Breastfeeding PTSD

Dear Amy: 

I am 10 weeks pregnant with my second child, and I am terrified of attempting to breastfeed again. My older child is 7 months old and we ended our breastfeeding relationship at 7 weeks. I don’t in the end even know what the problem was, but I know it wasn’t her – every person that ever saw her breastfeed said she had an amazing latch. She also cluster fed like a fiend whenever she hit a growth spurt, which I happily indulged. Nevertheless, we couldn’t cut it. I don’t know if it was a family history of undersupply (my mom tried to breastfeed each of us and stopped each time around 6 weeks), a slow flow, my nipple on my left which looked a little flat, a suspected case of thrush, and/ or my lack of reaching out for support whenever I suspected there was a problem (see: thrush – I have no idea if I actually had it).

In the end, however, I think it all stemmed down to my utter anxiety about breastfeeding and my inability to relax. I suspect that inhibited let down tremendously…and, I think it stopped me from breastfeeding on demand enough – I started watching the clock, trying to put off feedings as much as possible. I hated every second of breastfeeding – the first few days when she’d fall asleep the moment she hit the breast and we had to resort to extraordinary measures to wake her, the pain I had every time she latched for the entire 7 weeks (which probably speaks to some sort of problem! The few times it was pain free I was like, “huh, this is nice”); the stress of nursing in public; pumping less than 1/2 an ounce each time; fighting with her as she popped off, cried, popped back on, cried, popped off; the hour long nursing sessions; not knowing if she was getting enough and strongly suspecting she wasn’t, and finally, the terrifying trip to the doctor’s office at 7 weeks with a listless unhappy baby who hadn’t pooped in 7 days where I found out she weight 7 pounds 10 ounces..the same she weighed at her one month checkup.  

Honestly, the two happiest moments of our breastfeeding relationship were 1) the first time we supplemented based on doctor’s orders. She nursed on me, fell asleep, and I woke her back up with 2 ounces of formula. She chugged it down sighed happily, and grinned and 2) the day I realized she had gone on a nursing strike. Yes, the nursing strike. The thing that breaks mothers’ hearts, prompting tearful calls to La Leche League. My reaction was, “Thank GOD. It’s time to stop”. And in that instant every depression and anxiety symptom I had since she was born disappeared.

So, that’s the opus. I’ve read up on what you did with Ezra to up your supply and I will be following those instructions to the letter. But what about the anxiety and fear? Do you think that if I take measures to up my supply, and see things calmly as a second time mom should (ie, nursing in public isn’t a big deal, a little formula won’t kill your baby, etc) that things will be okay, even if breastfeeding fails again? Or by reading this do you think I have serious issues that I need to talk through with a professional (ex: be on the lookout for PPD/PPA and take BF friendly meds the moment I suspect a problem?) As you can see, this isn’t just about breastfeeding – if I fail, the new baby goes on formula…been there, done that. It’s not the end of the world. It’s about those emotions…my first 7 weeks as a mom were scary, and I wasn’t bonding with my daughter at all. I don’t even think I liked her. So if there’s an issue there – who the heck do I talk to? The doctors in my OB/GYN practice aren’t that great about postpartum mental issues. I have friends who are LCs (who I will actually be using as breastfeeding resources this time around..sheesh!) but they aren’t anxiety counselors! Do I actually need to find a therapist? Or, again, will this be a problem that will resolve itself if I just take control of breastfeeding and supply from the beginning?

I have said — repeatedly — that there is no amount of money anyone could pay me to go back to nursing a first baby. It was and still is the thing I found to be the most stressful and anxiety/angst-ridden of any of my new-baby/postpartum experiences.  In fact, breastfeeding Noah probably ranks pretty high in my top five list of stressful/anxiety/angst-ridden PARENTING experiences, perhaps second only to having him diagnosed with special needs. I had built breastfeeding up in my head to such a degree that I really was measuring my success as a mother with it, and when Noah’s weight plummeted and he went on nursing strikes and my nipples bled and we got thrush and my supply was crappy and I wanted to hide from him at feeding times because I was afraid it would hurt physically or he’d reject me and it would hurt emotionally…well, goodness, I felt like a big fat failure.

But I wasn’t. Neither were you. I could spend a lot of time rehashing the experience and figuring out every “mistake” I made or “problem” that could have been solved — like you seem to be doing right now, and shifting all the blame onto yourself, painstakingly listing every thing you think you did “wrong” — but seriously, it’s just not worth it. It’s done. It’s over. Your daughter got colostrum and several weeks of breastmilk and then you did what you had to do and give her formula to get her weight up and for you to pull yourself out of a bad mental place. There is no shame with ANY OF THAT. Begone, shame!

When I was pregnant with Ezra and knew I planned to try again, I did my research on supply issues and well, that was about it. I definitely found comfort in the fact that 1) I was better educated about breastfeeding in general, thanks to my 200-momblogs-a-day reading habit, 2) I’d learned that damaged breast tissue and milk ducts can naturally heal themselves with each subsequent pregnancy and nursing experience, and 3) breastfeeding is ALWAYS a two-way street and different with every baby. But that’s as far as I let myself obsess or “plan” for breastfeeding. I bought nursing essentials AND bottles and a container of formula. I told myself I would give breastfeeding a shot but if it didn’t work, that was okay too. And then I pretty much refused to let myself think about it any more for the duration of the pregnancy. (Easier said than done, I know. More on that in a bit.)

And nursing Ezra was a completely different experience from day one. I was calmer. Though I desperately wanted breastfeeding to work, it was just…obvious that something was different. I don’t know how much of it was me and how much of it was that Ezra was not Noah, but…it was so, so much easier. Even figuring out early on that Ezra was tongue tied barely rattled me. Oh! We can fix that. No biggie. I popped supplements and tea and got on the pump — something I HATED with a PASSION the first time around, finding it kind of horrifying and weird because I was so uncomfortable with the process — and was just…better with it. Yep. Milk comes out of boobs. I wasn’t self-conscious about leaking on my husband or nursing in public. Breastfeeding actually felt as natural as you’re told it is — something I’m not sure I ever really managed to feel with Noah.

And Ike? Well, once again I told myself we’d do our best. I’d do my part and see if he was willing to do his. And it worked out great. Pumping hasn’t been quite as successful as I’d like — I can’t quite manage to build up a decent stash and am usually only able to pump a couple ounces at a time — but whatever. If I need to be away from him and miss a feeding, he drinks the occasional bottle of formula and that’s okay too. He’s a happy, healthy growing baby and he has a happy, healthy, totally-mostly-sane mama.

If you believe that your anxiety about breastfeeding is NOT something you can control for the duration of your pregnancy — if it seems to be an intrusive, daily stressor that doesn’t fade at all as you enter the second trimester — then I see no harm in finding someone to talk to. Someone who can put your fears of failing (at breastfeeding, bonding, being a mother of two, etc.) in perspective and give you some tools to cope with those fears. Or at least, someone you can add to your speed dial in case of a postpartum PPD/anxiety emergency, so you can feel secure knowing that you have a place to turn this time. (How awful that there are still OB practices that don’t focus on postpartum mental care! Talk about SHEESH. If they aren’t your only option, remember it’s totally okay to shop around at any point during your pregnancy.)

It’s possible that things are coming to a head for you because you’re in the thick of first trimester hormone shifts and you may be able to simply take a deep breath and a c’est la vie attitude in a couple more weeks. If not, talk to someone. No shame. Look up a La Leche League chapter in your area and talk to someone there, or any of your LC friends about the feelings you’re writing about. (Obviously you’ll want to find an LC who can make you feel BETTER about sticking things out for seven weeks instead of piling on more guilt or “you should have done X, Y or Z instead” judge-y suggestions. You want someone who will support your “I’ll do my best but am not going to kill myself trying” approach rather than a hardcore anti-formula zealot. Luckily I’ve mostly encountered the first kind.)

Success at breastfeeding does not measure your success at motherhood. I think it’s awesome that you’re willing to try it again! Really, that’s kick-ass of you to face your fears and anxiety and get it all dealt with. And I want to stress again that nursing my subsequent babies really was sooooo much easier for sooooo many reasons, and I of course totally hope you have the same awesome experience. But if not, and it doesn’t work, it’s okay. And you know it’s okay.

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