By Kathleen Kendall-Tackett, PhD, IBCLC, member of API’s Resource Advisory Council and API’s Editorial Review Board, adapted from Breastfeeding Made Simple by Nancy Mohrbacher and Kathleen Kendall-Tackett

For survivors of childhood sexual abuse or sexual assault, breastfeeding can pose challenges. Unfortunately, sexual abuse and assault are relatively common experiences, affecting 20% to 25% of women. The reactions of abuse survivors to breastfeeding run the whole range of responses – from really disliking it to finding it tremendously healing.

Surprisingly, research has shown us that abuse survivors are more likely to breastfeed. The two published studies on this topic showed that abuse survivors had a higher intention to breastfeed and a higher rate of breastfeeding initiation. Our research has also shown that a higher percentage of mothers who were abuse or assault survivors were breastfeeding compared with mothers without a trauma history. We have also found higher rates of Attachment Parenting behaviors, such as bed-sharing, among the abuse and assault survivors.

If you are an abuse survivor who wants to breastfeed, I congratulate you for making a positive life choice to overcome your past and parent well. However, there still may be some difficulties you face as you breastfeed your baby or child. If you are having a difficult time, here are some suggestions that might help:

• Figure out what makes you uncomfortable – Is it nighttime feeding? Is it your baby touching other parts of your body while nursing? Is it when the baby attaches to your breast? Or all of the above? The intense physical contact of breastfeeding may be very uncomfortable for you. You might find breastfeeding painful, because your abuse experience lowered your pain threshold. The act of breastfeeding may also trigger flashbacks.
• Can you address the problem? – If skin-to-skin contact is bothering you, can you put a towel or cloth between you and the baby? Can you avoid the feedings that make you uncomfortable? Nighttime feedings are often good candidates. Would you be more comfortable if you pumped and fed your baby with a bottle? Can you hold your baby’s other hand while breastfeeding to keep her from touching your body? Can you distract yourself while breastfeeding with TV or a book? Several mothers have shared with me that works well for them. Experiment, be flexible, and find out what helps.
• Remember that some breastfeeding is better than none – You may not be able to fully breastfeed, but every little bit helps, even if you must pump milk and use a bottle or if you are only breastfeeding once a day. Some abuse survivors find that they never love breastfeeding, but they learn to tolerate it. And that may be a more realistic goal for you.

Past abuse does not have to influence the rest of your life. I know many abuse survivors who have become wonderful mothers. I’m confident that you can, too. Nurturing your baby through breastfeeding is a great place to start.