Breastfeeding Aversion and Agitation (Aversion)
There is very little understanding or research on breastfeeding aversion, also known as breastfeeding agitation or nursing aversion , but it is a real condition with complex physiological and emotional causes. As a nursing parent myself who experienced aversion for
several years over the course of my nursing relationship with my two children, I searched desperately for answers to why this was happening to me and for solutions that would enable me to continue nursing my kids until they self weaned at a biologically normal age. Nursing aversion is characterized by a negative reaction to the sensation of breastfeeding ranging from mild to very
intense . Parents’ descriptions of their aversion or agitation include irritability, anger, rage, a “skin crawling” or creepy
crawly feeling, or an intense urge to run away or to harm their child when nursing. The feeling almost always begins upon latching or shortly after beginning the nursing session and ends directly upon delatching the child, although some people struggling with aversion may even be triggered by thinking about nursing, seeing other parents feeding their children, or having their breasts or chest touched by their children or anyone else. Some parents experience aversion every single time they nurse, while others may find that their agitation appears while feeding at night, at certain times during their menstrual cycle, or at other specific times.
Aversion differs from nipple pain or Dysphoric Milk Ejection Reflex (D-MER). It also stands apart from postpartum depression or anxiety or other mood disorders, although they can coincide and PPMDs may be a risk factor for developing aversion. Due to the lack of knowledge and research about aversion in the breastfeeding field, medical providers may misdiagnose a parent’s reports of aversion symptoms as one of these other conditions, and treatment may not be very effective, which puts the breastfeeding relationship at risk.
There appear to be a number of risk factors that increase a breastfeeding or chestfeeding parent’s likelihood of experiencing aversion, including:
● Nursing during pregnancy
● Tandem breastfeeding (two or more children)
● Nursing an older child
● Past physical, sexual and/or psychological abuse
● Hypersensitivity to stressors
● Return of menses
● Fatigue, lack of sleep
● Malnutrition, vitamin deficiencies, and dehydration
● Postpartum mood disorders
Hormonal shifts during pregnancy are probably the most common cause of breastfeeding agitation. Aversion may go away after pregnancy ends but may continue postpartum as well, triggered by nursing one or both children. In my case, my aversion began while nursing my older child during my pregnancy with my second child. After the birth of my second child, nursing my older child became unbearable and I began feeling agitated toward nursing the new baby as well, particularly when I was overstimulated and depleted by parenting and work.
If you're not very familiar with nursing during pregnancy or tandem nursing, the book Adventures in Tandem Nursing by Hilary Flower is a great resource for understanding the complex issues that are unique to the experience including nipple pain, nursing aversion, and supply changes. It's an apt way to gain insight into the variety of concerns and experiences of pregnant nursing parents and is the only publication that includes first-person descriptions of nursing aversion ranging from mild to intense.
Aversion caused by nursing an older child may be caused or exacerbated by the emotional reaction of having very urgent and frequent requests for nursing when it isn’t desired by the parent. As you can imagine, this is more likely to happen with a toddler or older child who is a very avid and frequent nurser. With children like these, there can often be an imbalance of the parent’s needs and the child’s, and some children are quite persistent with grabbing at a parent’s chest, pulling their shirt down, and attempting to nurse against a parent’s wishes. This may be triggering for any parent, and especially one who is sensitive to stress or conflict, or is a survivor of past physical, sexual, or psychological abuse. I’ve developed a flow chart to help professionals and advocates understand the physical and emotional experience of aversion or agitation. Click here to see the flow chart if it doesn't show
The increase in stress hormones interferes with the hormone oxytocin’s role in the milk ejection reflex, simultaneously stimulating in the parent the “fight or flight” response, which is why parents with agitation report a strong urge to run away from their child or to hurt their child in some way. Lacking a letdown of milk, the nursling engages in behaviours to attempt to bring on milk letdown including rapid
suckling, kneading, and twiddling, which in many cases increase the aversive feeling, and so on. For this reason it can be very difficult for a nursing dyad to overcome the challenge of aversion and it can often lead to premature weaning, which can lead to feelings of failure, guilt, anxiety and even depression in a new parent, particularly if they feel a lack of understanding about the cause of their aversion and have not received knowledgeable support with the issue. Parents who are predisposed to strong reactions to stressors and to mood disorders due to past trauma are more likely to experience extreme negative emotions if aversion leads to premature weaning.
In my own experience with aversion, by far the most helpful resource I found was peer support from a La Leche League
Leader friend of mine who had struggled through her own aversion. I believe peer support is one of the most helpful
resources for parents struggling with aversion, and online groups can be a great place to get this support, with the
network of breastfeeding and chestfeeding parents who have connected on social media. Clearly, more research is needed
about this topic, so that pediatric and postpartum medical providers can also be resources for help and support.
In my next article, I will discuss approaches to dealing with, treating, and overcoming breastfeeding aversion. There is hope
for parents with aversion to continue nursing and to redefine and meet their own breastfeeding goals, with the right support.
Anna Brauch is a Certified Lactation Specialist, a breastfeeding and chestfeeding educator, and La Leche League Leader in Minneapolis, Minnesota, USA. Anna has nursed two children through aversion and facilitates several breastfeeding and chestfeeding support groups both in her community and online, including the Facebook groups Minnesota Breastfeeding Support, Nursing Aversion/Breastfeeding Support- North America, and Pregnant and Tandem Breastfeeders North America. Anna has presented on lactation-related topics for iLactation, the Breastfeeding and Feminism International Conference, and La Leche League. You can contact her at email@example.com or visit her at annabrauchlactationsupport.weebly.com