Better to be upfront about the hard stuff?

[krystyn33]

The Rosin & response articles got me thinking about an issue that has concerned me for some time. When we push the "benefits" (I agree with the problems of using this word--BFing is not superior, it is normal, etc.) of breastfeeding, including the ease and convenience of nursing on cue versus bottle feeding, the fact that it can be so much harder than FF for some of us in the early days seems conspicuously omitted. I'm thinking of cracked nipples, round the clock constant nursing which can be exhausting (with FF someone else can feed baby & give mama some sleep), the pain of engorgement, complications like mastitis, thrush, painful latch, etc.

At LLL meetings I would be upfront with any moms-to-be and say that while for some moms it comes easy, for many of is there are challenges at the start. Worth every tear and bit of effort to stick it out--absolutely! Establishing breastfeeding was like a rite of passage--succeeding gave me a tremendous sense of accomplishment and pride.

I always wonder if it helps or hurts to point out the difficulties and negatives of breastfeeding. We live in a quick-fix culture which places so little value on the "character-building" sort of challenges in life. People want shortcuts and often feel entitled to a life of comfort and ease. Pain and difficulty are not tolerated but avoided and viewed as "something wrong." So for many, knowing it might be painful or hard at first--even with the promise that it gets SO MUCH BETTER and is wonderful--would out them off from even trying to BF. But for others (like me), knowing ahead of time that the pain can be normal and is temporary--part of a learning process, was essential for success.

But clearly, not having room to not love breastfeeding--keeping the stiffness in that upper lip--has its down side. We need support to make breastfeeding work. Mothers need postpartum care--someone to shoulder the responsibility of keeping life moving along so we can freely invest in the intense care for our newborns. And families need paid leave so the need to work outside the home to make ends meet doesn't sabotage the start of the nursing relationship.

Like parenting itself, breastfeeding can be HARD and have moments when you feel like throwing in the towel. But as the bitterness in the articles mentioned above indicates, such venting about the challenges of breastfeeding can be taboo for some.

What do you think--does it help or hurt to be open and upfront about breastfeeding's less pleasant aspects?

[Bluegoat]

I think it's important to be upfront. Partly it is a trust issue. Also, a women who thinks it will be easy feels incompetent and frightened when it isn't. And finally, if they don't know what the difficulties might be, then they have no idea how to overcome them, or if they can be overcome.

[jempd]

I recently attended a breastfeeding support group that the lactation consultant I hired runs, and I went to a session when dd was older, about 2 months old, and there were a few first-time mothers there with much younger babies who were clearly frustrated and having a very hard time. They were well-educated about bfing but couldn't believe how much difficulty they were having. The woman who ran it kept having me and another mother who had an older baby who had gotten over the usual humps (bad latch and so on) tell them that it gets better. I think that the women were much more receptive to the whole idea of it after hearing from women who'd just been through it that persevering and using the right techniques does pay off and eventually it gets so easy you don't have to think about it. Now I was just about as determined to breast feed as anyone can be but there was a point with dd (born in December) with a wicked over-active let down, that I was close to throwing in the towel. So I can relate, but I also knew that the key was getting good intervention so that's why I called the lactation consultant, something that a lot of people don't know or feel that they've failed if they have to do that. But in general, I agree with you: Yes, why not be up front about the problems? It might scare some people off but the thing to communicate also is that the problems are temporary and can be resolved.

[MaryJaneLouise]

I also agree that it is best to be honest about the potential challenges. I know some think this will scare people off, but I think we need to say yes, these things can happen, but that is why you need a support system. You don't need to know how to fix everything, but you do need to know whom to contact. Your LLL leader, or a lactation consultant can help.

[AutumnAir]

Yes.

By touting BF as 'easy' all you do is set up the majority of women who will experience *some* difficulty, especially in the beginning, as failures, simply because they're having a hard time doing something that should be easy. And those who do succeed despite the problems don't feel that they should be proud of themselves, because it's supposed to be easy.

Having BFing being perceived as 'easy' also takes away from the very crucial support that a mama needs to help establish BFing, and undermines the worth placed on Bfing by society at large.

Also, as others have mentioned, being prepared for difficulties is far better than being blind-sided by them and not knowing where to turn.

[AFWife]

As a brand new mom I'm SO GLAD that people on MDC are upfront about the hard stuff. It keeps everything in perspective. I also think it's going to keep me from stopping because, while it may be difficult at first, it's WAY worth it in the end.

[mamarootoo]

i always talk about how hard it is in the beginning. i think one of the best ways to discourage a new mama from nursing is to make her feel like she's doing something wrong because it's not working out easily.

[haurelia]

I think being honest is important, if you're talking to a new mom.
I benefitted greatly from mom's stories while I was beginning...with lots of trouble. I am an RN in a birth center, and on the breastfeeding support team. I know a lot about initiating breastfeeding, what good breasfeeding looks like and common challenges, and I still had sooo much trouble.

Quitting breastfeeding was never an option for me, but I have a new understanding for those who "throw in the towel." Perhaps they wouldn't if they had more role models of mamas who stuck through some really hard stuff without weaning to artificial milk.
At my first LLL meeting last month, there were three first time pregnant mamas who asked questions to the group about nursing. I was the only one there with my baby (6 weeks old at the time). I talked about my experience, and (nursing my kiddo the whole meeting), offered for anyone who wanted to to watch us nurse or check his latch out, or whatever. Nobody came over to us, except for a veteran mom who was trying to break the ice for the new moms.
Going through our nursing challenges was far far harder than giving birth. I am very happy that I stuck through it, because it's a piece of cake now, and such a lovely part of my relationship with my son. Hearing about similar issues from real people let me know that I could persevere too.

[UhOhWhatNow]

I wish someone had told me that my nips would blister and bleed and ache... that I would be sleep deprived and so forth... it wouldn't have stopped me from BFing, but it would have made me realize right away it was normal!

[Zadee]

I think it is SO important to be up front that BF can have some challenges, sometimes really tough ones, in the beginning. Otherwise women, when they run into trouble, don't think "Ah, a bump in the road" but "I am failing at something easy, I must not be able to do this."

[spughy]

Yes, absolutely it's better to be upfront about the challenges. Other aspects of parenting aren't typically whitewashed - you don't hear people saying "oh, diapers are no trouble at all. You hardly ever have to change them and they don't smell one bit." Nor do people say "getting up every few hours is easy." It's part of having a baby, and it can be hard, just like everything else associated with having kids. But, like everything else, it gets easier, and that needs to be stressed too - it might be hard in the beginning, but after you get the hang of it you can latch a baby on without interrupting a conversation or waking up or whatever, which is more than you can say for prepping a bottle!

[proudmomof4]

Originally Posted by spughy

Yes, absolutely it's better to be upfront about the challenges. Other aspects of parenting aren't typically whitewashed - you don't hear people saying "oh, diapers are no trouble at all. You hardly ever have to change them and they don't smell one bit." Nor do people say "getting up every few hours is easy." It's part of having a baby, and it can be hard, just like everything else associated with having kids.

The diaper part really made me laugh!
One of the hardest parts of breastfeeding is maybe that expectant mothers usually don't see a whole lot of examples. As we all know, BF is not just an instinct but a learned social skill (among humans and all "higher primates"). Too many new mothers still feel they are all alone - and life with children was never meant to be that way.

[allisonrose]

I agree that it is better to be upfront with the difficulties that can come with breastfeeding. I was pretty surprised at the pain of engorgement as I was nursing my newborn as often as he was interested. I was also surprised by nipple pain despite being told that our latch was good. I did feel like a failure for a while. I was very committed to bfing and had in mind that someday it'd be easy.

I'm very glad that I kept at it. I am upfront with all new moms I meet that although it can be tricky in the beginning, it does get easier.

[Sagesgirl]

I think we should be honest in our discussions. But not negative. I'm honestly quite annoyed by the negativity that has abounded here lately. Yes, sometimes it is hard! But sometimes it is not! If we're talking to a woman who's trying to make the decision, then going on & on about things like cracked nipples and plugged ducts and thrush and other things that might not happen is IMO counterproductive. By all means, acknowledge that some women deal with these issues. But at the same time emphasize that they can be overcome, are usually minor and temporary, and that breastfeeding is worth it anyway.

Quite honestly my problems were minor, and some of them I never "knew" were problems until I was told they were. (Over-active letdown, for one.) I thought they were quirks that got dealt with. Most women I know IRL who have breast-fed have had similar experiences. I do not personally know anyone who had to deal with cracked nipples; I am the only person who's dealt with constant nursing and poor latch (with my oldest) and even thrush. Why on Earth should we tell women "Oh, expect that you will never get sleep, your nipples will crack and bleed, and it will hurt like the dickens" when there's no guarantee it will happen?

Another thing we should all know is that our expectations play a huge part in shaping the reality of our experience with something--or at least our perception of it. I would have hated to go into breastfeeding with a fearful mind worrying about what could go wrong.

[Claire and Boys]

When I was pregnant with my first I spent a lot of time on BF forums and learned about all the possible pitfalls - I know exactly what to expect, and what to do if things didn't go right. I'm a bit OCD like that - I like to be really prepared. I had sore cracked nipples but that was about it. BF was actually nowhere near as bad as I had expected given all the negative stuff I read.

[krystyn33]

Originally Posted by Sagesgirl

Another thing we should all know is that our expectations play a huge part in shaping the reality of our experience with something--or at least our perception of it. I would have hated to go into breastfeeding with a fearful mind worrying about what could go wrong.

I agree that we should always be careful with our language and that often negative expectations can turn into a self-fulfilling prophecy.

Frankly, I expected BFing to be a breeze--I mean, it was natural and instinctive. I even spent time on the forums here and read about challenges, but I assumed those moms were in the minority. When the toe-curling pain did not go away for me within the first couple days, I was convinced I was doing things all wrong and failing at nursing. Fortunately, I am extremely stubborn and I refused to give up. It helped me tremendously to hear from other friends that it can be hard at the start but it will get better. I do know three mamas who had no issues with pain and a fairly easy time establishing their nursing relationships. But when the question gets posed at LLL meetings--how long did it take before nursing felt easy for you?--most moms said 2-3 months.

This reality for so many nursing moms makes selling breastfeeding a bit tricky. So many times the ease and convenience of BFing over bottle feeding is emphasized. Comfort and convenience are major addictions in mainstream American culture--the consumer industry caters to this. For so many moms BFing in the first couple months is anything but comfortable and convenient. Honest disclosure can make a hard sell.

What I generally tell moms who ask is that yes, breastfeeding is natural and for some it is a breeze. But there can be a learning curve and adjustment period at the start, so it is important to have support and to get help (IBCLC or LLL) for any problems. I also let them know they can expect to spend a lot of time nursing at the start--and that is their most important job, so they should enlist as much help as possible with cooking and other household tasks. For someone coming from a culture in which FF is the norm, the sheer amount of time spent nursing at the beginning can be a shock. We're a long way past the "lying in" custom which facilitated breastfeeding success--so many of us don't even have extended family around to help out at all.

I think there's a way to balance realistic experience with positive expectations. But I also think the cultural change needed to improve breastfeeding rates goes WAY beyond just nursing.

[proudmomof4]

"What I generally tell moms who ask is that yes, breastfeeding is natural and for some it is a breeze. But there can be a learning curve and adjustment period at the start, so it is important to have support and to get help (IBCLC or LLL) for any problems. I also let them know they can expect to spend a lot of time nursing at the start--and that is their most important job, so they should enlist as much help as possible with cooking and other household tasks. For someone coming from a culture in which FF is the norm, the sheer amount of time spent nursing at the beginning can be a shock. We're a long way past the "lying in" custom which facilitated breastfeeding success--so many of us don't even have extended family around to help out at all." (krystyn33)

I really like this balanced approach - BF is natural and most women will be able to succeed with it but for some women the start can be pretty rough.
For what you said about the loss of the "lying in": I totally agree with you on that one. As far as I know you don't even use a term like that anymore in English, do you? In German, we still say "Wochenbett" ("week bed"), implying that a new mother should spend her first postnatal week in bed. Imagine my shock when not even 2 days after my 3rd child's birth my neighbor came to take me for a walk. (Hello? Leave my newborn for an hour without mom / access to BF? Ever heard of afterpains and lochia?) She even tried to make me look ridiculous for not coming along. Obviously, in her book I hadn't earned even the usual "hospital time" because I had had such an "easy" homebirth. :

[jimblejamble]

YES it is best to be upfront! My sister has a 3-year-old little boy. When he was born she tried once to nurse, he didn't latch on right away, so she immediately went to formula. She didn't ask for help or anything. Just, "Well it didn't work perfectly and he was hungry so I just did the next best thing."

[GoBecGo]

Definitely be honest!

It really bothers me when ANYone lies or glosses or exaggerates in order to make their case (whether it is BF or FF or any other choice one might make) seem stronger.

Breastfeeding BECOMES far easier than bottles, but even for someone like me (who had no cracks, no mastitis, no thrush, no latch problems beyond the usual small-mouth-big-boob-tendency-to-slip-off when she was very new) it isn't a walk in the park in those early weeks when sleep and time alone has gone entirely out of the window. I was very very keen to BF, but i hadn't thought through what it is like to NEVER be alone (i had a frequent feeder and an unhelpful partner) or have a moment to one's self. BFing is really full-on to begin with and mamas need to know that.

In addition i met with several lactivist-type mamas when i was having problems later on (i got a thyroid condition and ended up having to wean at 7 months due to complete loss of supply and refusal of my doctor to treat me until i'd had a radioactive scan, which i couldn't nurse through, to check my goitre wasn't cancer) whose attitude was that nursing is really easy and thus i couldn't be having problems, milk is supply and demand so i was obviously not nursing enough to keep my supply up, nursing cannot make you ill or make illness worse (i am guilty of glossing this but unmedicated my thyroid function improved by just over 400% in the fortnight after i weaned my DD) and so i was blaming my illness because of a character flaw or deep-seated desire to "get out" of BFing. I even had one say to me, when i was so sick i was unable to get off the sofa, was almost bald, and had a goitre bigger than a grapefruit "if you want to quit BFing, just quit, why all this public drama about being ill?".

It made me miserable that i had to wean and i am very optimistic that i will be able to get through next time (with a better support system, a knowledgeable and BF-dedicated endocrinologist and a LOT more learning under my belt) but i never lie to pregnant women about how easy BFing is. The TRUTH is that BFing is normal, healthy and becomes a wonderful part of parenthood for most mums. That truth, delivered sensitively and with love, is enough.

[Altair]

what annoys me the most as a new mom is hearing from BFers "it's not supposed to hurt."

yea, no crap it's not supposed to hurt. but it does. I've been a birth and PP doula for 9 years, I know how to get a good latch. still, my nipples were bloody, raw, and infected. The IBCLC who came over said our latch was perfect, I was just getting torn up as my body got used to it. some antibiotic ointment cleared everything up eventually.

yea, it can really, really hurt in the beginning. let's be honest about that.