Breastfeeding offers many benefits to mothers and babies1 but is often not an easy journey. Unfortunately, medical misconceptions and public stigma keep mothers in the dark about many of these challenges until they struggle with them firsthand.
While breastfeeding is natural, it is not instinctive and doesn’t come naturally to many women. Like other skills with a steep learning curve — made steeper by sleepless nights and the anxiety of first-time parenthood — breastfeeding requires practice, patience, and lots of support tailored to both baby and mom.
With such high stress and high stakes, the first few days can be decisive. These factors are among the most influential:
- Unrealistic expectations about the realities of breastfeeding
- Lack of preparation for what it’s really like to care for a newborn
- Limited support for postpartum mothers
- Getting help too late
- Gaps in support from family, friends, and work
Reason 1: Unrealistic expectations about the realities of breastfeeding
Although many pregnant women hear about breastfeeding from friends and family, this is one activity that is very different to experience firsthand. As a result, once a baby arrives moms are often surprised to discover how hard it can be to get a good latch, establish a consistent feeding frequency, learn productive and comfortable positions, and wait for full milk to come.
Since breastfeeding’s realities are not discussed openly, and because breastfeeding is often celebrated as mindlessly easy or just plain blissful, mothers are unable to make informed decisions and fully prepare in advance. Normal challenges can be interpreted as mom’s personal failure, and failure to care for her baby.
How to help?
- Pregnant women and their partners should take prenatal breastfeeding classes and get a chance to learn, ask questions and prepare before the baby's arrival
- Pregnant women should talk to their healthcare providers about how to get help with breastfeeding questions, both before and after the baby's arrival
Reason 2: Lack of preparation for what it’s really like to care for a newborn
During pregnancy most activities focus on the medical wellbeing of the baby and mother, and how to ensure a safe pregnancy and delivery. An unintentional consequence of this emphasis is that guidance around postpartum care can take a back seat and many mothers learn what’s really like to care for a newborn by doing it firsthand — while sleep-deprived, in physical pain, and emotionally overwhelmed.
Basic knowledge such as how many times a day newborn needs to feed, how tiny their stomachs are, or how short their sleep cycles are is critical and not so hard to learn, but in a high-stress low-energy state, the newborn period can overwhelm parents and make them feel like they are failing.
How to help?
- Healthcare providers and the community should inform parents of the realities of postpartum life and how having a good support system can help with the transition
- Parents should evaluate their available support system and plan on hiring service providers such as Doulas, Lactation Consultants, Sleep Consultants and other Postpartum support services for guidance and support during the transition
Reason 3: Limited support for postpartum mothers
Our society places so much emphasis on the newborn, and has so little understanding of how hard it is to be a new mom, that when a baby is born, mothers become invisible at their greatest moment of need. In addition to learning how to be a mom, she is also expected to be a housekeeper, worker, and maintain many other past responsibilities. All these physical, emotional, social changes, and lack of postpartum support can make her breastfeeding journey more difficult 2, 3.
How to help?
- Learn about the support system which you might need for your postpartum recovery
- Create a postpartum plan — and if you need help to make the right plan for you, get it
- Research which services, products, and classes you may need for your postpartum care, and where in your community to find them
- Partners should be educated about the postpartum period and how they can support the birthing partner in their transition
Reason 4: Getting help too late
While other above mentioned factors can result in not so optimal start to breastfeeding, lack of needed timely interventions are one of the biggest factors for discontinuation of breastfeeding. After moms leave the hospital/birthing center, they often have questions/concerns about their latch and lactation. When they don’t get continuous and timely support for their issues, the likelihood of stopping breastfeeding earlier than they plan to go up.
How to help?
- Hospitals and birthing centers should create supportive policies to provide timely and continuous support to new mothers
- Improving support providers training in to help families who have trouble breastfeeding
Reason 5: Gaps in support from family, friends, and work
Although the federal Family and Medical Leave Act (FMLA) guarantees eligible employees up to 12 weeks of unpaid leave to care for a newborn and recover from pregnancy, only 25% of women take nine weeks or longer of maternity leave, paid or unpaid 4.In addition many workplaces, childcare facilities and public places do not have breastfeeding supportive practices. This lack of support also plays a big role in mothers discontinuing breastfeeding earlier than planned.
How to help?
- Policies that support breastfeeding in places like workplaces, child care facilities, and public spaces encourage optimal breastfeeding practices
- Employers provide flexible work schedules and the ability to safely and privately prepare, pump, and store breastmilk
Promoting, Protecting and Supporting breastfeeding is crucial for mothers to initiate and continue breastfeeding for the welfare of mother and child. It’s a collective effort, which requires physical, emotional and social support from families, healthcare providers, workplaces and society.
- Sriraman NK, Kellams A. Breastfeeding: What are the barriers? Why women struggle to achieve their goals.J Womens Health (Larchmt). 2016;25(7):714–722.
- Feltner C, Weber RP, Stuebe A, Grodensky CA, Orr C, Viswanathan M. Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries. [PDF-343KB] Agency for Healthcare Research and Quality (US); July 2018.
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