“All women can breastfeed!” It’s a popular slogan among breastfeeding advocates and lactation consultants, designed to give women confidence in their ability to feed their babies. And while it’s certainly true that most women are physiologically capable of producing enough milk to feed their babies, it’s never been true that all women can breastfeed.
Experts estimate that roughly 15% of women are physically unable to breastfeed, for a wide variety of reasons, including thyroid or hormone imbalances, breast hypoplasia, Sheehan’s syndrome, polycystic ovary syndrome, hypoprolactinemia, and prior breast surgery. Anxiety and depression also interfere with breastfeeding, as do inverted nipples, a baby’s tongue-tie, or simply their ability to latch.
It’s also always been true that many women who are physically capable of producing breast milk still can’t breastfeed because they have responsibilities outside the home.
Recent data shows:
- 42% of women are primary breadwinners
- 22.4% of women are co-breadwinners
Before the invention of formula, many women relied on wet-nurses or homemade combinations of watered-down cow’s milk, and many babies died of malnutrition and diarrhea.
In 1981, the World Health Organization (WHO) published its International Code of Marketing of Breast-Milk Substitutes, and resources were poured into breastfeeding advocacy.
Today, 83.8% of babies born in the US start on breast milk. The rise of attachment parenting, feminist and organic movements, have also had a positive impact. And in the meantime, formula continues to improve, as parents demand higher quality.
But, public health policy now pushes breastfeeding, with no comparable policy changes that would make it easier to breastfeed your baby exclusively for six months, such as federally-mandated paid maternity leave. This conflict sets most moms up for failure; within the first three months breastfeeding rates drop to 46.9%. And, nearly half of women in one study reported early, undesired weaning.
The 2010 amendments to the Affordable Care Act that facilitate pumping in the work-place are a way closing the gap between the recommendation for six months of exclusive breastfeeding and the absence of maternity leave. Even so…. Most companies don’t comply, and the policy has no enforcement mechanism.
Moms are trying harder than ever to do the right thing and comply with recommendations, but faced with this impossible gap, the best option for many moms is to combination feed, using breast milk whenever possible and formula whenever needed.