The ability to breastfeed a growing infant is one of the “special powers” given to women, and we know that it’s beneficial to the health of both mom and baby. While some women experience few or no problems with breastfeeding, there are many potential roadblocks other women experience that can prevent this journey from always going smoothly. We spoke with some experts in the Lactation Consulting field about the problems they typically see in their practice and how they help moms move forward with breastfeeding their babies.
Ayelet Kaznelson, IBCLC (International Board-Certified Lactation Consultant), RLC (Registered Lactation Consultant), a Manhattan-based Lactation Consultant, and Leigh Anne O’Connor, IBCLC, who is also based in New York City, listed the following challenges that they’ve helped breastfeeding moms face:
AK: To name a few:
- Nipple pain
- A woman may think she isn’t making enough milk
- Baby is not getting enough milk during breastfeeding
- Prematurity of baby
- Finding comfortable positions at home, especially after a Cesarean Section
- Breastfeeding twins
LO: There are so many. The social aspect is probably the most challenging. This means that community support is lacking. Many moms feel they have to be sequestered in order to breastfeed. There is a lack of understanding of the complex relationship that is breastfeeding.
Another big challenge is employment – most American women have about 12 weeks of paid (if they are lucky) maternity leave. Balancing pumping, parenting, and career/job is really challenging.
Having sore nipples is another common problem.
We also asked Ms. O’Connor about the mechanical issues of breastfeeding and the feeding relationship she frequently sees and how moms can get help with these issues. Here’s what she told us:
LO: I see moms using too many props or trying to get a “perfect” latch. I often see moms moving their breasts to the baby or laying the baby on a special pillow and then leaning forward to drop her breast into the baby’s mouth. Ouch! That makes for a sore back and shoulders. I encourage moms to get as comfortable as possible, then bring the baby to her.
Often moms will pop the baby off and on looking for just the right latch. I find that if the latch is not perfect, rather than trying over and over again, which is frustrating to both mom and baby and can cause more pain, making adjustments while the baby is still latched can be more effective. These adjustments can include pressing the baby’s chin open and flipping open the baby’s lips. I also encourage parents NOT to press on the back of the baby’s head. Many parents are told to shove their baby’s head into the breast – that makes for a painful latch and a baby who may be uncomfortable.
There seems to be a lot of confusion and misinformation about breastfeeding vs. formula feeding. We asked Ms. O’Connor whether she could share any insights into why new moms may be told to supplement their breast milk with formula. Here’s her response:
LO: This is usually recommended because of a lack of education on the part of her support team, which may include the pediatrician, OB, extended family, and hired help. Many people are told that they do not have enough milk or they are told to give formula until their milk comes in. If there is a true reason to supplement, the mom can hand-express or use a pump to take the milk out of her breasts to feed her baby. The need to supplement is not as common as it is treated. There is so much fear and misinformation about breastfeeding. There is also a myth that feeding a baby formula will make the baby sleep better – this does not prove to be true.
We asked Teresa Peters, IBCLC, ICCE – CD, of Los Angeles’ Huntington Hospital Breastfeeding Center, what advice she offers moms when they can’t successfully breastfeed their children. Here’s the wisdom she offered:
The advice varies depending on the situation and the age of the baby. As a whole, when a mom or baby cannot breastfeed it is helpful to let the mom know that she and the baby will benefit from the practice of skin-to-skin. The baby on the mother’s body may fill some deep needs for the mother’s desire to offer tender nurturing, as well as offer physical comfort for baby. Breastfeeding is not always about the milk. Even if the mother is unable to produce sufficient milk, the baby may latch and suckle for comfort. If the issue is the baby’s inability to attach to the breast, yet the mother can produce milk, expressed breast milk can be fed by bottle. When it comes to bottle-feeding, moms and babies do well when the baby is held close during feedings. Propping a bottle is a lonely way to feed and possibly dangerous for the baby.
Emotionally, some mothers feel sadness when they cannot breastfeed. It is essential for Mom to find someone to listen to her express her thoughts and how she has been affected. Mothers who wanted to breastfeed often say they feel guilty. Misplaced guilt is demoralizing and can lead to depression. Many times, the reason for not being able to breastfeed is out of the mother’s control. More often, the mother is seriously grieving. Helping her to see that she is grieving is valuable; it helps her to shift the weight of self-blame. The ability to lovingly mother goes beyond breastfeeding. After the birth, any mother experiencing sadness, anxiety or intrusive thoughts interfering with a healthy sense of self, should know that help is available.
Huntington Hospital offers outpatient help. The link is here: https://www.huntingtonhospital.org/Our-Services/Womens-Health/Obstetrics/Maternal-Wellness-Program.aspx#~b0S1P7. The state of California hosts a page for additional resources for postpartum mood disorders: http://www.postpartum.net/locations/california/.
Finally, we asked Ms. O’Connor what advice she could give moms who’ve mastered the mechanics of breastfeeding but are struggling with combining the demands of breastfeeding with a busy work schedule. Here’s what she shared with us:
LO: I advise moms to be easy on themselves, to ask for help and accept it. Delegate work that others can do – cleaning the house, preparing meals, caring for any older children. Nurse the baby when mom and baby are together. Put pumping on her calendar as she would other appointments. Plan ahead and let your company know that you will be pumping. If possible, have mom and baby meet for a nursing session during the day.
When breastfeeding seems impossible, or the mom is struggling to keep up the milk supply to meet her baby’s needs, remember that breastfeeding does not have to be an All or Nothing proposition – sometimes moms need to supplement, but that does not mean she is not breastfeeding.
For more on breastfeeding and Lactation Consulting, see the other articles in this series, Why New Breastfeeding Moms Benefit from a Lactation Consultant and The Future of Breastfeeding.