Dear New Mother,

It’s miracle isn’t it … the exquisite new human being that you and your partner created! You may be overwhelmed with love, overwhelmed with fear, and overwhelmed with the desire to do everything possible for your new baby. Perhaps breastfeeding has been the way you always imagined nourishing your newborn — you’ve heard that it provides a myriad of benefits — and now you are having difficulties. Maybe breastfeeding is painful; maybe your baby is not getting enough milk; maybe you’re struggling with mild or even severe postpartum mood changes.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]A baby who is failing to thrive with exclusive breastfeeding is a tragedy of mothering, not a triumph of breastfeeding. [/pullquote]

You didn’t expect this and now you’re not sure what to do. I want to offer some reassurance.

1. It’s not your fault!

In their zeal to promote breastfeeding, lactation consultants and lactivists have convinced themselves that the only limitation to successful breastfeeding is a mother’s will and the support that she receives. There’s absolutely no scientific evidence that these are the causes of breastfeeding difficulties. Indeed, to my knowledge, the breastfeeding industry has never asked women why they stopped breastfeeding or inquired about the real barriers and limitations. They don’t want to know. They’d prefer to pretend that any problems with breastfeeding can be traced back to the mother, not breastfeeding itself.

2. You’re not doing anything wrong!

The most damaging fiction of the many fictions that are promoted by lactation consultants and lactivists is that difficulty is always the fault of the mother. You’re not holding the baby properly; you aren’t ensuring that the baby’s latch is correct; you’re not breastfeeding often enough; you’re not pumping between feedings; you’re not taking the unproven supplements or off label medications that would increase your milk supply.

The truth about breastfeeding — the truth that the breastfeeding industry struggles mightily to deny — is that breastfeeding is OFTEN painful, especially in the early weeks; that milk can take days to come in while a newborn screams in hunger; that not every mother can make enough milk to fully nourish her baby; or, anathema to lactivists, some women have a greater need for medications incompatible with breastfeeding than the baby has for breastmilk.

3. From 5-15% of women (and maybe more) cannot make enough breastmilk to fully nourish a baby.

That’s a biological fact, just like it’s a fact that up to 20% of recognized pregnancies end in miscarriage. Just like there’s nothing you can do to prevent most miscarriages, there’s nothing you can do to prevent a mismatch between the amount of breastmilk that you can produce and the amount your baby needs. For women in that situation, the decision to continue breastfeeding exclusively is actually a decision to let a baby suffer and starve. It’s cruel, especially when safe formula supplementation is so easy to provide.

4. Supplementing with formula does NOT destroy the breastfeeding relationship and it causes no harm to the baby.

Without any scientific evidence, lactation consultants and lactivists have insisted that formula supplementation is an enemy of successful breastfeeding. In contrast, the scientific evidence shows that judicious use of formula in the early days, to assuage a baby’s hunger when breastmilk hasn’t come in, or to calm a baby who is so hungry that he or she cannot figure out how to latch properly, can actually AID the breastfeeding relationship by tiding babies and women over until breastfeeding is working well.

5. Hypernatremia dehydration and hyperbilirubinemia are serious complications of inadequate breastmilk.

Lactation consultants like to talk about the “risks” of not breastfeeding, but they are dwarfed by the risks of newborn dehydration and elevated bilirubin. Both excess sodium and excess bilirubin are brain toxins that can lead to permanent intellectual impairment, seizures and death. Don’t let any lactivist tell you that breastfeeding is more important than protecting your baby from these brain toxins.

6. There is no known benefit to feeding your baby another mother’s breastmilk and there may be actual harm to feeding your baby breastmilk purchased on the Internet.

To my knowledge, there has not been a single study on the impact of another woman’s breastmilk on a baby. I’m not talking about wet nursing where the composition of the breastmilk could theoretically change to match a baby’s needs over time. I’m talking about supplements of breastmilk taken at random from women whose babies might be older and might have different bacterial flora. If mothers make breastmilk to match the specific needs of their own infants (highly speculative but often asserted by lactivists) then their breastmilk isn’t matched to your baby’s needs.

Based on what we know, purchasing another woman’s breastmilk to feed a term baby is a monstrously expensive, totally unnecessary endeavor. Any woman who has extra breastmilk should donate for use in premature babies where it can be lifesaving.

7. The solution to most breastfeeding problems is NOT to breastfeed harder.

If there s a biological reason for low milk supply, no amount of breastfeeding or pumping is going to overcome that; it’s just going to exhaust you without any benefit to your baby.

8. Breastfeeding has nothing to do with mother-infant bonding.

That’s just another fiction fabricated by the breastfeeding industry to promote itself. There is NO scientific evidence of any kind that mother-infant bonding is contingent on any specific action. A baby will bond to anyone who meets its basic needs for nutrition, care and comfort; it doesn’t matter how those basic needs are met. Moreover, mother-infant bonding occurs spontaneously over time, and spontaneous bonding is incredibly strong. It’s not weak; it doesn’t need to be supported by any specific action, and it requires tremendous abuse or psycholopathology to interfere with it. Adoptive mothers bond just as strongly to their children as biological mothers; the same goes for fathers and for grandparents.

9. In industrialized countries with access to clean water, breastfeeding simply isn’t that important for term babies. The only proven benefits to breastfeeding industrialized countries is 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infants in the first year. That’s it! Most of the other purported benefits of breastfeeding are based on scientific evidence that is weak, conflicting and riddled with confounders. Unfortunately, lactation consultants and lactivist organizations like The Baby Friendly Hospital Initiative are still promoting benefits that have been debunked long ago.

10. Outcome is more important than process.

A healthy, growing baby meeting its developmental milestones is infinitely more important than the process used to get there. Lactivism is an obsession with the process of breastfeeding at the expense of the physical and mental health of mothers and babies. That’s wrong. A baby who is failing to thrive with exclusive breastfeeding is a tragedy of mothering, not a triumph of breastfeeding. A mother who refuses to take medication for pre-existing conditions or postpartum depression because she’s been told that breastfeeding is more important than her physical and mental health is a tragedy of mothering, not a triumph of breastfeeding.

Do what YOU need to do meet your baby’s need for nutrition; that’s what a good mother does. Don’t let anyone tell you that breastfeeding is more important than your baby’s health, or your mental health.