Dr. Rebecca B. Singson, MD, FPOGS

1. No pre natal preparation – many women get poor advise, or even no advise from their obstetrician during their prenatal check up. On the 1st meeting, ideally, the mother should already start psychological preparation for breastfeeding by reading books on breastfeeding, accessing websites on pregnancy & breastfeeding. It is never too early because those mothers who decide to breastfeed during the pregnancy are those who end up successfully breastfeeding. Especially with pregnancy adolescents, the chances of getting them to breastfeed increases over fourfold if they are given. Younger women and women with moderate to poor emotional support visitor were less likely to still be breastfeeding at three months.(Hodinott)
2. No intrapartum/postpartum support – women who had a rough labor, prolonged labor and end up with a C-section usually want to sleep to recover from the exhausting experience and prefer to defer breastfeeding for a later time. Studies also show that mothers who spent 1 night in the hospital were almost twice as likely to breastfeed than mothers who spent 2 or 3 nights in the hospital. This may mean that hospitals, perhaps because of the Nursery set up, tend to separate the mother from the baby unless rooming- in occurs.(Margolis).
3. Poor latch on – Women who experience pain when the baby starts to breastfeed and try to withstand the pain it instead or re-latching. can end up with cracked and sore nipples. This can result from wrong positioning of the baby. The mother & baby should ideally be in the tummy-to-tummy position with the ears of the baby directed to the ceiling. The baby’s mouth should include not only the nipple but the areola too and must not be allowed to tug on the nipple. Upon  withdrawal of the nipple, it must not assume the shape of the end of a lipstick but should be a round structure.
4. Wrong feeding pattern – Some women think that babies should feed only every two or 3 hours and only for 10-20 minutes. Babies should be fed on demand because it may take up to 2-4 weeks to establish a good milk supply. Most babies will gain weight if they are fed on demand or at least every 1 1/2 to 2 hours. Waiting more than 2 hours may cause the breasts to become engorged and painful. This decreases milk production.  Women who think they will gradually build up breastfeeding by supplementing with formula or glucose water are setting themselves up for a higher likelihood of failure to establish breastfeeding. This is because introducing alternatives to breastmilk in the first 6 months will cause the baby to become full and decrease its demand of breastmilk which in turn will decrease its supply.
5. ”Did not produce enough milk” – so many women are so insecure and so unempowered to believe that if nature had allowed them to bear a child, nature would also equip them with the means to keep their baby alive. It is all based on supply and demand. The moment you start to mix fix with formula, the demand for breastmilk decreases since the baby is fuller for a longer period of time. Logically, this is because the proteins of formula milk stay undigested for upto 60 mins  (allowing the proteins to reach the intestines and cause major allergies) while breastmilk is digested within 15 mins.
6. Unrelenting frustration – Women who end up with a comedy of errors that can start with a poor latch on then end up frustrated when she gets sore nipples or baby rejects her. The problem is the moment Mom gets stressed, she won’t release the hormone prolactin which is released from her pituitary gland at the base of the brain & is responsible for the milk let down reflex. .
7. Poor home support – Some of the first people who may discourage you from breastfeeding may be your very own mother, aunt, or relative who grew up in a generation brainwashed by ads to believe that formula is superior to breastmilk. Some overbearing Moms may find it ridiculous why you should make like difficult for yourself when there is formula milk to free up your body and your time. This may lead one to believe that since your family members didn’t breastfeed you won’t be able to either (so untrue).
8. Illness/infection – Sometimes a hospitalization for a serious illness, a fever or infection can prompt your pediatrician to shift you to formula feeding. Even during a fever or an infection, as long as it is not AIDS or active tuberculosis, one may continue to breastfeed. Research suggests strongly that any risk of transmission associated with breastmilk is negligible compared to the high risk of exposure to maternal blood and body fluids at birth. However, cracked or bleeding nipples or lesions with serous exudates could possibly expose the infant to infectious doses of Hep B.. (Stevens & Harvey)
9. Work Interference – Many women stop breastfeeding once they go back to work 6-8 weeks after delivery. Leaking breasts can be embarrassing during a corporate meeting or the stress of the work itself can jeopardize the release of prolactin essential to the milk let-down reflex.
10. Simply don’t want to – Some Women, however, who pregnant under adverse circumstances, like after a rape, are not  psychologically prepared to breastfeed since they feel further violated..
11. fear of pain – Those who imagine themselves being bitten on the nipples or have seen the suffering of some women with engorged nipples are afraid to undergo the experience themselves.
12. uneasy with the thought – women don’t have the confidence that they have it within them to keep their baby alive through their natural faculty of breastfeeding.
13. suits her lifestyle – some women don’t want to be tied down at home because of work or leisure reasons. Breastfeeding just simply cramps her style. The truth is, we can bring the baby everywhere and feed as needed. With a drape over your breast and the baby’s head, one can continue to breastfeed without even being noticed. All the baby really needs after all is is to be fed and changed.
14. Our breastfeeding culture has disappeared – We live in a society where we do not see women breastfeeding if public. So if you haven’t grown up seeing women around you breastfeeding successfully, if it’s something that’s hidden away, then it becomes even harder for you to succeed yourself. Many women feel embarrassment with public exposure.

What Can Be Done?

1. Consult a lactation consultant – a breast massage with lactation counseling does wonders to make your milk flow within the hour. Contact them through ReBirth Spa at 7719206/09178063339.
2. Inquire about donated breast milk –  If despite lactation counseling and best intentions, the milk is inadequate, (evidenced by less than 6-8 wet diapers per day after the 1st week, less than 3 stools in 24 hours or birth weight is not regained after the 10th day), you can ask your pediatrician or friends to patch you up with other breastfeeding moms willing to donate breast milk to you. It has been done and you can make it happen if you so desire.

Hoddinott P, Pill R, Hood K. Identifying which women will stop breastfeeding before three months in primary care: a pragmatic study. Br J Gen Pract 2000;50:888-91

Margolis LH, Schwartz JB. The relationship between the timing of maternal postpartum hospital discharge and breastfeeding. J Hum Lact 2000;16:121-8

Beasley PR, Shiao I-S, Stevens CE, Meng H-C . Evidence against breastfeeding as a mechanism for vertical transmission of Hepatitis B, , Lancet 1975;ii:740-41

Woo D, Davies PA, Harvey DR, Hurley R, Waterson AP . Vertical transmission of hepatitis B surface antigen in carrier mothers in two west London hospitals, , Arch Child Dis, 1979;54:670-75