bonding advice for mom w/ b-feeding problems who "feels nothing" but anger for her 3-wk old?

[blake201]

I'm desperately trying to help a good friend of mine who recently had a baby and is struggling with some severe postpartum issues, the biggest of which are (1) difficult breastfeeding and (2) difficult bonding w/ her baby (I'm thinking these are related).

I don't know what to do--I've tried searching for bonding advice online but a lot of it is about immediately after birth--what about for moms who still haven't bonded/attached with their babies a few weeks after the birth?

She lives far away from me, is isolated with no friends or family to help her but her husband (who goes back to work in two weeks) and I work full time, so while I was able to take a few days off to go stay with her (with my toddler on my back the whole time) that was only temporary help....

Here's what's going on:

When in the hospital...

• She had an all-natural birth and the baby was placed on her chest right away (which I know is supposed to help with bonding).
• BUT she had trouble breastfeeding (couldn't figure out how to do it and when she tried it hurt so bad she screamed) and there was no LC at the hospital so the nurse told her to pump and give formula (since she couldn't pump anything--of course not, all she would have had was colustrum!)
• She tried quitting the bottle-feeding but the baby wouldn't latch and wouldn't suck...

Now, three weeks later:

• She got help from  two different LCs so far but the baby continues to refuse to latch and her supply has suffered--she is now pumping 10-12 times per 24/hour period and drinking fenugreek tea and eating oatmeal and whatnot and is desperate to get her milk supply up and get the baby nursing directly... the baby is now getting about 75% breastmilk and 25% formula.
• The baby often screams and fusses for a long time and flails at her sensitive sore nipples when she tries to get him to latch (she tries many times per day) and she gets really frustrated--she says she can't help feeling "angry" at him and she just wants to hand him off to her husband and go nap in another room.
• Her husband is doing most of the actual feeding and holding and babywearing and snuggling and parenting of the baby. She's basically just pumping and sleeping.

My bonding advice to her was basic attachment parenting stuff--babywearing, snuggling, kissing, holding, cosleeping, breastfeeding, etc. And I suggested she go to La Leche or a breastfeeding group nearby, but she says she can't leave the house, it's too difficult. She says she can't sleep next to the baby (his noises wake her up) so she's been leaving him in the cosleeper next to her husband while she naps in another room... I don't think she's doing much babywearing/snuggling either. She seems to feel distance/anger at the baby and lots of frustration. And of course she's really emotional and sleep-deprived.

In sum, I had love at first sight with my daughter and can't imagine not feeling total head over heels crazy joy about my child. I hesitate to just say "oh, it's ok that you feel nothing for your baby, it will come in time" because I don't know if it really is ok--sounds like an emergency to me? But I don't want to judge her or scare her.

thanks so much in advance for any help!

[blessedwithboys]

This mama needs professional help!  Have her dh make her an appt with the OB/MW to discuss PPD. 

You are a very good friend.  :)

[wehrli]

oh, how very sad for your poor friend... I agree, she NEEDS professional help!

on the bright side, it sounds like her DH is doing great! and I agree, you are truly a wonderful friend!

[Marissamom]

I would say she may have PPD, and that because pumping is so stressful and keeping her from interacting which her baby it may not be worth it, babies need their mamas more than they need breastmilk. 

[blake201]

Her DH is GREAT and loves and supports her and the baby very much... but I think he's a bit overwhelmed and he's only at home with her full-time for another two weeks. I looked it up and she does seem to have 90% of the typical PPD symtoms.

I just called and talked to him and he's going to speak to their doula and midwife about it.

I think the challenge will be finding a good therapist to help her and not someone ineffective--she has struggled with depression for years but has never been able to find a therapist she liked who could really help her and has kind of given up on it. I think she was hoping having a baby would just be so joyous it would make the depression recede but I think it's been the opposite.

I so wish I could just take a few weeks off of work and go stay with her to help but I don't have enough vacation time for that.

[wilddreamergrl]

PPD is often related to the massive hormone drop after birth. She doesn't just need therapy (or even primarily) - she needs to get hormone levels checked and possibly on some supplements. Thyroid would be first thing to check (and is safe to take while bf'ing.)

[blake201]

Marissamom, I am worried about all the pumping, too... (and I HATED pumping when I had to do it for four days to heal from severe nipple damage in the early weeks) but I know she so VERY badly wants to be able to breastfeed in the long term, and protecting her milk supply will help her do that.

I got her a pumping bra so she could hold and mother the baby while pumping but she seems too depressed to always remember to do so.

I think losing her milk supply might just make it all much worse, and once she is able to breastfeed directly it should be a huge help to her mental health, I think (I also have depression/OCD issues and it's been really helpful to me and I've heard that elsewhere).

And I do think she feels good that the baby is getting mostly her milk.

I hesitate to undermine her already weak confidence in her ability to be a mom by helping to take away the one thing she is proud of doing for him... though I certainly will not judge her at all if she decides she can't keep pumping.

[holothuroidea]

I went through that (without the breast feeding issues) with my first. I ended up being hospitalized and subsequently medicated and did some therapy. Although that helped get my footing so that I could at least take care of myself and my baby, I was far from thriving and it did not help long term. In hindsight, what would have been best for me is to have someone around during the day. I know you can't because you work full time but maybe you can help her find people who can come and visit, preferably someone who also has a baby so they can share experiences. What she needs now is a support network and she doesn't sound strong enough to build one for herself, so maybe you could help her do that.

[blake201]

Thank you holothuroidea--I really appreciate you sharing your experience with this. I've been hospitalized for mental health issues briefly myself and I also worry that it doesn't help long-term... so while I want her to get help for PPD I want to make sure it is really good help. I wish I could just get her local La Leche group to come visit her regularly but I think the closest meeting is an hour away from her. I SOOO wish I could go stay with her to help. :(
 

Originally Posted by holothuroidea 

I went through that (without the breast feeding issues) with my first. I ended up being hospitalized and subsequently medicated and did some therapy. Although that helped get my footing so that I could at least take care of myself and my baby, I was far from thriving and it did not help long term. In hindsight, what would have been best for me is to have someone around during the day. I know you can't because you work full time but maybe you can help her find people who can come and visit, preferably someone who also has a baby so they can share experiences. What she needs now is a support network and she doesn't sound strong enough to build one for herself, so maybe you could help her do that.

[APToddlerMama]

So, the baby is only three weeks old?  If that is the case, I really have to disagree that the fact that she hasn't bonded with baby is an emergency.  There are moms who bond with baby immediately at birth, and moms who take their time bonding.  This is *normal.*  The fact that she is feeling abnormal is probably creating a lot more stress that is adding to the stress she's already feeling.  I was one who did feel an immediate bond with my baby, but I have a lot of friends (part of this is the field I work in people are willing to talk about this...all social workers and therapists), who flat out admit that it took them weeks or even longer to feel bonded to their baby.  One of my best friends told me she remembers sitting at home and she and her husband were both thinking "ehhh. It's a baby.  Doesn't really feel like 'my' baby.  Don't really feel like I have any connection to this kid.  He's just a baby, and I guess it is my job to care for him."  That all changed in time obviously.

PPD is obviously very real and very serious, and fortunately, there is a big focus on identifying women with PPD and getting them help.  That is a great thing.  However, I do think there is a range of emotions that are completely and utterly normal when baby is a newborn that people are quick to label as problematic.  My DS was preterm and we had a very tough time with breastfeeding.  All I did was breastfeed, pump, and try to sleep for the first month.  I was sad.  Very sad.  I was in pain.  Although I loved and felt very bonded to my son, I kept thinking over and over in my head "Would I give him back if this was going to be my life forever?" and the answer was yes.  I felt like though I loved him deeply, the sleep deprivation and breastfeeding obstacles were so great that if it was going to go on forever I'd rather not be a mom.  Obviously a silly irrational game I was playing in my own head. 

If this mom is having thoughts of harming herself or the baby, or anything that leads you to feel she is in greater danger, then yes, I'd immediately seek help for PPD.  However, the baby blues and taking a little time to bond with a baby are truly normal.  Lots of women go through that, and if people talked about it more, I think women would get less stressed when it isn't love at first sight with baby.  This mama needs help breastfeeding and help getting enough rest.  There is a decent chance if those needs are met, everything else will fall into place.  Again, I don't want to minimize PPD because I also have some close friends and family members who have experienced it, but I do think in many cases we are too quick to label PPD when really mom just needs support breastfeeding, some rest, and some time, and to know it is okay and she's not a horrible person if she doesn't bond immediately.  And to know, that it doesn't mean she won't bond very very soon with baby. 

[holothuroidea]

I see your point, APToddlerMama, but I have to disagree. I believe that a close friend would be able to identify suffering better than someone who is uninvolved and the fact that she has posted on this forum because she is worried for her friend is telling enough. OP mentioned that she has also suffered with some mental health problems and knowing what it is like makes you very sensitive to it. I trust the OP's assessment. 

Besides, even if she is "ok" it wouldn't hurt to have a good support system anyway!

I would also like to state that it may not be that she hasn't bonded with the baby. In my case, I was definitely bonded to the baby but so depressed that I wouldn't allow myself to feel it. I put up a shield of numbness because the feelings (even of love) were too intense for me.

(Also, not to be combative, but it is somewhat insulting to insinuate that there is no real "problem" and if we just stopped stressing out it would go away.)

[matte]

For what it's worth, and I don't know much about PPD or the situation, I think that APToddlerMama is saying something very useful and important. As a very new mom, I read it this way "It's totally normal if you don't feel bonded to your baby in the first few weeks. You are super exhausted. Before seeking psychiatric help fix the proximate issues: get enough rest and get help with breastfeeding." Very good advice in my book. It's good to know that it's ok and not totally wrong to just feel overworked and tired and stressed in a situation like this. There's so much pressure to be immediately 'in love' etc that I think people don't recognize that it's ok to just be exhausted and hormonally overwhelmed. Not Ok as in 'feels good' but ok as in 'not psychopathological.' 

I think that the OP should do what she can to get her friend practical help for when her husband goes back to work: someone to come and help her during the day and be a presence there and also more breastfeeding support. 

Ok, like I said, I don't know much about the situation...

[gemasita]

I had horrific bf'ing problems in the beginning.  There was literally no time to do anything except pump.  In order to sleep, I had to get someone to take care of DS and I had to put earplugs in.  It was just terrible the first few weeks and I felt so guilty all the time.  I would agree with some of the posters who are saying this is normal for someone who is exhausted and trying so hard to build her milk supply (like I was doing).  I desperately wanted to bf and just felt like I had to work my a** off to do what was best for my baby.  In retrospect, who knows if I did the right thing by spending time and energy pumping when I could have been cuddling DS.  I do feel like it paid off in the long run though.

It DOES sound like there is some ppd and I'm sure not sleeping is not helping.  Physical pain is not helping.  She is in survival mode and I understand why going out to an LLL meeting seems like a waste of energy right now.  But if she does have ppd, medication can certainly help.  Sleep too.  So...like someone else said, daily help would be great for her.  I didn't really want to be alone too much with the baby.  I felt like I was going a little crazy.  And I needed so much help just to get myself food, drink, showers...all those basic things.

Co-sleeping and babywearing REALLY helped me feel bonded to DS.  She says co-sleeping isn't that helpful to her.  Sounds like she really needs sleep.  I've heard some people say that co-bathing has helped them feel bonded.  Maybe she can find something like that that feels nice to her.  I also agree with the others who say the bonding will continue in time.  She doesn't even know her child that well yet and she's probably really focused on trying to make the bf'ing work.  She'll get to know her baby more and more and while I can't say for sure that the bonding isn't something to worry about, I, like others, have had friends who needed time to get to know their baby before bonding with them.

Can a postpartum doula help her?  That was so useful for us because I needed someone who would give me practical help, breastfeeding help, and wouldn't say the wrong things!

[APToddlerMama]

Originally Posted by holothuroidea 

I see your point, APToddlerMama, but I have to disagree. I believe that a close friend would be able to identify suffering better than someone who is uninvolved and the fact that she has posted on this forum because she is worried for her friend is telling enough. OP mentioned that she has also suffered with some mental health problems and knowing what it is like makes you very sensitive to it. I trust the OP's assessment. 

Besides, even if she is "ok" it wouldn't hurt to have a good support system anyway!

I would also like to state that it may not be that she hasn't bonded with the baby. In my case, I was definitely bonded to the baby but so depressed that I wouldn't allow myself to feel it. I put up a shield of numbness because the feelings (even of love) were too intense for me.

(Also, not to be combative, but it is somewhat insulting to insinuate that there is no real "problem" and if we just stopped stressing out it would go away.)

I am sorry you feel that it is insulting.  You are incorrect in your assumption that I haven't experience mental health issues that would make me "sensitive" to this new mom's issues.  I spent time in therapy and used medication to deal with anxiety for years, and I have dealt with depression in pregnancy.  In our culture, women are basically sold this fable that they will immediately bond with their newborn and fall madly in love with them, when in fact, that just is not the case for a lot of women.  Feeling some resentment, anger, and sadness when you're getting zero sleep and your breasts are killing you and you feeling like you're failing because breastfeeding isn't going all that well AND because you've been told you aren't normal if you aren't instantly madly in love with your baby...is pretty situational to me.  When these things improved for me, it became clear that I did not have PPD, even though plenty of people were suggesting it to me (which just made me feel worse).  I was a tired mama who needed rest and support bfing.  I hope this is the case for this mama, and I hope at least someone will tell her it is *okay* if she isn't totally in love right now, and it is okay if she thinks motherhood sucks right now too.  If this doesn't improve soon, then yes, I'd definitely seek treatment for PPD, but I think some of this is in the realm of situational and normal.  Hormones are totally out of whack for everyone at 3 weeks PP. I don't know why we have to make women feel more anxious and stressed by the assumption that it is an emergency that they aren't immediately in love with baby and thrilled with motherhood. 

Also, even if OP is a close friend, if she is under the assumption that one must immediately fall in love with their newborn, the realization that many women simply don't feel this way immediately and end up being wonderfully bonded to their children, might be helpful to her in assessing what the situation calls for.... lots of support, bringing over a meal here and there, linking mama to a good LC, lending an ear, etc. OR gently suggesting she consider mental health services. 

Originally Posted by matte 

For what it's worth, and I don't know much about PPD or the situation, I think that APToddlerMama is saying something very useful and important. As a very new mom, I read it this way "It's totally normal if you don't feel bonded to your baby in the first few weeks. You are super exhausted. Before seeking psychiatric help fix the proximate issues: get enough rest and get help with breastfeeding." Very good advice in my book. It's good to know that it's ok and not totally wrong to just feel overworked and tired and stressed in a situation like this. There's so much pressure to be immediately 'in love' etc that I think people don't recognize that it's ok to just be exhausted and hormonally overwhelmed. Not Ok as in 'feels good' but ok as in 'not psychopathological.' 

I think that the OP should do what she can to get her friend practical help for when her husband goes back to work: someone to come and help her during the day and be a presence there and also more breastfeeding support. 

Ok, like I said, I don't know much about the situation...

That is exactly what I meant...thank you!

[APToddlerMama]

Originally Posted by blake201 

My bonding advice to her was basic attachment parenting stuff--babywearing, snuggling, kissing, holding, cosleeping, breastfeeding, etc. And I suggested she go to La Leche or a breastfeeding group nearby, but she says she can't leave the house, it's too difficult. She says she can't sleep next to the baby (his noises wake her up) so she's been leaving him in the cosleeper next to her husband while she naps in another room... I don't think she's doing much babywearing/snuggling either. She seems to feel distance/anger at the baby and lots of frustration. And of course she's really emotional and sleep-deprived.

In sum, I had love at first sight with my daughter and can't imagine not feeling total head over heels crazy joy about my child. I hesitate to just say "oh, it's ok that you feel nothing for your baby, it will come in time" because I don't know if it really is ok--sounds like an emergency to me? But I don't want to judge her or scare her.

OP--I know you are totally completely concerned and trying to help so I don't want to come off rude (although I probably will and I am seriously sorry.  I am not the best at wording things gently).  Here is the thing though.  A lot of what you're pointing out *is* judging this mama.  According to your assessment, she's not doing enough babywearing and snuggling, she's not co-sleeping (eeeek!!!) because his noises wake her so she sleeps in another room, she's not leaving to get support, not kissing and holding enough, etc.  By these standards, I might have been considered a crappy mom in an emergency situation the first month too, even though I felt deeply bonded to my son, and we are very bonded now.  But, yeah...I went in another room to sleep sometimes when I could because I also couldn't sleep with the noises early on. DH was with baby and perfectly fine.  It was my way of addressing my own mental health concerns.  I also breastfed, pumped, and passed the baby off, desperately trying to catch up on sleep so I didn't feel so exhausted I wanted to puke.  Babywearing?  If someone had suggested it I would have asked if they were kidding.  I mean, I literally had DS on the boob 12 hours a day, so when I got an ounce of space, I *took it*.  And crazy head over heels joy?  I had zero joy.  Pain from a 3rd degree tear, no sleep, bf problems, and no joy.  But I ended up totally okay once my sleep and pain needs were met, and bfing improved.  You're expecting a lot from this mom.  It just isn't that easy for all of us...  Offer her what you can in terms of support, but please try not to convey to her that she has a list of chores to meet the "good ap mama" standards. 
 

[motherhendoula]

I agree with APToddler Mom - i wouldnt call three weeks an emergency...i WOULD call this a breastfeeding emergency!  Has she tried nipple shields?  i know they can be a pain getting the baby to STOP using them - weeks down the road...but they can help when a young baby prefers the bottle over Mom.  Can you get her a postpartum doula???   if you and more friends can chip in - or maybe they can afford to pay one - or maybe you can find a postpartum doula who will work for less $ in a situation that may be or may lead to PPD.  That would give her some reassurance, and maybe some good breastfeeding advice.  It sounds like she is really aggravated by the breastfeeding situation...and frankly, anyone in that situation would be!   If she is determined to breastfeed - i would try and hire a postpartum doula with b-feeding experience who can keep her on track to get this baby to latch.  Good Luck to her!

[matte]

Just to chime in again, I think that the best thing that you can do for your friend, OP, is get her some practical help. Have you tried asking her what you can do to help? I just checked and I see that you are in Brooklyn, and you say your friend is 'far away.' Far away like Inwood or far away like Iowa? I imagine that thinking about her husband's coming return to work is probably VERY STRESSFUL for her. Maybe you could help to ease that current stress by doing some things to help ease that transition. Can you help to assure that she will have prepared food delivered to her? FreshDirect? Neighbors and friends? How about someone to come help her with cleaning? 

I think that it is OK that your friend feels 'anger' and is willing to admit it. She's doing something very difficult, she's in pain, she's sleep deprived, and she doesn't have enough social support (as you mention above). I bet that if she had more support to ease her stress, pain, and fatigue, she would feel better. I don't think bonding is the problem right now, she obviously cares deeply about her baby: she's working herself to the bone to provide breastmilk. She's focused on her baby's well being to the point that she is feeling herself collapse. Sure, that might make it hard to really vibe on her baby. She's also probably too exhausted to be able to cuddle or cosleep, when she has downtime she needs to be sleeping. She's also maybe in so much breast pain that she's not up to other tactile stimulation. Right now her bond with her baby is in working super hard to nourish him/her. That's an intense bond. 

Right now your friend needs someone to care for her, in simple physical ways (time for sleep, time for shower, meals, clean sheets) and in emotional ways.

[holothuroidea]

Let's all just drop the drama and the judgments and agree that this mama needs help. Nobody here is qualified to diagnose her. But OP you are her friend and you are worried, she clearly needs some support. Help her find a support network and encourage her to get out with her baby to meet people. Do whatever you can for her, even if she stops answering the phone and acts like she doesn't want it (I know I would).

[blake201]

Thank you everyone again for your helpful comments. matte, when I say "far away" I mean a few states away--a six-hour trip for me via Amtrak and car, and I don't have a car. I wish it was just Inwood!

Those are all good ideas. My mom bought her a few hundred dollars worth of gift certificates for local food delivery, and when I visited her I brought her a bunch of prepared food... but not sure about trying to enlist friends and neighbors. She only just moved to where she lives a few months ago (she used to live in NYC near me) to start a job there and has almost no friends there--nearest one is an hour away and not herself a mom. She doesn't know any of her neighbors yet either.

She would never let me pay for a cleaning service as she knows I can't afford it (my husband has been unemployed almost a year) and I already spent a bunch of $$ buying her nursing/pumping bras and a baby carrier and various things, and it was hard enough to convince her to let me do that!

So I'm focusing on trying to give her the best emotional support I can over the phone (which is crap compared to being there but I think it's something!) get her to go to some breastfeeding groups nearby and meet some moms she can develop some connections with, as that was SOO helpful for me. I'm going to take a few more vacation days and go visit her again this weekend, too.

I'm going to check in with her and her DH today and see what her doula and midwife said about PPD, too.

Originally Posted by matte 

Just to chime in again, I think that the best thing that you can do for your friend, OP, is get her some practical help. Have you tried asking her what you can do to help? I just checked and I see that you are in Brooklyn, and you say your friend is 'far away.' Far away like Inwood or far away like Iowa? I imagine that thinking about her husband's coming return to work is probably VERY STRESSFUL for her. Maybe you could help to ease that current stress by doing some things to help ease that transition. Can you help to assure that she will have prepared food delivered to her? FreshDirect? Neighbors and friends? How about someone to come help her with cleaning? 

I think that it is OK that your friend feels 'anger' and is willing to admit it. She's doing something very difficult, she's in pain, she's sleep deprived, and she doesn't have enough social support (as you mention above). I bet that if she had more support to ease her stress, pain, and fatigue, she would feel better. I don't think bonding is the problem right now, she obviously cares deeply about her baby: she's working herself to the bone to provide breastmilk. She's focused on her baby's well being to the point that she is feeling herself collapse. Sure, that might make it hard to really vibe on her baby. She's also probably too exhausted to be able to cuddle or cosleep, when she has downtime she needs to be sleeping. She's also maybe in so much breast pain that she's not up to other tactile stimulation. Right now her bond with her baby is in working super hard to nourish him/her. That's an intense bond. 

Right now your friend needs someone to care for her, in simple physical ways (time for sleep, time for shower, meals, clean sheets) and in emotional ways.

[MoonWillow]

I think there is some good discussion going on here and that in the grand scheme its helpful for OP to see different perspectives on what her friend is going through. So with that being said, as long as we keep the conversation civil and respectful, we're all good.

Let's all just drop the drama and the judgments and agree that this mama needs help. Nobody here is qualified to diagnose her.