Breastfeeding is a common goal for many Singaporean mothers. But for some, the breastfeeding journey can be challenging and lead to unexpected emotions, including grief.
Research suggests that around 7% of women experience breastfeeding trauma [2]. A study by Moran et al. (2010) found that mothers who stop breastfeeding often feel a deep sense of loss, disappointment, and inadequacy [1].
• Who is this article for?
This article is for mothers who have had to stop breastfeeding before they felt ready to do so or whose breastfeeding journey was unexpected or different from what they had hoped it would be.
If you feed your baby formula and have made the decision to not breastfeed or combination feed – and both you and your baby are happy and it’s a win-win all around – this article does not apply to you.
Breastfeeding facts
A study by the Health Promotion Board in Singapore showed that 99% of new mothers had breastfeeding initiation [3]. However, this becomes increasingly challenging and breastfeeding is discontinued with 80% babies being breastfed and 28% babies being exclusively breastfed at 2 months old and less than half the babies receiving any breastmilk and only 1% babies being exclusively breastfed at 6 months old.
Globally, 44% of infants under 6 months of age are exclusively breastfed (WHO).
According to the WHO, we know that breastfeeding is one of the most effective ways to ensure child development and survival as well as not only protective of maternal health but maternal mental health too [4].
It can make you feel empowered, confident and help heal birth trauma. Breastfeeding hormones are thought to reduce the impact of stress and sleep deprivation and several studies have found that when breastfeeding is going well, it lowers the chances of a woman developing postnatal depression [5].
So, with such obvious benefits, why are there such low rates of breastfeeding at 6 months when breastfeeding initiation is so high?
• Why doesn’t breastfeeding always work?
Despite valuing breastfeeding [6] many mothers face challenges such as perceived or real low milk supply, a traumatic birth, lack of professional and social support, myths about how breastfeeding works, a belief that formula is needed, pressure from others, false advertising which contributes to pain, public attitudes, placing barriers in the way which can eventually lead you down a path of eventually stopping breastfeeding [7].
What then are the emotional experiences of mothers who wish to (?), need to (?), have to (?) discontinue breastfeeding?
What is so meaningful about breastfeeding and why does ending it matter so much?
What is so meaningful about breastfeeding?
Women describe an urge to breastfeed as something that is instinctual; physically, in that their body produces milk without their choice, and emotionally, in that women often cannot describe why they so strongly want to breastfeed, they just do [8].
Breastfeeding is typically much more than just feeding. It’s an emotional and bonding experience, a way of healing after a birth that did not go as planned, or used as a mothering tool to nurse a sick infant. Many women have an expectation that they should be able to breastfeed. It can be highly meaningful and fulfilling and form a core part of the mother’s identity. It can also be a source of pride, pleasure and achievement.
One of the biggest emotions women face if they cannot breastfeed is a shock that their body did not work as expected. Brown notes that there are other emotions experienced as well – grief, anger, loss – all reflective of your desire to engage in biologically normal behaviour [5].
What is breastfeeding trauma and grief?
Breastfeeding trauma and grief can show up in many insidious ways. It can show up when a mother is told that fed is best and that she should be grateful that ‘at least her baby is fed with formula.’ It may show up even with mothers of older babies or children who feel that the choice to breastfeed has been taken away from them.
According to Dr Amy Brown, mothers may feel happy that their baby is fed but still grieve the loss of the breastfeeding experience, you can feel angry at not getting the support you were promised, frustrated that breastfeeding problems were met with the suggestion to give formula, miserable that your feelings were dismissed (a key feature of trauma) and your complaints that your body was not working the way you hoped were ignored [9].
Typical breastfeeding trauma symptoms may include negative thoughts and feelings around inadequacy, failure and feelings of guilt. A mother may re-experience memories of her distressing breastfeeding experience, or avoid breastfeeding reminders (like breastfeeding friends).
You may have seen your baby crying, losing weight, and felt powerless to meet their needs. You may be witnessing other mothers in the ward who have been successful. You may have experienced many breastfeeding professionals touching your breasts, and received conflicting advice on when to feed the baby, latching techniques or even not received any information at all and been left alone to figure it all out.
Breastfeeding trauma can also compound other trauma for example if the baby is in the NICU, or a mother has experienced birth trauma or there has been sexual trauma in the past [2].
A mother living in Singapore might experience breastfeeding grief due to the culture pressure to succeed at breastfeeding or a lack of support from professionals or not having access to any or even short hospital stays where one leaves before breastfeeding has been established.
Dr Brown makes a strong case that breastfeeding women should be supported emotionally by society – empathetically and without judgement – on learning to breastfeed and then to cope with the grief around its loss [9].
What can you do about it? For yourself, to support someone you love, as a society
• Know that grief is a process. Make space for your feelings and be kind to yourself. Don’t push them away.
• Talk to someone you trust about how you are feeling. Show your loved ones this article to help them be more supportive.
• If your loved one is experiencing breastfeeding grief/trauma, do not dismiss their feelings. Validate and empathise with their feelings. Listen to their story. Words like fed is best or just give your baby formula may make things worse.
• If you realise that you are struggling with trauma symptoms, you might benefit from trauma focused therapy such as EMDR, or CBT. Please consult a professional.
We can help
If you need help processing your trauma or grief, please don’t hesitate to contact us. We have a team of experienced perinatal counsellors who can help you with pre or post natal issues including anxiety or depression, birth trauma, miscarriage and loss.
To meet with a professional psychologist or counsellor, call The Other Clinic at 8809 0659 or email us hello@theotherclinic.sg.
References:
[1] Moran, A., Davies, G., & Knibbs, L. (2010). Women’s experiences of ceasing to breastfeed: Australian qualitative study. BMJ open, 9(5), e026235. https://bmjopen.bmj.com/content/9/5/e026234
[2] Better Beginnings Breastfeeding Trauma Support https://www.motherlove.com/blogs/all/breastfeeding-trauma-is-real-and-we-need-to-talk-about-it
[3] Chua, L., & Win, A.N. (2013). Prevalence of Breastfeeding in Singapore chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.singstat.gov.sg/-/media/files/publications/society/ssnsep13-pg10-14.pdf
[4] World Health Organization. https://www.who.int/health-topics/breastfeeding#tab=tab_1
[5] Brown, A. (2018). Breastfeeding is Good for Mother’s Mental Health – But Those Who Struggle Need Support https://theconversation.com/breastfeeding-is-good-for-mothers-mental-health-but-those-who-struggle-need-support-103788 )
[6] Ayton JE, Tesch L, Hansen E. Women’s experiences of ceasing to breastfeed: Australian qualitative study BMJ Open 2019;9:e026234. doi: 10.1136/bmjopen-2018-026234
[7] Association of Breastfeeding Mothers (2018). chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://abm.me.uk/wp-content/uploads/mag10-featured.pdf
[8] Díaz Meneses, 2013; Lööf-Johanson, Foldevi, & Rudebeck, 2013. https://connect.springerpub.com/content/sgrcl/9/4/200?implicit-login=true&sigma-login=has-d&sigma-token=Az3ZUHdDkRsilIkkYUpFtwlLVQqAffpHQdkMbFD0dZU
[9] Brown, A. (2022). Supporting Breastfeeding Grief – a Collection of Resources. https://professoramybrown.co.uk/articles/f/supporting-breastfeeding-grief—a-collection-of-resources