Hi Jennifer,
I am in a unique position of working in a facility that delivers mostly middle class, insured, educated moms that are on average 25 to 35 years of age. So I can only address that particular demographic, and therefore you may or may not find my thoughts helpful, but here goes.
As you can imagine, we have a wonderful breastfeeding initiation--85%. Our 2002 duration rates were 46% and our 1 year duration rates were 22%. My fear is that the next round of calls for 2003 rates will reveal that duration has fallen because of parent's comfort level with lipil being a "good" replacement for breastmilk. We have certainly heard comments from weaning mothers to indicate this may be an issue. 2003 rates should be interesting.
Your post caught my eye because your thoughts on the reasons some mothers stop breastfeeding are different than mine. I think we are both right in some ways. I have felt for years that many mothers wean because they thought they were supposed to love and/or enjoy breastfeeding 24 hours a day. The day or week that they no longer "felt" like they were loving/enjoying it, they thought it was the right time to stop. Our duration rates increased after the AAP Statement was issued and we became verbal in sharing the statement's duration recommendation. We encourage our mothers not to look at breastfeeding as something they will enjoy or even like all the time, but as a commitment to their infant's/child's health--similar to the commitment of staying married even when you don't particularly like your husband for a few days, or staying in college when it is really rough for a while. We tell them that there are peaks and valleys with breastfeeding and sometime they will thoroughly enjoy it, and sometime they will resent it--but that in the end they will not regret one day that they stuck with it, even when they were not feeling that joy. When they are in a valley, we assure them that the joy they have felt with feeding in the past will reappear and they will be glad they waited it out.
Our culture has become so addicted to the concept that we are supposed to only do what makes us happy or brings us immediate joy, that we lose a lot of the good stuff along the way--pride in accomplishment, joy in fulfilling a commitment, feeling of achievement through meeting a goal. I don't think this means people are more selfish today than they were in the past, I just think they have been taught to have different expecations about what they are supposed to feel and how they should respond to those feelings.
Does this work? I don't know. But I feel good about the message and mothers do seem to respond when we discuss those thoughts in a non-judgemental, friendly way. We never lecture, we just share thoughts of that nature like a friend. Much of our conversations begin with--I can see how you would feel that way; Many mothers tell us; I know a mother who; I know what you mean...
I hope that some of my thoughts have been helpful to you. It was fun to read your post and "e-listen" to the joy you have felt through your breastfeeding experience. There are many mothers out there just like you, that do love breastfeeding and can continue on those feelings. Breastfeeding is the ultimate gift a woman gives her baby--because she chooses everday whether to continue or to stop. Some of us are more giving and receive more joy from giving than others. It is just who we are and how we are wired--not good or bad, just different. Those that have a more difficult time with that gift sometime need our help in seeing reasons to continue from a different perspective.
Thank you for allowing me to share with you!
Glenda Dickerson
B'ham, Alabama USA
----- Original Message -----
From: Jennifer tieman
Sent: Monday, March 22, 2004 9:27 PM
Subject: Promoting breastfeeding continuance
I have been musing again about the poor continuance rate for breastfeeding
in my community. I have pretty good success in encouraging moms to initiate
breastfeeding (my patients have the highest initiation rates of any of the
docs who attend deliveries here) but still have a lot of moms who wean very
early, and very few who practice exclusive breastfeeding.
The last couple days I have seen in follow up several moms and babies who
weaned very early, either due to difficulties getting going initially, or
other more obscure reasons. I had one mom telling me how hard breastfeeding
was for her, since she had to be available 24-7, no one else could take her
place, family wasn't supportive and the baby didn't even seem to appreciate
it (because in that newborn phase he only slept, ate, and fussed for the
most part.) I felt so sad for her that she never got to enjoy the
breastfeeding relationship, but quit while it was still more chore than
anything else.
As I am now nursing an older baby, I am reminded daily of all the joys of
nursing an older baby, and am trying to share these with my patients who are
struggling through those early, frustrating days. I think too often in the
US we tend to see breastfeeding as some duty moms fulfill for the health of
their children, and don't always appreciate the joy and pleasure both
parties get from the breastfeeding relationship.
In the early days, my little girl was all about the milk and getting fed,
but now she so clearly loves me and enjoys nursing for the closeness and
comfort as well as the milk. She smiles at me constantly while nursing, and
often latches on with a dramatic flourish that would make you think she
hadn't eaten in a month. (She has a new method I call "leading with the
tongue" She lunges toward the breast with her tongue hanging out, then as
soon as her tongue touches me, she throws her head back and her mouth wide
open and executes a perfect assymetric latch. I actually really appreciate
the protruding tongue, as it completely covers her razor sharp new teeth!)
So many moms I assist have never seen a nursing baby, or if they have, their
experience is limited to the newborn or young baby stage. I'm trying hard
now to tell all new moms in the first days that breastfeeding won't always
be work, especially those moms who are struggling with problems in the first
days. I wish I could loan every new mom a day with an experienced, happy
older baby! Since that's probably out of the question, what are some ideas
others are using to promote continued breastfeeding out there?
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose, born 5/31/03
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