It's National Breastfeeding Awareness Month, but Dr. Marianne Neifert, a pediatrician, nationally recognized expert on breastfeeding and author of "Great Expectations: The Essential Guide to Breastfeeding" (Sterling, September 2009), is well aware of the recent breastfeeding backlash, a movement in which women are writing about their not-so-positive experiences with nursing.

Neifert says part of the reason for the backlash — and women's negative associations with breastfeeding — is the rosy message breastfeeding advocates have offered while leaving out some of the realities for so many women.

We talked to Neifert about these messages, and the importance of getting off to a good breastfeeding start.

Q: Why the backlash?

A: It's not enough to clobber women over the head with the advantages of breastfeeding, and especially to frame them as risks of not breastfeeding.

One of my phrases is, 'Each woman, with her own circumstances, her life, her baby, her reality, her personal commitment and what she faces, she makes breastfeeding uniquely hers.' And so I want to get away from saying there's one right way to breastfeed. I think we universally agree it is the way babies were meant to be fed. It is the desired method but it can be a challenge.

What it's about is helping women make informed choices and then putting in all the social and health care system supports to help women reach their own goal and feel good about it. So the breastfeeding backlash makes me sad, but it also, I think, tells us that there are a lot of women who didn't get the support that they needed.

Q: In the breastfeeding community's efforts to be positive, what messages have been left out?

A: We may underplay that it is difficult in the beginning. It is a big commitment, and little things can go wrong that really put a damper on new parenthood, and so I want them to know that yes, babies are hardwired to breastfeed, they are, but yet there are latch-on issues.

The mother needs to come into the hospital empowered to know what to ask for, to know what the ideal maternity practices are that support breastfeeding, so that her baby has every chance to use all their innate reflexes and try to get it right.

I think we don't tell mothers to budget money for working through your breastfeeding. We tell mothers you're going to make money breastfeeding. But it costs money to feed a baby; how do you want to spend that, on the best nutrition or the second-best nutrition? So budget money in case you need to pay for a breastfeeding consultation or in case you need to rent a pump, and unfortunately, we don't get the good medical coverage for these things women deserve. That's a whole other issue.

We don't tell them that it does get better when they are struggling early on. I think mothers think, 'Gosh, I can't breastfeed this many times a day for a year. I can't get up at night this much for a year.' And we need to tell them to put the rest of your life on hold, get your breastfeeding launched, and then it starts to get a whole lot easier.

Q: How important is it to get support?

A: More and more hospitals are offering follow-up breastfeeding support classes for women to come back, and I think that is a wonderful trend or just an informal breastfeeding support group where women in the neighborhood get together. Support of other mothers, support if you're in the workplace, a colleague that maybe has breastfed before you, a mother, a mother-in-law, a sister, we need a cheering squad to get through breastfeeding. We really do.

Q: Bringing home a baby is an emotional time for a new mom, really any mom. How do emotions sometimes get in the way of breastfeeding success?

A: You've really hit on something there because women have no idea: their own hormonal changes or the baby blues, or the 10 or 15 percent that go on to get full-blown postpartum depression. The sleep deprivation, the nighttime feedings; you can't delegate to somebody in the beginning, and so you're tired.

And then the pressure if the breastfeeding isn't going well, and then you're thinking somehow you should have known, your body should have worked better. Breastfeeding is an area where putting forth three times more effort doesn't necessarily get three times the outcome.

Hear more from Dr. Marianne Neifert, pediatrician and author of "Great Expectations: The Essential Guide to Breastfeeding" at blog.timesunion.com/parenting.