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Thursday, October 10, 2013

Breastfeeding Expectations (bit of a vent)

I like this image.  It would be even better if they clarified that "at first" may mean 3 months.

I think most women want to breastfeed these days.  Every baby book says it is best and most doctors (unless you have a preemie).  It is rare that I meet a mom-to-be who wants to formula feed prior to birth. 

So why does anyone do this?

My two cents....

1) It's difficult and uncomfortable.
2) We are not adequately prepared for the difficulty.

Firstly, breastfeeding is difficult and uncomfortable in the beginning, even if the baby is able to latch perfectly.

- Many women leak all the time, yet find pads itchy and uncomfortable.  This means either they are in constant discomfort or are wet, sticky and sweet smelling from milk for extended periods of time.  I still am in this phase and honestly don't know which is worst - being wet or the itchiness.  

- Many women also get engorged in the beginning.  It is painful and leads to plugged ducts and mastitis.  I got mastitis - it's not uncommon.  Dr.'s prescribe the medication over the phone without even seeing you, as it is that common.

- Newborns nurse around the clock and you bear the full burden.  This means very little sleep over extended periods of time.  It can lead to you being not as good a mommy during the day - using a bottle means someone shares the burden.  Using formula often means babies sleep for longer periods of time.

Let down can be painful.  It is painful for me, but some women says it brings them to tears.   

- Breastfeeding can be painful even if the latch "looks" perfect to professionals. 

Now, those are difficulties (and there are more) that are a problem for women when latching and supply goes perfectly.  It seems from speaking to women that it is rare for there not to be some difficulty.

There are too many difficulties to list, really.  Tongue tie and lip tie was our primary difficulty, but Julianne also has a shallow latch and difficulty opening her mouth widely enough.  A shallow latch can result in sucking for hours without getting milk, lipstick shaped nipples, bloody nipples, part of the nipple or areola coming off due to damage, blisters, etc.  

Mothers sometimes have a fast let down, an oversupply or not enough supply. Babies have high palettes, mothers inverted or flat nipples. Breastfeeding is not always intuitive and in order to get these issues worked out it often costs money up front. Yes, there are free sources, but they aren't always up to speed with what you need.

It was $150 for the lactation consultant to come out.  $400 for the frenectomy, not covered by insurance.  It was recommended that Julianne receive cranio-sacral therapy which would be $50-100 for session.  Then, you know, I really need to see the Lactation consultant again - another $150 and on and on and on. 

Furthermore, if you have a preemie who is started on the bottle, you may have to deal with "nipple confusion"/bottle preference. 

More damaging than the physiological discomforts of breastfeeding, however, is the psychological damage.  I believe this is because most of us are not prepared for difficulty.

Not Adequately Prepared
Before Julianne, I had read about breastfeeding and heard about the difficulty in the beginning from other women.  I didn't realize, however, what a marathon it would be.  The "beginning" wasn't really etched out correctly for me.  I would think the first couple weeks.  From what I read online, however, it is not rare for it to take 6 weeks before it starts to get better.  And you know, sometimes it takes 12 weeks.  That is THREE months. Most of us can not even keep a New Year's Resolution for 3 months.  And you know what... sometimes it takes longer!

And while I had been prepared for nursing around the clock, I did not know about some of the other issues listed above.  It would have been nice to have been told about them and then also to have been told that these discomforts are TEMPORARY.  You will not always have to put up with the leaking, engorgement or all night feeding sessions.  Even the painful letdown gets better.  For most women, nursing gets less painful as well.  Your body will adjust. 

It would also have been  nice to know how common issues are and how long they take to resolve.  Labor is a sprint compared to breastfeeding.  If you prepare for a marathon, you will be equipped regardless of how long the race is.  If you prepare for a walk in the park and face a marathon, you are much much much more likely to give up.

Now, let's talk about the psychological/emotional side to this.

Breastfeeding advocates and baby books speak of breastfeeding as almost a magical experience.  They speak of the beauty of breastfeeding and the bond that comes from it.  They speak of a mother's ability to provide for their child and they make it seem intuitive which it often is not.

How does it make the mother feel when there are difficulties?  It makes her feel like a failure.  It makes her feel inadequate.  It is painful and sad that the mother is supposed to be able to provide for their baby and meet their child's needs and yet they are unable to.

How does a mother feel when don't like breastfeeding? They feel like a bad mother.

Bad Parents
The magical experience is true, as is the bond.  Yet, it takes place later for most women.  I feel that there is a sentiment that those who use formula or give up on breastfeeding are lazy, selfish or not good mothers. 

It is much more accepted for women to receive an epidural, intervention or c-section to safely deliver.  "As long as the baby and mother are healthy" is the mantra you hear. 

But what about for breastfeeding?  If breastfeeding is not working the way it's supposed to, then the baby loses weight, doesn't thrive and could die.  My baby would have died without a wet nurse, if I was to rely on breastfeeding alone.  Bottle feeding allows the baby to be healthy, happy and thrive.

If the mother is unhappy and does not know that her situation is normal and will most likely improve, why should she not make a choice to make herself happier.  Doesn't happy mommy = happy baby?

We won't scare them away
Mom's want to do what is best for their babies.  Telling them a realistic and possible path for establishing breastfeeding will not scare them away.  It will help them adjust expectations and prepare accordingly.

What will scare them away is unrealistic expectations.  Thinking they have failed at 2 weeks, not knowing their path may take 10 more.  Thinking they have tried everything they could, when they are only 4 weeks in.  Thinking they can't stand 5 more months of torture when they are only a week in.

We need to know what we are facing, as well as why it is worth sticking it out.

Also - you bond with your baby when you bottle feed.  You bond with your baby when you burp them.  You bond with your baby any time you hold them and give them what they need.  It is a special moment to be one of two people on earth destined to lovingly keep this little baby alive and to have the means to do so.

What is not bonding?  Holding your baby at your breast and watching them scream with frustration for hours on end and literally starve.  That is not a magical experience.  It is also not an uncommon experience during those early months.  That is not bonding.  It feels like a betrayal to your child (especially when you can give them a bottle) and is traumatic to mom and baby.  It creates a rift between baby and mom.  This should be addressed.  Will that rift go away??

Also not magical or bonding is a mother dreading the pain of nursing and bleeding into her baby's mouth (also common).

Many educators wish to increase rates of breastfeeding by trumping up the experience.  I feel they would be better served by being honest.

**Some women will experience an easy breastfeeding relationship for the start.  HOWEVER...

-  It can take up to 12 weeks to establish a good breastfeeding relationship.
-  There are many initial discomforts and difficulties, which will improve.
-  Despite these discomforts and difficulties, there is a good chance you still can succeed if you hang in there.

It is worth it for your baby.  


  1. I think you're amazing for pumping so Julianne can still get breast milk! That shows you are a good and selfless mother (not that moms who don't are bad or selfish; you're just willing to go the extra mile, which is very hard). I hope things get better. And if they don't, you're not a failure. No good thing a mom tries hard to do should be labeled failure if it doesn't work out. Like I didn't fail giving birth to Caden because I had a C-section, or if I had not had my VBAC. We need to eliminate that word out of the parenthood vocabulary. We do our best with the knowledge, efforts, and skills we have, and hope for the best. Whatever the outcome is doesn't mean we failed. But we can learn from them and do something different (not necessarily better since we did our best the first time) the next time.

    As for lactivists, remember their purpose is to educate and support women, not make anyone feel guilty. Sometimes it comes across that way because we are human and don't always say things the right way.