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When breast-feeding fails It's a natural thing, but it isn't easy Tuesday, July 04, 2000 By Lexie Verdon, The Washington Post
The simple act of nursing a baby -- it looks so tender, so effortless. And since it's "nature's way," it must be easy. But the truth is, for many women, breast-feeding is difficult, painful and unsuccessful. A host of problems can occur, some easily addressed and others troublesome enough to lead to formula feeding.
The honor is for workplaces that provide a supportive environment for breastfeeding mothers.
The winner of this fifth annual award will receive a free, six-month rental of an electric breast pump from the Health Department. And the nominator of the winner will receive a free gift certificate from Mommy Gear in Castle Shannon.
Nominations are due by July 16. Entries may be obtained by calling the Health Department at 412-687-2243 (ACHD). The winner will be announced during World Breastfeeding Week, Aug. 1-7.
These women can feel tremendous guilt. Public health officials, pediatricians and many women's health groups have urged that babies be breast-fed because mother's milk confers numerous benefits. Mothers who can't master this ancient ritual of nursing often feel like failures.
Yet until recently there has been little formal recognition among doctors and health-care professionals of the emotional impact of breast-feeding problems on the mother.
"A substantial number of health activists, policy-makers and health providers assume all women want to breast-feed and that all women should," James Sargent, a pediatrician and researcher at Dartmouth Medical School wrote in an editorial in a recent issue of the journal Effective Clinical Practice. "Too often, programs that support postpartum lactation in the United States are less about assistance and more about advocacy. . . . Providers of postpartum lactation support must acknowledge that there is more than one viable choice" for women.
And in the current American Journal of Maternal/Child Nursing, four researchers from the University of Tennessee in Knoxville found that women interviewed in the two weeks after birth spoke poignantly about the clash between their idealized expectations of breast-feeding and the problems they encountered. Many opted to stop nursing but were left with a sense of failure.
It's clear that many women attempt breast-feeding but give it up. Federal surveys find that about 60 percent of infants in this country are ever breast-fed, well below the target of 75 percent set by public health officials. Yet only 30 percent of those babies are breast-fed for at least three months. Reasons often include problems the baby has learning to nurse, the mother's difficulties producing milk, discomfort for the mother, and inconveniences when the mother goes back to work outside the home.
Part of the issue, according to Sargent and the Tennessee researchers, is the difficulty getting lactation counseling once mothers leave the hospital. A study in Effective Clinical Practice surveyed more than 5,000 new mothers who were enrolled in managed-care health plans and found that only 1 percent of the women were given breast-feeding assistance after the birth.
The American Academy of Pediatrics issued a strongly worded advisory in 1998, calling on women to nurse their babies for the first year, citing research showing fewer infections and lower incidence of diarrhea, less risk of disease, and "possible enhancement of cognitive development."
Sargent points out in his editorial that these benefits are significant for developing nations, because of the "reduced exposure to contaminated water sources." But in this country, he writes, "the risks of bottle-feeding are much smaller."
In an interview, Sargent said research has shown that there is "no question [breast-feeding] has a protective effect [for the baby] . . . but it is on the order of only a few percentage points" in areas such as diarrhea, respiratory problems and ear infections. In addition, the "evidence is very weak for more far-reaching issues" such as cognitive development, he said.
"For 20 to 30 percent of women, it takes a fair amount of hard work" to be successful at breast-feeding, he said. "The downsides can very frequently outweigh the benefits, especially if they are portrayed realistically. . . . And it can compromise the short time the mother has with her baby."
Or, as he said in his editorial, just as health providers are "careful not to make a mother feel guilty about her decision to send her child to day care, we must not make her feel guilty or inadequate about her decision to discontinue breast-feeding."
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The La Leche League Hotline for Greater Pittsburgh, 412-276-5630. The hotline provides the numbers of local league leaders who can answer breast-feeding questions. You can also find which La Leche group is closest to you.