July 31, 2020

When breastfeeding doesn't come naturally

Learning to breastfeed can take patience and persistence. Kaiser Permanente offers help every step of the way.

As an ob-gyn for Kaiser Permanente, Amani Zewail, MD, had always encouraged expecting moms to prepare for breastfeeding. She gave them information, asked about their concerns and urged them to take breastfeeding classes.

But she never anticipated the challenges she would face in breastfeeding her own first child.

“I was in excruciating pain each time he tried to nurse, and he was making these strange clicking noises,” she recalled. “It just didn’t seem right.”

At the baby’s 2-day appointment, a lactation consultant quickly diagnosed the problem: a condition known as tongue-tie, in which the tissue connecting the tongue to the bottom of the mouth is too short. The problem could be fixed with a simple outpatient procedure; until then, the lactation consultant showed Dr. Zewail how to pump her breast milk for bottle feeding.

A healthy start

Exclusive breastfeeding for 6 months is one of the best things a mom can do to give her baby a healthy start. Breast milk is easy to digest, strengthens the immune system, prevents illness, and reduces the risk of obesity. But breastfeeding doesn’t always come easily, and many women struggle at first.

“Women’s breasts don’t start producing milk automatically, and babies don’t come out of the womb knowing how to nurse,” said Kari Carlson, MD, chair of Obstetrics and Gynecology for Kaiser Permanente Northern California and national clinical lead for Women’s Health. “Our goal is to do everything we can to support them on their journey.”

Respecting each family’s journey

The decision to breastfeed is highly personal and may not be possible for all women for a range of personal and medical reasons. “A preemie might not be able to nurse, but the mom can still pump her milk and feed it to the baby in a bottle,” said Dr. Carlson. “And if a mom needs to supplement her breast milk with formula, her baby still benefits — any amount of breast milk is good.”

For women who choose to breastfeed, support is available every step of the way. At prenatal appointments, Kaiser Permanente providers ask patients about their breastfeeding plans, answer questions, and refer them to prenatal breastfeeding classes. In 2018, 96% of pregnant women at Kaiser Permanente received timely prenatal care, according to the National Committee for Quality Assurance, compared to a national average of 86%.

Breastfeeding support continues throughout the hospital stay. To encourage breastfeeding in the “golden hour” after birth when babies are alert and curious, nurses are trained to place the baby skin-to-skin on the mother’s chest. Throughout the hospital stay, if the baby has trouble latching or the woman can’t find a comfortable breastfeeding position, nurses offer coaching and advice. Lactation experts are available to help as needed.

Breastfeeding concerns are also addressed at the baby’s first pediatric appointment, typically scheduled within the first few days after birth. And round-the-clock support is available through a 24/7 advice line.  

This comprehensive approach has helped make Kaiser Permanente a leader in supporting breastfeeding. One example is our high rate of exclusive breastfeeding during the hospital stay, meaning that infants receive only breast milk ― no other liquids or solids. The national average is 51% according to The Joint Commission. But 74% of babies born at Kaiser Permanente hospitals in 2019 were exclusively breastfed during their stays. 

Sweet success

Now the mother of a thriving 5-year-old, Dr. Zewail is happy she stuck it out through the hard times.

“Breastfeeding my son was the best experience, and I owe it all to the lactation consultants who helped me,” she said.

Learn more about breastfeeding.