When the Past Meets the Present: How Trauma Affects Breastfeeding

Ashley Strengholt
4 days ago
6 min read

Breastfeeding is natural, but it is not always easy - especially for mothers whose bodies carry the imprint of trauma. Trauma from childhood sexual abuse (CSA), sexual assault, PTSD, birth trauma, or perinatal mood and anxiety disorders (PMADs) can profoundly shape a mother's emotional and physical breastfeeding experience. Because breastfeeding requires closeness, touch, vulnerability, hormonal surges, and relaxation, trauma-surviving mothers often face unique challenges that deserve compassion, validation, and specialized support.

Trauma and the Body: Why Breastfeeding Can Trigger Emotional Pain

Trauma is stored not only in thoughts but also in the nervous system. Research shows that traumatic memories can be reactivated by sensations, touch, hormonal changes, or emotional states (van der Kolk, 2014). Breastfeeding involves:

Continuous physical touch
Exposure of breasts
Surrender of control
Oxytocin-driven emotional openness
Close proximity to another person

For trauma survivors, these demands may activate old protective patterns like hypervigilance, fear, dissociation, or panic.

Oxytocin’s Double Edge

Oxytocin - the hormone responsible for let-down - increases feelings of bonding and vulnerability. However, in trauma survivors, oxytocin surges can trigger emotional dysregulation or discomfort (Brockington, 2004). Many women report sadness, anxiety, or flashbacks during let-down because emotional openness once felt unsafe.

Childhood Sexual Abuse (CSA) and Breastfeeding

Breastfeeding may trigger distress in mothers with CSA histories. A landmark study found that women with CSA backgrounds were significantly more likely to experience breastfeeding difficulty, emotional discomfort, or aversion (Kendall-Tackett, 1998). Another study found that tactile triggers and feelings of bodily exposure can interface with unresolved trauma stored in sensory memory (Ammerman et al., 2012).

Common challenges include:

Feeling “exposed” or invaded
Feeling trapped when baby latches
Emotional numbness or dissociation
Guilt for not “enjoying” breastfeeding
Confusion about bodily boundaries

These reactions are not signs of poor bonding - they are physiological trauma responses.

PTSD and Breastfeeding

PTSD rewires the body’s fight/flight/freeze mechanisms. Research shows PTSD increases cortisol and decreases oxytocin levels, which can impair let-down and reduce milk transfer (Sperlich & Seng, 2008).

Mothers with PTSD may experience:

Hyperarousal during nursing
Difficulty relaxing for let-down
Panic when “touched out”
Emotional overwhelm during cluster feeding
Sleep disruption that intensifies symptoms

This does not mean breastfeeding is impossible - only that mothers need trauma-informed care, safe environments, and support.

Birth Trauma and Breastfeeding

Birth trauma impacts up to 45% of mothers depending on how trauma is defined (Beck, 2004). Causes include emergency interventions, loss of control, disrespectful care, obstetric violence, NICU separation, or fear for the baby’s life.

Birth trauma affects breastfeeding because:

The traumatized body may feel foreign or unsafe
Oxytocin release may be blunted (Bell et al., 2018)
Mothers may associate feeding with failure or loss
Medicalized birth may undermine confidence
Physical pain or surgical recovery interferes with positioning

Mothers may feel guilty or ashamed, which further affects milk let-down.

PMADs and Breastfeeding

PMADs include postpartum depression, anxiety, OCD, PTSD, and psychosis. They affect roughly 1 in 5 mothers (Wisner et al., 2013).

PMADs influence breastfeeding by:

Reducing oxytocin
Increasing cortisol
Disrupting sleep
Heightening irritability and fear
Impacting milk transfer
Triggering intrusive thoughts at night

It is crucial to differentiate PMADs from D-MER or temporary breastfeeding stress. PMADs are persistent; D-MER is let-down specific. Both deserve support.

The Science: How Trauma Impacts Lactation Physiology

1. Oxytocin Suppression

Stress and trauma elevate cortisol, which directly inhibits oxytocin (Uvnäs-Moberg et al., 2015). Without adequate oxytocin, milk ejection becomes difficult.

2. Hyperarousal

The autonomic nervous system may misread normal breastfeeding sensations as danger (van der Kolk, 2014).

3. Increased Pain Sensitivity

Trauma survivors often have heightened pain responses (Seng et al., 2006), making nipple pain or latch issues feel emotionally overwhelming.

4. Body Memories

Touch-related trauma is stored somatically; sensations at the breast or chest can trigger flashbacks or dissociation.

5. Dysphoric Milk Ejection Reflex (D-MER)

Some research suggests trauma survivors may be more vulnerable to D-MER, a dopamine-related emotional crash during let-down (Heise & Wiessinger, 2011).

Supporting Breastfeeding Mothers with Trauma

1. Normalize the Experience

Validation reduces shame. Mothers often say, “I feel guilty for struggling.”Education helps them understand that trauma affects physiology, not love.

2. Create a Safe Feeding Environment

Dim lights
Quiet spaces
Predictable routines
Option to stay covered
Supportive partner presence
No forced latching

Safety equals oxytocin.

3. Use Trauma-Sensitive Positions

Side-lying (less pressure)
Laid-back (less intensity)
Football hold (less chest-to-chest contact)

Autonomy in choosing positions reduces triggers.

4. Support Body Autonomy

Mom controls start/stop
Permission to take breaks
Permission to pump instead if safer
Use of nipple shields if helpful
Flexible feeding goals

Trauma survivors need agency restored.

5. Mind–Body Supports

Grounding exercises
Deep breathing during let-down
Somatic therapy
Craniosacral therapy
Yoga
EMDR for trauma

These help regulate the nervous system.

6. Encourage Mental Health Support

Studies show that trauma-informed therapy significantly improves breastfeeding continuation and maternal well-being (Sperlich & Seng, 2008). Encourage:

Perinatal mental health counseling
Christian/biblical counseling if preferred
Trauma-informed IBCLC support
PMAD screening

7. No Shame if Weaning Becomes Necessary

A healthy mother–baby relationship is more important than exclusive breastfeeding.A fed, safe baby and a mentally well mother are always the priority.

Important Evidence: Sexual Abuse Survivors Are Not Likely to Abuse Their Children

Many mothers with a history of childhood sexual abuse (CSA) secretly fear that their trauma will somehow predispose them to harm their own children. This fear is heartbreaking - and not supported by evidence. Research consistently shows that the vast majority of CSA survivors do not become abusers (Widom & Ames, 1994; Berliner, 1997). While trauma can influence emotional responses, survivors overwhelmingly parent with greater protectiveness, empathy, and consciousness around safety (DiLillo & Damashek, 2003). Studies indicate that the intergenerational cycle of sexual abuse is very rare, with rates far lower than popular belief - often less than 5%, depending on the cohort studied (Bottoms et al., 2001). In fact, survivors who receive support, therapy, or healing interventions are even less likely to perpetrate harm (Hall et al., 1998).

In other words, being abused does not make a mother dangerous - it makes her a survivor who deserves compassion, support, and reassurance. This myth has caused deep shame for many women and deserves to be put to rest with evidence, truth, and grace.

Conclusion: Trauma Doesn’t Define Motherhood

Trauma does not disqualify a woman from breastfeeding. It does not mean she is broken or incapable. It means she has survived something hard - and that survival shapes her body’s responses. With trauma-informed care, compassionate support, and appropriate mental health resources, many mothers successfully breastfeed, heal emotionally, and bond deeply with their babies.

Breastfeeding can be part of healing - but even if a mother chooses another feeding path, she remains a good mother, worthy of support, love, and grace.

References

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