Breastfeeding and post-natal depression

The tragedy of Felicia Boots has resonated with many mums this week. In case you are not familiar with the name, Felicia is the woman who gave up her antidepressants because she was worried they would harm her baby through breastfeeding. This set Felicia on a downward spiral of severe post-natal depression, culminating in her believing her children would be taken from her. She then took the lives of her two little children, Lily, 14 months and Mason, 10 weeks.
Harrowing doesn’t even cut it. I am sure any parent cannot even begin to imagine what would drive a new mum to do something so horrific to her own children. The rational conclusion to take here is that she must have been so seriously ill and not of sound mind. This was post-natal depression in its most aggressive form, more like puerperal psychosis. There is simply no other explanation for what she did that day.
Indeed subsequent coverage of the issues raised has been respectfully muted, confined to raising awareness of post-natal depression whilst highlighting that such cases of sufferers harming their own children are extremely rare, on average less than one a year. But it seems like one particular aspect of the case has got off lightly in escaping relevant analysis and much-needed discussion.
I am, of course, talking about the part breastfeeding played in this whole tragic story. I am not for a moment insinuating that there is any sort of conspiracy going on among the breastfeeding advocates of the world here, but I do feel that certain commentators may be sensitive to the way that such advocates will complain in their hundreds if breastfeeding is subjected to even the slightest bit of criticism. I understand this and indeed have praised this worthy fanaticism in this blog in the past, but Felicia’s reason for not taking her medication was because she was worried it would harm her baby through breastfeeding. Breastfeeding was a factor here and therefore needs to be discussed.
Clearly she was a mother who wanted to do the best by her newborn and breastfeed but really was she in a fit state to do so? Physically yes but mentally, well, I cannot help but wonder if she wasn’t. We know breast is best and in most cases new mums take to it really easily which is why it must continue to be encouraged in 95% of mums at least.
But in Felicia’s case, she had an illness, a severe illness, constantly working against her and the thought of having to breastfeed seems to have been an extra pressure that she could have done without. I’m not saying for a moment that without this pressure her children would have been saved; what I am saying is that there would have been more of a chance that she would have continued to take her medication and who is to say whether or not this would have led to a different outcome.
There is nothing to be gained from ‘what ifs’ or hindsight speculating. As I said, cases like Felicia’s are extremely rare, but if health professionals can learn anything from the tragedy of these two children, perhaps it is this.
Where a new mum is known to be suffering from post-natal depression or at a strong risk from it – Felicia, for instance, had suffered PND with her first child and was clearly going through it with her second – the advice should be plain: breastfeeding is not priority. You and your children are the priority. Take the medication you have been prescribed and if the medication is likely to affect your baby through breastfeeding, then do not breastfeed.
There are other medical conditions that simply mean a woman is unable to breastfeed and it’s time to seriously consider classing PND as one of them. Even in less severe cases of it, it could help. Breast is best, but, where your mental health is at risk, there are other options. We must stop this ‘oh only one group of society stands to benefit from the reporting of these cases and that is the formula milk companies’ mentality because, quite frankly, it is nonsense.
The main group of society who will benefit from this way of thinking will be mums suffering PND and their children and their families. Get them to understand the ‘breast is best’ message to a point, sure, but do not force it upon them to the extent that they feel they must do everything they can to breastfed, even if that includes not taking the medication that is there to help them. How dare anyone force such a message upon them. They are ill, seriously ill, and just look what could potentially happen if their illness isn’t treated. We have to help these mums and making them feel pressure about having to breastfeed doesn’t help them in the slightest.
Indeed the fact that some PND medication isn’t compatible with breastfeeding is probably nature’s way of saying: ‘give yourself a break, kid – do not breastfeed.’ What harm is there in this, if meanwhile 95%+ of new mums who are healthy are still being encouraged to breastfeed. Bottle-feeding (there I’ve said it) will not be to the detriment of babies whose mums are suffering from PND and it will most probably help their mum get through this bad time. And it doesn’t mean their mums have to stop breastfeeding altogether; they can do the two in unison if they are feeling up to doing so. But, again, no pressure, no pressure at all.
I hope Felicia and her husband Jeff find a way through this and that their tragedy makes our society better prepared to help people like them in the future.


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