Emotional & psychological aspects of breastfeeding
From the women we spoke to, it seemed that breastfeeding was as much about emotions as it was about the physical transfer of breast milk from mother to baby. It was an emotional roller coaster, especially at specific times like getting started, when dealing with difficulties and weaning. There were great highs when things were going well and the women were feeling confident and lows that could be devastating when they were not. One woman said,
“It's a very emotional time. I think your hormones are all over the place after birth”.
Many people talked about the satisfaction and joy of breastfeeding or watching their wife/partner breastfeeding. Many women talked about the strong emotional bond that developed between them and their baby and they were proud that they had managed to sustain and nurture another person.
He felt absolute joy watching his wife breastfeeding their baby.
It felt the right thing, it just felt very natural it just felt right really, that was the only thing I can think and very happy and quite emotional about the whole thing but of course it was, you know, the whole roller coaster of the baby arriving and then the reality dawning and seeing the whole thing sort of take place very, very touching, very moving, very moving.
Can you describe the emotion?
Joy, I mean we've got a lot of photographs of me at the time holding my daughter just sort of staring at her, and you know, I'd been at the hospital as soon as I was allowed to be and because my wife was in hospital for a few days just afterwards, first baby and, you know, a few complications, but we were, you know, I was in hospital every opportunity, just going home to get changed and occasionally to eat but that was about it, but absolute joy, absolute joy, and it hasn't changed.
When she looked back, proud was the word that she used to describe how she felt about her...
Many women talked about growing in confidence as their breastfeeding progressed and their baby thrived and was happy, and as their family grew in size. Some women talked about being embarrassed and lacking in confidence with their first child but being more relaxed and easy going with their second. Some felt that the hands-on approach of some midwives crossed personal boundaries and did not help their confidence (see 'Positioning and attaching/latching the baby at the breast' and 'Support from hospital staff').
Having the midwife shove her breast into her babys mouth did nothing for her confidence in...
Several women talked about simply needing reassurance and eventually developing the confidence to follow their own instincts. Breastfeeding was, for many women, a powerful symbol of their new role as mothers but sometimes when it didn't happen quite as they had hoped they talked about feeling guilty or disappointed that they had failed to live up to their own expectations of being a mother. Several women made comments similar to this woman's'
“Breastfeeding is so wound up in your emotions and your psyche if somebody puts a question mark of doubt in your mind it is going to have a negative effect even if you think it won't.”
For example, one young woman, whose six week old baby had not had a dirty nappy for a few days, was told by her doctor to give a bottle of water to her baby. He said that her milk was too thick on account of her not drinking much water herself. She preferred tea. It was clear that the doctor's comments had undermined her confidence in her milk, because she said,
“I'm going to keep giving her water because there is obviously something wrong with my milk”.*
She got in touch with her body through pregnancy and breastfeeding and tried to follow her...
Yeah getting in touch with my body through the pregnancy and through the breastfeeding. Well I don't know, while you're in the pregnancy the hormones were so strong because I was, like really going through a process of withdrawal because I was nurturing myself through a process of withdrawal and using yoga and swimming to help that process I was, producing my own endorphins, I was pretty fit, I was producing strong hormones and they were just totally evident during my pregnancy. When the breastfeeding came along and it came to that point, God I have, I mean at that point I [laughs] it was almost a back seat, I just wanted to, get somewhere safe with [daughter], without people picking on me. And, I ended up staying with my school friend's mum and there we shared a bed and so it was, you know, it wasn't, you know, again I'd get a lot of stuff from, from her and from them about, you know, don't over-breastfeed and, you know, do it at certain times and, you know, let the baby be on their own a lot and don't, you know, carry them round all the time. It's all like, you know [laughs].
How do you feel about that sort of stuff now?
Well I just, I just feel, oh right that was the right context, you know, they bailed me out of this situation, and she came all the way to London and said, “I'll let her live in my place, she can keep her baby”. Look I was in another subservient position and I just had to sort of like, take it and like, you know, take on as much as I, because it was all well meant, there was no, there's nothing not well meant in any of the regulation that was going on. But just basically tried to go with my own instinct.
Don't answer this one if you don't want to but I'm wondering was your decision to breastfeed in any way a lever to make sure you kept your baby with you?
I wouldn't put it as strongly as saying it's a lever, but it was absolutely obvious to me and [daughter] that we were, we hadn't landed in the, safe place we expected to land, and through the pregnancy, I know there were lots of ups and downs but I was really making an effort to try and make sure that she, in a physical form landed in a safe place, and it was a safe place but it was quite different to what we both were heading for in terms of a ship going on a particular course or something, and so we were drawn together very much by the breastfeeding, we were drawn together by everything. And then when I came to live here it was a bit, it was a bit different and so I would even say that probably, you know, maybe that's where I might've started to get it wrong because, you know, she was happily breastfed and she's still happily breastfeeding and, you know, this doesn't seem like there's any, you know, we've talked about her stopping when she's four, on her birthday, and that's what we talk about now, all the other drinks she's going to have instead.
Many talked about adjusting to their loss of independence and some talked about getting their body back at the time of weaning. One woman, who found breastfeeding physically and emotionally hard work, said that she had never heard the psychological impact of breastfeeding discussed by health professionals.
Her exhaustion affected her milk supply. She needed to call on family support and slow down. She...
What was happening to her weight at this stage?
Well I don't know because I didn't actually get her weighed, that was different experience with, with the first one I, I'd, I lost sort of, I lost interest and faith in the whole weighing [laughs] procedure I just sort of, my personal view is that too much emphasis is put on weighing babies at that very early stage and for me it started to be counterproductive in terms of my own feelings about nurturing and nourishing my baby. And I could see that he was thriving despite that fact that he was towards the lower end of the spectrum in terms of weight. But there was this constant reference to the sort of [sighs] point on the chart that he was at, and I didn't feel it was helping me or him to be constantly told that he was still only at the eighth centile and so I stopped having him weighed and with my little girl.
So how did you tell that he was okay?
Well I had plenty people who knew about babies like my mum and sisters, reinforcing that, it was more with our little girl that I literally didn't ever take her to be weighed. If a health visitor called round and wanted to weigh her that was fine I wasn't going to say no, but I wasn't going to just make a special trip to go and get her weighed because, I didn't see the point.
So in terms of her weight gain, I wasn't really sure whether she was okay or not but she was developing in terms of, you know, starting to be more aware and holding her arms out and grabbing things and the, the milestones that you look for, and so I didn't have any particular concerns about the fact that she was undernourished as such, it was just this cycle of not sleeping properly and my physical deterioration really and an onset of mastitis which didn't help.
Tell me a bit more about mastitis.
The mastitis manifested itself through me feeling just very, very unwell very, very suddenly and I'm the sort
A few women talked about the grief of having a sick baby and the psychological benefits of being able to focus on providing breast milk for her/him. It gave them the satisfaction of feeling that they could do something.
Being able to provide breastmilk for her daughter, who was very ill in hospital and so helpless,...
Was that all it was about providing the nutrients and stuff or was there some other deeper psychological sort of connection or bonding or whatever of providing for this child?
It's a difficult question, it's always difficult to kind of split the psychological with the practical, I suppose that I mean, there is a psychological side and yes you feel like you're kind of doing something for your child, you're so helpless in that situation. And you are therefore doing something, you can go off each day, and the encouragement from the nurses was absolutely fabulous actually they used to laugh and go off and say, "And here comes Daisy', as I came back but, yeah you, I think there is a psychological side as well you really feel as if you're doing something. It's also, it's knowing that there's, you never quite know what's going to happen the next day, I suppose the idea that you're continuing to breastfeed means that psychologically I suppose the idea is that you're actually going to get back to normal at some point, but psychologically it's, I think so it probably keeps you going as well.
So was that what kept you going that feeling that at some stage you would get back to normality?
I think it's not necessarily about, it's not necessarily about going back to normality, you don't really think, you kind of focus on the now and the immediacy of the day and, and you get into a routine, and then you just kind of, yeah, you kind of feed her. It's funny it's almost even down to the fact that you know that she needs feeding every four hours, it's best that you kind of get, kind of know that you want to give her some breastmilk, you kind of you go and you do it and you get into the routine again actually as well as moving forward.
So this was something that allowed you to order your days in this surreal environment?
I think actually, it doesn't really allow you to order your day, because your day is what it is and it is a fixed day and you have your ward rounds and the doctors and the nurses, you've got, you actually have to force yourself to do it quite a lot. But, it's bizarre it, it's difficult to explain because it, it does force you into a kind of routine as well, you're kind of having to force yourself to get into a routine and yeah it does, at the end of the day you are trying, you are hoping that you're going to get back to normal. I think there's, that's, as you say, there's the psychological side of it, you don't think about it at the time but you are hoping at the end of all this if we get back to normal, then you'll take them home, my husband kept saying to me, you know, 'The thing that'll keep us going is we will go home, the three of us will go home at the end of this' and we did, so, and everything did go back to normal so, I suppose, if you can keep doing this because it's, it's very.
Being unable to breastfeed her baby felt like grief because she had lost something that was very...
After the operation did you try to put him to the breast at all?
I did have this fantasy that after the operation, if I could keep my milk going till after the op, not only would he have benefited from my milk but we might be able to breastfeed. And I did try, quite a few times, but the truth was, it was more for me than him because it, he well he didn't get the comfort from being at the breast, he didn't know what it was for, what it was about, what he needed was cuddles and I gave him plenty of those. And it was sort of a second moment of mourning when I realised that it was never going to happen but I could, give myself a lot of comfort from all the goodness I'd given him. My goodness most of these Pierre Robin babies when you see them go into theatre, they're scrawny little things, they generally are not strong babies because they generally have such a tough time taking in any food and liquid whereas mine, he's quite beefy even pre-op, and I felt quite proud that all of that had come from me all apart from the first few weeks of solids that we were just beginning to introduce. So I knew I had done all I could for him and that was very kind of curative, that was very empowering because it was a tough six months the first six months he'd had and into the first year, I mean to be honest you look back and you just think, 'How this can be the same boy' because he's so, he's doing so well.
Many women talked about anxiety and being anxious for a variety of reasons. Some women were anxious when they were separated from their baby after the birth and unable to breastfeed straight away (see 'Dealing with difficult times' and 'The first breastfeed'). Others, especially first time mothers, felt anxious about the responsibility of looking after a baby (see 'Going home with a breastfed baby'). One woman laughed at herself for being so concerned about germs that she would not take her baby out of the house for the first couple of weeks and then, when she did, she wiped the supermarket trolley with wet wipes before putting her baby into it. Some women, who were away from family and friends, were very lonely and this loneliness sometimes affected their ability to breastfeed their babies.
Away from family and friends, she was very lonely, her baby was unsettled and she weaned...
What aspect, what was it that you were anxious about? Do you remember?
I think that I, it was, anxiety overall about the fact that I was, I was probably so lonely and on my own that then, it negatively affected the way that feeding went. I remember my first baby crying a lot, I think that it felt like she cried for twenty hours a day, and I mean I can remember my mum-in-law came out to be with me for about three weeks after I came out of hospital because I'd had a caesarean section and I can remember the two of us being in tears with this baby crying so much, I mean she's an experienced mother of two and so I think that, looking back on it, yeah my baby cried a lot, I was probably anxious about that, which fed into her anxiety, and we just didn't gel really as a, as a mum and baby, we love each other to bits now but we didn't gel as a mum and baby I think for, probably, the first six months of her life. So it was, yeah, feeding was probably one symptom of all the other things that were going on around my anxiety about being somewhere that I, really wished I hadn't been really, being so far away from people that I felt close to.
So you said the weight gain was fine?
It was, looking back on it, it was excellent, she was a scrappy little two point four kilo baby born, and if I'd had my lets say, my midwifery head? Yeah am I? No don't want it? No okay, right okay.
Just say my midwifery head.
So, yeah she was a scrappy little two point four kilo baby born and that was at term so she, you know, so she was little. Looking back on it she was actually feeding really quite well and her weight gain was good and, so I think that I was probably anxious about, you know, being lonely and didn't want to admit it and I kind of, if it makes sense, I took it out on the feeding, and the feeding became the problem but actually the feeding wasn't the problem, it was the fact that I was on my own all the time because I couldn't drive at that point, so I really was stuck, on the ninth floor of this huge apartment block, and I do remember you know, my husband and I we laugh about it now but, I used to take my baby for walks around the car park, and there was nothing else to do and just, you know, and all that I think fed into what I portrayed as an anxiety about feeding so, interesting.
Is there anything else you want to say?
Nothing other than, I do think, and again it's only based on my experience, it, it may not be accurate but, I do think that how women do with feeding, whether they live up to their expectations is something that I think potentially they carry with them for a long time. So, and I think that it does go on to perhaps affect the relationship they have with their baby for some time to come. I do still occasionally have, have guilt feelings about the fact that I didn't do as well at feeding first time round, you know, I'm really very close to my oldest daughter but you do, I do sometimes reflect and think 'goodness how did I manage to have done so, so badly at it?' but then you look at the way I was living and you think 'of course that I, you know, why it didn't go according to plan', so.
Several women prematurely weaned their baby onto infant formula because of circumstances at the time but later regretted it (see 'Breastfeeding and working'). Many said that they felt guilty and like a failure when breastfeeding did not go according to expectations (see 'Getting support for breastfeeding' and 'Monitoring baby's growth'). One said that she felt jealous when she saw other women happily breastfeeding. Another, who was unable to breastfeed her baby who had a cleft palate, said that it was painful to watch other breastfeeding women at a mother and tots group (see Interview 13 above). A few women felt like a failure because their birth experience had not been what they planned and so they focused on their breastfeeding experience as a sort of compensation (see 'Dealing with difficult times').
She naively assumed that breastfeeding would be easy but found that it wasn't. She was determined...
I didn't really, to be honest I didn't look into it, my mother had breastfed, my mother's side of the family, my grandmother, my aunt, had all breastfed so they were very much for, my partner's mother hadn't and not, I don't think many of his family had so it's, but because I've grown up like that and I'd grown up watching my aunt breastfeed my cousins etcetera, to me that was just what happened there wasn't another option I wasn't, I didn't look into it I just and I just naively assumed it was easy, which I think, you know, for some people is it but not for all people and there is, you know, it can be hard, but going back to it I, because I had this bad labour and I felt a bit of a failure for not doing things my, I felt I didn't do things myself because it was assisted, that made me even more determined to succeed at breastfeeding, because I didn't want to give up on the two things that were really important to me because, you know, unlike some women and I was really looking forward to the labour, that was a very special thing for me to have a natural special labour was, something that I was looking forward to and enjoy rather than being scared of, and with the breastfeeding I was looking forward to that. So when my labour didn't quite go to plan it made me even more determined that I was going to succeed at one of the things that I set out to do.
And that made you feel better about things?
Yeah, yeah definitely I, because I was confronted with so many problems, you know, now that I've got over that and it is a pleasure to feed but in looking back I do feel very proud that I stuck with it. So I go to a breastfeeding group, Bosom Buddies, and they've been fantastic there as well, the support that I receive there is fantastic. And all the time they say, you know, how much they admire me because not a lot of younger mums these days do breastfeed or they, you know, according to them they said, you know, they perhaps wouldn't have stuck with it as much as what I've done, so that's nice to hear, it's always nice isn't it when you get praise but yeah.
Lizzie says that the official support saying ‘breast is best’ made her feel isolated and that she wasn’t a good mum.
But yes, I did feel like a failure. Yes, I did feel that I wasn’t a very good mum and, you know, I felt that isolated. And, you know, there was some indication but it, for me, it wasn’t an indication of postnatal depression. It was an indication of, there’s this thing that is not working that’s kind of central to all the other things working. So, you know, if it, they always say, you know, “If a baby cries, they’re either hungry, they need their nappy changing or they’re tired.” And I’m sort of going, “Well, I can change his nappy as much as I like, but actually if he’s hungry he’s not going to sleep.” And so it felt like the hunger was just this central point to all of these other things that weren’t going well. And, and so until I addressed that hunger, then all of the other things that are, you know, should happen, shouldn’t. So it was sort of, yeah, just feeling like I had, like I had failed at the, you know, the thing that, the only, the thing that mums need to do without even trying, I was failing at. So how could I be a good mum otherwise? And so you sort of, I just felt a complete mess.
Jessy explains why she couldn’t continue breastfeeding and how she felt when she decided to prematurely wean her baby.
I had everything I could possibly have, I had nipple cream, I had the training, I watched the video, I read the books, I have a doula with me, a friend, a friend I could trust. I have, I even bought nipple shields and I used everything I could, I did everything I could possibly do. But then I was still obsessed with the, “I’ve got to do it, this, my boobies are not going to win, I’m going to win, I’m going to be able.’
But then it got to a point my chest was covered in, were covered in blood. I was in so much pain that my breasts felt like they were on fire, like my whole chest felt on fire. And the last thing I did was the - he start crying, I took the nipple shield, I tried to feed him with the nipple shield and even the, even with the nipple shield it was extremely painful.
And I was, he was crying, I was crying and then my partner came in and said, “What are you doing? Stop it. I just going to give him formula, it’s not the end of the world”. He had to convince again - to me it was really sad, I spent a couple of nights, I felt, I felt like a, I was grieving that I couldn’t breastfeed for five days. But, but when the midwife hand me over again to the health visitor, the health visitor talked to me, she realised that I did the best, I did as much as I could to breastfeed. And she told me, “Well, I must let you know, that there is a small percent of people who can’t physically breastfeed, like it’s, it’s not physically possible.”
And she asked me, “Do you suffer from, from cysts in your breasts? From lumps?” And I said, “Yes”. “OK, that’s one of, could be one of the reasons, because your tissue doesn’t heal quickly enough to carry on doing this, so if you might actually be doing more harm than good, on the one hand. And on the other hand if you’re, if you are not well enough to look after baby who’s going to look after him, he needs you. So it’s better for mum to be good, baby’s happy, you are happy. And then it will go, and, she said - and then made me feel a little bit better but I was still secretly crying like, I didn’t tell my boyfriend that I was crying. Like, “Oh, I can’t breastfeed”. It was really horrible. But I still feel -well is the best I could have done?
A few women described their emotions as having a strong physical component. For example, one woman talked about taking her sick baby out of his cot and curling up together like spoons so that it felt as though they were still physically connected (see 'The first breastfeed'). This same woman talked about breastfeeding being associated with closeness which she described as “a warmth in the belly”. Another woman talked about how her previously breastfed baby suddenly decided to breastfeed again after a long period of tube and cup feeding in hospital and the relief could be seen in her gestures and posture (see 'When extra care is needed for mother and/or baby'). One woman gave a very graphic description of how her milk let-down even when her baby was not with her.
Her emotions at hearing her baby's cry over the telephone translated into the physical experience...
I have yes, particularly to start with I don't get it so much now that she's, that she's six months but I did used to get it quite a lot whether the baby was with me or not, I would be feeling a let-down. I've never been one of these people that it's been triggered by seeing other people's babies, or hearing other people's babies cry, but there was one time I was in [Supermarket], I was visiting my parents and we nipped to the shops to get some photographs developed, and I left the baby with my partner and said to him, 'Phone me when she starts to wake up and I'll come back'. And when he phoned we were in the queue, at the till, and it was a really, really long queue and I could hear the baby in the background, I could hear her crying, now I'd heard probably four or five babies around [Supermarket] and none of those had had any effect, I could hear my baby down the phone and there was milk everywhere, the milk just started flowing and I had to abandon my stuff in the queue, well I left it with, with my dad and just had to go home because there was just milk everywhere so, that was probably the worst one. I've had a few minor ones but that was probably the worst one, and I think that was because I could hear her, I could that was what she wanted and, you know, you're a mother and you can feel it in your tummy that your baby's crying and she needs you and, you know, nobody else could give her what she wanted and it was just I had to get back as soon as I could and by the time I got back my t-shirt was drenched so that was the worst let-down I ever had away from her.
Some of the more unusual emotional reactions included a few women who talked about losing or taking control of the situation. One woman said:
“I felt quite humiliated almost … I remember thinking before you have a baby you have bodily fluids but somehow they're more kept away or discreet or something, and then you suddenly have a baby and it's like bodily fluids are everywhere. There's baby posset [regurgitated milk], there's milk coming out of your breasts everywhere, you're bleeding after the birth and it just seemed like suddenly I'd kind of gone back to this state of nature or something and I didn't feel like, kind of, the modern professional woman I'd felt before.”
*Footnote: It is quite normal for a breastfed baby to have several dirty nappies a day or to go for several days without one. It is normal for a breastfed baby over six weeks old to go for up to ten days without a dirty nappy. Babies who are being breastfed without restriction do not need extra water. Mothers should drink to satisfy their thirst and it does not always have to be water.
Last updated September 2015