PND & My Struggle Breastfeeding

As I begin, let me state plainly – I am an advocate for Perinatal Mental Health, I am not an advocate for Breast Feeding or Formula Feeding. I am “pro” whatever is best for you and your family – only you, and yours, will know the right answer to that.

I have no interest in adding to the debate on “Breast is Best”, as I’m not sure it ever does anything other than draw in those who agree or disagree, firmly, with one side or the other.
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My disclaimer is, I formula fed Reuben. For me, it was a lifeline. With that said, I stand for your rights, your hopes, your dreams, and for whatever you deem best and most suitable for your circumstances.

I had no plans to formula feed (FF), perhaps in the same way I didn’t plan to have PND. It’s something I never gave much thought to, assuming that I would ‘just’ breast feed (BF), in the same way I assumed I would ‘just’ be emotionally well. We had no formula in the house, to plan for Reuben’s birth, and only owned a couple of bottles – that had come in some sort of set. I think I had mentioned once, to Gavin, that maybe we should think about having some formula in the cupboard. But in a sort of “do you think we need it?” way. I recall thinking it might be important for an ’emergency’ or because I’d read somewhere about mixed feeding. It was much more to do with me feeling unprepared and over-anxious, than it was about me making a choice between breast and bottle. That’s not to say I thought BF would be straightforward – I’d read and heard enough to know that wasn’t the case – but I think I imagined that we’d work it out when we got there. I could not have been more wrong, but more on that a little later.

The more I have connected with mums, particularly over the last few months, the more I realise that BF is not always an easy story. For many mums, BF comes with its up and downs. For what it’s worth, so does FF! I’m not sure we should be surprised by that – of course it’s a natural experience (in that out bodies are made for it) but being natural does not mean it always ‘comes naturally’ or easily. Just like birthing a baby – it’s ‘natural’ for a baby to be born from a mummy, but it’s not without its pain, complications and emergencies. That’s life.

I know there are lots of campaigns to ‘Get Britain Breastfeeding’ with some good ideas on how this could and should become a greater reality. I tend not to spend much time reading or commenting on them. This article from the Daily Mail is an interesting read but bothers me with some of its content, none more so than this phrase –

“child obesity, diabetes and infections could all be significantly reduced if more mothers could be persuaded to breastfeed.”

It’s the word ‘persuaded’ that bothers me that most. I’m not convinced that’s the right turn of phrase. I’m not sure mums are really looking to be ‘persuaded’ to BF, in terms of incentives, powerful tales, or “oh go on then, you’ve twisted my arm”, kind of why. In fact, I think many mums don’t want to be persuaded they need to be supported, encouraged, nurtured, taught and loved along the journey. Those words don’t bring the image of ‘handing out the rewarded jelly tots’ in the same way ‘persuaded’ does, but perhaps I am just being pedantic.

Anyway, I firmly believe it was PND that caused me to give up on BF. Of course, I can’t be 100% sure, but I have a good hunch I’m right. I know there are many mummy’s for whom BF has been an important lifeline in PND and I’m so delightedScreen Shot 2016-05-05 at 20.40.24 to hear that. I love to know that’s it’s played a key part in their journey with the illness and been a positive in their experience with motherhood.  (I wish I could say that I wasn’t just a little bit jealous!).

For me that wasn’t the case. Let me share why.

Straight after Reuben was born, in the recovery ward, a nurse said “Are you hoping to BF?”, I said “Yeah,  I am”.

And that’s where my hopes/dreams began and ended. After being wheeled into the Maternity Ward, my Midwife was introduced and I was instructed that she’d be back soon to get me started on the journey. Back she came, as promised, but the journey never really began.

(I think it’s important to point of that with hindsight, treatment and proffessional help, I now understand I was already suffering from Antenatal Depression, which was un-diagnosed.)

She wasn’t the warmest or most compassionate in nature – I accept she had a busy job – but I do think those attributes are key, when dealing with mums who have just given birth. The first time she gave Reuben to me there was A LOT of tutting and signing, as I didn’t seem to “grasping the concept”.

Screen Shot 2016-05-05 at 20.41.09That continued, as she began to ‘man handle’ me, to get Reuben into the right position. Turns out, both Gavin and Mum where annoyed by her manner and nature, as they didn’t think her approach was helping, but neither felt they had the authority to say – which I understand. That approach wrecked my confidence and heaped fuel onto the fire, with all I was already feeling PND wise. It didn’t get better – as they began to ‘manually’ get “something” from me, into the syringe, to give to Reuben. This continued all night – on and off – with someone new sent each time to “retry” my technique. I dreaded their visits, which always ended with the syringe being produced.

Thankfully, the following day a new midwife was assigned and she was lovely. I honestly think I was traumatized by the previous efforts – feeling like a major failure and guilty that I was starving my baby. When she said I could give him some formula AND continue to try to BF, I almost jumped at the chance. I cannot tell you the relief that came over me when I put the bottle in his mouth and he sucked, drank and slept immediately. Finally, I had got something right! It was such a pleasure to feel I had given my LO something he needed. I never looked back. Gavin and Dad headed to Asda to stock up on supplies, and I discharged myself, 36 hours after my c-section, and walked home.Screen Shot 2016-05-05 at 20.41.28

I’ve heard it all where FF is concerned. From being told how “selfish” I am, to how “disgusting” my choice was.  I’m not honestly sure I ever felt that I had a real choice, but that’s another argument. I don’t regret Formula Feeding Reuben.  But I do believe Antenatal /PND meant, that even in those early hours, I was not myself and did not possess the strength of character to pursue what was I really wanted or hoped for. I regret that. It’s led me to wonder – how many other mums are there in the world, who feel like I do?

PND statistics don’t tell the real tale, as far as I’m concerned. I honestly doubt that half of the mums who struggle ever get properly diagnosed, though not for want of trying. So there are many, many more mums suffering than we will ever really know.

So what about PND and Breast Feeding? I can’t help but wonder if there is some sort of correlation. I’m not, for one minute, suggesting that everyone with PND decides to FF, or that PND interrupts BF, for all mums. But I reckon it might for many. Maybe it’s not that a mum does as I did, and Formula Feeds. Maybe their journey with BF is just so much harder, than it needs to be, with PND in the mix as well. Perhaps a mum ‘gives up’ much quicker than she’d hoped, because BF on top of PND is just too much to cope with, for months and months on end. I wonder if milk supply can reduce, if a mummy is very unwell and struggling very deeply. Alone, exhausted, desperate, heart-broken, sad, guilty, ashamed, self-loathing, frightened and fighting for survival…surely all those emotions must have some sort of impact on the practical aspects of mothering?

Screen Shot 2016-05-05 at 21.04.51Even if I am only slightly correct, and even if it’s only a small percentage of mums, for whom PND and BF is not a good mix, should the Government not be even more keen to improve our Perinatal Mental Health services? If the UK’s BF record is not as it should be, and the Government really wants to get behind improving it, is PMH not a great place to start? It strikes me that if we really want to improve BF rates then we must improve Perinatal Mental Health care.  Is that link too tedious? I don’t think so.

If I had be given proper support in pregnancy, so that someone had realised that I had antenatal depression and got me treatment, I may well have made very different choices.  If I had been given meaningful support, when Reuben was born, and someone had asked a few in-depth questions, which pointed to the very deep struggle I was waging against Antenatal/PND, I think my BF journey could have been a different one.  If’ I’d heard “this can take time”, “getting a rhythm with BF isn’t plain sailing”, “you’re not doing anything ‘wrong’, “there’s no rush”, insteand of the tutting, sighing and general stress/expaseration that seemed to surround me, I wonder what the outcome would have been?

Again, this isn’t pro BF or against FF. I would never seek to tell you what choice youScreen Shot 2016-05-06 at 09.37.44 should make. But as the Government and Health Service would like to tell me what choice they believe I should have made, should they not be putting every effort into making sure that what they promote, can actually become a reality for all, not just for some? If you really want to make me, or any other mum, feel empowered to BF then you must make sure you hit the issue where it really matters. For me that would absolutely have been addressing, diagnosing and treating my Perinatal Mental Health issues.

I realise there are lots of different experiences of BF, especially where PND is concerned. If you'd like to share yours, to highlight another angle or point of view, please get in touch and we can chat -

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  1. Natalie says:

    I’m writing because your article struck a chord With me. When I had my first child I was sure I would breast feed and that all would be fine, like you I developed PND and like you I ended up formula feeding (combined with BF night feeds) by 12 weeks. There is a link between PND and breastfeeding being discontinued although I cannot find the article to refer to at this time.
    I am pleased to tell you that there is a major review of perinatal mental health provisions currently so hopefully things will improve, there needs to be more awareness in primary care eg. GPs for certain. As a mental health professional I approached my GP several times and health visitors saying I was ill and needed help but despite it being my area I was brushed away and told I was “fine”. I most certainly was not fine. Women who consider breast feeding tend to be woman who are acutely aware of the reported benefits and outcomes of breast feeding, PND is an illness that constantly criticises mothers and makes them feel inadequate and that they cannot care for their child, this links in with the relief you felt giving him formula (and me my son). With formula it is in front of you, you can see the quantity they have consumed you know they are full and hydrated and it therefore dampens down some of those fears. PND robs women of many things it is only rational breastfeeding in some cases is one of those things.
    Thank you for writing such an honest article.

    • Thank you for your reading and taking time to reply. You’re made so many great points which help me think even further what we need to do in this area. I am so pleased that the RQIA are doing a review and I’m sending many women their way – the more we share the more we can hopefully change! I hope you are doing much better now. xx

  2. tippytupps says:

    I just want to leave some hugs and let you know there are people out here who agree that a happy fed baby I’d what’s best, regardless of whether that comes from boob or bottle. I was lucky in that bf worked out for us but that’s not to say it was easy or a smooth road – I almost gave up 10 times a week at one point but that mama guilt kept me going.

    What I’m trying to say is be gentle with yourself. You made the best choice for the both of you at that time and therefore it was the right choice so good for you xx

  3. I think there is a definite correlation between pnd and breastfeeding ‘failures,’ its interesting you say you had pnd so soon after birth. I’m sorry you weren’t supported properly in the hospital. So often formula is seen as the life saver from starvation but that isn’t the case, it actually stretches a newborns stomach. Colostrum is all they need. Better education and support is what’s needed. I don’t blame you for your choices you did the right thing for you and a well cared for child in a loving home is most important.

  4. creative pixie says:

    Great post. I had a horrible time at the Ulster with my 1st delivery (going through labour only to need an emergency c-section). I spent about 24 hrs in and out of consciousness so bottle feeding was essential. I was treated like a 2nd class citizen in the hospital because I was bottle feeding which upset me at the time but I realise now that new breastfeeding Mums need extra help. Perhaps this shows a lack of staff available , all 1st time Mums should be treated the same no matter how the baby is being fed. Personally I don’t care how a baby is fed (bottle or breast) a happy baby means a happy Mummy and that’s the most important thing.

  5. Great, powerful post. I don’t doubt there’s a link – most of the women I know who have suffered PND link it to struggling with breastfeeding (some as a trigger for PND; some as a side effect of it).

    I was lucky; I didn’t develop PND. I was unlucky; breastfeeding didn’t work for me. There are various reasons BF didn’t work but I was physically capable of trying for longer than I did – I didn’t because it was becoming such a stressful, upsetting thing for both myself and my baby that I didn’t feel I could cope with it once my partner went back to work. Every attempt ended in at least half an hour of me crying; I needed him there to comfort me, support me and care for our daughter while I got myself together. I believed that if I battled on alone, I would develop depression. So, how could the government have encouraged me to keep trying to BF? Improved paternity leave. And less loud voices telling me I was failing as a parent at the very first hurdle.

  6. rmcconk says:

    Great post as usual.
    I am that one in a million that breastfeeding was pretty easy for…hence why I did it and exactly why I will never ‘judge’ or pass comment on whichever method another mother chooses (or doesn’t choose but finds herself doing)
    In fact with second child I decided not to bother waiting for a midwife to come do the whole boobhandling thing and just let him snuffle and shuffle and find his own way to the milk!

    I mix fed with my son a bit sooner than I did with my daughter because of circumstances that were going on in my life at that time and I will never feel any remote sense of guilt about it! It’s what needed to be done to keep me semi sane and him alive.

    Motherhood seems to be one constant battle sometimes and before our babies are even born we are made to feel guilty. It never ends!
    I think a balance shift back towards the time when being a good mum meant getting your child to age 16 without killing them would mean we all excel at our mummy jobs and don’t end up (like me tonight) crying because we’ve been so busy the last month we haven’t had any “quality outdoor family time.”

    Breastfeeding seems to be the big subject (closely followed by ‘natural delivery vs c section) when will we women ever just learn that life is not a constant competition and having babies is when we need each other most?
    It’s when women should stick together and offer support and celebrate the fact that things like c sections and formula and antibiotics and dummies and disposable nappies and all the other stuff exists otherwise some of our precious children would not be here with us and some of us mums just wouldn’t have got through!

  7. Kate says:

    I am so sorry you went through such a rough time. I agree that how you are treated in those early days in hospital has an enormous influence on your mental health. Like you I had developed symptoms of PND prior to having my first. I was coerced into having a planned CS that I didn’t want and wasn’t convinced was necessary. I had cried and shaken most of the weekend prior to having it done and was so exhausted before it that I just wanted it over and done with. We didn’t get immediate skin to skin, but they did put her to my breast in the recovery room. I was numb from my upper chest downwards so I couldn’t feel if she was on right. I was left with a big blood blister after this first attempt and things didn’t get much better after that.

    Postnatal care on the ward was poor due to under-staffing. The MWs were nice enough, just rarely there, eg. I had my surgery at 4pm, and because no-one would come when I buzzed, I was up changing her first nappy myself at 9pm. I mopped up the floor at my feet (remember how messy those first few days are -Ugh) as I leaked when I got up. One day she wouldn’t feed for 11 hours, just sleep. One MW tried to shove her onto my boob when I’d buzzed 3 times, but when she wouldn’t feed she just shrugged and said that she mustn’t be hungry. I got about 5 hours sleep between Tuesday and Saturday. The lack of sleep due to a poorly feeding, screaming, starving baby and lack of support I think contributed a great deal to my 2 years PND. I went home exhausted, with shredded nipples and a baby who still couldn’t latch properly. I ended up doing mixed feeding and eventually phased out the formula as she got the hang of feeding at 6 weeks. I felt such a failure for not standing up for myself against the CS, that I couldn’t “fail” at BFing. I wouldn’t have seen it as a failure in anyone else, but of course PND makes us cruel, unrelenting critics of ourselves.

    That was 16 years ago and I still have some issues with depression, but I have had some tough experiences since then (my second child died of his genetic condition when he was 6), but I have won some tremendous victories with 3 amazing births. I discovered that I am great at giving birth. 2 of my babies were born at home, one before the MW got there. I developed a backbone when it came to dealing with my Obstetrician and no-one dared push me into any decision I did not agree with. I even made her watch her language – it is NOT for them to say whether they will “allow” or “let” us do anything, only for us to all them. I hope that she will remember that informed consent is the prerogative of the woman, not the doctor. I learned some useful lessons from my PND experience and I believe I am a better person because of it. It was a shit way to learn those lessons, but maybe there was no other way. I hope your journey to recovery is a gentle one, and that you find some positives in your experience too. My 16 year old daughter is an incredible young woman and I am more than proud of her. It was worth the pain and torment to watch her grow into the wonderful person she is.

  8. As a pro-breastfeeding advocate I am always horrified to hear how so many midwives, doctors and nurses make it worse for mums-to-be and new mums. From the idea that everyone should get some formula in ‘just in case’ to the formula company names emblazoned across their diaries, notebooks and pens. Then there’s the anti-breastfeeding nature of our society. I remember reading an article by the editor of a major baby magazine a few years ago where she said no baby would ever be getting hold of her ‘fun bags’!!! The same society that uses a bottle as the universal symbol for babies; the one in which people comment negatively to or about others breastfeeding in public; the one where formula can be advertised on television and in the media as a norm. It’s not, and never can be good for babies. Your story is so typical of what many new mums go through and how they are treated, it is so desperately sad.

    The key sentence for me is this one: “I think many mums don’t want to be persuaded they need to be supported, encouraged, nurtured, taught and loved along the journey.” If that were to happen, and all women were surrounded by women who breastfeed, things would be very different. There’s a reason 99.9% of mothers are ‘able’ to breastfeed in so-called primitive societies, it’s because it is accepted as the norm. If only it would be here.

    Thanks for linking up to #FridayFabulous

  9. Stephanie says:

    Great article. I respect women who breastfeed, but for some of us it is not possible or preferable. While I didn’t struggle with PND, I did have third degree tearing from a LGA baby. This lead to temporary incontinece issues, extreme pain and discomfort (emotional as well as physical) on top of the standard newborn and birth exhaustion. At a certain point I decided I must give my body a break in order to heal, so I stopped breast feeding. My baby was term and healthy, so formula was perfectly acceptable. I was able to heal, and be a better mother because I wasn’t feeling so sick.

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