Maternal Fatigue While Breastfeeding - Causes, Signs, and Management

Introduction

Most first-time mothers and women who have recently delivered a baby feel exhausted and experience fatigue after childbirth. Both mental and physical efforts are required in taking care of infants. Irregular sleep patterns of neonates and frequent breastfeeding during the early stages after delivery are associated with maternal fatigue. Maternal well-being, routine functioning, and also mother-baby interactions are widely affected by such maternal fatigue situations. Moreover, maternal fatigue is considerably ignored in modern parenting, and increased priority is placed on breastfeeding and lactation.

What Is Maternal Fatigue?

Maternal fatigue is defined as the subjective and wholesome experiences of the maternal body that includes the physical, emotional, and cognitive functioning in postpartum (after recent delivery) women. Around 60 % of postpartum women go through the fatigue phase, which seriously affects their wellness.

Fatigue is generally defined as an imbalance between the activity period and the resting stage. After giving birth, women experience weakness in the early postpartum stages and their tiredness is further increased by frequent breastfeeding and unaccustomed infant care. Maternal fatigue, also called postpartum fatigue, refers to tiredness, a feeling of suffocation, and reduced physical and mental capacity which affect maternal and child wellbeing.

What Causes Maternal Fatigue?

Postpartum or maternal fatigue does not represent a single clinical entity; rather it is a conceptualized finding and often involves multidimensional factors such as emotional, physical, and cognitive aspects. Diverse factors are responsible for developing maternal fatigue. Some primary factors that cause maternal fatigue are as follows -

• Prolonged Labor - increased first phase duration of the labor causes high fatigue levels.

• Type of Delivery - difficult labor associated with perinatal trauma results in postpartum fatigue.

• Primiparae (Women Delivering for the First Time) - experience higher scores of fatigue. Vaginal delivery contributes to more tiredness in them.

• Healing of wounds such as episiotomy healing.

• Involution - the uterus transforms to a normal state after delivery, which could cause cramps in some women leading to postpartum fatigue.

• Lack of adequate rest or sleep.

Associated Factors That Influence Maternal Fatigue

Postpartum fatigue is also influenced by various other factors such as individual, physical, and psychological parameters such as -

• Maternal Age - younger women less than 19 years and older women more than 35 years report more fatigue. Women aged between 20 to 35 years show better endurance.

• Education.

• Prior depression.

• Increased metabolic needs.

• Hormones.

• Anemia - women having normal hemoglobin levels experience lower fatigue.

• Thyroid dysfunction.

• Cardiomyopathy - rapid cardiovascular adaptation is essential to provide energy following delivery which is severely affected in cardiomyopathy.

• Nutrition - Breastfeeding women generally require more calories. Decreased nutritional intake causes maternal fatigue.

• Alcohol intake.

• Smoking - smokers get tired easily and show increased maternal fatigue.

• Breastfeeding Behavior - mothers experience more postpartum fatigue if they started breastfeeding late and also breastfed their babies less frequently and also women who do not need assistance while breastfeeding experience significantly lower scores for fatigue.

• Meal-Time Duration - meal times per day influence maternal fatigue. Lactating mothers who took a longer duration for meals experienced decreased levels of maternal fatigue.

What Are the Signs of Maternal Fatigue?

The signs and symptoms of maternal fatigue vary diversely among women. Also, the severity of fatigue reduces with an increase in postpartum duration. Mothers report more fatigue in the first month of postpartum which gradually reduces within one year of the postpartum period. Some of the signs of maternal fatigue are as follows -

Physical Signs of Fatigue

• Feeling tired.

• Nausea.

• Vomiting.

• Sense of exhaustion.

Emotional Signs

• Anxiousness.

• Depression.

Cognitive Signs

• Unfocused and unmotivated.

• Diminished ability of the mother to concentrate.

• Increased parenting stress.

How Does Maternal Fatigue Affect Breastfeeding?

Maternal fatigue shows negative effects such as maternal health impairment, delay in return to women’s daily lifestyle, and early weaning of babies. Some of the consequences of maternal fatigue and its influence on breastfeeding are listed below -

• Maternal fatigue creates a negative impact on mother-baby interactions resulting in early weaning of breast milk in babies.

• Fatigue reduces the concentration of postpartum women, which involves the risk of developing postpartum depression.

• Maternal fatigue negatively influences breastfeeding behavior by causing premature weaning off breast milk. This reduces the essential nutritional supply to the babies.

• Communication and healthy interactions between mothers and their infants are greatly compromised due to maternal fatigue.

• Early weaning and decreased interaction delay the development of the babies.

• Postpartum fatigue affects maternal physical activities and adequate infant care in mothers.

• Due to the stress created by maternal fatigue, an imbalance occurs in lactating hormones resulting in insufficient production of breastmilk.

• This is considered one of the most important causes of early cessation of breastfeeding and lactation.

• The level of fatigue in the first days and weeks after birth reduced the self‑efficacy of breastfeeding

How to Overcome Maternal Fatigue?

One of the common features of maternal fatigue is all women regardless of the influencing factors experience a high level of maternal fatigue in the first month of postpartum and its severity of fatigue significantly decreases from the fourth month of postpartum. This period is crucial and the need for more supportive care is required in relieving maternal fatigue. Following are some proven scientific measures for reducing maternal fatigue during breastfeeding.

Satisfaction of Adequate Sleep

• Sleep disturbances occur after childbirth because of the increased need for infant care and also particularly in exclusive breastfeeding (only mother’s milk is given to the baby).

• Frequent feeds at night reduce sleep quality and poor sleep efficiency leading to maternal fatigue.

• Planning short naps and rest during the daytime help to compensate for irregular or interrupted sleep duration at night.

Pre-planning and Self-Care

• Setting up ‘feeding stations’ in the living spaces which include diapers for changing, napkin materials, water, healthy snacks, music, and reading materials, would contribute to well-planned breastfeeding sessions being more easier and relaxing.

• Studies show that women starting to breastfeed their neonates within one hour of delivery and also shorter intervals of less than one hour feel significantly less tired.

• Being prepared and willing to breastfeed makes the mothers more active and reduces fatigue.

• Prioritizing self-care activities such as talking with family members and friends, and peer groups, going outside for small walks, and taking a relaxing and uninterrupted bath or shower.

Proper Breastfeeding Techniques

• Partial breastfeeding by mothers causes more fatigue than completely breastfeeding the babies.

• The level of fatigue is reduced when self‑efficacy with breastfeeding improves.

• Feeding babies according to hungry cues reduces fatigue rather than scheduling breastfeeding.

• During breastfeeding, encouraging the baby to consume breast milk fully and completely would avoid unwanted frequent feeds.

Supportive Care From Partner and Family

• Household activities and baby care should be shared between the partner and family members.

• Managing excessive household duties along with breastfeeding increases maternal fatigue.

• Putting the baby to sleep especially during the night by the partner or other family members provides emotional support and reduces fatigue.

Conclusion

Lactating women feel tired and exhausted during the early stages of the postpartum period due to childbirth. Continuous breastfeeding and baby care increase maternal fatigue which is a normal phenomenon. However, ignoring maternal fatigue during lactation and breastfeeding causes deleterious effects on the mothers’ as well as the baby’s health. Appropriate knowledge and well-equipped interventions along with emotional support help women overcome maternal fatigue and feel a rewarding breastfeeding experience.