A mother shares her experience with lactivism, guilt and postpartum depression

Crumpled adhesive notes with sad faces

Anne, a long time reader, read my post about breastfeeding and bullying and felt compelled to share her story in the hope that it will help others.

Every mother wants the best for her baby. The minute they place that little burrito-wrapped bundle in your arms and your eyes meet, that’s it. From that day forward, you’re responsible for another human being who is totally dependent on you and one of the most basic needs is food.

For most of human history, babies were fed breast milk—whether their own mother’s or a wet-nurse. Only relatively recently has there been a safe, nutritionally balanced formula alternative to breast milk. And although it is safe and nutritionally balanced, there is a massive pushback against it and another type of pushing: that of lactivism, or breastfeeding activism. No one denies that breastfeeding is biologically appropriate food for human babies, but when we insist it is the ONLY appropriate choice, we do both babies and their mothers a disservice. How do I know this? I tried to breastfeed my baby. I succeeded, but at great personal cost. Now I wonder if that level of effort was really necessary or even beneficial.

My first child was born on a beautiful June day. There was only one issue; he had passed meconium when my water broke and he had to be deep-suctioned the moment he came out just in case any had been breathed in. None had, and he was pronounced healthy and handed over to me via his beaming father. Our son was absolutely perfect and as I looked at him I noticed his jaw trembling just a bit. It turned out the suctioning process had left his mouth sore. I was instructed to put him to the breast every hour during the day. The nurses left the room, the doctor said she’d check back the next day, and we were alone.

Suffice it to say that our first session was an absolute failure. He cried, I cried, my husband stood there helpless and saying things like “He’ll get it. It takes time.” He wasn’t getting it. The nurses told me “first time moms always think the baby’s not latched on.” He wasn’t latching on. He was frantic, rooting and crying and not getting anything. Exhausted, I agreed to give him sugar water. We were discharged 72 hours later with no luck at feeding; I was sobbing in the glider rocker at home when the lactation nurse arrived. “I want to breastfeed and it’s not working,” I told her. “Oh honey, it’s okay,” she said, “if you really want this we can make it work.” She set me up with a nipple shield and a sample bottle of formula. She explained that “normally, we don’t advise formula, but he’s lost over 10% of his birth weight and you must build that back up.” He drank it ravenously from the syringe and wanted more. Then he latched on the nipple shield and tried to nurse. There was no milk, so we gave more formula.

Next, the LC told me “you must pump every two hours to get your milk to come in, then mix it with the formula and feed that to him with a syringe. Put him to breast as well and he will get some from that.” So now I was pumping every two hours, nursing, caring for a newborn, attempting to care for myself, and, unfortunately, dealing with a severe case of hormonal postpartum depression, which only worsened with the sleep deprivation of the schedule we were on. I was miserable beyond belief. “Can I really do this?” I asked her. “Of course you can,” she said, “just focus on your baby and let the rest go.” “When do I sleep?” I asked. “Well, there isn’t going to be a lot of that,” she chuckled, “but it’s temporary.” I was fortunate to have my husband home for ten days, by the way. Most women don’t have that privilege.

The lactation nurse came to check on us every few days for a few weeks. She encouraged me and said I was doing so wonderfully! Wasn’t it great to give my baby breastmilk? It’s so good for them. He was nursing successfully after the first week or two with a nipple shield. I didn’t have to supplement anymore. I was a success! But I was still having severe panic attacks like tetanic contractions, one right after the other. I cried randomly and often. I could not shake the feeling of despair and I was so terribly tired. She told me “it’s unfortunate about the formula, but it couldn’t be helped. Don’t beat yourself up.” I did anyway. I was sure his colic and general fussiness was from his rough start and the formula. I read about gut flora and cried some more. On the Fourth of July we watched the fireworks as I pumped and the motor whooshing sounded like it was saying “help me, help me, help me.” Please, someone help me, I thought. I continued to try. The class we’d taken on breastfeeding at the hospital (prior to birth) had us say a mantra: “It’s always too early to quit.”

So we were two weeks in, my PPD was not improving despite additional medication and my stitches from delivery were infected because I hadn’t had two seconds to do the sitz baths that I was supposed to do. The pregnancy and birth forum I belonged to online, who had been so supportive and full of information while I was planning birth and postpartum, had suggestions like eating more fruits and vegetables, or counseling, or herbs. Considering I was on the verge of hospitalization for my PPD, these suggestions were useless. I knew I had to wait for the drugs to kick in fully—the only ones that were safe for nursing, apparently—I couldn’t have most of the medication that would be of immediate help because I was nursing. Despite struggling mightily, I never once considered quitting. I had seen the statistics my group pulled out on articles they discussed and people they discussed; namely, people who didn’t measure up to their standards. People who weren’t willing to make the sacrifice to breastfeed their babies and give it their all. I was not going to be that person. After all, I knew from reading online that breastfeeding has many benefits—immunity, intelligence, even bonding. Breastfed babies are statistically more likely to survive their first year! (I don’t know where this statistic comes from, but I suspect not first world countries). All this swirled around in my already-anxious brain like a toxic cocktail.

It was a hot summer and my son was three weeks old. I felt like I was going to die. I couldn’t possibly go on like this. He was sleeping two hours at a time maximum, and I wasn’t pumping anymore but I was being awakened by horrible nightmares. I was so tired I couldn’t function. My mother had to come stay because my husband had to return to work. I didn’t trust myself to care for the baby other than nurse him. I was literally afraid I would fall asleep nursing in the chair and drop him or squash him. He nursed constantly, until he was overfull and would vomit. I phoned the lactation nurse in desperation again. “Can I give a pacifier?” “Well,” she hedged, “it’s really not great if he’s still establishing nursing, but if he’ll eat until he vomits you can try it. But he might get nipple confusion and only want a plastic nipple.” After a maximum of two consecutive hours of sleep in a month, I was willing to take that bet. And it made absolutely no difference other than getting me three consecutive hours of sleep, which I welcomed.

Finally about six weeks in I felt okay. Not great, but okay. Things looked brighter. I wasn’t desperate and despondent all day. The nipple shield went in the trash, the baby nursing like a pro. But while I remember the awful, sinking into a black abyss, nearly indescribable feeling of PPD and the guilt of hearing my hungry baby screaming, I remember nothing other than that from his first six weeks. We have pictures and for most of them I pulled it together, but I still looked like I felt: terrified and exhausted. I breastfed my baby successfully no matter what.. in the end, did it actually matter? What were the real advantages to what I put us both through? The more I know now, the less convinced I am that there are many, if any. Would he really have been irreparably damaged if I had listened to the doctor who said “you know, breastfeeding is not a requirement,” and treated my own mental health so the baby could have a healthy mother? Would he not be the smart, healthy, amazing kid he is now if I had given him formula?

In so many ways, the breast vs. formula debate is no win. But it is especially so with conditions like PPD. Mothers are guaranteed to lose either way—neglect your own health and breastfeed the baby, or give formula and suffer the guilt from that. The conditional support of lactivists inherently involves guilt. Most of the people who supported me while I tried would have withdrawn that support if I had stopped. So when one of the women from our forum was struggling the same way I did, when she clearly had terrible PPD and needed medication, my advice to her was loud and clear: your needs matter. You cannot care for others unless your own basic needs are met. Take the medicine, give the baby formula, more importantly hold the baby, love the baby, meet its needs and accept no guilt. In the end, breastfeeding is not the yardstick by which your parenting will be measured.