Almost every class, website, online discussion, book, brochure and conversation related to breastfeeding references a statistic:
- “only 1-5% of women are unable to breastfeed.”
- “an estimated 1 to 5 percent of women are physically unable to produce enough milk to feed their babies.”
- “less than 5% of women experience lactation failure.”
As one of the illustrious 1-5% of women who didn’t produce enough milk, I wondered, what does this statistic mean and where does it come from? It almost always comes up in one of the following contexts:
- Reassurance: “You are likely able to produce enough breast milk for your baby. After all, only 1-5% of women can’t.”
- Advice: “If you try harder, you can do it. After all, only 1-5% of women can’t. Here, let me tell you some ways you can increase your supply…”
- Shame: “You shouldn’t have weaned early. You didn’t have a legitimate reason. After all, only 1-5% of women can’t breastfeed.”
As a woman who experienced “lactation failure,” firstly, fuck that term in the neck, and secondly, I hate hate hate it when a statistic doesn’t reference something definable or specific and doesn’t really add much to a discussion of whether or not a woman is able to breastfeed, for how long or to what extent.
So…I went to the original source. What did I find? A 1990 study, which included 319 mostly white, middle class, college-educated, first-time moms, who were motivated to breastfeed their healthy, full-term, singleton babies. Fifteen percent of the women were unable to produce sufficient milk by three weeks postpartum. While many of them were able to overcome supply challenges with assistance, 4 percent of the 319 women appeared to have chronic low milk supply. The results of that study really don’t tell us anything about supply issues in the wider population. Not to mention women in other countries. The study’s own co-author, Marianne Neifert, a clinical professor of pediatrics at the University of Colorado Denver School of Medicine, was quoted in a 2013 article – “You cannot find a number for this,” and “she hasn’t been able to find any additional studies that support those numbers.”
When I was diagnosed with insufficient glandular tissue (IGT), I searched extensively and discovered that research on IGT is almost nonexistent. My breastfeeding specialist physician shared with me a 2000 study, conducted by well-meaning nurses and lactation consultants who sought to understand IGT/breast hypoplasia and document how women with different breast characteristics that they had associated with low milk production fared when breastfeeding. This study was important, but limited in size and scope, including only 34 women. Also, some women with the markers they identified had no problems producing milk.
Not to mention that there are a ton of other physical causes of low milk supply, including thyroid disorders, retained placenta, polycystic ovary syndrome, insulin resistance, hormonal disorders and surgery. But, again, having one or more of these conditions doesn’t necessarily mean that a woman will be unable to produce milk. Additionally, other conditions can make breastfeeding excruciatingly painful or impossible. Baby may not be able to latch or transfer milk. A woman may not respond to the pump. A woman may have inverted nipples. A woman may have a trauma history or post partum depression or other mental health issues that make breastfeeding impossible and/or that require medications that are incompatible with breastfeeding. This challenges lactation consultants and peer advocates, who are trying to help women navigate their own bodies and babies (who contrary to popular mythology may not instinctively know how to latch and transfer breast milk). How can you predict when a woman won’t be able to breast feed? The answer is frustrating – you can’t. Thus, they reach for a handy statistic to encourage women to try.
Literally the only way to know for sure if breastfeeding will work is to try it and see if it works. Which, I can tell you from experience can be a horrible, demoralizing, scary process. We are talking about feeding a newborn. Failure can mean starving your baby. And if you don’t have access to experienced professionals and advocates, you are likely to hear a lot about a mythical 1-5% of women.
Bottom line – any reference to the percentage of women who can or cannot breastfeed is made up, pseudoscience bullshit. There’s no way to measure how many women can physically lactate, make enough milk, get baby to latch/or respond to the pump, not experience pain or infections and continue to produce enough milk over the long-term for baby’s health and nutritional needs. There’s no fucking study or body of research that provides that figure. It’s fake. And even if it was real, physical ability is by far not the only factor influencing the ability to breastfeed – limited or no maternity leave, not being able to pump at work, illness, lack of support, lack of time/energy, past history of sexual trauma, medications, not wanting to or choosing to, etc. fucking etc. can result in a woman not being “able” to breastfeed.
Using this statistic is shaming, a red herring and not relevant to general discussions about breastfeeding and more importantly, discussions with individual women about how they feed their babies and why. So, please, cut it out.
Featured Image: from the 1977 edition of the Womanly Art of Breastfeeding, La Leche League. Illustrated by Joy Sidor
Beautiful baby image: Steph, all rights reserved.