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No one talks about how difficult breastfeeding is. That’s hurting all moms.

Why do we only learn about breastfeeding when we have to do it ourselves?

Perspective by
December 23, 2020 at 9:08 a.m. EST

Six weeks after my eldest daughter was born, my husband and I packed up her swaddles and burp cloths and boarded a plane to Massachusetts, where our extended family was gathering for a reunion. I was nervous. The original plan was to leave our daughter with my husband’s aunts for a day while we attended a nearby folk music festival. But at some point during the first exhausting weeks of my life as a parent, I realized that wasn’t going to work — and I knew everyone would be disappointed.

Before, it seemed simple: I could leave my family with a few bottles of breastmilk and then spend a relaxing day sitting on a blanket in the sunshine. But after struggling to establish a still-fragile breastfeeding routine, it sounded ridiculous. How could I possibly pump an entire day’s worth of milk before we left for the festival? Where would I pump at an event taking place in an open field, and what would I do with the expressed milk afterward? Plus, my daughter had only just gotten the hang of latching — would a full day of bottle-feeding upend all of the progress we’d made? Would she even accept a bottle from someone she’d only just met?

Articulating these concerns to my extended family members was difficult. “Can’t you just pump?” my aunt asked. I didn’t know where to begin, so I just told her I wasn’t ready to spend a day away from my daughter and left it at that.

The whole experience made me wonder: Why do we only learn about breastfeeding when we have to do it ourselves?

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I had always planned to breastfeed, mainly because it’s what most doctors suggest. The American Academy of Pediatrics (AAP) recommends that mothers breastfeed exclusively for about six months, because breastmilk provides “species-specific” nutrition that is easier for babies to digest than formula. It also contains antibodies that help the baby’s immune system fight off ear infections, pneumonia and a host of other bacterial and viral infections. I was prepared to supplement with or switch to formula if need be, but I was determined to attempt meeting AAP guidelines. By the skin of my teeth, I did — but, like a lot of mothers, I was surprised by how difficult it was. (For Black mothers, barriers to breastfeeding are even greater — a result, experts say, of racism and bias.)

The first week, for me, was brutal: cracked and bleeding nipples, clogged milk ducts and marathon nursing sessions, the better part of which were spent begging my daughter to latch. Even after these issues began to settle out, I was shocked by how often my daughter nursed — every two to three hours, as is typical — and how much her appetite fluctuated as she grew.

Bottle-feeding, to my disappointment, didn’t make the process less demanding. It allowed my husband to help, yes, but I still had to empty my breasts every couple of hours to stave off engorgement, which is not only painful but signals to your body to produce less milk. I remember how silly I felt when I realized how inflexible the nursing cycle is — you can’t speed up or slow down breastmilk production to suit your schedule. You can’t pump extra milk in the mornings to avoid pumping in the afternoons. You definitely can’t take a day off to go to a music festival.

It was 2017, and I was in graduate school at the time. I was one of two parents in my 64-person cohort. I didn’t have an office or a room for pumping — I took classes in buildings all over campus on a schedule filled with sporadic midweek events and meetings held at shifting times and locations.

Even with the most deliberate planning, I kept bumping up against the expectation that I pencil nursing and pumping into the windows of my schedule like I would any other errand. The ever-present need to explain why I couldn’t was a constant source of anxiety and frustration — especially given that many people were visibly uncomfortable discussing breastfeeding.

These frustrating and awkward memories came to mind in October, when I read that a professor at Fresno City College told one of his students not to breastfeed during his four-hour Zoom class. “There are other ways of feeding the baby besides feeding it with their breasts. You can feed it with the bottle,” he told The Lily about the incident.

She said she had to breastfeed during virtual class. Her professor’s reply shocked her.

Setting aside the fact that the child’s diet is not up to him, feeding a baby just isn’t that simple. The truth is, not all babies take bottles. Not all babies take bottles all the time — especially when their mom is around. And even if her baby did take a bottle, the mother would probably still have to empty her breasts at some point. While I don’t blame anyone for not understanding the complexities of infant nutrition, I think it’s worth asking why the demands of a process so fundamental to the human life course aren’t more widely understood. After all, widespread ignorance on this matter leaves mothers fighting for the time and space needed to feed their children.

“What we hear from [moms] is that people don’t understand just how much dedication is required to make breastfeeding work. And this shouldn’t surprise us, given that we live in a society where the first time most people talk about or really think about breastfeeding is when they are in the delivery room,” says Blythe Thomas, chief strategy officer at 1,000 Days, a nonprofit organization devoted to improving nutrition and the well-being of mothers, babies and toddlers.

Poor support for nursing is one reason many mothers stop breastfeeding after returning to work. Even in workplaces that offer accommodations like a place to pump, mothers often face judgment from co-workers for doing so, which affects breastfeeding success. According to a recent survey of 500 working mothers, 15 percent chose to continue breastfeeding after returning to work because their co-workers or supervisors encouraged them to do so.

Kristin Tully, a breastfeeding and infant-sleep expert at the Center for Maternal and Infant Health at the University of North Carolina at Chapel Hill, says a better understanding of the varying challenges nursing mothers face could help foster more empathetic and supportive environments.

“Breastfeeding education would ideally be provided throughout the life course … as children in homes and school, as a part of higher education for health-care professionals and broadly, for pregnant people and their companions being supported by health-care services, and as grandparents learning the latest science,” says Tully.

The World Health Organization and UNICEF have long recommended including breastfeeding in school curriculums, which some research suggests holds promise for improving support for and attitudes toward breastfeeding.

But the best way to improve public understanding of breastfeeding is simply to adopt policies that empower more mothers to do it, says Thomas. Although more than 4 in 5 mothers start out breastfeeding while still in the hospital, just one-quarter breastfed exclusively through the first six months, as the AAP recommends. And 3 in 5 mothers stop breastfeeding earlier than planned, according to the Centers for Disease Control and Prevention.

“Most moms aren’t meeting doctor-recommended goals, but they’re not even meeting their own personal goals,” says Tina Sherman, campaign director for the Breastfeeding and Paid Leave Campaigns at MomsRising, a mothers’ advocacy organization. As a result, “their partners and their siblings and their co-workers don’t actually know what it looks like to be breastfeeding, because they haven’t seen it. It’s not normalized.”

The difficulty mothers face meeting their breastfeeding goals is partly due to the fact that few American women have access to supports, such as paid leave or lactation consultants, that help them to establish a breastfeeding routine. This is particularly true of Black women, who are less likely than other moms to receive breastfeeding guidance from health-care professionals and counselors, and more likely to need to return to work soon after giving birth.

“If it feels like you are the only woman breastfeeding in your peer group, your family, your workplace or your community, it’s going to be that much more difficult for you to get the support you need to breastfeed,” Thomas says. “But, if our communities are designed in a way where breastfeeding is the norm, we’ve removed a major hurdle.”

Difficult as it was, my crash course in infant nutrition with my first child paid off when I gave birth to her sister a little less than two years later. I was better prepared for breastfeeding’s sometimes unpleasant physical consequences and less overwhelmed by its unyielding demands. I even got better at explaining how it works to friends and family members.

More than anything, though, I became more supportive and understanding of other moms, breastfeeding or not, struggling to feed their babies. And I wish it hadn’t taken having a child myself for that to happen.