Why is it so hard?
Breastfeeding. It seems like it should be the most natural and simple thing in the world. And yet, for most of the 66% of North Carolina moms who have stopped breastfeeding before the recommended 12 months, its been anything but simple or natural. Why is it that so many women start off wanting to breastfeed, but so few are able to realize their own personal hopes for breastfeeding their baby? The modern message we hear in playgroups, online chatter, and over coffee with our girlfriends is that our bodies (breasts) just don't work. We hear countless tales of not enough milk, pain, confusion, disappointment, and frustration. Rates of postpartum depression skyrocket when breastfeeding doesn't work out. But is the problem really a failure of our breasts to be able to carry out their most basic function, making milk? Or is it a cultural phenomenon that withholds real, true support from moms and instead passes on expectations and systemic "booby traps"? I would argue its the latter for most American women. Here are 6 support systems moms REALLY need for success:

Personal Support - Be your own best advocate by arming yourself with accurate knowledge. Many moms are quick to sign up for a childbirth class, and yet skip the breastfeeding class despite the fact that labor usually lasts less than a day but breastfeeding lasts for (hopefully) months and has a very dramatic impact on mother and baby's lifelong well being. A thorough breastfeeding class should cover not only breastfeeding basics, but also help women understand how their breasts make milk so that they can be in control of their own milk supply. It needs to include info on the keys to success, pumping, how/when to give a bottle without causing confusion, common problems (and how to prevent them!), normal infant behaviors, and how to know when things are going well and when to get help. If your class is less than 2 hours, you can be sure there is a lot of information being left out. Try reading or listening to Breastfeeding Made Simple during your pregnancy to sure up your breastfeeding knowledge and ward off all the myths and bad advice you are sure to hear. Keep the app Breastfeeding Solutions handy for looking up common questions or concerns. (Find out when Carolyn is teaching the next Breastfeeding Essentials Class.)

Partner Support - When baby's dad is supportive of breastfeeding and has basic breastfeeding knowledge, moms chance for breastfeeding success greatly increases. Make every effort to get dad to that breastfeeding class, and tell him how much breastfeeding means to you. If he knows its important to you, he's more likely to help you work through challenges instead of pushing formula early on. Keep a breastfeeding reference sheet on the fridge or in plain view where you can ask dad to "look up" information for you - in the process he will realize what is normal. (I mention "normal behavior/expectations" a lot, since this is a huge booby trap in the western world. Our ideas of normal have been shaped by formula-feeding for several generations, and it has thwarted many a breastfeeding mom!) If possible, have dad be present for your lactation consults during the early weeks so that he can watch your breastfeeding professional show you how to position baby (something he may be able to help you recreate later) and hear about what is important to make breastfeeding work. 

Peer Support - Unless you are lucky enough to have a slew of friends who have successfully breastfed, you'll most likely want to talk to other mothers who are breastfeeding babies and who have had positive experiences. When seeking out peer support, look for moms who reached their personal breastfeeding goals and didn't have to wean early, since these women are most likely to have good advice and positive vibes. Having friends or a social circle of women who think of breastfeeding as normal and are ready to cheer you on can be a real confidence booster! Try your local chapter of BreastfeedingUSA or La Leche League for meetings held locally where fellow mothers and breastfeeding counselors come together to encourage and support one another. Facebook groups such as LegendairyMamas can also provide encouraging peer support.

Physician Support - This includes your midwife/OBGYN, hospital nurses, and pediatrician. Often moms are "booby trapped" in hospitals by inconsistent and bad advice, or formula and pacifiers are pushed on them when appropriate breastfeeding support would have made the difference. Some hospitals, designated "Baby-Friendly", have earned that credential by providing standardized breastfeeding education to the staff that come in contact with mothers and babies. They've also put in place 10 hospital polices have been proven to increase mom's breastfeeding success. If possible, deliver in one of these hospitals. In contrast, its unfortunate that many pediatricians have only received an hour or two of breastfeeding education in medical school, so unless they have pursued continuing ed on the topic they may not be giving moms evidenced-based breastfeeding information. Studies have found that pediatricians (and presumably nurses) often let their personal experience influence the support they give moms - so a formula-feeding physician may not be offering moms unbiased facts on formula risks or the essential steps to breastfeeding success. If your pediatrician suggests formula when you are having difficulties instead of referring you to a lactation consultant to fix the breastfeeding problem, then find a new pediatrician who will support your goals and give evidence-based advice.  Ask in a local breastfeeding group who the breastfeeding friendly pediatricians in your area are, and click here for questions you can ask when interviewing pediatricians.

Professional Lactation Support 
- Get a breastfeeding professional (lactation consultant) on your team who is going to be available to mentor and coach you along the way. To find one, google "lactation consultant near me" and compare reviews. Start by scheduling a prenatal consult to go over your medical history (in case something may cause breastfeeding challenges) and get your questions and concerns answered. In the hospital, insist that the staff lactation consultant spend as much time with you as necessary to help you get a comfortable latch and address your concerns. Too many hospitals have under-staffed lactation staff, resulting in rushed or nonexistent breastfeeding support. You may want to bring the phone number of a private lactation counselor who can "unofficially" come visit you in the hospital if you aren't getting adequate help. If possible, find a breastfeeding professional who offers breastfeeding well checks. Studies have found that when moms get regular breastfeeding support from a specialist (not because there is a problem, but with the goal of preventing problems and sharing breastfeeding information specific to baby's age), they are much more likely to breastfeed successfully. At the very least, find a consultant who extends a welcoming invitation for mothers to regularly schedule appointments beyond the newborn stage. Bonus points if affordable home visits are offered, so you can practice breastfeeding in your natural environment with the same chairs/pillows/bed you normally nurse on.

Postpartum Support
 - Most non-westernized cultures have traditions in place to give new mothers several weeks of focused rest and nurturing. This usually involves a family member coming to stay with the new family for the purpose of waiting hand and foot on the mother, cooking meals, cleaning the house, and caring for any older children. In these cultures, new mothers are not expected to resume their normal life schedules for at least 40 days (and sometimes much longer). The mothers are able to stay in bed resting, snuggling with baby, and learning how to breastfeed during this 40 day period. Due to the geographical break up of families and the shift in cultural expectations, most women don't have access to this kind of family support. Or, if extended family support is available, it may come in the form of a relative who views themselves as a "house guest" for the purpose of seeing and enjoying the new baby, with little regard for the mother's well being and recovery. Older generations are also the most likely to be pushing outdated information and formula-era advice on confused new families. In the absence of helpful family support, a postpartum doula can be an invaluable resource. She is able to reverently enter the sacred space of a new family in a way that prioritizes nurturing the new mother, empowering the family with guidance on baby care that is hands-on, practical and evidence-based, and providing light housework or cooking support. Local mamas, check out Galia at Mamale CLT and the other postpartum doulas of the Charlotte Birth Collaborative!

Be the Change You Want to See
My dream is that someday these 6 support systems will be the norm for American women, making breastfeeding success a more achievable goal for the millions who embark on motherhood each year. At Lake Norman Breastfeeding Solutions, we absolutely love offering moms breastfeeding support and connecting them with resources that will help them reach their personal breastfeeding goals. Each of us can also play our part by being the friend who cheers on and encourages a new mom, delivers a hot meal, picks up the older kids, gives the gift of a housecleaning; or the sister or aunt who takes a week off work to be a postpartum doula (not houseguest!) for a family member. Together, let's build a culture that doesn't just pass on expectations and lofty ideals to new mothers, but actually comes around them to support, cheer, help and empower them!

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