Guest Post Week: The Bottlefeeder in Room 1 (or, why I think extreme baby-friendly policies aren’t very friendly at all)

FFF Lililly recently had her second child, a ridiculously beautiful little girl. I was anxious to hear how her delivery and hospital stay went, as I was aware that she was giving birth at one of New Zealand’s “Baby Friendly” hospitals, a place where a mom who was choosing to formula feed would have to bring her own formula and supplies. Right around the time Lililly went into the hospital for her c-section, this type of policy had been hot news, provoked by several British hospitals initiating similar “baby friendly” initiatives. The internet was abuzz with debate (inspiring discussions on sites like this one and that one), but despite understanding why someone might feel that withholding formula could raise breastfeeding rates (in Norway, the “lactivist mecca”, for example, banning formula from hospitals has correlated with an incredible rise in breastfeeding initiation), my argument remains thus:

In their most extreme version (i.e., only allowing formula if it is deemed medically necessary), “baby friendly” initiatives are not mother friendly. 

Rather than argue this point on an intellectual level, I asked Lililly if I could reprint the following entry (actually, a hybrid of this post and this post) from her own blog (which, incidentally, has the most gorgeous photography- I’d highly recommend checking it out) to illustrate the point in a more visceral way. When I read her story, I couldn’t sleep for two days – I was that angry about it. I’m interested to see if any mother can read this and not feel angry about how this woman was treated. This goes so far beyond “promoting” breastfeeding, in my opinion. This is taking us back to a time where women were at the mercy of medical professionals; a time where we were knocked out for the birth and not trusted to manage our own bodies or babies. I know that reminiscing about this anti-woman type of healthcare is a popular argument to support pro-breastfeeding policies, but this logic is flawed. As Lililly says, there has got to be a middle ground here, a way to support women in whatever manner they decide to feed their babies.

***

The Bottlefeeder in Room 1

by “Lililly” (reprinted with her permission from her blog)

After her daughter was born via c-section, Lililly’s birth experience took a bad turn:

…The recovery room wasn’t very nice. I had nice nurses looking after me but there was a major kerfuffle over the fact I wasnt breastfeeding and being so emotional and tired I was just losing the plot. They kept saying how hungry she was and how she needed to be fed. We hadn’t realized we would need our bottles and everything for the recovery room as well, so we had left that behind in the car. It was stupid of me as it was my idea to do that and I KNOW what Auckland hospital are like about bottle feeding. Simon ended up having to get changed quickly and run down to the car to grab everything. Meanwhile nurses kept coming in and out saying how starving Evie was, and how I needed to feed her right then. I lost the plot and started bawling my eyes out. The lady next bed over was trying to breastfeed but her baby wouldn’t latch. I heard htem telling her it was okay and that babies didnt actually need to be fed much right away and it would all be fine. Why the double standards for me?

Both my midwife later and a couple of nurses on the ward I stayed in mentioned they could of just rung up to the ward for a bottle to be sent down. And anyway..they had all the stuff there as well.

Simon returned, but by this point I was utterly beside myself. I couldnt even sit up so I couldn’t feed Evie myself and I asked Simon to do it. I was dissapointed. Another baby I missed out on the first bottle with.
I don’t care what anyone says, but it’s a pretty strong bonding moment, especially those first few feeds, and I felt horrible about it.

It wasn’t until I was settled into the wards that I got to really spend some time with Evie but it was so worth the wait. She hardly cried, and was so alert just looking around at the world. I will never forget those first few moments if just staring into her eyes no matter how many years pass.

My stay in hospital was an interesting one. I really thought this time I would be more prepared, more mentally able to cope with any questions, looks, having to give reasons 1 millon times to the 1 million different staff. But in all honesty, I really wasn’t… Not in the slightest. In fact in some ways I think I was less able to cope. Like the past 19 months of judgment have worn me down to next to no coping reserves.

After the utter crap that was the recovery room, I didn’t hope for much getting to the wards. My midwife had told me a few weeks prior to the birth that Auckland National Woman’s was a ‘baby friendly’ place and therefore no longer supported formula feeding, so in preparation, we had brought everything of our own including sterilizing tablets and a container to put them in. But of course we still needed water and boiled water to make up the bottles so Simon went off as soon as we got wheeled into place to organize things and figure out where to get this boiled water from. We had NOT brought our own kettle from home because we assumed there would be a way of acquiring boiled water at a hospital. After a short time he was back with us saying ‘this place is weird!’. He explained that he wasn’t hopeful for help either after what had just happened, but the first nurse he came across and had explained what he wanted to had actually pointed him not only in the direction of the ‘Formula Feeding Room’ (a locked room where the ONLY kettle in the ward is and bottle feeding supplies are) but also said ‘oh and you will need sterilization tablets etc..’ and made a move to get them for him. When Simon explained we had everything and what we had been told the nurse apparently had looked a bit shocked and said ‘jeez we are not that bad now are we!?’.

Yeah guys, you are.

The first night I was there was kind of horrid. After a c-section you are not really able to move for a few hours but of course being a ‘baby friendly’ hospital, baby is also roomed in with you. Which is fabulous except if your baby starts crying you cannot do anything except ring for the nurses and midwives and hope someone turns up shortly to help. The first midwife I called gave me this long stare as i told her baby was hungry and I needed a bottle made up. Eventually she sorted out the supplies but instead of using our formula went and got some of the pre-mixed stuff and used that. It requires no boiling water of course (which is down the other end of the ward behind that locked door) and just needs heating up. But she wasn’t friendly about it at all and immediately I started feeling bad.

I sat and berated myself for being so selfish. And then I sat berating myself for berating myself over it.
The midwife who was actually meant to be looking after me came in with her helper not long after to sort me out and make sure I was recovering all okay. Round two of the ‘I’m bottle feeding conversations’ ensued when I asked if they could fill my flask up with boiled water so I could make bottles myself. The midwife went off somewhere and the helper asked me if i wanted to use the pre-mixed stuff as it was easier and I was shocked. ‘But you don’t support formula feeding here’ to which the helper said, ‘well some of us don’t, but we don’t say anything about it.’ before walking out. The midwife returned shortly after and actually asked me what my reasons for bottlefeeding were so that she could ‘tell the others to shut them up’.

What? They are talking about me? Are they sitting their referring to me as the ‘Bottlefeeder in Room 1’?
I explained to her, all the while thinking ‘I shouldn’t HAVE to do this!’. I was angry, and I was ashamed.

All those feelings from earlier came rushing back and I began to cry – which, I think, made the midwife feel guilty and so off she went to ‘shut the others up’, I presume.

I had wanted to ask for milk suppressants that night, because I figured they wouldn’t offer them to me (and I was right) but I actually was too scared. I was too scared to ask for medication to make myself more comfortable. Isn’t that stupid? When I did finally get the courage up to ask for them by the way, I was told it was too late and I should of asked the day baby was born. I would have to deal with the consequences.

The next day was abysmal also. I was feeling pretty low already though and I got sick of explaining myself every two seconds which made those low feelings even worse. I got comments and I got the looks.
 I really started feeling like a second rate citizen. Like I didn’t deserve being cared for.

I realize now that I’m obviously still hung up with guilt about formula because from that moment on I really started punishing myself. I stopped using the pain meds as much sub consciously and I didn’t ring the bell for the nurses/midwives unless I was totally desperate for help. I would do more than I should of moving wise because I didn’t want to explain again and again or have them sigh as they went off to find boiled water. I didn’t want the bell to be rung and then look up at the screen and think ‘oh its that bottlefeeder in room 1 again’.

Idiotic. I know.

By the time I had some nice supportive carers I had given up completely on the feel good about myself feelings and I was really worried about what all the hospital staff were thinking of me. I was totally paranoid.
One night a lovely tiny Indian looking midwife started working my end of the ward. She came in and saw me being a bit distressed (pain, Evie not sleeping etc) and asked if she could take Evie from me down to the nurses station for a few hours so I ‘could get some rest’ and since I was ‘bottlefeeding and it was a quiet night it was no problem to do at all’. I was so paranoid that I actually refused. My immediate reaction was ‘then they could prove I’m a lazy bottle feeder by handing my child off!’. No way, all the breastfeeders no doubt have their babies with them, I will do so to.

Eventually I ended up breaking down in front of this midwife and she was the nicest person I have ever come across in a hospital. She was angry and demanded to know who had asked me my reasons, as it really was irrelevant to anyone and non of their business. She wanted to know who had said bad stuff to me but I shut down and didn’t answer.  I had to deal with these people again, I wasnt naming names. I told her in between heavy sobs how I felt I was a bad mother because I was so selfish. She listed reason after reason explaining how I wasn’t.

Each night she would come in and ask to take Evie and on the third or forth offering I took her up on it. She made sure I was medicated enough and after a while she was the only one I really trusted on the ward.

I really wish I had said goodbye to her and wish I told her how much she did for me before I left. She made all the difference to surviving my stay mentally (event though she must think I’m a crackpot for the amount of times I broke down in front of her!).

The other thing that got me about hospital was the lack of knowledge on formula feeding by the nurses and midwives. Some thought it was okay to use the Zip water for making up feeds (which I didn’t). One asked if I wanted to make up a whole lot of bottles in advance and keep it in the little coffee kitchenette at the end of the hall so it was accessible (which I didn’t think was a good thing to do).  Most thought it was fine to keep a small supply of boiled water in a flask in my room with the bottles but another one, when asked to let me in the locked room so I could fill my flask up, kind of told me off for doing it that way and told me that I should always always boil the kettle and let it cool for 10 minutes before making any bottle up.

I think that’s what makes me angry the most about my stay – the lack of knowledge. If I wanted help breastfeeding I would of had 10 trained professionals bear down on me within seconds. If I needed help and advice for safe preparation of bottles – no one knew. That is ridiculous… and unsafe!

I kind of want to write a letter but I think it will fall on deaf ears. The whole problem with this ‘baby friendly’ pro breastfeeding stuff is that I think its a good thing deep down. I want it to be the social norm to breastfeed your child but I also want to have proper advice and measures in place for people that can’t or don’t.
Why is so difficult to have a happy and safe medium?

I don’t know if we are done having kids yet. I don’t know if can keep having children as I have a buttload of scar tissue apparently and I’m not sure what that means for future c-sections. But one of the biggest reason I may not have any more is the fact that hospital scares me now. I let it all get to me and I let them make me feel bad about myself. I let myself believe I’m a bad mother and it’s not a good way to start off with a new child.

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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12 thoughts on “Guest Post Week: The Bottlefeeder in Room 1 (or, why I think extreme baby-friendly policies aren’t very friendly at all)

  1. I am so so sorry that this happened to you. I also gave birth in a NZ hospital (Wellington)and I also had a c-section. I found the whole experience of the five days I spent there before I was finally discharged quite traumatic and I wasn't dealing with the kind of crap you were. Your story made me cry and it made me angry.

    (Actually, you are the person who put me onto FFF through your link in the OhBaby forums – thanks so much for that.)

    I had planned to BF but my milk never came in properly. I am pleased to say that the hospital encouraged me to formula feed when my baby showed signs of dehydration and told me that it would be ok if I wanted to give up on breastfeeding instead of starting a grueling pumping regime (although I elected to pump). The hospital also provided me with formula and assisted me to feed with lactaide although they would have given me bottles if this is what I had chosen. They provided me with pamphlets on formula feeding and the LC gave me advice on how to use formula,what kind to buy and how to sterilise the equipment. The only sour note came when some clinician I had never met before came into my room before I was discharged and lectured me on how I 'shouldn't become too dependent on formula' once I got home. Guess he didn't know about my baby losing more than 10% of his body weight and my strenuous efforts to make my milk come in.

    I like to think that if I had decided to formula feed from day 1 that the hospital would have been as supportive but I really don't know. Certainly they were pretty inflexible about letting my partner stay with me on the first night. I have never felt so disempowered as when my baby cried and I couldn't even sit up because of my caeserean wound and being hooked up to the bed with an IV and catheter. I could barely even reach the call button to get someone to help me.

    I so respect you for being strong enough to make the best decision for you and your family and sticking to it despite all the crap the hospital gave you.

  2. First off, congrats on your sweet new baby! Give her extra love and hugs from all of us here, okay? 🙂
    Second, I'm stunned at how horribly you were treated. You are NOT a bad mother! At all! That hospital staff simply were ignorant beyond words. We know you are doing what's best for your family. You know that too. I hope you are able to gain your confidence back now that you're home. Don't let “the man” get you down, girl!

  3. Oh, Im so sorry to hear that…it's not the place of the medical professionals to judge you and make you feel bad. That is very UN professional and does the baby no good, if the mother is a wreck.
    It's very inefficient to not have some kind of standard in place for formula feeding, because even if BFing is preferred, reality is that formula feeding is sometimes necessary and it should not be difficult for FF moms to feed their children.

    I hope things, including your feelings about yourself as a person and a parent, have improved since your DD came. (congratulations, btw!) I'm glad there was at least one midwife there who was a kind, gentle person.

  4. It's over-correction. Most hospitals have treated breastfeeding moms so horribly and ruined so many perfectly good breastfeeding relationships with really bad information in the last… oh, 50+ years that they are now over-correcting.

    Even just 18 months ago in an affluent hospital in the San Francisco bay area I had formula pushed on my baby behind my back. They refused to let me keep him 24 hours a day, they always had to take him to the nursery for some reason or another and he always came back with a full tummy, too sleepy to nurse and with a pacifier in his mouth (which I always promptly threw away!). If I had not been an experienced breastfeeding mother, I may well have given up when he wouldn't latch due to nipple confusion. I cried for months thinking about what they did to him and worrying about how damaged his precious preemie insides may have been and feeling guilty because I ALLOWED it to happen (may have been mostly hormones!). I, too, am scared to get pregnant again due to the horrible treatment I've had at two separate hospitals. The first was great about breastfeeding, but horrible about me wanting a natural birth. The second was great about allowing my natural birth, but horrible about breastfeeding. I fear I am left with no choice but to homebirth this next one! Keep all the riff raff out!!

    In any case, it's not okay for any hospital to treat any mother poorly, or to go against her wishes. WE pay THEM and sometimes they need to be reminded of that. I do think it's going to take a long while for them to find balance. In a place with so many people and so many different opinions… each one really has to be able to balance and as is well demonstrated by the “mommy wars”, that's not an easy thing to accomplish.

    And I'm sure each hospital has formula and feeding supplies for it. I think baby friendly hospitals are simply required not to give infants any other liquids unless it's medically indicated (exact words:”6 – Give newborn infants no food or drink other than breastmilk, unless medically indicated.”). So, if formula feeding is elective, the hospital isn't allowed to provide the formula and still be in compliance with the initiative.

  5. Wow…just wow. I am so sorry that you had such a horrible experience, I cannot imagine going through all of that. It sounds like you handled that with grace and poise, and I commend you for that.

  6. I think the “baby friendly” hospital, at least in this context, and how Leanne interprets it is horrific! It's the exact thing breastfeeding mothers have been fighting against. Formula isn't harming children (unless prepared improperly) why should it not be supplied in hospitals? Breastfeeding or formula feeding whatever the mother chooses should be what the hospital respects and follows, and doesn't try to undermine EITHER realtionship.

  7. This story is so sad, and makes me so angry. What's supposed to be a joyous time is being turned into a traumatic one, so this hospital can claim to be doing what's best for baby.

    As FFF said, there MUST be some way to find a middle ground. I don't understand why any hospital would believe that the best way to encourage breastfeeding is by crushing formula feeders into a fine paste. Is support for EVERY mother really that difficult of a concept?

  8. Your story brought tears to me. I'm so sorry you had to deal with that. Baby friendly hospitals in general (even here in the US) are so not good. They just make you feel bad if you have problems.

    I'm really hoping I can have a homebirth next time, I don't want to deal with a hospital, nursing staff, and all. I hated my stay with a passion.

    You are a wonderful mother!

  9. You are very strong for standing by with what you think is best for you and your family despite the horrific experience at that hospital. I cannot believe the great disparities in today in our hospitals for maternity treatment. It always seems one extreme to the another and didn't they tell us in school 2 wrong does not make a right? I think it is awful that you the patient lending yourself to their care and they cannot even at least give you proper care after a C-Section. These are major surgeries. Anyone who has receive open abdominal surgery would expect the nurses and staff to do the same by bringing them x,y, and z and your case your beautiful baby when they call for nurses to help. Also to add, it is dangerous they cannot accommodate formula fed babies as it the best to give newborns ready made disposable bottle formulas so that you would not need to worry about contamination with formula powder and water.
    On a different note. I sometimes believe that care women were given over 50 years ago wasn't all that bad. It was unfortunate that they did not encourage breastfeeding, but I have spoken to many elderly women in an interest group I belong to and some of them actually breastfed in the 50's. Most of tell me the same thing:they believe they received better care then than women do now. They spent at least 5 days for normal vaginal delivery. C-Sections were 10 days. They had nurseries and received sitz baths throughout the day. Mind you my hospital sent me home 2 days later with a really crummy sitz bath bucket as I was told they don't do sitz baths there in the hospital. This one was useless. Overall it seems like according to these women I spoke to they were just more well-rested and had time to adjust when they went back home.
    Lililly -Many hospitals have patient advocates or something of that matter. I do not know what New Zealand's policies are, but I do hope that you can bring this to the attention of someone there that's in charge. In the meantime, give yourself a pat on the back for sticking up for yourself during such a vulnerable time and enjoy your new little one.

  10. Thanks for the support everyone. It was a seriously trying time, like the first few days after having a baby are not hard enough!

    @Helen from NZ
    Isnt it horrible not being able to get to your baby after a CS!? I loved that the Eclair was roomed with me but at the same time it was hellishly stressful waiting for a nurse or midwife to come change and prepare to feed her.

    I do know they were much better with women who supplemented in National Woman's, as other mamas i know had their babies there and when they had the occasional issues they were treated really well and if they wanted it, formula was given. Its the double standards that pissed me off.

    @Amy – Don't worry there is a 'Formula feeding room' which had supplies in it for those who needed it, however it was locked (although i ended up ninja-ing the code so i didn't have to ask to be let in constantly!) and as i said just above, mums who needed formula because they were having trouble BFing were treated well so that is really good.

    @leanne – the 'only if medically neccesary' thing is scary. There are other reasons women don't breastfeed. I am one of them.
    And as i had said, I was quite prepared to use my own supplies, i didn't care that they didn't give out formula to those of us who 'elected' to use it from Day 1, that is fair enough IMO as breastfeeding SHOULD be the number 1 go to and their supplies should be used for emergencies.
    What pissed me off was the next to no support i received as a new mother and the shear lack of knowledge on formula by hospital staff. AND the guilt tripping in an effort to get me to BF by some of the nurses was utterly disgusting. It had been written in my notes in a hundred different places that i would be artificial feeding by a range of doctors and midwives before i was even admitted into the hospital – no one should of questioned that or made shitty comments about my 'choice'.

    Really really like what the Anonymous person above said – “Breastfeeding or formula feeding whatever the mother chooses should be what the hospital respects and follows, and doesn't try to undermine EITHER relationship.” – EXACTLY.

  11. Wow! So sorry you had such a bad experience. How you feed your child is a very personal decision, and your hospital should never give you a hard time about it– whatever you choose. Here in the US hospitals vary a lot. If you decide you want another child, you might try another hospital. A lot of US hospitals will actually let you take a tour and ask questions. Some expectant parents do so early in the pregnancy– so they have time to to switch if they don't like what they find. We also have these agents called patient advocates to help you resolve issues with the hospital; federal law requires them to give you one if you ask. I have no idea how the NZ system works. Sorry if the above advice doesn't apply.

    As Michelle K wrote, it might be helpful to just bring some ready-made formula in disposable bottles for your hospital stay. That way you wouldn't have to prepare or ask for them. They're a bit pricey, but perhaps worth it for a few days in the hospital.

    It kind of bothers me that WHO and UNICEF call their initiative “baby-friendly”. Breastfeeding can be great. Those who want to attempt it deserve support. So do FF mothers. I think the name “baby- friendly” could induce some guilt for moms who don't BF. (Do WHO and UNICEF mean that formula is baby un-friendly? I don't, just to be clear.)

    If babies could talk…I think a lot would say “Thanks so much for helping us BF!”

    I suspect others would say things like “When I was in Mommy's tummy, she spent a lot of time reading and thinking about how to feed me. She chose to FF– and for good reasons. When I was born, you [i.e. the hospital staff] were really nasty to her for not BFing. You made my mommy cry. You jerks! Those were supposed to be happy, peaceful moments, and you ruined them for us. I'm doing just great on my formula. I have a happy, healthy and well-adjusted mom. That's a huge gift to me in and of itself. It's MY MOMMY'S body, HER baby and HER decision– NOT YOURS. Bugger off.”

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