Monday, January 10, 2011

The things we're not allowed to say

While pregnant, I took the time to read about breastfeeding, convinced that this was the way I wanted to feed my child. It seemed much easier to me than fussing with bottles, it's definitely cheaper, and I wanted the bonding time with my little one. The saying "breast is best" has been drilled into our heads, and most new moms are willing to give it a try. In Canada, about 72% of babies are breastfed following birth. However, at 4-5 months of age, only 31% of babies are breastfed (LLLI, 2010). Why such a significant decline?

When discussing breastfeeding with doulas, midwives and other health professionals, the message I was given consistently was that "breastfeeding should not hurt." I was told that if it hurts, something is wrong with the latch, and I should seek professional help as soon as possible (by visiting one of the breastfeeding clinics around the city or hiring a lactation consultant). Sore, cracked and bleeding nipples are supposedly signs that something needs to be "fixed."

The first time A latched on, the midwife asked me how it felt - was it uncomfortable? Painful enough to make my toes curl? I thought for a moment, and said that although it wasn't painful, it certainly didn't feel pleasant. It was actually kind of irritating! Within several days, I had a big crack on one nipple, and I dreaded each feeding for the intense pain it caused. I told my husband we had to get help right away, and even though I was exhausted and still very sore, we went out to visit one of the local breastfeeding clinics. The woman there was helpful, and A latched pretty well. However, as soon as I got home, I couldn't get her to latch again, and called the midwife in a panic.

The following weeks, I dragged A (and my poor mother) to various breastfeeding clinics around the city. I hired a lactation consultant at $80/hr, and I read every book and website I could get my hands on. I even emailed breastfeeding guru Dr. Jack Newman, who gave me a very curt and unsatisfactory response to my message (as a side note, I'm sure Dr. Newman is wonderful and I know his books and website have been very helpful to many moms out there. Not trying to slam the big guy, but I was put off by the tone of his email.) The breastfeeding relationship was full of stress and anxiety, and I would wail away about the fact that I might not be able to breastfeed. My normal, unhormonal husband and mother tried to help, but they just couldn't get why I was so distraught. So what if I had to give her some bottles? What was the big deal?

My saving grace was the student midwife at my birth, who also happens to be a good friend. She counselled me a bit on the phone one night, and told me she knew I could do it. She said "give it until 6 weeks, and I promise you, you will make it." And you know what? She was right! At about 6 weeks, things got better, my crack healed, and I didn't have intense pain while feeding. I still felt like the latch wasn't quite right, but as long as she was healthy and growing, I kept going.

My daughter is now 16 months old, and I am a rarity amongst friends. I don't know too many people still breastfeeding at this age. Since the troubles I dealt with, I have eagerly polled every mother I know about her own experience with breastfeeding. I wanted to know if I was the only one who found things so difficult. And, (gasp), I wasn't! I can count on one hand the number of moms who have told me that breastfeeding was not painful. Almost everyone I have spoken with (including my mom and many women from her generation) has a story about sore or cracked nipples.

So what's the deal here people? Why are we telling women that sore and cracked nipples equals a problem, and that breastfeeding should not hurt? Here's the argument: if we start telling women that breastfeeding is supposed to hurt, a) no one will try it; and b) women who truly have problems won't bother seeking professional help, the problem will get worse, and they will give up on breastfeeding.

I agree with the second statement. I'm not trying to propose that women just suck it up and deal with the pain. Going to breastfeeding clinics and attempting to make a latch better will certainly help in the long run, and I think everyone should do this if you're feeling sore. Just the support of other moms and professionals is a wonderful way to reduce some of the stress (and maybe even have a laugh or two!) And hiring a lactation consultant to help with more serious problems is a necessity. But breastfeeing is a new relationship between you and your newborn. Neither of you really know what you're doing - we haven't grown up in a tribal culture where women breastfeed out in the open, all day long (and often practice communal breastfeeding!) So it is an adjustment period, and there will be a learning curve.

A part of that learning process will involve, for many women, sore and/or cracked nipples (I can hear the gasps and cries of outrage coming from the breastfeeding community...she's not supposed to say that!!) I've said it because I know it to be true. Who wouldn't be a little sore with someone sucking on your nipples for countelss hours a day? It's not like they've ever been stimulated so much! Imagine if someone repeatedly pulled and stroked on one part of your arm for 8 hours a day? Wouldn't you expect it to be a little tender after a while?

As a comparison, why do we prepare women so much for the pain of labour? Because we want them to realize that the intensity of contractions is a normal part of the process; we want to avoid the overuse of medicationas and interventions if we can. If women are well prepared for labour and birth, then they will feel confident in birthing naturally and will probably have better satisfaction with the whole experience. It's not like we tell women "oh, labour should not be painful...if it is, there's a problem."

If you believe that women aren't talking about how breatfeeding is painful, then you are quite blind to the conversations that go on amongst mothers. As I mentioned, it's a rarity in my circles that someone has breatfed without feeling uncomfortable at some point. Just yesterday at a baby shower I attended, one woman brought up her painful experience with breastfeeding, and soon the whole room was piping in. They warned the mom-to-be that things might be tough going for a few weeks, but that eventually it would all work out.

So let's start saying the things we're not supposed to say. Let's get truthful about breastfeeding, and perhaps women will be better prepared for the difficulties they might encounter. Heck, the least it could do is save a husband or other support person from having to deal with a new mother sobbing about her failure to produce a "good" latch.

I'm going to go hide out now and wear dark sunglasses and a wig for a while, just so I can avoid the angry mob of breastfeeding experts from tearing me apart.


  1. You're too funny, Misty! I don't think you have written anything offensive :-)
    I am one of those breastfeeding professionals who teaches that breastfeeding is NOT supposed to hurt simply because many, many women have pleasant bf-ing experiences. More often than not, though, there are challenges. My concern is that there is a myth out there that somehow nipples need to be prepped or "toughened" up for bf-ing which is silly since your nipple shouldn't really be so involved. It's called BREASTfeeding not NIPPLEFeeding. The problem is usually a matter of how deep the latch is. The latch can look great from the outside but if the mom is experiencing sore nipples then there is a good chance the baby doesn't have enough breast in his or her mouth. When mothers understand the mechanics of breastfeeding, it tends to make a heck of a lot more sense. It's not as simple as sticking the nipple into the baby's mouth which usually results in the nipple rubbing against the hard palette (?). I think a lot of preparation involves talking about how to tell if the baby is getting enough, how many pees/poos per day, different positions, how often to feed, etc. etc. but little info is shared on the actual mechanics of breastfeeding. I think mothers are overwhelmed by all of the info out there and the fact that a large percentage of it is inaccurate. I still think breastfeeding isn't supposed to hurt but I think that it hurts for the majority of women.
    And, Dr. Jack Newman is great to answer his emails but he lacks in bedside manner. I hear that all of the time. Good piece!!

  2. Great post! As an RN working in a Neonatal ICU as well as working in the community as a Primary Health Care Nurse Practitioner - I am also one of those health professionals that teach breastfeeding isn't supposed to hurt. However, the reality is I hear time and time again from many women how much it DOES hurt! I completely agree with Julie's above post re. mechanics of breastfeeding. It is important for the nipple and surrounding areola to be far enough into the mouth to bypass the hard palate to the soft palate. Personally, I was extremely fortunate to breastfeed both of my children until 15 months and 10 months pain free - however I may be a rarity!
    Thanks for sharing this post! You have a great blog :)


I love comments and emails, as most bloggers do! You can reach me by clicking on my "about me" page and sending me an email, or leave me a note below a post and I'll be sure to get back to you!