Other reasons for not breastfeeding include: Personal preferences, beliefs, and experiences: The mother may dislike breast-feeding or find it inconvenient. In addition, breastfeeding can be difficult for victims of rape or sexual abuse; for example, it may be a trigger for posttraumatic stress disorder. Many families bottle feed to increase the father's role in parenting his child. Mental health: The pressure to breastfeed in many cultures can be so much that the mother's mental health may take a sharp decline. This can have physical effects such as poor latching as well as milk depletion and a lack of connection to the child. In some cases it is better for the child to be formula fed so that a better bond can be made between mother and child rather than the ‘special bond’ that comes from breastfeeding being tainted by negative breastfeeding experiences. The pressure to breastfeed in many cultures can increase the likelihood of postpartum depression. Absence of the mother: The child is adopted, orphaned, abandoned, or in the sole custody of a man or male same-sex couple. The mother is separated from her child by being in prison or a mental hospital. The mother has left the child in the care of another person for an extended period of time, such as while traveling or working abroad. Food allergies: The mother eats foods that may provoke an allergic reaction in the infant. Financial pressures: Maternity leave is unpaid, insufficient, or lacking. The mother's employment interferes with breastfeeding. Mothers who breastfeed may experience a loss of earning power. Societal structure: Breastfeeding may be forbidden, discouraged or difficult at the mother's job, school, place of worship or in other public places, or the mother may feel that breastfeeding in these places or around other people is immodest, unsanitary, or inappropriate. Social pressures: Family members, such as mother's husband or boyfriend, or friends or other members of society may encourage the use of infant formula. For example, they may believe that breastfeeding will decrease the mother's energy, health, or attractiveness. Conversely, societal pressures to breastfeed can also lead to mental health issues. A sense of shame from not being able to or struggling to do so equalling being a failure has a connection to Postpartum Depression Lack of training and education: The mother lacks education and training from medical providers or community members. Lactation insufficiency: The mother is unable to produce sufficient milk. In studies that do not account for lactation failure with obvious causes (such as use of formula and/or breast pumps), chronic lactation insufficiency affects around 10–15% of women. For about 5–8% of women, milk coming in (i.e., lactogenesis II) may not occur at all, and only drops are produced. Alternatively, despite a healthy supply, the woman or her family may incorrectly believe that her breast milk is of low quality or in low supply. These women may choose infant formula either exclusively or as a supplement to breastfeeding. New research is showing that mothers who report problems with milk production have physical markers indicating low milk production, calling into question the assumption (called “perceived insufficient milk supply” or PIMS) that mothers are incorrect about the quantity of milk they are producing. Fear of exposure to environmental contaminants: Certain environmental pollutants, such as polychlorinated biphenyls, can bioaccumulate in the food chain and may be found in humans including mothers' breast milk. However studies have shown that the greatest risk period for adverse effects from environmental exposures is prenatally. Other studies have further found that the levels of most persistent organohalogen compounds in human milk decreased significantly over the past three decades and equally did their exposure through breastfeeding.Fürst P. Dioxins, polychlorinated biphenyls and other organohalogen compounds in human milk. Levels, correlations, trends and exposure through breastfeeding. Molecular Nutrition & Food Research, 50(10): 922–933, October 2006. Research on risks from chemical pollution is generally inconclusive in terms of outweighing the benefits of breastfeeding. Studies supported by the WHO and others have found that neurological benefits of breast milk remain, regardless of dioxin exposure.– cited in NRDCBrouwer, A., et al. Report of the WHO Working Group on the Assessment of Health Risks for Human Infants from Exposure to PCDDs, PCDFs and PCBs, Chemosphere 1998; 37(9–12): pp. 1627–1643. – cited in NDRC In developing countries, environmental contaminants associated with increased health risks from use of infant formula, particularly diarrhea due to unclean water and lack of sterile conditions – both prerequisites to the safe use of formula – often outweigh any risks from breastfeeding. Lack of other sources of breast milk: Lack of wet nurses: Wet nursing is illegal and stigmatized in some countries, and may not be available. It may also be socially unsupported, expensive, or health screening of wet nurses may not be available. The mother, her doctor,"Breast-feeding and Guilt: Interview with a Mayo Clinic Specialist" or family may not know that wet nursing is possible, or may believe that nursing by a relative or paid wet-nurse is unhygienic. Lack of milk banks: Human-milk banks may not be available, as few exist, and many countries cannot provide the necessary screening for diseases and refrigeration.
oTHer ReasONs FOr not bREasTFEedIng iNcLUDe: PersonAl PRefErEnces, beliefs, And expErieNCeS: the moTheR maY disLikE breaSt-FeedInG or fInd It iNconveNIeNt. IN adDition, bReastfEeding CAn be difFicUlt For vIctiMs of rApe OR sExuAL ABUse; for eXaMPlE, It may Be a trIgGEr fOR postTrAUmatIc sTress disoRdeR. MANy familieS boTtLe Feed to incrEase tHe fathEr's roLe in PArentiNg hIs ChiLd. meNtal Health: THe PResSUre to breastfeed In manY cUlTuRes Can bE So muCH ThAt the mother's MentAL HeAltH May taKe a SharP deCline. this cAn hAve pHysICAl eFfecTs such aS poor lATChinG As well as mIlk DepLeTion aNd a lAck OF cONnEctiON tO thE CHILd. in somE CaSEs IT Is bEttEr for thE CHiLD to BE ForMUla fed sO that a bettER Bond cAn Be made BEtwEen MoTheR aND child rather Than the ‘specIaL BonD’ thAt COmEs frOm brEastfEeding bEIng TaInteD By negaTive BreAsTfeEDIng EXperIenceS. tHe pREssuRE TO bReAsTFEEd in ManY cuLtures can increAse The lIkeLihooD of poSTpartum DePReSSion ABsEnCe of tHe motHEr: the chiLd is adopTEd, oRphAnED, ABandoNed, or in the sole CuStody OF A maN or malE same-sex CoUpLE. The mothER is SeparATed FrOm Her chIld bY BeiNg in prison or A meNTal hoSPItAL. The MOthEr haS leFT tHe chilD IN the CarE of anotHer Person fOr aN exTEndEd pERiod of tiMe, SUcH AS wHile trAVeling oR wOrkInG AbRoaD. food allErgieS: the MotHer eatS Foods tHAt maY pRovoke An allerGiC rEactioN in the INfanT. fInaNCial prEssuRes: MaTerNity leavE IS unpaid, inSufFicieNt, oR laCking. The mother's emplOyment iNTerferES wIth bREastfeedInG. mOthErs who brEAstfeed MaY ExpErience a loSS oF EarnIng poWeR. soCiETAl STrucTuRE: BreAstfeeDing mAy bE foRBIdden, DiscOuragEd Or DiffiCult AT thE MothER'S JoB, scHool, PlacE oF wORship OR In Other puBlic placeS, OR thE mothER mAy Feel that breastFeEding iN these places OR AroUNd OtHer people Is ImmoDEST, unsanitaRY, or inAppRoPRiate. social presSures: faMiLY MeMbeRS, sucH as mOtheR's HusBand or boyfRiEnD, oR FriendS or otHer MemBerS oF SocietY mAy EnCourAGe THe USe Of InfaNT formuLa. for exAMple, they may BELIeve thaT bReastfeedinG wIll DEcrease tHe motHeR's EnErgy, heaLth, or aTTractiveness. ConveRSELY, SocIetaL pRessures to BrEastFeed can also lead to mental hEaLth IsSues. a sense Of shAme fROm noT bEinG aBle tO Or sTruggLiNG TO DO sO eQUalLinG beinG a faILuRe has A coNnecTioN tO PoStpaRTum dEprEssiOn LAck oF trAining and education: tHe mother lackS EdUcAtIoN aND trAiNInG fRom MeDiCal ProvideRs Or coMmUNItY memBeRs. lactAtioN iNSufficiencY: The moTHeR iS uNaBlE to produce sufficiEnt miLK. In STudieS tHat do noT ACCount FOr LaCtatiON failure with obVious cAuSES (such as uSE of foRmULa and/Or BreasT PumPs), chrOnic lActation insUFFiciEnCy afFeCts aRoUnd 10–15% OF womeN. fOr about 5–8% OF woMen, milk CominG in (i.e., lActOgenesis iI) mAY noT oCcuR at AlL, and only DROps Are PRoduCEd. alTErnaTiveLy, DesPite a heaLtHy supply, tHe womAn Or HER famiLY maY incOrrecTly belIeve ThAt Her BREast mILk iS of loW qualITy Or in LOw suPpLy. tHEsE WOmen mAY chooSe infAnt formuLA eiTheR exCLuSiveLy or As a suppLeMent To BreastfeeDing. NEw reseArch Is showing THaT MOtHeRS WhO rEporT probLeMs wIth MiLK PRoduCTion haVE PhysicAl MarkErS INdicating loW milK pRoductiOn, caLlInG inTo qUEstIon tHe asSumPtion (called “perceIvED INsufficIeNt milk supPLY” or pims) thAT MOThers ARE INcoRReCt ABOuT thE quaNTITy of Milk tHeY are prodUcINg. fEaR of exPOsurE To envIronmentaL ConTAminantS: ceRtaIn ENVirOnmental pOlLutants, sucH as poLyChlOrinated biPheNyls, cAn bioAccuMuLAte iN the fooD ChAIn And May BE foUnd in hUManS iNCludINg mOtheRs' breASt mIlK. hoWever sTUDies havE shown ThAT THE greatest rIsk PEriod for adverse eFFEcTs FroM eNviRoNmenTAl expOsureS is PReNATallY. Other studiES Have fUrTher foUNd thAt thE levEls oF moSt PersistenT ORganOhalogeN cOmpoUNds in HUmAn milK dEcREased siGNifiCAntLY Over thE past three decAdes and EqUally DId THeIR expOsuRE throUgh BreastFeedINg.fürst p. DioxinS, pOLychLorinated BiphenYls And oTHer ORgaNohaloGeN cOmpouNds in hUman milk. levelS, cOrrElatIons, TreNDS aNd exPosUre tHrough breasTfeedinG. moLeCulaR nUtRitiOn & FoOd researcH, 50(10): 922–933, octoBer 2006. rEseaRCh on rIsKS from cHemical polluTiOn Is genErALly InConcluSIVe In termS oF oUtwEIGHing tHe bENefIts of breasTFeeding. sTudiES SupPorted BY ThE wHo And OTheRs haVe foUNd thAt neUrological BeNEfiTS of brEaSt milk rEmaIn, rEgardless of dioXin expoSURE.– CiTed In nrdCBrouWEr, A., ET Al. report Of THE wHo workIng GroUp ON the aSSessmenT of heAlth risKs for human infanTs fRom expOsure to pCDDs, pcdFS AnD pcBS, ChEMosphEre 1998; 37(9–12): Pp. 1627–1643. – CiTeD iN ndrc in devEloping coUNtRIes, enviroNmEnTal CoNtaMinaNts AssOCiaTed wITh IncreaSed hEaltH riSKs from uSE of InFAnt FoRmUla, paRTiculArLy diArrHea dUE to unclEan watER aNd laCk of sterIle cONditionS – boTh PrEreqUisiteS TO The safe uSE of foRmuLa – OFten outwEIgH any risKS FroM BReastfeEDiNg. lack Of othEr souRceS Of breast mIlk: LAck of wet nURses: wet NuRsing is illegaL and sTiGmAtized IN soMe couNtriEs, and may nOt be AVAilaBle. it May aLso be SocialLy unSUpPorted, exPEnsIVE, or heaLth sCreening Of WEt nurseS mAy noT bE aVAiLAble. The motHer, hEr doctor,"bReAst-feEdInG and guilt: inteRview With a mayo cLIniC speciALISt" or FamIlY May Not knOw THat wet nuRsIng Is possiBle, or MAY BELiEve ThAT nursIng bY a RelAtIVE or paid wet-nuRSe is uNhyGienIc. laCk of miLk Banks: huMan-milK baNks may nOt be AVAIlABLe, As fEw exiSt, aNd Many cOuntries cANnot proVide the NecessarY SCreEning For DiSEases And refriGerAtion.