Pregnancy Forum - Maybe This Can Make You Feel Better...

For some women breastfeeding isn't easy—making the decision about whether to continue nursing or stop can be a difficult choice. Learn how to decide what's best for you and baby.

Before the birth of her first child, stephanie meredith of canton, georgia, thought she was prepared for anything. An avid researcher, meredith knew she would nurse her baby. Beyond studies from the national women's health information center showing breastfed babies are healthier, smarter, and a host of other benefits, meredith felt it would be the best way to bond with her baby.

After a difficult delivery, meredith learned that her baby had down syndrome. Although babies with down syndrome have greater difficulties nursing due to weak facial muscles, meredith was determined to nurse. Yet after five weeks of carefully recording every aspect of her baby's nursing habits from one and one-half hour feedings to different positioning, meredith could barely function. Her baby's occupational therapist gently prodded her to bottlefeed, pointing out that her son was expending more calories trying to nurse than he received from breast milk.

Meredith started bottlefeeding her infant but was racked with anxiety. "i felt tremendously guilty because all the research says that nursing is better for your baby—even improves the iq," explains meredith. "i knew I already had a baby with special needs, who was going to have challenges. I felt like I was making it worse by not breastfeeding him, by not giving him every advantage I could."

meredith sought out a therapist to help her deal with her feelings. On the first visit she explained everything she had tried and offered her detailed five-week notebook as proof. "i'm not a quitter," she recalls saying. The therapist told her to throw away the notebook. "after I did, it was such a release. I finally started to relax and feel like a mom."

with pressure from many sources, such as the national breastfeeding awareness campaign, pushing for women to breastfeed, moms like meredith are in a bind—they desperately want to nurse their babies and yet it just doesn't work out for them. Healthcare professionals who, with the best of intentions, might push women either to nurse at all costs or advise them to stop nursing even if the mother wants to continue, complicate feelings of failure. Add to that pressure from friends or families to stop or continue and some women are left emotionally drained.

National breastfeeding trends
since 2003, the centers for disease control (cdc) has been tracking breastfeeding patterns in the united states. In 2005, the cdc found that just over 72 percent of women tried breastfeeding at some point. Around 60 percent of women were breastfeeding exclusively when their infants were seven days old. When babies reach five to six months old, breastfeeding rates drop dramatically to 19 percent at five months and just under 14 percent at six months.

Women on the west coast are the most likely to breastfeed their babies exclusively, while women in southern states were the least likely to nurse. A study reported in the december 2005 issue of pediatrics indicated reasons why many women stopped: "[those] who discontinue breastfeeding early are more likely to report lack of confidence in their ability to breastfeed, problems with the infant latching or sucking, and lack of individualized encouragement from their clinicians in the early post-discharge period."

healthcare professionals like Dr. Lauren feder, md, a homeopathic physician and the author of natural baby and childcare, say that few medical conditions rule out nursing—chemotherapy or hiv status among them. But more often, "there's a difficulty on either the mother's side or the baby's side," says Dr. Feder. "many women go into breastfeeding believing that it is some kind of innate behavior. A lot of women are surprised by how much education it takes to nurse."

feeling blamed for not nursing
looking back, lindsey johnson points to everything she did "wrong" when she tried nursing her first baby two years ago. Her baby stayed in the newborn intensive care unit (nicu) for the first few days of her life. "i knew I wanted to nurse her," says johnson who lives just outside new york city, "but I didn't think anything about nurses giving her bottles or pacifiers, I was just so concerned about her health."

today, johnson doesn't know if it was nipple confusion (when babies mistake the breast for the bottle—feeding from a bottle requires less effort and a different sucking technique), a lack of adequate milk supply, or simply her daughter's stubborn personality that made her baby refuse to breastfeed after they left the hospital. Johnson resolved her baby would have breastmilk—she pumped every three hours day and night when her baby was still an infant and kept pumping until her daughter reached nine months old.

"i would cry everyday," recalls johnson. "i blamed myself because I thought, 'obviously, i'm doing something wrong.'" soon johnson resented around-the-clock pumping and felt like her relationship with her daughter suffered. Along with her personal grief, johnson felt bombarded by seemingly helpful advice, which compounded her feeling that her baby's unwillingness to nurse was her fault. "i can't tell you how many times people would tell me that I just needed to do this or that, like put corn syrup on my nipples."

working with your healthcare provider
"as a healthcare professional, my job is to support women exactly where they are at," says Dr. Joanne motino bailey, phd, a certified nurse midwife who also teaches women's studies at the university of michigan. "yet sometimes women feel a lack of support (for their difficulties nursing) from healthcare professionals because the party line is that breastfeeding is best. And even providers can be caught in the trap of not listening to the individual woman about her concerns." Dr. Bailey suggests that you state your concerns clearly to your healthcare provider, and if you feel like you're still not being listened to, "find someone else."

getting past the guilt
meredith and johnson both expressed that they still feel the need to justify their decisions to stop nursing whenever the subject comes up. Hearing their stories, Dr. Bailey admits, "women are often too hard on themselves. First of all, we live in a society that implies guilt on a mother for everything, implies that you should be perfect. The idea is expressed in a variety of different ways, and breastfeeding is just one of them."

"in my own parenting and what I share with my clients is that we all do the best we can given our circumstances." Dr. Bailey continues, "if you take a step back and feel like you're not producing enough milk and you supplement with formula, you need to realize that that is part of making a good decision—using all the information you have at any given moment to make the best decisions you can."

dr. Feder adds that she "applauds any woman who breastfeeds for even the shortest amount of time."

moving on
the good news is that women who have difficultly nursing one baby often find that they have better success the second time around. One small study published in a 2001 edition of practice nurse indicates that women had an increase of milk supply with their second children versus their first. Dr. Bailey has observed this in her own practice. Recently two clients who'd had difficulties nursing their first babies found success with their second. "i would attribute it to multiple things," suggests Dr. Bailey. "before mothering was an unknown entity—huge and scary. With the second baby, each mother had worked through a variety of nursing issues and felt more relaxed."

with her second child, johnson was surprised at her baby's nursing prowess. Though she had some nipple soreness the first few weeks, her nursing experience improved and she has had an easier time bonding with her baby.

Meredith expected her second child's nursing experience would be far easier, yet her daughter never seemed satisfied. Meredith stopped breastfeeding after two weeks, rehashing her old feelings of inadequacy. It was not until the birth of her third child that meredith was diagnosed with a medical condition that limits her milk supply. "i felt so vindicated," says meredith. Yet she found success the third time around. "i went into nursing thinking I would take it one day at a time. I didn't say, 'i'm definitely going to nurse or not nurse,' but I thought, 'i'll just wait and see how it goes.'" so far, her three-month-old daughter is nursing well.