Parenting

Ep. 3: Breastfeeding difficulties (Developing Mighty Minds w/ Dr. Lisa Durette)

Ep. 3: Breastfeeding difficulties (Developing Mighty Minds w/ Dr. Lisa Durette) thumbnail
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In this episode of Developing Mighty Minds, we dive headfirst into the pains and challenges of breastfeeding difficulties. While this is a common parenting challenge, it can be uncommonly painful — especially when parents are already fatigued and stressed. Here is information to help parents navigate and put breastfeeding challenges into perspective. 


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Prefer to read rather than watch the video? Or want to follow up on something you heard?

Here are highlights from the Week 3 Baby discussion with parent Aaron von Frank (Susan couldn’t join) and child & adolescent psychiatrist, Dr. Lisa Durette: 

1. Question: This week, we experienced challenges with breastfeeding. Given how hard breastfeeding actually is, what should parents expect around their own experiences of breastfeeding? Where do unrealistic expectations and internalized myths about breastfeeding come from?

Dad (Aaron):
Susan (momma) and baby are not joining the discussion this week. Susan had a physically and emotionally overwhelming week due to difficulties with breastfeeding.

As prepared as we thought we were for things, we had no idea how hard breastfeeding was going to end up being. Baby started losing a small amount of weight in Week 3 due to low milk production, and we had to begin supplementing with formula to make up the deficit.

Susan is also using a Spectra S1 breast pump to pump milk about every 2 hours to try to stimulate increased milk production so we can get back to exclusively feeding our baby breastmilk.

Week 3 is generally considered the point when breastfed babies meet or surpass their birth weight. As soon as we noticed baby’s irritation and weight loss, we immediately went to our pediatrician and utilized their in-house lactation consultant.

Week 3 baby Sebastian sleeping at pediatrician's office.

Week 3 baby Sebastian sleeping at our pediatrician’s office.

This situation caused Susan to experience feelings of inadequacy and despair, saying things like, “I’m failing my baby,” and “I can’t even provide for our baby.” As we’ve come to find out, this is a surprisingly common (and perhaps drastically under-reported) phenomenon with new moms.

Dr. Lisa:
As a mom, I (Lisa) experienced the same problems breastfeeding (not enough initial milk production) and the same overwhelming sense of disappointment, failure, and despair.

A lot of this has to do with romanticized ideals of what we should be and do as a mom. The majority of moms in my personal network have experienced difficulties breastfeeding as well.

Breastfeeding is difficult, and it’s helpful for new moms to know that — and to know that their perfect ideals and expectations about breastfeeding may not be realistic… And that’s ok!

Ghosts in our nurseries: how our past and perceptions haunt our present and future selves

Dr. Lisa:

There’s a classic article called Ghosts In Our Nurseries describing how moms all carry ideals, traumas, and influences (often from their own childhoods) with them into parenthood. These “ghosts” influence who we think we should be and how we think we should act as moms/parents.

When the idealized mental representations don’t match up with the actual parenting dynamic, it can set parents up for enormous disappointment and stress.

Expectations and reality aren’t always the same. How do we deal with that?

Aaron:
This reminds me of the saying, “Expectations are the enemy of happiness.”

The phenomenon is similar to beauty models in a magazine: photoshopped images of perfection create expectations of perfection we can’t live up to, thus leading to feelings of inadequacy. Our parenting expectations (including breastfeeding expectations) can have a similar effect.

Much of Week 3 was spent stressed and exhausted in moments like this: doing everything we could around the clock to get our baby to take in enough nutrition to gain weight.

Much of Week 3 was spent stressed and exhausted in moments like this: doing everything we could around the clock to get our baby to take in enough nutrition to gain weight without losing interest in breastfeeding.

Great myths of child development   

Dr. Lisa:
It’s normal and ok to feel sad and disappointed if you aren’t able to meet your baby’s needs via breastfeeding. Feeling hopeless, helpless, and worthless — or losing interest in baby or experiencing desire to harm baby — may indicate something more serious like postpartum depression.

Myths that we learn about parenthood/motherhood shape our expectations. Fabulous book: Great Myths of Child Development by Stephen Hupp and Jeremy D. Jewell. One example from their first chapter: Myth #5: The Attachment Parenting Approach Strengthens the Infant Bond.

Dr. Sears was one of the first to talk about attachment parenting. However, some of the primary research behind that theory comes from Konrad Lorenz’s research into geese, and it’s very difficult to then extrapolate that data and apply it to human infants. Nevertheless, there are myths around attachment parenting that still persist.

Another example of a parenting myth (and a very dangerous myth): the belief that vaccines cause developmental disabilities and autism. This myth started from a small snippet of misinformation which then grew like wildfire.

Back to attachment: attachment is VERY important between primary caregivers and infants, BUT it’s not a one-time shot, it’s a process that’s developed and reinforced over the first few years and repeat interactions.

Providing nutrition via breastfeeding is one of many sources of where attachment develops between mother and infant, but it’s not the only one AND you can still develop attachment between mother and baby via bottle feeding.

Experiencing breastfeeding challenges doesn’t mean you failed as a parent/mom

Aaron:
The way we looked at is we had a goal of breastfeeding based on good evidence of its many benefits. However, just because we can’t 100% meet our expectations/goals around breastfeeding doesn’t mean we’ve failed or aren’t good parents.

Life is messy and imperfect. Do the best you can and keep going.

From the outside, it may be hard to understand the anguish moms can experience when they aren't able to produce enough milk for their babies. Thankfully, we soon found out why (our baby had a tongue- and lip-tie) so he was unable to provide enough stimuli to cause adequate breastmilk production.

From the outside, it may be hard to understand the anguish moms can experience when they aren’t able to produce enough milk for their babies. Thankfully, we soon found out why (our baby had a tongue- and lip-tie) so he was unable to provide enough stimuli to cause adequate breastmilk production.

Dr. Lisa:
Keep in mind that this is the first unforeseen event you (Aaron and Susan) have experienced as parents. There will be many more! But the first one is the hardest.

When I had a baby, I thought the world was ending because I couldn’t breastfeed properly in the beginning, too. Things got better. It’s a process.

Aaron:
Our lactation consultant (who is also a RN at our pediatrician’s office) also experienced the same difficulties with breastfeeding as we did when she became a mom — and she’s a lactation consultant/breastfeeding expert! These things happen, so moms/parents shouldn’t beat themselves up too much.

Dr. Lisa:
Yes, but allow yourself the space to acknowledge the sadness that a difficult or disappointing infancy experience brings with it. Let that feeling come in, experience it, and let it pass through. Don’t push it to the side!

As a parent, it’s a really good experience to begin articulating emotions and giving descriptions to emotions, because that’s how you’re going to be teaching your children about emotions when they get older.

Question 2. What are some tips or best practices for helping your partner deal with the disappointment and/or sadness they experience when breastfeeding goals/expectations (or other parenting goals/expectations) don’t go according to plan?

Aaron:
When Susan said things to me like, “I can’t even feed our baby” or “I’m failing my baby,” in expressing her disappointment around not being able to provide enough breastmilk for our baby during Week 3, my first instinct is to fix it or tell her not to think that way. See the book Men are from Mars, Women are from Venus which depicts this stereotypical male/female dichotomy. However, over the years I’ve learned to recognize that this instinctual approach is not necessarily helpful or what she needs.

Instead, I’ve learned to hold back that initial thought and make sure I’m fully listening to her and allowing her to express what she’s feeling and be heard rather than muting her or blunting her need for emotional expression, which allows her to work through it in her own way (which is not necessarily my way).

What tips does Dr. Lisa recommend for people who are trying to help their partners come through a sadness like the one experienced when mom is unable to meet her baby’s food needs via breastfeeding?

Dr. Lisa:
First, it’s important for the partner to have an awareness of what the signs of postpartum depression are versus normal sadness and disappointment, which we’ve discussed before. (See American Psychiatric Association’s Expert Q & A: Postpartum Depression.) 

Also, keep in mind that in this situation, everyone’s stress tolerance is way off because of sleep deprivation and other factors. It’s important for partners to allow themselves the grace to say, “we’re probably going to screw a handful of things up.”

It’s also important to do what comes naturally in the relationship when your partner is going through this type of situation: put your arm around them, give them a hug, ask them if they want to talk about it, let them know that you’re listening, and caution yourself to go against that “male” impulse to fix it. The best thing that you can do is just BE, which feels very foreign for somebody who is a doer.

Aaron:
One hack I do in this type of situation is just pause for a minute and think: “what question could I ask to help this person probe through the feelings they’re experiencing?”

Example, when Susan says “I feel like a failure” because she’s not able to provide our baby with enough breastmilk right now, I pause then ask her, “why do you feel that way? Let’s talk through that…” 

It helps her talk through it and go through the appropriate emotional levels she needs to get out of the negative emotional state herself.

Dr. Lisa:
Cognitive behavioral therapy might even go so far as to ask the patient, “what makes you think you’re a failure? Can you prove that to me?” Asking the person to prove an erroneous thought is a helpful exercise.

If someone has the perception that they’re a failure and there’s no evidence to support it, finding ways to pull that out of them can be helpful. Whatever feels natural and doesn’t feel false, while allowing the space for the processing to happen.

Aaron:
The physical touch that comes naturally in the relationship (hugging, kissing, petting) also helps as part of the process of working with your partner through these difficult parenting situations.

To other parents going through difficulty breastfeeding: know that you’re not alone. Hopefully, partners can take tips from this article/video to help!

Question 3. Is it true that you’ll screw up your child by not breastfeeding?

Dr. Lisa:
No, you’re not going to screw your child up if you don’t breastfeed consistently!

Best practice recommendations are that you at least try to breastfeed for the first 6 months. You have to ensure that your child is growing appropriately, so if you’re having a growth drop-off you need to supplement until your baby gets back on track.

The media — and social media — is one of the worst culprits of spreading angst and a sense of disappointment about breastfeeding. Celebrities/influencers can spread and advocate things that are not evidence-based, causing harm.

It’s important to be cautious what you absorb in various forms of media and to question the claims. Develop a keen eye to critically evaluate the information being presented to you.

Aaron:
So you’re saying what you read or see on Instagram is not necessarily peer-reviewed science? (Haha)

Dr. Lisa:
In fact, you (the audience) should check what I’m saying. No one person or one expert knows everything about a particular topic.

Aaron:
I think it’s important to think about sourcing evidence-based information as a process. One way to do this for medical or parenting information is to more heavily weight information provided by organizations like American Academy of Pediatrics, rather than assuming someone you see on Instagram with a large following has the same degree of expertise, knowledge, or trustworthiness.

Contagions of misinformation can end up spreading actual contagions sometimes.

3 week old baby Sebastian bonding with dad, despite dad's lack of mammary glands.

3 week old baby Sebastian being held and bonding with dad, despite dad’s lack of mammary glands.


Special note: Even in hindsight, reading and watching this episode arouses a lot of parental pain, especially for mom. As we found out later via an outside lactation consultant, our family’s breastfeeding challenges were due to Sebastian having a tongue and lip-tie. With a lot of effort and hardship, we were able to get this condition corrected and get Sebastian back to a fully breastfed baby. Read: Our breastfeeding nightmare: overcoming a tongue-tie (ankyloglossia).


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