When I was pregnant, I heard about the importance of breastfeeding at every turn. The message "breast is best" was repeated at the doctor's office, in parenting books, by other moms, on social media, and even on cans of formula. The message was not, "You could or should give nursing a try" or, "Give your baby as much breast milk as you can or want to." Instead it was, "You should breastfeed exclusively for at least six months." That message, I think, sets most of us up to fail. Honestly, exclusive breastfeeding is impossible for most moms, and for so many reasons.
According to the Center for Disease Control and Prevention (CDC), only 22 percent of babies in the United States are exclusively breastfed at six months of age. And it's not just an issue in the United States. According to the World Health Organization's (WHO) Global Breastfeeding Scorecard, only 23 countries in the world report six month exclusive breastfeeding rates above 60 percent, and not a single one meets the goal of 100 percent.
So, why are so many moms unable to meet this goal? Is it even possible? Moms cite so many reasons for stopping. According to a study published in the British Medical Journal, many moms find the reality of breastfeeding to be so much harder than they expected. Another study found milk supply issues, returning to work, and infant and maternal illness to be reasons for stopping breastfeeding or supplementing with formula. In Lanisoh's survey of over 13,000 new moms, the main challenge for moms across the globe was pain while breastfeeding. None of the aforementioned reasons for weaning came a surprise to me at all, and most can't be changed by more breastfeeding education alone. The truth is, exclusive breastfeeding is another example of something that sounds great in theory, but completely falls apart in reality for so many moms.
To explore how this happens, it's important to examine a few things that most breastfeeding literature either minimizes or ignores completely, including but not limited to: some people can't breastfeed or produce enough breast milk, breastfeeding exclusively isn't just a matter of lactation, breastfeeding is difficult, and nursing is not necessarily "best" for all families.
Let's start with the fact that not everyone can produce enough breast milk. According to many books, websites, breastfeeding organizations, lactation classes, and health professionals, most women can breastfeed and undersupply is rare — only impacting one to five percent of people. The aforementioned statistic, however, isn't even remotely true. Dr. Shannon Kelleher, a human milk researcher told the website themomvist.com, that between 10 to 15 percent of women suffer from overt lactation failure, and as many as 40 to 60 percent of moms experience undersupply. Whoa.
The pressure to breastfeed exclusively at all costs almost killed my daughter.
I have to admit that when I discovered that undersupply was so common, I was both relieved to not be alone and upset that so many of us have been made to feel as though our situations are fictitious. The pressure to breastfeed exclusively at all costs almost killed my daughter. After she was born I let her starve for five days, because countless people told me she was getting enough milk and that I shouldn't supplement with formula. She had to be admitted to the NICU for dehydration, jaundice, and weight-loss, and the guilt I felt then will stay with me forever. A few weeks later, I switched to formula.
Of course anyone who has breastfed knows that supply is only part of the equation. Some babies can't latch, and others, like my youngest baby, have health conditions and require formula to thrive. Others refuse to latch, go on nursing strikes, get sick, or self-wean. What's a mom to do? Feed her baby, of course.
A person's ability to breastfeed at all, let alone exclusively, depends on so many other factors, too, including their health, trauma history, stress level, having the right kind of support, access to parental leave, having access to healthy food, having a breastfeeding-friendly employer, having time to breastfeed or pump, whether or not she has other kids who need her time and attention, and so many others.
The truth is, exclusive breastfeeding is another example of something that sounds great in theory, but completely falls apart in reality for so many moms.
We also need to acknowledge that breastfeeding challenges are linked with postpartum depression. We have created a culture where women are literally dying because they can’t breastfeed, and babies like mine are starving because moms are afraid that one bottle of formula will hurt their babies. Our culture's obsession with exclusive breastfeeding is putting new moms and their babies at risk, creating insurmountable guilt and shame, and making moms feel like they are failing, when they are totally not. When I look back, it wasn't until I was finally able to ditch exclusive breastfeeding as a goal and redefine what "breastfeeding success" meant for me and my baby, that I was able to feel like I was a good mother.
So where do we go from here? As Dr. Ruth Ann Harpur, Clinical Psychologist, writes in a recent blog post for the Fed is Best Foundation, "I propose we collectively redefine successful feeding to take into account the unique needs of each mother, baby, and family. Rather than focusing on the feeding process, we should set goals which prioritize healthy outcomes for families and which are attainable through all available safe feeding methods."
I couldn't agree more, and I hope that we get there. To all of the moms out there that couldn't breastfeed exclusively, I want you to know you aren't alone and you didn't "fail" at anything. The bar was just set way too high. Besides, formula and combo-feeding are awesome, healthy ways to feed babies, too. Whether you supplement early before your milk comes in, or because you didn’t make enough breast milk, had to return to work, couldn't pump or had supply issues, or discovered that breastfeeding exclusively was bad for your physical or mental health, you are in good company, and are doing the best you can. Fed is best, and you are enough.
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