In cultures where we have become reliant on formula, many women see breastfeeding as having a downside. Women are worried about being embarrassed in front of others, getting sore, and whether breastfeeding will make their breasts sag. They see breastfeeding as impractical; how can they leave their baby if he relies on a breast? How will they know how much milk their baby has taken? How can dad share the feeding and take over at night? They worry about leaking milk in between feeds, or that breastfeeding will interfere with being intimate with their partner. And, believing they may have to give up alcohol, or eat more healthily creates more concerns. Left unchallenged, these worries are seen as disadvantages of breastfeeding.
Myths and misinformation
Most of these disadvantages of breastfeeding are muddled up with myths and misinformation. This article looks at popular breastfeeding stumbling blocks to examine how much truth is in each, how much of a disadvantage they really are and whether there is a solution.
Debunking the disadvantages of breastfeeding
#1 How can you know if you have enough milk?
Although you can’t physically see or measure how much milk has been drunk, there are lots of ways to tell if your baby is getting enough milk. You can let your baby feed on demand, listen for swallows, count dirty nappies and measure your baby’s weight gain. See Is My Baby Getting Enough Milk? for more information. And if you do encounter any problems with your baby not gaining weight, there are lots of ways to increase your milk supply, and lots of friendly breastfeeding advocates willing to help you.
#2 Does breastfeeding tie you down to your baby and make him clingy?
Once you have a baby, looking after him is your responsibility and will “tie you down” however you feed him. And all babies love to be with their mother, to be carried and cuddled and to feel safe in her arms. It’s not being ‘clingy’, it’s normal behaviour and lasts for a very short time in your life (and his!). Meeting your baby’s need to be picked up and cuddled and breastfed ensures healthy brain development and independence later on. Many nursing mothers see tucking baby into a sling and taking him with her as an advantage of breastfeeding—you have milk on board at just the right temperature in just the right amount and you won’t have to worry about transporting bottles or whether your baby is alright without you. If you do need to be separated from your baby, expressed breast milk can be left with your baby sitter.
#3 What if you find breastfeeding in public embarrassing?
In places where formula has become the normal accepted way to feed a baby, mothers can feel embarrassed to breastfeed in front of others. However if more women breastfed openly in public it would become normal and unremarkable. Although news reports like to sensationalise instances where a mother received an ignorant remark while she was breastfeeding in public, this is rare. Most people don’t notice or mind a breastfeeding mother. By quietly breastfeeding wherever you need to and without “asking permission” you are paving the way for more acceptance and making it the social norm. In the United Kingdom breastfeeding in public places is protected under the Equality Act 2010, see UK Breastfeeding Laws for further information.
Nothing to see here
Careful choice of clothing can help if you feel self conscious about showing too much skin e.g. try wearing two tops, one that can pull down such as this Breastvest which keeps your tummy covered—plus another layer that pulls up. With a little practice, there is literally nothing to see but a warm fuzzy baby’s head. If you prefer to use a ring sling or wrap (Breast and Bottle Feeding Safely in a Sling by Dr Rosie Knowles discusses how to use a sling safely), there will be nothing to see at all. Nursing covers generally draw more attention to yourself and make for hot and flustered mothers and babies.
Leaking milk can be seen as a disadvantage if your milk begins to flow and you don’t have your baby handy. Not all women leak milk and if you do, breast pads will save the day. Wearing dark patterned clothes helps hide any wet patches in the unlikely event they break through. Pressing on a leaking nipple with the flat of your hand can stop the milk flowing.
#4 Is breastfeeding difficult, painful and paved with problems?
No. Breastfeeding is a normal and natural way to feed your baby, if it was difficult and painful the human race would have died out long ago—after all formula is a relatively modern invention. Breastfeeding does not hurt if your baby is latched correctly, even at the beginning. And your baby can’t bite you if he is feeding correctly. If breastfeeding feels painful or is starting to make you sore, it’s your body’s signal that something is wrong. Sometimes problems do come along, because in some cultures we have lost the art of breastfeeding, but virtually all problems have solutions. Getting good help quickly from an IBCLC lactation consultant is the best way to get breastfeeding on track and see our article Why Does Breastfeeding Hurt?
Is bottle feeding quicker and easier?
No. Some women who have never tried breastfeeding or who ran into breastfeeding problems may feel bottle feeding is easier but when breastfeeding is running smoothly it is much quicker and easier than bottle feeding. Aside from the financial and environmental cost and the risks to your baby’s health and normal brain development, feeding industrial milks involves a lot of time consuming washing, sterilising and preparation of feeds.
#5 Will my partner miss out on bonding if they can’t share feeding?
Some mothers think that being the only one who can feed their baby could be a disadvantage of breastfeeding. But it’s simple biology that fathers can’t get pregnant and don’t usually breastfeed. If we can accept the former why not accept the latter too? Breastfeeding takes over from the placenta to continue your baby’s development. It is full of living cells, immune factors and perfect nutrients to grow your baby’s brain and body normally. There are lots of other ways a partner can bond and care for baby by carrying them skin-to-skin in a sling to soothe them between feeds, bathing them, playing with them, and feeding solids a little later on. Expressing milk into bottles so that your partner can join in with feeding may work for some couples although it can sometimes interfere with getting breastfeeding established and may create more work for mum.
Breasts can be shared!
If you or your partner feel that your breasts “belong” to your partner or that breastfeeding is in some way sexual or on a time limit, get more informed about the value of breastfeeding and seek support from other breastfeeding mothers. See Pressure to Stop Breastfeeding and How Long Should I Breastfeed?
#6 Do breastfed babies feed more often and wake more at night?
Breast milk is much easier to digest than industrial man-made milks so breastfed babies do tend to feed more often. And because the amount of breast milk a mother can store in her breasts varies, some breastfed babies may need very frequent feeds. Does it really matter? With breastfeeding there is no preparation, just put baby to breast and carry on.
Waking often at night is developmentally normal, and being able to rouse easily from sleep is thought to be protective against Sudden Infant Death Syndrome (SIDS)1. Studies also show that a breastfed mother doesn’t get any less sleep than a formula feeding mother2. See Baby Waking up at Night for more tips if you’re worried about your baby frequently waking up at night.
Can dad do the night shift?
It may seem an attractive idea to let your partner take turns with night feeds but breastfeeding can be undermined by your partner feeding your baby by bottle in the night while you sleep, even if breast milk is in the bottle. Frequent feeds or frequent breast emptying stimulates the breasts to make more milk; conversely, full breasts and long intervals between feeds will reduce a milk supply. Sleeping for long periods at night while a partner feeds the baby can mean breasts become very full and engorged; slowing down milk production. In addition, prolactin (an important hormone involved in milk production) has higher levels at night making night feeds particularly valuable to getting a milk supply established.
What about using me as a dummy?
Worrying that your baby is using you as a dummy is back to front thinking. Dummies were invented for bottle fed babies who had nothing to suckle in between feeds. It’s normal for a breastfed baby to feed frequently and to like to fall asleep with the breast in his mouth. There is no harm in it and no disadvantage to it from your baby’s point of view. Frequent snacking provides extra calories for your baby, helps shape his mouth correctly, relaxes both mother and child and sends baby to sleep.
#7 Does breastfeeding cause saggy boobs?
Pregnancy, ageing of skin and smoking are the main causes of changes in breast shape and skin elasticity, not breastfeeding. Pregnancy hormones affect your breast shape whether or not you plan to breastfeed3 4. Of course, if your breasts swell from a B cup to an F during pregnancy and you’re an H cup for breastfeeding, there might be some stretch marks and changes after the milk has gone, unless you have particularly elastic skin. So some mothers will notice changes due to breastfeeding and others won’t, just as some mothers’ bodies will have stretch marks on their hips and tummies or a “baby bag” belly from pregnancy yet others will fit straight back into their pre-pregnancy jeans. The rewards of breastfeeding or pregnancy are worth these normal changes.
#8 Do you have to watch your diet and avoid alcohol?
A healthy diet is better for you, but you can eat a less than perfect diet and still make great breast milk. Breastfeeding mothers can eat pretty much whatever they like although including a balance of healthy fats is recommended because the fats in breast milk are the one component most affected by diet. A vegan mother will need to ensure she is getting enough vitamin B12 otherwise her baby might fail to thrive or have developmental problems. See Best Breastfeeding Diet and Foods to Avoid for more information. There are rare occasions when a baby is particularly sensitive to something in a mother’s diet and a chief culprit is often dairy produce. It can be a disadvantage to have to exclude reactive foods like cows’ milk products from your diet for the time your baby is breastfeeding, however some mothers find excluding the food that upsets their baby can benefit their own health. Bear in mind the heavily processed formula alternatives may not suit your baby either—after all they are made directly from cows’ milk.
Only very small amounts of alcohol reach breast milk and drinking up to one or two units per day is not thought to cause a problem for your baby 5. For ways to reduce any potential effects of drinking alcohol on your baby see Breastfeeding and Drinking Alcohol on this website.
As with alcohol, only a small amount of caffeine enters breast milk, however some babies can be sensitive to it, particularly newborn babies. For information on levels of caffeine recommended see Coffee, Caffeine and Breastfeeding.
# 9 Is it difficult stop breastfeeding?
No, your baby will outgrow his need to breastfeed, gradually dropping feeds one by one. How long you breastfeed is up to you and your baby, it’s something you can decide day by day without planning ahead or worrying. As it is developmentally quite normal for a child to breastfeed for years instead of months, you might find your baby is keen to carry on breastfeeding longer than you would like. If this happens, there are lots of ways to gently hasten weaning, see How Long Should I Breastfeed? and How to Stop Breastfeeding for more information, or contact a breastfeeding charity such as La Leche League for more support.
#10 What about taking medications and spreading infections
As with alcohol, only a very small proportion of a medication usually enters breast milk and most medications are compatible with breastfeeding including several antidepressants. There are several reputable places for you and your health professional to check compatibility of drugs with breastfeeding. If one drug is unsuitable there is often another that can be prescribed. See Medications and Breastfeeding on this website for more information.
Very few infectious diseases prevent breastfeeding but Human Immunodeficiency Virus (HIV) 6 and Human T-lymphotrophic Virus (HTLV-1) 78 may be passed to the baby by breast milk. You can continue to breastfeed if you have a cold, sore throat, flu, sickness bug, or mastitis 9.
With the right help, most of the perceived disadvantages to breastfeeding have workable solutions. An assumption that “formula is just as good as breast milk these days” is misleading because formula has its own disadvantages 10 and assuming it is safe can prevent mothers seeking the help they need to make breastfeeding work. Breastfeeding is very important to the normal health of mother and child as a new series of papers released by medical journal The Lancet reveals;
…infants, children, and mothers who do not breastfeed experience an increased risk of mortality and morbidity. Breastfeeding is nutritionally, immunologically, neurologically, endocrinologically, economically, and ecologically superior to breastmilk substitutes (BMS), and does not require quality control of manufacture, transport, storage, and feeding mechanisms.