Breast is... Best? Why It's Not That Simple

August 1-7 2023 is World Breastfeeding Week, and this year the focus is on helping women overcome the barriers to breastfeeding, especially in the workplace.

By now, most of us are aware of the benefits of breastfeeding, but it’s still worth taking a moment to acknowledge how truly miraculous the female body is, in creating nourishment individually tailored to the baby we have birthed (based on the baby’s saliva, which is absorbed into our bodies through the skin, our body assesses what’s going on for the baby – such as, if it has an infection – and changes our breastmilk accordingly. How incredible is that?!).

While the benefits to baby may be well-known (such as that breastfeeding helps reduce ear infection, reduces the chance of the baby developing high cholesterol as an adult, reduces the risk of infectious disease, and increases the efficacy of vaccines), fewer women are aware that breastfeeding benefits the woman, too. For example, breastfeeding reduces the risk of osteoporosis, cancer, haemorrhage and stress, it increases bonding with the baby, it helps to space out pregnancies (which is better for the mother’s health), it helps with weight loss in the first 6 weeks postpartum, it’s cheaper and it’s environmentally-friendly.

While formula milk contains proteins, fats, carbohydrates, vitamins and minerals that are present in breastmilk, there are additional important factors that are unique to breastmilk, such as certain enzymes, growth factors, hormones that help the baby sleep (as babies don’t have a circadian rhythm for the first 3 months), antibodies, antiviral factors, antiproteases, oligosaccharides, probiotics, nucleotides, anti-parasitic factors, stem cells, and hamlet cells.

Ok, so we know that, ideally, ‘breast is best’, but then why are fewer than 50% of under 6-month-olds exclusively breastfed?

Clearly, education is not the only factor, and it’s all well-and-good saying that we should breastfeed, but it’s much more difficult and complex to actually implement.

So, what are the most common challenges to breastfeeding?

#1 Sore and damaged nipples

If this occurs, one of the first things to check for is that the baby has latched properly. For a good latch, try to bring the baby to the nipple, rather than the other way around. If the breast still feels firm after feeding this might be a sign there wasn’t a good latch. If you’re not sure, please seek out a qualified lactation consultant who can advise on getting a good latch.

For sore and damaged nipples, it's also important to allow the nipples to breathe as much as possible. Finally, it’s worth checking for other possible symptoms, such as thrush, or whether the baby has tongue-tie.

#2 Too much milk

If there is ‘forceful/overactive letdown’, you can try the ‘scissors’ hold of the breast to restrict the milk flow, or try placing the baby in biological or side-lying hold for breastfeeding.

#3 Not enough milk

Often this is more about the perception of the woman breastfeeding, rather than reality; many women experience anxiety that they can’t produce enough milk.

The first thing to check would be whether the latch is good, and, if you still feel there is too little milk, seek the guidance of a lactation consultant, who may be able to recommend certain galactagogues (herbs that increase milk production) or other tips and support.

#4 Blocked duct

For a plugged duct you can try applying a heat compress or using a massage ball (gently) on the breast (both also help with very hard breasts). You can also try vibration against the duct or resting the baby’s chin on the duct during feeding.

#5 Premature baby

For a premature baby, it’s recommended that the mother pump every 3-4 hours if she’s not able to start breastfeeding from the beginning (pumping between 1am and 5am is seen as the most important!).

Social and cultural barriers

The above challenges are common physical reasons why women may struggle with breastfeeding, but what about social barriers?

Many women are expected (or wish) to go back to work mere weeks after giving birth, and most companies do not provide adequate facilities or policies for women breastfeeding, nor do many women have access to childcare or other postnatal support.

This is what 2023’s World Breastfeeding Week seeks to highlight; that we need national laws in place that protect women’s right to breastfeed, if they choose to, as well as better support systems for women such as free local workshops and classes, access to (for example) lactation consultants, free or heavily reduced childcare, and supportive, inclusive employers who factor in places and protected time for women to safely and comfortably pump or breastfeed.

None of this can be achieved by us individually, but hopefully, as a collective, we can place pressure on our institutions to make change; in the meantime, supporting each other as best we can.

If you are struggling with any of these issues please seek support in the first instance, as you shouldn’t have to go through this alone.

If you’re having trouble with a physical challenge to breastfeeding, please seek out a lactation consultant or get in touch with La Leche League who can further advise you (they can also help with informing you about your legal rights if you are returning to paid employment).

Have you experienced any of these challenges to breastfeeding? Do you have any tips on how we can achieve social change in this area? Please let us know in the comments below!