To breastfeed or not to breastfeed? That is the question—which many moms quickly jump to judge other moms about.

They’ll fault each other for breastfeeding too long, not long enough, for doing it in public, for not feeling comfortable enough to do it in public…the list goes on.

But what if you can’t breastfeed? For some women, health issues make breastfeeding a no-no. Other moms face challenges that make the act difficult, if not impossible.

85% of women set out to breastfeed exclusively for at least 3 months, only 32% actually met their intended goal

Source: July 2012 issue of Pediatrics

Here are a few reasons why.

The doctor said no

Various health issues can make breastfeeding dangerous for the mom and her baby. One is that it’s a direct way to transfer infection from mom to baby.

According to the US Centers for Disease Control and Prevention (CDC), Other health issues that absolutely prevent breastfeeding include:

  • Infant diagnosed with galactosemia—a rare metabolic disorder
  • Mother infected with HIV or on antiretroviral medications
  • Mother has active tuberculosis
  • Mother uses illicit drugs
  • Mother is undergoing certain chemotherapy or radiation treatments

Other issues that potentially could (but don’t always) keep a woman from breastfeeding include:

  • Anthrax exposure
  • Breast implants
  • Environmental toxin exposure
  • Food- or waterborne illness
  • Hepatitis
  • Certain prescription drugs
  • Tobacco use

If your physician directs you to stop breastfeeding based on a health condition, take her advice seriously—even if it interferes with goals you had set.

Common challenges

Medical issues aren’t the only reason women give up breastfeeding. Sometimes the very real challenges outweigh the potential benefits.

From sore nipples to an oversupply of milk, many women experience at least 1, if not multiple common breastfeeding challenges.

According to the US Department of Health and Human Services Office of Women’s Health, some of those common breastfeeding challenges inlcude:

  • Engorgement—When your breasts begin producing milk, they’ll feel heavier and tender. But that feeling can quickly turn to swelling, throbbing, hardness, and pain. You may run a low-grade fever. To avoid it, try breastfeeding often, massaging the breast and using cold compresses.
  • Infection—Fungal infections, known as yeast or thrush, thrive on milk. This makes them especially common. If your nipples are sore for more than a few days after weeks of pain-free breastfeeding, or if they become blistered, itchy or cracked, you may have an infection. It can take several weeks to cure, so to avoid spreading the infection, wash everything—clothes, pacifiers, breast pumps and your baby’s hands—in hot water daily.
  • Inverted, flat, or large nipples—Each of these can make it difficult for the baby to latch on while breastfeeding. Meet with a lactation consultant if you’re worried.
  • Sore nipples—Moms often report tender nipples when they begin breastfeeding. This tenderness will become especially prominent if you’re only feeding from one nipple. If you’re not ready to give up, make an appointment with a lactation consultant or try changing positions.
  • Nursing strike—Your baby has been breastfeeding well when she suddenly stops for no apparent reason. The root cause could be anything from change in routine to an ear infection. Try expressing your milk regularly and continue to offer the breast.
  • Plugged ducts—This commonly occurs when breastfeeding, and results from a milk duct not draining properly and becoming inflamed. Breastfeed often and use a warm compress if you feel soreness.

Time challenges

Not all breastfeeding troubles are physical. For many moms, time is a very real obstacle.

Not everyone can stay at home and create a schedule that works around their baby. Moms may need to work upwards of 8 hours a day, tend to other children or attend school.

In those situations, you could try pumping and leaving the milk with a nanny, or stocking up on it in the freezer.

While the American Academy of Pediatrics supports breastfeeding as the best option for moms and babies, formula is still a legitimate option if you experience obstacles. Making the switch to formula, is 100% okay. Remember: Most moms don’t breastfeed for as long as they intended to.

Women commonly face many challenges in breastfeeding—in addition to countless other challenges they face in raising a child, working and managing relationships. It’s no easy task having another human being rely on your body for food.

Breastfeeding can hurt. You’ll be in demand every waking minute. And it’s a major adjustment. Choosing not to breastfeed is a perfectly reasonable option, especially with healthy formulas available everywhere from Babies ‘R’ Us to Target.

It’s important to do what’s healthiest for you and your baby, not everyone else. Your decision on breastfeeding affects only you and your baby.