Monthly Archives: September 2010

Message In a Bottle: Real Stories of Formula Feeding in America

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I’ve been working on a few FFF-related projects lately, one of which being a little documentary-style video series which is basically a film version of FFF Fridays, with a bit of my own opinion thrown in for good measure. It’s also my attempt at a measured response (even though the kid in me, like that old cereal commercial says,  would really prefer the frosted deliciousness of a more petulant response) to the upcoming “Formula Fed America”, which I fear is just more one-sided, anti-formula propaganda, completely ignoring the very real experiences of moms like the ones featured in the following videos.

I’m hoping the film medium will bring a new audience to the discussion, so feel free to spread this around the Interwebz if you like it. I apologize in advance for the cheesy music; this was a low-budget project and I fell mercy to the high cost of licensing… just pretend you’re in the early 1990′s and get down with the synthesizer. If you go with it, it’ll be less jarring. Hopefully. God help us all.

Anyway – the original intent was to make one cohesive video, but it turned out much longer than I’d intended, and far lengthier than is “appropriate” for online viewing. Therefore, I split it up into a series of three shorter videos, and also made a short, 9-minute “trailer” or “synopsis” version for those of you with limited time. You can the trailer below – or follow the link to Vimeo, where you can watch it in fullscreen mode.

I encourage you to watch the actual series, though; the women interviewed are truly phenomenal and I think you’ll find it well worth the time to hear their stories and opinions. I’ll be releasing a new “chapter” every few days; today, I’m giving you the trailer, and over the weekend, I’ll put up Part One, which includes detailed personal accounts from three different families. Part Two (coming next week) opens up the discussion with a few more amazing women and tackles topics like peer pressure, advice from the medical establishment, and guilt. Part Three (also available next week) focuses on the political/social side of the debate.

I look forward to hearing your thoughts on the series. Two of our FFFs are involved – Megan and Meghan – and I’ll be posting a FFF Friday from the latter tomorrow to compliment the release of Part One (which will be up the following day).

Bracing myself for the sh_tstorm to come…

Love,

The FFF


Message In A Bottle: Real Stories of Formula Feeding in America TRAILER from Formula Feeder on Vimeo.

Drying Up: What to do if you aren’t breastfeeding at all

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Turns out there’s quite a few of us pregnant chicks on my private message board who struggled with breastfeeding the first time around who are panicking about feeding our second/third kids. A bunch of people are considering formula feeding from the start, (for the record, the majority are planning on trying again, and even some who formula fed from the beginning with the first child are excited to breastfeed the second), and this got me thinking about the drying-up process.

When I switched FC to hypoallergenic formula after exclusively pumping for about 5 weeks, I was overwhelmed and confused by the weaning advice I found online, and even more befuddled by the advice I got from my OB, who told me to just “go cold turkey”. I’d read on Kellymom that this course of action can cause mastitis and plugged ducts, and that it would be far better to slowly wean off the pump, decreasing my pumping sessions and times every few days. On the other hand, I hated pumping by this point, and resented my breasts and all things having to do with lactation (I’ve healed quite a bit since then, but at the time, with the open, festering wound of PPD still ever-present, I wanted to hurl my nursing bras, nipple shields, breast pads and the pump out the window and never look back. Of course, the pump was a rental, and an expensive one at that, so I’m glad I didn’t succumb to this impulse. I expect that this would have been a case of “you break it, you buy it”…)

Ultimately, I decided to go with the OB’s advice. I hunkered down for 2 days of utter hell, stuffed cabbage in my bra, popped some leftover post-oral-surgery Vicodin, and waited. It honestly did take a mere two days – I was still slightly leaky for about a week, but the bad part was over with pretty quickly.

But those two days were more painful than anything I experienced during labor; painful enough to scare me into nursing this time around just so I can avoid the inevitable “drying up” process that I’ll have to endure if I opt to formula feed from the start. Now, I’d built up a considerable supply by 5 weeks; it might be a less arduous process if one didn’t establish a supply in the first place. Knowing the pain of engorgment though, I worry about the new moms who either have to stop breastfeeding a few weeks in, like I did, or who are choosing not to breastfeed. It seems punitive that there isn’t better guidance or medical assistance for these women. And what about those who experience a stillbirth or infant death?

In some countries, medications are still available to assist with lactation cessation. Not in the US. The most common drugs used for this purpose were taken off the market years ago, due to some serious potential side effects. A newer drug, Cabergoline, is now being used in several other countries, but far as I can tell, there is no real call-to-action in the States for a new lactational suppressant. The latent conspiracy theorist in me struggles with the fact that when the old drying-up meds were taken off the market, it was the same time period that breastfeeding advocacy became part of the medical mainstream. I haven’t had the time to do the necessary research into the frequency of the side effects cited as evidence for the “danger” of these drugs; I wonder if statistically, the risk of side effects was any greater than, say, birth control pills or Viagra or weight loss drugs that are still readily available. The consensus in most of the articles (both scholarly and not) I’ve found is that the “natural” way is better; well, duh, but what if a woman wants some extra help? Doesn’t she have that right? Especially in cases where the lactation cessation is tied to a traumatic event?

A great piece from a 2003 issue of Pediatric Nursing (Moore, Debra Busta and Catlin, Anita; Lactation Suppression: Forgotten Aspect of Care for the Mother of a Dying Child. Pediatr Nurs. 2003;29(5) ), focusing on lactation suppression for women who’ve experienced the loss of a child, explains further:

Very little information exists in the literature on lactation suppression for those women who cannot or do not breast feed. In a comprehensive educational review of alternative nutrition with bottle feeding for newborns (PBM Products, 2001), no mention is made of lactation suppression. Spitz, Lee, and Peterson (1998), in a 100-year review of the literature, found nothing new or helpful to induce milk suppression or to treat the pain or discomfort of engorged breasts. Yet a mother who has established a full milk supply through breastfeeding or pumping will need counseling on strategies to diminish her milk production. Under the tragic circumstances of a baby’s death, the mother’s comfort must not be overlooked (Merewood & Philipp, 2001). Abrupt cessation of breastfeeding or pumping may lead to severe engorgement, extreme pain in the breasts, and possibly to mastitis.

Suppression of lactation prior to the 1990s was done with medications that influenced the brain’s directions to the breast regarding milk production, such as parlodel and bromocriptine. These were eventually found to have other brain-related side effects and taken off the market for milk cessation (Stehlin, 1990)…

What puzzles me is that I can’t find much information on this subject, anywhere. There’s plenty of advice for all types of lactation issues, but not getting your milk to dry up safely and with limited pain. Shouldn’t lactation cessation be considered part of post-partum care for those who are not breastfeeding? Especially as an oft-cited study on how breastfeeding reduces the risk of breast cancer mentions that a similar protective effect was conferred to those who took those lactation suppressants which are now considered “too dangerous”, suggesting that there might be something in the abrupt weaning process that is associated with increased cancer risk?

Anyway. I’m rambling. Point is, I’d like to offer some suggestions for those who are facing the “drying up” process with little support or guidance from the medical authorities or Internet Gods.

1. Cabbage is your friend. Seriously. It sounds bizarre, but this old-wives’s tale is a winner. Buy a head of cabbage (the yellow, not the red kind, unless you want to be bleaching stains out of your clothes for the next century), wash and separate the leaves, and throw them in the fridge. Once chilled, stuff leaves in a snug sports bra, covering the entire breast. Remove and replace with new leaves when the old ones are wilted and no longer cold. I did this whenever I was at home, and it helped so much that I wanted to donate to the Cabbage Association of America, if there even is such an organization.

2. Medical sites like MayoClinic.com suggest taking over-the-counter Ibuprofen to help with the pain. I’m not condoning this, but if you happen to have some leftover heavier painkillers in a drawer somewhere from a c-section or other past surgery…. well, all I’m saying is, there’s no reason to be a martyr.

3. A friend mentioned that Sudafed (the real kind that you need to ask the pharmacist to get for you, since kids these days are making it into meth or something. At least they’re paying attention in Chemistry class) can supposedly help. Not really sure about this one, but Kellymom mentions it as well, so it must have some popular literature backing it up.

4. Speaking of Kellymom, check out this article on herbs used to suppress lactation. It’s geared towards those in the weaning process or who have an oversupply issue, but it might be helpful.

FFF Friday: “Best for her, best for me, best for my family.”

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In honor of Guest Post Week, I chose this submission from FFF Darcie, because she included some great tips at the end of her story – I think this helps it bridge the divide between a guest post and what we normally expect in a FFF Friday story. I also find it really fascinating that she was immune to societal pressures and refused to turn to the Internet for answers – instead, she looked at the research directly. This is rare nowadays, where Dr. Google is the medical expert of choice, and I think it gives her a unique perspective. 

***
I live in a community where, I feel we are allowed guilt free, to feed our children the way we choose.  Maybe I am oblivious or maybe I am lucky.  I am a mother of 2 little girls (2 and 4 years old) who were breast fed for 2 weeks each and then formula fed for the remainder of their first year.  
When I was pregnant with my oldest I didn’t even consider breastfeeding her until a close friend of mine had her son a few months before me and breastfed him.  She has a PhD in epidemiology and is a very “crunchy” person, but doesn’t impose her lifestyle on anyone.  I started to think about breastfeeding and did some reading about what was involved and decided I would breast feed my daughter. It’s simple as that. Black and white. My understanding was it was something that would require practice, but in the end if there were issues it was because you weren’t doing something right, and to go see and LC. 
After giving birth (traumatically – I hemorrhaged and went into shock – thinking I was never going to see my daughter again) I was so happy to be able to hold and nurse her at every moment.  She was a good latcher/sleeper from the beginning and didn’t have a problem. Phew!  Until… I got a uterine infection and had to go on antibiotics.  My choice was to go into the hospital and receive them so I could still breastfeed or stay home but, not breastfeed.  I chose to stay home. I did NOT want to go back into the hospital. I asked my OB if I could pump for the 2 weeks I was on the medication and she said don’t bother she won’t be able to latch again (wrong, but what did I know).  
I was ok about stopping breastfeeding at first. I didn’t (don’t) think formula is bad or I am disadvantaging my children by giving it to them.  I never grew up or had this idealized view that I had to breast feed to fulfill my dream of being a mother.  I unexpectedly missed breastfeeding her and was sad about it for a while, but she was doing well and so was I so, I moved on without a second thought. 

Seeing how well my daughter grew up (never getting an ear infection until she was 2, no allergies, smart, overall a healthy girl) I started to do some research on all the benefits of breastfeeding I had read about while I was pregnant.  I didn’t look on blogs or websites. I went directly to the source research.  I was even more confused! There were just as many studies saying formula-fed babies are just as healthy as breastfed babies as there are studies that say breastfed are healthier than formula fed babies…what’s the deal?  So, I discussed them with my “crunchy”, well-educated-in-such-research-matters, friend.  She said those studies are very inconclusive and her decision to breastfeed was solely a monetary and lifestyle decision. Really?? WOW!

Fast forward 2 years. Pregnant with my second daughter.  I still wanted to breastfeed her because I felt cheated out of my first experience by the improper guidance I had received and really looked forward to having that same positive experience with this child (It was all about ME). Once again, life took over. Daughter #2 was not a good latch and tore me to shreds after one week. She wasn’t sleeping, I wasn’t sleeping. I was stressed about how much time it took to get her to eat all the while in pain, her screaming, me crying and feeling like I was neglecting the needs of my older daughter who only wanted mommy.  I was heading toward an emotional breakdown.  I gave her a bottle of pumped milk and she downed it like I hadn’t fed her in a week  That was it.  Decision made.  Best for her. Best for me. Best for my family.

Come to find out, when my second daughter saw a developmental specialist, she has low muscle tone along with a high palate.  That is why she couldn’t latch properly.  That reaffirmed that I made the right decision – guilt free.  I know there are many people out there that have gone through the same or much more difficult experiences, or there are those that could point to 10 different instances in my story where I was lacking support or whatever keyword of they day may be. It comes down to the fact that everyone has different tolerance levels and desires to overcome the roadblocks involved with breastfeeding.  That’s life, it’s not perfect.  No one is the same. No one has the same combination of life’s circumstances.  Get over it and move on, sista!

Life’s about learning and growing so, here are my lessons learned for new moms:

1. You don’t know what life is going to be like when the baby comes and under which circumstances.  Go in with the best intentions and come out with realistic goals.
2. Surround yourself with people who have your (family unit) interests at heart and are willing to do what it takes to support you.
3. Don’t fall prey to people with ulterior motives.  Educate yourself and make a decision that works for your family.

4. Trust your instincts!
 

***

Ready to share your FFF Friday story? Send it on over, red rover… formulafeeders@gmail.com

Guest Post Week: Formula feeding and maternal happiness

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For our last Guest Post Week feature (well, not counting FFF Friday tomorrow), I chose a submission from Joy Paley over at  An Apple A Day . Originally, when this article was pitched to me from someone who works for what is described as a “guide to health care schools” blog, I wasn’t sure the material would be relevant or appropriate to what I’m trying to accomplish here. I was really surprised, then, when I read the actual piece, and found it to be right up the FFF alley… it’s great to see someone else taking a closer look at one of the many studies comparing breastfeeding to formula feeding.
***
Study reports (surprise) no difference in psychological health or infant attachment between breast and formula feeding moms
Joy Paley is a blogger for An Apple A Day and a writer specializing on medical assistant schools for Guide to Health Care Schools.
I know you frequent readers of FFF might initially roll your eyes at this study about maternal happiness, since its conclusions may seem obvious. The research, which looked at psychological health of new moms and their attachment levels to their infants, showed no significant difference in these arenas between women who were breastfeeding and those who had weaned their babies.
The research, out of the School of Psychology at Australian National University, isn’t terribly new; it was published in The Journal of Reproductive and Infant Psychology in 2006, but there are so many gems in it that when I found it I knew I had to share. It directly challenges many popular notions about breastfeeding and maternal health and is refreshingly unlike the scientific rhetoric in other studies that FFF has helpfully picked apart before.
For one, the authors directly recognize that maternal happiness has not even been mentioned in the large amounts of literature that have come out in support of breastfeeding. In their focus on physiological and immunological benefits of breastfeeding, these studies have completely left out the experience of the mother. “Possible negative maternal experiences of breast feeding and those experiences of formula feeding mothers have largely been ignored in research to date,” says this paper.
Another remarkable part of this study is that it recognizes and discusses the methodological shortfalls of previous studies about breastfeeding moms and happiness. These studies had some serious issues in how they evaluated the psychological health of new mothers; they didn’t differentiate between current or past breast feeders, or women who had used formula from the birth of the child. Some had very small sample sizes, and others measured the women’s psychological health at varying times throughout the pregnancy.
Wait, there’s more: these studies also used psychological distress scales that are inappropriate for a woman who has just given birth; i.e., they count sleep disturbances and tiredness, normal parts of becoming a new mom, as probable signs of depression.
With these previous issues in mind, the researchers in this Australian study stated that the empirical evidence claiming that breastfeeding mothers were happier was mixed at best, even though that is the popularly held assumption. They set out in their study to challenge these commonly held notions and correct the methodological problems found in previous research.
To do the study, the researchers collected data on 60 new breast and formula feeding mothers using a 30 minute interview and a questionnaire. Standardized methods of quantifying psychological states such as life satisfaction, happiness, anxiety, depression, and maternal attachment were used to assess the well-being and attachment levels in the two groups.
And, drum roll please: no significant difference was found between the breast- and bottle-feeding mothers in psychological well-being, anxiety, or feelings of attachment to their infant.
“No evidence was found to support assumptions that breast feeding mothers have greater psychological health or have greater perceptions of attachment with their baby than mothers who are formula feeding their infant after weaning,” said the researchers.
I found the posture of these social scientists and the way they framed their research question to be quite encouraging—here are academics who were not simply looking at data on infant immunity and ending their papers with curt statements like “breast is best.” I’d probably attribute this to the fact that the researchers here are psychologists rather than, say medical doctors. There is an effort made to look at the potential social impact of the dominant opinion that breastfeeding leads to more happy, caring moms, and to thoroughly put to question that popular assumption.
Their final statement of the paper reflects this, and I have to agree with them: “Until more research is undertaken on maternal experience of feeding a baby, widely help assumptions may continue to place excessive and unnecessary pressure on new mothers.”

Quick thoughts on the Similac Recall

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In light of the Similac recall, I debated breaking into Guest Post week to blog about these current events. I was torn – on one hand, I would love to be conspicuously silent on this, out of respect for the parents and children affected by this recall, and as a peaceful protest against those who are blowing this out of proportion in order to add fuel to the anti-formula fire. On the other hand, it’s important to make sure people do not panic. And I feel like if I ignored these events altogether, it would be unfair to any readers affected by the recall.

I hope that Similac is handling the recall in the most responsible way possible. So far, I think they have been doing a fair job. (Although I just heard that their site crashed last night, making it difficult for parents to get the answers they so craved – I hope that this has been resolved.)  For my part, I just want to point out a few things to try and alleviate some of the understandable terror that formula feeding parents are experiencing – and then we will get back to Guest Post Week, I swear!

1. While the thought of beetle larvae in our children’s food is utterly pukeworthy, it may help to realize that bugs aren’t arsenic. I’m in no way excusing what happened, just trying to provide a bit of perspective. Obviously, you don’t want to feed your child the tainted formula, but at the same time, if you did unknowingly offer Junior some Beetlejuice in a bottle, he will be okay. As Similac stated on their website, there is a risk of some gastrointestinal problems or a “refusal to eat”. (Um, yeah. If my mom gave me food with ground up beetles in it, I’d probably want to avoid her cooking for awhile…) But with these recalls, legal departments make sure that companies mention any possibility of worse-case scenarios to avoid litigation. I don’t believe that the tainted formula is life-threatening. Just gross and disturbing.

2. I don’t blame anyone who wants to switch brands after this disgusting development, but I also think we need to remember that ALL formulas are subject to recalls, just like any man-made or man-handled product (and this includes banked breastmilk, for the record… just because it comes from a human does not mean damage or tampering can occur in the transfer process. That milk still needs to be stored, transported, and delivered). Recently, some cans of Nestle’s Good Start Formula were found to have been tampered with. This is an unfortunate aspect of formula feeding, and while I think it’s inappropriate, immature and just plain rude for people to be gleefully yelling “breastmilk doesn’t have beetles” from the rooftops, the fact is, they are right. For most of us, though, our decision not to breastfeed did not come lightly, and we have already performed endless risk-benefit analyses. It’s kind of a moot point. Companies should be held accountable and pressured to uphold the strictest of quality standards… but other than that, you have to take a leap of faith. They will never be able to control everything. At risk of perpetuating the fear mongering atmosphere of the past 36 hours, I have to bring up the fact that tampering can happen long after a product leaves the auspices of the company that produced it. (Think of the razor-blades-in-Halloween-candy scare that happened in our childhoods. I bet most of us still eat Snickers bars though…) Raging against formula companies is only attacking part of the problem here, unfortunately. But I’m taking a step back, and reminding myself that millions of babies (including mine, who was raised entirely on Similac after his first month of life), over several decades, have been nourished perfectly safely by these products. Statistically, we’re in pretty good shape.

3. If you don’t feel comfortable using the same old Similac you’ve been using, it’s perfectly okay to switch to a comparable version made by another brand. In my completely unprofessional opinion, I’d choose one of the “sensitive” formulas as a temporary replacement, simply because they are gentler on the stomach, and sometimes when you switch brands there can be a little adjustment period. Another option might be to switch to the liquid version of your usual Similac formula, as these were not affected by the recall. I think this goes without saying for the readers of this blog, but just in case – do NOT give cow’s milk, any other kind of milk, or Pedialyte as a replacement for formula. That would be far more hazardous to your baby’s health than a few bug limbs.

I’m not going to go too far into my feelings about how the mommy-blogosphere has used the Similac recall to demonstrate its ugliest side. At best, we’ve seen pity towards formula feeders; at worst, unrestrained gloating about yet another benefit of breastfeeding. Interestingly, when the recent Tylenol/Motrin recall happened,  I didn’t notice anyone posting about how proud they were of letting their child burn up with fever rather than allowing them to have potentially tainted medication.

I lose more faith in humanity by the day, but especially in the portion of humanity that have vaginas. This is why I had so few female friends in high school. You don’t see fathers turning on each other like this. (Thank god for people like this, who help me think all is not lost.)

Speaking of which, check out this post – a dad’s point of view on the whole mess. It’s rad. Really, really rad. I think I have a crush on this “Christian” dude.

And now…back to Guest Post Week (considering how my hits have skyrocketed in the past few days, it’s clear that y’all would rather hear from other people than from me, so I better get back to it, huh?) Later tonight, I’ll put up an interesting piece on a study about the psychological health/infant attachment of breast and formula feeding moms, by a blogger from An Apple A Day.

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