Breastfeeding: Balancing Idealism With Realism

Recommendation to breastfeed for six months too idealistic, study finds.

March 14, 2012, 9:58 AM

March 15, 2012— -- After nine months of pregnancy and no less than six parenting books, Vanessa Vancour was ready to raise a breastfed baby.

"I thought, 'This will be this perfect. I'll breastfeed for a year or maybe more,'" said Vancour, 27, who lives in Reno, Nev.

Because breast milk is rich in nutrients that help babies grow and antibodies that ward off infections, the World Health Organization recommends exclusive breastfeeding for the first six months -- a feat less than 15 percent of U.S. moms manage to tackle.

But Vancour was lucky. Her daughter, Billie Skye, quickly latched on. Everything was going according to plan until Vancour's 12-week maternity leave came to an end.

"I had to go back to work, and I hated pumping," she said, describing the inconvenience and downright awkwardness of pumping milk twice daily in her office and carrying it home in a cooler. "That's what did me in. I kept thinking, 'How selfish of me.'"

Without regular pumping, Vancour quickly stopped producing milk. And despite her plan to breastfeed Billie Skye for a year or longer, she had to switch to formula after five months.

While most moms want to breastfeed for six months, a new study suggests many find the goal unrealistic, and the push to do so unhelpful.

"There are many competing demands on new parents: lack of sleep; crying, unsettled babies; other children to look after; and work commitments," said Dr. Pat Hoddinott of the University of Aberdeen, U.K. who lead the study published in the journal BMJ Open. "Families very carefully weigh of long term benefits of breastfeeding with the family's immediate wellbeing."

The study, based on series of interviews with new parents, revealed a mismatch between expectations and the reality of infant feeding -- one that leaves mothers feeling guilty.

"It puts a lot of strain on new families," Hoddinott said. "Instead of stating the World Health Organization guidelines, we should be telling women to breastfeed as long as they can. There's accumulating evidence that breastfeeding for as long as possible has heath benefits for both mother and baby."

Breastfeeding may be natural, but it's far from easy, according to Dr. Marjorie Greenfield, chief of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland.

"On one hand, it's better for the baby to breastfeed. On the other hand, you don't want it to interfere with the relationship between you and your baby or the rest of your family," she said. "I wish people had adequate support so they didn't feel like they had to make a choice."

On top of the guilt, Greenfield said some moms feel judged by their peers who could keep breastfeeding for the recommended six months -- an experience 26-year-old Louisa Gehring of Wilmington, N.C., knows firsthand.

"I felt like every other mom made a point of mentioning how she breastfed for a year," said Gehring, who switched to formula when her 2-week-old when her daughter wasn't gaining weight. "I admit there are times when I hoped, "maybe they think I pumped breast milk into a bottle.'"

Breastfeeding Moms Need More Support

While the country is becoming more breastfeeding friendly, new moms still struggle to find the support they need to keep it up for the recommended six months. In January 2011, U.S. Surgeon General Dr. Regina Benjamin released a "Call to Action to Support Breastfeeding" -- a plan to promote breastfeeding at work, at home and in the community.

But according to Hoddinott's study, some parents "view breastfeeding promotion as 'propaganda' andsuggest that the 'breast is best message' has been overdone."

"I don't want to say it's propaganda because I do believe in breastfeeding," said Dr. Gabrielle Gold Von Simson, assistant professor of pediatrics at NYU Langone Medical Center. "But what these women don't hear enough is that they have options and they shouldn't beat themselves up over giving a bottle if that's what they need to do."

Vancour, who is now seven months pregnant with her second child, said she's ready to ditch the parenting books and play this one by ear.

"I think we tend to inundate ourselves with literature and set unrealistic expectations," she said. "You can plan all you want, but at end of the day every kid is different."

And while she'd like to breastfeed for at least six months, Vancour won't let it stand in the way of enjoying motherhood.

"I have more realistic expectations this time," she said. "Knowing how I felt first time around, I don't want to revisit those feelings."

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