even in a pro-bf environment...

[spughy]

I've been mulling over something I learned at the Breastfeeding Challenge on Saturday. In the region where I live, Vancouver Island, we have the highest rate of breastfeeding amongst moms leaving the hospital - 94% (I don't know if home births were counted, but we have a really high rate of those too). That's fantastic. But, two months pp, the rate drops to 47%. We have great support here for breastfeeding, it is socially more acceptable than bottle feeding, the public health nurses (in my experience, and I had a LOT of problems) are knowledgeable and helpful, and there are lots of LCs and LLL meetings and a couple really great doctors who run breastfeeding clinics weekly and see people who are having breastfeeding emergencies. I'm sure that there are a few in the medical community here who could benefit from some more information, but generally, everyone is super-supportive of bf'ing.

So what's the deal? Why do half the women who start bf'ing stop? I went through a lot of challenges bf'ing - low supply, mastitis, etc. and was always able to find good help without hardly trying. I am left to sadly conclude that the half that stop bf'ing didn't really want to do it in the first place, and only started because of pressure from their ob/gyns/midwives/whoever. What I don't understand is why they wouldn't want to, and what we (not the royal we, I mean lactivists) can do about that.

I just can't get over how sad it is that less than half the mamas on the Island bf past two months. Remember this is Canada, we get a year's partially paid maternity leave - most mamas don't go back to work after 6 weeks or whatever.

It seems that you can give out all the "it's best for the baby" reasons you want, but there is some indefinable factor that makes some moms want to breastfeed so bad they'll go through hell to do it, whereas other mamas are like "yeah whatever, I'll give it a shot but if it's at all inconvenient, meh..." How do you convince a mama like that to do it, once her nipples start hurting and the baby wants to nurse every half hour? How do you get a mama who didn't really want to nurse in the first place to tough it out through a bout of thrush or mastitis? Can you? Is 47% the best we can hope for?

[sunshinestarr]

Maybe they start ff after they go back to work? I'm interested to hear other opinions.

[bobandjess99]

the work idea is interesting...
i also think the "oh, it's not going to be 100% easy, so..meh" idea is valid....

BUT, my number one suspicion is the following...

I would also wonder HOW they got the 94% statistic...??..
To be quite honest, here, in order to basically inflate the BF rates at the local hospital, any mom who EVER, at any point during her hospital stay, puts the baby to her breast at all, is counted as "initiating BFing"...so the nurses get even staunchly-know0they're-going-to-FF moms to at least "try it" once..using browbeating if necesary....because if they do, they get to count that mom as "initiating BFing", which makes the hospital look better.

I would wonder how many of the 94% REALLY ever had any intentions at all of BFing? I'm betting probably somewhere around 47%.......

[My4Boys]

Originally Posted by sunshinestarr

Maybe they start ff after they go back to work? I'm interested to hear other opinions.

The original poster stated that Canada has very liberal maternity leave laws and many moms do not go back after the typical 6wks as they do in the US. There must be other reasons and my vote still lies with lack of support from their every day pediatrition. People don't like to go out of their way for help. They want help to come to them.

[spughy]

No, most of the moms aren't going back to work until a year. This is Canada. We are enlightened that way.

I don't know about the hospital inflating the statistics though. Vic General (which is probably where about 75% of the babies on the island are born) is a WHO breastfeeding-friendly-designated hospital - or they are working on it, I forget which. Either way I agree they might have some incentive to inflate the stats that way - but from my experience there, it seemed more that the nurses assumed you were bf'ing and helped you latch your baby whether you wanted the help or not. One in particular was super-pushy and actually really unhelpful and disrespectful. But that's another thread

ETA: I forgot initially but they actually are reluctant to discharge you until bf'ing is going ok, IIRC.

[LittlePeanut]

I know the numbers here in Halifax are based on the number of mothers that leave the hospital after a 2-5 day stay still BFing. From personal experince with a few moms I have seen the "It was too hard". I agree with you though, I just don't think they just don't want it bad enough so when the going gets tough...

LP

[ndunn]

Spughy, I'll tell ya something. It may seem as though we have some great things going on in Victoria, and we do. Don't get me wrong.

But...

I personally have had 2 friends RECENTLY who had visits by the public health nurse because of various difficulties w/ breastfeeding and were encouraged to give supplementary bottles of formula, etc. And these were in cases where it wasn't necessary, baby was gaining, etc.

I actually just had this conversation w/ someone at mothering touch and the paper that was given out at the BF Challenge was a topic of discussion. I don't know if you read it, but it was in your pack, and it went on to say "10 ways to ruin the breastfeeding relationship" or something like that.

I think I can count on my hand the number of times recently that I've had a friend have at least one of those things done to them by a health professional in this city.

It's really sad, but also, alot of docs still encourage really early solid introduction, which can contribute to problems if someones supply isn't great to begin with because of the day we live in where bottles are given frequently so mom can "have time". We all know the key to a good milk supply in the first 3 months is to bond with babe and nurse nurse nurse, in most cases. Not to say there aren't exceptions, I know you had a struggle in the beginning and I think you're such a wonderful mother for persevering like you did.

Well, thats park of my take on things....
Nak, so I'll write more later.

[Ruthla]

I do beleive that it's far better for a baby to BF for a week or two, then switch to ABM, rather than to not be BF at all. If you have a mother who really doesn't want to BF for whatever reason, and she feels pressured into BF for a few weeks, that's GOOD pressure IMO!!

My guess would be that many of these mothers who quit by 2mo were the ones who weren't particularly dedicated to BF in the first place. Either they BF a little bit just so they could say they BF (again, positive peer pressure) or they just figured they'd BF while it was easy and switch to formula if things got tough, no real preference either way.

[siobhang]

Bfing is still not the norm. It IS the norm to start breastfeeding for a few weeks/months and then slowly start weaning, even if this is not what it is called or identified by the moms.

From the moms I know IRL (and most are NOT working moms, btw), the reasons why they weaned before age 1:

* didn't like it/felt tied/bottles were easier
* baby starting preferring bottles
* nursing strike (but usually described as "self weaning")

Now, it is quite common for moms to:
* give bottles 1 - 2 x a day even when they aren't working. The reasons are to "give mom a break" or "Let X bond with baby"
* sleep away from babies after the first few months
* work hard to get baby to sleep through the night after those first few months
* start baby on solids around 3 - 4 months (especially with the belief that it makes babies sleep more soundly).
* allow bottle propping or self-feeding with bottles

All these behaviors sabatoge breastfeeding relationships.

I think the problem is:
* moms don't know/believe that these behaviors do sabatoge;
* moms get bad advice from their docs and families when they do have problems, and they are told that formula isn't bad or that nursing for X months is good enough; and
* most moms ideally want to nurse for one year, but when they run into roadblocks, think "oh, it isn't working out for us, just like my friends" and quit without finding help.

It is frustrating to talk to a woman who gives bottles 2 x every day, saying "see, there is no such thing as bottle preference" and then a few months later, the baby refuses the breast, and she says "see, he has self-weaned." No, he has bottle preference.

And it is damned hard to be working outside the house and maintain supply, avoid bottle preference, and get enough sleep at night to be able to function the next day (especially with a reverse cycler baby).

I don't think any of these moms are selfish, stupid or bad moms. There are too many moms like this - it is a broader societal norm of how breastfed babies are to be cared for that needs to be addressed if we want to get breastfeeding rates up.

[My4Boys]

Originally Posted by siobhang

I don't think any of these moms are selfish, stupid or bad moms. There are too many moms like this - it is a broader societal norm of how breastfed babies are to be cared for that needs to be addressed if we want to get breastfeeding rates up.

[bri276]

I'd guess it's the help they're receiving. I bet they are not getting great advice from doctors or LCs. It's absolutely amazing the difference between an LC like kellymom and an average professional who is supposedly knowledgable about bf'ing.

[eepster]

I think some moms do indeed start BF out of presure and guilt and are just waiting for an excuse to stop. I know of one mom who back in the '90s had an infection postpartum and "had to quit BF b/c of the antibiotics."
When I mentioned to her that it's not as hard these day b/c there is a long list of antibiotics you can take while BF she said "oh yeah, that was around then but I chose to take one that wasn't on the list." :

It just seems like she was waiting for an excuse to stop.
BTW I usually find these are the moms that give me the most flack about going to the trouble of seeing a LC and then an occupational therapist for suck swallow training (ignoring that I have mentioned that it will also help DS not need speach therapy later.) :

[Mama Poot]

Some people honestly are not educated enough to understand the importance of breastfeeding. I believe they are in the majority of those who drop out of it, and largely because they know they can get formula for "free". If formula was not just handed out and you could only purchase it at full, ridiculous retail price at the store or go through your doctor or insurance company to get a script if there are bona fide problems, more women would HAVE to put more effort into "making breastfeeding work". Formula is JUST too available, plain and simple. Until that changes, our breastfeeding rates will remain substandard compared to the rest of the world.

[milk_maker]

This is my theory (because I've seen it happen so many times)

Mom gets home, BFing is going well for the most part and mother copes fairly well with sore nipples and other beginning discomforts. Once the first growth spurt hits (around the time of the first WBC) the mother begins to feel inadequate because the baby is nursing so much, so often, and seems to be unsatisfied. She brings this up with her doctor who assures her that a single bottle to top off the baby can't hurt anything. So she supplements with one bottle...then another...and another until her supply starts to dwindle at an alarming rate. Within two to three weeks after that first growth spurt, the baby hits another spurt and her supply dwindles to nothing as she's heavily supplementing with formula and finally dries up.

Lack of education and knowledge of the functioning of the human breast is probably the biggest culprit in the major decrease of breastfeeding rates after the first month.

[mammal_mama]

Another factor is societal attitudes toward public breastfeeding and child-led weaning. One friend weaned her daughter to formula at seven months because she didn't want to be nursing a two or three-year-old and she felt it was kinder to her daughter to make the switch at an age when she'd be more amenable. Sadly, people still tend to think about weaning as something moms "do to" their kids rather than something kids do gradually over time -- and for moms who don't want the struggles that inevitably come with mother-led weaning, it's often easier to wean them before they really know what's happening.

[myrmom]

soooo many breastfeeding moms Iknow(also in canada) were encouraged to supplement at one time or another. I truly believe if a baby is given formula in the beginning at some point it can and often will lead you down thatslippery slope of early weaning.

both my cousins did this...one cuz shewas told her baby wasn't getting enough and then it just became easier to bottle feed full time. The other was supplementing due to jaundice and then she was leaking tomuch and not comfortable with that. Both sad.....

[tallulahma]

Originally Posted by milk_maker

This is my theory (because I've seen it happen so many times)

Mom gets home, BFing is going well for the most part and mother copes fairly well with sore nipples and other beginning discomforts. Once the first growth spurt hits (around the time of the first WBC) the mother begins to feel inadequate because the baby is nursing so much, so often, and seems to be unsatisfied. She brings this up with her doctor who assures her that a single bottle to top off the baby can't hurt anything. So she supplements with one bottle...then another...and another until her supply starts to dwindle at an alarming rate. Within two to three weeks after that first growth spurt, the baby hits another spurt and her supply dwindles to nothing as she's heavily supplementing with formula and finally dries up.

Lack of education and knowledge of the functioning of the human breast is probably the biggest culprit in the major decrease of breastfeeding rates after the first month.