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Common breast-feeding difficulties fixable

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Many of the most common barriers to long-term breast-feeding, such as sore nipples or feeding difficulties, are either preventable or correctable with proper education and support, a new study finds.

Unfortunately, only about half of all mothers who begin to breast-feed continue for longer than four weeks, according to the report from the U.S. Centers for Disease Control and Prevention.

"Basically, our findings from this project show that we need to encourage women to breast-feed for as long as they can," says the study author Indu Ahluwalia, an epidemiologist in the division of adult and community health at the CDC. "The quit rate could be lowered if women are supported and adequate counseling is provided."

The study appears in the December issue of Pediatrics.

Part of the problem with breast-feeding is that it doesn't come naturally and isn't always easy, at least initially, says Dr. Adam Aponte, medical director at North General Hospital in New York City.

"It's not as innate as one might think it is. It's really very difficult, and it takes a lot of encouragement and support," he says.

However, it's certainly worth the effort. Breast milk confers a broad range of benefits to the baby, including antibodies that help reduce the number of ear and respiratory infections, according to the study. Breast-feeding also reduces gastrointestinal distress and may reduce a baby's risk of death, the study researchers says.

Additionally, breast-feeding provides the mother with benefits.

It helps speed the recovery of a mother's body after birth, and recent studies have suggested that breast-feeding may lower a woman's risk of certain cancers, including breast cancer, and type 2 diabetes.

To see what's keeping women from breast-feeding longer, the CDC researchers reviewed data from the Pregnancy Risk Assessment and Monitoring System, which includes information on more than 30,000 American women. Overall, 32 percent of the women didn't start breast-feeding, 4 percent breast-fed for less than a week, 13 percent breast-fed for one to four weeks, and 51 percent breast-fed for more than four weeks, according to the study.

Those who were least likely to breast-feed for more than four weeks were young women, those with lower incomes, and women who smoked. Black women were less likely to initiate breast-feeding and less likely to continue breast-feeding for longer than four weeks than white women, the researchers said.

Planning on breast-feeding prior to delivery was a big factor in initiating breast-feeding, according to the study. Before the baby was born, 50 percent of the women said they planned to breast-feed, while 16 percent says they thought they might breast-feed. Almost 5 percent were unsure, and 30 percent says they didn't plan on breast-feeding.

Some of the most common reasons cited for stopping breast-feeding included sore or cracked nipples, not producing enough milk, the baby had difficulty feeding, or the perception that the baby wasn't satisfied by breast milk.

"Having difficulty with breast-feeding is a common experience," says Ahluwalia. "It's a learned behavior, and it needs to be encouraged in the most supportive way."

If you're having trouble breast-feeding, Aponte says you shouldn't give up. "Don't be afraid to ask for help.

Breast-feeding can be a wonderful thing once it's established and successful," he says. If you need assistance, he says, you can call your child's pediatrician or see if a lactation consultant is available in your area. Other mothers who've breast-fed are also a great resource.

If your nipples are sore or cracked, the baby probably isn't latching on properly, Aponte says. The baby shouldn't just be sucking on the nipple, so make sure the baby is really opening wide when latching on to the breast. Also, don't let the baby nurse on one breast for more than 15 minutes. After about 10 to 12 minutes, he says, the breast is empty. Babies will still suck because it's an innate reflex, but they're probably already full, he says.

Ahluwalia says this study points to the need for continued education efforts, both before and after childbirth. And, she says, it indicates the need for extensive support for breast-feeding mothers, especially in the early weeks when women have the most difficulties establishing breast-feeding.

(The HealthDay Web site is at

c.2005 HealthDay News

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