It’s 4 a.m. You’re sitting in the dark, frantically trying to breastfeed your screaming, crying baby. You plead with them to eat. Sore and concerned by their refusal, you switch to a pump.

Anyone would feel overwhelmed. Exhausted new parents still recovering from pregnancy and childbirth are even more vulnerable to the stress. Pressure to be a “good mom” means that those who don’t immediately take to breastfeeding often feel deep guilt and shame—raising the risk of postpartum anxiety and depression.

On the flip side, poor maternal mental health can make nursing even harder—if mom tenses up, for example—and lead to interruptions and worsening self-esteem.

Read: Support for Nursing Parents

“All of those factors create a snowball effect,” said Wendy De Leon, lead lactation consultant at Cedars-Sinai.

Mood disorders are the number one pregnancy complication. Often underrecognized, they can be fatal. Research in JAMA Psychiatry identified poor mental health as the root of nearly one quarter of all maternal deaths—the largest driver of a national crisis.

However, breastfeeding mothers don’t have to suffer. You can prioritize your mental wellbeing as you take on the ins and outs of lactation and parenthood.

“Feeding a newborn every two hours around the clock is not just physically demanding, but also emotionally demanding,” said Eynav Accortt, PhD, director of Cedars-Sinai’s Reproductive Psychology Program. “Give yourself grace.”

While the parenting journey might look picture-perfect on Instagram, more than half of new parents struggle when breastfeeding for the first time.

“The myths and stigma that mothers should just intuitively know what to do are wrong,” said Accortt, whose team runs a breastfeeding emotional support group.

Health officials recommend six months of exclusive breastfeeding. But families must weigh substantial breastfeeding benefits for the infant and parent (including breast, immune, metabolic and respiratory health) against family dynamics, work schedules, specific nutritional needs (such as allergies), and breast milk and formula access.

Whatever you decide is right for your family, be ready to pivot.

“Even if you veer off your original path, it doesn’t mean that all is lost or that you’re a failure,” De Leon said. “Goals change.”

Your child could have acid reflux, a tongue tie or another latch problem. You might have challenges producing enough milk. Similarly, if you’re constantly crying or panicking, you might need a pause to reevaluate your needs and obtain infant feeding support.

Work with a lactation consultant first for better positioning and nursing strategies, De Leon suggested, and tackle treatable issues, such as tongue-tie surgery.

Breastfeeding isn’t all or nothing: You could gradually introduce supplementary feeds like expressed milk or formula and let your partner or another trusted loved one take shifts with the baby.

Read: Tongue Tie: What Is It and How Is It Treated?

Self-care is crucial for nursing moms’ mental health. Accortt encourages active relaxation, such as deep breathing, gentle yoga poses or a grounding meditation, before each breastfeeding shift. These techniques power down the body’s fight-or-flight instinct, lowering the stress hormone cortisol. And they work in just five to 10 minutes.

Your own nutrition is vital. Stock up on healthy, ready-made snacks—for example, carrot sticks, apple slices and peanut butter—for quick fuel.

"If you always put the baby's needs first, you can’t meet them, because you’ll be too depleted," Accortt said.

As you recover, add in movement to boost energy—but take baby steps, she said. Consider going on short walks with your stroller, not "bouncing back" to runs.

Sleep, too, is precious. Sleep deprivation is closely linked to postpartum depression and anxiety. In early parenthood, your body uses those hours of rest to heal from delivery or cesarean section. Practice consistent routines and sleep hygiene, and lean on others whenever possible.

Accortt encourages new moms to aim for solid stretches of sleep, which are more restorative than shorter bursts, in between feedings.

Read: Good Sleep in Times of Stress

Cedars-Sinai’s “Stress Less” breastfeeding support group provides both technical and emotional help, focusing on mood regulation, fears, sleep, healthy social media use (such as limiting scrolling time and comparisons) and boundaries.

Other groups guide new moms on postpartum wellness and coping with depression, anxiety, self-doubt and isolation through the transition.

“You don’t have to go through this alone,” Accortt said.

Stay connected to family and friends. Your support network can lift your spirits and remind you of what matters to you and what’s normal, often spotting psychological warning signs before you do.

“Emotions are useful guides as we navigate life,” Accortt explained. “When strong negative emotions reach over and start driving your car—controlling your behavior and reactions—it’s time to seek help.”

For example, reproductive psychologists assess and treat mental health conditions—including postpartum anxiety and depression—with therapy, while reproductive psychiatrists might prescribe antidepressants.

If you already have a personal or family history of mental health issues, you’re more susceptible to postpartum mental health conditions. Doctors recommend reaching out before you get pregnant to come up with a strategy. Stick to your treatment plan, experts caution. Randomly discontinuing medications can be dangerous, and many are safe for both nursing mothers and babies.

Read: Pregnancy, New Motherhood and Mental Health—What You Should Know

For some, lactation could strengthen mental health.

Emerging evidence shows nursing can ease postpartum depression. Oxytocin and other bonding hormones are released that calm both mom and baby, even lulling them to sleep. The benefits aren’t limited to exclusive nursing, either.

Skin-to-skin contact reaps similar advantages.

“After you have a baby, you have a huge hormone shift, and your estrogen levels are all over the place,” De Leon said. “Breastfeeding helps you to balance out your hormones and regulate everything faster.”

Still, early parenthood is tough for almost everyone.

“The first few months aren’t forever,” Accortt said. “There’s a light at the end of the tunnel.”