Barriers to Breastmilk Feeding
If you type this title in a search bar, there are dozens of articles that appear. This is a topic that seems to be one that many find interesting. This is also a topic that tends to stir up debate. Many have feelings from personal experiences both positive and negative about breastfeeding that can affect their opinion on this matter.
I have spent many hours studying this particular topic both for certifications that I was working on as well as just out of curiosity. Here are some observations that I have made over the years. I hope they provide some insight and help you to encourage mothers feel supported in their feeding decisions.
The first barrier to breastfeeding seems to be lack of knowledge and unrealistic expectations going in. New parents expect breastfeeding to be easy and natural and many are unprepared for a sleepy baby, a baby that feeds frequently or a baby that feeds poorly in the first 24 hours. Many parents believe that when babies cluster feed (eat frequently or cluster multiple feeds together throughout the day or night) they must not be getting enough nourishment at the breast.
Another barrier to breastfeeding seems to be confusion about when mature milk is produced. There have been many instances where new parents have requested supplemental feedings because they believe something is wrong when their breasts don’t quickly fill with milk after baby is born. The normal timeline for lactogenesis II is on average about 3-4 days. Babies receive colostrum at breast, which is extremely nutrient dense, until this transition takes place. When post-gravid individuals request a pump and are unable to pump out copious amounts of milk in the first day or two postpartum (which is normal and expected), many get frustrated and decide breast milk feeding is too much work or that they are unable to produce enough milk. The parents that have taken infant feeding and newborn classes in preparation for baby tend to have more realistic expectations.
One of the more unfortunate barriers that I have seen is lack of family support. I can’t tell you how many times I’ve been in a room and have walked in and introduced myself as a lactation consultant just to hear a family member or in-law loudly make an ugly remark that undermines the mother’s feeding choice. I do my best to try and educate the entire family in those rooms but when moms are criticized during such a vulnerable time and offered no support it can set them up for breastfeeding not working long term, especially if the family members being critical are going to be providing childcare.
A legitimate barrier to uncomplicated breastfeeding is situations that make it difficult for mom or baby to nurse baby at the breast. These include but are not limited to: general anesthesia, NICU admission, structural abnormalities of baby’s face, tethered oral tissue, unsupportive caregivers, understaffed units, unavailability of breastfeeding help, blood sugar issues, late preterm gestation, jaundice, chromosomal anomalies, hypoplastic breasts, previous breast reduction, etc.
When facesheet data was analyzed , it was apparent that being without a supportive partner played a major role in choosing not to pursue breastmilk feeding or continue breastfeeding if initiated. Individuals that identified as single were the least likely to both initiate and continue breastfeeding throughout their hospital stay.
There are programs that have been initiated that help hospitals assist mothers with maintaining exclusive breastmilk feeding if that is their chosen feeding method. Sometimes these programs are misunderstood by the general public. Programs such as the Baby Friendly Hospital Initiative were not created to force anyone to do something they do not want to do or to shame those who have made the informed decision not to breastfeed; however, this is how they are often potrayed. These programs are geared toward simply ensuring that the barriers to successful exclusive breastmilk feeding are removed so people are more likely to be successful in exclusively providing breastmilk feedings to their infants.
If you are struggling with feeding your newborn for any of the reasons listed above or have concerns about baby’s feeding habits, do not hesitate to reach out to a lactation consultant.
You may hear a lot of chatter about “breast is best” or “fed is best”. While I agree that fed is absolutely best, my personal belief on the matter is informed and supported is even better. I want all families to have the information to make informed feeding decisions and I aim to support parents in their choice of feeding method. I also want parents to know that if their plans change that is okay too.