The Perfect Storm: PPD, PPA, Breast Reduction Surgery, and Breastfeeding Stuggles

[Editor’s Note: Today’s guest post comes from Samantha Konikoff. Her unique experience might help you feel less guilt about your unique experience. -Jenna]

The Perfect Storm: PPD, PPA, Breast Reduction Surgery, and Breastfeeding Struggles -postpartumprogress.com

From the time I was a kid, I always remember just thinking having a baby was “easy.” Breastfeeding was natural and what your body was made to do. So when that wasn’t the case for me, it was heartbreaking.

What made it more heartbreaking? Because of my postpartum depression and postpartum anxiety (PPD/PPA), I thought I was a failure as a mom because breastfeeding just was not working. My mind lied to me and told me that I was selfish and hurting my child just because I didn’t want to breastfeed.

This, as I would learn after a few months, was a lie. I am not a failure and I made the best choice for me and my son. I needed to stop listening to everyone around me, the depression and anxiety in my head, and the world I thought was judging me.

I already had some challenges before I even had my son with the possibility of breastfeeding. I was 31 when I had my son, but at 18, I had a breast reduction. I remember asking the plastic surgeon if I would be able to breastfeed and him saying that I should be able to. Sadly, I gained all my breasts back plus some a few years after surgery and they stayed big. So between being very large breasted AND not sure if everything would work anyway, I wasn’t too hopeful. I don’t know if it was naivety or being hopeful, but I really thought I could do this natural thing of feeding my child.

My son was born and it was clear that breastfeeding wasn’t going to be this wonderful, easy, and bonding experience I expected. From the get go I needed a nipple shield. Whenever I needed to feed him while we were in the hospital, I would call a nurse to help me figure it out. Looking back, I can see my anxiety creeping in. I was getting nervous and constant worry that I wasn’t doing it correctly and I was hurting my son.

Add to this how large chested I was and I was so so scared that I was going to smoosh or suffocate my newborn baby.

These fears continued and got worse when we got home. My PPD/PPA had pretty much started soon after my son was born, and I was not doing so well mentally three days later when we were in our own home. I had to set up all the “pieces” I needed to feed him, and it had to be set up correctly so I could reach what I had to. I would get ready to have my son latch and I would start getting nervous and why wasn’t he latching and did I get the shield on right and was he getting enough? What if he didn’t get any milk? Was I just making this worse for him since I couldn’t tell if I was feeding him or not? Could he breathe with this HUGE breast in his face?

As the days went on, my thoughts were not much better. Again, those images I had in my head of this easy way to feed and bond with my child was the way to go. This was not the reality. My son always seemed to have his eyes closed and I didn’t see how this could be a bonding experience. I caught up on my reading. I never really looked at my son’s face, just a 200-300 page book would have majority of my attention.

I remember one of my first doctor appointments for my son. They asked how I was doing and I broke down. Everything was so hard and I thought I was failing at it all, especially giving my son the most natural thing of all, my milk.

“Just try it for six months” they told me. I started to not say much at follow up appointments with the doctor and nurse because it was always the same feedback. “We know it’s tough, but just try to keep with it for six months.”

Thinking of doing this for six months?! I would just get worked up and anxious about how it was going to work out. I didn’t like feeding anywhere but home and I couldn’t figure out when to pump in between feedings. I never produced much when I pumped anyway. My anxiety took over this and I would just go into question mode. “When can I go out and make sure to be home to feed him?” “What if we are in public and he is hungry?” “Am, I ever going to be able to leave him if I can’t pump?”

My son was about four or five weeks old when I got help and put on Zoloft for my PPD/PPA. I still kept trying to breastfeed and it still was a trigger for me. I just felt all this pressure. From mom groups that would stress breast is best and that anyone can find a way to breastfeed. From medical professionals that kept telling me to keep with it and it’s what’s the best for the baby.

Then it happened, one night I wasn’t producing enough to fully fill my son. My husband had to run out and get formula. I cried. I cried because I felt like I was a total failure to my kid. I cried because I felt like not trying anymore made me very selfish and that I was just doing this for myself and not putting my child and his health before mine. I cried because I just wasn’t enough. I cried because I worried of what everyone would think of me. I cried because he was crying and I couldn’t just make it stop.

I can’t tell you how long that guilt lasted because I think there will always be a little part of me that still thinks I should have tried more. But the further away from it I get and the talk therapy I have been in since my now six year old was two, helps the guilt lessen and let’s me see it was not selfish and I was helping us both by making a choice.

Sadly, I don’t have any moments of breastfeeding my son that are what I always wanted and thought I would have. BUT, I have memories of sitting with a bottle and feeding my son and looking at him and singing and connecting, because I wasn’t stressing out and my anxiety wasn’t taking over me.

When we had our daughter three years later. I again gave breastfeeding a try. I lasted five days. The nurse who came to our house the day after we got home and wanted me to take supplements to up my supply and then wanted me to pump and then breastfeed and then feed what I pumped. All of this overwhelmed me and I felt that anxiety and stress rising, this time though, I chose to switch to formula. I didn’t sleep the night before I knew I would have to tell the nurse and I was so nervous to tell the pediatrician, but to my surprise, they were both supportive of my decision. They both knew of my history with PPD/PPA and both said that my health had to come first and that was just as important.

Today I have healthy and happy and normal kids who are six and three. No one can point them out and tell if they had formula or breast milk. And they have a healthy mom. That matters.

~Samantha Konikoff

The Joy of Breastfeeding the Second Time Around

The Joy of Breastfeeding the Second Time Around

My daughter’s name is Eleanor, but no one really calls her that. Her big brother calls her “baby seeter” and melts my heart with his constant excitement to see her and his toddler accent. Her dad and I call her Rory (yes, I love Gilmore Girls that much). When she’s yelling about something, I call her Roary because I love a (bad) pun. Depending on who you ask—grandfathers, great-grandmothers, aunts, uncles, cousins—she is Rory, Grace, Gracie, Nell, Ellie or Princess. My mom calls her Miss Piggy though, and of course my mom is right.

This little girl LOVES to eat. She eats like it’s her job. And maybe it is. It seems to be her job to help me heal from the postpartum depression and anxiety I had with her brother and to help me learn to live with the PTSD.

I couldn’t breastfeed my son.

Technically that’s not true. I had milk, an overabundance actually. I could do it. Yet every time I tried, it hurt worse than I can even begin to describe. There was physical pain that radiated from his mouth up through my breast.

There was also wave after wave of anxiety, fear, and panic that gripped me each time. This thing that was supposed to be so natural and bonding was brutal and brought me to tears multiple times a day. I saw lactation consultants and went to support groups. I talked to my pediatrician and tried a nipple shield, every hold imaginable, and everyone’s grandmother’s advice. It always ended in excruciating pain, panic, confusion, and tears.

Eventually I stopped breastfeeding and began pumping. I called this my Bessie period.

I do that a lot; turn things into a joke that actually really hurt me. I felt like a failure, like a wimp, like I didn’t deserve to be called his mother. I did a great job of beating myself up.

Before our Little Miss Piggy was born, I didn’t really have a lot of hope that I would be able to breastfeed her. I knew that I wanted to try, but I also wanted to avoid having expectations of myself that could be crushed like they had been the first time.

I had a scheduled c-section that went like clockwork. We were in the recovery room in no time and my baby was on my chest. My doula told me to just keep breathing and just see what she did.

What she did was start healing me.

My tiny little person did the funniest crablike shuffle you’ve ever seen while making the first of the little snuffle-snorts that would come to be her signature. She found the breast. She latched on. All I did was support her.

And that’s our relationship today. I breastfeed on demand and she demands. That is what works for us. After everything I went through, it amazes me each time I click open the catch on my nursing bra. Each pound that she gains feels like a victory. Those rolls on her thighs? I did that.

Am I staring into her eyes lovingly as she nurses every single time? Nope. But in the middle of the night when I’m nursing and watching Netflix, or scrolling through blogs on my phone, and she does that snuffle-snort or she stops and burps only to start again, in those moments I stop and laugh and breastfeed at the same time. That feels like magic.

My Postpartum Anxiety Started With My Boobs

[Editor’s Note: Today’s guest post is by Hilary Covil. She tells a story many moms feel familiar with; one of how her postpartum anxiety began with a difficult breastfeeding relationship. We know she’s not alone in this, and neither are you. -Jenna]

My Postpartum Anxiety Started with My Boobs -postpartumprogress.com

I was on the couch when it happened, and the baby was screaming.

This helpless girl didn’t know that her Mommy could not breathe. I found out later that I had had a panic attack, and it began my journey to figure out why.

I think it started with my boobs, and an a abrupt couple of hospital nurses who tried to make breastfeeding work for me.

I found out the first reason of why I had the worst possible equipment for breastfeeding: flat nipples that are notoriously hard for babies to latch to. But many nurses tried. One told me I was not patient enough, and in my exhausted, hormonally strung state, this made me feel terrible. Another told my husband that those who bottle fed were very lazy.

Breastfeeding is harder for me than labor, I told the humor-less pediatrician at my baby’s first doctor’s appointment. She shook her head, thought I was crazy, and said, “This isn’t how it should be.”

I went to see a lactation consultant and found out the second reason why breastfeeding was going to feel like the Battle of Gettysburg: I had mammary hypoplasia, or low milk supply. For a bit, I muddled through. Breastfeeding a bit, pumping a bit, giving her formula a bit. Omigoodness, it was too freaking time consuming for what I was getting. And I dealt with so much guilt that I wasn’t doing enough.

The worst thought ever: that I wasn’t a good enough Mom because I couldn’t move heaven and earth to get this to work for me. I decided to bottle-feed.

I got some judgment from others around me. I began to feel so ostracized for the first time in my life, something I hadn’t experienced before as a middle class female. It was a new experience for me.

I think the breastfeeding experience, coupled with my propensity towards being an emotional flower led me to the panic attack on the couch, which led to a couple of well-meaning EMS workers staring into my hollow face, offering to do my dishes for me.

We ended up in the ER because they wondered if there was something more wrong with this sleep deprived mama. They attached probes to me and a nurse asked me where things hurt. The doctor asked my husband if I usually had trouble answering long questions. We will try simple questions, she said. I remained safely trapped outside of this forlorn woman: a neverland region where I was safe from my body, my mind, my truth.

The truth? I wanted to detach myself from what had happened on that couch during my first week alone with my baby; that I thought I would meet my end on the cushions on a cold January day with my infant screaming in the pack and play.

But while it wasn’t the end, I was forced to facedown my Goliath: anxiety so strong that it had taken residence in synapses of my brain, causing me to think I was dying. Yes, dying.

Today, I am in therapy working on the task of understanding where the panic attack came from and why. It is a cold, lonely journey and terribly hard. And I feel woefully not up to the task. I am trying to be patient with myself as I remember that my life has recently changed by this eight pound baby girl.

I try to hold on to the advice one of the best nurses at the hospital had for us when she came with Similac bottles in tow to our room: Have peace that you are a good Mom. No judgment. Just telling me to breathe. Alright, now, breathe, Mama, breathe.

~Hilary Covil

Weaning and PPD: I Didn’t Know You Could Get Postpartum Depression Any Time During the First Year

[Editor’s Note: Today’s guest post comes from Jessica. She writes about the depression she experienced after weaning her baby. -Jenna]

Weaning and PPD: I Didn't Realize You Could Get Postpartum Depression Any Time During the First Year -postpartumprogress.com

Post-weaning depression, huh? That’s a thing. A very real thing, with physical manifestations, anxiety, and a whole cocktail of emotions and hormones mixed to make life feel so very difficult. Just when everyone is telling you “oh, it must be getting easier now that your baby is getting older,” life seems to be getting worse. But instead of admitting it, you nod, you smile and deep down you think, if only you KNEW how hard this is. How very taxing, how completely irrational and how guilt-ridden.

Eight months after my second son was born, I decided to wean completely. He was already breastfeeding only twice a day and it felt like a light at the end of the tunnel to think that I wouldn’t have to pump while at work. I weaned quickly and without physical or apparent emotional difficulty.

I slowly started an unrecognized spiral towards anxiety which led to depression. A lot of attention has been given to postpartum depression but I was eight months out. I didn’t know that postpartum depression could happen at any time within the baby’s first year. I should feel happy and free and thrilled to get my body back. Baby was sleeping through the night, no more pumping, no more worrying about freezing milk. FREEDOM right? Wrong.

I knew something was seriously wrong a month after I had stopped weaning. It was Christmas day and my husband and I had just had a huge fight. My usually supportive husband was in a different room seething in front of the fire place while I was crying uncontrollably on the couch. I don’t remember where my two-year-old or nine-month-old were at the time. I just remember thinking this is the end of my marriage, he hates me, I hate myself, I’m a bad mother, my kids shouldn’t have to see me like this.

At the time I attributed it to marriage difficulties. We were in that seven year slump I rationalized. We have a good and supportive marriage; this will pass if I work harder. I became more and more anxious, felt like I was scared to be home alone with the kids, and most unfortunately tried to control every aspect of my day, my husband and my kids because it gave me a feeling of safety. I thought that I was communicating effectively and couldn’t understand why my closest friends and husband didn’t seem to get how very emotionally fragile I was. I didn’t understand that my husband couldn’t see that my crying and controlling was due to fear. He knows me; how could he not know this part of me and just get it?

I didn’t understand myself and that scared me. This was not me. All I could see was that I was physically nauseated, shaky, and that I made lists and lists endlessly because they gave me a sense of control. I knew something wasn’t right and I was so confused. I had never been depressed. I had done some research and was almost a year out so I didn’t think it could be postpartum depression, and I was scared to death that this was the new me.

There are two things that stick in my head from that time that were triggers to finally get me into counseling. One was my husband calling my mother behind my back and having her come from Germany to help with the kids for two weeks. I had told him that I absolutely did NOT need her there and that I was going to be fine. The second event that occurred was me crying on the phone to a friend and having her say that she didn’t realize how badly I was doing.

With much support from family and friends, I finally got into counseling. I spent the first two sessions just crying on the couch and worrying that I wouldn’t get better. And I didn’t for a while. It took a lot of grieving and letting go. A lot of grace towards myself and those around me and a lot of just being in this dark space and accepting it.

However, it did get better. Not all at once, but one day I realized that the knot in my stomach was loosening. I didn’t have to make lists any more. I exercised, I took time for myself and when the feelings of guilt for taking time came in my head I accepted them for what they were. Untrue.

I share this story because I now have my third child. It is eight months out and I have weaned. Last week I started to feel that anxiety again. I decided to give it the weekend to see if it was just food poisoning or if it was anxiety. By Monday I knew that I am headed back toward depression. It doesn’t feel any better the second time around. It’s hard. It’s guilt-ridden. It’s overwhelming. But what I do know this time around and what I hope can help those in the same space is firstly that I need help. NOW.

Secondly, I realize that I don’t do a good job of communicating even though I thought I did. So I am communicating with all those around me, as bluntly as possible, as much as possible and all the time. My husband knows what he is in for; he understands that he doesn’t understand what is happening with me, but he does know where I am at.

Lastly, I know and hold on with a tight grip to the thought that this is not me and this will end. On days when the anxiety is high and self judgement is at its worst I repeat this mantra to myself. This is not me. This will pass. Be kind to yourself. There is not always a visible light at the end of the tunnel but there is a light. Hopefully I will give myself more grace and demand less from myself this time around.

~Jessica

The Secret Companion of Pregnancy After Loss: Postpartum Anxiety

The Secret Companion of Pregnancy After Loss: Postpartum Anxiety -postpartumprogress.com

Birth trauma, you could call it that. My first daughter was stillborn at full-term in December of 2012. I went into labor and delivery that night expecting to soon meet my little girl only to be told by the doctor while sitting in front of a still and silent ultrasound that there was, “No heartbeat.”

Crushed, heartbroken, devastated, and numb, I fought for my life when I delivered her, because the infection that killed her, it could have taken my life too. I think it’s safe to say that birth trauma is what happened during the silent entrance of my daughter’s body into the world.

Seven months later I was pregnant again, terrified beyond what doctors and therapists would think was just normal grief. As my belly grew with my daughter inside, both of us getting closer and closer to her due date, I would panic almost daily. At night I would wake in up in sweats as nightmares of not being able to feel her move would haunt me. Then I would spend an hour at three in the morning making sure she would move, making sure she was alive, because there were days when my anxiety convinced me that she had died too. I would mentally prepare myself to go to yet another ultrasound appointment and once again hear those dreaded words, “I’m sorry. There is no heartbeat.”

While pregnant after the death of my first daughter, it was almost impossible to get through my job everyday. I was always worried that she might have stopped moving or that she died while I was engrossed in a work task. The fear engulfed me. I frequently needed to step out of meetings to splash water on my face and poke at my baby to count her kicks and make sure she was still there, still moving, still alive. I also took extra ‘sick’ days just to manage my anxiety, to try to relax at home and take it easy, which proved challenging.

Then on the days I would make it through work, I would come home in the evening and break into tears of fear as I lay sobbing on my bed. My husband held me as I cried, crying with me, and I would scream between my wails, “I can’t do this! I can’t do this anymore!”

Being pregnant again after a loss is like living inside your trauma, which, unfortunately, is your own body that you cannot escape from for nine months. It’s torture, trying not to let your fears and anxiety control you. However, now you know; you know all that can go wrong. You know you are not guaranteed this baby, just like you weren’t guaranteed the one who died

Some might think that once the baby arrives safe and healthy relief would settle in, and the anxiety and worry would disappear. However, this did not happen for me. The anxiety increased daily a few months after my living baby was born.

In the hospital, two days after she was born, I had a mental break down. I was obsessed with my health, afraid that if I breastfed her, I would somehow give her a new infection, and that my body would cause her to die too. Irrational fears like this one flooded me, and only proceeded to get worse when we went home. Yes, I was relieved and happy that my daughter was here, that I finally got to bring home a baby after 18 months of being pregnant. But the irrational thoughts kept creeping in. I would stay up late at night, unable to fall asleep because I was convinced the world was going to end due to the eruption of the super volcano in Yellowstone. I would seek reassurance from all my family members around this issue, and most of them looked at me like I was crazy.

In the days and weeks after my irrational thoughts had taken over, I visited the doctor and talked to my therapist about my postpartum anxiety. I learned that I was at a higher risk for postpartum mood and anxiety disorders because of the birth trauma from my first daughter’s stillbirth.

Slowly, over time with the help of my doctor and therapist, I learned that breastfeeding my baby would not kill her, as I thought it would. When done with breastfeeding, we discussed medication to address the anxiety, which ultimately was the right choice of treatment for me, along with continuing talk therapy that utilized dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT) techniques.

My daughter is now 11 months old. Each day that passes, I seem to have less and less anxiety. I’m still going to therapy, and I’m still taking medications, and thanks to these treatments I get to enjoy more moments with my daughter and use this second chance at motherhood as a time to heal. Even if anxiety continues to be my companion I now know how to keep her at bay.

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Lindsey Henke is the founder and editor of Pregnancy After Loss Support, writer, clinical social worker, wife, and most importantly a mother to two beautiful daughters. Tragically, her oldest daughter, Nora was stillborn after a healthy full-term pregnancy in December of 2012. Since then, she has turned to writing on her blog, Stillborn and Still Breathing, to soothe her sorrow and has found healing in giving voice to her grief. Lindsey is also a monthly contributor to Still Standing Magazine and was featured as Pregnancy and Newborn Magazine’s Knocked Up Blogger during her pregnancy with her second daughter, Zoe who was born healthy and alive in March of 2014.