FAQ 2. Able to breastfeed?

Q. Will I Be Able to Breastfeed? How will I know if I can?

A. Will you be able to breastfeed? This is a very important question. The quick answer is that “Yes, with proper information and support in all probability you will be able to breastfeed.” This is absolutely true!

But it’s not quite as simple as that in modern society. A lot of moms know people who had nothing but problems, and then just struggled a lot on their own, and then finally gave up and just reluctantly switched to formula.

If we look a little deeper, we discover that the moms with the challenges sometimes didn’t check with a nurse or lactation consultant before they changed to formula, because they just figured that there wouldn’t be anything that the health worker could do, and so the mom didn’t want to waste anyone’s time trying to resolve something that seemed un-fixable.

Or the mother just figured that breastfeeding is supposed to be instinctive, and if you don’t get it right on your own, then it seems like you just don’t have the knack, or maybe there’s something wrong with your baby, and there’s nothing else you can do besides giving formula. And maybe the mom saw a health worker at this point, who suggested formula — possibly before even considering other options that might work besides supplementing with or maybe even switching entirely to formula.

And what about the birth experience itself? Were mom and baby separated at any time? Did mom have any medication during the birth? These factors definitely can and do impact baby’s experience with breastfeeding, baby’s readiness and eagerness to breastfeed, and their ability to latch. Of course moms need help when interventions affect the breastfeeding experience!

Now, for some moms breastfeeding DOES go smoothly from the beginning and if so, that’s great. It can happen that way too. But when it doesn’t, this does not indicate that there is necessarily a medical problem. It can sometimes mean the mom just needs some more help and information.

I sometimes hear someone say things along the lines of: “My mother and next door neighbour had lots of problems with breastfeeding. In fact, so did my cousin and sister. In all cases, they said it really hurts a lot, and most of them gave up in a month or so when it either hurt too much and they couldn’t stand it anymore or they just seemed to run out of milk for no reason. Will I have the same problems that everybody seems to have? Or does breastfeeding trouble run in families like allergies or something?”

These were moms who no doubt wanted to do the very best for their children. They didn’t want to starve their babies, and even though they wanted to breastfeed, they just figured they didn’t have enough milk, and it sure seemed like there wasn’t any real choice other than giving formula. And besides, did breastfeeding ever hurt!

So for these moms, formula seemed like the only reasonable solution. And they heard that so and so did okay on formula. And they had a coupon for a discount. And they heard that breastmilk and formula are pretty much the same anyway, right?

Not only that, but if mom was having any sort of problems with baby latching effectively, and formula and bottles seemed to make the latching even worse, it just seemed like switching over to bottles and formula was the most realistic option — but then moms don’t realize what they are giving up — or that they traded one set of problems (the struggle to get the baby to latch and for breastfeeding to feel okay) for another (baby having middle ear and respiratory infections, and so on).

So even though these moms were trying to do what seemed like the best (or only) choice, I am guessing that these women didn’t get all the information and help they should have had — and nowadays COULD have — to make a fully-informed decision and find a breastfeeding solution that works for themselves and their babies.

Well, guess what? I was one of those moms who encountered difficulties and wondered about all these things too.

I experienced the same problems myself when I was a new mom: breastfeeding hurt a lot, I was switching sides a lot, timing the feedings (like I got used to doing in the first few days), trying not to feed more often than every two or three hours, and my baby seemed hungry and unhappy all the time. Plus, I had a health worker who advised me to start giving formula, since my baby was not gaining weight well and that nurse was concerned that I didn’t have enough milk and felt that it was unrealistic of me to think that I might ever catch up — my baby was about three weeks old by then and really obviously hungry and underweight.

I, too, was one of those moms who had assumed that breastfeeding was instinctive — and since I wasn’t figuring it out on my own and my baby wasn’t gaining weight very well, I thought that I probably just didn’t have “what it takes” — whatever THAT is. And I got very sad, and phoned the local crisis line.

Luckily I got a pretty savvy guy (that’s right, a man, who happened to be quite well-informed about available resources). When I told him, sobbing, that I “couldn’t” breastfeed, and begged him to tell me how could I live with having to give up my dream, he suggested I might be making that conclusion prematurely, and recommended a local breastfeeding self-help group, which I was not aware existed.

He said that it might help if I sought advice from women at La Leche League, a mother-to-mother breastfeeding support organization that has groups in many locations (as well as online support now too). He thought that they would likely be able to help me, and that it would be good for me to talk to them first, rather than just immediately resigning myself to the idea that breastfeeding just wasn’t “in the cards” for me.

Good advice! I hope he’s reading this, and that he realizes how much of a wonderful difference he made in my life and my mothering experience.

The point here is that there might be information that you don’t have which would be helpful to know — assuming you get that information from qualified sources.

In my case, I learned quite a lot from the very knowledgeable moms at La Leche League. First of all, breastfeeding advice is never “one size fits all”. What works for one baby might not work for another. Some babies only want to breastfeed a few times every day and others need to breastfeed many times, sometimes as often as an hour and a half, especially if they are going through a growth spurt and need to catch up. Or maybe you have been exposed to a virus and they need the antiviral ingredients they get when you breastfeed. Or maybe they just need the comforting that breastfeeding provides.

Some babies only need to breastfeed from one breast at a feeding or even for more than one feeding before switching sides. Others need both sides at every feeding. If a baby only breastfeeds from one side, it’s important during the first few weeks when milk production is getting established, to make sure to massage and/or pump the other side so that milk production is stimulated. In any case, it’s important to let the baby finish a side before offering the next.

Sometimes mom has a forceful let-down during a feeding and after it subsides, baby might very well want that same side until the hindmilk starts flowing. And only THEN after s/he spontaneously comes off that side, you can offer the next side.

I also learned that breastfeeding should NOT hurt and that if it does, this indicates a change is necessary, and if this is not resolved this might very well affect milk production, as it most likely means the baby is not latching properly, and therefore not stimulating proper milk production and flow.

I learned that repositioning the baby’s overall body alignment and repositioning baby’s mouth on your breast is probably needed to fix this. I also learned that mothers often need help from someone knowledgeable to learn how to do this! Sure, if we grow up in a society where we view top-free women breastfeeding every day, we learn throughout our whole lives and then once we have our babies in a drug-free birth in a totally natural and supportive setting, we know exactly what to do. But in a modern society, without the rich experiences these moms in more natural societies have, a lot of us need some coaching and assistance.

One thing we do know now is that regardless of individual babies’ needs, there are a couple of things that are important for all those who are breastfeeding: frequent feeding and thorough drainage — especially in the first few weeks — are really key elements to establishing good milk production and keeping mom’s milk supply meeting the baby’s needs. So if you think you might need help, the sooner you do it, the greater the likelihood that you will be able to establish and maintain an ample milk supply.

Once I got some highly qualified help with latching and breastfeeding management, things went much better.

That’s what worked in my case, and it turned out that I didn’t need to supplement at all! In fact, with proper latching that stimulated my milk production, I discovered I was able to make a ton of milk. Even more than my baby needed, in fact. (P.S. if that happens for you, why not consider donating milk to a local milk bank? And if you have already stopped breastfeeding, there is such a thing as re-lactation and a lactation consultant can help you with that too.)

This kind of happy outcome often happens when women get the help they need — and they discover what a joy breastfeeding really is. And they feel very empowered. And they discover that breastfeeding meets baby’s psychological needs and not just nutritional. No need to hurry weaning . . . .

My only regret is that I had not known about La Leche League meetings before my baby was born. If I had only known about the League first and attended meetings during my pregnancy, then I would have known more about what to do to keep that problem from happening in the first place and what to do if a challenge did arise.

And I also would have learned a lot more ahead of time about breastfeeding myths vs truths. And I would have felt more empowered to find another source of help (ie a second opinion) if I felt the first person wasn’t really supportive of breastfeeding or knowledgeable that the situation could be turned around and that I COULD make enough milk.

The main word of caution I would offer moms nowadays: there is a lot of breastfeeding info out there, more so than ever, particularly online. But if any of it is from a formula company or if a website is sponsored by a formula or bottle company or has ads for those things (which are in direct competition with breastfeeding) then it will NOT be objective information. This website includes links to good information.

So only trust info that comes from a lactation consultant or a health or breastfeeding organization, or from another health professional who is experienced with helping breastfeeding mothers. Or get info that comes from other breastfeeding moms who have GREAT breastfeeding experiences — and who will help you find help if you need more than they can offer.

And realize that, like moms throughout history, it is NORMAL to sometimes need help, and luckily there are resources in most communities now, such as lactation consultants, who can help you solve your breastfeeding challenges and help you have a happy breastfeeding experience.

by Marilyn Hogan, IBCLC