“I hate the feeling that he’s on me all the time. I dread breastfeeding him. It makes me feel really low. People keep telling me that breast is best. I want to give him formula but I feel like I am letting him down.”
This was whispered to me by a tearful mum with a five week old baby at our feeding drop in. We had talked about her problems – her sore nipples, her isolation, the baby’s total dependence on her. Finally she admitted that she hated breastfeeding. Sometimes she felt an almost overwhelming low mood as she fed her baby. This seems to be one of mothers’ best kept secrets, why don’t we talk about it?
What could be going on? Often there are many complex and subtle issues at play. Women can dislike breastfeeding for many reasons: physical, physiological, and psychological.
For some women, breastfeeding is not going well. Maybe her breasts or nipples are uncomfortable, or her baby fusses, bites or tugs at the breast. There are many reasons why a mother might come to dread each feed. Most of these can be resolved or managed with some dedicated, sensitive support from a lactation professional, so if this applies to you please reach out for some help.
A little understood phenomenon is Dysphoric Milk Ejection Reflex (D-MER). Mothers suffering from this physiological condition feel intense sadness and low mood from just before a breastfeed and for a couple of minutes of it starting, some experiencing it again with subsequent let downs through the feeding session. This is a chemical response in the brain to inappropriately dropping dopamine levels. The low dopamine triggers temporary but overwhelming sadness, anxiety, irritability and/or restlessness. It is not associated with physical pain or nipple trauma, or depression, and a mother cannot “think herself out of it.” There is more information and support for mothers with D-MER here https://d-mer.org/.
It may be that a mother is finding the overwhelming need for her attention just too much. There is something so intensely draining, physically and emotionally, about being entirely responsible for the well being of a baby. Baby is utterly dependent on her, demanding attention at unpredictable times of day and night with no let up. She is constantly on edge, waiting for the next time baby needs her. Add to that sleep deprivation, which is used as a form of torture for a reason, and a woman can feel like she is losing her mind. If this is you, please recognise that this is often a totally normal response to an intense physical and emotional transition. Be kind to yourself. This is doubly true if you have had a difficult birth or another situation in your life that is compounding the issue. Becoming a new mother can a difficult, as well as incredible, part of your life’s journey. As a society we are not good at acknowledging this and giving appropriate loving support. Please call on your friends and family, take as much help as you can, and reach out to professionals and supportive communities who can assist you. Please note that this is general advice. If a mother or her partner is worried about her overwhelming low mood, hallucinations, or thoughts of harming herself or her baby, she needs some urgent medical attention.
Some women find that breastfeeding exacerbates their existing low mood, anxiety or depression. The isolation, especially if worried about going out or feeding in public, makes it worse. Others find that breastfeeding can help in increasing oxytocin and bonding and lessen the symptoms.
Breastfeeding researcher Dr Alison Strube writes “We have much to understand about the biology of postpartum depression…when a mother is experiencing depression and anxiety symptoms, my job as a clinician is to ask what parts of her day bring her joy and peace, and what makes her symptoms worse.” This is key. For some women, breastfeeding makes her dislike her baby eight to ten times a day. We need to acknowledge this. Sometimes there are strategies that can make the experience better, and other times a mum and baby can be better served by a move to formula milk. If this resonates with you, please call me or one of the many breastfeeding organisations who can really listen to you without judgement, and help you to find a way forward.
I have worked with women who have experienced sexual assault or abuse, for whom birth and breastfeeding can be especially challenging. For some, the process has been handled sensitively and has been healing. In other cases we must recognise that mum’s mental health comes first, and that bottle feeding might be much more appropriate. Babies thrive on love and formula milk.
Feeling like a failure
“I called an independent midwife because I am so anxious and not coping. I am ashamed. We are such failures.”
This was the whispered confession of a mum of a two week old, just this week. I think she was surprised to hear me say “Getting help is such a positive first step. Of course you are not coping, you are a brand new Mum suffering from the after effects of a traumatic birth and huge blood loss. Your poor body is trying to recover, to make more blood and work on that damaged perineum. You family live in another country, so it is great that you are able to call a professional for help.”
Where does this feeling of failure come from? When I asked her more about it, she said that this was the first time that she had not succeeded in something. All through her professional life, she followed the rules and achieved the outcome she expected. A new baby had thrown her completely. Her baby daughter would not settle in the Sleepyhead, she would only sleep on Mum and Dad, who felt like they could not close their eyes. Everything was overwhelming.
It can be really hard to admit that you are not coping, and to reach out. As new parents we need to learn how to be nurtured again, to be out of control and vulnerable and to seek and accept help from others. This is not a failure! It is a new way of being.