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Katherine's avatar

Thank you for writing this and for all of your nuanced and thoughtful work on this topic.

Breastfeeding was probably at the level of traumatizing for me, and undoubtedly what led to PPD with my first child. Even seeing "breastfeeding" in a headline, even for work as compassionate as yours, causes me to pause and wonder if I have the stamina to read on. Like you say in your post, I think "breastfeeding" is a trigger word for me now.

Feeding decisions/breastfeeding challenges belongs in the CENTER of the new-mom stressor map alongside sleep deprivation. Babies exclusively eat, sleep, and poop for several weeks. A woman's entire mind and body is in service of this for a very intense period of time. And the fact that feeding mechanisms and decisions are at the heart of all of this, and the way we talk about it has been so exclusively been focused on the baby and not the mom, means that feeding to me goes smack dab in the center of a map of stressors for the first few months in my view.

My baby was excessively sleepy and had a very hard time waking to eat (we put ice cubes on her belly, played "turn down for what" in her ear - our pediatrician friend came over and said he wouldn't have believed it until he saw it) and she was born on the larger side and genuinely didn't seem to want to eat. I triple-fed her for one month. Triple feeding, in my experience, which is more common than I realized (SHOCKINGLY), means feeding, pumping, feeding baby through a syringe, and repeating this 90-minute process every 2 hours in the first few weeks. I remember thinking (while I still had brain function): what am I going to do with this 20-minute chunk of freedom? Eat? Get off the couch? Poop? Shower? Sleep? My life was live in increments of 90 minutes of pain and plastic tubes and switching positions and resenting the baby, and 30 minutes "to myself." I wept several times a day. The lactation consultants and home visitors all normalized this, saying "breastfeeding takes a little while to get used to" and "you're doing well" and "you have to keep going until she gains more weight." No one validated that triple feeding was CRAZY and next to impossible and should only be an extremely short-term tactic - it was just a price to pay to get breastfeeding established. One day I felt my mental health slip so low that I called it. My doctor helped, she said "it sounds like you're just done." But it felt like I was FAILING in the most enormous way, and every single thing I read about women loving breastfeeding or the wonders of breastmilk just make me fill with rage and sadness.

I hear of other moms who triple fed for as long or longer, or I hear of moms pumping for a year, and I feel so wholly inadequate. I experienced this as pure torture that just made me resent my baby - what's wrong with me when other people are normalizing this? I saved every. single. article. on the internet about feeling okay quitting breastfeeding/using formula, for which there were SO few in 2019. I must have spent a hundred hours just looking for anyone to tell me that that level of commitment was NOT worth it. That my mental health was worth it.

Thank you, Molly, for being that voice. There are a few more now. And the fact that studies are moving a little more into that direction around BFing and mental health is promising, but I just think about all the suffering moms out there who feel like they are failing out the gate when it isn't working. And carry that with them for a long time, even though their own choices to switch to formula proves they made the right call. We still have to change the narrative. And center the mother in the discussion. That's what ultimately convinced me to stop: healthy mom = healthy baby. Full stop.

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Susan Landers, MD's avatar

Thank you for introducing this topic. Having followed the medical literature on benefits of breastfeeding over the last forty years, and followed the posts of social media greats like Scary Mommy, and having read the influential work of Emily Oster, it is no wonder that mothers are still confused and we are all still struggling with this topic. We know that difficulty breastfeeding is highly correlated with postpartum depression. No hormonal cause-and-effect has been delineated, but there is work being done to investigate this. We also know that inadequate support is a crucial factor in breastfeeding failure. Moreover, many pediatricians are inadequately trained to support problematic lactation. This is changing, but formula remains an easy out. Yes, fed and adequate growth is best, but we have far to go to assess the cultural, community, and familial factors that influence mothers’ behaviors. PPD is the most common complication of childbirth and depressed mothers rarely BF successfully. We have much left to learn!

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