A recent clinical miss for me was waiting too long to have “the talk” with a pregnant client whose baby arrived early.

A few years ago, I began noticing a pattern: Clients who were six to 12 months postpartum were coming into session describing unexpected shifts in mood and anxiety. We would search through possible triggers. Then it hit me: Breastfeeding might be playing a role. My clinical education hadn’t prepared me to assess breastfeeding experiences at all, and I didn’t see other providers asking my clients about it either. These clients would see their OB-GYNs and return with no more answers than before. In some cases, physicians even told them that changes in nursing or weaning don’t actually affect Mental health, making them feel like it was “all in their head.”

The Hidden Toll of Early Feeding Struggles

At the same time, I began seeing more clients struggle with the emotional impact of early breastfeeding difficulties. Research shows that for parents whose breastfeeding experiences instigate worry, fear, anger, and anxiety, there can be a considerable emotional toll. While many studies focus on how these emotions influence breastfeeding duration, what matters most in therapy is that my clients are often navigating intense, uncomfortable, and unfamiliar emotional states.

Breastfeeding, nursing, chestfeeding, bodyfeeding—all are terms for feeding an infant breast milk. Parents may feed directly from the breast or provide expressed milk through a pump and bottle. They may exclusively feed with breast milk, supplement with formula, or breastfeed for any length of time. All of these scenarios are clinically relevant and deserve space in therapy, yet we’re still battling the legacy of “hysteria” and systemic bias when it comes to integrating women’s health into Mental health care.

Hormones That Heal (and Hijack?) Your Mood

Neuroendocrine alterations—hormonal shifts that occur during nursing—can have significant mental-health effects. Two key hormones involved in breastfeeding are prolactin and oxytocin. When an infant latches, the pituitary gland secretes prolactin and oxytocin. Oxytocin, often called “the love drug,” causes milk to release and can also contribute to feelings of connection and pleasure.

The Unexpected Emotional Side of Feeding Your Baby

In psychoanalytic and attachment theories, feeding plays a central role in shaping early relational experiences. A mother’s sense of identity and competence is closely tied to her ability to nourish and care for her baby. Meanwhile, the infant’s earliest experiences of safety and bonding unfold as their needs are met consistently by their caregiver.

“If I could wave my magic wand, every family would automatically receive comprehensive and individualized lactation and infant feeding support, not only after the baby is born, but during pregnancy and throughout the postpartum period.”

Kyle Vereyken, a certified lactation counselor, perinatal educator, and full spectrum doula, highlights the gaps in care she sees daily when supporting new parents.

When considering what support to seek, Vereyken advises, “It’s really important to find a lactation support professional that you feel comfortable with. Postpartum can be such a vulnerable time, so finding someone that is supportive, non-judgmental, and who is wholly on board with your own values and goals is key.”

The Questions Therapists Avoid, but Parents Desperately Need

Here’s my approach. By the third trimester, I explore these topics, starting with broad, open questions:

• What have your thoughts or plans been for feeding your baby?
• Who have you seen in your life, real or fictional, who has influenced your understanding of feeding a baby?
• What are your hopes for feeding your baby? What about your fears?
• Based on your answers and goals, let’s talk about support options, because anyone who wants to try to breastfeed would benefit from care. (Some options include prenatal lactation classes, home visits, lactation consultants, lactation peer groups, social support, and more.) Let’s figure out what feels best for you.

From here, we shape a referral plan together, adapt therapy to the feelings that come up, and agree to return to this topic as the pregnancy moves forward.

Vereyken explains, “I think it can be helpful to frame breastfeeding/chestfeeding as a skill, and like learning anything new, it can take time to figure out. Not only is it a new practice for the parent, but for the baby, too. I like to think about it as a relationship and ability that both baby and parent are figuring out and learning together.”

Despite this reality, structural support for breastfeeding parents is deeply inadequate. Accessing help often requires significant self-advocacy, organization, and emotional labor, all during a period when parents are most vulnerable.

When AI Becomes Your Lactation Consultant

Increasingly, people turn to chatbots and LLMs like ChatGPT to fill these gaps, or to social media where wellness influencers offer advice with varying levels of accuracy. These tools can be helpful, but they do not replace human connection. Recognizing the limitations of virtual or chatbot tools early allows parents sufficient time to determine, both emotionally and practically, the type of support they might want to pursue.

This is where therapists have a critical opportunity to ask neutral, caring questions that often go unasked:

• Do you like breastfeeding?
• What is the hardest part for you?
• What do you feel most proud of?
• Does it bring up any emotions that feel particularly intense?
• If you could change anything, would you?

When Weaning Feels Like a Psychological Freefall

Understanding the intertwined roles of hormones, attachment, psychology, and identity in breastfeeding helps clarify why weaning, the shift from breastfeeding to other foods and liquids, can be emotionally charged or destabilizing. Yet the hormonal and psychological impacts of this transition are often dismissed. Therapy is one of a few important spaces where these experiences can be validated and supported and critical referrals can support the parent.

Closing the Care Gap: What Clinicians Must Do Now

We can show up where systemic support falls short and help clients build individualized plans that align with their needs, values, and goals. When we integrate conversations about feeding, hormones, and emotional well-being into therapeutic care, we not only normalize these experiences, we empower parents to navigate them with far more clarity and support.

To find a therapist, please visit the Psychology Today Therapy Directory.