From the glow of pregnancy to the beauty and bonding of breastfeeding your newborn, many women enter motherhood with an idealized image of what their experience will be. When reality crashes in, many mothers feel pressure and stress closing in on them.
Breastfeeding is one part of motherhood that rarely goes as planned and usually comes with a set of difficulties and concerns. It’s a big responsibility to be the sole source of nutrition for a growing human. Many mothers do not make their breastfeeding goals. A little awareness and support can make
a difference, though, according to Liz Naylor, lactation counselor and founder of Enlightened Mama. With more information, better understanding of the process, and a strong support system, more families can flourish and thrive in their breastfeeding journey.
How Many Women Breastfeed?
Globally, breastfeeding is acknowledged as the best way to feed a baby through at least the first six
months of life. At six months, solid foods can be gradually introduced, but the World Health Organization recommends continuing breastfeeding alongside those foods for the first two years of life. Other health organizations recommend that babies are breastfed through the first year of life.
Breastmilk is perfectly suited to help an infant grow and thrive. However, only a little over 60 percent of newborns are exclusively breastfed and by 3 months less than half are exclusively breastfed. Not even 85 percent of infants are breastfed at birth. With so much information showing its benefit, why are the numbers so low?
Challenges of Breastfeeding
In today’s high-pressure, high-speed life, breastfeeding is a nearly impossible feat. “We’re not a breastfeeding culture,” says Naylor. Mothers find obstacles to breastfeeding from delivery onward. Few receive adequate time, space, and support to breastfeed.
1. Lack of Information
Most mothers are not properly informed about the effects that delivery has on breastfeeding. Everything from the IV fluids to the method of delivery (vaginal or caesarean) impacts the initial milk production. When milk supply is lower than expected or a baby doesn’t gain weight as expected, mothers blame themselves, often giving up on breastfeeding. A little information can change that
perspective, allowing them to continue breastfeeding.
2. Lack of Support
The majority of issues with breastfeeding happen in the first month of life. And less than half of those mothers find help and support by a health professional. Most struggle to either figure it out by themselves, give up on breastfeeding, press on through pain, or find help in friends and family. There simply is not enough support. “Lactation and infant feeding care needs impact families during a vulnerable time. Every community needs more lactation care specialists,” says Danielle Downs Spradlin, lactation consultant and founder of Oasis Lactation Services. Parents need a place to turn to for help. “You have to dig pretty deep to find where in the system someone who will support you,” according to Naylor
3. Returning to Work
Returning to work is often a large barrier to making breastfeeding goals. The workplace rarely adequately supports breastfeeding mothers. Again, mothers encounter difficulties immediately after giving birth as most employers in the U.S. do not offer paid maternity leave. After returning to work, mothers must juggle pumping and their job. Recently, a federal law outlined more rights for nursing mothers to a private space and sufficient breaks to pump at work. For some mothers, getting this workplace time and space still proves difficult and not all working mothers are covered in the 2022 PUMP law. Regardless of how well workplaces practice these laws, most mothers face a lot of anxiety over milk production, pumping schedules, and bottle feeding their baby as they return to work. Some give up on breastfeeding or quit their job.
4. Psychological Challenges
Beyond the physical challenges of breastfeeding, there are a host of psychological challenges that mothers and families face. Fatigue can be overwhelming as mothers get up through the night to feed their little one. Worry over milk supply constantly overshadows as mothers struggle to find the time to regularly pump or feed their baby. Insecurity over whether or not your baby is getting enough nourishment can nag at mothers. And having issues with painful or cracked nipples, a poor latch, or a baby not gaining weight properly simply fuel those fears and worries. Most women who have difficulties with breastfeeding having a higher risk of developing postpartum depression.
Common Breastfeeding Issues
Over 70 percent of mothers have difficulties with breastfeeding, yet many feel alone in their situation. Every baby is unique and every family is different, yet certain common problems often arise.
- Nipple/breast pain – This is common, but not normal. “Pain is a message that something needs to change,” according to Downs Spradlin. Both Downs Spradlin and Naylor, encourage families to get support from a healthcare professional rather than relying on social media and the internet. “It’s okay to keep asking new people for help until you find the right person to help,” says Downs Spradlin.
- Latch issues – A baby that is not latching well may not get enough and may cause pain to the mother during nursing. Naylor described how she assesses both the baby’s anatomy and how well the baby is sucking and nursing. Positioning and tongue and lip ties can contribute to how well the baby is able to nurse. Suck training or addressing ties may resolve problems, helping both mother and baby enjoy nursing more.
- Infant’s failure to thrive – A baby that is not gaining weight, is lethargic and sleepy, and does not poop often may not be getting enough nutrients. Babies should nurse 8-12 times a day and have regular wet and soiled diapers. Very short or long feedings may also be a signal that something is
not right.
These are the most common problems that mothers and babies have, but Naylor emphasizes the importance of a holistic approach. Rarely, is it “as simple as one thing,” says Naylor. In a similar way, Downs Spradlin looks at the whole family and everything from diet to movement to blue light exposure when looking to support breastfeeding.
Raising Awareness and Support for Breastfeeding
Better information and support can make a world of difference in the feeding experience, according
to Naylor. Research backs this up. Women who go into the experience of breastfeeding with support or a positive role model are much more likely to successfully achieve breastfeeding goals. Families that received support during the breastfeeding journey are almost 50 percent more likely to exclusively breastfeed at birth and 26 percent more likely to continue breastfeeding.
Part of supporting families is as simple as helping them understand expectations of what is normal. Naylor strives to make “sure people know that this is a normal process, but there’s a learning curve; it’s a learned behavior.” Expecting everything to happen easily because it’s natural will not set you up for success. And for those who experienced a difficult delivery or a caesarian delivery, milk production may not come as fast. The “body is going to prioritize healing, but if someone doesn’t know that, someone may think, ‘I’m low on milk,’” says Naylor. Understanding the process can help lower stress and improve your frame of mind. Instead take it one feeding at a time. And expect it to take some time to get things working more smoothly. “That’s the beauty of it—you get a lot of practice,” Naylor says.
A Necessary Support System
It takes a village to raise a child, the age-old wisdom states. Where breastfeeding is concerned, this rings true. Raising awareness and bringing support to communities significantly impacts breastfeeding rates with 86 percent more mothers beginning breastfeeding at birth and 20 percent
more mothers exclusively breastfeeding.
Both Naylor and Downs Spradlin emphasize the value of supportive partners and friends. Naylor encourages partners to be present and involved in sessions, saying this is not something a mother should be expected to do on her own. Rather, “it’s a family affair.” Downs Spradlin encourages partners to make a list of non-feeding baby chores and household chores to take on. Breastfeeding “works best when the parent and baby stay together for frequent nursing.” Free up the time and space for mother and baby to focus on feeding and not on the long daily to-do list.
In today’s digital world, many mothers turn to social media and the internet to solve their breastfeeding problems. However, Naylor strongly encourages finding face-to-face connections in your breastfeeding journey. Find a friend who has experience, ask questions, and see if someone is willing to let you learn from them. Use the International Board Certified Lactation Consultant (IBCLC)
network to find a lactation consultant who can work with you to address concerns and bolster your confidence. You’re not alone, and it’s important to find support.
Psychological Support
For many mothers, breastfeeding can be a journey filled with anxiety and stress. Many mothers worry that their baby is not eating enough or sleeping enough. So many mothers wonder if their milk supply is not enough or if they are giving their baby the nutrients needed. Eighty-two percent of new mothers feel pressure to breastfeed, feeling guilty or insufficient if they struggle or are unable to make their
breastfeeding goals. Naylor finds that because of this pressure it’s “critical to think about the psychological side of feeding.” Two of her top three goals are that parents “feel sane” and that they “enjoy their baby” and their family.
For new parents or those who did not make breastfeeding goals in the past, Naylor encourages parents to process their feelings, journaling and talking through their experiences. It’s not possible to go into this without carrying previous experiences with you.
She told the story of one mother who was breastfeeding her second child after not making her breastfeeding goals with her first. There was a lot of emotion tied into the experience, and she was struggling. Ready to give up, she came to Naylor’s home to see if they could figure out the problem. Naylor’s son came over to her and asked her if she needed help feeding her baby. When the woman responded that she did, Naylor’s son sprinkled magic fairy dust over the baby with his wand. And at that moment, the baby latched. Not only that, but the baby continued to latch well at feedings.
“She needed the extra psychological push – that belief in herself – whatever he did helped her to believe,” says Naylor.
Often when working with mothers Naylor encounters this same dilemma. Women who are struggling to believe and trust that this is natural, and nature and instincts are working in their favor. Naylor believes that her clients have what it takes to breastfeed successfully. A big part of her work is helping them believe as well.
Benefits of Breastfeeding for Mothers and Babies
With all these concerns and obstacles to overcome, why put in the effort and psychological distress to breastfeed? The science shows clearly that in almost every case, breastfeeding is the best option for both mother and baby. Mothers who breastfeed have a lower risk of breast cancer, ovarian cancer,
postpartum depression, hypertension, cardiovascular disease, and type 2 diabetes. Their breastfed babies have a lower risk for sudden infant death syndrome (SIDS), certain skin conditions, gastrointestinal issues, and ear infections. In the long term, those who were breastfed have healthier
immune systems, and higher IQs. They have a lower risk of type 2 diabetes and social disorders, like autism spectrum disorder.
Breast milk is rich in nutrients that are specifically suited to an infant’s needs in order to grow and
develop quickly. Breastfeeding helps a baby’s gut microbiome develop as good bacteria from a mother’s microbiome transfer to the baby from the mother’s milk and skin. A baby’s immune system is supported by breastfeeding. And breastfeeding helps a mother’s body recover physically and psychologically.
Fed is Best
At the end of the day, though, Naylor says that her goal is a well-fed baby, a sane mother, and a family that can enjoy each other. If that means finding another feeding method, she will sleep the same at night. Supplementing with formula or feeding with formula may be the best choice for your family. A healthy baby and family is most important.
References:
https://www.cdc.gov/breastfeeding-data/breastfeeding-report-card/index.html
https://www.washingtonpost.com/business/2023/10/26/pump-at-work-horror-stories/
https://www.bls.gov/ebs/factsheets/family-leave-benefits-fact-sheet.htm
https://www.dol.gov/agencies/whd/nursing-mothers/faq
https://www.ohsu.edu/school-of-medicine/moore-institute/breastfeeding-and-microbiome
https://karger.com/anm/article/78/Suppl.%202/29/827475/Breastfeeding-in-the-Modern-World
https://pmc.ncbi.nlm.nih.gov/articles/PMC6096620/#Sec2
https://pmc.ncbi.nlm.nih.gov/articles/PMC6008960/#tbl1
https://pmc.ncbi.nlm.nih.gov/articles/PMC9052351/
https://lactationnetwork.com/blog/four-common-breastfeeding-challenges-and-how-to-overcome-them/