Why Don't More Women Breastfeed?

[Zadee]

I think the basic goal of all lactavists is to get more women to breastfeed. I was thinking about what the barriers are (and this is very US centric, sorry) to breastfeeding. My list thus far:

1. Genuine medical problems. Rare, but it happens.

2. Poor advice/knowledge base. We all know people who really wanted to BF but got derailed by craptactular advice from friends, medical professionals, LCs and so on.

3. No support at home.

4. Unsupportive work environment. I live in a state with GREAT BF laws. Your employer has to provide you with a place to pump that isn't a bathroom. However, as a teacher, insisting on pumping would have been very difficult and required a lot of, umm, determination (read: flat out pushy bitchiness) on my part. I stayed home so it hasn't been an issue, but I suspect a lot of women even here just don't have the energy to fight that battle, and in states without protective laws it must be much harder. And I'm only talking about white collar jobs. Women who work in the service industry, for example, must get screwed if their employer isn't on board with pumping.

5. Genuine misinformation. Are there still women who really think that formula is just as good?

6. Just don't care. I've actually met one of these. She had a high paying white collar job and it wouldn't have been any problem for her to pump at work, but she quit after one month because BF, though it was going just fine, made her feel like a cow. She knew BM was better, her husband was pissed she wouldn't do it, she just didn't care. Formula was "good enough."

I'm thinking knowing the problems makes it easier to brainstorm ways to tackle specific barriers. So...what else. What other major barriers keep women from BF?

[prettypixels]

I believe that more women have *true* supply problems than many people think, honestly. I sure never expected to have a supply problem. I had a home birth and nursed my baby within 20 minutes of the birth. She was on my belly from the time she came out until then. I still wound up with low milk supply. I had help from two lactation consultants, attended LLL meetings, got a hospital grade pump, am still on domperidone, had my hormones checked twice by two different endocrinologists and I still have low milk supply. It sucks, but here I am.

(I am proud to still be nursing at 8 months out, even if 2/3 of my baby's food comes from formula.)

Anyways.

Yes, moms do have low supply and very few mainstream mamas are going to go to the lengths I have. Also I think very few mamas realize that it doesn't HAVE to be all or nothing... that if they wind up with a supply that is less than perfect they can supplement and still have a good nursing relationship. Then again I think most moms are very uneducated about breastfeeding overall.

If DOCTORS are so badly educated about breastfeeding, how do we expect all moms to be better educated than they are? It is such a shame.

Recently on a local mainstream board a mom posted, "I use X Formula Brand, because it is just as good as breastmilk!" *sigh* So, yes, some moms really do believe that.

I also think most moms are not really aware of how intense the bonding is and how powerful a TOOL breastfeeding is for a mother.

So many things I think and believe... the one thing I know is that beating women over the head with it will never MAKE them breastfeed. We have to be advocates for breastfeeding by simply being happy breastfeeding mothers who are *available* to others for information and support... NOT try to shove it down anyones throat.

[D_McG]

Originally Posted by Zadee

5. Genuine misinformation. Are there still women who really think that formula is just as good?

My unofficial research shows this to be a really big factor. I am on a mainstream message board and VERY often I read "formula is great and convenient and DH can feed the baby and babies sleep longer and my friend's BF baby is always sick but my other friends FF baby is never sick".

A lot of people really do not believe that the benefits of breastfeeding are significant enough to offset the supposed inconvenience of being the sole feeder.

[alllyssa]

I think that you missed 2 huge contributing factors in why more women don't breastfeed:

Bad body image (confidence in their body's ability to nurish their baby)

and

prior sexual abuse/assault - this can screw people up forever. Associating baby's breast fondling/sucking with past abuse is a HUGE trigger for many women with this history. And I've heard really high stats regarding the prevenance of sexual abuse in childhood so this would effect a lot of mothers.

Of course, most of these women don't just come out and say, "my stepdad felt me up when I was a teenager and I can't stand the thought of my baby slurping all over my nipples". This happened to a very good friend of mine and as a result of knowing this I NEVER bother anyone who chooses not to breastfeed or pry as to their reasons.

[Momma Aimee]

5. Genuine misinformation. Are there still women who really think that formula is just as good?

i really realy really DOUBT this one.

i fully understnad many of the reasons -- but this is bunk -- : : :

I am sure thre are people who claim to believe this

and while foumual is a perfectly valid choice in the case of adoption or some medical conditions in the mother --

I think it is common knowldge now-days that is NOT better by any means.

it may be what they choos-- and that is fine if they what to choose it so they can leave the baby with DH or whatever --

but i think everyone knows that it is not the BEST FOOD .. mayeb they feel it si the best chose for them, but it is not the best food for the baby.

-- putting on my flame suit -- i think a lot just don't care, and don't want to go to any effort. like PP most wont go to the extent she has gone ... Parenting, in all aspects is hard, and there are a lot of parents who what the baby to fit into their life, not the other way around. so when BF is a challange, as it more often is, they just choose something easier

[~MoonGypsy~]

For the one woman that I was closely involved with when her son was a newborn, it was that she didn't want to be tied down. She wanted to be able to leave the baby and go out and party. She decided that pumping was too much work, even though I loaned her my PIS and offered all the help I could.

[MamaBear1976]

Originally Posted by prettypixels

I believe that more women have *true* supply problems than many people think, honestly. I sure never expected to have a supply problem. I had a home birth and nursed my baby within 20 minutes of the birth. She was on my belly from the time she came out until then. I still wound up with low milk supply. I had help from two lactation consultants, attended LLL meetings, got a hospital grade pump, am still on domperidone, had my hormones checked twice by two different endocrinologists and I still have low milk supply. It sucks, but here I am.

Me, too, hon. You are not alone.

Recently on a local mainstream board a mom posted, "I use X Formula Brand, because it is just as good as breastmilk!" *sigh* So, yes, some moms really do believe that.

What you saw could also be what's known as "viral marketing" where a formula representative or someone paid by a formula company (or benefitting in some way from them) goes into a chat room or a forum like this one (well, maybe not MDC specifically 'cause she'd get booed out of here for it! ) and speaks, very casually, like an ordinary mom, about formula brand X and says how great it is. When speaking as an ordinary person, all kinds of lies can be told ("It's just as good as breastmilk!" or "It's BETTER than breastmilk because it's more convenient!") because there's no way to prove that the "casual opinion" of the person who wrote it works for a formula company. It's insidious, but it happens, probably thousands of times a day.

Obviously some of these opinions will be by REAL moms, who have been led to believe that these lies are true (mostly by all the marketing done by formula companies, whether viral or overt), which further confuses the issue. You can never tell who is for real and who isn't, unfortunately.

So many things I think and believe... the one thing I know is that beating women over the head with it will never MAKE them breastfeed. We have to be advocates for breastfeeding by simply being happy breastfeeding mothers who are *available* to others for information and support... NOT try to shove it down anyones throat.

I have nodded to just about everything you said. Yup, yup, yup...

[Bellejar]

My personal belief one of the main reasons women stop breastfeeding is that it is hard, especially in the beginning. People expect because it is natural it will be easy. Latching comes easy to some babies not so for others. Often it is very painful in the beginning. I think lack of education about what will happen definitely contributes on this front.

Also if you have to be seperated from your child, pumping is no easy feat. If I had gone back to work instead of staying home I know I would have probably only breastfed for 6 months, just because of the stress of pumping. I realise none of my other household responsibilities would not have changed. I would have done everything I am doing now, only had to drop and pick up from daycare and pump and go to work. I have successfully breastfed two daughters now a total of 3 1/2 years, I am still breastfeeding my two year old. My decision to breastfeed basically cemented my decision to stay home.

[MamaBear1976]

Originally Posted by Zadee

I think the basic goal of all lactavists is to get more women to breastfeed. I was thinking about what the barriers are (and this is very US centric, sorry) to breastfeeding. My list thus far:

1. Genuine medical problems. Rare, but it happens.

2. Poor advice/knowledge base. We all know people who really wanted to BF but got derailed by craptactular advice from friends, medical professionals, LCs and so on.

3. No support at home.

4. Unsupportive work environment. I live in a state with GREAT BF laws. Your employer has to provide you with a place to pump that isn't a bathroom. However, as a teacher, insisting on pumping would have been very difficult and required a lot of, umm, determination (read: flat out pushy bitchiness) on my part. I stayed home so it hasn't been an issue, but I suspect a lot of women even here just don't have the energy to fight that battle, and in states without protective laws it must be much harder. And I'm only talking about white collar jobs. Women who work in the service industry, for example, must get screwed if their employer isn't on board with pumping.

5. Genuine misinformation. Are there still women who really think that formula is just as good?

6. Just don't care. I've actually met one of these. She had a high paying white collar job and it wouldn't have been any problem for her to pump at work, but she quit after one month because BF, though it was going just fine, made her feel like a cow. She knew BM was better, her husband was pissed she wouldn't do it, she just didn't care. Formula was "good enough."

I'm thinking knowing the problems makes it easier to brainstorm ways to tackle specific barriers. So...what else. What other major barriers keep women from BF?

You make some really excellent points, and I think in terms of people thinking formula is "good enough" even though they could choose to continue breastfeeding... I think they either aren't telling you the whole story (like maybe the baby started going through a growth spurt and it was hard to keep up while pumping and working) and they just didn't want to deal with the hassle of figuring it out....So they tell themselves formula is "good enough" so they can give themselves permission to not deal with the hassle of coordinating this new skill into their lives.

Breastfeeding is such a dynamic thing, constantly changing... A mother and child are constantly learning, especially in the trying first few months. It doesn't help that, like you mentioned already, there is genuine misinformation on behalf of the medical community, which is disincentivized to learn more about breastfeeding or support it (I blogged about this very problem today, if you are interested.)

I think also the misinformation isn't just about the act of breastfeeding, but about the quality of breastmilk itself, and how it isn't just better than formula, it's SO FAR SUPERIOR as to not even be in the SAME LEAGUE as formula. This is a huge problem, because, though the formula companies give lip-service to "breast is best," they neglect to mention just HOW truly INFERIOR formula really is. It's like comparing drinking a soda to eating an organically grown orange that you just plucked off the tree. There NO comparison, in terms of nutrition. Is a soda easier to find? Yes, in most places. Is a soda more convenient? Well, if you're in a orange grove, no, but in our modern way of life, in a big city, very busy, yes, a soda is more convenient. So there's that, too.

It's definitely multi-faceted, but I don't think it's hopeless, not at all.

[Purple Sage]

I think that not wanting to be tied down (or the only one who has to get up in the middle of the night) is a huge reason for a lot of mothers who choose not to bf.

I also think that a lot of people really do think that formula is just as good. I've seen it said on countless message boards. : The formula commercials certainly add to this problem - "nutrients found in breastmilk" and "like breastmilk" are taken to mean that there's literally no difference. And I've heard so many people say that their ff kids are smart and healthy, so how could breastmilk have made them any smarter or healthier (or whatever breastmilk benefit you're speaking of)....and the classic "I was ff, and I'm just fine." People can't see that there's a difference, so they don't believe it.

Regarding low supply - my best friend tried everything to nurse both of her children, and didn't ever make but a few drops of milk despite taking medication, herbs, pumping round the clock, seeing LC's and doctors. Her endocrinologist said that 20% of women can't breastfeed. (Where did that statistic come from, I wonder.) She wouldn't run any tests on my friend to find out why she wasn't making milk, and actually questioned why she was so concerned about it because, after all, "there's always formula." It makes me sad that doctors aren't even a little bit concerned when a women isn't producing milk.

[melissakc]

I think another issue, kind of related to the sexual abuse problem, is the sexualization of breasts. It took me some significant self-talk to convince myself that there was nothing wrong or weird with what I was doing when I was BFing. I think if someone else had those same feelings but wasn't dedicated to BF, it would have made BF hard.

Is that weird, or did anyone else experience that?

[Purple Sage]

Originally Posted by melissakc

I think another issue, kind of related to the sexual abuse problem, is the sexualization of breasts. It took me some significant self-talk to convince myself that there was nothing wrong or weird with what I was doing when I was BFing. I think if someone else had those same feelings but wasn't dedicated to BF, it would have made BF hard.

Is that weird, or did anyone else experience that?

I don't think you're weird at all. I think a lot of women feel that it's just "icky" to bf because of this.

[T&D2005]

Ya know, I can answer this for myself and I beat myself up every day because of it. I know what to do with the next one but that doesn't solve what's going on now. I blame it mostly on being uneducated about bfing . I really wish there was more support out there (I didn't find out about this forum until DS was 5 weeks old).

1. I was pressured at the hospital because my DS had a bad case of jaundice. They scared me into what will happen if he doesn't get enough milk ect and they told me "if he doesn't latch on in the next 20 min, we need to feed him formula or he can die". I didn't do my bfing research beforehand and thought it would be simple. I thought you put baby up to boob and let the baby do it's job- I was naive because no one in my family breastfed. DS had bad latching issues and I was scared into using formula or else I was a bad mom.
2. They sent us home with a bunch of formula samples and told us if he's jaundice got worse, they would have to keep him in NICU. I didn't want him back in the hospital so I fed him with formula many times to make sure he was getting enough nutrition. Plus, I wanted help from DH during the night so I could sleep.
3. DS had problems latching and my nipples started to bleed and were very painful- got mastitis. I cried everytime I had to feed him and nothing was working. I have everything you can think of here to help with latching problems.
4. I was unemployed at the time and didn't have health ins (DS was a surprise baby, please no flames for that because I wouldn't change a thing) so I didn't feel like I could get the medical resources I could for bfing.
5. Family flew in to visit when DS was 3 days old. We have a very small, open house and I didn't feel comfy having my boob hanging out in front of others. We had family visiting in turns for about a month.
6. I had a manual breastpump and pumped every 3 hrs with it but apparently that wasn't enough because my supply went away but was too late because it was never established to begin with. I bought an electronic double pump and used that for 2 months before part of the attachment broke.
7. I had to return to work when DS was 2 months. I work the night shift and my workplace doesn't support bfing moms.. I had no where to do it in privacy and I was so tired from watching ds during the day and working at night that I decided to give up and go to formula.
8. I went into a deep depression from the pressures of everything and I still feel like crap 5 months later. Everytime I feed DS formula I think "oh god what is this doing to you?" I am on antidepressants and can't bf while on them. My supply is gone and I never really got support at home either.

[katheek77]

I'm sure this is a very small minority, but, I'm wondering if some moms do deliberately shorten the duration of bf-ing in order to get their fertility back, esp. if they're around 40 or so, and hoping to have another child.

Along the same vein, I do know people who said they had to stop breastfeeding while pregnant with another because it just became too painful (and these were people who had an established bf-ing relationship, not people just starting out).

Your OP didn't state whether you meant breastfeed at all, or just shorten the bf-ing period, so, I thought I'd throw those out there.

[kittywitty]

I think that supply issues are actually overreported/diagnosed.

Every woman in my family (mother, 3 aunts, cousin, sdad's family) has bf just fine with no supply issues or formula.

They are literally the *only* people I know IRL that have even tried to bf (except for the Natural Parenting groups I have sought out and rarely found).

Working in the hospital, it was really rare for any of my co-workers even to bf, in my birthing classes, I would be one of maybe 3 that would say we would even attempt out of 20+. None of my friends have bf, though one I haven't seen in years said she hoped to someday.

None even tried. It was either:

1. convenience. They wanted to go out drinking/start back smoking/work and not bother pumping.

2. I "want my dh/so to bond and feed baby, too" (usually included in other excuses.

3. It's "gross". This would be from my best friend and every single person in dh's family.

[cycle]

I know that there is a small percentage of women who are physically incapable of breastfeeding, there are far more women who are physically capable and don't breastfeed.

I think a big problem still is that in a lot of cases there isn't a lot of support...in the hospital when ds was born a nurse brought in formula without asking me first. If I had not researched I would have been persuaded easily to just feed him formula.

If I had listened to my mom and grandma I wouldn't even have tried to bf, they were both told by their Drs. that they didn't have enough milk so neither of them even tried to bf. They were positive I would not be able to bf.

However, I think the main reason a lot of women don't bf is laziness.: I know many women who don't bf and thats what it is, laziness. They want to be able to have other people feed their babies, they don't want to take the time to pump, its not convenient (this one I don't get at all), they don't want to be the only one getting up at night.

Another excuse I have heard several times is that their breasts are too sensitive or that their breasts are sexual. I don't get it.

[Bellejar]

I wouldn't equate not breastfeeding to laziness. I think lack of commitment might be a better description. Most of the women I know who don't breastfeed are not lazy, they just have different priorities - which goes in part to lack of education. Most women I know not only work but run there households and shuttle children, do the wash, and everything else under the sun. If they are fed the line formula is just as good (heck they give you samples at the hospital) with all the other responsibilities that are heaped on them, I understand why it ends up that way. I don't think its the right decision, but I empathize.

Also, which is harder at 2am whipping out a boob or making a bottle. I don't know how people bottlefeed at night. Heck I haven't ever bottlefed either of my children, the inconvenience of it all just astounds me. Imagine what you would have to tote along with you.

[lolar2]

Originally Posted by Bellejar

Also, which is harder at 2am whipping out a boob or making a bottle. I don't know how people bottlefeed at night. Heck I haven't ever bottlefed either of my children, the inconvenience of it all just astounds me. Imagine what you would have to tote along with you.

That is true.

[Momma Aimee]

Also, which is harder at 2am whipping out a boob or making a bottle. I don't know how people bottlefeed at night. Heck I haven't ever bottlefed either of my children, the inconvenience of it all just astounds me. Imagine what you would have to tote along with you.

I have experience first hand with the situational disadvantages of formula and exclusive bottle feeding.

I HAVE done the formula game -- with foster babies in an emergency shelter (and for the record NONE of the were BF before we got them) ........ and it si teh BIGGEST PITA you can dream of!!!!!!!!!!!!!!!!!!!!!!

I have to laugh, and KNOW the mom is LIEING to herself, or me, when anyone tells me that FF is just "easier" or "makes night feedings better" I have BTDT and while I am willing to respect it as a mother's choice, and maybe what she feels is better for her and her family, it is NOT easier.

The hassle of making bottles with a screaming baby, of washing bottles and nipples, of constantly having to worry if you had enough formula with you, or clean bottles with you or water with you – or how to heat up a bottle, as well as the major issue of running out and the cost of formula.

it maybe a choice some moms make -- feeling it si better for them personally -- but it NOT easier.

My youngest sister had to pump, and feed via a nasal tube till her son learned to nurse (after a stay in NICU) ... that effort .... His mom worked diligently to teach him to latch-on and nurse; he had lost the suck-swallow-breath reflex and had to work with a speech therapist. He reacted strongly to anything placed in his mouth due to medical procedures and life-support he had experienced. A pumped every 2 hours around the clock the whole time DN was in the hospital, and for many months afterwards. Once he was ‘eating” he had to be fed via the nasal tube, while being held to the breast and helped to nurse every 90 minutes, in addition A then had to pump after each feeding to maintain her supple and also milk for DN to be tube fed... the clean the pump and the feeding stuff from feeding him, then POOF it is time to start oaver again because it is time for his next feeding or he is fussy and so in the vein of cue-feeding, needs to be feed...............THAT was worse than FF the foster babies, butttttttttttttttttttt didn't last 12 months :

I simply do not accpet eh "easy" arguemtn -- BTDT and Know it is not ture

[cycle]

ITA that formula feeding is a lot harder! I wasn't saying it was easy. For whatever reason a lot of women think it is easier, I think because they know that someone else can get up at night and feed the baby. They also feel like breastfeeding will tie them down, well in kind of does but for me there was nowhere else I would have been than with my baby who needed me.

I now first hand of several moms who don't breastfeed out of laziness...even though we know it is so much easier.