The Most common breastfeeding challenges
Written November 10, 2023
It is safe to say that it is a mother’s instinct to care for her baby kicks in immediately after birth. Maternal comfort is often driven by biological impulse; we hear our baby cry and we need to solve whatever ailment is the cause. Many times, these infant cues are driven from hunger. And while a mother may instinctively want to solve this issue by feeding the baby from her body as designed, many women aren’t fully educated on the learning curve required to be successful at breastfeeding. There are a range of challenges that occur, many of which aren’t widely known. The reality is, these challenges and their solutions need to be proactively taught, so that all new mothers understand that there is an element of a learned skill involved. Women can then learn that these challenges can most often be overcome with proper education and support.
Perhaps the greatest obstacles are in fact psychological. Our healthcare system has no inherent design for breastfeeding education for pregnant women; in fact, many OBGYN providers are woefully unhelpful in this area, as their residency trainings don’t provide this type of education [3]. Routine prenatal care involves things like; checking on the baby via measurements, doppler scan and weighing the mother, but virtually no education on her impeding breastfeeding. Women may be given a half-hearted pamphlet, or told to seek out their own form of (non-uncovered) education.
Without this crucial support and guidance, women aren’t provided the tools to boost their lactation confidence heading into birth, and this affects their subsequent commitment to breastfeeding. Fears arise such as worries of pain, lack of production, or losing their independence and freedom.
Further aggravating this educational inadequacy, baby formula companies often widely advertise their products, even going as far as sending samples directly to a pregnant woman’s home; and implying their milk substitutes are an equivalent alternative to a mother’s milk.
These external factors create a predisposition to resorting to formula either immediately, or soon after the first sign of breastfeeding difficulties. In 2011, the Office of the Surgeon General reported that many mothers quit breastfeeding after the first two weeks due to the impact of challenges they weren’t expecting.
A very direction solution to this issue would be to implement lactation education into routine prenatal care.
This can come in the form of properly educating OBGYN providers to support their patients, or alternatively, including covered prenatal consultations with a qualified lactation consultant during pregnancy.
By being educated and supported proactively, a woman will feel prepared to breastfeed when the time comes, and knowledgeable about seeking assistance with challenges that arise.
Other physical obstacles to breastfeeding arise when the time finally comes: A woman goes home with all the love in the world for her baby, but no knowledge on what to do, what is normal, or how to make effective changes when necessary.
Some of the most common misconceptions among newly-breastfeeding women are understanding milk production, and how to facilitate a proper latch. The former of these is especially confusing, as she cannot visually see how much milk intake is occurring when breastfeeding.
A baby may be on the breast for 45 minutes, but not getting sufficient milk. Conversely, a short feed may be more than enough for an efficient drinker. A new mother may not understand to look for the cues that a baby is satisfied after a feed; such as a relaxed appearance, gently releasing or ‘falling off’ the nipple, and a breast that feels softer (Lauwers & Swisher).
Alternatively, baby crying after a successful feed could actually be due to other reasons such as needing a burp, a soiled diaper, or exhaustion; but a mother may confuse this for a hunger cry. A mother can then feel guilt and stress that her baby isn’t being fed, she may feel inadequate, and may ultimately resort to formula when it was never necessary to begin with.
Proper latch is one of the biggest challenges to new mothers. While initial nipple pain is common at the very start of breastfeeding, an improper latch can lead to pain, cracked nipples, lack of milk intake, and frustration by mom and baby [1]. Often times this can be corrected with proper technique, such as ensuring the baby’s mouth opens wide, and that they are positioned correctly to latch. A mother who doesn’t understand the importance of latch, will often experience significant pain, which increases the likelihood of ‘giving up’ and resorting to formula feeding.
These physical obstacles can most often be fixed, again, with proper education and support. Given the commonalities of these challenges and the well-researched benefits of breastfeeding, this should be included in routine healthcare. New mothers should have covered lactation support built-into their perinatal care. With one-on-one support and education, a mother who would otherwise feel isolated and guilty due to a lack of education, can instead feel reassured and confident that she is feeding her baby well with the wonderful nutrients of her milk. With this support, breastfeeding can become an enjoyable bonding experience for mothers and their babies.
[PLEASE NOTE: As a Certified Lactation Educator, I understand that breastfeeding may not be for everyone. I will never, every pressure someone to breastfeed if they feel it isn’t the right path for them. This information is intended to provide education on the topic of breastfeeding, and never any judgement for personal choices made.]
XO,
Sondra
References
[1] Lauwers, Judith, and Anna Swisher. Counseling the Nursing Mother: A Lactation Consultant’s Guide. Jones & Bartlett Learning, 2021.
[2] Office of the Surgeon General. “The surgeon general’s call to action to support breastfeeding: 2011.” PsycEXTRA Dataset, 2011, https://doi.org/10.1037/e518002011-001.
[3] Radoff, Kari, and Rosha Forman. “Lactation education for resident obstetricians: Promoting breastfeeding advocates for the future.” Journal of Midwifery & Women’s Health, vol. 64, no. 6, 2019, pp. 754– 762, https://doi.org/10.1111/jmwh.13037.
