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Olive is almost five months old and we're still nursing. Not sure if I'll keep it up for 18 months like I did with Josie, but it's going well so far so who knows.

I've been thinking more about breastfeeding and my attitudes towards it because it's a big issue in communities of mothers - who breastfeeds, how we can get more women to breastfeed, how we can keep formula samples out of hospitals and let everyone nurse in public and get lactation rooms in every company for women to pump, etc.

But in my circle of friends, the women who stopped breastfeeding didn't do it because the "breast is best" posters weren't colorful enough. They quit because the milk just wasn't there. Or the baby who wouldn't latch no matter how many consultants they saw. Or they had medical issues that weren't compatible with breastfeeding. In other words it wasn't about society... they quit because breastfeeding was not working.

Online, I come across rare stories of someone whose friend-of-friend-of-friend said she wouldn't breastfeed because it just seemed gross or inconvenient, but those are the exception. Most women I know try to breastfeed. And what separates me from them? I'm pretty lazy. Not terribly educated on the topic... I went to a one-hour class before we had Josie, that was the extend of it. I don't own a $1000 hospital grade pump.

It's just dumb luck. My babies both came out and latched on like they had nothing better to do. And then there was the milk, one might even say excessive milk.

So how do we get more women to breastfeed? I think we're coming up with the wrong answers. Or maybe the wrong questions! After all, how important is breastfeeding? The world is full of doctors, lawyers, particle physicists etc, who were raised on formula. Should we be "encouraging" it?

And does it do you any good to encourage something that people may not be physically capable of? It's like telling every kid to practice his basketball dunking skills... give him a basketball, sure, let him try for the first few days of practice. But then encourage him to move on! Have a great passing game, kid, there are probably scholarships for that too.

Or maybe we need to find more medical solutions. Is it just me, or are we faced with very limited options when the milk supply drops? There's some teas, and fenugreek. Some cookie recipes.

Anyway, in my current discussion forums people randomly post up articles like this one: 85% of mothers plan to breastfeed for three months, only 32% make it. And the comments are along the lines of "oh how sad, our society just makes it too easy to switch to formula!" It does? People just think it's "too easy" to start using some expensive stuff you have to go to the store and pay for? No, I suspect there's more to this issue. And maybe most breastfeeding moms overlap too much with the hippies who love nature, and don't think they need scientists in a lab to solve a problem... but I love scientists in labs. Dear scientists: do we need to make breastfeeding easier? If we do, is anyone working on it? Because I think the demand is out there! Just not the supply.


( 25 comments — Leave a comment )
Sep. 27th, 2013 07:16 pm (UTC)
Most people I know quit because...well frankly it's just so darn hard, especially the first month. Even if the milk is there, having someone want to nurse on you 12-20 times a day/night is exhausting.

But it's also true that the whole LLL-like claim that almost everyone can produce enough milk doesn't seem to be true in the case of anecdotal evidence. It seems like a lot of women go to extreme measures and still can't.

But a lot of people also seem to have an all-or-nothing approach too and maybe if there was more information on how to maintain a half supply (let's say) more people would at least nurse part time.
Sep. 27th, 2013 07:20 pm (UTC)
Totally agree on the info about combo feeding. I have seen way too many moms quit breastfeeding because pumping at work wasn't working out or they needed a break, etc.
Sep. 27th, 2013 07:17 pm (UTC)
I have thought a lot about this,a nd agree,somewhat. What I see as an issue is the lack of sense of reality of what nursing a young baby (the under 3mo set) is like. Certainly there are legitimate issues, often many of them at once compounding one another, but I also see a lot of women really worried about what seems like a perfectly normal frequency of nursing with no red flags (great output, baby sleeps well between feedings, no pain with latch, normal weight gain). Or they worry that they can't produce obscene volumes of milk with a pump while nursing a newborn.

I think the kind of posters you mention might be good for a certain population- many of the recent immigrants living around me are surprised to see me nursing my babies at the neighborhood park- they picked up the sense that Americans feed babies with bottles somewhere and do that too (obv. other issues there too, including language barriers, cultural barriers).

Really? The best remedy for less than stellar breastfeedign rates is for women (and to a lesser extent men) to see babies being breastfed long before they have a baby of their own to breastfeed. It normalizes feeding at the breast, it gives a better sense of the normal frequency and duration of feedings, etc. I try to openly breastfeed my children where ever I happen to be. I've seen this work with my (much) younger sisters- when I nursed my first baby in their presence they were grossed out and already had the idea that a newborn should definitely not eat every 60-90 minutes. Now its no big deal when I sit down on the sofa to nurse the baby and they understand that it is what it is.
Sep. 27th, 2013 07:17 pm (UTC)
Also a lot of the ideas promoted by society (such as the notion that rather young infants should sleep through the night) can also doom milk supplies...

Not to mention how few women are able to manage it in terms of working/work life, getting enough sleep to enable them to work, etc. Lack of real maternity leaves is a big part of the problem I think.
Sep. 27th, 2013 09:38 pm (UTC)
I don't think that's necessarily true. The UK has excellent maternity leave provision and yet the statistics I could find regarding the UK rates (from 2010) say that only 46% of mothers were still exclusively breast feeding at one week old, and only 23% at six weeks.


Compared to these rates quoted for the US


and the UK is far behind continuing breast-feeding rates, despite our statutory 52 weeks maternity leave.

This has recently come to my attention as my cousin has been struggling a lot with breastfeeding, including severe mastitis and latch problems. The only reason she is continuing to persevere is for financial and convenience reasons, she'd rather the milk be 'on tap' than have to think about sterilising/warming bottles, preparing set amounts of milk etc. And breastmilk is free! I don't think she'd find it easy to switch, but she's also not finding breastfeeding easy, she says it's the worst part of motherhood so far.

Sep. 27th, 2013 11:18 pm (UTC)
Did you see this story in TIME earlier this year?:


I think it makes a great point -- lactation sort of falls into this no-man's-land of medicine, and so no one really knows a lot about it, from a scientific perspective. With the amount of conflicting advice I've received about breastfeeding, milk production, etc -- well, I feel very, very fortunate that I was able to work it out with very little help because the chances of getting the right advice from an accessible source was pretty slim.

Not to mention that I feel like LLL and other breastfeeding consultants' advice is very different from what's worked for us. Most of them will tell you to feed on demand. I've always, always scheduled my kids' feeds, and it's worked out great for us. This does not mean that I don't feed a hungry baby if they get hungry before it's "time" to eat, but it does mean that I wake up a sleeping baby to eat, and this has been absolutely KEY to my sanity as a mother (and I believe maternal sanity is an essential part of successful breastfeeding relationship!). It has given me a little bit of control and predictability, which I really need/needed (especially when I had twins!). I feel like a lot of mothers get the message that scheduled feedings are some kind of child abuse and if they want to be successful at breastfeeding, they must completely subject themselves to a random on-call life at the mercy of their newborn's stomach for the first few months. It doesn't have to be that way.
Sep. 28th, 2013 01:38 am (UTC)
That's an excellent article!! We were just talking on similar thoughts in our BF group!
Sep. 28th, 2013 01:08 am (UTC)
My opinion is that the women who breastfeed the longest are the ones who really like it. I don't exercise because I hate exercising and sports, so most of my attempts to do it, although good intentioned, eventually fail. I loved breastfeeding, so in spite of some really frustrating things that popped up, I made it work. I just really really loved sitting there with a baby on my boob.

All women are different and I don't think it's a failing not to enjoy breastfeeding. It's just a difference in likes/dislikes.
Sep. 28th, 2013 11:49 pm (UTC)
I think you have a great point here. I love breastfeeding, and therefore I do what it takes to make it work. (I have a friend who absolutely loathes it, but she does it because it's been drilled into her that it's what's best for her children. Once she reached a year with each child, she went and bought herself a fabulous piece of jewelry to celebrate her accomplishment.)
Sep. 28th, 2013 01:33 am (UTC)
Someone had recently posted in our local BF group, how/why American/Western society feel it should BF or nothing. Most developing nations, like India, mother (working) breastfeeds on demand while on maternity leave, and when goes to work, BF in morning and evening and supplements with formula/cow milk during the day. The whole pumping is a luxury that India can't afford with unreliable electricity source.

My own cousins were flabbergasted that D never had formula. They didn't understand how I could do it! And the more I think of that, it makes sense. I hear more often than not mothers BF well past 2 years this way. In the lower economic strata the rates are higher. But yeah, it usually means morning and night feeds. The only qualms I have though is how hushed it all is back home.

ETA: I do have to pinpoint though Pediatricians need to do a better job and painting better/realistic expectations. I still remember at the 4 month appointment he was concerned that D wasn't sleeping through the night! Simple thing like that could/often does scare parents away. Night feedings are so poorly looked on. My working mom friend felt that was one way to bond with the child when she couldn't during the day.

Another friend who is taking a nursing course, got HALF an hour in her whole course on breastfeeding. Doctors rarely get more than that on the subject. So, yes there's a lot more the medical field can do about it! But I guess though, you can measure how much formula you put in but not really how much breastmilk goes in. It's too varying amounts by case.

Edited at 2013-09-28 01:36 am (UTC)
Sep. 28th, 2013 03:38 am (UTC)
When women say "the milk just stops", for the most part, in my personal, biased and limited world, when I dig a little deeper, most of them have alraedy began to sabotage (perhaps unconsciously) the breastfeeding relationship by (a) not constantly offering and just waiting for the child to demand, and (b) supplementing!

As for "no matter how many consultants they saw", I've found that the ones I've spoken to say they "tried really hard to talk to someone" but upon further investigation, this is normally a couple of missed phone calls, a few voice messages, never attended an LLC meeting, and did not try going directly to the hospital at all.

Women go back to work. Breastfeeding and working full time is hard. Pumping is hard. Do you know how many women complained their milk supply tanked when they went to work, and then in the same breath, told me that I was crazy when I suggested "reverse cycling" and feeding the baby throughout the night?
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Sep. 30th, 2013 02:01 am (UTC)
Absolutely, it's understanding the "supply and demand" idea. If you supplement with the bottle, the baby is full and your breast thinks there is no demand. Every time you give a bottle, whether it's with formula or with pumped milk, it's another time your breasts miss the cue to make more milk.
Sep. 28th, 2013 08:14 pm (UTC)
Oct. 4th, 2013 12:35 am (UTC)
Sep. 28th, 2013 05:29 am (UTC)
I'm exclusively pumping for my new (3 week old) daughter right now. It's taken some sacrifices: I've had to forego taking a medication I kinda need because it's not compatible with bf'ing (but I can get by without it for awhile longer, so I'm taking things a week at a time) + my toddler needs things at the same time as my baby at the same time as I need to pump, and even going hands-free doesn't allow me to help everyone, so my toddler is struggling to learn patience and my husband is really having to pitch in a ton when I pump. I'm also more sleep-deprived than "usual" because I have to pump *and* bottle-feed in the middle of the night.

Despite all of this, I like knowing she's getting my milk. However, I've only been able to provide her with about 1/2 of what she needs in a day, so she's getting at least 12 oz of formula per day. It's very much a 50/50 hybrid system, and PPs are right that I almost never hear of women doing this. It's very all-or-nothing here. Even a lactation consultant (not LLL even but a hospital LC) was not very thrilled with my plan and made me feel like I should be doing *more*... but I think that I'm doing what I can, and what I can live with, and am just grateful my baby is able to have whatever I can give her.
Sep. 28th, 2013 12:17 pm (UTC)
"They quit because the milk just wasn't there.[...] In other words it wasn't about society."

Or was it? There is a large and little understood role that psychology and confidence has in breastfeeding and milk supply and the society someone lives in can definitely affect her in those areas.
Sep. 28th, 2013 11:10 pm (UTC)
I personally find it to be 100% societal that so many woman quit for latch reason or supply issues. I truly believe we have as a society lost the art and far too few woman are exposed to other nursing women before they have their first baby. By the time they are reaching out for help it's often too late. I certainly don't think all women have to breastfeed, but I'd like to see it at least be the majority. If we reach that point and still see all the problems we see now I would surprised.
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Sep. 30th, 2013 02:00 am (UTC)
" But out of the hundred+ women I talked to who said the "milk just wasn't there", EVERY SINGLE ONE had used some sort of bottle or pacifier in the first few days."


I still stand by my statement that it is sabotage, browngirl. Pacifiers, bottles, if you give it to them, then you can't expect to succeed. It doesn't mean bottle is bad, or that I'm judging you, but you can't have your cake and eat it too, honestly.

If your baby's weight dropped dangerously, and you choose to supplement with formula, then that is a decision you have to make, and you shouldn't feel judged by other parents; but if your goal was to breastfeed, there's no mincing words: you didn't.
Sep. 30th, 2013 04:07 am (UTC)
... you know what? I ended up contributing much more heat than light to this discussion, and I am bowing out, which I should have done preemptively.
Oct. 1st, 2013 08:18 pm (UTC)

Have you seen the Best for Babes "Boobie Traps"? It talks about this sort of thing: http://www.bestforbabes.org/what-are-the-booby-traps

I think that in moving into the medical realm and away from the woman-to-woman care, in moving away from village living to nuclear living we've lost a lot of the "women's knowledge." Yes, I'm super thankful that there are medical things that can help save women and babies. But just seeing breastfeeding, talking to women who breastfeed, knowing things like "babies lose weight after birth," "babies will cluster feed before a growth spurt," "Some babies don't sleep through the night," etc can help mothers. We don't routinely look for tongue-ties after birth anymore because bottles and pacifiers can't complain about a bad latch. I waited 7 months to get my son's snipped. I wish I'd insisted on doing it earlier.

I'm on a Breastfeeding support group on FB and you'd be amazed at how many of the same questions come up over and over again. The research and the knowledge is out there, but people don't know where or how to find it. And so many don't have that older female relative who has breastfed to help them.

Did you know they found nipple shields from hundreds of years ago? They were made of wood. So it's not like women didn't have trouble back then either.

Edited at 2013-10-01 08:19 pm (UTC)
Sep. 30th, 2013 10:28 am (UTC)
I think it's wrong to say "we can't encourage this at all" simply because some people can't do it, although of course whilst encouraging you have to remember not to claim that everyone can do it (because they can't). If we never encouraged people to do (or try to do) things because some people can't do them we'd never encourage anyone to do anything.
Sep. 30th, 2013 10:34 am (UTC)
Oh, and in general, I think we (society) need to be a LOT better at accepting that although perhaps "everyone could if they tried hard enough" that "hard enough" is often simply *too damn hard* for one person, even if it isn't hard for another person, both because they might actually have to do more and also because they might view the same amount of actual "trying" as harder because it is less pleasant for them.

Sometimes people claim something is actually impossible, when really it's just too hard, because there's such a stigma about saying "I know I could, if I did this and that and the other but it's too hard for me to do those things whilst doing all the rest of the stuff in my life and this is the balance that works best for me".
Sep. 30th, 2013 03:10 pm (UTC)
See, reading the mess that's happening in these comments I can't help but think about the basketball example some more.

Person 1: I really love basketball, but I could not jump high enough to slam-dunk.

Person 2: Oh that's sad, did you think about setting your alarm clock to wake up up every 3 hours throughout the night so you could hook your legs up to a machine to pump your muscles? Because I've heard that helps. And did you starve your child for a few days practicing, watch them lose weight and cry for food? Because that's no big deal, really they'll be okay.

Person 1: Uh, you sound crazy.

Person 2: Oh, well I guess basketball wasn't important enough for you to really try.

See, we'd never say that! Because being able to slam dunk is just not that important... if you can do it, great. If not, who cares! And like I said... I'm someone who easily breastfeed, and I wonder if some of these "you didn't try" comments are coming from people like me, who also easily breastfed, and somehow think we did it because we tried harder than those other people? I did not try harder.
Sep. 30th, 2013 03:50 pm (UTC)
Yeah, so that would be advice that may help, but it doesn't matter because it's advice that most people simply don't have the ability to take without trashing their life.

But maybe a few people do, and that's why they are handing it out. Or maybe actually they didn't need to work that hard, because for them it was just *once* a night, or something.

Like, I do long distance running. So I could say to someone who couldn't run at all right now "all you have to do is run or run/walk for an hour a day until you can do it" and that would be advice that I myself *have taken*. But some people don't have an hour a day, or they hate running and so doing that would super-suck, or maybe it actually is impossible because they don't have legs; I think there's a difference between "I don't have legs" and "I don't want to give up watching CSI to get an extra hour" where at one end the advice is *actually impossible* and at the other end it's simply *impractical*; but they are all good reasons for not taking the advice.
Oct. 5th, 2013 03:30 pm (UTC)
New science is coming out (though maybe slower than is ideal).

I had an emergency c-section and was pumped full of fluids to keep my blood pressure from crashing (yay science, right?). Prior to giving birth I would have told you that I would never supplement and that I would do whatever it took to avoid it. But my milk took longer to come in due to the fluids I got during the c-section and my baby developed a fever due to dehydration. She was screaming and going horse from it in a way that I haven't heard again since thankfully. When the doctor told us we'd have to supplement until my milk came in I was both deeply saddened and yet relieved that there was something I could do to make her feel better (even now typing this months later, thinking about her distress makes me cry). However! Both my husband and I were greatly cheered when the person who came in with the formula was the lactation consultant. She set up a modified SNS system for me (here is an example of a full one http://www.medelabreastfeedingus.com/products/51/supplemental-nursing-system-sns). In essence what this did was put a small tube to my nipple through which to administer the formula. Thus my baby sucked, stimulating my milk supply but she got the fluid she so desperately needed. It was ingenious and it made me feel like I was doing everything I could for my baby, both in the short and long term. Only 2 supplemented feeds later my milk came in and we've been nursing successfully ever since! I would say that was a pretty clever way for science to solve the problem, no?

I do also think it's important to let people know that any amount of breast milk your baby gets is better than nothing. So if you're only able to feed morning and night but not pump during the day, that's still better than nothing. I think making it an all or none approach is a disservice.

Also, my understanding is that women tend to have better supply with second babies. That's the funny thing about nature - unlike you, it doesn't need ALL your babies to survive, just enough to perpetuate the species. This is confirmed by anecdotal experience of people I know. I have talked to several mothers who had major supply issues even while doing all the pumping, etc. to keep up supply with first babies and things just working on their own with subsequent babies.

And finally, I definitely know people who had supply issues never having supplemented or given the baby anything to suck on. Some people just get unlucky and trust me many of them feel bad enough on their own. I know the intentions are good but kindness towards women in a very vulnerable place in their lives is perhaps just as important.
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