Do We Still Need World Breastfeeding Week To Raise Awareness, Or Is It Time To Turn Our Attention To The Risks And Complications Of Breastfeeding?

Have you ever heard that "breast is best"? 

Have you ever heard that breastfeeding helps protect babies from diarrheal diseases, obesity, diabetes, and pneumonia, as well as that breastfeeding may be excellent for cognitive development and increase academic performance later in life? Have you ever heard that breastfeeding has health benefits for mothers, too — by lowering their risk of breast cancer and ovarian cancer, as well as high blood pressure, for the rest of their lives?

Have you ever heard that breastfeeding can save lives — and that is why the World Health Organization strongly recommends that every baby is breastfeed exclusively for the first six months of their lives and for 18 months or longer after that, alongside solid foods? 

The World Alliance for Breastfeeding Action started World Breastfeeding Week in 1992, to raise awareness of and support for breastfeeding. Whether or not this particular campaign has played much of a role, the fact is that breastfeeding rates have risen significantly.

Take the United States. In 1972, only 22 percent of new mothers even attempted to nurse their babies. By the year 2016, that percentage had risen to an impressive 84 percent — and nearly half of all US babies are nursed exclusively for at least three months. 

Sure, global breastfeeding rates fall short of the World Health Organization's targets, and it's true that mothers across the globe face challenges with nursing, whether it's because they need to return to work at workplaces not designed to be accommodating to breastfeeding mothers, because they lack the medical support needed to overcome breastfeeding complications, or because they don't get the social support they need. 

These are all problems that should be fixed — so that every mother who can breastfeed and wants to gets the opportunity. 

Do we still need to raise awareness about the health benefits of breastfeeding and encourage mothers to nurse their babies, though? At least in modern western nations, a whole industry has arisen around breastfeeding. Hospital staff are very much informed about the benefits of breastfeeding, and lactation consultants are everywhere. In this globally-connected world, information about breastfeeding is everywhere on the internet. 

Breastfeeding: Perfectly nourishing when it works, but what happens when it doesn't?

Breastfeeding is wonderful when it works — as, indeed, it did for me. Though I didn't know anything about babies before I became a mother, I was able to start nursing my firstborn nearly immediately after she was born. Just like the WHO recommends, she had nothing but my milk for the first six months, and I continued breastfeeding until she turned two. There were no problems. No supply issues, no latching difficulties, no pain, and no mastitis. The same was true with my next child. 

Some mothers instead encounter cracked and bleeding nipples, painful bouts of mastitis, or blocked milk ducts. Some babies cannot latch properly, and some develop thrush. That's what our doctors, midwives, and lactation consultants are there to help with. 

However, there is another breastfeeding complication that we may not be aware of — perhaps precisely because the message that breastfeeding is so important has reached far and wide. More and more medical professionals, such as those within the Fed Is Best organization, are calling attention to this problem, as worrying numbers of newborns have to be readmitted to hospital because they aren't getting enough food. 

Know the red flags: What are the signs that your baby isn't getting enough breast milk?

This puts them at serious risk of excessive jaundice, caused by hyperbilirubinemia or too much bilirubin, a condition that can ultimately lead to seizures. It also puts them at risk of hypoglycemia, or low blood sugar levels, along with excessive weight loss (more than seven percent of their birth weight), dehydration, and high sodium levels. 

These complications aren't rare:

• Excessive jaundice affects 10 to 25 percent of exclusively breastfeed newborns.
• Up to 50 percent of exclusively breastfed newborns are at risk of losing so much weight it's considered dangerous.
• Research suggests that 36 percent of exclusively breastfed newborns have hypernatremia, or excessive blood sodium levels. 
• Up to 10 percent also suffer from dangerously low blood sugar levels. 

It's time to recognize that breastfeeding — just like any other aspect of human physiology — isn't perfect. While breastfeeding has important benefits, we might have been forgetting to raise awareness of the warning signs that it's not working out.

Signs that a newborn is in distress because they are hungry, and parents need to seek medical attention as soon as possible, are:

• Low blood sugar — which can manifests as an unusually low body temperature, shaky hands, a blue-tinted skin tone, an inconsolable, high-pitched, cry, and ultimately seizures.
• A baby that won't stop nursing, fussing for the breast for hours on end without seeming satisfied afterward — the baby will continue to cry after they have fed.
• Lethargy — low energy, a limp body, a newborn baby who doesn't want up to feed at least once every three hours.
• Excessive weight loss — more than seven percent of the baby's birth weight. 
• Dehydration, as manifested by a lack of wet diapers (they should appear at least once every six hours), dry lips, and crying without producing tears. 
• Jaundice — a yellowing of the skin and eyes.

Many mothers whose milk has not come in yet will be able to breastfeed perfectly fine later on. However, research has shown that a shocking 37 percent of rehospitalizations within a baby's first month of life are related to feeding problems. This is a problem — one worth raising awareness of. 

Breastfeeding can be wonderful, but recognizing that it has risks and complications as well as benefits is part of the task of the whole medical community, as it helps mothers and babies everywhere be as healthy as possible.