FFF Friday: “I’m grateful to the midwives who stepped out of line with hospital policies to connect with what was really going on…”

Last month, I received a PM from a woman named Sarah. She wrote: 

“It is hard to describe how depressed and lost one feels when someone takes it upon themselves to remind you of how exclusive breastfeeding halves the risk of SIDS, when they know you will be formula feeding. And when you tell them you don’t have a choice they just keep reiterating. As though you are choosing to kill your baby willfully and wantonly. And you start to doubt if you should even be a mother at all if you can’t breastfeed exclusively. It’s a lonely place.”

My heart broke for her. She was expecting her baby in the next few weeks, and I hoped against hope that when he or she arrived, all this self-doubt would wash away. 

And then, yesterday, she sent another message. She agreed to let me share it as an FFF Friday of sorts, even though that wasn’t her intent. I share this not to scare anyone who is currently expecting, because when Baby Friendly is done right, it can be a really positive experience. I share this to show that when Baby Friendly is done wrong, it’s done very wrong, and we can’t allow the good to overshadow the bad. It doesn’t matter that 20 women have a good experience if 5 are put through this kind of hell, because this kind of hell is inexcusable. End of story. And if anyone thinks what Sarah went through is acceptable, I doubt their opinions are malleable or their empathy is intact, so there’s no real reason to debate about it. 

Happy Friday, fearless ones. 

The FFF

** Please note – the names of everyone involved in this story have been changed, and the author refers to her baby as “they” rather than her or him to protect the child’s identity as well. Just so you don’t think she had twins! : ) ** 

 

Sarah’s Story

My baby, R, was two weeks old at 9.31pm two nights ago. Yesterday I lay next to them on our bed, watching them sleep and kissing their teeny tiny face, their squishy belly, their downy head and relishing them. I am still getting to know them, and our bond is still slowly growing as each day passes. Formula is largely responsible for being able to connect with them like this.

 

I would like to tell you about my experience so far of motherhood and feeding my baby while it remains fresh in my mind, because formula is at the centre of my story; formula and my breasts, and the both truly negligent and outstanding care I received – all within the same hospital.

 

There’s background to how feeding and by association, attachment, has gone down for me. I have a difficult history around fertility and mental health. I had two traumatic miscarriages before this baby was conceived, and their conception happened after painful, invasive fertility testing. A lot of emotions rode on the creation of their new life, and my pregnancy with them felt heavy every day with fear of loss. I found it difficult to connect with them as they grew inside me, and sought counselling to help me do so.

 

I also have mental health issues that I take daily medication to treat; medication that, while it does an excellent job at keeping me functional and well, passes into breast-milk, with unknown long term consequences for breastfed babies (not enough studies have been done, and even short term studies are limited in number and scope). Women who take these medications are generally advised to limit breastfeeding or use formula, though that information varies depending on who you talk to. The idea that breast-milk is the elixir of life weighs heavily in the “risk vs benefit” equation which means I’ve been told by some doctors that breastfeeding would be “worth it”.

 

After months of discussion with my husband (who has always maintained that breastfeeding or using formula was ultimately an issue of bodily autonomy and thus, my choice – I highly recommend being married to a feminist) I decided I wanted to breastfeed a little bit after our baby was born, but mostly use formula and let my supply dwindle naturally. This was for two reasons: so I could get enough rest to mitigate the likelihood of developing post natal depression and post puerperal psychosis, which I was in a high risk category for, and to minimise how much exposure our baby was getting to my medications.

 

The circus around advocating for this feeding plan began well before I gave birth. I raised it with one of the midwives handling my antenatal care and she refused to tick the “not breastfeeding” box on my antenatal card, insisting I speak to the lactation consultant. I left the appointment angry and disheartened at being patted on the head in this way. However, this LC was wonderful; she listened to my concerns, and said she would work with me to teach me how to bottle feed, and how to express colostrum which I was still keen to give our baby – provided I get advice saying it was safe to do so (I did). I spoke to a leading expert who recommended I breastfeed more than I was comfortable with (because breast is best, of course) and met with the LC again, who wrote a plan that included pumping – which I’d also never wanted to do -and demand feeding during the day, using formula at night to assist sleep. This was the start of the parade of conflicting, confusing and ultimately destabilising advice around feeding that marked the next few months.

 

My labour with R was long, intense and difficult. I didn’t eat or sleep for three days and was in labour for around 30 hours, with my waters breaking, my labour stalling and ultimately being induced with syntocin when everything stood still. By the time my little one was lifted onto my chest – a purple, heavy, wet and warm tiny human still attached to me by our shared cord that pulsed with lifegiving blood – I was completely exhausted. But they were here, finally, after so much fear that we’d never meet. During that first hour of skin to skin, they had their first breastfeed. Looking into their face in that moment I felt such a rush of love and contentment that I’ve never experienced before and don’t think anything will ever rival again.

 

I wish I could say my stay in hospital ended on such a high note; unfortunately it didn’t. I was transferred to the post natal ward for a long stay, with my husband staying on the fold-out beside my bed and R in a tiny cot on wheels at the end of my bed. Nobody in those first couple of days seemed to put two-and-two together and note my mental health history, detailed in my file, and the fact that I hadn’t slept at all in days. I was, as we say in Australia, completely knackered – but I’d anticipated this happening, having brought in seven syringes of precious colostrum I’d expressed ante-natally for my husband to drip feed R, and thinking we could use formula as well. Right? Wrong.

 

Our precious syringes of colostrum were (apparently accidentally) defrosted all at once. What was supposed to last days had now to be used up in the next 12-24 hours, which scuttled our plan. Then, the first nurse I asked to make up a bottle of formula so I could get some sleep flatly refused. I didn’t know how to reply. She said she’d only give the remaining expressed colostrum I’d brought and when I expressed concern that this wouldn’t be enough to feed our baby she said I’d just have to wake up and express more and the baby would have to “make do with a snack” and I’d have to have a shorter sleep. Beyond tired, I agreed and walked back to my room wondering what had happened. Hadn’t they read the lactation plan our LC had written?

 

Over the next few days I was awake every few hours, wildly expressing, and trying to latch a hungry baby on to nipples that increasingly felt razor-shredded with shaking anxious hands. I had loved that first breastfeed and had such confidence in our plan, but now I was doubting myself, and hating breastfeeding on demand. Eventually we found a midwife that would make us up a bottle of formula but I now felt I was doing the wrong thing by giving R a bottle. A different LC visited and heavily encouraged breast-feeding even though I kept mentioning the lack of longitudinal safety data surrounding my medications. My sleep debt was growing and so was my despair at our plan going out the window.

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On day three the baby blues hit, compounded by sleep deprivation, and I felt my attachment with R withering away. I didn’t want to touch them or look at them or tend to them because every cuddle had now become about providing food – and it hurt, and I struggled with the latch, and I was so so worried about how much of my medication was coming through in my milk. Expressing so often encouraged my milk to come in, big time, and soon I was painfully engorged and living with ice packs down my bra to deal with the excruciating sensations. I was not coping.

 

Day four came and I was officially a mess. The tipping point came when I sat on the bed watching my husband have a long, warm, stress-free cuddle with our baby while I was hooked up to the pump feeling like I was going to pass out from lack of sleep. I began to cry in that ugly-cry way you do when you feel like you’ve hit bottom. My husband began to cry too. And this is where one heroic midwife entered the picture.

 

Jill* walked in at that exact moment to do some observations, and seeing our faces and our tears, nestled herself into the armchair by the window and asked “what’s happening?” I explained how tired I was, how this was never our plan, how much I hated pumping, and how I felt I was losing my attachment with my baby and it scared me. She listened as I spilled forth my distress in an angry rush, and paused, considering my words carefully and choosing her own just as carefully. This after all was a Baby Friendly Hospital and she was supposed to recommend breastfeeding.

 

She told me then the following: breastfeeding is not motherhood. Motherhood is about so much more than how we feed our babies.

 

She then went on to recommend I stop breastfeeding or dial it right back, and switch to formula. She said it was time to take the stress out of feeding and that I really, really needed to get some sleep ASAP. She also said she was going to call one of the obstetric doctors and someone from the psych team to come and talk to me because she was worried about how things were going mental health wise for me.

 

The doctor came first after being called and brief on the situation, and there are no words to describe how negligent and inadequate she was in how she handled her care of me. When she walked in I was curled up under the covers, having cried continuously for hours and still going.

 

She tried to get my husband to leave the room (which by instinct I didn’t allow – and am so glad I didn’t). He sat close by, holding R and listening. She then launched into a rehearsed sounding spiel about why breastfeeding was best for babies and why formula was detrimental. I felt myself inwardly curl away from her – she was not here to help, it was very clear. I said I needed sleep, I was not coping and she replied in a patronising tone “you do know that someone needs to feed the baby every four hours, whether you’re breastfeeding or using formula, don’t you?”

 

What a ridiculous, insulting question – as if I had intended to starve my baby? As if I didn’t have a perfectly capable partner sitting beside me, also quite able to hold a bottle and feed our child? Clearly, in her view, feeding was entirely the responsibility of mothers. I was pretty pissed off at that point, which only intensified when she turned to my husband and said “and how do you feel about your wife stopping breastfeeding?” My husband arched his eyebrows so high I thought they would pop off the top of his forehead, and replied bluntly “I feel like it’s her choice, not mine.” She then read some compulsory questions in a bored tone off a piece of paper like “have you had any thoughts of harming yourself or your baby?” and then when she’d ticked all her boxes, she left. I was in even worse shape, now full of rage.

 

Then someone visited me from the psych team. He was wonderful. He suggested that formula was the best, safest option at this point and he pieced the last week together for me. The long labour. The three days with no sleep or food. The difficulty breastfeeding, the stress from pumping, the concerns about medication, the continuing lack of rest…as well as worries about our baby being jaundiced and having some investigations on a sacral dimple over their lower spine (all of which turned out fine). With all of this laid out, he said it was understandable that I wasn’t coping.

 

He and our midwife Jill suggested that we send our baby to the Special Care Nursery overnight so we could both “reset” ourselves with a full night of sleep. We were both pretty horrified by the suggestion that we have our babe removed from our care so young…and I felt like a failure for things having gotten this far. I didn’t want to agree to this. We both initially said no. Eventually, after a lot of discussion, we agreed – knowing that if we didn’t, things would probably get worse.

 

Leaving my baby in the nursery that night with the very kind, gentle nurses who would attend to R while we were apart was easily the hardest thing I’ve ever done. After nine months of fearing I would lose them, of thinking miscarriage or stillbirth would rip us apart, it had turned out that my mental health (or so it felt in that moment) was what had done it. I sat clinging to R before walking away, unable to look at or speak to the nurses with fat hot tears rolling down my face. How had we gotten here? Once we were back in my room I was given two sleeping tablets to calm me down and sent to bed to sleep. We picked R up at 6am the next morning, practically sprinting back to the nursery.

 

Now with some sleep under my belt, I was able to function again and advocate properly for myself. Everything looked better and I could think clearly for the first time in about a week. I knew then that I wasn’t going crazy; this wasn’t my fault. It was about the feeding and the sleep, it wasn’t about me.

 

After that everything improved. Another wonderful midwife – Harriet – took to the task of teaching us to bottle feed properly, showing us tips and tricks to do it well. We researched, we read, we tried to learn what we needed to know to move things forward and away from the dark place we’d been in as a family and to right what had felt like a sinking ship. Jill had barred the useless second LC from visiting again and unhelpful people were kept away. My fantastic parents wholeheartedly backed our decisions, and gave us lots of pep talks.

 

We’ve been at home for two weeks now. We are formula feeding 95% of the time, but I sometimes breastfeed because I want to, for a burst of ten minutes a day, once or twice a day. I lay down on the bed to do it, as it makes for an easier latch. I stop when I get frustrated, because that time is precious and intimate and I do not want it to be marred by anxiety. Such tiny periods of time also limit any effects from my medication and mean my supply is slowly fading away, and I’m getting my head around that. I know it’ll stop eventually, and I’ll find a way to be ok with it. I’m working on my bottle feeding technique, and using that time for attachment, looking into their eyes, kissing them, chatting to them. Just getting to know each other.

 

Reflecting now on the turbulence of that first five days, and how it nearly wrecked me, I am overwhelmed with both anger at some of the care I received around feeding, and gratitude for the midwives who stepped out of line with hospital policies to connect with what was really going on, and helped me. There’s a Carl Jung quote which feels so apt here – “Learn your theories well, but put them aside when you touch the miracle of a living person.”

 

If only more health care providers could set aside their theories when they touch each mother’s nuanced, lived experience, so many more women would be flourishing as mothers rather than falling apart. Hell, if they even just read the file, that would be a start. As it is, I’m going really well now, and repairing the hurts my bond with my child sustained in that first five days. It could have been very different for me if it hadn’t been for Jill though; and this is what is core to my story.

 

Every midwife, every doctor, every LC, should be like Jill. Promoting feeding that sustains and nourishes the child, the mother, and the bond between them – not forcing both of them into a slow-motion train-wreck neither may survive. Thank goodness for the rebels. Maybe one day they’ll be the norm.

***

Share your story, Email me at formulafeeders@gmail.com

 

FFF Friday: “We will bond no matter how she is fed…”

Earlier in the week, I shared an expert’s perspective on the emotional and mental health impact of formula feeding. Megan’s story feels like the perfect corollary to the insight offered in that post; a raw, brave account of mental illness and how this illness influenced a truly informed decision not to breastfeed. 

It is so incredibly humbling to get stories like the one below. The fact that you trust me and this space enough to share them here is not taken lightly… and while I hate that any of you even have to write these heartbreaking accounts, I can’t help but celebrate your resilience and willingness to speak your truths in the hopes of helping others feel less alone. 

So thanks, Megan. And thanks to all of you who share and read and participate – you are all amazing.

Happy Friday, fearless ones,

The FFF

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Megan’s Story

During the summer of 2014, I spent two months separated from my husband.  I took our 4 kids, packed up and went to another state to stay with my parents.  Things were pretty tough.  Traumatic would put it mildly.  But there’s a happy ending.  We both desperately wanted our marriage to succeed.  With blood, sweat and tears on both sides, we reached a really good place by the end of the summer – a fantastic place, even!  That fall, reunited both physically and emotionally, we finally made significant progress in so many areas of our lives that we had been struggling to move forward with over the decade of our marriage.  We remodeled our house (which we bought bank owned and in need of repair).  We instituted family rituals and routines that we had always wanted in place, but never quite could manage because we often couldn’t be in the same room with each other – hurt feelings make it hard to pretend that everything is fine.  But mostly, we both felt very strongly that there was another child ready to come to our family.  It was a very exciting, exhilarating time.  And a very anxious time.  Things were still so new.  We had just demolished the foundation our entire lives had been built upon for the last 11 years, and our new foundation was yet to be truly tested.  We were about to do just that – and how.

 

The day after my birthday in September, I started what would be my last menstrual cycle.  We were so thrilled!  This baby was figuratively and literally a symbol of our renewed and healing relationship.  Hope for the future of our family.  Evidence and a symbol of just how far we had come, of the new life we had brought to our union.  I was basking in the glow of being pregnant again.

 

Eventually, however, elation began to give way to a gradual sinking… At first I just thought it was exhaustion from first trimester blahs’.  But as the days began to grow shorter, and colder, we began to see that this was depression.  Depression wasn’t something foreign to me.  I had struggled with major postpartum depression with 3 of my 4 babies, with depression in-between postpartum periods as well.  I had a history of childhood sexual abuse, though, so I mostly attributed my depressive episodes with my work to resolve the effects of that abuse.  I kept figuring “once I get past this issue, I’ll be able to move on with a normal mood”.  Grieving and untangling trauma can be very difficult, and often looks like depression.  As we neared December, however, I hit a new low, even for me.  I went from being just fine and functional in the morning, to being so low that afternoon that I began thinking not just suicidal thoughts, but even thinking that my children would be better off being spared the agony of living with such a mother.  I thought to myself, “I can see how those mothers end up drowning their children in the bathtub.  I can see how that would be merciful”.  Then I wondered, as I brought up the image of the logistics in my mind, how you would drown multiple children, and what would you do with the bodies?  If you did them one at a time, they would freak at seeing the bodies of their siblings…..”  OH MY GOD!!  Did I really just think that???  Right as I thought that, the very clear phrase came into my mind “I need medication”.  That snapped me out of it, and gave me a surge of energy and forward momentum to act on a solution.

 

I reached out to my husband.  I told him he needed to come home.  I was shaken, I was ashamed, I was afraid.  What was happening?  That was NOT like me.  What was going on?  I couldn’t wrap my brain around it, but I knew that this couldn’t happen again, something had to change!  Dealing with things in psychotherapy wasn’t addressing this issue.  What else would??  Could medication really help?

 

 

Near the end of the two months I’d spent at my parents, when things began to calm down and my husband and I had a solid timeframe and plan for our reunification and going back home, my mother sat me down and had a talk with me.  That summer she was finishing up her rigorous PhD program in psychology.  She later said she was too close to the situation to be able to see it clearly for a time, but by the end of the summer, she finally had drawn a few conclusions that put the pieces together.  She read me the DSM-V definition of Bipolar I.  I was crushed.  I fit the description to a t.  I didn’t want to believe it.  Bipolar meant something was wrong with me, and I didn’t want to own that.  That was shameful.  And it meant I had a part in the separation, and I wasn’t the innocent victim.  I needed to be the innocent victim, and I needed him to be the perfect bad guy.

 

Fast forward again to that dismal and garish December.  At this point, my mother’s conversation came back to me in vivid detail.  Maybe she was right!!  A sense of relief washed over me.  This wasn’t my fault!!  I can do something about this that would actually work!  Exercise wasn’t cutting it, praying and reading my scriptures diligently wasn’t cutting it, having a close connection with my husband wasn’t cutting it, having good friends wasn’t cutting it… But if this is bipolar and not just me not “trying hard enough”, then I could see a light at the end of the tunnel.

 

So, at 20 weeks pregnant with my 5th child, I was officially diagnosed with bipolar I disorder, and began taking lamotrigine.  It pulled me out of my depression!  What elation, what relief!  Of course, I obsessively looked up and read every scientific study I could get my hands on, and I was very worried about the effects on my baby, but most studies concluded that after the 1st trimester, baby was at relatively low risk.  Then I began to notice a ramping up of anxiety.  It started gradually, but I began to notice feeling really great, and very productive, but increasingly I began heading toward fully anxious, crawling out of my skin feelings.  And then I realized, 3 weeks in a row, getting to the point where I was becoming paranoid again.  That was enough.  I went back in to my doctor and pretty much insisted he start me on lithium.  I was 32 weeks pregnant.  It helped!  I was so excited, and the case studies on lithium said that as long as baby didn’t have any troubles eliminating or getting dehydrated, that as far as they could tell, lithium didn’t have any measurable side effects.  Yes, they knew it was transferred to baby in breastmilk, but didn’t really see consistent harmful effects.  I felt comfortable with those odds.

 

Then came the day, at 37.5 weeks, when I began to wonder how the hormones of breastfeeding would impact me postpartum.  My biggest fear was having a major mood set back after birth, and for good reason.  I had a very clear history of it.  And, the medications were still helping, but I wasn’t actually feeling rock solid stable yet.  I still was having some ups and downs, just not so extreme.  All the research said that breastfeeding was protective against PPD, but nothing was said about bipolar.  So I asked my psychiatrist and my OB what their clinical experiences were.  They both said that almost universally, when moms are having postpartum mood issues, they fairly immediately improved after ceasing to breastfeed.  Clinical experience has to account for something, doesn’t it?

 

I think the biggest reason I could see their point and trust it was that not even a week before these discussions, I had about 4 hours of “warmup” labor, and it put me into a manic place, followed a few days later by a depressive place.  We increased the dosage of both my mood stabilizers, and that noticeably helped.  So when both my providers agreed with each other about stability and breastfeeding in my situation, I whole heartedly could see their point of view.  If I wasn’t even mood stable before birth, what would be the after birth chances when things really got screwy with my hormones?  It also occurred to me that my psychotic episode the summer before happened while I was still breastfeeding my one year old.  They were right.  Breastfeeding was not the option for me if my main goal was emotional stability.  I was crushed.  And peaceful.  And then obsessive about ordering just the right bottle feeding supplies.  And then crushed.  And then peaceful.  And then obsessive about looking up research to tell me that my doctors were wrong and I could actually breastfeed and I would be able to stay mood stable at the same time….

 

And then my shipment of bottles, pacifiers and all things formula feeding came in.  I could barely look at the unopened amazon box for a few hours.  I placed it on my couch where it could torment me every time I passed it.  Then I’d have a good cry, and busy myself with something to forget it.  Then I finally screwed up enough courage to open the shipping box.  Then I had a good cry, but left all the bottles and things in their original packaging – I wasn’t really going to use these, was I???  Eventually, after enough tears and grumpiness, I decided I would stop thinking about it.  I invited my older daughters to help me open them.  They were thrilled.  They wanted to touch everything, suck on everything (of course) and figure out how everything worked. Bottles and pacifiers are definitely a novelty in our home.  To this point, the only bottles I had ever owned always lived safely covered in thick dust in the cabinet above the fridge (you know, the useless one you can never get in and out of because it’s too high and you always have stuff on top of your fridge in front of it?).  Boy is this a change.  It did comfort me that the small size bottles, when I held them up and imagined feeding my baby from them, felt very close…. Like maybe I could bring baby really close to me like if I was breastfeeding.  Bottles and pacifiers safely in the dishwasher and ready to be sanitized, I needed a good cry again.

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And why was I crying?  I had hope for stability.  I was making choices that would not only benefit my new baby, but all my children and my marriage too.  I was making a choice to skip the living hell that is the ups and downs of bipolar – a choice that would afford me the chance to be in the world of people, living in the moment and enjoying that living.  Bipolar depression is completely exhausting and isolating, and bipolar mania is terrifying and crazy making because you can’t trust your gut or calm down enough to take in the moment.  Why would I want that?  Wouldn’t I want the best thing for everyone I love, including myself?

 

That night, my husband held me while great sobs wracked my frame.  I didn’t want to grieve.  I didn’t want to have to grieve.  I didn’t want to need to grieve.  I wanted to just treat this as a matter of fact, and then move on.  Grieving is scary – what if I get going and can’t stop – what if it’s not actually grief but just that ugly old depression again?  I felt broken, helpless, like a failure… Why did I have to be bipolar?  Why couldn’t I be stable?  Why did I need medications?  Why weren’t they working better yet?  Where was the line between a normal emotional response and a bipolar swing?  In truth, I don’t think they can really be distinguished, after a point.  The feelings are there either way.  The options are learn to sit with it in a way that isn’t destructive, or adjust medications.  After my intense crying session, I felt better.  That was a good sign that this was grief!  But grief usually comes in waves. I woke up the next morning after nightmares about having to bottle feed next to my breastfeeding friends.  I felt so surreal, to be bottle feeding – and horrifying.  I got up, sad and even angry.  Angry that this is my situation.  Angry at myself, angry that this is just part of living and having a body.  I’m grateful for my body and the children I have been able to conceive and give birth to, and the four I was able to breastfeed, even if it was a great struggle for my mental health in every postpartum period.  I’m grateful for this baby too – this little miracle child of the seaming back together of my marriage that was hanging by a thread only just one year ago.  And I feel raw.  I don’t want one more thing put on my plate that I don’t feel I have the capacity to do and do well.  I don’t want to see anyone pregnant and brimming with excitement about breastfeeding.  I don’t want to imagine them taking their brand new baby onto their chest, and having their baby root and suckle.  I don’t want to imagine that and a hundred other images I have in my head from my own babies.  I just want to fall down face first and sob until I have no strength left to sob.   And I want to not have to sob, to be able to either breastfeed, or get over it.

 

So why is it so emotional?  Why can’t I just “get over it”?  I never realized how much of my self worth was wrapped up in my ability to breastfeed, and ultimately in my capacity for perfection.  Good mothers feed their babies, but the best mothers know that “breast is best” right?  Good mothers know that emotional stability and consistency are keys to raising well-adjusted children, but the best mothers are just born with that natural ability.  Good mothers often sacrifice and put their children first, but the best mothers never have needs of their own and can endlessly give whatever their children require without resentment or burnout.  Wow.  What a load of distorted thoughts!!!  Does any of this sound familiar to you?

 

The truth is – the best mothers recognize their limitations, and plan for them.  The best mothers accept reality, get help, surround themselves with supportive people, and don’t try to brute force themselves into good mental health through sheer force of will and determination.  The best mothers recognize that breastfeeding, while extremely biologically engineered to create bonding, is not the same as bonding.  It’s a tool.  Bonding is a choice – one that continues through the child’s entire life span, and has many stages and phases.  You can’t breastfeed your teenager back into a close relationship with you if you haven’t stayed close through his earlier childhood and tween years…..  The best mothers understand that our imperfections are gifts to ourselves and our children.  Seeing that we aren’t perfectly put together all the time lets them know that it’s okay that they aren’t perfectly put together all the time either.  It gifts us all a sense of “we’re in this together – I’m ok, you’re ok”.  Which brings the sweetest sense of safety, connection and reassurance I’ve ever known.

 

The best mothers know that when we love ourselves, warts and all, we are providing the greatest example for our children we possibly can.  An example of just showing up, being transparent, and having self-compassion and self-kindness.

 

And that’s why my bottles are currently sitting in my dishwasher sanitized and ready to be packed into my hospital bag.  That’s why I have histamines and decongestants ready to go to dry up my milk supply.  That’s why I have a list of friends and family who have agreed to help support me after birth.  That’s why I’m still taking my mood stabilizers.  That’s why I’m going to finish writing this, and then go enjoy the last precious days of being a family of only 6, before our world changes to welcome our new one.  She’s precious no matter my weaknesses, and we will bond no matter how she is fed, because I will be emotionally stable enough to enjoy her.

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Want to share your story? Email me at formulafeeders@gmail.com.

Mothering Through the Darkness

Throughout the publication process for Bottled Up, there was a lot that ended up on the cutting room floor (um, like my entire first draft). I’m incredibly grateful to my editor, Naomi Schneider, who turned what was basically a disgustingly navel-gazing account of my own breastfeeding struggle into a serious, research-heavy social commentary. But one thing I do regret is that much of my struggle with postpartum depression was removed from the final manuscript, because as years go by, I become more and more passionate about the intersection of breastfeeding and postpartum mood disorders. I think it’s easy to dismiss anecdotal evidence of women claiming that breastfeeding provoked or exacerbated their PPD or PPA, until you’re faced with the bloody, exposed guts of what this actually looks like. The more we speak out about our experiences, the more people will (hopefully) listen and consider what the pressure to breastfeed is doing to the collective mental health of mothers. MOTHERINGTHRUDARK-1

That’s a big part of why I’m bouncing up and down with excitement today, as the announcement for the next HerStories Project anthology goes public. Coming from SheWrites Press in the fall of this year, Mothering Through the Darkness: Women Open Up About the Postpartum Experience features a diverse group of incredible writers (including #ISupportYou co-founder Kim Simon and a forward by Katherine Stone, founder of Postpartum Progress) coming together to battle the stigma and silence associated with postpartum depression. I’m honored to be one of those writers, and my essay – “The Breast of Me” – details how intricately entwined my breastfeeding experience was with my postpartum depression.

As I said on the Contributor Page for the book,

“As soon as I delivered my first child, I felt a cloud pass through me, over me, erasing all happiness and hope. I remember them handing him to me, and thinking, ‘please take him somewhere safe.’ In the weeks that followed, I failed to breastfeed in every which way, and hearing him scream at the sight of me, at my incompetence, my inability to nourish him, reaffirmed what I already thought: I wasn’t fit to be a mother. This piece is about my first important lesson of motherhood: that in some circumstances, what society says is the right way to mother can sometimes be the absolute wrong way…

What I wish people understood about postpartum mental health struggles is that there is no blanket way to understand them or approach them. Sometimes it is hormonal, sometimes it is situational, sometimes it’s a combination of both. And for this reason, it is vitally important that we approach women as individuals. What will help one won’t help another. We need to do a better job of listening, and realizing the impact our media (and more importantly, social media) messaging has on vulnerable moms…

…The most important aspect of my recovery was giving up breastfeeding. It still took medication to truly resolve my depression, but I wouldn’t have been able to heal if I had kept on nursing. I needed the bodily autonomy, the lack of physical pain and dependence… I needed to be important to my son for my brain, and not my body. It may not make sense to most people, but that was what I knew I needed, and it was so hard to have nobody listen or respect that.”

 

I also want to share that HerStories Project is asking other mothers to step up and join the conversation, through a blog post link-up and social media blitz. My hope is that the FFF community – who include some of the most insightful, honest writers I know, if your FFF Friday essays are any indication – will answer this call and speak your truth. For more info, visit HerStoriesProject.com.

And no matter what, keep talking. Keep sharing. Because there’s always another mother out there, stumbling around in her own darkness, needing to know she’s not the only one to falter; needing other survivors to light her path.

 

 

Why The World is So Screwed Up About Breastfeeding Research, In Several Paragraphs & A Few Headlines

The headlines:

“Study: Breastfeeding can ward off postpartum depression” (Press TV)

“Breastfeeding mothers less likely to get postnatal depression” (The Independent)

“Breastfeeding ‘helps prevent postnatal depression'” (ITV)

“Breastfeeding could help prevent postnatal depression, says Cambridge researchers” (Cambridge News

“Breastfeeding ‘cuts depression risk’, according to study” (BBC

“Failing to breastfeed may double risk of depression in mothers: study” (Telegraph)

“Mothers who breastfeed are 50% less likely to suffer postnatal depression” (The Independent)

“Mothers who choose not to breastfeed are ‘twice as likely to get postnatal depression because they miss out on mood-boosting hormones released by the process'” (Daily Mail, UK)

“Breastfeeding Keep Mothers Happy and Reduces Postnatal Depression” (International Business Times)

“Breastfeeding moms have lower depression risk” (Health Care Professionals Network)

“Breastfeeding protects mothers from postnatal depression, study finds” (The Australian)

 

And the reality:

New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women’s Intentions.

Borra C, Iacovou M, Sevilla A.

Abstract

This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers’ mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers’ mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to.

In other words, women who wanted to breastfeed and did = low risk of PPD. Women who wanted to breastfeed and couldn’t = high risk of PPD. The researchers stress “providing compassionate support for women who had intended to breastfeed but…found themselves unable to”.

This does not prove that breastfeeding cuts depression risk. It proves that women who had a goal and met it tend to have lower rates of depression. It does not prove that there is a biological reason that breastfeeding may be protective against depression. That may indeed be the case, but then the depression risk would have been similarly high in women who never intended to breastfeed.

Our societal confirmation bias is so damn strong, that we blatantly overlook the finding that suggests something potentially negative about breastfeeding promotion. But here’s something to ponder: while we can’t force insufficient glandular tissue to produce adequate milk, or force women to breastfeed who don’t want to, we CAN ensure that every mother gets support in her feeding journey. We CAN listen to research that suggests the pressure to breastfeed is contributing to feelings of guilt, shame, and judgment – a potent trifecta of emotions for those prone to depression – and do something about it. If we are going to take this one study as “truth”, as so many parenting-related studies are mistakenly interpreted, something good might as well come out of it.

At this point, there is a pretty clear correlation between not breastfeeding and PPD. Instead of using this as ammunition against formula use, we could be asking the tougher questions: Why are women who don’t breastfeed more depressed? If it is something biological, wouldn’t the rates of PPD have been skyrocketing in past generation where breastfeeding was rare? If we stop making breastfeeding seem like the only-best-right choice to raise a happy, healthy child, would it mitigate this risk?

Source: http://en.wikipedia.org/wiki/Albert_Szent-Gy%C3%B6rgyi#Medical_research

Source: http://en.wikipedia.org/wiki/Albert_Szent-Gy%C3%B6rgyi#Medical_research

One of my favorite quotes about research comes from the Nobel-prize winning scientist who discovered the importance of vitamin C, Albert Szent-Gyorgyi: “Research is to see what everybody else has seen, and to think what nobody else has thought.” These days, the reverse seems to be true – research is to confirm what everybody else has seen, and everybody has already thought. This needs to change, and it won’t, as long as our society and media turns even the most interesting findings into self-confirming soundbytes.

 

Vital Signs: Ignoring postpartum depression and psychosis won’t make them go away

Another horror story. Another mom. Three beautiful girls who will never have another birthday, whose last memory will be terror at the hands of the person they trusted the most.

I don’t know the details. I don’t really want to know the details. I do know that this mother reached out, told her own mom she was “feeling crazy”. I do know that she had three babies in a row, and that the youngest was 2 months. I do know that there’s a strong chance that this was the result of postpartum psychosis.

And I know that this has got to stop.

Can we protect every family, prevent every case? Of course not. But postpartum mental health is taking a backseat when it should be sitting shotgun to every maternal and child health program. That’s a start, at least. We spend so much time worrying about a woman’s breasts, while we dismiss her mind. We worry about how hormones and birth practices affect lactation, while we disregard how they affect our emotions.

After we give birth, we are whisked off to the maternity ward. Our vital signs are monitored, but other vital signs are ignored. A mom who can’t seem to connect with her baby. Who is scared, and asking for help. Who is alone and voiceless. Her pulse may be steady, but her hands shake. Her breasts may leak colostrum, but her eyes may leak silent tears. And we ignore this.

GE-Healthcare-Dash-2500-v4-Vital-Signs-Monitor

OB/GYNs don’t see mothers until 4-6 weeks postpartum. In some cases, that will be too late.

Pediatricians see moms with their newborns several days postpartum, but they are focused on the infant. As they should be. We don’t expect a heart surgeon to be concerned with the diabetic foot of his cardiac patient’s wife.

When I see the role of lactation consultants and breastfeeding counselors growing, gaining more attention, more insurance coverage, I also see an opportunity. What if these professionals could be trained to screen for postpartum mental health issues, if they could recognize red flags and know how to refer families to the proper resources? What if they were trained to support families in their feeding journeys, with the goal being a happy, healthy family and not just a breastfeeding statistic?

With the state of our health care system, I don’t expect that an entirely new support staff can be instilled at every hospital, for the sole purpose of protecting maternal mental health. But when 1 in 7 mothers suffer from postpartum depression or anxiety, I think that constitutes just as much of a public health concern as the supposed risks of “sub-optimal breastfeeding practices” in developed countries. If we are going to focus so heavily on breastfeeding, could we at least give a little simultaneous attention to a mom’s mood while we inspect her breasts?

What happened to the Coronado family is sub-optimal. What passes as “support” for postpartum women is sub-optimal. There is no reason we can’t support breastfeeding while prioritizing maternal mental health. Both are important, but one has been systematically ignored, shoved under piles of paperwork, given lip service. We only seem to worry about postpartum depression in terms of how it affects breastfeeding “success”. There are so many things wrong with that sentence, with that mentality. It’s like worrying about prostate cancer only in terms of how it will affect sex and procreation. Biological norms are important, but support also means protecting those whose biology turns on them.

If we can only speak of maternal needs under the umbrella of lactation support, I can live with that. As long as those needs are met, I can live with that. As long as those needs are being met, maybe we can all live with that.

Survive with that.

Thrive with that.

 

 

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