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August 20, 2018

It’s OK Not To Breastfeed

As I entered exam room 11, I spotted this adorable newborn baby. She was dressed in a beautiful pink onesie with a matching bow, wrapped to perfection in a coordinating blanket. Her skin was a healthy shade of pink and she was resting comfortably in her mother’s arms. Her poor mother on the other hand looked exhausted. Her blood shot and baggy eyes showed signs of many sleepless nights and countless tears following her long and difficult delivery.  She had milk stains all over her pajamas which she later told me she had not changed in two days. I empathized with her frustration, understood her exhaustion, and could easily remember overwhelming feeling I faced after having my own first child.

When I asked her what brought her to the ER, her eyes immediately began to tear up. She explained that she did not think she was producing enough breastmilk for her baby. We went through her feeding schedule and her baby’s symptoms. The baby was constantly crying and rooting, even after her feeds. Mom became nervous because her baby girl had fewer wet diapers and was sleeping more than normal. I had her pump breastmilk and we confirmed that although she was making some milk, it was a very little amount. We spent a good amount of time talking about the importance of hydration while breastfeeding, tips to increase her milk supply, and the appropriate technique to ensure her daughter was successfully latching. A lactation consultant came down to the ER to help her and to give her resources for support groups, and lactation consultants to contact after being discharged. I called her pediatrician to coordinate close observation during the next 12 to 24 hours to ensure mom’s milk supply increased, and the baby was getting the appropriate amount of nutrients.

But then I gave her some advice that in the healthcare field, we don’t give to enough mothers that are struggling with breastfeeding. I told her that it is ok if she doesn't breastfeed! I told her to try her best and use all the resources that we are giving her, but that if it does not work, she is still a great mom and wants to do the best for her baby. I promised her that formula is not poison and that her child could still grow up to become the President of the United States. We had a good laugh and you could immediately see the stress relief.

There is not a mother that I have met that doesn't want the best for their child. The research, which has been performed through decades, has supported and confirmed the benefits of breastfeeding for both the mother and the baby. As a pediatrician, I truly believe it is one of the best things you can do for your newborn. However, the pressure that is placed on a woman to breastfeed from the media, mommy blogs, healthcare providers, and other moms is incredibly intimidating. So much so that it can produce a sense of failure for a new mom who is struggling with breastfeeding. But a mom suffering from mastitis, clogged ducts, low milk supply, a baby that cannot latch, a busy career, a jealous sibling, or just does not want to breastfeed, does not love their child any less. Those who do not breastfeed are not failing as mothers, and their babies are still getting the nutrients they need from formula. The most important nutrient that you can give to your newborn is love, and if you are completely stressed out from breastfeeding, it can become counterproductive.

It is very rare that I get an opportunity to follow up with patients I see in the ER, but I was actually stopped by this patient's husband about one year later. He had remembered me and wanted to show me pictures of their daughter's one year birthday party. He told me that his wife was able to continue to breastfeed, and how much it meant to her that I took the time to help. I thanked him, but told him that his wife did not need a doctor that day, she just needed a friend to let her know that she is a loving and caring mother and doing the best for her baby, whether she breastfeeds or not!

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