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American moms don’t breastfeed long. Here’s why.

Ashley May
USA TODAY
While women are breastfeeding, they aren't continuing for the recommended six months to two years.

While moms are breastfeeding, they aren’t keeping it up.    

About 81% of moms across the nation reported breastfeeding at some point, CDC data shows, but that number drastically decreases to about 22% when looking at exclusive breastfeeding for six months, recommended by the American Academy of Pediatrics. Breastfeeding at one year is about 31% in the 2013 data. The World Health Organization recommends breastfeeding for two years.

Breast milk has many proven benefits, including improved immunity and lower risk of Sudden Infant Death Syndrome. Some studies even show breastfeeding improves a child's cognitive function, but that's up for debate.

Still, many moms who hear "breast is best" have intentions of breastfeeding for a year or longer. 

Here are some reasons they stop early.

It's awkward, painful and hard to know if baby is getting enough milk.

Helping a baby latch properly is about as easy as grabbing a stuffed animal in a claw arcade game. Exhausted new moms, learning how to hold a tiny, fragile human, have to grab their breast and bullseye a nipple into a small, crying mouth. Even if the baby takes a nipple, he might not have a good latch and there's no way to know how much he's drinking, unless he's weighed. 

Regina Maria Roig-Romero, the chair of the board of directors for the International Board of Lactation Consultant Examiners, said concerns about milk supply is the most common problem she hears about.

"In terms of milk supply, most healthy women are perfectly capable of making enough milk they need, even enough for twins," Roig-Romero said. 

Dr. Andrew Bernstein, spokesperson for the American Academy of Pediatrics, said many moms also don't understand the first days of latching can be painful. 

“Breastfeeding isn’t easy,” Bernstein said.

Nursing can cause cracked, bleeding nipples. Women who don't seek support from a doctor or lactation consultant might not know that help is available and give up. (Once a proper latch is established, breastfeeding shouldn't hurt.) Those needed resources often come at a cost, as private-practice lactation consultants aren't always covered by insurance. 

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The work-pump grind.

Most American moms return to work just a few weeks after giving birth, and the decision to continue breastfeeding usually means they will need to pump. Initially, they have to talk to their employer about breaking three to four times daily to go into a room, partially undress, piece pump parts together, hook up to a machine, express milk, clean the pump and head to a refrigerator to store the milk. Then, go about their work day. Pumping can be intimidating and overwhelming.

Laura María Gruber, a board-certified lactation consultant, said the time when working moms in America go back to work can also be problematic. 

“Moms go back to work six to 12 weeks out of the hospital," Gruber said. "Those are two critical times. At six weeks, moms establish their supply.”

If moms don't have a supportive work environment or supportive caregivers, it can be difficult for them to meet their breastfeeding goals. (Support is key even for moms who don't work and simply need to get out of the house. While breastfeeding in public is legal in most states, societal stigmas still discourage it.)

Most moms returning to work in the U.S. need three to four breaks a day, if they want to exclusively breastfeed.

Employers covered by the Fair Labor Standards Act (and not exempt from FLSA’s overtime pay requirements) are required to provide breaks and a private pumping room (not a bathroom) for up to a year after birth. But, as a recent Washington Post article points out, some women pump in conditions that are illegal and frankly, demeaning. 

The U.S. does not have a paid family leave policy like other developed countries around the globe, which is also a breastfeeding roadblock. Access to paid maternity leave is shown to increase the duration of breastfeeding

In 2016, women working or looking for work with children younger than 1-year-old was 58.6%, according to the U.S. Bureau of Labor Statistics. The Family Medical Leave Act, gives women 12 weeks job-protected unpaid leave, but many workers don't qualify for that. Twelve percent of U.S. non-government workers have access to paid family leave, according to the Department of Labor. Recently, President Trump proposed a federal budget that, if passed, would grant mothers and fathers six weeks of paid leave after the birth or adoption of a child. But, whether that will be passed is to be determined, and critics say it's not enough. 

They do what's best for them. 

Danielle Campoamor worked as a freelance writer and social media manager when her son was born. She had no leave, and started working the moment she returned home from the hospital. Campoamor, who now works as Romper's Identity Editor, said she wanted to breastfeed for two years — one year, minimum.

"I got into the idea that I would have been a really bad mom if I supplemented or stopped," Campoamor said. "Trying to breastfeed and trying to continue to work and live up to expectations definitely contributed to my postpartum depression."

Campoamor breastfed exclusively for seven months. She cried when her partner gave her son formula, but felt healthier after making the decision to stop. 

"Looking back, I wish I would have quit sooner," she said. 

Campoamor's is one of several unique situations moms face, when breastfeeding for a year isn't best. In some cases, needed resources and help aren't available or affordable. In others, like those who have HIV, breastfeeding isn't recommended for a baby's health. 

"People do what they think is best for them and their families," Roig-Romero said. "There are reasons for why people stop breastfeeding ... We need to point our lens not at them but at the reasons why."

Ashley May is a new mom, who is all too familiar with the breastfeeding struggle. She's also the voice behind the podcast Due Date, an uncensored journey through pregnancy. Follow her on Twitter: @AshleyMayTweets