I’ve written repeatedly about the toll of illness, injury and death that the relentless promotion of breastfeeding takes on babies. That’s because it is easy to see the damage: tens of thousands of babies readmitted to the hospital each year, as well as babies who suffer permanent brain injuries or even die due to dehydration, hyperbilirubinemia and hypoglycemia.
But as bad as that is — and it is inexcusable — the toll on women may be worse. It’s just less visible because it involves their mental health.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Women who choose to stop breastfeeding often do so for the BENEFIT of the baby.[/pullquote]
A reader shared a fascinating scientific paper that attempts to outline and explain those harms. The paper is Existential security is a necessary condition for continued breastfeeding despite severe initial difficulties: a lifeworld hermeneutical study.
There’s a lot of jargon in the paper, but it’s not hard to wade through to reach valuable insights.
The authors start by attempting to understand what happens to a mother when her baby fails to thrive on breastmilk. Of note, the study takes place in Sweden, a country with one of highest breastfeeding rates in the world, with extensive support for breastfeeding and with maternity policies designed to promote breastfeeding.
Nonetheless:
Almost 30% of mothers initiating breastfeeding experience some kind of difficulty and is a major reason for breastfeeding cessation. Breastfeeding success is often taken for granted during pregnancy and difficulties are thus largely unexpected by mothers. Such idealistic expectations evoke emotional distress when difficulties occur. Severe initial breastfeeding difficulties can lead the mother to feel lost in her role as a mother, leading to a constant struggle both emotionally and practically.
In other words, even when women have substantial breastfeeding support, almost a third of all mother-baby dyads will have difficulty.
Moreover, in contrast to the lactivist insistence that women who stop breastfeeding are lazy and selfish, many do so for the benefit of the baby.
The mother’s perceptions of the infant guide her breastfeeding decisions and her experience of herself in the breastfeeding relationship. Her own understanding of the infant’s response will determine whether she feels confirmed as a breastfeeding mother or not. When the mother … does not feel confirmed [because the infant is not thriving], she loses faith in herself as a breastfeeding mother. She concludes that the infant is mistreated by breastfeeding and her motivation to continue breastfeeding is lost.
In such situations, breastfeeding can become psychologically unbearable:
When the body gives positive responses, such as a good milk supply or less painful breasts, it provides hope and confidence in the body’s ability, which becomes a positive sign. A lack of positive signals from the body contributes to a sense of being trapped in the body, making the mother mistrust its function. The feeling that the body desires to be released from suffering arises and the situation is so painful that breastfeeding becomes unbearable.
But doesn’t she just need more support? It depends of what’s being supported, the act of breastfeeding or the wellbeing of the baby and mother.
…[C]are can be experienced as non-caring as, for example, intrusive hands-on breastfeeding help, or care that focuses solely on the infant or the body. Such care is degrading in that it objectifies the woman and reduces her to solely an instrumental functionality…
Such “care” is the opposite of support:
An instrumental way of giving care undermining mothers’ breastfeeding and seems to be based on the idea that a woman who has just given birth does not have the same need for extra care as for patients who, for example, are being treated for some medical condition. A new mother can nevertheless be exhausted, in healing from surgical procedures, and under the influence of the hormonal transition that occurs when the milk comes in… Being allowed to have the same care needs as for a “real” patient appears to be significant for the mother’s possibility to overcome breastfeeding difficulties … [I]n the absence of such acceptance, suffering becomes overwhelming, leading to her feeling forced to cease breastfeeding. (my emphasis)
The result?
Mothers who initiate breastfeeding with severe difficulties may feel overtaken and violated by the needs and demands from her infant, the extensive pain and/or changes in her body, and her own as well as others’ expectations for her to succeed. Contact with professional carers whom she experiences as too demanding or her own feelings of anger and loneliness may further enhance these feelings of being overtaken and violated…
Continuing breastfeeding in this situation can harm the mother-infant relationship.
When feelings of being overtaken and violated make her consider her body primarily as a biological tool, separated from the mother-infant relationship, feelings of alienation easily emerge. The intended reciprocal and intimate relationship with the infant becomes the opposite wherein it is difficult to feel closeness…
It’s hardly surprising then that stopping breastfeeding in such situations is an act of love.
The mother’s overwhelming feelings of suffering, anger and loneliness lead to a feeling of alienation from the breastfeeding relationship that can encourage her to see the decision to stop breastfeeding as an act of caring responsibility.
How should healthcare providers respond?
It is therefore important that health care professionals have the ability to extend their care beyond the biological body and the instrumental way of caring …
With this in mind, new mothers, especially those with severe initial breastfeeding difficulties, need to be met in a sensitive way that allows them to reconcile themselves to their feelings of alienation and come close to their infant, regardless of continued or stopped breastfeeding.
In other words, lactation professionals should be focused on WOMEN, not just on their breasts. Most importantly, they should understand that many women who stop breastfeeding do so not out of selfishness but out of love.
