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We aren't doing enough for mothers who want to breastfeed

Posted by Dr. Claire McCarthy  September 23, 2013 09:34 AM

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Of the many reasons why women who want to breastfeed end up stopping, lots of them are reasons we can’t fix. Some women simply can’t breastfeed, no matter how hard they try. Some have medical conditions, or have to take medications that make breastfeeding impossible. Some of them can’t do it because of work or other life circumstances.

But way too many women stop for reasons we can fix. And that’s not okay.

In a really interesting study just released in the journal Pediatrics, researchers interviewed more than 500 first-time moms before birth and then at regular intervals through 2 months. They found that women who had at least one concern about breastfeeding at day 3 (which is when most moms are going home from the hospital, away from the hands-on help) were 7 times more likely to give formula and 9 times more likely to stop altogether. 

This is hardly a shocker. Think about it: they are physically and emotionally exhausted and hurting in places and ways that they had never imagined before, and now they are expected to stick this brand-new human being for whom they are fully responsible onto a part of the body that has heretofore only been sexual, and cross their fingers that the baby is actually going to get milk out of it, let alone enough milk?

Yeah, right.

Add to that the fact that breastfeeding is hard work. Despite the media depictions of blissful, peaceful moms with babies at the breast, the inconvenient truth is that breastfeeding hurts at the beginning and takes both mom and baby some time to learn.

So it shouldn’t be a surprise to anyone that while 75 percent of new mothers start out breastfeeding, only 13 percent do it exclusively for 6 months, which is what the American Academy of Pediatrics recommends. This is a shame, because breastfeeding has all sorts of health benefits for baby and mom, and can help with bonding (it can be a lot easier, too—no need to worry about having enough milk, you just pull up your shirt). 

In the study, the women were most likely to stop when they had trouble breastfeeding or when they were worried about having enough milk. That’s what makes me the most sad, because with some trouble-shooting and support most problems can be worked through—and most of the time when mothers are worried about not having enough milk they actually have plenty. Breastfeeding is different from bottlefeeding; breastfed babies like to be at the breast a lot, both because the milk is so quickly digested and, well, because for them the breast is just about the best place in the world. Too many mothers think that their babies want to nurse all the time because they don’t have enough milk, when it’s actually normal.

That’s the problem: we don’t do a good enough job of teaching women about what’s normal for breastfeeding, let alone supporting them when they hit the inevitable bumps in the breastfeeding road.  We need to do a better job of both.

We could, and should, make teaching about breastfeeding part of prenatal care. We also need to make lactation support easily available for any mother who needs it (given the health benefits of breastfeeding, we should be able to make the case to insurers).

We need more Baby Friendly Hospitals, where mothers are actively supported in breastfeeding—and babies aren’t given formula unless it’s medically necessary. We need more workplaces to give mothers the time and space they need to pump, so that they can breastfeed after returning to work.

I think it would help, too, to have more breastfeeding in the media (like in movies and TV shows), and more public breastfeeding. If we made breastfeeding more ordinary, it might make it more likely that people would talk about it, ask questions about it and learn about it. 

Not everyone can breastfeed, and not everyone wants to. That’s fine; there’s way more to parenting than breastfeeding. But the mothers who can, and want to, should get the help they need. This is about feeding babies, and about the health of our future adults. We can do better.


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This blog is not written or edited by Boston.com or the Boston Globe.
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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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