The suicide of a young mother is an unspeakable tragedy:
Thirty-two-year-old Florence Leung went missing without an explanation in late October, causing New Westminster police to launch a massive search. It was revealed she was suffering from postpartum depression and her family was concerned about her well-being.
On Nov. 16, Leung’s body was found in the waters near Bowen Island. No foul play was suspected.
Her husband knows that breastfeeding pressure contributed to her suicidality:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]How many dead babies and dead mothers will it take before we repudiate the tactics of breastfeeding advocates?[/pullquote]
Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes. Apparently the hospitals are designated “baby-friendly” only if they promote exclusive-breastfeeding. I still remember reading a handout upon Flo’s discharge from hospital with the line “Breast Milk Should Be the Exclusive Food For the Baby for the First Six Months” , I also remember posters on the maternity unit “Breast is Best”. While agreeing to the benefits of breast milk, there NEED to be an understanding that it is OK to supplement with formula …
Postpartum depression, like all clinical depression, is a multifactorial problem. No one can say for certain what causes it. But we can say for certain that bullying makes it worse. And contemporary breastfeeding advocacy is BY DESIGN a form of bullying.
I finished my medical training before breastmilk became “the elixir of life” and before colostrum became “liquid gold.” What scientific evidence came to light in the last 35 years to elevate breastfeeding from one of two excellent forms of infant nutrition, the other being infant formula? No evidence. Indeed most of the scientific evidence around the purported benefits of breastfeeding is weak, conflicting and riddled with confounding variables. To the extent that there is definitive scientific evidence about the benefits of breastfeeding in first world countries, it appears to be limited to 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of term infants in the first year. In other words, the vast majority of term infants will experience NO OBVIOUS BENEFIT from breastfeeding.
So if the scientific evidence hasn’t changed, what happened? Two things: the monetization of breastfeeding and the adoption of bullying as a deliberate marketing tactic.
Organized breastfeeding support originated with La Leche League, started by a group of seven traditionalist Catholic women whose goal was to keep mothers of young children out of the workforce. They reasoned that Mary, mother of Jesus, would not have worked because she was breastfeeding. Therefore all mothers should breastfeed so they wouldn’t be able to work either.
La Leche League was originally a volunteer organization that shared breastfeeding information and offered free support. It had to be a volunteer organization because the whole point was to prevent mothers of young children from working. But by the early 1980’s, mores had changed and the folks at LLL reasoned that they could charge for information that they had been giving away for free. They spun off the organization that created the lactation consultant credential and began campaigning vigorously for the employment of lactation consultants in hospitals, doctors’ offices and private practices.
Initially they met the existing demand for breastfeeding support. But like any industry, they wanted to grow and that meant expanding the market for their services beyond those women who wanted to breastfeed to those women who didn’t. They hit upon the perfect tactic: grossly exaggerating the benefits of breastfeeding, fabricating “risks” of infant formula, and, above all else, bullying new mothers.
Make no mistake, bullying is not an unfortunate side effect of contemporary breastfeeding advocacy. It is a deliberate tactic designed to increase market share. It is meant to create a sense of fear, obligation and guilt.
As I have written in the past, the foundational document of marketing breastfeeding through bullying is Diane Weissinger’s Watch Your Language.
All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances …(my emphasis)
In contrast, all of us within the medical profession want HEALTHY BABIES and HEALTHY MOTHERS to be the biological reference point. We are concerned with outcome; the breastfeeding industry is concerned with process, specifically the only process by which it can profit. And profit depends on bullying ever more women into breastfeeding.
The breastfeeding industry induces fear by lying about the benefits of breastfeeding and ignoring the risks (dehydration, starvation and death); it induces obligation with bullying catch phrases like “breast is best,” and “Baby Friendly Hospital Initiative,” and it induces guilt by insisting that “even one bottle of formula” is the mark of a mother who doesn’t truly love her baby.
The breastfeeding industry has perfected a particularly vicious forms of bullying, gaslighting. This is a specialized form of invalidation that involves denying reality. A mother says her baby is hungry? Tell her all babies scream like that. A mother worries that she is not producing enough breastmilk? Lie and say that all women produce enough milk. A mother needs medication incompatible with breastfeeding? Tell her she doesn’t really need it. A mother says that breastfeeding is harming her baby’s physical health and her mental health? Tell her that she is a failure at mothering before she’s really even started and imply that her baby deserves a better mother than her.
Is it any wonder then that some women will commit suicide as a result and a far greater number will experience significant postpartum depression?
We MUST put an end to the vicious bullying of new mothers by breastfeeding advocates.
- Take down the “breast is best” posters and acknowledge that fed is best.
- Stop lying about the benefits and risks of breastfeeding.
- End the Baby Friendly Hospital Initiative immediately.
- Stop pretending that “even one bottle” of formula harms breastfeeding or babies.
Breastfeeding advocates like to prattle about the theoretical “cost savings” from increasing breastfeeding rates. But what does it cost to hospitalize a mother for postpartum depression? What is the cost of the lost earnings of a mother who commits suicide? And what is the cost to a child of losing his or her mother? Incalculable.
How many dead babies and dead mothers will it take before we repudiate the bullying tactics of breastfeeding advocates?
Fed is Best!
Thank you so much for this i struggled with guilt with my first cause i tried breastfeeding her the first week until they deemed her failure to thrive. Not only was i killing my mental health but my child was starving and could have died! This is a serious issue that needs more attention. I now have two identical twin girls that i strictly formula feed because im actually one of the woman that have no breast milk at all with any of my pregnancies! i did not think twice what was best for my beautiful babies this time around. I love how you highlighted that there is no difference between a breastfed baby and a formula fed baby because its true. I have people in my family that were breast and formula fed and we are all happy and healthy people!
Thank you. Thank you. Thank you for posting this. I just put up a personal statement on my own blog which is almost identical to this perspective. http://www.batshitcrafty.com/time-end-breast-best-campaign/
Intense pressure to breastfeed was a major contributing factor to my three year battle with postpartum depression. Now I am looking for ways to push back against the system that destroyed me so completely. Breast is Best must stop. While women should definitely be supported to breastfeed if that is what they want for themselves and their babies, no one should feel like a failure for taking a different path. I deeply appreciate your perspective and I hope others in the medical profession begin to speak out and help to make a change.
gcsi http://google.com
That poor, poor family. I can’t imagine what they must be going through. Shame on the people who kept pressuring her to do something she didn’t want or couldn’t do. Why can’t those people see what they are doing to others?
I remember the pressure not just from the lactation consultant at the hospital but also a couple friends, one even ‘asked’ me to promise her I would at least try to breast feed once my son was born. I basically told her I wasn’t sure what I was going to do, I may try to BF, but I wasn’t totally sold on the idea and was keeping my mind and options open. I had a feeling that my son would end up formula fed for one reason or another. Turns out I was right, not only did I not produce enough but I ended up on blood thinners when he was four weeks old due to a pulmonary embolism (blood clot in my lung). I didn’t give into the pressure and risk my son’s health, but not everyone has the where with all to ignore the bullying. I wish these women, the so called advocates, could see what they are doing to other women.
I’ve had three babies and the pressure to breast feed was overwhelming. It starts early; from before you have the baby to the first few moments of your lives together and beyond. I managed a couple months with each one but it wasn’t easy. These mamas need to be given a break and not be made to feel guilty or less of a mom for not exclusively breastfeeding. Thanks Dr. Tuteur for being an advocate for moms & bringing some sanity to the table!
Yes, the pressure is insane. I actually thanked one friend of mine for asking “Are you breastfeeding?” instead of just assuming I was. And the pressure is so bad here that I think the reason she didn’t just assume is that she’s French and lives in France.
I have never had a baby, but those posters are all over my OB/GYN’s office. I have no choice but to go to him, as he’s the only person in a 100 mile radius that is trained to do Nexplanon implant BC. Luckily I only have to go to him every three years to get a new one, I do my annuals with the NP at my regular doctor’s office. There was one right by where I was sitting with all the supposed benefits that pretty much say a formula fed baby will die young, fat and very unhealthy. What a horrible thing to tell mothers, who are already pressured to not dare to have a single cup of coffee!
I just turned 34, and that pretty much ignoring any needs of the mother is the status quo when it comes to pregnancy, childbirth and mothering just solidifies me never having a baby. I’d either end up in jail for cutting a bitch or like this poor woman and killing myself from the pressure.
This poor woman and her family. Boob milk uber alles permeates pretty much everything that has to do with pregnancy and infancy. Why does it surprise people that a woman would feel bad if she has any trouble with bf’ing, even to the extent that the world would be better off without her? They’re blinder than my Demodocus.
I think what I hate most about the pressure to breastfeed is the way it invades my psyche, even though I know logically that the benefits are small. Pressure to EBF contributed to my PPD with my first kiddo, not because I felt like a failure for supplementing with formula, but because I felt like I was constantly on eggshells around other mothers who had no compunctions about telling me I wasn’t breastfeeding “correctly.” This time, I’m feeling better, but I can’t shake this weird feeling of guilt for encouraging another mother in the hospital to supplement with formula. This woman had undergone a protracted, unmedicated vaginal delivery, her baby was being treated for hyperbilirubinemia, and here she was attempting to pump and not a drop was coming out. Why am I feeling guilty for giving her good advice?
PS: BabySpork 2.0 is EBF since her release from the hospital due to 1.0 and my husband both having stomach bugs (and for sure cross-contaminating every surface of the house while I was in the hospital). The decision to EBF went something like, “F***, we’re in a situation where breastfeeding has tangible benefits.”
Invading the psyche is the best description! I’m sorry everyone is sick.
I’m sorry most of the world is assholes.
I recently had a newborn try to die on me. Few days old. Mom’s milk not yet in. Noted at local urgent care center to have a very low blood Glucose. They called to let me know baby was headed over to see me and I asked, did you give baby any formula? “No, but we started an IV” (no dextrose given as they didn’t have any). I all but yelled: give baby a bottle to try en route. Moron doc says “well we can’t give anything through the IV, but baby will be there in 10 min.” UGH!! Gave baby a quick sugar bolus through the IV and stuck a bottle in the mouth. Took 1oz in ten minutes and was a different child. Seriously perked up, looking around. Amazing what a bit of food will do.
Oh, and some crazy woman was texting the family demanding we use donor breast milk instead of formula. Parents rightly ignored that. Good for them!
#FedIsBest
Being a person whose life was saved thanks to IV dextrose, I get all ragey when I read these breastfeeding websites that make the claim that IV dextrose and formula supplementation are never needed for hypoglycemia. Maybe they aren’t most the time, but sometimes they are needed. My mother nursed me, sugar still low, then they gave me formula, sugar still low, then they put me in NICU and administered dextrose and struggled even then keeping my sugar stabilized but eventually my sugar did come up and stayed up.
Until my husband was dxed with diabetes, I didn’t know that hypoglycemia could be more dangerous to a diabetic than hyperglycemia. Having sugar around IS important.
Although I am not diabetic, my severe migraines often respond to a little bit of sugar and/or salt. So we keep a good supply in the house: mostly plain chocolate with a high cocoa content, so a serving of 2 squares has less sugar than an entire regular average candy bar. Sometimes all hubby needs to do is stick a square of chocolate in my mouth.
I still get occasional hypoglycemic episodes. Nothing that I can’t nip with some carbs – like 50s low. I think the lowest I’ve seen it is in the upper 40s and that’s because I had a couple of beers. I rarely drink because sometimes it triggers low blood sugar and then triggers feeling crappy the whole next day, even if I was very moderate with consumption. With the exception of alcohol, it only happens during PMS times so I assume it’s a hormonal trigger. I was diagnosed with gestational diabetes, but never experienced high blood sugars but while I was pregnant, every morning, I’d wake up with a blood sugar usually in the 60s, sometimes upper 50s. The morning after birth, it was 80 and continued to be around that.
Holy hell!
Jesus fucking CHRIST! (sorry)
I did not give birth at a BFHI hospital but even so I definitely noticed the overtones of “breast is best” everywhere I went. The posters on the wall, all over the NICU, in the pumping room. I was actually on medication where the doctors weren’t sure if I should breastfeed or not so I actually got a lot of the “real story” about the minimal proven benefits of breastfeeding. But I couldn’t quite reconcile that with all the “breast is best” messaginging I was getting everywhere else, including overhearing the same doctors talking to other parents. I totally get that most of the babies in the NICU were preemies where there is a proven benefit of breastmilk but the one that got me was overhearing the beloved head of the NICU questioning a new father on why his wife wouldn’t breastfeed knowing that it really is the best. The baby was full term and only brought to the NICU as a precaution for some ox sat issues. The dad said mom had tried bf-ing the first one and wasn’t able to make milk then and didn’t care to try this time. There were some very disapproving looks and more attempts to convince dad that he should convince mom to pump while baby was in the NICU. Exchanges like that made me feel as though the drs were just trying to make me feel better by saying breast is not that important. I stopped taking my meds so that I could breastfeed until he was 9 months and i had done noticeable damage to my kidneys and had to go back on all my meds and quit bf-ing.
Mine was a term baby who just took too long to figure out this breathing thing. (Did you know we’re expected to do it constantly?!? WTH!! I can joke because she’s fine) Even with her, we got a disapproving look from one of the nurses in their nicu
Breathing is so annoying sometimes. 😉
So my first was born at a hospital that was not yet BFHI but getting there. I got crazy conflicting advice on how to breastfeed, what I was doing wrong, etc. And the biggest issues were 1) baby’s mouth needed to get bigger, 2) vasospasm, and 3) once my milk came in it was a fire hose. I persisted and weaned kid at 14 months. Would have been nice to get some realistic “yes it will hurt for the first month” and then decide from that whether or not to continue. Rather than driving myself insane. If I had stopped during that first month I would have felt incredibly guilty, but am not sure now if it was worthwhile.
I’m in a similar situation: on meds that keep me alive, but probably mean I can’t breastfeed. You gotta do what you gotta do.
Oh, that poor woman. That’s just heartbreaking. Having dealt with PPD myself, (though not due to BFing bullying), I wouldn’t wish it on anyone. I think it is getting more attention now, but still is not taken as seriously as it should be, and it seems that many women fall through the cracks and don’t get the help they need when they need it (or at all maybe).
These posts over the last few days are timely—for my class this session, I have to design a health issue program, and I had already decided I would do something around the issue of women’s treatment in BFHI hospitals as a potential contributor to PPD. The program I am going to design for class will be theoretical, and not actually pitched to anyone who could use it, but I would love to actually pitch the program for real someday.
That sounds like a great idea! Let us know how it goes?
I am lost for words. I can not describe how sad this story is for me. I am so sorry this family is going through such a difficult time.
My heart goes out to that poor woman and her family. Shame on all of those that hurt her. Shame on all of them.
I came here today to post a link to this story. This family lives one city over from me and no doubt she had her baby at the same “baby friendly” hospital as I did, 2 months ago. I had some depression shortly after my baby was born and it was largely due to breastfeeding. My nipples constantly hurt. The nurses and LC at the hospital only said “it shouldn’t” and “put breastmilk on it” (which of course did nothing). I ended up with a blistered and cracked nipple that would cause me to burst into tears every time baby latched. The other breast had a blister causing a plugged duct – absolute worst pain I’ve ever felt. You bet this suffering made me depressed. You bet my quality of life was affected. At least I KNEW the source of my depression, and told myself I could quit at any time. Thank god for a place like this, where I have been able to feel truly supported in whatever way I feed my baby. Thank you Dr. Amy for writing about this family. There but for the grace of God go I…
I am so sorry you went through that. I had vasospasms (a special kind of hell) when I first started nursing. Thankfully, the LCs I saw actually helped me figure out how to correct my baby’s latch and gave me tips to help my nipples heal from the bad latch.
Thank you. That sounds awful.
I too had vasospasm. It turned out I had to be very careful about not being uncovered because temperature change was a trigger for me. I’d layer clothes so that literally my nipple was the only thing exposed to the air and I’d rip it out a microsecond before latching. Once the kid was done, cover immediately and slip in a pacifier.
I hate that circular logic. “It shouldn’t hurt so you’re doing it wrong and we know you’re doing it wrong because it shouldn’t hurt.” I’m sorry you went through that.
Thank you. I was told by all of them the latch looked correct so I don’t even know what the implication was…but you do get the feeling you’re being told you’re doing something wrong – but none of them could tell me what it was.
I guess “Breastfeeding shouldn’t hurt” is what they say when they can’t say, “Breastfeeding hurts sometimes, even when you do everything right. Consider supplementing with formula if it makes you miserable.”
Because they didn’t know. Everyone also has a completely different opinion on whether something is wrong and also, what that thing might be.
Right. I could see a look of “well, this wasn’t in the textbook” on some of the nurses faces. But someone who allegedly specializes in human lactation, I expected some kind of troubleshooting from. And none of them admitted they didn’t know, they said putting breastmilk on it was the solution. And since I left the next day and they never had to see me again, they won’t know that never worked.
I got told the same damn thing. “Her latch looks great!” Me: “Then why won’t she stop screaming?” Them: “…well, her latch looks great!”
I guess I had PPD too. At least I felt like a complete failure throughout the first year of motherhood. I had failed at natural birth. I had failed at breastfeeding. I had failed to get my body back and 6 months on still looked pregnant. I was feeling extreme fatigue having to care for my daughter almost on my own as other members of my family were forever working due to the difficult economical situation in the country. I remember walking with the pram for hours feeling completely alone in the whole world. My PPD didn’t go as far as suicidal thoughts but I had never felt so desperate in my entire life. God, I just imagine her taking this last look at her baby, quietly leaving the house knowing she wasn’t coming back. Walking towards her last destination. I feel deep compassion for Florence and her family. Pressure on new mothers is insane.
I hope you’ve since found some healing and support.
Luckily I did and this blog has contributed so much to the healing.
Where are Brooke and Nikki Lee?
They had better just STFU. Anna Perch had better not make an appearance here either.
I’m flattered that you were thinking of me. 🙂
I’m not sure about Brooke, but Nikki Lee is at the problematizing infant safety post avoiding giving direct answers.
You know, some of the incoming trolls have motives that are just so abundantly clear. Nikki Lee’s shtick seems to be to sow FUD to keep herself in a job. Once I thought that, all of her dancing around made more sense. Particularly the bits where someone would lay out data in a clear way in response to her claiming Y, and she would admit that X was indeed the case instead of Y – and then she’d show up elsewhere in the thread still claiming Y.
Stupid Flanders is all about pandering to the lactivists while still trying not to look like the asshole that his views make him.
Brooke wants to justify her own choices to herself by making other people agree they’re the best choices for everyone.
Not sure if I had mentioned it here before but knowing someone who knows Nikkilee IRL, I know that she thinks her husband’s health problems are down to the fact he wasn’t breasted as an infant
Nikkilee’s husband, or the person who knows her IRL’s husband?
Nikkilee’s husband.
Maybe jen will make an appearance here. In the past, she stuck with the anti-vaxxer schtick but she’s been making cross-over appearances. If you aren’t aware of her, her style is to find an abstract with words she likes, find another abstract with similar words, and then maybe find another abstract with some more similar words and the mash them together to form a “conclusion.” Then when she’s questioned, she throws some big pharma conspiracy theory in the mix.
Lactivists do so much gaslighting surrounding the depression/breastfeeding link.
When women tell their stories about how breastfeeding contributed to their PPD, they claim that’s impossible and that breastfeeding actually prevents depression by releasing oxytocin. They claim that it’s not the breastfeeding pressure that causes depression but rather “when a woman doesn’t reach her breastfeeding goals” and their solution is “more breastfeeding support”.
When a woman and her psychiatrist make a plan to get her uninterrupted sleep at night by combo feeding or switching to formula, they claim that “studies show” that breastfeeding mothers actually get MORE sleep and pressure the mother to co-sleep with the baby, “you don’t even have to fully wake up to do it.”
I quite enjoy breastfeeding, enough to keep at it for 2 years per kid. But I got a similar response when I had ppd following unmedicated birth. When I reached out for help, I was told I couldn’t possibly have ppd because natural birth prevents ppd. I was also told that the the reason it hurt so much as to be a trauma was because I didn’t exercise enough during pregnancy. I actually had a precipitous labor that was under an hour from start to finish with no break between contractions and undiagnosed GD and that baby was 9 pounds and blew a nice second degree hole in me.
Infertility is supposed to guard against it too, as in “you don’t have ppd, you’re too happy and grateful to be sad.” Except I was also under immense pressure to breastfeed, which had landed my son back in the hospital and made me feel like a total failure. And even without that, infertility is a risk FOR ppd exactly because you are made to feel like you can’t experience anything but joy, even at 2am hooked up to a breast pump.
Yeah, that’s total BS. Infertility is a RISK for PPD–like you said, probably partly due to the heightened expectations not meeting reality, but also, dealing with infertility is enough to make anyone depressed before even getting pregnant. 🙁
Previous stillbirth also ramps up the PPD risk.
can’t upvote, so *hugs*
Yeah, I asked my counselor if infertility is considered a risk factor because you’re already miserable before you get pregnant, then anxious during pregnancy, and then completely strung out by the time the baby arrives. She said yeah, pretty much!
I was diagnosed with PCOS before getting pregnant. I had about 8 months of invasive tests and monitoring and feeling like it was all my fault before becoming pregnant. Then 12 weeks of miscarriage worry because of PCOS and ‘advanced’ maternal age. I turned out to be normally fertile and have had a great pregnancy but it’s been an anxious 18 months. I’m done with ‘advice’ and looking forward to having full ownership of my body again. I’ll be on high alert for PPD.
In my case, the infertility was all on my partner’s side, but by god i was anxious throughout my first pregnancy! Fearful that I’d loose him like I’d already lost his twin or like Mom lost my stillborn sisters, and that we couldn’t afford to try again. We were able to try a second time because DH’s grandmother died a fortnight before our son was born and left DH some money. The 2nd one was a hormonal mess that just exacerbated a rather thorough case of depression I’d already been working on.
I got pregnant while my sister was struggling with infertility and had awful all-day sickness. I was laying on the couch at my parent’s totally miserable and complaining and she made some comment to me about how she would never complain about being sick during pregnancy because she would just be so happy to be pregnant. It took a lot of self-control on my part not to smack her. After her son was born, she struggled with depression and later admitted the reality of a baby was much different than her fantasy and that part of the depression was feeling guilty for not being overjoyed all the time. I hate the idea that you must always be grateful and overjoyed with parenthood. There are a lot of part’s of being a parent that really suck. It’s not all one way or another.
Infertility really screws with your mental health. I remember having a similar attitude during our struggle. And the same thing happened to me when the reality of having a baby hit. Nothing has made me eat my words more than having a baby.
I think my oxytocin on switch is broken.
Mine seems to work, but all I get is feeling woozy and light-headed. None of this “rush of motherly love” crap.
Mine actually does make me feel drunkenly happy–with the occasional crying jag. Hormones are weird, and telling a woman that you “should” be feeling X or Y is dumb and cruel.
I’m willing to bet that the oxytocin increase from breast-feeding treats PPD exactly as well as it treats pre-ecclampsia symptoms.
For the week I was hospitalized, I always had higher BP readings during or immediately after pumping. This was a no-brainer for my husband and I since pumping before my milk came in was vaguely uncomfortable and I was still weak enough from anemia that I needed to alternate the arm I was using to hold the pump assembly to my breast.
This was also a no-brainer for the nurses. Just the sound of my pump as enough to have them come back after I was done when I had had a few minutes to relax.
This was not a no-brainer for some lactation consultant in the past. The high risk OB unit had had a lecture from a lactation consultant who patiently explained to them that women who were pre-ecclamptic and pumping should have lower blood pressure readings because oxytocin during pumping. (The silence was stunning.)
She had no real explanation as to why none of the RNs had ever gotten a lower BP on a patient who was pumping or nursing…
I suspect this was one of the reasons the Special Care nurses were so willing to keep the LC away from me after our first meeting; they had already seen the crazy up-close and personal.
I never felt the oxytocin high with breastfeeding. It is probably just another of my body failures.
Breastfeeding as PET treatment. Now i’ve heard f’ing everything. Ugh
I tried co-sleeping to breastfeed once. Nevermind that it WAS NOT safe for my infant son, it was just gross all around. He woke up, I popped a boob in his mouth and lay uncomfortably on my side, unable to be comfortable because the angle had to be just right for him to latch. At some point I dozed off anyway. Woke up three hours later in a bed that was absolutely soaked with breastmilk, because I never put the boob back in the bra with the nursing pad. And by soaked I mean it was a wet patch with a three-foot circumference that went all the way down to the mattress protector.
You know what’s not great for nursing? Having extra laundry that needs doing.
This is so sad for Florence and her family.
I have insomnia and anxiety issues and have tried to find research on the link between breastfeeding and mental health. All the studies I’ve found seem to find a positive link between breastfeeding and an improvement in PPD / PPA. Every family is individual but from my own point of view I cannot see how this makes sense and suspect confirmation bias.
Already the pressure I feel to breastfeed in my third trimester is setting off my issues. I don’t see how the pressure, lack of sleep, lack of ability to take a break and potentially painful problems with exclusive breastfeeding can help anyone’s mental health. I very much like the idea of mixed feeding but there are no resources available to guide me through establishing this.
My theory on this is that when mom wants to breastfeed and it does work out, the chances of her having PPD/PPA are lessened because she gets a boost from being able to do something she wants to do. And the corollary is, I’m sure, true as well: if mom really wants to breastfeed but it doesn’t work out, it’s another nail in the coffin of no sleep/little nutrition/no support that new moms have to deal with.
I agree – it’s like the “VB gives better outcomes.” If everything is working swimmingly, a VB will happen as part of it, but forcing a VB doesn’t make everything go swimmingly – and only makes a C/S look worse overall, since you’ve had all of the delay and labor on top of it. The more you hold out before using formula, the worse formula looks from a mom and baby health outcome standpoint (eg, the mom who barely sleeps for weeks to try to EBF, then ‘gives in,’ uses formula, and with her depression, gets put in the non-EBF category) – but in both cases, the intervention (formula or C/S) was the rescue from things not going right! Gah, the popular conception of these things is so backwards.
They need to look at ITT-ish studies – planned EBF from the get-go vs planned FF from the get-go. To put the ‘rescues’ in the right ‘bucket.’
Yes! Exactly!
Also wanted to add: I know one mom for whom breastfeeding worked out but who also had bad PPD/PPA associated with breastfeeding. She started out with the attitude of “I’ll give nursing a shot, see how it goes” and found that physiologically, it worked out very well, but that she personally hated a lot of stuff about it and wanted to switch to formula. However, she and her husband made just too much money to qualify for WIC, but too little to afford formula, so she found herself stuck breastfeeding for a year. That did *not* help her PPD/PPA, although there wasn’t anything medically wrong with the breastfeeding itself.
Hopefully, one of the sensible LCs in this group can chime in on a combo feeding plan. If sleep deprivation is a driving factor for you, I would think that night feeds with formula would be an excellent plan.
The thing with the association between successful breastfeeding* and lower rates of PPD/PPA is, which causes which? Lactivists say that it’s the breastfeeding that makes you happier because of oxytocin, etc. – but it’s just as likely that when you’re depressed and anxious, it’s harder to put yourself through breastfeeding. i.e., depression might cause less BFing, rather than BFing causing less depression.
*More accurately, “successfully feeding your baby the way you wanted to.” Breastfeeding is actually associated with higher rates of PPD in women who did not plan to breastfeed (http://link.springer.com/article/10.1007/s10995-014-1591-z).
Yep. Equally, it’s not hard to see how a woman who wanted to breastfeed but wasn’t able to at all might also be at higher risk. It’s almost like, you know, not being able to use your body the way you want to might be the thing causing the issues.
Hmm, link fail. For the curious, the study I was trying to link to is “New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women’s Intentions” by C. Borra et al. Maternal and Child Health Journal, 2015, 19:897.
When I was pregnant I wanted to keep all my options open, plus I was anxious in general so I tried to internet research every feeding method. I found virtually nothing on combo feeding. I ended up combo feeding. :o) For me that just meant I breastfed and if he was still hungry I topped up with formula and later when we started getting out and about I decided whether to breastfeed or formula feed based on what made sense at the time. I don’t know if that’s the ‘right’ way. I have no information to back it up. But anecdotally, my son (11 1/2 months old) is thriving by every measure. And incidentally so am I.
Did you get any advice from your medical team or did you fly solo? I’m worried about getting pressured into EFB or told that it absolutely won’t work if I bring it up with a midwife or lactation consultant.
If some midwife/LC is impertinent enough to say such a thing, I recommend responding cheerfully, and with every appearance of sincerity, “Oh, thanks for the warning! Guess I’d better stick to just formula, then.”
That should shut ’em up. 😉
I recommend interviewing LCs ahead of time to find one who is supportive of combo-feeding. I got lucky in that, when I called the local night nurse company, the woman who runs it mentioned, “I also do lactation consulting, including combo-feeding.” That ended up very convenient because I was ready to give up breastfeeding entirely due to pressure to EBF by the time I got out of the hospital.
I would add to this, some pediatricians offices have lactation consultants (or nurses who know a lot about lactation) on staff. I have generally found them to be more supportive of “feed the baby” than others. You could certainly ask to talk to someone as you are looking at pediatricians. Best wishes!
Yes! The LC at the hospital I gave birth at was a loon, but the one at my Ped is amazing, compassionate, sensible and kind.
I pretty much figured it out on my own. My little guy is an easy baby. When he was a newborn he cried when he was hungry and when he was tired, so it was pretty easy to figure out what he needed.
We worked it out via a combination of trial and error. I was a bit of a mess when we came home from hospital and had a very hungry, clusterfeeding little boy. For his first weeks, I would feed him during the day but when he woke up for his 2/3am feed, my OH would get up and give him a bottle and let me sleep. That way I was getting about 6hrs a night for those first 4wks. Eventually we settled on a routine where he would have a good-sized bottle of formula before bed and by 8wks he was sleeping from around 7/8pm until 4/5am in the morning. He’s a terrible napper and I think we’ve been quite lucky with his night-time sleep- I’m not convinced it was all down to that formula feed.
Essentially, we just tried things and ended up settling on a routine that worked for us. I also suffer with insomnia, although back in those early weeks after all the daytime breastfeeding and lack of ability to take daytime naps, at night I was shattered and would sleep well.
I couldn’t find any decent information at the time on combo-feeding but we did it from day 1 and I saw literally no evidence of nipple confusion or any of those other things I was repeatedly warned about. Idk if it helped that initially, only wee man’s Dad gave him bottles, I don’t think I gave him one until he was at least 6wks old.
I guess what I’m trying to say (sorry for rambling on a bit) is that you’ll work it out and find something that works for your family. Until you know what your baby is like (you may have an excellent night sleeper or one that naps well and gives you an opportunity to nap too or one that is content to have gaps of several hours between feeds, your supply may be abundant or it may not) it is difficult to say what sort of feeding routine might work best for you. I worried about it almost continuously in my third trimester, but we seemed to get there ourselves fairly easily. Just be kind to yourself, and be prepared to change plans.
I remember when my son was a newborn breaking down because I was so sleep-deprived. After so much sleep-deprivation, you can’t think or function clearly. I didn’t contemplate suicide, but I remember being so exhausted and have a baby crying to eat, I’d think to myself, death wouldn’t be so bad right now. (As a person who has caught up mostly on sleep, partly due to throwing that Medela pump in the trash and never looking back, thoughts like that don’t cross my mind.) I’d feel guilty if I slept in if the baby let me because I could be pumping! For a few weeks, I was convinced it was all my fault my supply hadn’t really come in – I occasionally skipped a session to get a measly two hours of sleep. I didn’t even think formula would harm my son or that breast milk was some magic elixir, but I was still a bit damaged from breastfeeding sites.
There were times I was even scared the lack of sleep would get to me so much, I’d accidentally harm my baby. Fortunately, I had resources, and at least I knew my child would be just fine on formula. I’d ask my husband to work from home or get my in-laws to come over and watch him while I got some sanity-saving sleep.
I remember lying on the kitchen floor bawling, telling my husband I wanted to die in those early days, because breastfeeding wasn’t working for us. The pressure was mostly from LCs and vile comments on the Internet – no one in my family really cared how my baby was fed – but it was there, and deeply internalized. The sick part is that I have had depression for a good chunk of my life. The nurse even asked me about it at the hospital, and told me to watch for PPD. But none of that mattered to the LCs at that hospital. “Breastfeed at all costs,” and all that.
I’m forever grateful to my husband for the way he handled me in those early days. I know part of it was the hormones, but he is the one who made sure I got what I needed to start recovering.
I’m so sorry you went through that. I feel lucky that I did not experience anywhere near the pressure so many of you more recent mothers have had to face.
“Breastfeed at all costs”. They do say it themselves, “regardless of other circumstances”. Reprehensible.
Dh is a numbers sort of guy, and tried to walk me through a cost/benefit analysis of taking Reglan to increase my milk supply. Short version: on the one hand, it might increase my milk supply, on the other hand, it could cause both obsessive, depressive thoughts and give me potentially permanent symptoms of a debilitating stroke (drooping face, needing a cane to walk, etc).
He just about threw the pad across the room when I rated not breastfeeding DD as on par with not being able to run after my kid in terms of how it would affect my parenting/her development.
He sounds sensible 🙂
And then there are a chunk of women who will go on, carrying their burdens on their own, who will never come to the fore with what they are experiencing out of the judgement they fear will come should they admit that mothering is anything less than some kind of wonderland.
Yes, postpartum depression and suicide are multifactorial. No single thing is the cause. Yet it is time for us to call out Lactivism as one of the factors. Jenny Gibbs Bankston is another example of a situation where a mother’s struggle to breastfeed may have contributed. Both she and her baby son were lost.
I’ve mentioned my PPD support group before. It’s now grown to over 2000 women. The topic of breastfeeding as a cause or contributor to PPD comes up more frequently than I would have imagined it would prior to starting the group. We have a pretty strict “no lactivism” rule on account of just how many women report that this type of behavior played a major role in their mental health.
Even if others are not lactivizing you directly, the internalized pressure can be huge. Been there.
I am so sorry for Florence and her family.
And they just can’t see what the problem is. I remember one seemed nice enough, and certainly sincere, but she had no clue how those of us with bf issues were reading her.
Yup. I know one IRL who doesn’t understand why telling me that “I just needed more support to succeed in breastfeeding” is NOT EFFING SUPPORTIVE.
You can probably imagine how many times we talk about how mom’s mental health is more important than method of feeding, and how many women are so convinced that they’ll permanently harm their babies if they don’t breastfeed that it’s an uphill battle. Over and over again we face this issue. It’s heartbreaking.
But then we have the women who tell us they’re so relieved to finally find a group where they don’t have to be afraid to admit they used formula or had trouble breastfeeding, and how they are finally able to start the process of working through the guilt that they’d been carrying. It’s sad that they even had that guilt.
Telling someone who is struggling to TRY HARDER is never going to go over well.
You see someone struggling to climb stairs with crutches. You say “Hey, you’d be able to do that better if you could get someone to help you.”. They look at you, confused.
They say “This is hard. I’m doing the best I can.”.
You respond. “I know. You are doing a good job. But you could be doing better.” and then you walk away.
They continue to struggle up the steps, only now they grumble about stupid randos.
Yup, we’ve kicked more than one person out for that kind of behavior. You should see some of the private messages the admins get when people get called out on their bullshit. It’s kinda funny to watch the temper tantrums.
…I probably shouldn’t see them. The topic is still tough for me. I feel a little bad for them (and the other believers in not-so-evidenced-based stuff) because they really think what they heard *is* evidence. But not that bad.
I’m the only admin or mod that isn’t actively in the baby/toddler/pregnant stage of life, so it’s a touchy subject for a lot of the admins as well. We’ve recently instituted a rule that if somebody messages one of us with something accusatory/argumentative/nasty, we ALWAYS add a second admin/mod to the conversation in case the first admin has trouble with the topic.
Good plan. We’re all there for a reason, unfortunately. 🙁
This could so easily have been me. That poor, poor woman and her family. May she rest in peace, and may her family eventually find healing and hope.
One thing I did want to address: “They reasoned that Mary, mother of Jesus, would not have worked because she was breastfeeding.” This is an entirely nonsensical line of reasoning, of course, even from a biblical and/or Catholic perspective. Joseph and Mary were refugees in Egypt for the first couple of years of Jesus’ life. That time and place were even less kind to refugees and outsiders than we are now. While no one knows for certain, I think it’s much, MUCH more likely that Mary would have been helping Joseph put food on the table. He’d lost his client base and reputation (I doubt anyone in Egypt could or would give him a reference, or much in the way of referrals), two things that are utterly vital when you own a small business. Dollars to donuts, she was cleaning houses, helping with the harvest, watching children, perhaps cooking or weaving or sewing or what-have-you. She was *not* lying in bed for weeks at a time on a “nursing vacation.”
But then, why use logic when you can use religion to bully people?
(As I’ve mentioned here before, being Catholic and finding that most Catholic mom books are directed to things I physically can’t do, i.e. natural birth and breastfeeding, played a massive part in my PPD both times.)
Oh, this is dark, but…
Scene: 2000 years ago, give or take.
Mary: “So, it seems our lunatic king has decided to massacre any boys under the age of two. Joseph and I are thinking it’s a really, really good time to get out of Dodge.”
LLL Leader: “But all that travel and walking could adversely affect your supply! You really need to lie in bed and do nothing but nurse for the next two weeks!”
Mary: “Yeah, I’m thinking that getting speared to death will probably be worse for Jesus’ long-term health than getting a bit of goat’s milk if necessary…”
LLL Leader: “If you REALLY cared about Him, you’d make Joseph hire a palanquin and a few oxen or slaves to carry you to Egypt so you don’t disrupt the nursing relationship at all!”
Mary: “Was there some part of ‘fleeing to save our son’s life’ that you’re not understanding? Also, we aren’t exactly independently wealthy, here. Not to mention–SLAVES?!”
LLL Leader: “Well, I certainly hope you’re at LEAST planning on sitting backwards on the donkey so that your baby will be rear-facing!”
Mary: *contemplates having Joseph stop at the winery on their way to Egypt*
Ha! It’s funny because it’s true…
On a tangential note I love how so many of them are so convinced that mothers in the good old days spent every waking and sleeping hour attending to their babies. I don’t think they understand what life was like before washers and dryers, dishwashers, ovens, microwaves, store-bought goods, etc. Heck I work 2 jobs and I’m pretty sure I get more quality time with my baby than 99.9% of women in the ‘golden’ pre-modern era of motherhood.
I’m not any sort of expert, but bundling a kid up on a papoose board and slinging it on your back so your hands and legs are free to work doesn’t exactly sound like modern AP. :p
Women had pretty much always worked, leaving child care to the older women and the children old enough to be kinda responsible but too young to work themselves. The only difference between then and now is that women are getting paid for their work. This idea that moms should be focused 100% on babies is a very, very new thing.
My great-grandmother had 13 children.
In Holland
During a god damn war.
Between the cooking, cleaning, washing, mending, gardening, and looking after the other 12 kids I doubt she had more than a few minutes at a time to look at the newest one, let alone hours to sit and bond while BF-ing.
Rear facing on the donkey slayed me.
I think you and I may be kindred spirits. Also raised Catholic here (though I don’t really associate myself with a specific religion anymore), and studied the Bible from a historical-critical perspective.
Anyway thanks for posting this. I going to point out myself that there was no way Mary on a “nursing vacation.” 🙂
Unless someone’s definition of “nursing vacation” includes “riding a donkey over crappy roads while recovering from childbirth and caring for a newborn with the everpresent threat of having your newborn slaughtered in front of you if you’re caught, followed by trying to live in a new country with no support and adjusting to new customs, language, et all.”
Not really my idea of a way to relax and build up a milk supply, I must say…
Nursing vacation sounds like a nightmare to me. I remember a few days postpartum really wanting to start to get to my routine. My in-laws were staying with us and would go get or prepare all our meals. It was nice, but one day I told them, I am making our breakfast – I want to! I needed to do something besides just lay around. Then I remember being glued to my pump, feeding the baby (mostly formula!), changing his diaper, rinse, repeat while my house was not maintained like I like and getting sick of frozen meals or takeout because I only had time for nearly fruitless pumping and feeding.
I’m somewhere in between: I admit that I really loved having my wonderful best friend and MIL come in to help me. BFF was especially good at the “I’ll get up with baby, you go sleep” thing, while MIL was wonderful about making homecooked meals for us and tidying the kitchen after. Nonetheless, the first time that I caught up on the laundry and vacuumed the living room after DS was born was just plain awesome!
I definitely appreciated all the help family offered, too! However, the idea of laying all day in bed for two whole days or more, especially when you still don’t get to sleep but instead nurse around the clock, sounds absolutely miserable to me.
I AGREE. I hated the single night I let my ds sleep in our bed and nurse alll night, so this sounds miserable to me.
This really hits home for me. The amount of anxiety that I was feeling postpartum about my milk not coming in with our first child was truly awful. I couldn’t sleep at all, I came to dread feeding our son, and I was exhausted from the pumping, feeding, and cleaning of parts and bottles (at one point, I had maybe 30 minutes between each cycle of this madness). I receive all of my care from the same hospital system. My CNMs knew that I had remained on medication for major depression. Anyone who looked at my chart, including the LC, could see that diagnosis on the main page. No one said anything about it. No one asked about it.
Sleep deprivation has a very negative impact on me, and it feeds into my depressive episodes. I’m certainly not unique in that, and given the number of women who will have PPD, it is absolutely wrong that breastfeeding seems to be the overriding focus of postpartum care. We know that PPD can lead to psychosis and suicide. So why are we ignoring a well-documented condition while promoting a campaign based on pseudoscience?
I weep for Florence Leung and her family, especially her husband and baby. And to every lactivist who comes here and downplays the severity of PPD, or who claims that breastfeeding is protective against developing it, you must acknowledge that you have blood on your hands. Your lies are killing people.
Breastfeeding when one is having problems doing so is so fraught with emotion. I could not exclusively bf my first child (and had to temporarily supplement my second as well). I dealt with the guilt by developing an extremely anti-formula mindset. Basically it was okay if I was doing it, because I had to, but at that point I honestly felt that formula should only be available by prescription… yadda yadda yadda.
Thank goodness I never said any of this out loud!
I am pretty sure for me this was a direct result of pressure to breastfeed–most of the pressure was internal, because of various pregnancy & baby books, websites, etc. I didn’t get any from my doctor or the lactation specialist I was seeing, but she was a pediatrician and her focus was on giving mothers the tools they need to nurse as much as possible while erring on the side of caution and giving formula as needed.
I’ve mellowed a bit since…
I am so sorry, so very, very sorry that you went through this. That’s gross negligence on the part of the HCPs.
I feel like continuing my medication probably saved my life. Going back to therapy almost a year ago gave me an opportunity to work through a lot of the baggage that I had related to my first delivery, breastfeeding failure, and long-term health problems related to birth. I wish I had gone back a long time ago, but at least I’m starting to make peace with it now.
Meds are awesome; having experienced the PP period and associated serious depression with and without them, I can say I will never again have another kid without a prescription lined up to start immediately after delivery. I stopped mine probably too early this time (awesome on the antidepression front, wretched on the side effects), though I have promised myself that when things settle down a bit here, I WILL start seeing a therapist to work through a lot of the stuff that bothers me so much.
I’ve accepted that I will be medicated for life. I’m fortunate in that after several unsuccessful trials, I found a drug that works very well and has very few side effects. If I was dealing with major side effects, I would certainly want to limit my use as well. You’ve probably already done this, but let your doctor know about how bad those side effects are. S/he might be able to find a different drug or some other strategies for reducing that unpleasantness.
Yup! I didn’t realize until I got off of them which things were definitely side effects, or I might have checked in with him sooner. As it is, if there’s a next time, I will likely ask him to either prescribe something else, or get me a referral to a shrink who has experience with PPD moms.
I was able to stay on my SSRI during my pregnancy with Spawn. The only side-effect that my OB wanted me to be aware of was that Spawn might be a bit more sleepy and mellow during the first few days of life.
I said I was willing to risk that 🙂
Honestly, it didn’t seem to affect him at all after the CS. He came out wiggling his arms and legs and grabbed on to my husband’s finger in the OR which is pretty unusual for a 26 weeker. He also was audibly crying with the CPAP on which was simply amazing….
Edited to add: Ditto for breast-feeding. The NICU staff told me that there were only a handful of medications that were contraindicated for breast-feeding and that those medications were also contraindicated for pregnancy so anything I was on was totes OK for the foreseeable future.
I continued to take my low-dosage antidepressant during my pregnancy 15 years ago. I see now that it is on the list to not be given to pregnant women, but fortunately it worked all right for us. No way was I going through pregnancy unmedicated, it would have been life-threatening.
He is Spawn! Brave and Strong!
Someone should make “He is Spawn! Brave and Strong!” into an awesome banner that somehow incorporates both Cthulhu and cows for Spawn’s NICU space.
Cthulu milking a lovely Holstein. Or eating it. Oh, oh, oh…I know! Eating a lovely Holstein and washing it down with a lovely glass of milk he milked out of her before eating her!!
In soft, cuddly pastel colors, of course.
Oh, I hope I didn’t imply that a mom shouldn’t take antidepressants during pregnancy! Not at all what I meant! (Obviously, check with your OB about your particular meds, blahblahblah.)
I was only speaking to my specific situation: in ordinary circumstances, I have a low level of depression that is extremely well-managed with regular exercise and a reasonably balanced diet, but for a year or so postpartum, meds are a MUST for me.
I didn’t take it that way. 🙂
I occasionally add tidbits like that when I’m rather tired from actually getting a middle-of-the-night pumping session.
It was more of a steam-of-consciousness reply.
*nods understandingly*
*passes Mel really high-quality chocolate and lattes*
My heart is full for your suffering so needlessly, moto.
Thank you, Sean. I feel for everyone that has experienced some degree of this. I feel like I got of comparatively easy – I was never actively suicidal – but I also know that what happened to Florence could have happened to me. And that is why I will keep fighting against lactivism.
Thank you.