Breastfeeding After Traumatic Birth

This article is part of the Traumatic Birth Prevention & Resource Guide by PATTCh. Access the complete guide to learn more about traumatic birth and find resources for women and families.

By Teri Shilling, MS, LCCE, CD(DONA), IBCLC

The image of a baby's arrival into the world often shows a calm, romanticized picture of a beautiful baby being gently lifted into the waiting arms of the baby's mother, followed by the mother putting the baby skin to skin, leaning triumphantly back while releasing a relieved sigh in the spirit of I did it. The baby is then supported in doing its dance to bop and wiggle to find the breast and latch on.

What if instead the journey has been fraught with challenges and struggles and separations or surgery? What if fears and trauma and suffering have colored the experience? What if the mother is overwhelmed or not supported or unable to deal with anything other than the basic survival of the experience? What happens then to early breastfeeding?

Cheryl Beck and Sue Watson (2008) in their research on the impact of birth trauma on breastfeeding, cited that over a third of all mothers have reported experiencing a traumatic birth. The breastfeeding research lists challenges to early and successful breastfeeding as unscheduled cesarean birth, psychosocial stress, and pain related to labor and birth. Other influences include loss of control, exceptionally long labors and dissatisfaction with care and support.

By closely looking at the impact of birth trauma on breastfeeding, there seems to be two paths -- on one path women persevered and on the other path, breastfeeding is curtailed. What allows a woman to take the path toward a fulfilling breastfeeding experience? Beck and Watson (2008) identified three themes:

• sheer determination
• a motivation to make up for a baby's less than optimal arrival or
• the time spent breastfeeding was soothing

The path that led to less than the desired length of breastfeeding was influenced by:

• a fear that breastfeeding was just one more way to fail
• no emotional or pain-coping reserves were left to cope with possible breastfeeding pain and discomforts after the overwhelming physical pain of birth
• a feeling that the traumatic birth created an insufficient supply of breast milk
• flashbacks that intruded on the breastfeeding experience
• a feeling of detachment from the baby created by the birth trauma

So what guidance is there for the women who have had a traumatic birth who want to follow their own path to a fulfilling breastfeeding experience?

• Seek intensive one-on-one support to establish breastfeeding. Set short-term goals. Discuss options like pumping or substituting skin-to-skin time for breastfeeding or supplementing early feeding with donor milk.
• Find respectful support. Often it's preferable to find help from someone who can provide support and assistance while verbally guiding you and building your confidence vs. someone who grabs your breast and pushes the baby on for the sake of efficiency.
• Locate non-judgmental help from someone who will support you in your choice to continue or stop breastfeeding without guilt or judgment.  This person should be someone who can listen to your birth experience and knows the symptoms of traumatic stress and knows to whom to refer you to for dealing with these feelings and reactions to a traumatic birth.

Find the support and resources to follow your path to feed your baby!

Reference

Beck, C.T., & Watson, S. (2008). Impact of birth trauma on breast-feeding. Nursing Research 57(4), 228-36.

Teri Shilling, MS, LCCE, CD(DONA), IBCLC is the director of Passion for Birth, the largest Lamaze accredited childbirth educator training program, creator of the Idea Box for Creative and Interactive Childbirth Educator, and instructor at the Simkin Center for Allied Birth Vocations at Bastyr University.  A past president of Lamaze International, she now focuses her volunteer work with PATTCh, Skagit Valley Breastfeeding Coalition and W.I.S.E. Birth (a 3 county Doula Collective.) She has a small private practice providing doula support, lactation support and birth education in her Mount Vernon, WA, community.

PATTCh is a not-for-profit, multidisciplinary organization dedicated to the prevention and treatment of traumatic childbirth. Our mission is to develop cross-disciplinary relationships, research, and programs that:

• prevent PTSD following childbirth through education, interdisciplinary collaboration, and multidisciplinary research;
• educate perinatal care providers and paraprofessionals in the prevention and treatment of birth and reproduction related trauma;
• encourage the development of culturally appropriate therapeutic approaches to post-traumatic stress symptoms following childbirth;
• promote healthy birth practices for all women and families;
• promote evidence-based research regarding PTSD secondary to childbirth;
• increase global awareness of the prevalence, risk factors, and effects of PTSD secondary to childbirth; and
• support collaboration and understanding among all stake-holders, including: researchers, policy makers, medical and mental health care providers, educators, community members, volunteers, women, and families.