Review by Orla Dorgan
Short book 135 pages. ‘Why Matter’ series published by Pinter and Martin.
I was excited to be able to review this book by Professor Amy Brown. Breastfeeding grief and trauma is something we deal with very regularly in our personal lives and also in a professional capacity. It can really affect women’s’ mental health.
Professor Amy Brown is based in the Department of Public Health, Policy and Social Sciences at Swansea University. She first became interested in the many barriers women face when breastfeeding her first baby. She has spent the last 12 years exploring psychological, cultural and societal barriers to breastfeeding with an emphasis on how we can support these women and how we can increase our breastfeeding rates.
The book is a research book written over 3 years. It is collections of experiences that Amy has analysed over these years.
The book discusses why breastfeeding matters so much to mums and why we really want it to work. Breastfeeding is natural, a way of mothering, can help heal traumas, is healthy for baby and can be for cultural and religious reasons. For many mums, for these reasons, breastfeeding matters a lot. Many mums contribute their stories. One mother was breastfeeding her pre-schooler when her child was diagnosed with Cancer at the age of 3.5 years. Its importance was brought into sharp focus. The toddler suffered less due to breastfeeding – less pain, eased her nausea, never suffered with painful ulcers. It was her connection to normal.
The emotions women feel when they are unable to meet their goals can be long lasting even until those babies are fully grown children. “If you can redirect and attribute the emotions you feel to an external cause, particularly a justifiable one such as lack of professional support, the feelings of guilt and failure can ease”. I think this is a big statement and shows how much of an impact we have as IBCLC’s, midwifes, practice nurses, GP’s, Consultants and other HCP’s to breastfeeding mothers. Every encounter counts.
The risk of post natal depression (PND) and stopping breastfeeding is often overlooked when in fact it can be a grieving process. “Grief is an utterly normal reaction to loss”. Loss of breastfeeding goals, experienced pain or difficulty can all suffer from PND. Breastfeeding helps protect mental health.
Post Traumatic Stress Disorder (PTSD) is associated with soldiers post war. But Amy argues that Mums who have suffered breastfeeding trauma and grief can suffer with PTSD. “The oldest baby in the study was 36 years old. Thirty six years old and the mother still felt hurt and the guilt and the frustration of the system”.
“Epigenetics have shown that trauma can be inherited. Imagine a trauma your grandmother experienced while 5 months pregnant with your mother, when the egg that would one day make you that is present and fully formed”. It can influence what can be experienced many generations on. Mental health can have many implications not from just our lifetime but our generations back.
Amy goes on to discuss why do so many women struggle to breastfeed? Rates in the UK and Ireland are among the lowest in the world. 2/3 of women in Scandinavian countries are breastfeeding at 6 months compared to 1/3 in the UK. Amy believes it then cannot be “purely physiological issue that are preventing women from breastfeeding – something complex is going on at the societal level that is directly and indirectly harming their ability to breastfeed”. Approximately 1% of women have physiological issues that doesn’t allow them to breastfeed.
The wider environment can affect how women feel about breastfeeding, the lack of professional support, family support and critical friends play an important part in mothers’ lives and if it is not present, it can make breastfeeding seem impossible. “Society just doesn’t ‘get’ babies”. “It believes babies should be ‘good’- sleep through the night, feed in a routine and be happy and put down. And the messages that women get from society imply they are failures if their baby breaks the rules”.
Generational experiences have led us to this point. “Back in the 1950’s we were sold the idea that formula milk was scientifically superior to breastfeeding and freed women from being tied to their babies”. The natural way to feed our babies was lost and the experience that comes with that. This has been detrimental to our breastfeeding mothers. And some of our own mothers who weren’t able or couldn’t breastfeed for whatever reason be it support, knowledge or pressure to formula feed may still be grieving their own lost breastfeeding experience. And in a way “consciously or subconsciously” they find themselves harming their daughters’ chances and passing on an inter-generational trauma”.
To help grieve this lost or traumatic breastfeeding experience, feelings need to be validated and mums need to be listened to. Many mums in her research believed this was a big part of healing and important. Letting mums grieve like they would do a loved one. Talking, attending counselling and certain therapies e.g. Cognitive Behaviour Therapies can help, including many more.
To look at the bigger scale of things, we need to be able to make things better to help future generations. These suggestions came from mums who were still hurting deeply after a failed breastfeeding journey. These included more skilled support, better training for professionals, being honest about what breastfeeding is really like and further suggestions which all sound achievable but will they be acted on!
I have really enjoyed reading this and it has made me think about it, in simple ways and avenues we can explore with these grieving mums. As a private IBCLC, time and support is what we do have to a certain extinct and one on one time with our mums to give them time to talk and we listen.
This book was a great read and I would highly recommend to anybody who works with breastfeeding mums and also, for mums who have not reached their breastfeeding goals. They would find comfort in this. Professor Amy Brown has done great work and I agree wholeheartedly with all she says.
She says it in a simple and straight forward way.