Normalizing Nursing Complications: Breastfeeding Challenges, Perinatal Mental Health, and Lactation Support
Thrive • August 2, 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:
- Fatigue during the baby’s newborn stage: Exhaustion from caring for a new baby may make it difficult for parents to regulate their emotions and can also contribute to perinatal anxiety and depression.
- Hormonal changes in the postpartum period: The fluctuation of hormones following childbirth can contribute to shifts in mood that can lead to a deterioration in mental health.
- Other experiences in this life stage: An array of circumstances may manifest during the perinatal period that can harm mental health, such as dealing with the implications of unresolved trauma , experiencing fear over becoming a parent , trouble with one’s partner , or other life stressors .
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.
This Eating Disorders Awareness Month, we’re focusing on fighting the misinformation and stereotypes surrounding eating disorders that so often create barriers to diagnosis and treatment. Myths about eating disorders can perpetuate harmful stereotypes and keep people from receiving effective and timely treatment when they need it. It’s no secret that the field of eating disorders is riddled with misinformation, leading to confusion, stigma, and shame for those struggling. In this blog post, we'll explore the common myths about eating disorders and fight them with concrete facts in the hopes of building a more informed and educated community when it comes to these serious mental health conditions. Eating Disorder Myths Versus Facts Myth: Only those who are medically underweight have an eating disorder. Fact: Someone can have an eating disorder at any weight. In fact, less than 6% of those diagnosed with an eating disorder are medically underweight. There is even a specific diagnosis for those who are not underweight showing the symptoms of anorexia called atypical anorexia. People of all sizes are at risk for serious complications from an eating disorder, not just those that are underweight. Myth: Only women have eating disorders Fact: Although often associated with teen girls, eating disorders can affect those of any gender and age. While stereotypes and stigma surrounding eating disorders may tell us that men are not commonly affected by them, research has found that nearly 25% of those who present for eating disorder treatment are male. Keeping an open mind around who can be affected by eating disorders allows for more accurate and timely diagnosis and treatment for those who need it. Myth: Eating disorders are just about food. Facts: While eating disorders always involve an unhealthy relationship with food or body image, they also are rooted in biological, psychological and sociocultural aspects. Eating disorders cannot be treated just by changing eating behaviors, but by addressing the mental aspect of the illness as well. This is why integrated treatment involving a team of social workers, primary care specialists, therapists, and in some cases occupational therapists or psychiatrists is so crucial: a holistic approach is needed to treat all aspects of an eating disorder. Myth: Eating disorders aren’t that serious. Fact: Eating disorders are extremely serious and life-threatening mental disorders that require dedicated treatment. In fact, anorexia nervosa has the second highest mortality rate of any psychiatric disorder. By taking eating disorders and their diagnosis and treatment seriously, we can save lives. Myth: Eating disorders are a choice. Fact: Just like any other illness, eating disorders are not a choice or a phase, nor is recovery from an eating disorder just a simple decision to start eating more or less. Recovery is not dependent on willpower, but on ongoing professional treatment and long-term support. The recovery process can be lengthy and challenging, requiring patience and a supportive environment and team on your side. It is a gradual, step-by-step journey, rather than an instantaneous decision made on one person’s part. Myth: Eating disorders always involve negative body image. Fact: Avoidant/restrictive food intake disorder (ARFID) does not have to do with body image. Those with ARFID may avoid many foods because of texture, taste, color, or smell, or feared outcomes of eating like choking or vomiting. Like any other eating disorder, ARFID is serious and requires specialized treatment like exposure-response prevention therapy. Myth: Eating disorders only affect White people. Fact: Although Black, Latina/o/x/e, Indigenous/Native, and Asian people are historically underrepresented in studies of eating disorders, large-scale studies have found that rates of eating disorders are the same or higher in all racial and ethnic groups as compared to white individuals (NEDA). Removing racial stereotypes around eating disorders can help to remove barriers that BIPOC individuals commonly face when seeking treatment. Dispelling the Myths: A Path Towards Understanding By addressing and dispelling these myths, we can create a safe space that promotes understanding and empathy. Eating disorders are not choices or phases, but debilitating mental health issues that can affect anyone. Recognizing the seriousness of these disorders is so important in reducing stigma and ensuring that those who are struggling receive the care and support they require. This month and every month, we encourage you to fight misinformation and stick up for those experiencing eating disorders, because knowledge and education can be one of the greatest assets to recovery for those who need it. If you or someone you know is in need of eating disorder support, don’t be afraid to reach out , our team of healthcare professionals are here for you. To learn more about eating disorders and the journey to recovery, download our free eating disorders guide .
Did you know that February is Eating Disorder Awareness month? Here at Thrive, we're passionate about educating our community and providing tools for eating disorder recognition while offering the specialized support and treatment that those with eating disorders deserve. Join us this month in the conversation around eating disorders and putting an end to harmful stereotypes and misinformation. Let's cover six reasons why building awareness around eating disorders is so crucial. 6 reasons why eating disorder awareness is important 1. Eating disorders are serious. Despite often being termed as a "choice" or a "phase," eating disorders are an incredibly serious psychological condition that require specialized treatment and support. Anorexia Nervosa has the second highest mortality rate of any psychiatric diagnosis in the United States, and every 52 minutes, 1 person dies as a direct consequence of an eating disorder (NEDA) . By spreading awareness and providing early intervention in eating disorder treatment, we can not only change lives, but save them. 2. Eating disorders are more common than you think. 9% of the US population will have an eating disorder at some point in their lives and 22% of children and adolescents worldwide show symptoms of disordered eating (NEDA). Since eating disorders can be challenging to detect, many go undiagnosed. Raising awareness for eating disorders and educating our community partners about their symptoms can allow us to catch eating disorders as early as possible and bring these statistics down. 3. Fight harmful eating disorder stereotypes. A common stereotype in association with eating disorders is that of the "thin, white, affluent female," however, anyone is at risk of an eating disorder despite their appearance or background. Stereotypes associated with eating disorders around weight, gender, age and race can create serious barriers to seeking care and major disparities in treatment. People experiencing an eating disorder can face challenges in seeking and receiving treatment or may feel unworthy of recovery when they don’t fit a stereotype, preventing them from gaining needed support and treatment. Promoting diversity and representation through awareness and education can help to break down the harmful stereotypes that have historically surrounded eating disorders. 4. Eating disorder recovery is not a one person job. Family and loved ones’ involvement in eating disorder treatment is crucial for recovery. Family-based therapy (FBT) has proven to be effective in 50% of patients being treated for anorexia nervosa, and is effective in the treatment of other eating disorders as well. A strong support system and steadfast relationships through the struggles associated with eating disorders can lead to more effective and long-lasting recovery. With more awareness and education, people will be better equipped to provide assistance to their loved ones in recovery. 5. You’re not alone. Eating disorders can be an isolating and painful disorder, making those experiencing it feel like they’re the only ones, or that no one understands what they’re going through. Building an informed community through awareness and education can be the first step towards diagnosis and treatment for those who need it. 6. Recovery is Real. Those with eating disorders are capable of long-term recovery through appropriate treatment. Research has found that the earlier intervention takes place in the treatment of eating disorders, the better the odds of long-term recovery are. Awareness and education around eating disorders helps the people that need support find it sooner, resulting in a repaired relationship with food and the body and a fuller life. How can I get involved in eating disorder awareness efforts? To get involved in eating disorder awareness efforts, start by educating yourself about the complexities and different types of eating disorders. By gaining a deeper understanding, you can become a more effective advocate. You can also consider participating in local or national events such as walks, trainings, or online webinars that aim to raise awareness, provide support to those affected, and offer education around eating disorders and their diagnosis. Another simple step for building awareness can be using your social media platform to share factual information, personal stories, or relevant resources that can help demystify eating disorders and reduce stigma. Additionally, supporting legislative efforts that promote mental health education and funding for eating disorder research can help in creating systemic change. By taking these steps, you can contribute to this important movement and work alongside us to foster acceptance, encourage early intervention, and ultimately save lives. Eating Disorder Treatment and Support Thrive offers a free eating disorder guide with more information about eating disorder symptoms and recovery. If you or someone you know is struggling with eating or body image, don’t be afraid to reach out to professionals for support. At Thrive Wellness, we offer a number of treatment options for all ages and genders, including a partial hospitalization program, an intensive outpatient program, outpatient therapy, occupational therapy, nutrition services, and more. Don’t wait to get started on treatment, contact us for a free eating disorder assessment today.
You’ve probably heard of “Dry January” or are even participating yourself. More and more people seem to be experimenting with or embracing sobriety from alcohol, but what benefits are there from abstaining? In this article, we’ll explore alcohol’s effects on mental health, the symptoms of alcohol use disorder (AUD), and the benefits of cutting back on drinking. Alcohol's Effects on Mental Health Commonly consumed as a way to relax after a long day or to lighten up in social interactions, alcohol is a widely used and culturally accepted drug despite warnings of its dangers by health experts . When a person regularly drinks, it can result in a slew of complications for their physical and mental health. Although often consumed in an attempt to escape stress, sadness, or other unpleasant emotions, alcohol itself is a depressant that can contribute to negative feelings and exacerbate existing mental health conditions, especially with prolonged use. Alcohol influences thoughts, mood, and behaviors by impacting the central nervous system in a way that slows the communication between the brain and the body. Without the ability to process information effectively, the brain isn't able to regulate emotions and consider consequences effectively which may promote unhealthy behaviors, including drinking to excess. Ways that alcohol can affect cognitive functioning include: Lowering inhibitions Contributing to poor judgment Causing confusion Causing lapses in memory Disrupting sleep Contributing to shifts in mood Alcohol and Mental Disorders According to the Journal of the American Medical Association, 37% of people with alcohol use disorders also have at least one serious mental illness. Furthermore, alcohol abuse commonly occurs alongside depression and anxiety . Research has shown that those with major depressive disorder and those with generalized anxiety disorder were more likely to report life‐time moderate to severe alcohol use disorder than those without these conditions. Frequently, individuals struggling with depression or anxiety self-medicate by drinking alcohol. Although alcohol may provide temporary relief, it expends the chemicals in the brain which help ward off anxiety and depression. When the initial effects of the drug fade, individuals are typically left feeling more depressed or anxious than they did before they began drinking. Related: Eating Disorders, Substance Abuse, and Substance Abuse Disorders Alcohol Use and Depression The slowed functioning of the brain caused by alcohol can allow individuals to numb to their suffering. As such, those experiencing depression may be inclined to drink to avoid the sadness, pain, and hopelessness associated with depression. This maladaptive coping behavior is so prevalent that research shows a clear relationship between alcohol use disorder (AUD) and major depression. Using alcohol while depressed can be extremely dangerous. Not only can alcohol negatively interact with antidepressants, but it can also place individuals experiencing depression at an increased risk for suicidal thoughts and behavior . If you're experiencing suicidal thoughts or behaviors , you can reach the National Suicide Prevention Hotline at 1-800-273-TALK (8255). Alcohol Use and Anxiety According to a study on anxiety and AUD , a person with an anxiety disorder is two to three times more likely to develop an alcohol abuse disorder. When individuals with anxiety drink alcohol, they may feel an initial alleviation of their symptoms as well as a sense of euphoria. However, the symptoms of hangovers and alcohol withdrawal following heavy drinking can heighten feelings of anxiousness and interfere with ones daily obligations, contributing to even more agitation. This feeling of dread and anxiety associated with a hangover is commonly referred to as " hangxiety ," but for those with existing anxiety conditions, this side effect of drinking can feel unbearable. Individuals with anxiety may be driven to drink more to tamper their stress and re-establish the sense of euphoria, resulting in a dangerous cycle of alcohol abuse. Unhealthy Drinking Behaviors and Alcohol Use Disorder (AUD) Most who regularly drink alcohol don't have AUD, which develops when addiction is present. However, alcohol-related side-effects on mental health are still common, and they may still benefit from mental health support . Signs of unhealthy alcohol use include: Feeling a need to consume alcohol to make it through the day Feeling unable to stop consuming alcohol Progressively feeling a need to increase consumption of alcohol Drinking to prevent or alleviate symptoms of hangover or withdrawal Feeling ashamed of ones alcohol consumption Having loved ones express concern over drinking habits AUD is a condition that is often driven by genetics, abuse, trauma, or unhealthy family dynamics. Healing from AUD is possible and it can be treated with the help of mental health professionals and a dedicated treatment plan. Signs of AUD include: Alcohol use that interferes with the ability to carry out daily activities Drinking despite the behaviors adverse effects on their life Often drinking more or for a longer period of time than intended Persistent desire and unsuccessful attempts to curb alcohol use Revolving their schedule around drinking Experiencing strong cravings for alcohol Continuing to drink despite experiencing recurring illness or social issues as a result of alcohol use Giving up activities one used to enjoy in favor of drinking Using alcohol during situations where its physically hazardous to be impaired Continuing to use alcohol despite knowing that it exacerbates a known existing health condition Developing a tolerance for alcohol, or needing more alcohol to feel the same effects Experiencing alcohol withdrawal or drinking more to avoid withdrawal What are the Mental Health Benefits of Going Sober or Drinking Less Alcohol? Reducing or eliminating your alcohol consumption can lead to a variety of mental health benefits, improving your overall quality of life. When going sober or cutting back on your alcohol consumption, some of the benefits you can look forward to are: Improved mood stability, including reduced feelings of depression and anxiety Improved sleep quality Enhanced cognitive function Increased energy levels Improved concentration and productivity Increased self-esteem More authentic social interactions Improved relationships Limiting your alcohol consumption has the capability to change your life for the better, as it can help you establish a healthier mental environment, build better connections, and improve your physical health. Support for Alcohol Abuse and its Mental Health Impacts As humans, it can be uncomfortable for us to process difficult experiences and feel intense emotions. Therapy can help heal the source of your struggles driving alcohol abuse, while also guiding you in implementing healthy strategies for processing painful emotions. Through professional mental health support, you can be empowered to embrace life without having to rely on alcohol. Thrive offers outpatient therapy for substance abuse struggles in addition to other mental and behavioral health conditions. Reach out to learn more. Additional Resources SAMHSAs National Helpline : A free, confidential, and 24/7 service for individuals and families facing mental health conditions and/or substance use disorders, reachable by calling 1-800-662-HELP (4357) or texting 435748 (HELP4U). National Institute on Alcohol Abuse and Alcoholisms (NIAAA) Treatment for Alcohol Problems : A guide for individuals and their loved ones who are looking for options to address struggles with alcohol use.
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