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Why some mothers choose not to breastfeed

Dr. Puffer says discomfort and latching issues are among the reasons some mothers decide not to breastfeed.

Breastfeeding is recommended for all newborn babies, but not all mothers choose to do it. Dr. Sheri Puffer is an OB-GYN with Women's Health Services in Arlington and Texas Health Arlington Memorial Hospital. She talked with KERA’s Sam Baker about some of the reasons why.


Reasons some mothers choose not to breastfeed

One, they don't feel like they're making enough milk. There's a lack of education about the first couple of days. There is something called colostrum that comes out, which is very important for the baby. It’s drops full of nutrients and disease-fighting antibodies. The infant's tummy is so tiny that it's all the baby really needs, and they'll feed more often, and that's just how it's meant to be. The more the baby nurses or that you pump, the more that tells your body to make milk and the milk comes in.

Physical discomfort and latching issues

It's very different having a baby nurse and sometimes their family hasn't done this before, and so they don't have support from home or know anybody that's breastfed.

At Texas Health Resources, every patient sees a lactation consultant while in the hospital. It's very important for education and allowing people this newness of “How do you do this? How does this baby latch without hurting me?”

Some women say they don't always get that kind of support in the hospital or after.

I can only speak for the hospital group I work for, and I know that that is available. You're also able to get lactation support afterward. Different insurances pay for it, as well as Medicaid. It'll pay for you to visit the lactation consultant afterward. So we tell all of our patients to let us know and we can send a referral. But home support is very important, and there are some disparities that occur.

The culture of breastfeeding

The culture of breastfeeding has really changed in the United States. The common use of formula in the 1960s was seen as a women's way to go to work, and they weren't tied down to breastfeeding a baby because breastfeeding a baby takes a lot of work, a lot of time and energy. If you're breastfeeding a baby, you are the one who has to be with that baby all the time.

That's a major issue because there might not be that support to take time off of work. There might not be that support when they go back to work, even though legally the federal labor laws tell employers that they need to provide a place that is away from other people that is private and not a bathroom, which is key. Nobody wants to pump in in a dirty bathroom, and I can't tell you how many times this comes up that the only place women are given the pump at a place of work is a bathroom that is shared.

But federal laws require that employees provide time to pump and the space to pump for up to one year after the child is born. Can I say that all places do this? Of course not. But that is the law.

Are women ever made to feel inadequate or ashamed because they can't or choose not to breastfeed?

You can definitely feel terribly alone and terribly ashamed like you can't provide for your child. And that's really difficult. We need to get away from that because you know, the best thing for a baby is to drink milk. It doesn't matter if it's breast milk, pumped milk, formula. That's the best thing for a baby, and every person has a very individual circumstance with their life.

Maybe they have many children at home and they can't spend the time it takes to breastfeed a baby and really devote that time. Maybe they have to go back to work very quickly, and they really don't have that ability to be able to pump and store their milk at work. You know, there are so many different reasons people might not be able to breastfeed and want to.

And I think we just as physicians, my job is to support them in whichever way they choose. But my job is to give education before the baby is born, which is very important. I recommend some websites and I say, go look at these because breastfeeding is not easy if this is something you desire to do. It's very important. You kind of read about it a little bit and look at things.

I ask my patients, Do you know anyone that's breastfed? That could be a help to you when you first start. I have three children and I have breastfed all three of my children and each time it got easier. So I feel like that really helps me counsel my patients because I've personally been there. I've done that. I have been a busy doctor and pumped milk at work, seeing many, many patients a day. So I have tricks and tips on how to do that in a busy environment. So I feel like those kinds of things can be helpful because it is definitely not inherent. And how to do this.


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Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.