The Real Reason Not Everyone Can Breastfeed
Breastmilk is undeniably the best milk for infants' physical and mental development. Breastfed babies have better eyesight, suffer from fewer and less severe infections and diseases, and have a lower risk of Sudden Infant Death Syndrome. The benefits are long-term, with breastfed babies having fewer health problems as they get older (per Johns Hopkins Medicine). With all of these benefits in mind, it is no surprise that experts recommend feeding your baby only breastmilk for at least six months, and then continuing to feed your baby breastmilk in addition to complementary foods until your baby is at least a year old (per Centers for Disease Control and Prevention).
In an ideal world, every baby could be breastfed. In the real world, however, this is not the case. For some people, the reasons are practical or financial. For instance, some mothers must choose between breastfeeding and bringing in income — according to a study in the journal Birth, mothers who do not receive paid maternity leave are less likely to breastfeed. There are also some physical reasons that a mother may not be able to breastfeed.
Some infections and medications can make breastfeeding dangerous.
Some health problems make it dangerous to breastfeed. For example, people with HIV are advised not to breastfeed because the virus can spread through milk, according to the CDC. Mothers with tuberculosis are advised to breastfeed only if they are taking medication to treat it (per Healthy Children).
The CDC reports no evidence that hepatitis B and C can be transmitted via breastfeeding. However, mothers should temporarily stop breastfeeding if their nipples are bleeding, because these infections are known to spread via blood. Likewise, mothers with herpes simplex virus can generally breastfeed, but should temporarily stop if a lesion is present on the breast (per Verywell Family). If you have any other infectious disease, it would be wise to consult your doctor before deciding whether or not to breastfeed. In most cases, your infection will not restrict you from breastfeeding. Breastfeeding may even be beneficial because the milk can provide antibodies to the baby, reducing the baby's chance of getting sick (per Healthline).
Moreover, a mother's use of drugs can make it dangerous to breastfeed. For example, babies can experience seizures if they are exposed to cocaine in breast milk (per University of Washington Medical Center). Many experts also discourage breastfeeding while using lithium. But especially when it comes to prescription medication, most drugs are transferred to breast milk in harmless amounts (via Drugs). If you are in doubt about whether you should breastfeed while taking a certain medication, ask your doctor.
Some people have a low milk supply.
Oftentimes, a low supply of milk can be alleviated by feeding more frequently and latching the baby onto the breast properly. However, some people have a true low milk supply that won't improve using these practical methods. This can be caused by stress, fatigue, and medications. It can also be caused by physical health issues such as hypothyroidism, PCOS, cancer, a retained placenta, and an unhealthy weight. Certain lifestyle choices such as smoking, drinking alcohol, and consuming too much caffeine can also impair milk production (per Verywell Family).
According to the Journal of Midwifery & Women's Health, some women are unable to breastfeed due to a condition called mammary hypoplasia, which means they don't have enough glandular tissue in their breasts. Contrary to popular belief, this has nothing to do with breast size (via Medela). As breast size is primarily from fatty tissue, not glandular tissue (per United States Lactation Consultant Association), mammary hypoplasia can affect women with breasts of all sizes. Some women with this condition still produce enough milk to feed their babies, but others do not. Mothers will also be unable to breastfeed if they've had a double mastectomy, as the procedure removes the tissue in the breasts that produces milk (via BabyCenter).
People with low milk supply who wish to breastfeed should consult their doctors to determine and hopefully treat the cause. If breastfeeding is still impossible, or if the mother chooses against it for practical or other reasons, a baby can still enjoy many of the emotional and physical benefits of breastfeeding by comfort nursing (via Verywell Family) and being given donor human milk (per Children's Hospital of Philadelphia).