“There is a breastfeeding solution for every breastfeeding problem.”
I don’t know where this phrase originated (perhaps Nancy Mohrbacher?) but it seems to have established itself in our collective consciousness over the last number of years. When I first entered private practice I believed it to be true and that all that was required to ‘fix’ a breastfeeding problem was obtaining the right support in order to find the right solution.
The above phrase sounds good doesn’t it? It’s logical. And in a black and white world where everything is straightforward, it could be easily applied. But humans are complex, and mother-infants dyads even more complex as two humans are involved. Sometimes breastfeeding can be very challenging for a myriad of reasons. For the most part, these problems can be overcome with skilled help and support. But sometimes, there isn’t a solution to a breastfeeding problem. This might be a controversial statement, because we want to be able to tell women that everyone can breastfeed, or least 98.5% can. But I have to say honestly that in my experience in private practice, where you see the most challenging cases, we don’t always achieve the desired outcome and a ‘solution’ that the mother is happy with.
So the phrase “There is a breastfeeding solution for every breastfeeding problem.” doesn’t sit well with me, and I feel that to some extent it diminishes the difficult experience of some women who have given all they can give to making breastfeeding work, and yet haven’t quite found the solution they were hoping for.
I have worked with some women who have a condition called Insufficient Glandular Tissue, whereby the breasts don’t have enough glandular tissue (ie the part of the breast that contains milk producing glands) to make all of the milk that their baby needs. A couple of these women managed to breastfeed and supplement with formula and/or breastmilk from another mother, using a either supplemental nursing system at the breast or a bottle. But I have also seen a couple of heartbreaking cases where women just did not manage to establish a milk supply at all. I worked closely with one client who had IGT and we did everything possible to maximise her milk production, but after 3 weeks of pumping 8 times a day, she was exhausted and still only getting 20-30ml per day. It was devastating for her as she had had her heart set on breastfeeding. She shed a lot of tears, and I have to admit I shed some tears too. She made a decision to stop pumping, formula feed and focus on enjoying her time with her baby. We talked about how she had given her baby every drop of her milk that she could possibly have given her, and that every drop of that milk would have made a difference. But for her, there will always be some pain and grief about her experience of trying to feed her baby. Having said that, this amazing woman plans to try breastfeeding again if she has another baby, because one of the other things we also discussed was the fact that many women who have been unable to achieve a full supply on their first baby, often do better with their second and subsequent babies.
Many of the women I see have had traumatic birth experiences which are a factor in their breastfeeding difficulties. Or they may have experienced trauma or grief prior to giving birth, which is stirred up during the raw postnatal period. Mostly, these women can work through their breastfeeding challenges, but sometimes they can’t. I worked with a client who had a pretty horrendous experience in the hospital (induction at 38 weeks, attempted instrumental delivery followed by c-section). She was traumatised, her husband was traumatised and her non-latching baby was traumatised. I would love to say that there was a happy ending and that we managed to get baby feeding at the breast. But we didn’t. The mother pumped for a number of weeks, but for a lot of reasons, couldn’t establish feeding at the breast. There was no easy solution for her. Yes, in theory it should have all worked out, but unfortunately the reality proved otherwise. So I focused on encouraging skin-to-skin with baby, reaching out for support, and addressing the birth experience with counselling and a face-to-face meeting with staff in the hospital.
Sometimes women don’t have the family or social support they need to make breastfeeding work. Sometimes babies just won’t feed at the breast, perhaps due to structural issues, medical conditions, sensory issues, or trauma. Sometimes previous traumas can be stirred up in the early postnatal period eg memories or sexual abuse or giref, and these can issues can get in the way of making breastfeeding work. I had one client who hated touching her breasts, and for obvious reasons this made breastfeeding difficult. Of course the solution is for the women to get psychological support, but at a particular point in a time a woman may not have the personal resources to face into that kind of process. I will always remember the words of one client who said to me “I’m just not in the right headspace for this.” So I suppose what I’m trying to say is, it’s not always that simple to just find a solution for a breastfeeding problem. People are complicated. Life is complicated. And breastfeeding can sometimes be really bloody hard….and it doesn’t always work out as we would like it to.
And when breastfeeding doesn’t work out as we had hoped, what can make that situation easier to deal with and process is compassionate and empathetic support from an IBCLC, HCP, voluntary breastfeeding supporter, family members or friend. Lots of talking, time, and lots of cuddles with baby.