Thursday, July 15, 2010

The difference between "I can't" and "I won't" - and why it matters to all of us.


This should sound familiar.

A woman posts on a public online parenting forum, expressing feelings of discouragement about how her breastfeeding is going. She doesn't think she has enough milk, and has been supplementing with formula in a bottle, including one overnight feeding, as her mother-in-law wants to help her get more sleep (and has insisted that she move the baby from the bassinet in the master bedroom to the crib in the nursery). She has tried pumping but says she's not getting more than an ounce at a time, further cementing her belief that her breasts are just not working correctly. She confesses she's about to throw in the towel.

In just about every forum that exists, the response is usually immediate: breastfeeding advocates of all stripes begin offering advice for all kinds of different strategies she could use to get her nursing back on track. (If you're reading this, you probably thought of a few things right off the top of your head already, didn't you? I know I would have, if I hadn't written it myself.) Some of the comments are phrased more supportively and sensitively than others, but the objective is to arm the mother with information and cheer her on. Then, when the mother quits breastfeeding, if she feels guilty about it, the source of that guilt, in her mind, becomes the breastfeeding advocates who she now perceives as pushing and judging her.

And the lactivists feel frustrated that their advice and efforts seemed to go unused, or fell on deaf ears altogether. But why be frustrated? This was just one woman, and it's ultimately her choice, her prerogative as a parent to weigh the risks and benefits of her feeding choices and how they will impact her child. It doesn't affect the lactivists personally. It's really none of their business.

Why DO breastfeeding advocates, or lactivists, if you will, often get very worked up about, and seemingly invested in, other women's breastfeeding stories, particularly if their attempts to breastfeed were unsuccessful? Why do we seem to insist on making the personal into the political? Where does individual choice come into the discussion? Sensitive questions with complicated answers. Part of the answer includes the public health aspect, the impact on both infant mortality, and even the economy - all of which are extremely well-covered by other bloggers and a huge variety of articles.

One aspect of the answer I'd like to zero in on: I think one major reason many lactivists work so hard at helping women to succeed does go beyond helping that individual woman. This individual help is the most important thing, of course, and while one could argue that breastfeeding might not be the right choice for every mom, as some have observed, it is right for every baby*. Yet here's where it goes deeper: every time a woman publicly struggles with some aspect of breastfeeding - say, on a message board, or a blog, or on Twitter, and then succeeds due to being given good resources, support and information, other women see this example and learn from it. And every time a women publicly struggles and does NOT get the same quality of response, other women see this example and learn from it as well - and may not have any idea that the right resources, support and information could have made any difference. [Disclaimer: there are situations where breastfeeding is truly not possible, as in the infant conditions in the footnote, and the exceptional instances where low milk supply is a reality. They are incredibly rare, but also very real and certainly deserve respect (and frankly, more research).]

But even beyond that, there's another part of the picture that circles back to the matter of mother's individual choice. I saw this comment by Mary Woodring on the Facebook page for Peaceful Parenting the other day, and hereby hit "Like" a thousand times over. THIS is the rub, and the inspiration for this post:

"When a woman is unwilling to breastfeed, but tells people she was unable, it inflates statistics and seeds fear in other women that breastfeeding is an unreachable ideal for most women."

Yes.

Thank you.

There IS a flip side to that - and I can already feel the murmurs. In order for women to feel safe about publicly admitting that they were simply not willing to breastfeed, and that it was a choice, not some failure of their anatomy or - another frequent claim - "refusal" by their child*, we, as a breastfeeding advocacy community, need to be able to accept those choices and not condemn or harass these mothers who have made different choices.

Now, two immediate points: First, I definitely feel that the lactivists who TRULY do bully and judge mothers are in the minority. Far too often, advice is solicited, and then when things aren't working or the mother makes a different choice, the advocate becomes a scapegoat and a target of their own guilt, as in the example above. We've all seen it happen. But we also all know there are times when lines are crossed and unfair judgments are made . . . even insults. This needs to stop, and we need to make an active effort, even in the cases where guilt over the choice to formula-feed is directed at us inappropriately, I feel that it IS worth it to make doubly sure that we are kind and nonjudgmental. Annie of PhD in Parenting recently wrote a masterpiece on this matter, a post which I have made my personal mission to work on embodying. It's not easy. It does involve biting my proverbial tongue and sitting on my literal hands at times. But in order to move forward and start being able to make a clearer distinction between the "I couldn't" moms and "I wouldn't" moms, I think it's very much necessary.

Secondly, and I can't emphasize this part enough: being willing to accept mothers who have made the choice to formula feed and treat them respectfully does not, not, NOT mean cutting back on promoting information about the benefits of breastfeeding/risks of artificially feeding. Nor do we reduce efforts to provide moms with solid support and resources and information, and especially easing the access to all of the above. On the contrary, I feel it's all the MORE reason to redouble such efforts.

There are many, many moms out there who had no desire to breastfeed for any number of reasons, many of them cultural but some of them personal - and yet, after learning more, and more, and more about how dramatically it would benefit not only their babies but themselves, they slowly changed their minds. I know one such mother who started out being totally turned off by breastfeeding with zero plans to do so herself - who is now becoming a lactation consultant as a result of her experience. You probably know one too. They're out there, and they matter, and they can become some of the best counselors of all, since they've been there themselves.

If information and resources are copious and available, some of those moms who were initially unwilling might make the transition all on their own, and then, in the absence of judgment, the remaining mothers would be able to be honest and forthright about their choice WITHOUT perpetuating myths about their "inability" to breastfeed.

Let's all assume that mothers, with very few exceptions, actually do do the very best they can with the information they have at the time. Look how this gives moms the benefit of the doubt, assuming the best intentions, AND underscores the need for copious, accurate, easily accessible information. I am CERTAINLY not saying we throw in the towel, far from it. I'm saying we need to work harder and work smarter. Getting the information out there as positively and honestly as we can without diluting the message (that might seem cryptic, but it's best saved for another post) is mission critical. And I feel that reducing the number of mothers who state publicly that they could not breastfeed when it isn't actually true could have a major impact.

You may say I'm a dreamer, but I'm not the only one (I hope).

*Remember, only one in every 30,000 to 60,000 of all babies actually has galactosemia, and congenital lactose intolerance/lactase deficiency are likewise extremely rare - the conditions unrelated to mom's own diet that would cause a baby to have difficulty with the milk that was biologically designed for them, and are true contraindications.

[And no, the picture doesn't have much to do with this post unless you really stretch it into the abstract. But I thought it was fun nonetheless, no?]

50 comments:

  1. What a great post. I am a new mother, struggling with my own breastfeeding issues and making it work. My baby was underweight at her 3rd weight check in a row, still not gaining her birth weight back. I never thought I would have trouble breastfeeding, that was one of the things I knew for certain going into my motherhood journey, was that I would breastfeed, and to have problems with supply and my baby gaining weight on my milk was not something I have anticipated. We have had some bumps in the road, but I am determined to make it work. I am wondering how I will have enough supply to leave with the day care when I go back to work, but for now I'm going to do all I can to bf and supplement as little as possible so baby receives the majority of her nutrients from me. Breast IS best, but sometimes you run into trouble, and it is nice to know that other moms are out there to lift you up, offer advice, and help you out. Thanks for the post.

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  2. Jen, you rock for working so hard at this, and i hope you've gotten good local support! I can relate to how you feel, as our own nursing story was pretty intensely difficult for a long whole (you can read it all here if you're in the mood for something stressful and emotionally draining, heh). The very best vibes to you!

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  3. Very thought-provoking post (and the link to PhD in Parenting's which is super awesome too...) I wrote a long comment and it got out of control and probably deserves its own blog post, so I deleted it and start over, the gist of it being, it's really hard for me to distinguish between "couldn't" and "wouldn't" moms. I saw a mom today who has been struggling for over a month and just wants to be able to enjoy her baby instead of every hour of every day being a struggle. She was so upset about her decision to stop, tears running down her face. Do I think she COULD get baby back to the breast? I think she has a couple more avenues to explore before we give up all hope. If I was asking nosy questions later on, I could say "Well, you didn't go to that ENT to check the tongue tie like the LC suggested". Everyone has their own line to draw. Does it get frustrating on a personal level when some moms draw it at "My nipples were really sore at three days and I was so tired from waking up so often" when others are still struggling at "we've seen 4 different LCs and a speech pathologist and bought $300 worth of equipment"? Yes. But who's to say that the first mom "wouldn't" and the second mom "couldn't". Each of them "could" likely have tried something else, but each decided she had hit her own personal line. I can't draw it for someone else (as often as I would like to!) It's just hard to tease that out sometimes.

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  4. You are absolutely right that it is not always so black and white. I completely agree and thank you for pointing that out.

    "Does it get frustrating on a personal level when some moms draw it at "My nipples were really sore at three days and I was so tired from waking up so often" when others are still struggling at "we've seen 4 different LCs and a speech pathologist and bought $300 worth of equipment"? Yes. But who's to say that the first mom "wouldn't" and the second mom "couldn't". Each of them "could" likely have tried something else, but each decided she had hit her own personal line."

    Yep, this is a good example of the complexities of the situation. I do feel that if we had the winning combination of excellent resources, support and information (which, by the way, would include DRAMATICALLY more medical professionals knowing what the hell they're doing with breastfeeding, in my fantasy world) AND a climate of acceptance and compassion, that first mother would be able to be more forthright about the combination of reasons for her decision.

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  5. Excellent post! I've responded to tons of those types of posts you describe in the beginning - part of me gets very frustrated when I hear a new mama say "I think I have a supply problem because I'm getting drops when I pump" - at 1 week in (or something else to that effect!). But I have to remind myself that that frustration should be directed not a new mama who is struggling to make the right choice for her family, but at the lack of information and education mamas (and daddies!) are provided in order to make the best choice. The number of times someone has posted about getting bad BFing advice from their doc or their pedi is just appalling.

    Education and caring support make all the difference!

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  6. This was brilliant! I wanted so badly to breastfeed my daughter, and found out months after quitting, that I could have if only there had been better support for me. I had an easy time of it on my one side, and on the other, my nipple was utterly ravaged. I can't even describe the level of pain that occurred when I would nurse on that side. After feeding from that breast, my daughter would vomit blood from my destroyed nipple. Not a single doctor, nurse or LC could explain why it was happening, although they all agreed it was "not normal" and "not good." Upon discharge from the hospital, I was told that I could try pumping exclusively. With a colicky baby, later diagnosed with very severe GERD, pumping only lasted a short while. I was so sad that I wasn't breastfeeding, and over the next several months, I made it my own personal mission to try to discover my problem. Over time, I came to realize that the issue was that my one nipple was simply inverted, where the other wasn't. My daughter could never latch right onto that side, because it never went deep enough into her mouth. This should have been simple enough for a team of professionals to identify, and not too difficult to remedy, yet it went completely unnoticed, until I figured it out on my own! How very disappointing. Now that I know, I have learned different things I can do to remedy the issue, should I have a second child. I just can't believe that I basically had to become my own lactation consultant in order to figure it out. It shouldn't be that way. The system totally failed me.

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  7. Great post. It frustrates me to no end those that claim to be unable. My mother was one of those rare women that could not breastfeed, nearly starving my sister in her attempt, she never had milk come in, with either of us. It really cheapens the struggle of those few women that truly cannot breastfeed and what they go through.

    I nursed for four weeks with my now five year old, and was devestated when after gallbladder surgery I dried up within two weeks (thanks to a combination of lack of information on my part, a non supportive environment and a bunch of idiots at my local ER) and I was devestated. I admit I felt failure. Failure, not guilt. There is a big difference between the two. Guilt comes from knowing or thinking you are wrong and should have done something different. If a woman who is unwilling to breastfeed knows she made the right choice, there should never be guilt. It is when someone feels they may have made the wrong choice, so they get defensive over it.

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  8. As a low supply mom, I'd like to say that frankly I feel that low supply is, if anything, UNDERdiagnosed. I've talked to so many moms who've had serious trouble with supply.

    And no, it didn't stop me, though my daughter got 90% formula... she still breastfeeds now at 3.5. So, seriously, lay off the moms doing the best they can. Posts like this are why I cried when I had to give her formula. Stop saying it never happens. It does.

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  9. Nice post! I'm sharing this to my FB page--hope you don't mind!

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  10. AMEN. Less judgment, more freedom to be honest about what's going on!

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  11. JoAnna, I absolutely, positively never intended to make light of the very real situations where breastfeeding is not possible. I do say so explicitly in the post: "there are situations where breastfeeding is truly not possible, as in the infant conditions in the footnote, and the exceptional instances where low milk supply is a reality.". Minimizing the reality of such difficulties defeats the entire purpose of what I've intended to express.

    My own IBCLC worked with many moms dealing with low supply issues, getting to the core of its causes, and I struggled side by side with them in a very intimate way during those early, crazily difficult months. If you choose to read my own personal nursing story (linked in my first comment), you'll see just how much I can relate to severe, devastating breastfeeding difficulty.

    I am also sorry if you've felt hurt by others' judgment at times. Very unnecessary and counterproductive.

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  12. I have flat nipples. If you don't than don't make a big deal about me not being able to breastfeed. you have NO idea what I went through.

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  13. Oh, definitely, Nick! Flat and inverted nipples are a major challenge. It was one of the most difficult things I had to overcome, for sure, combined with my daughter's tongue tie and a few other factors as well! Dealing with the nipple shields on top of everything else was so incredibly frustrating.

    With my next baby, should I get to have one, I'm going to try using Supple Cups if we should start to have some of the same problems, though a baby's suckling WILL (and eventually did) draw the nipple out into a less inverted or flat shape, so my next baby is likely to be easier in that one aspect. The problem, as you know, is getting them on in the first place to allow for that to happen! Not so easy, to make an understatement.

    I wish the Supple Cups been around for Lily; it could have saved us weeks off the total time it took to get her on the breast.

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  14. I'm a low supply Mum too - though only discovered when I had baby number 4 (just felt a failure with the previous 3) but I am currently breastfeeding baby number 5 though she does have to have some formula too but because I was informed and knew what to do it helped me succeed - great post though and so true I feel like I'm forever having to explain that I really do have low supply it's not just an excuse!

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  15. To those that feel hurt by the post or by the reactions of others in the past because of their own struggles with nursing, I think that's exactly what the author is trying to address. That if there was more understanding for women who choose not to breastfeed and therefore more women admitting that they've chosen not to rather than claiming they couldn't, then there would be a lot more compassion for those who truly do have real issues that can't be overcome or are only overcome with great difficulty. I've known many women who put themselves in the couldn't breastfeed category when it was fairly obviously either a wouldn't or a case of gross misinformation on the part of those who should have been assisting her. For example, I've heard so often things like "my nipples hurt, cracked and bled so I couldn't nurse" in a woman who does not have flat/inverted nipples but was never referred to an LC to check the latch or "I didn't have enough milk so I couldn't nurse" when she was told to begin supplementing heavily with formula a day or two after birth when her milk hadn't come in yet even though baby had no health issues that called for supplementation. These kinds of things truly lessen the struggle of those of you who really did have problems that were dealt with appropriately and still weren't able to nurse and I think that's the point that the author is trying to get across, that it's not fair to those with real problems because then you do often get lumped in with women who chose not to nurse or who had minor problems that weren't dealt with but could have nursed with more effort when that's just not the case.

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  16. Awesome post!

    Strange, but I have flat nipples and I never made a big deal of them and thus, never had a problem with them. I just pulled them out enough for baby to latch on and continuous breastfeeding for 40 months means that they're no longer flat like they used to be. I know plenty of moms with flat and inverted nipples that nursed without difficulty past the first 6-8 weeks. It's not comfortable in the beginning and like with all breastfeeding, there's a learning curve. Just further proof that lack of information and assistance ruins breastfeeding relationships, IME, and further illustrates the points in and need of this post.

    I also had a baby who screamed and arched and refused to nurse, had a weak suck, was too sleepy, I had PPD and couldn't bond for six months, bad latch, terrible pain from nursing, refusal to latch, etc.

    She never once received a bottle of formula. She never went without and with the help of these wonderful little tissue salts called Hyland's Colic tablets, her pain vanished. Got her to latch using the Happiest Baby on the Block techniques. Taught her to suck better. Worked at her latch until her tiny mouth could do it right with my humongous, cannot-nurse-hands-free-due-to-severe-ptosis size I breasts.

    It's a matter of believing you can do it and following the advice. It's not easy. It's work. Formula might have destroyed my poor baby's stomach, as she had real GI tract issues that she's growing out of (she's 18 months now and still primarily breastfed). It was never an option, I didn't let it become one, even when I felt like none of it mattered (depths of depression feeling like I was the only one ever taking care of my baby... who felt no more mine than my niece until she was 6 months old and then, it was still 9-10 months before I really was able to bond with her).

    I have yet to meet another mom with the number of problems I had with just my one baby (both babies had totally different problems, except for those caused by my breasts--overactive letdown, oversupply, overlarge, ptosis, flat nipples, etc.) who was able to continue breastfeeding (or at least, not exclusively).

    I had one friend who had many of the baby-related issues and I felt so bad for her for how hard she tried to nurse and was just unable in the end. She tried harder than any other mom I knew. Nothing was wrong with her or her baby and she had great advice, great LCs, etc. So it's not ALWAYS misinformation, but about 90% of the time, it is :(

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  17. Sarah, I wish you the very best!

    Something that I'm pondering as these comments come up - related to the part of my post where I discussed the motivation for sharing as many suggestions as possible whenever mothers post about various issues they've been facing. Sometimes, when an advocate suggests "Okay, low supply, have you tried goat's rue?" or "Okay, flat nipples, have you tried reverse pressure softening?" I KNOW it can *feel* like "I don't really believe you. I think you're either lying or lazy." Especially when they're things you HAVE tried and had no success with.

    Forgive me for flashing my nursing challenge creds once again, but if you want a glimpse into the pandemonium of my first few weeks, check out this thread I posted on Mothering.com's forums under my pseud. (It's a little embarrassing sharing this, but hey, greater good.) My GOD, reading it takes me right back to the grief and frankly terror I was feeling - it's so raw, since unlike the post I wrote on this blog detailing the entire story in retrospect, I had no idea what was going on or what was going to happen. I was only a couple of weeks in - I certainly didn't know it would take five months to get there (and maybe it's better I didn't know).

    But I digress - what specifically made me think of that was the feeling I got at so many TOTALLY WELL INTENDED suggestions (on this and other 4 AM desperation threads as well). I clearly recall wanting to rend my garments if one more person suggested I spend some time skin-to-skin. JESUS CHRIST, I'm already spending 7/8 of every day skin-to-skin, what am I supposed to do, suture our bodies together? And it's obviously not that simple! Nothing is working. Nothing. I feel like a failure already.

    I do remember. Oh, how I do. And even though I know everyone posting meant well (some suggestions were better than others, but they were all trying to help), I still hope I never make another struggling mom feel that way - even if it is her own path to walk, I always strive to be as sensitive as possible. I may fail, but I do try.

    And I also want to emphasize, as I stated in the post, that along with trying to help the individual mother, part of the purpose is also to give examples to other moms with similar issues. Even if YES, for crying out loud, you've already eliminated dairy and gluten from your diet - some other mother reading this exchange on a public forum may not have done so, and so the shared information has the potential to help us all.

    [Note: I am a HUGE believer in skin-to-skin. :O) My point was not to disparage that, just using it as an example of a suggestion that hit me in *just* the wrong way at the wrong time.]

    Again, Sarah and others, we're all mothers doing our best to nurture our children.

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  18. i think that failure to successfully breastfeed my first child was the most difficult thing i have ever experienced. i tried daily until he was four months old to get him to latch with no success. i pumped until he was 8 months old, when my supply truly dried up completely. i had supply issues simply because pumping is not as efficient as a nursing baby. i succeeded in making it all the way to my son's eight month before he ever tasted formula. i am grateful for all the support that i got along the way!! my second baby was born two months ago and breastfed with no problems from her first moment on the breast. what a huge blessing!!! Having said all of that (and knowing first hand the benefits of breast milk to a baby), the mental and emotional strain of those months is something that i never want to experience again and i often wish that i had supplemented with a little formula earlier on. it would have meant enjoying more of those early days with my baby instead of being frustrated, angry and tired all of the time. this time around has been heavenly and nursing is really something so precious and worth working at!

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  19. Well said!

    As the daughter of an LLL Leader and IBCLC (and now a mother of two, myself) I am constantly frustrated by the lack of support and genuinely good information that my peers have received to support their breastfeeding experience.

    Breastfeeding cannot be declared a choice if the woman was never given a legitimate chance to succeed in the first place.

    It is shameful that many of our pediatricians are so ignorant about breastfeeding and unable to advise mothers on how to take care of their child's most basic need at birth.

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  20. Amen to this! You have written a clear and brilliant piece! This has been my biggest pet peeve lately. I am so tired of the judgemental and forceful breastfeeding "support" I have seen dished out by both mothers and professionals alike (i.e. doulas). I am a Certified Birth and Postpartum Doulas as well as a Certified Breastfeeding Counsellor and it is my deepest desire that we can all begin to come from a place of gentleness and compassion when working with other mothers and for the love of God, GIVE THE MOTHER THE BENEFIT OF THE DOUBT. Even if you KNOW that she is "making excuses", trust that there is a reason why she is and just give her the message that you do not judge her. I think what you have written here is really, really valuable. Distinguishing between the "I can't" and "I won't" is important. I think that when a mother ends up ff after struggling for 3 days or 3 months, we must remember that this decision was likely heart breaking for her and show her some love instead of judgement. Ask ourselves, "How will this information I am about to give be helpful to this mother?" If it isn't going to be helpful, zip it.
    I plan to share this post far and wide.

    Julie
    www.theletterwritingrevolution.blogspot.com

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  21. When I wrote this: (http://minimalistmum.blogspot.com/2010/07/breast-is-best-please-turn-on-sense-of.html)

    the reason it is NOT a satire of FF mums is because when a mum says "I was unable to BF" she is actually saying "I have a problem I can't overcome." She might have been given the answer, but not have the support to use it.

    For example, advice about tongue-tie could be useless if you can't summon the energy (or money, or...) to take your baby (AGAIN) to the doctor and explain, and request treatment, and risk disappointment AGAIN...

    So how can anyone draw the line between "medically unable" and "didn't want to"? How can we expect any mother to admit to "didn't want to" when she did and that next hurdle just got to be too much?

    While I fought a _lot_ of hurdles to successfully feed my first (and lots more easily, my 2nd), I did this with a lot of support.

    I have a lot of emotional attachment still to the idea of home (or natural) birth. I had surgeries for both of my children and I feel a keen sense of failure and disappointment about this which no logic will shake. That's why I have empathy for those who "failed" to BF.

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  22. I understand the article and your purpose and I support it. I do however have to disagree with a few things/commenters. As a breastfeeding momma of 6 months, who had a really hard 1st 4 months, I am sick to death of hearing mothers who were not successful -for whatever reason- push their feelings of guilt, failure and shame onto lactivists and those mothers who were successful. No one makes you feel a certain way. Something you did or something within yourself did and you chose to feel and think that way. Own your feelings - and stop putting them off onto others.

    I don't agree with lack of information being used as an "excuse", not in today's world where information is so readily accessible. Lack of support - possibly, because I have to admit that without my husband and good friend cheering me on it would have been hard to maintain my level of commitment. That is just a component though...

    What it comes down to 100% is a woman's and baby's physical capability and the mother's desire. If a woman is dedicated and motivated to breastfeed and has no true physical difficulties... then breastfeeding will be successful because that woman, that mother chose to do so and was dedicated and committed to doing so.

    I honestly think the medical realm and commercial realm could fix the entire situation by removing formula from the shelves in the stores and requiring a prescription for it. Unfortunately that won't happen because its become too profitable.

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  23. I think this is great. I went through hell trying to breastfeed my first, and quit after 4 weeks of bleeding nipples. I do NOT say I "couldn't" breastfeed that baby though - I say that it was a challenge I just wasn't up for at the time. I didn't know enough to get the right help, and the circumstances of my birth put us at a disadvantage from moment #1. But given that my second son has never had any formula shows me that there's nothing wrong with my body - it was my spirit that was unable to make nursing work that first time.

    The second time, I had lactivist friends, and their support helped ensure that I breastfed as I wanted to. Thank goodness for them. I shudder when I think about all the times I was ready to give up, but then went online and got exactly the advice or encouragement I needed.

    Which is why I give help to women who want it. If they don't want to breastfeed - different story - but I would hope that if they did want to, and sought out help, that they wouldn't turn around and blame the very women who are only trying to help them if it doesn't work out.

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  24. Not bad. You make some valid points and at least recognize that overly agressive breastfeeding promotion can be counterproductive.

    But I think there needs to be more nuance between "willing" and "unwilling." I nursed by four older children into toddlerhood, and I was willing to nurse my twins. I knew I was able, too; I am a copious producer. I could have handled the sleeplessness, the soreness, and being tied to the house in a way I never was with my singletons, if the decision was as simple as my physical ability, the boys' physical ability, and desire. But my daughter had needs that were just as real as my newborn sons', and in the end, I could not sacrifice her needs on the altar of breastfeeding. I was willing to nurse the boys--but unwilling to nurse them to my daughter's detriment. Formula's not perfect, but it's not poison, and there was no substitute for what my daughter needed from her mother.

    I responded here for the same kinds of reasons you wrote the post. Mothers who make the difficult choice to formula feed need to know that there are experienced, willing moms out here who made the same choice--that it can be a valid choice, and it's not necessarily just unwillingness, laziness, selfishness or stupidity that takes a mother in that direction.

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  25. Incidentally--my eldest EBF baby turns 21 next week. I was a willing nurser long before the latest movement.

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  26. This discussion also reminds me of the divide between those who are sure that anyone can lose extra weight because it's just a matter of calories in and calories out vs those who continue to be overweight or obese regardless of the "information" available (for a combination of reasons including the toxic food environment we live in).

    We also live in an environment toxic to successful breastfeeding. When we strive to label most FF women as "not wanting to BF" I think we discredit all of our struggles and triumphs.

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  27. Jess, your earlier comment reminded me of the parallels I see between cesareans and breastfeeding. That's an incredibly complex discussion, perhaps to be had elsewhere, but there are themes of unwarranted tension between natural birth advocates and those who have had to have cesareans. There should be no guilt nor regret nor shame nor blame, in an ideal world where only the necessary sections are performed. But emotions do run high on the topic, and it's often hard to know where to find the balance of support and advocacy. (Does that make sense? it's getting awfully late for me to try and make coherent analogies.)

    mejaka, I definitely agree there is much nuance to be taken into consideration, some of which has been discussed here. In another discussion on this post, via Facebook (thanks, Raising My Boychick), the matter of medications came up, another excellent example. There was an example of a mother who COULD have gone off her lithium in order to nurse, but she was not willing, and for very good, very understandable reason. One thing I wish I had made more clear in my post was the fact that "not willing" does not equal "bad". This is a perfect example of that, as is your case, as are many other cases out there, we can be sure. This is a huge part of why we need to be able to own our choices honestly and deserve respect and compassion in return - along with my yadda yadda yadda about improving resources and information.

    I hope that came across as it was intended. I appreciate your perspective very much.

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  28. Galactosimia is actually not the only thing that can prevent an infant from nursing. As a child-led weaning advocate , I find myself FF my son. He has a posterior anklygosia (sp?) also called a rear tongue tie. He is physically incapable of nursing efficiently and as a result did not even gain a whole lb from birth to twelve weeks. I certainly pumped my heart out but as I am not actually a cow, the pumps just do not work well for me and I dried up very quickly, despite help from my nursing toddler. The condition is smetimes correctable via survery but my insurance didn't cover t and recovery was likeluto be painful enoughthat nursing would still be impossible.

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  29. I understand what you're trying to do with this post. But I think you're misguided.

    It's not important to distinguish between those who "can't" and those who "won't," because frankly, it's none of your business.

    If you want to help, make breastfeeding help available to every woman, the day she gives birth, and in the weeks thereafter. Give her a card at the hospital (or wherever she gives birth) that says, "If you're having a hard time breastfeeding and need help, call ________ for immediate assistance."

    And then leave her alone unless she asks for your help.

    I nursed both of my children, with extraordinary difficulties. I did everything. (Yes, everything. Thousands of dollars, prescription drugs, specialists out the wazoo, phone consults with Dr. Newman, craniosacral woo therapy, tongue tie intervention, more...)

    It was not worth it. I regret the time I lost with my babies, the money I spent, the emotional attachment to succeeding, and the depression I suffered. I nursed my older child for 2 years and my younger for 1 year.

    You who say you "get it," because you struggled and overcame a lot of things... you do NOT get it. You don't get what it's like to try and then quit and feel like you've failed, then have people tell you the hundred and one things you could have tried if you had really wanted to breastfeed or hadn't been so uninformed. You don't know what it's like to try everything and still fail. You haven't experienced anything but your own experiences.

    The truth is, you don't know if any of those things you are suggesting would have worked. But that doesn't stop advocates from acting as if it would have.

    When a mother tells me she couldn't breastfeed, I say one thing and only one thing: "I'm sorry. It's hard when things don't turn out like you thought they would."

    If she opens up and tells me her story, I will offer empathy. If she sounds like she plans to have another child is regrets not being able to make breastfeeding work, I may say "some women find that ______ can help in that situation. It doesn't always work--it didn't for me--but if it does, it's such an easy fix, so I figured I'd mention it."

    Truth? If I had a third, I would formula feed from day one. I am not interested in trying anything else, even if it would guarantee a successful breastfeeding relationship. I just want to--one time--enjoy having a baby in my home.

    And having nursed two children into toddlerhood, then moved on past that stage, breastfeeding vs. formula feeding matters less and less to me every year. Places like Mothering.com just fuel the mommy inferiority and superiority complexes.

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  30. Great Post! I have many friends that have, despite my efforts to help, given up early in their breastfeeding attempts. I tried to remain supportive, but felt sadness for them and what they would be missing.
    I am a birth doula in training, and make breastfeeding support a big part of my prenatal meetings. I think confidence for the new mom, is pivotal in helping them stay with it, even through difficulties.
    Thanks again, for a great post!

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  31. Rebekah C, if you read my own story, you'll see I'm all too sadly familiar with posterior ankyloglossia. This was part of what made our journey so incredibly difficult. I was lucky enough to find a pediatric surgeon who charged a very low flat rate (we were also paying for ongoing LC consultations, chiropractic and craniosacral, homeopathy and on and on), so we managed the cost. Despite being far from well off, I do recognize that we were lucky enough to be able to take that financial loss, when it is truly NOT an option for a lot of people.

    The contraindications I was listing are contraindications to actually digesting breast milk itself, conditions which indeed are very rare. I absolutely agree that tongue tie IS a significant *barrier* to physically being able to breastfeed if it cannot be corrected, but this isn't the same thing as being unable to digest human milk. Those conditions are the ones I as distinguishing in my footnote

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  32. Rebecca F, I love the way you phrase this: "If she sounds like she plans to have another child is regrets not being able to make breastfeeding work, I may say 'some women find that ______ can help in that situation. It doesn't always work--it didn't for me--but if it does, it's such an easy fix, so I figured I'd mention it.'" That's such a useful and gracious way to word it. I am always striving (really) to find more sensitive and compassionate ways to approach this, so I appreciate it.

    And believe it or not, I can relate to the feeling of loss of the whole babyhood period. It still gives me serious pangs. One of my most fervent hopes for my next child, if I'm able to have one, is that nursing will go better, NOT just for the sake of nursing, but so that I can do just what you mention, ENJOY having a baby. I look at the pictures from those early days, weeks, months, and realize that in many ways, I was so disconnected from the whole experience.

    You and I have processed our experiences differently - I mean, whatever the similarities, we're different people with different stories - you regret the time you spent, and for whatever reason, I don't, but I really do relate to that sense of loss. One of the posts I've been kicking around for a while addresses my experience with nursing struggles and a PP mood disorder, something I've never discussed publicly at all. Perhaps it's time I bite the bullet and spill.

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  33. I breast fed my children for 3.5 years each, for a total of 7 years. I got wonderful support online for the issues I did have, and they were quickly remedied. I learned more over the years that I wish I could have known in those early years, that might have saved us some discomfort.

    I never hesitate to share those things, if someone posts a specific question, but most of the time, I refer them to the wonderful, searchable data base at Kellymom.com because, that way, she can search as much as she wants for anything that may come up along the way.

    I also encourage her to join her local LaLeche League, because the personal connections can really boost her spirits in a way that on line resources just can't quite manage. There she can get more personal referrals for lactation consultants, pediatricians who are knowledgeable about breast feeding problems, and so forth.

    I think as for the concept of "can't" and "won't", I have to agree that offering positive, non-judgmental support is the only way to go, but that few mothers who make the decision to quit, (at whatever point along the way), may feel the need to defensively lash out at those who've tried to help, to in some way justify her decision.

    Getting defensive back at her, is totally unhelpful. Making sure to maintain your cool, and continue being supportive through a difficult time for her, could mean she doesn't lose that connection, and perhaps she'll still be able to get support for other issues in the future.

    I don't condone anyone being mean or name-calling on line, but pain and defensiveness can do that, to even normally nice people. Getting snarky back at them, just creates a lot of unnecessary drama that doesn't help anyone.

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  34. I tried. I really, really wanted to nurse until my daughter was 2. I barely made it two weeks. Flat nipples, low milk supply, tongue tie. Even once we "fixed" the tongue tie, I still couldn't get the baby to latch. She would just scream and scream and scream when I tried to nurse her. Yet, when she got a bottle, she was happy and content. I tried pumping--I'd get nothing, maybe an ounce if I was lucky. My midwives tried to help me, I visited with them twice. They got her to latch, but I couldn't. For months, I felt a tremendous amount of guilt for giving up. And, yes, I know breast is best, of course, but some of the things women say on these sites are anything but peaceful. Yesterday, somebody wrote something along the lines of "if you give your child cow formula, they will have the brain of a cow." I was so upset when I read that. Yes, it's fair to talk about the benefits of breastmilk. But to write mean and offensive comments like that? I defintely feel that every woman should at least TRY to breastfeed but it's not fair to judge when someone gives up. Regardless, I hope to be more successful the next time around...

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  35. I believe this blog was very tastefully written!
    I do have a very complacated situation. I will write of it, take it as you may. I hope I do not come accross as anyting negitive. But just another side to the story.

    After successfully BFing my first child, I then delivered my second child at 27 weeks Ga. After a very long pregnancy in the hospital, then a much dreaded c-section (very necessary) I gave birth to a 2 pound baby. I began to pump for her as soon as she was born. She wasn't even able to eat till 2 weeks after birth. And then it was given to her through a tube. At 30 weeks ga(3 weeks of age) and 3 pounds I was aloud to introduce the breast to her.

    Long long story short she was unable to actually nurse. So I continued to pump for her and give it to her in a bottle. She came home after 9 weeks in the NICU. It was then my obsession to physically nurse her began. I spent A LOT of money on LC's and equipment, not to mention the monthly rental of the pump. I tried to nurse her 2 and 3 times a day for 5 months. Even at one point I had myself fooled that she was actually nursing as I had stopped pumping and giving her bottles for 3 whole days. I was starving her.

    I exhausted so much energy and time that I can hardly even remember her first 6 months of life. At 6 months it was then I completely dried up. That was when my depression spiraled out of control.

    All that to say, during all of that time I realized that 1-there were not that many out there that where able to help me bc I was trying to nurse a micro preemie. But when I would get advice it would be things like "Well Dr Jack Newman is a pro with breastfeeding a micro preemies and even had a 28 week nursing" and "your not going to give in now and give her formula after she's come this far and never even had it...you NEED to find someone who will pump for you". Not very encouraging.

    I have this very empty place in my heart that just longs to have been able to nurse my sweet baby. As time has gone by it gets better. It has been 3 years and I still get very emotional about the whole thing. I have since given birth and just completed 2 yrs of nursing her. It was very healing for me.

    I am proud of the fact that my micro never received formula or anything of such while in the NICU. And that I was able to give her my milk. Even after I gave birth to my 3rd child I then began to put my milk back into her bottles. So she went about 4 months with formula. I very quickly realized that formula ISN'T poison, and became very grateful that God gave man the knowledge to create this "other food" even though not perfect.

    I am very pro breastfeeding but at the same time I would never make another mother feel a failure if it didn't work for them. Even if I did see excuses were being made.

    I truly did everything I could. My baby truly couldn't nurse. The grief I have, I believe I will always carry with me. But I own up to it, I don’t blame anyone, but I did learn from MY experience WHAT NOT TO SAY or DO when dealing with others.

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  36. Thank you for posting this. It was well written and thoughtful...As a lactivist, I too have difficulty keeping my mouth shut, but your post has definitely given me food for thought :)

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  37. Marisa, I cannot BELIEVE that cow-brained comment! UGH. Thanks a lot, whoever you are, for saying such a mean and moronic thing to a struggling mom. Way to make us all look like intolerant bitches. I suppose that means I have the brain of a cow, too, since I myself was formula-fed. I mean, for Maude's sake.

    Rebecca F, I had one further thought: did you read the piece by PhD in Parenting that I mentioned in my post, and that I say I strive to live by? I really do mean that. When you talk about it the simple fact of "can't vs. won't" being none of our business, this is exactly Annie PhD is talking about, and I couldn't agree more. The complications enter when advice HAS BEEN solicited, and publicly so, and thus the delicate matter of how to approach it begins. I hope that clarifies things somewhat.

    And most importantly, regarding your story, I AM sincerely sorry. It IS hard when things don't turn out like you thought they would.

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  38. 3 brown eyed girls, you were really put through the wringer, weren't you? I'm so sorry. You were a total trooper. I'm so glad you've been able to find healing. Bug hugs from over here.

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  39. Thanks Anne! I did have a few mother's backing me up most of the time. Even then, there were times I could see on their faces that they just didn't know what to do for me.

    I was put through the wringer. But there isn't anything I would do different this very day to save my sweet baby.

    After having the perfect pregnancy, the perfect delivery, and the perfect breastfeeding experience with my first baby. It was a hard pill to swallow with my second.

    Being put on bed rest @ 22 weeks due to premature ruptured membranes. Then put in the hospital at 25 weeks. TO going into labor at 27 weeks then finding out I had a complete previa, therefore having to have a c-section. Not only the c-section I then had to be cut vertically bc she was so little and I had no water.

    While in the NICU I couldn't hold her for 2 whole weeks bc of the vent then bc she was just so fragile.

    I was really banking on her breastfeeding. I didn't know it would be so hard for her do to. At that point I was thinking "could some one just throw me a bone here" NOTHING was going as I had perfectly plan in my head.

    But in the end I did prevail!!! I have a very healthy 3 year old girl who has absolutely NO delays of any kind. She beat EVERY odd. Through the grace of God and the Power of prayer WE came out on top!!!!

    Now back to breastfeeding. I am 100% convinced that my daughter who was born 13 weeks (3 months) premature did as well as she did not only bc of God but also bc she ONLY received breastmilk. She only spent 9 weeks (2 months) in the NICU. That may seem like a long time to many of you but really for a baby born that early and the circumstances leading to her very early birth. That was a very short time. She was on a vent for 5 days. She gained weight at a pace that was pleasing to the NICU Dr's so they never hassled me about formula or extra calorie packets.
    They even made a comment at one point saying how much they wished ALL NICU mother's would provide milk for their babies bc the babies seems to do so much better. My baby NEVER got an infection or illness of any kind while in the hospital!!! So yes breast is best!!!

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  40. I never, ever comment on blogs I don't read on a routine basis. However, here I am.
    I am a mom to four kids, 6 to 3.5 months. I was breastfeed, my mother a LLL leader and my baby book came from LLL. I knew I would bf and my goal was to make it to 2 for each child. My oldest was nursed until 15 months when I had horrible nipple pain from being pg and my supply tanked. My second weaned at 21 months because we were both done. My third weaned at nine months, when I was preg with my fourth.
    I never, ever thought I would consider weaning to formula for a newborn. We used formula for about 8 months with Pudding Pie, because he weaned before a year. I was slightly disappointed to not nurse a full year, since he was a preemie and I battled to get him to the breast. He never had formula during his NICU stay and during his first winter, which was important to me. Since I was at high risk for PTD again, I felt "okay" with his weaning.
    Number four was a chanllenge. I now have alot of guilt for the ensuing years. ;)
    In hinsight, the problems began at delivery. In hindsight, he should have been hospitalized for dehydration at 2 weeks old. In hindsight, he wasn't fussy; he was STARVING. In hindsight, I should have looked beyond my horrible fear and PTSD from Pudding Pie's birth and told them about the blood in his diaper. In hindsight, I should have pushed more that something was wrong and it didn't feel "right" to nurse him. In hindsight....
    What DID happen was that at 17 days old, I finally pushed aside the "it is normal to lose more than 10 per cent of the birthweight, he'll get it soon, when your milk comes in" etc comments and begged for help. A LC, who used to be my LLL Leader came out and did a before and after weight check, watched him nurse and did a digtal exam. She suspected a Type Four Tounge Tie and recommended hard core supplementation with a bottle to get him back to birth weight. A written plan and 125 dollars later, I was overJOYED to have a plan to get my baby back to birthweight and possibly nursing.
    It took 2 trips to different ENTs to get his tounge tie clipped. Neither one knew about about this type of tie. It was only because I am lucky enough to be well connected in the lactation and natural birthing circles that it was "only" eight weeks of pumping and bottle feeding. Thankfully, he was back to breast 1.5 weeks after his surgery.
    Oh, did I meantion I nearly had flashbacks to the NICU while waiting for his surgery?
    I did alot of soul searching, thanking God for my anti depressants and talking with my therapist during this time. It was hard to manage the needs of three other children, pump, take care of the baby, myself and make sure I bonded well with him. I said more than once it was stupid that my happiness depended so much on how I fed him. (And I felt like I was getting my comeuppence since I said I would rather formula feed than do the NICU again! Ha! Joke on me!) I finally decided that I wanted to bf because I like it. I just like nursing. It has nothing to do with the benefits of bm, the fact that a large group of my friends nurse, the convience, etc. I like it. And if I didn't like it, I still would have had his tie clipped for his speech/language later on but what kept me going was the simple fact I liked nursing.
    Would I have kept pumping if he never got to the breast? No. I could not do it and take care of everyone. I could not provide milk for my son at the expense of 3 other children.
    I cannot judge anyone who would chose differntly. It was a hard, hard road to travel. I don't want to travel it again. For someone else in a similar situation, I wouldn't view it as quitting but as knowing their personal limits.
    And,Anne, if you ever need someone to blog about PTSD, depression, anxiety, bfing, pregnancy, the whole nine yards, I'm your woman. I have the labels to prove it! :)
    Laura

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  41. I think what you wrote here is great. I see your distinction not as we need to sort moms into categories...but rather that having such a popular notion that it is common that women "can't" breastfeed...well, it sabotages those who run into challenges but want to continue. If as many women who think or say they "can't" really couldn't, we would not have survived as a species. Sure, some women truly cannot and thank goodness they have safe options. For that matter, thank goodness we all has safe options (at least where clean water is available...don't want to open that can of worms right now)! But on a societal level, it is concerning how many of us think we can't make milk for our babies.

    I had an epidural for both babies. I knew the risks. I know that I probably could have birthed without it--definitely with the second birth. The first one I am not sure...I might have ended up with a c-section without the epidural with the first. I chose to have an epidural because, in the moment, it seemed like the right choice. If I have a third, I may take additional steps to avoid making that choice. I do not feel judged during discussions that it would be better to lower the rate of epidural use because overall, that is true.

    We need to get back to a point in our culture where we understand ourselves as capable of birth and feeding our babies--and within that there is plenty of room for choice and for being grateful for the technology that saves lives in anomalous circumstances.

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  42. Normally, I'm not drawn to comment. This was different. Childbirth and nursing are such guilt producing topics. Since I was judged, I've tried not to comment on anyone's choice. But it's oh so easy to say the wrong thing when you didn't mean to say anything hurtful.

    My sons are 21 & 25 years old. My first was an emergency C-Section. It took me a long while to recover both physically and emotionally from it. I got zero support and no extra help from anyone except my husband. I cried in private at every "oh, you had him the easy way" comment, and there were a lot of them. It took me awhile to realize that with a doctor with a 7% C-Section rate, it was just one of those things, and nothing that I'd done wrong.

    Nursing after a C-section is not easy. I'm sure that a big part of my being able to nurse my first son, was that my husband didn't allow our son to go to the nursery or be feed anything. He'd read my maternity books. He also insisted someone help me, when my young nurse didn't know what to do, and everyone except him was in tears. The nurse they found was an old battle ax, but when one way didn't work, she tried another. We left the hospital after two days with him having gained weight.

    It went downhill from there. When we got home, my son was fussy and hungry all the time, and I never seemed to have enough for him. He lost weight. He didn't sleep much and wanted to nurse all the time. No one I knew had ever successfully BF before. Our doctor was supportive, but didn't have a clue. I called LLL and they said come to a meeting, which I couldn't. I hung up in tears. So my husband went to the library and got every book he thought might help.

    A LC would have been a godsend, she would have told me to take some pain meds. I had TWO Motrin after my C-section. I never thought to ask, because after all they were the medical professionals. She would have seen if my latch was good, and done oh so many things. Instead we fumbled with my drinking more, eating better and doing nothing for two weeks except nurse, sleep, eat and drink. We saw that wet diapers and weight gain meant he was finally getting enough.

    I know what I went through just overcoming fairly normal problems with my husband's support. I would never judge any woman for making a different choice, and saying enough was enough.

    My second child was a VBAC (same doctor) and our nursing relationship from the start was like night and day from his brother. I really do feel that the first several months didn't have to be that hard with the first.

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  43. I'm a new mom to a 6 1/2 week old. She has been exclusively breastfed, and things are going well now. I plan to continue indefinitely, including when I go back to work at the end of the summer. The first few weeks were horrible, though, because my nipples were so cracked, sore, and painful. I considered switching to formula. What got me through was the support of family, friends who had breastfed, and professional help. And, importantly, the fact that my family and friends would have supported me if I had decided to switch to formula. Knowing that I had their support regardless took away some of the pressure and guilt I was feeling. It also affirmed that I was capable of making the best choice for me and my daughter, whatever that choice ended up being.

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  44. As a lactivist myself, I've always made it painfully clear that weaning my son onto formula at 9 months was purely my not being willing to breastfeed any longer. I found myself unexpectedly pregnant with #2, working full time (and struggling with pumping), going through an ugly divorce with a man hell-bent on me not breastfeeding and tons of other stress in my life. I know that I could have continued nursing my son but it just wasn't worth the work invovled with what little support I had. Thankfully there were no tears from him or I over weaning and he's done just fine on formula. I don't regret that I weaned him and absolutely will nurse #2 with the same goal of child-led weaning that I had with my son.

    So glad to see someone else make the distinction between "can't" and "won't". It really DOES make a difference to be honest =)

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  45. I thought this was a good article and understand that it is not at all intended to contribute to the angst of those of us with low supply. But like Joanna who posted on the 17th of July, I am sick to the teeth of hearing / reading from women who have been lucky enough to be able to breastfeed exclusively that milk supply issues are "incredibly rare." Excuse me, but Bullshit.

    The short version of my story is that my baby, despite her "perfect latch" (according to the private lactation consultant we paid for a pre-natal bf prep course and 4 different visits after coming home from hospital) and my near-obsessive zeal about exclusive bf, ended up in the neonatal icu on her sixth day of life because she was literally starving after spending her whole, short, tortured life on earth to that point sucking frantically at my empty breasts. And I, having heard again and again and again how EXTREMELY unlikely it was that I could actually have supply problems, resisted giving her that bottle of formula until I damn near killed her.

    Turns out I have breast hypoplasia, a NOT VERY RARE condition which is very UNDERDIAGNOSED and FREQUENTLY causes low milk supply.

    She is five months now and I am still nursing her at every feed, though I'm sure it is only because of the nutritious, lifesaving formula that follows my breasts' meagre offering that she is thriving.

    I am well aware of all of the benefits of breastfeeding exclusively, for my baby and for me, and I cried for weeks over the loss. But by far and away the most painful aspect for me was NOT BEING BELIEVED when I said that I just simply could not produce the milk.

    Putting "can't" in quotes is so, incredibly hurtful to me. It's cruel. I know my body and my desires for my child better than anyone else does, and if I say I can't, it's because I can't.

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  46. I thoroughly enjoyed reading this blog. What a great opportunity it was for me to learn from the information posted. Now I now my C's and W's (wink)

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  47. Sloopy, I'm glad you posted. Women with hypoplasia are most DEFINITELY among those who usually truly can't, and deserve the utmost in compassion. I think it's also something that is sorely under-researched, and I hope this changes in the future. I wonder if you've seen this post on the Academy of Breastfeeding Medicine's blog on the topic of the lack of research for "lactation failure"? I think it's excellent.

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  48. As one of the "rare exceptions" and having been in lactation support groups filled with other "rare exceptions" I tend to believe that it is not as "rare" or exceptional as the blogger believes. There are lots of good supportive points in the article. There are women who prefer convenience and modesty to nourishing their child but there are those of us who were devastated and did everything they could to exclusively breastfeed. It wasn't until my daughter started losing weight at 3 mos (after VERY slowly gaining) that I began to supplement. I still breastfeed when possible during the day and morning and night. Just like most hot button topics, there is far too much judgment flying around. I was judged by almost everyone I spoke to and much of the most critical were complete strangers devoid of understanding for my personal situation and history. I sought out all the information I could, took herbs, went to specialists, pumped but still did not have enough out of my enormous (DDD/E) breasts to provide for my precious darling. It was important to me to breastfeed. If it's important to others they will seek until weary and then some. More research into low milk supply would be great.

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  49. I totally agree that more research is long overdue and in desperate need. I hope that this changes in the near future! I'm sorry you had such a hard time and felt judged - you clearly worked your tail off.

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  50. I feel bad that it took me so long to comment on this great post. I've opened it and read it several times and then got stuck trying to figure out what I could possibly add. In other words, you said it all and did so fabulously! Thank you for this post.

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