Is it ever physically impossible to breast feed?

[ThePowerof3]

I know that there can be a lot of mental barriers to breastfeeding but what are the physical ones? Is it ever possible for someone's milk not to come in?

That's the other annoying thing - as Horry says, there are a lot of people in that 2%, and yet there are some people out there who seem entirely unwilling to believe that any given individual they encounter is unable to BF.

So where are these 2%? Locked away in some dungeon for the milk-less?

Even if you are encountering people every day who are saying "I couldn't BF" - and to be fair, a lot of people do say that when they mean "it was prohibitively difficult", which isn't much different, or when they feel understandably defensive because of other people's reactions - you have no way of knowing whether they are one of the 2% or not, so the compassionate and courteous thing to do is to accept them at their word and not start on the "well, everyone can BF" spiel.

I think a lot more women would find the support they needed to push through the difficulties if they weren't made to feel that they were failing at something simple and natural, and the relatively small number with a complete inability to feed would feel much less judged and disbelieved.

In retrospect, dd's failure to feed is part of the same genetic condition which has caused my bowel to sink into my vagina this summer causing me to cancel my holiday and waddle around like a malfunctioning duck. But not even the surgeon at the hospital, anxious as they are to save money for the NHS by talking patients out of unnecessary operations, has suggested that this wouldn't have happened if I had only studied enough diagrams of bowels and vaginal walls.

I couldn't breastfeed DC1 - he just constantly refused to latch on. I do have one inverted nipple, but he would refuse the other breast. Maternity Unit wouldn't discharge us because of his refusal to feed. It was just awful. After five days of constantly trying, and him crying all night, one of the midwifes just said 'give that child a bottle of Cow and Gate' and he drank it straight down and started on a second one.

It is just one of those things, but I felt a total failure. Sadly, a lot of people are very judgey about bottle fed babies, without realising that unfortunately it isn't always possible to breastfeed.

With DC2, after talking through with midwifes and my GP about the experience with DC1, I didn't even try and she went straight onto a bottle.

It's surprising common in countries where there is no access to formula/bottles for a sister or other female relative to wet nurse a baby that the mother is unable to feed. So, based on this alone, the answer is yes.

Disclaimer: I fed my second DC for 2 1/2 years, but managed only 5 days with my first. He became jaundiced and dehydrated. I spent the first 4 1/2 months of his life on heavy duty antibiotics for a breast abscess. It's fair to say that if we were a breast feeding culture there would have been a better chance that our myriad of problems could have been addressed, but I was very grateful for formula milk and, having seen some very weak and scrawny babies on their travels around the world, my parents (despite being staunch bf supporters) were very grateful too.

What anecdotal evidence does imo is suggest a series of possible causes which you could then go out and investigate, or simply keep an open eye to.

Masectomies are not all of the same magnitude: sometimes they take more, sometimes they take less.

Another thing to bear in mind is there may be an undiagnosed physical cause. And then neither the mother, not the breastfeeding advisors will have anything to go on. As I said, dd was 10 when we found out.

(But then we had to wait until just before her 9th birthday to find out why she was often in too much pain to walk: before that, the doctors had simply told us she was attention seeking.)

I produced milk and all seemed fine except my DS refused from the start. I saw bf counsellors and various midwives but nobody could persuade him to do it. He wasn't tongue tied and about once every 3 days would astound us all by bf'ing then refuse again the next time. So there was a physical problem somewhere in that he just wouldn't do it.

When DD was born I was even more determined and made the hospital staff wheel me up to her in nicu to try. She actually bf and I was over the moon ... for about 3 weeks til she refused too. Again various experts came and poked around but we just couldn't make her do it.

Both times I had been determined and tried really hard. It was horrible to have so many successful bf'ers tell me I must be doing something wrong.

When I was having DD there was a lady in the next bed who had had a breast reduction after - she thought! - completing her family. She had been told she would not be able to breast feed but couldn't care less as she was not planning on having any more children. One unplanned pregnancy later . . . she was very sad about not being able to breast feed. She said that her boob doctor had said that just about any breast surgery messes up your chances to breast feed, because the milk-producing mechanism of breast is so complicated.

I had no problems bf but I was FAR to tense to express. I just couldn't do it, the let down just wouldn't happen properly. I tried all the things they say - a photo of the baby, thinking of the baby - all I could ever get was about 1 oz. The more I tried the tenser and more upset I became and the worse it got. I can totally believe that if people get stressed and tense about trying to breastfeed then nothing comes out.

I have had breast surgery which made it extremely difficult to start with, But in my first pregnancy I did experience the physical sensation that something was 'happening' in my breasts. And after the birth there was the sensation of the milk coming in. I tried so so hard to feed, but was really only able to produce a few drops of milk.

In my second pregnancy I felt no changes at all to my breasts. Nothing. And after the birth there was no sensation at all of milk coming in, and not a drop of milk appeared to be produced.

Having felt the physical difference between the two experiences, I feel certain that I know the difference between not producing much milk and not producing any.

Naturally, I've been told plenty of times that it was all in my head and I just didn't try hard enough. Fortunately for my sanity, I can console myself with the fact that my boobs are attached to me and I know what they were doing, and I try to remind myself that random sly dig person does not.

I have hypoplasia breasts too and am not sure if ill make any milk at all. It's likely I'll make a small amount but not enough- wont know until I actually have a baby!

When I had DS1 my milk didn't come in. I had colostrum, but even after 3 weeks of trying I had no actual milk. A friend is a BF counsellor and she gave me loads of support, but without actual milk there was nothing that could be done. They put it down to the fact that I had had an emergency c-section under GA (it was a proper emergency, we both could have died) and that the milk producing hormones just hadn't switched on as my body was in shock.

I went on to BF DS2 and DD (despite DD having tongue tie) successfully.

My SIL survived breastcancer. So surely all women should be able to manage that? Except my friend didn't

The other thing anecdotal evidence does is give you a little insight into how experiencing physical barriers to b-fing may have a psychological impact on mothers. We aren't just mental causes and physical causes. Lots of posters have said the challenges of dealing with tongue-tie or supply problems caused by medication interacted with their confidence when dealing with a tiny newborn etc etc. Sensitive peer support could be the difference between stopping/not stopping. Or stopping feeling like a positive decision made to make parenting better or a failure. I always feel sad when I hear mothers talk about how they 'failed' to breastfeed. No one fails.

"and yet there are some people out there who seem entirely unwilling to believe that any given individual they encounter is unable to BF."

That 2% are medically unable to breastfeed, even with top notch breastfeeding management, is lost because there is another 60% who believe they can't breastfeed.

If in real life we encounter 100 women who initiate breastfeeding, statistically the likelihood is that 90 of them will stop breastfeeding within a few weeks, and that 30 or 40 of these women will sincerely believe they 'can't' breastfeed - mostly because they feel they don't make enough milk. Is it any surprise that the 1 or 2% who have intractable medical problems that make normal breastfeeding impossible, even with good management, get lost in the crowd?

I don't recognise a mumsnet that judges people for using formula, or who denies that some women are physicallyunable to breastfeed - there are individuals who pop up with these ideas, but they are not especially common and it's certainly not part of the 'culture' of mumsnet. It's important to get that clear, otherwise people who have questions about formula/difficulties in bf may worry about posting.

There are real physical conditions that affect breastmilk production from the start, or which cause milk to 'come in' very late indeed, and there are conditions affecting the baby which make it difficult/impossible to breastfeed, and combinations of problems in the mother and the baby that mean it's effectively sabotaged. For some mothers and babies, it's not that they cannot breastfeed at all, but the 'full supply' doesn't happen.

I am always sceptical of figures stating that x or y or z per cent of women cannot breastfeed. It's a guess only.

Oh here we go.

I think some people feel that a physical inability to breastfeed is more 'accepted/justifiable' than if they are struggling with it for other reasons or finding it difficult in general. I think that's quite sad. People should be able to get the support they need regardless of the reason behind it.

I think this can also have a negative effect in that it gives the impression that there are lots of physical barriers to breastfeeding and people start to worry that there is something physically 'wrong' with them when they are just experiencing 'normal' gettingtogripswithit issues.

One of mine doesn't produce, never did. In fact when I was encouraged to pump, only blood came. Very weird and the hospital said they had never seen it before. The only thing they can think is the excessive scar tissue I have on that nipple caused by a skin condition has something to do with it.
Ok the other one, it came in a bit but I could never pump more than .5 an ounce every 2 hours. All a bit pointless in the end because DD wouldn't latch. No tongue tie, no other issues, just lazy apparently.
Being a peer supporter is great, good for you, a lot of people are very successful. The biggest thing I had an issue with was the guilt. It is huge.

My nipples are so flat DD physically couldn't latch onto them. She didn't even know something was in her mouth. Tried nipple shields but the nipple could only be drawn halfway up.

Starved (and dehydrated) my daughter for five days. She was having violent attacks of shaking. I now know it was low blood sugar.

Midwives were stumped. I could not have persevered for a moment longer. Switched to formula and don't feel a twinge of guilt.

I'm adding something else probably controversial but never mind- ill live on the edge for a bit
I cannot BF due to all sorts as I've explained. I was offered all sorts of help. I chose not to take it in the end. I was stressed to the nines and it was no good for me or my DD. I if you like chose to FF. and if I'm honest, I think I would chose it again. If they worked another time, I think the emotions now linked to BF would cause problems. It would be nice to have encouragement from a peer supporter in that sense.
Moot point because I am never doing that again!!!!!

You are quite right to point out that the general MN culture is supportive of struggling breastfeeders, tiktok, and you do a great job. But it is still the case that if you post that you are unable to bf, somebody is bound to shoot back a reply to the effect that this is what x % of women think- making you feel as if you are making your problems up.

I am sure 99 point something children are also able to walk on their 10th birthday. But if I had posted in the SN section for support, I wouldn't have been particularly comforted by having that pointed out. What I would want is not statistics but practical suggestions: have you seen this type of specialist? have you tried this? what about if you were to...?

It's possible for it to be impossible. For me I had the odds stacked against me but it perhaps wouldn't have been impossible long term.

My milk didn't come in after losing an awful amount of blood during labour and my nipples remained completely flat whenever DD tried to latch. No matter what I tried I couldn't get them erect, including the midwives showing me how to use nipple shields. Once I made the decision to ff my milk came in four days later . But DD had lost a lot of weight and I was not prepared to carry on.

Who knows, if I'd waited until my milk finally came in then maybe something would have clicked, or maybe DD would still have been completely unable to latch due to my uncooperative nipples. Who knows?

But yes, it is definitely perfectly possible to be unable to breastfeed through physical reasons.

I never produced enough milk, literally drops came out. With my second I was given a hormone spray to encourage let down, but again I only produced a tiny amount of milk. I was extremely upset by it and persisted breastfeeding for 3 weeks with my first and 2 weeks with my second, but obviously had to mix feed. On both occasions I stopped when my milk dried up even though I was still attempting to breastfeed.
It made me feel like a total failure as a mother and took me a long time to come to terms with it - even worse was the horrid judgey comments I was given when people saw I was bottle feeding.