Approximately 4 million babies are born each year in the United States alone.  While 3 out of every 4 mothers initiate breastfeeding, only 13% breastfeed exclusively for six months.

Why mothers stop breastfeeding has been the subject of countless articles and numerous studies.

In an effort to explore this and other questions, BabyCenter conducted an online survey.

What was surprising wasn’t the answers, but the number of respondents—27,000 women.

When 27,000 breastfeeding moms speak, I listen.  If for no other reason than to see if what I think is true about breastfeeding is really true, partly true, or completely false.

Survey results
The survey, “How is breastfeeding going for you,” was an attempt to quantify women’s breastfeeding experiences—the good, the bad, and the ugly.  Participants were asked to respond to the following questions:

• How old is your baby?
• What did you expect breastfeeding to be like?
• Before your baby was born, what your your biggest breastfeeding worry?
• Which best describes your first week of breastfeeding?
• What was your main source of help with breastfeeding?
• Did you feel pressured to breastfeed? If so by whom?
• What do you like most about breastfeeding?
• Physically, what’s been your biggest breastfeeding challenge?
• Emotionally, what’s been your biggest breastfeeding challenge?
• At what age did your baby first have a bottle of formula?
• How did you feel about supplementing with formula?
• How do you feel about moms who choose not to breastfeed?
• How do you feel about mothers who give up on breastfeeding because it’s too hard?

While the statistical significance of the results are limited due to the fact that participants were self-selected (volunteers), the sheer number of respondents makes the results worth noting.

• The majority of respondents (62%) expected breastfeeding to be difficult or challenging. Only 21% thought it would be easy and 16% weren’t sure what to expect.

• Not enough milk (33%) and pain (23%)  topped the list of concerns; respondents were least concerned about eating, drinking, sleeping (8%) and weight loss (1%).

• Fifty-nine percent described the first week as difficult and/or painful.

• The main source of support for nearly half of the respondents were nurses/lactation consultants at the hospital.

• Fewer than 5% felt pressured to breastfeed. While nearly 75% were supportive of women who either chose not to breastfeed or tried to breastfeed and were unable.

• Nearly half of the women surveyed cited fatigue and feeling tied down as their biggest emotional challenge.  The most common physical challenge was nipple pain/sore breasts (29%).

• What mothers liked most about breastfeeding were the health benefits for their baby (48%) followed by enhanced bonding (22%).

• Surprisingly, 66% of those surveyed had a baby under the age of 6 months and 53% reported not having given their baby formula. Of those who had given their babies formula, 28% gave it in the first month and only 10% reported feeling “guilty” as a result.

Take home message
Women appear to have increasingly realistic expectations with regard to breastfeeding, as evidenced by the fact that few (21%) thought breastfeeding would be easy.

The fact that nurses/lactation consultants were the main source of support bodes well for lactation consultants but highlights the need for increasing the number of lactation consultants. Right now there are too few to go around.

Given that nearly two-thirds of those surveyed described the first week as difficult and/or painful, perhaps it’s time for health care providers to acknowledge what a majority of mothers have been telling us—breastfeeding is painful at first—and to put parameters on the pain, helping mothers understand the source of the pain and that it is short-lived.

Concerns related to feeling tired and tied down need to be addressed along with strategies for managing both.  Breastfeeding can and should fit into every mother’s life.

The fact that the majority of mothers cited health benefits and the chance to bond with their baby as reasons to breastfeed shows that mothers truly want to do what is best for their children. At the same time, no woman breastfeeds in a vacuum. Breastfeeding requires the support of family, friends, employers, and health care providers. It truly takes a community to breastfeed.  Just ask any mother who’s been there done that.