Lifting the Breastfeeding Guilt

Illustration by Emma Moreman

Years ago, I heard a lactation specialist describe breast milk as “liquid gold.” She was referring to the panoply of health benefits that breast milk bestows upon infants. These days, many women are aware that breastfeeding provides a range of advantages over feeding babies formula. Breastfeeding is not always an easy thing to do, though. And for those who struggle, breastfeeding can be a source of tremendous distress.

With some regional differences, nationwide and in New Hampshire, about 80 percent of women initiate breastfeeding, according to Wendy Jordan, BS, IBCLC, a lactation consultant at Seacoast Lactation Services in Exeter. Many women fail to exclusively breastfeed for the recommended six months, however, and often stop breastfeeding much earlier — in some instances, due to feelings of frustration, defeat and failure as a mom.

“When a mom can’t breastfeed her baby and that’s what her plan was,” Jordan says, “it’s very emotional. We’re talking about our babies, and we feel very strong emotions. … Whether it’s breastfeeding or something else, we feel guilty when we can’t give our children everything.”

One of a parent’s primary tasks in the early days after a baby’s birth is to feed the child, “so having that first thing not work out is really a blow to mom,” Jordan says, “and it’s not just because they want the best for their baby; it’s also tied up with thinking about ‘What kind of mom am I?’ It’s all wrapped up in a lot of things.”

Breastfeeding difficulties can be especially tough on women whose social circle or culture stresses the importance or expectation of breastfeeding. Women who want to breastfeed but don’t “can feel a sense of grief and loss, just like they can feel a sense of grief and loss when they had a cesarean delivery instead of a vaginal delivery,” says Nancy Ramirez, RN, IBCLC, a lactation consultant at Elliot Hospital. “[But] they shouldn’t feel judged or stigmatized. They should be supported no matter what [their] feeding choice is.”

It’s clear, however, that science supports breastfeeding over formula. “We say, ‘breast is best’ because there’s really no point of comparison,” Jordan says. “Breast milk is a biochemical, live substance, specific to the mom and the needs of the baby.” Formula-fed babies can be perfectly healthy, of course, but they are at greater risk of certain health problems, including ear infections, diabetes, obesity and some cancers.

In comparison, breast milk provides complete nutrition for baby’s growth and development and lowers the baby’s chances of an array of health troubles, including asthma, sudden infant death syndrome, diabetes, childhood leukemia, ear infections, diarrhea, respiratory infections, childhood obesity and eczema. It also helps the mother recover from childbirth faster and lowers her risk of type 2 diabetes, heart disease, and breast and ovarian cancer, Ramirez says.

Still, some mothers choose not to breastfeed for a variety of reasons — they believe it will be too big a commitment and will virtually tether them to their baby. Others are uncomfortable with the idea of breastfeeding, or just don’t have any interest in doing it, Ramirez says. They like that formula is measurable and allows anyone to feed the baby.

Many women who do choose to breastfeed are surprised to discover that it requires some guidance and practice. “There’s this misconception that it will be easy,” Jordan says. “There are many natural processes that we do have to learn, and that’s what [breastfeeding] is — it’s a process.” Finding breastfeeding awkward or difficult, she says, is more common than feeling that it is a breeze to master.

Indeed, breastfeeding is a learned skill, and cultural and societal factors have created a dearth of what might have been women’s teachers. “Mother Nature intended [for] us to learn how to breastfeed our whole lives long by watching our mothers breastfeed our younger siblings, our neighbors breastfeed, [and] our friends breastfeed,” Ramirez says. “But in 2019, in the US and in New Hampshire, we miss out on that natural learning, and the link — our own mothers — might not have breastfed. Our natural teachers aren’t always skilled or available.”

Fortunately, professional help is readily available to more women today, with hospitals, doctors’ offices, and communities providing resources and support groups. “The majority of women are biologically capable of breastfeeding, barring very few medical disorders,” Ramirez says. “Mostly it’s the management of breastfeeding that women get into trouble with.”

“The majority of women,” she says, “given time and support, will succeed with breastfeeding.”

Breastfeeding at Work

Good news for Granite State moms: New Hampshire has earned high marks for its initiatives that support new moms and infant nutrition, and on the federal level, employers covered under the Fair Labor Standards Act (FLSA) — which includes most, though not all, workplaces — must now provide time for women to express milk, and a private space that is not a bathroom for women to use each time they need to pump breastmilk. “It’s been a huge step forward in workplace support,” says Nancy Ramirez, RN, IBCLC, a lactation consultant at Elliot Hospital.

Plus, thanks to the Affordable Care Act, Ramirez says, breast pumps are covered in most cases. Increased access to breast pumps — lifesavers for many women, regardless of whether the women work outside the home — “has actually helped increase breastfeeding rates, because it allows flexibility for the mother. She can go back to work, she can go out for an evening with friends, she can go out on a date.”

For more information: See womenshealth.gov/supporting-nursing-moms-work/what-law-says-about-breastfeeding-and-work/what-breastfeeding-employees and dol.gov/whd/regs/compliance/whdfs73.htm.