tempered side. Once I noticed the connection, and without telling her what I was doing (i.e. single-blind), I’d deliberately skip the mid-week dose one week and note her weekend temper and mood. The following week I’d be sure she took a capsule mid-week. Next week back to skipping. Then, just to be sure, I had her double-dose one week. The double-dose had her in the best mood of all.

At first I was amazed. It was so neat, so mechanical — like flipping a switch. But it occurred to me that if two capsules in a week vs. one was enough to noticeably change her mood then she was obviously deficient as every mg was being put to use with no spare capacity in her system. I wondered if her body was scavenging omega-3 from her own brain for the developing fetus. That was a sobering thought. After that she went to supplementing daily and had no mood issues throughout the rest of the pregnancy or while breast feeding. She did have some of the typical “baby blues” that set in at the three day mark, but they did not last long. Also, she had good days and bad days, like anyone would. I’d say the omega-3 returned her to her normal bearing, irrespective of the demands of pregnancy and nursing.

There is zero doubt in my mind that omega 3 helped both my wife deal with a severe and yet all too stereotypical mental health problem. I’m a pretty sharp, pretty well-read guy who’s always had an interest in biology and medicine. After the experience with our son’s weaning, I wondered if nursing could cause or complicate PPD.

Seven years ago, when my wife was pregnant for the second time, I had searched the web for material related to those two (nursing and PPD) and came up empty-handed. I know I’ve never read something dealing with those two in mainstream outlets because it’s the type of thing I would mentally file away for future reference if the situation ever came up. It seemed like I was the only one willing to consider there might be a connection between them. Diet suggestions for nursing mothers are full of the usual bromides about getting enough complex carbs, fiber, and protein. Search engine auto-completes on “postpartum depression” don’t offer “omega-3” or “diet” anywhere in the top 10. You have to type the first two letters of each before they pop-up as auto-complete options. Today, the first hit for “postpartum depression diet” (I use Bing) is http://www.postpartum-living.com/depression-diet.html, which makes absolutely no mention of fats or lipids. It mentions vitamins, of course, but, incredibly, nothing specific.

During the two years my wife had PPD after her first pregnancy, no one suggested omega-3. At the time, I attributed her PPD to the delivery complications and the blood transfusion. I knew that depression is well-known among heart-attack survivors and IVF recipients, and, in my opinion, IVF is a pretty severe complication. Among the health professionals she saw about her PPD, the only thing the MD did was give her a prescription for Prozac or something similar, which she didn’t use because, well, of course — she was nursing. Had she quit nursing to take the prescription we would have attributed the improvement to the drug when it actually came from ceasing nursing. The naturopathic practitioners — she saw two different ones — gave her B-12 shots, SAM-e, melatonin, and a bunch of useless diet advice that one could read at all the usual places. The B-12 was good for a 24-48 hour energy boost. Other than that, none of them made the slightest difference.

Part 2, about using omega-3 to treat ADHD, will appear tomorrow. Allan Folz is a software developer in Portland, Oregon. He recently co-founded Edison Gauss Publishing, a software house that makes academically rigorous educational apps for children in grades K-8. Their apps are suitable both classroom and home use, and have proven to be particularly popular among homeschoolers that appreciate a traditional approach to practicing math.

14 Responses to “Journal of Personal Science: Omega-3, Nursing a Baby and Postpartum Depression (Part 1 of 2)”

  1. nicole Says:

    Did you see this? http://www.theatlantic.com/health/archive/2014/04/postpartum-depression-can-happen-to-any-parent/360918/

    I wonder what would account for Dad’s getting PPD…

  2. Allan Folz Says:

    Wow, crickets. :) Let me guess tl;dr? Sorry.

    As for the Atlantic article (and I thought I mine was long), not impressed. Didn’t make a clear enough distinction between “blues” and depression. Beyond that, sure, Dads are sleep-deprived too and experience negative effects. No surprise there. However, it didn’t offer any prescriptive advice beyond the usual “communicate, get rest, eat well, brush your teeth well and floss.” Ok, maybe not that last one, but I didn’t read the whole thing so maybe it’s in there after all. :)

  3. Andrew Says:

    Hi, Allan, it’s a good article. Maybe people are waiting for part two before commenting?

    Anyway, I enjoyed this, and I’m very much looking forward to reading the second part.

  4. Allan Folz Says:

    Thanks Andrew. I was a little worried I missed the mark with it.

  5. Thomas Johnson Says:

    Did the midwife note anything about prenatal vitamins? Nearly all prenatal vitamins include omega-3, and all of the doctors my wife and I have talked to suggest continuing to take prenatals during nursing. Here’s the nutritional information for one of the most popular prenatals (one-a-day): http://labeling.bayercare.com/omr/online/oad-womens-prenatal.pdf

    Note that it includes 223mg of omega-3. It seems like traditional medical advice could have saved some self-experimentation here.

  6. Seth Roberts Says:

    I’m guessing that 223 mg of omega-3 is not nearly enough.

  7. Allan Folz Says:

    Thanks for your question Thomas. It is a good one.

    With our first she took the Rainbow Light pre-natal all through the pregnancy and the whole time she was breastfeeding. It was a hard multivitamin so certainly had no O3. 10 years ago I’m not sure any of them did. Also, “Does your prenatal vitamin have O3?” was certainly a question no one asked us. Nor is it all that far from “Are you taking an O3 vitamin?” which definitely no one asked, much less recommended.

    With our third, she took the same pre-natal multivitamin. After three children, I know the routine. They ask, we tell them yes, Rainbow Light, they smile, nod, and say OK, good.

    But I’ll respectfully dispute O3 is traditional, or even contemporary, medical advice. DHA is “a thing” now, but is it ever linked to mental health of the mother? Please show me where. I only see it marketed as important for the baby’s development, akin to Folic Acid and Vitamin D. If the baby is healthy, who is going to know to take O3 for mom’s benefit?

    Finally, the One-a-Day of 200mg of DHA and 23mg/day of EPA is very questionably adequate. From the Bloch/Qawasmi paper that Seth linked to on Monday we know EPA has greater efficacy than DHA. It’s why O3 was discredited for ADHD treatment early on — all the early studies used DHA and the effects were mixed at best. For my wife, 400/200mg of EPA/DHA respectively, ie. 1 capsule a week, was not enough to keep her mood level, and twice that amount was the bare minimum. OaD is ~1500/wk. If the woman is lucky enough to have the DHA work for her, she might be fine, but if not I think she’ll have a very hard time knowing how to fix it if she is relying on conventional advice (switch to EPA and 2-5X the dosage) . My fear is doubling up on her OaD, a reasonable thing to attempt, is unlikely to help. So she’ll give up on O3 for the wrong reasons.

  8. Allan Folz Says:

    Seth, you beat me to it.

    For the record, the Bloch-Qawasmi paper.

  9. Thomas Johnson Says:

    Regarding links to mental health of the mother, I don’t have a link to the original study, but a quick search found this article on WebMD: http://www.webmd.com/baby/news/20110412/omega-3s-may-cut-risk-of-postpartum-depression

    The study mentions 300mg of DHA 5 day/week in the experimental group.

    There’s also this http://www.medscape.com/viewarticle/775013 and this more recent article: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0067617

  10. Seth Roberts Says:

    “she’ll have a very hard time knowing how to fix it if she is relying on conventional advice (switch to EPA and 2-5X the dosage)”

    this isn’t clear. what is the conventional advice?

    apparently YOUR advice is switch to EPA and 2-5X the dosage.

  11. Allan Folz Says:

    Sorry. What I meant to say…

    She’ll have a very hard time knowing how to fix her depression if she is relying on conventional advice, which either completely ignores O3, or at best recommends 1000-1500mg of DHA a week, which is too low an amount to make a difference.

    Instead, I believe women should be ready to take 400-800mg of EPA a day, which works out to 2800-5600mg/week.

  12. Max Says:

    Excellent article, thank you Allan. I encouraged my wife to take 2 capsules, daily, of the Nordic Naturals pro-omega/ultra-omega product, which has 650mg EPA / 450mg DHA. Through two pregnancies (2011 and 2013) and breastfeeding, we had excellent results – calm, alert babies and and no PPD. It’s impossible to know how much to credit the O3 but your report reinforces my belief that it helps.

  13. milly Says:

    Thanks for the post, very interesting. I suffered from terrible insomnia (and PPD/moodiness) since my son’s birth, and once I weaned him at 2.5 years a few months ago, my sleep (and thus, mood) drastically improved. I took fish oil while pregnant (in addition to my prescription, iron-heavy prenatals which I continued taking until weaning) but less vigilantly while breastfeeding. Conventional advice warns mothers of potential depression post-weaning, and bracing myself for that, was shocked to find the complete opposite.

  14. Stephanie Pires Says:

    I had a very severe PPD with my first son, who has very mild autism. I feel that I am lucky to be alive. I noticed that the less I nursed, the less depressed I was. When I finally quit at 11 months, I was back to normal within a month. It was like a miracle. I too had complications and thought that I might die during his delivery. I always assumed the PDD was actually a form of PTSD. I didn’t know anything about omega 3′s 30 years ago, but I have to say, it was the single most awful event of my entire life. I canunderstand now who something like that would have helped. At the time, no one took me seriously, except my mother. She called me every day twice a day and finally, when my son was 3 months old, I went and spent a month with them. I was somewhat better after that. I think my strange labor and delivery were related to oxytocin.