Message from leader in breast milk research: 'You aren't a failure if you don't breastfeed'

“Breastfeeding is wonderful, but it isn’t always rainbows and sunshine,” says Heather Gordon, a young mother who admits to the challenges in breastfeeding her first-born, Lily.

“My daughter is still feeding on demand which means I am breastfeeding every two to three hours,“ she says. Gordon is able to do this interview, a rare moment of quiet, while her daughter soundly sleeps in her crib.

Gordon felt frustration in the early weeks of parenthood because her newborn needed formula as her breast milk was not adequately flowing. “I really felt shame, coming from all avenues in our society, that I was not living up to being that good mom,” she says.

Common condition that inhibits breastfeeding

Gordon’s difficulties were explained when her daughter was diagnosed with ankyloglossia or tongue tie, a fairly common condition in which the infant’s tongue is held to the floor of the mouth, causing the infant to bite the breast instead of suckle. A quick surgical procedure corrected the condition, but the setbacks and extreme pain from her daughter’s poor latching disappointed Gordon and she was ready to give up.

Gordon was able to resume breastfeeding through help from lactation consultants and her own mom, who happens to be a leading breast milk expert. Dr. Tanis Fenton, PhD, gives an understanding nod to her daughter’s near abandonment of nursing. The situational irony causes Fenton to smile. For three decades, Fenton has tirelessly emphasized the science behind infant feeding in her recommendations to world health agencies, and now her own daughter faced a difficult decision.

“The world has promoted that the breast is best,” says Fenton. “But I really am now more moved to support mothers who don’t breastfeed by emphasizing that infant formula is a safe alternative to breast milk.” Fenton notes that infant formula, usually made from cow’s milk or soy protein, is formulated to meet all of the nutritional needs of growing infants.

Newborns require large amount of nutrition to double their weight  

Fenton knows a thing or two about nutrition. She helped babies thrive in the neonatal intensive care unit at the Foothills Medical Centre for 18 years, along with a team of specialists and allied health workers, treating some of the most fragile babies born in southern Alberta. An infant dietitian and epidemiologist, she provides expertise on premature infant nutrition and growth around the world. Fenton is also member of the Alberta Children’s Hospital Research Institute and the O’Brien Institute for Public Health at the Cumming School of Medicine and an associate professor in the Department of Community Health Sciences.

Fenton helped support her daughter during those early weeks, covering the night feedings with formula and pumped breast milk. Babies double their weight in four months and so require a great deal of nutrition. In Canada, most newborns (90 per cent) will start out breastfeeding. But only half of these babies will continue until four months. Breast milk is a perfect form of nutrition that changes as a baby grows and helps protect against multiple infectious diseases and even sudden infant death syndrome. Sugars in breast milk also help shape a baby’s microbiome and promote overall health. The World Health Organization, Health Canada and the Canadian Paediatric Society all recommend breastfeeding exclusively for the first six months, something only a quarter of Canadian mothers complete.

Stress and lack of support behind drop in breastfeeding

“There is a huge drop-off, and that’s likely because parents lack sufficient support,” says Fenton, who emphasizes that families need calm and relaxation in their lives for successful breastfeeding. Lack of social support as well as stresses such as financial pressures can often be factors that lead to this drop off. Fenton and her daughter both attest to the need for good support through extended family and trained lactation consultants.

Gordon persisted in breastfeeding and is now one of those moms who reached and surpassed the six-month recommended goal. Recently Lily began sleeping through the night with just one feeding and is exploring solid foods, giving Gordon renewed energy. Another milestone achieved.

“I love breastfeeding, but I have empathy for those who can’t, and understand those who don’t,” she says. And that sentiment is echoed by Fenton. “We need to provide more supports for mothers so they can choose to breastfeed, and remove the shaming for those who don’t.”

Dr. Fenton is a nutrition research lead for Alberta Health Services. She is also Chair for the Preterm Infant Expert Workgroup of the Dietary Guidelines for Americans. She is best known for her work developing the Fenton Preterm Growth Charts, which are widely used across Canada and internationally.