The overzealous push to get all moms to breastfeed

Mommy wars aside, I think you’d have to be living under a rock if you haven’t heard the enormous and real benefits of breastfeeding. Breastfeeding is awesome on so many levels. Health of baby and mom alike. Both physical and emotional.

But, what if it doesn’t work? What if you’re a mom (like me) who couldn’t produce enough milk? Hardly any in my case.

What if you’re an adoptive parent or your baby has latch issues, or a medical condition precludes you from exclusively breastfeeding?

What if you simply (gasp) choose not to breastfeed?

What then?

Ask any mother or parent who found themselves in one of the above scenarios.

What you get is a pile of guilt, shame, and unnecessary judgement from the well meaning masses of breastfeeding advocacy.

It’s not necessarily the advocacy, the education, or the support that ends up hurting these moms. It’s the trickle down effect of our overzealous push to get all moms to breastfeed.

Moms are continuously just told to keep at it, it will come. Don’t worry, you two will get a hang of it. Don’t give up, your baby doesn’t need anything else. Don’t give your baby a bottle or pacifier. If you keep trying really hard, you will succeed. Here’s your baby, start breastfeeding. If you can’t, here’s a pump, now get to it.

Now, perhaps for first time breastfeeding mothers without any of the above obstacles, this advice would suffice enough.

But this doesn’t work for everyone and those women who truly need guidance, support, and well informed medical experts will never get anything beyond the above remarks and this is a real problem.

An underestimated and real problem.

Moms and babies will suffer. Feeding becomes a time of angst and guilt instead of a time of peace and love.

I went through 3 lactation consultants before finding one that could help me. I still thank God for her. She diagnosed my IGT and helped me more than she’ll ever know. But, many others will go unrecognized. They’ll be left feeling like they’ve failed their child because breastfeeding is the most natural thing in the world and every mother should be able to do it.

The unfortunate reality is that by declaring breastfeeding a public health issue and pressuring hospitals and medical personnel to encourage breastfeeding, it’s like putting the cart before the horse. Women need more than words. They need more than study after study declaring breastmilk and breastfeeding as the superior way to feed your baby.

They need real action. Real support by having access to certified lactation consultants who know how to diagnose and treat milk supply issues and latch problems. It’s why I’m thankful for breastfeeding advocacy groups such as Best for Babes and The American Academy of Breastfeeding Medicine that are making strides to do just that.

I support trying to make some headway with maternity leave and making the workplace more conducive for breastfeeding and pumping mothers.

But if you have never heard of Insufficient Glandular Tissue (IGT), low milk supply, baby latch issues due to tongue tie, or have never even considered these issues in a mother struggling with breastfeeding, please never casually say, “Just keep at it, it will happen.”

Because for many, it won’t.

It didn’t for me. And while my story is merely an anecdote in the great sea of successful breastfeeding mothers, there are others out there like me. Thousands actually. But no one has studied us. No one has taken our collective anecdotal stories and compiled them into evidence for the world to see.

We often suffer in silence. Riddled with shame and guilt. And all we want is to feed our babes in peace, the best way we are able to.

Yeah, we may use formula and bottles. But for heavens sake, we are not poisoning our children. We did not give up.

Our babies will still thrive and grow up healthy and smart in our loving arms.

And we don’t need a study to prove that.

Melissa Arca is a pediatrician who blogs at Confessions of a Dr. Mom.

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  • J Manitou

    Though I had read every book imaginable when I was pregnant, including an entire Dr. Sear’s Breastfeeding book, I was clueless when I was handed my newborn son. At hour 18, with absolutely no interest in the boob or sucking on anything so began two weeks of breastfeeding craziness. Our two hour start to start cycle went something like this: attempt to get non-latching baby to latch (including ‘gently’ ramming baby’s head onto the breast, trying out all possible holds, fiddling with the pillows and fiddling with the pillows some more), finger training baby’s rooting reflex, blowing forcefully onto our tiny jaundiced newborn’s skin: ‘WAKE UP BABY, SUCK, YOU CAN DO IT LITTLE GUY’, pumping (my trusty Peter and Paul (aka: suction cups)), then finger or tube feeding the minuscule droplets of colostrum, transition milk, and finally full milk, all while blowing on our baby, wiggling his chin and praying the support pillows didn’t move. With 25 minutes left until the cycle started up again, why sleep? I survived the first 8 days with an hour and a half of sleep each day. It was an out of body experience and one that I was completely unprepared for.

    After two weeks of insanity and twenty different pairs of hands on my boobs, we finally got the hang of it, prop-free. We would not have ‘made it’ without the daily lactation consultant visits during those two weeks. For so many new moms access to certified lactation consultants is not easily available. Their services are essential.

    Of the two dozen mom friends with whom I have had the pleasure of swapping breastfeeding stories, I can easily say that at least twenty have experienced significant breastfeeding issues: no milk (pumping, domperidone, you-name-it-herb), IGT, cracked nipples, incredible pain from a poor latch, blocked duct, no latch, tongue-tied, premie, etc. When I meet a mom who is not breastfeeding, I don’t need to ask why, for whatever the reason is, there is a reason. I look at the beautiful baby in her arms, the loving gaze in her eyes as she looks into their little eyes, and as time goes by the incredible, thriving, healthy child running around in the school yard.

    As a final note, I thank my mother-in-law for the amazing, incredibly talented, smart, loving, bottle-fed husband I have.

  • http://www.twitter.com/alicearobertson Alice Robertson

    I, too, couldn’t breastfeed…desperately wanted to…and I gave birth to six children. But I think the best angle to take is to agree. Yeah, breastfeeding is the best…the very best and every mother should try her hardest to breastfeed if it’s at all possible…if not bottle fed with gratitude. Very few moms genuinely can’t breastfeed, so encourage them to nurse their babies, while displaying regret you couldn’t (I am not defensive about it). . I read the most important aspect is the eye contact. I, agree, with the group that shares that the government should be out of the purchasing of formula for moms when 90% of them could be nursing.

    My kids are mostly grown now…so I am in the comfortable zone of having my youngest turning sixteen years old and knowing they did well without nursing. Just don’t go peeking at the militant breastfeeding sites….wowwee:) I read a parody once from a frustrated mom who said she dreamed one night she was in prison. While at group therapy they each had to confess their crimes aloud. Her crime? She had bought store bought bread! Ha!

    • Anti-lactivist

      “While displaying regret that you couldn’t”. I’m sorry but that is opposite to the point of the article. We should not encourage mothers to feel guilty or regret because they could not breastfeed. As a physician, I understand there is some benefit to breastfeeding but if you can’t breastfeed then your baby will be just fine. It is not like you are feeding your baby bottles of soda when you give a baby formula. Women already have so many other reasons to feel guilty lets not add too them.

  • http://twitter.com/nicu_doc Christopher Nitkin

    As a pediatric resident and future neonatologist, I’ve been trained as you’ve written above, to be “baby friendly,” and have been encouraged to strongly question any mother who chose to formula feed. I have the luxury of working at a dedicated children’s hospital where lactation consultants are a click or a phone call away and apart from “poor latch,” I have precious few tips or knowledge on how to actually breastfeed an infant.

    I appreciate you sharing your story and educating me, as well as the entire KevinMD community, on something I knew little about (on top of the fact that, as a male, I probably won’t be breastfeeding myself!). And although the evidence definitely supports “breast is best” and I encourage breastfeeding, I’ll be inclined to investigate a little more if a mother seems frustrated and unable to do so. As a final thought, I’m adopted so grew up on formula (and not the fancy stuff they have now!) – I’d like to think that I turned out pretty well :) Thank you!

  • Tasha van Es

    I could write a book on this topic. Suffice it to say, I struggled with breastfeeding for both of my children, and very much wanted this to be our path. I had a very supportive husband, worked with several lactation consultants, read everything I could, located medications… But it just wasn’t tenable (though I tried for months with each child), and I went through incredible feelings of failure and grief both times – yes, grief – when I ultimately switched to formula. It wasn’t supposed to be that hard, right?

    I would love for someone to study the stories of my efforts with both kids, rather than have lingering feelings that I couldn’t do enough. At least that way, it would help some other mother/parents down the road. And I definitely would appreciate some greater understanding from the advocates who either did make it through their troubles, or those who never had them to begin with…

  • http://www.facebook.com/laura.mitchell.3781 Laura Mitchell

    The way baby friendly has been implemented in this country is appalling. What baby friendly is about is NOT accepting freebies from the formula companies and treating formula like any other hospital supply and PURCHASING it. It’s not about totally eliminating formula for normal newborns. On the other side of the coin, we have the “Nipple Nazis,” who, in many cases, intimidate women into breastfeeding. I once had a patient who told she didn’t want to breast feed, but everyone in her family expected it of her.

    Admitting a patient to OB, breast or bottle feeding is a standard question. Many of our Hispanic patients said they would do both (Mexican Hispanics may believe that colostrom is bad and bottle feed until their milk comes in. Personally, I’ve never seen a “nipple confused” Hispanic baby). I would tell my patient I would support her decision, no matter what. A lot of my patients would be going back to work in a few weeks, and let’s face it, the US is not a particularly breast feeding friendly culture, especially in the work place. I don’t really care how a baby gets fed, as long as the baby gets fed. And sometimes, just breastmilk is not enough.

    And I ended up doing both.

  • Antonia Sears

    Thank you for writing this! I too am one of those mothers who had very little milk, not enough to sustain my son who, at two weeks was below his birth weight despite me nursing round the clock, pumping in the middle of the night, seeing lactation specialists, you name it. He thrived on formula. I tried again with my second child, getting the hospital grade breast pump started immediately. Same story. Both my children thrived on formula and at 5 and 7 they are two of the most healthy children around – no allergies, one ear infection between the two of them in 7 years. My mother had a similar experience with all four of her children, minus the media hype of course. This is a real issue.

  • http://www.facebook.com/sue.jacoby Sue Jacoby

    Oh my goodness! “I really don’t care how a baby gets fed, as long as it gets fed?” ” I have precious few tips or knowledge on how to actually breastfeed an infant? ” You guys are doctors? I think it is nothing short of a scandal that a medical professional, ESPECIALLY one who is a specialist in BABIES, could with a straight face, say “I really don’t know anything much about breastfeeding- or I don’t think it’s that important.”
    It’s just the normal feeding method for mammals… nothing to get excited about, right?
    No wonder we have so many problems trying to help mothers breastfeeding in the lactation community. With partners like you guys, who needs enemies? Take a class, for heavens sakes! You should AT LEAST know as much as your educated patients. Geesh.

    • http://www.facebook.com/laura.mitchell.3781 Laura Mitchell

      Breast feeding isn’t for everyone for a variety of reasons, both maternal and neonatal. Breast feeding is the ideal, but sometimes it’s hard to live up to the ideal. New moms have enough stresses without being made to feel guilty for not breastfeeding or having difficulties doing it.

      Conservatively, about 50% of new moms return to the work force within 6 months. Start making the WORK WORLD breast feeding friendly (e.g. by providing places for new moms to nurse or pump) and see that breast feeding is normal (not an inconvenience) and we might actually make progress to the goals of Healthy People.

      Lactation consultants need to be supportive of the mother’s choice because SHE’S the one who goes home with the baby, not you. Go into HER reality, instead of trying to drag her into yours. Lobby to promote legislation to make communities, including businesses, breast feeding friendly. We have a statute in California to support breast feeding in the work place. Unfortunately, there’s no enforcement mechanism, and even if there was, there’s nobody to enforce it. Get legislation passed with some teeth and penalties.

  • http://twitter.com/thosekennedys Notthosekennedys

    It didn’t happen for me, despite the medications, lactation consultants, and a variety of “holistic” approaches. Now that my daughter is 6-years-old, I realize she’s just fine, but I freaked a little when she was a newborn, and was really treated like a bad mom by some in the “nipple nazi” crowd.

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