During pregnancy, you'll often hear how wonderful breastfeeding is (and this is true), but what people don't seem to broadcast is how demanding and tiring it can also be. Learning to nurse comfortably can take weeks and is often harder than many new moms anticipate. Breastfed babies need to eat more often than those on formula, which translates to less sleep and less downtime for moms. Breastfeeding in public can still bring uncomfortable or rude looks, and siblings (and husbands) may be jealous of the new baby's intimacy with Mom. And though most nursing mothers find that the rewards outweigh the drawbacks, for some women the obstacles are greater. Here are a few of the most common reasons women stop breastfeeding, or don't do it at all:
• They have physical conditions that make nursing impossible or risky. Glandular issues or prior breast surgery often make it difficult to nurse or produce enough milk to keep a baby satisfied. Women who need certain medications, like large doses of aspirin used to manage arthritis, or cholesterol-lowering drugs, should not nurse because these drugs can be transmitted through breast milk. The same goes for women with certain illnesses, like HIV, because they can pass the virus on to their babies. In some cases, the baby may have a health condition that prevents nursing. Infants with galactosemia (a rare genetic disorder that makes the baby unable to metabolize milk or milk-based formula) should not be breastfed, for example.
• They have to go back to work. Pumping can help working moms breastfeed, but it's not always a silver bullet. Some women may not have the time or privacy to pump on the job, which can cause milk supply to dwindle.
• Breastfeeding can be painful. Although discomfort during breastfeeding is usually temporary, it can be intense (including sore, cracked, and even bleeding nipples).
• They find it depressing. Some moms feel that the nonstop cycle of nursing and pumping saps all their energy and independence, and they start to resent it.
To breastfeed or not to breastfeed or when to stop breastfeeding can be difficult choices with feelings of guilt. But if in the end, you decide that nursing is just not right for you and your family, don't feel bad about it. Although many breastfeeding advocates encourage women to nurse for at least a year, most experts agree that your baby is better off being bottle-fed by a contented mom than breastfed by one who's miserable. --Melissa Balmain
Originally published in Parents magazine, June 2000. Updated 2009.