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Breastfeeding in Times of Chaos

Kathleen Whitfield
Riverside CA USA
From: NEW BEGINNINGS Vol. 18 No. 6, November-December, 2001, p. 204

Even in the most innocuous ways, many mothers have discovered how visual images can affect their breastfeeding. "I remember trying to nurse my first baby while my husband and I watched a scary movie at home," Deb Roberts of Minneapolis, Minnesota, USA says. "I was so tensed up that my milk wouldn't let down."

The September 11 terrorist attacks on the World Trade Center in New York City and on the Pentagon in Arlington, Virginia brought a new level of horror to visual images seen on television sets across the world. The days immediately after the attacks were filled with confusion and uncertainty as people tried to comprehend what had happened and what would happen in the world.

Sales of antidepressants, anti-anxiety medication, and sleep aids went up 27.5 percent in New York City in the weeks after the attacks, according to NDCHealth, a medication information service that took the figures from retail sales. The uncertainty clearly led to a lot of stress for many people, including breastfeeding mothers.

Around the world, breastfeeding mothers face stressful situations within their families, during natural disasters, and during wartime. And, as with Roberts, that stress can affect breastfeeding. "The mother in a stressful situation may say that she has 'lost her milk,'" according to THE BREASTFEEDING ANSWER BOOK. "It is not unusual for breastfeeding mothers to notice a temporary drop in their milk supply or a delayed or inhibited let-down, or milk-ejection, reflex when they are under great stress" (Mohrbacher and Stock 1997). The drop is temporary, however, and with time and conscious efforts to relax, a more normal milk ejection reflex will occur.

"The new mother is particularly vulnerable to stress," says Kathleen Kendall-Tackett, a La Leche League Leader and psychologist who works with victims of trauma. "She's already in a vulnerable place because she's not sleeping much." In addition to this, the psychological weight of caring for another human being can make horrifying events all the more shocking. "All of a sudden it's not just herself she's responsible for," Kendall-Tackett says, "but this new life as well."

Watching extensive media coverage of stressful events can make things worse, according to Kendall-Tackett. The images that come out of some tragedies, with mothers clutching babies and running in fear, don't help. "Those are awful images for most people to see," says Kendall-Tackett. "For a new mother, they resonate particularly deeply and painfully as she identifies so closely with other mothers."

Residents of the US, which has not had an attack on its shores in more than 50 years, were struck particularly hard by the attacks. Many mothers in other countries have had more direct experience with war. A certain level of stress becomes part of everyday life in places where threats are more constant.

"Terrorism or war almost never impacts breastfeeding in my experience," according to Brandel Falk, who lives in Israel. Another Israeli, Susan Nachman-Srebrnik, explains further. "As incredible as it sounds, you adapt. Every Israeli child knows to stay away from suspicious objects just as American children learn not to get into cars with strangers. You open your car trunk and handbags for inspection before entering any parking garage, government building, or shopping mall. It becomes part of the daily routine. Life does go on. After the initial shock when people are glued to their TVs and radios; after the funerals and 'shiva' (period of mourning), you go on. You have to."

French Leader Genevieve Treille, who lived in Iraq during the Iran-Iraq war and in Saudi Arabia during the Persian Gulf War, did identify with the feeling of paralysis that struck many in the US after the September 11 attacks. She says: "One of the essential needs of human beings is being able to imagine the future and make plans, even very loose ones, ahead. What happens with insecure situations is that making plans seems hazardous because the future is very difficult to imagine. The natural behavior is to stay where you are, halt and wait and see."

Being in vulnerable situations has given Nachman-Srebrnik and Treille some methods of coping. "The most helpful suggestion I can give is to spend lots of time with your friends and talk, talk, talk," Nachman-Srebrnik says. She also urges people to:

  • Limit the amount of time you spend reading media speculation or watching graphic, crisis-related coverage;
  • Remain active through exercise. Aerobic and strength-training exercises are known to aid in releasing endorphins, which create a sense of well-being.
  • Eat nutritious meals; don't reach for unhealthy snacks.

Treille says that keeping a good attitude can have a lot to do with the company you keep. "Another thing I learned was to stay away from pessimists," she says. "I don't completely cut myself off from the news because I need to be informed to be able to make decisions when needed, but I don't want to let myself be hypnotized by what I see, read, or hear. Zapping through different channels on the day the US initiated their response I was amazed at all the speculation around the event. A lot of talking, analyzing, and commenting from people who were just doing that-talking."

If staying informed helps you cope, try reading newspaper or magazine articles instead of watching television news. Written accounts are often less disturbing than the onslaught of sights and sounds in television coverage. If what you're reading becomes too intense, it's easy to put down the newspaper and take a break from the news. Later, you can go back to reading on your own schedule instead of the network's. Listening to the news on the radio can be more manageable than television's mesmerizing images.

Normal Reactions

It's also important to realize that although many people join together to mourn after a collective tragedy, it's not unusual for people to switch into bickering and irritability soon afterwards. "Irritability," says Kendall-Tackett, "can be a sign of depression."

Forgetfulness, being accident prone, and even a feeling of disconnection from reality can all be natural reactions in times of chaos. (See sidebar.) Lost car keys, forgotten grocery lists, making a wrong turn-small mishaps seem almost comical in proportion to world events. It's important to be patient with yourself and your loved ones while everyone processes their feelings of shock, grief, and fear.

Breastfeeding Calms Mothers

For many women, the act of breastfeeding is comforting. The relaxing hormone, prolactin, increases in the bloodstream while babies feed and can help bring a feeling of normalcy to an unusual situation. During major natural disasters, in addition to ones created by people, other benefits of breastfeeding really become clear. "One of the things that we've learned during disasters is that sometimes the babies who weren't nursed didn't survive," Kendall-Tackett says. Because of limited access to formula, bottles, or water, babies who are not breastfed are particularly vulnerable during serious disasters.

Parents of children past babyhood also face a difficult job to help their children cope with tense situations in their own lives and in the world. Barbara Coloroso's latest book, Parenting Through Crisis, deals specifically with how parents can deal with certain everyday tragedies such as death, divorce, and serious illness, but she also offers some more general insights. "Whether we are dealing with a death, an illness, an accident, a divorce, or mayhem, we will need peace of mind, optimism, and resolve to handle the chaos, the loss, and the suffering that come hand in hand with each of these," she writes. "How we handle our mourning will give our children tools to handle theirs."

Kendall-Tackett tells a story of talking to a grown woman who lived through war and had to be evacuated quickly when she was a child. When asked about her memories of the situation, the woman commented that they were rather peaceful and not particularly troubling because her parents seemed confident and in control, even in a chaotic atmosphere. In dealing with difficult times, a calm parent makes a world of difference, she says, even when the situation is still up in the air. "You don't necessarily know things are going to be all right," she says, "so you can't say that, but you can say, 'This is what we're doing as a family.'" Those who have lived in countries during war have learned to project that same confidence. Not giving in to panic is difficult for some, but it makes living under challenging situations easier.

Genevieve Treille, who lived in the Middle East during wartime and gave birth in Baghdad during bombings, explained: "There is far less risk statistically of being directly endangered or hurt by this war than there is in driving in heavy traffic or long distances, being a victim of crime or natural disaster, or facing a serious illness. We are used to living with these fears. They are part of our lives. We are not permanently stressed or fearful. We go on living. We can do the same with what is happening now."


Coloroso, B. Parenting Through Crisis. New York, NY: Harper Resource, 2000.
Mohrbacher, N. and Stock, J. THE BREASTFEEDING ANSWER BOOK. Schaumburg, IL: LLLI, 1997.

Coping Tips

A disaster of any size will cause unusual stress in people who have been directly and indirectly affected by it. Each person will react differently and a range of responses to a disaster are normal and to be expected. Emotional responses to disasters can appear immediately or sometimes months later. Here are some common responses to disasters:

Responses to Disaster

  • Disbelief and shock
  • Fear and anxiety about the future
  • Disorientation, apathy, and emotional numbing
  • Irritability and anger
  • Sadness and depression
  • Feeling powerless
  • Extreme hunger or lack of appetite
  • Difficulty making decisions
  • Crying for "no apparent reason"
  • Headaches and stomach problems
  • Difficulty sleeping
  • Excessive drinking or drug use

Most of these reactions will decrease as time passes and you focus attention on daily activities. Because everyone experiences stress differently, don't compare your progress with others around you or judge other people's reactions and emotions.

What You Can Do

  • Talk about it. Not expressing your feelings will keep you from being able to work through what happened. By talking with others, you will relieve stress and realize that other people share your feelings.
  • Get plenty of rest and exercise. Remember to eat well. Avoid excessive drinking and risk-taking activities.
  • Spend time with your family. Encourage children to discuss their concerns and feelings with you.
  • As soon as it feels comfortable, go back to your usual routine.
  • Do things that you find relaxing and soothing.
  • Recall other times you have experienced strong emotions and how they were resolved.
  • Do something positive that will help you gain a greater sense of control (for example, give blood, take a first aid class, or donate food or clothing).
  • If you feel overwhelmed by the disaster, ask for help. It's not a sign of weakness. Talk with a trusted relative, friend, social worker, or clergy member.

If you have strong feelings that won't go away or if you are troubled for longer than four to six weeks, you may want to seek professional help. People who have existing mental health problems and those who have survived past trauma may also want to check in with a health care professional. Being unable to manage your responses to the disaster and resume your regular activities may be symptoms of post-traumatic stress disorder (PTSD), a real and treatable illness.

Source: The National Mental Health Association:


Should a Lactating Woman Donate Blood?

Opinions vary as to whether or not it is a good idea for a breastfeeding mother to donate blood. The American Red Cross says that nursing mothers may donate blood if they wish to do so. However, they suggest waiting at least six weeks after an uncomplicated term delivery or cesarean birth. They also caution that a pregnant woman should not give blood, and blood donation should be deferred for 12 months if a blood transfusion was necessary during delivery. For more information see their webpage on this topic.

The Canadian Blood Service, a division of the Canadian Red Cross, suggests that breastfeeding mothers wait six months before donating blood.

La Leche League sources also differ in their opinions. Dr. Gregory White, long-time senior medical advisor to LLLI, has always recommended caution in regard to breastfeeding mothers donating blood. On the other hand, Dr. Jack Newman, another member of the LLLI Health Advisory Council, says that any otherwise eligible mother can donate blood whether or not she is breastfeeding.

A breastfeeding mother who wishes to donate blood can consider these viewpoints, discuss the situation with her own health care provider, and make an informed choice. If a breastfeeding mother does choose to donate blood, she should keep in mind that she will need to replace about 16 ounces of fluid in her body in order to stay hydrated and continue producing an adequate supply of milk. All blood donors are cautioned to eat well before donating and drink large amounts of fluid afterwards. Donors are also advised to avoid heavy lifting with the arm used to donate, in order to avoid excessive bruising. This may also be a consideration for a mother who cannot avoid lifting her baby or older child.

Is there a risk of anthrax being transmitted through human milk? Can a breastfeeding mother receive the anthrax vaccine?

Carol Huotari, Manager of LLLI's Center for Breastfeeding Information (CBI) investigated these questions by contacting the US Centers for Disease Control and Prevention and the manufacturer of anthrax vaccine. She was told that anthrax is not transmitted from person to person (including breastfeeding), is not excreted in bodily fluids, and it is very unlikely that anthrax bacteria would transfer into human milk.

The CDC Web site states that: "No data suggest increased risk of side effects or adverse events associated with receipt of anthrax vaccine by breastfeeding women or breastfed children. Administration of non-live vaccines during breastfeeding is not contraindicated." For more information see the CDC website.

In Dr. Thomas Hale's book, Medications and Mother's Milk, the author concurs that the anthrax vaccine can be safely administered to breastfeeding mothers. He cautions against administering the vaccine to pregnant women.

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