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Insomnia and Breastfeeding: Causes and Treatment

by Dale Cudmore | Updated: May 21, 2021

Pregnancy insomnia affects more than half of pregnant women. For most women, sleep troubles don’t stop immediately after birth.

There are a few different potential causes, and breastfeeding is often a main concern.

We’ll take a brief look at what research on this topic shows, and possible treatment methods.

Insomnia in new mothers is linked to perinatal depressive symptoms, which affects both the health of the mother and child, so it’s important to manage it as much as possible (1,2).

Does Breastfeeding Cause Insomnia?

A decent amount of research has looked at causes of insomnia in new mothers.

One study in particular looked at a wide variety of factors and their correlation to sleep quality in new mothers, including feeding methods (i.e. nursing, formula). They found (3):

No significant correlation between feeding method and insomnia severity.

This doesn’t mean that it’s impossible for breastfeeding to cause insomnia, but it’s unlikely for the average mother.

In other words, insomnia is typically due to other factors unless the pain or discomfort from breastfeeding is so immense that it makes it much harder to get to sleep.

SummaryWhile there aren’t too many studies specifically looking at the effects of breastfeeding on sleep quality, current research indicates that it is rarely a significant factor in a new mother’s insomnia.

If Breastfeeding Doesn’t Cause Insomnia, What Does?

Research shows that sleep quality after delivery increases, but sleep duration declines (7,8):

Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased.

The graph below shows how sleep duration decreases during each trimester and after delivery (the final bar):

Causes of insomnia during pregnancy and after birth can overlap, but there are some important differences too.

During pregnancy, the main causes of sleep trouble are:

  • Hormonal changes
  • Physical pregnancy symptoms (e.g. nausea, cramps, etc.)
  • Stress

The pain and discomfort of carrying around a baby should be mostly gone, however, in some cases breastfeeding can cause enough pain to disrupt sleep.

And what about the other 2 main causes?

How Hormones Change After Birth

Reproductive hormones go kind of crazy during pregnancy.

In particular, estrogen and progesterone levels continue to rise through the pregnancy until delivery, where they drop like a stone (4):

In other words, hormones are unlikely to be a major cause of insomnia after delivery.

The Stress of Caring for a Newborn

Stress is the most common of insomnia in general, not just for pregnant women.

The stress of having a child begins during pregnancy, but doesn’t stop after.

In most cases, worries shift from being about having a safe delivery, to factors like:

  • Worrying about getting back to sleep after frequent wake ups to check on the baby
  • Worrying about the baby’s health
  • Worrying about the future of you and your child and family
  • Money issues

These issues may somewhat resolve on their own as a mother gets used to caring for a child, but some of them will not.

Therefore, it’s important to learn to manage stress if it’s causing insomnia.

Treating Postpartum Insomnia

Hoping that insomnia clears itself up is dangerous. It can lead to other side effects, most notably depression (depression and insomnia are heavily interlinked).

Like all parts of pregnancy, insomnia treatment should also be prescribed by a doctor and supervised.

Treating Pain from Breastfeeding

In the case of immense pain from breastfeeding, a doctor may recommend switching to formula, or consulting with a certified lactation consultant to improve technique and limit pain.

A doctor can also recommend medication to deal with the pain.

Treating Insomnia from Stress

When it comes to treating insomnia that is caused by stress and anxiety, research is pretty clear that cognitive behavioral therapy (CBT) is by far the most effective and safe treatment plan (5).

One study specifically looking at treating new mothers with insomnia with CBT found (6):

Statistically significant improvements were observed in sleep diary-rated sleep efficiency and total wake time, and subjective mood, insomnia severity, sleep quality, and fatigue

Another option is relaxation therapies like yoga, massage therapy, and acupuncture. These aren’t as effective in general, but have been shown to have a significant effect still.

Finally, in some cases a doctor may prescribe sleep medication or a natural sleep aid for some short term relief.

Summary: Insomnia and Breastfeeding

We’ve seen that breastfeeding isn’t usually the cause of postpartum insomnia.

It’s typically caused by stress and anxiety.

Once a doctor confirms the most likely cause of insomnia in a particular case, they can recommend an effective treatment. This can range from consulting a lactation specialist or prescribing CBT.

References

  1. Link between insomnia and perinatal depressive symptoms: A meta-analysis
  2. Effect of maternal depression on child behavior: a sensitive period?
  3. Postpartum Maternal Sleep, Maternal Depressive Symptoms and Self-Perceived Mother-Infant Emotional Relationship
  4. Hormonal changes during pregnancy
  5. Non-Pharmacological Treatment of Insomnia
  6. An open pilot of cognitive-behavioral therapy for insomnia in women with postpartum depression
  7. Can Insomnia in Pregnancy Predict Postpartum Depression? A Longitudinal, Population-Based Study
  8. Effects of pregnancy on mothers' sleep

Medical Disclaimer: The information on SnoozeUniversity.com is not intended to be a substitute for physician or other qualified care. We simply aim to inform people struggling with sleep issues about the nature of their condition and/or prescribed treatment.


About the authorDale is the founder of Snooze University and a sleep researcher. I overcame my sleep issues and now I'd like to help you do the same by summarizing the latest sleep studies for you.