Lactivism: socially sanctioned mother-on-mother bullying?

Accusation

Wouldn’t it be great to know that you are a better mother than other mothers?

Wouldn’t it be even greater to tell those mothers to their face that you are an awesome mother and they are mothering failures?

In most times and places that would be considered unspeakably rude, even if it were true. But the rules of social propriety go right out the window when the subject is breastfeeding. Not only is mother-on-mother bullying socially sanctioned, it is actually institutionalized in programs like the Baby Friendly Hospital Initiative.

Think I’m exaggerating?

Consider Ashleigh’s story, “Breastfeeding destroyed me psychologically.” featured on The Fearless Formula Feeder’s blog. Her eloquent description of the psychological agony she endured is difficult to read:

Breastfeeding took my happiness

Breastfeeding destroyed me psychologically. Destroyed me. It took my happiness, it took my feeling of worthiness, it prevented me from fully bonding with my child, it contributed deeply to my postpartum depression, and it made me want to die. I no longer wanted to live, and that is terrible. Even today, on the days I forget to take my medication, I find myself in fits of tears over the loss of what should have been, but wasn’t, because of my broken body. I shouldn’t feel broken, but I do. I shouldn’t feel unworthy of motherhood, but I do. I shouldn’t feel like I failure, but I do. I shouldn’t fall into spells of depression and self-loathing all from seeing a photo of a friend breastfeeding, but I do. I shouldn’t feel a deep despair simply from noticing another woman’s breasts grew during pregnancy, but I do. Breast will never be best when it makes a mother feel like that… when it makes a person feel the way I did, the way I still do. My identity has become reliant on my lack of ability to breast feed, and it shouldn’t. I am a good mom, even if I did formula feed. Every day for the rest of my life I will struggle with the feelings of guilt and shame, and I hate that. But as long as there are lactivists who shame and humiliate formula feeding mothers, there will always be that feeling of incompetence in my heart- and its truly not fair.

There was a biological reason why Ashleigh had so much difficulty breastfeeding. She suffered from IGT, insufficient glandular breast tissue. That’s different from small breasts. Typically small breasts reflect a lack of fatty tissue surrounding the milk glands. In Ashleigh’s case, she literally did not have enough milk glands to make the milk her daughter needed.

Suzie Barston, the Fearless Formula Feeder, responded:

I’m sorry things haven’t changed. I’m sorry that this situation gets more ridiculous by the day. I’m sorry we are arguing over the perceived dangers of formula advertising in resource-rich countries when we could be focusing that attention on the very real dangers of postpartum depression. I’m sorry feminism – or, rather, those who dwell at the intersection of feminism and motherhood – has failed to see the full scope of the infant feeding issue, essentially turning its (their) back on women for whom the Patriarchy is not a formula company, but rather those who insist on reducing women to biological functions. I’m sorry I haven’t made a dent in this fucked up discourse. I’m sorry you are hurting. I’m sorry. I’m just so damn sorry.

I wouldn’t say you haven’t made a dent, Suzie. You have accomplished a tremendous amount, but the problem is so large that it is going to take many people working together to get this insanity under control.

We need to recognize and acknowledge that lactivism as it is practiced in first world countries has nothing to do with health; it is just a form of socially sanctioned mother-on-mother bullying.

That type of bullying has existed since the beginning of time (“He’s 4 months old and not sitting up yet? So sad that he’ll never be a great hunter-gatherer.”) But I suspect that even in pre-history such obnoxious behavior was deemed socially unacceptable.

What’s the difference with contemporary breastfeeding in first world countries?

The bullies justify their bullying by invoking “Science.” As Charlotte Faircloth explains in ‘What Science Says is Best’: Parenting Practices, Scientific Authority and Maternal Identity:

The scientific benefits of breastfeeding … serve as a (seemingly) morally neutral cannon about which mothers can defend their mothering choices and ‘spread the word’ about appropriate parenting. I noticed that for some particular women, sharing ‘information’ with other mothers.

Science is used as a cudgel to beat other mothers, and not merely by individual lactivists, but by institutions created by lactivists:

… [U]nder the assumption that science contains ‘no emotional content’, a wealth of agencies with an interest in parenting – from policy makers and ‘experts’ to groups of parents themselves – now have a language by which to make what might better be termed moral judgements about appropriate childcare practices…

Science actually shows that while breast is theoretically “best,” its benefits in first world countries are trivial. Therefore, the decision to moralize infant feeding, which is what lactivism has become, is not based on science; it’s based on an abuse of science for the self-aggrandizement of lactivists.

Why are we spending society’s time and money to promote breastfeeding when the science does not justify the tremendous effort and expense?

Because some women enjoy the fact that lactivism is socially sanctioned bullying. The Orwellian Baby Friendly Hospital Initiative is emblematic of the misuse of institutional and government authority to enable mother-on-mother bullying.

The greatest threats to babies are vaccine preventable diseases and unintentional injuries. A truly “baby friendly” hospital initiative would educate women about the benefits of vaccination and about keeping their babies safe in cars, and from household poisons and other threats. Breastfeeding would be extremely low on the list of safety initiatives.

But lactivism was never about babies. It was always about mothers and their need to not merely feel superior to other mothers, but to blare their own superiority to everyone else.

Let’s get a grip. Several entire generations of Americans were raised nearly exclusively on formula and all possible health parameters continued to improve. There’s no reason to expect that lactivism is going to have any impact on infant health, and plenty of evidence that it is having a harmful effect on women’s mental health.

That’s got to stop.

  • Sarah

    This was linked through a SciBabe Gawker article, and I’m beyond happy I found it. I would like to ask a question (and I hope all of the discussion hasn’t died down here) but a pretty regular retort I’ve noticed in online forums when people discuss their inability to breastfeed (for whatever reason) is donor milk banks. I’ve never felt comfortable using these resources, and I wanted to see what other people’s opinions were.

    • Karen in SC

      Donor milk banks should use screening and be used for preemies only, where there is a clear benefit. Full term babies can and do thrive on formula.

      • Sarah

        Thank you. 🙂

  • Tam

    I am so irritated by the number of women (mothers, expectant moms and never-been-pregnant women) who judge other women (also mothers, expectant moms and never-been-pregnant women). It has reached the point where I am afraid to venture a preference for anything to do with my chosen manner of delivery and feeding method, as someone is bound to say something to “subtly” disagree with my personal choice.

    But there is that word: personal. The choices we make regarding our birth plans and how we raise our children *are* personal. If we choose to share our choices with others, we open ourselves up to their inevitable critique and opinions, much the same as if we express a preference for one type of home/food/exercise/etc over another.

    Every person is different and entitled to their choice or preference and acting it out, with one very important proviso: that, considering the process of child birth and rearing involves not only oneself but the life of a helpless child, one picks a choice that will not deliberately endanger the life of one’s child or one’s self.

    This means that if your choice is to deliver vaginally and the qualified doctor (not your doula/mother/friend/that kind lady on your baby club chat forum) gives you the thumbs up, go for it. If you pick elective cesarean and your qualified doctor is happy, go for it. If you want to breastfeed and are able to, fan-friggin-tastic. If you don’t want to or are unable to, and you choose a medially-approved, nutritional formula instead, hoo-to-the-rah!

    If, for medical or safety reasons, one cannot do what one wants/chooses to do, be it a vaginal birth, an elective cesarean, a water birth, having an epidural, breast feeding, using a recommended brand of formula, etc. then so be it. The health of one’s baby/babies an one’s self is far more important than the opinions of “fauxsperts”. What is safe and works for one does not necessarily mean it is a universally applicable method.

    The cold, hard fact is if you delivered a child successfully and you and that child are as happy and healthy as is medically possible, you are doing it right. Well done, you!

  • sdsures

    What would the world say (or other men, for that matter) if a certain sample of men had an equivalent physiological lack in their bodies (ie IGT) to make reproduction or feeding a child difficult, and further, there was an artificial way (ie formula) to overcome this and make sure the infant thrived?

    Would men bash other men if they used the alternate, safe and readily available substance to nourish their offspring, and further, that the availability of this alternate substance decreased fathers’ postpartum depression?

    (I will double check this, but I read somewhere that fathers, too, can suffer from PPD.)

    A quick Google says that there have been very few studies on the subject of fathers suffering PPD or PND (post-natal depression) – but that it does exist. So sayeth the NCT, the UK’s largest charity for parents:

    “What causes postnatal depression in fathers?

    Similarly to mums who experience PND, there is no single answer as to why some new dads are affected by depression and not others. Generally, depression is triggered by emotional and stressful events and having a baby can be an unsettling and challenging experience.
    The increased pressures of fatherhood and associated responsibility, financial pressures and change in lifestyle, as well as changes in relationships, combined with a lack of sleep and increased workload at home, can all play a part in a new dad’s mental wellbeing.

    There are two factors that do appear to have a significant impact on dads experiencing PND:

    1) Strained relationship with partner
    It would appear that new dads are more prone to depression, both antenatally and postnatally, if the relationship they have with their partner has been strained throughout the pregnancy.

    2) Partner experiencing postnatal depression
    There is also a moderate but clear link between a dad experiencing depression and his partner also suffering from depression.”

    Source: http://www.nct.org.uk/parenting/postnatal-depression-dads

    • Roadstergal

      “equivalent physiological lack”

      Of course, I immediately thought of erectile dysfunction. And when were the little blue pills ever stigmatized or locked away? They’re covered by insurance, they’re in advertisements for cars, they’re a party drug.

      • KarenJJ

        Although there was a huge amount of shame and ridicule from other men prior to it becoming recognised as a biological function gone wrong and easily fixed with a pill. Similar now to the “just not trying hard enough” that women get told when it comes to breastfeeding issues.

        • sdsures

          Yep! :-/ There are still some adverts for it (the Cialis one comes to mind) that never actually says what it’s for, like a guilty secret that people nervously giggle about. The one I was thinking of has a couple sitting in a movie theatre, and then they suddenly get up and leave. The announcer then intones, “CIALIS”. That’s it – that’s the whole commercial.

          But this clip from “Ellen” is pretty funny, too. https://www.youtube.com/watch?v=APLdlTRkkik

      • sdsures

        Exactly!

        They are also used in treating pulmonary hypertension, since they’re vasodilators. I have a friend with primary PH, and she’d get odd looks when she told people she was on Viagra as well as Coumadin (an anti-coagulant). “But you’re a woman!”

  • A

    “Every day for the rest of my life I will struggle with the feelings of guilt and shame.”

    I so hope that this turns out not to be true.

  • Maya Markova

    Are there any studies on the factors influencing lactation? My anecdotal observations (of the women around me) show that it is generally proportional to breast size. Of course, I know that such observations are junk, but I haven’t any better.

    • Cobalt

      http://www.skepticalob.com/2014/08/can-pumping-increase-inadequate-breastmilk-supply.html

      http://www.istest.cctest.umanitoba.ca/faculties/medicine/units/obstetrics_gynecology/media/Recognizing_and_treating_milk_supply_issues_JMWH_2007.pdf

      Here’s what I got on a quick search. Lactation research is sketchy, a lot of it is better described as “research”.

      And breast size really isn’t a factor, most of the breast is fatty tissue that is unrelated to milk production.

      • Maya Markova

        Thank you for the references! Actually, the second one claims that breast size IS a factor:

        “Wide-spaced, tubular in shape, underdeveloped breasts have been associated with failed lactogenesis (Ref. 33) (Figure 1).” Figure 1 is a photo.

        • araikwao

          But that’s referring to the typical presentation of insufficient glandular tissue rather than just having small breasts. I am very flat chested but had oversupply, for whatever my anecdote is worth!

          • Maya Markova

            You are quite right that the rule is not absolute, it is just a tendency, with many exceptions. However, I am happy that the cited article acknowledged this tendency. My observations (anecdotal, as I said) among women wishing to breastfeed generally were that those with small breasts had little problems when starting breast-feeding, but after some days or weeks, breastmilk was no longer enough for the baby. Those with large breasts often had severe pain in the breasts at the time of birth, and some developed mastitis, especially when there was no one to help. But those who successfully passed this phase (good nurse midwives, if available, could help much) could breastfeed for a long time without the need to supplement.

        • Cobalt

          The physical markers of IGT can present in large or small breasts. It’s not the quantity of tissue, but the type.

  • Rosalind Dalefield

    I was a great breastfeeder. I produced abundant high quality milk for all four of my children. I always got them back to their birthweight in 4 to 5 days after birth. My eldest once, as a very small infant, spilled all his milk down his front just as the child health nurse walked through the door, and she just looked at it and said ‘You’re a very full-cream cow, aren’t you?’ to me.
    Do I feel proud about that? No, I feel lucky. It was simply dumb genetic luck that breastfeeding was easy for me, just as it was dumb genetic bad luck that I have an android pelvis and could not give birth easily. It is stupid and pathetic to feel proud of things that are just the roll of the genetic dice. Women should feel proud of their qualifications, work experience and things that have taken diligent mental or physical training to achieve. Being proud of your genes is pitiful. Condemning others because they did not enjoy the same genetic luck is even more pitiful.

    • Ellen Mary

      Except everyone does this all the time. It is just dumb genetic luck to be born beautiful or able-bodied. If you work out or invest in salon services, that is work . . . It actually requires work & willingness to nurse a child . . . As it does to bottle feed a child. So just like a mother can be proud her bottle fed child has always had a prompt feeding, a nursing mother can be proud of the same.

  • peanutmama

    i agree. i was so embarrassed when i was a first time mother that i had a bottle of formula with me in public. i felt people were judging me. but i have since breastfed 3 other kids after her. but i cannot see a difference between my formula fed child and my breastfed children. just like there really is no difference between a c-section kid and a vaginally born one. bottom line is for me, kids’ gotta eat. not feeding them what they need due to an ideology is so not right. kids’ need trumps our feelings about something as crucial as food.

    • sdsures

      Hugs.

  • Mom to a Boy

    Thank you for this post. I have seen many people online claiming that we live in a bottle-feeding culture, so a mother feeding her baby with a bottle would NEVER be treated rudely. Maybe it depends on where you live. I live in the Seattle and it is common for mothers to breastfeed past 2. I don’t think anything is wrong with that. I have been treated rudely for switching from BF to formula. Family members, women at the library, women in my mom’s group, a dental hygienist and a nurse I spoke with over the phone all shamed me for switching to formula. Someone even told me I needed to “get him off that stuff.” My whole experience with feeding my son has been ridiculous, mostly because of people that know nothing of my situation and because they or their wife breastfed they think they get to talk down to me to my face. I’m much stronger now and won’t put up with that BS with my next child.

  • Alissa Max

    Thank you for this post. I have seen many people online claiming that we live in a bottle-feeding culture, so a mother feeding her baby with a bottle would NEVER be treated rudely. Maybe it depends on where you live. I live in Seattle and it is common for mothers to breastfeed past 2. I don’t think anything is wrong with that. I have been treated rudely for switching from BF to formula. Family members, women at the library, women in my mom’s group, a dental hygienist and a nurse I spoke with over the phone all shamed me for switching to formula. Even my father-in-law told me I needed to “get him off that stuff.” My whole experience with feeding my son has been ridiculous, mostly because of people that know nothing of my situation and because they or their wife breastfed they think they get to talk down to me to my face. I’m much stronger now and won’t put up with that BS with my next child.

  • lawyer jane

    It’s really a political question – only you know how your particular hospital works. You need to consider whether coming out of the gate as a skeptic is the best strategy, or whether you have to be a little more underground at first. Part of the battle is engaging in a somewhat subtle rhetorical campaign to reinforce & reframe that the mother is a patient too – emphasizing that her need for rest and assistance are also part of the story, and that this might take precedence over breastfeeding. Another aspect is making sure that breastfed babies are actually healthy when they leave the hospital and have not lost too much weight – for this, you can use the study that indicates that supplementation actually increases breastfeeding success, as well as studies on the risks of dehydration/jaundice in EBF babies. You frame it not as “baby friendly hospitals suck,” but rather, “supplementing IS baby friendly.” Current BFH practice seems to be to discharge babies that have lost close to 10% of their weight without really much concern – it seems like you need some better benchmarks for this.

    It would be great if you had an ally who would introduce some polemic so you can seem like the more rational one, but the polemicist pushes the debate in the right question even if they are considered an outsider.

    • lawyer jane

      This was to CanDoc 🙂

  • CanDoc

    I have been drafted to our hospitals Baby Friendly Initiative committee as the physician representative. I’m not sure how to navigate this, armed with both tact and science.

    • araikwao

      Congrats! Mothers in your area should count themselves lucky. I hope you are not a lone voice of reason.

    • KarenJJ

      Would it be possible to drop the ‘tact’ part, do you think?

    • CharlotteB

      Wow, what an opportunity!!

      Maybe suggest that parents NEED to know how to make a bottle safely, just like they need to know about car seat safety, SIDS prevention, and shaken baby syndrome?

      I learned how to formula feed from the Fearless Formula Feeder, who is great-but if parents don’t know where to find that info, it’s suprisingly hard to find.

      • KarenJJ

        Definitely safety must come first. Also prioritising mum’s mental health and confidence in caring for her baby.

  • Petanque

    The online presence of the Fearless Formula Feeder made a big difference for me when I was trying (and failing miserably) to breastfeed. Thankyou Suzie!

    • KeeperOfTheBooks

      Me too!

  • Sue
  • Jessica

    Nearly two years ago a friend of mine gave birth. She planned to breastfeed, and the initial efforts in the hospital seemed to be going well. Unfortunately, the nurses insisted on getting baby latched on while she was still numb from the C-section. It took a long time for the anesthetic to wear off completely, and within a short time my friend realized how painful the latch was. She had bruised, swollen, and bloody nipples; she had the initial postpartum engorgement and then…nothing.

    As she was getting ready to leave the hospital she got so desperate about how she was going to feed the baby that she emailed me to ask me if I had any frozen breastmilk that I would be willing to give her. I told her no, I’d quit pumping at work six weeks earlier. I told her that although our hospital offers donor milk, it was expensive, and when we’d run out of the four ounce bottle given to us at discharge, we used formula. My friend told me later that she had not even been thinking of formula, and felt so embarrassed for asking me for my frozen milk.

    The saddest part is that she struggled with breastfeeding and milk supply for MONTHS – would apparently spend a significant time hooked up to the pump, only to get an ounce or two per DAY, but felt compelled to pump and pump because “even a little bit helps!” I always tried to tell her that her son was healthy and happy and formula was okay, but I think she felt too guilty about it all. I really hope that with her next baby (due in the next couple of months) she is able to move on to formula guilt-free if breastfeeding doesn’t work again (she wants to try).

    • Mac Sherbert

      Still numb from C-section as in numb from the spinal/epi? I have to say I was never numb that far up. Wow. I knew BF hurt with my just not how bad until I stop taking my pain meds…I joked I needed pains meds for BF not the C-section! 😉

      • Dr Kitty

        Dermatomes are funny.

        In order to get good anaesthesia for a C section, you need to be numb up to T4 (nipple line) as the innervation of the peritoneum comes from T4, even though the incision is much lower.

        This article explains a bit:
        http://www.frca.co.uk/article.aspx?articleid=100728

        I absolutely loved that the first breast feed in recovery was painless due to the good spinal block I had, and it didn’t cause me later issues at all.

        • Mac Sherbert

          Well, then I guess I was. lol. My first was just painful from the very first. He was a barracuda and I really do remember the first latch and looking at the nurse and saying WOW!…maybe it had worn off a bit by then. Sounds like the lady in the post above would have had trouble BF regardless. However, she does have a point. If you are nursing away numb or the pain is covered up by pain meds, it’s hard to know there’s a problem and fix it before damage is done. I know I didn’t really understand just how bad it was until I went off pain meds and I might have gotten help sooner if I had known.

          • Mac Sherbert

            Oh, and a second thought. In my experience when you complain about pain bf, it’s dismissed. I can’t tell you how irritating it is to be in be agony and told “Well, yeah it does hurt.” If a mom, is taking pain meds and complaining about pain BF, seriously there’s probably a problem!!…also if the LD nurse declared you had a high pain tolerance and you are complaining about BF pain while taking pain medicine there might be a real problem!!

            I think first time Moms are also ignored…I had no idea just how bad and wrong the pain was until my second baby!!

            If someone would have listened to me…If someone would have told to me supplement my barracuda baby before my milk came in…Oh, how it would have turned out differently.

            The way to get women to BF is not to say “Well, yeah it does hurt. It will get better.” That’s exactly what sent to me formula and because when BF pain is serious it doesn’t just get better.

  • KeeperOfTheBooks

    “He’s 4 months old and not sitting up yet? So sad that he’ll never be a great hunter-gatherer.”
    This made me smile, and boy did I need to smile today. Thank you.

  • First Time Mama

    It takes a special kind of cognitive dissonance (well, hypocrisy, really) to reject best scientific practices when it comes to things like the birth process and vaccines, yet embrace it wholeheartedly when breastfeeding is involved. Drives me batty.

  • luckymama75

    Being so heavily involved in woo is exhausting and annoying. I speak from experience because when I was a first time mom I was constant wreck. What if I don’t have organic food to give for lunch today? I couldn’t enjoy an evening away from my son because what if I didn’t pump enough? No way could i subject my baby to formula, he might collapse and die on the spot! I nursed for 3 friggin years because everyone I knew did. And I forced myself to hate my docs over my c section, they obviously just had a golf game to get too. Once my daughter was born I just couldn’t do it anymore. I gave her a bottle of formula when I wanted an evening free. I weaned her at a year, she eats regular food, even junk on occasion. And life is so much more enjoyable. And obviously she’s just as happy and healthy as her brother.

  • Emily

    Thank you. Thank you for sticking up for those of us that have been verbally and emotionally beaten down by Lactivists and their agenda.

  • Cobalt

    OT: if you have postpartum depression that is getting worse, and are between insurances, what’s a good plan of action? I’m getting worried about one of my friends (she’s worried about herself, too) and would like to help her get help. I don’t think she’s at all a danger to her baby, but she is totally miserable and there’s not but so much a support network of friends can do.

    • just me

      Is there a low cost clinic she can go to to get an rx ? Then maybe get an rx at costco? Usually pretty cheap even without insurance. Based on my exp meds are generally needed and work well. Counseling was ok but not really that helpful. Maybe a free support group in her area?

      • Cobalt

        I don’t know, and I’m not sure how to find out. We’ve got a lot of crisis pregnancy centers and addiction counseling services, but neither of those is right. She’s not totally broke, either, just limited.

        • bbb0420

          Where I live there are mental health clinics that see people on a sliding-scale fee–maybe Google could help you find one in your area? Before the Planned Parenthood was shut down in my town, the NP at my OB’s office worked there part-time and, as far as I’m aware, could write prescriptions for meds.

          • just me

            I know in Calif an np can write an rx

        • bbb0420

          staceyjw makes some great points above…and I forgot, I’m reading “Pregnant on Prozac” and in the Resources section there are #s for the Postpartum Stressline: (888) 678-2669 and Postpartum Support International: (800) 944-4773 in case things get really bad and she needs someone to talk to ASAP.

          • Cobalt

            Good info to share! Thank you!

        • Is there a medical school or teaching hospital in your area?

          • Cobalt

            Not conveniently, with traffic it’s about an hour each way, if I’m remembering correctly which is which. I know the 2 local hospitals are not.

    • staceyjw

      Tell her to do *whatever it takes* to get treatment, even if it means panhandling, begging her friends, whatever. And HELP HER, please! I am not kidding! Please do not let her put it off. PPD can get SO BAD, SO FAST. And it can become more intractable if you don’t catch it soon enough.

      I say this because the same thing happened to me. I got PPD, and when I couldn’t get back to work in the few weeks allowed, I lost my job, and insurance. I should have found the $150 too see my doc, and paid out of pocket while waiting to get into a low income clinic (wait was 6+ months where I was at).

      Even if meant not eating, it wood have been worth it. The stall in treatment sent me on a nasty spiral that took years to dig out of.

      Practically speaking- First, have her put a call in to her OB, as she may not have to pay for a visit for PPD meds- make sure she tells her exactly whats going on money wise. She can ask about lowest cost effective meds since she has to pay out of pocket, docs usually know which ones they are.

      Also, any doc can treat for PPD, so if she has a GP she can call and tell the situation to, try there. Even though they might not be a specialist, this will get her started.

      If she has no docs she knows well outside enough to call on, she can try a community clinic, or find a PPD helpline (google this, they do exist). At worst, she would need to pay to get into a new doc, which can be up to $350 for a psych. But it is STILL worth it. I cannot stress that enough. Had I known what I was facing, I would NOT have waited to get into a cheap place, which ended up being a huge mistake.

      • Cobalt

        I’m helping as much as I can, but she needs a doctor. I’m going to look up the helpline idea and see what comes of that. I want to do as much of the logistical fussing as possible, because advocating for yourself when you’re depressed is a lot harder.

        • Guesteleh

          University affiliated mental health clinics will charge on a sliding scale and have lower rates if you are seen by a student supervised by a faculty member. That’s how I got free mental health care once and it was a godsend. Also try local hospitals, who may also have similar setups. Try the social work department at the hospitals you contact.

        • Does Planned Parenthood do anything for PPD? I know they handle a lot of women’s health issues, but I honestly have no idea if they can handle PPD or not.

          • Cobalt

            Our local refers to the local community services group, with a ridiculous wait list. I’m finding that in this area, if you’re poor, all society cares is that you don’t get pregnant. Disheartening, for sure, but that’s why I’m doing the leg work.

          • That is disheartening. Good luck!

        • KeeperOfTheBooks

          Is there a Catholic Charities in your area? I know this isn’t (unfortunately) universal, but our local one supports a low-cost clinic that has an arrangement with a number of local doctors of various specialties to come in and volunteer their time for X hours per week to help low-income patients.

          • Cobalt

            Our local Catholics seem to be spending on a little on food security and a lot on abortion prevention. I would like to shake them sometimes, but that’s neither here nor there.

          • KeeperOfTheBooks

            Ugh. 🙁 Around here I’d say a fair amount of money/effort is spent on both, but I know I’m spoiled from being in one of the larger archdioceses in the country.

      • JJ

        Yes to this.

    • Bombshellrisa

      Is there a suicide prevention line in your area? They can often give referrals to community mental health programs (usually sliding scale fee). Please help her get the help she needs.

      • Cobalt

        I totally didn’t think of that. She hasn’t said or done anything to make me think it’s that severe (yet-given enough time without treatment, who knows how dark the road gets), but that’s a really good idea.

        • Bombshellrisa

          It doesn’t have to be so severe-if someone calls and says “I have really awful PPD, I need help and I don’t have insurance” I am sure they can help somehow.

        • Dr Kitty

          Absolutely get her to call whatever suicide prevention hotline is in your area.
          We have a fantastic one here that can arrange face to face CBT or interpersonal counselling, and I tell my patients that they don’t have to have a rope in one hand and a bottle of pills in the other before they think of calling- the whole point is to help people before it gets to that point.

      • just me

        Not everyone, probably most people aren’t, with ppd are a danger to themselves/babies.

        • Bombshellrisa

          I wasn’t suggesting that, but since this person has no PCP and no insurance, calling that number be the most direct way to get help. I struggled with severe depression in pregnancy and because I came to doctor’s appointments showered, dressed nicely and groomed, my depression wasn’t taken seriously. Calling that number (for me) got a referral to a psychiatrist that specialized in depression in pregnant women and ones with PPD.

    • Jessica

      If I were her, I’d say, “Call your OB and explain that you’re suffering from PPD, and it’s getting worse, but you’re between insurance and may need to work out payment arrangements.” I have a very, very hard time believing that a compassionate, decent OB wouldn’t see her on an emergency basis and either write off the cost of the visit or allow her to make payments.

      Seven years ago I began to suffer from very severe depression. I finally called my gynecologist’s office and said I was suffering from depression and asked for an appointment to discuss the matter with my doctor. I was not postpartum, but oh my goodness – they confirmed I was not considering suicide, booked me for an appointment the very next day, and then later in the day called me back to see how I was doing. The kindness and sensitivity was greatly appreciated – I so hope that your friend’s OB is similarly compassionate and accommodating.

    • JJ

      Sometimes there are low-cost mental health services in the community:

      http://captainawkward.com/2011/09/22/how-to-locate-low-cost-mental-health-care-in-the-us-and-canada-guest-post/

      Also, I as survivor of severe PPD/anxiety, here are some things that can help until she gets seen:
      1.Make life as low-stress as possible as get as much help as possible. Find out what she needs help/overwhelmed with.
      2.Getting enough sleep, even if in the meantime it means taking OTC sleep meds. (Don’t breastfeed on these!) I had severe anxiety that gave me insomnia and then worsening depression.
      3.Eat balanced meals. Walks in sunshine if possible.

      More ways to get help here:
      http://www.postpartum.net/
      http://postpartumprogress.org/

    • Cobalt

      Update:

      I made a ton of phone calls (her OB, my OB, and the hotlines you guys recommended) and have a short list of counseling services that both offer reduced costs to the uninsured and take the insurance she’ll have next month (continuity of mental health care matters, starting over in a month would suck). Another friend is calling that list with her to see how soon they can get her in and handle logistics.

      In the mean time we’re folding laundry together and planning low stress hangout sessions and daily walks to fight off loneliness and the feeling of being overwhelmed and isolated.

      I want to thank you all for being a great circle of support for moms and babies and families. If more of the parenting world was like this, then it would be a better place.

      • D/

        “and there’s not but so much a support network of friends can do”

        Not from what I’m seeing here. You are a piece of the great close support I wish every new mother had. One who really pays attention to friends, recognizes and listens to that little voice that makes us worry about them AND then follows through *now* and does what needs to be done.

        Completely impressive contribution that’s sure to make a difference for your friend … and in less than 24 hours 🙂

        • Cobalt

          I’m doing what I hope someone would do for me, because I care and because I understand there’s no good reason it’s not me, just luck of the draw. I’m glad I can ask for help here, and I wish the sense of community support for and among parents was more universal. Many hands, light work or some such.

      • Bombshellrisa

        This is great news!

      • Zen

        Can you come over and be my friend in a couple years when I give birth?! You sound like an amazing person.

        • Cobalt

          Thank you! I am sometimes very good, and sometimes a total dolt, but I am generally willing to help.

    • Liz Leyden

      Does her area have 211, a dedicated line for human services? http://www.211.org/

  • Sara M.

    Admittedly, I am exclusively breastfeeding my little one. But I supplemented my previous two and it was fine, no regrets. Any mother who puts the health of her baby first is a great mom in my book. If that includes formula feeding then fine. I don’t judge. I produce more milk than the law should allow so I have to pump everyday, but we still have back up cans of formula, just in case something compromises my ability to feed or the baby’s health. It’s okay people. Thriving babies should be the only goal.

  • GuestK

    I hated nearly every moment of breast feeding. And I did it for 8 months. Because I felt i had to, and because I gullibly believed my midwife that it would eventually stop hurting. So I kept on, month after month. You can’t imagine the shame I felt when I was complimented in public for breastfeeding. The woman was kind, and meant well, but what would she think if she knew how much I despised it? And how could I complain when I made so much milk? The times I had the courage to talk about how hard it was, I was torn down, told I should be grateful for having more than enough milk when some women don’t make enough.

    It never stop hurting. The times between feedings felt like my breasts would burst. Little things – shower water, bending over, even thinking about the baby – could trigger let down and enough milk to soak my pads and clothes. Let down itself was agony each time, and since the baby fed hourly for months I was constantly sore.

    The first time I “cheated” and gave my baby a bottle of formula (pumping wasn’t exactly an option when you are feeding a baby hourly and already have oversupply), I cried from relief, and from guilt because I felt happier and closer to my baby than I ever had breastfeeding her. I felt so broken. When I finally quit at 8 months, it took about 2 weeks of painful fullness and leaking but I was, at last, free. Free to bond with my baby without pain, free to catch up on sleep because someone else could feed the baby, free from feeling like nothing more than a milk producing machine.

    I am so much more to my daughter than a supply of milk. I wish I had realized it all sooner, seen how it wasn’t worth the misery. I wish women could support each other during our most vulnerable times, rather than tearing each other down.

    • demodocus’ spouse

      I found it unpleasant at best, and often painful but kept at it too. Some woman (not one I know) at my local knitting shop was complementing me and waxing eloquent about the joys of bfing. I got her to shut up by telling her I hate it.

    • Maria

      I am sorry breastfeeding was so hard for you. Virtual hug coming your way!

      I also had someone come up and compliment me when I was breastfeeding my first and it felt really intrusive and annoying. Like you, I know she meant well, but I really didn’t need to be talking to a stranger at that particular moment.

      I refused to pump with my second. If I needed or wanted to be away from my baby, it was a bottle of formula! It felt so good to not feel like I was the only source of food for my baby!

      • GuestK

        Thanks for the kind words. I follow this site a lot, though i post rarely. It has been a valuable place to go for me, it made me feel less alone when I was starting to reject the home-birth and breastfeeding dogma.

  • JNSB

    OT: http://blogs.babycenter.com/mom_stories/how-to-avoid-a-cesarean-that-you-dont-want/

    This little gem was my favorite: “You need to enter the delivery room knowledgeable and even savvier than your doctor.”

    • Cobalt

      She call cord prolapse an acceptable reason for a “non-emergency, planned cesarean” and at the end encourages moms to wait for threat of imminent harm and to disregard reasonable expectation of harm.

      She’s an idiot.

      • Mattie

        Yeh I was confused, she stated cord prolapse and placental abruption as non-emergency planned c-sections…but those happen in labour, so they are by definition emergency sections, maybe not crash GA sections (although probably) but not elective. The only 2 I think on the list that would be elective are placenta previa and fetal malpresentation because those are diagnosed in pregnancy and then a plan for birth (by section) is made. What an odd article

        • Elizabeth A

          And let’s be clear, because people get confused about what “elective” means – elective means we can decide when to do the c-section. It doesn’t mean the section is optional, or that mom and baby will be healthy without it.

          • Inmara

            Really? I always thought that elective means “no medical indications, just because woman wants c-section”, whereas MRCS is “planned”, i.e. you set the date and time, but to have c-section is not optional due to medical reasons. There is of course gray area with indications where both options are acceptable, but truly elective C-section in my book is when it’s not medically recommended.

          • An elective procedure is actually a medical term of art. It means what Elizabeth A says- that the procedure isn’t optional, but one can schedule it mostly at one’s leisure instead of it being an emergency procedure. It has nothing to do with actually being optional. MRCS, on the other hand, actually is (or can be) completely optional. You actually just got the two terms reversed!

          • MarieM

            I’ve seen MRCS used to mean both multiple repeat c-section as well as maternal request c-section, just to further confuse things. I dislike using the term “elective” c-section when discussing mine as it seems to make the average person think I chose it for kicks and giggles. Planned seems to be easier for most people to understand.

          • Dr Kitty

            Planned pre-labour CS is good too.
            I use that one.

          • Inmara

            I see, apparently I got lost in translation, thanks for clarifying! (thought that MRCS means “medically recommended CS”, should have looked it up). This distinction plays big role in my country, where CSections can be requested by pregnant woman without any medical indications (example that Dr Kitty listed) and then they are for a hefty fee, or they can be assigned by doctors and then it’s free of charge. It’s a source of tension because hospitals try to reduce government-funded CSections as much as possible, and women sometimes have to fight tooth and nail to get doctor’s approval for C-section, otherwise they can’t afford the price.

          • Dr Kitty

            Elective and Emergency are used in all of surgery.
            They are synonomus with “planned” and “unplanned”, not with “necessary” and “unnecessary”.

            Let us say you are in a car accident and your leg is crushed beyond salvage- you will have an EMERGENCY amputation then and there.

            But if you have a tumour on your leg, and the leg needs to be amputated, you and your surgeon will pick a day and time in a week or two and do the surgery then- an ELECTIVE amputation.

            Or, you have an ovarian cyst that torts and the ovary has to be removed immediately (emergency) vs a strong family hx of ovarian cancer and you decide to have your ovaries removed at a convenient time for you (elective),

            Elective doesn’t imply that that the procedure is unnecessary or frivolous, it merely means that it can be predicted and scheduled in advance.

            Most cancer surgery is “elective” in medical terms, for example.

            ERCS is Elective Repeat CS- i.e. having another CS because you’ve had one before and can’t/don’t want to VBAC.

            MRCS (or occasionally CSDMR- CS Done for Maternal Request) is maternal request CS- i.e. there is no “medical” reason. It is a singleton, vertex, normal sized, term baby, but you prefer not to labour (which is rare, and often has underlying reasons such as tokophobia or PTSD).

            In obstetrics any CS done during labour is defined as “emergency”, even if the “emergency” is that someone had planned ERCS, doesn’t want to VBAC and goes into labour before her planned surgery date ( which is getting more common with the 39w rule).

            Unplanned/planned or Unscheduled/Scheduled are probably easier terms for people to understand, but really only are CS open to scrutiny and judgement like this.

            Nobody questions anyone’s right to have cosmetic surgery if they want it or asks whether their hysterectomy was elective or an emergency, because adults are otherwise assumed to have weighed up the pros and cons for and against surgery and discussed it with their surgeon before making a decision.

            If a doctor and a patient have agreed CS is a good option for her, then really it is no one else’s business why, or whether it was “really” justified or a “truly necessary” or any of the other terms used.

          • Inmara

            Thanks for clarifying, I got confused with acronyms and different meaning of terms in English, see my response to Feminerd below.

          • Elizabeth A

            The problem is that surgical statistics are created using the scheduled/unscheduled definition of elective, and then interpreted by the public as meaning necessary/unnecessary.

            My c-section for placenta previa was “scheduled” twenty minutes in advance because I’d done some hemorrhaging. It went on the books as elective.

    • The Computer Ate My Nym

      What’s sad to me is that I ended up feeling like she was one of the more sensible ones. She at least acknowledged the fact that breech position is a reason for a c-section. Though the idea that cord prolapse is a non-emergency is truly bizarre.

    • Azuran

      It always makes me roll my eyes when people are complaining about surgeon talking about their week-end or other things while doing surgery. You actually want your surgeon to be talking with his staff about his week-end plans. That means that you are doing fine and everything is going well. If your surgeon is silent, then that’s because something is going wrong.
      It has nothing to do with the surgeon not caring whether you live or die. Spending you day doing surgery is silence is just very boring.

      • baileylamb

        I’ve said this before, but usually my OBGYN does not do noon c-sections. So a lot of the nurses the Room weren’t familiar with him. They asked him about his life and his practice in PR. Then one asked him what was the worst c-section he witness. I guess the nurse thought he would mention something about PR’s lack of resources or something. The OBGYN proceeded to tell him that the worst experience was in FL were the anesthesiologist did not show up (this was in the day time btw) and they had to section a woman w/little medication. My husband and I made faces at each other. Also, I think Imtotally remember hearing about that anesthesiologist on the news or something.

        • FormerPhysicist

          My OB was in surgery when the hospital he was at had a power failure and the backup generators did not come on correctly. Luckily, I think it was an ablation and not a c/s. I believe heads rolled after that little incident.

      • MHAM

        I appreciate your point, but I don’t agree. During my very scary c-section, one thing that really comforted me during the procedure was the doctor very calmly explaining to my husband and me what he was doing, what he was seeing, and what would happen next. “As I suspected, there is meconium present. So when I take her out, you won’t hear her cry right away – we’re going to try to suction her first before she can aspirate any of it. I will tell you the moment she is out, but I don’t want you to be alarmed if she doesn’t cry immediately.” Things along those lines, not like, gory details. And he continued like that as he closed up after my husband and daughter left the room together. He was an extremely gifted and compassionate doctor and his kindness to us during that time was profoundly comforting.
        I get that talking about golf vs. stony silence is a good sign, but I think I prefer something in the middle. 🙂

        • Cobalt

          I like narration, too. I already know there’s nothing I can do, not even knowing what is going on is worse.

        • Azuran

          Well I meant in a ‘general anesthesia’ setting. I don’t expect any doctor to make golf plans in front of someone while they are awake.

      • Mattie

        See, I wouldn’t want my surgeon talking about his weekend plans over me like I was a piece of meat, I’d rather he was talking to me or my birth partner, equally I wouldn’t want silence because that would make me more anxious. I’m also against nurses just having a chat over patients, it’s quite disrespectful and demeaning for the patient.

        • Who?

          I don’t mind all that tbh-whenever someone is cutting me (or at the dentist) I am v keen to be elsewhere myself, and am quite happy to be ‘ignored’. Maybe I’d feel different if it were a cs, since the little human is a pretty big part of the picture, and my active presence ie seeing, hearing, touching baby will be important to me at the time and down the track. But I think once baby was out I’d be quite happy to go back to being the subject.

          • the wingless one

            That is how my c-section went. My OB narrated until the baby was out. They told me how he was doing and brought him over for a quick hello kiss and then he was sent down to the NICU and hubby with him. After that my OB told me how he planned to close me up and then all the doctors started chatting. It was actually very calming to hear them discuss their kids and some hospital politics. The anesthesiologist actually said to me, “It’s a good thing to hear chit chat during this part because it means everything is going smoothly!”

        • Azuran

          I’m pretty sure the vast majority or professional who are doing procedure on people who are awake are actually talking with them. Basic professionalism. When you are operating on someone who is under general anesthesia doing a pretty basic and simple procedure is an entirely different matter, I don’t think it means they are lacking respect or that they think you are a piece of meat.

      • rachel

        My OR staff and anesthesiologists know that if I’m laughing, joking, and telling funny stories about my kids everything is just peachy. It’s when I get quiet everyone realizes something is wrong. Good surgeons don’t freak out, we just get really quiet and somewhat abrupt. The entire mood will change in the OR without me really even having to say a word. I generally narrate the c-section until the baby is delivered–lots of (“everything is going well”, “almost there”, “just getting through some of the scar tissue from last time”) but after delivery mom and support person are focused on the baby and I’m usually telling my funny kid stories again. Of course, many of my patients have already heard those during our office visits.

    • Mel

      As a teacher, that one makes my head hurt.

      Let’s think for a second. If I am being delivered by someone LESS knowledgeable than myself, I am being delivered by someone with NO MEDICAL training, NO livestock experience and NO biology degree.

      Why?!?! Why would I let someone like that deliver a child? That puts you in the “Sit over here and you can watch the calf be born!” category not “Hey, can you decide if my baby is having problems with labor?”.

      *Shudders*

      During medical procedures, I like being the least knowledgeable person in the room. I listen to the medical professionals and chat with them as they do their thing.

  • OttawaAlison

    I had my eldest daughter to be a mother to nurture her and see her grow. I didn’t become a parent to be stuck behind a pump every 2 hours after spending an hour and a half bfing my daughter who wasn’t getting anywhere near enough. I wanted hugs and snuggles and gummy smiles. I didn’t want nights filled with no sleep because I needed to pump to try and get more milk from IGT breasts. I gave up pumping quickly though, I got perhaps 0.5 ounces per session. It was utterly demoralizing and the “reward” didn’t measure up to the sacrifices of sleep and trying to nurture my daughter.

  • Cobalt

    Second to last sentence should be “…harmful effect on women’s…”

    Otherwise excellent.

  • JJ

    Thanks again to Dr. Amy. A true champion for women and babies. I also love the FFF and her blog has helped me so much! I knew I had to make peace with bottlefeeding if I wanted to have another baby. I am so glad to have that weight off of me now. My PPD prevention plan includes having bottles and formula in the house.

    I actually had a stranger in the mall come ask me if I was going to breastfeed because I was visibly pregnant! Um, who are you?

    • momofone

      Good for you! I hope your experience is completely different the next time around if you decide to do it again. 🙂

      I was amazed when I was pregnant by the things people would ask, and by the number of people whose first impulse was apparently to share every labor and delivery horror story they’d ever heard. And when I’d say, “Oh gosh, I’m going to stop you there–this doesn’t sound like something I need to hear,” the horror-sharer was puzzled about why I might not appreciate the sharing.

      I eventually reached the point of saying, “(Husband) and I have decided that only the people involved in conception will be involved in decision-making. Thanks!” Bright smile and move on.

      • MegaMechaMeg

        I have to fight the overshare horrible pregnancy story impulse and I truely have no idea why! It’s like “Congrats, you are pregnant! Let me tell you about my bff whose kid had a giant head and tore her up but good! She tells me the recovery was hell and she is still incontinent! I am so excited for you!!!”

      • JJ

        Well we did decide! I am currently 17 weeks with my 4th child and I am really looking forward to enjoying my baby without the pressure. (And the opportunity to have an epidural for the first time too.)

        • MegaMechaMeg

          Thats amazing, congratulations!!! I bet you would love this story about my aunt’s first baby… 🙂

        • momofone

          Congratulations!! (And I apologize if you’ve said that and I totally missed it!)

        • Maria

          Congratulations and enjoy that epidural! I loved that I could rest while my body did the work of labor.

      • demodocus’ spouse

        Good answer, though since we conceived via IVF it might not work so well for us, lol

    • The Bofa on the Sofa

      I, OTOH, go the other way. I don’t want to tell you about our pregnancy, and I don’t want to hear about yours. In fact, I have to cover my ears to stop from hearing if it’s a boy or girl. I don’t want to know. Hard to keep from hearing it.

    • baileylamb

      I’m sorry, if you don’t mind me asking, where do you live where people say such things.

      • demodocus’ spouse

        A few have said such things to me in Ohio.

      • staceyjw

        People will ask you about BF (and HB, NCB) here in Eugene OR, the center of the woo-niverse. I say “people”, because it’s not just women!

        I really wish that lactivists would support all moms; the positive changes they helped pushed through for BF moms need not come with a heavy helping of sanctimonious derision for FF moms.

        An example of this is how (in Eugene) you can openly, publicly, BF, preschool aged kids, anywhere, uncovered, with little to non negative feed back. When BF my 3+ yr old in public, I even get positive comments, at a rate of 25 nice ones to 1 dirty look. This is great! But have a bottle in hand? Suddenly, that kindness turns into meanness, and you are getting 25 negative comments for every 1 nice one.

        Several times moms have shared nasty remarks about FF with me, assuming that I was an AP lactivist because my kid was BF in an Ergo. The instant I disagreed, and pointed to my slightly older, EFF kid…well, lets just say their expressions were priceless. Some furiously backpedaled, but worse were the ones that took that opportunity to shame ME!
        NOT COOL.

        • Megan

          I recently visited Niagara Falls with my family and while eating at a restaurant a random woman came up to us and said to me, “Are you BF’ing? I had 9 kids and BF’ed all of them. It really is “best!” I was so pissed that a stranger would presume to tell me how to feed my child I was speechless. At least she had the decency to then say, “I guess that’s a personal question” in response to my probably horrified look. My BF “failure” story is below in the comments. I just don’t feel I should have to justify that to a complete stranger!

          • Roadstergal

            She _guessed_ it was a personal question?

            That sounds like the perfect setup for “Have you tried anal sex? It really is _best_!”

      • KeeperOfTheBooks

        For whatever it’s worth, I live in Texas, where (thank goodness) a certain amount of Southern politeness still remains. It can be really irritating at times, but I do like that I’ve had exactly one person (a total stranger, mind you) ask me if I was breastfeeding, and when I replied with a line straight from a Miss Manners column (“The baby is eating well, thank you for asking”), had the grace to wander off looking confused rather than push the issue.

        • Dr Kitty

          I give thanks to all the higher powers that Irish people, generally speaking, have a MYOB attitude and really don’t like to get up in people’s faces about things.

          Oh, you might get disapproving glances, but nobody would come and actually talk to you!
          I don’t think I had anyone say one word to me about feeding my baby (and I didn’t use a nursing cover).
          I was oblivious to any dirty looks, because I don’t usually pay much attention to the facial expressions of strangers.

          I do have a LOT of lovely, perfectly polite but very cutting put downs that my grandmother used, which I never got the opportunity to use.

          “I wonder why you should think that I would care to hear your opinion?” is my absolute favourite, but she had a lot, and they were all excellent.

          “I’m terribly sorry, we don’t seem to have been introduced, and I have always been told it was wisest not to follow the advice of perfect strangers” is another one.

          Basically- access your inner Dowager Countess.

          • KeeperOfTheBooks

            I love your grandmother. 😀 She sounds a great deal like mine. Her family nickname was actually Miss Manners (after Judith Martin, the etiquette columnist), but she could say what needed to be said with the greatest etiquette and while leaving you in no doubt that you were just told to commit an anatomically improbable act to yourself.

          • Dr Kitty

            Oh yes…that’s my grandmother too!

            The most charming, pleasant, lovely person, who made everyone feel welcomed and accepted…right up until the point where she felt you had crossed a line and then you were left in absolutely no doubt, without one cross word or inappropriate remark having been uttered.

            “Darling, if they don’t know what they’ve done wrong, that’s one thing, if they ought to know better and don’t, it’s another”

            Which meant that “I would think you ought to know differently” was as close to screaming obscenities as she got.

          • bbb0420

            These are great comebacks! I am expecting my first baby in June, am struggling with prenatal depression, and am planning on getting on meds after I have my boy…I’m already preparing to endure judgment from the crunchy people in my life who just assume I’m breastfeeding…I plan on keeping these responses in my back pocket in case anyone gets snooty with me about formula feeding!

          • Michele

            You don’t necessarily have to wait until after baby is here to get on meds. Let your doctor know that you are struggling with prenatal depression.

          • bbb0420

            True…I know that the SSRIs in pregnancy have been very well studied, but the only thing that works for me is Wellbutrin, which as far as I understand doesn’t affect serotonin, just dopamine…and that hasn’t been studied as extensively from what I could find so I guess I was feeling nervous about taking it while pregnant…I don’t know, trying not to play doctor when I know nothing about medicine, just figured maybe my kid would be better off with a medicated, stable mom and a steady diet of Similac or whatever as opposed to taking the (probably really, really small) risk of unknown long-term effects of bupropion exposure in utero or through breastmilk.

          • Michele

            I was fortunate in that Zoloft works for me so that’s what I went on while I was pregnant, but I know that’s not an option for everyone. Do bring it up to your doctor though if you haven’t already. Perhaps s/he’d be willing to write you a prescription before the birth so that you can fill it and have it at home to start taking when you come home with baby? That way no running around trying to obtain and fill a script with a newborn. Best of luck to you.

          • bbb0420

            Good idea–I will ask her. Thanks!

          • Bombshellrisa

            I had severe prenatal depression. Have you been able to talk to your doctor about it? It’s best to seek help now. Then you don’t have to worry about trying to get to other doctor appointments (if your OB won’t treat the depression and refers you to a psychiatrist) with a newborn.

          • bbb0420

            I’m going to talk to her next time I go in–been trying to manage on my own but I’ve been down this road before and I definitely want to have a plan in place for the duration of my pregnancy and after the little guy arrives. Good to know I’m not alone and that others have been through this–this blog has been a godsend!

          • demodocus’ spouse

            When people ask “Are you breastfeeding?” I like to tell them I gave it up 35 years ago.

          • bbb0420

            Haha! That’s awesome.

      • One of my friends had someone walk up to her in the grocery store as soon as she was visibly pregnant and lecture her on how she shouldn’t vaccinate her baby.

        She lives in a college town in the Northeastern US.

        • KarenJJ

          We had a strange lady do this to my mother’s group in suburban Sydney once. It was an odd thing to approach a group of young mums at a cafe bouncing 6 month old babies on their laps (there would have been a good 8 or more of us) and proselytise about the dangers of vaccines and how they caused her son’s autism.

          As it was it sparked a discussion after she left and a few people in my mum’s group had looked into the “other side” of vaccination and found the info lacking. If I come across an anti-vaxxer on the internet I picture this nutty lady with the crazy grey hair and hippy skirt.

  • Claire

    Have you guys seen this?

    • Roadstergal

      Please tell me that’s a Poe. There’s no place to even _start_ with the wrong…

      • Amy M

        I hope so. That’s not feminism, that female-superiority + misandry (or however you spell it.) Feminism is not about hating men and trying to make them powerless, its about equality. If this person is for real, I can only imagine that something awful has been done to her, at the hands of a man or men. And that she never has a son.

      • Liz Leyden

        Poe? Like the band?

        • Mattie

          I had to look it up, according to urban dictionary it’s someone who pretends to be a fundamentalist, but does it so convincingly that you can’t tell if it’s true or not? These kids and their new-fangled wordy-bops 😛

        • Roadstergal

          Poe is mocking a position by taking it to a point just a little more extreme than those who hold it, and I’ve too often thought something was a Poe only to find out it was real…

          • Megan

            Like the Alpha Parent blog? I totally thought it was a poe when I first read it.

          • Roadstergal

            Lordy, yes, like that. And Mike Adams. And that “Vaccination is just like rape!” meme.

    • Ann

      This has been bouncing around the Internet for years now. It’s a poe.

      • Amy M

        Oh Good! I am so glad to hear that! Disregard my response below, then.

  • Megan

    I read Ashleigh’s story last week and it really hit home because it’s my story too (minus the relactation bit). My milk took two whole weeks to fully come in and I made at my best, 10-11 oz a day. My daughter was hospitalized for jaundice before the extent of my breastfeeding “failure” was acknowledged and the LC’s suggested supplementation. I tried herbals, oatmeal, pumping every two hours round the clock to the point of tears, clipping my daughter’s tongue tie twice (reattached after the first time), craniosacral therapy for my daughter, etc. I went through 4 lactation consultants, and all basically just told me to pump more until my last LC (whom I love) who finally said to me “It seems you feel you need permission to stop and I’m giving it to you. You have tried everything possible and are a good mom.” Even despite that I still continued to pump for almost 3 more months for a total of 7 months of my daughter’s life. My close friend who has a baby and a good milk supply donated milk to us throughout this time. Now my daughter is exclusively formula fed and you know what? She’s finally gaining a good amount of weight, seems happier and I am now much happier that I stopped pumping. We still comfort nurse at night because I luke the closeness. I had to mourn what I had hoped my breastfeeding relationship would be but I now realize that I was crazy to do all I did and we all would’ve been happier had I just stopped. But the rhetoric to breastfeed is there and it’s powerful. Now I know that for my next child, I will try breastfeeding (since we don’t know why I had such a hard time this time around, IGT vs my difficult delivery/severe PPH/postpartum thyroiditis) but if it doesn’t work I will formula feed without guilt. And if he or she needs supplementation while my milk comes in I will do it despite any shaming by my BFHI hospital. I will not be a space to my pump again. If much rather be s slave to my baby!! Anyway, I think the most toxic thing that I always heard was that “every woman can breastfeed” so I felt like a total failure as a mom when I couldn’t. I’m so happy I’ve stopped measuring my self worth in ounces…

    • Cobalt

      “I’ve stopped measuring my self worth in ounces”

      I get so sad, and so angry, every time I read something like this. Not because you (or any parent) stopped killing your sanity and relationships for the sake of a bit of milk, but because our cultural pressures create this demand to go to ridiculous lengths to provide breastmilk in the first place. The stories featured on FFF shouldn’t have happened that way; those moms, all moms, all parents, should be supported in making the choices that meet the needs of their babies, themselves, and their families. No guilt, no shame, no artificial costs for doing what works best in whatever situation you’re in.

    • anotheramy

      God bless your last LC for giving you permission to stop!

  • fiftyfifty1

    “The greatest threats to babies are vaccine preventable diseases and unintentional injuries.”

    And another important threat to babies is intentional injuries. New parents need more down-to-earth education about how to handle babies that cry a lot. And we need to start treating people like their mental health matters. And work on access to safe, affordable, quality daycare for the working poor.

    • KarenJJ

      One of the most honest things I’ve heard one of my friends say when she became a parent for the first time “I always wondered why the nurses always went on about shaking a baby in our prenatal classes? I mean, who would do something like that? What kind of horrible parent would you be? But then I had a baby and I really understood, because I could feel that sort of helpless rage too and can see how it could happen”.

      • Mel

        My mom, aunts and mother-in-law have all shared stories about times where they could not handle another second with an inconsolable baby and so put the baby somewhere safe – usually a crib, but in one case an empty dresser drawer – and left the room to calm themselves down.

        One relative relates opening a door one day and having her sister hold out her very much wanted infant son and say “Take him. Just take him.” She took the baby and let her sister get some badly needed down time.

        We had a woman show up at our blueberry patch with a very young, very fussy infant. She looked on the verge of tears herself. My mom-in-law said “I love babies. Can I hold him while you rest for a bit?”. MIL, me and my sis-in-law more than happily walked a cranky-as-hell newbie for about an hour.

        I’m grateful that they’ve shared their stories because it’s given me a framework for my own life and a way to talk about shaking a baby with my students.

        Bluntly, it takes a freaking village to raise an infant.

        • EmbraceYourInnerCrone

          My sisters 4th child was the colicky one(totally breastfeed ironically) and she told me once that if he had been her first, she might not have had more than one…hours of inconsolable crying, doctor visits, etc. Her doctor said that he thinks its at least partly due to an immature nervous system in some babies and that her son would grow out of it around 4 months..and he did. I was luck, my baby just did the projectile vomiting a couple times a day..like a scene from the Exorcist

          • Guesteleh

            Colic is so terrible that I can’t even really talk about it, eight years later. It’s so unbelievably awful and painful to look back on it. Thankfully, my husband and I are mature, calm people and were able to work through it without hurting our son.

          • KeeperOfTheBooks

            Colic is HORRIBLE. I remember my best friend’s kid had it, and it exhausted his poor parents. One time, I got over to their place and mom was about to break down–totally wiped out and stressed to the max. I said, firmly, “Is he dry? Is he full? Okay, that’s quite enough of this. You go lie down. I’m taking him to the far end of the house where you can’t hear him. He can scream at me just as well as he can scream at you, and I haven’t been listening to it for the last several hours. Get some sleep. Now.”
            Naturally, the kid shut up and went to sleep shortly thereafter, probably in part because I just wasn’t as stressed as his parents were, and I imagine he picked up on that. (Either that, or shrieking incessantly for hours wore him out…I know it would wear me out!)

      • The Bofa on the Sofa

        One of the main reasons that “Dad’s Boot Camp” was started was to address the problem of shaken baby syndrome. And the approach to addressing is it education. It’s not beratement or denial, it’s education on recognizing the situations where it will occur and teaching appropriate responses to those situations.

        What happens at boot camp stays at boot camp, but I can tell you that the discussion usually starts with that concept, “Who would do such a thing? What kind of horrible parent would you be?” And the answers are, anybody COULD do it, and the key is to help you avoid doing it.

        then I had a baby and I really understood, because I could feel that sort of helpless rage too and can see how it could happen”.

        And this is the direction we go. Every “veteran dad” who I have worked with at boot camp has said it, “I’ve been there. But because I knew how to recognize it and knew what to do, it was not an issue.”

        There’s a really ugly story about a guy (Yurko) who was convicted of SBS, and has tried to blame it vaccines. He is the darling of the anti-vax world. He denies shaking the baby. However, he DOES admit to holding the baby upside down by its feet and hitting it. I have always said about that case, I’d be FAR more sympathetic if he admitted to shaking the baby. I can sympathize with the situation, and although I don’t condone the response, it is really a case of lack of education more than anything. Hanging a baby by its feet and smacking it, however, is the deliberate act of a monster.

        • demodocus’ spouse

          My husband took the boot camp course; it really helped soothe his nerves for a while and give him some pointers. He still freaked out the first time he was alone with the baby, who started to cry. Alls I heard from the bathroom was a totally panicked “I didn’t shake him! I didn’t shake him!”

        • Amy M

          Our hospital went over SBS before we could take the babies home. It was standard procedure there, and I hope, in most places.

        • KeeperOfTheBooks

          I wonder if he’s related to the idiots who insisted that vaccines caused their kid to “develop” brittle bone disease. (For the record, brittle bone disease is congenital.) You see, that’s why their kid had a dozen or so broken bones when he was taken to the hospital some time after the vaccines, and it’s All A Plot by the Evil Vaxxers to steal this child away from his parents and claim that they’re abusive. The vaccines made his bones break! Duh!
          *facepalm*

          • The Bofa on the Sofa

            Yes, the “brittle bone disease” group supports Yurko.

          • KeeperOfTheBooks

            Of course they do. Naturally. Pun intended.

      • D/

        I spent nearly two decades as one of those nurses educating newly postpartum parents on the trials of inconsolable babies and the dangers of shaking but frankly didn’t really have an even remote clue what I was talking about until faced with my first grandkid. It literally took a household of five adults and even moments of ‘Ok, you’re fed, dry, you’re loved … you can lay here for a bit and I’ll be back’ from every one of those five adults at some point to survive those first many months.

        I remember during one of my tours of duty looking into that shrieking little face (of one of my now very favorite little people) and thinking ‘OMG, *this* is how just shaking them until they shut up actually happens.’

    • Cobalt

      So true. Our oldest two were colicky screamers. I mean up to 12 hours a day of inconsolable screaming. So many doctor and ER visits, just to look for any cause, but it was just colic and there was no treatment but time. I thought I was going to die or go insane, and I was afraid to get a sitter because I was afraid they might hurt the baby (I knew what the constant crying did to the inside of my head, and I was their mother! What would a stranger who didn’t love them do?).

      • FormerPhysicist

        I can (and always could) handle any baby crying for hours. Except my own. That made me insane. But babysitting for 5 hours an infant that wouldn’t stop? I just checked for what was wrong, kept trying, and reminded myself that the parents would come home.

        • FormerPhysicist

          Replying to myself to clarify that for anyone with a colicky baby that needs a sitter – do try to book a sitter and just be honest and ask if they think they can handle it. Or get two at a time who can trade off. The potential sitter may be able to handle it much better than the parent – because it ISN’T their job to fix it and it isn’t for forever. Or even for all night.

    • guest

      That’s why Dr. Sears bothers me so much. HIs formulation of attachment parenting means, for some parents, subjecting yourself to never-ending screaming right up next to your ear. I had a colicky/refluxy baby (never did figure out which was causing the crying) and the only thing that stopped me from getting violent was the fact that I could set him down and walk away when I needed to. Holding him didn’t seem to comfort him, but it caused me intense psychological pain, and whatever kind of physical pain loud noise is. I was anxious at first that allowing him to cry was doing him permanent harm, thanks to Dr. Sears and his AP minions. IT’S OKAY TO PUT YOUR BABY DOWN IN A SAFE PLACE AND TAKE CARE OF YOURSELF.

      Bit of a rant, there, but we definitely could use better guidance on how to manage a crying baby, guidance that takes the entire family’s well-being into account.

      • EmbraceYourInnerCrone

        Rant away, it needs to be said. My daughter wasn’t colicky but when she fussed sometimes as a newborn weird things comforted her: running the vacuum, riding in the car, siting her infant seat on top of the dryer. I think part of it is that the womb is a very noisy place and the rhythmic, constant background noisy was familiar.

        • Sarah

          Vacuum is quite a common one I think. Heard that one before.

          • DaisyGrrl

            A friend of mine swore by a youtube channel that played hours of vacuum noises. She’d put it on then take a nap while baby was finally quiet.

          • KarenJJ

            Oh that’s a good idea. Much better than what I did. I just turned the vacuum cleaner on and left it next to the cot while it was running. It wasn’t all that successful thankfully, I’d hate to see my electricity bill if it had worked better. One of my kids would not more than 20 minutes during the day time.

          • araikwao

            Ugh, my son went through a 20 min nap phase. It was crap.

          • KarenJJ

            It was such a full on day with a baby that never gave me much of a break. She dropped down to one day nap of an hour at around 8 months and then stopped day sleeps on most at 14 months. Even now she’s a busy little person who finds it tough to wind down at the end of a day. Thank heavens she slept pretty well over night.. After a few miserable days of trying to “resettle” I gave up and decided to enjoy the quiet evenings and nights instead.

          • araikwao

            I’m glad one part of the day was sane!

          • An Actual Attorney

            My mother tells me that the wise old country GP told her to put me in a crib, turn on the vacuum, go to the bathroom, turn on the radio, and take a shower.

        • Mishimoo

          Sewing machine was the best one for my youngest. Pop him in his bouncer (which had a slight incline – great for his reflux) and start sewing, he was out like a light. I wish I’d tried it for my eldest.

        • guest

          With my son, nothing seemed to comfort him. It wasn’t the worst colic ever, but it felt awful when I’d pick him up and the crying would just intensify instead of getting better. After a couple months I found that turning him on his stomach sometimes worked (not to be left to sleep, of course). Oh, I tried the Happiest Baby on the Block, too. Didn’t do much for my son, but at least Harvey Karp didn’t make me feel like an asshole for *not* doing his thing.

          • The Bofa on the Sofa

            When I was doing Boot Camp, we always got the question, “What do you do to get them to stop crying?” And my answer was, try everything and see what works. Of course, check their basic needs – hungry, diapers, sleep. If they are all up to snuff, then try things out. Swaddle, don’t swaddle, sit up, lay down, walk, rock, sing, play music, vacuum cleaner, car seat, drive them around the block, whatever you can think of to do differently from what you are doing now. My oldest like to be held while sitting on my arm facing out (kind of like in a Bjorn except held) and we would walk laps around the house singing. However, every baby is different so what worked for us is irrelevant for you.

            Just try everything and hope something works. And if it does, you go back to it.

            And then in two weeks, it all changes and you start over….

      • Guesteleh

        Sears isn’t about what’s best for the baby. Sears is about cementing your socioeconomic status through time intensive parenting and practices only available to the affluent I honestly think he doesn’t give a shit about whether or not it’s better for the baby. He’s making bank by flattering rich people/exploiting people’s fears about their social status.

        • guest

          Yeah, he’s speaking to my perceived class affiliation for sure. But I’ve had to let go of that for a variety of reasons. It’s scary to be pushed out of your social group.

      • KeeperOfTheBooks

        Hear, hear! Rant away!
        I bought into that crap hook, line, and sinker. I felt like I was neglecting DD if I ever put her down and let her cry, even if holding her didn’t help, her tummy was full, her diaper was dry, and she’d been burped/given a binkie/whatever. It was horrible. If and when the next kid comes, he/she’ll be spending a lot more time in a swing or rock and play than DD did. Sheer insanity. I’m honestly shocked I never snapped, though I’m grateful I didn’t.

        • The Bofa on the Sofa

          When our kids were inconsolable, and all their needs were met, my response was, “OK, I can hold you and you can cry, or I can set you down and you can cry. Since you are going to cry either way, you can just lie on the floor and do it there.”

          Give them some time, try again, and it it doesn’t work, start over.

          • KeeperOfTheBooks

            That was pretty much my DH’s attitude to a T. He’s the oldest of 8, so babies don’t especially phase him. It boggled my mind, because Dr. Sears et all all basically said that doing that was child abuse. DH would come home and find a hysterical baby and a not-far-from hysterical wife because I couldn’t take the screaming one. more. minute. He’d take kiddo, set her on the floor propped on her boppy pillow, sit down on the couch with a book, and send me off for a walk. I’d feel like the world’s worst mom in doing so, and was quite convinced he was just about the worst dad for being so unfeeling. Thing is, having either of us get so worked up just because she was worked up wouldn’t do her or us any good, and he was right about that.

          • The Bofa on the Sofa

            The only difference I’d say is that I would try to console the baby (and send mom off for a walk), but, as I said, if that doesn’t work, I’d put them down and let them cry. I can hold them while they cry, or not hold them while they cry. If they are going to cry either way, I’ll take the easier way.

            But I really would go through all the things I knew to do, and would try others.

    • Guesteleh

      Yes yes yes yes yes. And YES to the last bit about childcare.

    • MHAM

      Gah, this is so freaking true. I am so distressed about the fact that EVERY SINGLE new mother in my circle is being treated for postpartum depression. Every single one of them are on antidepressants prescribed by their OBs.
      It doesn’t distress me that they are getting help for a very real disorder and it doesn’t distress me that their treatment includes drugs, which are often hugely beneficial. It distresses me that when a new mother shows up depressed and distraught, the thinking is, “She has something wrong with her. Give her some pills.” Not, “What is her social situation like? Is she getting adequate support? Does she have a support network? If so, could her existing network do more to help her?” An individual doctor has little to no impact on these concerns for an individual patient and writing her a prescription is maybe the best he can do to ease the situation.
      But culturally, we set these women up for failure and then act like they are sick and broken when they do fail. “You’re supposed to solely provide for ALL of baby’s needs 24/7. You should be fine with doing so in almost complete isolation from the rest of the world at your house alone. You should return to your normal housekeeping, caregiving, and work obligations almost immediately following delivery. You should be able to function on next to no sleep. If your partner or family give any help, no matter how little, you should be grateful – but probably also worried that it will affect your bonding with the baby. While you’re at it, you need to lose the baby weight as quickly as possible. And hold your baby at all times. But above all, you should be glowingly, radiantly happy about this situation at all times and under all circumstances. Otherwise, you’re a terrible mother and obviously hate your baby. What’s wrong with you? Why are you stressed out? OMG, you have PPD, don’t you? Yes, you totally have a chemical imbalance.”
      I’m not saying that there is no such thing as PPD. And I’m glad that there are drugs available that help. But we owe women and babies in this country so much more, in addition to drug therapy.

      • Amy M

        From my understanding, PPD occurs due to hormones and circumstances. Women who have already had depression/PPD are more likely to get PPD (again, if applicable.) However, it seems to me that its a circumstantial factor that tips the predisposed over the edge—the pressure that you describe above, to meet crazy expectations when the reality is very different. Once someone is depressed, medication is often a key part of the treatment, but for sure, changing the circumstances would help too—feeling like you have enough support, enough sleep, and that its ok to dislike a specific aspect of parenting a baby would probably help a lot of women.

        • just me

          As a person who had ppd twice I have to disagree that a change of circumstance would make it go away. With my first I was getting no sleep bc she was a horrible sleeper. My 2nd was a comparatively really easy baby yet I still got ppd. I tried like hell to will it away for 6 weeks but meds were key. Again, easy baby, no tipping factor. Why is it that people feel the need to question meds for mental illness? you wouldn’t question why a mom got antibiotics for mastitis.

          • Amy M

            I had PPD too and got medication for it…I’m not saying a change would make it go away, wo/any other intervention. I’m saying, as part of the treatment—getting more support so the person doesn’t feel so isolated or helpless. Getting more sleep (if possible–perhaps the extra support could help there.) NO, someone with PPD DEFINITELY needs to see a doctor to determine the right course of action, which may or may not include medication, therapy and adjusting a situation as best as possible to aid recovery.

          • Amy M

            Oh–and your major risk factor was that you already had PPD once. In your case, maybe there was no external trigger, just predisposition. I’m not a doctor, I’m just speculating.

          • KeeperOfTheBooks

            I suspect that in at least some cases, both circumstances and brain chemistry are at play. I had PPD, and I certainly should have taken meds. However, I think my PPD wouldn’t have been quite as bad if I could have left the house occasionally or if I had friends to spend time with, or even just a couple of supportive family members. As it was, I didn’t have the use of a car, we aren’t in walking distance from anything, and I’d moved to the area after DH and I’d gotten married and had no friends or family around–not even one person. Again, I’m sure that I should have taken medication and that there were plenty of brain chemistry problems afoot, but I’m also sure that the loneliness and isolation actively sabotaged any attempts at recovery for a long time.
            I should add that one long-term result in all this is when I’m asked at showers and so on what my suggestion to a new mom would be, it’s inevitably “If you’re feeling bad, call your OB and get on antidepressants if prescribed, and do so that day. Don’t wait it out, and don’t feel like that makes you a bad parent. You’re demonstrating to your kid how and when to ask for help, which is one of the most important things they can learn.”

          • Wren

            I do think circumstances can play a role, but honestly I don’t think they did for me. When I had my first, I knew almost nobody with kids, had spent a chunk of time on bedrest early on leading to feeling alone except for my husband before I even had the baby, had an unplanned c-section and he was not an easy baby. My second was an easy VBAC, I had help from the start, I had friends with kids by then and she was an easy baby. It was only with the second that I had PPD.

            Once I figured out I had a real issue, treatment was easy to get and meds really helped. I don’t know why getting meds for that should be any different to getting meds for any other problem.

            I’m not denying the importance of support, I just would like to see the attitude that medication for mental problems should be avoided unless absolutely necessary changed. Taking antidepressants is still somehow seen as a failure in many circles.

          • just me

            Yes, agree completely

    • Montserrat Blanco

      The best thing when we brought our son home was taking turns to care for him. That daily feeding I missed and my husband gave him… Pure bliss.

    • Dr Kitty

      I give all new parents the Cry-Sis website.
      It is a UK charity to help parents of babies that cry, won’t sleep or are demanding.
      http://www.cry-sis.org.uk/cry.html

      They have a checklist of all the things you can try to do to settle you baby, and at the end:

      “Still crying? Put baby down in a safe place, walk out of the room and shut the door, take a short break
      Give baby to a trusted friend or family member for a few hours if possible
      Use any time away from baby to look after yourself
      Eat well and unwind
      Go out with baby
      Phone your GP, Health Visitor, NHS Direct, The Cry-sis Helpline, friend or relative”

  • Bugsy

    Another great post. Thanks, Dr. Amy.

  • lawyer jane

    Enjoying all the cites from social science research lately!