As printed in the January 2007 Issue of Pregnancy Magazine
Breastfeeding
by Linda Villarosa
The
Surprising Reasons Why Many Moms Stop Nursing Too Soon
— Plus Real-Life Solutions
As printed in the January 2007 Issue of Pregnancy Magazine
When my second child Nicolas was born several years ago, I already
knew the drill. Among other things, I planned to give him only
breast milk for the first half-year. At four months, I would
return to work with my rented super-duper double breast pump
in tow and keep the breast milk flowing. Then, as I had done
with my daughter, at six months I would gradually transition
him to cereal and solid food before easing him off the breast
sometime around his first birthday.
But that's not what happened. As fate would have it, my father
died the same day my son was born, leaving me so empty I thought
I'd dry up and blow away. Between the newborn, my energetic toddler,
work, and grief, I couldn't keep up with my son's growing appetite
and the breastfeeding started to fall apart. Despite my resolve
to only feed my baby breast milk for six months, at month four
I gave in and mixed some formula into his bottle of pumped milk.
On some evenings, I even threw in a little cereal to fill him
up and help him sleep. By six months, I had weened him altogether.
Mountains
of research support the idea that "breast is best"
both for mothers and infants. Evidence compiled by the American
Academy of Pediatrics (AAP) Work Group on Breastfeeding shows
that breastfed babies have lower rates of diarrhea, allergies,
digestive disorders, and infections. Breast milk also helps protect
against sudden infant death syndrome, meningitis, diabetes, obesity,
and future heart disease. Some studies even suggest that breastfed
children develop fewer psychological, behavioral, and learning
problems as they grow older.
For moms, breastfeeding reduces the risk of both breast and
ovarian cancer. It protects against osteoporosis later in life,
encourages weight loss after pregnancy, and it helps the emotional
bond between mother and child. Plus, breast milk is free, compared
to formula that can cost thousands of dollars per year.
"Breastfeeding is simply the gold standard for babies and mothers,"
says Katy Lebbing, a certified lactation consultant who manages
the Center for Breastfeeding Information for La Leche League.
But
it's not just breastfeeding that's important. According to
the experts breastfeeding exclusively—with no formula
supplementation—for six months is key. Both the AAP and
the American College of Obstetricians and Gynecologists encourage
women to feed babies only breast milk for the first six months
and then breast milk and solids for a year or longer.
And there's the rub. Like me, the vast majority of women fall
short of this standard. While some 70 percent of American women
breastfeed initially, by six months the number is down to 33
percent, according to AAP research. These rates are even lower
for black women. Why? What causes the disparity between what
experts so strongly recommend and what real mothers actually
do?
Expectation Vs. Reality
On
paper, it seems like millions of American moms are simply ignoring
indisputable medical evidence about what's best for their babies.
But that's not true. A recent survey of more than 1,000 women
conducted by Lansinoh Laboratories, a maker of breastfeeding
products, examined the reasons why new moms stop breastfeeding
early. Among those surveyed, the vast majority—85 percent—understood
the importance of breastfeeding and had planned to do so for
at least one year. But for various reasons they didn't make it
through the long haul. By 12 weeks, nearly a third of the mothers
surveyed had weaned their babies altogether.
Like me, nearly half the women in the survey believed they weren't
producing enough breast milk and their babies weren't getting
enough to eat. Other top reasons included difficulties getting
baby to latch on, work-related issues, and sore or cracked nipples.
Many women reported that breastfeeding was too physically and
emotionally draining.
"What happens to a lot of women is that there's a disconnect
between expectation and reality," says Barbara Dehn, a nurse
practitioner in Northern California and author of a series of
women's health guides, including Your Personal Guide to
Breastfeeding.
Dehn
adds, "Some
women aren't prepared for the different stressors they might
be having post partum. Breastfeeding takes between 8 and 10
hours a day. That's like having a full-time job. Others are
in significant discomfort, especially if they've had a C-section.
Some babies take to it easily, while others have challenges.
When you add everything together, for some women all of it becomes
too much and they aren't able to stick with it."
Stephanie
Neurohr of Dallas, mother of seven children and director of
a video series on breastfeeding, www.Motherof7.com, agrees. "Mothers
think breastfeeding will be a natural experience, but all of
the suddden a new baby is handed to us and we don't know what
to do," she explains. "Breastfeeding is only natural
after you know how."
Is Baby Hungry?
Worried
that her baby daughter wasn't getting enough to eat, Arlene
Cabrera stopped breastfeeding after three months last year. "My breasts weren't producing all the milk they should've,
so my baby was always hungry," says Cabrera, 26, a full-time
mom who lives in New Market, MD. "She was crying and totally
cranky, because she wanted a full tummy. When I'd mix the milk
with formula she was totally happy."
Experts
don't like to hear stories like Cabrera's, especially because
many women who believe they can't produce enough milk are probably
mistaken. "Every woman has enough milk," says Dehn.
"Even a woman with small breasts has enough. Even one breast
can get four to six ounces."
To
know whethere your baby is getting enough, watch her weight.
Though newborns typically lose 10 percent of their birth weight
right away, in two weeks, they should gain it back. Your infant
will be weighed at each "well baby" check up, including
at least two visit during the first two months. If you're worried
that your baby isn't eating enough, don't assume, but do share
the concern with your health-care provider.
"A healthy baby gains about half an ounce, maybe more, a day
in the first few months," says Dr. James Sears, an ob/gyn
and co-author of The Baby Book: Everything You Need to know About
Your Baby from Birth to Age Two. "That means if your
baby is gaining about a pound or two a month, that's great."
Outside
of the doctor's office, keep an eye on the diapers. Four to
six very wet diapers every 24 hours means your baby is getting
plenty of milk. Or inspect your baby's stool. "On about
day five, look for a bright yellow bowel movement," says Dr.
Jane Morton, a Stanford University professor of pediatrics and
medical director of breastfeeding medicine at Lucile Packard
Children's Hospital. "That's a sign that your baby is getting
enough breast milk. In general, if your baby is passing stools,
everything's fine."
Crying,
on the other hand, is generally not a good way to gauge hunger.
Your newborn may not always be crying for food, but for something
to suck on. "Babies are programmed to suck, not just
for food, but for comfort, for fun, or to put themseleves to
sleep," says Dehn. "Some babies may seem hungry, but really all
they might need is some extra suck time." To figure out the difference
first offer your baby a clean finger or pacifier. "A baby who
is truly hungry will not be satisfied with a finger or pacifier,
so she needs more millk," Dehn explains.
Workplace Woes
Nearly
half of all mothers return to work sometime within the first
year of their baby's life, studies show. But breastfeeding
on the job can be inconvenient and uncomfortable. Many women
give up after returning to work because they're unable to find
a private room to pump in or a safe place to store breast milk.
Others are just too tired from work and lack of sleep to pump
enough milk to keep up with baby's demand. Hope Levav, 37, of
Brooklyn, NY, had planned to breastfeed her son, Aaron, for up
to a year, but by the end of her first week back at work as a
middle school teacher, she started supplementing with soy formula.
"I had loved breastfeeding Aaron, but pumping wasn't the same.
It was disruptive to my day, but even more, I was worried that
his demand was exceeding what I was producing," she says.
"We don't live in a culture that values breastfeeding," says
Lebbing. "It makes no sense that companies give employees
breaks to go outside and smoke but are reluctant to give women
time in the work day to breastfeed. The bottom line is that it
is to an employer's advantage to support a breastfeeding mother."
Experienced
working moms have discovered some tricks to make the transition
easier. "I invested about $40 in a hands-free
pumping bra, so I could pump breast milk on my way to work,"
says Robin Elise Weiss, a doula and childbirth educator who lives
in rural Kentucky. The bra holds the pump in place. Adds Weiss,
who is also a pregnancy/childbirth expert for about.com, "Renting
a double pump is a huge timesaver. I was working in a cubicle,
so I borrowed an office and pumped during lunch and during my
breaks. With a double pump, it's like you pumped for 20 minutes
during a 10-minute break."
Ultimately
it's up to you to make sure your employer and co-workers understand
the value of breastfeeding. "You have to ask your employer—before your baby is born—to
provide a private place for you to pump, the time to do it,
and someplace to keep it," says Neurohr. "Make your case in
financial terms. Breastfeeding saves the company an enormous
amount because babies and their mothers aren't sick. Employers
will hear that. Returning to work and continuing to breastfeed
is only a problem if you make it one."
Dehn, who has an 11-year-old son, offers moms this practical
advice: Pump some extra extra milk in the morning and give it
to your baby at night. "Morning milk has a higher fat content,
because Mom has been able to rest," she explains. "After a day
of working, doing laundry, cooking dinner, and running after
a toddler, the milk a woman produces has a higher water and sugar
content and isn't as satisfying. So rather than formula, let
Dad or someone else give baby that nice rich milkshake from the
morning. Both you and the baby will be able to get some rest."
Some Breast Milk Is Better Than None
Many women find breastfeeding difficult and frustrating, particularly
at the beginning. "If a woman expects to put her baby on her
breast and it'll just happen, she may be disappointed and take
it personally," says Weiss. "When a baby isn't latching on correctly,
a woman may think 'I don't know what I'm doing; my baby's going
to starve.' Or worse, 'my baby doesn't like me. He doesn't cry
when he's with the nurse.'"
A number of issues, including babies who don't latch on right
away and painful nipples, can often be avoided by learning the
proper technique as early as possible. It's wise to get practice
by taking a workshop or class while you're still pregnant and
seeking help from a certified lactation consultant in the hospital
or birthing center immediately after your baby is born.
It's also essential not to panic. "Studies show that 90 percent
of babies aren't that good at latching on right away," says Dr.
Morton. "But babies aren't born starving. They don't have a high
need for calories, so there shouldn't be a desperate urge to
figure everything out right away."
Even more importantly, there's no need to beat yourself up if
you aren't able to exclusively breastfeed for the entire six
months. "I know it's against the official recommendations, but
if you're giving your baby a bit of formula or cereal is going
to make a big difference in how soundly you sleep or how well
you're parenting, then I wouldn't hesitate to do that," says
Dr. Sears. "There's no reason to feel guilty if you can't follow
the breastfeeding advice to the letter. A woman has to do the
best she can Guilt is a bad feeling to have as a mother."
Agreed.
My son Nic is now in second grade; he's got bright eyes and
boundless energy. He towers over the other kids in his class
and eats like a grown man. He does have allergies, and sometimes
I worry that not breastfeeding him exclusively for six months
prompted his hair-trigger sneezes and stuffy nose. Then I look
at the pile of discarded tissue beside my own bed and remember
my father's runny nose during hayfever season. I may never
know if I'm responsible for his allergies—except through my
genes—but I do know his health and happiness are about
much more than that.
Linda Villarosa is a freelance writer specializing in health.
The author of several books, she lives in Brooklyn, NY.
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