Intro

All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Is breastfeeding always bonding?

WARNING GRAPHIC IMAGE CONTENT (MEDICAL CONTEXT)

We typically don't hear that much about breastfeeding and bonding - it's an area that provokes strong reaction. A popular piece on the blog is this one, written by a mum of eight, some formula fed and some breastfed; it highlights perfectly the beauty of oxytocin (the primary bonding hormone) at work.

Something else we often hear though from some mums, is that they felt they only started bonding with their baby when they stopped breastfeeding.  Whilst we know of course bottle feeding mums can bond (ie it's not exclusive to a breastfeeding mum) stating stopping breastfeeding and starting bottle feeding facilitated this is confusing for many, so that's rarely discussed either.

But we should.

Many mums find it extremely difficult to admit they are struggling to bond with their baby; afterwards once they've got there they can, but at the time it's hard.  We perhaps read it more online than in person - because the faceless forum can sometimes allow people to be more honest than they otherwise would be.

Yet when supporting a mum in person with severe feeding problems, highlighting that it's important these issues are rectified, because they can amongst other things lead to problems bonding with baby - is so often met with a look of pure relief and frequently tears, that I think it's too significant not to talk about.

Imagine that every hour your husband walked over and nipped your arm, hard.  Sometimes he held the nip so hard it cut the blood supply from your arm, other times he released it quickly, but sat for ages repeatedly nipping over and over again.  Your arm became bruised and sore, but you felt you had to endure it for the sake of your marriage.

Pretty soon you would be flinching when your husband came near you, whilst he may be the best husband in the world outside of the nipping, you may think him gorgeous and love him dearly, when you knew nipping time was looming you would start to dread him coming near you!

Over time that would get you down, you may avoid being close in case he signalled he was about to nip you....

Some I'm sure will be wondering how this is in anyway comparable to breastfeeding, so let me show you what one mother showed me during my last visit.




It's probably not that comparable, because nipples are a lot more sensitive than arms!

But the question is, why on earth would anyone consider anything that caused such pain bonding?  You think this mum is going to get an "oxytocin high"?  In case you're wondering the midwife commented they looked sore, suggested lanolin and to hold the baby more firmly on to the breast.

It's also incredibly easy for a mum in such a situation to become tearful and down, and so PND may be diagnosed rather than situational stress.

The baby had a disorganised suck, clamped and bit down when anything came in contact with his gums, tongue tie and couldn't even trigger the let down reflex - yet the mum was told to stick at it, which she had for 5hrs straight one night; is this what people mean by toughening up?

We need to address breastfeeding problems before they have a chance to cause trauma, not only the kind of physical damage visible in the pictures, but to mums mentally and emotionally. Ultimately that can take much longer to heal than even the sorest nipple.

30 comments:

  1. Thank you for posting this AA. It is so important that people understand this, especially just before they say "if you tried hard enough"... Expressing 6+ times a day is hard, it's time-consuming, and emotionally it's not what I wanted, it's absolutely second-best in some way for me. However, my nipples have always ended up looking like those above whenever I tried for any amount of time (like, more than a day or so) to breastfeed my son. When he was three weeks old, I was terrified of him waking up. Expressing milk and bottle-feeding it to him has been the best I can do for him. Breastfeeding him directly just hasn't been an option, and now he's 6 months old I have to accept it never will be. All of that time, I have been working on feeding him my milk, as much as I could get, and getting him well (there was a lot more going on than "just" a TT, and cranial osteopathy has been the key to it all). Plus trying very slowly to heal myself from a traumatic birth. There has been no "oh, feeding gets easier at 6 weeks/after the 16-week growth spurt/at 6 months" for us. In some ways it has got a lot lot harder and no doubt it will carry on being hard until finally we stop our version of breastfeeding.
    And you are right about the mental and emotional trauma of unresolved breastfeeding problems - it does take a lot longer to heal than the nipples do.

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  2. oh gosh this is so true! I breastfed my DD1 and still didnt bond with her til she was 9 months+ anyway. I had to mix feed her due to no weight gain and the stress of feeding her and having her weighed was torture...i don't believe it was bonding at that point at all.
    in those early days when you're getting used to breastfeeding, its painful too, getting latch right and the early latch pain, i don't believe breastfeeding becomes bonding until its established and 'easy'.

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  3. Oh that poor mum. Those pictures brought tears to my eyes, I know how much that hurts. How can anyone look at that and think it 'a bit sore'?! You're so right, problems need addressing well before they interfere with bonding. It's absolute hell to resent your newborn (and to go through all that pain both physical and emotional).

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  4. My God, that poor mum. Thank goodness you have come to the rescue AA. Can a complaint be made about this midwife?

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  5. If this midwife works 4 a Trust that's claiming to be Baby Friendly then aside from a complaint she should urgently receive some breastfeeding training. Unfortunately totally believable that this is what happened. I'm curious about mums saying they bonded once they finished breastfeeding. It wasnt until stopping bf at 9 months that I realised how cuddly my son was, because he was getting all of his cuddles during his feeds. Seems weird that it hadnt occurred 2 me. I wonder if this is what other mums think is missing, no cuddles, just feeds?

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  6. I remember not bonding with my son right away and the tears. Although I never had trauma to that extreme my son had a mild tongue tie however he did have slow weight gain and I dreaded every baby weight, every midwifery appointment. For the first three weeks prior to getting his tongue tie clipped if was painful when he latched on. I think health care professionals need to become more aware about the issues that tongue-tie cause and the damage it can cause to the mom emotionally and physically. Had it not been for my midwives referring me to a lactation consultant his tongue-tie would never had been diagnosed and rectified.

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  7. Anon, I never thought about the whole cuddling thing that way. I have been thinking that my daughter doesnt like to cuddle... when she could just be getting it in while she is nursing. This makes me feel better. Thank you for your post!

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  8. This brought tears to my eyes too. I was lucky enough to get help before things got that bad. I'm amazed by the dedication of this mum. How do you help someone in this position, AA? Nipple shields, just expressing, topping up?

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  9. I had damage like that - and then it got worse until 5 weeks later I was hospitalised for infection and finally moved on to formula feeding. Life was certainly much easier, nicer and less anxious once i'd stopped bf, and I could enjoy life with my baby instead of enduring it, but for me, I wouldn't say bonding was any different either feeding through that or bottle-feeding afterwards, compared to bonding with my two younger, breastfed till toddlerhood children. It had a whole host of other effects, none of them good, but not on bonding - though perhaps it would have if i'd continued bf for longer.

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  10. Thanks all - Buzzfloyd, division has thus far made a significant difference for this baby. Mum is continuing to feed on the right side with no further damage, and expressing and supplementing back to allow the left to heal a little. Some babies need more, suck training/desensitisation exercises, but we will remain in close contact with mum x

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    1. I realize this is an old post, but I have a six week old and am currently dealing with nipple trauma on one side only slightly less horrific than the pic above. I have been working with wonderful lactation consultants and am currently BF on right breast and pumping and bottle-feeding from the left to allow that nipple to heal. But it seems to be healing very, very slowly. Any suggestions on ways to promote healing while pumping 8 + times a day? I'm otherwise extremely healthy and haven't suffered any infections.

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    2. Has your LC identified how/why the baby is causing trauma? :-)

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  11. Breastfeeding for me was not just about bonding, it was a stalwart desire to give my child the very best I could. This was an approach I had taken throughout my pregnancy,with ante natal vitamins and a healthy diet and one I have continued to take when weaning and feeding all of my children. I believe my children's bodies deserve the best I can give them to help them develop and grow. With my first daughter I had some difficulties feeding but got there in the end and bf until she self weaned at 11.5 months when I was 10 weeks pg. My son was harder, we got thrush and it never went away, feeding was excruciating, support other than my husband was non existent and I was miserable and exhausted and when he stopped at bf I, in all honestly, relieved. Between having my son and my second daughter I did further research into formula (which I had used in the latter stages post weaning with my son) and learned about the virgin gut theory. I was full of evangelical vim when my daughter was born and determined that not a drop of "evil" formula would cross her lips. I didn't bargain for the return of the thrush at 8 weeks. This time, despite my very best efforts, it became deep rooted ductal thrush and by ten weeks every feed was agonising followed by hours of agonising after pains. We went on holiday and I joked to my two 13 yo nieces who watched me wince in horror "you better remind her I did this for her when she's 15 and decides she hates me".

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  12. By 18 weeks I experienced the horror of bleeding profusely at every feed, blood running out of my baby's mouth down her chin, covering her mouth and coating her tongue. I bled so heavily as I fed that her poo became completely black. I joked that at least I needn't worry about her needing iron supplements. At this point I was getting desperate, my health visitor could offer me no advice, the breast feeding network was worse than useless and my only hope was a very kind la leche league supporter who let me cry down the phone to her and emailed her colleagues for support and advice. My gp was supportive and sympathetic, a course of antibiotics stopped the bleeding but not the pain. I battled on, hiding from my other children when I was feeding so they wouldn't see the pain, I didn't want them to 'blame' the baby. I took massive doses of acidophilus, changed my diet, washed my clothes with vinegar, painted my nipples with gentian violet and drank soluble paracetamol while I was feeding to try and alleviate the pain. Each day I drank freshly juiced wheatgrass juice and washed it down with a cocktail of vitamins designed to try and help my body heal

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  13. Then my baby started losing weight and all the health professionals could do was suggest formula. I went to the supermarket and cried in front of the shelf of formula tins. I refused to give in and took my poor, mottled breasts home to feed my baby and try and regain the precious 11oz she'd lost.I started feeding her every 1.5 hours to ensure she was getting enough, I ate a protein rich diet to try and ensure my milk was as rich as it could be. I had a second course of double dosed antibiotics to try and shift the thrush. Each time I took her to be weighed she'd stay the same or have lost another half an ounce. I was heartbroken but determined. I knew my milk was the best thing for her. I hadn't realised, in my focused determination, that I had become introverted,miserable, short tempered with my husband and other children and listless around the house. I lived from feed to feed trying to smother the pain. Eventually at 24 weeks I began to introduce foods.I weaned using mashed banana and avocado, so desperate was I to see her gaining some weight and to get the hv off my back. Slowly, slowly things picked up and she gained regularly. But the thrush never went away. The damage to my left breast in particular added in the painful complication of vasospasm. I had stopped asking for help, no one seemed to have an answer that worked other than stopping. I scoured the internet and tried everything that kellymom and jack newman suggested. Eventually, at 9.5 months, I couldn't take it anymore,I stopped feeding dd from my left breast and supplemented at bed time only with 4oz of formula. I felt sick. Ashamed. Guilty. Like a failure. I hadn't managed it, the most simple,motherly task-to feed and nourish a baby and I had failed. The vasospasm meant stopping that bedtime feed turned out to be abad idea. MY breast became badly engorged, I couldn't express a drop, the moment air hit my nipple it clenched and turned white. I got full blown mastitis, I was ill and miserable, and still feeding from the right side. I was terrified to do anything other than feed as often as dd even hinted she might like to lest she lose weight again. Eventually my very understanding gp found someone who had used adalat for breastfeeding woman, she prescribed it and twenty minutes after taking the first dose the vasospasm released and the milk started draining out. The mastitis passed and I began to have some relief from pain. For the first time in 8 months. The ductal thrush was not as painful on the right side, I was able to bear it for another few months until dd self weaned during a bout of chicken pox at 11 months. Stopping breastfeeding was like emerging from a fog. I saw my family again and realised how disengaged I had become, how being riddled with pain had compromised my skills as a mother and wife.I am pregnant again and I am going to be honest and say that while I remain a staunch breastfeeding advocate I am personally dreading breastfeeding again. I just don't seem to be 'good' at it.

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    1. Good at it?! You're a bluddy super woman! Due to poor latch woth both my girls ive had thrush/mastitis from couple weeks each time. The pain is awful but thankfully it passed by 5wks and I bf each for months. First stopped at 8mo (she was combi fed with formula once a day from birth anyway) and second is still going at 9mo but top teeth n ult are seeing an early end I fear.

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  14. Oh, this looks like my nipples 15 months ago! it took at least 2 months and a removal of my daughter's tongue tie until I started to enjoy breastfeeding! didn't stop us bonding, but definately made life harder!

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  15. I has a similar traumatic experience. No one taught me how to get my little girl to latch on, and by the time I knew I was doing it wrong, I was in serious pain. Upon going home from hospital - still in serious pain - I thought I'd at least ot it sorted, and that I'd be ok from then on. No. Apparently midwives telling me conflicting information didn't give me the necessary tools to et it right by myself, and I ended up in hospital again a week later delirious with fever and severe mastitis. I still breastfeed, but I really wish that ONE midwife had taken half an hour when Indigo was born to show me what to do.

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  16. I cannot imagine how a mother feels when her nipples are this destroyed and her care provider tells her "the latch looks perfect". Sadly I have seen too many of these mums in my practice. If it hurts, something is wrong..period!

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  17. I couldn't have continued breastfeeding without la leche league and lactation nurses. Mainstream md's are clueless regarding nipple issues. One even told me that she, nor anyone else in her practice "does breast or nipple issues"-I suffered needlessly due to this. I had major yeast infection on nips (major pain) and tongue tie. Hadtongue tie cut late at two months due to all the issues and confusion. After that, and anbx the yeast resolved and we were ok....except she didn't take a bottle after she was cut....took two months and finally takes agent 4 month sip cup.

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  18. Claire was your baby ever checked for a tongue tie?

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  19. No she was never checked .the HCPs viewed my commitment to exclusive bf as odd and inconvenient.they referred to me on one occasion as 'oh this is our non conventional mother ' in front of many other women.i felt embarrassed and humiliated. Bf rates are v poor here and bf support workers pretty much non existent.my nearest la
    Leche group is 45minutes away by car.

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  20. I see alot of this . I cant understand how anyone would tell a mother this is normal . I want to cry for these mums , they spill lots of tears in my office .

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  21. Dear Claire, I am a midwife working in NZ and have a passion for breastfeeding both professionally and personally, but your story has my heart broken - tears rolling down my face. I cannot believe the horror you have been through and your incredible determination. For you, with the repeated history of difficulties and a lack of available support - when would YOU believe that formula has a place in your life? Surely, a happy formula feeding mother and happy baby is better than an unhappy breastfeeding mother and baby? Good luck with your next breastfeeding journey, and please take care of YOU - mothers matter more than breastmilk xxx

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  22. I cried and bleed with both of my little ones for the first three weeks..... Yes it was horrible.. However, personally for me not breast feeding is not an option.. it is one of the most important gifts I can offer my little one..

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  23. I stopped before my breasts looked quite this bad. After the pain got really bad to where i was clenching my teeth when he would nurse, and it is so upsetting to see the baby get blood with the milk, but anyway at this point I quit and pumped and we bottle fed him for about a month. Our first ped. said he didn't have a tongue-tie. I've heard that medications given in c-sections and in epidurals can disrupt the latching procedure, otherwise I've no idea why his latch was so off.

    Anyway at barely 1 month old we were bottle feeding him expressed milk. About 1 month later I tried nursing him again and he went right back to it with no issues. By this time he had matured and had a better latch and was a very good nurser.

    I don't know why more people don't try to bottle feed expressed milk and then go back to breastfeeding once their breasts have healed. I've heard that babies won't go back to nursing but I'm here to testify that mine did EASILY. Maybe it's not quite as true as everybody thought. I bet more babies than just mine can go back to nursing and no harm done, in fact a lot of good has happened from the short break!

    Peace and love to all you Mamas and your children.

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  24. Wow. I am completely awestruck by Claire's dedication to breastfeeding. It also makes me feel a lot better to discover that other mothers have battled through months of pain, got little useful help, and didn't enjoy feeding their babies, much as they knew it was the best thing to do. I now feel quite lucky that my feeding difficulties with my two boys only emerged when they were 11 months and 14 months respectively, when i started to get eczema on my nipples.

    With number 2, I later started getting recurrent mastitis as well, and realised that this was caused by his habit of having a long snoozy feed in bed with me for an hour or two from 6 am. I then felt I had no choice but to night wean him completely.

    He is now only feeding for half an hour first thing in the morning (not lying down) and for a few minutes before going to bed at night, but the eczema has not gone and feeding is still often very painful. I think this is partly because he doesn't quite know what to do with his teeth, and tends to grip too hard, especially when he is teething.

    Anyway, now it's only twice a day, it's a lot more bearable, but it is definitely a trial and I won't be sorry when he finally stops.

    Thank you AA for making a space for mums who actually believe in and have committed to breastfeeding their children, to say that it isn't necessarily all blissful and marvellous, as everyone seems to think if you haven't given up by 6 months, it must be because you "love" breastfeeding. I don't love breastfeeding, I just love my children!

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  25. Ouchie ouchie ouchie! I stopped bf just before mine got to that stage because the pain was excruitiating & I really was panicking about the next feed... I too was told that "the latch looks fine" but as the damage had already been done & my midwife at the time was worried about my state of mind we decided to go onto formula 2 weeks after Izzy was born.

    The guilt I felt at not being able to do it was awful, so much so that 9 months down the line I was diagnosed with depression, which I'm sure my unsuccessful attempt at bf contributed to.
    I was also "manhandled" which didn't help at all.

    We are now expecting baby number 2 (in three weeks) & although I have attended a bf workshop & read a number or articles/books I am still incredibly anxious of what lies in store this time.

    If I end up expressing and then ff again, I will be disappointed, but I will also be trying to not let my guilt get the better of me.

    I tell you what though, never again will anyone say to me "latch looks fine" if it's clearly not, & at least this time I know where to try & get help.

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  26. That is awful.I suffer from nipple vasospasm and with my first child endured awful pain I got very sick also.M y poor bubb would not gain weight and the nurse who visited made me feel like a terrible mother all I heard was you have to Breastfeed.Thankfully I had a wonderful mother inlaw yes thats right I did say mother inlaw haha.She encouraged me to go to my doctor who wanted to put me and bubb in hospital because we had both become so ill,I think we were just hungry.My Dr recommed formula straight away and we didn't look back.I now have gorgeous 1yr old who has been BF and while I do endure occasions where my nipples are so sore I could cry I know she is my last so plan to keep it up a bit longer.My point is I have bonded with booth my little wonders just the same, nobody has the right to make us feel unfit as mothers if we choose not to bf for whatever reason.There needs to be more support for our choices.Not the opinion of someone who thinks they no better.

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  27. Thank you for the supportive comments. In answer to the mw in New Zealand- I have no idea what I am going to do this time round if I face the same kind of difficulties. I am dreading bf but remain determined. I can only hope that if the same things start to happen I can get to the root of the problem faster. But I won't make my family suffer in the same way again. If I can manage to ebf until solids are introduced and then have to supplement with ff then so be it.And no doubt there are many who will judge me for that but I'm not sure I could go through that ^^ again.

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