Support for Breastfeeding Can Make All The Difference

The following post by Ruth Moss is #4 in my series on Mental Health and Breastfeeding. The other posts can be found here, here and here.  Ruth was one of the first breastfeeding moms I made friends with on Twitter. Her talent for writing can be enjoyed all over the internet. For a list of the blogs she writes at see the bottom of this post.

A traumatic birth, which left me feeling powerless and unsupported by the people who were supposed to love me, got me off on the wrong foot when it came to breastfeeding. My baby’s “first feed”, documented in the “little red book” given to all new Mums in the UK by a health visitor, was “formula from cup”. Before I’d even recovered from the narcotics I’d taken in the false hope they’d ease the pain of an induced back labour, I already felt a failure.

The hospital was little to no help getting me started on breastfeeding, but thankfully my baby was hardwired to do this thing, despite one midwifetelling me at three in the morning, when I had tears streaming down my face, “some babies just aren’t meant to. Would it really destroy you to give him a bottle?” (Answer: yes, it almost did.) It didn’t come easy though, and I found myself in a huge amount of pain and with a constantly screaming, hungry baby. On the advice of the home-visiting midwife, I started supplementing his breastfeeds with formula. He refused a bottle, so it dribbled down his cheeks from a tiny open cup, while tears dribbled down my face.

If you know about breastfeeding, you’ll know what a vicious cycle this was in terms of supply and demand. And although the midwives and health visitors were no help (the script: “you’ve done so well, most Mums don’t make it to three weeks, no one would think badly of you if you gave up now”) I knew instinctively that supplementing was making it worse. I started to express milk to cup feed my baby when nursing became so painful even pure lanolin couldn’t stop my nipples from bleeding. His latch was shallow and painful and I knew that, but every midwife and health visitor insisted nothing was wrong, it was meant to hurt, it had hurt for them, this was why people stopped, this was why they’d stopped, this was why I should stop.

My then-husband’s family (I’m estranged from my own family) called me stubborn, they said I’d “give myself” postnatal depression, they attributed the mess the house was in to the fact I was constantly in tears and dealing with a sad, hungry baby, whereas if I’d just go to the doctor and get myself some meds, and quit with the breastfeeding and give him formula, everything would be better. And who knows, it might have been better for them. But I might have been dead.

Because yes, I did start to become incredibly depressed. I started having panic attacks that took me back to when I was separated from my baby in the hospital (he was taken into special care where I was not able to room in with him at first). I cried all the time. I started to wonder if there was much point me being alive at all; after all, anyone could bottle feed formula to my baby, and I was such a terrible Mum anyway he’d be better off without me. I contemplated suicide daily. I was terrified that I would have to stop breastfeeding. That was another thing that kept me awake at night, the thought that I might have to “put him on the bottle” like everyone told me to. I wanted a midwife or health visitor to tell me how to fix this, so I could be happy again. Instead they all told me the same; stop.

When my baby was just six weeks of age, my then-husband became so angry with me over the “stubborn refusal” to bottle feed and my unwillingness to go to the doctor regarding depression, that I went and stayed with my mother-in-law. Eventually he relented over the bottle feeding, but said he’d only have me back if I went to the doctor.

I did, but was very, very careful. I assumed that anti-depressants meant that I’d have to stop breastfeeding. Before taking the Edinburgh test, I asked her, “if I went onto anti-depressants, would I have to stop breastfeeding?” “Yes,” she replied immediately. Then she thought about it. “Well, there might be a way to get around it by pumping and dumping your milk, and taking care when you take tablets, but it would be a lot of effort and even then I’m not sure.”

So I faked the Edinburgh test. It’s really simple to fake. “I have suicidal feelings: a. all the time b. sometimes c. almost never d. what, me? I’m Ms Cheery McCheeryson me!” and so on. She diagnosed simple “baby blues” and pretty much sent me on my way. I was pleased I didn’t have to stop but still desperate for help and support. The local La Leche League group (not one run by a leader; a SureStart Children’s Centre group run by a Peer Supporter [who was also an employee of the centre], and not a particularly good one) was no help to me; but via sheer luck I learned about another group, one run by a midwife at the local hospital, a midwife who, despite her NHS training actually knew a lot about breastfeeding and would be able to help me. A group, incidentally, that not one of the Community Midwives or Health Visitors had told me about. So much for a joined-up service!

And help me she did. Using techniques like biological nurturing and altering the position in which I fed him from the “textbook” ones, to ones that were unique to me, as a woman with very large breasts and a small baby, suggesting we bedshare against FSIDs advice, giving me information about slings and babywearing to calm and soothe him; basically, by going against all the “advice” I’d received from the NHS and government-run SureStart employees, she saved my breastfeeding relationship, and might even have saved my life.

She also told me the doctor was wrong about anti-depressants and gave me information from the Breastfeeding Network on various SSRIs. I went to a different doctor, and armed with this information, I told the truth on the Edinburgh test and got prescribed Fluoxetine (Prozac) which, although it had various unwanted side effects, helped me a lot with the panic attacks. The constant crying resolved itself as I started to breastfeeding my baby without pain, and without his constant crying. His own, lively, happy personality started to come out as he started to put on weight and cry less and less. I fell madly and suddenly in love with this bright, cheeky, funny, curious baby in a way I hadn’t been able to prior to this.

Two and a half years after my baby was born, my mental health is still a long way away from what I’d like it to be. Aside from the early breastfeeding difficulties I still have flashbacks to the trauma of the birth; I do not deal well with any form of separation from my child and have a (hopefully irrational) fear that he will be taken from me. On the nights my ex-husband has our child, I really feel the lack of him and have to fight I the panic attacks that I still suffer, and depression is a constant in my life. But I can manage it, to an extent, and currently I’m managing it without the support of medication (for various reasons).

Sometimes I wonder what would have happened if I’d been given support with breastfeeding from day one. If in the front of my little red book it had said “first feed: breast” instead of what it says now. If the first midwife who’d looked at my baby’s latch had said “no, that’s not right, no wonder it hurts you poor thing!” and helped me to feed him. If I’d not had to deal with the constant crying and hunger in the early days and the feeling of utter worthlessness because I couldn’t make it better for my own child. If the doctor had referred me to the hospital’s breastfeeding support group straight away. I suspect the birth trauma and initial separation alone might have caused me some mental health problems, but I doubt they would be anywhere near as severe. I doubt I’d still be suffering the after effects now.

If doctors and health care professionals knew the difference breastfeeding could make to a mother’s mental health, wouldn’t their initial reaction be “fix the breastfeeding first, if that’s possible, and see what that does”?

And erroneously telling breastfeeding mothers that they must choose between breastfeeding and medication? You see, I don’t think that doctor did it out of spite. I think she did it because she had no knowledge and training on suitable medications in breastfeeding and made an incorrect assumption. But that assumption itself was made out of another assumption; the assumption that breastfeeding doesn’t matter, and that it isn’t related to postnatal depression at all. My relatives made the assumption that trying to breastfeed was making me ill, whereas in fact, trying to breastfeed without support was making me ill. The initial answer to all these things should be “fix the breastfeeding.” But it so rarely is.

Ruth blogs at:

http://leftofthepleiades.blogspot.com
http://allaboutbertie.blogspot.com
http://mossy.dreamwidth.org
http://normalparenting.wordpress.com
http://feministmums.wordpress.com
http://iblamethemother.wordpress.com