statistic on % of women who are physically unable to breastfeed? - Mothering Forums
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#1 of 37 Old 04-15-2008, 10:29 PM - Thread Starter
 
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Ok, does anyone have a referenced (from a reputable source) statistic on the percent of women who are physically unable to breastfeed?

I swear there was a discussion thread on this a while back, but I tried like 6 searches and couldn't find it. I've also been through every single BFing book that I have looking for one and haven't come across anything...

Thanks!

Mama to two wonderful DDs (10/06 and 09/08) and expecting a DS 1/1/11!
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#2 of 37 Old 04-15-2008, 10:33 PM
 
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I don't think any real research has been done that would give a real good solid number.

-Angela
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#3 of 37 Old 04-15-2008, 11:19 PM
 
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I think a good way to go about it might be to see if you can find a statistic on how many women breastfeed in a country that hasn't been touched (or as touched) by the formula companies. I think I read a statistic on here somewhere (awhile back) that 99% of women breastfeed in countries where formula isn't an option. Sorry I don't remember the exact source.

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#4 of 37 Old 04-15-2008, 11:51 PM
 
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I remember reading that the number is something along the lines of 5% of women are physiologically unable to fully sustain an infant with breastmilk. I believe that statistic included when who could make enough milk. I'm sorry, but I don't remember where I saw it. I do know that I read it when I was an LLL leader though. Maybe you could call LLL - or they have an email helpline, too (or they used to anyway). They could probably track it down.
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#5 of 37 Old 04-15-2008, 11:54 PM
 
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I don't have a source, but 5% is the number I have heard as well.

If there are areas that formula has not touched, I imagine there would be wet nursing, which would have been the solution before formula and it's precursors.

DS 12/22/05 and DD 5/24/09
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#6 of 37 Old 04-16-2008, 08:09 AM
 
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I don't have a source, but 5% is the number I have heard as well.
The 5% came out of a small study in Colorado - the study followed 319 women who were highly motivated to breastfeed. They were mainly white, mostly married, mainly college grads, and mainly earned >$35,000/yr in the late 1980s. While the study was interesting (10 % of the women needed help to increase their milk supply, and 5% never could produce enough milk), the numbers were small, and the population studied was not similar to that of the rest of the USA. Because of this the results can't be applied to the rest of the country or a different population.

Unfortunately, the study that would really uncover the percentage of women who are physically unable to breastfeed hasn't been done.

(Study that showed 5% of the 319 Colorado women couldn't produce enough milk was: Neifert et al. 1990. The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain. Birth 17(1): 31-38)
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#7 of 37 Old 04-16-2008, 10:06 AM
 
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I just wanted to throw in my two cents that I believe the number of women who "can't" physically breastfeed is higher in our country than others because of poor nutrition and the fact that our mothers were not breastfed (and thus we did not receive the proper gut flora when we were born), we were not breastfed (thus bad gut flora) plus all the abx and vax as well. I have read posts from firefaery and I think uccomama that over and undersupply are the result of gut problems. I totally believe this (just think of the ways that milk production in cows is controlled by farmers). And I think there are other factors attributable to nutrition and physical degeneration that make BFing difficult or impossible - like shallow and cleft palates, and possibly tongue-tie as well. Not a completely developed theory, but these thoughts have changed the way I view women who "can't" breastfeed and the lactivist tendency to think they "just didn't try hard enough". I really think lifestyle has made it increasingly difficult for this generation to BF successfully. JMHO

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#8 of 37 Old 04-16-2008, 10:14 AM
 
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Crossposted from the low milk supply stickie in BF challenges. As with any statistic, its measurement depends highly on what your definition of "is", is. What is low supply? What is breastfeeding? Do you include supplementers? Do you include exclusive pumpers? Women who had breast reductions, augmentations, or other surgeries? Babies with congenital defects, cleft palates, high "bubble" palates? Preemies? Women with multiples? Etc.

Occasionally people will ask here what the "true" incidence of low milk supply is. I recently found a couple of good studies measuring this.

One thing to remember is that breastfeeding involves both mother AND child(ren) and many factors can affect supply, including infant factors, and pumping and/or WOH.

http://www.ncbi.nlm.nih.gov/pubmed/1...RVAbstractPlus

This study estimates that 12% of healthy, singleton, term infants had excess weight loss. This is in a "crunchy" area (Davis, CA) with high educational levels and motivation to breastfeed, and where moms had good access to care with lactation consultants, etc. In other words, in an uncomplicated hospital birth with lots of support, 12% of singleton moms still had low supply problems.

http://www.ncbi.nlm.nih.gov/pubmed/2...ubmed_RVDocSum

This study measured 319 healthy, motivated, first-birth women who were breastfeeding full term, healthy, appropriate for gestational age or large for gestational age infants, and where only 7% had undergone previous breast surgery. It found that
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15 percent had persistent milk insufficiency despite intensive intervention.
I personally believe that low milk supply is a much more common than many health professionals recognize, and that it is an important area for ongoing research. Rather than burying our heads in the sand regarding this issue, I think breastfeeding advocates need to get the information out there for women that this is a real problem, and that there ARE some things that can be done to optimize breastmilk production. Off my .

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#9 of 37 Old 04-16-2008, 03:04 PM
 
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I personally believe that low milk supply is a much more common than many health professionals recognize, and that it is an important area for ongoing research. Rather than burying our heads in the sand regarding this issue, I think breastfeeding advocates need to get the information out there for women that this is a real problem, and that there ARE some things that can be done to optimize breastmilk production. Off my .
Interesting...I was just coming on here to post a few tidbits from a review of studies by Frank Hytten in which he suggests that as many as 1/3 of women can't produce enough milk (based on his review of various studies). He suggests reasons for this might include the ready availability of other lactating moms in early human societies (regular cross-nursing) and thus less need for EVERY woman to produce enough milk for her offspring, and age (women over 30 produced less milk and milkfat than women under 20). There are other reasons too, like breast augmentation/reduction surgery (I wonder if the surgeons tell women ahead of time that this is a potential side effect).

When I first read Hytten's article, it felt like a slap in the face, but I realized we do have to ask the hard questions, and if the reality is many more women than we expect have trouble producing adequate milk, then like PP said, that needs to be addressed. His article is called "Science and Lactation," and it's reprinted in Infant and Child Nutrition Worldwide: Issues and Perspectives, edited by Frank Falkner. Hytten's is the only piece in there that isn't exclusively pro-breastfeeding. Anyway, I'm not ready to sign on to his conclusions just yet, but I agree more studies need to be done.

And in some of those countries where bfing rates are touted as 99%, that's only at discharge from the hosp/birthing center. Rates at 3 and 6 months were down significantly. Here's a link from kellymom to some bfing rates. http://www.kellymom.com/writings/bf-numbers.html#world

The Swedish study shows bfing down to 72% at 6 months. Interestingly, that's a drop-off of about 1/3. Hmm.
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#10 of 37 Old 04-16-2008, 03:52 PM
 
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I just wanted to add that every mother CAN breastfeed. I could never produce enough to fully supply for DD (due to tubular breasts, i think) but i STILL breastfed...and continue to now almost 3 years later.

I hate hearing that mothers cant breastfeed - maybe they cant produce enough milk but they can still give their baby SOMETHING.
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#11 of 37 Old 04-16-2008, 03:58 PM
 
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I would like to see a statistic on how much is spent each year on lactation aids - LactAids, SNS's, herbal teas (several companies make them), motherlove products, herbal supplements, etc. I think it would be interesting to get those facts!
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#12 of 37 Old 04-16-2008, 04:01 PM
 
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I just wanted to add that every mother CAN breastfeed. I could never produce enough to fully supply for DD (due to tubular breasts, i think) but i STILL breastfed...and continue to now almost 3 years later.

I hate hearing that mothers cant breastfeed - maybe they cant produce enough milk but they can still give their baby SOMETHING.
This is a very good point. No one could ever figure out why I didn't produce enough milk for ds#1. And I had support galore. But by the time it was established that I was never going to produce enough for him, of course I wasn't going to stop nursing. (Even though nursing and supplementing is the worst of both worlds)

I'd be interested in knowing how many women who aren't able to exclusively breastfeed their first child go on to succeed with subsequent children. That's what happened to me.
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#13 of 37 Old 04-16-2008, 04:04 PM
 
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It also varies PG to PG and different circumstances involved . I was unable to BF DS1 very long, my milk dried up after 2 weeks but I nursed DS2 for 2 years with no problem.

SIL nursed DS1 for 1 year no problem, hes DD was born 8 weeks early. She pumped/ BF while he DD was in the NICU for 5 weeks. Got her home, nursed a few weeks (even took reglan) and her milk dried up.

Unassisted birthing, atheist, poly, bi WOHM to 4 wonderful, smart homeschooling kids Wes (14) Seth (7) Pandora Moonlilly (2) and Nevermore Stargazer (11/2012)  Married to awesome SAH DH.

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#14 of 37 Old 04-16-2008, 04:07 PM
 
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I'd be interested in knowing how many women who aren't able to exclusively breastfeed their first child go on to succeed with subsequent children. That's what happened to me.
REALLY? Oh man i hope so. No one could really tell me why i wasnt producing milk - and i tried everything. Sometimes i worry about having #2, should i just start with a SNS from the get-go, or wait until he/she looses weight and isnt peeing again? Was anything different with your 2nd pregnancy and birth? DD was a c-section and i always wonder how much that had to do with our breastfeeding probs.
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#15 of 37 Old 04-16-2008, 04:08 PM
 
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I really have to wonder about all those "breastfeeding exclusively at 6m" statistics. Are they ONLY talking about formula, or are they including solids as well? Technically, any baby who's had a quarter teaspoon of mashed banana at 5.5mo would no longer be "exclusively breastfed at 6mo."

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#16 of 37 Old 04-16-2008, 04:13 PM
 
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I just wanted to add that every mother CAN breastfeed. I could never produce enough to fully supply for DD (due to tubular breasts, i think) but i STILL breastfed...and continue to now almost 3 years later.

I hate hearing that mothers cant breastfeed - maybe they cant produce enough milk but they can still give their baby SOMETHING.
It's nice to hear a positive spin on it like that! My sister, even though she continues to nurse (with SNS), considers herself a breastfeeding failure. I wish she could see that despite great struggles and, as you say, the worst of both worlds, she IS successfully breastfeeding in her own way.

DS 12/22/05 and DD 5/24/09
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#17 of 37 Old 04-16-2008, 04:17 PM
 
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REALLY? Oh man i hope so. No one could really tell me why i wasnt producing milk - and i tried everything. Sometimes i worry about having #2, should i just start with a SNS from the get-go, or wait until he/she looses weight and isnt peeing again? Was anything different with your 2nd pregnancy and birth? DD was a c-section and i always wonder how much that had to do with our breastfeeding probs.
I know exactly how you feel. Nope, nothing different about pregnancy #2. If anything, it was more stressful, because I had a toddler clinging to me while I threw up and I could never flop down on the couch to rest.

Both kids were late. First birth was induced. Pitocin, no painkillers. Second time I went into labor on my own, but got back labor. So really, the two births were just different flavors of excruciating.

Both babies were initially very sleepy, wouldn't wake to nurse. Both snapped out of it at about the same time (2-3 weeks). But everything clicked with ds2. I really don't know why. I don't want to say it was psychological - because what does that say about my experience first time around? But this time I did have a terrific lactation consultant on board from day one and I was ready for problems. First time I was just blindsided.
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#18 of 37 Old 04-16-2008, 04:21 PM
 
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I just wanted to add that every mother CAN breastfeed. I could never produce enough to fully supply for DD (due to tubular breasts, i think) but i STILL breastfed...and continue to now almost 3 years later.

I hate hearing that mothers cant breastfeed - maybe they cant produce enough milk but they can still give their baby SOMETHING.
I think we always need to be careful when we are dealing in absolutes such as always, never, can't, etc....you never know what a particular mother is dealing with in her life.

My best friend is about to have her first child. Long story short she has just recovered from a decade long eating disorder. She is diagnosed bipolar and is finally being managed correctly by her psychiatrist. The meds she is on have had her functioning well for nearly a year.

However, the meds she is on are contraindicated for breastfeeding. So what is her choice? Breastfeed and risk her fragile mental health or formula feed and have a chance at being mentally healthy for her daughter?

I think *most* women can give their babies something, but not all.
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#19 of 37 Old 04-16-2008, 04:29 PM
 
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I wonder the percentage of babies who can't breastfeed. Whether it be cleft palate, severe tongue tie, unknown reasons for failure to latch, etc.

I also think the percentage of women not being able to produce enough milk is higher than 5%. Just look at all of the women here on mothering with low supply issues. Some women go through great measures and can't produce much. Back in the days before formula, those women probably just brought their babies to women like me with oversupply issues. People don't cross nurse much now a days.
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#20 of 37 Old 04-16-2008, 04:30 PM
 
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Of course women may need to take medication that precludes breastfeeding. No one disputes this. But we're talking about women who physically don't produce milk - why and how often this occurs.
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#21 of 37 Old 04-16-2008, 06:00 PM
 
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There are other reasons too, like breast augmentation/reduction surgery (I wonder if the surgeons tell women ahead of time that this is a potential side effect).
I always think about this. My cousin had major reduction at age 20 (she is 5'2" and had some seriously gigantic breasts) and the nipples had to come completely OFF in the process and then back on. So she is not "hooked up." She was told it would be physcially impossible, but it was barely worth her mention at the time, though I think it sank in over 10 years later when she had children.

But, I actually went in myself for an augmentation consultation once (what was I thinking??) and was *assured* it would NOT interfere if I did become pregnant again. Thanks for that. At least I didn't do through with it.
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#22 of 37 Old 04-16-2008, 07:53 PM
 
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But, I actually went in myself for an augmentation consultation once (what was I thinking??) and was *assured* it would NOT interfere if I did become pregnant again. Thanks for that. At least I didn't do through with it.
I know a girl who had augmentation at 18. I seriously doubt the question ever crossed her mind, and now it's too late. I know that probably wouldn't have occurred to me to ask at that age. Well, augmentation wouldn't have occurred to me either, but that's neither here nor there.
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#23 of 37 Old 04-18-2008, 02:46 PM
 
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I think the question is actually impossible to answer with any degree of accuracy because, as PP's have pointed out, there are *situational* variables, and breastfeeding is a partnership, not something one undertakes completely on one's own. There's gotta be buy-in on the other end, so to speak.

I am pretty sure I COULD, under more ideal circumstances, produce adequate milk to sustain a child. But I had a massive post-partum hemmorhage, a sleepy baby, and a pile of IV's in my left arm for days after the delivery, making nursing DD on that side very difficult. My left boob never produced much, but eventually with iron supplements, weight gain and domperidone, I did produce enough milk for DD - but I had to supplement at the beginning, in some part just to get DD strong enough to nurse for more than a minute, since she lost almost a lb in the 3 or 4 days I was in hospital (when I was vehemently protesting even the thought of formula).

Anyway. I just don't think statistics are all that helpful, because there are just SO many variables. I too think that we should not try to downplay low-supply issues (or ANY issues!). We kind of operate from an assumption that women *don't* want to breastfeed and any mention of possible problems will send them running for the hills; that may be true in some instances, in which case those women will find any excuse possible to quit no matter what. But for women who really DO want to breastfeed, arming them before birth with the problems that may occur, how to recognize them, and what to do about them - along with the idea that ANY breastfeeding is GOOD even if they have to supplement - is more useful than telling them that their problems are imaginary because everyone can breastfeed.

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#24 of 37 Old 04-18-2008, 11:28 PM
 
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Originally Posted by ErinsJuneBug View Post
I just wanted to add that every mother CAN breastfeed. I could never produce enough to fully supply for DD (due to tubular breasts, i think) but i STILL breastfed...and continue to now almost 3 years later.

I hate hearing that mothers cant breastfeed - maybe they cant produce enough milk but they can still give their baby SOMETHING.
I have to agree here. Another PP said that there are so many reason's women can't, but most of those are not reason's one can't, just things that make it harder. DS had tongue-tie (we had it clipped), I had vasospasm, we went through jaundice, failure to thrive, and a hospital stay, then "milk jaundice", pediatricians told us to supplement with formula at a few different times within those first few weeks, poor latch, mastitis, my milk supply was late to come in, and so on and so on. I kept nursing, kept pumping, kept nursing, all the time, through the pain and the cracked nipples and the doctors telling me to quit and family telling me to quit- guess what? Still nursing a very healthy, happy boy at 22 mos. So some of those reasons could have been included in a study of "not being able to nurse" if I wanted to play it that way, but thankfully I didn't.

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#25 of 37 Old 04-19-2008, 10:52 PM
 
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I don't agree. It's dismissive of the fact that we are emotional creatures as well as physical ones. Everybody has their breaking point.

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#26 of 37 Old 04-20-2008, 09:48 PM
 
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I personally know of three mothers who couldn't BF, and that is definitely more than 5% of the women I know. One said that her milk never came in (didn't question further). Another had a child with a cleft lip (not really relevant since she produced milk but DS couldn't nurse). The third woman was in a near-fatal car accident which crushed and destroyed 3/4 of her mammary glands and she nursed as long as she could but had to supplement.

IMHO, I think that the promotion of BFing as the biological norm causes mothers to assume that what is natural is therefore easy. Perceived failure to do something that is "normal" may lead women not to seek help, or not even to know where to go for help (the lactation consultant at the hospital where I gave birth was useless). I love seeing pregnant women at LLL meetings, where they can get help and support before the fact.

FFing terms are still used in mainstream BFing discussions (emptying the breast, frequency of feedings, "how much the baby is getting) and a lot of well-meaning family members and medical practitioners (well, probably not so well-meaning doctors, they should know better) want to see fat and happy babies. The pressure to supplement can be intense. And supplementation of a healthy supply only leads to a decreased supply. It's like the chicken and the egg. Which comes first, supplementation or low supply? It can be hard to determine.

I also think that there is a big difference between small babies and those who fail to thrive. Some babies are just small and it has nothing to do with BFing. DD2 was a normal weight at birth, and now at 2 1/2 years she is still 23 lbs. I avoided taking her to the doctor for nearly her entire life because I was afraid of being told to supplement. There is nothing wrong with her, she is healthy, intelligent, active, just small.

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#27 of 37 Old 04-21-2008, 07:18 PM
 
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I always think about this. My cousin had major reduction at age 20 (she is 5'2" and had some seriously gigantic breasts) and the nipples had to come completely OFF in the process and then back on. So she is not "hooked up." She was told it would be physcially impossible, but it was barely worth her mention at the time, though I think it sank in over 10 years later when she had children.

In my experience, breast reduction surgeons either tell you "yes you can" or "no, impossible".

The reality is "it depends".

It is totally possible to breastfeed after reduction - I did - but most women will need to supplement. The real question is how much supplement is needed. There is really no way to know ahead of time unfortunately - there are far too many factors, like type of surgery, length of time between surgery and pregnancy, inherent lactation capacity, the baby's ability, other complications, etc.

I had full supply after my breast reduction surgery and I am not alone (I even was able to tandem nurse my two boys). However, my experience is kind of unusual. Anecdotal evidence shows approximately 30% of women have full (or near full taking fenugreek or dpd, etc) supplies, with the remainder needing to supplement a little or a lot.

And while, technically, yes, all you need is one nipple to breastfeed, supplementing can be really hard going for some moms, especially with multiple children or other complications. Sane mom is more important than breastmilk, if in the unfortunate situation to have to choose between the two.

My attitude is that every ounce of breastmilk is gold - no one should feel like a failure for not breastfeeding "enough" - breastfeeding is not a marathon where only those crossing the finish line get a medal. Every mom who puts baby to the breast has breastfed, and every baby who gets breastmilk has been breastfed.

www.bfar.org is a great resource for women who want to investigate breastfeeding after reduction.

You know the attributes for a great adult? Initiative, creativity, intellectual curiosity? They make for a helluva kid...
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#28 of 37 Old 05-15-2008, 10:55 AM
 
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Originally Posted by siobhang View Post

And while, technically, yes, all you need is one nipple to breastfeed, supplementing can be really hard going for some moms, especially with multiple children or other complications. Sane mom is more important than breastmilk, if in the unfortunate situation to have to choose between the two.

My attitude is that every ounce of breastmilk is gold - no one should feel like a failure for not breastfeeding "enough" - breastfeeding is not a marathon where only those crossing the finish line get a medal. Every mom who puts baby to the breast has breastfed, and every baby who gets breastmilk has been breastfed.

That's so well said! Unfortunately breastfeeding has become something of an all or nothing issue.

I also agree that true low supply due to physical issues in the mother is more common than people think. I mean think about it, with so much pressure to breastfeed would you want to admit "defectiveness?"

To play devil's advocate for a minute - and I want to make it clear that women who BFAR no matter what reason they had surgery are amazing - should women who have had breast surgery be counted in a study like this? Shouldn't a study on true low supply include only women who were born unable to produce a full supply, without the influence of other factors like surgery, medication, problems in the baby, etc.?
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#29 of 37 Old 05-15-2008, 11:18 AM
 
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Ah, but medical intervention goes both ways.

For example, PCOS makes it more difficult to establish a full milk supply. BUT, without medical intervention, a lot of women with PCOS may not have become pregnant in the first place...so, do you count those women in the study?

I have Type II tubular breasts. I just was not able to produce a full milk supply for DD. And I tried everything except domperidone (I have an irregular heartbeat, and didn't want to mess with that..personal comfort level). There was a very small study done about women with tubular breasts and breastfeeding...One of thirty-four was able to produce enough milk in the first week for their babies and 85% were producing less than half of what their babies needed...however, with interventions (pumping after every feeding w/a hospital grade pump, galactalogues, lactation consultations, etc), at the end of the fifth week, about about 39% produced all their babies needed and 6% were producing 51-99%...so, do you count those women?

I think it's just a very complex issue that would be tough to measure...you'd need to figure out how many women bf w/o issues, how many can produce a percentage of the milk but not a full supply, how many can get a full supply WITH interventions, how many have a full supply, but have a baby who doesn't nurse (for whatever reason)...I think it would be very interesting, but very difficult, to do a study like this...
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#30 of 37 Old 05-15-2008, 01:04 PM
 
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[QUOTE=katheek77;11224824

For example, PCOS makes it more difficult to establish a full milk supply. BUT, without medical intervention, a lot of women with PCOS may not have become pregnant in the first place...so, do you count those women in the study?

[/QUOTE]

From what I have reead, about a third of PCOS sufferers have low supply, a third normal and a third oversupply (according to some LLL stuff I was reading).

I suffer from major oversupply and that nearly stopped me breastfeeding the second time around. The pain, was unbelievable and not a single thing I tried remedied the oversupply. Over a year after DD2 was born, I would be in terrific pain even after less than 24 hours not breastfeeding (and at that point I was in hospital with morphine drip, paracetomol and every other bloody pain killer they would give me, I had an ankle op which hurt like hell but nothing like my boobs).


So anyway, around 5-10% of women are said to suffer from PCOS (although it might be slightly more these days) so I take of a tthird and add that to the 5-2% who physically can't breastfeed and then of course you have those that have issues due to surgery and then not only that, but the birth can impact upon breastfeeding as well affecting when milk comes in etc, so you add it all together and it becomes quite a large number.

I think thsat a lot of the problems can be over come with maybe medication and supplementation but most of all, they need support and explaining why it hasn't worked so well for them.

I found this to be an interesting book:
http://www.amazon.co.uk/Impact-Birth...0867678&sr=8-1

Anyway, thats my take on stuff.
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