Have you read Kathleen Kendall-Tackett's research on this?
I learned a few things about PTSD the hard way (I was a paramedic in my
former career). PTSD is treated very, very differently from depression.
I've seen highly qualified psychologists miss this important distinction.
Please, if you have a mother suffering from PTSD, make sure she gets in to
see a person who uses EMDR. Those sessions are spent in putting memories
back into order and helping the brain process the.. Unfortunately,
mothers who are children of parents with PTSD (usually war vetarans) are at
very high risk for devolping it themselves. In my opinion, breastfeeding
and newborn parenting can be the perfect triggers for women. Much of it
depends on their own formative years as a child. Building resilience is
one of the key factors in overcoming these events.
I think your email brings up this very, very important concept. We,as
professionals, can really enter into a new mother's most vulnerable time.
The last thing we need to do is to add to the trauma by dismissing their
feelings. I am glad you could help her. I hope that she continues to get
more help, not just a medication. KKT also has a book out about
non-pharmacological techniques for treating PPD. I would suspect that
simply acknowledging her breastfeeding trauma was healing.
Thanks for the post!
Melissa Senf, RN, IBCLC, LLLL(retired)
On Tuesday, October 8, 2013, Jeanette Panchula wrote:
> I have been helping a mother for the last 10 days through problems that
> most
> of you will think are just basic lactation help. And it is.to her, I am
> the
> local La Leche League Leader. However, there is no "just" about it!
>
>
>
> By the time I saw this mom, her nipples looked like raw hamburger - and she
> was still breastfeeding, because, she said, the nurses at the hospital told
> her the baby was "breastfeeding fine". Despite this, baby was only 2
> ounces below birthweight and she could easily hand express her milk!
>
>
>
> There was no way to accomplish any sort of latch without total agony, so
> the
> plan was to have her pump and feed her baby using any of the options she
> and
> her husband deemed appropriate - I taught them a variety of methods I'm
> sure
> you all know.finger feeding, tongue extension (AAABBRE is my "trigger word"
> as "open" is a tiny mouth), finger sucking/massage, etc.
>
>
>
> Two days later her nipples were in much better shape and a painless latch
> was accomplished with my help on one side and by mom by herself on the
> other. By the next day, mom was e-mailing me about other questions - but
> latch-on and breastfeeding was wonderful, she said.we continued with
> various
> e-mails with the usual questions.
>
>
>
> But this is not the end of the story. Three days later, mom called me
> crying and crying and unable to stop. Baby had latched on and slept next
> to
> her, and her nipple had again been damaged. Mom was terrified - didn't
> want
> to see me - could not sleep. The next day she called the doctor and was
> prescribed Zoloft for PPD.
>
>
>
> In my opinion - this mom was not suffering from PPD - but from
> Post-Traumatic Stress Disorder! We often (in our specialty) want to blame
> poor childbirth care as a cause for PTSD - long labors caused by
> inductions,
> more interventions followed by unplanned c/s due to failed inductions and
> many other "horror stories".
>
>
>
> But what about a mom who had a natural, normal vaginal delivery and then
> reports, over and over, that her baby is hurting her nipple.and no one
> believes her, diminishes her reality and sends her home with no
> breastfeeding follow-up? In her case, I would even compare this to a woman
> who reports a rape and people tell her "don't worry, it'll get better".
>
>
>
> I believe she was re-living the horrors of her first breastfeeding days.and
> even though she wanted to breastfeed, she could not bring herself to put
> her
> baby to her breast - this contradiction was playing on and on in her head -
> making it impossible to eat, sleep or even care for her baby - she just
> cried and cried.
>
>
>
> This situation has improved - she got some sleep (thanks to the medicine),
> we talked about how she is in total control of whether and when to put her
> baby to the breast (she pumps all the milk her baby needs and more), and
> yesterday she breastfed (baby was hungry, they had no more bottles and they
> were out, and she did.with no pain), and we also went over better
> positioning techniques while in bed.
>
>
>
> At the same time, I reviewed with her how she was feeling the first three
> days, how helpless and fearful she was when breastfeeding was so horribly
> painful - and how that may re-emerge when (for whatever reason) she has
> pain
> when breastfeeding. Even though this sort of pain is usually transient
> (most of us breastfeeding moms have had periods in which breastfeeding is
> painful), to her - it re-ignites the memories of the helplessness and fears
> she felt the first few days. She needs to be aware of this, and develop
> her
> own ways of dealing with it. I encouraged her to attend La Leche League
> meetings so she could meet other mothers she can talk and even walk and
> have
> play dates with, but if these fears emerge again, she should try to talk to
> a counselor.
>
>
>
> This is a cautionary tale. I know you are aware to never diminish the
> report that a mother has pain. (I cannot imagine if mom reported pain in
> any
> other part of her body that was a 7/10 that Health Care Professionals would
> ignore it.)
>
>
>
> Hospital policies need to go beyond the childbirth experience - and
> "exclusive breast milk feeding" is not the only measure of adequate
> maternity practices.mothers need to be heard, and helped, too!
>
>
>
> Jeanette Panchula, BSW, RN, PHN, IBCLC
>
> Vacaville, CA
>
>
>
>
>
>
>
>
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