Surviving the “baby friendly” hospital: Tips for those planning to formula feed

As we’ve discussed before, if you frequent the Internet or read breastfeeding literature, you probably suspect there are only two kinds of hospitals in the United States: those that are ardently pro-breastfeeding, and those that sabotage breastfeeding from the get-go. I honestly think that most hospitals fall somewhere in between; there are so many great physicians and nurses out there who simply want to ensure that baby and mother are healthy and surviving, and while they hopefully support breastfeeding, they also do not pressure anyone into doing something they’re not comfortable with.

However, I also realize that there ARE hospitals in this world that do fulfill these black and white “myths”, and depending on what side of the fence you fall on (planning to breastfeed or planning to formula feed), it can be a daunting prospect to enter your labor and delivery suite knowing that you must stay on the defensive. For those planning on breastfeeding and potentially dealing with a less-than-breastfeeding-friendly care center, I highly recommend going here and here, where there are some excellent tips for handling the situation and keeping your breastfeeding goals intact.

This post concerns those who have chosen to formula feed from the start, though. And I have particular concern for these women, because as more hospitals veer towards implementing baby-friendly policies, I fear that they will be in a sensitive situation, at a time when the last thing they need is more pressure or worry. This is not intended as an argument against Baby Friendly Hospitals; it’s simply here to provide some guidance and foresight for those who might be making an “unpopular” choice within the microcosm of their intended hospital for delivery.

I’ve never encountered this situation, personally (with my first, I was committed to breastfeeding and found the hospital to be supportive but not dogmatic, which I appreciated; as for the second, well, that still remains to be seen – I’ve heard from friends that they’ve upped the ante quite a bit in the two years between my deliveries), so I asked readers and Twitter folks to share their tips/idea/experiences. The following are the best tips I could find on making your bottle-feeding postpartum experience as positive as possible.

1. Forewarned is forearmed. OttawaAli suggests, “Call the hospital ahead of time and find out the responsibilities of parents who plan to formula feed. What they need to bring, etc. Find out what is available at the hospital.” Adds Lililly, who recently survived her own baby-friendly experience, “Make sure to take all your own equipment that you will need. This may already be policy for formula feeders in the hospital but it also means you don’t need to use their stuff constantly.” If you are delivering in a truly baby-friendly designated hospital, they may not provide you with bottles, sterilized water, and formula. The easiest thing to do is to bring a bunch of those ready-to-feed, newborn-size bottles – you can order them on Amazon (for example, these little suckers are what our hospital gave FC when we had to supplement for his jaundice). That way, all you need to do is attach the nipples and you’re ready to go.

2. Enlist help. Says OttawaAli, “Let the care provider (OB or Midwife) know, and ask them their advice/ opinion on what to do and how the hospital handles people who do formula feed.” Another anonymous mom advises that you meet the staff ahead of time and “find your allies”. With the state of our healthcare system, neither of these suggestions may be feasible, but you probably will find some nurses more friendly and receptive than others. As soon as you find one you can trust, confide in them. Let them know your concerns and ask if they can help you out. 

Also, put your significant other, friends, or family to work. This is seriously the last thing you should be dealing with, considering you just birthed a baby. Rather than flowers or balloons, ask your loved ones to bring their game face and make them do your dirty work for you. They can talk to the charge nurse and politely let him/her know you have made your decision and expect it to be respected; bring you supplies if you need them; and generally be available for emotional support. 

Still, if push comes to shove, you might be surprised at your inner lioness. “I was frequently visited by an extremely pushy LC. The first visit, she gave me the Breast is Best lecture and said she would be back – even after I asked her not to come back,” Mary (of Another Mommy Blogger) tells me. “I explained to her that there were probably other new moms in the hospital who would love her advice and she was wasting her time with me. She came back one more time, by this time I was able to walk (I had a c-section). I got up and firmly (yet politely) told her to leave my room and she was not welcome back. My fiancé thinks I over reacted, but the postpartum hormones didn’t help and looking back, I’m proud that I didn’t just flip out on her!” I’m proud of you too, Mary. I probably would’ve kept quiet and then cried myself to sleep that night. Ah, the joys of postpartum depression…

3. Consider including your feeding intentions as part of your birth plan. That way, you have it in writing. You may want to include a wish to avoid a visit from the lactation consultant – just let them know it would be a waste of your time, and hers. OttawaAli also suggests making a sign for the bassinet, saying “something to the effect of ‘we have decided to formula feed, we hope that you will respect our decision’. 

4. Put pen to paper. With those postpartum hormones raging, it may be easy to fall prey to judgmental or guilt-inducing comments. Lillily provided my all-time favorite suggestion, via a lament about her own experience. “I wish I had written down all the reasons why I was going to use formula and why I’m a good mother so I could read it during weak moments.” If you have legitimate reasons why you don’t want to breastfeed, own those reasons. (This is not to say that you can’t change your mind – that happens all the time, in both directions, and that’s a really cool, go-with-the-flow way to approach things, too.) You are a good mom because you put your time and research (not to mention your heart) into making this decision; the best thing you can do for your baby is FEED him/her and be happy and confident doing it.

It’s important to note that the nurses and doctors are often caught in the crossfire, here. If hospital policy is breastfeed-or-bust, they have an expectation from their employer to comply. There’s a fair amount of political pressure, and no one wants to be seen as “anti-breastfeeding”. So give them a bit of a break. As Lauren, a postpartum nurse (and formula feeder) wrote to me, “We do not pressure anyone into breastfeeding. We are advocates for it, however we do not look down upon formula feeders. Every momma chooses what is best for her and her babe! Now the lactation consultants like to pressure, but only if you come in and declare “breastfeeding” – and that is because they don’t want anyone to give up if they really want to breastfeed.” 

On that note, I want to end this post with a story that I received through my plea for help with this subject matter. I think it exemplifies the difference caregivers can make.

R’s story:

“When I got to the hospital for my induction, we told the nurses we weren’t breastfeeding for medical reasons, so don’t come wake me for feedings or whatever. I don’t know if we got into details, but the nurses didn’t seem to care either way. But I had prepared my husband to keep pesky lactation consultants away once the baby arrived.

Then the baby arrived. And peed on the doctors. And had a seizure. And stopped breathing. Suddenly, lactation didn’t matter. I never got the “breastmilk will save your NICU baby speech” because my son wasn’t allowed food (for very good reason). We didn’t hold him until day 6, and that was also the first day he got real food, not through a PICC line, not through and IV. He got food through a feeding tube, and it was formula. None of the doctors or nurses seemed to care what he got – his diagnosis was no longer something life threatening, the new diagnosis meant he could eat, and we were all over the freaking moon. Nobody butted in and said “breastmilk is best”, all the doctors and nurses instead “boy that kid can EAT!” (Which is a very good sign for a NICU baby). Every time I made the long walk to the bathroom – and I made the walk a lot, as any post-partum mom knows – I passed the pumping room. I saw the heavy duty milking machines, occasionally saw the room closed and in use, and didn’t really think much of it. Believe me, in a Level IV NICU, where my 6 pound baby was a GIANT, everyone is so focused on keeping the dangerously premature and sick babies ALIVE that they don’t care much where the nutrition comes from.

My milk came in an hour after I held my son for the first time… I told our primary nurse about it, but she didn’t rush to get me on a pump, she just smiled and asked if I needed some wipes for my bra. And when it came time to take our brave little guy home (Day 12, he was the picture of health and still is), our primary nurse raided the pantry and got us extra formula samples at our request. Since Level IV NICUs very rarely ever discharge babies straight home (their patients are too sick for anything than a lower level NICU), she didn’t have more than a basic goody bag, and she tried to add as much as she could.

I’m guessing that my hospital experience is much more positive than most… But I can’t tell you how nice it was to have everyone NOT adding pressure I certainly didn’t need during the hardest 12 days of my life.

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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8 thoughts on “Surviving the “baby friendly” hospital: Tips for those planning to formula feed

  1. I worked in a baby friendly hospital that required a doctor's prescription for formula. People might want to find that out in advance and make sure their doctor is on board with their choice. I heard of a situation once with a crying mom, a hungry/crying newborn and a resident who refused to write the script. (I clicked through to the other post, but haven't read yet, sorry if this is duplicate info.)

  2. Amy,
    OMG that is appalling. Humans have invented a lifesaving breastmilk substitute only to then ban it?

    I would just rush to the nearest store and get formula and bottles in that case. I find it funny how so many people who are pro-choice in regards to a woman's uterus are very anti-choice when it comes to the use of her breasts.

  3. After having a traumatic home birth which ended with a transfer to the hospital (totally not home birth was sold to me as btw) I was so exhausted and miserable by the time I had my daughter that breastfeeding was about the last thing I was interested in. I wholly planned to breastfeed (and did), but literally pulling her out of my crotch and shoving her in my face saying “GET HER TO LATCH RIGHT NOW” was a little too much for me. “Can this wait, just a little bit?” “NO, DO IT NOW!”

    Millions of babies spent the first 8 hours AWAY from their mothers and breastfed just fine. I don't see why waiting AN HOUR before getting started would have been the end of the frickin world. I was scared, traumatized, in a lot of pain, and generally upset by the previous 20 hours. Way to make me feel like just a couple of tits instead of a thinking, breathing, feeling human.

  4. Formula is NOT rat poision! It has come a long way since I was born, and I turned out fine. I am hardly ever sick, I love my fruits and veggies and I am not obese. I have cared for both breast-fed and formula fed babies. The breast-fed babies were sick as often as the formula fed babies. Some breast-fed babies sicker then formula fed babies and vice versa. I don't think it matters how you choose to feed your child…all that matters is that your baby is fed and loved. HAPPY MOTHER EQULS HAPPY BABY!

  5. When I had my son, the nurses at the hospital would ask every mother-to-be if she intended to breastfeed or not when she was admitted for the birth. I said yes and never bothered to ask why, but I'm guessing that if a woman says no they probably give her some hormones to save her from the agony of having her milk come in. They weren't anti-formula, and respected the decision of mother's who wished to formula feed right away.

    It was a hospital that adheres to the WHO recommendations of “kangaroo care” (skin contact between the mother and child for an hour immediately after birth), and I actually enjoyed that. I thought it was a bit much when they told my husband he couldn't hold his son and when they tried to get him to latch on (and painfully squeeze colustrum that I had none of) right away though.

    I think the key is finding a hospital that respects your wishes.

  6. I understand a lot of people think formula is better for babies, and hospitals therefore feel obliged to support it.

    What confuses me it that some hospitals seem so obsessed with being “baby friendly” that it doesn't occur to them to be “mommy friendly”. A woman who has just given birth is an admitted patient, too. Don't her needs and wants matter?

  7. being a new mother is exhausting physically and emotionally, just let the poor women relax for awhile, dang…

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