Breastfeeding difficulties
Problems arising from breastfeeding and infant health.
Breastfeeding difficulties encompass problems that can arise from the act of feeding an infant or young child with milk from a woman's breasts. Although human breast milk is typically the best nourishment for human infants and babies possess a sucking reflex, certain circumstances can make breastfeeding problematic or, in rare instances, contraindicated. These difficulties may involve the breastfeeding process itself or the health of the nursing infant.
Breastfeeding problems
Putting the baby to the breast soon after birth helps avoid many breastfeeding difficulties. The American Academy of Pediatrics recommends delaying weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding. Many problems can be resolved with research-based hospital procedures, properly trained staff, speech pathologists, and lactation consultants; La Leche League also provides information. Factors that can interfere with successful breastfeeding include ankyloglossia (tongue tie), formula feeding, distractions during feeds, long separations from the mother, tachypnea (rapid breathing) from conditions such as transient tachypnea of the newborn or respiratory distress syndrome, physical barriers between mother and infant, swallowing difficulties from prematurity or gastrointestinal tract abnormalities like tracheo-oesophageal fistula, pain from procedures like circumcision, latching problems, hypoplastic breasts, galactorrhea, lactation failure, polycystic ovarian syndrome, diabetes, maternal stress, insufficient rest or support in the first six weeks postpartum, early return to work, cleft palate, thrush, hypoglycemia or hyperglycemia, hypotonia, hyperlactation syndrome, and overactive let-down. Premature babies may have difficulty coordinating sucking with breathing, need more frequent feeds due to smaller stomachs, and may become sleepier during feedings; those unable to take enough calories by mouth may require enteral or gavage feeding, often combined with Kangaroo care. For suckling difficulties such as with cleft lip or palate, a Haberman Feeder can be used.
Infant health problems
Infants with classic galactosemia cannot digest lactose and thus cannot benefit from breast milk. Breastfeeding may harm the baby if the mother has untreated pulmonary tuberculosis, is taking certain immunosuppressive medications, has HIV, or uses harmful substances like cocaine, heroin, or amphetamines. Apart from acute poisoning, no environmental contaminant causes more harm to infants than lack of breastfeeding; although heavy metals such as mercury are of concern, the neurodevelopmental benefits of human milk tend to outweigh potential adverse effects of neurotoxicants. Artificial teats or pacifiers can suppress the sucking reflex, and shorter time at the breast reduces milk production; the CDC reports that early pacifier use can negatively affect breastfeeding success and recommends delaying it until breastfeeding is firmly established. Mothers with active, untreated tuberculosis should not breastfeed until no longer contagious; in areas where BCG vaccination is standard, the WHO advises mothers to continue breastfeeding, and tuberculosis may be congenital or perinatally acquired through airborne droplet spread.
Diet
When a baby is exclusively breastfed, their sole source of nutrition is breast milk, making the mother's diet and overall health important. A daily intake of 1500 to 1800 calories can lead to a weekly weight loss of about one pound. Although mothers facing famine can still produce milk with high nutritional value, a mother who is malnourished may have lower levels of certain micronutrients like iron, zinc, and vitamin B12 in her milk, and her milk supply might also be reduced. No specific foods are completely off-limits while breastfeeding, but some babies may react to certain foods the mother eats.
Workplaces
Many mothers return to work soon after childbirth, and lack of support from employers and coworkers—such as not providing a private breastfeeding room with a fridge for expressing and storing milk—may lead them to stop breastfeeding. A Cochrane review in 2012 found no eligible studies on workplace interventions to support breastfeeding among mothers returning to work. The return to work can affect breast milk production due to the stress and changes of leaving the baby.
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