A few things you might not know, starting with the numbers:
A reported 27% of childbearing-aged women were sexually abused in childhood, and an estimated 40% including adolescent/teen years. According to LLLI, 90% of abusers are male, 70-90% are known to their victims; and for girls, 30-50% of abusers are family members.
These are just numbers. Numbers don’t speak, but many of the individuals behind the statistics are doing just that. Sexual abuse causes lasting trauma that cannot be isolated by a number; it follows the victim throughout life, and if this person is a woman on a path to motherhood it has many specific, new chances for recall of its memory. Pregnancy, birth, and breastfeeding bring enhanced susceptibility to a woman’s life, leaving her in jeopardy of rewounding.
Karen Wood, PhD, who notes that 1 in 3 to 1 in 5 Canadian girls are sexually abused in childhood, observed in her paper “Infant feeding experiences of women who were sexually abused in childhood”:
“A history of [childhood sexual abuse] can affect a woman’s experience of breastfeeding, including acting as a trigger for remembering or re[-]experiencing the abuse. Women who were sexually abused as children need to experience a sense of safety, acceptance, sensitivity, and understanding.”
You might assume that women who were sexually abused would be more hesitant to attempt breastfeeding than other mothers, but in fact the opposite has been found to be true. In a nationally representative sample study, women who self-reported past sexual abuse were more than twice as likely to initiate breastfeeding. They also were found to breastfeed at the same rate as those without a history of past abuse.
However, women who were or are currently sexually abused are at greater risk for postpartum depression, disturbed sleep, and perinatal complications. Interestingly, exclusive breastfeeding has been shown in a study to reduce rates of depression and poor sleep among survivors, as compared with formula feedings and mixed feedings (read about the study’s background and a podcast interview with the author here).
Still, night feedings are often especially frightening for survivors of abuse. They may have an especially difficult time managing views of breasts as both sources of nourishment and sexual objects. They may also have significant anxiety around the exposure and vulnerability brought on by public nursing.
Sterile, cold, impersonal interactions with health care providers may decrease their willingness to seek assistance for breastfeeding problems. The consequences of how mothers are treated in health care situations take root in well-woman exams, then trail her into prenatal care, birth, and finally into her breastfeeding journey.
Past sexual abuse can affect how a woman approaches medical authority of whom she would expect to provide support, assistance, and responsible care when in need of breastfeeding help. Sexual abuses are an example of undermining of a survivor’s personal power and authority; the abuser takes advantage of their place in a trusted position. Being forced to work with medical authority in a similar dynamic can be all too reminiscent of past abusive exchanges. This increases the chance that a survivor cannot feel confident to confront or question her care provider without emotional or physical ramifications.
“Whether the experience is traumatizing or healing might well depend on the skills and sensitivity of the health professionals providing care,” wrote
A few women in the aforementioned study explained:
“I wasn’t in a space where I could have [expressed disagreement] to a physician. Because of course they knew more than me. They knew it! It was an authority, a power over things; I couldn’t have done that then.”
“If the physician isn’t helpful, then you’re screwed. I had no support from my physician. And very little in the hospital. I had no idea what I was doing, and that actually really made me quite angry. Because the assumption was that the bottle was the best thing for him, and it isn’t!”
“[T]hey won’t be able to question the medical professionals who are giving them conflicting or inaccurate advice. They won’t be able to just go with whatever their natural instinct is with regard to caring [for] and feeding the baby and part of that [is] in the labour and delivery.”
“I got such bad mastitis, they recommended that I just stop. Unfortunately I took their advice.”
“When health care people consider a history of violence in a person’s life, then they have to consider that the mind is going to have an effect on the body. And when they treat somebody, or they consult with somebody, they have to get that history and know it, and be sensitive.”
How some sexual abuse survivors feel about breastfeeding*:
“I think a part of my experience was that I didn’t really have a body. I was a head with legs. Or with feet. I was just kind of a walking turtle … I ignored everything in between .… I remember the breastfeeding. I remember the frustration. But I can’t say I remember any feeling from it—physical sensation. I didn’t register any body sensation anyway. I was just—the breasts were functional for that time.”
“It always amazed me as to how beautiful of an experience [breastfeeding] could be, and yet for me it was such a trauma. I was so ashamed of my body.”
Her body shame negatively impacted her ability to breastfeed, which in turn deflated her sense of self-esteem:
“Here I am, a failure again.”
Some women expressed embarrassment at the notion of their bodies being seen publicly, and others admitted feeling guilty over a perceived inability to bond with their children.
“I feel like I never bonded with either kid because I was so afraid of hurting them. I didn’t know there could be positive physical interactions between a parent and child. I blame myself for not getting over the trauma and doing what should’ve been a great experience.”
Many women experienced emotional challenges to being touched by their infants, having to touch certain parts of their own bodies during feeding, and touch by health care providers (especially when unexpected and uninvited).
Some women described unexpected touching by medical professionals (such as when getting baby latched properly after birth) as “invasive,” “intrusive,” and “really traumatizing.”
“[A]t 6 weeks he went on the bottle … and it was a loss for me. I was touched-out, and I’d had all the physical contact that I could possibly take in those 6 weeks.”
“[B]ecause of the negative body image I was never comfortable with touching my body at different places”
“Everytime I had a let down[,] I had body memories of being sexually abused as a child.. Everytime he latched in the beginning, I felt sick to my stomach like I was being violated again…”
“[R]eliving my assaults has brought an overwhelming ‘touched out’ anxiety and I’ve ran out of the room crying and pushing my girls away in anger. I yelled ‘stop fucking touching me’ at my babies (1&2) […] I couldn’t handle their hands on my skin while they were nursing.”
“[A]t night, I’d cry when she’d feed because I felt gross. I felt like I was hurting her, like I was hurt. The sucking noises would make me start shaking. And everything was louder at night so I constantly played music. She was close to a year before I couldn’t continue anymore.”
Some women see their breasts as the cause of their abuse.
“If I hadn’t had large breasts, then none of this [sexual abuse] would have happened. That’s what I thought. If I hadn’t developed so young, if I hadn’t started menstruating, if I wasn’t already a woman, none of this would have happened.”
“Breasts were not a good experience. My father has always made fun of women’s breasts.”
“If [my breasts] were gone, I wouldn’t miss them.”
“My breasts were usually the first thing noticed about me, commented on, and touched, often without permission. It’s like I had some sort of block when I went to try [to breastfeed], panic attack and all, remembering my experiences.”
Though many women have largely depressing experiences with breastfeeding their infants, many others find the new relationship to be a tremendous source of pride — empowering and significantly healing. By nourishing babies with the power of our bodies, fear and stigma have the chance to transform into confidence and a sense of self-value.
“And everything was so new, and it was, but in a wondrous way, not in a rejection way, like I have always rejected my body. But in a wondrous way! You know how it’s almost like seeing things for the first time? It was so strange.”
“This is what my body was designed for! That’s what those parts were for.”“It was a validation. That is what [my body and breasts] were for. My breasts can have a positive story.”“At first I was ashamed of my breasts. They were often touched by my first offender.Once I began to willingly have sex with a partner, my breasts were often off-limits. I wouldn’t even take my bra off. When I had my first baby and learned about breastfeeding, it actually boosted my confidence. Not only did I have milk to feed my baby, but I felt sexy and it was okay for me to feel sexy. I had that child at a young age, but she was my way away from the boogie man forever.”“I can nurture him and provide for him and that’s making him grow. It’s quite amazing to me that it happens, and that I can do it. I love it.”“She began to root, and crawl up towards my breast. Her mouth was open and ready and my heart began to accept the idea. She was going to latch on, and no part of my being wanted to stop her. My sweet daughter latched on, looked me deep in the eyes, and healed wounds that had been part of me for 29 years.”“I felt empowered. My son is my chance of creating a decent man in this world. I know I can’t make every decision for him. But it starts with desexualizing breasts.”“[W]ith every month that passed I developed a strength within me, that sickness [feelings of aversion] was being overpowered by love for my precious baby.”
*Quotes were extracted from this study, this story, this article, an information sheet from South Eastern Centre Against Sexual Assault & Family Violence, and provided by women who wished to share their experiences for this post.
Help For Survivors
If you’re struggling with breastfeeding as a sexual abuse survivor, the most important thing to remember is: it is NOT your fault. The next most important thing to know is: you are NOT alone.
- Be clear about your boundaries with any breastfeeding helpers including hospital staff, lactation consultants, well-meaning family members, and so on. For example, you can state that you do not want your breasts to be touched or that you need space while nursing. A partner can be tasked to advocate for you if you feel uneasy speaking up.
- Older infants and toddlers often play with, pinch, grab and otherwise touch their mother’s breasts while feeding. This is normal behavior that may surprise abuse survivors, who may wish to prepare a plan regarding teaching ‘breastfeeding manners.’ Other ideas include using a nursing necklace, holding baby’s hand, plus more here and here).
- Learn about covering methods for nursing in public if the thought of visible breastfeeding gives you anxiety (ideas here). Practice nursing in front of individuals of whom you trust to build confidence before taking baby out.
- Nighttime feeds might feel scary. If they become truly intolerable, have a partner feed baby with expressed milk at night while you pump. Finding a safe place to nurse with adequate lighting can help. Set an alarm for scheduled feedings during the night to avoid the being woken up by a person instead.
- Distraction techniques can lessen emotional distress. Some ideas include reading, watching television, listening to music, or texting/talking on the phone while nursing.
- Know that strong sensual feelings may be experienced while breastfeeding. This is normal; these feelings are not sexual in nature.
- Experiment with clothing. If too much touching is a trigger, try nursing baby with a receiving blanket between you as a barrier. Contrarily, you can try increasing skin-to-skin feeds (baby in nothing but a diaper, your top is removed). This can help you associate baby’s touch with love and bonding; the oxytocin hormones generated help turn pain sensations into more pleasant ones.
- Increased sensitivity to pain or feelings of numbness and disassociation can be related to prior sexual trauma. This are not caused by the mother and does not preclude her from being a “good” mother or a successful breastfeeding mother.
- Breastfeeding beyond infancy is a valid choice. It is not indicative of deviant sexuality. The World Health Organization recommends breastfeeding for a minimum of two years and beyond for as long as the mother and child mutually wish.
- Nursing aversion has been linked to prior sexual trauma. Nursing aversion has psychological symptoms with an oft-mysterious root cause, though at times it can be attributed to hormonal shifts or lifestyle choices. This is BY FAR the number one breastfeeding issue about which I receive worried messages. Solutions found here.
- Timing feeds with a phone alarm is an effective way to feel more in control. This can help not only with phases of aversion but also make the chaos of infant feeding a more organized, conquerable task, and give you a chance to (literally) count on something reliable.
- You may feel threatened by the idea of sharing your body with your baby, or feeling out of control. Managing nursing sessions with more of a routine can help. Scheduling daily time for self care is essential for connecting with your own body. Offering to breastfeed instead of always waiting for baby to demand it can also help you feel more autonomous.
- If you have historically used drugs or other risky mechanisms of coping with painful wounds, seek professional assistance to find resolve in a way that won’t endanger your health or damage your breastfeeding relationship.
- Open, regular discussions and early treatment with a mental health provider can help prevent progression into a postpartum mood disorder such as postpartum depression, postpartum anxiety or postpartum psychosis, of which survivors are at higher risk.
- Let breastfeeding helpers know how you want them to react in the event that you choose to wean. They should be educated about the harm of pressuring a mother to continue breastfeeding, and should be prepared to unconditionally support her decision. Likewise, helpers should be advised to keep negativity to themselves should a mother choose to breastfeed past the helpers’ personal point of comfort.
- Remember, even if you’re breastfeeding, your breasts are YOURS, your milk is YOURS, your decisions regarding breastfeeding and for how long are up to YOU.
- “Breastfeeding and Maternal Touch After Childhood Sexual Assault” – Janice Yvonne Coles, Centre for Health and Society, University of Melbourne
- “Breastfeeding After Sexual Child Abuse” – PDF by South Eastern CASA
- “Breast Feeding and Sexual Abuse Survivor” – Family Research Laboratory, University of New Hampshire (Domestic Violence Information and Services)
- “Breastfeeding and the Sexual Abuse Survivor” – PDF by Kathleen Kendall Tackett, PhD, IBCLC
- “Breastfeeding and the Sexual Abuse Survivor” – for leaders, by LLLI
- “Breastfeeding as a Rape or Sexual Abuse Survivor” – Katy, Pandora’s Project
- “Breastfeeding as a Survivor of Sexual Abuse” – Morgan Gallagher
- Information Sheet on Infant Feeding for Women Who Were Sexually Abused in Childhood – National Network on Environments and Women’s Health
- “Healing Through Breastfeeding: A Sexual Abuse Survivor” – Nikki Patrick for The Badass Breastfeeder
- “How a History of Sexual Abuse Affects Breastfeeding” – Booby Traps Series by Best for Babes Foundation
- “Laboring to Mother in the Context of Past Trauma: The Transition to Motherhood” – Helene Berman et al., University of Western Ontario
- “What is the Impact of Sexual Trauma on Breastfeeding?” – Kathleen Kendall-Tackett, PhD, IBCLC, FAPA