Feeding your baby - either by breastfeeding or bottle-feeding - can come with challenges.
As with other stages in the journey of pregnancy, birth and motherhood, breastfeeding may come easily to you, it may be a challenge, it may not be possible, or you may choose to bottle-feed.
What you need to know about breastfeeding
Many women report difficulties with breastfeeding initially. Often with time, assistance and support these difficulties can be overcome. Midwives in your maternity setting, maternal child health nurses and lactation consultants can all provide guidance in these early days and weeks.
For others however, breastfeeding challenges continue to cause frustration and pain, leading many to decide that breastfeeding is not working for them. These experiences are often compounded by our own expectations, pressure we put on ourselves, pressure and conflicting advice from health professionals and/or well meaning advice given by others about breastfeeding or bottle-feeding. Furthermore, messages informing us that ‘breast is best’ places even more pressure on women.
As a result, being unable to breastfeed can cause additional feelings of guilt and failure.
I struggled with breast-feeding. Cracked nipples, mastitis, incredible pain ... there was a lot of frustration and disappointment there.
Support services for breastfeeding
Ultimately it is up to you to decide if, or for how long, you want to continue to persist with breastfeeding. If you decide that you would like additional support for breastfeeding, a good place to start is by talking with your midwife or maternal and child health nurse.
Often these health professionals will have access to others who have specialist skills in this area – including lactation consultants. You can also access further information and support from the Australian Breastfeeding Association, who have a 24 hour support line on 1800 686 268, and the Raising Children Network who have information, resources and a helpline to assist you as well as helplines.
Your primary focus is that your baby is feeding – and thriving – whether that be via breastfeeding or bottle-feeding. If breastfeeding is important to you, access quality information and support from health professionals to give yourself the opportunity (if that’s what you want to do).
The local health care nurse saw that I got anxiety – mainly from trying to be successful to breast feed. They got help for me straight away, they were fantastic and it really helped.
I felt under immense pressure to breastfeed and that breast was best for baby. What I learned was that when a mother is struggling, it is the recovery of the mother that is best for baby.
Breastfeeding challenges
D-MER
Dysphoric Milk Ejection Reflex or (D-MER) is characterised by an abrupt wave of negative emotions during milk-letdown. Breastfeeding parents describe a number of different feelings including anxiety, anger, sadness, irritability or homesickness, which last between one to five minutes.
I thought I was going mad. I assumed it was panic attacks because I had D-MER symptoms with spontaneous let-downs, so they would just come on out of the blue when I’m not even breastfeeding. I used distraction to manage the symptoms. Once I realized what was going on, and that the symptoms were physiological rather than psychological, it was a huge relief.
While the cause of D-MER is still unknown, it may be related to dysregulation of the lactation hormones oxytocin and dopamine.
Mild symptoms may resolve within the first three months, while moderate to severe symptoms (including thoughts of self-harm or suicide) might take six to 12 months or not resolve until after weaning.
Research indicates that one in six parents with D-MER stop breastfeeding due to their symptoms.
What helps manage D-MER?
For some women, simply understanding that this experience has a name, and that they're not alone can be comforting. Having a supportive partner, prioritising sleep, and using distraction during breastfeeding (such as reading or eating) may also alleviate symptoms. Having longer periods between feeding may also help. The Australian Breastfeeding Association Helpline is also available on 1800 686 268 for further guidance and support if needed.
Breastfeeding Aversion Response (BAR).
Breastfeeding aversion is characterised by intense negative emotions and physical sensations that occur specifically while the baby is latched. It is different from D-MER where the feelings typically last only a few minutes, rather than for the duration of the feed.
How common is it?
Recent research involving over 5,500 Australian women indicates that BAR is common, with approximately one in five women (22%) reporting they have experienced it at some point. It is more frequently reported by women breastfeeding while pregnant, those tandem feeding a toddler and a newborn, and women feeding their first-born child.
What does it feel like?
Breastfeeding parents describe the feeling as "fingernails down a chalkboard," an unbearable tickle, or like having something "crawling underneath your entire skin".
When she nursed I felt like my skin was crawling to the point my toes were curling under, I was biting my nails/my fingers. I had to breathe deeply and mentally talk myself through it, so that I didn’t show my frustration to my baby girl. I hated it.
It often triggers an overwhelming urge to unlatch their baby as well as feelings of confusion and conflict around continuing to breastfeeding. For some women, it leads to ending a feeding session before their baby is ready.
It can also cause deep feelings of guilt, shame and isolation.
Aversion is really horrible - it takes away that loving feeling you have knowing that you are able to feed your child. It makes you want to stop it all together, and then it makes you feel guilty for feeling like this.
Strategies to manage breastfeeding aversion
- Nutritional Support: Many women report that taking a magnesium supplement helps manage the aversion sensations.
- Cognitive Distraction: Using a phone, watching television, or listening to music during the feed.
Practical Support and Boundaries: Setting breastfeeding boundaries with older children or having a partner/family member provide distraction during feeds.
[My partner] would recognise what was happening and would take [child one] away and distract him with something, like ‘let’s go check a letterbox’ or ‘let’s go and feed the chickens’. While I stayed inside and fed [child two] quietly without someone hassling me for that feeding session.
- Physical Adjustments: Reducing external stimuli or changing breastfeeding positions.
- Peer support: Connecting with others experiencing breastfeeding aversion such as through online support groups or calling the Australian Breastfeeding Helpline.
What you need to know about bottle-feeding
While in the past there has always been a focus on providing such support for those trying to breastfeed, it is only in more recent times that there is now also additional supports for those who are bottle-feeding.
In particular, this includes a range of website and books which have been written and developed in response to the significant pressure and guilt that many women are left experiencing as a result of not breast-feeding their baby (for what-ever reason).
Support services for bottle-feeding
A review of these websites including Raising Children can help you draw on the insights of others and very importantly, help you to realise that you are not alone.
Your role as a parent is to feed your child. If breast-feeding is not working for you, or not what you choose or are able to do, you are no less of a loving mother or provider.
Either way, it’s important to remember to consider what is right for you. There are also a range of places to access help and support for which ever decision you may make.
