Kathleen Kendall-Tackett, PhD, IBCLC, FAPA examines how exactly caring for ourselves is caring for others.

Compassion fatigue

Compassion fatigue can be described as a form of burnout that affects people in caregiving roles.

A grassroots champion of breastfeeding and colleague of mine was shocked to see how beaten down and discouraged the members attending her local breastfeeding coalition meeting were. I’ve seen that too.

I have thought about this issue with particular regard to the field of lactation consultancy and breastfeeding advocacy because this is something my colleagues and I may be particularly vulnerable to.

Think about it.

Many of you may be in that field—or in other roles as carers or volunteers—fighting uphill battles. You are frequently the only one doing the work. Many of you are in danger of losing jobs because the skills you offer are not valued. In the breastfeeding field, you may get labeled as a fanatic (or worse) because you care about mothers and babies. And then there is the issue of pay …

Health Care_Caring For OurselvesIn some ways, we may have brought this on ourselves Thinking about the history of the lactation field, many of us came in as volunteers. We work with mothers and babies because we love to. We want to make a difference. I started my work in breastfeeding as a volunteer. I was a La Leche League (LLL) Leader for 18 years, and took on many roles in that capacity, eventually becoming Area Coordinator of Leaders for LLL of Maine and New Hampshire, and serving on the international board of directors. I’ve spoken at LLL conferences throughout the U.S. and Canada, and in many other parts of the world, so I have seen firsthand the amazing work these volunteers have done. I wouldn’t trade that experience for anything. I’ve made many lifelong friends, and entered a field that I never expected to be in.

Because we cared so much, we often did whatever it took to meet the needs of mothers and babies. For example, many of my fellow LLL Leaders had bake sales to buy copies of Medications and Mothers’ Milk¹ for all their local doctors—great activity, but something is wrong with that picture.

Without those countless volunteer hours, we would not have lactation consultants. This work is a real force for good in the world. But it often comes at a high cost that involves devaluing ourselves and not practicing regular self-care.

In the midst of compassion fatigue, time—or, more specifically lack of time—becomes the enemy. To compensate, caregivers may try to do several things at once, for example eating lunch while catching up on case files. Practitioners, who may be struggling with it too, cut out activities, such as exercise or spending time with family and friends.

The results of compassion fatigue are often:

  • depression
  • anger
  • blaming
  • a diminished sense of personal accomplishment
  • exhaustion
  • hopelessness
  • irritability
  • sleep disturbances
  • cynicism

All or any of which can lead to substance abuse or other self-destructive activities.

If any of this sounds familiar, you are not alone.

Nurse / doctor upset sad crying

Compassion fatigue is NOT a character flaw. It’s often people who care the most that are the most prone to it.

Trauma experts Charles and Kathleen Figley describe why caregivers need to take time to care for themselves. Trauma workers, for instance, cannot sustain their work if they are not diligent about their own needs. In fact, a caregiver who does not practice self-care can become impaired. So we owe it to ourselves and those we serve to become aware of this issue.

Recommendations from a trauma expert

Christina Simantiri

According to Charles Figley, we need to make a specific commitment to self-care. Figley said that when helping others, we should first do no harm to ourselves. Second, we need to attend to our physical, social, emotional, and spiritual needs as a way of ensuring high quality in the services we offer to those who look to us for support.

Figley recommends that we make a formal, tangible commitment to our self-care.

  • Put it in writing
  • Set deadlines and goals for self-care activities
  • Develop specific strategies for letting go of work during time off
  • Embrace rejuvenation activities that are:
    • fun
    • stimulating
    • inspiring
    • and that generate joy
  • Set tangible goals for acquiring:
    • adequate rest
    • exercise
    • eating well
  • Set reasonable limits on what we take on
  • Practice saying “no” once in a while
  • Don’t be so quick to volunteer for everything—let someone else have a turn
  • Find supportive people, particularly peers
  • Find a self-care buddy and hold each other accountable
  • See The Caregiver’s Bill of Rights 
  • Know when to ask for help

I know it’s hard, but you can do it!


If the groups you work with are suffering from compassion fatigue, maybe you can address this issue as a group? You can also join with local and national groups to advocate for the pay you deserve.

Charles Figley, in talking about disaster relief following Hurricane Katrina, noted the following.

“The main thing with regard to self-care is that those who are selfless and compassionate have an Achilles heel—they don’t pay enough attention to themselves. So we have to save them from themselves. The people who are drawn to [social work] are extraordinarily vulnerable to compassion fatigue. The same is true for the faith community, for nurses, even certain specialties within the military, and Red Cross volunteers. There’s a tendency to be selfless and to help other people. So they have to recognize that they’re more vulnerable than most people because they neglect their own needs.”

In short, self-care is not selfish. It’s the thing that will allow you to continue in your work.

Medications and Mothers' Milk¹ Medications and Mothers’ Milk by world-renowned Clinical Pharmacologist, Dr. Thomas Hale is the drug reference on the use of medications in breastfeeding mothers and provides what is known about the transfer of various medications into human milk in breastfeeding mothers.

Kathleen Kendall-Tackett, PhD, IBCLC, FAPA

Read her biography here.


Buy it here

20–25% of women have been sexually abused, 25% have experienced intimate partner violence, more than 50% of adolescent mothers have experienced childhood sexual abuse, an untold number have experienced birth trauma.
How likely is it you don’t know someone who has experienced some form of abuse?