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Despite the benefits of early breastfeeding, many women find it unexpectedly difficult and painful

Breastfeeding has regained popularity in North America during the past decade; however, breastfeeding during the first month after birth can be physically challenging. Christa M. Kelleher, Ph.D., of the University of Massachusetts, interviewed 52 women from Canada and the United States approximately 1 month postpartum about their experience of breastfeeding. Nearly two-thirds (63 percent) of the women mentioned the pain and/or discomfort associated with breastfeeding.

These women were generally surprised by the extent, intensity, and duration of the discomfort and pain, which ranged from mild to severe. Several women even noted that the discomfort of breastfeeding affected their relationship with their baby. Other women said that they were hesitant to continue the practice due to feelings of physical vulnerability, pain, and/or discomfort. Finally, assistance provided by health care practitioners had both positive and negative effects on women's experiences of breastfeeding.

Many women, particularly first-time mothers, said they felt overwhelmed by the enormous responsibility of breastfeeding, concerned about failing, and guilty when they acknowledged their own physical limitations or personal needs. Of all the women who initiated breastfeeding during the first days following birth, the vast majority were still breastfeeding by the time of the interview 1 month postpartum.

Of these women, more than half (53 percent) were breastfeeding exclusively at the time of the interview, 17 percent fed their infants pumped breast milk in addition to breastfeeding, 21 percent used formula in addition to breastfeeding, and 9 percent combined breastfeeding with pumping and formula feeding. Dr. Kelleher recommends that acknowledging the physical challenges of breastfeeding would better validate many women's experiences. Her study was supported by the Agency for Healthcare Research and Quality (HS10790).

More details are in "The physical challenges of early breastfeeding," by Dr. Kelleher, in the November 2006 Social Science & Medicine 63, pp. 2727-2738.

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