Pregnant for 2nd time post PP considering breastfeeding this time…any advice?

[Newmumhere]

Hi all, I am coming to this community again for advice and wisdom.

I had pre partum psychosis with my first in November 2022. I tried to breastfeed with her but after she spent time on NICU where she was bottle-fed she never really got the hang of latching and wouldn’t consistently take it. So I ended up combo feeding (offering boob, formula and pumping) for 3 months which was mentally and physically exhausting. Ultimately I stopped on advice and just went with formula which worked really well for us; she got in some great sleep routines and my husband was able to help with night feeds.

I am pregnant with my second and would really like to try breastfeeding again but I’m nervous to do it with 1. The drop in hormones when I ultimately stop and that causing pp again; 2. The night feeding disturbing my sleep when sleeplessness was a big warning sign of my pp last time. I’d be really grateful for any advice or shared experiences of breastfeeding with a history of pp.

I am honestly not entirely sure how to approach the nights with or without breastfeeding while trying to get sleep so I stay well. I was at an MBU for the first few months postpartum so in those early days I had overnight help. Any advice or shared experiences of how others have approached night feeds would be really helpful too.

Thank you all so much.

Kath x

[Jenny_at_APP Partner]

Hello Newmumhere,

It's good to hear from you and congratulations on your pregnancy, lovely news!

I chose not to breastfeed my second child, apart from the first feeds, so I don't have any relevant experience to share on that front but I'm sure others will share their experiences with you. My decision was very much based on the fact breastfeeding became such a 'thing' for me when I became unwell with PP - I just decided to take it out of the equation - but I know others manage it successfully

I worried about the nights too - my older son was sleeping really well when we were discharged from the MBU so we didn't really know how we were going to achieve that ourselves! My husband and my mum did the night feeds for the first few weeks with my second and I started getting more involved once I felt confident I was feeling ok and could manage. I have to say our younger child was not as good a sleeper as my older child, but we got through it!

I hope you find lots of helpful information and support here - any questions do please just ask

Best wishes,

Jenny x

[Newmumhere in reply to Jenny_at_APP]

Thanks Jenny, it’s interesting to hear your experience as I wonder if that is where I will get to. There are lots of positives with formula feeding especially since others can help. Thanks for sharing your experience. X

[Seasky18 Volunteer]

Hi Kath

Breastfeeding peer supporter here who also had PP (with my second baby).

First I wanted to say a massive well done on combination feeding your first with PP that's amazing - I think combination feeding especially in the early days with pumping as well is so much tougher than exclusively breastfeeding. I had to pump with my second baby and it is so much harder than if you are able to feed directly.

I breastfed both my children. I didn't have PP with my first but I do recognise that I had some of the similar early symptoms that I had with my second, the difference being I got out of the maternity hospital much sooner and was able to relax at home and sleep.

While I am so very aware that breastfeeding can be a stress and a negative factor for some, I know that for me it was hugely beneficial both times. I believe it helped me avoid illness with my first, and recover faster and re-connect emotionally more easily with my second.

My first baby was exclusively breastfed even though I had an emergency CS, my second who was premature but born naturally had some formula top ups and donor breastmilk (I was unfortunately separated from him as unable to access a MBU, he was in the neonatal ward and I was sectioned and sent to a different hospital). I was lucky that I knew a lot about breastfeeding after successfully feeding my firstborn (it was after his birth that I trained as a breastfeeding peer supporter and volunteered helping lots of mums struggling to feed for different reasons)

It's a huge topic and so much to say but from my experience, if you get the right support and can feed directly especially without having to pump it can actually be beneficial for sleep. Our bodies are magic that way and feeding at night releases hormones to help you sleep, it can be incredibly relaxing and calming for mother and baby.

It's also an amazing tool especially as they grow giving comfort and nutrition especially any time they are ill or hurt themselves. There's no bottle prep and when you go out and about you don't have to take anything with you apart from yourself util they wean and even then you have a backup instant food supply on tap! I liked the reassurance that gave me.

A few things I wish I'd known with my first baby and helped with my second:

Feed on demand and prioritise your sleep - sleeping as much as possible the baby sleeps (day and night), especially in the early days while you're establishing your supply, the wake ups aren't so bad. A safe, next to me type of crib is ideal so you don't have to disturb your sleep more than necessary. Expect them to wake regularly and plan for it.

Key is to make sure you have support around you from family and friends so you can nap in the day, especially in the early days. Seek out some specialised support ahead of time - there will be breastfeeding groups and peer supporters local to you, find the groups, go along and find someone you connect with. Online support too (there's a great Facebook group Breastfeeding younger babies and beyond that's a wealth of information and advice, Kellymom also has some great information.

Make sure everyone knows it's what you want to do. Trust your body - It's made to do this, but also trust that if it feels really uncomfortable, get help to check your latch ro for any issues such a tongue tie. Remember this is new for you and your baby, you both have the instincts to do this but you're also both learning a new skill.

Feed on demand - being aware that babies cluster feed and that's normal (often in the evening), they have times when they might sleep longer and times when they feed every two hours - they re building your supply when they do this, it will change, your supply adapts to their needs, if they're fighting off a cold or something they will feed more, but this often means they will avoid being as ill, so although there is some disruption, you also are helping them to get better faster, so you avoid the disruption of an ill baby.

You also ask about stopping - well if you can do this gradually then there shouldn't be the sudden change, it wasn't a problem for me but I did stop very gradually and I am aware that some people struggle - but again key is having th support in place in case you need it.

With the right support breastfeeding can be calming and comforting, for me it helped massively to ease anxiety and rebuild my bond with my baby, I'd even go as far as to say I don't think I'd be here without it, but we're all different so it's all about feeling the right pathway for you.

There's so much more I could write, but my reply is long enough already! Please know if I can help in any way or answer any specific questions I'm very happy to.

Wishing you all the best with finding the right path for you x

[Newmumhere in reply to Seasky18]

Thank you so much Seasky18 for your comprehensive and helpful reply. I hugely appreciate it especially how you have outlined the positives of breastfeeding. Thanks again, Kath

[Isabella5991]

Hello lovely, congratulations on second pregnancy!

I had pp with my second in lockdown 2020. I had a week long but much milder episode when I stopped breastfeeding a couple years ago. It was not traumatic and I stayed mostly in my mind. Not like the severe break when I had pp. I then developed PMDD every month around my period, but again much milder and I am very medicated which helps masses.

These are my experiences and I hope make you feel better about when you stop breastfeeding that if some symptoms happen it will hopefully be much milder, If any. No one is the same of course and others have no symptoms!

I breastfed both of mine for three years each and suffered terribly really. I loved breastfeeding, but I was so underweight and utterly sleep deprived. They were still helping themselves ten times a night for a couple years and looking back I can’t believe I did that! If we were to have a third, I would combi feed like you. There’s no way I’d give my entire body mind and soul again to parenting like that again. I would probably consider sleep training as well, where as with my first two I was a proper attachment gentle parent. Happy mum, happy baby! Try not to feel guilty for putting things in place to make your mental and physical wellbeing a calm place xx

[Newmumhere in reply to Isabella5991]

Thanks so much Isabella for your honesty in sharing your experiences. One of my concerns with breastfeeding is that it’s hard to move from the feeding on demand approach especially overnight with lots of wakeups. I really need to protect my sleep at all costs. Whereas we were able to get into a great routine with formula. One to think on for sure. Thanks for sharing your experience. Kath

[Maria_at_APP Moderator]

Hi Newmumhere, congratulations on your pregnancy, lovely news.

I had pp in 2018 and the separation from my daughter for 10 days and combination of drugs I was on meant I stopped breastfeeding and gave her formula instead. It is a bit heartbreaking and left me wondering if things could have been different.

I went on to have my second baby in 2021 and I did combination feeding for some months but mostly breastfed, he had a bottle in the evenings to help my sleep. I had harvested colostrum before giving birth, so that in those early days I could supplement and also protect my sleep. I stopped breastfeeding when I started to feel that my mental health was taking a toll and I think having that flexibility of combination feeding did help me in adapting to how I was feeling. There is no right or wrong way at the end of the day, it's entirely up to you.

I did not have pp the second time around, but I did have some postpartum depression which was treated at home with therapy and medication.

I am wishing you all the best, do what you feel is best for you and your baby and I know it is very difficult to shut out the background noise. One thing I did mentioned to my extended family is that I strictly didn't want opinions on feeding and we rarely spoke about it.

Maria

[Newmumhere in reply to Maria_at_APP]

Thanks so much for sharing your experience Maria. That’s really helpful. X

[greta90]

Congratulation on your pregnancy ❤️

Before my daughter was born I was really keen to breastfeed I was reading a lot of books I even signed up to see lactation specialist before she was even born everyone knew that I wanted to do that little did I know my early motherhood journey will be so different to what I have imagined . It was going really well in hospital after she was born but when we got to MBU I was on such a strong medication that I couldn’t breastfeed her at night so she’d have bottle I was only breastfeeding her during the day . When Id had my psychotic episode she would also get bottle instead of my breast as I had to wait couple of hours to get the drugs out of my system I guess . When we got back home from MBU my mum gave up her job to look after me so she’ll watch me at night whilst I was trying to feed her she would be really fussy at the point because she had super easy flow from the bottle before so it was hard work. I manage to weaned her off at nearly 22 months and it was very smooth transition even been off my meds I didn’t struggle mentally at all I was really worried about that . Looking back now I feel like I would really struggle to bottle feed her at night at home anyway because I was so drugged from my meds I remember I couldn’t get up it was soo hard they later switched me to appriprazol and I was taking tables in the morning so gave me control over my night feeds . Regardless if you breastfeed or bottle feed I think going through something so horrible you need all the support you can get to survive .

[Newmumhere in reply to greta90]

Thanks Greta for sharing your experience. X

[Alpav]

Congratulations on your pregnancy! I went for pregnancy planning advice before we started trying for our second. I have bipolar 1 so was told that staying on lithium would be the best chance of staying well if I do have a second baby. But I have got other high risk factors e.g. in my late 30s

I can massively understand why you’d want to breastfeed though. For me one of the most traumatic parts of being in the MBU was when they put me on lithium and I had to stop breastfeeding. Like your baby, my son was in NICU and had two further hospital admissions so I was desperate to get the antibodies into him.

I cant say about the nights as I was never able to do them in hospital and my husband took over when we were home.

A bit of a ramble but hope something’s helpful in that.

[Newmumhere in reply to Alpav]

Thank you Alpav that is helpful. It’s just reassuring to hear other’s experiences and tips. Thanks for sharing xx