What New Moms Really Need to Keep Breastfeeding

by Maryann Tomovich Jacobsen, MS, RD on April 17, 2012

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I wrote this essay over 4 years ago chronicling my difficulty breastfeeding Big A — and what I learned in the process. During this time there just happened to be government-sponsored TV ads geared toward getting more women to breastfeed. While Fearless Feeding will not cover breastfeeding, it helps prepare parents for all the potential pitfalls that can happen during the 18 years of feeding. While we hope parents won’t experience too many feeding challenges, we know preparation is power!

“My boobs would have to fall off for me not to breastfeed,” I wrote to a friend, thanking her for buying me a nursing pillow. During my first pregnancy I watched, with a touch of arrogance, the government-sponsored TV ads promoting breastfeeding.

These ads showed a pregnant woman riding a mechanical bull with the voice over: “You wouldn’t take this kind of risk with your baby so then why would you take the risk of not breastfeeding.” I thought to myself, I certainly won’t.

Yet after my beautiful baby girl was born, breastfeeding proved to be the most challenging aspect of motherhood. That’s because every three hours I had a hungry baby who couldn’t always latch on my breasts, caused me intense pain and managed to make my nipples unrecognizable. Each nurse had a different opinion on how to remedy my situation. One urged me to use a nipple shield. The lactation consultant at the hospital, who visited me daily, said nipple shields slow down milk production. Another nurse already had me pumping milk and feeding my daughter through a bottle.

Looking back now the hospital seemed like a joy ride compared to my experiences at home. After my baby had trouble latching on my breasts her first night home from the hospital, I arranged to meet with a lactation consultant. This was just the beginning of what seemed to be a never-ending battle. Just when one problem was solved another reared its ugly head. I discovered that my daughter was inefficient at removing milk which is why even after hour-long nursing sessions she still wasn’t gaining enough weight.

One of the pediatricians in my daughter’s medical group recommended I supplement with formula. I had already started pumping milk and told her I preferred to supplement my baby with expressed-breast milk. I was surprised when she tried to talk me out of pumping. She said it would tire me out and feeding formula would allow me to sleep longer at night. But I did my homework. I knew that adequate removal of milk is what stimulates more milk production and my baby wasn’t removing enough. So, in my eyes, I had to be vigilant about pumping breast milk.

The lactation consultant supported my decision to pump and put me on a pretty strict schedule. First, I would breastfeed my baby. Second, I’d supplement her with a bottle of expressed-breast milk. And third, I’d hook myself up to a breast pump for 10-15-minutes. There was a direct link between my mood and how well each nursing session went. And just when I thought we were over the hump, at seven weeks, my daughter totally refused to breastfeed. Disappointment doesn’t even come close to describe my emotional state.

baby

My mind wondered back to those government ads and anger soon replaced my previous arrogance. According to Centers for Disease Control and Prevention, 74 percent of women attempt breastfeeding in the hospital but by six months only 41 percent are still breastfeeding. I began to sympathize with all those women who couldn’t make it to six months.

Then I thought about my own situation. After all, I felt as prepared as anyone to breastfeed. I read books, took classes and had the fancy nursing pillow. But did I have a realistic picture of what it would be like? I only learned what could go right and not what could go wrong. Every brochure and book tells you, “breastfeeding shouldn’t hurt if you’re doing it right.” “It’s rare that a woman can’t breastfeed.” This advice, which comforted me when I was pregnant, became utterly useless to me after I had a baby.

What I needed to know was what circumstances could come between me and my desire to breastfeed. I needed to know how inefficient newborns can be at breastfeeding. I needed to know what to do if my baby did not gain enough weight. I needed to know that my baby could prefer the bottle weeks after breastfeeding. I needed to know that even doctors and nurses can sabotage my efforts. I needed to know how important establishing a plentiful milk supply is those first few weeks. And, yes, I needed to know that it hurts.

But instead, new moms like me get guilt-ridden messages and the “breast is best” tag line. Wouldn’t our tax dollars be better spent finding ways to break down the barriers that keep women from continuing to breastfeed?

My baby is over a year old now and I’m proud to say she received breast milk for 11 months. After getting the biggest rejection of my life, I relied on the breast pump to keep my milk supply up and nourish my baby. I kept trying to nurse my daughter and it wasn’t until she was between four and five months old that she really started catching on.

Throughout this process I’ve learned more than I ever thought I would about breastfeeding, milk supply and pumping milk. And despite my difficulties I’m still pro breastfeeding. In fact, I can’t wait to make it work the second time. But the next time I will handle things differently. Most importantly, I will be prepared for all that can happen between deciding to breastfeed and my boobs falling off.

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{ 18 comments… read them below or add one }

Amelia @ Eating Made Easy April 17, 2012 at 10:08 am

I love this article, and so agree with you that what many women need is not to be told to breastfeed, but instead practical tips and support during the first few weeks of their baby’s life – when milk supply is being established. My mom is a great lactation consultant, so I had the ultimate scenario, and still was thrown off by all the mixed advice I received from nurses and doctors at the hospital – they just didn’t know what they were talking about – but how was I to know that?!

Thank you for the supportive yet informative post :)

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Maryann Tomovich Jacobsen, MS, RD April 19, 2012 at 9:43 am

Your welcome Amelia! I know health professionals mean well but I too wasn’t prepared for the inconsistencies. The second time I was much more confident!

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Anne @ Always Half Full April 17, 2012 at 11:54 am

Glad you repeated this. I am currently breastfeeding my second (2 weeks old – my 1st I was able to breastfeed until he was 7 months and then I just had to give it up) and while I did not and do not have the troubles you had, I agree that it is MUCH more difficult than the books and brochures make it out to be.
Even for me having (so far) a pretty easy time, I have found 2 major barriers. 1 – in the hospital, I found very little help to get nursing going unless I specifically asked for it and even then (with my first) was shrugged off. If a woman is attempting to breastfeed I feel the lactation consultant or nursery nurse should be there to help start each feeding for the first 2 days. This is the baby’s main/only source of nourishment – the mother needs all the help and support she can get to do it well. 2 – babies are always so good in the hospital and when you come home it all seems to fall apart. My daughter nursed so well in the hospital and then when we came home I felt like everything fell apart. Luckily she was gaining weight and her current growth spurt has cleared up any inconsistencies – but I was really feeling stress, anxiety, and guilt until things got better.
Where I live there is a great resource, though insurance doesn’t cover the visit ($80), of a lactation consultation center. I went there with my first and learned how to correctly get my son to latch on, support him properly, and understand what and how my body was doing. But not everyone has a resource like this, or the means to pay for a visit.
There needs to be a lot more support out there for women who are trying to breastfeed. And there needs to be less guilt if we just can’t do it.

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Maryann Tomovich Jacobsen, MS, RD April 19, 2012 at 9:42 am

Anne — glad you got the support you need and things are going well. I found the breastfeeding support groups to be really helpful — and luckily they had lactation consultants there (for a fee) to help. It is so hard when baby isn’t gaining — it almost sent me over the edge! You are right, support and being non judgmental is key!

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Mandi S. April 17, 2012 at 12:23 pm

I, too, was determined to breastfeed my first-born no matter what. But while I was determined, I also faced obstacles. Obstacle #1- My child was born severely tongue-tied. But nurses, doctors, and lactation consultants were wishy-washy as to whether or not clipping his tongue would help. It took 9 days before we finally got a ENT to clip his tongue. I had no idea that tongue-tying could even be issue, and to try to learn all I could while being a sleep-deprived first time mom was not the best. Once his tongue was clipped, he was able to go back and forth from bottle to breast just fine. Obstacle #2- Unsupportive hospital staff, pediatrician, different views from different lactation consultants. With the tongue-tie, everyone wanted me to give up and go straight to formula. No one would give me encouragement that fighting to breastfeed was the right answer. Obstacle #3- Low milk supply. Because no one supported me, even lactation consultants, no one set me up with a reasonable pumping schedule and I just couldn’t keep up. Obstacle #4- Allergies/colic. My son had colic. Everyone said that it would go away eventually, or that it was something in my diet because he was still getting some breastmilk. I questioned the formula, and no one believed that an ingredient in the formula could be giving him colic. They kept telling me to eliminate. After getting down to just chicken and rice, I gave up after 3 months of half breastfeeding/half formula. Obstacle #5- I had a benign tumor in one of my breasts that suddenly reared it’s ugly head while breastfeeding. We weren’t sure if it was clogged ducts, the beginning of mastitis, etc. To make a long story short, we switched pediatricians and it turns out it was the formula (he was allergic to dairy and soy), and not my breast milk, causing the colic, and once he went on they hypo-allegenic formula, the colic stopped in 8 hours. Yes, it was like a switch was turned.

To this day (he’s 5 now), he has been extremely difficult to feed. I believe that many of the issues I face with feeding him began on that first day of his life, when I had to struggle to feed him, based on what information I had, which wasn’t enough, and what the “experts” were telling me, which was the norm, but not true for my son. If I had been better educated about the kinds of problems I could potentially face feeding my son, and if I had had supportive doctors and nursing staff, I believe I would’ve been successful. He had no problem going back and forth between breast and bottle once his tongue was clipped. But no one helped me with my pumping schedule or anything else to increase my supply. Because of the issues we faced with feeding him, I fought like hell to breastfeed my second. I found a lactation consultant before I delivered that could support me through any problem I faced. She gave me the resources I needed (websites, Jack Newman book, etc.) as well as the ability to call her if needed if we had any problems. And I was able to nurse my second for 15 months. I believe that it was the education and support I had that made me successful the second time, and the lack of education and support that caused me to fail the first time. And I really think that successful breastfeeding, or just feeding baby in general without guilt or problems, that leads to successful feeding of toddlers and preschools. I still feel like I’m on a huge learning curve with my first, and the issues we still face. But I don’t feel that way with my second. And he’s healthier, gained weight at a more healthy rate, and is a better eater than his older brother. I really, really think that cycle began with successful breastfeeding, and continued with better educating myself on how to feed children.

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Maryann Tomovich Jacobsen, MS, RD April 19, 2012 at 9:39 am

Mandi — sorry you had a tough time. I think the bottom line is moms need more support to get feeding off to a good start. I’m glad it worked well for your second child. Little D never had trouble latching. In fact, he wanted to breastfeed so much it wore me out and caused me pain. But all worth it in the end!

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Shauna @ Balancing Bites April 17, 2012 at 2:03 pm

I loved this post. I felt the exact same way about breastfeeding. There wasn’t going to be anything that got in my way. I breastfed my twins at the same time. I ended up using a nipple shield, from the advice of a lactation consultant, because my daughter wasn’t latching. Eventually, my daughter did latch and everything worked out until they started biting. Around six months old, about the time the biting started, they were more interested in playing than nursing. I pumped exclusivly until they turned 1 years old. It was definitely frustrating, but I would do it again.

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Maryann Tomovich Jacobsen, MS, RD April 19, 2012 at 9:45 am

Shauna — I think all women need to know exclusive pumping is an option if breastfeeding doesn’t work out. It sounds like you did an awesome job with twins….I know that can’t be easy!

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Rebecca April 20, 2012 at 7:09 pm

Great post, Maryann! As a fellow RD, I was also convinced I would breastfeed, but then had many problems when my first was born. It is all well and good to know why you should breastfeed, but the physical act is another thing. Support and education is so important. Here is a post I wrote on my experiences: http://www.totstoteensnutrition.com/2011/12/14/to-breastfeed-or-not-to-breastfeed/

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Maryann Tomovich Jacobsen, MS, RD April 24, 2012 at 8:51 am

Thanks Rebecca. Great article!

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clothespin May 12, 2012 at 8:57 am

My daughter was born in AL… the hospital isn’t the most progressive in birthing centers and I ended up not really liking my OB… BUT… the follow up lactation support staff were FABULOUS. They were part of the nursing staff in the OB ward and were FREE even for follow up visits. They started a lactation support group in a meeting room on the OB floor every week that any nursing mom and baby could attend – complete with scales to weigh the babies and an LC in the room to answer any questions or problems – nursing related or baby related or post partum related… Again, all for free. I honestly had no idea how insanely rare this sort of program was, but looking back on it, I know that without a doubt there would have been no way that I would have nursed longer than week without it. And, it should be the model of care that all hospitals provide.

My LC came to our room the next morning after my daughters birth and after chatting with her, we learned we lived only a few miles apart… After serious struggles to get my baby to latch, a visit to the hospital to visit the LC who was on duty (who was great but didn’t know about the specific issue we had) I ended up on my neighbors doorstep within a week after the birth, in tears… In her home, not being paid, she helped me and my baby and diagnosed tongue tied. It took a trip to the pediatritian, who didn’t think the tie was bad enough to cause nursing issues (despite severe pain and severe latch issues) but at my persistance, referred us to an ENT. He was much more empathetic and clipped her tongue at one month. Immediate relief!

We still faced issues with milk supply and used a shield for months due to latch issues… but that too went away with time and we managed to make it to 17 months. And I owe it all to the LC staff at the hospital, the group of nursing mamas who became my friends and support both in the hospital and out and my dogged persistance and instistance that nursing was the answer.

By the way, I had real frustration to the La Leche League and their book, who barely touched on the topics of tongue tie or reflux, which my daughter also had a significant case of. LLL is a good group to be sure and have done much to promote breastfeeding as a good thing, but for those of us with troubles, I did not find the support or knowledge that I needed.

Four years later, a different state and a new baby on the way, I am armed with more knowledge. I know that tongue tie is genetic and there are good odds that this baby will also have it. I plan on talking to her pediatrician BEFORE the birth and having an ENT lined up in the wings just in case. Circumsicions happen in the hospital, there is no reason the much more minor procedure of clipping a tongue shouldn’t happen there also. The pediatrician is also very pro breastfeeding and has a strong base of knowledge regarding the topic. I dropped a doc based on one visit after she gave totally inaccurate information regarding nursing and havn’t looked back since. (Yes, I gave a pop quiz to the new doc – and she wasn’t phased in the least.)

More importantly, my wonderful LC wants to be here, all the way from AL, for the birth of my 2nd baby. I totally heart her! I will get my own private nurse for post surgery care and help with the nursing… and go into this knowing that we have the greatest odds ever of making it work this time too. I only wish that every hospital was as amazing as my first was… there are a LOT of babies in AL who were nursed because of that wonderful and continuing program!

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Lauren May 15, 2012 at 1:04 pm

I’ve nursed four babies for twelve months each, with only the third receiving formula at all. I now work part time as a breastfeeding peer counselor. Each child was completely different, so while you can go into a second or third (or tenth!) pregnancy expecting things to go better because of what you learned the first time around, women should also realize each child may face unique challenges. My first two children had to learn how to latch, but on the whole did really well. I always get mastitis at some point, but really, it’s just a little bump in the road if dealt with properly. My third child had torticolis (a short neck muscle on one side of her neck) that made feeding difficult in any form. While I hated she ever had to have formula, it did help me to break into the world of moms who aren’t so adament about breastfeeding. We certainly need grace and understanding when life happens and formula must be used. My fourth child was such a natural that had he been my first child, I would’ve never thought breastfeeding was so difficult! Even though he was a great eater, we still had to go through the pains of thrush and mastitis. All worth it for a healthy baby – not to mention all the benefits it brings moms, my favorite being the 500 calories a day it burns! I’ve never had a problem losing all my baby weight!

While you’re right that moms need to know how difficult it can be, knowing some of the difficulties can make it hard for many women to make the commitment to begin with. I think it’s best for women to know it can be hard at times, but to hunker down and seek help. It really is just a very short season in the whole of parenting. As far as the expense of seeing a lactation consultant is concerned, those who qualify for WIC, in most states, can receive the help of a lactation consultant for free through their health departments. Peer counselors like myself are there to provide loving support throughout the breastfeeding journey, offering encouragement, and contacting the lactation consultant when we see problems arise, before they get out of hand and moms quit!

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Melissa Olson, RD August 31, 2012 at 2:35 pm

Wonderful post Maryann! My son is now 5.5 months old and we got off to a rocky breastfeeding start too (he was born 4.5 weeks early, in the NICU for a week, and was therefore weak at nursing for his first month of life….I felt like I was bonding w/ my pump instead of my son and cried every single day). I agree with you that our tax dollars would be best spent promoting breastfeeding resources when challenges arise. For me, the life saver was attending a breastfeeding support group to develop confidence that what I was experiencing was normal and learn strategies to make it a better. I would say what moms really need to keep breastfeeding is to feel supported so they won’t give up!

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A-M August 6, 2013 at 7:44 am

I’ve not had any children yet, but also plan on breastfeeding when I do. I’m so grateful for articles like this as I had noticed that everything seems geared to the motivation (which I don’t need any help understanding) and not the method.

Unfortunately many women do not experience even the sight of breastfeeding until the very first time they do it (well I vaguely remember my mum feeding my baby brother but that hardly counts) I have no idea how long it should take or how to hold the baby or what to do if there are problems. I’ve had friends with babies who were far more vigilantly pro natural everything than I am, who encountered problems they weren’t expecting and felt absolutely devastated about their ‘failure’ as mothers as a result. It’s a lack of passing on knowledge that’s failing us, not individual mothers.

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MWYon, MS, RD August 22, 2013 at 10:06 am

Maryann,
I am going through nearly the exact scenario with my newborn baby girl (08/14/2013). She latches, good some not good some, but is a slow sucker and not a vigorous sucker. I am trying to express and trying to use formula or expressed milk via SNS system. This is hard. I have had to supplement with formula bottles at night because so tired (long BF and still not satisified – breasts not producing as much yet due to insufficient sucking it seems). I have met with LC twice (besides a couple visits while in hospital). I want the LC to move in with me at this point.
I do have a similar express schedule and it is so tiring (BF, express each time). The SNS is difficult and cannot do each time (so should do like you stated and BF then bottle feed, though would have to do formula since I am not up to sufficient volume when expressed). Sometimes the volume is greater but still not enough for a stand alone feeding with one session’s pumped volume. I am conflicted – I so want to BF but hate the feelings of fear and frustrations. I am hoping the continued expressing will eventually lead to sufficient volume to do bottle feeding with expressed milk and hope, like your girl, she will develop the sucking and desire to BF strongly in coming weeks or months. Any more suggestions from your experience is welcome. Regards, MWY

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Betty Craig December 14, 2013 at 12:26 pm

I had my kids back in the 1980′s and breast fed the three of them for six months, a year, and a little over a year. I did not have much instruction from medical professionals and had little support from family. Everyone wanted me to breastfeed, but did not take into account what might be required of them for me to do so. Breastfeeding is a commitment and others need to acknowledge that and do their part.
I found with all three of my kids that they required more frequent nursing in the late afternoon and early evening, just when it was time to prepare dinner. I tried to cook meals ahead of time, but it was not always possible. I vividly remember during my mother-in-law’s first visit that she refused to cook and would sit and wait to be served her evening meal. I had to nurse the baby, then cook, then serve others their dinner, and then nurse the baby again. Only after that would I get to sit down and eat.
Other family members made outrageous requests that would have taken away valuable time from nursing my baby and made me feel inadequate that I could not meet their demands.
In spite of these kinds of obstacles, I persevered. I have often wondered if anyone else had to deal with such inconsiderate behavior.

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Sara August 2, 2014 at 7:19 pm

I’m expecting my 2nd in a few weeks and I just stumbled upon your blog. I breast fed for over 6 months and had a hard time for most of it. I enjoyed every bit of what I could do and I hope I have a better time of it this go around.

It makes me sad that formula is still poo-poo’d. I had no choice but to feed my son formula because he lost to much weight in the hospital. I had no chance to pump enough to do anything. I don’t understand why it can’t be embraced to do both at once. It’s easier to not feel like a failure if you can do both and it’s accepted. It would be great to see a list of best formulas on here too.

I do enjoy your blog. thank you

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Lindsey August 19, 2014 at 3:41 pm

Amen. I had the same arrogance until I did it myself. What a challenge! So glad we were able to get the support we needed to keep it going, now at 5 1/2 months it’s the best ever! But wouldn’t have gotten there without a lot of tears, some bloodshed and the support of family and a good lactation consultant!

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