Breastfeeding: Changing the Plan Does Not Mean Failure
Aug 11, 2023
Note: We use the term “breastfeeding” to encompass all forms of lactation, including direct breastfeeding, chestfeeding, and providing expressed human milk in a bottle.
Emily Perl Kingsley wrote an essay called Welcome to Holland and if you haven’t read it, I urge you to do so. It’s about the great plans you make to go to Italy, but when you step off the plane you find yourself in Holland.
The main premise is that things don’t always turn out the way we expected, but if we focus on the disappointment then we miss out on the potential beauty before us. As a neonatologist and breastfeeding advocate, I often reference this essay in the neonatal intensive care unit, but it could apply to many aspects of life.
Many women decide to breastfeed when they are pregnant. These women make a conscious decision, but there is often an underlying fear that goes along with that decision. Horror stories are easier to find than successes. Breastfeeding can be hard. What if it doesn’t work? What if I fail? Failure is a term that is often heard, but poorly defined.
Every day I see moms who planned to give birth and gaze lovingly at their child while providing the nutrition that her body made. When these moms develop complications like premature labor, or deliver a baby who is sick, something unexpected happens and, instead of breastfeeding, she has to learn to pump with a machine. This was not the plan.
Some new mothers experience their birth plan exactly as expected and nursing comes naturally. Everything is perfect. But, then she goes home and things change.
Maybe breastfeeding becomes painful; so painful that she dreads feeding her baby. Maybe her new baby loses too much weight, the pediatrician is concerned and mom fears she has been starving her child. Maybe she has a high-needs baby or experiences postpartum depression - a confusing illness that is not always understood by friends and family members. This was not the plan.
Many mothers who decide to breastfeed during pregnancy attend a prenatal breastfeeding class to learn tricks and collect contact information for resources. But, maybe the lactation consultant she picked has a waitlist and cannot see her for a week. Maybe her pediatrician and lactation consultants have conflicting opinions, because nothing in breastfeeding is straight-forward. Maybe she did everything to prepare, but still finds herself feeling alone and full of questions instead of answers. This was not the plan.
Things don’t always go according to plan. Sometimes, the plan has to change. Breastfeeding is complex; it involves two completely independent individuals learning to work together. Sometimes it fits just right from the very beginning, but more often it requires tweaks, adjustments or changes. Breastfeeding demands flexibility at a time when it is difficult to feel flexible.
As parents, we make the best decisions we can with the information we have at the time. Change is hard and it is okay to grieve the loss of a plan. Changing a plan does not mean there weren’t successes somewhere along the breastfeeding journey, and too often we forget those successes.
The first time a baby latches, the solace of giving a baby breast milk and all the goodness it holds, the peace a mother may feel when she decides to stop, knowing she was making the right decision for her child despite everything else she was feeling inside.
Maybe she can’t be exclusive with her breastmilk. Maybe she can’t feed her baby directly at her breast. Maybe her baby can’t have her milk. Maybe things didn’t go according to plan. But that doesn’t change who she is. A mother, never a failure.
Vanessa Shanks, MD is a neonatologist at Nationwide Children’s Hospital and Wexner Medical Center at The Ohio State University. She is also assistant professor of pediatrics for The Ohio State University College of Medicine.
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