While many studies state that breastfeeding helps reduce postpartum depression, this is not the case if a mother’s intent was to breastfeed and she wasn’t able to due to milk supply, a baby’s latch, postpartum anxiety, medications, and the list goes on and on. When a mother is unable to breastfeed but planned to do so, she is 50% more likely to develop postpartum depression. I know in my own support group, breastfeeding is one of the topics we can’t stop talking about, like rubbing an old scar again and again. For most of the women I know, breastfeeding was one of the main triggers that caused anxiety. Breastfeeding also causes many mothers to get up all throughout the night, every night, on their own, so breastfeeding mothers are often more sleep deprived. Once I began pumping and my husband could feed our daughter during the night, my anxiety level decreased, a little.
When I talked with Sara, breastfeeding was definitely still a wound she was trying to heal. She’d spent two years trying to get pregnant, but didn’t spend “one minute of that time thinking about the future.” Then her entire pregnancy, she imagined horrible scenarios of miscarriages and disfigured babies. Her anxiety level was growing along with her daughter. However, she had a natural birth that was “great,” and she thought she just had the baby blues at first. But then the excruciating pain began for her: breastfeeding. Now I know that La Leche League will tell you breastfeeding doesn’t hurt, that it may feel slightly uncomfortable. I’ve talked with a lot of moms about this and I’m calling bullshit. Breastfeeding hurts, for many moms, even if it’s going well.
But it wasn’t going well for Sara. Her daughter had a tongue-tie. My daughter also had a tongue-tie, so I know what this feels like: imagine your nipples being scraped with sandpaper. That’s about what it felt like after being abused every two hours.
Even after the tongue-tie was fixed, the pain continued for Sara. Sara began pumping breast milk, and she continued to pump exclusively for nine months. She felt the pressure of “breast is best,” and put this above her own mental health. For those of you who haven’t pumped, to put it mildly: that shit sucks. You strap your breasts to a machine multiple times a day, which is nearly impossible to do because you have a baby, so your free time is just a little limited. Oh, and then you have to clean all the intricate parts of this contraption as well. Pumping is a part-time job in itself.
But Sara continued to pump and refused anti-depressants due to the pressure she felt to breastfeed. She was having suicidal thoughts and this still didn’t push her to seek medication. She would spend days just “staring at a blank wall,” only able to care for her daughter but nothing more for herself. Finally, she began having such disturbing intrusive thoughts about her daughter’s “head cracking open” that she began taking Zoloft, one of the only anti-depressants approved for breastfeeding. Sara wondered if she was “going crazy.” Her brain would “start imagining things and I couldn’t stop it.” The first low dose of Zoloft didn’t work, but she still had to wait six weeks to make sure of this. Doctors have to wait and see how the drug works at its full capacity. Then her doctor upped her level and it was another six weeks of waiting without any change. Sara spent over a year suffering, and still at two years postpartum, Sara continues to heal and seek answers. Why did I breastfeed for so long at my own detriment? Why didn’t anyone give me permission to stop? Why did I need permission?
I can’t imagine spending this much time in the pain of postpartum depression and anxiety. It took me six weeks to get help and medication, and another two weeks before Zoloft worked for me. Those two weeks, I was white-knuckling to get through the days. I just kept telling myself relief was coming soon, like someone stranded on an island. And what if relief hadn’t come soon? So many women have to wait for long periods of time due to the pressure to breastfeed or shame or medications not working.
“Breast is best” is often said as an absolute to new mothers, and it’s a chant that gets stuck in their minds, playing on repeat along with other anxious thoughts. Breast is not best when it causes severe anxiety and overwhelm. A relaxed mother and baby is best. Lactation consultants and doctors need to push mental health above all else since postpartum depression is the leading cause of complications after childbirth, not formula-feeding.