100 Reasons Why Women Stop Breastfeeding

There are many reasons women stop breastfeeding but one of the most common is that they say their milk either ‘dried up’ or they weren’t producing enough. However, if you delve a little deeper every woman will have a story particular to her that explains why she stopped and it is usually much more complex than there just not being enough milk. There are in fact way more than 100 reasons why women stop breastfeeding but what I want to discuss in this post is what ‘not enough milk’ means and why it happens so much more than medical research allows for, i.e. I found scant evidence for physiological causes of low milk supply in my research.

breastfeeding model
This is how you breastfeed right?

Breastfeeding is a perfect example of how you can’t look at human activity in isolation from its wider context, whether it’s breastfeeding or mathematics, what we do is shaped by our surroundings and shared beliefs. Obviously this doesn’t mean there are no bodily facts, breastfeeding can only be done by women with breasts (apart from the men who breastfeed but let’s not complicate matters), but I wonder if the tendency to just look at breasts and breast milk as almost separate from the woman herself has skewed our understanding and our experience of this essential activity.

Looking for images about breastfeeding for example google rarely brings up any pictures with women in a social situation, it is almost always just the breast and the baby without the rest of the woman!

This reveals the cultural bias in the West to see breastfeeding as biological and nutritional but not social. This explains why so many women despite knowing that breastmilk is superior nutritionally, on a social level it is still an awkward thing to do and in some situations it is actively disapproved of as the poet Hollie McNish expressed so eloquently.

We see breastfeeding as a slightly embarrassing nutritional, biological activity but how do we see nutrition and biology? There are strong arguments that industrialisation and the Enlightenment both contributed to an idea of the body as a machine, a series of processes a bit like a factory, separate from the mind and one that can be understood using the language of economics. What does that have to do with breastfeeding? Well just look at the language midwives and mothers use.

In an ethnographic study in the north west of England the anthropologist Fiona Dykes found several words kept being used by those she spoke to: producing; supplying; demanding; controlling and productive.  Only one woman spoke of breastfeeding using terms like intimacy and nurturing and she was from Gujarat. Nurturing and intimacy imply relationships not just inputting nutrition by providing the right quality and quantity of milk at the correct times. Terms like keeping up your supply, not giving in to controlling babies using you as a dummy (aren’t dummies supposed to be mimicking breasts, not the other way around!?), on demand feeding, producing enough and so on, all contribute to an idea of breastfeeding as a production line. It’s no wonder that some women feel they are failing and have anxiety about ‘producing enough’.

Another ethnographic study in the UK, completed recently, highlighted the effect of regular weighing of newborns. What it discovered is that the centile charts and the often weekly weigh ins were causing unnecessary concern in both health professionals and mothers which often resulted in the introduction of formula. The centile charts used by most health visitors and midwives are based on a study monitoring only formula fed babies in the US. This new study reveals that breastfed babies do have small fluctuations in weight: some weeks they may decrease in weight and others they’ll increase. I emphasise that these are small discrepancies and if you are advised to consider formula this may well be the best choice for you. But it’s another reason why some women stop breastfeeding based on the feeling that there are correct weights, volumes, supplies and demands when in fact they may be doing just fine. Breastfeeding is about feeding and nurturing your baby in your every day life, it is not a production line nor a medical procedure.

I want to make clear that I have no desire to diminish the real experiences of women who did not have enough milk for their babies. For many women stopping does not feel like a choice but an absolute necessity and I have no wish to put their experiences into question. As I expressed in a previous post, bottle feeding is just as natural as breastfeeding and there is no judgement here.

I have a million other things to add and I hope to continue this topic but for now let me finish on a health initiative undertaken in India with 299 women who all came to the medical centre with concerns that their babies were not getting enough milk (it’s definitely not just a Western worry, it’s incredibly common across the world). After 3 months they were all discharged and were exclusively breastfeeding their babies. What did they do? All the usual strategies of correct latch etc that you’re probably familiar with but two further things stand out. Medical staff were told not to use words like ‘wrong’ ‘right’ or ‘enough’ and grandmothers were actively encouraged to advise and support the young mothers. This was because as the report outlined, ‘Casual comment by relatives or health professionals that the mother may not be having enough milk may be sufficient to reduce the mother’s confidence, suppress oxytocin reflex and cause lactation failure’. These women were spoken to in a positive non quantified way and their social relations and context were taken into consideration. I wonder if we can learn something from this project here in the UK.

 

Resources

I read loads of different articles for this post so if you have any questions just ask and I’ll send you the relevant papers.

If you’re struggling to breastfeed then see what your local health visitor or midwife can provide, lots of boroughs and counties have excellent specialist lactation support. If you don’t have access to that or it’s not working for you La Leche League provide excellent if slightly biased advice. This is the UK site but there are groups all over the world  https://www.laleche.org.uk

If you want to try mix feeding or switch to bottle feeding here’s some excellent practical advice on bottle feeding technique: http://nurturedchild.ca/index.php/pumping-bottle-feeding/bottle-feeding/

Is Breastfeeding Natural?

(This is me breastfeeding (it isn’t))

Of course it is but the whole question of what is natural can cause a lot of damage when discussing breastfeeding. I recently had a bit of a ‘debate’ on FB with a friend of a friend about breastfeeding. A modern phenomenon and not the best place for reasoned discussion, I succumbed nonetheless. The friend used the word ‘breastapo’ to describe breastfeeding advocates, which I took umbridge with but after stewing for the best part of a day I decided to look at things through an anthropologist’s eyes Continue reading

Does Your Baby Actually Want You to be Tired?

vintage-tired-mum

So in a small departure, this week’s post takes a look at a theory from evolutionary biology not anthropology. This is not my specialism so apologies for any over-simplification but I thought it was so interesting it was worth writing about.

Mother and baby: a relationship in harmony or in conflict?

Most people in the West have pretty incoherent and conflicting beliefs around the relationship between mothers and their babies. On the one hand having a baby is seen as the most natural thing in the world, mothers and babies are seen as working in harmony, each biologically programmed to work together for the best possible outcome. On the other hand, birth is incredibly dangerous, babies are exhausting and are occasionally described as ‘manipulative’ for wanting more milk or crying a lot. Harmony on the one side and conflict on the other. Evolutionary biologist David Haig, addresses the subject of infant sleep with the intention of illuminating just how little harmony there often is. Continue reading

When Was the Last Time You Had a Good Night’s Sleep?

ab6

Interrupted sleep is the most common complaint of new parents in the UK. Tiredness, fatigue, exhaustion, all the synonyms come into play when describing what for many is the hardest part of being a parent, especially when the children are still very young. Everything I’ve read indicates that we have unrealistic expectations of how well and long babies should sleep but also how well and long adults should sleep too. There’s such a lot of fascinating research on sleep that I’m going to write this in a few parts.

There is a school of thought that says that babies and toddlers who don’t sleep through the night shouldn’t be expected to. If we look at sleep practises around the world, bed sharing and breastfeeding during the night are so common that putting babies in their own room to sleep all night can seem rather bizarre. Are we really the only culture that doesn’t sleep with their babies? Would it be better if we did? Should babies be sleeping through by six months or a year? Continue reading

When to stop breastfeeding

 

When it’s time time to wean* your child from breastfeeding the advice currently is to take it at the child’s pace and not to force it. However, if the Bofi in central Africa are anything to go by that might not be until they’ve reached the age of three or four which is pushing it, as far as most Western mothers are concerned. I’ve been wondering how best to go about it with my very keen to feed toddler and found the accounts of differing methods amongst the Bofi very interesting.

Whilst both communities call themselves Bofi and share the same language, one community are farmers and the other foragers and live in distinct ways.

Bofi foragers let their child decide when they want to stop breastfeeding and make no conscious effort to hurry the process along although they do progressively spend less time with their children as they work more, allowing other members of the family to hold and care for them. Letting their children decide when to stop is in line with how they see themselves and their offspring. They value independence and Bofi adults respect their children, seeing them as capable of making their own decisions. Children aren’t warned off playing with sharp objects and they are given the choice of whether they would like to help their mothers or to play instead. When a mother was asked when she planned to stop breastfeeding she laughed and replied ‘Only he knows. Ask him. I cannot know how he thinks/feels.’

Bofi farmers on the other hand encourage obedience in their children and use fear and corporal punishment as methods to achieve this. Which sounds harsh but is actually very similar to Western parenting. e.g. ‘don’t go in the forest because it’s dangerous, the spirits might get you. Don’t touch that knife, you’ll cut yourself.’ etc When it comes to stopping breastfeeding the age of two is considered optimum. Mothers start by feeding less and working more until finally they choose a day and then either paint their nipples red with nail varnish or bandage up their breasts telling their toddlers that they have injured their nipples and can no longer feed them.

As a result Bofi farmer children cry and fuss a lot more than their foraging counterparts during weaning which is probably also made worse by the fact that they are held a lot less than forager children and that once they are weaned they aren’t really held by anyone at all, spending their days with siblings whilst their mothers work.

What are the consequences of the two different methods? Well, they both get weaned eventually and there is no evidence that the attachment is any weaker in farmer children nor that they suffer emotionally later on. Western mothers, like Bofi farming mothers, often have to or want to return to work earlier so weaning will be more upsetting for their children but you can ease the process by making sure they get plenty of cuddles from you or others. I on the other hand feel reassured that I’m not some weirdo for still feeding my toddler so perhaps I’ll wait a little longer.

*By weaning I mean stopping breastfeeding altogether not introducing solid food.

If you want to read more here’s the academic article by by Hillary N. Fouts, Barry S. Hewlett, and Michael E. Lamb where I got most of my info.