Diagnosing Breastfeeding Difficulties: Where Do We Stand?

Despite lactation being a natural occurrence in mammals, many structural barriers and individual factors can impact the ability of a woman to breastfeed her newborn. At the individual level, evidence has widely documented several risk factors and societal barriers for impaired lactation, many of which have been steeply increasing in human societies in the past few decades (e.g., psychosocial stress, metabolic disorders, births interventions, etc.). Yet the healthcare system worldwide does not seem to be prepared to support women facing such breastfeeding difficulties. Pregnant women are often provided with unrealistic expectations of how the breastfeeding experience should unfold, which can then translate into negative feelings when they encounter difficulties. In this context, the development of objective diagnostic tools able to help healthcare professionals and women identify breastfeeding difficulties that could then be treated accordingly would seem an ideal solution. Previous studies have tried to provide evidence for the use of milk compositional variations during early lactation as a tool to identify delayed secretory activation of the mammary gland, which often results in impaired lactation. However, despite portable technology for this purpose being successfully developed and/or validated, a consistent research gap remains around the true diagnostic power of such biomarkers in relation to clinically significant outcomes. This obstructs the development of effective diagnostic tools that could be employed in clinical practice to improve breastfeeding outcomes and breastfeeding rates.