Tag Archives: bottle feeding

1. Pregnancy & Birth, 2. The Infant

World Breastfeeding Week 2014: Parent Support Deserts in the USA

Leave a comment

By Rita Brhel, Editor of Attached Family magazine, API’s Publications Coordinator

World Breastfeeding Week 2014What this year’s celebration of World Breastfeeding Week is really about—more than updating the status on breastfeeding acceptance or increasing understanding for mothers who are unable to breastfeed—is advocacy for parent support.

While the primary goal of Attachment Parenting International (API) is to raise awareness of the importance of a secure parent-child attachment, the organization’s overarching strategy is to provide research-backed information in an environment of respect, empathy and compassion in order to support parents in making decisions for their families and to create support environments in their communities. API extends beyond attachment education, also promoting the best practices in all aspects of parenting from pregnancy and childbirth to infant feeding and nurturing touch to sleep and discipline to personal balance and self-improvement through such innovative programs as API Support Groups, the API Reads book club and the Journal of Attachment Parenting, just to name a few.

API is a parent support organization made up of parents located around the world with a deep desire to support other parents.

Parent Support Deserts

In this spirit, API created the Parent Support Deserts project through which we mapped gaps in local parent support opportunities specific to Attachment Parenting (AP). The goals of this multi-layered project are to identify communities, regions and nations in need of conscious-minded parent support and to encourage collaboration among like-minded organizations to address these gaps.

The first part of the project was identifying key nations of the world that we feel would ideally have organized, like-minded parent support options available. We focused on developed countries, because societal advance encourages separation from the natural world, including biologically instinctual ways of living and relating to one another, as is reflected in family structure and mainstream parenting philosophies. Industrialized nations lead the world in ideas and developing, and less-industrialized and underdeveloped nations tend look to these societies for guidance. We used the World Bank’s list of Developed Countries and Territories. All of the nations included in the project are defined as high-income economies as determined by Gross National Product, per-capita income, level of industrialization, widespread technological infrastructure and high standards of living.

The second part of the project was identifying key parent support organizations. We were looking for representative organizations with local support groups or classes with an approach to parent support that closely matches that of API—advocating for conscious, informed parenting choices that challenge the status quo:

  • Attachment Parenting International
  • Babywearing International
  • Holistic Moms Network
  • International Association of Infant Massage
  • International Cesarean Awareness Network
  • La Leche League International
  • Pathways Connect

API recognizes that there are myriad local parent support opportunities in many communities that are not affiliated with these key parent support organizations, such as peer counselors, professionals, groups and classes available through hospitals, clinics, faith-based organizations, schools, etc. and that some of these may be quality, AP-minded programs. We appreciate this and welcome these independent programs to nominate themselves for inclusion in the Parent Support Deserts project through rita@attachmentparenting.org.

We have a bias toward local support groups because the research validates the importance of a parenting support network. This may be provided through family, friends, coworkers and others in an informal way, but a community of like-minded parents is an empowering environment for parents learning about and growing in their parenting approach.

It is to be noted that not all communities identified as having a parent support option may have an active local support group at any one time, as some local leaders hold groups while others, depending on their own life stage or lack of interest from the community, opt not to lead a group but to remain available for one-on-one support. What was important in mapping communities was identifying those with an active parent support leader affiliated with one of the key parent support organizations who is either leading a group or class, or is available to provide support in this way should the interest from parents arise.

It is also to be noted that local support groups or classes unaffiliated with API may provide varying degrees of AP education that may or may not be aligned with API’s Eight Principles of Parenting. However, each of these representative organizations promote an environment that empowers parents in finding their own path for intentional parenting.

The third part of the project is dissecting each nation into both parent support deserts as well as oases. The first nation we are focusing on is the United States.

Future steps include cross-examining data according to risk factors such as areas with low breastfeeding rates, high infant mortality, high Cesarean rates and other aspects of public health, as well as creating maps to illustrate parent support deserts and oases, and inviting discussion among the AP community in how to address gaps in parent support.

Infant-Feeding Parent Support Deserts

Local parent support for breastfeeding has grown at an astonishing rate since La Leche League (LLL) International was founded in Illinois, USA, in 1956. LLL groups are located worldwide in nearly all developed nations as well as other less-developed countries. LLL has expanded its resources as cultures have evolved with technology and the changing roles for mothers, assisting mothers in providing breast milk to their infants whether through exclusive or partial breastfeeding or pumping as needed.

As research pours in on the benefits of breast milk and breastfeeding, evidence continues to point toward AP practices, such as using fewer interventions during childbirth, avoiding early mother-baby separation, rooming-in at the hospital, breastfeeding on demand, interpreting pre-cry hunger signals, encouraging skin-to-skin contact, room sharing, discouraging cry-it-out sleep training, helping the father in supporting the mother, and others. As a result, the vast support network that many communities now have for breastfeeding mothers—from a breastfeeding-friendly medical community to lactation consultants and peer counselors to doulas and childbirth educators and parent educators trained in lactation support—tend to direct breastfeeding mothers toward Attachment Parenting.

By contrast, there are few organized AP-minded support opportunities for mothers who are unable to or choose not to breastfeed or feed expressed breast milk. Formula-feeding parents are relatively on their own in terms of finding support that rightly points them in the direction of Attachment Parenting, as this choice or necessity to bottle-feed exclusively is seen less as part of the relationship context and more solely a nutritive option—though certainly we know, and research in sensitive responsiveness is finding, the behaviors surrounding bottle feeding are as much a part of the parent-child relationship as is breastfeeding. Unlike breastfeeding support, formula-feeding support is much less cohesive, with some information sources putting forth questionable science regarding formula versus breastfeeding benefits.

This gap in support provides an opportunity for API Support Groups and other like-minded organizations to offer acceptance, validation and support in AP practices to non-breastfeeding mothers. One program in the United States that does this is the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), putting as much attention on formula-feeding mothers as those who choose to breastfeed.

For this introductory look at the Parent Support Deserts project, we examined locations of parent support groups in terms of infant-feeding in the Attachment Parenting context. We focused on LLL for breastfeeding support and API for both breastfeeding and formula-feeding support. Specifically, we were looking at:

  • Unsupported Key Communities = Communities of 100,000 or more, or state capitals, without either an LLL or an API presence.
  • Undersupported Key Communities = Communities of 100,000 or more, or state capitals, with either an LLL or an API presence, but not both.
  • Notable Communities = Communities of any population with both an API and LLL presence as well as other Attachment Parenting-minded support.

Key communities have a population of at least 100,000 or are state capital cities, because of these communities’ population density and centrality to policymaking and lawmaking.

We recognize that families in less-populated areas are as much in need of support. The Parent Support Desert project has found that LLL’s distribution worldwide and within the United States includes both urban and rural population centers, making LLL unique among like-minded organizations. API considers LLL to be an important partner in the Attachment Parenting movement, not only because of its representative size, reach and longevity but also because the parenting support provided in addition to breastfeeding education is directly in line with that promoted by API.

While this list is in flux, following are state reports of API’s Parent Support Deserts specific to Attachment Parenting infant-feeding support in the United States as spring 2014:

Alabama

  • Undersupported Key Communities: Mobile, Montgomery (capital)
  • Notable Communities: Huntsville-Madison

Alaska

  • Undersupported Key Communities: Anchorage, Juneau (capital)

Arizona

  • Unsupported Key Communities: Chandler, Gilbert, Mesa, Peoria, Tempe, Scottsdale, Surprise
  • Undersupported Key Communities: Tucson
  • Notable Communities: Phoenix (capital)

Arkansas

  • Notable Communities: Little Rock (capital), Searcy

California

  • Unsupported Key Communities: Anaheim, Carlsbad, Chula Vista, Concord, Corona, Costa Mesa, Daly City, Downey, El Cajon, El Monte, Escondido, Fontana, Fullerton, Garden Grove, Hayward, Huntington Beach, Inglewood, Moreno Valley, Norwalk, Ontario, Palmdale, Pomona, Rancho Cucamonga, Rialto, Richmond, Riverside, Salinas, San Bernardino, Santa Clara, Santa Maria, Sunnyvale, Torrance, Vallejo, Victorville
  • Undersupported Key Communities: Bakersfield, Burbank-Glendale, Elk Grove, Fairfield, Fremont, Humboldt, Lancaster/Antelope Valley, Marin, Modesto, Oakland-Berkeley, Oceanside, Oxnard, Pasadena, Pittsburgh-Antioch, Roseville-Citrus Heights, San Jose, Santa Clarita, Santa Rosa, Simi Valley, Stockton, Temecula-Murrieta, Thousand Oaks, Tulare-Visalia, Ventura, West Covina
  • Notable Communities: Long Beach, Los Angeles, Monterey, Sacramento (capital), San Diego, San Francisco, Santa Ana/Orange County

Colorado

  • Unsupported Key Communities: Westminster
  • Undersupported Key Communities: Arvada, Aurora, Boulder, Centennial, Colorado Springs, Fort Collins, Lakewood, Pueblo, Thornton
  • Notable Communities: Denver (capital), Parker

Connecticut

  • Unsupported Key Communities: Hartford (capital), Stamford
  • Undersupported Key Communities: Bridgeport, Greenwich-Stamford, New Haven, Southington-New Britain, Waterbury

Delaware

  • Unsupported Key Communities: Dover (capital)

Florida

  • Unsupported Key Communities: Cape Coral, Coral Springs, Hialeah, Miami Gardens, Palm Bay, Pembroke Pines, Pompano Beach, Port St. Lucie, St. Petersburg
  • Undersupported Key Communities: Clearwater, Fort Lauderdale, Gainesville, Hollywood, Miami, Miramar, Orlando, Tallahassee (capital), Tampa
  • Notable Communities: Jacksonville

Georgia

  • Undersupported Key Communities: Athens, Augusta, Columbus, Savannah
  • Notable Communities: Atlanta (capital)

Hawaii

  • Undersupported Key Communities: Honolulu (capital)

Idaho

  • Undersupported Key Communities: Boise (capital)

Illinois

  • Unsupported Key Communities: Elgin, Joliet
  • Undersupported Key Communities: Aurora-Montgomery-Oswego, Peoria, Rockford, Springfield (capital)
  • Notable Communities: Chicago, Naperville

Indiana

  • Undersupported Key Communities: Evansville, Fort Wayne, Indianapolis (capital), South Bend

Iowa

  • Unsupported Key Communities: Cedar Rapids
  • Undersupported Key Communities: Cedar Falls-Waterloo, Quad Cities
  • Notable Communities: Des Moines (capital)

Kansas

  • Unsupported Key Communities: Olathe, Overland Park, Wichita
  • Undersupported Key Communities: Kansa City, Lenexa-Shawnee

Kentucky

  • Unsupported Key Communities: Frankfort (capital)
  • Undersupported Key Communities: Lexington
  • Notable Communities: Louisville

Louisiana

  • Unsupported Key Communities: Shreveport
  • Undersupported Key Communities: Baton Rouge (capital), Lafayette, New Orleans

Maine

  • Unsupported Key Communities: Augusta (capital)

Maryland

  • Undersupported Key Communities: Annapolis (capital), Baltimore, Washington D.C. (nation’s capital)

Massachusetts

  • Unsupported Key Communities: Cambridge, Lowell
  • Undersupported Key Communities: Boston (capital), Worchester

Michigan

  • Unsupported Key Communities: Flint, Sterling Heights
  • Undersupported Key Communities: Ann Arbor, Downriver, Grand Rapids, Lansing (capital), Warren
  • Notable Communities: Detroit, Saginaw

Minnesota

  • Undersupported Key Communities: Bloomington-Richfield, Rochester
  • Notable Communities: Duluth, Minneapolis-St. Paul (capital)

Mississippi

  • Notable Communities: Jackson (capital)

 Missouri

  • Unsupported Key Communities: Independence
  • Undersupported Key Communities: Columbia, Jefferson City (capital), Kansas City, Springfield
  • Notable Communities: St. Louis

Montana

  • Undersupported Key Communities: Billings, Helena (capital)

Nebraska

  • Undersupported Key Communities: Omaha
  • Notable Communities: Lincoln (capital)

Nevada

  • Unsupported Key Communities: Carson City (capital), Henderson, Reno
  • Notable Communities: Las Vegas

New Hampshire

  • Unsupported Key Communities: Manchester/Merrimack Valley
  • Undersupported Key Communities: Concord (capital)

 New Jersey

  • Unsupported Key Communities: Elizabeth, Patterson
  • Undersupported Key Communities: Trenton (capital)

New Mexico

  • Undersupported Key Communities: Albuquerque, Las Cruces, Santa Fe (capital)

New York

  • Unsupported Key Communities: Oyster Bay, Yonkers
  • Undersupported Key Communities: Albany (capital), Bronx, Brooklyn, Buffalo, New York City, Queens, Rochester, Staten Island, Syracuse
  • Notable Communities: Long Island, Manhattan

North Carolina

  • Undersupported Key Communities: Cary, Charlotte, Durham, Fayetteville, Greensboro, High Point, Raleigh (capital), Wilmington, Winston-Salem
  • Notable Communities: Greenville

North Dakota

  • Undersupported Key Communities: Bismarck (capital), Fargo

Ohio

  • Undersupported Key Communities: Akron, Cincinnati, Cleveland, Columbus (capital), Dayton, Toledo

 Oklahoma

  • Unsupported Key Communities: Broken Arrow
  • Undersupported Key Communities: Norman, Oklahoma City (capital), Tulsa

Oregon

  • Undersupported Key Communities: Eugene-Springfield, Gresham, Salem (capital)
  • Notable Communities: Portland

Pennsylvania

  • Unsupported Key Communities: Allentown
  • Undersupported Key Communities: Erie, Harrisburg (capital), Philadelphia
  • Notable Communities: Pittsburgh

Rhode Island

  • Undersupported Key Communities: Providence (capital)

South Carolina

  • Undersupported Key Communities: Charleston, Columbia (capital), Grand Strand

South Dakota

  • Unsupported Key Communities: Pierre (capital), Sioux Falls

Tennessee

  • Undersupported Key Communities: Chattanooga, Clarksville, Memphis, Murfreesboro
  • Notable Communities: Knoxville, Nashville (capital)

Texas

  • Unsupported Key Communities: Abilene, Beaumont, Brownsville, Carrollton, Grand Prairie, Laredo, Mesquite, Midland, Odessa, Richardson, Round Rock
  • Undersupported Key Communities: Amarillo, Arlington, Bryan-College Station, Corpus Christi, Dallas, Denton, El Paso, Fort Worth, Garland, Irving, Killeen, Lubbock, McAllen, Pasadena, Plano, Waco, Wichita Falls
  • Notable Communities: Austin (capital), Houston, McKinney, San Antonio

Utah

  • Unsupported Key Communities: Provo, West Valley City
  • Undersupported Key Communities: Salt Lake City (capital), West Jordan

Vermont

  • Undersupported Key Communities: Montpelier (capital)

Virginia

  • Unsupported Key Communities: Hampton, Newport News
  • Undersupported Key Communities: Alexandria-Arlington County, Chesapeake, Norfolk, Richmond (capital), Virginia Beach
  • Notable Communities: Fredericksburg

 Washington

  • Undersupported Key Communities: Bellevue, Everett, Kennewick-Pasco-Richland, Kent, Olympia (capital), Seattle, Spokane, Tacoma, Vancouver
  • Notable Communities: Port Angeles

West Virginia

  • Undersupported Key Communities: Charleston (capital)

Wisconsin

  • Undersupported Key Communities: Kenosha, Madison (capital), Milwaukee
  • Notable Communities: Green Bay, Oshkosh

Wyoming

  • Undersupported Key Communities: Cheyenne (capital)
You can read more in the double "Voices of Breastfeeding" issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members--and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.
You can read more in the double “Voices of Breastfeeding” issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members–and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.
1. Pregnancy & Birth, 2. The Infant

World Breastfeeding Week 2014: When Breastfeeding Doesn’t Work

Leave a comment

By Lisa Lord, Assistant Editor of Attached Family magazine

World Breastfeeding Week 2014When a woman makes the choice to breastfeed, she usually doesn’t anticipate that it won’t work. After all, we are told that almost everyone can breastfeed—and this is true: Lactation is a robust biological process that almost always works.

But though there are only a few medical conditions in which breastfeeding may be limited, there are many medical circumstances that can present lactation and feeding challenges. Mothers who wean early for medical reasons or who are never able to breastfeed at all suffer a loss and may experience a spectrum of emotions that range from disappointment, frustration and anger to guilt, sadness and grief to relief and acceptance.

Editor’s Note: The description of certain medical conditions and breastfeeding recommendations contained in this article are specific to individual cases. It is not advice. Contact your health care provider for medical advice on these or other conditions. Contact an International Board-Certified Lactation Consultant (IBCLC), La Leche League (LLL) Leader or another breastfeeding specialist for more information regarding breastfeeding concerns in your individual case.

A Heartrending Choice

Kim Barbaro of Warminster, Pennsylvania, USA, faced the difficult choice of weaning when she developed a breast abscess that required surgery. Her surgeon explained that the incision would be long and deep, extending into the areola, and would remain open for some time, requiring packing twice a day.

Kim says that while her doctor gave her facts about the surgery, she was also understanding and empathetic: “She absolutely left the decision up to me,” she said. “But she didn’t just talk about the medicine; she talked about the bonding and the quality of time and being a working mom, and that really pulled me to her. It was that level of compassion and understanding that made a gigantic difference.”

“At first I was just confused, definitely torn between two worlds,” Kim added. “I think one of the biggest things for me was that bonding piece [with the baby], because it is so strong, and I didn’t want to be without it. I finally felt like my body was doing what it was supposed to do.”

In the end, Kim decided to wean: “After I started really thinking about it and took the emotional piece out, I knew there was just no way,” she said.

During her recovery, her emotions swung from grief to guilt to resignation, Kim says: “I went through a period of just sadness at that time I was feeding with a bottle. Logically I knew I made the right decision—it was not going to be possible—but emotionally it was another world. I would bounce back and forth, and just when I would get emotional, I would try and tell myself I wasn’t being realistic. You have to convince yourself and get support for that.”

When a mother must wean immediately for medical reasons, support is essential. Mairéad Murphy, IBCLC and La Leche League Leader in Dunboyne, Co. Meath, Ireland, explained: “It’s important that such moms get help on a practical level, because they may need to do some expressing to avoid engorgement and mastitis. But they also need support just to come to terms with the whole thing. It is very much a process of loss and grieving, because this portrait they had of being a mother has changed drastically.”

Kim had planned on a natural labor and birth with midwives, but she ended up with a last-minute Cesarean section. Neither Kim’s birthing experience nor her breastfeeding experience turned out as she wanted.

“I had expectations about how my birth was going to go, and it didn’t go that way,” she said. “And if you go to breastfeeding class, and they tell you all of the benefits and how it is so superior to formula, then you do feel guilty [if you can’t breastfeed]. It’s that mother nurture instinct—you just want to provide.”

When Weaning is the Only Option

It was about the time of her daughter’s first birthday when Wendy Friedlander received the devastating diagnosis that she herself had a rare form of cancer that would require her not only to wean her daughter but to live apart from her for a year while she underwent chemotherapy treatment.

“That was the hardest conversation I ever had in my life,” said Wendy, who lives in New York City, USA. “I wept three boxes of tissues. The doctor literally told me I had to give up a year of my life to save the rest. I had a week before treatment started, before I knew I would have to wean. And it wasn’t just stopping the nursing, it was everything—the babywearing, the breastfeeding, the cosleeping.”

Daytime weaning was easier than expected, as her daughter filled up on hugs and smiles instead of nursing for comfort throughout the day. However, night weaning was more traumatic. In her blog post “Weaning Early,” Wendy wrote: “The night weaning was like ripping off a Band-Aid. Where I was the Band-Aid, and just like that, I was taken away, and it was up to my daughter and her father to get through those first milk-less nights.”

With her large supply of milk, it was imperative for Wendy to continue pumping regularly because a blocked duct could turn into a life-threatening infection. It was a difficult balancing act, removing enough milk to prevent problems while at the same time trying to decrease milk production, all while she was extremely ill from treatments and living apart from her family.

“Everything else seemed so big, weaning was just an aside,” Wendy wrote. “And yet, the pain and heartbreak were tremendous.”

Education and Support are Critical

Apart from genuine contraindications to breastfeeding, there are many medical conditions and circumstances that may affect breastfeeding. With the right diagnosis, information, intervention and support, some breastfeeding may be possible if desired by the mother. Sometimes temporary weaning is needed, or a mother may need to supplement with expressed milk or formula.

Medical professionals may act as barriers to breastfeeding at times: “There are some conditions where breastfeeding is contraindicated, and it’s quite right,” Murphy said. “And there is another group of conditions where mom is told not to breastfeed, and it’s not the truth.”

This is not a condemnation of physicians, most of whom are caring individuals who have the best interests of their patients at heart. However, crushing patient loads, the critical need for good outcomes and simple lack of the most up-to-date information on lactation may lead them to make recommendations that unnecessarily compromise breastfeeding. This underscores a mother’s need for self-education and support.

Mihaela [last name withheld by request] had hepatitis B as a child but had no further problems with the condition for the rest of her teen and adult years. When she was 26 weeks pregnant, a blood test showed what her doctor called “pregnancy hepatitis.” Upon receiving this frightening news, she began having contractions. She spent the next seven weeks in the hospital on bed rest, taking medications for the hepatitis and to prevent further contractions.

“Later on, I learned that even if I had had hepatitis, the chances that the baby would have caught it were minimal,” Mihaela said. She also learned she might not have needed to take the medications she was on.

“I didn’t think to read about it myself. It’s a doctor’s responsibility, and if he doesn’t tell you and can’t self-educate, then you can’t protect yourself,” she added.

Her daughter was born at 34 weeks and was placed in an incubator almost immediately, so Mihaela didn’t have the chance to see her for several hours and didn’t hold her until the next day. Her doctor told Mihaela that she shouldn’t breastfeed because of the medications, and she was given pills to stop lactation.

“I was really sad because I imagined that I would be able to do that, but I didn’t have too much time to think about it [the doctor’s recommendation],” said Mihaela, who had assumed she might be able to begin nursing the baby after a day or two.

She and her daughter spent two weeks in the hospital, in separate rooms, until the baby was gaining weight steadily enough to go home. Looking back, she still feels regret and sadness.

“I feel it would have been much, much easier with breastfeeding,” Mihaela said. “I had moments when I was holding her, and she was close to me…breastfeeding would have complemented that.”

It was especially tough when her daughter would nuzzle her breasts, searching for a way to nurse, Mihaela said: “I would have to take her away from the proximity of the breast. It was really hard.”

Common Complications

If a mother requires medication, she may be told she shouldn’t breastfeed, advice based on resources doctors commonly use, such as the Physician’s Desk Reference or information from the drug manufacturers. According to La Leche League International (LLLI), these resources do not contain complete information about effects on breastfeeding, and very few medications are truly incompatible with breastfeeding. A more useful reference is Dr. Thomas Hale’s Medications and Mother’s Milk or LactMed, the U.S. National Institutes of Health’s Drugs and Lactation Database.

Before Wendy’s biopsy, she asked her anesthesiologist for a list of medications needed for the procedure, “and he didn’t want to give them to me, because he knew I wanted to know for myself when I could nurse my daughter again,” she said. The anesthesiologist told Wendy he would not do the procedure unless she agreed to wait 24 hours to nurse. In the end, Wendy did obtain the list of medicines and learned that she only had to wait eight hours to breastfeed.

There are a number of common conditions that generally should not hinder breastfeeding but often do.

Mastitis is an inflammation in the breast requiring frequent and thorough removal of milk, along with plenty of rest for the mother. “Empty breast, lots of rest,” recommends LLLI. Weaning is not required and may actually worsen the condition. If an antibiotic is needed, there are choices compatible with breastfeeding.

“But it’s still very common that a mother will go to her doctor with symptoms which may or may not be mastitis, and she is often told she needs antibiotics and she must wean in order to take them,” Murphy said. “Sometimes I find moms are told to wean for the duration of antibiotics, but this may be seven to 10 days, and for a very young baby, that may create difficulty getting back to the breast. Or a mother may have trouble keeping her milk supply up. Whereas if she was given the direction of getting into bed, feeding a lot, taking painkillers and so on, it may resolve quickly by itself.”

Many of the common causes of mastitis can be resolved with the help of a lactation consultant, and this is especially important if mastitis occurs more than once.

Jaundice, an excess of bilirubin in the infant’s blood, may cause him to be sleepy and less interested in eating. However, because bilirubin is excreted in stool, it’s critical for babies to continue feeding often to resolve the condition. Mothers may be encouraged to supplement with formula while continuing to breastfeed, which can interfere with milk production and baby’s interest in feeding. Rather than go down the route of giving formula, Murphy says mothers can be shown how to rouse a sleepy newborn, how to get him to take extra feeds and how to supplement if needed.

Once a mother begins supplementing with formula, she might not want to stop, because knowing the exact amount the baby is eating helps moms feel more confident, especially in the face of medical problems. It can be hard for a mother to regain trust in her ability to know that her baby is getting enough milk from breastfeeding.

“Sometimes I think with breastfeeding issues, if you could bottle confidence and give it to mom to drink, then everything would be sorted,” Murphy said. “We are so distanced from the knowledge of normal baby behavior. That lack of recognition causes a lot of problems.”

Deciding to Wean

Sometimes a mother may feel that weaning is the best option for her and her family.

“It all comes down to giving the mom information and letting her make a choice with her specific caregiver,“ Murphy said. “Lots of moms have a different path they are prepared to take with breastfeeding.”

When a mom decides to wean, a good lactation consultant or breastfeeding counselor will respect that and reassure her of the good she has done by breastfeeding up until that point.

“And it truly is good, no matter if she has breastfed for two days,” Murphy said.

Due to the stress and uncertainly caused by breastfeeding difficulties, weaning may bring great relief to an anxious mother. The day I (the author) brought my oldest son home from the hospital was the most stressful day of my life. Breastfeeding was not going well, possibly due to a related medical condition, and I was overwhelmed with worry. After well-intentioned but misguided advice from two counselors didn’t help resolve the issues, and after nine exhausting weeks of nursing, pumping and bottle feeding around the clock, I decided to wean. Though I felt tremendous grief and guilt, I was so relieved be free from the ongoing stress of breastfeeding. It was the right decision at the time—and it also fueled my determination to educate myself and get more support when my second child was born. Mothers who wean may appreciate tips on how to mother the baby in a way as close to breastfeeding as possible.

“Sometimes moms see the end of breastfeeding as the end to all that loveliness, but there are still important ways to enjoy the baby,” Murphy said.

Otherwise known as “bottle nursing,” a term coined by Attachment Parenting International founders Lysa Parker and Barbara Nicholson, authors of Attached at the Heart, mimicking breastfeeding behaviors when bottle-feeding include plenty of eye contact, snuggling at feeding times, skin-to-skin contact and feeding on demand. Mothers may also find bathing together and cosleeping helpful for establishing that initial bond with baby.

Moving On

The process of making peace with weaning is different for every mother, and regret may linger.

“I only listened to one person,” Mihaela said. “I didn’t investigate the problem too much. What I would do is read more, ask more. If I had known more about how the baby would be affected, then probably I would have made other decisions.”

Kim had a strong support network of friends with a variety of breastfeeding experiences, friends who helped her come to terms with her experience.

“You have to say to yourself: This does not make or break your relationship with your child, this is not going to be the one and only bonding thing with your child,” she said.

Now a few years past her successful treatment, Wendy said, “It was a gift in so many ways in the end.”

She says her experience improved her relationships with everyone in her life, and it also left her daughter with a huge network of adults with whom she is very close, though the relatives caring for her daughter during Wendy’s illness didn’t always adhere to the same secure attachment-minded practices that Wendy did.

“In the end, it doesn’t matter because they loved her,” she said. “When it comes to a situation where you are low on reserves and low on support, there is only so much one person can do. Your   children are getting served by love. That is the number-one thing that serves them.”

You can read more in the double "Voices of Breastfeeding" issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members--and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.
You can read more in the double “Voices of Breastfeeding” issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members–and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.