The Doula Issue 39 Autumn 2020 - Flipbook - Page 12
I suggest a simple-to-remember, step-by-step process, to help tackle aversion with my pneumonic
BROMPHALICC, which stands for;
Breastfeeding aversion triggers - identify them in the mother first as they can be highly individual, both
physical and mental - and even from external pressures.
Reactionary behaviours - is the mother letting out her negative emotions and causing a vicious cycle where her
nursling requests to breastfeed in order to feel calm again? This step is about a mother acknowledging how she
responds and reacts to her nursling, and if she is in a position to change this or if she needs to reach out for more
Ovulation and Menstruation - female hormones and the return of the post-natal menses can be the cause of
aversion in some women. Particularly, for example, if they experience a spike in testosterone when ovulating as
this is an oxytocin antagonist. App-tracking and recognising hormonal changes affect nipple sensitivity can help.
Prevention - Using the first few steps, in conjunction with understanding pressures on mothers in modernity and
the lack of biologically normal mothering, can be used to prevent aversion kicking in or getting worse.
Hydration and nutrition can be adjusted to help manage aversion, because, whilst a mother can make milk
even if she isn’t having the best diet, we all know that our bodies talk to us to tell us when we need to make
changes and treat our bodies better. Aversion can be a sign that mothers need to hydrate more, particularly at
night, and also eat better food with more nutrients in order to feel more comfortable with breastfeeding. Metadata suggests mild aversion in some mothers disappears when adequate hydration and nutrition are addressed.
Active distraction and redirection - if a nursling is old enough taking steps to set boundaries, create other
loving bonds outside of breastfeeding and re-direct their attention elsewhere to lessen feeds can sometimes help
Lifestyle changes - these include changes to the family home to improve sleep hygiene for the whole family,
which can have a knock-on effect to the mother and nursling (s), and include many small changes to help
everyone ‘get sleepy’ - which is really the only thing that matters when we consider how to get to sleep.
Interventions that are non-invasive and require a shift in habits and thought, including mindfulness and
minimalist approach, not to objects and ‘stuff’ per se but to life, to let go of anything that no longer serves you
and in order to ‘create space and time’ to breastfeed because it takes time and energy to do it!
Counselling and other therapies - this is when aversion has deeper roots in a mother, for example if it is linked
to birth trauma or childhood trauma and the mismanagement of stress. With some discussion with a mother, she
may be able to identify additional causes for her aversion if the above steps have been taken and it doesn’t abate.
Cessation of breastfeeding - there is a strong argument that aversion is a biological trigger to start the weaning
process, and this can make sense for older nurslings but not so much for those under 12 months as their main
source of nutrition for the first year of life is milk. If aversion is so severe and does not abate when trying the
previous steps, and the mother wants to stop breastfeeding, support through the process is key because it can
be as difficult and emotional as continuing to breastfeed through aversion.
Breastfeeding grief, commemorating the breastfeeding
journey and understanding that breastfeeding is only one
point in a very long parenting journey with plenty of other
opportunity for connection, love and bonding to take
place if the initial stage wasn’t quite as they anticipated,
is a conversation doulas are well placed to have with
breastfeeding mothers who struggle with aversion.
And also with those who struggle with stopping
breastfeeding due to aversion. With high rates of obstetric
violence, birth shock, birth trauma, mothering without a
village and lack of maternal mental health support, there are
so many factors to consider in the rise of aversion amongst
breastfeeding women. Talking about it is key, because
silence never makes anything better.
Zainab Yate BSc, MSc (Medical Ethics & Law, Imperial College) is an independent infant feeding
researcher & campaigner. She is currently Vice Chair of the North London Research Ethics
Committee, with the Health Research Authority in the UK (HRA). She is founder of Infant Feeding
Research Ethics, and a member of the King’s College London Research Ethics, Governance Policy
& Integrity Committee (KCL). She lives in Hertfordshire with her family.
Instagram: @breastfeedingaversion | Facebook page: @breastfeedingaversion | Twitter: @bf_aversion
When Breastfeeding Sucks by Zainab Yate is published by Pinter & Martin, £12.99
12 The Doula | Autumn 2020 | © Doula UK