The Realities of Breastfeeding

The majority of new parents in the United States intend to breastfeed. The health benefits of breastfeeding are well known and many parents long to have a breastfeeding relationship with their babies, but many are surprised by unexpected challenges in the early days that can be discouraging. Although breastfeeding is the "natural" way we are intended to feed our infants, that does not mean it is easy! In our "natural" state, new parents were surrounded by a village of community support in the postpartum period, and generations of experienced nursers were close by at all times to help. In modern times the majority of us do not have that kind of support, so we have to create the village for ourselves.

So what is breastfeeding really like?

  1. You will be exhausted: Newborns need to feed at least every 2-3 hours, including overnight. Part of establishing a healthy milk supply is making sure you are emptying your breasts frequently was well (at least 10-12 times per day in the newborn period), so this means the breastfeeding parent is waking up a lot overnight for these feeds. Get support from others to rest when you can during the day to make up for lost sleep overnight. "Sleeping through the night" is a goal of many parents, but truthfully most babies (breastfed or not!) do not sleep through the night until they are at least 6 months, and often not until they are over a year old.

  2. You will count diapers and celebrate poop: Counting wet and dirty diapers is an important way to make sure your baby is getting enough to eat in the early days while your milk is coming in. The change from black sticky meconium just after birth to yellow, seedy, loose bowel movements is one sign that your baby is getting enough milk and their bowels are working normally.

  3. You might feel obsessed with your baby's intake and weight: Because it is harder to quantify exactly how many ounces your baby takes in when they breastfeed, some parents become very anxious about making sure their baby is getting enough milk. This is especially true if there are initial difficulties with breastfeeding such as pain or poor infant weight gain. Postpartum mood disorders such as postpartum anxiety and depression can make this feel even more overwhelming. Getting as much help, support, and rest as possible is important. If you are feeling overwhelmed with worry, reach out to your doctor or midwife right away so that you can get the mental health support you need.

  4. You might feel like you no longer have control of your own body: Sometimes it can feel like you are constantly breastfeeding and have little time for yourself. "Cluster feeding" is common in many babies in the evenings- in these periods babies sometimes feed every hours for the last few hours of the night. This helps to stimulate milk supply and allows baby to fill up before a longer stretch of sleep and during growth spurts. Many breastfeeding parents describe feeling "touched out" after so much contact with their babies and feel less interested in intimacy with their partners.

  5. It is NOT free: One of my least favorite "benefits of breastfeeding" that is often claimed at hospital breastfeeding classes is that "breastfeeding is free." Nothing could be further from the truth! A new parent's time and effort has value and there are many sacrifices that breastfeeding parents make to provide breastmilk to their children. On top of that, many breastfeeding parents have to pay for various "gadgets" to support their breastfeeding relationship, especially if they are having difficulty or are separated from the baby early on, or if returning to work outside the home. These can include pumping/nursing bras, various breast pumps and parts, coolers with ice packs, breastfeeding/pumping-friendly clothing, bottles, etc. Lactation support is supposed to be covered by insurance companies, but in many cases the support that is covered is just basic counseling, not professional lactation consults. Parents who are having breastfeeding difficulties often choose to pay for additional support from a lactation professional to help them succeed with breastfeeding, and this additional support may be only partially reimbursed or not covered at all.

  6. It should NOT hurt: Mild discomfort while adjusting to nursing is common, but pain and nipple damage usually mean there is a problem with the latch that needs to be addressed. Often, some positioning adjustments can make a huge difference in improving the latch and eliminating pain. This website has some excellent resources and videos on how to get a good latch. Many new parents think that pain is normal and will try to nurse through the pain, leading to nipple damage, infections, and even poor weight gain in the baby or low milk supply. If you are having pain with breastfeeding- seek help from a lactation professional as soon as possible to prevent bigger problems down the line.

Despite some of these unpleasant realities, breastfeeding can be incredibly rewarding. In many cases, early difficulties can be overcome with support from family, friends, and a lactation professional. If you are struggling with breastfeeding and would like support, we would love to help! Please reach out to schedule a lactation consult. If you are an expecting parent and would like additional guidance to help prepare for breastfeeding now as well as high-level support throughout the postpartum period, we also offer a 4th trimester package that includes a prenatal consult, in-home lactation consults postpartum, as well as all the virtual support you need throughout the 4th trimester.

Dr. Rebecca Berens

Dr. Rebecca Berens is a board-certified Family Medicine Physician and International Board Certified Lactation Consultant (IBCLC) with expertise in Women's Health and Breastfeeding Medicine.

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