Breastfeeding Expert Amy Spangler Tells Mommyish Why Nursing Mothers Need Goals That They Can Achieve

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amy spanglerAmy Spangler is known to many as a world-renowned breastfeeding expert. The registered nurse and International Board Certified Lactation Consultant has penned multiple books on breastfeeding including Amy Spangler’s Breastfeeding: A Parent’s Guide, now in it’s ninth edition. President of Baby Gooroo and a mother of two, the breastfeeding advocate chatted with Mommyish smack in the middle of National Breastfeeding Awareness to talk first-time breastfeeding woes and why mothers should aim to breastfeed for six days before six months.

What are the most common challenges that first-time breastfeeders encounter?

Lack of confidence predicated by a lack of knowledge and a lack of support. While nearly nine in 10 U.S. mothers initiate breastfeeding, only two in 10 breastfeed exclusively for six months, citing pain, too little milk, and the need to return to work/school as the main causes behind their early stoppage.

Would you say that generally, most breastfeeding problems can be solved with proper lactation counseling or support?

Absolutely. With rare exception, nearly every mother and baby can breastfeed with adequate knowledge and support.

What advice do have for women who feel like they’re being judged or improperly advised by a lactation coach?

Never hesitate to get a second opinion and don’t let your breastfeeding goals for yourself be displaced by someone else’s goals for you.

 At what point should a mother hang up the mommy guilt and choose formula? What health situations are truly compromising for a mother and should not be “nursed through”?

There are only a few true contraindications to breastfeeding—babies with galactosemia or phenylketonuria (some babies with phenylketonuria can partially breastfeed); mothers with untreated tuberculosis (breastfeeding must be interrupted only until the mother is no longer infectious); mothers infected with HIV or HTLV type I or II (this is true only for mothers in developed countries with access to breast milk alternatives; those same mothers in developing countries are urged to breastfeed exclusively); mothers receiving cancer chemotherapy;  and mothers receiving certain radiologic tests or treatments. Most contrast agents do not contraindicate breastfeeding; agents used for treatment are more of a concern than agents used for testing.

 What is your response to the “formula bans” in some hospitals and of course by Mayor Bloomberg?

Hospitals and Mayor Bloomberg have not “banned” formula, they have simply urged staff to make formula available ONLY when medically indicated and ONLY with a physician’s order. Their actions help to ensure that babies are given every opportunity to breastfeed. Sadly, infant formula has become the default solution to every breastfeeding problem.

What work, if any, do you feel needs to be done with regard to the cultural encouragement to breastfeed? Many of our readers can find it off-putting.

Incorporating breastfeeding into the K-12 curriculum is the one strategy that would best ensure the reestablishment of breastfeeding as the “normal” way to feed babies. Breastfeeding, as a human behavior, is essential to short- and long-term health. As such, it should be taught right along with information about immunizations, use of seat belts and bicycle helmets, and dangers associated with smoking, alcohol, and drugs. A K-12 breastfeeding curriculum was developed by the state of New York but has never been implemented. Georgia is currently working toward implementation given breastfeeding’s proven role in preventing childhood obesity.

The fact that readers find breastfeeding encouragement and support “off-putting” is an indication of how much work we still have to do in better communicating the tremendous impact breastfeeding has on the health of women, children, families, and the environment.

 What do you feel is currently missing from the conversation surrounding getting more women to breastfeed? 

In our efforts to get more women breastfeeding, we have emphasized the recommendations of the AAP (breastfeed at least one year and exclusively for six months) and the WHO (breastfeed at least two years and exclusively for six months), but the fact is mothers must first breastfeed exclusively for six days and six weeks. Therefore, setting goals that mothers feel they can achieve needs to be the first step, and the second step must be to deliver the message that any amount of breastfeeding for any amount of time is beneficial. While MORE is better than LESS, SOME is better than NONE. The final thing missing from the conversation is worksite support for breastfeeding. The fact that nearly nine in 10 mothers initiate breastfeeding indicates that mothers know breastfeeding is best for their children. The fact that many mothers stop breastfeeding within two to six weeks indicates that we lack the support structure needed to enabled continued breastfeeding including extended maternity leave, worksite childcare, flexible work hours, job-sharing options, etc. It’s time for employers to show by their actions that we, as a society, truly value women and children.

(photo: L_amica/ Shutterstock)