Breastfeeding and Perinatal Mental Health
Maternal mental health is challenging with the arrival of a new baby. The dynamics of family life change, relationships change and wellbeing can often be affected.
One area that can have a big impact on wellbeing for new mothers is how they feed their baby, especially if they wish to breastfeed.
Especially if there are perinatal mental health issues or a difficult birth breastfeeding can be become complicated. Many voice that they have not had the support or the journey they wished for. Others have shared how it can be the assumption that if you struggle with your mental health or face challenges during birth that it is a journey that may just not be possible.
In this blog I wanted to share the stories of a few families who have experienced the joys but also the challenges of breastfeeding.
The stories share how they coped, what their experience meant for them and where to get support and help. These stories share hope, information and raise awareness that while ones may suffer with perinatal mental health, breastfeeding is still possible and can in fact be a very important part of maternal wellbeing.
So here’s what a few mums had to say;
Helen
“Anxiety cut short my breastfeeding journey with my eldest son. I gave up at 10 weeks, unable to cope with the responsibility, his constant needs, the broken sleep…. I didn’t realise at the time that I had anxiety, and I was totally unprepared for how I would respond to having a baby.
Second time around, months of CBT had tackled my anxiety, and I was far better prepared for motherhood. I have been able to breastfeed for two and a half years (and counting), which is incredibly important to me due to my son’s heart condition.
I am taking Sertraline for depression and anxiety and am very grateful that my GP was informed about drugs and breastfeeding so knew which medication would be safe. I am so very glad that my mental health hasn’t interfered with my choice to breastfeed my youngest.”
Helens story show’s how support around perinatal mental health and the needs of a new baby can impact on maternal wellbeing and also make a difference to a breastfeeding relationship. However that even though with her second baby they faced the challenges of serious medical complications with support Helen was able to breastfeed her baby. Also that there are medications that are safe to use in breastfeeding that support mental health conditions. Helen’s experience led her to set up #hospitalbreastfeeding helping to raise awareness and campaign for support for families in hospital with sick babies/children.
Anja
“I’ve breastfed both children, 1 and nearly 3, throughout my journey from being admitted to hospital when my second was a month old to now where I’m finally regaining control of my life.
It has kept the bond with them both strong even when I was at my worst, even when I felt the worst mother in the world there was still one thing left that the illness couldn’t take away from me or my children. I could still comfort and provide for them. No matter how ill I was I always had something I could do right for my children and I’m so glad I was supported to carry on.”
Anja’s story shows how important a breastfeeding relationship can be especially when it comes to maternal mental health. That for some breastfeeding helps support bonding with their baby, as well as the importance of the right support.
Lucy
“Both of my breastfeeding journeys have been very tied up in my mental health. I felt so depressed, anxious and guilty after I stopped breastfeeding my eldest that I went on to spend 8 weeks re-lactating. The sense of achievement that gave me was far more powerful than any antidepressant. It also led me to attend a local breastfeeding group where I made friends and became a peer supporter; this had a wider reaching impact on my mental health as I had a focus each week, and new friends with babies all going through the same as me.
My youngest baby wouldn’t latch when he was born, and I pumped until he was finally able to breastfeed at 18 weeks. Those 18 weeks were a true grieving process for me as I came to terms with him not breastfeeding. A lot of those weeks are just a blur but one thing I remember really clearly is the sense that while I felt trapped and miserable pumping, I would feel worse if I stopped and closed that door to our breastfeeding relationship.
I felt quite strongly that while my baby had my breast milk I was somehow separate from any other carer he had – I felt like a Mother because I was making all of his nutrition myself. But I was low, that’s undeniable, and I spent many days crying about him not breastfeeding, and feeling like he didn’t like me, or that I had failed him. I was convinced I had done something really bad somewhere along the line and the universe was punishing me – my anxiety and compulsive thoughts were through the roof. When he did eventually feed, things got worse initially because I’d wanted this thing so badly, but his latch was painful and shallow, and I ended up with mastitis 3 times in 5 weeks. I felt very low for a while then, as I also felt unable to complain because I’d achieved my goal!
It’s only now we’re over that difficult start, that I can really appreciate how good breastfeeding makes me feel – and how low I felt when it was difficult. The support I had was outstanding, and I believe wholeheartedly that I wouldn’t have been able to continue without it.
Now that breastfeeding is working, my anxiety has returned to a more manageable level, and I’m not depressed at all. I enjoy going out with my boys, and I’m back to peer supporting – a love I had felt unable to fulfil when he wasn’t feeding.
Breastfeeding makes me feel worth something. Part of my problem is awful self esteem and mild body dysmorphia, I hate what I see in the mirror, and have never felt my body is worthy of respect. Breastfeeding shows me how powerful and worthwhile my body is. My baby is thriving because of the milk the body I see as flawed and wrong is making. How can I abuse the thing that is keeping my child alive? How can I not at least respect it?”
Lucy’s story is powerful because it shows the two-sided coin that breastfeeding can be. When breastfeeding is difficult and mothers are struggling this can greatly impact wellbeing and mental health. Again support was a major factor for Lucy. But the impact of then building a breastfeeding relationship for her self-esteem and her wellbeing is evident.
When we are considering support for families around mental health it is so important that we look at all areas of caring for their baby and support all choices, including the desire to breastfeed. Sadly I have had women voice that breastfeeding instead of being supported, is often suggested to be the cause of mental health difficulties. Sadly this can lead to feelings of failure and negatively impact a mother. Instead support to reach breastfeeding goals and how to manage issues can in time result in better outcomes for all.
Ellie
“I’ve breastfed my 3 (including twins) while on Sertraline for anxiety and depression. GP initially told me I wouldn’t be able to breastfeed and refused to prescribe my meds while I was pregnant. A topic close to my heart as many friends have either not got help with mental health, or have given up breastfeeding due to incorrect info from GPs.”
I hear this alot from families that if they are on medication for anxiety or low mood they will be told they cannot breastfeed. This is very common and many mothers face this issue when wishing to breastfeed. Information and support for healthcare professionals to support families is so important, which includes the right advice around drugs in breastmilk.
Susanne
“My son was born via a category 1 emergency c-section, under GA. I missed his birth. I missed his first cry. I missed his first breath in this world. When I awoke, he had been cleaned, swaddled and named. And while I was shaking my head NO, he was thrust into my arms. While I was telling them that this was NOT my baby, he was thrust into my arms. While I was grieving for the baby who had kicked inside of me, he was thrust into my arms. I was told to feed him. He needed me. But I needed to get away.
We were discharged after a couple of days and things continued to be strained. My son was diagnosed with severe reflux and esophagitis which meant that every feed was a nightmare. He would comfort feed for hours, then throw it all up and we’d start again. My breasts were sore and my heart was heavy. I felt like a machine, existing only to keep this baby alive. This baby to whom I felt no connection. But I continued as I felt I must. I felt a pull towards breastfeeding and at the time I didn’t really understand why. I now know that it was this that saved us.
During one feed, in the early hours of the morning, I allowed a single tear to drop onto my son’s face as he fed angrily from my breast. Pain was contorting his body and my own was stiff with fear, pain and anxiety. But as that tear fell onto his face he looked up at me and the most amazing thing happened. He smiled. And as he nuzzled against me I suddenly realised that this was the most perfect thing to me. I was giving life, love and nutrition to this person, and he was still here because of me, maybe despite me. From that evening on, I was fiercely protective of our breastfeeding relationship. It was the difference between bonding and wanting to run away. Between feeling a mother and a failure. Between loss and love. And although my son’s health meant that our journey was cut short, it still remains one of the most important parts of our relationship. I was suffering after his birth. I felt useless, powerless and utterly alone. But when I fed him, slowly but surely I came to see that what I was doing was amazing.
I went on to breastfeed two other babies, one exclusively for 15 months and another through tongue tie, reflux, cpma and allergies. And although the latter journey was every bit as hard as my son’s, I knew all along that there was no other way for me. Breastfeeding calmed my soul. It gave me hope, joy and a purpose. And yes, it gave me a strong and loving relationship with that one baby. The one I wanted to leave behind at the hospital. The one I refused to believe belonged to me. The one who taught me so much in the end.”
Breastfeeding can help with the feelings of disconnection, of moments lost and support a mother to re-connect and bond with her baby. It can also help build confidence her in herself and her ability to care for her baby. Susanne’s story really shows how important this is but also how we can empower women, supporting them with choice and help support maternal wellbeing.
Sophie
“I fed my little boy till 18 months, that 18 months included battling my bipolar and a stay in an MBU, my saving grace was breastfeeding it allowed me to be physically close when mentally I was too ill and it let me believe that I’d got something I needed to be here on earth for! Never as a mother have I ever been so grateful that he refused bottles lol.
Breastfeeding was so important in so many ways. It was important to my little boy for all the usual reasons plus it meant he got to stay with me when if I hadn’t of been feeding him myself it would have been likely that we would have been split up (wrong I know but true) and for me it was so important for the reasons I have already said and it was the one thing I felt I could control when everything around me was pretty out of control.”
Breastfeeding can keep mothers and babies together and be a way to keep those bonds close. Even in the most hardest of times it can be important to women. This show’s how we can support women emotionally in ways that are really important to them, including if they wish to breastfeed.
Polly
“I was prescribed Sertraline and continued breastfeeding. I breastfed until J was 7 months but had to stop because of the impact on my mental health. Breastfeeding IS possible with medication but sometimes the impact on the mother has to be of greater consideration.
I was fortunate to have had a very supportive breastfeeding support worker and breastfeeding group I went to who were very understanding and kind and recognised that it was best for me to switch to formula. I am proud of the fact that J was breastfeed for 7 months and I try to think about it in terms of achievement and not “failure”. (I had always envisaged breastfeeding until he self-weaned)”
Polly achieved so much. Often mothers have no idea of their amazing achievements, whether they are able to do one feed or feed for many months. Support to breastfeed but also to stop when it is right for a mother is so important. Maternal mental health matters, and support so important whether that is to continue breastfeeding or support to stop.
Jen
“I said I wanted to Breastfeed when I was pregnant but in all honestly I thought it wasn’t the be all and end all if I didn’t. Following a major obstetric haemorrhage where I ended up in ICU getting Breastfeeding established was a hard slog. I can’t pinpoint what exactly was the trigger but suddenly, breastfeeding became a really, really important thing to me…so much so that when one midwife offered to give my daughter some formula to give me a break (the Midwife in question was VERY pro breastfeeding so I must have really looked terrible) I growled at her as I insisted I wanted to breastfeed. I’m normally such a placid person!
For me, there were two reasons why I really wanted to make breastfeeding work. Firstly I felt like I owed it to the midwives who had put so much effort in to help me get breastfeeding initiated and secondly because my daughter had almost needed to be formula fed. If I hadn’t made it there would have been no choice…so now I owed it to myself to stick two fingers up to what had happened…defy the odds and exclusively breastfeed.
It’s only now that I will properly admit that I struggled with the bond with my daughter. Whilst I never blamed her for what happened I couldn’t shake the feeling that if it hadn’t been for her I wouldn’t have been in the situation in the first place…but then that also got confused with terrible feelings of guilt for not being with her in the early hours. Emily’s cries would trigger flashbacks, but breastfeeding stopped her from crying. It was not an easy journey, she would cluster feed well into the early hours of the morning every single night and this continued for months and months…but slowly it got better and the bond got stronger.
Breastfeeding forced me to hold her close and in the early days I would feed with tears rolling down my face onto her head as I repeatedly apologised to her for almost leaving her. Breastfeeding gave me some control back, something to focus all my efforts on and block out the horrible memories that were haunting me day and night. So many times I almost gave up but from somewhere found a bit more strength to try just one more day…after all I’d fought a worse battle hadn’t I? It was something only I could do, the thing that she’d almost been robbed of…that time where only a mummy will do. Successfully feeding gave me a sense of real achievement.
When I read that only 30% of women who lose 3l of blood go onto breastfeed and an even smaller percentage exclusively, I became immensely proud of what I’d done and extremely grateful for all the support I’d received. Statistically I shouldn’t have been able to do it, but I did. I do look back in wonder at what I actually achieved…how long those cluster feeding sessions would go on for, how traumatised I was through them and if you’d told the pre-birth me that I would do it I wouldn’t have believed you, I just wouldn’t have thought I had it in me. 2 years 5 months and we’re still going with number 2 (6 weeks) happily guzzling alongside.”
Jen’s story is so moving. Breastfeeding can really be an anchor in the darkest of times. We should never underestimate the importance of helping mothers to breastfeed and the impact this can have on their mental health.
Jo
“I had a traumatic manual removal of placenta following transfer to hospital after the birth of my third baby at home. The first days and weeks afterwards are a complete blur. Breastfeeding was an absolute lifeline.
We had a rocky start; tongue-tie snipped, fair bit of syringe feeding, but got into a routine pretty quickly.
Then the PTSD and other symptoms hit and the cloud descended at about 6 weeks. In the most frightening moments, the mechanical need to ‘still be there’ to feed was literally the only thing that kept me going, that made me fight the intrusive thoughts, and that in the dark hours in the middle of the night stopped me from walking out of the front door and escaping from the horrible reality I was stuck in. The lifeline which I clung to that gradually helped to bring me back out of crisis and towards the road to beginning the process of recovery.
The lifeline that slowly but surely began to have an emotional as well as a physical thread that eventually, because it was so intense, enabled me to feel more bonded emotionally with all three of my children than ever before.
For Jo breastfeeding was a lifeline, which helped the process of recovery from PTSD. It is important that this is seen as important and the needs of a mother are considered/respected when offering support around maternal wellbeing. A lot of damage and even trauma can result when women are not supported in their choices.
Emma
“For me breastfeeding kept me alive, on the days when I had no idea if I would make it, I lived to express for my baby. When I went home, when I was battling flashbacks and nightmares from the birth, when I was scared and worried about my baby, breastfeeding was my lifeline.
When I held her to my breast I felt calm, and safe. The terror went away and the fear eased. Close to me, she was mine, I could protect her, and nothing could harm her or take her from me. My body that had failed her, was now keeping her alive once more, giving her everything she needed. It was also saving me, keeping me from losing myself to the terrors of PTSD that sought to take over my mind. In the night when I woke and heard her crying I could run to her, take her in my arms and place her to my breast, unlike all those nights in hospital when I couldn’t be with her, couldn’t care for her.
For me breastfeeding was a beautiful gift. It is a gift that I cherish, because it was a battle no one said we could win. But win we did and I will forever be grateful for the fact that we achieved what was seemly impossible, given all the odds – a lifeline in the darkest of times.”
Breastfeeding can be a gift that actually helps mothers cope with the impact of a difficult birth or in the grips of struggling with their mental health. If we listen to women we are able to see what matters to them and safeguard them emotionally.
Natalie
“Since being a teenager I have always suffered with anxiety and panic attacks. They controlled my life and I was scared of everything. My biggest strength was becoming a mother to my son. I was even more overjoyed when after a devastating loss I found out I was expecting a princess.
I never expected to deliver her 3 months early weighing only 2lb. I was determined to express for her religiously every 3 hours until I could feed her myself. Expressing meant I could do something that the Doctors and nurses couldn’t and it was so rewarding. When the day finally came where Millie could attempt to breastfeed I was so excited and the pride I felt when she latched first time was indescribable. As I fed my daughter I felt the anxiety melt away. I felt her warm body and her heart beating against my chest. My heart melted and my panic attacks became less often. I felt stronger knowing that I was nurturing my daughter and keeping her alive. On top of that the emotional bond that grew between us was so special and has influenced our bond today. It made me feel like her mum and after so much heartbreak it was a sign that my beautiful girl was fighting for me.
I thought I would struggle to bond with her as I missed out on so many firsts, skin to skin etc. I didn’t see her for 8 hours after she was delivered, I left hospital without her, I missed that first most important breastfeed and instead I had to be milked by a machine.
Now 13 months since her birth and I am the proudest I could be. She has thrived. When I look back on what I did I feel so proud. My milk kept my daughter strong and in turn kept me strong feeding her.”
Even the smallest of babies can breastfeed and support in neonatal units is vital. There is so much evidence around the importance of breastmilk to premature babies, but we also need to think about the importance that providing breastmilk for their babies while in neonatal can have for women and their mental health.
Eve
“For me, breastfeeding was instrumental to my recovery from postpartum psychosis. In the midst of delusions, so full of fear of the son I’d given birth to that I couldn’t be on my own with him, terrified of him, my life, the world and most of all being alive, it provided me with a comfort that I never knew it could have. As my mind was rejecting him, as my body shook with nerves at the thought of his presence here forever and the debilitating fear of the lifelong responsibility in front me, my heart had a longing to nurse him.
Feeding him meant he was near me, which was an enormous step, and for my situation and me, it helped my head to start bonding with him. My heart began to love the smell that came from him as he nursed, instead of looking at him full of fear, I loved seeing his little lips take milk from me. My own mum looked and said “isn’t nature amazing” and she was right. My mum didn’t breastfeed me but she could see how it was helping me accept my son and to me, that’s beautiful. My circumstances are mine and what worked for me might not work for others. Do what you need to do to recover and always know that you’re a good mum “
Eve’s story shows that for some breastfeeding enables them to do something they never thought possible, and can mean a vital bond when their mind is consumed by serious mental illness. However as Eve says, it has to be right for that person, in their circumstances. This is how we safeguard maternal mental health.
Kim
“I have been a breastfeeding peer support worker for 6 years and was excited to be expecting my 4th baby. As birth sometimes goes things didn’t go quite to plan and our little boy went to neonatal. It was overwhelming to have my baby so poorly. I grieved for those first hours after birth not to be able to have skin to skin or see him. I knew the only thing I could do was express. Finally on the 4th day I was able to hold and feed my son for the first time. It took time for him to realise that my touch was not going to hurt him. He fed well but was scared of me.
We have overcome this now. Our son is a huge bundle of joy! I love to see his smile when his eyes meet mine during a feed and he gives me a big smile. Breastfeeding taught us how to be close together and allow him to trust me. Happy baby, happy mommy, happy family.
Kym’s story shows how we can go through experiences during pregnancy or birth that can threaten our emotional wellbeing. For Kim breastfeeding was an important part of her journey to reconnecting with her baby and helped them both with the difficult time they had been through.
It is possible.
With support and help breastfeeding can play an important part in maternal mental health. It is possible to have a breastfeeding journey despite struggling with maternal mental health. Breastfeeding can mean putting a baby to her breast, expressing for her baby, giving breastmilk via a syringe or cup or mixed feeding with formula. Every journey matters.
There is help and support available and also information on medications that are safe for mothers to take. Sharing stories helps us see what we can all do to support families in the choices they make and also see how important those choices are to them.
Sadly some women may have the choice taken from regarding being able to breastfeed their babies. Some medications, a lack of support, in correct information or a medical illness can be so severe that breastfeeding for them isn’t possible. Their stories, their feelings and being able to grieve something they may have wanted really matters too. Never should we judge each other but be there to support, listen and comfort each other. This also includes women who chose not to breastfeed or that stop because they feel that it is the right thing to protect their mental health. There should never be any judgement or pressure only mutual respect, compassion and understanding for each journey.
So let’s work together to raise awareness, share accurate information and build better services so that families have the support they need. Because maternal mental health matters, to mothers, to babies, to families.
Further information around medications that are safe to be taken while breastfeeding is available via the Breastfeeding network and the drugs in breastmilk helpline on 0844 412 4665.
For support to breastfeed please visit;
The Association of Breastfeeding Mothers
UNICEF Baby Friendly Initiative
Also speak to your midwife and health visitor for help and support.
