While breastfeeding initiation rates are on the rise in America (three out of every four women breastfeeding when their baby is born), only 16.4% of moms are exclusively breastfeeding their babies at six months of age. 1 Despite this the World Health Organization and American Academy of Pediatrics recommends exclusive breastfeeding for the first six months, citing significant detrimental health outcomes when babies are not exclusively breastfed. More and more mothers want to breastfeed their babies.
So why are so many not meeting their breastfeeding goals? Here is my list of the top 5 reasons breastfeeding fails for some women:
- Invasive Birth
Birthing practices are strongly related to breastfeeding initiation and duration. Natural childbirth does help to get breastfeeding off to a good start. Stress is strongly linked with delayed milk onset. 2 Cesarean sections and instrumental vaginal births typically delay skin-to-skin initiation and the first breastfeed, both of which have a high impact on breastfeeding duration. 3 Pain medications given to the mother affect the baby causing drowsiness and disorganized suck. 4 Some of these pain medications continue to impact the newborn for up to a month after birth!
- Separation of mom and baby after birth
The single most important thing to getting breastfeeding off to a successful start is skin-to-skin contact (SSC) immediately following birth. All non-essential items (weighing, bathing, etc.) should be postponed for at least the first two hours following birth. SSC triggers a baby’s innate responses to seek the breast and nurse. It has many benefits: regulation of mom and baby’s temperatures, stabilizing baby’s heart rate, lowering serum cortisol levels, stabilizing blood sugar, stimulating self-latching and coordinated suckling, increasing mom’s oxytocin levels, regulating adequate milk volume, promoting bonding, and heightening a mother’s confidence. This time immediately following birth is precious, so postpone everything else and enjoy these sweet moments of cuddling and bonding with your new baby.
Whether a baby is supplemented with formula, water, herbal tea, glucose water, donor milk, or her milk is “fortified” all of these have an impact on the long-term breastfeeding relationship between mother and baby. There are many reasons given for this: mom needing sleep/recovery time, prevention of hypoglycemia or jaundice in baby, or because mom’s milk “hasn’t come in yet.” (Though none of these reasons are good indications for supplementing breast milk.) Actual research shows that supplemented babies are significantly less likely to be exclusively breastfed after hospital discharge, breastfeeding duration is shortened 4-fold, and moms remember which brand of formula was used and most will then use that brand because they see it as an endorsement by the medical establishment. 5
- Lack of support from friends, family, and/or doctor
Family, friends, and the medical community strongly influence a mother’s decision to breastfeed. Research shows that a mother’s impressions of breastfeeding are closely linked with those of her doctor. 6 If you are pregnant or nursing, it is so important to find a supportive environment of others who will help and encourage you when the going gets tough. . . a sleepless night, a fussy baby, pain, a poor latch, cracked nipples, or a myriad of other solvable problems that are so much easier to get through with someone by your side. Without this support, when you are walking the road alone, the chances of not succeeding are much greater.
- Mom isn’t convinced of it
Maternal determination is a huge factor in overcoming breastfeeding obstacles and helping mothers meet their breastfeeding goals. Even in cases of emergency c-sections and other unplanned birthing interventions, premature births, multiples, etc. research shows over and over that maternal commitment goes a long way in overcoming strikes against mom or baby in breastfeeding and allowing the breastfeeding relationship to succeed. 7 Conversely, when a mother is not convinced she wants to breastfeed she will likely be much quicker to turn to formula when problems arise.
- Breastfeeding Report Card – United States, 2013, accessed October 13, 1013 from http://www.cdc.gov/breastfeeding/pdf/BreastfeedingReportCard2013.pdf ↩
- Dewey, KG. The Journal of Nurition. Maternal and Fetal Stress Are Associated with Impaired Lactogenesis in Humans, (2001), accessed September 10, 2012 from http://jn.nutrition.org/content/131/11/3012S.full ↩
- Dashti, Manal, Jane Scott, Christine Edwards, and Mona al-Sughayer. International Breastfeeding Journal. Determinants of breastfeeding initiation among mothers in Kuwait, International Breastfeeding Journal, 5, 28 July 2010. Accessed September 10, 2012 from http://www.internationalbreastfeedingjournal.com/content/5/1/7 ↩
- Torvaldsen, Siranda, Christine Roberts, Judy Simpson, Jane Thompson, and David Ellwood. International Breastfeeding Journal. Intrapartum Epidural Analgesia and Breastfeeding: A Prospective Cohort Study, 11 December 2006. Accessed September 11, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1702531/ ↩
- Casiday, R.E., Wright, Panter-Brick, and Parkinson. University of Durham, UK. Do Early Infant Feeding Patterns Relate to Breast-Feeding Continuation and Weight Gain? September 2004. Accessed September 13, 2012 from http://www.researchgate.net/publication/8647596_Do_early_infant_feeding_patterns_relate_to_breast-feeding_continuation_and_weight_gain_Data_from_a_longitudinal_cohort_study ↩
- Lu MC, Lange, Slusser, et al. Department of Obstetrics and Gynecology, UCLA. Provider Encouragement of Breast-Feeding: Evidence from a National Survey. Accessed September 12, 2012 from http://www.unboundmedicine.com/evidence/ub/citation/11165597/Provider_encouragement_of_breast_feeding:_evidence_from_a_national_survey_ ↩
- Hung, Kristina and Ocean Berg. The American Journal of Maternal/Child Nursing. Early Skin-to-Skin After Cesarean to Improve Breastfeeding. Accessed September 13, 2012 from http://www.nursingcenter.com/prodev/ce_article.asp?tid=1225224 ↩