Normalizing Nursing Complications: Breastfeeding Challenges, Perinatal Mental Health, and Lactation Support

Thrive • Aug 02, 2022
By Thrive Wellness Waco Registered Dietitian and Certified Lactation Consultant Courtney Anderson M.S., RD, LD, CLC

While natural and beautiful, the personal choice to breastfeed, also known as chestfeed, one’s baby can present challenges for many. A survey from the UC Davis Medical Center found that 92% of the new mothers who participated reported having problems nursing three days after giving birth. 

If moms experience issues breastfeeding, it can add distress to an already tumultuous experience of bringing home a new baby. With specialized support from a lactation consultant, however, mothers can succeed in breastfeeding their babies if that’s their intention. 

If parents choose to go the formula-feeding route, that’s completely acceptable and encouraged too. We’re fortunate to live in a time in history when nutritionally complete infant formula is available. In my own practice, when I have clients who are struggling to breastfeed, I regularly remind them that “fed is best” and that no matter how they nourish their babies, they are incredible mothers. 

COMMON BREASTFEEDING CHALLENGES

Expecting mothers often imagine that breastfeeding is simple and instinctive. Contrary to this widely-held perception, however, many find nursing to be anything but easy. In all actuality, breastfeeding can be complicated, imperfect, and exhausting.  

Some common breastfeeding concerns include:

  • Positioning that causes discomfort
  • Problems with the baby latching to the mom’s breast, causing the mom pain or decreasing the transfer of milk to the baby
  • Struggles establishing or maintaining breast milk supply
  • A clogged duct, a condition that causes an obstruction of milk flow 
  • Mastitis, a condition characterized as inflammation and infection in the breast

HOW BREASTFEEDING COMPLICATIONS IMPACT PERINATAL MENTAL HEALTH

Moms who struggle with nursing may feel various negative emotions that can contribute to mental health concerns during the perinatal period , which describes the time surrounding pregnancy, birth, and up to a year following birth. They may experience:

  • Self-doubt caused by judgment from self or others: Choosing how to feed one’s baby is a highly personal decision. Even still, parents may self-inflict or encounter unfair criticism over how they nourish their babies. This may contribute to worry, lack of self-esteem , and other distressing thoughts and feelings.
  • Upset over unmet expectations: Many moms imagine that breastfeeding will be an easy and enjoyable experience. If nursing presents obstacles and doesn’t align with what they anticipated, parents may feel an array of confusing and adverse emotions.
  • Guilt and shame if nursing isn’t available: Sometimes breastfeeding may not be possible or the best choice for mom and baby potentially due to medications they’re taking, low milk supply related to medical complications, or other medical reasons. Moms may feel unwarranted guilt or shame if they aren’t able to nurse their babies, possibly due to the misperception that nursing is the “best” way to feed babies.  
  • Loneliness if they aren’t comfortable nursing in front of others: Although breastfeeding can be an opportunity for a mom to bond with their baby, if a mother prefers to nurse her baby in private, the activity may pull her away from other loved ones and cause her to feel isolated.

A mother’s mental health may suffer further when exacerbated by other perinatal circumstances, such as: 

LACTATION SUPPORT SERVICES

For moms who intend to breastfeed, professional lactation support can offer guidance, strategies, and tips for making nursing as seamless as possible. Midwives, doulas, nurses, dietitians, and other perinatal health care providers commonly serve as lactation consultants. These professionals typically have earned certifications in lactation support. Some common types of certifications include:

  • Certified lactation educator (CLE): This credential entails 20 hours of coursework. Those with the CLE designation are trained to educate parents about breastfeeding through counseling or teaching classes.
  • Certified lactation counselor (CLC): This certification requires 45 hours of coursework. Those with the CLC designation are able to provide clinical breastfeeding support to families such as by guiding them through the process of breastfeeding and addressing issues that may arise. 
  • International board certified lactation consultant (IBCLC): TEarning an IBCLC requires extensive coursework and testing and is therefore the highest level of lactation support. Those with the IBCLC certification are most likely to provide clinical guidance for acute feeding struggles such as severe mastitis.

Often beginning during pregnancy, lactation support usually involves education about the logistics of breastfeeding. Within the first few hours or days after a baby is born, a lactation consultant may conduct infant feeding assessments, which are helpful for proactively detecting any issues that may create barriers to parents’ feeding goals.

Lactation support can also provide guidance around:

  • Exploring breastfeeding positions
  • Improving a baby’s latch
  • Building a mother’s breast milk supply
  • Pumping breast milk
  • Implementing a bottle for feeding if desired
  • Developing a feeding plan if a mother intends to return to work while still nursing
  • Wearing nursing-friendly clothing

PERINATAL MENTAL HEALTH CARE AT THRIVE WELLNESS 

At Thrive Wellness, we understand that breastfeeding doesn’t come easily to everyone, and when this is the case, the mental health of new parents can severely suffer. In my own experience as a mom to a new baby, I struggled with postpartum depression that I believe began with the intense difficulty I had breastfeeding and many unfulfilled hopes throughout my nursing journey. As part of Thrive Wellness’ integrated health care approach, we involve medical professionals, therapists, dietitians, and lactation consultants in our perinatal health care services, so that parents receive multi-faceted support as they adjust to life with a new baby. To learn more about perinatal health care at Thrive Wellness, reach out

While all Thrive Wellness locations offer interdisciplinary clinical teams who collaborate to treat eating disorders, perinatal mood and anxiety disorders (PMADs), and additional mental and behavioral health conditions, programs and services may vary by location.

About the Author

Thrive Wellness Waco Registered Dietitian Courtney Anderson M.S., RD, LD, CLC

Courtney is a Registered Dietitian Nutritionist and Certified Lactation Counselor passionate about helping clients use food as a tool for health and joyful living. Her practice is built around the marriage of medical nutrition therapy with the principles of Intuitive Eating.

She began studying nutrition science because of her fascination with food and the body. In her practice, she hopes to educate and empower others to harness the awesome benefits of the food around them, and to provide them valuable skills to apply nutrition principles in their everyday life.

By marrying her experience of disordered eating with her knowledge of medical nutrition therapy and her skills as an adjunct lecturer at the university level, she has been able to create a holistic approach to health and wellness for clients that focuses on education and practicing new skills that not only improve her clients’ health but also their relationship with food and body.

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