Breast is Best Except When It’s Not

“Breast is best” is a nice slogan with a catchy rhyme and good cadence. Fortunately, many new mothers and their babies find that breastfeeding is easy and natural. However, some women find breastfeeding to be difficult, painful, or unpleasant. Moreover, the relationship between breastfeeding and a new mother’s mental health is complicated. For every study demonstrating that breastfeeding protects a new mother from experiencing anxiety or depression, there is another stating that breastfeeding difficulties can contribute to their incidence and/or severity.

My good friend, Lynne McIntyre, and I have been saying for years that “Breast is best…except when it’s not”. Today we are thrilled to share an article we wrote for the Journal of Human Lactation about what happens when breastfeeding challenges and maternal mental health issues converge. Here’s the link:

Web Link

We have been working with women experiencing perinatal mood and anxiety disorders, such as postpartum depression and anxiety, for almost 15 years. We’ve talked with hundreds of women experiencing PMADs (on the phone, via email, at support groups) and breastfeeding is almost always a topic of conversation. At least half the mothers who seek counsel our counsel struggle either emotionally or physically (or both) with breastfeeding. Some want to breastfeed but are not able; others do not want to breastfeed but feel enormous pressure to do so.

Some wean earlier than planned; others breastfeed, pump, and bottle-feed round-the-clock for many months. The majority indicate that their breastfeeding experience and their mental health are inextricably intertwined.

The current recommendation from virtually all parties concerned with maternal-child health, from the World Health Organization to the American Academy of Pediatrics, is that infants should be provided only human milk for the first 6 months of life. Although this recommendation for exclusive breastfeeding is derived from solid research and is widely considered most beneficial for the infant, it does not necessarily take into account the well-being and mental health of the mother. Unfortunately, adhering to this recommendation can sometimes exacerbate the depression or anxiety of mothers experiencing PMADs. We must remember that recommendations are guidelines, not rules, and that each woman and family should incorporate these recommendations into their own, unique situations.


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