It’s been more than a week since the husband of Florence Leung, a young New Westminster mother who was found dead last November, shared an emotional post talking about his wife’s struggle with postpartum depression (PPD) and breastfeeding pressures. And now, mothers, who have lived through similar experiences, are hoping the conversation does not stop there.
In his Facebook post, Kim Chen talked about the pressure to breastfeed his wife had experienced, which may have contributed to her PPD.
“Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes and teachings at breastfeeding classes,” said Chen in his post.
Thirty-two-year-old Leung went missing without an explanation in late October, causing New Westminster police to launch a massive search. It was publicly revealed she was suffering from PPD and her family was concerned about her well-being. A couple of weeks later, Leung’s body was found in the waters near Bowen Island. No foul play was suspected.
In his post, Chen goes on to say,
“Apparently the hospitals are designated “baby-friendly” only if they promote exclusive-breastfeeding. I still remember reading a handout upon Flo’s discharge from hospital with the line “Breast Milk Should Be the Exclusive Food For the Baby for the First Six Months,” I also remember posters on the maternity unit “Breast is Best.” While agreeing to the benefits of breast milk, there NEED [sic] to be an understanding that it is OK to supplement with formula, and that formula is a completely viable option.”
Chen’s post, which has now gone viral, unleashed a deluge of response from women who have experienced PPD and pressure to breastfeed first hand.
A 28-year-old Lower Mainland mother, who would only go by “Brittany,” fearing the stigma associated with PPD, says she cried the first time she read Chen’s post.
Brittany had her baby in 2015 and says she is still working through her PPD symptoms.
She planned for a home birth, but had to go through an emergency C-section instead, which she says, right off the bat, caused her a great deal of anxiety.
Then, she had to try breastfeeding her baby.
“Immediately following my son’s delivery, we were bombarded with messages about breastfeeding at the hospital,” said Brittany. “My husband and I were quite shocked when all of a sudden people were throwing my son onto my breast, clamping his mouth down, twisting my nipple and yelling at me.”
She says her son could not latch and she could not produce any milk of her own, so she resigned to feed him baby formula.
“Every time they brought us formula, they would say, you really need to get over this and figure this breastfeeding thing out,” said Brittany.
She says she was already feeling “like a complete failure” for having complications and abandoning home birth, but her inability to breastfeed added a whole new level of stress.
After leaving the hospital, the problem grew worse. No matter what pumps, supplements or old wives’ tales Brittany tried, she says her milk just was not coming.
“For the first week of my baby’s life, every time I tried to feed him, I cried — because it was painful and nothing was coming out. I did not even want to see my baby anymore. Him being near me meant pain for me and screaming for him.”
Together, Brittany and her husband made a decision that her mental well-being was as important as their son’s health. “He could not be happy and healthy unless I was able to give him what he needed, and that was — being fed, regardless of how it happened,” Brittany said.
Confident about their decision, they went, what Brittany calls, the full-on formula route. They hoped it would bring them the long-overdue relief and peace of mind, but what followed was ridicule and snarky remarks.
“I had mothers in the mommy group ask me how I felt about my poor decision-making,” said Brittany. “I had women stop me at the mall while I was feeding my son, saying that they really hoped what I was giving him was pumped breast milk.”
Brittany says she had to hide in bathroom stalls to mix her son’s formula when she was out in public because she just did not want to deal with the criticism.
She says even her husband, who was fully supportive of her, got ridiculed, with people asking how he could let his wife make such a “terrible decision.”
The criticism and messaging got so overwhelming, Brittany says she stopped going to mommy support groups and that’s when her PPD got worse.
“There is so much shame,” she said. “If you don’t think you are a failure, public health will tell you, or mommy groups will tell you or the Internet will tell you. It is just massive, widespread shaming. It’s so rooted into everything.”
Regardless, Brittany says she is still confident about her decision to fully switch to baby formula and says if she had to do it all over again, she would formula-feed her son from the beginning.
“I would not even put myself through what we went though. All those moments that I lost with my son because I was upset and feeling like such a failure, they were wasted on that. I just would not do it again.”
In fact, she says she believes formula feeding helped her husband bond with their baby better.
She says she is terrified to think what would happen if she was a single mother or had a partner who was not as supportive and engaged in her mental health.
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“Without the support of my family and recognizing what I was going through, I don’t know where I would be right now. It was scary, it was really scary.”
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Pacific Post Partum Support Society is a community-based organization that offers support for women and families affected by PPD across B.C.
Sheila Duffy with the society says they handled 3,500 support line calls in 2015-2016. The bulk of the calls came from B.C., but over 200 came from the rest of Canada and even the United States.
Between the end of March and September 2016, the society handled 1,912 calls, which is higher than the year before. Duffy says they expect that number to keep growing.
She says it’s estimated one out of every six women experiences troubling depression after the birth or adoption of a child.
But she says even though many women don’t necessarily identify with depression, many are experiencing postpartum anxiety symptoms.
“We have certainly noticed locally that there are more women reaching out to us,” Duffy said.
She says they have also noticed over the years that a lot of moms are feeling very upset and distressed if breastfeeding is not working out for them.
While it is impossible to say just how much of a factor breastfeeding pressure played in Florence Leung’s PPD, Duffy says anxiety around breastfeeding can be an important contributing factor.
For Brittany, it was the messaging around breastfeeding that added to the unnecessary stress for her.
She says she felt maternity facilities she went to were “plastered with ‘breast is best’ posters,” making her feel like — if breast milk was the best or only option for her baby, then she was a failure for being unable to breastfeed.
Last year, the U.S. Preventive Services Task Force changed the wording of its breastfeeding guidelines. In 2008, the independent panel of experts recommended that physicians “promote and support” breast-feeding among their patients. But in 2016, the guideline only contained the word “support” in it. The panel says it has not changed its confidence in the benefits of breastfeeding and that it continues to recommend interventions to encourage breastfeeding, but the change in the wording comes out of concern that the previous recommendation would lead to “undue pressure on women who decide not to breastfeed.”
The U.S. Preventive Services Task Force says it reviewed the language in the recommendation to ensure that “the autonomy of women is respected.”
WATCH: Certified lactation consultant Roxanna Farnsworth speaks with Global News about supporting new moms and the messaging around breastfeeding.
On its website, Public Health Agency of Canada explicitly says breast milk is the best food you can offer your baby.
It quotes Health Canada and the World Health Organization recommending that it should be the only food or drink for the first six months of baby’s life and after that, breastfeeding should continue for up to two years or more along with age-appropriate solid foods.
It also points out that “there are rarely reasons not to breastfeed.”
However, the site does acknowledge that commercial infant formula is the most acceptable alternative for the first 9 to 12 months for babies who are not breastfed.
“Breastfeeding is natural, but it may take time for you and your baby to learn to breastfeed,” the agency said online. “It can take up to six weeks or longer to establish breastfeeding, so don’t give up – it is important for your baby.”
The website also offers downloadable guides with messaging like “10 Great Reasons to Breastfeed. Breastfeeding is best for you and your baby.”
The B.C. Ministry of Health told Global News nurses and other health care providers are encouraged to consider the impact of breastfeeding difficulties on a woman’s mental health and provide additional support if and when needed.
“Our main goal is the health of mother and baby,” said ministry spokesperson Kristy Anderson in a statement.
Anderson says their latest parents handbook on baby care was developed to “prevent women from feeling stigmatized or guilty for using infant formula.”
She says examples of messaging for new mothers on the topic of getting help with breastfeeding include,
“Remind her that she does have a choice – and even though you have confidence that she can overcome her challenges, she can still be a good mother if she decides not to continue breastfeeding. Remind her that breastfeeding does not have to be all or nothing. Any breastfeeding is better than none. She could choose to breastfeed and offer some formula or express milk for a day.”
Anderson says the ministry will review current messaging in their parent resources to strengthen information available to support families to determine the feeding method that works best for them and avoid the unintended outcome of shaming or stigmatizing families who use infant formula.
WATCH: More awareness is being brought to the stress new mothers feel over breastfeeding in the wake of Florence leung’s death.
Child psychiatrist Ashley Miller, who also treats PPD in new mothers, says it will take a cultural shift to change attitudes toward how a baby should be fed.
“When people only focus on child or baby well-being and they are looking at the mother as someone whose job it is to take care of that baby, they are not looking at the mother as someone who might be vulnerable and in need of care as well,” Miller said.
She says breastfeeding is one of the many issues in parenthood where a dogmatic, one-size-fits-all approach won’t work.
“I think we need to have a focus that’s mother-friendly, in addition to child-friendly,” Miller said. “And I say that as a child psychiatrist. I deal with a lot of children and teens with mental health problems, and I can say from that vantage point, what’s helpful for the mother and family is helpful for the child. So if you want to focus on child well-being, you need to focus on mother and family well-being.”
As for Brittany, she says she agrees there should be a more multi-layered approach.
“The messaging needs to be that a mentally healthy mother and a fed baby is what’s important,” she said. “Public health providers need to recognize that breastfeeding is an amazing tool that our bodies have to feed our children. But some bodies and some brains are not built for that and that’s OK. So if a mother says, I’ve made this choice, then that’s it, enough said. That’s all that should have to happen.”