The Doula Issue 39 Autumn 2020 - Flipbook - Page 11
Breastfeeding can and does trigger particular
negative emotions and intrusive thoughts, and this
is known as the phenomenon of breastfeeding or
nursing aversion and agitation - aversion for short.
Whilst the prevalence of aversion is unknown in the
cohort of breastfeeding women, it is well known
to occur in a high proportion when breastfeeding
through pregnancy and when breastfeeding older
nurslings. It does also occur in women breastfeeding
only one nursling, for reasons I outline in my book,
and although not as common it can even strike when
breastfeeding a newborn.
Although the onset, severity, and duration of experiencing
aversion can vary, the self-reported subjective symptoms
of breastfeeding mothers remain the same despite dyad
variations. Aversion can manifest with emotions of anger,
agitation, or frustration, a skin itching sensation and
thoughts of feeling like a prisoner or wanting to run away all when a nursling is latched. In distinction to the medical
condition of Dysphoric-Milk Ejection Reflex (D-MER),
aversion stays throughout the whole feed, however long it
may be. Whereas, with D-MER it tends to dissipate after a
few minutes, or whenever the mother’s letdown ends.
And although some mothers may experience both, the
emotions are quite different, and so are the causes and
what can help.
With the pandemic and the unprecedented recent changes
to how we live placing restrictions and pressures on our
lives, pregnant and breastfeeding mothers have certainly
felt the brunt with support services being unavailable.
Spending much more time at home, many mothers have
felt the burden of breastfeeding as their nurslings request
to feed more, day and night. This can act as a trigger
for aversion, as many mothers state the feeling of being
‘touched out’ as a precursor for aversion. If a mother is
breastfeeding through pregnancy, she may have limited
options for support, and weaning may not be something
that is considered. Being sensitive around discussing
challenges a mother may face during labour and the
postpartum period when breastfeeding can bring a great
deal of relief as she can openly explore her feelings without
judgement. Many mothers are concerned that their
aversion will not abate once the newborn arrives.
However, for the majority of mothers it does, and with
the flood of oxytocin, they return to breastfeeding without
aversion. Anecdotally, magnesium supplements or topical
spray (which is better absorbed) has been cited by this
cohort of mothers to help them get rid of aversion,
although we are unsure as to why it helps some mothers
but not others.
In my book I outline my biopsychosocial theory of the
phenomenon of aversion, covering what physiological,
psychological and societal factors may contribute to
experiencing aversion. These could include hormonal
factors like the negative pairing or association of
oxytocin, causing mothers to have a mild stress response
instead of the usual loving calm effect it is known for
When in lockdown, breastfeeding certainly became more
stressful for some mothers as the frequency dramatically
increased - as did their desire to continue breastfeeding
to protect their nurslings and boost their immune system.
This meant that even though they felt breastfeeding was
becoming burdensome, and they may have liked to start
the weaning process, they couldn’t bring themselves to.
This tension is a quintessential aspect of mothering through
breastfeeding, where mothers find their needs and desires
at odds with what their nurslings need and so often put the
latter first. If this becomes unmanageable, I argue, aversion
I also cover some groups of mothers who are at risk of
experiencing aversion, for example, those who are survivors
of sexual abuse. Whilst the research shows these mothers
are more likely to want to breastfeed and do so, aversion
can strike at any point in a breastfeeding journey and some
mothers struggle if they have flashbacks or memories and
do not feel in control of a situation - particularly at night.
Breastfeeding appears to trigger this stress response in
some women, and with nocturnal adrenaline and cortisol
being released, it can be very difficult to cope with
breastfeeding at night, and also returning back to sleep
after breastfeeding at night. Explaining that this can and
does happen can often empower a breastfeeding mother
who is experiencing it to separate her past from her current
experience, to rationalise why she gets aversion and feels
the way she does, and also to reach out for help when she
feels alone and stuck.
As doulas are well placed to pick up the pieces when other
maternal services have failed, it is key to understand a
mother’s desire and goals when breastfeeding, and who
she was before she became a mother. Type A personalities
who have been over-achievers and come from a high-paced
working world may find the shift into rhythms and patterns
of mothers instead of the artificial constructs of structured
time very challenging. Acknowledging their frustrations
or feelings of inadequacy and signposting them to online
support groups on Facebook which explain the fourth
trimester, biologically normal infant sleep, and evidencebased breastfeeding can help them through the transition.
© Doula UK | Autumn 2020 | The Doula 11