A new study from the Centers for Disease Control and Prevention shows that less than 4% of U.S. hospitals provide the full support that new mothers need to successfully breastfeed. Finally, a study that doesn't slap me with guilt.
The American Academy of Pediatrics recommends babies be fed nothing but breast milk for about the first 6 months and continue breastfeeding for at least a year. My son's pediatrician, my obstetrician, countless women and a few men -- mostly strangers -- who have no business telling me how to raise my son and, of course, the highly-paid breastfeeding specialist (I can't recall her exact title or name, but I remember every pound of propaganda she delivered without ever offering an ounce of useful advice) all extolled the virtues of this "natural" act and insisted I should do it, often citing the AAP's recommendations as dogma.
The first few weeks after Michael Alexander was born were fraught with frustration, guilt and feelings of inadequacy, all because I was having trouble doing "what's best for your baby" -- breastfeeding. I was able to eke out enough milk for about two months to keep my son healthy, but it was obvious he needed more than I could provide. I'll describe to anyone who asks privately about my painful, failed attempts at pumping. Suffice it to say the futility compounded with the constant "encouragement" to "keep trying" drove me to tears most days. It's not surprising to me that a study by researchers at the University of North Carolina at Chapel Hill published this month in the journal Obstetrics & Gynecology found "Women with negative early breastfeeding experiences were more likely to have depressive symptoms at 2 months postpartum."
A voracious consumer of medical data and studies, I was inundated with reports by experts insisting I was robbing my son of essential nutrients and future health by not lactating. My OB suggested I pay for a private lactation consultant, a service not covered by health insurance. It wasn't until I sought the free advice of La Leche League that I was offered any support from someone other than my loving husband, mother, mother-in-law and other dear family members and friends who advised me to ignore the professionals and (totally unqualified) propagandists who kept insisting "You can do it!"
A woman at La Leche, who identified herself only as Heidi D., asked me a series of medical questions, including whether I had thyroid disease or polycystic ovary syndrome. I have both Hashimoto's Disease, an autoimmune disease in which the thyroid gland is gradually destroyed by a variety of cell and antibody mediated immune processes, and PCOS. Of course, my OB is well aware of both these conditions. Heidi D. cited a study which found that a third of women with my condition can't produce any or enough breast milk. It was one month and one day after my son was born that someone, an authority even, dispensed any evidence that this lack of lactation may not be my own fault or failure.
While La Leche is obviously an advocate of breastfeeding, it's where I found an ally who understood that this "natural" act can be unnatural, even impossible, for some of us. As Heidi D. wrote me in an email on May 20, 2010: "Baby needs to eat! and if there isn't enough breast milk, formula is a heck of a lot better than kool aid :)"
It made me think back to New York-Presbyterian, where dozens of esteemed (ahem!) medical professionals who knew I suffered from a double endocrine-autoimmune affliction, never, ever suggested this might ever hinder or hamper my efforts to breast feed. That breastfeeding specialist, who came to my room at least once a day with her pep talks and pamphlets, certainly never considered my condition. What's worse, is she never showed me how to breastfeed or pump, and she certainly never suggested that I might have a problem or what I should do if my ability to be a "good mother" eluded me.
I still get angry when I think about my overall experience at New York-Presbyterian, and have since spoken to other *new* mothers who say they will never return to that hospital. I'm especially upset about that specialist whose voice I hear every time someone else drones on about the importance of breastfeeding. She repeatedly applauded my decision to breastfeed, making me feel like I had to stick with it no matter what. Even at the hospital, I suspected I wasn't producing enough for my son, as he'd suck (sorry to the squeamish) and suck for up to three hours (yes, three hours!) and still seem hungry. Not once did she or any of the other staff suggest that maybe this wasn't normal, despite telling me that he "should be satisfied in 20 minutes."
Of course I am still bitter about this experience, but I am relieved to see my son is strong and healthy, consistently growing at the same rate (97th percentile for height and 75th percentile for weight.) And my long, lean son is happy! He's been happy since I introduced him to formula at two months and whole foods at about six months and organic cow's milk at 10 months.
It's not often that I'll give props to a government agency, but thank you, CDC, for recognizing that maybe mothers aren't to blame for all breastfeeding blunders. The CDC concluded that: "Unfortunately, most U.S. hospitals do not fully support breastfeeding; they should do more to make sure mothers can start and continue breastfeeding." I was shocked that New York-Presbyterian (ranked No. 1 overall in New York and No. 10 nationally in gynecology by U.S. News & World Report) offered me no practical breastfeeding advice and no support when I clearly under-produced. The CDC Vital Signs report released this month says hospitals should: "Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants." I was separated from Michael Alexander for what seemed like an eternity after giving birth by an unplanned C-section which I was told was medically necessary. He latched on immediately in the recovery room, but once we made it to our own private room (a topic for a future post) the only instruction I was given was on how to hold my son while he fed. I just wish I didn't latch on to all the bad advice I was given.
I can finally accept that I may not be evil for not being able to breastfeed my son for as long as the AAP recommends. As George Bernard Shaw famously, said: "Even mother's milk nourishes murderers as well as heroes.” Maybe I should have turned to a Nobel Prize winner for advice earlier.
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