Overview

New mothers go into breastfeeding with the best intentions. Unfortunately, many run into issues that make breastfeeding difficult or impossible. By six months, three in four babies are fed infant formula. Many researchers have examined why mothers supplement with formula or wean their children before age one to address the low rates of exclusive breastfeeding. There are recurring themes throughout the scientific literature from many countries. This episode examines the top five reasons moms stop breastfeeding early and how you can avoid these issues to reach your breastfeeding goals.

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Article and Resources

Benefits of Breastfeeding

The evidence in support of breastfeeding is overwhelming. Your milk contains every vitamin, mineral, and nutritional element your baby needs. While infant formulas have improved over the years, none come close to mimicking all of breastmilk’s beneficial properties. There are decades of documentation on the positive effects of breastfeeding on immunity, health, and the connection between mother and baby.

Breastmilk benefits your baby’s health in the short and long term. Your baby is born without natural immunity, and breastmilk helps build their immune system. Breast milk contains living cells to inhibit the growth of bacteria and viruses. It has antimicrobial proteins and peptides and anti-inflammatory and antioxidative factors. The microbiome in your milk shapes your baby’s intestinal microbiome. Breastfed babies are at a lower risk for ear infections, intestinal upsets, respiratory problems, and dental problems. There is evidence that breastfed infants are less likely to be overweight and have a lower risk of type II diabetes. Plus, breastfeeding is also associated with increased intelligence and higher IQ.

There are even benefits to you breastfeeding. Exclusively breastfeeding can act as a form of birth control. If you are exclusively breastfeeding (including at least once at night), you most likely will not get your period for at least six months after your baby is born. Please talk to your care provider about this and the specifics before relying on it to prevent pregnancy. Breastfeeding even reduces your risk of breast and ovarian cancer. Studies show that breastfeeding is associated with maternal responsiveness. Hormones released during breastfeeding, prolactin, and oxytocin help foster a connection to your baby and help you recover from birth better.

I support the decisions you make regarding feeding for you and your baby. If you want to breastfeed, you need accurate information and support to be successful. Whatever your breastfeeding goal, I hope this article’s information helps you along the way. See this page for all breastfeeding resources, episodes, and articles. You always have the option to stop breastfeeding at any time for any reason. See next week’s episode on weaning from breastfeeding for guidance and tips when you are ready to quit.

Recommendations for Breastfeeding

In 2022, the American Academy of Pediatrics updated its policy statement on breastfeeding. The AAP is consistent with the World Health Organization and many pediatric associations worldwide. You should exclusively breastfeed your baby for the first six months. At around six months, you should introduce your baby to solid foods with continued breastfeeding for up to two years and beyond.

Two years may sound like a very long time. Any amount of time your baby is getting breastmilk will benefit them greatly. If you stop breastfeeding before your baby’s first birthday, you must supplement with infant formula.

Rates of Breastfeeding

Despite the recommendations, data shows that most mothers do not exclusively breastfeed. In the United States, 83.2% of babies are ever breastfed. That number decreases to 55.8% at six months, and only 35.9% still receive breastmilk by twelve months. These numbers include mothers who may also supplement with formula, and the rates for exclusive breastfeeding are even lower. Only 45.3% of babies are exclusively breastfed by three months of age. At six months, that drops to 24.9%. Unfortunately, there is no data on exclusive breastfeeding beyond six months. Based on the declining rate overall, we can expect the rate of exclusive breastfeeding beyond six months to decrease.

Why Do Mothers Stop Breastfeeding?

Given the overwhelming evidence supporting breastmilk over formula, mothers go into breastfeeding with the best intentions. Unfortunately, many run into issues that make breastfeeding difficult or impossible. To be clear, you always have the choice to supplement or cease breastfeeding for any reason. If you want to breastfeed, this article will help you avoid the top five reasons moms stop early so you can continue to nurse as long as it works for you and your baby.

Many researchers have examined why mothers supplement with formula or wean their children before age one to address the low rates of exclusive breastfeeding. Throughout the scientific literature from many countries worldwide, there are recurring themes. Most mothers do not reach their breastfeeding goals because they don’t think they are making enough milk, run into a problem like pain or difficulty latching, or stop when they return to work. Other common reasons moms do not reach their breastfeeding goals. Let’s examine the top reasons and what you can do to avoid them.

Not Making Enough Milk

The number one reason mothers do not meet their breastfeeding goals or supplement with formula is that they do not make enough milk. Researchers use the term perception of insufficient milk supply in the scientific literature. If a mother thinks she is not producing enough milk, she will supplement or switch to formula. Evidence shows only about 5% of mothers experience actual milk insufficiency. That number increases if mothers do not effectively establish breastfeeding in the first month. You need accurate methods to gauge milk production to know whether you are genuinely producing enough milk.

Milk Production

During pregnancy, your body starts producing colostrum, nature’s perfect food, until your milk comes in. This first milk has immune factors, protein, sugar, fats, and critical agents that help seal, protect, and repair your baby’s intestines. Your baby’s stomach is tiny at birth. On their first day, they will only drink about an ounce of colostrum divided over several feedings. Around day 3 or 4, your milk will come in, and your baby will gradually increase their consumption for the first month. The milk your baby consumes will be relatively consistent from one to six months.

Demand and Supply

The amount of milk your body produces depends on how much you remove. This principle is the cornerstone of breastfeeding. The number one thing you can do to ensure you are making enough milk is to feed your baby frequently. You can expect to breastfeed your baby between 8-12 or more times in 24 hours. You cannot nurse too often; frequent feedings are critical to establishing your milk supply. This is especially true in the first few weeks. You may consider pumping, although pumping is not as efficient at removing milk as your baby.

Measuring Milk Production

You cannot know whether you are making enough milk based on breast size, how full your breasts feel, or ounces pumped. The best way to measure milk production is by your baby’s weight gain and diaper output. Your pediatrician will track your baby’s weight to ensure they eat enough. Your baby will naturally lose weight after birth before they start gaining. In general, your pediatrician doesn’t want to see your baby lose more than 10% of its birth weight and wants to see your baby back at its birth weight within two weeks.

IV fluids during labor can cause your baby to maintain higher fluid levels, leading to more excess fluid loss after birth. Your doctor may see this as weight loss due to not eating enough. Please keep this in mind if you have IV fluids during your labor. This is very common in hospitals, especially if you have Pitocin or an epidural. There is an entire episode on the evidence of IV fluids if you want to learn more.

While weight is important, the output in their diapers is another measurement of whether your baby is getting enough milk. For the first 24 hours, you will probably only see meconium, which is thick, tar-like, black poop. In the second 24 hours, you should see two or more brown sticky poops. On days 3, 4, and 5, you should see three poopy diapers a day, starting green on day three and getting to yellow by day five, which will be the norm moving forward.

If your doctor, midwife, or pediatrician voices concerns that you may not be making enough milk, talk through the reasons and what you can do to improve how much you are producing or how much your baby is eating. If you wish to continue breastfeeding, please talk to a lactation consultant before concluding that you are not making enough milk.

There is a separate in-depth episode on maintaining and increasing your milk supply.

Breastfeeding Problems

Your newborn is hard-wired to breastfeed and is born with instincts to help them latch right after birth. Despite these instincts, breastfeeding doesn’t always come naturally or go perfectly right from the start. In reality, breastfeeding can take practice and patience as you and your baby navigate your nursing relationship. Many issues can come up during breastfeeding in the first few days and even months down the road. Problems can include symptoms in your breasts like leaking, sore nipples, pain, vasospasms, blebs, plugged ducts, mastitis, and engorgement. Some issues can affect your baby, like jaundice, tongue-tie, yeast infection, thrush, food allergies or sensitivities, nursing strikes, and cluster feeding.

All of these issues can make it difficult to continue breastfeeding. The good news is that there are solutions and remedies for any problem that can come up. If there is a name for it, you can fix it. The key is educating yourself ahead of time and having resources available.

Educating Yourself

You can educate yourself about breastfeeding so that when an issue arises, you can identify it and know how to treat it. There is an episode of the Pregnancy Podcast dedicated to troubleshooting breastfeeding issues. This is a good starting place to educate yourself about common symptoms with tips for resolving the problems. The Womanly Art of Breastfeeding is a valuable book that covers everything about breastfeeding. It is a fantastic guide and reference tool throughout your breastfeeding journey. The Kelly Mom blog is an excellent online resource with detailed articles on every issue and question that can come up with nursing.

Professional Resources

No online resource or book will be a substitute for the value you can get from seeing a lactation consultant. The thought of hiring a consultant may sound expensive, but many times, you can find these resources for free.

Hospitals should have a lactation consultant on staff. You can request a lactation consultant stop by for a visit and spend a few minutes checking your baby’s latch, giving you alternative positions, and helping you troubleshoot any early signs of issues. Birth centers may have a lactation consultant or someone knowledgeable about breastfeeding. Midwives tend to be educated and can also assist with establishing breastfeeding after birth.

Once you are home with your baby, going to a breastfeeding support group can give you access to expertise and assistance. Plus, meeting other mothers who are also going through challenges can boost your confidence and make you feel supported. La Leche League is a great starting point for finding a support group in your area. Also, check with your birth venue or your doctor or midwife for recommendations for support groups.

You can mitigate or correct nearly any issue if you want to resolve it and continue breastfeeding. The key is not trying to power through issues alone and seeking help. Educating yourself, seeking professional advice, or attending a support group can fast-track fixing issues.

Lack of Support

From an evolutionary perspective, breastfeeding was critical for survival. Before the advent of infant formula, if a mother could not breastfeed her baby, she needed to find another woman who could. Breastfeeding infants wasn’t optional; it was the norm and necessary.

Perhaps nothing has dramatically impacted breastfeeding rates so much as a lack of support at the individual and community levels. It will be much easier for you to maintain your breastfeeding relationship if you have support.

Your partner, family, and friends are the first line of support. There are a lot of misconceptions about breastfeeding that shape people’s opinions. In my breastfeeding journey, I heard everything from you should stop when your baby gets teeth to breastfeeding will wreck your boobs. Thankfully, I was confident that none of this was true because I educated myself about breastfeeding. Most times, when someone gave me poor advice, I could counter it with factual information and blow it off. My partner and people close to me knew I was committed to breastfeeding and were mostly supportive. That support came from not encouraging me to use formula and being comfortable when I needed to feed my baby.

Dealing with a lack of support within your community or workplace can be more challenging. If you are uncomfortable breastfeeding in public, you can always find a secluded place to feed your baby or utilize a cover or nursing clothing to be more discreet. The more mothers normalize breastfeeding in public, the more communities will support and accept it. The key to getting support from your employer is hashing out all of the details of pumping at work. The people in your life are more likely to support your breastfeeding when you have made it clear this is important and a priority for you. The more confidence you have about breastfeeding, the easier this is.

Returning to Work

Another reason many mothers stop breastfeeding or supplement formula is because they need to return to work and cannot keep up with their baby’s demands and pump milk. If you are planning to pump, it is essential to understand the pumping-breastfeeding relationship. The most efficient way to remove milk from your breasts is to breastfeed. An electric or hospital-grade pump will not do as great a job as your baby. However, a pump can still do a pretty good job and will work in the absence of your baby.

When you remove milk from your breasts, you essentially tell your body that this is a meal; keep producing this quantity of milk at this time. If your baby is getting pumped milk in a bottle at noon on Tuesday, you need to pump at noon on Tuesday. It doesn’t have to be exact, but it should be relatively close to maximize your supply and keep your milk production up.

You must prepare if you plan to pump at work once your maternity leave ends. Talking to your boss or human resources department about needing to pump milk during work hours is essential. Ensure you nail down all details to build time into your schedule and have a place to pump. It will be challenging to keep up your supply if you skip pumping sessions. See the episode on pumping milk and building a stash for all the information you need to navigate pumping breast milk. That episode has details that will be helpful regardless of whether your goal is to pump occasionally, pump at work, or build a freezer stash of milk.

Getting Pregnant

Some moms who get pregnant decide to quit breastfeeding or feel like they need to stop breastfeeding due to their pregnancy. You always have the option to discontinue breastfeeding if you do not wish to continue, and you can continue nursing if you are pregnant. One of the raised concerns is that nipple stimulation causes the release of oxytocin, which can trigger contractions. A systematic review did not find a significant difference in the number of premature births between mothers who were breastfeeding and those who were not. Kelly Mom has several articles and resources on breastfeeding during pregnancy. It may also be helpful to work with a doctor or midwife who supports your choice to breastfeed during pregnancy if that is your goal.

Finding the Right Solution for You

You always have the choice to supplement or cease breastfeeding at any time for any reason. Any amount of time your baby is getting breastmilk will benefit them greatly. Breastmilk and formula are not mutually exclusive. You can supplement with formula and continue to provide the benefits of breastmilk at some feedings. You have to find solutions that are right for you and your baby. Whatever your goal is, I hope the information in this article helps you in your breastfeeding journey. See this page for all breastfeeding resources, episodes, and articles.

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