What Is Postnatal Depletion Syndrome?

An exhausted mother sits on the floor while her baby plays in a crib.

Postnatal Depletion Syndrome is not as widely recognized as postpartum depression, yet it is of significant concern as it can impact a mother's well-being for months or even years after giving birth.

Postnatal Depletion Syndrome (PNDS) is a condition that affects mothers and is characterized by a combination of physical, emotional, and cognitive symptoms caused by nutrient depletion that persist long after childbirth. Postpartum depression affects up to 1 in 7 mothers in the US (1), and research is showing that postnatal nutrient depletion may be involved in the development of postpartum depression (2).

This article explores the nature of Postnatal Depletion Syndrome, including its symptoms, contributing factors, and management strategies, to help new mothers and their families better understand and address this condition.

Postnatal Depletion Syndrome

Postnatal Depletion Syndrome is not as widely recognized as postpartum depression (PPD), yet it is of significant concern as it can impact a mother's well-being for months or even years after giving birth. Unlike PPD, which is primarily a mental health disorder, PNDS refers to the symptoms that stem from nutritional depletions that result from the immense physiological and psychological demands of pregnancy, childbirth, and early motherhood.

While Postnatal Depletion Syndrome is not the same as Postpartum Depression, Postnatal Depletion Syndrome may be a contributing factor to the development of Postpartum Depression. 

Symptoms of Postnatal Depletion Syndrome

The symptoms of PNDS are varied and can significantly affect a mother's quality of life. They can develop at any time after a mother gives birth or during the postpartum years. Some research shows recovery from pregnancy, childbirth, and nursing can take up to seven years and involves recovering sleep quality and quantity and restoring nutrient levels (3-5).

Physical Symptoms:

Emotional Symptoms:

Cognitive Symptoms:

An exhausted woman

Causes of Postnatal Depletion Syndrome

Several factors contribute to the development of PNDS, often interconnected and compounding each other.

Nutrient Depletion

Pregnancy and breastfeeding place significant demands on a mother's nutrient stores. Essential nutrients such as iron, zinc, vitamin B12, and omega-3 fatty acids are crucial for both maternal and fetal health (5). Without adequate replenishment, mothers can experience deficiencies that impact their physical and mental well-being.

Prior Birth Control Use

According to the CDC, 14% of women between the ages of 15 and 49 in the United States use oral hormonal contraception (the pill) as their primary form of birth control. Research shows that hormonal contraception can deplete B vitamins, vitamin C, zinc, magnesium and more (6). If a woman has taken hormonal birth control for years prior to conception, she may enter pregnancy deficient in several nutrients, which may be further compounded by the nutrient needs of growing a baby.

Psychological Stress

The transition to motherhood is often accompanied by significant stressors, including the demands of newborn care, changes in personal identity, and shifts in family dynamics. Stress is a nutrient-heavy process, using large amounts of minerals like zinc and magnesium, and vitamin C, too (7).

Sleep Deprivation

Caring for a newborn often results in chronic sleep deprivation, which can impair cognitive function, mood, and overall health (8). The lack of restorative sleep hinders the body's ability to recover and cope with the demands of motherhood. As lack of sleep is a stressor in itself, it may contribute to nutrient depletion. Additionally, studies show that when we are sleep deprived, we tend to reach for more processed and calorie-dense foods, rather than nutrient-dense foods (9).

Commonly Depleted Nutrients & Postnatal Depletion Symptoms

Certain nutrient deficiencies are frequently seen during the postnatal period and are known to impact well-being. Below are some common nutrient deficiencies and their associated symptoms.

1. Iron

Iron is essential for producing hemoglobin, which carries oxygen in the blood (11). Iron deficiency is common during and after pregnancy and can lead to anemia, resulting in chronic fatigue, weakness, and impaired cognitive function (11). It is not uncommon for women to experience significant blood loss during childbirth, further depleting their iron stores. Iron deficiency can be reversed through diet and supplementation. Beef liver capsules contain a good amount of bioavailable iron and its cofactors.

2. Zinc

Zinc deficiency can cause impaired immune function and mental fatigue (12). Zinc is a common postpartum deficiency, and lower zinc blood concentration has been found in women with postpartum depression (13).

3. Vitamin B12

Pregnant and postpartum women may be at higher risk of vitamin B12 deficiency due to the increased nutritional needs of the mother and fetus or breastfeeding infant. Vitamin B12 is primarily found in animal foods, such as meat, fish, milk, milk products, and eggs. Vitamin B12 is essential for red blood cell formation, neurological function, and DNA synthesis. A deficiency in B12 can cause fatigue, weakness, constipation, and loss of appetite as well as memory problems and mood disturbances (14).

4. Omega-3 Fatty Acids

Omega-3 fatty acids, particularly DHA, are crucial for brain health and function (15). They have anti-inflammatory properties and play a role in mood regulation. Deficiency in omega-3s has been linked to increased risk of depression, cognitive decline, and mood disorders (15).

5. Vitamin D

Vitamin D deficiency is something I see frequently in my practice. In one study, 59.5% of pregnant women were classified as vitamin D deficient in the first trimester, 54.8% in the second trimester, 58.5% in the third trimester, 66.9% at birth, and 60% 12 weeks postpartum, even though 66.4% of the study population reported daily pregnancy vitamin intake containing at least some vitamin D (16). Vitamin D is important for bone health, immune function, and mood regulation (17). A deficiency can lead to fatigue, bone pain, muscle weakness, and mood changes including depression (18).

6. Magnesium

Magnesium is involved in over 300 biochemical reactions in the body, including muscle and nerve function, blood glucose control, and protein synthesis. A deficiency can cause muscle cramps, fatigue, irritability, and mood disturbances (19).

Managing Postnatal Depletion Syndrome

Effective management of PNDS involves a comprehensive approach that addresses both physical and emotional needs. Here are some strategies to consider:

Nutritional Support:

Psychological and Emotional Support:

  • Therapy: Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) can be beneficial in addressing the emotional and psychological aspects of PNDS.

  • Support Groups: Joining a support group for new mothers can provide a sense of community and reduce feelings of isolation.

Lifestyle Adjustments:

  • Sleep: Prioritize sleep by going to bed early, avoiding screens before bed and during nighttime nursing sessions, and seeking help from partners or family to manage nighttime care.

  • Exercise: Gentle physical activity, such as walking or yoga, can help improve mood and energy levels. This may not be a time where your body is in a place to handle intense or long cardio sessions, such as High Intensity Interval Training (HIIT).

  • Mindfulness: Practices like meditation and deep breathing can reduce stress and promote relaxation.


Postnatal Depletion Syndrome (PNDS) is a condition affecting mothers, characterized by persistent physical, emotional, and cognitive symptoms due to nutrient depletion. It is linked to postpartum depression (PPD), affecting up to 1 in 7 mothers in the US. Symptoms include chronic fatigue, sleep disturbances, headaches, muscle aches, feelings of sadness, anxiety, brain fog, and difficulty concentrating. Potential causes include nutrient depletion from pregnancy and breastfeeding, prior use of hormonal birth control, psychological stress, and sleep deprivation. Commonly depleted nutrients include iron, zinc, vitamin B12, omega-3 fatty acids, vitamin D, and magnesium. 

Managing PNDS involves a comprehensive approach including nutritional support, psychological and emotional support, and lifestyle adjustments such as improved sleep habits, gentle exercise, and mindfulness practices.


  1. Anokye R, Acheampong E, Budu-Ainooson A, Obeng EI, Akwasi AG. Prevalence of postpartum depression and interventions utilized for its management. Ann Gen Psychiatry. 2018 May 9;17:18. doi: 10.1186/s12991-018-0188-0. PMID: 29760762; PMCID: PMC5941764.

  2. Sparling TM, Nesbitt RC, Henschke N, Gabrysch S. Nutrients and perinatal depression: a systematic review. J Nutr Sci. 2017 Dec 20;6:e61. doi: 10.1017/jns.2017.58. PMID: 29296279; PMCID: PMC5738654.

  3. Richter D, Krämer MD, Tang NKY, Montgomery-Downs HE, Lemola S. Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers. Sleep. 2019 Apr 1;42(4):zsz015. doi: 10.1093/sleep/zsz015. PMID: 30649536.

  4. Dr. Oscar Serrallach. (2018). The Postnatal Depletion Cure. Grand Central Life & Style.

  5. Beluska-Turkan K, Korczak R, Hartell B, Moskal K, Maukonen J, Alexander DE, Salem N, Harkness L, Ayad W, Szaro J, Zhang K, Siriwardhana N. Nutritional Gaps and Supplementation in the First 1000 Days. Nutrients. 2019 Nov 27;11(12):2891. doi: 10.3390/nu11122891. PMID: 31783636; PMCID: PMC6949907.

  6. Jouanne M, Oddoux S, Noël A, Voisin-Chiret AS. Nutrient Requirements during Pregnancy and Lactation. Nutrients. 2021 Feb 21;13(2):692. doi: 10.3390/nu13020692. PMID: 33670026; PMCID: PMC7926714.

  7. Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908.

  8. Lopresti AL. The Effects of Psychological and Environmental Stress on Micronutrient Concentrations in the Body: A Review of the Evidence. Adv Nutr. 2020 Jan 1;11(1):103-112. doi: 10.1093/advances/nmz082. PMID: 31504084; PMCID: PMC7442351.

  9. Khan MA, Al-Jahdali H. The consequences of sleep deprivation on cognitive performance. Neurosciences (Riyadh). 2023 Apr;28(2):91-99. doi: 10.17712/nsj.2023.2.20220108. PMID: 37045455; PMCID: PMC10155483.

  10. Greer SM, Goldstein AN, Walker MP. The impact of sleep deprivation on food desire in the human brain. Nat Commun. 2013;4:2259. doi: 10.1038/ncomms3259. PMID: 23922121; PMCID: PMC3763921.

  11. National Institutes of Health. (2023, August 17). Office of Dietary Supplements - Iron. National Institutes of Health; National Institutes of Health. https://ods.od.nih.gov/factsheets/Iron-Consumer/

  12. Wessels I, Maywald M, Rink L. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017 Nov 25;9(12):1286. doi: 10.3390/nu9121286. PMID: 29186856; PMCID: PMC5748737.

  13. Etebary S, Nikseresht S, Sadeghipour HR, Zarrindast MR. Postpartum depression and role of serum trace elements. Iran J Psychiatry. 2010 Spring;5(2):40-6. PMID: 22952489; PMCID: PMC3430492.

  14. National Institutes of Health. (2024, February 27). Office of Dietary Supplements - Vitamin B12. Nih.gov. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

  15. DiNicolantonio JJ, O'Keefe JH. The Importance of Marine Omega-3s for Brain Development and the Prevention and Treatment of Behavior, Mood, and Other Brain Disorders. Nutrients. 2020 Aug 4;12(8):2333. doi: 10.3390/nu12082333. PMID: 32759851; PMCID: PMC7468918.

  16. Palmrich P, Thajer A, Schirwani N, Haberl C, Zeisler H, Ristl R, Binder J. Longitudinal Assessment of Serum 25-Hydroxyvitamin D Levels during Pregnancy and Postpartum-Are the Current Recommendations for Supplementation Sufficient? Nutrients. 2023 Jan 10;15(2):339. doi: 10.3390/nu15020339. PMID: 36678210; PMCID: PMC9863354.

  17. Penckofer S, Kouba J, Byrn M, Estwing Ferrans C. Vitamin D and depression: where is all the sunshine? Issues Ment Health Nurs. 2010 Jun;31(6):385-93. doi: 10.3109/01612840903437657. PMID: 20450340; PMCID: PMC2908269.

  18. National Institutes of Health. (2017). Vitamin D. Nih.gov. https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

  19. National Institutes of Health. (2016). Office of Dietary Supplements - Magnesium. National Institutes of Health. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

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