Considering giving up breastfeeding for my own physical/emotional health

[Emma1979]

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.

[Liz]

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*

[Netix]

Hi Emma, firstly, huge , 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! A most fine effort indeed.

[Curly]

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.

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 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.

[Liz]

(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.

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

[Curly]

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.

[Snowy Love]

Have you seen a physio that specialises in continance?

[Barb Glare]

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.

[onthefly]

Sorry you're having such a difficult time Emma

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

[Feathertop]

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

[blu-k]

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).

[MantaRay]

Oh hun, how awful for you

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.

[Emma1979]

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.

[Kmn]

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.

[Janie]

Emma, . 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

[Curly]

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.

[Emma1979]

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.

[sloane]

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.