Breastfeeding Challenges: Unveiling Mental Health Struggles Amid Societal Pressure

In a culture that relentlessly emphasizes the benefits of breastfeeding, women share the honest toll it can take on mental, emotional, and physical health.

Breastfeeding offers health benefits to both the baby and mother, and experts recommend exclusively breastfeeding for the first six months of an infant’s life before adding in other foods. But while nursing may come easy to some, it presents immense challenges for others — and the struggle to breastfeed can take a serious toll on an individual’s mental health, leaving many to suffer in silence.

“Breastfeeding affected my mental health more than I could have ever prepared for,” Jan Brugger, a mother from Chicago, tells Healthnews.

Knowing that breastfeeding is considered the best source of nutrition for most babies, Brugger had hoped to exclusively nurse her child for the first several months, as the American Academy of Pediatrics recommends. But the process was far more difficult than she anticipated.

Physical pain from breastfeeding

Breastfeeding was extremely taxing and physically painful for Brugger, especially early on. She had read that it shouldn’t be painful, and this only added to her worry that something was wrong.

Feeding a newborn every two to three hours is hard enough without the added dread because you know it will bring toe-curling pain.

Brugger

Feeding her baby directly became so painful that she had no choice but to pump and feed her baby with a bottle. To make the process a little easier, she and her husband decided to supplement the breast milk with formula. In total, Brugger took three different breastfeeding seminars and saw two different lactation consultants, which she and her husband paid for out-of-pocket.

“We combo-fed her up until her first birthday but it took me several months to not feel guilty about feeding my baby formula,” she says.

According to perinatal mental health and trauma therapist Becca Reed, LCSW, PMH-C, breastfeeding can sometimes cause physical pain, such as sore nipples, or infections, such as mastitis. Milk ducts can also get clogged and cause soreness, and engorgement from an influx of milk can also result in pain. Many women also experience back pain throughout the breastfeeding period.

This pain can make the body react defensively, almost as if it's saying, "Something's wrong here!" Reed explains, which is confusing for new mothers who’ve been told the experience should be painless and easy.

“This reaction can lead to stress, anxiety, or feeling disconnected, which might make it harder for you to feel close to your baby or enjoy breastfeeding,” she says. “It can turn what should be a bonding experience into something stressful or even unpleasant.”

Postpartum anxiety

After giving birth, Brugger developed postpartum anxiety, and struggling to breastfeed only contributed to her fears.

While the pain did subside after several weeks, she says her anxiety didn’t.

“I would worry about every little thing: Does she have a lip tie? Is she pooping enough? Is she getting enough milk? Why isn't she napping?” she says.

Due to a lack of information, however, she didn’t know that postpartum anxiety was a real diagnosis and a common one at that. This resulted in shame around what she was feeling.

“Every once in a while when I finally left the house to take a break or head to a pediatrician appointment, I would remember that we're ‘fine’ and then feel foolish for all the time and energy I spent worrying,” she says. “People talk about postpartum depression, but I had no idea that postpartum anxiety was even a thing.”

Cyla Fisk, LMFT, PMH-C, a marriage and family therapist who’s certified in perinatal mental health and owns Her Space Therapy, tells Healthnews that struggles with breastfeeding can exacerbate perinatal mental illnesses.

“Frequently, women who come into my practice looking for support with postpartum depression or postpartum anxiety report distress around breastfeeding,” she says. “They might be successfully breastfeeding their child but experiencing high amounts of anxiety around the baby's intake and growth, or the mother was unable to breastfeed their child for one reason or another and are experiencing high levels of grief, fear, and shame.”

Fisk, who is also a mother, has personal experience with the latter.

Going into motherhood for the first time, she says she didn't think it mattered that much how her baby would end up being fed.

But once she had her daughter and she was not able to latch, she says her mind went into very dark places. She worried that her baby’s attachment to her would suffer, she feared that her baby wouldn’t have the right nutrients to thrive, and she felt that she’d failed as a mother.

“I have unfortunately seen the same happen time and time again with women in my practice,” she says. “The logical side of our brain might be telling us these statements are untrue, that our baby will be just fine, but it truly doesn't feel that way. The fear and shame is so strong.”

Hormonal imbalance

Some of the negative emotions individuals experience throughout the breastfeeding process may also be caused by a condition called dysphoric Milk Ejection Reflex (D-MER), Reed explains. This is when someone suddenly feels sad or upset right before milk comes in, and it’s caused by an abrupt drop in the hormone dopamine.

It impacts roughly 9% of those who breastfeed.

“It's not anything you are doing that causes this to happen,” Reed says. “It's simply a hormone imbalance that takes place right before the milk lets down during the process of breastfeeding.”

To deal with D-MER, Reed says it can be helpful to find ways to help your body regain its balance and feel safe and connected again during breastfeeding. This may include deep breathing, having a supportive person with you while you are breastfeeding, or engaging in something to distract you from the feelings.

“Thankfully the feelings of anger, sadness, or irritation subsides in about ten minutes of starting the nursing session,” she says. “It's important to get connected with other parents who are experiencing D-MER so you can reduce feelings of isolation.”

Societal pressure to breastfeed

In the 1970s, after formula companies’ aggressive marketing in developing countries led to a global decline in breastfeeding, health leaders from around the world initiated a movement to promote and encourage breastfeeding. That movement, which resulted in the well known adage “Breast is Best,” continues to this day.

But while breastfeeding does present many health benefits, including protecting babies against some short- and long-term illnesses and diseases, it is simply not feasible for everyone and not necessarily the best option for every woman and child.

As a result, societal pressure and judgment from those who think breastfeeding is superior in every scenario take a major toll on those who are unable to breastfeed, or choose not to, for any reason.

The 'Breast is Best' campaign, along with similar messaging from social media, has placed so much pressure on women in our society to breastfeed, even if it is at the expense of the mom's mental health. We all need more reminders that our own mental health and wellbeing is key in providing our children with the attunement and care they need to thrive.

Fisk

The importance of support

Reed says having supportive, positive people around you is crucial, especially when you're dealing with breastfeeding challenges. Without this support, you might start feeling lonely, sad, or anxious, she says. But a supportive environment can help you feel safe and connected, which can help improve your mood and make breastfeeding a more positive experience.

And there is no shame in getting professional help, especially if you’re struggling with breastfeeding and your mental health.

Fisk says lactation consultants and OB-GYNs who prioritize mental health are often the ones who can initially catch women slipping into postpartum mood and anxiety disorders due to their struggles with breastfeeding, and they can help point them in the direction of a therapist who can help.

“Fortunately, postpartum mental health issues as these are very treatable,” she says. “Especially if you find the support of a perinatal-focused therapist, you will overcome symptoms of postpartum mood and anxiety disorders and feel more grounded in yourself and your role as a mom.”