To Breastfeed or Not to Breastfeed?

While many pregnant mamas know—without a doubt—that they want to breastfeed, some remain unsure or simply decide it’s not for them. Others may be shocked and guilt-stricken to learn that they can’t, due to medical issues or other concerns. Whether you’re pregnant, planning to become pregnant or already a new mom, the decision to breastfeed is obviously a personal one. No matter what you decide, all experts will agree: fed is best.

Milk with Benefits
Of course, the benefits of breastfeeding are varied and widely touted by moms and medical professionals alike. Plenty of research shows that breastfed babies are less likely to develop asthma, allergies, ear infections, childhood diabetes, childhood obesity and respiratory infections, says Jessica Sember, a board-certified lactation consultant and perinatal coordinator with Geisinger Health System in Pennsylvania. Breastfeeding can also half the risk of death from Sudden Infant Death Syndrome (SIDS), according to research published in Pediatrics. Moms who nurse benefit as well from a decreased risk of decreased risk of breast, uterine and ovarian cancers, osteoporosis and anemia, says Sember. As an added bonus? “Mothers who breastfeed return to their pre-pregnancy weight quicker than mother’s who don’t,” Sember says.

How Long is Long Enough?
If you decide to breastfeed, you may have concerns about how long you’ll need to continue it to achieve maximum benefit. The World Health Organization recommends that new moms breastfeed exclusively for the baby’s first six months of life, and then continue, along with complementary solid foods, until the baby is at least 2 years old. The American Academy of Pediatrics, however, states that babies should continue to nurse until they’re at least 1 year old, says Tori Sproat, a board-certified lactation consultant with Tiny Tummies Lactation Services in Jacksonville, N.C. “I advise parents to consider these recommendations and make the decision that best fits their family. A breastfeeding relationship is exclusively between the breastfeeding parent and child, so duration is up to them,” Sproat says. “Many in the U.S. will be surprised to know that the natural term range of weaning is between 2.8-7.0 years, so the WHO recommendation is spot on!”

Unforeseen Difficulties
Some new mamas can want to breastfeed but struggle because of lack of support or health issues, including psychological ones related to abuse or trauma. For instance, women with active cases of tuberculosis should not breastfeed and in the United States, where safe alternatives exist, women with HIV or AIDS should not breastfeed their babies. In addition, women who are undergoing chemotherapy should “pump and dump” for the duration of the medication and its subsequent half-life before resuming breastfeeding, says Sproat. Since numerous medications can be transmitted to a baby through breast milk, be sure to discuss any concerns you may have with your physician. Additionally, women who have survived a sexual assault, have body dysmorphia or have experienced previous breast surgery can have difficulty breastfeeding.

“Each of these situations presents it’s own challenges, both physical and emotional, to overcome to initiate breastfeeding,” says Sproat. “I often tell parents that breastfeeding may be natural, but it does not come naturally! Find help as soon as you have questions.”

Handling Guilt
Women who can’t breastfeed—or who simply chose not to for personal reasons—can be confronted with guilt and even shame over doing what’s best for their babies. “The truth is that we’re all trying to do the best for our children,” says Sproat. “To the parents who are unable to breastfeed due to factors out of their control, I remind them that their child chose the perfect parent for them.”

Women who initially try but then fail in their quest to breastfeed often do so because of a lack of support, she says, pointing to barriers such as unsupportive family and friends; care providers, including doctors and midwives who aren’t “up-to-date” with the science of breastfeeding; and unsupportive work or childcare environments. “To the parent who feels they failed to meet their breastfeeding goal, more often than not, we failed them,” Sproat says. “It’s frustrating that a parent has to be Nancy Drew to discover there is breastfeeding support available in their community.”

Sember agrees, and likens breastfeeding to learning a new sport. “It may be difficult at first and you may need a coach to help you along the way, but with practice it will become easier and should be something a mother and baby enjoy together,” she says. “I think women may find breastfeeding difficult if they do not have a support system that encourages her to breastfeed the baby.”

Jennifer Brozak is a freelance writer from Pittsburgh who has a passion for all things parenting and education. She contributes to a variety of local and national outlets and blogs about her family’s escapades at One Committed Mama.