FFF Friday: “I know we’re doing the right thing…”

Lisa’s FFF Friday submission is superbly written (her last paragraph is one of the most beautiful things I’ve read about formula feeding), but beyond that, I think it speaks powerfully to the common misconception that women who “fail” at breastfeeding were simply lacking support, motivation or information. However, there’s a caveat to Lisa’s story, which I have included, and this suggests that the biggest booby trap might be a refusal of the medical profession to acknowledge rare, but very real, breastfeeding difficulties. I think if we spent half the time and money we do on promoting breastfeeding into solving breastfeeding problems, we’d see the rates go up faster than you can say “booby trap”.

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I always knew that I was going to breastfeed. It wasn’t even an issue of “if”. I knew that my child would be breastfed. Why not? It’s easy – just pop that baby on! It’s free! It’s the best thing for your baby! The bonding you will feel with your child is incredible! It’s what your body was made to do!

Now, I didn’t go into it thinking it would be all sunshine and rainbows. I did know that we might have difficulties. So, I made sure to educate myself – I read the books, I went to the classes, I watched the videos, I visited the websites. I prepared myself for if things didn’t quite go as smoothly as I hoped. I learned how to latch, how to tell if the baby was swallowing, what the different holds were … I prepared myself as much as I could. What I wasn’t prepared for, though, was the reality of what our breastfeeding relationship became.

I gave birth to my beautiful healthy daughter, C, on a rainy October morning. Labour went smoothly, delivery took a while, but after 4 1/2 hours of pushing and the vacuum later – she was out. We nursed right away – for an hour – and things seemed like they were working just fine. We nursed in the hospital and I kept track on her nursing record of how long she ate, on which sides, what her temperament was when she was put on the breast, etc. After the first day, crystals appeared in her wet diapers. I remember the nurses saying that she wasn’t getting enough and to feed her more often. So I did. But C wasn’t latching properly and I could tell. It hadn’t become painful yet, but she was leaving lines of blisters on my nipples. The nurses and lactation consultants in the hospital weren’t overly helpful. Everyone told me something different. Pull her in this way, hold her head that way, push her body in this way, pull her chin down, pull her lip out, her tongue needs to be over her gums, hold her body that way. Try as we might, I could not get that baby to latch properly.

Despite the issues we were already having in the hospital, I was discharged. I still felt a bit hopeful. Sore nipples were common. That pain would go away. C would learn to latch properly. We’d work it all out. However, the toll it was taking on me emotionally already began to rear its ugly head. I had already begun to resent my daughter. I was terrified when she awoke because her being awake meant that she needed to be fed. On our way home from the hospital, we stopped in to visit my in-laws. C was fast asleep in her car seat. Everyone oohed and ahhed at her and all I could think was “oh my god, please please don’t wake up the baby … please!” Of course, she eventually woke up and needed to be fed. While everyone else sat upstairs in the dining room, eating dinner, joking, talking, and having a great time, I sat alone on the couch downstairs, desperately willing my daughter to feed without torturing me, silently sobbing and wiping the tears off her tiny little head.

When we got home, things continued to worsen. The blisters on my nipples changed to bloody wounds to black scabs. I called Public Health for help. A lactation consultant came to the house and showed me a few things. First, she said, C was a hot baby so our body heat was making her fall asleep at the breast. I had to remove my shirt, strip C down to just her diaper, and nurse her with a fan blowing directly on both of us. I asked her if it would always be like this. “Oh no,” she said, “Winter is coming soon, so she won’t be as warm”. Not exactly the response I was looking for. Next, she helped me pull C in, and while my husband held C’s hands away from her face, I latched her on and the LC propped some receiving blankets under my wrists for comfort, positioned the baby properly when she popped herself off, and did breast compressions when she started to fall asleep. All of the sudden, nursing my daughter became a three-person undertaking. This was not helping.

“It’s easy – just pop that baby on!” But first, strip yourself naked from the waist up, strip your baby down to her diaper, make sure that fan is on you, and grow two extra pairs of hands. It’s that easy!

Despite the help from the LC (who I had come by the house once more), I still could not get C to latch properly. Every time I would think she latched, she would jerk her head, and pull her bottom lip in. Breaking the suction hurt worse than letting her stay on with a poor latch, so most times I let her nurse improperly while my toes curled from the pain and I counted down the seconds until I could get her off me. I tried a nipple shield and C bent the plastic with her tongue. I felt angry that other people get to enjoy their babies and all I could think was please hurry up and finish eating so I can take you off me. I had no problems passing her off to anyone who wanted to hold her. Everyone gushed about how sweet and beautiful and perfect she was … and I just stared with vacant eyes because to me, she was simply a source of pain. What a horrible thing for a new mother to think about her newborn baby.

The bonding you will feel with your child is incredible! Really? Because breastfeeding was getting in the way of bonding with my daughter. She didn’t even look at me because she was asleep at the breast and I looked at her through blurred vision due to tears and resentment.

When C was 17 days old, I was feeding her and she ripped a blister off my nipple with her tongue. The pain I felt in that moment was the most excruciating pain I had ever felt. That was it. I decided then and there that I couldn’t do this anymore. I stopped putting her to the breast and decided to pump exclusively from then on.

I pumped and pumped and tried to stay a few feedings ahead of C. It was becoming apparent, though, that she was eating more than I could get out. I never really felt “full”, I never felt let-down, I never felt my breasts empty, I never felt engorged, I never leaked. I pumped for about two and a half more weeks – until nothing more came out. My milk just quietly dried up almost as if it had never been there in the first place.

It’s what your body was made to do! Really? Our bodies are also made to push babies out of our vaginas, but c-sections and mothers dying during childbirth are quite a reality. My body made milk, but not enough to sustain my child.

For a few weeks after we switched to formula, I felt absolutely horrible. I felt like I was just the worst person in the world. I felt like I was going to be judged by everyone any time I pulled out my baby’s bottle. I felt like I had failed her. Soon, though, that guilt turned to anger. How dare anyone judge me! I am feeding my daughter, taking care of her, and doing what’s best for us – how can that possibly be a bad thing? I think that C would much rather be formula-fed than have a mother who resented her. Happy mommy, happy baby. Besides, I was formula-fed. My older brother was breast-fed and I was formula-fed because I had problems latching (jaw surgery 18 years later…). Am I overweight? Heck no, far from it. Am I stupid? My two post-secondary degrees say otherwise. Am I sick? I had my first ear infection at 25 years old. I have no allergies. I am very healthy. Am I less bonded with my mother? She is my best friend. It’s gotten to the point now where I am very skeptical about a lot of the so-called “benefits” of breastfeeding and I get very angry when anyone so much as suggests that my daughter will now somehow be inferior to a child who was nursed.

Now, six months later, I am a very proud formula feeder. I look at my beautiful, healthy, strong, happy daughter and I know we’re doing the right thing. And when I hold her close, give her her bottle, and she gently touches my face and twirls my hair in her little fingers, I know she thinks we’re doing the right thing too.

***

Then, just this week, I received an update from Lisa:

I’ve had some new developments with our experiences that I just wanted to add…
My daughter is now 9.5 months old. A few days ago, I came across a blog posted on the Bottle Babies Facebook site. It was a “cry for help” from a woman who’s daughter was having terrible difficulty with breastfeeding. I read the blog post and discovered something that I had never, ever heard about before: abnormal attachment of the maxilllary labial frenum. A light bulb went off. When C was very small, I remember remarking to my husband “do you think she’s going to have a gap between her front teeth because of that bump there?” That “bump there” was her frenulum that goes all the way from her top lip, down between where her front teeth will eventually erupt, and connects to her soft palate.

No one EVER told me about this. C was evaluated for tongue-tie and they found nothing wrong. For months, I’ve been dealing with the thoughts in the back of my mind that maybe I gave up too easily, maybe I just wasn’t strong enough to tough through the pain, maybe maybe maybe, what-if, what-if, what-if. I had never heard about this. Even Googling it now only results in a handful of websites that talk about the issues it may cause with breastfeeding.

The relief I feel now is incredible. It’s overwhelming. To know that there is an actual, real, legitimate, PHYSICAL, reason that my daughter was never able to latch and breastfeed is like the weight of the world has been lifted off my shoulders. I wanted to share this with you because I want other women to know about it as well. It’s something that, for me, was never even on my radar.

We have her first dentist appointment on Wednesday where I will (hopefully) be getting confirmation that it is indeed an abnormal attachment and then we’ll go from there.

***

Share and share alike. Send your story to formulafeeders@gmail.com. Oh, and do me a favor – if a few months go by and I still haven’t posted your story, send me a reminder email. Too many good stories have been lost in the cesspool of my inbox!!

FFF Friday: “I allow me to judge myself.”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They are also not political statements – this is an arena for people to share their thoughts, and I hope we can all give them the space to do so.


Jennifer’s FFF Friday piece is one of the most striking submissions I’ve ever received, and somehow it got lost in the disaster zone that is my inbox. I apologize to her, and to everyone, for not sharing her incredible story sooner.

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When I was a teenager I was diagnosed with PCOS (Polycystic Ovarian Syndrome), and told that when the time came I would likely be unable to conceive a child without medical intervention. This was fine, I didn’t care.

Many years later, my husband and I decided that we wanted to have a child. In the intervening years I had also been diagnosed with MS (Multiple Sclerosis) and I lived in constant pain. I was unable to walk unassisted and used a power wheelchair to get around in public. But this would not stop me. My husband and I wanted a child, and the one thing in my life that I had always been told was “You are so stubborn, you always find a way. No matter what it costs you.”

I went and saw an OB/GYN, who again reiterated that I would be unable to conceive naturally. She told me to go off my hormonal birth control, to go off my MS medications, and made me an appointment to see an RE (Reproductive Endocrinologist) 6 months later. I would be “fast-tracked” because of my health concerns, but I still had to have time for my body to “clear out” before they could start talk of hormone injections and the probably IUI or IVF I would need to conceive a child.

Imagine my and my husband’s surprise when two months later I peed on a stick and was pregnant.

We began researching like mad; we planned an all-natural childbirth which ultimately led to us planning a homebirth attended by a midwife. We planned to breastfeed, obviously. We planned to cloth-diaper. We planned to baby-wear and co-sleep. We were going to do this Right and Natural.

Pregnancy was good for my MS; I actually started being able to walk unassisted for short distances. It was amazing. I was sick my whole pregnancy, throwing up two or three times a day, but if this was the price I had to pay, that was fine.

We were shocked again when I went in to labor on December 26th, 2009. My due date wasn’t until January 15th, 2010! My parents rushed over to start putting together baby furniture and doing laundry. My husband helped me labor in our bed. My midwives rushed over to check on things.

And I labored for 36 hours at home. Around 2 am on December 28th, my midwives checked on the baby with a Doppler. The baby’s heart-rate suddenly dropped, then became erratic with contractions. This was not normal, this was not safe. My perfect natural birth was not going to happen.

I was rushed to the hospital. At 3:59 am on December 28th my son was born via emergency C-Section. My husband followed my son while they stitched me up. And I hissed at him “Do NOT let them give our baby a pacifier or any formula!”

My body had failed to bring my son in to the world naturally. But I’d be damned if my body was going to fail to FEED him naturally.

Trying to breastfeed after a C-Section is horrific. But I was determined. My son wouldn’t latch. He was a “lazy nurser” the LC said. I had to keep waking him up because he’d fall asleep nursing. I pumped and nursed, determined that I’d have enough of a supply. All I DID was nurse.

I was so tired. I was in so much pain. I didn’t take hardly any pain meds because I didn’t want them in my milk, and my son was nursing CONSTANTLY. I didn’t have the 2 hours to let them cycle out of my system.

My son was born at 7 lb 9 oz. When we went to the pediatrician a little over a week later, my son had dropped to 6 lb 7 oz. He looked so sick. I didn’t know what was wrong. He was so scrawny, so tiny, and so angry all the time.

But I kept trying. Because I was stubborn and determined and I NEEDED to be able to do this. Even when the pain from my MS was so bad I could hardly move, even when I was so tired I couldn’t see straight, even when my amazing husband said “Baby, please, please, let me just give him a bottle…”

The last straw came when my husband got called in to work at 3 in the morning. My son screamed for 2 hours while my husband was gone. My husband came home to find my son screaming beside me and me unable to stop crying in bed.

My husband took our son to the kitchen. He made him a bottle from a sample of formula that he had hidden from me. And I passed out, still crying.

When I woke up, my husband told me we weren’t doing this any more. He said that there was no way that the benefits of breastfeeding our son were worth this. He asked me when the last time I held our son and smiled was. I couldn’t tell him. But I looked at my baby, my happy, quiet, calm baby, and I smiled.

We ordered a case of formula online and had it delivered to the house. I couldn’t bear to go buy it.

I stopped crying every time I held my son. He stopped screaming all the time, he started smiling and cooing and being happy. He grew and thrived. People stopped being able to guess he was a preemie. I went back on medications and I stopped being in pain all the time.

My son is 9 months old now. He’s thriving and precocious, he keeps me on my toes and he is an absolute joy. He makes me smile and laugh constantly. He absolutely shows no signs of being “delayed” and he’s never been sick, not since I started feeding him formula.

I still struggle with the fact that I was unable to birth my son naturally and I was unable to feed him naturally. But I accept that my body has challenges, and that my job as a parent is to find ways to compensate for those challenges. I love my son unconditionally and I would do absolutely anything for him. I am a good mother because I put his needs ahead of my own. He does not suffer because he is formula fed, he thrives and all he knows is that his mommy and daddy and grammy and grandpa love him and make sure he is fed. All he knows is that he never goes hungry. Not any more.

I am the one who suffers the feelings of shame and guilt over being defective and over being judged by people who don’t even know me. When I give my son a bottle in public, I get looks. And it makes me angry. Those people don’t know me, they don’t know my struggles, and they have no right to judge me. But they do, and I allow them to. Because I allow me to judge myself.

Is breastfeeding more important than a healthy mother who is able to smile at her child? I don’t think so. Is breastmilk more important than a mother’s sanity? I don’t think so.

Will my son care that he wasn’t breastfed? I hope not. I hope that all he cares about is that he was loved and taken care of to the best of my ability.

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Viva la revolution! Share your story at formulafeeders@gmail.com.

Breastfeeding Promotion Tips from a Formula Feeder (Yes, you read that correctly…)

I am writing this post as part of the Milk Mama Diaries Breastfeeding Carnival (July). This month, the National Nutrition Council – Department of Health (The Philippines) celebrates Nutrition Month with the theme “Isulong ang Breastfeeding – Tama, Sapat at Eksklusibo!” (Loosely translated: “Promote Breastfeeding – Correct, Sufficient, Exclusive”.) Participants will share their experiences in promoting breastfeeding or their tips on how breastfeeding should be promoted. Please scroll down to the end of this post and check out the other carnival participants.
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Let’s tackle the elephant in the room first: why the heck is the FFF – an American formula feeding blogger – participating in a blog carnival that focuses on breastfeeding promotion in the Philippines?

To answer honestly, I’m not really sure why I decided to participate. I think partly it was because I really respect the blogger who was encouraging people to participate; partly because one of the most productive exchanges I ever had with a critic was over the promotion of breastfeeding in the Philippines, so it got me interested in that country’s infant feeding history; and partly because I feel like the fallout from misguided breastfeeding advocacy in the US can be a cautionary tale for those trying to find the right approach. Or maybe the word “carnival” made me think of pony rides and cotton candy, and put me in a celebratory mood. Regardless of why I wanted to participate, I hope that I am not offending anybody by doing so. I want to make it clear that the current status of breastfeeding – and thus breastfeeding promotion – is vastly different in the Philippines than it is here in the States, or in most of the countries represented by regular readers of this blog. There, formula feeding is still seen as a symbol of status; pretty much the complete opposite to what is going on in Western cultures, where formula feeding is correlated with lower levels of income or education. (On that note, I urge you to check out the other blog posts from the women participating in this event, because I truly learned a lot from reading their words. Links are at the bottom of the page.)

But for the very reason that breastfeeding promotion is still in its early stages in the Philippines, I hope that my post can help this country do it right, and not make the same mistakes I feel that breastfeeding advocates have made in my part of the world. Because I believe that positive breastfeeding promotion is not only possible, but necessary and beneficial for all women, both formula feeding and breastfeeding. It frustrates me that most of what I see is the reverse – negative breastfeeding promotion – and I feel that this approach is turning women against other women; society against mothers; and setting women up for failure.

Let’s consider my personal dream world. There’s a woman in this world who wants to breastfeed. She thinks it is something beautiful, a powerful connection that can be forged physically between mother and babe, something that only a woman can do. She doesn’t think formula is bad, or that formula feeding would make her any less connected to her child; she just wants to breastfeed because it seems like the natural extension of pregnancy. She has to go back to work after three months, but she isn’t stressing about it, because she figures she’ll see how things are going after those three months and either pump, supplement, or do a little of both. Since she’s not scared of formula, there is no pressure on her; she is only focused on the positives. The people around her have told her that breastfeeding is easier, empowering, and while it can be tough for the first month, they are all there to help her through it in any way they can. What happens to this woman?

a) Most likely, she has a great breastfeeding experience. She has positive, cheerful people around her, not warning her about everything that might ruin her breastfeeding goals, but rather helping her work through challenges as they arise; assuring her that no matter what, she should do what is best for her and her family, and that they are only there to make breastfeeding as easy and successful as it can possibly be. 

b) If she encounters serious problems, these same people will try and find solutions that work for her. Since there is no pressure involved, but rather her own desire and drive to breastfeed, whatever decision she makes will be guilt-free. Since she is stress-free and knows that no one will judge her for her decisions, nothing is complicating the situation. She works through the problem and goes on to nurse for a year, and becomes a inspiring force for every woman who knows her

c) She hits an insurmountable roadblock, and finds herself unable to breastfeed exclusively. But she still does her best, enjoying every minute of her nursing relationship because there is NO PRESSURE to meet some breastfeeding ideal. And if she nurses for a day, or for six months, or combo-feeds, or whatever – she remains a breastfeeding advocate, possibly even more empowered to help other women avoid the roadblock she encountered.

Now, let’s take a woman who lives in another world, where breastfeeding is promoted chiefly by pointing out how it can maximize your child’s potential – make him smarter, healthier, thinner. In this world, women who formula feed are seen as lazy, uninformed, or uncaring, because if breastfeeding is so superior, who in her right mind wouldn’t give her baby the best?

This world isn’t a dream world, it’s the world I live in. Every day I get emails from women who feel angry, isolated, judged and lied to. And these are women who wanted to breastfeed. The disappointment they felt about not getting the nursing relationship they craved was bad enough, but on top of that, because of the way breastfeeding and formula are presented in Western society these days, they also felt like failures.

Advocates have told me that accentuating the positives of breastfeeding hasn’t worked, which is why there has been a push towards focusing on the risks of formula. Essentially, though, this leads to women being “scared” or “guilted” into nursing. I suppose that if you feel strongly about breastfeeding, then the ends could justify these means – but I suspect that these tactics won’t lead to very productive ends, in the long run. Women who want to breastfeed don’t need to be convinced. And those who do need convincing? Fear tactics are not the way to go. A woman who feels coerced into breastfeeding is not going to go into the process with a positive attitude. And what happens to that woman? 

a) She breastfeeds because she feels she “has to”, but ends up loving it in the long run. 

b) She breastfeeds because she feels she “has to”, and is miserable because of it, and tells her friends how miserable she is, which isn’t great public relations for the practice – breastfeeding becomes seen as a “chore” or something to grit your teeth through, like birth.

c) She stops breastfeeding by choice, but then feel like she has to blame it on the infamous “booby traps” (ie, bad hospital practices, formula companies and their insidious marketing, unsupportive community, etc.) in order to save face, even though the biggest booby trap was the fact that she never wanted to nurse in the first place. She should be able to admit that and not be judged, but she knows she will be. 

d) She stops breastfeeding, tells the truth about why she stopped, and is made to feel like a terrible mom. 

e) She hits an insurmountable roadblock, and has to give up breastfeeding, and feels like she is torturing her child and is unfit to be a mom. A few years down the line, she is still hurting from that experience; meanwhile, she’s seen her child grow to be smart, healthy, and slender. So she starts to think that all the breastfeeding benefits were overblown. Which makes her resent the people who told her that formula feeding would ruin her child. Can you blame her for not being supportive of lactivism? 

I want breastfeeding to be promoted and protected. But I believe the way we are currently doing it is wrong.

Expectant friends have asked me if they should try breastfeeding. Now, if someone is asking the Fearless Formula Feeder this question, chances are she wants someone to talk her out of nursing, that she is a bit skittish about the whole thing. But that is not something I will do. That’s not something I want to do. Rather, I want to encourage her to try it, as long as she doesn’t feel strongly one way or the other. So here is my approach: I always start off by saying that first and foremost, it is her choice. That no matter what, her baby will be fed; her baby will be loved; their bond will still be as strong. I tell her I am happy to discuss the relative risks of formula feeding with her, and ways she can counteract those risks (for example, one study suggested that formula fed kids who start solids too early have a higher risk of obesity, yet if they start solids at the recommended 4-6 months, this risk is no higher than that of breastfed kids; on the other hand, it doesn’t seem to matter when breastfed kids start solids. So if she chooses to formula feed, this might be helpful information). 

Then, I tell her that if breastfeeding hadn’t been so complicated for me – if it hadn’t been so intricately tied up with my postpartum depression and some other more personal issues – I would have chosen breastfeeding, hands down. For most women, once you get past the initial learning curve of breastfeeding, it is easier than formula feeding. It is free. You can never forget to pack your breasts in your diaper bag. You have an instant way to soothe tears or help your baby sleep (bottles can do the same thing, but this can lead to overfeeding, whereas breastfeeding has the advantage of non-nutritive sucking). You burn like 500 extra calories a day, so you can keep on eating for two (the one thing I miss about pregnancy…!). Many of my friends also found it a bonding experience with other women, not just their babies – some of the best friendships they forged with other moms were in breastfeeding support groups. You will have a new appreciation for what your body is capable of – what a cool sense of pride, knowing you can single-handedly nourish your baby. My nursing friends also tell me that nursing sessions are incredibly relaxing, a way to step out of the rush of the day and just be.

I tell them that she could (not should, but could) at least try breastfeeding, because she may discover that it comes easy to her, and that she really enjoys it.

Does this approach work? I have no idea. But I can tell you that 5 out of 6 friends who I’ve had this conversation with have ended up primarily breastfeeding their children for the better part of a year. The other combo-fed and is still a huge supporter of breastfeeding. A small sample to be sure, but 5 out of 6 ain’t bad. And 5 out of 6 women feeling this positive about breastfeeding, on a national scale…? That could create the breastfeeding-friendly dream world we discussed earlier… and not harm the sisterhood of women while doing it.

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Take a minute and visit/comment on these other posts by Carnival participants:


The Low-Milk-Supply Mommy Did It! by The Odyssey of Dinna



FFF Friday: “Our breastfeeding journey comes to an end.”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They are also not political statements – this is an arena for people to share their thoughts, and I hope we can all give them the space to do so.

Reason #7,819 that it is ridiculous to pit “breastfeeders” against “formula feeders” is that quite often, they are one and the same. From combo-feeding moms to occasional supplementers, to women like Camilla (aka the Sexy, Savvy Mom) who start out exclusively breastfeeding but eventually switch to formula, there are a lot of women who fall into that nebulous gray area of the infant feeding battles.

What I love about Camilla’s story is that it exemplifies the importance of cost-benefit analysis, and if I preach anything, this would be it: Doesn’t matter how you feel about the benefits of breastmilk, if you think it is liquid gold or just another food… in the long run, what matters is how those perceived benefits balance with other costs.

***

I breastfed Sam for the last time just after he turned eight months old. It seems funny that I didn’t know it would be the last time. Now I replay that moment in my head — lying down next to my baby after a long trip to my parents well after his bed time, and nursing him until he fell asleep gently beside me. I knew he needed me then — not for nutrition but for comfort and warmth. He slept through the night until the next morning. He woke up happy.

Since then, he’s had exclusively Earth’s Best formula, which he seems to like. He hasn’t had any upset stomach, weight loss, or other adverse reactions — and it seems that he is thriving, growing, and meeting his milestones just as he should.

And yet. There isn’t a time that I feed him that I don’t think I’d rather be nursing him. He makes sweet little humming sounds when he eats — just like he did when he nursed. And it makes me feel deeply guilty and quite sad.

As I have said before, I wasn’t that enthused about breastfeeding from the get-go. And as natural-mama as I try to be (sometimes), I didn’t see myself breastfeeding too much beyond one year. (No hating for those who do … it just didn’t seem right for me.)

We have a healthy, thriving baby. I am a lady who knew she would make the switch sometime — to formula or cow’s milk. So why the feelings?

For one, I wasn’t ready. My body made the choice for me in a lot of ways. When I returned to work and started pumping, Sam was okay at first — and then, he started eating twice as much as I could pump in a day. I made up for that by pumping at night and on weekends. I took Lactation Support (which is primarily made of the herb Fenugreek), which worked but left me with some not-so-great side effects like intestinal cramping. When I was prescribed Wellbutrin, my supply shot down to the point where I had to start formula. (I don’t know why I responded to the medication that way — but apparently other women have had the same problem. And some don’t.) Once I started formula, Sam didn’t want to nurse as much, and when he did he was left hungry and fussing. He got so used to the bottle that he stopped nursing altogether — and now he doesn’t even remember that he ever did.

I look at my history with nursing — the complications and the inconvenience and the supply drop that made me quit. And I feel like that’s just what I did. I quit. I gave up on my baby when he still needed me, and still needed the perfect nutrition that is human milk. No formula compares. Handling formula makes me know that — it’s essentially sticky powdered cow’s milk mixed with corn syrup (or table sugar!) to make it sweet. Its fat content comes from added oils like palm and coconut. The fat in formula condenses in little yellow globules when it’s mixed with water. Just looking at breast milk, you can see the difference — the creamy milk fat rises to the top and separates (just like how cream separates from cow’s milk before it’s processed). Breast milk smells sweet, where formula smells strongly of iron and oil. Breast milk is living, full of nutrients and antibodies that no science lab could replicate into a powder.

I’ve gone through these punishing thoughts a fair number of times, letting them cycle over and over again in my brain. On better days, I respond to them by saying: “My husband and I were formula fed, and we’re fine, healthy and smart. Sam is thriving. I gave him eight months of my milk, and he will always have that. Formula is not unhealthy — it is designed for human babies, and it is researched and improved upon all the time. Plus,” I whisper, “It’s easier. You can drop Sam off with your parents and stay away for a night. You can let your husband feed him. You don’t have to worry that day care will run out of breast milk.” But still, I struggle, and I struggle to shut down the voice that says I didn’t do the right things, and I didn’t try hard enough.

I’ve talked a lot about judging in my two previous posts. If I’m to look back and take wisdom from my own words and thoughts, I would say that moms tend to judge themselves the most harshly. I know I do — I know I’ve always been my own worst critic, and when it comes to being a mother, I tend to make that critical voice ten times worse. There are certain things that I must let go. Even though I know that I could have bent over backwards to keep breastfeeding, with supplements and teas and endless pumping (and I applaud the ladies who do that — y’all are hardcore), for us, now was just as good a time as any to end. For other moms, maybe their journey is longer or shorter, or maybe it’s a formula feeding journey the whole way. What ends up being important is a healthy baby, who feels close to and trusting of his or her mother. Whatever way that is accomplished is, and will be, alright by me.

By writing this, I hope to release it and move on. My baby is beautiful, and every day, he shows me that he is strong and happy and loving.

***


A little PSA from FFF: A few weeks from now, FFF Friday will no longer exist – unless I start getting more submissions. I hope that the fact that I’ve been getting far fewer submissions in my inbox means less women are having feeding issues, but on a selfish level, I’m going to miss this feature of the blog. So if you’ve been waiting to send your story in, please don’t wait any longer! Shoot them over to formulafeeders@gmail.com.

A hypoallergenic by any other name… will still smell as stinky.

There’s a few definitive things one can say about hypoallergenic formulas:

1) They smell like regurgitated rotten potatoes
2) In order to feed your baby with them for one year, you will need to take out a second mortgage, and
3) They are lifesaving, invaluable substances for kids with food allergies, and many parents are eternally grateful for their existence.

According to this study, though (and please note I have not been able to track down the actual study – it does not appear to be in the current issue of JACI as the articles have implied; maybe it is forthcoming? – I am only going on the media reports, which as we all know are sketchy at best), there is one thing you can’t say about hypoallergenic formulas: that they prevent allergies.

But wait. I forgot! There is one more thing you can say about hypoallergenics: partially hydrolyzed formulas – the kind this study was using – are not technically hypoallergenic. A partially hydrolyzed formula is something like your favorite brand’s  “sensitive” formula. Or Nestle Good Start. These don’t smell as bad as Nutramigen or Alimentum. Nor do they cost as much. Most importantly, they don’t help one bit if your kid is actually suffering from a legit food intolerance or allergy.

Now, as far as I was aware, the evidence was mixed when it came to the actual hypos and allergy prevention. I’ve read some studies that have found a significant (remember, significant only means statistically significant; not necessarily significant in the way you or I might define the term) advantages to using a hydrolyzed protein formula in babies with a high risk of allergies. Others found no difference. But many studies have compared partially hydrolyzed to extensively hydrolyzed, and these have definitely found a difference between the two. This one, done in 2000, found that “the cumulative incidence of confirmed cow’s milk allergy was 1.3% (three of 232) in exclusively breast-fed infants, 0.6% (one of 161) in infants fed extensively hydrolyzed formula (Nutramigen or Profylac), and 4.7%(four of 85) in infants fed partially hydrolyzed formula (Nan HA). Partially hydrolyzed formula was found to be less effective than extensively hydrolyzed formula in preventing cow’s milk allergy, 0.6% vs. 4.7% (p=0.05), but because of the small number of cases the results should be interpreted with caution.“  Another study, published in 2009, showed a significant difference in allergy incidence between those fed partially hydrolyzed versus extensively hydrolyzed.

Okay, so we’re clear that we’re talking apples and oranges here, right? The reporting of this study frustrates me, because most people are probably going to assume that the findings hold true for actual hypoallergenic, extensively hydrolyzed formulas, and this is simply not the case.

My frustration is much higher, though, because of how each and every article reporting these findings had to throw in the requisite breast-is-best message. Even though this study did not compare exclusively breastfed kids to those fed any of the formulas in question (rather, they compared those fed a milk-based, soy, or partially hydrolyzed formula), and we have no way of knowing if breastfeeding would have been any more preventative (or any less) than the so-called “hypoallergenic”.

I want to bring your attention to a Cochrane Review (the “gold standard” of metastudies) which looked at all the good-quality evidence for prevention of allergies by way of childhood nutrition. The review didn’t find much of an advantage to using hypos as a preventative, but it also didn’t find any advantage to breastfeeding in this particular case. Although it’s hard to know, because….

Two trials compared early, short term hydrolysed formula to human milk feeding. 

Sorry to interrupt, but, um… Two. As in a number my son could count to before he could walk.

No significant difference in infant allergy or childhood cow’s milk allergy (CMA) were reported. No eligible trial compared prolonged hydrolysed formula to human milk feeding. Two trials compared early, short term hydrolysed formula to cow’s milk formula feeding. No significant benefits were reported. One large quasi-random study reported a reduction in infant CMA of borderline significance in low risk infants (RR 0.62, 95% CI 0.38, 1.00). 

Interestingly, though, the ‘authors’ conclusion then states, “There is no evidence to support feeding with a hydrolysed formula for the prevention of allergy compared to exclusive breast feeding.” This is a bit oddly phrased to me, because while it is certainly true, it seems a bit misleading. What their review actually found was that there were only a few studies actually comparing these two methods of feeding, and that neither fared particularly well.

Anyway – the takeaway message is that parents who want to prevent allergies in their kids might be wasting their money (and their nasal passages – both my kids had to be on hypos and the smell seriously haunts my dreams) on special hydrolyzed protein formulas. But there’s a few important things that I hope won’t get lost in the media dissemination of this study (gosh, I’m list-heavy tonight, aren’t I?):

1. This study had fudge-all to do with kids who are currently suffering from food allergies. THAT is what these formulas were designed for; the prevention thing was likely just a hopeful scientific extension of a marketing ploy (incidentally, this study was funded by Nestle…) And regardless, for those of us on extensively hydrolyzed formulas (like most with food allergies will be), the type of formula used in this study is not the same as what we are feeding our children.

2. Speaking of Nestle, this study also looked at one particular formula, made by everyone’s favorite company of ill repute. Formulas do vary, contrary to what you may have heard.  Nutramigen and Alimentum, the two most popular commercial hypoallergenics in the States, are nearly identical – and yet any GI will tell you that many kids who can’t tolerate Enfamil’s option will do better on the Similac version. There are tiny, incremental differences in these two similar formula – I think soy products are more heavily used in one, and corn in another, or something like that (I’m sure one of you FFF’s knows about this and can fill us in). These tiny differences might matter if we’re talking about allergens/immunoresponse to allergens.

3. Just in case this gets used as anti-formula ammunition, let’s be clear: this study does not say that hypoallergenics make allergies worse than breastfeeding. All it says is that this particular type of hypoallergenic does not help prevent allergies.

Now if you will excuse me, I must go wash the scent of regurgitated potatoes out of my hair.

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