By: Dr. Unjali Malhotra

We published a couple of articles about breastfeeding these past few weeks and the conversations have been quite heated at times. Healthy debate is always a good thing as we know but is it helping inform us in ways that are beneficial?

We heard from Amber Clothier, feature writer and mama extraordinaire with her controversial stance on the subject of breastfeeding, Kristen Yarker, resident dietician, expresses her opinions on how long to breastfeed your child(ren) and today we hear from Dr. Malholtra, creator and Program Director of a Women’s Health Residency training program for family practice residents at UBC and is the founder of the provincial HPV program through Options for Sexual Health.

In this article, Dr. Maltholtra breaks down the reasons you may or may not choose to breastfeed and why feeling pressure to defend those decisions may do more harm than good.

We all know breast is best

If you choose to breastfeed, your baby will receive immune support that can only be provided through breast milk. You will have a unique experience to bond yourself to your little one and likely have memories that will last forever. Breastfeeding allows you to save money and in most cases, be supported by your community.  It is recommended to breast feed exclusively for 6 months.

But what if it doesn’t work out? What if you have complications?

Some factors that can complicate breast feeding:

–     Trouble Latching  – It can take some time and effort to find that sweet spot that baby likes and it is important to ask nursing or a lactation consultant to help you out if things are not going smoothly.

–       Sore Nipples, cracked nipples  – Until a mom gets the hang of things, she may have sore and cracked nipples. Fortunately, this is short lived and usually requires no intervention. Moisturizing can help some mothers.

–       Breast engorgement – This is a sign of milk coming in and is not going to harm mom or baby. Swollen, hard, painful breasts are often sign of engorgement.  Massage, relaxation and feeding itself generally manage this condition.

–       Mastitis or Infection – Intense redness, heat, tenderness,  and (possibly) red streaking in one or both breasts can be an indication of an infection or mastitis.  A physician, breast feeding clinic or other provider should be contacted if these symptoms are experienced.

–       Low milk supply  – If baby is requiring more than mom can make, a visit to a local breast feeding clinic see another provider as you may require medication or other assistance.

–       Plugged duct – If baby isn’t feeding well consistently,  meals are being skipped (baby may be weaning), or if mom has a tight bra she can end up with a plugged duct. Breasts can be hard, red, tender, painful before feeding and better after a feeding. Massage can assist. Seeing a health care provider to rule out mastitis is recommended.

If you experience trouble breastfeeding…

If you are experiencing trouble breast feeding – let someone know. It is important to talk to someone you can trust and who will support you. If you know someone in this situation, please be empathetic to her situation. When a mom is postpartum, she is vulnerable and needs support.

Some reasons women may choose to not breast feed or may be unable to breast feed:

–       Medical contraindications – Most people consider that all new mothers are healthy – they did make a baby after all. But aside from the infrequent medical contraindications to breast feeding like HIV and active herpes on the breast, many women will have common medical contraindications. Examples are autoimmune disorders which are common among young childbearing women and can require medications that are not appropriate in breast feeding.  Examples of these disorders are Lupus, Rheumatoid Arthritis, and Multiple Sclerosis. With most of these diagnoses you many not know the mother has the condition and she may not want to divulge this personal information.

–       Baby refusal –  As all moms know, every baby is different, has a personality of their own and will have likes and dislikes. Ladies, some babies do not want to breast feed.

–       Choice  – Many women must return to work quickly, have never been interested in breast feeding or have other personal reasons.

Knowing the whole story may be helpful but do we need to explain?

The reason I am posting this is to remind women that you may not know the whole story and every woman should have her decision respected without having to explain it, defend it and without judgment.  Many women will feel a tremendous amount of guilt and a feeling of inferiority if they are unable to breast feed or struggle with feeding and bottom line is that these feelings do not need to be solidified by others but support would always be appreciated.

What do you think? Is breast always best?

Dr. Unjali Malhotra is a Family Physician with extensive training and expertise in Women’s Health and University program development and improvement in Canada. She is the former Medical Director of Options for Sexual Health (Planned Parenthood). She is the creator and Program Director of a Women’s Health Residency training program for family practice residents at UBC and is the founder of the provincial HPV program through Options for Sexual Health. You can follow her on Twitter.

References:

Kaneshiro N.K., National Institute of Health. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002452.htm
Breastfeeding  – Caring for Kids Available at : http://www.caringforkids.cps.ca/handouts/breastfeeding
Motherrisk: Breastfeeding and Drugs. Available at: http://www.motherisk.org/women/breastfeeding.jsp
Motherrisk: Drugs in Pregnancy Available at: http://www.motherisk.org/women/drugs.jsp
Resource: La Leche League Canada : toll-free breastfeeding line for a referral to someone in your community: 1-800-665-4324