Anxiety and Breastfeeding

As part of my day job, I talk to mothers by phone about breastfeeding.  At its essence, the main reason most mothers call the pump company where I work boils down to anxiety. 

When breastfeeding matters to a mother, it’s natural for her to worry.  But the more anxious a mother feels about breastfeeding, the more likely it is that her anxiety will undermine it.  If her worry centers around her baby’s milk intake, she may try to relieve her anxiety by feeding some formula, which may temporarily make her feel better.  However, if her baby seems more satisfied for longer periods—which is common with formula—it may confirm her worries and increase her anxiety about breastfeeding, leading to more formula use and less milk produced.   

Or she might decide to express her milk and feed it to her baby in a bottle.  Seeing how much her baby consumes may temporarily reduce her anxiety, but trying to keep up with a grueling pumping schedule may increase it again.  A routine of pumping, feeding, and cleaning can take two to three times the effort of direct breastfeeding.  One study found, not surprisingly, that among mothers of preterm babies, 72% of those whose babies made the transition to the breast were still going strong at 4 months, whereas only 10% of those 4-month-olds whose mother pumped and bottle-fed were still receiving mother’s milk.1 It’s difficult to make pumping and bottle-feeding work long term.

Today I spoke to a mother who described her intense emotional upheavals during the first week of breastfeeding.  Her baby was struggling at the breast and the visiting nurse told her that her baby seemed to feed better from the bottle, which convinced this mother to stop breastfeeding.  By the time we spoke, she had been pumping and bottle-feeding for 3 weeks and was convinced that breastfeeding was impossible for her baby.  I explained to her that babies are hardwired to breastfeed and that even babies adopted between 6 to 12 months of age successfully transition to the breast.  I told her that there’s a world of difference between a 1-week-old and a 4-week-old and that although breastfeeding had been traumatic before, it didn’t have to be traumatic now.  I described laid-back breastfeeding positions and encouraged her to help her baby to the breast while in light sleep.  And I described how direct breastfeeding could make her life easier.

Many have rightfully referred to breastfeeding as a “confidence game.”  Encouraging a mother one-on-one can help boost her confidence and decrease anxiety.  Another great confidence booster is experiencing the oxytocin-rich zone of a breastfeeding support group.  Being with other breastfeeding mothers, hearing their stories, and seeing first hand thriving breastfeeding babies have helped many mothers take a deep breath and just keep breastfeeding.

Reference

1 Smith, M. M., Durkin, M., Hinton, V. J., Bellinger, D., & Kuhn, L.  Initiation of breastfeeding among mothers of very low birth weight infants. Pediatrics 2003;111(6 Pt 1), 1337-1342.