Why don’t more moms breastfeed?

If breastfeeding is so great and natural, then why don’t more moms breastfeed?

This is an excellent question, and one that researchers have been asking for many years. The answers are diverse and complex.

The fact is that there are very few actual physical reasons a mom can’t breastfeed (we’ll get to the baby later).

And in a lot of cases, if breastfeeding is challenging, a health worker will suggest that the mom should start supplementing. Instead if she gets help ASAP to actually resolve the breastfeeding issue itself, she might never need to supplement. And often moms are not told that if they supplement without resolving the cause of the breastfeeding issue (such as a poor latch) then her own milk production will decline — and unfortunately this can happen when it is not even necessary.

Except for a really tiny percentage, moms have the ability to make milk — in fact, usually enough to feed twins or more babies. So plenty for just one baby. The few who can’t make enough milk to satisfy their baby’s nutritional requirements include those who have glandular insufficiency or lack of breast tissue — or those who have had breast tissue removed of course, including some who had a lot of tissue removed during breast surgery or who have had surgery that damages nerves around the nipple or going to the breast.

But with help many of these women can at least partially breastfeed or give some of their own milk to their babies.

Those moms can sometimes breastfeed using a supplementer system (which can even be homemade) that allows the baby to breastfeed while receiving the supplement (either expressed breastmilk, donated breastmilk, or formula) at the same time as breastfeeding. A little silicone tube goes down along the breast to the nipple and delivers liquid while the baby nurses at the mom’s breast.

There are some excellent protocols that help make that easier to do, such as prescription medicine that can increase a mom’s milk production. And massage techniques can also increase milk production. A combination of breast massage and a breast pump can sometimes increase mom’s milk production and output more than pumping alone.

The reasons a baby can’t breastfeed or shouldn’t be given a diet of 100% breastmilk can be related to metabolic problems such as galactosemia or other metabolic disorders. These are very rare condition though. And even in some of these cases, the baby can handle a little bit of breastmilk. Of course, if you or your baby have a medical condition that precludes or limits breastfeeding, you should stay in close contact with your doctor, and not just your lactation consultant.

Sometimes babies have problems latching or sucking because of tongue tie or other medical reasons but those babies can often be helped to breastfeed if the mom gets qualified help from a lactation consultant or other health workers who have had training in these areas.

But what if the mom and baby are healthy? What’s stopping them?

Often the causes of not breastfeeding have to do with difficult birth experiences, or hospital practices that involve lots of separation of mom and baby and lack of adequate support to get the mom’s milk production going and no one warning the mom of the difficulty of returning to breastfeeding if it is delayed or interrupted. Moms have a right to know what procedures and drugs might affect their breastfeeding — and what to do to solve the problem!

For example, if a baby is drowsy after a birth that required medication, the mom should be told to expect the baby not to be able to latch well at first, and then actively helped to get her milk flowing even in the absence of efficient breastfeeding until the baby can latch well, and breastfeed spontaneously and effectively once the drugs wear off.

Of course, if medication can be avoided altogether, both the mom and  baby will likely be alert after birth, and so breastfeeding will probably get off to an easier start.

Ideally the baby will breastfeed often (at least every couple of hours or maybe even more often) and with a great latch that effectively removes a lot of milk soon after birth — these combine to signal her body to make more milk! But if baby isn’t breastfeeding often enough and with an effective latch, she should get help to solve that. But in some cases, she does not and then the baby is given a supplemented instead. And this is what creates more challenges in many cases.

Babies can get too full from the supplemented and adapted to sucking on a bottle and then they don’t want to breastfeed. Bottles and artificial nipples can totally affect latching at the breast, and a downward spiral begins. Or moms are separated from their baby completely and given only bottles, and then it’s hard to get back to breastfeeding. IT’S POSSIBLE TO RETURN TO BREASTFEEDING — BUT IT TAKES EFFORT AND IT HELPS TO HAVE LOTS OF SUPPORT.

That’s right. Breastfeeding is still possible but if a mom is in a really challenging situation, she will likely need lots of information and help and will need to realize that it will take work, so that way she will be better prepared mentally to do what it will take. It can be tiring and stressful — but it can also be stressful to lose the breastfeeding if that was something the mom was hoping and planning to do.

Help is out there in some places — fortunately in many places across Canada there are well-qualified lactation consultants, known as IBCLC’s. Most big cities have lactation resources. It takes work and dedication to learn or re-learn how to breastfeed if baby has never done it or it’s been a few weeks or months.

But even a little breastfeeding is still breastfeeding, and if the family gets dedicated help it can be amazing how the breastfeeding experience can get better, baby’s latch can dramatically improve, and mom’s milk production can significantly increase, especially if she has plenty of coordinated support from her midwife, doctor, nurse, and lactation consultant.

Moms can even re-lactate who have weaned or almost weaned and I do know of actual situations where moms have gotten back to breastfeeding after stopping or almost fully stopping it.

Sometimes moms stop breastfeeding because they think they don’t have enough milk or that the medication they are taking is incompatible with breastfeeding — which is often NOT the case. Sometimes factual information and help is all that is needed  to discover the milk is there, but getting more into the baby is all that is needed. Or to realize that the drug is okay — Dr. Thomas Hale is probably the world authority on drugs that are compatible with breastfeeding.

As for returning to work, that does not need to be and should not be a reason not to breastfeed. There are lots of creative ways to combine breastfeeding and working — again with good support from peer support groups like La Leche League or lactation consultants, mom can develop a breastfeeding strategy even while returning to the office.

These can include working part-time and breastfeeding when they are at home. Or having someone bring baby to work for breastfeeding breaks for a few months. Or maybe doing a home-based business so you don’t have to be away from baby at all. Or reframing what is really needed so you don’t have to have as much money.

There is a lot of pressure to return to work and maybe even expectations that you will do so in six months or a year. But it’s also a wonderful thing to stay at home and take care of your own baby or toddler for as long as you sense s/he needs you there.

Some moms are able to find ways to put their work plans on hold so they can stay home and breastfeed. Sometimes it’s a matter of deciding to live with less and streamlining the budget. Besides, breastfeeding itself is a great way to save money — and baby would always prefer to have mom holding him than having a fancy new gadget or stroller. Maybe dad can be the breadwinner for a while so mom can provide baby with breastfeeding and plenty of together time. That’s a great start!