If I asked myself if pumping was being used as a magic fix for common, yet easily managed, breastfeeding concerns I would have to say "yes, it is". The idea to pump instead of, or in conjunction with, breastfeeding is often suggested to mothers by their support people. These support people include other new mothers and experienced mothers at places like Mommy and Baby Yoga, Mommy and Me time, Kinder Music, Baby Signs, the museum, StarBucks, any place mom's and babies hang out together; you all know where mommy's go. Other support people are their mothers and mother-in-laws, sisters, sisters-in-laws, aunts, grandma's, that old family friend; again, you know who these people are. Of course, other new mother's support people include Health Care Providers like doctors, nurses, midwives and the complementary support people like doula's and childbirth educators. And, in case you are not aware, these people include many that did not breastfeed themselves or were not successful in their attempts to breastfeed.
Most moms new moms have the intention of breastfeeding, as so as expected, it comes up in conversation. People feel the need to ask new moms how breastfeeding is going, new moms feel compelled to seek out support in these early weeks or health care providers are following up mom and baby. When moms are asked about breastfeeding they share the concerns they have with breastfeeding in hopes that someone can help them. Here is the list of common complaints and one likely answer they will receive to alleviate that concern.
Sore Nipples -> Pump and bottle feed
Baby not effectively sucking -> Pump and bottle feed
Thrush -> Pump and bottle feed
Engorged -> Pump between feeds
Plugged Duct -> Pump between feeds or pump and bottle feed
Needing to feed in public -> Pump and bottle feed
Over Active Let Down -> Pump before feeding
Low supply -> Pump between feeds or after feeds
Baby not sleeping -> Pump and bottle feed or have someone else feed
Colic -> Pump and have someone else feed
Foremilk/Hindmilk concerns -> Pump before feeding
It appears that pumping can be a common suggestion to alleviate the most probable breastfeeding issues. We need to be aware it is not a magic fix, it is most likely to be a band-aid, and it does not "fix" anything. We also need to be aware that pumping can create more issues.
These are just a few ways this pumping band-aid could create more issues for mom and baby.
With sore, bleeding, cracked nipples, generally the most common concern, generally easy to fix, pumping only results in double the work. Why would a new mother want to add in all the extra work of pumping and bottle feeding when getting some assistance with position and latch could make the problem go away, in even the very next feed? Often long term pumping is not going to sustain a babies needs and milk supply like breastfeeding directly from the breast would. Often breastfeeding relationships end far sooner than mother's intended due to supply issues because it leads to supplementation or another feeding method all together. This might not be the case all the time, as some mothers, do exclusively pump, but there is unique difference between a mother who makes the decision to exclusively pump compared to one who is trying to get baby nursing pain free at the breast and needing to pump in addition to.
How about that baby that just is not sucking effectively or will not latch? Let's see, how do people learn? We learn by doing. If we take baby away from the breast, how does he learn? Again, we need to support moms and babies in positioning and latch and innate instincts that babies have to feed and let them learn together. If habitual placement is still not getting baby latching and sucking, we need to further evaluate what might be going on with that baby. Ignoring the difficulty baby is having and turning solely to the pump does not make the original issue baby was having go away.
Thrush is no reason to stop feeding at the breast. The reality with pumping with thrush is that mothers now have more parts and equipment to treat or throw away. Thrush can sometimes take time to clear up but it spreads so easily, we need to restrict what comes into contact with the thrush to stop the spread of it, not add more to it. There are medication and alternatives that we can use to treat thrush and the discomfort of thrush as we are trying to eliminate the nasty little bug it is.
Milk supply works on supply and demand so as well as pumping to relieve engorgement seems like a good idea right now, later on the fullness comes back and generally more full then the previous time, as a mother's body thinks that is milk that baby needed. If moms are engorged because a baby is not eating or draining the breast, then the answer is to get the baby eating and draining the breast, not pumping. The more baby is at the breast the less engorged mother's will be, assuming baby is eating well. Again, back up to latch and sucking. If baby is not waking to feed and mom is starting to fill up, mom can put baby to breast and encourage that baby to eat, to play his role in this breastfeeding relationship. Another concern with engorgement is that as much as it may seem logical that when mothers are engorged, it means they have a good, healthy milk supply, in fact the opposite can occur. The more often a women is engorged, the faster her milk supply will start to decreased. When breasts are full it sends a signal to the part of moms brain responsible for milk supply to slow production down and milk making cells start to shut down, resulting in less milk in the days ahead. Pumping when engorged can also pull more fluid, and not just milk, into the breast, resulting in edema. Often that fullness is confused for milk and "good supply".
Plugged ducts are uncomfortable, in fact down right painful, and yes moms want them out, but pumping is not the most effective way to unplug a plugged duct. In fact it can lead mom right back to the engorgement stage and create the spiral onwards from there, when the easiest way to get rid of that plug is by using baby, again.
I am starting to see a larger amount of women pumping so they can feed their baby while out and about. First, people that want to go out in public just need to accept that mothers and babies go out in public, too, and mothers and babies use breasts to feed. Secondly, mothers need to be informed about how this "solution" really is only one that is feasible for a small time. Each feed mom misses at the breast impacts that supply and demand mechanism again. If mom is out and is not feeding baby or replacing a feeding session without pumping again her body and brain communicate this to each other and the process of milk supply slows down. This again goes back to what I mention early about keeping up supply, supplementing and ending the relationship early than expected.
Over Active Let Down is a problem that some moms struggle with but again pumping can just aggravate this problem. It is an easy problem to aggravate as it can lead to the engorgement issue and when baby is ready to feed, mom is ready to burst with milk and when the let down occurs it is like opening up a dam. Baby gets flooded with milk, has trouble managing flow, staying latched, becomes upset and this all causes frustration in mom and baby. Positioning, latch and frequent feeds are the easy fix here. On the other side of it, some babies have a hard time handling a normal let down, but it mimics and over-active let down. We need to be sure that we know if we have a baby that is struggling with a normal flow or a true over active let down.
For the healthy, full-term infant pumping for perceived low supply should be the last resort. Babies truly are the best solution here again; baby to breast = more milk in breast. Secondary low milk supply is a different issue and does not fall into the category of common yet easily managed breastfeeding concerns., which is what I am addressing here. I am also not addressing primary low milk supply which are maternal factors in less than 5% of mothers who do not make enough milk. These conditions should be determined with through evaluation with an IBCLC and primary health care providers. I am talking about common breastfeeding concerns that most mothers face.
Pumping to top up or to force more milk into that non-sleeping baby:. Fuller tummy does not equal more sleep in babies. Babies have very small tummies, breastmilk is readily absorbed and digested so babies feed frequently. The issue here is not the amount of milk the baby takes, but rather unrealistic expectations and misunderstandings babies. If babies are really struggling with sleep, it is worthwhile seeking out a feeding assessment to ensure all the things above are not an issue.
Colicky babies are much better soothed at the breast than any other way, pumping to feed another way removes that comfort source from this already high needs baby and can make the baby even more upset. There is no real understanding behind colic and why some babies are colicky and some are not but there is good understanding that skin-to-skin and mothering at the breast calms these babies best. Again, all things above should be ruled out before we just assume we have a colicky baby.
Foremilk/hindmilk imbalance or what is being perceived as such seems to be rampant these days. It seems like a viral condition that has spread. So many moms seem to feel they have this issue, when in fact it is very rare. However, if a mother thinks this is an issue she has and pumps to get to the hindmilk, we go back to the engorgement cycle where mom has too much milk, can have a forceful let-down and then babies do get more foremilk than hindmilk, they are upset by the flow of milk and we end up in a vicious cycle. Worst case scenario, in fact, this could create that colicky baby we all fear. Foremilk/ hindmilk is best controlled by frequent feeds and proper positioning.
I am pleased to see fewer mom's grabbing for a formula can when breastfeeding challenges arise but I am not thrilled to see more mom's grabbing for the pumps.
Mom's please seek out appropriate, knowledgeable, support when you encounter these easily managed breastfeeding concerns.
I would really like to see the documentary Breastmilk vs reading an article about it, however I have not been able to see it yet. So far I have only really seen this article, "Eat It, Drink It, Pump It, Freak Out Over It".
Sounds like there are some extreme scenes, but it is media. Media is made to grab attention. Breastfeeding is not extreme, at least I do not see breastfeeding as extreme or work in extremes with my mothers.
The naked breasts in the documentary likely are not intended to grab attention but rather normalize breasts, in a non-sexual manner. The more we see them in a different manner the more comfortable we will be with them as non-sexual objects.
I am understanding that the film does not sensationalize breastfeeding. Thank you. You are not a super-star if you breastfeed. You are a woman with a child. It should be an ordinary experience. Again, it should be an ordinary experience. If you live in North America, it likely is not an ordinary experience.
In other parts of the world we have toddlers nursing at the playground, entire groups of them. In Canada we don't see that often at all because most of our toddlers didn’t get breastfed must past a few weeks. Toddlers are nursing in Canada, I reassure you of that, but how often does any see this? How often are these mothers comfortable to tell anyone this? And why is it that she is uncomfortable sharing this, when in reality it is recommended in Canada that we breastfeed our children until the age of two and beyond. Shouldn't she be proud she made it to the recommendation?
I am also understanding the film to avoid the formula vs breastmilk debate. Again, I say thank you. Not all of the discussions around breastfeeding need to have formula involved. They just do not. Most mother’s who have decided they would like to breastfeed, want to breastfeed. That doesn’t mean it is going to be easy, without struggle, doesn’t need support. That would be silly. It is an aspect of motherhood and motherhood is hard, there are struggles and we need support. We need this regardless of how our babies are fed. If a mother has chosen to breastfeed, it is not a debate. (If a mother makes an informed decision to choose formula, so be it. It is also not a debate.) If a mother choose to breastfeed, she should be encouraged to breastfeed that baby then, and given the supports to do so. Supporting breastfeeding is not to offer formula when it becomes hard. We are culture 3 generations into formula feeding as the ordinary experience, and in culture we look for sameness. This is not a mommy-war, this is how humans function. We look for sameness to find where we fit. Another example is if your mother formula fed you and your are struggling, she doesn't know how to help until she makes your experience more like her own, which is to suggest that you try a bottle. Could this looking for sameness for the reason that the mothers that do breastfeed toddlers are not sharing? In our culture sharing that information does not bring a lot of sameness amongst our community. In small pockets, yes, and those are safer places to share, but our overall culture is still not there.
New mothers should not be under pressure to breastfeed. It should be an ordinary experience, with the supports to do so. The weight of the world shall not be on the mother’s shoulders. In fact, I want those shoulders relaxed with arms gently crosses and a baby in those arms.
There is a gap in the current health care. You see big decisions about public policy are made at meetings with CEO’s and upper management sort people & doctors looking at research etc. They decide that they are going to have a position that breastfeeding should be recommended and all the reasons why and the hospital and public health offices need to encourage breastfeeding and be on board with the policies. Sounds great. Until you realize the people working directly with the new moms and babies have an even harder job than those making the decisions. They need to actually make it so that moms and babies can breastfeed and they simply do not have the skill set and time to do so. There lies the difference between the 95% that start and the 33% that might still be breastfeeding after several weeks. That weight again is not on the mother’s shoulders. That is society’s responsibilities. The front line workers and their employer's also don't seem to know what they don't know so they share misinformation. Mother’s take that misinformation as truth because these are the people who we trust to do right by us. Or they do not have the time needed for each dyad. Pumping and supplementing or formula supplementation is a faster means to get to the goal, which might be weight gain, mother's to be pain free, etc.
Mother's grieve the loss of what they expected. They expected breast-feeding to be easy. Maybe they are succeeding but it is still much harder than they expected. They might not have expected to make a formula choice (which they probably did not make but had to succumb to because the support needed was not there). And so they grieve a loss. We think mother’s feel that as guilt. It is not always guilt mothers feel, it is grief. And it is not always judgement other feel, it is sympathy. I sympathize with the majority of mothers, my clients or not, because it is hard, hard work. And mothers ask for help, identify needs, but those needs often go unmet. They go with mothering let down & disappointed. They feel they failed and are disappointed in themselves. The truth is, they are failed. Mothers do not fail at breastfeeding. They are failed to be able to succeed.