History of Breastfeeding Failure

Rationale

Most mothers are not prepared to experience any difficulties or problems when breastfeeding their first baby, and they are alarmed by commonplace issues. (Colin, 2002) Yet mothers are more likely to blame themselves for lactation failure, rather than the hospital system that may have contributed to it. Primary organic causes for lactation failure are rare.

The most common reasons for early abandonment of breastfeeding are:

1. Perceived insufficient milk production;
   
2. Problems with attachment (latch-on or effective milk transfer):
   
3. Lack of maternal confidence (Ertem, 2001; Taveras, 2003; Kuan 1999; Dewey, 2003).
   

Most breastfeeding problems are secondary phenomena, commonly related to suboptimal practices in the early post-partum period leading to delayed, infrequent or ineffective breastfeeding. A lack of maternal confidence can undermine a mother’s experience with a subsequent baby.

Suggested Measures

1. Discuss the issues associated with the mother’s first experience.
2. Provide clear guidelines focused on the establishment of milk production and infant attachment (latch-on and milk transfer).
3. Encourage participation in the group breastfeeding class.
4. If there is concern for a primary organic cause, such as “insufficient mammary glandular development” (Neifert MR), request bedside Lactation Consultation.

Suggested Script

Most mothers believe that breastfeeding comes easily for everyone else. The problems you had last time are quite common. Breastfeeding is natural, but it does not come naturally for most babies…anymore so than walking.

Usually, however, the earlier any problems are taken care of, the more likely you are to overcome them. Let’s see what we can do to give you and your baby extra help and extra practice. The more frequently you breastfeed in the first 3 days, the less likely problems will develop.