Breastfeeding
Evidence suggests that autistic people may experience aspects of breastfeeding differently to non-autistic people. Knowing that you are autistic and having strategies to communicate your specific needs can be helpful.
Autism and breastfeeding
Breastfeeding can pose challenges for anyone. The NHS advise that you should not ignore any issues you are having and speak to your health visitor, midwife, GP or breastfeeding specialist as soon as possible so they can help you.
Evidence suggests that autistic people may be more likely to face certain challenges, including:
- sensory sensitivities and sensory overload
- this could be due to being touched more than you are comfortable with or used to, by your baby or by nurses, for example
- triggers can include milk let-down (the reflex that allows breastmilk to flow), and sounds and sucking sensations made by your baby
- some people may feel pain due to hypersensitivity to touch
- some people may be less sensitive to pain and therefore not realise that their nipples have become damaged, for example
- health professionals may not understand autistic needs, leading to misunderstandings and/or inadequate support
- for example, being expected to take in long lists of verbal instructions without these also being provided in a more accessible format, such as a written list
- lack of sleep and uncertainty can disrupt your coping strategies
- discomfort with uncertainty may lead to a lot of time spent researching breastfeeding.
Challenges around breastfeeding can impact autistic people in various ways, including:
- being touched more regularly than they are used to can be overwhelming and lead to shutdowns or meltdowns, or the autistic person might mask their discomfort, which can lead to autistic burnout
- an increased likelihood of meltdowns due to feeling overwhelmed by anxiety, frustration or stress – for example, because:
- your baby is struggling to latch on
- your schedules and routines are disrupted by feeding your baby on demand
- becoming intensely focused on breastfeeding and researching breastfeeding to the exclusion of doing other things.
Strategies for self-management
Autistic people have suggested various self-management strategies, including:
- go to a room with no bright lights or other distractions to help you remain calm while breastfeeding
- deliberately distract yourself while breastfeeding – by watching TV, reading, listening to the radio or a podcast, or by looking at your phone, for example
- use a nipple shield to create a boundary between your breast and your baby
- ask someone else (such as a partner, family member or friend) to hold the baby while you breastfeed
- give yourself time to adjust to new sensory sensations
- give yourself permission to try alternatives such as pumping breastmilk or using formula (or a combination of these) some or all of the time if breastfeeding becomes too painful or distressing.
Support strategies
Healthcare professionals can lack an understanding of how breastfeeding might be experienced differently by autistic people. It is important for perinatal services to understand autistic experiences of breastfeeding in order to provide accessible support.
To support autistic people breastfeeding, healthcare professionals are advised to:
- listen to what the autistic person is communicating about their particular experience, which may be different to non-autistic people
- use clear, direct and unambiguous communication, and allow time for processing and responding
- ask permission before touching them when possible and explain exactly what you are going to do, without euphemism
- check frequently that they are OK and happy to continue
- understand that being touched without consent can lead to shutdowns or meltdowns, or the autistic person might mask their discomfort, which can eventually lead to autistic burnout
- ask them about their sensory sensitivities and accommodate adjustments to the sensory environment, considering lighting, sounds and smells
- provide opportunities for movement – for example, the use of a birthing ball or rocking chair
- ask them about and/or assess their learning style and tailor teaching and instruction methods, considering audio (in person or recorded speech), visual aids (illustration, photos or video) and the use of props or physical guidance
- ask them about and accommodate their communication preferences, for example:
- telephone calls can be inaccessible, so provide a text-based way of requesting support
- individual support may be more appropriate than group-based settings
- use alternative communication methods – for example, one finger raised for yes and two fingers raised for no.
Despite the additional challenges some autistic people face with breastfeeding, it is important to note that many do want to breastfeed and can do so successfully. Healthcare professionals should ask them what their breastfeeding goals are and support them as much as possible to pursue them.
“Allow yourself to feed your baby in whatever way works best for you. While there are many benefits to breastfeeding, if it is painful or causes you to experience sensory overwhelm, then give yourself permission to pump breastmilk, formula-feed or use a combination of both.”
– Linda Hollenberg, Reframing Autism
“Motherhood – and even more so when you're breastfeeding as well – is a sensory shock for many autistic people, when you are used to being able to control, for the most part, how much sensory input you get on a day-to-day basis, and a baby comes along who wants to be near you the entire time, who is feeding, crying, creating noxious smells, puking and pooping.”
– Yo Samdy Sam, Being an AUTISTIC mother: what’s it like?
“Breastfeeding as an autistic parent is complicated, but it is fair to say that a large number of autistic people want to breastfeed despite the unique challenges we face. … I was told many times to give up breastfeeding by professionals who I expected support and encouragement from. They were way too quick to recommend the bottle without any attempt to understand what I was experiencing as an autistic breastfeeding mother. If perinatal services understood that breastfeeding is a very different experience for autistic people, they would be able to provide accessible and relatable support for autistic breastfeeding parents.”
– Esther Whitney, Autistic Parents UK
-
- Autism Services Directory: for services and support
- Branches: offering support, information and social activities for autistic adults, children and their families in their local areas
- Community: our online community is a place for autistic people and their families to meet like-minded people and share their experiences
-
- NHS – Breastfeeding
- NHS Inform – Breastfeeding
- NCT – Breastfeeding support
National breastfeeding helpline: 0300 100 0212
-
Research
Author: Wilson and Andrassy (2022)
Title: Breastfeeding experiences of autistic women
Source: MCN, American Journal of maternal Child Nursing, 47(1).Author: Hampton et al (2021)
Title: A qualitative exploration of autistic mothers’ experiences II: Childbirth and postnatal experiences
Source: Autism, Volume Online First:1.Author: Grant et al (2022)
Title: Autistic women’s views and experiences of infant feeding: A systematic review of qualitative evidence
Source: Autism: The International Journal of Research and Practice, Volume Online First:1.Professional practice
Author: Kalie VanDewater and Aimee Grant (2022)
Title: Q&A: Autistic mothers experience ‘exacerbated’ breastfeeding challenges
Source: HealioAuthor: Clare Farquhar, accessed August 2022
Title: Breastfeeding if you are on the autism spectrum
Source: The Breastfeeding NetworkAuthor: Breastfeeding Network, 2022
Title: Mums Supporting Mums
Source: Breastfeeding NetworkAuthor: Stiller and Yate (2021)
Title: Considerations of Sensory Sensitivities of Adult Women on the Autism Spectrum During Lactation
Source: Clinical Lactation, Volume 12 (4): 7 – Nov 24, 2021Lived experience
Author: Esther Whitney, 2022
Title: Personal Account: Breastfeeding as an Autistic Parent
Source: Autistic Parents UKAuthor: Lucy Parker, 2019
Title: The truth about being autistic and a mother
Source: MotherlyAuthor: Yo Samdy Sam, 2019
Title: Being an AUTISTIC mother: what's it like?
Source: YoutubeAuthor: Linda Hollenberg, 2021
Title: The Autistic Doula: Navigating the sensory challenges of motherhood
Source: Reframing Autism