Parenthood is full of both joy and decisions – breastfeeding versus formula, staying at home versus daycare or sleep training. For many, one of the most complicated decisions is whether or not to breastfeed, which has a number of benefits but can be challenging or unfeasible for many individuals.

“There can be a lot of guilt and shame around parenting, so one of the biggest things from a support standpoint is to help people regain their confidence and success in meeting the nourishment needs of their little ones,” said Andrea Westby, MD, a full-spectrum family medicine physician with University of Minnesota Physicians (M Physicians). “While there are significant health benefits for both the parents and child with breast or chest-feeding, in my view, the most important thing is helping meet the individual needs of the family and infants.”

Dr. Westby practices at the Broadway Family Medicine Clinic and North Memorial Medical Center where she helps patients understand all their options from prenatal to postpartum care. Dr. Westby recommends that those actively trying to become pregnant schedule a preconception appointment, which usually involves a review of medications and conditions that might impact early pregnancy along with a guide through the perinatal experience. M Physicians family medicine providers, obstetricians and certified nurse midwives can also partner to provide high-quality, individualized care.

“It’s important that we identify problems or risk factors for breastfeeding challenges early so that we can get patients outpatient support and treat any physical conditions that are impacting success,” Dr. Westby said. “The number one issue I see for nursing folks is latching — so either a painful or less effective latch.”

To produce an adequate amount of milk to nourish an infant, the breast needs to be emptied so the body knows to make more milk, which doesn’t happen as effectively or completely with a bad latch.

“It can also be incredibly painful, which might make a breastfeeding person feel like they aren’t doing it right,” Dr. Westby said. “This is a huge problem in the postpartum period, and people experience a lot of shame and inadequacy if there are breastfeeding challenges.”

For individuals facing these challenges, support is available.

“We start with good breastfeeding education and offer many ways to support that goal,” said Ann Forster Page, DNP, APRN, CNM, nurse-midwife service director at M Physicians. “We individualize our approach given our patients’ desires and experiences, making sure all options are available – donor breast milk, pumping and feeding with breast milk or high quality formula.”

M Physicians has nurses and providers who know how to best position the infant on the breast in the first few hours and days after birth, which can help create a more effective and less painful latch. This can also help prevent nipple bleeding, cracking or infection. If the infant’s tongue movement is restricted or impaired because of a tongue-tie, there are treatments and therapies that can help before leaving the hospital.

“It’s important for us to help troubleshoot and not discount the investment patients have in breastfeeding, while also supporting that sometimes the costs outweigh the benefits,” Dr. Westby said. “We want to make sure people don’t feel like a failure or that it’s a bad decision to feed their child in whatever way they need to.”

Patients have different levels of investment or expectations around breastfeeding, which might result in different conversations about how to best meet their nutritional needs.

“It’s important for babies to get the caloric and volume needs for survival and growth,” Dr. Westby said. “There are a number of additional benefits that both feeding on the breast and receiving breast milk can provide if that’s something people want.” 

Whether patients feel strongly one way or another about how to nourish their young ones, M Physicians providers support their choice and partner to help meet their individual needs.

“Pregnant and postpartum people and families should know their power and value and have the right to feel respected and supported in their prenatal, postpartum and lactation care,” Dr. Westby said. “We are working really hard to hear our patients and partner in a way that promotes health for all our patients and communities.”

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