Breast Feeding Blues

As a physician, I will most likely tell you all about the amazing benefits of breastfeeding if you ever visit my office. According to the USPSTF, AAFP and AAP some of the benefits include in-creasing the child’s chance of basic survival and boosting their immune system. Breast milk changes every day to meet your child’s specific need. Mothers benefit as well. Per the AAFP and USPSTF breast feeding reduces mom’s risk of ovarian and breast cancer. Lactation is also shown to improve glucose tolerance and insulin sensitivity. Personally it has helped with my postpartum weight loss in both my pregnancies. I could go on and on about the benefits of breast feeding but I am positive we all have heard at least some of them at some point.

What most people don’t warn new mothers about is how much it initially sucks (no pun in-tended). And that this “suckage” can last for the first couple of weeks. I believe if we don’t talk about how hard it is we will continue to have 84% of new mothers start out with breast feeding at birth with only 25.8% of new mothers continuing to exclusively breast feed through six months of age (CDC 2017).

Knowledge and determination is power. I have successfully given my two children breast milk, but it was not easy. The first ordeal was the breast engorgement. This is the part I hate the most and it is a double-edged sword. Breast Engorgement is the breast fullness and firmness which is accompanied by pain and tenderness. Primary Breast Engorgement is caused by swelling of the breast and onset of copious milk production. This usually occurs between 24-72 hours post-partum. Not all women experience moderate or severe symptoms but if you’re like me it is se-verely uncomfortable. It usually resolves over a few days with supportive care being the only treatment and CONSISTENT nursing. Supportive care includes either warm compresses or warm baths before breast feeding or wearing a tight sports bra. ice can help with the inflamma-tion as well. The other edge of this double-edged sword is that there is no way to avoid getting this breast engorgement and most supportive care treatment will decrease your milk supply! Not what any new mother wants to hear – especially one wanting to breastfeed.

During the week that I delivered, the story at the top of every news cycle was about the short-age of baby formula. This was due to a series of unfortunate events including bacterial exposure at a manufacturing plant in Michigan, people stockpiling formula due to pandemic related short-ages - which was made worse by the closure of said Michigan plant and strict importation laws. (Shortly after the Michigan plant resumed production it was forced to close again due to storm related flooding) (Avery, 2022).

With my second child before I went into the hospital I had my mind made up that I wasn’t going to force the breast feeding process, I was gonna just relax and go with the flow with my baby. I initially don’t make enough milk for my babies. So a couple days in I sent my husband to the pharmacy. I got a video call that there was basically no formula on the shelf except for one. Which was ok at the time but what if my baby became lactose intolerant? What if that particular formula didn’t agree with her, what would I do next?

I decided (had no choice really) to stick with breast feeding, even though my nipples were crying every time she latched and held on. With every breastfeeding I had loads of pain. My nipples were not made for breastfeeding. So I went to pumping then feeding - double the work but it was psychologically what was best for me and my baby. Due to mainly pumping, having a baby with a big appetite (40 oz by day 2!), and treating my breast engorgement, my milk production was struggling. I decided to use the Lactation nurses - a very good resource for women both in and out of the hospitals. I highly recommend mothers make use of lactation nurses as much as you can in and out of the hospital if you decide on breast feeding, I cannot stress this enough. See them at least every day while in the hospital even if it is for reassurance you that what you are doing is right. Then call them every day. I began pumping every 2 hours during the day to get my milk supply up, and pumping 1-2 times at night for 20 mins at a time – this still didn’t help. I went to eating oatmeal, then milk thistle, then Fenugreek (with lots of water - at least a gallon a day). Finally, after a week of trying, my milk supply finally caught up; eventually I was pumping way more than she needed so I had to back off to slow down the production a bit.

Breast feeding is a lot of physical work, but it is also lot of mental work as you do get so worried about if your baby is eating enough and the more stress and lack of sleep increases, the more your milk supply decreases.

There are contraindications for breast feeding: for example HIV patients and mothers on certain medications or drugs that would harm the child are not recommended to breastfeed. There are also mothers who physically cannot breastfeed their children. But if you are able and willing to, I recommend it to ensure your baby has the most healthy start in life.

It is my hope that by more women sharing our stories, more mothers will make a more well-in-formed decision to breastfeed and determine to stick with it.


USPSTF = United States Preventative Services Task Force, AAFP = American Academy of Family Physicians, AAP = American Academy of Pediatrics, CDC = Centers for Disease Con-trol and Prevention.