Why cant some women breastfeed?

**bon** · May 30th, 2007, 10:02 AM

With DS I had pre-eclampsia and PPH. During the birth I had pethidine and epidural, as well as blood pressure meds and the synto drip because I was induced. Afterwards I did not produce milk, only very small amounts of colostrum - and I don't believe this is because he wasn't on the breast enough, or because of bad attachment (I did have an LC come out to the house) - he was feeding constantly, meanwhile I was getting more and more exhausted. Because of the PPH I was physically drained anyway, and constant BF and a screaming baby didn't help. Come day 11 and a breast pump on one boob for 20 mins could only get 10ml of colostrum out of me. By that night I had had enough. So formula it was. Oh yes, I could have persisted but I didn't. I am not ashamed to say that I 'gave up'. I literally felt at the time like I had nothing left to give. I felt like the life was literally being sucked out of me, and I am not being melodramatic. That is how it felt. So I chose my sanity and my physical wellbeing. I did not want to martyr myself to breastfeeding. Selfish? Maybe to some, but I don't believe so.

DD #1, I had another induced birth and then PPH and my BF experience was much the same - milk didn't come in. But this time I will admit my attitude was different - I chose formula although I knew that I could have got the right help and made a real go of breastfeeding.

DD #2 and this time, my birth was fantastic - active, no drugs, no PPH. Afterwards I felt great - well as good as anyone can feel after giving birth! But again my milk didn't come in. Matilda's attachment was good, her sucking was good and she was on the boob regularly. Come day 6 and the LC comes out and says all is good, except my milk still has not come in. Up till that point I always thought it was the PPH that caused my milk to not come in, but now it seemed that it was just me, a physical thing with me that means my milk does not come in till late, if at all. I was tired. Not the same kind of tiredness as with DS and DD because I didn't have PPH but it was the kind of tiredness that comes with having a newborn, toddler and young child. I wanted to BF, I really did. While I was still pregnant, I had said that I would probably FF, but once I had given birth I found I really did want to breastfeed. But in the end I guess I didn't want it enough. With Matilda, in particular, I will wonder the most whether I might have been successful had I really tried. But I don't let myself get bogged down with that. I made my choice, that's it. And I know in the long term my worth as a mother is not based on how I fed my kids.

Anyway it's all well and good to point out a statistic such as 95% of women can and should breastfeed. All that means is that 95% of women have the physical makeup to BF. Which we all do. But as somebody has already said, there is more to breastfeeding than just having the equipment to do it. I know some women in here worked damn hard to keep breastfeeding, went through all the difficulties and persevered. Good on you. It is really great that you did that. I didn't. I could have chosen that path but I didn't and whats more I didn't want to. Maybe I chose the easy way out and I know there are some on here that will think that. That's fine, I don't mind. What you think is not going to change how I feel, or change the reality of my experience.

pebbles2820 · May 30th, 2007, 10:36 AM

I had no problems with my production, even though birth no.1 was extremely problematic. However I have alot of allergies and develop allergies quickly, became allergic to DD's saliva about 6 weeks in and so had to give up. BF DS#1 for 11months but DS#2 only 3 because I had an extremely painful infection, not mastitis, and couldn't cope. My mother Bf me but produced no milk with my brother. My BF had her daughter premmie and produced no BM, but I think her problem was that she only drank Coca Cola.

**Mikenzees mum** · May 30th, 2007, 10:36 AM

Interesting question Kelly. I wonder the same thing. We are told that 95% of women are able to bf, yet I have heard so many stories of women saying they didn't have enough milk. IRL many of my friends are in this group, and of course there are heaps here on BB too.

A bit off topic, but I saw a GP the other day who I hadn't seen before, and the topic came up about Jack's tongue-tie and how he couldn't attach until it was snipped. The GP told me that he was no expert in bfing, but that he had been told by LCs that a tongue-tie did not prevent attachment. My experience says otherwise, and I'm sure it depends on the degree of the tongue-tie. But if the LCs don't know, what hope is there for everyone else.

With the tingue ie i completly agree at does depend on the severity of the tongue tie kenzees was really tight she actulay looked like she had no tongue it didnt lift up at all and she couldnt suck on breat or botle

**BellyBelly** · May 30th, 2007, 10:37 AM

Sorry, I didn't want to offend anyone... I just was curious to know if the advice was coming from friends, family, experts etc.... not judging anyone. I want to make a presentations which is accurate.

**Jennifer13** · May 30th, 2007, 10:45 AM

I know there can be issues with pituary gland or thyroid function that can affect a woman's breastmilk production (either at birth or later on). Or if a woman has formerly had breast surgery (for cosmetic or medical reasons) that can also prevent milk production. I believe hormone imbalances can also affect milk production. I'm sure there are other medical reasons that I don't know about.

This would be the very small percentage of mothers that are physically unable to bf. Other women have problems with bf, for so many reasons, which then affects supply, etc, etc, but they are physically capable of bf in that their breasts produce milk.

I too always thought women in the jungle manage to do it. Only I used to think, if I had a baby a hundred years ago I would have learnt how to bf because there was no alternative!

**MelH** · May 30th, 2007, 10:49 AM

Melanie, just wanted to say that it sounds like I had much the same experience as you. DS had tongue-tie. Pead and midwives said it wouldn't effect breast feeding and the pead wouldn't snip it either. It isn't the done thing now (2003) as it isn't required - according to him. I believed them and perservered with breast feeding for 6 weeks. DS seemed to latch on ok and would feed for an hour and come off screaming for more. I hired a private lactation consultant since my hospital couldn't see me for two weeks to help. She confirmed I was doing everything correctly and gave me tips to build my milk supply. I started feeding 2 hourly and expressing inbetween. My milk did seem to increase somewhat but DS just didn't seem to be able to get it. This lead to mastitis and having to massage out lumps after every feed. I also tried the ABA - who I think I had bad luck with. I got someone on the phone who was incredibly rude and nasty to me and basically told me I was being a bad mother. I ended up just hanging up in tears and didn't try them again.

DS started losing weight and was very unhappy and had a very unhappy Mummy. At no point was I encouraged to give formula (quite the opposite) but I truely believe the tongue-tie impacted the feeding and therefore my supply of milk. I also had nipple blanching which when I rang the ABA they had never heard of and my private LC had also never heard of. I was in constant pain between the feeds due to this and dreaded the next feed knowing it would start again. Maybe this was due to DS not attaching properly due to tongue-tie. I never really found out. The LC also measured DS before and after a feed to try and determine if he was getting milk - and he wasn't.

After six weeks I made the decision to give formula feeds. It was a decision I did not take lightly and I cried for days. I still breast fed twice a day until DS stopped at 5 months. I always hoped he got something from those feeds. At 3 months we found a pead who snipped the tongue tie for us. I guess I will never know the exact problem and neither did any of the many people I went to for help. I have since had comments such as "you didn't try hard enough", etc. Maybe not. I did everything I could do at the time and chose my sanity and a happy baby instead. Had there been signs of improvement I might have also perservered but something just wasn't right and no-one could help. It has taken me 3 years to come to peace with my decision but looking back seeing what a happy thriving baby I got once he wasn't hungry I think I made the best decision for us and I would do the same again.

In a couple of weeks time I will try my best to feed this next baby and see what happens. I think there is definately a lack of support and lots of contradicting information given to new Mums. I couldn't get any free support at all after leaving the hospital. Luckily we could afford a private LC which was not cheap (we were living on Sydney's lower north shore at the time). Even then she was not able to answer many of my questions and her advice was much the same as I had been able to find on the Internet myself. Anyway, that is my story and I have my fingers crossed I don't have a repeat of it. I will seek help again next time if I have problems and I will try for a period of time. I won't let it take over my life though and impact on me being able to enjoy my baby and have time with DS.

**bon** · May 30th, 2007, 11:03 AM

I wasn't offended - sorry I came on a bit strong. I was just trying to make the point that, with me, there was the physical side of it (milk not coming in - as confirmed by LC) and also the emotional side. I didn't mean to come across as defensive, but I guess I did!

***becstar*** · May 30th, 2007, 12:14 PM

I'm totally with you Bon, all the way! Couldnt have said it better myself.

I was told by midwives and the LC that my milk hadn't come in yet....not that I had none. After 5 days it was enough for me. I decided that I coudn't keep on persevering so I was the one who ulimately decided I had no milk.

**expat** · May 31st, 2007, 03:39 AM

So for the percentage of women with thyroid or pituitary issues, is it safe to give them meds or even just straight synthetic prolactin or thyroxin to boost supply?

I can only say that in my situation, I have a pituitary adenoma which caused me to start lactating about a decade ago....quite disconserting at the time! -Now, I have a massive over supply due to all the extra prolactin in my system!

We had a hard time starting to BF all the same as Logan had low blood sugar and was a sleepy baby for his first few days of life. On a few occasions in his first few days he went 6-8 hours without a feed just because he didn't ask for it and when we tried to make him take the boob, he'd rather sleep than suck. On top of that I was swollen up to what I'd say was at least an H-cup (settled on G now) and that coupled with small nipples gave the poor kid nothing to grab hold of. On top of THAT was the most unbelievable pain from my poor ducts being stretched out. On 2 occasions I was actually crying with pain whilst feeding him. I ended up hand expressing and syringing milk into the side of his mouth for the first few days and now we use a shield to help us out.

I was determined to keep going and persevere but I can totally understand how a less strong willed woman would find it all too hard and go for the formula.

I think Formula is not seen as an option for when you really, really can't feed but as just the other alternative to boob and that makes a lot more woman say that they 'can't' physiologically, when actually it's more about will.

paradise lost · May 31st, 2007, 05:50 AM

I think if formula was available on prescription only the medical system would be FORCED to do better at helping Mums BF. It seems so often midwives/LC's are giving out bogus advice, and i recently found out that the woman who did my own BFing class was a CBE with an NC (national certificate), not a midwife, nurse, doctor or LC! Having said that, everyone but me at that class was going to "try" breastfeeding and had a very "well i showed up, now convince me" attitude, so maybe the converted all go to a private LC class instead.

Having said that, if formula suddenly became prescription-only it would be a choice taken away, rather than better care for those who choose to BF... Toughie to solve really. It's all stick and no carrot.

Hana

**Liz** · May 31st, 2007, 09:38 AM

I think it should be prescription only, simply because its a complete artificial meal replacement. I believe there are actually meal replacements for adults, often used in paliative care (correct me if I'm wrong) but none of us would just go and buy that off the shelf at the supermarket and drink only that. It's available only via professional advice and prescription.

Being the entire diet replacement for a new baby, I reckon formula should only be accessed via professional advice too. Not just at the supermarket where the manufacturers can mislead with all their labelling etc.

This doesn't necessarily take away choice, if you rock up to a health professional telling them you refuse to breastfeed any longer, well, they're not going to let the baby starve.. you'd still have access to formula.

**bon** · May 31st, 2007, 10:23 AM

I don't think making formula prescription only would force health professionals to do better at helping mums breastfeed - for me, for example, all I would have had to do would be to go to the doctor, tell her I don't want to breastfeed anymore for these reasons and get my prescription. Perhaps she might offer me extra help, but all I would have to say is 'no thankyou I would rather just get the formula' and that would be it. A doctor/CHN/LC cannot force me to get extra help with breastfeeding if I don't want it.

Perhaps having to make the effort to actually go to the doctor might put some women off and thus encourage them to persevere with breastfeeding, but at the same time when you first have a baby you usually have to see your GP within the first week or few weeks anyway. And you could even get your prescription while still in hospital if you decided to FF - so it really is not going to make formula harder to access, just more inconvenient.

**Trillian** · May 31st, 2007, 11:00 AM

I don't think that is should be made available only on prescription purely for logistics. Have you ever lived in a small country town with no Dr and no Chemist? I am over 40kms from the nearest town with a Dr and a chemist and 30km from a town with only a Dr and no chemist so for those of us in rural areas it would be impractacle.

Not to say that it isn't a good idea, just that it isn't suited to everywhere.

And we struggle with access to LC's too - the closest one to me is 80km away and 40km away they have only started ABA meetings after a 20yr hiatus, but only with 2 counsellors and not certified LC's. So for a desperate mum trying to keep her BF going, she really does have to battle. It's not as easy as just going to a clinic or day stay place (the nearest one of those is in Canberra). Some hospitals will let you go there for the day, but only if they have the room.

**Impatient** · May 31st, 2007, 11:06 AM

If formula had been prescription only I would have killed myself before I got to the doctor.

Remember, new mothers especially are going through a tough time already, without the added stress of not having a substitute available if there are problems with BF.

I think the mortality rates of babies would go up if that was the case too. I know it sounds horrible, but when I had DD#1, I had a horrible husband who was no support, I had no milk (feeding 12 times a day and starving all the time and losing weight), was in an amazing amount of pain with sore and cracked nipples. If I didn't have a tin of formula handy when I did (late one night), then I don't know what I would have done. There were several times where I had to just close her door and walk away as I didn't trust myself to hold her when she was screaming (most likely with hunger). Some mothers would not be able to exercise self control when they're at the end of the rope.

I had a MUCH happier baby after giving her first bottle and I didn't look back.

I know breast is supposed to be best nutritionally, but sometimes it's not best emotionally (for both mother and baby) and I know my daughter has not suffered at all.

**~breeze~** · May 31st, 2007, 11:33 AM

Well my story of not being able to breast feed is short & sweet lol

I had a breast reduction in 2003 & as a result the doctor damaged my milk ducts (he told me before the op that he does a number of these ops EVERY day for the past 10 years or so & has never damaged any milk ducts or had a patient not be able to BF after having one, but there is always the slight chance they may get damaged) Well guess what, he either lied to get me to have the op or there are other woman out there he operated on who can't breastfeed either (being able to BF was my biggest question, I may have put up with the health probs if I knew there was a bigger risk of not being able to BF)

Anyway I cant turn back time & my health & back have been dramatically better since having the op. I will again try to breastfeed with my next baby... & after hearing alot from other BF mothers in here I will try HARDER next time as I admit I didnt try too hard last time as the midwife told me straight out "your babys not getting milk, I suggest fully putting her on formula before you leave the hospital"

If I can BF next time it will be great but if I cant I'm not worried as DD is a very healthy 2 yr old & has a couple of friends her age who were BF (one for 6 months & one for a year) who have health probs, so I don't think it all comes down to whether the baby is BF or FF (I don't mean that as an attack on anyone, it sounds harsh but I cant think of the right words to use sorry)

Good luck to anyone trying to BF

**Phoenix** · May 31st, 2007, 11:42 AM

I don't think formula on prescription is going to work until the BF rates in Australia are higher and society is more BF friendly. Prescription only works very well in Pupua New Guinea (sorry for spelling) because there is support and information and the majority of women do BF(something like over 90%). If you make formula prescription only before the basics to ensuring BF has the best chance of working then there will be an increase of 1) mothers using poor substitutes like they used to and like they do in some 3rd world countries (condensed milk, powdered milk or just plain cows milk) 2) mothers going to the Dr while pregnant to get a prescription 'just in case'.
There is huge problems happening in the UK at the moment because the goverment and health professionals are pushing BF BF BF at all costs but there is little support and no education amongst health professionals on how best to help mothers. They have the best intentions but I hope the same thing doesn't happen in Australia. They need to educate Drs and nurses and midwives, and educate society because by doing that the mothers will be educated and supported and the BF rates will go up without the mothers and babies having to suffer.

**Liz** · May 31st, 2007, 02:42 PM

I don't think formula on prescription is going to work until the BF rates in Australia are higher and society is more BF friendly.

Very true.

paradise lost · May 31st, 2007, 07:30 PM

Yeah, this is all true - i was just thinking out loud about the prescription only thing - i didn't know other countries did it, makes you think though!

Here in the UK there IS a big drive to get more in line with WHO BF guidelines. Formula and the problems associated with not BFing (ear infections, more colds, weaker immune systems to begin with etc.) cost our NHS money - that's why they're pushing it, for the same reason they've banned smoking in public places and are considering adding extra VAT on high-calorie junk foods. It costs us all money to treat things which were preventable so the government is out to save save save wherever it can (so it can spend it on "defence" makes me SICK!).

I think the scenario with healthcare folks is changing slowly - i had a homebirth but a pretty good breastfeeding workshop (with weighted dolls to show us various "holds" for feeding, lots of videos and a real live mumma and baby we could sit with to see a good latch) was made available (and free) and my midwives stayed after delivery until DD had fed and left me with a phone number for a 24-hour hotline to an LLL counsellor should i need it. They were in my house every day for 10 days too and always stayed until they'd seen DD feed to make sure we were doing ok. The support is coming, it just takes time.

I think the main problem is that women who are determined to FF from the start feel bullied because midwives are instructed to question the decision, but this usually gets done after birth when Baby is hungry and mum is exhausted - it'd be much better to have this discussed earlier. THere was a box on my antenatal book for "Feeding discussed". The midwife said "are you going to breastfeed?" i said "yeah" and she ticked the box! That was it! No advice or anything - luckily the next week i had a different MW and was a bit swollen (water retention) and she sent me to the BFing workshop to get me the afternoon off work so i could rest. There were a few very supportive midwives, a few paying lip-service and a few who obviously didn't care at all either way. Most of the women i know who didn't want to try BFing at all had a friend or relative who tried and failed and that put them off, or a previously BF child who had problems which put them off. So changing their mind or helping them re-think their decision when they already have a hungry newborn in their arms is madness!

B

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