is exhausted the new normal?

Postnatal depletion has symptoms that are accepted by most as just a normal part of motherhood - but some simple strategies can make a real change to daily life

Words Helen James @blackhorsecommunications

Images Poppy Peterson @poppypetersonphotography

Postnatal depletion is an under-recognised yet widespread condition robbing new mothers of their energy and impacting mental and physical health, sometimes for years after birth.

Kate was tired. Bone-crushingly, brain-numbingly tired. Even when she managed 7 or 8 hours of uninterrupted sleep, she still crawled out of bed lethargic. Add to that hair loss, creeping anxiety and a sense of overwhelm, and Kate was not her old self. But with a 3-month-old baby and a busy 2-year old, wasn’t that normal? Her sons were thriving and she didn’t feel depressed, so she wasn’t about to complain to anyone.

But had Kate known about postnatal depletion, she might have shared her experiences sooner. It wasn’t until much later at her son’s 6-month health check that her community nurse asked about Kate’s nutrition, and raised postnatal depletion as a likely contributing factor to her symptoms.

“I was really surprised” says Kate. “This was my second baby, and I’d never even heard of postnatal depletion”. Kate’s experience is common. Although it’s estimated that half of all mothers are depleted during the postnatal period - and can remain so for up to a decade - many simply accept their symptoms as part of the motherhood package.

“I often suggest home delivery meals to mothers as well. There are now a variety of healthy, inexpensive options that save
shopping and cooking when you’re worn out.”

Postnatal depletion describes the effect that the huge demands that pregnancy, birth and raising young children places on their mother, and if unrecognised, can persist for up to a decade. First defined by Australian family practitioner Dr Oscar Serrallach in 2010, signs of postnatal depletion include anxiety, overwhelm, hypervigilance and difficulty focusing, as well as physical symptoms like lowered immunity, loss of libido, hair loss, worsening of existing medical conditions and of course, fatigue.

Depletion starts during pregnancy. “The placenta passes many nutrients to the growing baby including iron, zinc, vitamin B12, vitamin B9, iodine, and selenium stores, along with omega 3 fats like DHA and specific amino acids from proteins,” states Dr Serrallach. This process leaves many starting motherhood already lacking key nutrients. After birth, breastfeeding places a further demand on the body for kilojoules and nutrients, particularly essential fatty acids. And if subsequent children are born in close succession without recovery, the depletion is compounded.

Nadine Campbell is a university qualified naturopath with a Masters in Reproductive Medicine at Amelie Private. Specialising in reproductive health, pregnancy nutrition and postpartum support, Nadine regularly recognises postnatal depletion in her patients.

“Most have never heard of it, or are unaware of the signs that they already have it,” Nadine says. “The fourth trimester is a vital time for a mother to replete her nutritional stores. In traditional cultures the village supports this process, bringing special nourishing foods and helping with the baby so the mother can sleep”. But modern society’s fast pace and pressure to be task-oriented often leaves mothers relying on quick, processed foods rather than prioritising nutritionally dense choices.

Your GP, naturopath or nutritionist is the starting point to assess nutritional profile and make specific recommendations but “there are some key nutrients all new mothers need to replenish” says Nadine. “Omega-3’s, iodine, magnesium, B-group vitamins, choline and iron are essential”. Healthy fats and complex carbohydrates are also foundational.

“Complex carbs from healthy sources, like wholegrain bread, sweet potato or brown rice will sustain energy, and are needed for serotonin and dopamine production, the neurotransmitters that support mood”. Nadine estimates it takes around 12 months for the body to replete its stores, even if optimal nutrition and supplementation is utilised. If postnatal depletion goes unrecognised or remains unmanaged, Nadine has seen mothers chronically suffer the symptoms year after year. “Untreated postnatal depletion may make mothers more vulnerable to developing postnatal depression” she cautions.

Brittany is a first-time mother to a baby girl, and like Kate, has never heard of postnatal depletion, despite being a scientist working in the reproductive health field. “I was told to continue my pregnancy vitamins after birth by my obstetrician,” she says “but I dropped off after about a month. I wasn’t given a specific timeframe, so when it wasn’t raised at the 6-week check I didn’t think it was important”.

Although managing to maintain a mostly balanced diet postpartum, Brittany is keen to further boost her physical and emotional health and is restarting her recommended vitamin supplement. “Of course, I’m tired and sometimes feel like I don’t know what I’m doing - you can’t change some aspects of new motherhood. But if adding a daily supplement may help, it’s an easy fix.”

Nadine agrees that adding a recommended pregnancy vitamin, plus a high-quality fish oil supplement, can go some of the way to correct deficits and rebuild micro and macronutrient stores. “I often suggest home delivery meals to mothers as well. There are now a variety of healthy, inexpensive options that save shopping and cooking when you’re worn out.”

Replenishment also means prioritising sleep, even though it’s notoriously difficult, and incorporating gentle exercise into the daily routine. Kate has now asked extended family to help out more and grabs a nap if she needs it during the day instead of rushing to fold the washing and pick up toys.

“I’ve seen a nutritionist who has really helped me improve the quality of the food I eat. It’s not as hard as I thought it would be to make some simple changes. And in a few weeks, I started to feel like the old me again. I’m not just trying to survive the day anymore.”

This article is for informational purposes only and should not be considered medical advice. If concerned for your or your baby’s health, please consult your healthcare professional.