The challenges of breastfeeding: supporting choices, and optimising success

Breastfeeding can be one of the most rewarding yet challenging experiences for new mothers.

For many, it is an experience filled with both joy and immense challenges, which highlights the importance of support and understanding from healthcare professionals.

What support would you provide?

A young mother presents with concerns about feeding, how do you best assess the situation and provide the most appropriate intervention? A systematic review published in the Cochrane Database of Systematic Reviews found that professional support, including lactation consultants and trained healthcare providers, significantly increases the duration of breastfeeding. The review included 52 trials with over 56,000 women and concluded that women who received professional support were more likely to continue breastfeeding up to six months compared to those who did not receive such support.

What do our patient’s experience?

“My daughter was gaining weight well until she was about six weeks old, when her weight gain suddenly plateaued. I knew something wasn't right. She looked too skinny, lacking the healthy chubbiness most babies have. Concerned, I sought professional help…after recommendations to commence domperidone to improve my supply I felt an overwhelming sense of failure…” 

“In the midst of this emotional turmoil, my husband stood by my side, supporting me regardless of whether I chose to continue breastfeeding, switch to mixed feeding, or quit entirely. His unwavering support was a beacon of hope during this difficult time.”

When addressing lactation challenges, consulting with an independent board-certified lactation consultant (IBCLC) can be a critical step in providing comprehensive care. Performing a home visit and creating a shared treatment plan can help to establish effective support that alleviates being overwhelmed or feelings of inadequacy often accompanied by breastfeeding difficulties. Dellen et al (2019) published a study in the International Breastfeeding Journal that found women who received support from healthcare professionals, such as midwives and lactation consultants, were more likely to continue breastfeeding at six months. The study emphasised the importance of tailored support in addressing breastfeeding challenges and promoting sustained breastfeeding.

“...after observing my feeding technique, she set me up with a Supplemental Nursing System which allowed a small tube with a bottle of my expressed milk to be inserted into my baby’s mouth while she continued to breastfeed, this not only encouraged my milk supply, but allowed me to continue to bond with my daughter…”

“...with the IBLC’s expert advice and support, I was able to breastfeed successfully until my daughter was nine months old. Her guidance was instrumental in overcoming the challenges I faced, and I cannot overstate how grateful I was for her help.”

What support can be offered?

1. Be sensitive and supportive: Understand that new parents, especially first-timers, are vulnerable. Work with parents to develop their confidence and emotional wellbeing.
   
   
2. Explore alternatives: As a first step, consider referral to an independent board-certified lactation consultant (IBLC) or local community health centres that have health nurses and midwives. These professionals can provide invaluable support and alternative solutions.
   
   
3. Educate and empower: Provide information about different breastfeeding aids, such as supplemental nursing system, and other methods that might help them overcome their challenges.

Breastfeeding can be a complex and emotionally charged journey, but with the right support and guidance, many of the hurdles can be overcome. A collaborative approach to care creates an understanding and supportive environment for new parents.

Resources for health professionals:

• Breastfeeding Medicine Network Australia/New Zealand https://www.breastfeedingmed.com.au/
  Non-profit organisation of medical doctors who specialise in breastfeeding medicine, support of breastfeeding, education and advocacy in Australia and New Zealand.

• Australian Breastfeeding Association: https://abaprofessional.asn.au/elearning-modules/
  Offers a variety of resources, including professional development courses for healthcare professionals, information on breastfeeding management, and support services.

• Lactation Consultants of Australia and New Zealand (LCANZ): lcanz.org
  Provides access to certified lactation consultants, educational resources, and professional development opportunities.

• Raising Children Network: raisingchildren.net.au
  Offers comprehensive information on breastfeeding, including articles, videos, and guides specifically for healthcare professionals.

• The Royal Women's Hospital Breastfeeding Service: thewomens.org.au
  Provides resources and training for healthcare professionals to support breastfeeding mothers effectively.

• Karitane: karitane.com.au
  Offers services and resources for healthcare professionals, including training in breastfeeding support and management.

• Tresillian Family Care Centres: tresillian.org.au
  Provides education and support for healthcare professionals on managing breastfeeding issues and supporting new mothers.