Pregnant and considering bottle feeding? This one’s for you.

Yeah, maybe it was born from the unholy union of laziness and apathy, but you guys made my Q&A post yesterday well worth it.

A few of the questions came from pregnant peeps, which I thought was pretty awesome, and I decided to tackle these inquiries in this separate post. And keep the questions coming, y’all… I will answer them in the comments section unless they merit so much chitter chatter that I feel the need to post independently on the subject…

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Q: I’m 18 weeks pregnant with my first and haven’t committed to a feeding method yet. I’ve moved from having no desire of any sort to breastfeed to being open-minded about the options. It is a challenge to find information that isn’t a thinly veiled agenda (on either side), one masquerading as objective data. I think I’ve read just about every argument/counter-argument as to why ‘breast is best’ or why formula isn’t poison. I’m curious now about real-life contrasts of FF babies and BF babies. Like, did you switch to formula early on with your baby or perhaps BF one child and FF the next? Were there any measurable differences in health or temperament that you felt could be attributed to feeding methods?

I don’t know if this is something you can address personally or is widely interesting enough to answer but I couldn’t turn away from a triple dog dare.

What I feel I really need right are a few good sources (books, articles, personal experiences) that I can reasonably trust are straight forward so I can make up my own mind without feeling as if I’ve just ‘sided’ with someone. Does that make sense? 🙂 (BTW – I found your blog through the Mainstream Parenting site and I’m glad I did! It has been a good resource so far.)  


-Jessica

A: Jessica, you’ve hit the really-difficult-to-hit-with-the-hammer-because-it’s-a-really-complicated-nail on the head. The best studies on breastfeeding would take sets of twins, raised by the same parents, in the same environments, and feed one breastmilk and one formula. But this would be unethical, so it ain’t gonna happen anytime soon. You’d need a lot of sets of twins to make it a decent study, too, because even in these conditions, a lot of “chance” factors might play in, capiche? Like, what if one twin was a better behaved baby, which meant that the parents had some deep-seated favoritism which resulted in more positive attention being placed on that twin… later on, the enhanced self-esteem and school performance of that twin could be attributed to breastfeeding, even if the feeding method had nothing at all to do with it. Or, since one twin was being breastfed, and the other bottle fed, one baby would be getting more skin-to-skin contact and bonding time than the other (which wouldn’t be the case if both were bottle fed or breastfed, as the feeding methods would be identical), and that could skew the results.

Point being… it’s really hard to compare formula fed babies to breastfed ones. This is true in ALL studies, because there are differences in the parents who breastfeed and those that don’t, when you look at the numbers of people necessary to carry out a legitimate study. My biggest complaint with these studies is that most don’t take into account all the social and emotional factors tied in with infant feeding. It’s just really impossible to know.

So, we’re left with purely anecdotal evidence, which really isn’t evidence at all. But for the hell of it, I can tell you this – I breastfed my son for a month. Or, I tried to – I had to pump for 3 out of those 4 weeks, because the little guy couldn’t latch, despite the help of multiple lactation consultants and a procedure to correct his tongue tie. Perhaps if the breastfeeding had worked out, the eventual diagnosis of his severe milk protein allergy would have been more devastating. But as things were, I was happy when it turned out he’d be better off on hypoallergenic formula. I was miserable. More importantly, he was miserable. He was sick to his stomach, constantly hungry (before we switched him to pumped milk in a bottle), with a terrible rash all over his body. When we got him on the right formula, he was a different kid. So yeah, if you looked at my child, he thrived on formula, and was miserable on breastmilk.

BUT. That is not a typical case. At the same time, it’s not the only case like this – read through the comments and FFF Friday posts and you might see a trend towards the conclusion that some kids do better formula feeding than breastfeeding – but then again, this is a blog for people who formula feed, and many of us have medical or emotional reasons for doing so. I strongly believe that happy mom (or dad) = happy baby. So if someone is miserable breastfeeding, no one is going to benefit from that. I think that is the fundamental difference that alienates me from some of the breastfeeding advocates – they encourage moms to keep going in the worst of circumstances, and in some cases, that is what is best – especially if breastfeeding is important to the mom. While I believe breastfeeding is best if its something you want to do and can do without going to extreme measures (which a lot of women can – don’t let this blog scare you!), I don’t believe it is so much better that it is worth vast amounts of pain or anxiety.

Back to your question though – I would tell you that this is a completely personal choice. Unfortunately, I don’t think it’s possible to find a completely accurate, unbiased answer. If you are even slightly considering breastfeeding, I would 100% go for it. Give yourself every opportunity to succeed. Take a class. Read some books. Read some of the blogs mentioned in last week’s FFF Friday post. Chat with those women. I have so many friends who breastfed, and many who had trouble in the beginning but loved it later. I think overall, if there aren’t problems, once you figure nursing out, it’s easier than formula feeding. And definitely cheaper!

But if you try it and it either doesn’t work or you hate it, switch to formula and don’t look back. Your baby will be healthy and happy because YOU are healthy and happy. Formula is a great option too, and thank god we have that option.

As for book and articles… I have some links listed in the “Factivist Finds” section that might be helpful… although I need to update the darn thing. I haven’t come across too many books that don’t shove the breastfeeding thing down your throat – I thought “Breastfeeding Sucks” was pretty good (and don’t be scared off by the title – it’s realistic about the challenges, but funny and helpful without being preachy). There’s only one formula feeding book out there, and it’s hard to find- called “When Breastfeeding Isn’t an Option” by Peggy Robin. I think it’s okay, but skews towards the anti-breastfeeding side, which I don’t like. I’m trying to write a book that talks about this all logically, but no one wants to publish it yet, because they think there is a “limited audience”. Blecch. Hopefully someone will take the chance and there will be another option for those considering formula feeding some day.

Good luck with it all, and feel free to come back here and ask me anything, anytime.

Q: I’m almost 26 weeks pregnant and plan on FFing. What I’m wondering, is how do you pick the right formula? Where do you start? Also, I’m all about generic food for me and hubby, but is it the same with formula? Do you have any guidelines or suggestions for new moms who are going to FF as far as what to buy and try? Thanks!!!


-Shannon

A: Choosing a formula is a bit like choosing a stroller- which I assume you’ve either already done or are about to do soon. There are a ton of options on the market; some have name recognition (like Bugaboo for strollers or Similac for formula), others have the “cool” factor (UppaBaby or Earth’s Best Organic), and others are far lower in price, with less bells and whistles – but just as safe and functional (Chicco or Target Brand).

All infant formulas currently on the market must adhere to certain nutritional and safety standards, as per the FDA. The rest of it is just designer bells and whistles. For example, if you want an organic formula, you’re limited to certain brand name options (although I’ve heard WalMart makes an organic formula – anyone here know it/tried it?), and there’s always some “new” type on the market promising less spit up, more DHA/ARA, or longer sleep at night (and for that last one – don’t believe the hype. Enfamil kind of lost me on that one. I’m a Similac girl anyway, but I thought that marketing this “restful” formula just made us formula feeders look more selfish than some people already thought we were. Plus it’s kind of creepy).

You get into tricky territory when it comes to the hypoallergenic or elemental formulas – but unless you’re unlucky enough to have a baby with food allergies, you probably won’t need to go there.

A lot of people end up sticking with whatever formula they were given in the hospital (if your hospital is still able to give out formula, that is) or received coupons for in the mail. Since the taste and makeup of the formulas is slightly different, there can also be some trial/error involved. I know some people (like my sister-in-law) who remained on the same formula from start to finish, and others (ahem, moi) who tried everything on the market before finding “the one”.

If I were you, I’d see if my hospital hands out sample bags – some still do, at least if you request them – because it’s usually the “premium” version of either Enfamil or Similac, and they give you a good amount to start. Just one less thing to think about. If your baby likes it, and seems to tolerate it well, then you can sign up on the formula company’s website and they will send you some great coupons, which usually makes the cost a bit less steep. When your supply of freebies runs out, you can make a decision – if you want to stay on the name brand stuff; try the generic; or if you want to try a more “specialty” version like Gentlease or something, if your baby is gassy or whatever. You can also ask your pediatrician, but most will just tell you it’s a personal choice. They may have an abundance of free samples of a certain kind though, and if they are willing to give some to you, that’s a pretty sweet deal.

Switching formulas doesn’t need to be a big production. You can do it slowly – like half and half of the old and new to “ease” your baby into it – or just do it cold turkey, as long as your kiddo isn’t prone to stomach issues. All milk-based formulas are pretty identical; if you are switching to soy or elemental for some reason, the transition might be a bit tougher, as these taste and metabolize differently.

In sum: 1)you can’t really go wrong in choosing a formula, because the worst that happens is you end up switching to another, either because your baby hates the taste, seems to have more stomach distress/spit up with the formula in question, or the cost becomes prohibitive; 2)generics are just fine, and a heckuva lot cheaper, and 3)don’t buy into the marketing – as long as the formula was made in the USA, it’s got the nutrients your child needs!

Q: I’d love to hear your thoughts on nipple confusion… I’m currently pregnant with my first, and we’re planning to combo feed. However, I’ve heard so much about nipple confusion from the lactivist side of things that I wonder if it’s worth breastfeeding at all. Not exactly the point that lactivists wanted to make, I’m sure…

-Sara

A: This is the six million dollar question, Sara. I honestly don’t know what I believe. Because if I’m being entirely truthful… while I knew all about nipple confusion, when the doctors told me my growth-restricted baby was jaundiced and my milk had yet to come in, I gave the go-ahead for the nurses to give him a bottle. And after that, we never quite got the latching thing.

However, I think combo-feeding is the best of both worlds. I expect that if my son hadn’t had a tongue tie, he would’ve been able to latch, regardless of that bottle he had. Kids are resilient. I’ve heard friends say that they did bottles of pumped milk or formula from the beginning and didn’t have problems switching from bottle to breast.

If I were you (assuming that you would like to try breastfeeding) I’d take the time in the hospital after you deliver to establish breastfeeding. Focus on getting the latch going and your milk flowing. Then, as soon as you and the babe know the drill, go ahead and offer that bottle. I’ve heard some people do feedings at the beginning where they nurse first, then offer the bottle after the baby has fed from the breast, so that the kid can go from one to the other easily. I think the important thing is to establish breastfeeding first – but there’s no need to wait weeks or months before you start the bottle.

That being said – are you concerned with combo feeding in the hospital? I know from experience that after a long labor, sometimes being awoken every 2 hours to feed a baby who hasn’t quite figured out how to feed can be draining – and some women feel better letting the nurses feed the baby during the night so they can get some rest. That’s a perfectly legitimate desire (and one I share for my second birth, if it’s half as exhausting as my first labor was). If that is the case, then I would still take advantage of any help you can get establishing breastfeeding, but I’d also go ahead and allow some bottle feeding to occur. In my opinion, whatever is going to make breastfeeding a more viable option for you is a good thing. If you’re on the fence, and the fear of nipple confusion may stop you from trying at all, then of course you should say “fudge it” and combo feed from the start. It’s a no brainer. At least you’ll be giving yourself the chance to discover if you enjoy breastfeeding, which there’s a great chance you will.

Incidentally, I agree with you that discouraging combo-feeding is to the detriment of lactivism. Combo feeding is a way for breastfeeding to be mutually beneficial and enjoyable for mom, baby, and dad, who gets to take part in the feeding process. Good luck and let me know if I can help with anything!

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.


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14 thoughts on “Pregnant and considering bottle feeding? This one’s for you.

  1. Great advice, FFF! I think using a generic formula was one of the best decisions I made as a new mother. We used the Kirkland Signature brand from Costco, and it was half the price of Enfamil Premium. Walmart's Parent's Choice line is also really good, and they do make an Organic version.

    I do wish I had considered combo-feeding, but for whatever reason, it never even crossed my mind as an option. When I couldn't breastfeed exclusively, I never once thought to try it out part-time. So weird, but I think I was just all lost in the haze of “all or nothing” that so many lactivists seem to spout.

  2. We started with Similac because that's what we got at the hospital but quickly switched to the Target brand (Up & Up). The price difference is huge. A can of Similac costs around $27 compared to $11 for a can of the Up & Up. I compared the ingredients. They are exactly the same. The Similac is a little bit finer than the Up & Up though. My daughter had no problem switching brands. Even though I now try to feed her Organic baby food, I never tried the Organic formula. Call me skeptical but I'm not sure how formula can really be organic anyway.

  3. I 100% agree on the lack of encouragement for combo feeding and how it is detrimental to getting women to breastfeed. I think it's great and will do it again if I have another kiddo!

  4. Thanks so much for addressing my question – it really helped! I spent a few hours yesterday reading previous posts and I can't tell you how happy I am to have this resource. 🙂 – Jessica

  5. Yes, I agree too. If it weren't for combo feeding I wouldn't even had made it to 6 weeks so I think it does more good to encourage it than discourage it. If you are pro breastfeeding than some breastfeeding should be better than none. My DD never got nipple confusion and we gave her both from the very beginning and when I spoke to her pediatrician he actually told it is not as common as the books lead you to believe.
    I also wanted to answer the question on organic formula. Personally it worked out really well for us and it actually made a difference in DD's poops. What makes organic formula different is that they do not use corn syrup. This is not to be confused with high fructose corn syrup and I say this because I will never forget when I was pg in my 8th month I went to a newborn parenting class and the instructor said they put HFCS in the infant formula. I shopped around and I have not yet found an infant formula with it. USDA Organic formula means they obtain milk from cattle that has not been given hormones or anitbiotics. I used Earth's Best and never worried about the melamine scare because they used tin cans that were made in the US and did not find any trace of it.

  6. @Michelle K- thanks for sharing that info! I didn't know that there was no corn syrup in organic formula. I was aware of the no-antibiotic cow thing – in fact, I was just watching an episode of SVU (I'm addicted even though it freaks me out) and it was all about the hormones in our milk supply… scary stuff. So yes, that is an advantage to organic formula!

    I was recently sent a frightening article about the source of DHA/ARA used in Earth's Best Organic Formula. However, I am assuming that this is the same stuff that is in the “regular” brands too, so I doubt that it really makes a difference. I'm trying to piece together a post on it so I'll get back to you on this one…

  7. I'll also add in that if you join any online groups for formula feeding, people offer coupon swaps ALL THE TIME. Basically, the Similac moms get Enfamil coupons in the mail and offer them up to whoever wants them, and vice versa. So if you can't do generic for whatever reason, check into that. 🙂

  8. Thanks so much for the advice / words of encouragement! It feels really good to hear stories of successful combo feeding. I think we're going to focus on breast feeding while in the hospital, because the hospital where I'll be delivering has lactation consultants on staff and is known for being very pro-breastfeeding. I figure, might as well take advantage of that while we're there… But, the plan is to start introducing formula within the first week or so, and just do what we can to avoid any problems switching between. I've really enjoyed this blog – it's a great non-judgemental place to go for resources and ideas!

  9. That's some really bad advice about “combo feeding”. Allowing baby to be given artificial milk in bottles in the first days after birth will almost certainly prevent mom from getting a full supply and likely lead to the early demise of the breastfeeding relationship. Not to mention the damage to the newborn's digestive system. Why don't you ever mention the baby's needs in this awful blog?

  10. Thanks so much for answering my question!!!! That was so helpful! I really appreciate all the research and thought that you put into your posts, it is really awesome! Thanks again FF!!

  11. @Anonymous-

    I think it was pretty clear in this exchange that the woman in question was unsure if she wanted to breastfeed AT ALL. Combo feeding was a way for her child to get some breastmilk, rather than none. If you believe that mother's milk is as important as you clearly do, I would hope that you could accept that an all or nothing approach is NOT in the best interest of her baby.

    If she is going to be combo feeding throughout her baby's first year, then her supply will never need to regulate to that of an exclusive breastfeeder anyway. In fact, that could cause her to become engorged, putting her at risk for mastitis, etc. That might also end the breastfeeding relationship.

    But I doubt that kind of moderate approach to breastfeeding will satisfy you, so let's leave at it this: this is a blog about FORMULA FEEDING. There are plenty of great blogs/sites about breastfeeding, and the author of this question is obviously an intelligent, research-oriented person. I'm sure she will get as many opinions as she possibly can, and like I suggested, take advantage of the LCs during her hospital stay. I'm sure she will take the advice of a medical professional over my “awful” blog or the comments of an anonymous poster on said blog.

  12. I have to say that I am an ardent Earth's Best formula feeder. I HATED the smell of most formulas, but EB doesn't smell, and it made it tolerable. I'm sure I also felt a little better about FF because it was organic. We did a lot of research, and EB seemed to have a lot of anecdotal evidence about helping sensitive stomachs. So that's what we went with, and we will start with EB next time as well (though I will likely combo feed if I can).

  13. Good info. I combo fed last time (Enfamil) and am open to it again, and glad to hear about the Earth's Best, especially since I think it's available at Target (much closer to me than Babies R' Us). I had no idea about the corn syrup either.

  14. “Point being… it’s really hard to compare formula fed babies to breastfed ones. This is true in ALL studies, because there are differences in the parents who breastfeed and those that don’t, when you look at the numbers of people necessary to carry out a legitimate study. My biggest complaint with these studies is that most don’t take into account all the social and emotional factors tied in with infant feeding. It’s just really impossible to know.”

    Let me make sure I understand what you’re saying. Are you taking the position that no knowledge can be generated on subjects for which one can write a list of potential factors that cannot be exhaustively directly tested? Would you agree or disagree with the statement that economics produces no useful information? Do you think it is theoretically possible to answer the question “What is the best human diet?” with research studies?

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