The Womanly Art of Breastfeeding Navigation in Today’s Health Reality

A few weeks ago, I had the pleasure of learning about a relatively new health device, called Momsense.  I found it particularly interesting because, having worked in the field of women’s health for over two decades, I hear new mothers ask me time and again, “Do you think I have enough milk?” or state, sadly, “I must not have enough milk.”  It makes me sad to see so many women think they don’t have adequate milk supply to feed their infants, when, in fact, only 3% of women actually are unable to make enough milk to feed their babies. 

Seeing this product got me thinking about one of those central health navigation themes in a mother’s life, breastfeeding.   You may ask, why would breastfeeding fit into a discussion on health navigation?  Either the mother chooses to breastfeed or not.  Where’s the complication?  But let me take you on a little journey.

Natasha gives birth to her 38-week-old infant at 10 in the evening.  She’s exhausted.  Prior to the delivery, she had decided that she wants to try and breastfeed, if she can.  After her 12  hour birth, the nurse in the unit, says, “Are you sure, honey, you want to nurse her?  If you want to sleep, just tell us and we’ll give her a bottle and let YOU rest.” CHOICE #1: Exhausted after her first birth, Natasha has to override the nurse’s decision, in order to convince her that she should breastfeed.

At 3:30 am, the nurse rings a bell in Natasha’s room.  “Natasha,” the voice booms, “your baby is crying.  She’s hungry.  Don’t think you think should come feed her?”  CHOICE #2: Natasha now has to trudge down the hallway to the nursery, feeling guilty that she is letting her hours old baby go hungry, but with her whole body aching to go back to sleep.  She sits down in the nursing chair, trying to maneuver the squirming infant to her breast, while not sitting too hard on her new stitches and aching lower back.

The nurse, busy taking care of another newborn, glances her way, and says, “isn’t she just 38 weeks?  Probably too little for full nursing. You should just give her formula till your milk comes in.”  Don’t want her to lose weight”, she adds with a smile.  CHOICE #3: Natasha must now go against the nurse’s recommendation, be confident in her choice to nurse a 38-week old baby, even though she feels no confidence what so ever, at this point, and declare, “No, I will nurse her. Thank you anyway.” [THIS STORY IS COMPLETELY TRUE AND ACCURATE, BY THE WAY].

Do we see the navigating concerns here?  A mother must not only know her own mind prior to birth, but she must also foresee hurdles, and figure out how to combat them early on.  Personally, I think this is an incredibly difficult task, which I think is one of the major reasons why 98% of women start of nursing their infants, but by three months, only a third still are.

If hospitals and well-baby clinics are going to truly be nursing mother-friendly, and encourage full breastfeeding until age 6 months, which is the WHO’s strong recommendation, we need to ensure that mothers are not challenged about their breastfeeding decisions at every turn.   

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