Why Breast Isn't Always Best for Moms with Chronic Illness

I’m a breastfeeding mom. I fought hard to nurse my son. And I believe in a woman’s right to breastfeed.

But I don’t call myself a breastfeeding proponent. Instead, I prefer to be an advocate for mothers with chronic illness (like myself) and their babies. What does that have to do with infant feeding? Actually, a whole lot.

A couple weeks ago, the Philadelphia Inquirer published an interview with Arnetta Stewart and Katja Pigur of the Maternity Care Coalition. Stewart and Pigur argue that Philadelphia’s breastfeeding rates should be much higher than they are. We need to push more mothers to breastfeed, they say, because the science unequivocally proves that “breast-fed babies are healthier babies.”

However, the breastfeeding data is much more nuanced than Stewart and Pigur claim. Mothers today have heard that “breast is best,” but some experts are now questioning whether that adage always holds true. One recent large-scale study in particular suggests that many of the purported benefits of breastfeeding have been dramatically “overstated.”

What we do know for sure is that when a mother is healthy, she is better able to raise a happy, healthy baby. When a mother has a medical condition, she has the right to the best treatments prescribed by her doctor. Despite oft-touted claims that most medications are safe for nursing, not all pharmaceuticals have truly been proven safe, and many rely on data with shockingly small sample sizes.

What’s more is that many doctors are not familiar with the studies that do exist, so a woman is forced to do her own medical research on her own time. Time is a scarce commodity for any mother, but especially for one also coping with a chronic medical condition. In the one ear women are told that they must breastfeed and in the other that their medications aren’t safe enough to do so – and both voices are coming from the medical establishment.

We can better educate doctors, but even once a mother begins treatment, breastfeeding while managing a disease is quite a balancing act. Often, for instance, a mother is advised to forego nursing for a number of hours after taking a medication. If she is prescribed multiple medications, this is a lot to keep track of on top of caring for a young baby. It is even more difficult during the early cluster feeding stage when babies rarely go any length of time between feeding sessions.

But when a woman’s condition requires a procedure that is truly contraindicated in breastfeeding, she can just quit nursing, right? Not so easily. I speak from personal experience when I say that once a baby is accustomed to receiving his or her comfort from the breast, it can be quite traumatic to suddenly remove that source of comfort.

Medications aside, breastfeeding can be difficult for a mom with chronic illness. When a baby is formula fed, it is easier to give mom a break – particularly if she is in pain and can rely on trusted family members for respite. When exclusively breastfeeding, the burden of infant feeding rests solely on mom. With certain conditions, it can even be difficult for a mother to hold the infant at her breast for the lengthy sessions young babies require.

Yet Stewart and Pigur never mention medical conditions as a reason that women choose not to breastfeed. Instead, they assume that a woman who chooses formula is simply too poor or too uneducated to select the wiser option. These women, they claim, need more support and encouragement from pro-breastfeeding parties, ignoring the myriad other reasons why a woman may seek formula — including chronic illness or a history of sexual abuse.

Stewart and Pigur believe that “breastfeeding should be the outcome of birth,” but shouldn’t we instead prioritize a healthy mom and baby as the ultimate outcome? Breastfeeding may be “natural,” as they say, but natural is not always healthiest, and we need only look to natural diseases for proof of that. When we refer to breastfeeding as “natural,” and a woman with a medical condition is unable to breastfeed due to her medical condition, we are only contributing further to the feelings of inadequacy and guilt she is likely already experiencing as a result of her illness.

Should women be given the resources to breastfeed if they so choose? Of course. But not without also being given support if they choose formula. Women don’t need to choose between their own health and the health of their babies – especially when a viable alternative is readily available.

This story originally appeared on the blog Mothering With Chronic Pain.

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