Even before her daughter was born, Noelle knew she wanted to pump. “The idea of breastfeeding just made me uncomfortable,” she says. But after giving birth, she felt unmoored — and had zero guidance. “There was no lactation coach to come in to talk with me, even about pumping correctly,” she says. “I felt like I was on my own.” She took matters into her own hands, joining mom groups online and doing her own research about pumping. That’s when the pressure to breastfeed began.
As most of us have experienced, once you start searching for something online, “your social media just starts advertising things to you,” Noelle recounts, adding that she kept getting pop-up ads that encouraged breastfeeding, with photos and messaging that made it seem like the end-all, be-all. “You don’t see that kind of picture or emotional support behind pumping or otherwise,” Noelle says. That, along with comments from people who praised the benefits of breastfeeding, led her to eventually give in and nurse her daughter. “I felt like I couldn’t fight it anymore,” she says.
For Noelle, the switch to breastfeeding coincided with postpartum depression (PPD), which stemmed in part from a sense of overstimulation. “It was literally my brain’s inability to cope with being needed, being touched, having to calm her even when I’m at my limit,” she says. “Breastfeeding played a very big hand in it.” And she’s not alone. Breastfeeding and PPD have a unique relationship, according to Michelle Markowitz, LMSW, a licensed social worker who specializes in perinatal mental health. Here’s how they influence one another.
How Breastfeeding Influences PPD, And Vice Versa
The pressure to breastfeed starts early — whether you realize it or not. “From the time someone gets pregnant, we are inundated with messages from friends, family, social media, society, and strangers about what is best for the baby,” says Markowitz. “And, while there has been some movement in this space, society still tells us that breast is best.”
So, when you can’t live up to that standard, whether you set it for yourself or feel pressured by others to reach it, it’s understandable that you might feel guilt, anger, sadness, or inadequacy. “This can lead to a spiral of negative thoughts resulting in depression,” Markowitz says.
But there’s a serious lack of research on the relationship between breastfeeding and postpartum depression, says Markowitz. (As is the case with many things related to maternal health.) “Interestingly, some studies suggest that there is a bidirectional relationship between breastfeeding and postpartum depression — meaning that mothers who already exhibit depressive symptoms may also struggle to breastfeed as a result of their symptoms,” she says.
How To Determine What You’re Dealing With
Anyone who’s breastfed will tell you that it’s hard, especially for first-time moms: It can be painful, boring, exhausting, or all of the above. So the lines between struggling with breastfeeding and PPD can get pretty blurry. That said, “if mom is exhibiting depressive symptoms triggered by her breastfeeding sessions, it’s likely something more,” says Markowitz. These can include crying, lack of interest in doing things, feeling hopeless, lethargy, and changes in eating or sleeping habits, she says.
While experts consider onset and duration — when the symptoms start and how long they last — when they’re looking for PPD, impact is another piece of the puzzle. “What is the impact of the symptoms on the person’s daily functioning?” Markowitz recommends considering. “Does their mood change based on whether they believe the baby had a good feed? Does their worth as a person depend on successfully breastfeeding their child? Has the tracking crossed the line into what some might consider overkill or obsessive?”
Another thing to consider is mom’s general attitude toward breastfeeding. Is she excited to try or resentful? Does her mood change during or immediately after breastfeeding? “For me, it felt like an obligation rather than a sweet moment,” says Markowitz, who also experienced breastfeeding challenges and PPD firsthand.
For those who suspect that the pressure to breastfeed has turned into something more, here’s what to consider:
Name It
First, take a moment to think about how you feel about breastfeeding. “It’s so important to name it and acknowledge it,” says Markowitz. She likes the terms “complicated grief” or “ambiguous loss” to describe grief over losses that aren’t typically acknowledged by society. “As with other types of grief, time, support, and talking about it are going to help,” she says.
Switch Your Thinking
It’s not uncommon for formula to be framed as the second-best option. “But there have always been babies who couldn’t latch or moms who couldn’t lactate,” says Markowitz. Before formula, those babies may have struggled with their health.
Not only can formula be critical for the baby in that case, but forgoing breastfeeding can also take the pressure off mom — and if that makes her happy and healthy, then that’s what’s best for the baby. Markowitz was personally relieved to know that her baby wasn’t hungry all the time and recognized that feeding could be a positive bonding experience for both her and her son. “We can hold both,” she says.
Talk To Other Moms
Markowitz considers peer support to be invaluable. “I personally didn’t find it helpful to hear ‘You’re doing great’ or ‘You’re a good mom’ because I didn’t believe it,” she says. “But I benefited most from connecting with other moms who struggled with breastfeeding and postpartum depression.” Moreover, a strong support system is a major healing and protective factor for postpartum depression, she says — so there’s a twofold advantage.
Talk To A Professional
The pressure to breastfeed, especially when it’s contributing to mental health issues, can be pretty fraught and emotional, which is why it can help to have a professional on hand. “The number one thing is to talk about your symptoms with someone you trust, whether that’s a family member, friend, or therapist,” says Markowitz, who recommends The National Maternal Mental Health Hotline and Postpartum Support International. “You don’t have to carry all of this alone.”
That support ultimately made all the difference for Noelle, who found a new therapist who specializes in PPD. “Getting that help and being able to discuss those emotions and to discuss the way it made me feel — that was really a turning point for me,” she says.
Presented by BDG Studios
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