An ancient practice that is in need of modern-day support
Breast milk provides a child with complete nutrition and protects it from infections and sudden infant death syndrome. Breast milk is dynamic in composition: The hormones, immune factors, and nourishing elements adapt over time and even throughout the day to fulfill the growing child’s needs.
The recommends that new mothers exclusively breastfeed for the first six months of a child’s life and then continue to breastfeed while introducing other foods for two more years.
The underscores the significance of breastfeeding this way: “Breast milk acts as a baby’s first vaccine, stimulates brain development, and protects a woman’s health. When mothers breastfeed, everyone benefits. It offers children unparalleled health and brain-building benefits. It has the power to save the lives of women and children throughout the world, and the power to help national economies grow through lower health care costs and smarter workforces.”
Despite all the known benefits of nursing, women who breastfeed are not given the support they need, and the consequences sometimes are devastating.
Quite an investment
Many people wrongly think that breastfeeding just comes naturally and is free. A new mother may struggle with lactation right away, and breastfeeding requires substantial financial, time, emotional and physical investments.
A new mother spends a great deal of time nursing — attached to an infant or pumping — to develop and maintain milk supply. She must try to perfect latching, heal sore nipples, deal with breast pain, and learn different feeding positions all while physically and emotionally recovering from childbirth. It’s no wonder new moms are exhausted, anxious and overwhelmed.
Plus, new moms need pumps, bottles and related supplies, lactation consultant services, nursing pillows and creams, which often are not covered by insurance. Lack of financial and lactation resources often makes nursing difficult.
Mixed messages
Inge Schotanus is a schoolteacher in the Netherlands who struggled with breastfeeding her child.
“My son was not drinking enough breast milk. The nurse was hammering so much on how good it was for my son to breastfeed. I felt a lot of pressure. I was recovering from childbirth and dealing with a lot of emotions, plus the pressure and the knowledge that my son was not getting enough milk confused me a lot,” she said.
At the same time, she received conflicting advice from her mother, who encouraged her to use formula.
“I was in between those two ladies. I had no clue and a crying baby that did not sleep well because it was hungry,” she said. “Luckily, the midwife came on a house call, which is a practice in the Netherlands, and said I could use formula and try to breastfeed at the same time and that all other information about bottle confusion was utter nonsense. Just do what feels right. This woman was my lifeline.”
Many mothers successfully combination feed — a practice that involves giving babies formula in addition to breast milk.
Negative experiences
Early support from family, lactation consultants, and a medical care team plays an important role in shaping a mother’s nursing journey.
Studies suggest that experiences may increase the risk of postpartum depression. Women who face nursing challenges and low self-efficacy report more symptoms of depression.
The reports that up to 80% of new moms — whether they nurse or not — experience mild mood disturbances, and one-fifth of new moms develop postpartum depression.
When Savita Patil learned that she had become a grandmother last year, she was thrilled.
“I was ecstatic. My daughter that given birth to her first child after 10 years of marriage and infertility struggles,” said Patil, who lives in a small town in Maharashtra, India.
But that joy soon waned. The new mother developed medical issues that prevented her from breastfeeding. She was eventually diagnosed with post-partum depression, Patil said, and the family tried to support her.
“I think her struggle with infertility and then her anxiety due to breastfeeding issues contributed to her depression,” Patil said. “She took this to her heart and was never able to recover back from a black hole of self-blaming.”
Patil’s daughter died by suicide. It was “a loss we will never recover from,” Patil said.
Mary Tayal, a clinical psychologist at Thriveworks in North Carolina, said that it’s common for women to “experience anxiety, depression or intrusive thoughts after childbirth.”
For some, Tayal said, breastfeeding is indeed a stressor. “Most women are concerned that their baby is not getting enough nourishment via breastfeeding,” she said. And while some abandon the effort for formula, some “mothers who continued to breastfeed were unprepared for the difficulty of breastfeeding and voiced feeling the difficulty was somehow their fault.”
Tayal said mothers cite a lack of support from their partners, family members and medical providers, including pediatricians.
Of course, it is important to differentiate between symptoms arising from the physical act of breastfeeding and those arising from health complications and cultural and situational associations.
A lot of women face physical challenges, such as latching problems, oversupply or undersupply of milk, breast engorgement, clogged ducts and mastitis. Infections in particular make breastfeeding painful. All of these physical symptoms can result in low mood and feelings of failure, inadequacy and unhappiness.
Balancing act
According to the Centers for Disease Control and Prevention in the United States supplement with formula by the time the baby reaches six months of age. Combination feeding helps sustain breastfeeding by lessening its logistical, physical and emotional demands.
Shweta Dambal Maravilla is a biomedical scientist working at Duke University in North Carolina and is a new mother who decided to combination feed to achieve a better work–life balance when her child was around seven months old.
“I was sleep-dep