Nurturing the Nurturers: Addressing the Unseen Trauma behind Human Milk Feeding

As we celebrate the bonding and nourishment that breastfeeding/chestfeeding provide this World Breastfeeding Week, we must also shine a light on the mental health aspects that are frequently overlooked.

While most are aware of the many well-known benefits of human milk for infant health, breastfeeding/chestfeeding also benefits the parent by releasing feel-good hormones, such as oxytocin and prolactin (Breastfeeding and Mental Health, 2017), lowering the risk of depression, helping them get more sleep, and overcome past adversity (Kendall-Tackett, 2019).

However, despite these benefits, a surprisingly small number of women breastfeed exclusively for the recommended duration (Pezley et al., 2022). The situation is not much better for transgender and gender-diverse parents, with only 33.5% exclusively breastfeeding or chestfeeding, and just 41.3% continuing up to 6 months (Yang et al., 2023). There are various considerations contributing to these statistics, with perinatal mental health being a significant underlying factor (Duncan et al., 2022).

Mental Health and Human Milk Feeding

Research points to a bidirectional connection between perinatal mental health and human milk feeding (Pezley et al., 2022). Birthing parents struggling with breastfeeding/chestfeeding may face heightened risks of anxiety, depression, embarrassment, and guilt (Elder et al., 2021). An individual's mental health could directly influence their feeding journey, and reciprocally, the journey could impact their mental health. This creates an intricate dance of emotional and physical challenges.

In a compelling case study, a woman’s struggle with breastfeeding was compounded by her pre-existing history of depression and anxiety (Elder et al., 2021). After two months of anxiety, frustration, and persistence, she decided to discontinue direct breastfeeding (Elder et al., 2021). This case underscores the need for comprehensive support for individuals who are breastfeeding/chestfeeding, considering not just the physical factors but the psychological ones too.

Unseen Trauma in Human Milk Feeding

Often overlooked in the breastfeeding/chestfeeding narrative is the breastfeeding aversion response (BAR). BAR is an intense urge to unlatch due to feelings of aversion while breastfeeding (Morns et al., 2023). Understanding and addressing such complexities from the individual's perspective are crucial for meeting personal feeding goals and boosting global human milk feeding rates (Morns et al., 2023).

Psychological trauma is another significant factor. While its impact on parental mental health is well-documented, its effect on breastfeeding/chestfeeding remains largely unknown (Kendall-Tackett, 2022). The sway of childhood and adult trauma on human milk feeding and mental health outcomes necessitates further exploration and understanding (Kendall-Tackett, 2022). Mental health professionals specializing in perinatal trauma have a significant role to play.

Let's take the opportunity World Breastfeeding Week offers to listen to each other's stories, explore the intersections between human milk feeding and mental health, and learn about the behavioral interventions (Pezley et al., 2022) and community-centered support programs (Duncan et al., 2022) that can help us create the nurturing, inclusive, and supportive environment our clients deserve.

Breastfeeding and Mental Health: Joint Statement from WABA & LLLI in celebration of World Health Day. (2017, April 7). World Alliance for Breastfeeding Action (WABA). Retrieved July 31, 2023, from https://waba.org.my/v3/wp-content/uploads/2018/10/Statement_World-Health-Day_2017.pdf.

References

1. Duncan, R., Coleman, J., Herring, S., Kawan, M., Santoro, C., Atre, M., Mason, A., Moore, S., & Kumar, A. (2022). Breastfeeding awareness and empowerment (BAE): A black women-led approach to promoting a multigenerational culture of health. Societies, 12(1), 28. https://doi.org/10.3390/soc12010028

2. Elder, M., Murphy, L., Notestine, S., & Weber, A. (2021). Realigning expectations with reality: A case study on maternal mental health during a difficult breastfeeding journey. Journal of Human Lactation, 38(1), 190–196. https://doi.org/10.1177/08903344211031142

3. Kendall-Tackett, K. (2019, January 16). Why Breastfeeding Is Good for Mothers’ Mental Health. Retrieved July 31, 2023, from https://llli.org/why-breastfeeding-is-good-for-mothers-mental-health/.

4. Kendall-Tackett, K. (2022). Psychological trauma and breastfeeding: What we know so far. Medical Research Archives, 10(11). https://doi.org/10.18103/mra.v10i11.3288

5. Morns, M. A., Steel, A. E., McIntyre, E., & Burns, E. (2023). Breastfeeding aversion response (bar): A Descriptive Study. Journal of Midwifery & Women’s Health. https://doi.org/10.1111/jmwh.13474

6. Pezley, L., Cares, K., Duffecy, J., Koenig, M. D., Maki, P., Odoms-Young, A., Clark Withington, M. H., Lima Oliveira, M., Loiacono, B., Prough, J., Tussing-Humphreys, L., & Buscemi, J. (2022). Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: A systematic review. International Breastfeeding Journal, 17(1). https://doi.org/10.1186/s13006-022-00501-9

7. Yang, H., Na, X., Zhang, Y., Xi, M., Yang, Y., Chen, R., & Zhao, A. (2023). Rates of breastfeeding or chestfeeding and influencing factors among transgender and gender-diverse parents: A Cross Sectional Study. eClinicalMedicine, 57, 101847. https://doi.org/10.1016/j.eclinm.2023.101847