Considering giving up breastfeeding for my own physical/emotional health

right, where to start...

bubs is 4 weeks old today, breast feeding has been going surprisingly well, besides a recent hiccup in bubs refusing breast during the day but cluster feeding through the night, which has me exhausted, but anyways, it has been going well and i have been enjoying it, something i never thought would happen after a bad experienced with my first born...

the problem is i have terrible stress incontinence, that is so debilitating i am in tears every night and day, and really avoid leaving the house... i need to go to the bathroom every half hour otherwise i am like a leaky tap... sorry for so much info, just wanting to paint a picture of exactly how awful things are for me at the moment, it is easily the worst time of my life...

i have been giving some literature on improving continence, and it states that many breastfeeding women do their pelvic floor exercises religiously but do not notice any affect/improvement until they stop breastfeeding. this is due to a lack of oestregen in a breast feeding mother, and apparently oestregen is vital in the functioning of the bladder/urethra.... often when a mum stops breastfeeding she notices a significant improvement in the incontinence...

so here i am struggling with what to do... for my own emotional well being i know i really should stop breast feeding in the hope that my condition improves, as i can see myself spiralling to depression, however at the same time, if it doesn't improve, what will that do to me, considering the breast feeding was going quite well and was something i wanted to continue with. i hate what this is doing to me, i feel like such an awful person, i am always yelling at my 3 year old who is an angel and taking it out on her, every time i have to get up from my seat and i sit and delay it or try to avoid it, as i know its going to end up in leaks which gets me so down, it really is affecting my life in a terrible way....

thanks for reading if you have gotten this far, i am just at a loss as what to do... if i could book in for surgery to fix this problem i would do it tomorrow, but unfortunately its something they want to see improve over a period of time before they opt for surgery, which i can understand, but in the meantime my life is awful and my family are suffering... i know there are lots of people out there with far worse problems than this but its a huge problem for me.

Wow, I'm so sorry you're going through this. TBH I've never heard of breastfeeding affecting the bladder. I'll be interested to hear what Barb says on that.

When you say it's "stress incontinence" is it caused by stress? Sorry, I'm a bit confused. Do you believe it's hormonal? or do you think it's emotional?

I really hope you can find some answers.. and I hope you can find a solution that maybe allows for part-time breastfeeding or something. If it's an emotion-induced problem I would think you'd have to very carefully weigh up how stopping breastfeeding would affect you. And btw.. well done on the successful feeding so far :) Whatever the outcome you've given her a wonderful start :)

*big big hugs*

Hi Emma, firstly, huge :hug:, it is a very stressful situation you have described. I understand yelling at a perfectly behaved child, as I have been doing at a lot to my nearly three year old too (but just relationship stress for me), and at being torn for continuing bf (also for other reasons). Don't worry yourself that there are others with problems, just concentrate on you for now (sounds a bit self centred maybe, but you are the most important person, okay?).

Is there another way that you are able to control the stress? Have you considered medication (natural or conventional) for controlling your depression? If your dr is unsure of that avenue, then feel free to speak to another dr (or naturapath), they may know of something the first did not. Is there something else that is causing you stress? Can that be improved? I have not heard of bf affecting the bladder either.

And silly me, congratulations on the new bubs and bf this far! :clap: A most fine effort indeed.

Oh Emma you poor darling.

I couldn't not reply to this one because I posted in your original thread about the post forceps incontinence.

(FWIW for others, stress incontinence is when you can't hold onto your urine and so the moment your bladder becomes "stressed" eg jumping up and down, getting a bit full, it leaks - you basically have no ability to "hold on"). It's not emotional - although the leaking certainly makes you feel emotional.:rolleyes:

This is a hard one for me to respond to because normally I am not a fan of posters being pushed to continue breastfeeding when they are considering giving up. Also it sounds as though your incontinence is worse than mine was.

But I honestly think that you should at least defer the decision until bub is past the 6 week mark and you've had your postnatal checkup. It is going to take a while to improve and it sounds like you are being really good with your exercises...give them a bit more of a chance.

I know I experienced a noticeable improvement when I was getting close to my 6 week check up...I remember thinking that I wasn't going to be so embarrassed at my appointment as I thought I was going to be :redface: because I was expecting to be telling my OB I was weeing everywhere but by that stage I was starting to get back my ability to hold on.

You also need to cut yourself a break. Learning to deal with 2 children, and going back to the newborn phase after experiencing the relative freedom you get with an almost 3 year old is incredibly difficult. Especially when you are the only one there with them most days, you are tired and sleep deprived, feeling low emotionally because of your physical state and you are physically unable to get out of the house because you are frightened of not being within coo-ee of a loo. It's depressing.

On top of this you are worried about the affect the baby is having on your older child and feeling guilty because neither of them is getting one on one time with you and you feel like you aren't being the best mummy you could be.

Well you know what? You ARE being the best mummy you can be and you are only going to get better.

You're in the middle of a huge learning curve and bubs is only 4 weeks old. Give yourself and your body a chance.

At the risk of you thinking "well bully for you" I want to reassure you that I breastfed my DS for 20 months and got to 6 months exclusive bfing before solids started and I still regained my bladder control.

I just think that at 4 weeks post birth you wouldn't notice a massive improvement with your incontinence by giving up breastfeeding, you would still have a lot of work to do exercise-wise and then perhaps regret giving up the bfing so soon. Personally (and only personally) I would try to push on till I got past the 6 week stage and then reassess how you are feeling. These early weeks are the worst time and it is hard to be clearheaded when you are feeling so awful.

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(FWIW for others, stress incontinence is when you can't hold onto your urine and so the moment your bladder becomes "stressed" eg jumping up and down, getting a bit full, it leaks - you basically have no ability to "hold on"). It's not emotional - although the leaking certainly makes you feel emotional.:rolleyes:

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Aah.. thank you for that. Sorry for my misunderstanding of that Emma :doh:

Me again...I was just thinking...

I don't think your hormone levels would be back to normal levels until up to 12 weeks post birth anyway... so I don't know how much of a difference giving up breastfeeding now would make at this stage.

Perhaps what you were reading applies to women who have been bfing for a few months and not seeing much improvement in bladder control. Check the "fine print" of those statements with your physio.

I totally understand the temptation - it must sound like a magic bullet to fix your problems, but I would just check this before making the decision on your own - because this decision can't be reversed.

Have you seen a physio that specialises in continance?

Hi, Emma,

You have had a really hard time. It is a very difficult problem. It is understandable you would do anything you could to fix the problem.
Breastfeeding doesn't cause incontinence. Women are designed to breastfeed, but are generally not incontinent. This is a separate problem. I suggest you go back to your medical adviser, and let them know just how difficult this situation in for you, and also that breastfeeding is important to you. Breastfeeding is important, and you should be able to get help with your problem without having to stop breastfeeding. What has your doctor suggested so far? Get a second opinion if needed.
Curly, thank you for sharing your story.

Sorry you're having such a difficult time Emma:hug:

I have had a little bit of stress incontinence. I also had a small prolapse of the vagina after delivery (also forceps). Doc also told me that estrogen is suppressed post birth when breastfeeding, and this weakened the walls of the vagina. I know it's all connected, but I'm not sure estrogen affects the pelvic floor muscles in quite the same way.

In any case, I think you might want to give it a bit more time before deciding, especially if this is your sole reason for giving up breastfeeding - I think it will take a bit of time to right itself even if you stop breastfeeding now.

there are physiotherapists that specialise in pre and post-natal care - perhaps you could find one in your area and get some help. Sometimes it's as simple as not doing the exercises quite right and once you get the right help, things improve out of sight.

Take care of yourself - hope you are getting lots of help around the place :hug:

Hi Emma, quick post as no time (I have a 2yo and a 4mo).

Have you seen a specialist physio, or in fact any physio about this? Most people who have pelvic floor problems try hard to do their exercises but their body isn't responding in the right way, and is actually bearing down when they intend to 'draw up and in'. A physio (or even a specialist continence nurse) can assess if you are managing to do them the correct way - that might help you at least know if you are doing some good with the exercises. Many women who have had children have some form of bladder control problem at some point in their life so you are not alone. It is the pregnancy and delivery rather than the bf which are responsible so I would encourage you to keep going at least until you have the 6 week check up and have got some other professional assistance.

Where do you live? I could try to find out about physios/continence services in your area for you if you want.

Al;l the best,
Fi

Hi Emma,

I had stress incontinence and was prescribed low-dose amitriptyline. This may be worth considering.

In high doses amitriptyline is an anti depressant (!!) this is at doses of 100 to 200 mg. When I was prescribed it for incontinence I was having 10 mg, so significantly less.

Checking on the internet the jury is out on it's effects on breastfeeding - so this is one where you will definitely need to be led by your OB or GP.

I mention it as another option to consider, particularly once you have stopped breastfeeding. I used it in conjunction with physio and it really helped, particularly with sleeping through the night (it is also given to children with chronic bedwetting problems).

Oh hun, how awful for you :hug:

I agree with the suggestions to see a physio. I had minor stress incontinence long after DS2 weaned. I'd been doing exercises and nothing had helped. Then I looked up a physio specializing in women's health and it was the best thing I did. Turns out mine wasn't just about muscle strength but also to do with my funny spine. She went through lots of strategies with me and in a few weeks it was actually fixed. I couldn't believe it. If only i'd seen her earlier.

Anyway, I just wanted to let you know that a physio can probably help you. All the best hun, I really hope you find some relief soon.

oh wow, we hadn't discussed medical/drug options.... that is interesting - i wonder what type of incontinence it is for? what sort did you have, stress or urgency or what? mine is so severe, honestly, if i am standing up i am literally wetting myself... i am fine sitting or laying down, but standing i am hopeless.... if only i could go through life laying down...!!

i have seen a physio and while she was reassuring about giving things more time to recover etc, i am not sure if she specialises in this sort of thing, so i might look for one who does...

i am still sore inside at 5 weeks, but just on one side.... i am thinking this might actually be a good thing, as it shows i still have'nt recovered, so there is a chance things may improve...

i suppose i just need to accept that the next 3-4 months are going to be horrible and i won't be leave the house too much.... then when enough time has passed if things aren't any better i can look at surgery and get things fixed (hopefully)... its a hard thing to accept though, these circumstances, but i think instead of fixating on it and constantly thinking how awful i feel, if i just accept it and get on with things, then maybe i will feel better somehow. not sure if that makes sense.

Have you seen a continence nurse? There are lots of (quite yucky but not as yucky as being housebound and messy) things like serious pads and disposable car seat protector thingies and semi-waterproof knickers that could help you over the next little while as you sort it out.
Are you having trouble emptying completely as well - there may be options to help there too, so that you can go to the loo and know that you will be right for a while afterwards.

Emma, :hug:. I highly recommend seeing a women's health physio in your situation. They really know what they're doing, it's amazing how they can whip you into shape! And please give yourself and your body more time, it really hasn't been very long, although I'm sure it feels like forever for you :hug:

No disrespect to your current physio but you will get better results, faster, with a specialist. Do you have your 6 week check coming up - you should be able to get a recommendation then, if you can't find someone yourself faster. And you'll be able to ask them about all the options people have raised in this thread so you can get some professional answers.

I wouldn't resign myself to being housebound for the next 3 months - with treatment you should improve enough in that time to feel more comfortable venturing out in less time. If your postnatal bleeding has stopped maybe you should invest in some incontinence pads just so you can get out of the house. Getting out of the 4 walls of your house would do you a power of good. Are you getting outside at all, even into the backyard? It sounds stupid but make sure you are getting some sunlight every day, it's good for your serotonin levels (happy hormones). Pineapple juice is also good apparently (sounds mad, I know! but that's what the midwives at the hospital told me when I was suffering the baby blues).

At only 5 weeks post birth there is no way you should consider yourself physically recovered. I still couldn't sit down comfortably at that point. I felt so fragile, both emotionally and physically, and I cried a lot. As I posted in another thread, after my own forceps birth and second degree tear I was still leaking occasionally until about 3 months post birth...it did get less and less, there was a good improvement at about 6-7 weeks post birth...and when I did the "cough and jump" test at around 4 months with a full bladder I was able to hold on (just! but I could do it).

Whilst my incontinence wasn't as bad as yours I wasn't seeing a specialist physio at all, but I did only have a newborn to deal with so much more opportunity to lie down. I did my exercises lying down as much as possible to start off with because that was the position in which I found it easiest to isolate the muscles...I remember that frustration of not being able to feel anything.

I really hope you are able to take the time to get away to see a physio...try to call in as many favours as possible. Is your mum around or any friends who can at least babysit your oldest child? I don't know what your DH does for a living, but can he take any time off here and there to enable you to get to some appointments (ie first thing in the morning or last appointment of the day). I really admire you for soldiering on, with 2 kids to look after you must have so little time on your hands.

i have made an appointment with a specialist physio that deals in this sort of thing in malvern for early march, it is going to be a fair drive so i don't know how i am going to make it in the car, but anyways i am going...

i have the incontinence pads, its just that without exagerating, if i am standing or walking, i can literally be weeing without knowing, until i feel wet.... so the pads are good, but if that happens it is a disaster.... last night i was brave and went out for tea, i thought i was doing so well, but when i went to the toilet i discovered my pad was soaked and my undies wet, and here i was thinking i was holding on..... its so frustrating....

also i am disheartened because it seems my problem is from the catheter being pulled from the bladder into the urethra, so the little valve thingi that is meant to shut off and open up for urine, has been stretched by this balloon catheter, so the valve isn't working at all, which is why i am leaking (plus a dodgy pelvic floor)... i'm not sure how much exercise etc is going to help, although i will do it obviously, but at the end of the day if the wee is coming out because of this injury by the catheter, what hope do i have....

i am meant to be going to qld in 2 weeks but really don't see how i can go..... i feel so guilty as my kids and family are suffering because i am so depressed and feel like i can't go anywhere... i have my mum helping out and my dp has taken time off work, but everytime i move i feel myself leaking and i am just so scared its going to be a huge leak, that i really don't want to go far from home at all.... i keep emptying my bladder every hour so its never really full, and i am trying not to drink huge amounts in one go, and space out little drinks frequently, but i am still so scared of having an accident....

thanks for reading it helps to get it out... i don't tell my partner much as he doesn't know what to say, he isn't much of a talker in these sorts of situations...

i don't know whether to just say stuff it and go to qld and deal with whatever happens, or stay home where i feel safer.... if i go and it is just awful it will make me feel even more depressed... everytime i have an accident or a huge leak it makes me feel worse and worse.... but i don't want my little girl to miss out on the fun we had promised her, plus its all payed for.... i dunno what to do.

:hug: emma, it sounds like you're having a seriously tough time. it's crazy enough with a NB, without extra stress on top of it.

i don't have any advice but wanted to pop in & offer some more virtual support. i hope the specialist in malvern is able to give you some assistance - and hopefully some of it starts working quickly. is the appt before your trip? i hope you're able to go on your holiday without any worry.

Sweetie - big big :hug: You sound so distressed. I had a small brush with incontinence while I was having chemo and it was very distressing & nowhere as severe as yours so my heart really goes out to you. :hugs:

First of all - DON'T WAIT. Ring the specialist physio back, explain that it's a severe incontinence issue and not a slight one - and ask to be placed on their cancellation list or speak to the physio directly. They may be able to squeeze you in earlier because of the severity.

Secondly - I'm sure the physio you saw meant to reassure you about it getting better over a period of time but that is not IMO an excuse not to treat this as proactively as possible. As Blu-K said, there are some medications that might help (Ditropan - sorted mine out completely) which is worth discussing with your GP, but at the very least you should be consulting with an incontinence nurse who will help you with some exercises as well as coping strategies. Underlined because you are doing an admirable job of getting on with things but it does sound like you feel like you're not coping. :hug:

BTW they have all sorts of gadgets to help, my friend had this thing she sat on which (??? not sure how it worked) but it re-taught everything how to work properly.

BTW don't give up hope with the pelvic floor exercises - you *will* reap the benefit, but it tends to be more noticeable in hindsight, kwim? But to me it sounds like you need more help than "just" the exercises, so make sure you communicate how severely this is impacting your life so you get that help NOW. :hug:

Emma - FWIW I bet I know exactly which physio you are seeing in Malvern - just down the road from Cabrini hospital, Wattletree Road? They are FANTASTIC. (I'm ex-Melbourne).

I saw them for back pain when I was pregnant with DS and they come and visit all the new mums in Cabrini one-on-one to teach them how to do their pelvic floor exercises and a give them a general assessment of their condition after the birth and a program to follow at home. I had both DS and DD at Cabrini. They also come to the prenatal classes at Cabrini and teach the pregnant mums how to exercise their pelvic floors. I still have all their literature in my bedside drawer for reminding me how to do my exercises now.

I just want to second what Marydean said - ask to be put on the cancellation list. Ring them every couple of days. There are lots of physios there and you should be able to get in to see someone quicker than March. From memory I am sure they have a toilet in the reception area so don't worry about the drive, just take a change of undies with you and you can get changed there before the appointment. They might have more "heavy duty" incontinence pads at the chemist rather than the ones at the supermarket if you feel you need extra protection during a long drive.

Parking is fairly easy there, you should be able to park on Wattletree Road or just around the corner on a side street.;)

Hi Emma, Just popping in because I've been thinking about you and wondering how you are getting on! It's nearly early- march now - so I hope some relief is at hand :hug:

i've just checked and the physio is on malvern road, not wattle tree road, but their brochure states they specialise in continence and pelvic floor rehabilitation, so i'm hoping that they are good...
my appointment is next friday, so a week to go... then we have a week's holiday, then we are getting a pool put in at home when we get back, its my daughter's 3rd birthday, and we are also having some friends come down to visit, so i have a busy few weeks prior to my next appointment with the head of Uro-Gynae at Monash - which i am hanging out for, as i want to start talking about the what if's... as in what if this doesn't get better, etc, when can i schedule surgery...

i think i'll feel loads better after i have spoken to him (which is at end of march) as i will know where i stand, how long i wait to see if things improve with exercises etc, i will know how much longer i have to put up with it until i make some decisions...

i suppose i am learning to manage things better.... i am wearing bigger pads (i was wearing ridiculously thin ones then getting upset when they didn't work)... i don't drink if i am going out, and when i am at home in the evenings i drink like mad to hydrate myself.... i suppose its not too bad to live like this as a temporary measure, but no way in hell i'd like this to be permanent.... i just hate the feeling of the leaking, its so scary, as you never know how much is coming!!!

anyways i suppose i'm in a better head space about it.... i just hope i make it thru our holiday to qld... i can sit and be fine, and lie down and be fine, but as soon as i stand up and try to walk thats when i have issues.... and if i am on my feet walking etc i know i will also have issues, so walking around dreamworld could be a bit dicey...

on a separate issue, i'm still persevering with the breast feeding.... he is still fussy during the day and doesn't feed well, but feeds well at night, and is putting on good weight, so i am trying to relax knowing he is getting what he needs.... it still annoys me to no end when he won't feed properly during the day, especially if we happen to be going out (rarely!) because he will be unhappy while we are out.... anyways i've typed an essay so will stop now.... thanks everybody for your support, its nice to know i can come in here and update you and tell you how i am going with it all... hopefully soon i will have good news.

Thanks for the update Emma - I've been thinking about you too and wondering how you've been getting on. I'm glad to hear you're feeling a bit more positive. I really hope this physio can help you out and that you don't have to cope for much longer :hug:

All the best for your holiday - I hope you can find some way to enjoy yourself, I think you've really earned a treat!

Good to hear you feel like you're coping a bit better - and esp that you're planning life as normal - will help with the cabin-fever feeling.

BTW I did wonder (but forgot to ask) about the type of pads you were using - learnt the hard way that the light ones really *are* :lol:. There are quite industrial strength ones out there - worth it for peace of mind IMO. :hug:

ETA - and an especially big woohoo that you have managed to peservere with the breastfeeding - as the ad says "every month is a bonus"! :)

It's great to hear you sounding more positive. You are doing such a great job of coping with a very challenging situation, good on you hun. I hope you get some great answers and lots of hope from your appointment :hug:

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i've just checked and the physio is on malvern road, not wattle tree road,

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Just looked them up - it IS the same physio I went to, they've just moved premises, that's all. You'll be in good hands.

Hey babe, just found this thread :hug:
I automatically get my back up nowadays when I hear some condition or other blamed on breastfeeding, or when someone is told the condition will improve upon cessation of breastfeeding. I was told exactly this about SPD and it has no basis in fact, as I found out. Lucky for me, I was prepared to go on friggin crutches had the 'advice' been true, in order to breastfeed my baby! I went for a second opinion with an osteo and never looked back. Not that I thnk an Osteo is your ticket, but as an example of not taking that feeble "it must be the breastfeeding and the hormones thingy" line as gospel. I've decided that blaming breastfeeding is a caregiver's way of saying :dunno:
On the OT, do you reckon there may be a relationship between how you feel during the day and how you feel about going out and your DS's fussiness at these times? I just have a theory I've developed from your posts that you feel more stressed during the day because of wanting to go out but anticipating the problems with the incontinence, and at night relieved that there is less need or expectation to leave the house. It's possible that DS is vibing off you and cluster feeds when your own stress hormones decrease at that end of the day. Just a theory that may help :)
There are so many things we have been conditioned to expect as part of bearing children because no-one has bothered to find solutions or even real explanations (after all, aren't there serious things like cancer to cure instead of 'womens business'?).
I'm glad you're still BFing - so often women listen to this initial, unqualified advice and see no improvement in their complaint and lose the BFing - double whammy.
I hope you get some real answers and support from your new caregivers!!

i now have a theory that perhaps he isn't feeding well due to being overtired, is this a possiblity? with our first born we always tried to follow the 'rules' about how long they should be awake for etc, not that it worked, but with him i only really bother to 'try' getting him to sleep if he seems to need it due to grizzling/crying etc.... he is often awake for several hours quite content in his little chair, or in his pram, or under the play gym, then when i think i'll feed him, he is all fussy and frantic and awful..... however he just had a sleep for an hour or so in his cot (after i rocked him and put him down asleep mind you) and when he woke up he fed quite well, and also during the night he feeds very well, after sleeping for 3 hours etc... so this is my new theory.... perhaps i need to be a bit more proactive in getting him to sleep during the day, which is hard with a 3 year old to run after.... he doesn't miraculously go to sleep by himself in the cot like other newborns do...

i did think maybe i am less stressed at night etc, but to be honest i'm quite relaxed during the day at home and still he hadn't been feeding well.... hmmm who knows...

also re: the breast feeding, i haven't actually been advised to stop, in fact quite the opposite, but it was just something i had read about lack of oestregen from breast feeding thinning the line of the vagina/urethra (which a lack of oestregen does) which can impact on incontinence, so in desperation i was considering giving up the breast feeding to see if it would make a difference, as the lining would then thicken and plumpen up a bit in the urethra which would help to stop leaks... however i really think my issue is beyond a bit of plumpening and don't think it would have any significant benefit at all... i have been taking oestregen pessaries which hasn't made any difference that i can notice...

so can anyone advise if an overtired baby would struggle to feed properly? he gets on and sucks then lifts his head up like he is looking around, then cracks it and repeats etc until i give up.

Emma, yes, an overtired baby can struggle to feed properly. Babies feed best when they are calm. Interestingly, babies can also feed during the light sleep cycle, so perhaps this is something else you could try during the day until he is feeding better again.

It does sound like he is missing his "sleep window" which makes it harder for them to fall asleep. At that age, 1 1/2 hours is probably the longest he can stay awake in one stretch without becoming overtired. Some mums find it helps to write down the time each time their baby wakes up, and make sure that he is fed and put back down before it reaches 1 1/2 hours past that time.

GL hun, you are doing really well - it is really tough with two young ones.

I am wondering how Emma went with her stress incontinence problem. I am experiencing the same problem with severe stress incontinence and I also had the catheter pop out with ballon still inflated during delivery and am thinking that this may be the cause. Emma, if you still visit this forum I would love to know how you got on. Thanks.