by Vanessa Shanks, MD

I am a firm believer that 80% of breastfeeding success relies on appropriate maternal support (okay, I made that number up, but I do think it is a very high percentage). The other 20% consists of those who need a latch tweaked, a tongue clipped, a shield for an inverted nipple, or some other assistance with technique or anatomy/physiology. Lactation consultants may not agree with this presumption because they see so much of what is abnormal, but most mothers and babies should not encounter very complicated breastfeeding problems. (As a point of comparison, I am a neonatologist and I was shocked to learn that 80% of newborns are born completely healthy and do not have a single thing wrong with them!)

Breastfeeding is a complex task; it involves two independent people who are both learning to do something for the very first time. Even if a mom has breastfed before, every baby is different, and every breastfeeding experience is different. This is why maternal support is so important, but I think maternal stretch is even more important.

Katie, Vanessa, & Sammie at “Breastfeeding Mamas VIP Day” in 2004.

Think back to when you were first learning to breastfeed. If you breastfed for more than a couple days, there was likely someone that you can identify who got you there. For most us in the Balanced Breastfeeding community, myself included, that person was Katie Madden. You needed someone to look you in the eye and emphatically tell you that you are stronger than you know, that you are capable of the insurmountable, that you can breastfeed. Someone you trust, even if you are meeting them for the first time—your lactation consultant, your pediatrician, your cousin, a stranger on the street who stops to say “good job!”—it takes just one person in one moment to get you to the next moment.

Over the last four years I have tried to be that someone for my friends when they have babies, sending them Katie’s blogs on a daily basis. I like this approach because it lets them know I am thinking of them, I am supporting and stretching them, and they don’t feel obligated to respond to email, but if something comes up they know I am there. Even those moms who would describe their breastfeeding experience as “unremarkable” have just as many doubts, they are just as hesitant, and they feel as if they are stumbling through like the rest of us. Even these moms need to hear someone tell them they can do this, that they are strong enough, that they deserve it. Moms need to hear this regularly and honestly: “You can do it; I know you can!”

This is the basis of support groups, online and offline—for someone to contradict the little bitch mama voice in your head. You may be embarrassed to celebrate the tiny wins on your own—it seems like such a small accomplishment–but it was such a big deal to you and is so worth celebrating! You need someone to step up and celebrate those tiny wins with you because they felt like mountains to you and you aren’t yet strong enough to celebrate them on your own. It is in those days that maternal support and stretch is so important. We need to highlight the great, no matter how small, and sympathize with the downfalls, but most importantly we need to pick her back up, look her in the eye and tell her she can do it. One person. It just takes one person to get her through. And then one day, she will learn to celebrate it on her own, to trust herself, to become the person who believes in herself and tells herself that she can do better than she thought she could. She will be able to recognize the tiny win, to hold it in her hand and say “I did this” and be proud. And then she will be the one telling you, “Look what I did; look how wonderful this is.”

Be that one person. To your sister, your friend, your cousin, your friend’s friend, your colleague. Take the step to cross into the area of unfamiliarity, to be uncomfortable and invade their private world. Breastfeeding should not be a private world. It has become so hard because we have closed each other off from all the support and help and strength these women need in a very vulnerable time. Break that wall.

If you know someone who had a baby and was planning to breastfeed, send her one email or text, just one, to say you are thinking of her and asking how she is doing: “I had a really rough first week after my baby was born; just wanted to check in and see how you were doing and let you know I am thinking of you.” That’s it. Easy. Innocuous. Potentially powerful.

I did this once with a colleague of mine. We were friendly to each other at work but not yet friends. I knew her baby had been born and for two days I agonized over whether I should check in with her or not. It would definitely constitute crossing boundaries—it was none of my business—but I knew she had had a late preterm baby and I was worried for her; late pre-term babies are tricky. So I took a deep breath, emailed her through her work email (because I did not know her personal email address), and told myself if she didn’t want me involved she could ignore it and use the excuse that she wasn’t checking her work email on maternity leave. “Just wanted to check in and see how you were doing, thinking of you”—that was all I said.

Dr. Shanks with her colleague Dr. Teeple (whom you may remember from HER blog)

Within 12 hours I received a response begging for help; she wrote that she was in tears as she was typing. Honestly, my first response was “Oh shit, now what do I do?” Then I sent her Katie’s blog “Lie #1: Breastfeeding is Easy” along with a short paragraph asking her if it was okay to continue sending these blogs daily, emphasizing she does not need to reply to them because I knew she was exhausted and would rather spend time with her new baby. I told her what an amazing job she was doing, I told her she was one of the strongest women I knew (which was true) and I gave her Katie’s contact information and told her to make an appointment as soon as possible. This colleague, now a good friend, made it through. Not once did she ever say, “This was none of your business” or “Why were you bugging me when I was already going through such a hard time?” or “This was awkward.” She has, however, expressed her appreciation on multiple occasions.

Despite this “success story” of mine, whenever I contemplate “butting in” during this “private” time, I still get the same butterflies in my stomach! Is this right? Will she be offended? Am I crossing boundaries? Even with my established friends, these thoughts go through my head. And I have to take a deep breath, and put myself out there. For her. Because even if I don’t know her well, or at all, I know she is worth it. She is worth my effort to make myself uncomfortable to check in on her.

A couple months ago, my four-year-old daughter was at her friend’s birthday party and I saw two women who were breastfeeding at the party. These same thoughts went through my head. “I should say something, this takes guts, I can tell she is not 100% comfortable and is afraid she will be judged.” Both of these women had older babies, over six months probably, yet they still had some degree of discomfort in their eyes.

I admit that I stepped up and told one of the women she was doing a great job, but with the other I chickened out. It is really hard to say something encouraging to a complete stranger when they are breastfeeding and you are unsure of how comfortable they are at baseline. But you can ask any mama on Katie’s facebook pages, “What would you think if a stranger came up to you while you were breastfeeding or pumping and told you that you were doing a great job?” I would bet money that these moms would unanimously tell you that it would have made their day.

So do it. Take the uncomfortable step and say something. It is one small sentence, and might make you feel wriggly for two or three minutes, but it will brighten a new mom’s entire world and may stay with her for years. You can be the one person who makes a difference. You can be the one person who gets her through that day, that moment, and brings her to her next breastfeeding win. Go forth. Do it.


Dr. Vanessa Shanks is originally from Baltimore, Maryland where she completed medical school before moving with her husband to Ohio for her residency training. She completed a combined residency in Internal Medicine and Pediatrics before moving back to the east coast for a Neonatology fellowship. While her original interests were in palliative care, it was during her fellowship that Dr. Shanks developed a love for supporting breastfeeding mothers. She was able to breastfeed her daughter, Samantha, for over a year during her fellowship.  She developed shortcuts and tricks necessary for her success – pumping on the train, in the back of a transport ambulance on the way to pick up a sick newborn and directly breastfeeding between 28 hour shifts at the hospital.  As she learned about the importance of breastmilk in the care for her NICU babies and saw the struggles of the women she worked with, she realized that every mother, herself included, needed a Balanced Breastfeeding approach to be successful.

Upon completion of her fellowship she returned to Ohio to pursue her academic career interests.  In 2016 she was named the Medical Director for Neonatal Lactation Services and last year she hosted her very own Big Latch On in her NICU!

Dr. Shanks spends her time outside of the hospital with her husband and daughter. In the little time Dr. Shanks has to herself, she enjoys clearing her head and refilling her cup through horseback riding, reading, and swimming.