I live in Portland, Oregon, and as both a mother and an acupuncturist who specializes in women’s health (read: I treat a lot of prenatal and postpartum concerns, including lactation issues), I am passionate about breastfeeding. But I do not, and will not, put down mothers who are unable to or choose not to breastfeed. Please do not try to read any bias or put-downs into this post, as none of them would be intended. It is an emotional topic, and we all have to make the best decisions for ourselves and our children. That being said, breastfeeding is fantastic for both mother and baby, so I am committed to helping as many women do it as are able and willing. The focus of this post is to offer some reality and support for women who have, plan to, or currently breastfeed. These two issues will be on tap: breastfeeding is not always easy, nor is it always accepted.
Ouch! When breastfeeding hurts.
For me there was no question in my mind about breastfeeding. Of course I would do it. I am an acupuncturist who strongly believes in the power of the human body. I also live in crunchy Portland, Oregon…breastfeeding felt almost expected. As a healthcare provider, I also know the health and bonding benefits for mom and baby. Also, if breastfeeding is working, it is easy, portable, and free!
I also thought that because it is natural, it would be easy and pretty painless. I remember hearing a midwife and lactation consultant say, “if it hurts, you aren’t doing it right.” So I didn’t worry about it at all during my pregnancy (unlike my dear friend, who read every book about it she could get her hands on). Then my son was born, and he had what one lactation consultant termed “a barracuda latch.” Sounds pleasant, no? Instead of buffering my nipple with his tongue when nursing, he clamped down with his gums and pulled. It made my nipples crack and bleed within 24 hours.
It turned out to be a relatively quick and easy thing to fix for us thanks to a knowledgeable LC. Within a few weeks, we were nursing like old pros (of course my nipples took a little while to heal).
Why did I tell you this story? For several reasons:
Nursing is absolutely natural, but it is not absolutely easy.
A lot of mothers and/or babies have a bit of trouble nursing correctly at first. I was lucky that we figured out a fix within a few weeks. I could have given up during that time. When you are tired, anxious, and trying to figure out how to manage a new baby, it can feel completely overwhelming to add breastfeeding issues to the mix. Sometimes it takes more than 2 weeks to work out nursing issues. It can be so much simpler to give up during this time. The more support you have, the more likely you will be to work through a rough start.
Find a good support team.
There are tons of options in Portland for lactation help, and around the country there is increasing support as well. Talk to your hospital’s lactation consultants as many times as you need to (coverage is mandatory under the ACA). If you are not getting the right support, ask for another LC (they’re not all created equal). Private practice LCs have more freedom, including having the ability to check for lip or tongue tie. Visit the La Leche League website to find a local support person. Contact the Breastfeeding Coalition or a local midwife school for free support. Get recommendations from friends who have breastfed. Talk to your pediatrician, OB, or midwife. Hang in there. It will get easier, and once you and the baby figure out that latch, you will likely have a successful breastfeeding relationship.
I also shared that story because I want you to know this: Breastfeeding is not painless….at first. Obviously if a latch is wrong, even subtly so, there will be more pain than is necessary. Often this is correctable with the help of an LC. You can also look into lip and tongue tie if you have a hunch there is something more going on. If you have cracked, bleeding nipples, if it is so painful you are crying during each feeding, seek help.
Breastfeeding does come with discomfort in the beginning. Just think about it: your nipples, those delicate little buds, are going to go from their protected bras, mostly ignored, to being sucked on for up to 12 hours each day. There will be some adjustment. Letdown (when your milk lets-down so the baby can drink it) happens during each feeding. Some women don’t feel it at all, and for other it is uncomfortable. Some moms love the feeling of letdown as it comes with a surge of relaxing oxytocin, but I thought it felt like little electric shocks through my breasts. Give yourself a week or so to adjust to the newness, and things should start to feel better.
Supply and Demand
Besides discomfort, another reason lots of new moms give up on nursing is because of supply issues. It is not uncommon for moms to have a hard time creating enough milk at first. There are lots of fixes for this, and although you can find tons of suggestions online, please seek expert help. Do not attempt to self-administer herbs. This can be especially tricky because many of those herbs will pass through to baby. With simple custom Chinese herbal formulas I have helped numerous mothers substantially increase their output. I also talk with my patients about foods that can be helpful in creating a higher output.
Sometimes there are women who think their supply is not enough when the real issue is just that the supply is not letting down efficiently. Acupuncture is a fabulous and fast fix for this problem. Finally, if you have tried everything you are comfortable with trying and still do not have enough output, you may need to supplement a bit with formula. If you are committed to breastfeeding, just know that introducing a bit of formula now does not necessarily mean that you cannot be an exclusive breastfeeder later. Work with your pediatrician and lactation consultant to decide when supplementing is the right choice.
The last issue I want to tackle, the one that inspired this post, is women who face a lack of support for breastfeeding. I saw this article online the other day that was about an ad campaign created by some college students and showed pics of young mothers nursing in bathroom stalls with captions like “Private Dining. Would you eat here?” They got tons of support, but there were also a ridiculously large number of negative comments. Some showed false support, “The rude comments people make are uncalled for, but having your boob out in public is trashy. Women shouldn’t be comfortable having their goodies shown to everyone and their brother.” Others were downright uncalled for: a man saying women should not bare their “sex objects.”
Like I said, I live in Portland, Oregon, where we consistently rank in the top 3 or 4 in the country in percentage of women breastfeeding. Even though I’ve never dealt with a lack of breastfeeding support, I’ve had friends who have been made to feel uncomfortable for nursing in public. When in public I covered up if I had something handy to do so with, or if I was in a place where I felt uncomfortable. Mostly I did not cover up. I was discreet, but I would take to task anyone who suggested I were doing something wrong. As one woman mentioned in response to the aforementioned ad campaign, “Why is it considered to be disrespectful of others to not use a cover? What about being respectful to these babies? Throwing a hot blanket or cover over their faces and not letting them see mom while eating is disrespectful to them.” And as another noted, “I have yet to see a woman breastfeeding that I even notice she’s breastfeeding. Most of the time it looks like a mom cuddling her child. So if you have a problem with it, the problem is you’re staring.”
If you face a less-than-supportive environment, you may need to be prepared to stand up for yourself. Rally the support of friends and family and LCs and nurses who can supply extra encouragement. Know your state breastfeeding laws. That way, if you are asked to stop, leave, or cover up, you know what legalities you have behind you. 45 states have laws that specifically allow women to breastfeed in any public or private location.
Breastfeeding can be one of the most wonderful things you get to do in your life as a mother. If it is something that you want to do, you need to commit to it. Committing is far easier if you have your support team lined up ahead of time. That way, if problems or issues arise (and they will), you know who to call and who can help. If you live in Portland, Oregon and are in need of some help, please use the resources I offered in this post, or feel free to contact me for more information or recommendations. Acupuncture can be a wonderful complement to the aforementioned resources, and is also very restorative, and what new mom can’t use that?