(Image: Raphael Goetter)
There has been some increased discussion this week about breastfeeding. Colleen shared her personal struggle with breastfeeding at Green & Clean Moms article “breastfeeding or bottle feeding.” It has generated a lot of discussion and debate, primarily due to a comment left from PHDinParenting who went on to discuss “when to give up on breastfeeding” because she took exception with a point from the original article. The original article was recently pulled from the site because it became personal rather than an opportunity to find some common ground as mothers. Sad that the debate missed a great learning opportunity for all because of the passionate nature of the topic. How can clarity be possible when comments are driven by emotion?
Moms who bottle feed are feeling like they need to defend their feeding choices amidst pressure from peers, friends, family and professionals. Breastfeeding Moms also feel pressure from the same groups while trying to master something that can be very challenging in the beginning.
A side note: Should we not also appreciate the fact that we have been blessed with a choice on how to feed our children, when so many die of malnourishment and starvation.
I’ll briefly share my breastfeeding experience, and then get to the heart of this article: Why is no one is talking about the fact that so many moms seem unable to produce milk for their babies these days? What has happened?
I had a successful experience with breastfeeding and would like to see as many moms breastfeed as possible. We could stand to be more understanding of the multitude of circumstances a mother considers when making her own feeding decisions BUT at the same time not giving blind support that only undermines the heart of the matter.
Call me crazy, if given the choice, I don’t see why I would pay a corporation for something I can get for free. I suppose I am mostly an activist at heart and this is also reflected in why I question our current vaccination schedule and why I refused to take anti-depressants at a low point in my life. I also question how formula can be that similar to breast milk with all the synthetic additives they include now, especially after reading Jennifer’s article Are DHA and ARA in Infant Formula Really Safe?
I should add that I did use some formula at 9 months but I breastfed my daughter until 14 months. I added formula to replace 2 feedings because I believed that this was the only way I could stimulate ovulation and get pregnant again. I loathed the formula the whole time. It was a slippery slope because the 1-2 feedings dropped my milk supply, and she saw how easy it was to drink from a bottle, further jeopardizing our breastfeeding. Shortly after introducing formula, Liv began to wean herself off the days so I was left holding on to the night feeds as long as possible. I didn’t expect formula to have such a dramatic effect on our breastfeeding.
I think it’s important to break the myth that “breastfeeding is easy.” You just put a baby to your breast and voila you are breastfeeding right? This may be the case for some, but certainly not for many Moms I’ve spoken with. We have not grown up in a culture that passes down generations of breastfeeding knowledge. Seems every 20-30 years breastfeeding is challenged either “the best” or becoming taboo once again.
Quite by chance, one of the most valuable things I did while pregnant with Olivia was attend a “breastfeeding group.” There were about 15 women discussing the challenges they were having. I arrived at the meeting a little aloof because I thought “hey, no problem, this is in the bag.” But not one woman said it was easy? They all were dealing with mastitis, thrush, poor latch, colic, lazy feeding, greedy feeders etc.. I left 3 hours later understanding that there are many challenges that come up and to keep my expectations in check.
I never thought that 5 weeks after Liv was born, breastfeeding would still a big learning curve for me. I remember saying ” Wow, here I am and I still cannot get this football hold or latch going correctly. What’s that white stuff in her mouth…do we have thrush now?!”
I would like to see pregnant moms who are planning to breastfeed more prepared for the (possible) big learning curve and therefore less vulnerable to society’s expectations that they get a handle on breastfeeding in such unrealistic time frames.
We are right to be discussing attitudes that hinder our connection with other women. Lets continue to discuss the challenges that exist with learning to breastfeed so that women understand that they are not alone and let’s dig our way out of all the contradiction and misinformation that frustrates all new mothers.
I think what best sums up my feelings about this thought provoking week was simply stated in the comments over at PhdinParenting by Hope at HippyDippyBebe”
I can say that for myself, I do not equate the idea of being supportive with avoiding value judgements entirely. As mothers, especially educated mothers and bloggers, when we present our opinions, I believe the presumption is that we do so out of a combination of our personal values and our informed research. The understanding is that not everyone shares our values, our limitations, or our strengths. What works for one mom doesn’t necessarily work for another!
But if we go to extremes in that regard — essentially saying, “Whatever way you do things, honey, that’s ultimately the best thing that you possibly could have done and I support it wholeheartedly because I support all moms.” — I think we undermine our ability to truly help each other.
I think it’s important that we do not confuse our desire to support each other with our desire to speak our personal truths.
Now on to the other issue…
Why so many stories these days of “insufficient milk?”
Every week, I am meeting more and more moms who had every intention of breastfeeding yet did not produce the milk.
I want to know why so many women are now dealing with empty breasts?
I remember seeing a Lucy Liu on Oprah where she interviewed women from Brazil. I was shocked when she reported that amidst all the plastic surgery and focus on beauty, Brazil’s breastfeeding statistics are apparently 90-97% so I gather they don’t have the same issues with insufficient milk supply?
Why such high breastfeeding rates?
From what I remember, Lucy Liu stated that breastfeeding may be so successful in Brazil because:
- Formula is provided only by prescription
- There is a strong breastfeeding family history
- Formula is a big expense
- Perhaps a more traditional family arrangement
- Our lifestyle is more hectic compared to more “relaxed” cultures?
Doctors seem to have a simple explanation for low milk (a missing chemical) but I wonder why this seems to be so common here? Is this a new issue or did our mothers and grandmothers experience this shortage as well and not discuss it as openly as we do today?
I tried to research as much as possible but I found articles mostly focused on social factors affecting breastfeeding rates or “perceived insufficient milk” rather than actual medical conditions of insufficient milk supply.
I finally came across another blogger who also addresses the insufficient milk issue. She quotes an big exert on her blog from “Our Babies Ourselves, How Biology and Culture Shape The Way We Parent”
Here is small portion:
In only about 5 percent of the cases is there something making it physically impossible for a woman to breast-feed. It is interesting to note that insufficient-milk syndrome appears only in Western industrial nations and has yet to be found in other cultures.
Even nutritionally deprived women, unless they are nursing during a major famine, have plenty of milk, and the composition of their milk is the same as that of better-nourished women. Oddly enough, the greatest numbers of women who say they cannot produce enough milk are highly nourished, well-fed Western women.
The author goes on to discuss the whole process of feeding an infant and the issues that come up and how we interpret the various infant cues. If this book’s statistics are well researched and show that this is a western nation issue, then it is worth discussing that we may have indeed fallen into a social situation of perceived insufficient milk rather than a true biological inabilility to produce.
*note – when I first began wondering about insufficient milk, I was expecting to find research on environmental toxins or another biological cause influencing milk production. I did not expect to find so many papers calling it “perceived insufficient milk.”
I brought the “insufficient milk” dilemma to light because I think that it is important to know that an actual inability to produce milk is much rarer than we think. Women need to know that their odds of being able to breastfeed are in their favor! Knowing the statistics, combined with supportive and accurate help for the first 4-6 weeks is very important so that a woman trusts herself and is empowered to succeed.
This idea that “insufficient milk” is the root cause for not being able to breastfeed has been creeping into into local playgroups. I am concerned because accepting this as the reason for not being able to successfully breastfeed is generating a false social belief that normal struggles with breastfeeding must be related to a biological inability to produce milk. In fact, there are many external factors (rather than biological) that affect milk production and this is the real issue that should be addressed! I was confident BF Mom, but for all the times a well intending mom asked me if I “had enough milk” when going through normal periods of infant growth and adjustment, I can see why moms would doubt their abilities because I even doubted myself at times!
Let’s discuss! Do you think if more moms knew that it is only 5% that cannot produce milk, it would encourage them to continue working through the common breast feeding issues?
These are my thoughts on living a healthy and simple life. I'm a modern mom with some traditional ideas. At home, I try to clear the confusion from all the conflicting health and parenting advice with some common sense and a natural philosophy. This is the sanest way I know how to navigate the 21 century.
{ 13 comments… read them below or add one }
Wow Monica! You’ve written a great post here. There are so many things to respond to but I will just comment on what stands out for me. First, even though only 5% of moms medically cannot produce enough milk, it is probable that these moms do the most reaching out to share their story because they really wanted to breastfeed and feel the need to defend why they chose formula, when it was the last thing they wanted to do. So it is likely that many moms you have talked to and the ones we read about on-line elsewhere really could NOT produce enough milk. This is a strange comparision but it is like crime. Crime gets reported on the news every night, yet it is still a rare occurrence. Most people will NOT be vistims of crime, yet because of the news it receives people assume it is much more rampant than it really is.
That being said, I also agree that MOST moms who think they couldn’t produce enough milk were indeed misperceiving their abilities. Latching on can very difficult and without the right latch a baby may not receive the amount of milk it needs to. I think a lack of knowing where to turn, doctors who aren’t trained in breastfeeding who well-meaningly tell frantic moms to just use formula, then the subsequent use of formula and then milk production does decrease. Moms see their babies love the bottle, feel discouraged and just stop trying.
If there was more support for new moms, more follow up, better training for doctors, more resources readily available to newmoms who eaily get lost in their new world of motherhood… you mentioned that we don’t get breastfeeding advice passed down from generation to generation and I think that is true now, but wasn’t always. The more moms who breastfeed today will have the knowledge to pass down to their daughters and grand-daughters. We’re coming out of the formula-friendly generations so we still have a long way to go. The best thing we can do is help educate and help support those we come across who don’t know where to turn.
I think I should end here. Sorry for the muddly-puddly all over the place comment. Again, great post. I hope lots of other readers will comment too.
Melodies last blog post..Breastmilk for Dinner Again!
I had plenty of training, support, guidance and knowledge about breastfeeding and I knew it would be hard and was okay with this. However, I DID not make enough milk. I have a hormone imbalance and I don’t make enough of the hormone that tells my brain to tell my breasts to make milk. End of story. I tried. I tried. I tried. My kid starved and nobody helped me and made me feel bad for quitting but looking back I only feel bad that I didn’t listen to my gut sooner.
I write about not making a line in the sand and you being here and me being there and us taking sides. We have a choice and need to support each other verses making one another justify the choices every step of the way.
Wow this is an interesting article for me. I just wish that I can turn back the clock. I would have benefited from having more info about breastfeeding when I first had kids. My girls are already big now and I am not planning to have any more kids. However, I remember facing challenges while breastfeeding my babies.
My guess for insufficient milk supply for new moms is about stress. As a new mommy, lifestyle adjustments can be difficult to handle. Also, from where I come from, moms are expected to go back to work one or two months (some earlier) after delivery. There is little incentive to continue breastfeeding. It is all too convenient to give our babies formula. Also, due to media advertising, many ignorant moms in Asia perceive that formula milk has more nutrients than breast milk. Sad, right?
Evelyn Lims last blog post..What Are The Akashic Records?
I agree with Melodie in this: “MOST moms who think they couldn’t produce enough milk were indeed misperceiving their abilities.”
I think our culture is much to apt to listen to doctors who say after only a week or two and few ounces of baby weight lost, that we must not be making enough milk and therefore supplement. Personally I did not even produce milk until 4-5 days after giving birth and of course by that time heard MANY say I should supplement but I held my ground and my babes had colostrum until I made milk. And I did have nurses and docs telling me that the weight loss was very serious and that my babes were starving and/or that I wasn’t making enough milk. I think half the time they have no clue what they are talking about.
For the 5% that cannot make milk I wonder if they conceived naturally or if they did in vitro or hormone therapy. Not that there is anything wrong with that persay but it does show that their body was telling them from an early stage it could not support human life so it would not be surprising then that they cannot produce milk. With the general health of Westerners too I am not surprised we seem to have this trouble.
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Interesting. I had not heard about Brazil’s breastfeeding statistics, impressive as they are. Now that I think of it, I am happy for the prenatal books and education I received (like attending La Leche League meetings while still pregnant) that encouraged me to continue nursing even when my daughter had jaundice and the doctors’ office discouraged breastfeeding my newborn. This is such an emotional topic for mothers, and I understand why. Personally, I chose to breastfeed because I believed that with time it would work out, but that said, I know there are many cases where women have a difficult time nursing. I too wonder why western cultures seem to have a higher rate for problems with nursing, but over all, I think that we as women need to support each other and try to understand the difficult and different choices that we make in raising our children . . . from breastfeeding, to schooling, to discipline.
Jessica/Green Mammas last blog post..Organic Bedding for Baby
@Melodie – I see you went on to write a great article on your blog about this! I agree that moms who could not BF are indeed sharing their stories, including the 5% who biologically cannot produce milk plus many more who believed they could not. The “insufficient milk” statistics and research raised the issue for me that we are to quick to draw the “insufficient milk” conclusion when as you said, there are many factors that have to fall in place in order to produce milk in the first few weeks. This conclusion then snowballs culturally and may be more harmful to future BF mothers who misread that the “insufficient milk” diagnosis is more common than it really is.
Thanks for visiting and sharing your knowledge!
@ Sommer – You are right to have followed your gut and you certainly do not have to justify your decisions to anyone. This is a issue though, judging from all the comments on your blog. You raise a great point about the “post decision” period when regardless of what decision a mom makes, we rarely know the whole story and should not be so quick to make a judgement about (eg) why a bottle is being used.
@Evelyn – Sadly breastfeeding has a ways to go in our society where a mother has adequate support to continue. All these factors play into our decisions and it is certainly a big dilemma for moms in our complex world. Hopefully, with continued discussion, we can continue to question some of the misinformation that exists. Yes, I have heard people regard formula as being more healthy as well. Yeesh!
@Tiffany – Yes, actually the story Sommer shared on her blog about Colleen raised a red flag for me when I wondered why on earth she would be led to believe she should have any milk 24 hours after delivery. It was 3 days for me. Liv lost 13oz in the first week but I had her to my breast every 1.5-2 hours to stimulate and soothe her regardless. Once the milk came in I continued to feed her on the same time schedule rather than a 3-4 hour routine many use. I believe this really helped my milk come in strong and abundant. I too would be interested in more research re: 5% and possible factors like health, toxins, in-vitro etc…Hmmm.
@Jessica – It is an emotional topic! My intention was to start a discussion that might help clear some misconceptions so new moms have the best chance of success while at the same time stress the need for mutual support between moms, regardless of the outcome. I hope I was able to do some of that, because it was a difficult article for me to articulate! You are right, in the end, less judgement and a little more understanding goes a long way
A lot of moms deal with supply issues. Some of them are perceived supply issues and some of them are real. Some of them could be overcome with proper breastfeeding techniques and realistic expectations. Some of them stem from medical reasons. The problem is that the lack of good knowledge about lactation about moms and health professionals mean that lost of moms lack confidence about their ability to feed their baby.
Low milk supply is quoted as the number one reason women quit breastfeeding. But the problem is that too few people understand how milk production works (http://www.kellymom.com/bf/supply/milkproduction.html) and too many of them think they have low milk supply or don’t know how to increase their milk supply (http://www.kellymom.com/bf/supply/milkproduction.html).
Often when people think they have low milk supply, they supplement. But supplementing is a slippery slope for a few reasons. First, it looks like the baby is hungrily gulping down the bottle, when really it is a sucking reflex when drinking from a bottle that forces one suck to be followed by another. It is a common reason why bottle fed babies (whether getting formula or breastmilk in the bottle) are overfed. Second, every time you give your baby formula and don’t pump in place of that formula feeding, you are decreasing your supply. The more formula you give, the less breastmilk you will make, and the more formula you will have to give.
Annie @ PhD in Parentings last blog post..BlogHer ‘09
Thanks, Monica for quoting my comment!
Great post! It’s exciting to read about the results of your research, and I agree that it’s fascinating to dig a little bit deeper with these kinds of social phenomenon, especially when there are obvious cross-cultural differences.
My biggest take-away personally from your post is your point about the value in seeking out support structures while you’re still pregnant. I actually didn’t do this with my second child because I was lucky to have an easy time with my first. Fascinatingly, Little D actually had a harder time, and it underlined for me that many of the problems women have initially with breastfeeding are actually out of the scope of their control. It’s so easy to judge ourselves when breastfeeding or weight gain isn’t progressing as we’d like. Yet though we can seek help and support, we are actually not the ones doing the feeding, it’s our babies!
I also agree that it’s important for that magic statistic of 5% be more visible in our culture, both because it clarifies for many women that it’s worth trying all their options as their chances are good, and because it reminds us all that 5% does exist — there are real biological problems that occur for 1 out of every 20 moms.
That having been said, I’ll end with an interesting anecdote that echoes Evelyn’s comment about stress. My mother herself may have been one of those 5%, and she still mourns her inability to breastfeed to this day. One of the support systems she personally had back in the 70′s was actually that of her mother-in-law, my paternal grandmother, who was from the Philippines and moved to the U.S. as a nurse in the late 60′s. This is what Grandma Espie had to say:
“Jan, what are you doing? Why are you doing all this work? You just had a baby and you need to rest. You shouldn’t be doing anything. You should lie in bed and eat soup. In my country, when the mother has the baby, she doesn’t cook, she doesn’t go anywhere. Someone does these things for her. You should lie in bed and eat soup so you can make more milk.”
A traditional remedy we can borrow here? Maybe we need to start telling the daddy bloggers about this one!
Hope (of hippie dippie bébé)s last blog post..Is it Wrong to Openly Support Breastfeeding?
Hey Monica,
An award for you awaits at my site. For all your support and help and encouragement in these semi-early days of blogging and of course your excellent posts.
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It’s 3:30am, and I have to get off the internet, so just leaving my 2 cents…
In the hospital, they take your baby away from you, stuff them with formula, and then bring them back a few hours later, sound asleep. I think it’s important to be nursing your baby every couple of hours during those first few days, in order to establish your supply early. The suckling is what cues your breasts to produce milk.
I had an emergency C-section, but still nursed my son minutes after birth, and did not allow him to stay in the nursery overnight. I nursed him every time he woke up or started rooting around in his sleep. I doubt he got much of anything, but that little bit of colostrum is so important. On my last night in the hospital my milk came in. My breasts were so full and uncomfortable, and LEAKY. My son was in the nursery being “checked up” or whatever, and when they returned him they had given him a bottle so he had no interest in eating and I had to pump to relieve the pressure. From that point on I never had any issues with supply (though I had latch issues, cracked and bleeding nipples, we got thrush a few days in, and I was actually producing too much milk and the foremilk/hindmilk imbalance gave him tummy upsets for a few weeks). I attribute my ridiculous supply of Mommy Juice to actually having the opportunity to let him suckle. Otherwise, how does your body know it needs to?