August is Breastfeeding Awareness Month, so I want to share my own breastfeeding story — not the tidy version.

I usually keep these posts scientific, and there are medical facts and tips at the end. But first I want to tell you what it was actually like, because I think new moms hear the polished version far too often.

My story

I’m Carolyn Clark. I’m a mom. I also work as a family nurse practitioner, but “mommy” is the first job title. I have two kids, and I breastfed both for their first year — two completely different experiences, much like their personalities.

With my first, I knew I wanted to breastfeed. As they say, “breast is best,” and I wanted to do what was best for my child. It also doesn’t hurt that I like to be frugal, and formula is expensive. So I was determined — not one drop of formula for a full year.

Much like many things in life, not everything went as planned. I read all about labor and delivery. I did not read a single thing about breastfeeding. How hard could it be? It’s natural, so it comes naturally, right?

Boy, was I wrong.

I delivered, we did skin to skin, and I put her to my breast. It did not feel natural. It felt like I needed five arms — latch her correctly, support her head and body, hold my breast in the right position, all at once. And it hurt. (Can I get an amen, ladies?)

I was lucky: I had a persistent baby who persevered through my early fumbling. I saw the lactation specialist at the hospital. She had plenty of wet and dirty diapers. Her weight was fine. But I was going back to work at two months, and nobody had told me when and how much to pump to build a stash, or how to even use the pump properly. (These are not things taught in nursing school, just FYI.)

Two weeks in I told my husband, “I just feel like a big boob.” All I could think about was when I was nursing next or pumping next. Just go ahead and send me to the dairy farm.

Then I went back to work, and the supply dwindled. I couldn’t stop often enough to keep up. I remember crying — more than once — because she’d eaten 12 ounces and I’d only pumped 8. I remember losing it on my husband over five accidentally spilled ounces of liquid gold. (Still sorry about that one.)

Eventually I had to supplement with formula. To show you how far into my own head I was: she was about nine months old at that point. Go ahead and roll your eyes. I nursed for 13 months and still didn’t finish a can of formula — but it was not a proud success story. My determination had turned into an obsession, and the obsession made me stressed and miserable.

So with my second, I told myself: hindsight is 20/20. Go in relaxed. If you have to supplement at two weeks, you supplement at two weeks. Do not pressure yourself.

And it turned out to be the happy, no-worries breastfeeding story I’d wanted the first time. I pumped like crazy before going back to work. I blocked out pumping times in my workday, no exceptions. And I didn’t need five arms — it came naturally. So naturally it was amazing.

Did I still feel like a dairy cow? Absolutely. I’m not sure how you couldn’t. But there was no stress, and that changed everything.

A friend said to me recently, “Everyone acts like breastfeeding is SO special, but it hurts, it’s SO hard, and what’s special about it?” My answer: “It is totally hard. But it is so special in the end — just not at first.”

About “breast is best”

I used that phrase above because it’s the one I had in my head back then. I’ve come to dislike it.

Breastfeeding genuinely does offer real benefits, and the major medical organizations still recommend it. But we — society, and health care providers very much included — pushed that slogan so hard that we made a monster of it. I see women in my office who feel like complete failures because breastfeeding didn’t work out. That is not what anyone intended, and it is not a good outcome.

So let me say this plainly: your job is to feed your baby and to do your best. If you gave breastfeeding your best effort and your child needed formula — low supply, poor latch, a return to work, any of a hundred reasons — then you are being the best mom you can be. Formula is safe, regulated and nutritionally complete. Be a proud mommy that your child is growing, whether by breast milk or formula.

Most of what stops mothers from meeting their own breastfeeding goals isn’t effort or love. It’s short leave, an employer with no private room, a long drive to the nearest specialist, and a baby who didn’t read the pamphlet. Those are the things worth being frustrated at — not yourself, and not each other.

What the guidelines actually say now

This has been updated since I first wrote this post. The American Academy of Pediatrics now supports exclusive breastfeeding for about the first 6 months, and continued breastfeeding alongside solid foods for two years or beyond, for as long as mother and child mutually desire — a change from the previous one-year framing. The World Health Organization recommends the same. That is a longer horizon than most American moms are told about, and it’s worth knowing it’s an option, not an obligation.

Tips

For moms-to-be: read up on breastfeeding. Don’t skip it like I did. Spend less time on sleep methods and more on how nursing actually works. You won’t regret it.

For moms struggling right now: don’t give up, but don’t white-knuckle it either. Stress mostly interferes with let-down — the reflex that releases the milk — rather than destroying supply outright, which is why a hard, tense pumping session can produce almost nothing and then a relaxed one goes fine. Call a lactation consultant. Phone a friend. Or come see me. It does get better, and the searing early latch pain does go away. I promise.

For working moms: start building a freezer stash about three or four weeks before you go back. Pump right after the morning feed, when there’s usually more than the baby takes. Once you’re back, pump roughly every three hours — about as often as your baby would have fed — because production follows removal.

On bottles: wait until breastfeeding is well established, generally at least three to four weeks, then offer one bottle a day to keep the skill alive. Have someone else give it if you can — many babies won’t take a bottle from the person they can smell milk on. If your baby fights it, that’s usually flow preference rather than “nipple confusion”: bottles deliver faster. Use a slow-flow nipple and hold the baby more upright, letting them pause.

If it didn’t work with your first: please don’t assume it won’t work with your second. You’ll feel like a pro by comparison, and the next baby may have a completely different style. Keep your head up and try again.

For everyone else: do not guilt moms who don’t breastfeed. Just stop. It is harder than it sounds and there are a hundred reasons it doesn’t work out. Encourage them. If you struggled, share that story — it helps more than the polished ones. And don’t judge women nursing in public. Would you want to eat your lunch in a bathroom?

You have a right to pump at work

This is genuinely new since I first wrote this, and I wish I’d had it.

The PUMP for Nursing Mothers Act took effect at the end of 2022, with full enforcement from April 2023. It covers the great majority of employees in the country — including salaried workers, teachers and nurses, who were left out of the old law.

Your employer must give you reasonable break time to pump, each time you need it, for up to a year after your baby is born, and a private space that is not a bathroom, shielded from view and free from intrusion. If you aren’t fully relieved of duties during that break, it has to be paid. Retaliating against you for asking is illegal.

You do not have to ask for this as a favor. It is the law, and you are allowed to say so.

Where to get help

If you need help with nursing, please don’t hesitate to call our office at (417) 332-3639 for an appointment, or set up a virtual visit. Beyond us: your delivering hospital’s lactation services, WIC peer counselors, an IBCLC-certified lactation consultant, and the National Breastfeeding Helpline at 1-800-994-9662, staffed weekdays by trained peer counselors in English and Spanish. Most insurance plans cover lactation support and a breast pump at no cost to you — see our Insurance & Billing page or just ask us.

As always, I hope you stay happy and healthy.

Carolyn Clark, NP-C