When Canadian expat Dina Saleh gave birth to her first child, everything was going according to plan. The interior designer had taken a break from working, so she could dedicate her time to her newborn. She had a supportive spouse, supportive parents and in-laws. She was breastfeeding her baby, just as the experts recommended.
The first issue she faced was lower milk production than she wanted. “I did everything my lactation consultant asked me to from eating fenugreek seeds to eating oats,” she recalls, but nothing worked.
Then she got mastitis, an infection of the breast, which meant she could no longer rely on breastmilk for her first-born. She had to switch to formula milk. As she dealt with her hormonal roller-coaster, she recalls, Saleh was also thrown into the deep end of a judgement pool. “I was definitely mummy-shamed,” she recalls of the tough time. When she’d go out, strangers could come over to tell her that she was wrong to feed her baby formula, that she should have gone back to breast milk.
“I was depressed,” she says.
Imane Bougueffa, Counsellor and Clinical Psychologist at Priory Wellbeing Centre, Dubai, says: “The stresses and strains that come with having a new baby [should not] be underestimated. Physically, women go through huge hormonal changes post birth, but there can also be mental challenges too. Common worries include questioning their parenting capabilities, feeling overwhelmed with their new responsibilities and the change in family dynamics, comparing themselves unfavourably to other new parents, and worrying about their appearance, career and finances.
The stresses and strains that come with having a new baby [should not] be underestimated... In addition to a huge variety of psychological pressures, there can be the internal as well as social pressure to breastfeed her child.
“In addition to a huge variety of psychological pressures, there can be the internal as well as social pressure to breastfeed her child. This can greatly affect the mental health of the mother and can make her feel isolated and as though there are no other options available to her.”
Saleh was definitely feeling the external pressure and the guilt, anger and sadness that came with it.
Negative self talk is common
These feelings are completely normal, explains Bougueffa. “The mother may develop feelings of guilt, shame and concerns about her inability to feed her baby, which in turn only perpetuates the inability to breastfeed. This behaviour will develop into a vicious cycle, and the more the mother tries to pressure herself to breastfeed, the more she feels like a failure in her role as mother. She may go on to develop negative thoughts, such as ‘I’m not a good mother’ or ‘I don’t deserve to be a mum’. It is this kind of negative thinking that can affect the self-esteem and the confidence of a new mum and can lead to the development of a range of psychological issues such as depression and anxiety, all of which may lead to the development of perinatal mood and anxiety disorder.”
Saleh calls herself fortunate because she had a supportive husband and family members who stood by her decision, who raged against the shamers. But depression is an isolating demon and Saleh recognised that she’d need help to exorcise it. She sought help. “I was diagnosed with postpartum blues and my obstetrics and gynecology doctor said it would pass within 6 months,” she recalls.
It took her months to feel normal. “The sadness passed by like in month three,” she says.
Dr Mrabet Jihene, Assistant professor and Director of the Office of counselling and disability at the American University in Emirates, explains that this is a common state for new mums not only because of lifestyle changes but also because of a sudden dip in oestrogen. The symptoms include mood-swings, anxiety, sadness and irritability. Sometimes the mother finds herself bursting into tears for no apparent reason. She may also have concentration, appetite and sleeping problems. This period is temporary. If feelings do persist for a while, she recommends seeking professional help.
When it was time for baby number two, the old worries resurfaced. Fortunately, she says, her partner was supportive about her decisions. And fortunately when she delivered a healthy baby girl, she was producing enough milk. Then came another problem, however; the baby was finding it difficult to latch on to the teat. “I tried a lot,” she says, but it was not to be. Saleh’s doctor then suggested she go a different route: “Pump milk and use bottle.”
It’s a tough choice to make. “I’d have to pump every two hours,” she says. Because the newborn would need to be fed every two hours and each time a feed was over, it was time to pump again.
Finally, having rejoined work, she decided to take charge and make a call; she was going to use a half-and-half strategy. She would be using a mix of formula and breastmilk. So far so good, she says, at two-and-a-half-months, her baby is happy and healthy.
But why are the early months of motherhood so confusing?
Bougueffa says: “Becoming a mother is a highly demanding role but it also brings huge amounts of joy and fulfilment – and this is why it often goes hand-in-hand with feelings of confusion, frustration and guilt.
“To help new mums overcome the daily challenges and potential negative thoughts, they need to focus on the importance of their relationship with their baby and the natural connection they have. This should involve cuddling and smelling the baby, talking to the baby and being present and connected with their child. Anxiety and stress will reduce as a result, and the ability to breastfeed might naturally improve.”
What are some things that can help a new mum relax?
Bougueffa recommends the following:
- Breathing techniques and grounding (connecting with the world around her using her five senses).
- Ask for help. It’s always best to seek advice, comfort and support from friends and family. This is very important and many new mums lack this in the first few months after giving birth. The partner, family and friends can contribute with words and actions because a new mum needs time to adjust and manage the many other responsibilities she may have, particularly when there are siblings, housework and employed work.
- Talk to your partner. You’re meant to be a team, so share your worries and concerns as a couple and discuss how you can help and support each other to get through this challenging time.
- Me-time. Schedule some regular time - no matter how limited - to focus on yourself and no-one else. Whether it’s having a relaxing bath, reading a book, or doing some exercise in another room. Just 15 minutes of time away from everything and everyone can do wonders for your mental health.
'With the mother in the mind' approach
There are a host of reasons a woman may not be able to breastfeed her child – some physical such as in the case of Saleh where she suffered from mastitis and lactation issues and others mental including depressive episodes that may get worse when forced to feed. Sometimes there may be an issue with medication where a mother might be asked not to feed the child. Dr Umut Dalanay, from the German Neuroscience Centre, explains that because there are so many factors that are in play, experts in the field 'do not support 'breast is best'' view established mainly by our society, but propose an individual approach 'with the mother in the mind'. This new approach puts several other factors into consideration while making the breastfeeding decision and not solely the ability of the mother or social and cultural customs and norms.”
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