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Breastfeeding: Not Always Easy, But Well Worth the Effort

Breastfeeding: Not Always Easy, But Well Worth the Effort

By Elizabeth Heubeck

Just as every birthing experience is unique, so too is the breastfeeding experience. Some mothers and babies click immediately, instantly enjoying the wonderful emotional bond that comes as a fringe benefit to breastfeeding. Other mother-baby duos struggle initially, reaching compatibility only after diligent practice. Still other mothers find the practice of breastfeeding too messy, painful, or otherwise unappealing and give it up before it becomes a routine. And then there are mothers who opt out of breastfeeding altogether.

Despite medical guidelines advocating breastfeeding, many mothers formula-feed

Every mother must do what feels right for her and her baby: breast-, bottle-feed, or both. But before making that important decision, it may be helpful to note that the American Academy of Pediatrics (AAP) has recently issued new guidelines extending the recommended period that infants should be breastfed, from the first 6 months of life to the first 12 months and beyond, “or for as long as mutually desired.” The recent AAP guidelines are based on compelling new evidence of the health benefits that breastfeeding provides to infants and mothers (see sidebar).

Many women do not breastfeed their infants despite the benefits: health boosters to babies and moms; the readily available nature of breast milk (in most cases); and the fact that it’s virtually free, as opposed to formula, which costs between $800 and $1000 per baby annually.

A recent study by the AAP concluded that approximately 60 percent of women breastfeed at the time of hospital discharge. By 6 months, that percentage decreases to about 21 percent. What’s more, breastfeeding appears to be on the decline—less mothers breastfeed now than did in the 1980s. What’s preventing new mothers from choosing this natural and low-cost method of providing nutritional and emotional support to infants?

Societal attitudes may sway a woman’s decision

Negative societal attitudes can be a subtle yet sometimes significant barrier to successful breastfeeding. I’ll never forget dragging a chair into the filthy restroom of a restaurant to nurse my baby. Following me into the restroom was a woman who stated: “Thank goodness you’re going into the bathroom. I’m appalled that some women feel the need to breastfeed in public.” Actually, I wanted to tell her, it’s not me who feels the need to breastfeed. Rather it’s my baby who feels the need to breastfeed—in public, private, or wherever—every couple of hours.

I happen to be modest and not particularly coordinated, which makes “doing it” in public a challenge. What’s more, my baby would rather look at what’s going on in a busy room than concentrate on the task at hand. So I seek out private places like restrooms, whether or not they are ideal—and most times they are not. But even if I did feel comfortable nursing in public, others (such as the woman in the restroom) make it clear that they do not approve. Moreover, the state of Maryland does not support a woman’s right to breastfeed in public.

Recently, the House of Delegates committee voted to reject a state Senate-passed measure that would have barred any attempt to “restrict or limit the right of a mother to breastfeed her child in public.” [In other words, the committee voted to protect the right to restrict breastfeeding.] Why? Because male committee members expressed “concern” at women baring their breasts in public. Go figure.

Returning to work can affect women’s decision and ability to continue breastfeeding

Many women return to work shortly after the birth of their baby. Some freely choose to do so; others do so out of economic necessity or pressure from their employers. Although not every place of business is adequately equipped for women to pump breast milk privately or comfortably, more and more companies are beginning to understand the value of making such accommodations available to their employees.

If you are planning to return to work after the birth of your baby and want to continue to provide your infant with breast milk, consider whether this is a realistic decision. Do you have the type of job in which you can drop what you’re doing (once or twice during and eight-hour shift), find a private place, and pump?

In addition to the sheer logistical challenges of breastfeeding upon returning to work, there’s the question of whether your body and your baby will cooperate with the idea.

Sometimes, the arrangement works well for both parties. Other times, mothers find that despite their best efforts, their milk supply dwindles when they return to work. Sometimes, babies learn to prefer the bottle over the breast.

Tips for breastfeeding moms returning to work

Although some women abandon breastfeeding upon returning to work for any number of reasons, others make the transition successfully. To facilitate this transition, Connie Getz, lactation specialist who has spent eight years helping new mothers and infants get acclimated to the “art” of breastfeeding at St. Joseph’s Medical Center in Towson, offers these practical suggestions:

  • Invest in a good double, electric pump.
  • Introduce a bottle about three or so weeks after nursing.
  • Begin pumping well before you return to work.
  • Always have a few days’ supply of breast milk stored in the freezer.
  • Scout out a comfortable and private place at work to pump.
  • When at work, try to pump during the times when your baby would be eating (at least twice in an 8-hour shift).
  • Wear patterned blouses to work instead of solids (to camouflage leaks).
  • Bring a change of clothing to work in case of leaks.
  • Conserve your energy: Share tasks or delegate to outside sources—breastfeeding consumes energy.

Embracing the commitment to breastfeed

Breastfeeding is an enormous commitment, both for moms returning to work and for stay-at-home moms. Just think, a newborn infant nurses an average of eight to twelve times each day. And sometimes, explains Getz, women’s expectations of breastfeeding are quite different from reality. “It’s something that’s natural, but it’s still a learned art. You have to practice it and your baby has to practice it,” says Getz.

As with any rewarding task, breastfeeding takes time and effort. But most mothers and babies who weather the sometimes rocky training period of breastfeeding and other associated glitches learn to treasure the time spent bonding at the breast. What’s more, the health rewards to baby and mom simply cannot be beat or duplicated by any formula. BC



  • Breastfeeding decreases the incidence and/or severity of
  • bacteremia (a blood infection)
  • bacterial meningitis
  • botulism
  • diarrhea
  • ear infections
  • lower respiratory infection
  • necrotizing enterocolitis (an inflammatory bowel disease)
  • urinary tract infection

Breastfeeding may protect infants from:

  • allergic diseases
  • Crohn’s disease
  • insulin-dependent diabetes mellitus
  • lymphoma
  • other chronic digestive diseases
  • sudden infant death syndrome
  • ulcerative colitis
  • Breastfeeding also may enhance infants’ cognitive development (“smarts”).
  • Breastfeeding results in:
  • less postpartum bleeding
  • more rapid uterine shrinkage
  • delayed return of menstruation
  • quicker return to pre-pregnancy weight (burns 500 to 1000 calories per day)
  • improved bone remineralization postpartum (leading to reduced incidence of hip fractures in postmenopausal period)
  • reduced risk of ovarian cancer and premenopausal breast cancer
  • Note: Instances in which an infant should NOT BE BREASTFED:
  • infant with galactosemia
  • infant whose mother uses illegal drugs
  • infant whose mother has untreated active tuberculosis
  • infant whose mother has been infected with the human immunodeficiency virus (HIV)
  • infant whose mother is required to take certain medications (check with your physician)
  • Source: American Academy of Pediatrics
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