I love research.
I think it comes as part of the “I-have-an-anxiety-disorder” package that I research things obsessively. Getting a dog? Buy ALL the dog books. Having a baby? Spend hundreds of hours trawling through research study abstracts.
So when I saw a notice at the Reproductive Mental Health Centre looking for participants in a study on infant feeding in mothers with depression and anxiety, I volunteered. Why not give back?
Infant feeding and maternal mental health are slightly controversial topic. Research has shown that mothers with post partum depression are more likely to be formula feeders than breast feeders.
What no one really knows is which causes the other.
Does breastfeeding make you happier? Does formula feeding make you miserable? Or does post partum depression just wreck your chances of breastfeeding success?
This last possibility is supported by the fact that many women report the onset of PPD before the cessation of breastfeeding.
The researcher I spoke with was an OB-GYN. She wanted to know how doctors could support women in breastfeeding.
Of course she did.
The medical profession and the Canadian government have a lot of reasons to want women to breastfeed.
One of the quirks of living in a place with socialized health care is that the government really WANTS you to be healthy. Every time I go to the doctor, including my shrink, the government gets invoiced. A healthy population saves Canada money, so they really, really push the doctors to push breastfeeding.
The hospital where I planned to have my baby gave me a bunch of forms to fill out beforehand. I swear, there were at least three pamphlets on the benefits of breastfeeding. They also had a disclaimer form that I would have had to sign if I wanted to pursue formula feeding. The gist of it was “Yes, I know that formula feeding EVEN ONCE will give him cancer and obesity and lower his IQ but I WANT TO DO IT AGAINST ALL MEDICAL ADVICE.”
I’m not the only one who finds it a little extreme. Hodgepodge over on the East Coast, who has breastfed all three of her children, is infuriated by the lactivist attitude of the public health sector.
Since the government foots our doctor bills, they are really motivated to endorse preventive medicine. Heck, the hospital where my son was born made you sign a waiver before they would let a bottle touch your baby’s lips.
Some women I know even feel that the hospitals are getting too pushy about it. It’s one thing to educate parents about the benefits of breastfeeding, it’s another thing to harass them about it, or to refuse to help mothers who cannot breastfeed for legitimate medical reasons (mastectomy, incompatible medications, etc).
So why is it that while almost all women at least start breastfeeding while in the hospital, only a quarter of them are still doing it by the time the baby is 6 months old? I don’t think the answer is “because we aren’t pushing them hard enough”.
- Did I always plan to breastfeed?
- How did the initiation of breastfeeding go?
- Did I find it difficult?
- Did I feel supported by the medical staff around me?
- How could they have helped me more?
Their study was qualitative, rather than quantitative, so I wasn’t just a number. They were looking for answers. They wanted to know how they could help. And I had thought about this. A LOT.
Breastfeeding can be a touchy subject.
Some breastfeeding proponents (who I call “Lactivists”) can be extremely negative towards the formula-feeders of the world. This, in turn, makes formula feeders defensive.
I frequently see battles online between the Lactivists and the Formula Moms. So one day I ran a poll in my favourite online forum. This took place shortly after a big blow-up regarding the subject, and I started to want some answers.
So I asked women about their experiences with breastfeeding, and I discovered some interesting statistics:
- Out of 70 respondants (most were from the United States or Canada), 98.5% at least tried to breastfeed. Some did it because they considered that the normal way to feed a baby – they had seen their mother do it, or someone else’s mother do it, or (like me) were simply told that that is how babies are fed. Others grew up thinking of formula as the “normal” way to feed a baby, but decided to breastfeed after they learned more about it. That tells me that the message is getting through.
In a way, this is good news.
It tells me that the “breast is best” message is getting through. People know that they “should” breastfeed. Even women who grew up thinking of bottle feeding as normal had their minds changed by their friends, their doctors, their prenatal classes, or their baby books.
But I discovered a more disturbing statistic:
- Of those women who were raised to see breastfeeding as normal, a whopping 92.5% were successful in exclusively breastfeeding at least one child to six months of age and beyond. But women who grew up unaware of breastfeeding, or had gained a negative perception of it (thought it was weird, heard negative remarks from adults, etc), only 67% were successful with at least one child.
That’s quite a disparity.
The two groups of women were pretty evenly split down the middle, but their success rates were wildly different.
I think it is telling that almost all of these women, no matter how they were raised, still tried to breastfeed. But it seems that the attitudes you were raised with can really affect your chances.
Why?
The odd thing is, when asked why they had not been successful, 88% of women from both groups cited a difficulty with supply or the baby’s latch. Some (American) women found breastfeeding incompatible with working full time – they simply couldn’t pump enough, which again came down to supply. This wasn’t a problem among Canadians, since we get a year’s maternity leave.
So, if the primary reason for giving up breastfeeding is physical, why should childhood attitudes make a difference?
I think that if we knew the answer to this question, doctors would have the key to increasing the number of breastfeeding women in the world. Clearly they are currently going about it the wrong way.
Where do you stand on the breastfeeding spectrum? Why did you stop or why did you decide not to start in the first place?
This is an original post to World Moms Blog from our researching, breastfeeding, anxiety-prone mom in Canada, Carol, @If By Yes.
The image used in this post is credited to Raphael Goetter. It has Flickr Creative Commons attribution license.
Carol (Canada)
Carol from If By Yes has lived in four different Canadian provinces as well as the Caribbean. Now she lives in Vancouver, working a full time job at a vet clinic, training dogs on the side, and raising her son and daughter to be good citizens of the world. Carol is known for wearing inside-out underwear, microwaving yoghurt, killing house plants, over-thinking the mundane, and pointing out grammatical errors in "Twilight". When not trying to wrestle her son down for a nap, Carol loves to read and write. Carol can also be found on her blog, If By Yes, and on Twitter @IfByYesTweets
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Thanks for posting this. I just gave birth to my second son. I breast fed my first for 2 years. Didn’t plan on it but ended up loving it, he was reluctant to give it up and I was lucky enough to have him in daycare in my work building, so I wasn’t tied to the dreaded pump.
This time around I’m feeling the pain yet again of feeding. It was at least six weeks of searing pain and cracked nipples, so i can see why people give up on it. Maybe the support isn’t needed so much at birth but with home visits for weeks afterward (incidentally when moms probalby need emotional support as well). The only reason I endured is because I had a lot of supportive women around me who told me to hang on and that the pain would go away.
In terms of the debate: I think the best and most even-handed advice I”ve gotten is: “formula is not poison!” In fact, I was raised on formula (I’m one of a set of triplets) and turned out pretty well -adjusted. There’s also this very good article by Hannah Rosen in the Atlantic called “the case against breast feeding” that generated a lot of discussion but I made me re-think things a lot. It’s worth reading!
In the end, as long as all women have good information, I think they should be free to make their own decisions. And to NOT be judged for it.
I think you’re absoultely right about the home support. I suspect this may be a key factor in explaining why women who come from a breastfeeding background are most likely to be successful… if your mom has done it and can help you through it…
I agree — the home support is key!
Canada sounds very similar to Norway – breastfeeding is the only option, and there is a warning on the formula bottle that says you should consult a dotor before giving it to babies! But as I had problems breastfeeding they did give him cups of formula at the hospital. I felt so guilty whenever I gave him a bottle, but after 3 months of trying I finally stopped breastfeeding, and only gave bottle, and luckily my GP supported my decision :/)
Wow, we don’t have the label yet, but I can see that happening some day soon.
I’m in Canada too…I am about to find out how all of this will impact me and my family. I am returning to work next week, and hubby is 100% sure that by the end of March I will be fed up with breast-feeding. Rainbow is 15 months so I am not stressed about it, but I can see how so many families feel pressured.
Are you serious about the waiver? Wow.
http://chasingmyrainbowbaby.blogspot.com
Breastfeeding when I went back to work has not been a problem. The amount has cut way down, but I don’t see getting rid of it any time soon! On the other hand, I can’t imagine going back to work with a baby who is still 100% dependant on milk.
Great post! I get very sensitive on hthis topic as I did have severe ppd that set on almost immediately after my sons birth. Breast feeding was complete hell as I slept only one hour a night the first two weeks, started to hallucinate and lost 40 lbs in a month. I had to quit breast feeding but the guilt I felt was so intense that I struggled until I got to my breaking point where my body collapsed from severe sleep deprivation and my hormones where out of whack. Finally I caved in and quit at six weeks, fed my son a bottle and regained my life. I was bottlefed too since my mom had a serious kidney problem and couldn’t nurse us and I am very healthy. Yes breast is best but in some cases where the moms health and life are at stake you’ve got to quit. I had my second child without Ppd thankfully and nursed her happily until four months. I quit for more me time and dont feel guilty or regret it one bit as I was able to remain the loving, happy mom that I am even with a bottle . It is such a hard topic but I really think that people shouldn’t judge what a mom does as long as she is doing what is best for all. It is also insane that mothers in the US get only three months off! I can’t imagine trying to breast fed and infant and be working at the same time.
I’m sorry to hear about your first experience. Now, research has proven that women who suffer PPD are much less likely to be successful breastfeeding – OR (and they aren’t sure which) – that women who are succesful breastfeeding are much less likely to be depressed. Hence the researcher’s interest.
Tell me – having experienced both, can you tell me – do you think the PPD impeded breastfeeding or that the poor breastfeeding experience prompted the PPD?
Good question. I think my PPD was completely unrelated to breastfeeding. I got it almost instantly after birth. I was on bed rest for a month before completely isolated and that is when I started getting anxious about the birth. THus looking back I believe I started getting the symptoms before the birth, had a hard labor and then had a baby that nursed every hour around the clock. After two weeks, I was in full blown PPD. The breastfeeding made my situation worse because it required more hormones and took everything out of my body. I didn’t get enough sleep either. Thus to answer your questions, I think I developed PPD unrelated to breastfeeding but in my case it made it worse. I would think that some women who have issues with breastfeeding may develop it but in my case it was different. Interesting post! Hope this answered your question.
The first time around, I found breastfeeding really difficult, so I sought out a lactation consultant that I met with 3 times after coming home from the hospital. I wouldn’t have been able to breastfeed, I believe, without her. I also was so super curious that my body was made to do this, so I was determined to at least figure it out.
I was a formula fed baby, so I knew my baby could survive on formula, but after reading all the benefits of breastfeeding, I wanted to give it a try. It blew my mind that my baby could get a virus, pass it to me in a feed, and then I could in turn create the antibody and pass the antibody back to the baby in the next feed. What??
I made it to 9 months of breastfeeding (with solids introduced at 4 mos.) and fully weaned at 11 months with my first. With my second, breastfeeding came easier, and it was quicker and more convenient. No matter what though, the first 2 months were trying with the pain both times around, but once that subsided, I had milk everywhere I went, and no bottles to clean. I wound up not pumping out of convenience the second time around. This Saturday will be a full year of breastfeeding my 2nd, which also blows my mind!
I’m an advocate of breastfeeding, IF it works for you. I’ve read Nicole’s (Melancon) PPD posts before, and when I hear about her PPD experiences, it tears me up inside that she, along with many mothers have had to have had to go through PPD, had to deal with PPD on top of everything else after giving birth.
I don’t know how Nicole could even make it as far as she did in breastfeeding with everything she was going through with her health. And if you read anything about her life story, she is not one to shy from a challenge or adventure and she has a super strong character. So, if a woman such as herself struggled with breastfeeding, then mothers who have done it cannot possibly assume that everyone can and should breastfeed. And, women who did not have the obstacles that Nicole was hurdling, may also find breastfeeding unbearable and stop for their own reasons. It is a personal choice.
So, my point when it comes to breastfeeding, is that different women go through different things after birth — PPD, no support after the hospital, other family or financial stresses, health concerns for themselves or their babies, pain tolerance, etc. Any one of these factors on top of recovering from birth and taking care of the many needs of a newborn makes breastfeeding challenging.
As a mom, I would tell my daughters if they have children, that I breastfed, let’s look at the pluses or minuses to it in their time in the future, and they can decide for themselves what works best for them. A healthy baby AND a healthy mommy are what is important, both physically and mentally! THAT is the priority. 🙂
Jen 🙂
Very interesting article.
I planned to breastfeed my son from early on. The fact that I got a severe pre-eclampsia when I was pregnant resulting in two hospitalizations and one whole month of strict bed-rest after my diagnosis followed by the emergency c-section when I was 35 weeks may plays some roles in my undiagnosed PPD. I said undiagnosed because I didn’t even know there’s a name for how I felt back then until the marriage counselor pointed that out to me after my marriage fell apart.
Anyway, back to breastfeeding…I was asked to pumped right away after I can wiggle my toes following my emergency c-section. During my stay in the hospital for a week after my son was born I was pumping and breastfeeding. Unfortunately, he lost a lot of weight and we were told to supplement with special formula. .
So we did just that along with breastfeeding and I breastfed him for 8 months until he decided to quit lol. Breastfeeding was difficult at first but I enjoyed the quiet moment where on our rocking chair.
Thirdeyemom, I can relate…to the anxiousness. I was a nervous wreck after dealing with severe pre-eclampsia and the bedrest.
I wanted to breastfeed so badly. My oldest, now almost 8, was an emergency c-section 15 minutes after an appendectomy. I didn’t even get to see her for over 24 hours after she was born. My body did not respond well to pumping and I wasn’t allowed take her out of the incubator to breast feed. My milk didn’t come in until almost a week later and then I was lucky to produce an ounce or two at a time.
My 2nd and 3rd children were different. Still c-sections but less traumatic. My milk came in right away and for the first 2 weeks I had enough supply and could even pump an extra ounce or two afterwards. Once they started needing more I couldn’t keep up. Because I couldn’t keep up I would tape a tube attached to a formula bottle next my nipple so they could get both and hopefully my supply would catch up.
After 6 weeks I started to dry up. I got so depressed about not being able to successfully breastfeed. My lactation consultant told me that my depression would likely negatively impact my supply. I ended up quitting, both times, by 9 weeks.
I wanted to so badly and I loved the experience, the closeness. Even now that my youngest is 4 just thinking about it makes me ache.
I decided from a very early age that if I ever had children, that I would breast feed. I was determined (and I am incredibly stubborn and strong willed) to make it work. When my son was born, via c-section, I started to try to nurse. I had never been warned of the pain that went along with it and was so surprised at how difficult it was. He nursed round the clock, and within the first few weeks I had an infection, and I was in so much pain, that my mother went out and bought a case of formula (which only made me even more determined to succeed). I basically had the lactation consultant on speed dial, and even though I never had an at home visit, even having her on the phone helped. I knew that formula feeding was ok (my mother formula fed us – she said she wasn’t a cow 🙂 ), but I really wanted this to work, especially after hearing all of the benefits. I am pretty sure that I was suffering from PPD at the time, but never saw anyone for it. And I am pretty sure that the hard time I had breastfeeding did not help the situation. Eventually (after about 2 months) it got easier, and less painful and ended up nursing him until he was 16 months old, at which point he had enough of me. 🙂
With my daughter, it was so much easier. Much less painful. She latched on right away after birth, she was born on her own 3 hour schedule (making the hospital stay much more pleasant for me). I don’t think there was anything close to PPD with her, and at 20 months old, she is still nursing (albeit only once a day, first thing in the morning when she wakes up).
I should also mention, that with both of them I went back to work after four months, and pumped (which I hated), but that stubborn streak in me kept me going. I think that going back to work helped to get me out of my PPD funk though, even though I had to deal with the dreaded pump.
Wow, what an experience! Kudos to sticking it out!
Way to prompt a great discussion! I breastfed both my boys for just a few months and then stopped….for me. While technically it was working, I really struggled with keeping my milk supply sufficient and getting the rest I needed. In the end, weaning them helped me to be my best… for them. I felt alot of guilt about what I “should” be doing and quitting for what felt like selfish reasons. But in the end, they are happy and healthy, as am I. I totally support breastfeeding, but I also support moms doing what works best for their household. Great post!
I agree with Maman Aya about the pain part – I had heard so much about the pain of childbirth but never the pain of breastfeeding! With my first son my right breast hurt intensely for the first two months and also bled some. I remember I had a pain in my jaw from grinding my teeth while he was on the right breast. However, I really wanted to breastfeed him for a long time as I myself had only been breastfed for 3 months. I didn’t really have a reference as to how long, so I decided to follow the WHO recomendation of 2 years. When I started to wean him he got ill and I extended it to 25 months. Today I regret that decision – I think he was not ready and part of me wanted to continue, but our families pressured me saying he was too old and would be too dependent. Now with my daughter, she is 14 months and still at it. I plan to go on as long as she likes this time, although I don’t think I could do it past 4 years!! 🙂 It didn’t hurt as much with her, but the challenge was that she bit a lot after her teeth began to appear (something that my son rarely did) and it is quite painful. Fortunately she doesn’t do it as much anymore.