You were really hoping to breastfeed. You’ve read all the books, gathered all the tips at your prenatal class, and chatted with your friends about their experiences with their babies. We are often told stories about how the labour came “easily” or was more of a struggle, but we don’t often hear the particulars about how breastfeeding can be challenging much beyond the remark, “Oh, I couldn’t breastfeed.” Breastfeeding is a skill. For a first-time mama, it’s something you have never done before, and you can’t really practice without your baby being born. Creating your village of supporters—friends, doulas, and lactation consultants, to name a few—is the first step in any breastfeeding journey. With encouragement and information from your “BF” community, there are ways to navigate the complications, obstacles, and indeed, sometimes the defeats, of breastfeeding.
The causes of breastfeeding difficulty
Count yourself in good company if breastfeeding doesn’t happen for you and find comfort in the fact that there are many reasons for it, stemming from a variety of issues.
Baby
Most babies can breastfeed or take breast milk. Even infants who have physical difficulties such as Down syndrome, cleft lip/palate, or were born very prematurely can usually take pumped milk and eventually go on to feed successfully. However, a few rare conditions may curtail it:
Classic galactosemia
The body cannot break down the galactose element of lactose, the main sugar in breast milk.
Phenylketonuria (PKU)
Baby can’t break down phenylalanine, an amino acid.
Maple syrup urine disease (MSUD)
Baby can’t break down the amino acids leucine, isoleucine, and valine.
These can have serious consequences if not controlled, but in milder instances, breastfeeding partially may be possible if monitored closely by a health professional.
Adoption
Most people assume adoption means you can’t breastfeed (unless you’re already lactating because you’re still nursing a child you gave birth to). But, in some cases, it’s actually possible to induce lactation. Though it’s uncommon to be able to nourish your baby exclusively via breastfeeding if you haven’t recently given birth, many benefits can still be reaped from nursing even just a little bit.
Trans or non-binary parents
Like adoptive parents, trans and non-binary people can experience a range of breastfeeding capacity. For example, top surgery may interfere with milk-making tissue and testosterone can impede production. However, if there are obstacles, it is possible to overcome many to some degree. Also important to note is that some trans and non-binary parents may experience gender dysphoria when confronted with the notion of breastfeeding and may choose to suppress lactation with medication.
Physical
There may be a structural reason that breastfeeding doesn’t work. Breast reduction surgery often fails to preserve milk production tissue. Breast enhancement or implant surgery can also interfere depending on the reason for the surgery and the location of the incisions and implants. Hypoplasia or IGT (insufficient glandular tissue), when mammary tissue and glands don’t develop adequately, may make breastfeeding unlikely or impossible.
Medical
Numerous conditions may prevent or contraindicate lactation (for you and/or your baby) including heart failure, PCOS, hypothyroidism, anemia, or serious infections like tuberculosis or HIV. You should not attempt to breastfeed if you are undergoing radiation or chemotherapy or are taking antithyroid or some mood-altering medication. It should also be reconsidered if you have a chemical substance addiction that you can’t manage while you want to nurse.
Emotional
Postpartum depression or other mental health conditions may sometimes be such that breastfeeding becomes an added stressor. If so, discuss this with your healthcare practitioner as emotional well-being should always be your top priority. And although increasingly rare, your personal community may not always champion your choice to breastfeed, and indeed may make it difficult to feel comfortable and self-assured about nursing in public or even your own home. It’s paramount that you seek support and guidance to help you find solutions to external pressures you may face.
Things to try before you give up on breastfeeding
It is quite common to struggle with breastfeeding, so if this is you and you’re determined to push through, make sure a few basic things aren’t being overlooked!
Check the latch
Often, babies develop a poor latch that makes breastfeeding difficult, creates pain for the mama, and can have a negative effect on milk production. Having a professional check your latch is the first step to resolving an issue that may make all the difference in ensuring a successful nursing experience. I would also recommend using herbal remedies to promote milk production, as an abundant flow makes feeding a little easier for a newborn and may lead to a correct latch with less effort. Herbs such as fenugreek, blessed thistle, fennel, and goat’s rue have all been used with great success. Please consult with a health care professional first to confirm these herbs are safe for you and your baby.
Go skin-to-skin
There is nothing better than having your baby’s sweet skin on your chest to prompt all those wonderful oxytocin hormones that encourage milk production and increase your supply. No matter how you feed your baby, having her resting on your chest is an incomparable feeling that benefits more than just milk production. Skin-to-skin contact:
- calms and reduces stress for both of you
- helps baby cry less
- stabilizes baby's temperature, breathing rate, heart rate, and blood sugar
- promotes healing
You can’t hold your baby too much, and partners and siblings also benefit from cuddle time too!
From breastfeeding to best feeding
Sometimes, despite all efforts, breastfeeding must be granted the space to look differently than planned.
Pump to bottle
Some women have a plentiful supply of milk, but even with all the lactation support, their baby just won’t latch. Being able to pump milk and feed your baby from a bottle can be an equally beautiful experience that can then be shared by family members and friends.
Milk donor
There are lots of women who graciously share their milk, so looking at local milk banks could be an option for babies who need human milk. Check with your local hospitals to find out more about receiving breast milk or even being a donor.
Fed is best
Remember that your job as a parent is to take care of your baby and that looks different for everyone. As is the case in many parenting adventures, often how we expected things to go got turned upside down and we need to accept, reframe, and roll with it. As long as your baby is lovingly connected to you, there is no “right” way to feed him. A fed baby is a happy and healthy baby.
Navigating new parenthood can be exhausting. What we think should come naturally is frequently deeply challenging. While some mamas breastfeed their babies for years, others have an equally beautiful experience feeding them with a bottle from day one. Whether it was an effortless choice or a decision that was made for you, there is room to embrace every unique family journey, including how little ones are fed. Practice the art of saying yes to help from your friends, family, and caregivers. Forgiving yourself, relaxing about “imperfect” outcomes, and having a supportive community makes being a new parent way more fun.
