Knowledge | Breastfeeding is hard and support is limited—US experts urge planning breastfeeding support during pregnancy



Knowledge | Breastfeeding is hard and support is limited—US experts urge planning breastfeeding support during pregnancy


“Breastfeeding is difficult, and most new mothers receive far too little help.” This is the central conclusion of a JAMA article from the U.S. Preventive Services Task Force. The federal advisory group reiterated that new mothers need continuous, proactive, professional breastfeeding support, not simply encouragement.


More than 90% of expectant mothers say they plan to breastfeed, but fewer than 60% are still doing so when their baby is six months old, and only 27% are exclusively breastfeeding.


“Many mothers are not unwilling to breastfeed; they simply do not receive the right support,” said pediatrician and University of Vermont College of Medicine assistant professor Dr. Michelle Shepard. “You can and should tell your doctor during pregnancy, ‘I need help.’”


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Breastfeeding offers more than nutrition

Research has established that:


Breastfed babies have fewer respiratory infections, skin allergies, and episodes of diarrhea


They have lower risks of sudden infant death syndrome, childhood obesity, diabetes, and leukemia


Breast milk contains antibodies that strengthen immunity against infections such as measles


Mothers may also benefit, including lower risks of postpartum depression and breast cancer


Unfortunately, healthcare and public-health systems still lack a truly practical support structure. The task force emphasized that one-time interventions have limited impact; breastfeeding support must remain available throughout the process.


The key to success is planning ahead

“Do not wait until you are exhausted after delivery to look for support,” said Jill Demirci, PhD, associate professor at the University of Pittsburgh School of Nursing. “Plan no later than pregnancy.”


You can:


Find local breastfeeding resources through ZipMilk.org


Ask a pediatrician whether the hospital or community offers breastfeeding support groups


Schedule a Lactation Consultant in advance, including remote video support


Check whether you qualify for professional support through WIC


Demirci noted that the first few weeks of breastfeeding are almost a full-time job and require both professional and practical help. “Who will cook? Who will do the housework? Who will help change diapers at night? These factors determine whether breastfeeding can continue after birth.”


If affordable, a Postpartum Doula can be extremely helpful. Those with limited budgets can organize support from family and friends in advance, such as a Meal Train or help with errands. “Support exists, but it usually does not arrive automatically. You need to plan ahead.”


When breastfeeding does not work or meet expectations, emotional support also matters

When breastfeeding plans encounter real difficulties, many mothers feel discouraged, anxious, or guilty. Demirci emphasized: “Breastfeeding Grief is a real emotional trauma, and an experienced perinatal mental health professional can help.”


You are not alone:


Join online parent communities or breastfeeding support groups and share your feelings


Discuss combination feeding, weaning management, and mastitis prevention with a professional lactation consultant


If you have stopped, you may try Relactation, even after six weeks


How should you decide whether to continue or stop breastfeeding?

Demirci and Shepard offer a practical set of tools to support your decision and protect it from outside pressure:


Write a pros-and-cons list for continuing and stopping breastfeeding


Talk through your thoughts with your partner, family, and doctor


Remember that you are still providing breast milk even if it is pumped, bottle-fed, or donated


Do not rush: you can decide not to decide yet and reassess after a few days


Prioritize sleep: even two uninterrupted four-hour periods can improve mood and thinking


Rest proactively: ask someone else to handle several feedings while you rest and regain emotional balance and clarity


If you do not want outside input, you have every right to set boundaries:


“This is my personal decision, and I do not want to discuss it.”


“I have decided to stop breastfeeding. It was a difficult but firm choice.”


Dr. Shepard concluded: “Healthy parents raise healthy children. We are here to support you, not judge you.”


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