By Laura Silvas, RN IBCLC

There are a million ways to mother your child - cloth vs. disposable diapers, home school or public/private school, screen time vs. none, gentle parenting vs. authoritative parenting, organic only or drive-thru dinner, and so the list goes on.

We all truly want what is best for our children. If you ask me, the biggest divider in our motherhood community is the breast vs. formula groups. With the recent shortage of formula across the US, the same question continues on social media forums, in conversations at the park, and even in the grocery store aisles, "Why can't you just breastfeed?"

As a Lactation Consultant, it is my job and goal to help moms and babies breastfeed. I preach the benefits, encourage moms when it seems impossible, and remind them why they started. I know that breastfeeding isn't a magical unicorn riding journey. It takes hard work and a lot of dedication. Nipple pain, engorgement, leaking, and pumping when you're away from baby - so much goes into something so ordinary. I also know that breastfeeding doesn't work out no matter how hard some women try. And then, some women don't desire to breastfeed, and that's okay too. I hope this article will help educate, encourage, and help bring our motherhood community back together as we look at some reasons why some women can't breastfeed.

Little To No Supply

Low supply is one of the most significant issues I see in breastfeeding women who schedule consults. We can try to do many things to increase a women's supply, including correcting the latch, showing moms how to measure their flange size, adding power-pumping, supplements, and sometimes even prescribing medications to help the situation. However, lactation consultants are not miracle workers (as much as we feel like one at the end of a successful day helping mothers). Some women may naturally have mammary hypoplasia or insufficient glandular tissue (IGT), a medical diagnosis that occurs when the mammary tissue doesn't develop fully. The good news is that true IGT is not extremely common; the bad news is that there aren't many lactation consultants available to help.

Other medical diagnoses hindering milk supply include hypothyroidism, hypertension, and diabetes. Typically, with any of these conditions, you will also see delayed lactogenesis or a delay in your milk supply postpartum. In addition, women with past breast surgeries, including augmentation or reductions, may also notice a low supply, especially if there was any interference with the glandular tissue, location of the incision, and size/ placement of implants.

Medications or Treatment

While breastfeeding your infant provides the best nutrition, the mother's health is equally important physically and mentally. Some diagnoses, such as HIV, place a hard stop on breastfeeding. Additionally, women undergoing radiation, chemotherapy, and/or those on some mental health prescriptions also prevent women from breastfeeding safely. However, women on Methadone and Buprenorphine for opioid addiction may safely breastfeed, according to AWHONN. But, if any illicit drug use resumes, breastfeeding should be discontinued immediately. If you are unsure about the safety of your diagnosis or medication regimen (including herbal or over-the-counter medications), check with your medical professional team.

Conclusion

While I genuinely know that "breast is best," and I hope always to help every mom who chooses the breastfeeding path to be successful, I know that "fed is required." Many factors play into a successful breastfeeding journey: health, medications, mental stability, and dedication. Sometimes, it just doesn't work out. The phrase "every drop counts" is accurate, but if there are no drops, that's okay too. I hope we can look back one day on this horrible time in our country and find ourselves reminiscent of mothers coming together. We should also stop criticizing the formula-feeding moms, as you may never know why they chose this path. It's time we unite and raise each other for being good mothers, regardless of our feeding choices.

If you are concerned or need help in any of these areas, please reach out to us here at Leva, and let us help you come up with a plan.