Breastfeeding and postnatal depression

[tiggy2610]

My DS is only 3 weeks old and I'm already caught in a bit of a black cloud, so I'm hoping for some words of wisdom from people who have experienced (and survived!) similar situations. (I'm sorry if this is long, I don't want to drip feed)

DS arrived early at 36 weeks and labour was traumatic for the both of us (emergency forceps delivery, episiotomy and tearing, and resusitation at birth) which lead to him developing severe jaundice and spending 7 days in an incubator undergoing dual phototherapy. While he was in the incubator we tried to establish BFing as well as possible but he was only allowed out of the 'box' for 30mins at a time so we mostly ended up latching and then topping up with formula from a cup. When we were discharged he was feeding OK, albeit a little hit and miss, with some feeds going perfectly and others being a few hours of crying from the both of us. He has an underdeveloped suck reflex and a mild tongue tie so I understand feeding will be as frustrating and upsetting for him as it is for me, which breaks my heart.

The past week has been hellish. His latch is often painful and he seems to be really struggling with his tongue but HVs are happy to wait to see if it does 'stretch'. I spend 1-2hrs moving him from breast to breast to try and get him to take a feed and then I express for 40+ mins once we've finished to try and keep my supply up (he will rarely take both breasts and I regularly feel engorged). By the time all of that is finished I will have around an hours respite before the whole cycle starts again.

To add to this difficulty, yesterday I was referred to the local mental health team with suspected postnatal depression by my GP. I cry uncontrollably for up to 4hours a day as I'm convinced my son will be much better off if I just got in the car and leave him with DH. This isn't solely connected to BFing but my current inability to feed him well is definitely adding to the strain. I have bonded with my son, I love him so much and my PND has manifested itself with irrational thoughts of his death and my ability to care for him. I have vivid images of him being drown (by someone else) and me not being able to rescue him . Due to this I haven't been sleeping and have managed around 2hrs a day since he was born, my appetite is non existent (my DH is encouraging me to eat at every meal time) and I'm exhausted. After a particularly bad day this weekend the community psychiatric nurse advised my husband to take DS for an evening to allow me to get some rest and he would feed EBM/Formula during the night, an idea I initially fought completely but eventually agreed to and managed 6hrs uninterrupted sleep. Since then I have reluctantly agreed to express and allow DH to give DS a bottle during the night so he can take over one feed and I can get some rest. Luckily I can express around 4oz at a time so bottle feeding EBM has been possible.

Yesterday I decided to venture out of the house to the local baby cafe to meet with a lactation consultant to assess his tongue tie. I was there for 2hrs and during this time the LC told me I had been latching his completely wrong since day one and therefore I was to blame for the wind he's suffering and that 'Breast is best' and allowing DH to bottle feed him was not sustainable as he had to return to work and I would end up not BFing which I would regret if I had further children. I left feeling wracked with guilt and like my son wasn't being correctly provided for. The hospital midwives, my community midwife and BF peer supporters had previously checked his latch and hadn't mentioned I was doing it incorrectly.

I feel like my failings at BFing are pushing me further into this god awful PND and is destroying my relationship with DH. He gets all the cuddles and happy time with our son while I'm exhausted by feeding and almost paralysed with anxiety of my son being taken away and struggling to not cry everytime I hear DS stir from a nap.

I've found myself considering giving up with BFing but am struggling to cope with the guilt and feeling like I'm letting him down.

I just don't know what to do. Struggle through with the BFing and hope to come out of the other side with a 12month old who I can still feed or try and regain some sanity and move onto EBM/formula and concentrate on working through these feelings of guilt?

[Laquila]

Oh bless you. Please don't feel alone and certainly don't feel that you're the only one going through this - these feelings are very common but that's not to say that they should be ignored. It was very unprofessional and insensitive of the LC to talk to you like that and completely misses the point of your situation, IMO.

If I were you I would do the following:

• call La Leche League (Google for number) for immediate helpful listening ear and advice, and find their nearest group to you
  
• if at all possible, take to bed with your baby, get some nice skin to skin and try your best to relax with him, without worrying too muchc about how much milk he's getting
  
• don't beat yourself up int he slightest about expressing and getting husband to bottle feed - if your priority is to bf, at the moment it sounds to me a though you need the relief and respite provided, both physically and mentally, by someone else doing a bit of the actual feeding
  
• have a look at kellymom.com for various fact sheets and advice on all aspects of bf, but please try not to drive yourself insane with research - there's a temptation to search and search for 'the right answer', and his doesn't always exist. In my experience they key to successful be after a rocky start is simply perseverance, but that doesn't mean you shouldn't address underlying issues such as potential latch problems.
  
• try to find out what you need for referral to someone to clip his TT - in some areas you self-refer and then the onus is on you to chase up the appt with the provider - don't be afraid to be very firm on this
  

I've never even met you but I can assure your that your boy will be infinitely better off with you than without you, believe me :)

I know it's not very helpful right now but I was in a very similar place to you about 16 months ago, and am now still happily feeding my boy mornings and night, and bf is completely and utterly WORLDS aaway from what it was back then. I promise it will get better!

[Laquila]

Meant to say too, there's absolutely no reason you shoulsnt top him up with formula of that's what you want to do, as long as you appreciate that it probably will decrease our supply in the short-term, but things like skin-to-skin, expressing and fenugreek tablets will all help with that, if you do want to keep bf.

[tortoisesarefab]

You will not be letting your son down by expressing/ formula feeding. I went through hell with my Ds, he didn't feed well at all, was feeding constantly and it nearly drove me to a complete breakdown. I gave him a bottle of ebm, he took it no problem and was happy and settled. I got a break and I questioned why I was breast feeding when neither of us enjoyed it or were coping. I fed him ebm for a while and then cut that out and introduced formula. I never looked back, I did feel guilty but that passed and he is now an amazing, happy 3 year old. I was much more content almost immediately as I felt that the pressure was taken off me. Obviously if you really want to continue breast feeding then you should seek all the help you can but I just thought I would offer an alternative view.

[TriciaMcM]

Lots of good advice but just to add- you need to eat. Wasting away will not help PND or supply so it's vital to eat something. Try anything tempting or even just not repulsive- if it's something you can stomach get your DH to source it. (I liked comforting food like shepherds pie even when had no appetite for example) Even lucosade sport or other caffeine free sports energy drinks are better than nothing. Little & often if big meals are too much & hugs

[Booboostoo]

Goodness I really feel for you reading this post!

Infant feeding is a tiny, tiny part of a very long parenting journey. FF, bf or mix feed it doesn't matter, they are all good and this is a stage your DS will outgrow very quickly anyway.

The LC sounds awful! If you do decide to continue with bf try La Leche. They usually have competent, sympathetic advisors.

Whatever you decide to do be kind to yourself.

[squizita]

Agree with all PP especially the one who says EAT. Low blood sugar and energy can affect depression and anxiety a lot (was there a few months back but on better footing now).
I found nutritious ready to eat food which had a lot of calories in a small portion (snack eggs, mini baby bels, sausage rolls, samosas...) helped when I couldn't do full meals. Also milky drinks if you like them.

Exhaustion also makes the intrusive thoughts much worse in my experience so absolutely get dh to help with expressed or formula. my dh helps with expressed milk and it really helps me on bad days!!

[tiggy2610]

Thank you for all the kind words, I was convinced I would get shot down for contemplating giving up after 3 weeks. Usually when I read these sorts of posts the mum has been at it for MONTHS not weeks.

I did call the NCT BF Helpline for advice after DS developed a 'click' when feeding, they told me it was an OALD and to feed in a reclined position which did seem to help. The lactation consultant yesterday completely poo-pooed that idea and said he was clicking due to his tongue tie and my incorrect latching. I feel overwhelmed with information. She is the method of getting a referral for 'the snip'! Midwife is calling over this afternoon so I will ask if there are alternatives.

We do get to have a little skin to skin each day but after a while he starts rooting for the nipple and then the whole saga begins again and I end up passing him to DH so I can compose myself. I feel like I'm missing out on so much of the good stuff.

I am trying to eat and DH, although a little clueless, is being as supportive as he can without fully understanding.

tortoise thank you for posting your experience. Ive read so much about perseverance and how much people regret giving up BFing, it's refreshing to see a positive outcome from an alternative view point.

I know full well I'm just waiting for a health professional to provide some sort of validation for me stopping BFing and don't want to have to make the decision myself!

[squizita]

Just think about the current adult population ... when we were babies very few people ebf. The majority of us are perfectly alright! Yes breast feeding does have extra antibodies and so forth, but the benefit of a healthy mum who isn't run ragged is essential.
If you feel you need to mix feed, formula feed, or if after talking to a decent lc you want to crack on with breastfeeding. .. you're right. You're a good mum making the right choices.

[Nolim]

in my case the delivery and first days were not as dramatic as yours, but i still had to stay in the hospital for a few days and my baby had trouble latching on. Also my supply was low. Having to wake up every 1.5 hours to pump/breastfeed was horrible, I hardly got any sleep.

Things that helped

1. Formula. It is not poison. It is baby food.
   
2. Already made formula. Personally I find all the boiling/mixing too much work on top of sterilizing and everything else.
   
3. Having DP help with feeds, we would take turn so that we could get some sleep.
   
4. Make sleeping and eating a priority. Everything else can wait.
   
5. Time. It will get better. I know that every day and every night seems an eternity, but it will pass. Seriously.
   
6. Realizing that as long as the baby gains weight, who cares if you bf or ff? Isn't it more important to have a healthy formula fed baby with a happy mum than an undernourished breast fed baby with a miserable mum?
   
   Please get help for your PND, for you and your baby's well being. Your sanity is more important than breastmilk.

[FreiasBathtub]

Oh tiggy, I really feel for you. Eight weeks ago I could've written pretty much this exact post. My DD also spent a week in NICU after her birth and we had real problems establishing breastfeeding.

I too had persistent intrusive thoughts about harm coming to my baby, was jealous of my husband and his ability to enjoy our tiny baby, and stopped sleeping.

Pp have given excellent advice. I would add that starting antidepressants made an enormous difference to my mood and ability to deal with everything else. They also got me sleeping again. I'd definitely recommend talking to your GP. I believe there is emerging evidence which shows a link between struggling to breastfeed and the onset of PND, which is hardly surprising when you think about it.

I would also say that for the first few weeks feeding feels like pretty much the only thing you can do for your baby so if it isn't going well it can be devastating. As they get a bit older and more interactive you realise that there is so much more to being a mother and the feeding becomes less important - or that was my experience.

At 13 weeks we are mix feeding, mostly breast but also formula when needed. At one point I was topping up with formula after almost every feed, so nothing is final. It took me a while to make my peace with not EBF and I do think that process of acceptance takes some time, but whatever you end up doing I do believe you will come to be happy with it - and that's the most important thing.

Also, that lactation consultant deserves a strongly worded letter at the very least. She's an idiot!

[geekaMaxima]

at that lactation consultant for being so utterly unsupportive. Telling someone "you're doing it wrong" as opposed to "let me show you a way to make it better" shows a dangerous lack of people skills. I wonder if she wasn't actually a qualified IBCLC lactation consultant, and rather someone with a lot less training who nevertheless is running the bf cafe?

First of all, well done on all the hard work you've put in so far. I know your PND might make it hard to believe, but you are doing a fantastic job of a difficult situation and your lo is lucky to have you. You are absolutely not "failing" at bf; what's happening is that the NHS are failing to support you properly by giving you conflicting and/or poor advice, and by not arranging an urgent referral for a tongue-tied baby whose feeding is causing problems for the mother. None of this is your fault.

Second, as a pp said, push as hard as you can for the tt referral. Or get your dh to do the pushing if you'd prefer to concentrate your energy elsewhere. Keep asking the HVs for an urgent referral NOW. If they're really not forthcoming, could you afford to get it done privately? Or if you could see an IBCLC lactation consultant privately, you should get to talk to someone who has plenty of experience with tt babies, and could advise you on whether it's really necessary to keep up your current cycle of feeding and pumping (which is very hard work; not what you need at the moment).

Also, seeing your gp for PND can only be a good thing. Lots of women find antidepressants make an enormous difference, and some are safe to take while bf (if you hadn't already been told that).

Lastly, bf doesn't have to be all or nothing. If your dh gives a feed of formula every day while you get some sleep, that's okay. If you prefer to keep going with ebm, that's okay too. Either way, if it helps, keep doing it. If you later want to drop the formula and go back to ebm or bf directly, it's possible to do that. If you later want to increase the number of ff each day, that's okay too.

Take things one day at a time and good luck

[NickyEds]

OP This is not your fault. Some women have a much harder time bf than others. Traumatic birth, PND, tongue tie, crap advise, "breast is best" lecures all make it harder not easier. You are providing for your son despite these difficulties and that is no mean feat.

If you want to carry on bf: Talk to you mw when she comes. Talk honestly and openly about your experience so far. We had a "wait and see" approach to the Tt snip and it was awful. Ds had his snipped when he was around 18/19 days old and the "clicking" noise that you mentioned went away and feeding was easier.
If you want to mix feed of switch to ff then do. Really, it's more important that you're ok at this point. Irl I know of a handful women who wish bf had worked out but very, very few who are wracked with guilt over it now (most of my friends babies are 1). I also know women who bf and do regret aspects of it. I sometimes regret letting bf take over everything in the early days with ds.

The first few weeks with a new baby are soooo hard op, no one's really ready for the bombshell that is their first baby. This too shall pass. It gets easier.

[tortoisesarefab]

tiggy if you want a health professional to tell you to ff then I am a health professional and I am telling you to ff! Give yourself a break, allow other people to help you out and just enjoy a cuddle with your baby.

[tiktok]

When the dust settles, do let the baby cafe know how unhelpful you found the manner and approach of the lactation consultant (wonder if she was really trained and supervised???).

[chillychicken]

FFS this whole 'breast is best' thing is really annoying me. I know it is. We all know it is. But formula isnt poison. I came extremely close to developing PND due to feeding problems and the guilt at having to give formula. Breast ISNT best when it's making the mother miserable, in my opinion. Your baby needs a happy mum more than he needs your milk. It's taken me 4 weeks to finally be at peace with my decision to give up breastfeeding and I'm in such a better place. I express and 50% of his feeds each day are breastmilk but I won't express forever. It's not affected our bond at all. There's something quite wonderful about having him look me in the eye and hold my hand as I feed him. My DH does evening feeds and any feeds between 5am and 7am. It works for us. Please don't feel like you're failing your baby - you're really not. I wish I could let you speak to my health visitor - she told me it was ok to stop and give formula. And it really is. Xxx

[BiscuitsofYum]

Wow op, I'm sorry you're first few weeks have been so upsetting.

My ds was born through emcs after a very painful 52 hours of early labour. I spent two days on the ward because of my blood loss mostly where the only sleep I had was the few hours I had when dp help ds so I could snooze.. On night one the midwives showed me how to start to put him on the breast, I managed to get the hang quickly and I was confident. I was then moved to the main ward where another midwife told me the position wasn't quite right and changed it.. The next day I was shown various other ways because the one before was not quite right.. By the time I left hospital I was confused and ds would get cross with trying to latch.. At home I had 3 different midwives come and see me each again saying it wasn't right.. Each time I took there advice It would be ages before I could get ds to latch properly.. The first few weeks I badly slept, hardly ate and just cried.. There was one night where I woke dp up and said if he didn't take him I would throw him put the window (I wouldn't but I was emotional).
Ds is 6 weeks now and I have developed breast feeding on my own after giving up with advice.. Feeding is good now and we have no issues, saying that I do express so dp can take ds to the shops or out for an hour so I can stop feeling like a cow and more like me. I have given ds a bit of formula, it hasn't hurt him and he slept that little bit longer again giving me chance to have a bath!
As for pnd, breast feeding is hard! And can be isolating, unless you're confident to get your breasts out everywhere , feeding out and about is awkward and hard! I felt like I spent all day stuck with my boobs out, and especially when my milk first came in a little gross as breastmilk poured from them as I fed. But I found getting out a little everyday helped, and the little things. Cuddling up in bed for an hour as ds snoozes and I take a cheeky kip. Once I started eating meals properly again I felt a bit better and talking it out with the gp and health visitor.

From what I read you are doing great for your ds, but please look after yourself too! Don't feel guilty over your feeding choice and don't let anyone bring you down about it. Its you're choice how you feed your ds and you'll be feeding your choice with him in mind, formula or breast both are ok!

[tiggy2610]

I can't possibly begin to explain how much of a relief it is to read all of your replies. I am so grateful for you all taking the time go respond to me and sharing your stories

The midwife that came round this afternoon wasn't my usual as she was on holiday. She happened to call round at a time I was sobbing in the bedroom after telling DH I was going to throw the baby if he didn't take him off me . DH explained what had been going on and she came up to the bedroom and we chatted for a good 40mins, she had only been a midwife for a few years but and was brilliant. She did tell me nothing would happen to my son if I fed him with a bottle and that it was OK to stop BFing if I wanted. We discussed what the LC said yesterday and she asked me to show her our 'normal' position which she said was perfect! We have developed a plan for the next 24hours and I am to attempt to latch for 10mins and if that doesn't work DH is to feed using cup/syringe. She's calling back tomorrow to see how we're getting on and if this hasn't been a success she said we can then discuss the best methods for introducing bottles of EBM/formula and keeping my supply up.

The mental health team are calling round to see me tomorrow for a further assessment for the PND which should help get things moving with shifting this black cloud.

Thank you so much to all of you

[geekaMaxima]

OP, I'm so glad you got a midwife who actually seemed to listen to what you needed.

Hope the next 24 hours are easier on you

[Nolim]

[squizita]

That sounds great news.

I agree with Tiktok ... Once it's better, do consider letting the bf cafe people know. The lc harmed your health with her unkind words.

[Imeg]

Aww, I really hope things get better for you soon, I'm glad the midwife has helped you to feel better about it all. Your baby will benefit from you being well so if formula will help you to sleep and eat then maybe that is a good option, whether temporarily to help you have the energy to continue breastfeeding or permanently.

[pigsunited]

I have had a crappy bf journey too so I really feel for you. I was slipping into PND in the first few weeks. I would just burst into tears at random times of the day for no reason. As others have said, feeding your baby is the main thing you do for them in the early days, so when it is not working well it feels awful.

Sounds like you have got some good advice from your midwife. If you do want to get the TT seen to, perhaps get in touch with a different lactation consultant - the one you saw sounds awful and unsupportive.

FWIW, at 5 months I now mix feed - a small amount of bf combined with EBM and formula. This system works for us and I don't feel any guilt that DS is not EBF. We were dealt a bad hand and that I had reached my limits in terms of trying.

[ApplesTheHare]

tiggy I just wanted to say it sounds like you've had a REALLY rough time, and that whatever you decide to do feeding-wise, your son will be healthy. What comes across in all your posts beneath the worry is love, so I am sure he will be happy, too. Be kind to yourself and I promise it will get easier...

[FreiasBathtub]

That all sounds really positive tiggy, I'm so pleased for you. Remember, every day that your baby gets some breastmilk is a real achievement. I forgot to say that one thing which really helped me was setting myself small goals - I'll breastfeed until the end of the weekend, the end of the week, to six weeks and so on. And I don't mean EBF, I mean the baby gets at least some breastmilk that day. I'm still doing it now. It helped me relax - I wasn't dreading the next six months but simply thinking day by day. It also made it easier to feel that when I do stop breastfeeding it won't be a failure, because I've had so many little successes.

You have done so well to persist this far against some pretty big obstacles completely outside of your control, I hope in time you can see it as the success it is and be proud of yourself.

[Booboostoo]

I am so glad you are feeling a bit more positive. I hope things continue to improve for you.