Breastfeeding, mental health, and the care our mothers are owed

Maldives has done something many countries have not: it has won the fight for child survival. Newborns who once would not have lived through their first days now do, across even our smallest and most remote island communities. Breastfeeding has been part of that story and rightly remains a national health priority. 

But alongside this progress sits a quieter, less examined reality. Across the islands of Maldives, in the hours after a child is born, two things are happening at once. A mother is learning, often for the first time, how to feed her baby. And she is also often silently finding her way through one of the most emotionally demanding periods of her life. We have long spoken about the first challenge. We have not spoken nearly enough about the second. 

What the evidence tells us 

Postpartum depression and anxiety affect millions of women worldwide, and Maldivian mothers are no exception. For many women living across our dispersed islands, the early weeks of motherhood can be isolating. A mother who is struggling to breastfeed may have no lactation counsellor nearby. A mother experiencing anxiety or depression may have no mental health professional to turn to, and perhaps no other new mother with whom to share her experience.  

Too often, our health systems, our workplaces, and our communities treat infant feeding and maternal mental health as two separate issues, addressed by different people at different times. But for mothers, they are deeply connected.  

Research on breastfeeding and maternal mental health is nuanced. Some studies find that breastfeeding is associated with lower rates of postpartum depressive symptoms, possibly through hormonal pathways, improved sleep, and a growing sense of confidence and closeness with the baby. Other studies find no such protective effect once additional factors are considered.  

What the evidence does show clearly is that the relationship works both ways. Depression and anxiety can make it harder to establish and sustain breastfeeding. At the same time, mothers who want to breastfeed but struggle—because of pain, low milk supply, exhaustion or inadequate support—may experience guilt, distress and a profound sense of failure. 

The lesson is simple: breastfeeding alone does not protect a mother’s mental health. What matters is whether she is supported, listened to and cared for throughout the experience. Breastfeeding should never depend on a mother’s endurance alone.  

Every postnatal contact should therefore become an opportunity to ask two equally important questions: How is your baby feeding? And how are you feeling? They were never really two separate questions. 

This raises an important question for us: how do we build a system in which a mother’s emotional well-being is supported alongside her baby’s feeding. This begins with a simple shift: treating breastfeeding and maternal mental health as one conversation, not two. Breastfeeding is more than a feeding method; in the earliest days of life, it connects a mother’s physical and emotional well-being with her baby’s health. 

What must change 

I believe three things are within our reach for sustainable support systems that this year's World Breastfeeding Week is calling for us to build.  

First, health workers in health centres and hospitals across the atolls need the skills and time to ask new mothers “how are you feeling”. Perinatal depression and anxiety are common and treatable conditions, not signs of weakness or failure. Early screening and appropriate referral integrated into postnatal care and breastfeeding support can identify distress before it deepens. 

Second, we must protect mothers from guilt. A mother who finds it difficult to breastfeed has not failed her child. Mothers need accurate information and practical support to make informed feeding decisions, not pressure, shame, or unrealistic expectations. Our responsibility is to support breastfeeding while always protecting the dignity, agency, and mental health of every mother. 

Third, we must invest in the conditions that make both breastfeeding and maternal wellbeing possible: adequate maternity leave, workplaces and public spaces that accommodate new mothers, peer support networks that reach mothers, and family and community members equipped to recognise when a new mother needs help.  

Supporting breastfeeding is not solely a mother’s responsibility. It is a shared responsibility. The strength of the system around her, from her home, her community, the places she shops at, or works at, or communes with others at, will often determine whether she can continue. 

Call to action 

This World Breastfeeding Week, under the theme “Prioritise Breastfeeding: Create Sustainable Support Systems,” I call on health workers to check on a mother’s emotional well-being as carefully as they monitor her baby’s growth. 

I call on employers to provide mothers with the time, space and flexibility they need to breastfeed or express milk safely and with dignity. 

I call on partners and policymakers to integrate breastfeeding support and maternal mental health into postnatal services across every island. 

And I call on families and communities to create room in their lives for mothers to breastfeed freely, and to notice when a mother is struggling, to listen without judgement, offer practical help and reach out rather than turn away. 

To every mother across Maldives who is awake tonight, wondering whether her baby is feeding enough, and whether she herself is coping: please reach out to a health worker, family member or trusted friend. Asking for help is not a sign of failure. It is an act of care for yourself and your baby.