Exclusive Interview: Trisha Ludwig, certified nurse midwife and breastfeeding medicine specialist shares thoughts and views on what makes breastfeeding in America especially difficult for mothers.
Despite statistics showing initiation of breastfeeding on the rise (70-75% according to the CDC), it is unfortunate continuation of breastfeeding past months 3 and 6 drop below 25% and 15% respectively.
A major obstacle is living in a culture that does not support breastfeeding mothers. Trisha Ludwig, CNM and breastfeeding medicine specialist, says since bottle feeding has been dominated the past fifty years, there are “a lot of health care providers that lack experience with helping and managing breastfeeding problems. If a woman comes at six weeks to her OB/GYN [with breastfeeding problems] that woman may not get appropriate advice, or may simply be told to supplement.” She advises women who are supplementing to continue pumping to maintain milk supply. Not every health care provider might be telling women to do this.
Another problem our culture perpetuates is treating breastfeeding like bottle feeding. “You’re much more likely to encounter women bottle feeding, so there is a natural tendency to treat breastfeeding with the same approach,” says Trisha. “We are outdated in our instructions – often trying to PUT the woman’s nipple in the baby’s mouth” the same way you put a bottle into the baby’s mouth. “The baby will [lead the way] if you put the baby on the mother’s chest. They will instinctively root to the breast and latch on.”
Finally, our culture has primarily been bottle-feeding for the past half century, so there is a lack of natural support. Trisha notes, “Women are not growing up surrounded by people who are breastfeeding. When you’re surrounded by a culture of women where you see your mother and your sister and your aunt and friends all [breastfeeding], it’s natural. The way you put the baby to the breast is natural. In our culture, it feels awkward because [breastfeeding] is not part of everyday life. This tends to set [mothers] up [to fail].”
Trisha advises mothers to seek support if breastfeeding is not going well after 3-4 days or if pain persists. She points out it “takes a lot of TIME to counsel women about breastfeeding. It’s not something you say ‘here are your symptoms, your diagnosis, your treatment.’ It requires observation, a lot of history, thorough evaluation of a feeding, the mother, the baby. There are other factors and variables in her life that may be contributing to poor feeding. Most health care providers are not equipped with that amount of time to evaluate.”
Our American culture doesn’t yet have the proper systems in place to support breastfeeding mothers. Besides lack of education, experience, and outdated information, cost is a factor. Breastfeeding medicine specialists are generally covered by health insurance, but are quite rare. In fact there are only about fifteen doctors in the country who exclusively practice breastfeeding medicine.
On the other hand, private lactation consulting is plentiful, but expensive, which can be a barrier to women getting proper support. The good news is, with the number of breastfeeding women increasing, there is a returning interest in educating health care providers about how to encourage breastfeeding. Hospitals are starting to implement the “Ten Steps to Successful Breastfeeding – Baby-Friendly Hospital Initiative” and become more supportive to nursing moms.
We can also lead the way by example, reversing our bottle-fed culture one breastfeeding mother at a time!
What are your thoughts about how our culture has influenced breastfeeding for mothers? Do you see change on the horizon?