Interview: Can stress affect a woman's breastfeeding experience?

Stress can affect a mother's ability to breastfeed, and challenges in breastfeeding can cause stress. Family support can help the new mother manage the situation better, says lactation consultant Taru Jindal

New motherhood is a time of several lifestyle changes and transitions. The experience of pregnancy and motherhood can be different for every woman, and this is true of breastfeeding too. Today, a new mother may not have enough awareness or knowledge of breastfeeding. And when the initial experience is unfavorable, it may get stressful and sometimes even traumatic.

White Swan Foundation’s Sriranjitha Jeurkar spoke to gynecologist and lactation consultant Dr Taru Sneh Jindal to understand the link between breastfeeding and mental health.

Most people think of breastfeeding as something that comes naturally, and as an experience all mothers enjoy. Is this true?
At one point of time, it may have been instinctive. Most mothers enjoy breastfeeding and want to breastfeed. But having said that, most of them are totally unprepared for lactation. And it ends up becoming a pain for many, because of a lack of support for breastfeeding and lack of medical support and advice. Many mothers suffer from bleeding and sore nipples because they don’t know how to get the baby to latch. So though they want to enjoy the process, many end up suffering through it.

Can breastfeeding be stressful?
Breastfeeding can be immensely stressful for first-time mothers if they are totally unprepared for it. Now, with nuclear families, they also don't get the support they need from the family during this time. The husband is often left out of the process, so a very important source of support is also lost.

Our workplaces are not breastfeeding-friendly. There is discrimination against breastfeeding moms, and they are forced to either stop lactation to continue work, or stop work to continue lactation. The lack of a steady income during this time adds to the stress.

How does breastfeeding (or not breastfeeding) impact a woman's mental health?
The oxytocin released during breastfeeding helps a mother relax. It helps her de-stress and brings feelings of love, bonding and joy. Not breastfeeding may deprive the mother of these. It also comes with the heavy physical toll of making formula every few hours and sterilizing. Some mothers find this more taxing than breastfeeding. Not breastfeeding can bring with it  feelings of guilt, and low self-esteem at not being able to do the most natural thing like breastfeeding their baby.

What about women who have difficulty breastfeeding? How does this affect them emotionally?
I have seen mothers get depressed because they are not able to feed their babies properly. Not getting support at that time affects their mental health.

For women who choose to not breastfeed, how can they deal with the reactions of people around them?
The reasons for not breastfeeding could be many–from the perceived ease of the formula and bottle to wanting their own space and freedom. These mothers often experience shaming from the society, which makes them feel like they have become inferior mothers by making choices other than direct breastfeeding. This can lead to feelings of guilt and lowered self-esteem. This doesn’t help the cause of nurturance and nourishment in any way, because stress is never good for mothers. For a start, stress can reduce milk output. Stress directly inhibits oxytocin from getting secreted by the brain. We need to be careful and ensure that a new mother is aware of the pros and cons of their choices, and respect whatever decision they make about the baby's feeding.

Some mothers do not have enough milk production for the baby - what is the issue then? 

These days due to hospital protocols, the baby is separated from mother immediately after delivery. Mothers are sometimes not allowed to touch their babies immediately after birth and the baby is taken away for procedures. Because of this, the most natural reflex of baby to find the breast and suckle on its own - which we call breastcrawl - doesn't happen. The first which must happen within one hour, is often delayed. For mothers who have gone through Caesareans, this is even more. No matter how the birthing was, a mismanaged start of breastfeeding messes with the mother's experience of the birth, and she ends up remembering it with feelings of sadness and hopelessness.

I think that if hospital protocols become more breastfeeding-friendly, we can reduce this stress to a great extent. Hospitals need to develop a “breastfeeding focus" in their systems so that mother-baby separation is kept to a minimum, and encouragement for the mother-baby pair to be together and breastfeed freely is maximum.

What can family and spouse do to support a breastfeeding mother, specifically with her emotional wellbeing?
A new mother can be totally overwhelmed at the birth of a baby if she does not get adequate support from family for simple things like laundry, cooking, or soothing the baby to sleep. The sudden increase in the number of tasks and decreased sleep can take a toll on the new mother if the family doesn’t support her. Without this support, the mother may have to prematurely stop breastfeeding, and switch to formula.

The role of the spouse is even more significant. Families may exclude the father from caregiving in the initial days because they assume he knows nothing, or that he won’t be able to support. This deprives the mother of the crucial intimate partner support she needs in this challenging time. If fathers also get themselves informed and involved in the caregiving process, breastfeeding is easy and more fulfilling for mothers.

Taru Jindal runs Lactation Matters, a Facebook page on breastfeeding. She also runs a support group for breastfeeding mothers on Whatsapp. She can be contacted on tarujindal@yahoo.co.uk.