Why are there so many women who can't breast feed? Is this modern problem?

Factual Questions
1

In some of the breast feeding related threads ofver the years I’ve noticed a number of women indicating difficulty in nursing, or simply an inability to nurse their child. From a survival of the species angle, how is this possible? Wouldn’t this trait be extremely strongly selected for as a survivial necessity?

Would women who stop trying and put the kid directly on a formula bottle be able to nurse eventually if the formula was not so readily available?

Do mother chimpanzees have similar problems?

2

Given that the species is in no danger of decline, the answer is obviously “no” (at least, not given our current environment). Especially if the cause of the problem isn’t genetic in the first place.

If civilization ended tomorrow, the answer might well be different.

3

in the middle ages and renaissance formula was called either a wet nurse or a convenient milch goat :smack: and a pottery equivalent to a neti pot was used to feed them [as well as bedridden invalids would be fed broth in a similar type of vessel]

4

Infant mortality rates were horrendously high in centuries past. And at least part of the reason was inadequate breast milk. This may have been due to malnutrition or other disease in the mother, but many otherwise healthy women can also fail to produce adequate, or adequately nutritious milk.

And if you read medical advisors from those eras (I have one from the 1870’s), they give copious advice to women (much of it bad) on how to ensure their breast milk is ample and nutritious.

And many mammals have high infant death rates due to inadequate lactation.

So no, it’s not a modern problem.

5

My Japanese grandmother in law bore a child every year for eight years of the second world war (and slightly after) and lost seven of them due to no milk. The 8th she saved by giving to a neighbour whose baby had died but who had milk.

But yes, in the modern western world with formula so readily available there are SOME women who could have breastfed if there hadn’t been some block such as cultural taboos, ignorance, lack of support, or fairly major (ok, hugely horribly major) pain associate with breastfeeding.

I had no trouble with my first, but struggled with little success for six months with my second, and was not given a lot of help. (Doctors telling my my kid was not thriving, no lactation assistance, the “nutrition advisor” turning out to have her salary paid by a major milk company, poor health for myself and an exceedingly hot summer all contributed to my failure.)

6

I suspect that many women who “can’t” breastfeed, actually could…if they had adequate information and support. But they don’t get that information, they don’t get that support, they have helpful family members feeding the baby a bottle (for “bonding”, or because grandma just loves to feed babies, or whatever) when what the mother/baby pair really need is for baby to be suckling every hour around the clock during a growth spurt. The delicate demand-supply system gets screwed up, and lo and behold, mom doesn’t have enough milk. Or, mom can’t know how much milk baby is getting at the breast, and believes baby can’t possibly be getting enough. Or well-meaning grandmothers or grandfathers criticize at every turn, insisting that mother can’t possibly have enough milk and baby needs formula. Or, mom has a cesarean section or operative vaginal delivery, her milk is delayed coming in due to the impact of the delivery, and when she hasn’t got milk after 3 days, she’s told she has no milk and must start giving formula. There are a LOT of reasons why women who might well have adequate milk, become convinced they do not.

Some babies learn inefficient suckling techniques or ‘laziness’ from overuse of pacifiers, from early introduction of artificial nipples, or even from intra-uterine sucking habits (such as sucking on their own tongues). These babies may be difficult to transition to the breast. Some babies simply don’t get the whole suckling-at-the-breast thing (so it’s not the woman who cannot breastfeed, but the baby who will not.)

Many women experience extreme discomfort and even extreme pain in the early weeks, and find it more than they can deal with. In some of these cases, it is undiagnosed or inadequately treated yeast infection (thrush). Some doctors give very bad advice to women suffering from thrush. I was one of these, so I know exactly how bad some of the advice can get. That kind of pain is excrutiating beyond belief, and exceedingly difficult to persevere through. Yet, if it were treated promptly and aggressively, these women might well proceed to breastfeed.

There are women who do not have adequate milk. Some of these could produce some milk, and make up the difference with formula if they wished.

There are also women who produce no milk at all. I suspect this is rare, comparatively speaking, and will typically have a medical explanation such as anaplastic breasts or a piece of retained placenta.

I think…a lot of the women who say they cannot breastfeed, actually could if circumstances were different - if they had more support, more information, or no ready option for formula. And some women who cannot, cannot. But it’s hard for us to sort out what percentages, and of course we’re told that formula use is a lifestyle choice, and that we are not to judge people for their choices, so it can be very difficult to tell what is ‘choice’ and what is truly life-and-death necessity.

7

I’ve heard that the whole idea of “nipple confusion” or whatever they call it is something of a myth - one that benefits the formula producers since it tells mothers that there’s now no hope that junior will be able to successfully breastfeed. But I don’t know it’s true (being a gay man who’s hardly seen breasts in real life and has no plans to start. :))

Of course, there are supplemental milk systems to help mothers whose own milk is slow in coming - they basically add a little tube so that a baby gets adequate formula while nursing at the breast, so the mother’s breasts can take their sweet time getting ramped up (as they seem to do sometimes) without endangering the kid. There’s a whole lot of mechanisms for getting a kid onto the breast instead of the bottle, for women who really feel it’s important to breastfeed. Personally, I think the fact that some doctors still don’t insist that babies be breastfed is an abomination. In some cases it’s impossible, but in a lot of cases, it can happen with a little extra work on mom’s part.

8

No offence to the physicians on the board, but modern medical advisors tend to give rather suspicious information as well. If my wife had followed our original pediatrician’s advice, she might not have had enough milk, either.

-lv

9

Nevertheless, the tongue motion required to extract milk from an artificial nipple is very different to the tongue/jaw motion required to express milk from a human breast. It’s not that babies get confused so much as…well, like the rest of us, they’re human. And lazy. Extracting milk from the breast is hard work. I’ve seen my daughters’ faces literally bead with sweat from the effort required to breastfeed, and this is not unusual. A baby who learns he can cry long enough, and a bottle which literally drips milk, and yields its contents very rapidly and with little effort, will be given him instead of the breast he has to work at…may simply begin to refuse the breast. It happens. This is not confusion, but it is preference. It doesn’t affect all babies, but it does affect some.

I know that one of my daughters became extremely careless in her latch, if she had a pacifier more than just a few minutes a day. When she became careless, she hurt me. And so she could not have a pacifier - let alone a bottle - very often. Why did this happen? I have no idea. It makes no difference. It happened, and it affected our breastfeeding relationship. I believe it can affect others.

It can be possible to transition a baby from bottle to breast, assuming the mother has milk, is willing to go to the effort, has adequate information and support, and (and this is very important) has a baby who will cooperate (because not all will). I transitioned one of my premature twins to the breast, beginning at the age of 3 weeks, when she came home from the hospital. It took 6 weeks. I had large amounts of support, and fortunately she was cooperative. However, I have talked with women whose babies, having once been given pacifiers and bottles in the hospital (often against the mothers’ expressed wishes, or behind their backs), never would suckle at the breast despite their best efforts.

10

In the past, before formula, there was usually a lactating female without an infant of her own to feed in the near vicinity, because so many babies died in infancy

Alternatively, your baby died and you had another one, hoping it would work out better the next time. We forget that people would have 8 or 10 babies, just to try and get 1 or 2 live adults at the end of it.

There are some cultures that have traditions of not naming newborns or giving them proper clothes until they have lived for a few days or weeks,

11

It’s also been reported that wet-nurses would nurse two or even three babies, if the parents were wealthy and could afford to support her. If you have nothing to do all day but eat, drink and nurse babies, you can produce milk for several. In many times and places, being a wet-nurse was a highly respected profession, and the most highly paid work a woman could find. Her diet was strictly watched, and she was not allowed to sleep with any man, not even her husband, lest the intercourse “taint the milk.” Which makes sense in the high infant mortality sense, because it is pretty hard on a woman’s body to nurse and support a pregnancy. By giving nursing duties to another woman, the high-born were able to concentrate on getting pregnant and giving birth again as soon as possible.

Here’s a neat page about a historical wet-nurse from Florence written for kids.