04 May

Breastfeeding was my lifeline while struggling with PTSD

I could barely hold the funnel to my breast. My hands, swollen and numb grasped as hard as they could, my body weak, hardly had the strength I needed to do this. I lay there, on the hospital bed, the noise of the machines sending me into a trance like slumber. Slowly the small drops of precious milk appeared, glistening in the light that flooded my room, and I felt relief relax my body. I closed my eyes, this, this was my lifeline, this was what was keeping me alive.

My baby lay in neonatal, she felt like a million miles away, this was all I could do, I couldn’t walk, couldn’t hold her or care for her, but I could do this, I could give her my milk. So, while my arms ached, the pain making my fingers tremble, my ravaged and traumatised body fought to give me what I needed, I would do this for her, for me.

While on HDU and then when I was well enough to go to the postnatal wards, pumping for my daughter became my lifeline. It kept me alive, because deep down I truly believed I was dying, so I would stare at the clock and will myself to live just a few hours longer, so I could pump again and provide another feed for my baby. It became my mission, my goal to live till the next time I had to express, and it felt like the last gift that my failing body could give her. The staff tried to make me stop, telling me that with the massive blood loss and a haemoglobin of 4.1 it was pointless. They told me I would never make any milk, let alone enough to feed her just breastmilk, but I wasn’t giving up that easy. I cherished every drop that my body gave me, like it was a magical potion that would keep my baby safe. Even after I was found unconscious in my room and at the brink of death, all I could think about was I needed to live, just a little longer to express my milk, I had to do this because soon I would be gone, and this was all I could do, all I could give her of me.

Every syringe, I sent to the unit was full of love, I couldn’t be there, to tell her I loved her, but my milk was like a message in a bottle. So, I would beg for the pump and even fetch it myself. It was such a sight, me in my wheelchair trying to also wheel the pump down the ward, but I was determined nothing would stop me. Gradually as the days passed my supply increased. It felt like a victory. I would prove them all wrong, I would do this, just wait and see.

As soon as I was well enough I would wheel myself down to the neonatal unit, placing the small bottles containing my milk, in the pocket of my dressing gown next to my heart. It was like carrying the most precious jewels, bringing my baby her gift. As I watched the nurses fill up the syringe and feed it through her nasal gastric tube, my heart would beat so fast, fit to burst. I had done that, I had provided her with what she needed, no one else just me. I was giving her life, giving her what she should have had from me, had she still been inside me, had my stricken body not failed her six weeks too soon. I would not fail again. My body would come good this time and provide her what she needed. As I looked at her small and fragile in the incubator, I willed my body to hold out and to keep going.

Soon my supply was increasing, and the nurses were amazed as I kept bringing down bottles full of milk. As my baby grew stronger they asked if they could start giving bottles, so they could wean her off the NG tube, but I made it clear that I wanted to feed her from my breast. Again, I was told we would never achieve breastfeeding but that I could try her at the breast and then they would offer her a top up in a bottle. However, this wasn’t good enough for me, we would prove them wrong again, because I knew that she could get this breastfeeding lark, we just needed time.

When I held her to my breast I felt calm, and safe. The terror went away, and the fear eased.

So, after two weeks I was discharged from the ward and my mission now was to be at the unit 24/7. The staff agreed to leave in the NG tube while I was trying to establish breastfeeding so that they could top up feeds if needed. So, I basically moved in. Every moment I could, I placed my tiny baby to my breast. It was terrifying, I had no idea what I was doing, she still had wires everywhere and the machines would beep and go crazy, but slowly I found a way to hold her and she would open her tiny mouth and latch. It filled me with the most amazing feeling, to know that I was caring for my baby this way. When most of her care was out of my hands, this was something I could do.

After two nights in the chair next to her cot, the staff knew I was going nowhere and I was given the tiny room on the unit that was only big enough to contain a bed and a tiny sink, but I was so grateful. I was just about able to walk very small distances, so it meant I had a place to rest at night till I was called to her bedside. I was watched by the staff like a hawk, and she was weighed daily. Many times the staff and family suggested I be kind to myself and take it easy and add in some formula. They said she wouldn’t gain weight as fast on breastmilk and it would take longer for us to go home. But I was determined and so was my little baby. She worked so hard, and she would open her eyes and gaze at me like she was willing me on and telling me she could do this.

So, it began, my breastfeeding journey, my lifeline. When we both finally went home, 5 weeks after her birth, my baby was fully breastfeeding, to the amazement of the staff. Together we overcame a traumatic, premature birth that nearly cost us both our lives, massive blood loss that should have robbed me of my milk and transitioning to fully breastfeeding when no one said we would. Even when we got home it wasn’t easy and we battled oversupply, awful colic, mastitis and tongue tie. But together we made it; for 15 months I fed and nourished my baby and she thrived, she put on weight and despite me being told to expect her to be behind in developmental milestones, to everyone’s amazement she was instead ahead. In fact, my little girl, even though only tiny, was walking at nine months.

For me breastfeeding kept me alive. On the days I lay in hospital when I had no idea if I would make it, I lived to express for my baby. When I went home, when I was battling flashbacks and nightmares from the birth, when I was scared and worried about my baby, breastfeeding was my lifeline. When I held her to my breast I felt calm, and safe. The terror went away, and the fear eased. Close to me, she was mine, I could protect her, nothing could harm her or take her from me. My body that had failed her, was now keeping her alive once more, giving her everything she needed. It was also saving me, keeping me from losing myself to the terrors that sought to take over my mind. In the night, when I woke and heard her crying, I could run to her, take her in my arms and place her to my breast, unlike all those nights in hospital when I couldn’t be with her, couldn’t care for her.

While everyone tried to get me to stop they didn’t understand that it was a vital part of my healing from birth trauma and also that it was helping me while struggling with undiagnosed PTSD. It was so important to me, my vital connection to my baby but also helping me to cope with everything that we had been through. It was my journey that years later moved me to train with the BFN so that I could offer others the support that I didn’t receive. To help other Mums like me who wanted to breastfeed and so they too could experience the joy I had. Those early weeks were hard, and I know how much I would have valued having someone by my side to offer encouragement and hope.

I now support others who have had a traumatic birth. It’s so important that we understand how birth can impact on maternal mental health and breastfeeding. That we listen and support women in their choices giving them accurate information and support, but also that we understand the emotional side and how kindness, encouragement and just being with them can make such a difference.

For me breastfeeding was a beautiful gift. It is a gift that I cherish because it was a battle no one said we could win. But win we did, and I will forever be grateful for the fact that we achieved what was seemly impossible, given all the odds – a lifeline in the darkest of times.

Emma Sasaru

Emma is a mother to two beautiful daughters. Her passion is to improve support for women and their families that have experienced birth trauma, had a premature baby and the difficult journey of neonatal. She is also a volunteer breastfeeding supporter with BfN.

Twitter: @emmajanesas

Beyondbirthtrauma.com

Finding breastfeeding support

Getting help with breastfeeding, at the time you need it, is really important. We know the relationship between breastfeeding and mental health is a complex one. Whatever our decision is to feed our little one, and however our mental state is affected during this time, we should expect to feel supported and respected in our feeding decision, and with our mental wellbeing. We are here to offer all families independent, non judgemental support with breastfeeding for as long as they choose.

Please don’t be afraid to ask for help. BfN Registered Volunteers want to help you with breastfeeding. It is why they have done training and offer their time.
Call the National Breastfeeding Helpline on 0300 100 0212

You may not need to venture beyond your front door to get breastfeeding support. BfN Registered Breastfeeding Supporters are trained to give support and information by telephone.

Drugs in Breastmilk Information Service

For enquiries in relation to taking medication whilst breastfeeding contact our Drugs in Breastmilk team.

Find a Drop-In Group

It can be helpful to get face-to-face help with breastfeeding and to meet other breastfeeding mums. There may be a Breastfeeding Drop-In Group in your area that can help you do this (we list groups on our website where there is a BfN Registered Breastfeeding Volunteer attending). Also it can be really helpful to have someone who knows about breastfeeding to sit with you as you feed your baby. If the person helping you can be there from before you start  a breastfeed until your baby has finished feeding, this is most helpful. The drop-in group can help you with this or you can ask your midwife or health visitor if they are able to do this.

Your local Infant Feeding Co-ordinator, Community Midwife or Health Visitor may have details of local support. Their contact details  might be in the discharge pack you were given when you had your baby. If you live in England or Wales you can find contact details for your nearest maternity unit on the NHS Choices Website.

 

 

04 May

Breastfeeding and maternal mental health

This week is maternal mental health awareness week and so it’s important that we speak up about the often misunderstood relationship between maternal mental health and breastfeeding. I hope this blog complements the fantastic offerings from Dr Wendy Jones’s live Facebook session in conjunction with the Perinatal Mental Health Partnership, and information offered by Dr Louise Santhanam of GP Infant Feeding Network (GPIFN). Both the Facebook session and GPIFN website are must-reads to any breastfeeding mother who is concerned about her mental health (that’s all of us by the way) or indeed for dads, partners or grandparents or anyone supporting a mother. It’s also the week BfN have been told that there is no funding available to continue breastfeeding peer-support in Blackpool. Since 2007 Blackpool Star Buddies have helped thousands of parents, babies and families to breastfeed against the odds and it is disappointing that such a high-performing scheme is being forced to close. Yet, still feeling the glow of BfN winning Charity of the Year award at the Mama Conference 2017, I am trying to work out how to feel about these highs and lows that are hitting the world of infant feeding, the charity sector and parents and families who are seeing services declining.

For those of you who had never thought about the connection between breastfeeding and maternal mental health or those who aren’t convinced, please read on. For those of you who are well versed in this you may want to make a friend a cup of tea.

The relationship between infant feeding and mental health is complicated, not least because a mother’s pre-natal mental state, pregnancy and birth experience can all result in stress and trauma – all of which can influence how a mother feels about breastfeeding. In other words the cause and correlation between breastfeeding and mental health isn’t a tidy one – it’s complicated.

There can be a lot of pressure on mothers to breastfeed fuelled by the ‘being the best’ campaigns, only slightly softened by the addition of ‘be the best you can be’. We know that pressure is not good for mental health so let’s just stop this rhetoric now!

What you may not know is that evidence suggests that ‘not breastfeeding’ can significantly increase the risk of postnatal depression, particularly if a mother wanted and intended to breastfeed. A 2014 study of over 10,000 mothers found that those who didn’t plan to breastfeed and who gave formula from birth were significantly more likely to become depressed than those who planned to breastfeed and who did so exclusively for at least four weeks. The same study found that those who planned to breastfeed, yet were unable to do so were at a higher risk of postnatal depression. This research tells us that breastfeeding is important to women and that good support is needed for women who want to breastfeed, but also good support is needed for women who intended to breastfeed but who find themselves unable to do so. So why are breastfeeding peer support services being closed down?

Supporting mothers for over 20 years we at BfN know that establishing pain-free, comfortable feeding makes for a good breastfeeding experience. So, we have to break down the culture of silence around pain and offer mothers as much support as they need, especially on positioning and attachment (typical cause of pain can be poor positioning of baby at the breast). Pain and injury are not acceptable characteristics of breastfeeding – if you are experiencing pain, don’t suffer in silence – talk to a mum who knows about breastfeeding. Call the National Breastfeeding Helpline on 0300 100 0212.

Scientists are trying to understand the relationship between breastfeeding and maternal mental health. Some theories say that the act of breastfeeding supports the hormonal surges of both oxytocin and prolactin which encourage a mother to feel more relaxed and reduce anxiety. Also breastfeeding helps to regulate / reduce the body’s inflammatory response – depression is associated with inflammation.

We know that some GPs lack time, training and opportunities to support a breastfeeding mother who is experiencing issues with her mental health. GPs can lack knowledge on breastfeeding and often are not sensitive to the needs of someone who is breastfeeding, unwittingly overlooking the issues or value the mother places on continuing to breastfeed. So, it is important to encourage awareness and better training for GPs. Information for GPs is available through the GP Infant Feeding Network and through the BfN’s Drugs in Breastmilk Information service.

Perhaps most importantly we should all be listening to mothers carefully. They know their baby more than anyone else and their experience is informed by instinct and regular contact. If something isn’t going well for them they are the best people to explain the situation and they shouldn’t feel worried about how it is coming across. A non-judgmental approach is essential.

With services to support breastfeeding cut to the bone we are all going to need to understand breastfeeding better – partners, grandparents, friends of new mothers will need better information to offer support. It’s vital that we share information and research on the relationship between breastfeeding and maternal mental health.

Shereen Fisher is Chief Executive for the Breastfeeding Network @shereen_fisher