By Tracy Cassels

maddy at the boobWe all know of the usual booby traps: having to return to work early, undiagnosed tongue ties and food sensitivies/intolerances/allergies, birth interventions, and unsupportive partners and family.  We know how detrimental they are for women who want to breastfeed.  However, I want to talk about ones that are rarely spoken of yet affect a sizeable number of women: Psychological and physical sensitivity or aversions.

For some women, the experience of breastfeeding is horrific.  It’s not one of joy or happiness, but rather pain, anxiety, and stress.  I can acknowledge that this is an area that has allowed me to have a wonderful nursing experience:  I love cuddling with my daughter and only occasionally do I feel touched out or too sensitive to her tweaking or playing with my nipples.  As such, breastfeeding has been an incredibly positive experience for me that has allowed me to go forward, but not all women feel the same and we need to start discussing it.

Physical Sensitivity

I have had messages from moms who described the act of breastfeeding as so physically uncomfortable that they felt sick, that they wanted to crawl out of their skin.  For these women, the act that many of us see as wonderful, or even that many of us tolerate, is like a form of torture and when you have a newborn who feeds round the clock, I’m hope you can imagine how difficult that can become.  For some women, it may be an issue of latch and this is something that women should look into if they are wanting to breastfeed, but finding it very physically aversive.  A bad latch can make it not only painful, but almost unbearable.

When I think of these women, I can’t help but also think of some of our babies who are unbelievably sensitive to various stimuli, including touch.  My daughter is on the upper-side of sensitive, but nothing like the children in some of the families I have met or emailed with or had questions from.  Some of these children can barely stand touch.  Premature babies have skin so sensitive that too much touch causes heart decelerations and they need breaks from their kangaroo care.  We accept this for our children and do everything to respect the fact that touch is very powerful and negative touch can have profound impact on our lives, yet somewhere we’ve decided mothers who are this sensitive are exempt from this compassion?

[Note: Lots of women report physical aversions or sensitivities when nursing while pregnant or tandem nursing with a newborn.  Although these sensitivities are very real and can have negative affects, I did not include them herein because they are often not “booby traps” in that they prevent a mother from nursing.  These mothers often have had successful nursing relationships (hence the nursing while pregnant or tandem nursing) and although they may need support or just know this is normal, it is less likely to lead to a failure to breastfeed.]

Psychological Sensitivity

For some women, they have a psychological sensitivity around their breasts.  Physically it may not be sensitive in the way it is for those with sensory issues during breastfeeding, but the outcomes can be the same with women feeling ill, stress, anxiety, and even depression.  Although it’s not exclusive, often this type of psychological sensitivity comes from women who have been sexually abused, and the effects of their abuse have led to their inability to handle the type of invasiveness and touch that breastfeeding involves.

There are a few things we must consider when we think of the woman who has undergone trauma and struggles with breastfeeding as a result (well, more than a few, but I will focus on a few here).  First, the woman may not be open about this being her reason not to breastfeed.  After all, how open are any of us about the traumas we’ve endured in our lives?  Often we keep them very hidden, revealed only to those we absolutely trust and feel comfortable with.  So if you are out in public and a woman just says she “just decided to use formula” or “couldn’t breastfeed”, chances are she’s telling you something at face value, but there will be a small percentage of these people who simply don’t feel like opening up to someone they don’t know or don’t know well enough about their history and the trauma involved.  (Perhaps it would be good if they did as it might shut up some nosey individuals, but that’s a topic for another day).

Second, a lot of people assume that if a woman is able to have sex she must be “over” whatever sexual trauma she may have endured.  The assumption is therefore that if a woman is pregnant, she most likely had sex (though not necessarily given artificial means of getting pregnant).  However, barring the aforementioned problem with this though (i.e., may not have had sex), it’s just simply not true.  Many individuals (men and women) who were abused work hard to be able to be intimate with partners but that does not extend outside that specific relationship.  Additionally, many may find they can be sexually active with certain people, but certain touches, stimulations, etc. evoke memories and anxiety from abuse that they do not have control over (at least at that moment).  One of the difficult things for people who suffer from any trauma, but particularly post-traumatic stress disorder (which is common in victims of abuse), is that it can be some of the smallest things that send them back to the trauma: smells, very specific touches, sounds, etc.  For some women, breastfeeding can be a trigger even if sex is not.

Third, and finally, if it’s not sexual abuse, we can be pretty sure there’s some event or series of events that have led to breastfeeding causing such strong aversions (it may be other violence or even a medical condition; if you have negative feelings surrounding breastfeeding at the time of feeding and these feelings pass after letdown, please looking into Dysphoric Milk Ejection Reflex, a condition which causes women to experience negative emotions just prior to milk ejection and is treatable).  We don’t need to know what it is that has caused this and we don’t need to hound a person about it.  Our lives are made up of millions of events, all of which will shape us in one way or another, some more so than others, and some so negatively they have an everlasting impact.  Of course we would hope people find someone to talk to and work through these events, but not everyone does, and even those that may eventually understand the effects of their past and be able to overcome may not do so in time to breastfeed.  The risk for these women isn’t just reliving experiences that caused trauma – whatever they were – but falling into post-partum depression which is not healthy for any woman or baby.  We have to remember this when we start questioning the validity of this type of aversion.

What to Do?

Unfortunately, we can often hear that moms should just “get over it” to do what is best for their baby.  Here is where I struggle: How can we ask moms to put themselves in harm’s way (because, yes, negative touch and flashbacks and all of this IS harm)?  How can we believe this is best for a family?  How can we think that a child would benefit from a mother who approaches feeding with stress and resentment?  Even at the physiological level, we know babies pick up mom’s emotions very clearly during this period and is this type of stress what we want babies to experience?

I have read people comment that they were one of these people and still breastfed and so everyone should be able to.  I hope I don’t need to point out how ridiculous it is to assume that our individual successes should be applicable to everyone.  Why one woman overcomes a particular booby trap has a lot to do with her environment, her support system, her upbringing, her temperament, etc.  Just thinking of my own experiences as a mom who has been nursing for over 3 ½ years and is still going strong, I am well aware that most women did not grow up witnessing two siblings nursing until they were near 4 years of age.  That it was so normal for me to see that that when I was pregnant, it wasn’t even a second thought that I would nurse until my child decided to stop (which she still hasn’t).  But I was the only person in my prenatal breastfeeding class (at a very crunchy-esque place that predominantly serves midwifery patients) who had that attitude.  The only one.  I don’t know what happened to others in that group – probably nothing for most of them – but I have no basis to tell anyone to “get over” anything, regardless of my own situation.  The only person I can tell to “get over” something is myself.

So what are these moms to do?  Just switch to formula?  For some, that will be the answer, but I hope that with understanding we can start to find ways to help these moms if they want to breastfeed.  One mom mentioned that nipple shields helped reduce the sensation for her and allowed some nursing.  Others have mentioned getting donor milk instead of formula; knowing that they can’t handle breastfeeding themselves, they opt for the next best thing: Breast milk from another mother.  As for the rest of us, we can offer compassion and fight for alternatives to formula.  We don’t know what another mother’s journey has been and even if we’ve experienced trauma or pain, we have to accept our bit of privilege in being able to overcome it, because not everyone will “heal” to the same degree as us.  Compassion can also be offering an ear to help someone simply talk about their experiences as we know that has the power to heal as well.  HELPING is what we need to be looking to do, and if you want to help all babies get the gift of breast milk, fight for wider access to donor milk via milk banks and peer-to-peer sharing networks.  Focus on education about breastfeeding and breast milk and help make formula a true third choice, left for moms who desire it, not moms who need it.  That is what we can and should do for these mothers and babies.