For all the good things about breastfeeding, there are also times when it can be excruciating, not possible for various physical reasons, a real emotional struggle, or something you discover you just plain don’t like, and trying to continue begins to have a far greater cost to you or your child than any real or potential benefit. If that happens, you are not alone, and it’s worth considering whether you want to continue or switch to formula-feeding or do some combination of the two that eases the pressure on you.
PUT YOUR EMOTIONAL HEALTH FIRST:
This is key and something so few of us do. After all, the job of motherhood is to take care of someone else, and usually that’s priority number one. But you know what? Taking care of your emotional health is taking care of your baby. Feeling more comfortable, not in pain, not preoccupied with stress around how many ounces your baby is getting, or whatever struggles you are facing will make for a much more enjoyable time for you and your baby.
Suzanne Barston had intended to exclusively breastfeed her first child—but a slew of problems, including complications during pregnancy, a tongue tie, jaundice, her son’s inability to latch, and postpartum depression made breastfeeding an all-consuming and eventually futile endeavor. The experience was so traumatic and transformational for her that she went on to become a certified lactation counselor and one of the country’s leading voices on supporting the feeding choices of all mothers.
“A lot of people can have a lot of difficulty breastfeeding and still feel okay emotionally,” says Barston. “But if you are at a point where you cannot connect with your baby, you’re not able to function, it doesn’t matter if you think you can hold on for another three weeks. You are at a breaking point, and you need to take care of yourself.”
When lactation consultant Carrie Bruno meets with moms who are having serious breastfeeding difficulties, she tells them, “You look like you’re struggling. You’ve given it 1,000 percent effort, but this is sucking the life out of you, you’re not able to enjoy your baby. It’s okay to give him the bottle.’ That’s usually the moment they’ve been waiting for,” says Bruno.
My hope is that you will give yourself space and permission to figure out the best feeding plan for you before you reach your
breaking point. But no matter what, it is never too late to take care of yourself.
TALK IT THROUGH WITH SOMEONE YOU TRUST:
“When women are sleep deprived, it can be really hard to make these kinds of decisions,” says Karen Kleiman, LCSW, founder and director of the Postpartum Stress Center in Rosemont, Pennsylvania. “If you are having breastfeeding difficulties—whether it’s supply, your nipples, fatigue—you really need to have a conversation with someone you feel is on your side to help you make a good decision for you. Sometimes the best thing I can do for women is to give them permission to stop.” Find your least opinionated friend / family member / acquaintance or a mental health professional and share what you are feeling and ask that they listen and talk it through with you.
If breastfeeding around the clock or pumping and breastfeeding is causing more problems than it is solving, then a first option can be supplementing rather than stopping completely. “It’s not always black or white and doing one or the other,” says Bruno. “When women are having difficulty, I will say, ‘You know we can do both. You can continue to nurse him and top him off with a bottle. There’s an array of options.’ It’s whatever works for that family.” And, says Bruno, opting for the bottle at times “does not mean it’s the end of your breastfeeding journey. It can be a rest, and that’s when you get help.”
Work with an internationally board-certified lactation consultant at your home or in a clinic to decide if a combination of formula-feeding and breastfeeding would help alleviate whatever struggles you are facing and come up with a plan to do that.
YOUR CHILD WILL BE OKAY—MORE THAN OKAY:
“No matter what, your baby is going to be okay,” says Barston. “To me, it’s the same as going into birth. Ideally, many of us want to have a drug-free, vaginal birth, but sometimes things don’t go the way you hoped and you end up with a C-section. It’s not what you intended, but things happen. It doesn’t mean you won’t have feelings about it, but your self-worth can’t be tied to biological functions. And as long as everyone is healthy, it’s all okay.”
And that means emotionally healthy. That’s the goal here. “Millions of babies are raised on formula,” says Barston. “I know for a fact what it is like to have postpartum depression and not bond with your child. So the second time around, my priority was that I get that gift and my baby gets that gift. In our case, a present, emotionally healthy mom was more important than breast milk.”
“I always say to moms who are struggling, ‘What do youwant?’” says Bruno. “Your baby will be fine however you choose to feed him. I truly believe that. You need to have the energy to
enjoy these moments with him. My oldest boy is nine, and now my biggest stress with him is screen time. Nobody asks me at the playground, ‘Was he breastfed?’”
IF YOU DECIDE TO WEAN, DO SO GRADUALLY IF POSSIBLE:
Find a lactation consultant who is supportive of your choice to stop breastfeeding and, if possible, come up with a plan to wean so that you don’t experience the extreme physical discomfort or possible physical and emotional complications that can come with stopping abruptly.
“The more abruptly a woman weans, the more likely it is to trigger some mood instability,” says Kleiman. “So, the recommendation is always longer, slower. The more likely you are to protect your mental health.” Although she points out that “some people stop abruptly and have no problems.”
GET GOOD SUPPORT—GET RID OF BAD SUPPORT:
“Make sure the people around you are supportive and shut out the people who aren’t,” says Barston, who discovered her “Mommy and Me” classes (where everyone was breastfeeding) made her feel worse. “I felt very isolated and angry during those classes, and it wasn’t a healthy place for me to be.” Barston recommends taking a break from settings that focus on breastfeeding (you can consider going back when you feel more hormonally and emotionally settled with your new feeding plan). Then reach out to online and other communities (see here) that are supportive of your choice and feel helpful. “That can be really comforting,” says Barston.
CONSIDER BEING THE DESIGNATED FEEDER:
One of the great things about feeding with bottles (whether it is pumped breast milk or formula) is that anyone can feed the baby, but if you are mourning the loss of the breastfeeding relationship, “it can help to be the only one feeding the baby,” says Barston. “And that’s totally okay.”
HAVE YOUR “BACK POCKET” RESPONSES:
“People are going to ask whether you are breastfeeding, and most of the time they don’t mean anything by it,” says Barston. In fact, they may be struggling too, but because there is so much pressure around breastfeeding, the question alone can feel like judgment—especially when you are in that fragile, sleep-deprived, post-birth state. Barston found that having some responses ready, such as “Formula-feeding was right for us” helped put an end to painful conversations.
Being ready for intrusive questions when you’re in a fragile state is just good emotional self-defense, but the bottom line is that you don’t owe anyone an answer. “You don’t ever have to give someone—your doctor, a friend, your mother, a stranger—a reason ever,” says Barston.
If you do switch to formula, see here for tips on bottle-feeding your baby.
If Breastfeeding Makes You Feel Temporarily Terrible—Dysphoric Milk Ejection Reflex (D-MER)
Some women experience a rare but disturbing condition in which they feel profound sadness or other negative emotions right before their milk lets down and for a few minutes afterward. Though it is not well understood, experts say it is a physiological response to breastfeeding.
“It’s a hormonal anomaly of the milk ejection reflex that causes an inappropriate reaction of the neurotransmitter dopamine,” says Alia Macrina, an internationally board-certified lactation consultant and creator of D-MER.org. “And it causes an intense, but brief, moment of emotional disruption and dysphoria.” (Dysphoria is a fancy term for “a feeling of unease”).
In mild cases of D-MER, one common way women describe the feeling is “like the pang of homesickness you got in your stomach when you were a kid,” says Macrina. Moderate or severe D-MER can include feelings of anxiety, panic, and despair or, rarely, thoughts of harming yourself.
Because the feeling often begins even before the tingling of the letdown kicks in, women don’t always connect the feeling to breastfeeding and wonder if they are experiencing postpartum depression. The difference, says Macrina, is that D-MER comes on suddenly and eases almost as quickly as it begins. “One minute you feel like, Oh my god, the world is going to end, and the next you think, Oh, the world is great again,” says Macrina, who experienced the condition ten years ago while breastfeeding her daughter.
“When women stumble across the description of the condition,” says Macrina, “they usually have an aha moment.” And, she adds, understanding the condition is usually enough “to help them feel better and learn how to ride it out.” However, she recommends that anyone who experiences D-MER talk with her health-care provider.
Note: Anytime you are having thoughts of harming yourself, contact a mental health professional or the National Suicide Prevention Lifeline to get support right away: 800-273-8255.
Been There, Done That: Moms Talk About Real Breastfeeding Struggles
Making the decision to switch was guilt-filled and awful. At one point, I told my husband that if he uttered the wordsbreast is best one more time, he was sleeping on the couch!Fed is best! My formula-fed babies are happy, healthy, and thriving, and switching was the best decision for them and my family.
—NATALIE, HOUSTON, TEXAS
I remember opening the formula container and just crying hysterically thinking I was such a failure. I was embarrassed and jealous when I saw other moms breastfeeding. Looking back, I was a huge stress ball, and my baby was stressed. I was able to finally take a breath when I started formula, and he was so much better, content, gaining great weight. Don’t give up right away, but if you are too stressed, it is okay to say, “You know, this
is not right for us.” Both my boys were mainly formula-fed. They are smart, sassy, and absolutely beautiful!
—STEPHANIE, TRAVERSE CITY, MICHIGAN
A fed baby is the best baby. A less-stressed mom is the best mom. If you are struggling nursing and stressed out, give it your best shot. If it still is not working, seriously consider either exclusive pumping or formula.
—AMY, HOUSTON, TEXAS
Once we made the switch to formula, our lives became much easier. My little girl was no longer screaming constantly because she was hungry and irritated. I was still able to bond with her, and her dad had the opportunity to bond with her even quicker. We were able to take turns with feeding, and I didn’t have to do all of the work by myself. It was 100 percent the best decision for our family.
—JENNIFER, ATLANTA, GEORGIA
I was so overwhelmed and consumed by feeding that I found it difficult to enjoy her. After I switched to formula, I was able to relax a bit. I can’t relate when people list enhanced bonding as a benefit of breastfeeding over formula-feeding. While giving my babies their bottles, I can cradle them and look into their eyes, whisper to them, sing lullabies, and I don’t have the stress of worrying about things like milk production, latch difficulties, pumping when I am away.