Este artículo en Español –> https://yournaturalbirth.co.uk/2015/10/26/por-que-la-mayoria-de-las-mujeres-no-pueden-amamantar/Breastfeeding versus Formula Feeding is a hot debate. Mothers feel judged, whether they choose to breastfeed or not, and we are in the midst of Mommy Wars. Mothers who breastfeed feel like society shames them for feeding in public. Mothers who formula feed feel like they are lambasted by lactivists for ‘being lazy’ or even ‘poisoning‘ their child. I’d like to shed some light on why so many mothers cannot breastfeed.
Only an estimated 1-5% of all women have the inability to produce enough milk for their baby. Even fewer, around 2% of women, cannot physically lactate or have problems that lead to the inability to breastfeed (child has a cleft palate, mother has glandular tissue problem, etc). From the rest of the 95% of mothers who have the ABILITY to breastfeed, 81% of mothers try to breastfeed, 17% are still exclusively breastfeeding at three months, and then it drops to 14% at four months. Exclusive breastfeeding at 6 months is only 1% in the UK (From the NHS 2010 Infant Feeding Survey). Is breastfeeding really so difficult? In our society, yes it is.
Our society doesn’t see breastfeeding as the norm. Mothers don’t get the support they need. The reason why most women can’t breastfeed is because they are missing these 3 essential things for successful breastfeeding.
Here are 3 Things that Women Need in Order to Breastfeed (if baby doesn’t latch on right away):
1. A Strong Desire to Breastfeed. There are many reasons to breastfeed: bonding, less expensive, more convenient, lose weight faster, healthier for baby, etc. If you don’t really care to breastfeed, you’ll probably end up giving formula.
2. A Good Support Network. If your baby doesn’t latch on right away, establishing breastfeeding is HARD. Sometimes it’s painful. Most of the time, it’s tiring from tending to your baby every 15 minutes to every hour just to feed. It’s embarrassing for some, since our society doesn’t embrace public breastfeeding. Other times, the baby isn’t gaining weight fast enough for your doctors. If you don’t have a good husband, partner, mom, sister, friend, or community group (La Leche League) telling you you’re doing the right thing to keep at it, you’ll probably start supplementing with formula and then maybe switch to formula full time.
3. Access to Good Breastfeeding Experts. There are good experts and there are bad ones. When I was struggling with breastfeeding, I called the local LLL leader and she came to my house the very next day after I called for help. She was able to give me moral support and recommend a lactation consultant. That lactation consultant was able to identify a submucosal tongue tie as well as a lip tie and was able to recommend a dentist who did multiple tongue and lip tie cuts every day! Plus, my insurance covered almost all of it! Sadly, some experts won’t be able to find the problem and can’t help a mother in need. And other people don’t have access to or can’t afford procedures that might be needed to establish breastfeeding. Don’t trust the hospital midwives, nurses, or doctors to give you advice on breastfeeding! Always find a LACTATION CONSULTANT. Hospitals advise ‘topping up’ with formula which leads to the Top Up Trap.
In order for a mother to breastfeed if baby doesn’t latch on right away, she would have to have all three of these things. To start, if a mother doesn’t have a strong desire to breastfeed, she will most likely switch to formula before pursuing other options (so they dropped off at #1). Others who have that strong desire personally may have been told by their husband, parents, or friends that they didn’t need to ‘suffer’ through breastfeeding and begin to believe that formula is ‘just as good’ (didn’t have #2). And if the mother had the support, but didn’t have good lactation consultants, found them too expensive, or needed procedures done that weren’t accessible (tongue tied or lip ties), they switched to formula. Sometimes mothers are given BAD advice (topping off with formula), giving supplements with bottles (nipple confusion), and lose milk supply due to the advice given. Mothers also don’t realise that how much you pump isn’t a good indicator of how much milk you are producing. There’s a huge misconception about milk supply, how it works, and how it can be measured.
It’s rare to have all three of these things. So even though 95% of women can physically breastfeed, this is why only 1% of mothers can establish breastfeeding for up to 6 months (even though WHO recommends exclusive breastfeeding up to 6 months and supplemented breastfeeding with food up to 2 years or beyond). There are factors outside a mother’s control that play into breastfeeding successfully, so even if you strongly desire to breastfeed, you may not be able to establish or continue to breastfeed without good support and good breastfeeding experts.
Some examples of POOR ADVICE given by “experts” are,
- “The baby is losing too much weight, you’ll have to supplement with formula.” This is wrong advice, because the best food for babies is breast milk, so a professional would recommend pumping in between feedings and supplementing with pumped breast milk.
- “It’s been two weeks and your baby is not back to his birth weight, it’s time to supplement with formula.” As already mentioned above, it is better to pump breast milk than right away go with formula. And secondly, this timeline doesn’t fit all babies. Some babies may take a bit longer to gain weight. Other babies were bloated from the extra fluid (received from the mother receiving IV fluids during labour and birth) that their birth weight was elevated (false). This is especially true for c-section babies. For more info on maternal fluids and birth weight click here. Remember, each baby is different, and experts need to be looking at other factors that may indicate failure to thrive. If developmentally, socially, and emotionally the baby is doing well, then the actual number when it comes to weight may not be something you have to worry about. In some cases, it may take up to 4 weeks for the baby to be back to birth weight.
- “The baby shouldn’t be feeding every hour, he must not be getting enough milk, you should top off with
formula.” Newborns’ stomachs are so small that feeding every 15 minutes is a variation of normal! Some newborns are efficient sucklers, so they may only need to be on the breast for 5 minutes and then sleep for several hours. Other newborns are still figuring out how to suckle and may be on the breast for 1 hour, sleep for 15 minutes, and then be up again to eat. Real signs to look out for are if it feels painful. Breastfeeding shouldn’t be painful. It may be uncomfortable for the first few seconds of latching, but the discomfort should go away. If discomfort or pain persists, seek a lactation consultant to see if there is a tongue tie, lip tie, or suggestions for different positions to improve the latch.
- “The baby shouldn’t use your breast as a dummy, it should be for feeding only.” Giving a newborn a pacifier (dummy) may cause nipple confusion, which makes latching onto the breast more difficult. Giving a newborn supplemental formula with a bottle also may cause nipple confusion. The way their tongue functions is completely different when sucking on a bottle compared to the breast. Newborns often enter a “fourth trimester” after birth and sometimes the only thing that comforts them is the mother’s breast. This is normal and should not be denied or substituted; plus, this best regulates a mother’s milk supply. (The b
est way for a mother to produce enough milk for a baby is by demand, putting the baby to the breast as often as he wants it).
- “If you’re not sure how much your baby is getting, try pumping instead to see how much milk you can produce.” Breast pumps are not as efficient as the baby. They cannot get out as much milk as a baby, and they don’t stimulate the breasts as well as the baby to signify to the mother’s body to produce more or less milk. If you’re worried that your baby isn’t getting enough milk from breastfeeding, don’t use pumping as a measurement of what you can produce. Instead, count your baby’s wet diapers.
What do I do if I’m struggling with breastfeeding? First, figure out why you want to breastfeed. Read 101 Reasons to Breastfeed to give you more determination and knowledge if you feel you are lacking. Second, find a good support network. If your husband, mother, or friends don’t support you, contact your local La Leche League or Breastfeeding Facebook Groups! Third, find a good, highly recommended lactation consultant. And Fourth, if you’ve done all three and still struggle, I encourage you to pump or express your own milk. In the WHO’s Global Strategy for Infant and Young Child Feeding, it recommends:
- Milk from own mother by breastfeeding,
- Milk from own mother, expressed,
- Milk from a wet-nurse, or
- Milk from a milk bank, or
- Breastmilk substitute fed by cup
In case you didn’t catch that, “Breastmilk substitute” (formula) is the last recommendation for feeding your baby. I have been so encouraged by fellow mums who couldn’t breastfeed due to cleft palate or other reasons but chose to pump and exclusively bottle feed their own pumped milk. Life doesn’t get more hectic than pumping every three hours and then bottle feeding your baby (You know who you are, and you are a hero)!
If you are pregnant and preparing to breastfeed your baby, you can work on establishing these three important factors to best ensure breastfeeding success right now!
What do you think? Do you agree? Where did you struggle with breastfeeding?