May 29, 2019


Breastfeeding struggles linked to postpartum depression in mothers.

The breastfeeding relationship is not always a dream. It can be challenging, physically painful and cause guilt and postnatal depression for many mothers.

As a doctor, I encourage mothers to breastfeed. Breastfeeding is affordable, helps with bonding and has health benefits for both the infant and mother.

In my medical practice, many new mums come to see me because they are having difficulties breastfeeding. Before having a child of my own, I would do a basic physical screen that included checking the infant’s oral cavity and checking the mother’s nipples to look for any structural problems that could make breastfeeding difficult.

Once I completed the initial screen, I would direct the mum to a breastfeeding clinic to see a certified lactation consultant.

I was so focused on the physical aspects of breastfeeding that I did not realize the psychological impact of being unable to breastfeed until I had my own daughter, Madi.

Breastfeeding pain and guilt

Breastfeeding was one of the things I looked forward to most when I was pregnant. In medical school I learned about the bond between mothers and babies when they are breastfeeding. I could not wait to experience this.

Stephanie Liu with her daughter, Madi.
Author provided

However, breastfeeding Madi turned out to be more challenging than I anticipated. I struggled to get her to latch and when she did latch it was very painful. As a result, my milk supply was insufficient. For the first two weeks, I supplemented with formula and was racked with guilt that I was not doing the best for Madi.

My experience with breastfeeding changed how I interact with my patients that struggle to breastfeed their infants. Rather than only doing the initial screen looking for physical causes of difficult breastfeeding, I now ask “How is difficulty breastfeeding affecting you?”

I ask this question because I felt like an inadequate mother when I was not able to breastfeed, but was too ashamed to talk about it. Since starting to ask this question, I have had patients express concern that they may have symptoms of postpartum depression (PPD) or felt like a horrible mother for being unable to breastfeed.

Are women who struggle with breastfeeding at an increased risk of PPD? Let’s examine the evidence.

Higher rates of postpartum depression

There is recent evidence that suggests women with difficulty breastfeeding may be at risk for postpartum depression. One large study of over 2,500 women found that women who had negative breastfeeding experiences were more likely to have symptoms of depression:

“Compared with women with no early neonatal signs of breastfeeding difficulty, we found that women who had negative feelings about breastfeeding and reported severe pain while nursing soon after birth were more likely to experience postpartum depression at two months.”

For some mothers, the dream of a relaxed and connected breastfeeding relationship is far from reality.
(Unsplash/Dave Clubb), CC BY

In the United States, statistics show that only 25 per cent of mothers exclusively breastfeed their infants to the recommended minimum six months, and 10 per cent of new mothers experience postpartum depression.

Another study published in Maternal and Child Health Journal found that the effect of breastfeeding on postpartum mental health differed according to whether the woman during her pregnancy had planned to breastfeed her infant or not. Women who had intended to breastfeed their infant, but were unable to breastfeed postpartum, had higher rates of postpartum depression.

There are other safe and healthy options

As parents, we intend to provide the best for our babies, so difficulty breastfeeding may lead to significant amounts of stress.

As a family doctor, I know that breast milk is the optimal feeding choice for health benefits, but as a mom, I know the extreme pressures that we are placed under as women to produce milk every time our baby needs it.

A strong mother-child attachment bond can be achieved without breastfeeding.

This is why I always support the idea to breastfeed if you can, to reach out for support, and if you are struggling, there are other safe and healthy options to ensure your baby is well fed.

Stephanie Liu offers evidence-based parenting and health advice at her blog Life of Dr. Mom.The Conversation

Stephanie Liu, Clinical Lecturer, Department of Family Medicine, University of Alberta

This article is republished from The Conversation under a Creative Commons license. Read the original article.

  • I think that breast feeding issues do have links with PND. I am speaking from experience. I think the worst thing is the pressure that we feel we have to. To this day, if I hear the phrase ‘breast is best’ I wanna explode!


  • Birth and breast feeding/feeding can be such a tough time for new mums.


  • This is a really sensible attitude for a doctor to take.


  • Wow I can’t believe that only 25% of Mother’s breastfeed til 6 months. Crazy figures! I would have thought it would have been much higher.


  • not sure why they needed to do a study on this, a mum is at her most emotional after giving birth, and the way breast feeding is rammed down our throats it is no wonder pnd has a foothold on them


  • The Mum’s I know that have tried and not been able to breastfeed feel terrible guilt. If your prone to depression I could see how this would exacerbate things


  • I could see not being able to do something easily or at all would cause depression. Just like anything that doesn’t go too well can. It’s tough being a parent, but kudos to those that keep trying to breast feed. As long as baby is fed though.


  • I know a Mum who had planned to breastfeed. After nearly 24 hours labour they decided she couldn’t have her baby naturally and had to do an emergency c-section. She went into shock and never produced any milk even though she got professional help immediately. All the Medical Professionals she saw came to the same decision. It was very severe shock


  • I struggled to breastfeed and I struggled with dealing with not being able to breastfeed my child. I was so lucky to have so much support around me because without it I wouldn’t have copped.

    • Me too. I had so much guilt believe it or not – from other mums in brestfeeding groups telling me I can’t give up, its best for my baby etc. My son was hungry, I was stressing and eating all types of things to try and increase my supply to no avail. All it did was make me more anxious and stressed. Putting my bubs on formula was the best thing I could have done, and looking back, I wish I had done it sooner and not listened to the mums in the group who point blank refused to acknowledge that formula might actually be the best thing for my baby. I know now a fed baby is best


  • I absolutely believe this. If I’d kept going I know this is how it would have ended. Breatfeeding doesn’t help with bonding if you hate every second of it.

    • That statement is spot on! You’re doing yourself or your baby no favors if you’re stressed and unhappy


  • I had really bad PND bought on by a few factors one of which wzd was I could not breastfeed it consumed me and I felt quilty but kept trying which made it worse.


  • I can see how the two would go hand in hand. I didn’t have an issue with breast feeding or post partum issues. I think I was extremely lucky in both respects


  • I never struggled to breastfeed my 3 children but now for the second time have PND. I had it after my second and now third child. Breastfeeding for me has been a protective factor but unfortunately I only get better on medication. :(


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