In the context of the World Breastfeeding Week, which each year aims to highlight the importance of supporting and protecting breastfeeding, it is also necessary to address the concrete difficulties that women who choose to breastfeed face. Because, although breastfeeding is often presented as a natural process, the first months can be marked by fatigue, difficulties achieving a good latch, the lack of a support network, doubts about milk production, and, later, the challenge of returning to work.
Support can make a difference in this regard. Not only from the family and partner, but also from health professionals and the workplace spaces, which play a key role in enabling women to sustain breastfeeding without it becoming another source of exhaustion, guilt, or anxiety.
About these challenges, the interview featured Para Ti with Dr. Mariela Retorta (MN 103872), a pediatrician, specialist in child development and lecturer in the Medical degree and the Annual Rotating Internship (IAR) at Fundación Barceló. The specialist reviewed the main obstacles mothers face, debunked some of the most common myths surrounding breastfeeding, and explained what kind of support women need during the first months and when returning to work.
“Many times the mother feels she does not have enough milk, but this is not always the case, and that feeling can cause her distress”
—What are the main difficulties women currently face when they want to start and sustain breastfeeding?
—The main difficulty is the hours spent away from home and the fact that at work there is no space to express milk and keep it in a refrigerated place to later offer it to the child, especially when the workday is very long.
In addition, mothers are not only exhausted by household demands but also by work schedules, leading to a double burden. Often, when children are small, they still have nocturnal awakenings and that becomes complicated too, because the mother does not get enough sleep at night.
It is also important for the mother to have a support network. Often they are young mothers and the grandmothers are also young and still working, so it is harder to rely on a broad network.
Added to this is the lack of accompaniment, especially if the mother had a cesarean, to help the baby latch onto the breast. Ideally, this would happen in the same delivery room or in the operating room, provided the baby’s condition is good. However, clinics and hospitals often have several deliveries at once and these mothers, still in pain from surgery and anesthesia, do not have a lactation consultant to assist them.
The initial suckling can also present a challenge. The baby may latch on firmly and, if the latch technique is not good, this can cause pain or cracks in the nipple. It is important to teach the mother that, after breastfeeding, she can apply a small amount of colostrum, the first milk she produces, since its high protein content helps to heal those cracks. At the same time, we must help her improve the technique so she can breastfeed correctly.
The perception of low milk supply is also common. Often the mother feels she does not have enough milk, but this is not always the case, and that feeling can cause her distress. Do not forget that after the baby’s birth there is a significant hormonal shift that can lead to postpartum depression, so it is essential to support that mother, back her up, and help her feel that she can do it.
On the other hand, if the baby does not suck from both breasts, milk ducts can become blocked or inflammations such as mastitis can occur. In that sense, it is important to be attentive so that the baby nurses regularly and frequently, allowing the breasts to empty properly.
Finally, fatigue also plays a role. Breastfeeding requires a lot of energy, and if there is no support network or someone who can take care of the rest of the household tasks, this makes it harder for the mother to breastfeed calmly.
“The mother is the one who bears the body, and we must be respectful of that”
—Many times breastfeeding is discussed as an individual decision of the mother. Why is it important to understand that it also depends on the accompaniment of the surrounding environment?
—It is an individual decision. Obviously, there are mothers who want to breastfeed and others who do not, and I think it is also important to respect that, beyond everything the breast milk offers to children, both for their development and growth and for the prevention of future diseases, since it reduces the risk of obesity and diabetes.
However, the mother is the one who bears the body, and we must be respectful of that. At the same time, it is important to understand that the accompaniment of the partner and family is essential, since a mother who does not have that network of support will likely face more difficulties in sustaining breastfeeding.
Everyday gestures, such as someone preparing meals, helping with chores, or taking care of the baby for a few minutes, allow her to dedicate that time to breastfeeding and to recover energy.
In addition, the guidance of a good pediatrician is very important, someone who can advise, support, and explain how to store breast milk and how to maintain breastfeeding, in case the mother wants to continue with it.
“To sustain breastfeeding, it is essential that the baby suckles”
—What myths about breastfeeding continue to generate doubts, guilt, or anxiety in mothers?
—One of the main myths is the idea that there exists a “milk that works” and another that “doesn’t,” or that some mothers can breastfeed and others cannot.
In reality, to be able to sustain breastfeeding it is essential that the baby suckles and that the mother has the time needed to breastfeed, eat properly, and feel confident that her milk will nourish her child well.
Very often there is the false belief that fortified milks help the child grow or gain weight better. However, a first-time mother only needs the accompaniment of a lactation consultant or a good pediatrician to help her begin breastfeeding and provide the necessary support during that process.
Breastfeeding is not something impossible to achieve: with information, guidance, and support, most mothers who want to breastfeed can do it.
“It is important that the mother can express milk every three hours”
—Return to work is often one of the major challenges. What concrete recommendations can help reconcile breastfeeding with working life?
—Returning to work is one of the great challenges because, to the extent that the baby does not suck, milk production also decreases.
That is why, it is important that the mother can express milk every three hours and have a proper space to store it and express comfortably. It is also essential that the workplace provides her with that time and space to do so.
In addition, it would be important to have laws that support this situation, allowing, for example, reducing the workday or performing part of the work from home.
There are countries that have regulations protecting these situations and offer longer leave than what our current legislation provides.
“There should be lactation rooms equipped with pumps, a sink, and a proper place to store milk”
—What should workplaces do to really become breastfeeding-friendly spaces?
—It would be important to offer flexible hours, such as the possibility to start later or leave earlier during the first months.
In addition, there should be lactation rooms equipped with pumps, a sink, and a proper place to store milk. It is also essential to train the rest of the staff, because motherhood is often ill-received in some work environments and that can create difficulties for mothers once the legal protection period ends.
Remote work or the possibility of fulfilling part of the shift from home would also support the continuity of breastfeeding.
In Argentina there is the Law 26.873 and Article 179, which provides two 30-minute breaks until the baby turns one year old, which can be consolidated. This allows, for example, starting one hour later or leaving earlier.
Additionally, the space designated for breastfeeding or expression cannot be a bathroom: it must be a private place, with a chair, table, and a refrigerator.
On the other hand, some places have maternity gardens within the workplace, which greatly facilitate the continuity of breastfeeding, since the mother can approach it 30 minutes every three hours to breastfeed her baby.
“It is important to strengthen breastfeeding”
—The theme for this year talks about “strengthening what works.” Which strategies do we know work and what should change so that all women can access them?
—It is important to strengthen breastfeeding. If we all help ensure the rights of the mother and child are upheld, and we collaborate to build support networks and accompaniment, I think this is achievable.
Additionally, we must always remember that breast milk is at the right temperature, it is the most economical option, and it provides everything the baby needs.
