A Dangerous Side Effect of Bottlefeeding Guilt?

A new study out of Britain, published last month in Archives of Disease in Childhood, found that moms who formula feed “may feel a range of negative emotions about this choice“. Nothing too newsworthy there. Guilt is something that comes up in nearly every conversation – online or in person – when women discuss the bottle vs. breast issue. I’m hoping that this is something we can change, but like any movement, it may take awhile. And of course we’re fighting an uphill battle, since the word “mother” is synonymous with “guilt”. It’s an emotion that you get in spades as soon as you earn the right to be called mom.

According to this study, however, there’s a strange (and somewhat disturbing) companion to the bottle feeding guilt: the potential for improper usage of formula:

“Since the vast majority of babies receive at least some formula milk during the first year of life, it is important that this is prepared and administered safely and correctly. While it is important to increase the initiation and duration of breast-feeding, it is also necessary to minimize the risks associated with bottle-feeding by providing adequate information and support in a sensitive and non-judgmental manner to parents who choose to bottle-feed their infants.

Apparently, this study found that women “often failed to follow safety recommendations for preparing formula”. I have to admit – I can’t really see what is so difficult about following the directions on the formula can. Seriously – you scoop, measure, shake. Not brain surgery. And certainly easier than figuring out how to successfully breastfeed.

But I do think this study brings up an interesting point. Breastfeeding advocacy is great, but at what cost? Where should we draw the line between supporting women who want to nurse, and alienating those who don’t?

I was very lucky to be in the hands of an amazing pediatrician, who told me point blank that a formula fed baby would be just as healthy as a breastfed one. “He can still be president,” she assured me. And she later admitted to me that while she was breastfeeding her infant daughter (simply because she didn’t want to deal with the flack she’d get from her fellow Southern California pediatricians), she had secretly hoped she would have problems that would force her to quit. “I am counting the days until she’s a year,” she whispered to me at my son’s six-month appointment.

However, I did see a pediatric G.I. for my son’s stomach issues who was less than supportive of my choices. He chastised us for quitting breastfeeding, saying that no formula would ever be as easy on his stomach than my milk (ignoring the fact that he was miserable while on breastmilk and practically dysfunctional until we finally switched him to lifesaving hypoallergenic formula). Sadly, from what I’ve heard from other FFFs (Fearless Formula Feeders), this is far more the norm than my lovely pediatrician.

I understand that the position of the AAP and WHO is that breast is ALWAYS best (although I definitely think we’ve been fed a lot of hogwash in that department too, but that’s something for another day). But a good doctor sees patients as individuals, and this should be no different. What’s the harm in offering education and support for breastfeeding, but still acknowledging that formula is a perfectly valid choice for those who opt not to nurse?

My dad loves to use archaic expressions like “the bees’ knees” and “best thing since sliced bread”. He also likes to go around misquoting Shakespeare and often says “methinks she doth protest too much” when he thinks someone is defensive due to insecurity. In this case, I am thinking that the medical community is protesting too much. Maybe we need to start some protesting of our own, and demand that our options are discussed with us without judgement or – dare I say it – guilt.

In sickness and in health

Guilt-inducing excerpt of the day:

“Breastfeeding for as long as possible is the most important thing you can do to ensure your child has a strong immune system… In addition to providing the absolute best nutrition for a growing baby, breastmilk supplies the factors needed to develop strong immunity and protect your baby against disease.

It’s baffling that some health professionals still believe that there is no benefit from breastmilk to babies after they are six months old. Long-term breastfeeding and natural weaning (letting your child decide when to wean) is by far the healthiest thing you can do. Immune protection continues to improve throughout the duration of breastfeeding (Hanson 1998). The longer you breastfeed, the stronger your child’s immune system becomes.

Breastfeeding also adds the loving touch and comfort that is crucial to the emotional well-being of your baby, toddler and preschooler, thus strengthening immunity on another level.”

-Immunology of Breastmilk By Jane Sheppard, Published 07/14/2004 on Holistic Pediatric Association.

Breastfeeding advocates love to extol the immunity-enhancing virtues of breastmilk. It’s one of the most well-known benefits – in fact, my neighbor, a childless biker dude in his forties, felt the need to inform my husband that feeding our kid formula would “make him get sick a lot more often”.

I’ve read numerous studies about this and yes, there does seem to be some statistical advantage for breastfed babies when it comes to immunity. (I stress the word some. My pediatrician told me that it comes out to be about 0.5 more ear infections a year. I think I can live with that.)

One thing that is seldom discussed is that many of these studies are done with children who are exclusively nursed, not fed expressed breastmilk in bottles. In order to exclusively nurse for several years like Ms. Sheppard wants us to, we would need to either stay at home with our babies, work from home, or have some VERY understanding employers and flexible nannies who would allow our kids to come to the office every few hours. That is just not possible for many women. Most of us get a few months of maternity leave, if that; after this we need to primarily pump, building up freezer stashes in order to keep up the nursing relationship (of which the actual “nursing” part is limited to a few times per day at best, and weekends). Anyway – point is, the benefits we’ve all had shoved down our throats have not really been examined when it comes to expressed breastmilk. (According to some breastfeeding advocates, using expressed milk is a poor country cousin to nursing. But that’s a subject for another post as well.)

What I want to mention here is that since these studies showing such vast immunological bennies are done with breastfed babies, not babies fed breastmilk from a bottle, that is ruling out a lot of kids with working moms. And what do kids of working moms have in common? Many of them are in daycare. Kids in daycare get sick. That’s been shown in numerous studies too – and it makes sense, since kids are little germ factories. I think we can all agree on that.

Okay…so: We have one group of kids who are exclusively breastfed, meaning that it’s likely they are usually at home with mom. Then we have the bottle-fed group, regardless of what is in that bottle, and it’s likely a lot of them have working moms, since most working moms can’t be in that exclusively breastfeeding (again, I’m talking nipple-to-mouth feeding here) category for obvious reasons. Follow me?

The bottle fed kids of the working moms are in daycare, getting exposed to all sorts of germs, and since daycare = more early childhood illnesses, using the transitive property of Factivist Logic, bottle fed, daycare-attending kids will probably be getting sick more often.

And then, there’s the anecdotal evidence. My generation was primarily formula fed; none of my friends are particularly sickly. Granted, we were raised with good nutrition in comfortable homes, which I’m sure has something to do with it, but since the Mammary Mafia doesn’t acknowledge socio-economic factors in their arguments, neither will I.

In my own social “mommy” circle, we’ve had several viruses passed around. A bad cold; a few gastrointestinal things; some ear infections. My kid – the only formula-fed one in the group – has been healthy as an ox, while his nursing peers have all been sick at one time or another.

Of course, one child doesn’t prove anything. So I’m curious – I’d love for other Fearless Formula Feeders to weigh in and let me know if your kid is sickly, gets more ear infections, etc. Speak up, ladies. Let’s do a scientifically irresponsible “study” of our own… god knows we’ve been subjected to enough of them from the opposing side.

Nursing old wounds: my story

A friend once lamented to me that there were a ton of things she felt very strongly about whilst pregnant, all of which got tossed in the trash when she actually had a baby.

In my case, breastfeeding tops that list. I was committed to nursing, I truly was. I hadn’t even bothered to buy a pump, so sure was I of my ability to offer my child milk directly from the source. Being stuck in a chair during growth spurts didn’t sound so bad; the breastfeeding books made this sound rather idyllic, a time where I could relax, unwind, read a nice novel or catch up on last season’s Weeds. Pumping so that my husband could give our baby a bottle and let me sleep through a night feeding? Eh, why bother? How hard could it be to roll over and let the little one (who was sure to be cuddling next to me in my bed,, another example of fantasy that reality kicked in the shins – my child was NOT into co-sleeping) partake? All the literature had me convinced that this would be a rewarding, intuitive process. Sure, there might be some cracked nipples; it might take some time for me to feel comfortable nursing in public; but all in all, I assumed this would come naturally to me. Just as the books said, this was the Womanly Art of Breastfeeding! So That’s What They’re For!

I remember this one description in a book a former client and attachment parenting guru gave me around the beginning of my third trimester. It spoke of how, straight out of the womb, a newborn would instinctively claw its way up its mother’s abdomen and root around, latching on to the maternal breast and suckling in an act of instant, symbiotic perfection.

And to be honest, it did go down pretty much like that. My son did find his way up to his expected food source, and he did try and latch on. Unfortunately, it was all downhill from there.

After about 24 hours, my son started making these pitiful, desperate cries whenever he tried to feed. We asked to see the hospital lactation consultant but were told that we had to wait, since there didn’t seem to be anything wrong with how my baby was nursing and the LC’s were there for people with real nursing “problems”. Call it mother’s intuition, but I was pretty convinced that we had a “problem” ourselves. My son couldn’t get my nipple to stay in his little mouth no matter how forcefully the nurses shoved him on there. He would fight and cry and sound so frustrated and hungry that it broke my heart, already heavy from a pretty severe bout of post-partum depression.

Three lactation consultant visits later, we were no better off. The LC’s would swear that my son was just lazy/tired/too weak to suck and given time, his latch would improve; he would keep crying as if he was starving to death, and keep losing precious ounces of weight. I felt terrible. I wasn’t sustaining him in the womb (I had an undiagnosed growth restriction), and now I was failing to nurture him on this level too.

Finally, my pediatrician suggested that we supplement with formula due to his jaundice and the fact that his already tiny body was losing too much weight. He took to the bottle like a champ, sucking formula down as if it was manna from heaven. I had no problem with the doctors giving him a little formula, even though I knew it was a no-no on the breastfeeding front. It just didn’t matter that much to me when I saw my baby starving. I only wanted him healthy and happy. A few ounces of Similac was a small price to pay for the sleepy, content, satiated baby it produced.

In the next week, we saw four more lactation consultants (at a significant cost – this is a big business, this breastfeeding “support”), the third of which finally diagnosed my child with a “tongue tie” that made it impossible for him to latch correctly. We got his frenulum snipped, but even this was to no avail. He simply would not nurse consistently, no matter what I, my husband, or the myriad of LC’s tried.

I wasn’t giving up that easy, though. I decided to “Exclusively Pump” my breastmilk and serve it to him in the bottles he so loved. I had no idea how hard this decision would make my life – there are entire message boards devoted to supporting those committed to EPing; one woman figured out that in order to pump and exclusively feed (meaning no formula supplementation) a newborn breastmilk, it would take 20 hours a week, basically the equivalent of a part-time job. I hated every minute of it. The thing with pumping is that you are getting all the disadvantages of bottlefeeding without any of the advantages. You’re constantly either hooked up to a machine that makes you feel like Elsie the Cow, or feeding your baby, leaving no time for anything else. And despite what some might tell you, there is more to mothering than what or how you feed your child. Babies need love, attention, play… they need a mother who is there and not exhausted and literally drained from being the Dairy Queen.

Did I switch to formula at this point? No way, Jose. I had a husband who had also read the studies, the literature, the – dare I say – propaganda, and he was convinced that depriving our child of my breastmilk was equivalent to letting him stick his tiny head in the oven. So we fought, and I felt guilty, and I kept on pumping. And pumping. And pumping.

Most of the time I managed to convince myself that this was for the best, that this “liquid gold” my pump was squirting into sterile bottles was well worth it. My baby would thrive on this stuff. And he was gaining weight. Now that we weren’t trying to force him to latch, he was eating almost too well. He finally got back up to his meager birth weight, and then some; nice little rolls started appearing on his wrists and thighs.

But I wasn’t sure you could consider this thriving. He seemed miserable all the time. I assumed it was colic; but everywhere I looked, colic was defined as only crying a certain number of hours, usually in the evenings. But this was all day long. He would fuss during every bottle and take breaks from drinking to cry inconsolably; after he’d finish the milk, he’d scream bloody murder for a good half hour to hour before calming down. He’d be okay until the next bottle, which would start the cycle over again. He was gassy and defecated blood-laced feces literally every 5 minutes, no exaggeration. We went through diapers like a guy with hay fever goes through Kleenex. He also had a weird rash in several places on his body.

I went online. I read Kellymom.com. I cut out dairy, soy, nuts, green leafy veggies… my diet was basically bread and water, which didn’t help how crappy I was personally feeling. I had no energy between the constant pumping/feeding/crying, my poor diet, and the baby blues. My husband did all the parenting in those early days. As if I didn’t already feel like a failure as a mother.

Long story short, my son ended up being one of those babies (and yes, they do exist) who couldn’t tolerate any milk, including his own mother’s. We got him on a special hypoallergenic formula and withing 48 hours, he was a totally different baby. He was happy, cheerful, engaged in the world, and ridiculously healthy. In fact, he’s now 8 months old and hasn’t been sick a day in his life since getting off my “immunity enhancing”, “liquid gold” milk. No ear infections, no stomach bugs, not even a cold.

I feel no guilt for feeding my child formula. All I feel is resentment and sadness that he spent the first 6 weeks of his life so miserable due to his parents’ stubborn refusal to question the mass breastfeeding hysteria.

What makes for a good parent? Would I have been a good parent if I had ignored my child’s numerous struggles with nursing and drinking breastmilk?

There are many people out there who would love to answer those rhetorical questions. They might throw studies in my face, or statistics, or worse, feel sorry for me for being a victim of a medical system that encouraged me to supplement, etc, etc.

But I refuse to feel guilty. I made the choice to care for my child in the only way I know how. By listening to him, and by listening to that vastly more important organ, lying beneath the breasts that have become so politicized: my heart.


Support for formula feeders: Why this blog exists

I live in a boob-eat-boob world. Otherwise known as the upper middle-class parenting circles of Los Angeles. Here, breast is not only best, it is the yardstick by which your parenting prowess is measured. And in this land of (breast)milk and honey, I stand alone. Not the only formula feeder (although definitely one a very small and shame-ridden few), but the only PROUD formula feeder.

If you’ve come to this blog, you are likely one of two people. You are either a fellow formula feeder, seeking support for your choices, or a lactivist, here out of curiosity. I welcome both of you. I want to make it clear that I fully support breastfeeding; I think it can be a beautiful, wonderful act between mother and child that offers great benefits to both individuals involved. I have many friends who are happily nursing and I support and respect them infinitely.

Here’s the problem: breastfeeding is not always the right choice for every mother and every child. Whether it be for medical reasons; psychological reasons; sociological reasons…hell, even vanity; nursing sometimes is not a beautiful, wonderful act. It can turn into a painful, emotionally-fraught, conflicted act between mother and child that can be detrimental to both individuals involved.

And for those women, who for whatever reason opt for formula feeding, there is little support.

Hospital maternity wards plaster posters screaming that breast is best. Headlines annouce new studies weekly about the superiority of children who are nursed. The politics of pumping becomes a feminist issue, making any self-respecting NOW member want to burn her bra for entirely different reasons.

A google search for “breastfeeding blogs” turns up a plethora of sites: The Motherwear Breastfeeding Blog. The Lactivist Breastfeeding Blog. Breastfeeding Mums. Celebrity Baby Blog Nursing Gallery. Black Breastfeeding. The list goes on and on. And on.

Google “formula feeding blogs” and what comes up? Other than a few posts from general parenting bloggers, there’s nothing. (And, great as some of them may be, they are usually just essays on the guilt involved with not nursing.) Not one blog specifically dedicated to the loving, concerned parent who is also a formula feeder.

So here I am, guys. Willing to take it for the team.

Who am I? I like to call myself a factivist. Kind of an anti-lactivist. (Again, to be clear, I am not anti-breastfeeding– I am just against making it into a political issue like the self-proclaimed lactivists do.) Someone who likes to look at the studies a bit more carefully, who likes to play devil’s advocate, and stand up for the underdog.

So let’s get this party started. Crack open that can of Similac or Earth’s Best or Target Brand formula,shake up that bottle, and join me in a toast: here’s to us, formula feeders. Here’s to taking back our choices, taking back our pride in ourselves as parents. It’s about damn time.

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