FFF Friday: “I will give you the moon, but I can’t give you my milk.”

Those of you who’ve submitted FFF Friday stories may have noticed it can take a looooong time for them to be published. It’s just a matter of the queue being ridiculously long; there is no shortage of hurt, anger, or conflict about infant feeding. But every story is equally powerful and important to share, no matter how long ago I received it. 

Today’s post is one of those stories that has been sitting in my inbox for awhile now. When I re-read it today, I was struck by how palpable the love the author has for her daughter is. The description she gives of their bottle-feeding times made my heart skip a few beats. THIS is #bottlebonding. It’s beautiful, and it’s real, and I wish more parents were told that it is possible. For those of us who’ve done it, this seems like an obvious truth, but the negativity about formula feeding has convinced parents that they will miss out on an essential connection if they do not or cannot breastfeed. So if you feel that way, read this. 

Happy Friday, fearless ones,

The FFF

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Rebecca’s Story

Today my baby girl turned 18 months old. A while back, her pediatrician had said in passing that he likes to see toddlers weaned off bottles by 18 months. At that time, it was a finish line and a time I would look forward to. I have hated those plastic bottles on my kitchen counter with a vengeance.

I was meant to breastfeed.I grew up with a La Leche League Leader, my mom. I remember those noisy meetings in our living room as I was trying to fall asleep down the hall as a little kid. I knew I was going to breastfeed. When I was pregnant, I had dumped out the cans of formula samples that had arrived in the mail swearing I wouldn’t give my baby that artificial stuff. My husband and I attended a breastfeeding class taught by the hospital’s lactation consultant. I remember asking the teacher if she would recommend purchasing a breast pump before the baby arrived or if it made sense to wait. Her response was that if you want to make breastfeeding work, you can. Go ahead and purchase one. I went ahead and ordered the pump through our health insurance and signed up for a few weekly calls from their own lactation consultants. It was ingrained in my head: breastfeeding was obviously the only choice if you had any desire at all to raise a healthy child. And then, 18 months ago, my body and my baby had other plans.

My daughter was delivered by C-section at the end of 37 weeks after a routine OB appointment. I was given 6 hours to pack my bag and meet the doctor at the hospital. I was really counting on those 2 or 3 more weeks to prepare myself for the baby. One item on my list was to read The Womanly Art of Breastfeeding. Of course I didn’t get to it. In the recovery room, when the baby was first put to my breast she rooted, bobbed her head and nuzzled. But, she never latched on. The nurse was excited and said, wow- when she gets it, she’s going to be a good nurser! Well, we never got it. I had visits from the hospital’s lactation consultants who were just too busy to stay and help. Both implied that there was something wrong with my breasts and never questioned whether something was going on with the baby. I remember a stressful visit from a technician who shoved the baby’s face into my breast and handled me in a way that was extremely uncomfortable and very stressful. I was afraid to ask anyone else for help after that.

After the addition of a nipple shield given to me by the hospital’s lactation consultant, the baby finally latched and achieved some suction. However, the nipple shield restricted the amount of milk flow due to the limited number of holes. The baby had some wet and soiled diapers that we tracked consistently on the hospital’s clip board. However she continued to lose weight and when questioned, the pediatrician said it was still within normal range and keep trying to breastfeed without the nipple shield. “You’ll get it. It just takes practice.” No one else seemed concern, but I still knew that something wasn’t right.

We had some very long nursing sessions, with the nipple shield, in the middle of the night at the hospital. When a nurse came in to check on me, I told her that the baby had been sucking for about an hour and was still going. “Oh, she’s just using you as a pacifier. Let me take her to the nursery so you can get some sleep.” Yet, an hour later, around 2AM I was pacing the maternity ward halls because I couldn’t sleep and really missed the baby. I wish the nurse had asked me why I couldn’t sleep rather than just trying to tell me the baby was fine and I should go back to bed. We were discharged from the hospital with no real suggestions or advice about how to eliminate the nipple shield. Just keep trying.

I spoke to my mom who insisted I call a La Leche League volunteer and looked up the number of someone in my area, picking her out by her pretty name. This LLL leader was extremely patient with me and asked me what the baby’s tongue looked like. Did it make a little heart shape when she cried? Well, sort of. As a speech language pathologist, I had studied the anatomy of the mouth and knew what short lingual frenum would look like on a toddler who was having speech problems. I never really knew what an infant frenulum should look like, nor did I look at her lips.

The next day at the pediatrician’s office, I mentioned the tongue tie to which he said the baby’s tongue looked fine, but she was still losing weight. He said we could continue to breastfeed without supplementing, but return the next day for a weight check. And of course the next day she had lost even more weight and was now a shade of peachy yellow from jaundice. The pediatrician instructed us to supplement with expressed breast milk after each breastfeeding session. And he sent us home with some formula samples, “just in case your milk dries up in the middle of the night.”. He also put us in contact with a lactation consultant who generously came out to our house that evening. I don’t remember whether she held the baby or examined her mouth in any way, but she stayed for a long time and showed us some techniques to help the baby latch. We were able to do it (and by ‘we’, I mean me, my husband, the baby, our recliner, 13 pillows and a bunch of rolled up blankets.) We kept up the new techniques and the baby fed without the nipple shield for the whole night which was both exhausting and overwhelming. I’m not sure anyone slept.

By this point in the game, I was beyond anxious. While I was on the look out for post partum depression, the anxiety piece wasn’t in the forefront of my mind. I believe it started with the surprise delivery and just continued to mount. I couldn’t relax enough express any milk with the pump and it just became a vicious circle. The baby needed to be supplemented after each feed, but I couldn’t produce any milk.

My husband called my mother who came immediately from Connecticut. A lot of that is still a blur- I didn’t know it was that bad. Finally, in a way that I don’t really remember, I was sent to bed with some medication and my husband and mother, armed with bottles and formula, fed the baby through the night. I think it was the first time I had slept for more than 30 minutes at a time for the past week. I was told that I should not feed the baby any of my breast milk because of the anti anxiety medication that was starting to help.

Slowly I lifted out of the fog and the baby began to thrive, regaining her weight and returning back to a healthy shade of pink. I think I cried every time I had to prepare a bottle for at least a week. The reminders of “breast is best” is EVERYWHERE. It just kept stabbing at my heart- on the formula container, on the coupon from Target (!), every other line on Facebook and in every baby/parenting book out there. I continuously recalled the lactation consultant who told me after class that if I wanted to breastfeed, I could. Well, I’m not sure I’ve tried that hard or wanted something to work that badly ever before. I just felt like my body had failed me and I had failed my daughter.

For some reason, I didn’t feel that I should keep seeking answers after 3 lactation consultants and a pediatrician told me that there really is no reason for the baby’s inability to latch (without the 4 adult hands and acrobatics that ensued). The pediatrician assured me that the baby was going to be ok when I questioned him (between sobs) about the differences in her life growing up on formula rather than breast milk. The psychiatric nurse practitioner that was helping me with medications for the post partum depression/anxiety, just couldn’t understand why it was so important to me to breast feed my daughter. “What’s the big deal?” she said. She doesn’t have children. At my 2 week check up with the OB, when I asked about ways to increase my milk supply, she said that pharmaceuticals don’t work well. And besides, she was raised on formula and she’s done pretty well for herself! This was not helpful advice.

Slowly, our family was establishing a routine. My husband returned to work and I began to venture out with the baby. The first event I remember going to on my own was a local babywearing group meeting. If I wasn’t going to have my daughter on my breast for feeding, I was going to have her as close to me as possible. I met some wonderfully helpful women and borrowed a wrap from their lending library. A few of the moms and newborns that I met through my prenatal exercise class were at the meeting as well. At one point I remember looking up and seeing at least 5 women nursing beautifully next to each other at the same time. I just held back tears. My daughter began to get hungry while we were at that meeting. Instead of mixing up the bottle of formula there and continuing to visit with other new moms, I said quick goodbyes to everyone and drove down the street to an empty spot in a parking lot to feed the baby. How ironic that some moms feel they need to find discreet places to nurse in public. I was afraid to bottle feed in front of my peers. Every where we traveled, when it was time to feed, I apologized to everyone as I mixed the formula. I spent so much energy trying to hide that we were bottle feeding- always aware when someone was taking a picture, I would do my best to get the bottle out of the shot. Instead of spending so much energy being embarrassed, I wish I had directed that energy at seeking answers from other lactation experts.recite-1owp3jx

At some point during the first month, I looked up re-lactation on the internet. When we were home alone on a quiet calm afternoon, I put the baby to my breast, watched her bob her head as she unsuccessfully tried to grasp me with her mouth. The feelings of overwhelming sadness and anxiety came flooding over me. I guess this is it, kiddo. I will give you the moon, but I can’t give you my milk.

Eventually bottles just became a way of life, although I complained every time I had to spend money of formula. As I learned more about nursing from friends and lots of questions about tongue ties and lip ties circulated on Facebook, I was more alert when I looked in the baby’s mouth. Somewhere around 5 months of age, I noticed her lip tie. At her 6 month well visit the pediatrician said it wasn’t an issue and we’d wait to see what happened when her teeth grow in. (Soon we will return to the pediatrician for her 18 month well visit. It will be her first visit with both front teeth grown in with the tell tale gap between the teeth. I am already a bit anxious for the doctor’s take on that.)

Somewhere around 11 or 12 months of age, when she had a diet full of solid foods, the baby stopped taking bottles from my husband or her grandmothers. Somehow she had equated bottle with mommy as I was the primary feeder being at home during the day. At 12 months we changed over to cows milk and I rejoiced at never having to buy formula again. I figured we would slowly make the transition away from bottles to sippy cups. But then I realized that something strange had happened and I was starting to enjoy our snuggle time with the bottles of milk. She would have one before each nap and one before bed. It was our special time. It wasn’t that I didn’t enjoy feeding my daughter before this, but something started to feel different. Over the past few months, I have really started to pay attention to what was happening when I gave her milk in her bottle. She always sits in the same position on my lap, with her cheek against my breast. Sometimes she nuzzles in. She often takes my hand and puts it on her leg so I will gently rub it. She holds my fingers with one hand and twirls her hair with the other. She has never tried to hold the bottle herself (despite all those other acts of independence that come with toddlerhood). She will pause sometimes to say something to me and when she wants to drink more, she raises my hand that holds the bottle, never reaching for the bottle itself. It’s become a very special time for me to spend with her. I consider it an amazing gift that she has given me that I will always cherish.

Motherhood is far from an easy journey. I really worried about my daughter’s future without being breastfed and those fears still creep into my thoughts periodically. But then I look at her in awe of what an amazing little girl she is.  To think, a child that has been on earth for exactly 18 months could teach a grown woman so much about love, making choices and finding the beauty in a challenging situation.

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Share your story: Email me at formulafeeders@gmail.com

Experiences of Formula Feeding: Results of a survey of 1,120 formula-feeding parents

We talk a lot in the Fearless Formula Feeder community about the negative experiences we’ve had with medical professionals, media outlets, and our peers. And this is good, and healthy – we need a place to chew on these bitter feelings, and hopefully digest them so we can move on with our lives. Still, I want to go a step further this year, and really think about (and act upon) what could be made better. I think the time for some positive, real change is now, don’t you?

Considering how much the infant feeding world likes research, I think some data is a good place to start. Mind you, what I’m about to talk about isn’t peer reviewed or even professional compiled data; it’s merely a Survey Monkey study, which any Joe Shmoe can do at any time. This one was written by me, and I am by no means an epidemiologist (although I like to pretend I am, and probably would have tried to be if I could wrap my mind around simple algebra, let alone statistics) or PhD or anything of the sort. So it’s important to take this data with a grain of salt; it’s simply anecdotal, self-reported data crunched by a website to give us some idea of what’s going on for a particular, self-selected group.

Let’s talk a little about what this all means. Basically, I posted this site on the FFF Facebook page. It was shared and spread around a fair amount, but it’s safe to say that the majority of the respondents were FFF members. Which means something, because as a group, we tend to be a few things: educated, interested in parenting, mostly white, mostly lower-middle to middle class, mostly English-speaking (although the respondents included people from the U.S., Canada, the UK, France, United Arab Emirates, Australia, New Zealand, the Netherlands, Bulgaria, South Africa, Russia, and Mexico), and people who read a lot and care a lot about formula feeding issues. Because of this, we can’t necessarily assume that our experiences are typical of ALL formula feeding parents, but considering we have a pool of 1120 people, from a variety of geographic areas who formula feed for a number of different reasons, we can infer some things from the data we have here.

That said, I think it’s interesting and helpful to at least collect our experiences in a way that can help us talk about them more clinically, to understand the experience of some formula feeders, who tend to be parents who think a lot about parenting. That’s important, I think, because it suggests that these answers are relevant for care providers who are trying to serve this market.

With no further qualifications and hemming and hawing, I’d like to present you with the results of the first ever Fearless Formula Feeder/I Support You Survey on Formula Feeding Experiences. 

 

Question 1: When did you begin formula feeding?

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The majority (32%) of respondents began using at least some formula shortly after birth, although breastfed at least once. But those who began using formula after one month were a close second, at 25%, and 19% formula fed from birth.

Real-world implications: If most of these respondents were formula feeding a one-month infant or younger, their responses on the degree of instruction they received carry particular relevance. In completely unscientific terms – we’re talking about tiny babies and brand new, very sleep deprived parents. If anyone needs explicit guidance on something which can, at times, resemble a junior high chemistry experiment, it’s these folks.

Question 2: What were your reasons for choosing formula?

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Respondents were able to select more than one answer here, so please note that there was often a combination of reasons that led an individual parent to formula feed. The most common answers were “I couldn’t produce enough milk” (44%); “My child wasn’t able to breastfeed successfully” (33%); and “Breastfeeding contributed to my postpartum depression” (22%). 17% of respondents chose “I did not want to breastfeed.” As respondents could elaborate on their reasons via a text box, some of the comments received were as follows:

“I am a survivor of childhood sexual abuse, and both childbirth and breastfeeding were intensely triggering.”

“I stopped because it was straining my mental health and I felt like I was missing my daughter’s life because I was so consumed with trying to make breastfeeding work.”

“When they tested my milk with my 2nd child (32 weeker preemie) it was as fatty and nutritious as tap water.”

“Doing all of the nightfeeds by myself was never a realistic option for our family because I earn most of our income, I can’t show up to work massively sleep deprived and I have no opportunity to pump during the workday. This little detail was glossed over in all our prenatal breastfeeding education. When I caught on to it in the first week postpartum my husband and I jointly decided that breastfeeding was not for us.”

“I had mastitis so severe I was hospitalized. It turned into an abscess that they tried 3 times to drain with a needle but it didn’t work. They eventually had to do surgery to remove it. I tried to breastfeed through all that up until the second time they tried to drain it with a needle when I finally decided to stop trying because it was killing me.”

“Child ended up hospitalized due to dehydration.”

“I had postpartum thyroiditis. Only ever… produce(d) 2 ounces of milk per day. It also triggered devastating insomnia that lasted for 12 days. I decided it was killing me, so i stopped.”

Real-world implications: The responses on this question are obviously all self-reported, and there’s no way to verify the validity of medical reasons such as an inability to produce milk. However, I’m in the business of believing moms when they tell me things, so I’m assuming that there was a valid reason each of these moms felt that breastfeeding did not work for them. The point of including this question, for my purposes, was to see the variety of reasons parents chose formula and to get an idea of what would be best discussed prenatally. For example, there are visual cues for Insufficient Glandular Tissue, which physicians could be trained to notice during prenatal exams. Or, for women with histories of depression or sexual trauma, it might be helpful to be more open about the effect breastfeeding may have on them in an individualized, sensitive way – because what is empowering and healing for one woman might be damaging and re-traumatizing to another.

Question 3: When you first began formula feeding, were you given instruction/guidance from medical/hospital staff?

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55% of respondents said that were not given any formal instruction or guidance on how to use formula. While 33% of the rest of the group did get some sort of verbal guidance from a medical professional, only 12% got a pamphlet or written material.

Real-world implications: This seems like a no-brainer – how hard is it, really, to give new parents a brief one-sheet on formula prep, with resources listed for further help?

This leads me to….

Question 4: Where did you receive most of your guidance on using formula?

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53% – just over half- said that the main source of instruction was from the back of a formula can.

Parents are also getting help from other sources – nearly 30% did cite their pediatrician/other medical professional as a resource, so that’s promising. Another 33% said that websites were helpful, and 23% got assistance from friends or relatives.

Real-world implications: Considering pediatricians typically give verbal or written instructions on how to administer baby ibuprofen, and discuss things like television use, potty training, and sleep training with patients, I think it’s odd that we assume the instructions written on the back of a can are sufficient for safe formula prep. Not all parents are native English speakers or fully literate. Not all parents can read tiny print on the back of a can at 2am, when they are sleep deprived and worried about a newborn.

 

Question 5: Do you feel you received adequate information about formula feeding safety and use?

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While 40% said yes, 34% said “no” and another 22% said “I’m not sure”.

Real-world implications: This suggests more than half of parents using formula aren’t convinced that they were given enough information to feed their babies safely. Not acceptable.

Some additional responses:

“Too many people I spoke to IRL seemed to be compelled to remind me that breast was best. That shaming did not help me during a time when I was very vulnerable and wanted information”

“Eventually, after I did my own research. The nurse in the hospital almost yelled at us for leaving the half consumed bottle of ready-to-feed out at room temperature. We had no idea as new parents what we were supposed to do with formula, and no one had taken the time to explain it to us. So any information I got was from my own research.”

“I feel I had to ask too many questions to the pediatrician that should have just been told to me. For example, in the hospital they gave him 2oz every 4 hrs. When we went home no one told us to change that so he dropped a lot of weight…”

Question 6: If you could choose the way you received info on formula, how would you like it to be given?

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Respondents could choose more than one answer here, but there were two methods which received the vast majority of responses: “a nurse or doctor to talk to you about it” and “a pamphlet or written materials.”

Real world implications: Medical professionals need to be informed on formula feeding safety and practicalities, and be allowed to impart the information in a judgment-free manner. Written materials should also be created to be given to parents at discharge. Since 18% and 16% responded that they’d like to learn about formula via a peer support group or websites/books respectively, it also may be helpful to offer a resource list to all expectant mothers that is truly comprehensive, and not just helpful for those planning to breastfeed.

Question 7: What was the hardest thing you faced when you began using formula?

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This was one of the most interesting questions on the survey, in my opinion; 65% of parents responded that “my own feelings about formula use (guilt, shame, fear, etc.)” was the hardest aspect. The other two popular answers were “the lack of social/emotional support from fellow parents” and “the lack of information on safety, choosing a formula, bottle feeding, etc. (practical issues).”

Real-world implications: Formula feeding parents need a safe space where they can access peer support, work through feeling of guilt/shame/fear, and learn about practical issues of formula feeding. To me, the simplest answer is that we need peer support groups, our own version of La Leche League. Kim Simon and I have been developing a platform for these peer groups through the I Support You organization, and I am really excited that two FFF members have already started their own local chapters (Atlanta and Baltimore). I hope that we can grow this movement so that every major metropolitan area has a resource for formula feeding/combo feeding parents, because as these numbers show, it is desperately needed. Need more proof? Here are some of the open-ended responses to this question:

“I became very depressed and felt worthless as a mother and human being. Luckily, my husband caught me in the middle of writing a good bye letter to my daughter as I had planned to end my life.”

“felt like a failure for not giving the “liquid gold.” I really had to search for good evidence. I remember finding a paper by 3 biostatisticians who had all breastfed. They dug into the evidence. Reduced mortalitly? One study had one infant death in the formula fed group, but the baby fell off the counter!!! Finding unbiased, easily accessible info would have been great. “

“The NICU lacation consultants were relentless. My doctor told me that I most likely would not be able to successfully pump. The NICU nurses understood that it didn’t work out. My baby’s doctor made arrangements for donor milk. However, the lactation consultants hounded me and made me feel like it was my fault it wasn’t working. They added unnecessary stress to a situation that was already a nightmare.”

“I didn’t know any other formula feeders. It wasn’t that my fiends/peers were unsupportive… but they were all breastfeeding and could not relate to formula feeding.”

Question 8: Did you have any trouble with the technical aspects of formula feeding?

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43% of respondents said no, they hadn’t had any issues in this regard. Of the remaining respondents, the most commonly-faced issue was reflux/other GI issues, followed closely by “I had trouble finding a formula that worked for my child.” A small but significant amount (14%) “(were) confused about formula or supplementing and felt lost on where to go for help.”

Real-world implications: More than half of those surveyed endured some sort of struggle with the technical aspects of formula feeding, suggesting that using formula is not as simple as “add powder and water” for many parents. I hear this excuse a lot from those who deny the importance of formula feeding education and support – that it doesn’t have a learning curve, that doctors don’t need to know much about it because every formula is the same, etc., etc. And that is certainly true for some people, but not for all. Not for over half of us.

Question 9: Did you experience any emotional challenges due to your choice to formula feed?

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Only 18% of respondents said no, that they hadn’t experienced emotional challenges. The rest (who were allowed to choose more than one answer) mostly struggled with their choice or need to use formula (58%), and worried what others would think (55%). 35% felt “left out by other moms” and a quarter of respondents (26%) felt that the emotions around infant feeding contributed to postpartum depression and/or anxiety.

The open-ended responses included:

“I would have felt very comfortable in my decision to formula feed from the start if I had not been pushed into breastfeeding by the hospital, and also my mother and stepmother made me feel incredibly guilty. I had asked for info on bottle feeding while in the hospital and was snubbed. These issues contributed to my emotional challenges. It took almost 4 months for me to realize everything was okay.”

“I felt guilty for not feeling more guilty. Also felt like I didn’t try hard enough and that subconsciously maybe I was using PPD risk as an excuse. Oh, and I ended up with PPD anyway.”

“I was worried that all the negative health outcomes would come true- it’s pretty dirty to scare a mom into thinking that one choice could make her child overweight, less intelligent, and generally unhealthy. Happily, none of these things have come true in 3 years!”

“Despite knowing better, I felt guilty that I wasn’t giving my baby “the best.” That I hadn’t “tried hard enough” for her. The pediatrician at the hospital compared bottle feeding to “taking your baby to the drive through.” Thankfully her actual pediatricians were wonderful and told me it absolutely makes no difference either way.”

“I did feel some guilt about not breastfeeding, though I got over it rather quickly. What resonates more with me, though, is the fact that I didn’t want to breastfeed in the first place, but felt pressured friends, my community, the hospital, etc. to do it. And while it’s true that my kid had serious reflux, allergies, etc., and I had production problems, I also just HATED breastfeeding. And even sites like FFF sometimes make it sound like it’s only ok to FF if you tried to breastfeed and couldn’t. I’d love for women to have permission to just chose not to breastfeed in the first place.”

“I knew that there was no way that I could carry on attempting to BF and pump while still taking care of myself and my child (literally I would feed, attempt to pump, and he would be ready to eat again). But I could not relay that kind of feeling of desperation and failure to other moms who had no problems BF. I thought I was doing something wrong.”

“…I was confident in my decision about FF from birth, well educated and versed BUT still got side-eyed and looks from some people. No matter how confident you are when there are people who truly believe formula is poison and if you don’t BF you don’t deserve to have children (even when you fought with infertility to get said child) it’s disheartening. The lack of correct info on FF and the slew of misinformation on the benefits BF make it difficult to even the playing field.”

Real-world implications: Mothers are hurting. When over 80% of formula feeding parents are talking about the emotional ramifications of their feeding method, we need to sit up and listen. We have a large body of breastfeeding research now, but an abysmally small body of research on the effect of postpartum depression and adjustment difficulties on both mother and baby (not to mention other children, partners, employment, future relationships, etc.). If the way we approach infant feeding is contributing to emotional duress in a generation of parents, it seems worthwhile to reassess the risk/benefit of promoting breastfeeding in the way we currently do.

If we insist on continuing down the same path, then we need to also make sure that the negative experiences of formula feeding parents are tempered by appropriate measures. This means ensuring that they are treated with respect and with regard to personal autonomy; setting up social support systems like peer groups or pre/post-natal classes which address other methods of infant feeding; and perhaps providing sensitivity training for those dealing with newly postpartum or expectant parents so that they learn to impart the benefits of breastfeeding in a manner devoid of shame, guilt, or fear-mongering. It is possible, and it is well worth it.

Question 10: What country do you live in?

Most respondents were from English-speaking countries: the United States, Canada, the UK, Australia, and New Zealand.

Real-world implications: Not sure we can take much away from this, except that the reach of FFF (which is how respondents were recruited) is mostly in the English-speaking world. But while we’re on the subject… let’s address the need for culturally-specific infant feeding recommendations and policies. Even within the countries we’re discussing here – which on the surface have many similarities – there are demographic, socioeconomic, religions, cultural, and political differences. People cite the World Health Organization as a good source for formula feeding best practices, but it’s rather simplistic to try and make this issue universal. Mixing formula in a place with unsafe water and hygiene issues is quite different than doing so in a Lysol-happy kitchen using filtered, purified, boiled water and a dishwasher with a “sterilize” cycle. And that’s not even mentioning the impracticality of assuming that genetic, lifestyle, and dietary factors do not affect biological processes; to say IGT only affects 1% of the Swedish population, for example, means nothing to a demographic of Eastern European Jewish women in Manhattan. There are higher rates of breast cancer and Crohn’s disease in some ethnicities; higher rates of genetic diseases in others. Why should breast tissue be immune to these same factors?

I know I’m going off into tangents here, but the point is: it is time to think of infant feeding with more nuance, even in seemingly homogeneous populations. At the same time, we need to recognize that feelings of guilt, shame and fear are common in Western, relatively privileged demographics, regardless of breastfeeding rates and months of paid maternity leave. This is complicated stuff, and requires far more complex analysis than we’ve been given it. It’s time to step it up.

Question 11: What would have helped your experience with formula be more positive?

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The highest amount of responses went to the following (again, respondents could choose multiple answers): more support and guidance from medical professionals (50%), more support and guidance from peers (45%), prenatal preparation for formula feeding (50%) and a peer support group for bottle feeding or combo-feeding parents (44%).

Real-world implications: All of this would be so simple to accomplish. If medical professionals were not scared to discuss formula, lest it be considered giving women “permission” to not breastfeed; if formula could be discussed in prenatal classes in an honest, clear, factual way; if we could stop making it “breast vs. bottle” and just make it two different, sometimes compatible, ways to feed a baby…. just imagine what could happen.

When La Leche League began, it was due to the inadequate support for breastfeeding mothers from society and physicians. While there are still battles to be fought, we are seeing more and more support for breastfeeding (as long as its done within the parameters of what is deemed “socially acceptable” – ie, for no more/no less than a year or two – which is most definitely a problem we need to address), if not from society as a whole, at least from the medical establishment, the government (at least in lip-service and funding for Baby Friendly and corporate lactation programs) and the parenting community. Now may be the time for a formula-feeding equivalent of LLL to do the same noble work – ensuring that moms (and dads – formula feeding is not gender-specific, and dads need to be included more in this conversation, especially those that are primary caregivers) are getting the support they need, when the powers that be cannot provide it themselves.

I will be following up with another survey soon, which will examine if there truly is a need for more “education” about formula feeding, or if it really is simple enough to merit the lack of focus given to it in prenatal and postnatal settings. But until then, I want to leave you with a few more of the comments left in the open-ended sections of this survey. My hope is that this will inspire those with the money and resources to conduct actual, peer-reviewed research on these topics to do so. At the very least, I hope it gets us thinking. Because we need to be thinking, and not just shouting at each other, endlessly, about who knows best.

 

“I just wish that they would give better instruction at the hospital to moms who choose to formula feed about mixing, feedings and choosing the right formula for your child. They send lactation consultants for breastfeeding moms. Why can’t they teach formula feeding moms a few pointers about formula feeding? We are all feeding babies. Why give one method so much attention and neglect another entirely? All that matters is babies get fed. Is that not the most important objective?”

“If there was more support (from) medical practitioners perhaps breastfeeding mums would be less critical.”

“I took a breastfeeding class, but looking back I wish it would have been a general baby feeding class. To learn about pros and cons of breastfeeding, formula feeding, using bottles, and starting solids. Because although not everyone will breastfeed, everyone will at least need to learn about several of these options.”

“I  had no idea what I was doing and didn’t even know where I should look to find the information. It’s hard to find good formula info online and I didn’t know what to trust, especially when I was emotionally and physically exhausted and felt judged by others as well as by myself.”

“Can you fix the world and let everyone know that formula feeding isn’t bad? As long as you feed with love. This is such a touchy topic and I just wish everyone would let it go bc they only make it worse for moms. I also hate the attitude that formula feeding is okay IF you tried to breastfeed or IF you have low supply. I really want the attitude to be that there is nothing wrong with a mom who chooses to formula feed from the get go. Essentially if you could fix the whole attitude about how we feed our babies that would be great.”

 

You’re Proving the Point

There’s this video that’s been making the rounds on the parenting pages for the past few days. If you haven’t seen it yet, feel free to do so now.

 

Yes, it was made by a formula company. Boo. Hiss.

Now that we have that out of the way, can we get to the real discussion?

Spoiler alert: no, we can’t. Because it was made by a formula company, and therefore anything the video stands for is nothing more than a cleverly crafted marketing message meant to scare women off breastfeeding by convincing them that their milk is made of Ovaltine and if they breastfeed even once, they will instantly be turned into a newt.

What, you didn’t see that? That’s because you’re naive. You don’t understand. Obviously haven’t read (fill in the blank with any blog or breastfeeding politics books here), because if you had, you’d understand that this is ALWAYS what formula companies do, because FORMULA=PATRIARCHY. Duh. Choice as feminism? That’s about as last century as Debbie Gibson.

But wait – if the problem was simply that this is a marketing tool (which it is, no doubt; formula companies – scratch that, all companies – are not in the business of throwing massive advertising dollars into PSAs about mommy wars if they didn’t think it would do them some good in the long run), I wouldn’t be writing this late-night post, my fingers shaking so hard from frustration that I’ve had to retype this sentence three times. I mean, being skeptical about advertising, I get. I personally hate Luv’s diapers, I think they suck donkey balls and leak like my junior year apartment’s jinky kitchen sink, but I love their “second time mom” commercials. Hell, I’ve cried at McDonald’s ads and I’m a card-carrying lifelong vegetarian. But if your morals are strong enough to temper your taste in entertainment, you’ve got my respect. It’s healthy and smart to analyze the endless array of shit that passes over our news feeds and DVRs.

The problem is that now, people have turned what could have been a great statement on being media savvy and critical of marketing messages into the same old, tired argument about why the mommy wars don’t exist, and why breastfeeding is a public health issue and therefore can’t be considered a choice in the same context as cloth diapering, or choosing to work rather than stay home, or even abortion.

But, see, you’re proving the point.

You’re proving that the perceived judgment among women isn’t all in our heads; that it isn’t something the formula companies and media have created, but rather capitalized on. Those are two very different animals. Of course formula companies are going to talk about judgment and choice and empowerment and all those other triggering terms in the infant feeding debate. Because it resonates. It’s simple advertising theory 101: inventing the need versus serving the need. This is a case of serving the need.

Formula companies see the need, because women who formula feed are made to feel ashamed of their choice. If you don’t believe this is true, and you happen to be a parent, for one second, close your eyes, clear your mind, and think: If your entire Facebook feed was full of memes about how gross (fill in the blank with something you feed your child, or a method or parenting you employ) was, or some study came out that suggested kids that (fill in the blank with something you do as a parent and feel strongly about, whether it be breastfeeding or time outs or co-sleeping or taking them to church) who did this have higher rates of obesity/attachment issues/lower IQ, how would you feel? How would honestly feel, in your gut? Forget about the reality or perception of the current research, forget about societal norms, forget about all of it – just think about how you would feel.

You feel it? In your stomach? That queasiness? The feeling that while everything you see in front of you says one thing – that your healthy, gorgeous child has no attachment issues, is smart as a whip, and is this amazing creature you have nothing but awe for – the rest of the world is entirely convinced that your lived reality is false, based on purely associative data that has nothing to do with your family or your child? That is how formula feeding parents are made to feel every day. Not by “breastfeeding moms”, which many of us have been/are/would like to be/are best friends with. This isn’t about breastfeeding moms vs. formula feeding moms. THAT, my friends, is a made-up mommy war. But formula feeding parents are being made to feel this way: by the media, by their physicians, by ads on the freeway, and by you. Yes you. The ones on the parenting pages, pretending to be so accepting of alternative choices; who rage on about how being able to choose how/if you vaccinate is a parent’s choice, science be damned, and then in the same breath tell parents that formula feeding is a public health issue, because the poor, sick formula fed babies will be messing up your gene pool 20 years down the line.

You’re right about one thing though. This isn’t a mommy war, not at all. It isn’t the mom at the park versus the other mom at the park. (Moms at the park are usually pretty nice, actually, in my experience. If anything, they judge you more for how your kid is behaving in the sandbox than what you’re feeding him.) This “war” is run by those with power – the ones running websites, hospitals, initiatives; the ones authoring books and selling their wares under the impenetrable armor of a PhD or MD (because no one with a PhD or MD could ever be wrong, or biased. Unless they work for Big Pharma, of course). Not because of the information they are sharing, but how they are choosing to share it. Not because of the research they do, but because they only deal in absolutes, refusing to see nuance or entertain other findings or beliefs.

This isn’t a war, even, because that implies some sort of mutual disagreement. It’s one side bullying another, refusing to hear the other side’s point of view, denying the other side’s right to exist. For that side, the only peaceful resolution involves accepting a totalitarian regime, no middle ground. And since there’s no way to argue against someone when they shut down your right to be heard, it’s a losing battle.

So let’s just say we give up. We’re waving the white flag. YOU WIN.

Go on – keep shouting from the rooftops that breastfeeding will save all of us from certain death and that formula will turn our children into baby seals. Go on – tell us we have no right to feel judged, and that we can’t be mad at you, we need to be mad at the formula companies because they provided food that kept our babies thriving fooled us into thinking our IGT was real, our depression was truly only helped by ceasing lactation, and that our history of sexual trauma would be exacerbated by nursing.  We hear you. We’ve heard you. Keep it going, because maybe you haven’t made that mom over there sufficiently remorseful.

But don’t sit there and tell me that the feelings Similac capitalized on are not real. That they don’t matter. That our experiences don’t matter. Don’t post sanctimonious rhetoric about feminism and scoff at anyone who dares to question your point of view, because last I checked, that seems a helluva lot more patriarchal than a can of baby formula. And you have a vagina, so that makes it worse. Formula cans don’t have vaginas. (Again, last I checked. Who knows. It’s been awhile since I had a formula-feeding infant.)

Or you know what? Go ahead and tell me all of that. I’m all for free speech. Who the hell am I to tell you what you can’t and cannot say?

Just don’t expect the rest of us to listen. We’ll be over here watching some kitten get rescued by a fireman and yelling about how it must just be a ploy for us to give money to the fire department. Because… patriarchy. Or something.

 

 

 

FFF Friday: “How breastfeeding nearly killed me”

All I can say about Maria’s story is that it is not the first I’ve read that nearly ended in tragedy. And I know it won’t be the last, until we start prioritizing maternal mental health over meeting breastfeeding recommendations. There is a perfectly acceptable alternative when a mother does not breastfeed. There is not a perfectly acceptable alternative when a mother does not receive help for severe postpartum depression or anxiety. 

Happy Friday, fearless ones,

The FFF

***

Maria’s Story

My name is Maria. I have two gorgeous children, who were both, ultimately, formula-fed. My youngest is nearing his second birthday, and I have found I still get bothered by the whole “breast is best” campaign. A part of me assumes I always will be. Since healing can be done through sharing stories, I thought I would share mine.

My first child was a girl. She was perfect, hairy, chubby, and amazing. I was a new mom of 22 with zero information on this whole parenting thing. Facebook was still new, and not every detail of life was out there. My choice to feed formula after a week of bleeding nipples was a quiet one, one met with little to no issue. My mother formula fed me, after all, and I was a single mom so it was no problem. Fast forward to my son. My husband and I anticipated the arrival of this boy like no other. We did not, however, anticipate preterm labor at 25 weeks, or preterm birth at 36 weeks. But he was perfect. 7 pounds, 12 ounces of perfection. His first cries were met with audible relief, as it meant his lungs worked. My first words were “He’s not small!”. He immediately latched to the breast, it was bliss.

He had mild jaundice at discharge two days later, and had lost 12 ounces. My first regained her birth weight in under a week, so I wasn’t concerned. I was determined to successfully breastfeed this time, but I did buy a pump and accessories in case the need arose. We went home a happy family. My milk came in some days later, and I knew something was wrong immediately. I wandering my son in bed, and when I pulled him away, I noticed my shirt was wet. Most of what my son pulled from me never made it into his mouth. Well, I figured my milk came in, so I will be more careful with latching after that.

Impossible. It was discovered at his 2 week appointment that he could not latch, due to a lip tie. I had already started pumping by then, and using bottles he could get his lips around. The downward spiral began.

He was barely gaining weight. 2-3 ounces were all he gained after coming home. His jaundice was technically in the zone of hospitalization, but the doctor said to try putting him in sunlight at home first. I was failing him. Then my milk started drying. I had a freezer stash. Excess coming out of my ears… and I was already dipping into reserves. His appetite grew, my supply shrank. I bought supplements, I pumped hourly, I drank dark beer, ate enough oatmeal to kill a horse, pumped less often, more often, for thirty minutes after nothing came out…. it was useless. He was insatiable, and drinking twice as much as I could produce.

I started to hate him. Every time he woke up at night I wanted to scream and run away. I would feed him and change him, then attach myself to the pump for an hour. Go back to bed and repeat. I got no sleep. Not “Oh I slept terrible last night” I am talking hallucinations. I hated my husband, he couldn’t help. He was on night shift and didn’t have boobs. I hated him. I hated this baby we made, I hated my family and myself.

One night, while the baby screamed in his pack n play, literally starving, I got the gun. I sat and listened to him scream for an hour, gun on my lap, weighing my options. Hearing over and over, “breast is best” “formula gives you cancer” “you don’t love your baby unless you breastfeed”, etc. Somehow I had the stamina for one more feeding.

The next day I went to the doctor. I was fine and then started bawling. After I became coherent I was scolded, lightly, for taking it this far. I should have switched as soon as I started having bad feelings towards my baby. He said breastfeeding is not at all a requirement of motherhood. He was formula fed and a doctor! I started antidepressants that day.

I switched my son to formula. He was 14 pounds by 2 months. By a year he had grown an entire foot! His jaundice was gone almost immediately, and he became a very happy baby. He is now nearly 2. One slight ear infection a month ago, a tummy bug last week are the only illnesses he can claim. He is happy, he is healthy, he is smart. All the things they say formula-fed babies can’t be.

So when I hear “breast is best”, I scoff. The breast nearly killed me, and was starving him. Tell me how that is best for anyone?!

Bottle or breast… FED is best!

***

Feel like sharing your story for an upcoming FFF Friday? Simply email it to me at formulafeeders@gmail.com.

FFF Friday: “There is no shame in making the best choice for both you and your baby.”

My car caught on fire last weekend, with me and my two kids inside of it. We all survived unscathed (well, not the car, our carseats, my iPhone, or my yoga mat, but whatever), but for a few scary moments there as I ran down the freeway, away from the burning vehicle with two kids in my arms, I wondered: what if. What if we had gotten a new car last month when my engine died, instead of having a somewhat shady mechanic put in a “new” engine? What if I hadn’t decided to let my husband sleep, so that I wouldn’t have been all by myself on the freeway, in the rain, when my car exploded? What if I hadn’t switched out my daughter’s car seat with the other one – the one with the sticky latch that always takes forever to undo? What if? What if?

There’s a common refrain in so many of the FFF Friday stories: If I’d only known then what I know now…what if…. It breaks my heart, every time, because I feel like these parents are punishing themselves for not knowing the unknowable. There are so many what ifs in that question, so many regrets. But listen to me, my friends: there was NO WAY you could have known what was ahead, any more than I could have known my engine would spontaneously combust. There are usually no warnings, and even if there are, the noise of the parenting world (or in my case, the car stereo) drowns them out. All you can do is pull yourself from the wreckage, get your babies out safely, and feel proud of yourself that you did all you could do to make sure you all survived.

This is what I told myself, all week, and this is what I want to tell Samantha.

Happy Friday, fearless ones,

The FFF

*** 

Samantha’s Story

When I discovered I was pregnant back in March 2013, I approached pregnancy with the same fervor and intensity as I did a final term paper back in college. I immediately began to meticulously research and plan. My to do lists were constantly evolving. I knew I wanted a natural birth with no pain medication and planned on exclusively breastfeeding. I rented every book at my local library about natural birth, hypnobirthing and breastfeeding. I researched local la leche league groups in my area and took a breastfeeding class at the hospital at which I would be delivering. I purchased a boppy, drank red raspberry leaf tea, and listened to my hypnobirthing cd every night before going to sleep. I took a class about cloth diapering and baby wearing and bought a boba wrap that I knew my baby girl would love to be carried in and would blissfully nurse away. I posted articles to Facebook about the benefits of breastfeeding and how “breast is always best”. When I received my sample formula packs in the mail, I was outraged. How dare they send their poisonous sludge to me!? I would be breastfeeding and had no need for their free products. When I found out my mom formula fed all three of her children, I secretly judged her wondering why she didn’t give us the best start in life.

Looking back, if I had the opportunity to sit down and have a chat with pregnant me, I would have cleared up some things. I’m almost ashamed at the naive way I automatically assumed that everything would just work out perfectly the way I planned. I am usually such a realist almost to the point of being cynical but somehow I approached childbirth and motherhood with the rosiest of rose colored glasses (I did end up naming my daughter Rose!). All of my research and planning did absolutely nothing to prepare me for the realities of motherhood. It actually did much more damage than good because I was utterly unprepared for how to adapt to my actual situation versus what I had assumed would occur.

 

My due date was December 16th 2013 and because my mom had gone into labor early with me, I assumed I would also deliver early. Well my due date came and went with no baby in sight. Being 41 weeks pregnant with Christmas just days away is no picnic! On Christmas Eve, my in laws stopped at our apartment to bring my husband and I some food and presents. I uncomfortably rocked back and forth on my birthing ball as I opened gifts. Around 11pm that night, I had a nagging feeling that something was not quite right so my husband and I drove to the hospital and sure enough my water was leaking. After a 2 hour wait to be seen by the doctor on duty, (the hospital was short staffed due to the holiday) I was hooked up to pitocin and the contractions began. I plugged my iPod in and tried to find my zen place. Well 10 hours later, there was no zen left to be found in my hospital room! I begged for an epidural as excruciating contractions rocked my weary body. Another 14 hours after my epidural, which needed to be redone twice by the way, around 11:45 pm Christmas Day night baby Rose made her debut into this world. At that point I hadn’t slept in two days and felt absolutely exhausted after 24 hours of labor. The nurse brought her to my chest and tried to help me breastfeed but I was covered in sweat and was trembling so much I couldn’t get a good hold of her. Tears welled up in my puffy eyes as I told the nurse I couldn’t, just couldn’t try breast feeding. I asked her to take my baby to the nursery. My husband fed me a few saltines and some sips of orange juice as I hadn’t eaten in over a day and a half. I felt dejected and disappointed that the first time my baby was handed to me, I didn’t even have the energy to hold her for long. Eventually I was taken to my hospital room where I was able to sleep for a couple hours before the baby was brought to me to breastfeed. I did attempt it this time and things seemed to be going fairly well from what I remember but I was so sleep deprived it’s hard to tell. Every few hours a different nurse would appear with my baby and I would breastfeed. My last day at the hospital, the lactation consultant finally made an appearance. I had put in a request for one upon going into labor but there are only a a few and they are in high demand. I told her the type of breastfeeding pump and pillow I had purchased and she immediately told me haughtily that both of those brands are terrible. As she arranged my breasts to try to get the proper latch, I felt like an object rather than a person. By the end of the hour, I was in tears of frustration from trying so hard to get the perfect position in order to feed my baby and falling short of her critiques. The experience left me feeling overwhelmed and frightened. It absolutely did not instill any confidence in me that I would be able to breastfeed successfully.

 

That afternoon we left the hospital and rather than feeling excited to bring my sweet, beautiful baby girl home, I was filled with a horrible, fearful dread in the pit of my stomach. The lack of sleep combined with the nervousness about being able to feed her snowballed into a dark cloud which remained over me for weeks. Those first few nights are a blur but what I remember the most is the constant crying, both hers and mine. My husband would prop me up with a thousand pillows and take note of how long she would latch on either side. It was never very long on either one and she would usually fall asleep at the breast and I would be unable to get her to continue feeding. My left breast had little bite marks all over the nipple from where she had tried to latch and each time she fed it felt like someone was stabbing me there. Around 3 am on the third night home, I had had enough. My poor baby cried constantly and only slept for an hour or so at a time. I felt like I was drowning, crying almost all the time. For the brief periods of time she did sleep, my heart raced and anxious thoughts plagued me so I couldn’t sleep. On that particular night, I opened up one of the formula samples we had received and shakily fed her the bottle. She sucked it down and quieted for what seemed to be the first time.  She then slept for 3 hours. I still tried to breastfeed after that first bottle of formula but she never seemed satisfied or full and I was so weak and depressed, I did not have the energy to continue. My milk came in the next day but only one breast seemed to produce milk. I hooked up the pump as my husband’s mom who is a nurse assisted and milk only came out of my right breast. She advised me if I wanted to pump I would have to do it frequently to ensure my supply would keep up. At that point, I admit that I gave up. I literally did not have the emotional capacity to continue breastfeeding. Later that week temperatures dropped below zero in central Ohio where I live and the pipes burst, flooding our apartment so we had to pack up everything and move just a week and a half after my daughter’s birth. Thank goodness I stopped breastfeeding because my baby had to stay at my in- laws house that week while my husband and I packed up everything, signed a new lease and moved all of our belongings.

I do not regret trying to breastfeed, nor do I necessarily wish that I had succeeded. What I do wish is that I had prepared myself for the fact that breast feeding might not end up being the best choice for me. I wish I had looked into formula and bottles and known from the get go the proper amount to feed a newborn. I ended up being blindsided because I had only prepared for one option. When I ended up formula feeding, I not only felt guilt from failing at breast feeding but was navigating uncharted waters because I had not looked into formula feeding at all. I struggled with post partum anxiety and depression those first few months and it’s still something I deal with to this day. I believe my experience with trying to breastfeed led me down a dark road due to the tremendous amount of guilt I experienced for not fulfilling the expectations I had placed upon myself. Whether it be breast or bottle, the best way to feed your baby is the choice that results with a happy and confident mom. I am still coming to terms with this whole experience and healing but want other new moms to know that it’s ok to change your mind and your perspective. At the end of the day what really matters is that you are healthy and happy and able to enjoy your new baby. I was so stressed out and worried those first few weeks that I feel like I missed out on precious time that I can never get back. I try now to enjoy each and every moment with my snugly, sweet little girl because she’s already grown so much. I know that this time in our lives is fleeting and I try to appreciate the little moments such as seeing her joyful smile. If I do decide to have another baby, I would like to try breastfeeding again. But this time I am armed with the powerful knowledge that if it doesn’t work out, it’s perfectly alright to formula feed. Feeding your little one should be a positive experience. There is no shame in making the best choice for both you and your baby. Had I not changed over to formula, my mental health would have further deteriorated and that’s not something that should be jeopardized. Switching to formula enabled me to empower myself and take control of a situation which was rapidly spiraling downwards. This experience has taught me to keep an open mind and realize that there are always options. Never feel trapped and there’s always light at the end of the tunnel!

***

Feel like sharing your story? Email me at formulafeeders@gmail.com.

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