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?

Cory, but most people do go on to offer advice. Quoting the 2% figure is probably to reassure you that it is more likely not a physical problem and so you could potentially overcome it.

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

Well I'm as guilty of bandying that figure around as the next person.

I suppose it would be impossible to know unless you could find a society where women's births and early parenting experiences weren't interfered with in a way which impacts on lactation. Can't imagine that these days this would be easy to find.

I'm just constantly flabbergasted at the extent to which culture impacts on the likelihood of success of a normal physiological act. I think the subject of breastfeeding is fascinating and controversial because of the way it is shaped by culture - in a biological as well as emotional sense.

I think stress plays an important part too. I did / am BF both of mine but one night when I was really stressed out I just couldn't let down. It just didn't happen. And you can easily see how that would be a vicious circle.

cory, I agree that if someone posts they are 'unable' to breastfeed, someone will ask them to 'unpack' that - not because they think the mother is making stuff up, but because it is often the case that they are mistaken and that they might indeed be able to breastfeed after all.

To take one example. It's a more or less weekly occurence for someone to say she needs to use such and such a medication and she has been told she cannot breastfeed because of the medication....and it turns out there are no problems with it at all (or fewer than she assumed).

bumbleymummy Tue 30-Jul-13 08:49:56
"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."

Cuts both ways though.

We had to wait nearly 10 years to get a diagnosis for dd's undeniably physical condition because everybody assumed that I was just clinging to that explanation because I felt it was more acceptable/justifiable.

If you spend time on the SN boards you will find the mothers whose physical concerns for their babies have been dismissed as maternal anxiety and the need to explain away their own inability to "get to grips" with things.

There is pressure on mothers with no physical issues to "get to grips with things" which can drive them to seek a physical explanation.

But there is equal pressure on mothers whose children do have physical issues, or whose children might have physical issues as yet undiagnosed, to stay out of the debate because it muddies the waters, because it might make others pay too much attention to physical issues, because it might make physical issues seem like something that could happen to anyone- and nobody wants that. It is a lonely place.

And the loneliest place of all is the one where you known that there is a physical issue but nobody wants to hear about it.

BFing never worked out for me either with both DCs. I produce colostrum but it just doesn't turn into milk.

DC1 was prem & in SCBU, I tried & tried but all I could do is syringe colostrum which I gave him, he ended up being tube-fed for a couple of weeks with whatever I could express + formula. I gave up trying to express after 3 weeks when I was only managing to express a few mls of very yellow milk after 30 mins of pumping.

DC2 was induced 3 weeks early (although yay! A full-term baby!) She ended up in SCBU as well though, due to suffering very bad withdrawal from meds that I had to take (& whilst I still feel awfully guilty about failing to breastfeed, it doesn't come close to the guilt I still feel about making her so ill). Again she was tube-fed, & again I had no milk except colostrum. Gave up trying to express after 2 weeks with her cos again, hardly anything would come out. The day I decided to quit was when I hadn't managed to express anything for over 48 hours - the tiny drops which were coming out got lost in the workings of the pump.

So should I "unpack"(kind of patronising)my infertility or any other bodily malfunction?

Why is it just bfing one has to justify?

I agree with Cory. There is loads of social psychology lit on stigma and social attitudes which has identified that what changes peoples behaviour in the face of negative social attitudes is not the majority but the nasty minority. A person with a history of mental disorder only has to believe that one person they meet will judge them for that attribute to permanently hide their history, even if they believe (rationally because the survey data says this is true) that most people have open-minded attitudes to mental disorder.

Similarly on Mumsnet we may be a community who are largely sensitive to the challenges of parenting a baby. But you just need one dipshit to turn up on a thread saying 'I bet you aren't really physically incapable, you just didn't try hard enough' for a vulnerable and guilt-ridden new mother to feel she cannot ask for support about bottle-feeding here. We are much more sensitive to negative than positive messages.

Which means that whilst I agree these people are not part of the culture of Mumsnet they are a real problem.

OP, physical / medical barriers to BF should form a chunk of your peer supporter training e.g. breast surgery, glandular conditions. Drugs that might not be safe for BF. HIV status.

There are also things that can in many cases be overcome (and sometimes not) such as flat/inverted nipples.

BF is a funny thing. If you take TT as an example, sometimes a massive obvious one causes little or no problems. Other times a tiny and easily missed one means the effective end of BF.

Each mum and baby is unique, there will be natural variations on 'the norm' (if that even exists).

Sometimes the baby is unable to breastfeed even the mother's nipples/ milk supply is fine. In particular tongue tie is a major problem and some doctors are reluctant to snip the tongue of a baby with tongue tie.

I have a completely unstantiated pet theory that prehaps years on the contraceptive pill might affect a woman's long term ablity to breastfeed.

tiktok Tue 30-Jul-13 09:04:01

"To take one example. It's a more or less weekly occurence for someone to say she needs to use such and such a medication and she has been told she cannot breastfeed because of the medication....and it turns out there are no problems with it at all (or fewer than she assumed)."

But the same response is given if the medication issue was in the past- because posters don't realise that the guidance on medication changes all the time. When dd was born nobody knew that the medication I needed would be fine, it hadn't been around very long, so I went through a horrendous time taking a medication with ghastly side effects. So it may have been an unnecessary precaution seen from the 2010s but perfectly justifiable in the 1990s.

Also on MN there is an awful lot more than unpacking re inability to bf and a whole lot of flat right refusal to acknowledge.....and judging.

I reckon that stress plays a huge part in women being unable to bf. Stress as we all know can have physical symptoms so it would be ludicrous to assume it wouldn't affect breast milk.
How many times do we see posts from stressed pregnant women on MN? There's such pressure piled on mothers nowadays to be perfect and anything less is a failure. And don't forget some women may have MH problems and need to take medications which they probably don't want to explain to strangers.
I bf my first 3 dc but dc4 was an emergency section and I was extremely ill afterwards and in intensive care. After almost three weeks in hospital we finally got home and I realised that I did not produce one drop of milk. No full breasts,nothing.

Thankfully not so in RL.

I wish somebody would come and unpack my vaginal wall. Things seem to be sliding into the glove department that don't belong there.

"Why is it just bfing one has to justify?"

You don't if you don't want to!

But there clearly IS a problem with how we manage breastfeeding in a medical and social sense, if 90% of women are stopping breastfeeding before they intended to, because (for the most part) problems which are amenable to intervention.

I think acknowledging that our culture puts emotional and physical barriers in the way of normal breastfeeding is important - it should be reassuring to mothers who are struggling with feeding their baby to understand that the difficulties they are having are common and are not their fault.

Buttercat, 'unpack' = invite to explain in more detail. As sometimes happens on a talkboard....you know, when someone asks for help, making an assertion that might be explained better with more information, so the help on offer can be more effective.

I don't see what's patronising about that, and its not confined to fertility or feeding issues, either!

You might post something like 'my dh is unable to drive and [insert problem here that might or might not be related to this]' and someone might ask for more details of how/why the dh is unable to drive eg permanently or temporarily.

"Also on MN there is an awful lot more than unpacking re inability to bf and a whole lot of flat right refusal to acknowledge.....and judging"

Even the briefest analysis of breastfeeding threads here would show you are wrong. Judgemental and unsympathetic voices are very rare.

The fact you believe there is so much more unkind judging than the evidence on this site shows there to be, demonstrates how much personal perception of other people's attitudes is distorted in relation to this subject.

When I had my DS I bfd - in our family it is just the norm, we all did (even helped me bond with one of my GM who had previously been a bit off with me). In my ward there was an absolutely lovely mum of four already who had extended bfd all and obviously wanted to bf the fifth.

It was really difficult for her with this child &, while still prepared to try on an ongoing basis, she did use a bottle. Thankfully the hospital we were in promoted bf but supported bottle if that's what mum wanted - the mum said to me she felt awful about having to use bottles but at least she wasn't made to feel bad about it by staff.

I really didn't think much about my experience of bfing until hearing about 'bad' experiences - now I think how lucky I was to have had my family, hospital staff & hv behind me whatever I was doing.

Cory, I'm not saying that you should stay out if the debate or that genuine physical issues should be ignored but is it better to assume the worst (in this case, that you are physically unable to bf) or to consider that yes, it might be the case BUT it is more likely to be something that can be overcome.

just putting my twopennies worth in. My milk came in but wouldn't come out. incredibly painful.

Might have been because my boy was in SCBU, I didn't see him for 5 hours, didn't hold him for 48. Then tried feeding (I had been expressing before). Also by that point we'd been moved to a different hospital and were 50 miles from home

not sure if that makes it a physical problem or a psychological one!!

good luck with your trainig if you do become a supporter.

I think the difficulties come partly in remembering which audience you are addressing. A struggling tearful mother doesn't need the same approach as a committee on national health, a group of expectant mothers might need a different approach from the lonely mother in SCBU. What I often find on MN is that an individual (the OP) is addressed as if she were a committee. Of course MN is an unregulated forum and should remain so. But if you (generic you= we) want to actually achieve something, then it is vital to think about how information is targetted at individuals. I find the SN forum are generally much better at this sort of thing.

"You might post something like 'my dh is unable to drive and [insert problem here that might or might not be related to this]' and someone might ask for more details of how/why the dh is unable to drive eg permanently or temporarily."

If we treated husbands being unable to drive in the same way we treat breastfeeding the responses would be like this:

"My DH can't drive either. We decided not to beat ourselves up about it - it really doesn't matter when you can drive or not, the most important thing is that you're happy".

Followed by three dozen posts from other people saying how they felt really judged that their DH was unable to get behind the wheel of a car. Judged by people whose husbands were formula 1 drivers and who couldn't even imagine what it's like to have a non-driving DH. Others would chip in with tales of being on the bus and getting the evil eye from the woman sitting in the passenger seat of a car next to the bus.

bumbleymummy Tue 30-Jul-13 09:20:45
"Cory, I'm not saying that you should stay out if the debate or that genuine physical issues should be ignored "

That is another thing that one learns on the SN forum: the fact that babies don't come out neatly labelled with "genuine problems", "no problems".

That often one has to wait for years to be told. That during those years, as the mother and often the only person who knows there is something wrong, you feel as if you are going insane because you see a different reality to everybody else.

No, I don't have any solutions. Except the general one of keeping the information for the committee on the back burner when addressing individuals.