Breastfeeding Barriers and Benefits

More than 60% of new moms report having to give up breastfeeding before they were ready. For many, this comes with feelings of inadequacy, grief, and remorse. We know that breastfeeding provides health benefits to both parents and baby. And most families leave the hospital breastfeeding. But after leaving the hospital, the lack of support and resources can present barriers.

Access to lactation medicine specialists, raising awareness of the problems that can negatively impact breastfeeding success, and making sure lactating individuals have the support they need are just some of the ways to support breastfeeding.

These are some of the reasons to keep trying breastfeeding, the most common problems people experience, and some of the ways they’ve overcome these barriers. Ann Kellams, MD, director of UVA Health's Breastfeeding Medicine program, and Lynn McDaniels, MD, pediatric hospitalist at UVA Health Children's both advocate for policies to help support breastfeeding.

What are the Benefits of Breastfeeding?

Imagine having every meal crafted to meet your unique nutritional needs. For breastfed newborns, that’s their reality.

“Human milk is made for human babies,” Kellams shares. “This is personalized to you, and we know that your milk is different if you have a premature baby to meet those needs, and we know that each phase of development, your milk changes to meet the needs of your baby.”

Benefits for Baby

• Lower rate of infections, especially for premature babies
• Lower SIDS rates
• Reduced diabetes risk
• Fewer ear infections
• Fewer allergies
• Better immune function

But the benefits aren't just for baby! The breastfeeding parent also benefits.

Breastfeeding Benefits

• Lower rates of breast & ovarian cancer
• Lower rates of type 2 diabetes
• Reduced risk of osteoporosis

There are also benefits for bonding, with many parents feeling it was an incredibly special experience.

Breastfeeding Barriers

With all the benefits of breastfeeding, and most families saying they’d like to breastfeed, why do so few babies continue to breastfeed after leaving the hospital?

Barriers to breastfeeding can disrupt feeding journeys, and force families into choices they may not have wanted. While some of these barriers are emotional or a lack of good information, many more are societal. And fixing them may take a village.

Here are some of the more common challenges that can impact breastfeeding, and how others have overcome them.

Pain during nursing

Breastfeeding may feel uncomfortable at first, but it should never feel painful. Pain can come from:

• A poor latch
• Infection
• Inverted nipples
• Positions that break suction

These are problems that can be fixed with lactation support. But if nursing hurts, it can cause milk supply to plummet.

Lack of support while nursing

Nursing a newborn can take 4-6 hours per a day. It's basically a full-time job all by itself. And when support systems don't help out by taking on some of the food preparation, house cleaning, errands, and other needs of daily life, it can be hard to keep up with.

Medication concerns

Caffeine, heart medications, antidepressants, there are a lot of substances that moms may need to take that can end up in breastmilk. But only a very few medications truly make breastfeeding unsafe.
Having breastfeeding medicine specialists and pharmacists educated in lactation can help ease worries. In many cases, there's a substitute medication available.

Returning to work

Perhaps one of the most significant barriers is that for many, returning to work happens very soon after birth. Kellams shares,“Many, many, many families are dual working families, and we see people going back to work at four weeks, at six weeks, at eight weeks, and that’s just when you’re barely getting things established.” But without paid maternity leave, it's often a choice that's out of families hands.

New parents do have additional legal rights though. Including the right to lactation breaks. This is not the ideal way to establish breastfeeding, but a lactation consultant can help you advocate for your needs and learn to use a breastfeeding pump.

Modesty concerns

In America, modesty is another cited reason for why people choose to stop breastfeeding. This one is largely about public education and helping breastfeeding parents feel confident that there is nothing immodest about feeding their child. While "nursing covers" have been pushed on people, they can often make it harder to breastfeed. Under a cover, a child may feel too warm and uncomfortable. Or, they may feel so comfortable they simply fall asleep.

Clothing made for nursing is often expensive, inaccessible, and uncomfortable. And what works for one person and their body may not work for another. Thinking about public breastfeeding and figuring out comfortable options is something that is less stressful if it's planned for.

But legally, breastfeeding is a protected activity. And knowing your rights can help you breastfeed confidently in public if you so desire

Plan Prenatally

By understanding the significant benefits and anticipating and planning for barriers, more families can be successful with breastfeeding.

McDaniel wants mothers to think “pre-conceptually. Post birth can be so stressful, I’d prefer that moms think about this before they deliver, when fatigue, pain, and stress make thoughtful decision-making difficult. Get as much info as you can beforehand. You need to come in with a commitment and a plan.”

That’s why the first step in the breastfeeding program begins with prenatal consultations. “We want to give you all the information, so you can make the best choice for you and your baby,” Kellams notes. “As a new mom, you need all the knowledge you can get.”

Help Is Here for You

What breastfeeding medicine specialists and lactation consultants wish more new parents knew? That they don’t have to overcome these barriers on their own. Many of the most common, like medication concerns, problems with a breast pump, or having a child with medical issues are ones that can be overcome.

More doctor’s offices are also following breastfeeding-friendly physician’s office protocols, which means you can find lactation support at your pediatrician’s office, follow-up OBGYN appointment, or even via virtual care.

But if stopping breastfeeding is what's right for you, you'll also find support for that choice. McDaniel says, “In the end, after all the info we give you, your choice is what we’re going to support. The thing we want most is for you to love feeding your baby and feel good about it.”