Wednesday, April 07, 2010

Breasts in Mourning

By Dr. Jesse Bering
Posted at DrMomma.org with author's permission
Article first appeared in Scientific American



Breasts in Mourning: How Bottle-Feeding Mimics Child Loss in Mothers' Brains ~ After a successful birth, opting not to breast-feed may trigger evolved mourning behaviors


Discussions of breastfeeding versus bottle-feeding usually focus on the baby: What’s best in terms of nutrition? Or an infant’s future mental health?

But we’re going to take a different route. Let’s talk about the mother, and more specifically, the changes in her body as it readies itself to nourish a hungry newborn. With her breasts enlarged and hormones flowing, what happens if no newborn appears to suckle? How will her body—and brain—react?

First, a little background.

The obvious physical changes in the pregnant human body (including swelling breasts) occur in response to escalating levels of the hormones prolactin, lactogen, estrogen, progesterone, adrenocorticotropic hormone (ACTH) and growth hormone. Placental birth serves as a sort of trigger event signaling to the mother’s body that it’s time to begin releasing milk. The baby’s physical suckling behavior—that is to say, lips tugging on teats—stimulates the first ejections, but eventually milk flow can start up by simply thinking about the baby, smelling it, or hearing it cry. "Involution," the physiological process by which women’s breasts revert back to a dormant state, coincides with slowly weaning the growing child from breast milk and onto solid foods.

So what happens when, for whatever reason, mothers do not breastfeed their healthy infants?

According to a new theory being proposed by University of Albany evolutionary psychologist Gordon Gallup and his colleagues, the decision to bottle-feed is tantamount, in the mother’s psyche, to mourning the loss of the child. At least, that’s how a woman’s body seems to respond to the absence of a suckling infant at its breasts in the wake of a successful childbirth. In a recent article in Medical Hypotheses, the authors argue that bottle-feeding simulates the unsettling ancestral condition of an infant’s death:

Opting not to breastfeed precludes and/or brings all of the processes involved in lactation to a halt. For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother’s decision to bottle feed unknowingly simulates child loss.

There is at least correlational evidence to support this evolutionary claim, too. For example, in a paper presented earlier this year at the annual meeting of the Northeastern Evolutionary Psychology Society, Gallup and his colleagues reported their findings that, among a sample of 50 mothers recruited from local pediatric clinics and who had given birth in the previous 4-6 months, those who bottle fed scored significantly higher on the Edinburgh Postnatal Depression Scale than breastfeeders did. This effect panned out even after controlling for the mother’s age, education, income and relationship status with her current partner.

Another telling finding to emerge was that the bottle-feeding mothers reported wanting to hold their babies significantly more than the breastfeeders did, which the authors believe:

...parallels findings among nonhuman primates where in response to the death of an infant, mothers of some species have been known to tenaciously hold, cling to, and carry their infants for prolonged periods after they die.

It’s an interesting (if morbid) idea that bottle-feeders are implicitly conceptualizing their babies as corpses, but there are plenty of alternative interpretations. For example, these women may simply want to make up for lost bonding time that would otherwise occur during breastfeeding.

In any event, if Gallup’s theory about the “unnaturalness” of bottle-feeding simulating child loss holds up in future studies, it would have obvious, and important, clinical applications. This would also be an excellent example of how evolutionary psychological explanations of human behavior can improve the quality of human life. Of course the reasons for bottle-feeding are complex and many, and not all women have the luxury of a choice in this regard. But for those who do, the present logic may give new meaning to the expression “breast is best”—if not for infants, then at least for their mothers.




Find Dr. Jesse Bering on Facebook and stay up to date on his latest research as a psychologist at Queen's University, Belfast.




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34 comments:

  1. The flip side of the coin on this is that after my stillbirth, breastfeeding my toddler when engorgement began was incredibly healing in a way I have never been able to define. Now, perhaps, I have one definition. Thank you for posting this article.

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  2. ♥♥♥ TouchstoneZ

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  3. as a surrogate mother I can tell you that after leaving the hospital pumping, freezing and shipping what breastmilk I could helped my new reality. My second surrogate baby I did not pump for it and it was different.... hard to explain. This helps some though!

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  4. For surrogate moms who can't send milk to their babies...there are other mothers out there who are always on the lookout for breastmilk donations! Post around online, and you'll be sure to find one!

    Here are a couple donation resources for those in the States/Canada: http://www.drmomma.org/2009/07/breastmilk-donation-for-donors-and.html

    Local mothers/midwives/doulas/LLL leaders/lactation consultants can also pair you up with mothers needing milk.

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  5. I still think about this concept a lot. I never got to breastfeed my daughter and although I was truly mourning her loss, the concept that her not breastfeeding told my body that she had died was something I even verbalized back then.

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  6. Wow! This makes a lot of sense and is very interesting

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  7. I have thought about this many times, and it really makes sense. I would like to write a paper about this at some point during my educational road to midwifery.

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  8. i would be interested in a study of the statistics/link between not breastfeeding and post-partum depression.

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  9. What many folks forget, we are ANIMAL before we are human. we can "deny" and "ignore" the human animal, but as society has proven, that leads to depression, aggression, anxiety and a feeling of general confusion.

    Mothers can verbally deny they don't have "loss" feelings, but they may be so disassociated with their bodies, that they don't even know the truth of their own selves.

    Sad.

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  10. I almost lost my ability to bf and my child, and I think it is absolutely comparable. You (personally) just happen to know that/what you were mourning, while a woman bottle feeding is experiencing symptoms without a "reason", her psyche is experiencing the mourning. I think that can have much more detrimental effects.

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  11. Agreed Luna. I struggled BF for 5 weeks, still suffer from the depression 2 1/2 years later and my heart still breaks to know I couldn't mentally handle the depression and breastfeeding at the same time. Props to those mothers who are doing it and have conquered it.

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  12. An interesting article... goes some way in explaining the feelings of grief I had when my breastfed babies weaned at 14 months...

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  13. I didn't BF. I didn't try hard enough. I didn't research enough. It took a long time to get over the guilt, to not feel like that bond was missing. I made sure to cuddle and nuzzle and always hold and be close to my babe while he ate...but still. I also had post-partum depression and I have always thought breastfeeding would have helped.

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  14. I couldn't breastfeed either on of my children.... My first was stillborn (there's one hell of an experience) and my second wouldn't take to it at all.... It is a lot like the loss of a child, and I ended up depressed because I spent my whole pregnancy planning to breastfeed :(

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  15. As a doula, I will now be aware that a mum who decides not to or can't breastfeed is more susceptible to postnatal depression, good to know

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  16. I had a lot of difficulties with Breastfeeding and ppd. I was to the point of quitting bf at 4 weeks old and for some reason I stuck it out. My depression has lifted completely and I couldn't imagine not nursing my son. Everyone has their own story but if you start... Try your HARDEST to stick it out, it will be worth it :) I find myself wanting to nurse him often. Just never thought I would get to this point, hearing of other women having difficulties really helped me through.

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  17. My son was born at 30 wks and after a hell of an unsupportive staff at the NICU for 7 weeks, pumping, Csection birth, I was so lucky to not go through the depression that I think I would have gotten without bf.


    LUNA~Here is your study.
    http://pediatrics.aappublications.org/cgi/content/abstract/66/2/183

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  18. Great article, very interesting. Will be good to see more research. Yet another reason why good breastfeeding support is so vital.

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  19. I do not see how a mother's body could react any other way.

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  20. I know of women who had crash c-sections or other major interventions that meant they didn't get to see/hold their baby right away and/or couldn't breastfeed, it was a majorly traumatic event for them, even several years afterward.

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  21. I am currently going through a tough time for this reason- I have been battling BF my little one for 3 months and nothing has worked. I am still pumping but barely getting anything. I truly feel like I am in mourning and for some reason I can't get over it. I looked for other mommas that could maybe donate to me since the thought of formula gave me '
    anxiety...it just didn't work out for us. Good article.

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  22. I remember the loss I felt when my daughter weaned herself. There was a lot of sadness. I always thought 'if I could just nurse her one more time.' I didn't get to say goodbye. I missed the closeness. I was even mad that she took the decision away from me! Since when was it MY decision?! Nevertheless that's how I felt.

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  23. @Luna, I'm with you.... very interesting! I know I would have a "loss" if I would not BF.

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  24. this just brings it all back for me. My daughter was sick in in hospital for 6 days when she was born and the doctors told me to pump and bottle feed her and top up with formula, so they could monitor her. So i didn't get to breastfeed until day 6 and by then she refused the breast. So by 5 weeks of pumping every 3 hours round the clock my little bit of milk I produced dwindled down to less than 1 ounce each pump. So i was forced to put her on formula 100% by my midwife because my child was so hungry. But I cried for weeks after every day and i still wonder if I made the right decision. But I tried everything to get her to latch on and she refused even to the point of pushing my breast away. Its a horrible feeling to have that you cant feed your child and I'm still dealing with the depression of it all and she's 20 months old. thanks for the article.

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  25. this article proves true for me personally. With my first i was very successful and bf for 14 months. I even prided myself on being a successful breastfeeder. My second has acid reflux and i was successful for 6 weeks. When i started experimenting with formulas and found he held a certain one down better than my milk, i was devastated. He's 11 months old now and i'm still heartbroken every time i feed him a bottle. I feel like i've failed.

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  26. Very interesting article!

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  27. Mothers milk please...

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  28. So true- my baby weaned herself at only a few weeks old (my long breastfeeding story here http://obsessedwithbreasts.blogspot.com/2010/05/our-breastfeeding-journey.html) and the grief was incomparible to anything I've ever felt... the peace and comfort of a breastfeeding babe is indescribable. Love articles like this

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  29. Remai - your story (posted in your blog) is incredibly touching and heart breaking as well. I can imagine that was very difficult to go through when you wanted so badly to give your daughter the milk made for her.

    It is very atypical for a newborn to reject nursing in this manner, and often is done because the let down is too intense. In this case, pumping for a few minutes before nursing can solve the problem and allow a tiny little one to feed.

    However, in your case it sounds like she also did not want to drink the milk even via other means? I am wondering if there was something in your diet (cow's milk, nuts, etc.) that she was responding to and (intuitively) rejecting? Cow's milk, nuts/soy are a couple of thee most irritating and trouble causing items for babies and some smart little ones will reject the milk altogether if it is upsetting to them to consume.

    There are also allergies and sensitivities (especially if a mother is taking particular pharmaceuticals) that can cause a baby to turn her head to mom's milk.

    I am so sorry you had to experience all of this, and the loss, without being able to get real problem-solving help from those you reached out to around you (LLL, etc.) Thank you very much for sharing your story. Hopefully we can come to understand situations like this more fully so other moms and babes don't have to endure the same.

    *hug*

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  30. I found this article to be fascinating and powerful. Makes total sense.

    I have a few friends who desperately tried to BF and were not able to make it work. They were so disappointed and saddened, feeling like failures and less motherly and womanly. I wonder how many of these "modern" expressions of mourning the loss of their nursing relationships were really speaking of a deeper, more primal feeling of loss?

    It would be fascinating to be able to go back to a period of time where wet nurses were common. Did those women who wet-nursed (either because they lost their children or because they were able) have less (of what we now call) PPD than peers who lost their children and did not wet-nurse?

    Fascinating. I am so grateful that I was able to nurse #1 to 15 months. It was a gradual weaning, both because he was ready, but so was I because I am of "Advanced Maternal Age" and wanted to get started trying for #2. Since it took over a year to conceive #2, I do wonder how much longer I could have nursed #1. Did I loose a significant amount of nursing time with him, or was it really time? No way to know now.

    I do know that I will be nursing #2 (when he arrives in December) as long as I possibly can. He'll be my last baby *sob* and I intend to enjoy him to the hilt.

    Nursing is such a blessing.

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  31. I wish I would have known this with my first :/ I was only 17 and nobody really talked to me about breastfeeding. I had ppd and was on medication for it...:(
    With my second, now 5 months old and a very active and successful bfeeder we are all so happy and never had one negative thought after his birth every time he nurses is like the best part of my day :)
    I still feel guilty now knowing what I could have had and missed out with on my first. This article really makes a lot of sense.

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  32. I understand where they're coming from with this, but as someone who has had a stillbirth and then breastfed my rainbow baby, I can say that this offends me a little bit. There may be a few triggers that are the same, but this really diminishes the enormity of the emotions and physical heartbreak that you experience with a late-term loss.

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  33. Reading all the struggles with BFing breaks my heart, especially the ones that "can't latch". My chiro (who is a certified paediatric chiropractor and works in a practice specifically for parents-to-be/pregnancy/post-natal/family wellness, and is momma to a gorgeous 5 month old daughter) says that babies who refuse to latch need a very simple and quick adjustment in their spine, that they're in pain trying to latch and that's why they're refusing it.

    Something to think about if people are struggling to latch. Chiro adjustment is good for colic too! :)

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  34. I have to agree with Anonymous. I understand the idea behind it but as someone who has experienced a stillbirth, I have a hard time comparing the actual death of a child to not breastfeeding. I struggled very much with breastfeeding my first born and gave up after 3 months (as she was going to be diagnosed as failure to thrive) so I know the disappointment that comes with not breastfeeding but to compare that to the grief of losing your baby just doesn't seem right.

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