Sunday
Mar082009
When to give up on breastfeeding
Sunday, March 8, 2009
I read a post the other day that upset me. It was the first of many things that upset me that day and I don't seem to be able to let go. In the past, I've turned comments that upset me into posts (like Birth Plan: Yes or No? and Lactivism and the Homelessness Problem), so I thought perhaps the best way to get past what bothered me so much about this post was to write about it.
A woman wrote an honest first person account of her difficulties with her attempt to breastfeed her baby. Her story is sad. She had significant difficulties breastfeeding. She got questionable advice. She had people judging her instead of helping her. In short, the cards were stacked against her and she was set up for failure. I don't blame her. This happens to a lot of women and it is unfortunate. I can't say for sure if she would have been able to breastfeed successfully if things had been different and even if she could have, hindsight is 20/20 and there is no point in rehashing that now. So while I was saddened by her story, I don't judge her (or anyone) for choosing formula if they feel that they cannot breastfeed for whatever reason.
That said, I think that any mom who does want to breastfeed should be encouraged to do so. I know that many moms have difficulty with breastfeeding at the start, but that they overcome those difficulties with time and with the right type of support. With that in mind, let me share with you what she said that upset me so much. She said that she had bottle fed formula and pumped for five weeks and that she feels after two weeks if breastfeeding isn't working for a mother, she needs to just bottle feed formula. This really upset me.
I ended up leaving a long comment there, but I'm not sure if my point got across and I also wanted to collect a bit of data to ensure I wasn't off base for thinking what I did. So I put up a poll on my blog and asked moms to tell me if they had a rough start breastfeeding and if it was resolved by the 2 week period. Here are the results (265 people voted):
Let's do some math. According to these results, 46% of women that did go on to have a successful breastfeeding relationship were still struggling at 2 weeks postpartum. If they are like me and hundreds of other women whose stories I have read, they would probably say that breastfeeding really wasn't working for them at 2 weeks. So what would the consequence be if all of these women followed this woman's advice and switched to formula at 2 weeks?
In Canada, almost 86% of women that do initiate breastfeeding end up breastfeeding beyond 2 weeks. In fact, almost 50% of them make it to 6 months and 9% end up going on for more than a year (source Statistics Canada 2003 data). Based on the data in my poll, if everyone that was having trouble breastfeeding gave up at 2 weeks, 46% would continue breastfeeding past 2 weeks, 27% would be breastfeeding at 6 months, and 5% would be breastfeeding at a year. What would the consequences of this be? Essentially, the well documented health benefits of breastfeeding for moms and babies would be cut almost in half. We would see more babies and children getting sick. We would see more mothers dying of breast cancer (I did the math on this in Save Yourself, Save our Health Care System).
To use an analogy, a lot of mothers have trouble giving birth vaginally and in Canada 1 in 4 babies are delivered by c-section (it is even higher in the United States). A lot of moms go into their first birth experience expecting to deliver vaginally, they may labour for a really long time, struggle a lot, go through a lot of pain and then ultimately end up with a c-section. Maybe that c-section was necessary in the end. Maybe that c-section happened as a result of unnecessary interventions. Either way, the mom is sure to be upset that she didn't have the birth experience that she wanted and may feel that she should have given up on trying to deliver vaginally earlier because that would have saved her from a lot of unnecessary pain, effort, and emotional trauma. Maybe she decides that about 4 hours of active labour is how much effort she should have given before giving up. If that is her choice, that is fine. But if she starts convincing other mothers that they should give up on having a vaginal birth after 4 hours of active labour, we would see the c-section rate soar astronomically, with significant costs to our health care system and increased risks to moms and babies.
That would be unfortunate and ridiculous.
A lot of moms struggle with breastfeeding. In addition to my story, you can read the stories of Lindsay, Maria, Dani, Katrina, Beth, Tara, Christina and many others that replied to my poll. You can go to message boards like the kellymom message boards and scour the newborn forum to see how many moms times how many different problems are possible. It is normal for it to be difficult, but with the right type of support most moms can overcome those difficulties.
Máire Clements, a lactation consultant and reader of my blog, left a comment outlining her concerns with the alarming percentage of mothers that struggle with breastfeeding. Here is part of what she had to say:
From my own experience and from reading the stories of many mothers, the problem is that a lot of well meaning health care professionals or friends with insufficient training in lactation will tell mothers things or suggest things that are detrimental to the breastfeeding relationship. If that was not bad enough, actual lactation experts and advocates often use language that is hurtful to moms that are trying really hard and that can turn them off of breastfeeding. They will say things like "every mom can breastfeed" or "if it hurts, it must be your latch". Even if those things are mostly true, lactation professionals need to choose their words carefully so that they don't place blame on the mother or make her feel inadequate. Like Máire said above, the mother is a thinking partner.
If a mom is struggling with breastfeeding, please don't tell her to quit at two weeks if it isn't working out for her. Instead, tell her that you know how hard it is. Tell her that you are proud of her for trying so hard. Tell her that it is her choice whether to continue or not and that you fully support her no matter what her decision is and that she is a great mother no matter what decision she makes. Read up about what it really means to support a breastfeeding mother. Give her a hug. Let her cry. Then let her heart guide her about when or if to give up.
I sympathize with the woman that wrote the original post and I know her heart is in the right place when she tells people they should give up at 2 weeks, but I don't think she realizes that she is undermining them if they do want to continue and that recommendations like this can have disastrous results for breastfeeding rates and subsequently for our healthcare system.
Thank you to everyone that took the time to vote in the poll and to these kind people who took the time to share their stories in the comments: bessie.viola, strwberryjoy, Jennifer, Amanda, Carla (MamaHeartsBaby), Anna, Fi, Shannon, Cynthia, Rhyah, Emily Jones, lifeafterjasper, TopHat, Tyla, Kelly, April ~ EnchantedDandelions, Tiffany, Brenda, Jennifer, Amber, Anisa, Tracy, Noble Savage, Ailie, joyce, Karen Angstadt, Tara @ Feels like home, Jessica, Judy - Mommy News Blog, Carrie, Brandy Tanner, diana, IrinaK, Carrie (a different Carrie), Paige, Lindsey, Bonnie, Sarah V., Alicja, Maria, Kimberly, Maria, Renee, Michele, Máire Clements, Samantha, Lindsay, Ashley and Melodie.
A woman wrote an honest first person account of her difficulties with her attempt to breastfeed her baby. Her story is sad. She had significant difficulties breastfeeding. She got questionable advice. She had people judging her instead of helping her. In short, the cards were stacked against her and she was set up for failure. I don't blame her. This happens to a lot of women and it is unfortunate. I can't say for sure if she would have been able to breastfeed successfully if things had been different and even if she could have, hindsight is 20/20 and there is no point in rehashing that now. So while I was saddened by her story, I don't judge her (or anyone) for choosing formula if they feel that they cannot breastfeed for whatever reason.
That said, I think that any mom who does want to breastfeed should be encouraged to do so. I know that many moms have difficulty with breastfeeding at the start, but that they overcome those difficulties with time and with the right type of support. With that in mind, let me share with you what she said that upset me so much. She said that she had bottle fed formula and pumped for five weeks and that she feels after two weeks if breastfeeding isn't working for a mother, she needs to just bottle feed formula. This really upset me.
I ended up leaving a long comment there, but I'm not sure if my point got across and I also wanted to collect a bit of data to ensure I wasn't off base for thinking what I did. So I put up a poll on my blog and asked moms to tell me if they had a rough start breastfeeding and if it was resolved by the 2 week period. Here are the results (265 people voted):
Question: Did you have a rough start with breastfeeding?
- No, it was easy - 27%
- Yes, but by the 2 week mark everything was going smoothly - 21%
- Yes, and it took more than 2 weeks to get all of our problems worked out - 41%
- Yes, and I ended up exclusively pumping - 3%
- Yes, and I switched to formula at or before the 2 week mark - 3%
- Yes, and I switched to formula after the 2 week mark - 2%
Let's do some math. According to these results, 46% of women that did go on to have a successful breastfeeding relationship were still struggling at 2 weeks postpartum. If they are like me and hundreds of other women whose stories I have read, they would probably say that breastfeeding really wasn't working for them at 2 weeks. So what would the consequence be if all of these women followed this woman's advice and switched to formula at 2 weeks?
In Canada, almost 86% of women that do initiate breastfeeding end up breastfeeding beyond 2 weeks. In fact, almost 50% of them make it to 6 months and 9% end up going on for more than a year (source Statistics Canada 2003 data). Based on the data in my poll, if everyone that was having trouble breastfeeding gave up at 2 weeks, 46% would continue breastfeeding past 2 weeks, 27% would be breastfeeding at 6 months, and 5% would be breastfeeding at a year. What would the consequences of this be? Essentially, the well documented health benefits of breastfeeding for moms and babies would be cut almost in half. We would see more babies and children getting sick. We would see more mothers dying of breast cancer (I did the math on this in Save Yourself, Save our Health Care System).
To use an analogy, a lot of mothers have trouble giving birth vaginally and in Canada 1 in 4 babies are delivered by c-section (it is even higher in the United States). A lot of moms go into their first birth experience expecting to deliver vaginally, they may labour for a really long time, struggle a lot, go through a lot of pain and then ultimately end up with a c-section. Maybe that c-section was necessary in the end. Maybe that c-section happened as a result of unnecessary interventions. Either way, the mom is sure to be upset that she didn't have the birth experience that she wanted and may feel that she should have given up on trying to deliver vaginally earlier because that would have saved her from a lot of unnecessary pain, effort, and emotional trauma. Maybe she decides that about 4 hours of active labour is how much effort she should have given before giving up. If that is her choice, that is fine. But if she starts convincing other mothers that they should give up on having a vaginal birth after 4 hours of active labour, we would see the c-section rate soar astronomically, with significant costs to our health care system and increased risks to moms and babies.
That would be unfortunate and ridiculous.
A lot of moms struggle with breastfeeding. In addition to my story, you can read the stories of Lindsay, Maria, Dani, Katrina, Beth, Tara, Christina and many others that replied to my poll. You can go to message boards like the kellymom message boards and scour the newborn forum to see how many moms times how many different problems are possible. It is normal for it to be difficult, but with the right type of support most moms can overcome those difficulties.
Máire Clements, a lactation consultant and reader of my blog, left a comment outlining her concerns with the alarming percentage of mothers that struggle with breastfeeding. Here is part of what she had to say:
The tug of war seems to be between those who insist on the baby doing it naturally no matter what that looks or feels like, and the experts micro-managing the process by emphasizing the use of gadgets and measurements to assess whether breastfeeding is successful.
What is often lost in the flurry of maternal hormones and well meaning encouragement from family and friends is the awareness that a positive breastfeeding experience will not always happen on automatic pilot.
It is a skill that needs to be learned, preferably not through painful trial and error...
We must shift our attention back to helping mothers achieve a quality connection which is pain-free and transfers ample milk to their babies. It is through consistency in the latch-on that feedings can become optimized and many problems can be avoided or resolved.
The mother is the thinking partner and her baby feeding well drives the breastfeeding system and milk supply.
From my own experience and from reading the stories of many mothers, the problem is that a lot of well meaning health care professionals or friends with insufficient training in lactation will tell mothers things or suggest things that are detrimental to the breastfeeding relationship. If that was not bad enough, actual lactation experts and advocates often use language that is hurtful to moms that are trying really hard and that can turn them off of breastfeeding. They will say things like "every mom can breastfeed" or "if it hurts, it must be your latch". Even if those things are mostly true, lactation professionals need to choose their words carefully so that they don't place blame on the mother or make her feel inadequate. Like Máire said above, the mother is a thinking partner.
If a mom is struggling with breastfeeding, please don't tell her to quit at two weeks if it isn't working out for her. Instead, tell her that you know how hard it is. Tell her that you are proud of her for trying so hard. Tell her that it is her choice whether to continue or not and that you fully support her no matter what her decision is and that she is a great mother no matter what decision she makes. Read up about what it really means to support a breastfeeding mother. Give her a hug. Let her cry. Then let her heart guide her about when or if to give up.
I sympathize with the woman that wrote the original post and I know her heart is in the right place when she tells people they should give up at 2 weeks, but I don't think she realizes that she is undermining them if they do want to continue and that recommendations like this can have disastrous results for breastfeeding rates and subsequently for our healthcare system.
Thank you to everyone that took the time to vote in the poll and to these kind people who took the time to share their stories in the comments: bessie.viola, strwberryjoy, Jennifer, Amanda, Carla (MamaHeartsBaby), Anna, Fi, Shannon, Cynthia, Rhyah, Emily Jones, lifeafterjasper, TopHat, Tyla, Kelly, April ~ EnchantedDandelions, Tiffany, Brenda, Jennifer, Amber, Anisa, Tracy, Noble Savage, Ailie, joyce, Karen Angstadt, Tara @ Feels like home, Jessica, Judy - Mommy News Blog, Carrie, Brandy Tanner, diana, IrinaK, Carrie (a different Carrie), Paige, Lindsey, Bonnie, Sarah V., Alicja, Maria, Kimberly, Maria, Renee, Michele, Máire Clements, Samantha, Lindsay, Ashley and Melodie.
Reader Comments (105)
When I talk to breastfeeding moms online, and when I share at my WIC pregnancy-breastfeeding peer group (at which I am the only mom who has breastfed before at all, having done so for 28 months and counting), I always mention the SIX week mark. Not that you should quit at that point, but that it's very hard at least until that point. I've had several other BF moms agree - Something about hitting six weeks and things seem to let up! And either way, I think that by 6 weeks you're more comfortable in your mom skin and less likely to give up.
I think that it's irresponsible to encourage others to give up, especially within such a short timeline. Yes, it's hard. Lactation consultants can be intimidating. But the mindset that breastfeeding is the only option - There is no backup option - was really helpful in my own struggles to breastfeed. The mental version of not keeping formula in the house if you're trying to BF.
Great post. I heavily researched everything on natural birthing and was adamant no drugs would be involved but after three days of very painful labour, no sleep or food, I couldn't take anymore so opted for an epidural as I could see no end in sight. In hindsight I could have probably have done with the support of a doula as my partner slept through those three nights meaning I was on my own with the contractions coming every few minutes. What I didn't research was breastfeeding and was quite shocked to find how difficult it was. Luckily the local healthcare in the UK sent round a breastfeeding support person although she couldn't see anything wrong with the latch. The healthcare system in the UK is very pro-breastfeeding with lots of posters in and around the hospitals about its importance and benefits. Unfortunately I don't think the breastfeeding support team have enough knowledge as they are basically mothers who have experience but no expert knowledge. What helped me in the end was hiring a lactation specialist. She came round three times and without her amazing knowledge and support I don't think I would have been able to continue breastfeeding. Even then breastfeeding was painful (sometimes excrutiating) for the first six weeks. I dreaded every feed but I took one feed at a time and I persevered. It suddenly got a lot easier after six weeks and after three months it became a very pleasurable activity. I am now 10 months in and love every moment of it and will be sad when it ends. The next hurdle I am facing is that people who were previously supportive think I should give up at 12 months. In the UK it seems that breastfeeding for over a year is considered extended breastfeeding as isn't the social norm to continue after a year (I don't know anyone who has made it past a year with most stopping at six months). Aside from the health benefits of breastfeeding, I've found it a powerful tool in helping my baby get to sleep and to resettle her quickly when she wakes in the night. I'm not sure how my baby or I will cope at night without the nursing. She has never cried at night because I respond to her straight away and offer comfort whenever she wants it but I feel without the nursing there will be tears.
I agree, 2 weeks is not long enough. It was a different adjustment period for each of my 3 babies, and by my 3rd when I considered myself a pro, I think I had the most difficulty. Now my daughter is 7.5 months and I'm struggling with the decision of whether or not I should stop pumping. I've already been back at work for 4.5 months and pumping this whole time, nursing in the mornings and evenings. I hate to give it up because it truly is a time for bonding with my daughter, not to mention the health benefits, but its getting harder and harder to manage at work. I just wish I knew what the right decision is!
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My infant is now 17 months and we are still breastfeeding. And I am so glad I stuck with it.
The issue I have is that even if you wean, she still might keep waking at night. Weaning is no guarantee of great sleep, or closer paternal bonding. Children do go through phases of being attached to one parent, and at this stage it's usually the mother. Also many of my friends' babies, long weaned, wake up multiple times.
At least with breastfeeding you have that wonderful comforting aid, and it is so amazing when they are sick and won't eat, yet they will breastfeed so you know they are ok.
My advice is to give it at least until 12 months, and then reassess. Also consider day weaning as a way to include your partner more.