1. Addressing Perceived Barriers to Breastfeeding STACY CLIFF, MS DIETETIC INTERN

2. Barriers Concern over how to get started. Would it be easy? Awkward to breastfeed outside of home Going back to work

3. Concern Over Getting Started… New mothers may be uncertain about what to expect with breastfeeding and how to actually carry it out. Health professionals, literature, advertisements, breastfeeding moms, etc. routinely refer to breastfeeding as “natural.” In reality some babies take easily to the breast while others struggle. When faced with this challenge mothers are surprised that something that should occur so “naturally” is not coming as easily as they expected. Breastfeeding is something that must be learned by mother and baby. Skills in how to position the infant, and how to achieve an effective latch may need to be taught. The incongruity between expectations and reality are a key reason many mothers stop breastfeeding after two weeks postpartum. They carry this experience with them and fail to nurse subsequent children because they believe they are unable to do so.

4. Health Professionals Role in Overcoming Concern Over Starting… Clinicians should acknowledge breastfeeding is an art and one that must be learned. Acknowledge breastfeeding may not come easy, which is also normal. Provide information to patients on: Breastfeeding Classes Peer Mentors/Role models Provide paternal breastfeeding education to encourage support Information provided as handouts may be ineffective especially for low income mothers. Goal should be to increase knowledge of benefits of breastfeeding, positively influence attitudes about it, and provide continued encouragement and assistance during the initiation.

5. Awkward in Public Only a minority of the public believes that a woman should be able to breastfeed in public Restaurant and shop managers have reported they would discourage or ask the mother to go somewhere more private Women breastfeeding in public who have been asked to leave or move feel embarrassed and fearful of being stigmatized. (I imagine this is worse for women who are immigrants and trying to adjust and fit in to a new culture) Exclusion from social interactions because others may be reluctant to be in the same room as a breastfeeding mom. Breasts as sexual objects and not sources of nourishment

6. Overcoming Fear of Breastfeeding in Public…  Paternal education to provide support and back-up when in public  Role models to accompany and demonstrate, increasing mother’s confidence  Helping the mother see her breasts as sources of nourishment and only as sexual objects  Provide a list of stores, restaurants and other public venues that are openly supportive of breastfeeding mothers. Encourage local business to display signs expressing this support.  Support groups

7. Undesirable Work Environment Embarrassed to pump at work Workplace did not have good facilities to pump breasts Coworkers/managers frowned on breaks to pump and the amount of time it took to pump

8. Overcoming Work Place Embarrassment  Address this early in the pregnancy and encourage the mother to have a conversation with her employer and coworkers about her desire to breastfeed and ask them for their support.