Monthly Archives: September 2011

FFF Friday: “Becoming Fearless”

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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.

I love how honest this account is, and how the author – “Katie from Brooklyn” – has become more confident in her decision as time has gone by.

As a preventative measure for the inevitable critique of this story from breastfeeding experts, I want to reiterate that this space is for PERSONAL ACCOUNTS of formula feeding stories, and should not be taken as advice or “facts” by those contemplating breastfeeding. Like Katie says here, her concerns about breastfeeding were speculative, and this is not meant to discourage anyone (for example, Katie’s milk may have come in sooner were she breastfeeding round the clock; she had already made the decision to bottle-feed, so she wasn’t attempting to establish supply). I think the lesson we can – and perhaps should – take from this story is that infant feeding decisions are not a one-size-fits-all type of thing, and we all deserve the space to come to our own “best”; our own “right”.

So, good for you, Katie from Brooklyn. You made an introspective, informed, and understandable decision, and I am so glad you are starting to own it fearlessly,

Happy Friday,

The FFF

***

Becoming Fearless
by Katie from Brooklyn

Before you read my story, you need to know some things about me. I’m a perfectionist and a people-pleaser. I also suffered from severe depression from which I have since recovered, but the memories of my suffering have haunted me for the last three years. A year after finding my turning point, I was able to go off medication and haven’t had any bouts of depression. I consider myself healed but actively work to avoid any triggers.

When I found out I was pregnant, I was elated but overwhelmed. I felt a lot of pressure to breastfeed because of all the literature and advertisements on TV and because of the unsolicited comments mothers would give me about feeding my child. I worried about the possibility of PPD. I worried what would happen if I failed at breastfeeding and if this would trigger depression.

I also knew that I would have very little support at home after the baby was born. My husband works 12-hour days and my sisters and my mother are three hours away in Philadelphia. Because my husband’s very small family lives Europe I would have no in-laws to call. None of my friends have children or would be able to help in times of crisis. I had to be “together” to take care of my baby so that my new family wouldn’t suffer. How could I do this if I were depressed? So I told myself I would try to breastfeed and do my best, even if it was just for a couple days, but if I failed or if I felt myself slipping into depression it would be OK. It would be OK to use formula.

Then the delivery came. I labored for 16 hours and had an emergency c-section that I knew was coming because of the various issues I had during labor. My body had been through major surgery and had a long path to recovery. I was given a boatload of medication that medical professionals promised me wouldn’t harm my baby, and I still felt pain in my incision through heavy-duty narcotics. How was I supposed to breastfeed, recover, and raise a child alone for 12 or 13 hours a day? Almost immediately I gave up on the idea of breastfeeding. For me I felt it wasn’t in the cards. I couldn’t do it – I didn’t have any strength left. An hour or two after she was born, I gave my baby formula. I just wanted her to eat and be nourished, which was of the utmost importance to me.

My husband supported the decision wholeheartedly and my mother breathed a sigh of relief, knowing that I wouldn’t have to suffer through breastfeeding. Unfortunately, I felt tremendous guilt and sobbed repeatedly every day for two weeks despite knowing it was the right decision for my family. I rehashed the decision over and over again and what it would mean for my daughter’s future. I worried what other mothers in my hippy-dippy Brooklyn neighborhood would think. I imagined the criticism and the unsolicited remarks I would receive – so much so that I avoided meeting other new mothers. I feared I created an insurmountable barrier with potential friends by this one decision. Just reading peoples’ views about formula feeding across the Internet was enough to make me feel alienated and hate myself for this decision.

As I write my story with my daughter asleep on my chest, tears fill my eyes as I wonder how I would ever have been able to breastfeed, even if depression were not an issue. My milk did not come in for 6 days. When my breasts were finally engorged, nothing came out, not even a drop. How would I have fed her, all ten pounds seven ounces of her, if I did not give her formula? My daughter needs me almost all of the time. When she’s overtired, fussy, and can’t sleep, I’m the only person she wants. How could I get a break if I were the only person able to feed her on top of this? How would we have managed the ups and downs of breastfeeding together? These questions and more spin around in my head every day and I don’t have the answers. Other women have successfully breastfed their children despite these issues, but I’m not sure I would have. All I know is I am confident I would make the same decision all over again. I just wish I could have felt less guilt and less shame about it.

Still, The guilt lingers. I mean, I tried breastfeeding once in the hospital mainly out of guilt, which ended in failure with a very hungry and frustrated 2-day old infant. So all the issues I worried about are completely speculative. However, every time I look back on my decision and the sequence of events that followed, I feel justified. I avoided unnecessary stress and the threat of depression. I am recovering slowly from the cesarean and I am able to be a good mother.

Now when my husband comes home from work, he can feed our daughter so that I have a break for 30 minutes. I can sleep later on the weekends because he can take care of all her needs. He has the opportunity to bond with her that he might not have otherwise and I have the opportunity to recharge. When my mother and my sister visited, they each were able to feed her and develop a bond with her as well. When I visit my family in a few weeks, I know my father will be able to do the same. This is all so very precious to me.

My four-week old daughter now sleeps eight hours through the night. She’s very strong and has been able to lift her head for almost two weeks. She’s not sick. Her skin is beautiful. She’s content and satiated. I love her dearly and we have an incredible bond. Her happiness means the world to me and I feel that I have achieved this by being the healthy mother she needs me to be and by giving her nourishment she needs to thrive.

Slowly, I am realizing that I’m not the evil mother that breastfeeding zealots make me out to be. My OB and my baby’s pediatrician have both been supportive. In fact, I have fed formula to my daughter twice outside of our home and there have been no unwanted comments, no hateful glares. Still I know how I will respond if they come because I know I made the right decision for my family. No one can tell me that I don’t love my daughter or deserve to have her in my life because I chose not to breastfeed.

***

“Your assumptions are your windows on the world. Scrub them off every once in a while, or the light won’t come in.” – Alan Alda. Make like a bottle of Shine Free and share your story for an upcoming FFF Friday. Email me: formulafeeders@gmail.com.

Guest Post: How Anti-Formula Propaganda Hurts Infants

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The following is a guest post from FFF “Antigone”. I don’t know much about homemade formula; I am not convinced that someone feasibly couldn’t come up with a concoction on his/her own that would be nutritionally sound, provided they had the resources, education, and expertise needed to do so – but most of us don’t fulfill those three requirements, which is why I strongly advise using a commercial formula. However, this post isn’t about homemade formula, but a far more dangerous practice: using goats milk or raw milk instead of commercial breastmilk substitutes. Regardless of my (lack of) opinion on homemade formulas, I do know that plain old goats milk is never gonna cut it. I think Antigone makes some great points in this post, and she attacks the subject with the type of evidence-based, hard-science approach we love here on Fearless Formula Feeder. I hope it will provoke some worthwhile discussion….

-The FFF

****

How Anti-Formula Propaganda Harms Infants

by Antigone

Recently, I had first-hand evidence of my theory that anti-formula propaganda convinces women to resort to less safe alternatives when supplementation is necessary or breastfeeding is not possible. When militant lactivists tell women that formula is poison, or that it is equivalent to junk food because it is “processed” “man-made” and “full of chemicals,” don’t be surprised when children who NEED formula when breastfeeding is insufficient or impossible don’t receive it. Instead, they are subjected to arguably higher risks from one or more of the following:

(1) not getting enough to eat, period, because mom is afraid to supplement

(2) informally shared, untested breastmilk from strangers that could contain viruses, prescription medications, and other contaminants

(3) mom’s breastmilk, but with prescription drugs not proven to be safe while breastfeeding

(4) homemade formulas of questionable quality

(5) unaltered milk from other animals, usually goat or cow

A dangerous precedent is being set where women are being led to believe that formula is so caustic and vile a substance, that they must avoid it at all costs, and virtually anything more “natural” must be better. (Although how breastmilk laced with Effexor could be considered more natural is beyond me.) While medical organizations and professionals of any influence advise against replacing breastmilk with anything other than FDA-regulated infant formula, their voices are going unheard in the world of online lactivism and mommy advice. I recently logged on to my cloth diapering forum to find a thread about how raw goat milk would affect a two month old baby’s poop. I was shocked to find many women endorsing raw goat’s milk over formula for feeding newborns and young infants. Here are a few choice quotes (warning: your blood pressure will rise after reading these):

“I’m not willing to use formula since it is more likely to mess up her digestive system and interfere with the absorption of nutrients from breastmilk. Goats milk is much closer to human milk.”

“You say you can’t imagine a doctor sanctioning the use of goats milk in an infant, but I’m sure you have no problem imagining a doctor suggesting conventional formula – and have you read the side of a formula can lately? Not something I’m willing to put in my baby’s body.”

“from what I’ve heard goat’s milk beats formula in nutrition for supplementing…It’s supposed to be easier to digest than formula too.”

“I would give my newborn baby raw goat milk if I had the choice of pumping vs. raw goat milk.”

“I’m shocked by how many people recommend formula over raw goat’s milk. Shows how many people are still fooled by formula companies.”

“Formula is cow’s milk based (unless it is soy). It is loaded with chemicals and other garbage you can’t pronounce. I’d feel much safer with a natural alternative.”

“Raw milk (goat, cow, or sheep) is the next best thing to breastmilk. I get raw milk via cowshare, and it’s the only kind of milk that my daughter gets other than breastmilk.”

“Last I saw, goat’s milk is the closest thing to breastmilk that isn’t laden with chemically man-made vitamins, chemicals, and corn syrup”

“because when supplementing this is the flow chart to nutrition mom’s milk, donated breast milk, goats milk, other formula good job on knowing and deciding on goat milk.”

The Facts

The fact is that goat milk is nowhere near nutritionally comparable to breastmilk. Formula, on the other hand, is designed to mimic the macro- and micronutrient content of breastmilk. This means that formula has about as much protein, carbohydrate, and fat by volume, and similar quantities of vitamins and minerals. Goat milk, on the other hand contains nutrients more appropriate for a developing goat. This page contains a summary of major nutrients in human, cow, and goat milk, per 100 grams of milk, reprinted below. This data can also be verified, and more nutrients compared, by visiting the USDA Nutrient Data Laboratory http://www.nal.usda.gov/fnic/foodcomp/search/

Fat (g)

Protein

(g)

Carbohydrate (g)

Calcium (mg)

Phosphorus

(mg)

Vitamin C

(mg)

Human Milk

4.0

1.1

9.5

33

14

5

Cow’s Milk

3.5

3.5

4.9

118

93

1

Goat’s Milk

4.0

3.2

4.6

128

106

1

If we accept human milk as the standard, the ideal food on which infant nutrition should be based, than goat’s milk, similar to cow’s milk, simply has the wrong nutrient balance. While the total fat content is the same, human milk has much more long-chain polyunsaturated fatty acids (such as DHA and ARA) when compared to goat or cow’s milk. Human milk contains .497 grams of polyunsaturated fatty acids per 100g of milk, compared to .149g in goat milk and .195g in cow milk (data from USDA link above). Polyunsaturated fatty acids have been shown to be important in brain development, which is why they are added to formula.

Goat and cow milk also notably contain triple the protein and less than half the carbohydrate of human milk. Excessive amounts of protein are known to strain kidneys, especially when combined with the excess sodium and other minerals which goat’s milk also contains. This article from the American Academy of Pediatrics (AAP) discusses the serious effects of this dangerous combination:

“Goat’s milk contains 50 mg of sodium and 3.56 g of protein per 100 mL, approximately 3 times that in human milk (17 mg and 1.03 g per 100 mL, respectively).6 The estimated requirements of sodium and protein for infants <6 months old are 100 to 200 mg/day and 9 to 11 g/day, respectively.7 The infant described here was receiving ∼500 mg/day of sodium and 30 g/day of protein, with a total intake of 32 oz of goat’s milk per day. The immature kidneys in very young infants have difficulty handling the byproducts of foods with a high renal solute load.8 Sodium excretion capacity matures more slowly than glomerular filtration rate and does not attain full capacity until the second year of life.9 Therefore, infants fed fresh goat’s milk are at substantive risk for hypernatremia and azotemia, particularly in the face of dehydration (as in the case described here), which may in turn result in major central nervous system pathology, including diffuse encephalopathy, intraparenchymal hemorrhage, or thromboses10 as manifested in our patient.”

To put this in layman’s terms, hypernatremia is an excess of sodium compared to water in the blood, which appears as severe dehydration. Azotemia is excess waste in the blood due to the kidneys being overloaded and unable to perform their function adequately. These two in turn can lead to brain damage, brain bleeding, or blood clots. The article also observed that metabolic acidosis has been observed in infants fed undiluted goat’s milk. This is an increase in acid levels in the body thus low pH in the blood and tissues, which can lead to coma or death. This study also mentions the link with metabolic acidosis, and states that goat’s milk consumption can lead to cases that appear to be tyrosinaemia type 1, which is an excess of the amino acid tyrosine caused by a genetic inability to break it down. Goat’s milk can’t cause tyrosinaemia, since it is genetic, however the symptoms are similar: failure to thrive, diarrhea, vomiting, jaundice, increased bleeding, and liver and kidney failure.

In addition, Goat’s milk is also deficient in several nutrients when compared to breastmilk, most notably Vitamin C, Folic Acid, and Vitamin B12. In fact the term “goat’s milk anemia” was coined to describe cases in the 1920s and 30s in Europe of infants fed goat’s milk. It was more severe and appeared earlier than anemia found in infants who drink cow’s milk, most likely due to lower B12 than cow’s milk. This article from the Canadian Paediatric Society describes an infant presenting with severe anemia and a murmur due to a diet of exclusive goat’s milk:

“Goat’s milk is known to be deficient in vitamin D, vitamin B12, iron and especially folate. Infants younger than six months of age need 65 μg/day of folate (the recommended daily allowance increases with age). Goat’s milk contains 6 μg/L of folate (breast milk and cow’s milk contain approximately 45 μg/L to 50 μg/L). The infant’s serum folate was less than 1.4 nmol/L (normal 7 nmol/L to 39.7 nmol/L), her serum vitamin B12 was 141 pmol/L (normal 200 pmol/L to 540 pmol/L) and her serum iron level was also low.”

Another issue is that many advocates of giving infants goat’s or cow’s milk also state that the milk must be raw to preserve nutrients. It’s well-documented, however, that unpasteurized milk can contain dangerous bacteria such as toxoplasmosis, brucellosis, and e.coli (link 1-scroll to page 6, link 2). Infants, with their weaker immune systems, are at much greater risk of serious illness or death from ingesting these bacteria.

Goat’s milk is clearly not a suitable replacement for breastmilk or formula. To express that formula is somehow less safe than goat’s milk, or raw goat’s milk at that, is absurd. The science does not support this. Goat’s milk may be “less processed” and “more natural” but that hardly advocates for it when less processing, in this case, makes it less nutritionally complete and less digestible. Even notable breastfeeding supporters such as Kellymom, La Leche League, and Dr. Sears also warn against feeding goat milk to infants as a replacement for formula. As Kellymom’s website states:

“While it’s true that whole goats milk (and whole cow’s milk) was commonly used prior to the advent of infant formulas it is also true that the infant mortality and morbidity rate during the times of such substitutions was very high.”

So why does there seem to be a large number of people with the misperception that formula is actually the worst option for breastmilk replacement? In recent years, breastfeeding advocacy has become more focused on using intensely negative, often hyperbolic language bashing formula. Convinced they can win more flies with vinegar, many lactivists use shame and fear to convince mothers that breastfeeding is the only acceptable option. What then, are women to do when breastfeeding fails, after being told that formula is inadequate, fake, unsafe junk? They look for an alternative. Unfortunately, the risks of these alternatives are not nearly as well-promoted as the so-called risks of formula. A widespread distrust of medical professionals and belief that a stranger on the internet will give better nutritional advice contributes to this problem.

Lactivists claim that their goal is to promote the health of infants and children. But when they say that mothers must breastfeed exclusively at all costs, that formula is poison and must be absolutely avoided, they act contrary to their stated goal. Infants could be seriously harmed in a myriad of ways by parents’ choice not to use formula when it is necessary. Not everyone can breastfeed, and not everyone should breastfeed. Formula is one of the most regulated products in existence. Is it perfect? No. Is it as good as breastmilk*? No. Could it be better? Sure. But let’s not mince words here: it is the only safe substitute for breastmilk. Period.

*from a healthy, well-nourished mother not taking harmful drugs of any kind, and assuming the infant in question is not allergic

Fat, Freebies and…Shtupping*: Formula feeding and breastfeeding in the news

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Some items of note from my nightly perusal of breastfeeding and formula-feeding related tweets:

1. CBS attempts to make the snooze-worthy hospital formula freebies debate newsworthy...

The only reason I’m even mentioning this is because it highlights the utter waste of time, money and energy of most breastfeeding “research”. CBS reports that a new study appearing in Pediatrics finds that the number of hospitals handing out formula samples is decreasing, but apparently not enough. They also mention that the CDC is criticizing US hospitals for perpetuating the practice, which as we all know, undermines breastfeeding (although I have argued otherwise). There’s no news here except the news that whoever funded this study could have been focusing on how to help women dealing with the REAL challenges of breastfeeding rather than perceived ones. How about looking at the social and marital status of women in these hospitals that gave out samples and presumably suffered poor breastfeeding rates because of it? How many were teenage moms, or single mothers, who had no help/ no resources/ and no time off work/ no ability to attend antenatal breastfeeding support groups? But no, that would be less about blaming Big Bad Formula, and more about blaming social constructs that are nearly impossible to change in the short-term. It’s way more fun and empowering to make like Jay Gordon and tweet things like “Hospitals Still Handing Out Free Baby Formula http://bit.ly/nvNBl6 Increases infant disease and deaths #Breastfeeding #AAPcollusion“

Lovely. Just lovely.

2. A possible opportunity for I-told-you-so’s goes to the DHA/ARA fan club – at least if you have daughters…

WebMD reports that a new study published online in Pediatrics found that premature girls who were randomly given formula supplemented with long-chain polyunsaturated fatty acid fared better on reading and spelling skills at the age of 10. (Interestingly, a different study in the same publication discovered that children who breastfed longer fared better on cognitive assessments, and hypothesized that this advantage was due to fatty acids in breastmilk.) So there may be some truth to the formula manufacturer claims that adding DHA/ARA makes babies smarter. If they are female. The lead author explains:

“To me, as a neuropsychologist, this must mean the effects on the neural structures supporting reading are different in the two sexes,” said lead author Elizabeth B. Isaacs, a senior research fellow at the Childhood Nutrition Research Centre at University College London’s Institute of Child Health. “There appear to be differences in how fatty acids are metabolized between genders, so that might be involved. But we really don’t know, and the answer, as always, is that more research is needed.”

More research, huh? Good luck with that. Your peers are too busy proving that formula samples are the devil – for the fiftieth time.

3. Tax breaks for breastfeeding moms – kind of….

BestofNewOrleans.com tells us that their state legislature has “passed Act 331, which exempts “breastfeeding items” from the state sales tax… Breastfeeding items identified in the bill include nursing bras, containers for storing expressed milk, breast pumps, pump accessories and replacement parts. The bill does not exempt nursing pads, nursing pillows or bottles.”

Okay, first of all, the items covered and not covered are kind of a bizarre and random list. What are you going to do with all that expressed milk you produced with your tax-exempt pump? And nursing bras are covered, but not nursing pads? That seems stupid, since if you don’t use breast pads, those bras are gonna get mighty nasty mighty fast, especially if you can’t get to your pump in time. I’d love to have a conspiracy theory that the list is divided by what working moms need versus stay-at-home moms, or things that might potentially benefit bottle-feeding moms versus those only for the lactationally blessed Chosen Ones, but that doesn’t seem to be the case. I suspect that this is more a matter of which companies lobbied the hardest, and I bet that there’s a few congresswomen with brand spankin’ new Pump N’Styles down there in N’awlins.

4. Let’s talk about sex, baby (but not while the baby is drinking from me, TYVM)….

I love, love, love this piece about breastfeeding and sex. It may not be the most well-written thing in the blogosphere, but while the prose is dry, it at least helps you not be (sorry, couldn’t resist). There are actual tips which aren’t couched in sanctimonious admonishments about how self-respecting breastfeeding moms always feel sexy, so something’s wrong with you if you don’t; the author acknowledges the bodily changes inherent in breastfeeding and how these can impact your sense of sexuality; some of the suggestions are truly outside of the box and really cool; and the tone is totally matter-of-fact and non-judgmental. If all “practical” articles on breastfeeding were actually this practical, there might be no need for this blog. Or at least I’d have less to make fun of.

*”Shtupping” = Yiddush (and PG) term for the f-word. Believe me, I was tempted…;)

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ghgh

Before I was pregnant, when having a child was just a hypothetical notion filed under “one day,” I always assumed I would breastfeed. I never thought of breastfeeding as a “crunchy” thing or something associated with a particular parenting style. It was just what you did. Everyone nowadays breastfeeds, at least for a little while. Beyond that, I didn’t give it much thought. The activist and rabble-rouser in me looked forward to flagrant public nursing, a copy of Ga. Code An. § 31-1-9 tucked into my hypothetical diaper bag. At some point when I was heavily involved in the feminist blogosphere, one of my favorite bloggers at the time wrote a post about how it might not be breastfeeding itself that’s so beneficial to babies, but the things that usually go along with it in the U.S.: social and economic privilege, a well-educated mother who is willing and able to go the extra mile for her baby and has access to preventive medical care, and that studies linking health benefits with breastfeeding have failed to control for these factors. This made sense to me and I filed it under “interesting and thought-provoking” in the back of my mind.

When I was pregnant, my breastfeeding goals were: definitely breastfeed for the first six weeks, and ideally breastfeed without supplementation for the first six months. (Up until my 36th week of pregnancy, I was planning to return to work after 10 weeks maternity leave, and I knew that some women see their supply decrease when they return to work and have to find time to pump during the day.) It was important to Rusty and me to share parenting responsibilities equally, so we planned to introduce a bottle at around three or four weeks. Beyond that, I had no plans or goals, preferring to take a “play it by ear” approach. I never envisioned myself as someone who would nurse past one year, and certainly not into the toddler years. Like many mothers-to-be, I wanted to give my baby the benefits of breastfeeding during the critical early period. I never viewed formula as “poison” or felt the need to refer to it with derogatory euphemisms such as “artificial milk,” and I felt strongly that no mother should be judged for feeding her baby formula, because there are a million complicating factors – physical, emotional, socioeconomic – that can necessitate its use (and of course it did not escape my notice that it was always mothers, not fathers, who were judged). The fact that breast milk was better than formula made sense in an obvious way, since it is created by the mother’s body specifically for her baby, but placing a value judgment on a particular feeding method was not something I was interested in. I simply wanted my baby to gain the benefit of immune system building and other early developmental benefits of breastfeeding.

I was nervous about breastfeeding for a few reasons. I worried that being the only person who could feed the baby in the first few weeks would take a toll on me in various ways and possibly strain my relationship with Rusty or hinder him in building confidence in his parenting ability. I tried not to get too caught up in these worries, reminding myself that it would only be that way for a few weeks and we have the rest of our lives to be egalitarian parents. I knew that women with thyroid conditions sometimes have problems making enough milk due to hormone levels. I reminded myself that I was on medication for my hypothyroidism, therefore putting my hormone levels where they should be. I tried to focus on preparation and education instead of worry. I read articles, blog posts, and book excerpts; Rusty and I attended a couples’ breastfeeding class (where I was disappointed that much of the class was a sermon against formula feeding rather than a practical how-to session, and where one of the instructors compared not breastfeeding to not using a car seat); I attended a La Leche League meeting; I talked with friends who had breastfed about their experiences, including getting a run-down from my friend and coworker Rochelle about the quirks of the “new moms room” (aka the Lactation Cell!) at work.

My dreams during pregnancy included a lot of anxiety-based dreams about “forgetting” the baby and leaving him/her somewhere for hours; but despite my low-level anxiety about breastfeeding during my waking hours, in all my dreams about it (and I did dream about it quite a few times), breastfeeding was going really well and was remarkably easy. As someone who has had prophetic dreams before, I took this as a good sign.

Fast forward to May 1. Fitz was born at home. He had a drug- and intervention-free birth and postpartum period. He was placed skin-to-skin with me immediately after birth and lay draped across my chest as I was getting stitched up. Theoretically, the stage was set for a positive nursing experience. I don’t remember exactly how long it had been after his birth the first time I tried to nurse him, but it wasn’t long. He didn’t seem interested. The midwives said not to worry and to just keep offering. When they left a few hours later, he still hadn’t nursed for more than a few minutes at a time, and something just seemed “off” to me, even though everyone was telling me not to worry.

When the midwife came back the next day for the first postpartum visit, Fitz had nursed a total of six times. We’d had two “good” nursing sessions, about 45 minutes each, where I could tell a difference in his suckling – instead of feeling nothing and being unsure that he was actually latched on at all, I felt an uncomfortable tugging, slightly painful. I told myself that I just needed to get used to the feeling of breastfeeding. People on Facebook told me he’d start eating more in the next few days. Still, my gut was telling me something was wrong.

On day 3, I crashed. I know now it’s a textbook case of the onset of postpartum depression, when the hormone levels plummet by something like 10,000% at 48 hours postpartum. Attempting to breastfeed was becoming increasingly painful. Fitz was popping on and off the breast, arching his back and screaming. I knew PPD had gotten ahold of me and I was downing placenta pills as often as I could but it wasn’t helping. I was following all the latching techniques from the breastfeeding class but still Fitz was a screaming banshee. I thought there must be something wrong with me, or I wasn’t trying hard enough, or somehow I was a failure no matter all my best efforts. Rusty called our postpartum doula. She came over that night and I broke down sobbing and told her I hated breastfeeding and wished I didn’t have to do it, I shouldn’t have had a baby, I wanted to run away and leave Fitz with Rusty. She helped me have our one good nursing session, propped in the glider with a million pillows and rolled towels and the Boppy and Fitz and I both stripped nearly naked. I thought there was no way I could go through this production every time, but I at least felt a little more confident that maybe things could turn around.

The next time Fitz was hungry, I tried everything she had shown me. But it didn’t work this time. I dreaded having to feed him and tried to delay it as long as possible with the pacifier. I began to have panic attacks when bringing him to the breast. I cried constantly. That night, I was done. I couldn’t take it anymore. Fitz wouldn’t stop crying and I couldn’t get him to stay latched on. My mom was still in town and she walked around the house with my screaming baby as I begged Rusty to go to the 24-hour Kroger and get some formula. I went to take a shower and collapsed in the bath tub, heaving with tears.

On the morning of day 4 we took Fitz to the pediatrician and in the waiting room, I met Anna, and I am so grateful for that chance meeting and our now friendship. She started talking to me and asked if I was breastfeeding and I broke down crying and said it wasn’t going well. She said that she and her son had a lot of problems with breastfeeding but were able to do it thanks to working with a wonderful IBCLC, whose name and number she gave me. We were called back into the exam room and while waiting for the doctor, Fitz wanted to eat again. I tried but it was still painful and didn’t feel right. When the doctor came in and saw us, she said, “That looks good!” and I broke down crying again. Like everyone else (except Anna), she said not to worry, it would get better. But we found out Fitz had lost 10% of his birth weight (and since I didn’t have IV fluids in labor, that’s an accurate number) and I did worry.

When we got home I read an email from someone purporting to help, telling me that giving Fitz a bottle was the best way to ruin a breastfeeding relationship and I should feed him with a syringe. That seemed so outside the realm of possibility that I felt completely abandoned. I had Rusty call Ann, the lactation consultant. When she called back, I sobbed on the phone with her and told her I hoped she wouldn’t be disappointed in me for giving Fitz formula. It was such a relief to hear her say that of course she wasn’t disappointed, and that she was glad I had done it, because the most important thing is that the baby has to eat.

She came out the next morning. Looking back, I don’t know what I would have done without her. She was the perfect combination of compassionate and professional. She had no judgment. Maybe after being in her field for over 40 years, she’s past the judgment and just wants to help. She presented information clearly and completely. She examined Fitz’s mouth and told us he had something called type 4 tongue tie. I felt such relief; I wasn’t crazy, something was wrong, and it wasn’t that I wasn’t doing everything right, it was that my baby had an actual physical impediment to breastfeeding! Ann said this kind of thing runs in families. She found that I had it too, but no one had ever caught it with me, because I was never breastfed. (Some babies with this type of tongue-tie have no problems with bottle-feeding, but Fitz had trouble with a bottle, too.) She explained the frenotomy procedure. She explained the possible effects if we decided not to do the frenotomy. She taught me how to hand-express. She showed me how to nurse with nipple shields. She found the correct size flanges for me to use with my pump, showed me the best way to pump to increase my supply, and sat with me while I did it. She taught Rusty and me the best way to bottle-feed Fitz. She presented cup feeding and syringe feeding as options and described each. She left photocopied articles about tongue-tie and frenotomy, and written instructions covering everything we had discussed. She held my hand as I sobbed and asked, “What if I just don’t want to breastfeed?” and answered that whatever I decided, she would support me and help me do it safely.

That morning with Ann was the last time I fed Fitz directly at my breast. The mere thought of breastfeeding had become too much of a trigger for me. I turned my attention to pumping. I pumped every 2-3 hours using the techniques Ann had taught me, and sure enough, just like she had said, my supply increased overnight. For the next three weeks, I pumped enough milk that we didn’t have to give Fitz any formula. I borrowed a huge trash bag full of milk storage bottles from Rochelle because I was rapidly using up all the ones we had. I started freezing milk. I was really good at pumping and my body responded really well to the pump. Even though these were my absolute darkest days of PPD and most of the time I felt like a worthless mother, pumping was the one concrete thing I was able to do for my baby.

With Rusty’s return to work looming on the horizon, though, I knew something was going to have to give. I knew I couldn’t keep up this pumping schedule while home alone with Fitz. I decided to wean off the pump. With Ann’s help, I came up with a plan for a gradual weaning process. It took me seven weeks to wean off pumping. I also started seeking donor milk through the peer-to-peer milksharing networks Human Milk for Human Babies and Eats on Feets, which I’ll write about in a separate post. I pumped for the last time on July 17. It was a bittersweet moment. For several weeks afterward, I still leaked milk, especially in the shower. I thought of all that milk going to waste. A few times on “good days” I considered starting pumping again, but reminded myself of all the reasons I had stopped and how it was helping speed my recovery from PPD.

I feel like I should close with some grand statement, but now that I’ve written this all out, I’m emotionally exhausted. In my heart of hearts, I feel with 100% certainty that I made the right decision. The guilt and doubt creeps in when I see the ceaseless posts about breastfeeding being best, from people who probably have good intentions but don’t realize how hurtful and alienating they are being. I still don’t know how to handle those situations. It wears me out to constantly “speak up” when I see thoughtless comments. My therapist says maybe the reason this was so traumatic for me is because I didn’t have a plan B. I had a backup practice and hospital in case the home birth didn’t work out, so that was my plan B for the birth; but we had no formula in the house. I don’t think that’s it, though. We also didn’t have any disposable diapers in the house but I can’t see myself being such an emotional wreck about it if cloth diapering hadn’t worked out.

I fed my son directly at my breast for five days. I gave him my milk for two and a half months. But what I’ve come to realize is none of that matters nearly as much as the fact that on a daily basis I give him my love in the unique way that only I can, because I am his mama. My baby needs a healthy mom more than he needs my milk. I am inching toward recovery, even though I still have days where I feel like a worthless mother. On those days, I try to remember these words from a recent Daily Hope email from Katherine Stone of the blog Postpartum Progress:

“Use what talents you possess; the woods would be very silent if no birds sang except those that sang best.” ~ Henry Van Dyke

Your baby would have very little without his or her mama. You are SO important, even if you feel like you’re blowing it. You have talents — you are feeding and clothing and speaking or singing or rocking or strolling or reading or bathing or whatever it is that you have done or will do. Keep on doing whatever you can do to the best of your ability. To you the things you are doing may seem like they don’t measure up, or they aren’t enough or you don’t have the right thoughts in your head when you’re doing them. To your baby, they’re like birdsongs in the woods.

FFF Friday: “I thought there must be something wrong with me…”

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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.

Happy Friday,
The FFF


After reading this FFF Friday submission from Amber, I am reminded of how important a topic breastfeeding pressure is for the postpartum depression community. Amber speaks of the dichotomy between feeling like giving up nursing will help your PPD, but also feeling so guilty because of it (which certainly doesn’t help the depression). Anyone using the argument that we shouldn’t stop pushing breastfeeding simply because it might make moms feel guilty should keep one thing in mind: postpartum mood disorders are prevalent in our society. It’s one thing to care less about making a healthy bottle-feeding mom feel guilty, but those with PPD often have no ability to put things in proper perspective, and that same guilt can take on epic proportions. We need to be protecting mothers in the thick of postpartum hell just as much as we need to be protecting breastfeeding. We can’t sacrifice one for the other, in either direction… so maybe it’s time to rethink how we are approaching things, you know?

This was originally posted on Amber’s blog, along with a follow-up post – so check it out for an update on this fearless mama…

***

Before I was pregnant, when having a child was just a hypothetical notion filed under “one day,” I always assumed I would breastfeed. I never thought of breastfeeding as a “crunchy” thing or something associated with a particular parenting style. It was just what you did. Everyone nowadays breastfeeds, at least for a little while. Beyond that, I didn’t give it much thought. The activist and rabble-rouser in me looked forward to flagrant public nursing, a copy of Ga. Code An. § 31-1-9 tucked into my hypothetical diaper bag. At some point when I was heavily involved in the feminist blogosphere, one of my favorite bloggers at the time wrote a post about how it might not be breastfeeding itself that’s so beneficial to babies, but the things that usually go along with it in the U.S.: social and economic privilege, a well-educated mother who is willing and able to go the extra mile for her baby and has access to preventive medical care, and that studies linking health benefits with breastfeeding have failed to control for these factors. This made sense to me and I filed it under “interesting and thought-provoking” in the back of my mind.

When I was pregnant, my breastfeeding goals were: definitely breastfeed for the first six weeks, and ideally breastfeed without supplementation for the first six months. (Up until my 36th week of pregnancy, I was planning to return to work after 10 weeks maternity leave, and I knew that some women see their supply decrease when they return to work and have to find time to pump during the day.) It was important to Rusty and me to share parenting responsibilities equally, so we planned to introduce a bottle at around three or four weeks. Beyond that, I had no plans or goals, preferring to take a “play it by ear” approach. I never envisioned myself as someone who would nurse past one year, and certainly not into the toddler years. Like many mothers-to-be, I wanted to give my baby the benefits of breastfeeding during the critical early period. I never viewed formula as “poison” or felt the need to refer to it with derogatory euphemisms such as “artificial milk,” and I felt strongly that no mother should be judged for feeding her baby formula, because there are a million complicating factors – physical, emotional, socioeconomic – that can necessitate its use (and of course it did not escape my notice that it was always mothers, not fathers, who were judged). The fact that breast milk was better than formula made sense in an obvious way, since it is created by the mother’s body specifically for her baby, but placing a value judgment on a particular feeding method was not something I was interested in. I simply wanted my baby to gain the benefit of immune system building and other early developmental benefits of breastfeeding.

I was nervous about breastfeeding for a few reasons. I worried that being the only person who could feed the baby in the first few weeks would take a toll on me in various ways and possibly strain my relationship with Rusty or hinder him in building confidence in his parenting ability. I tried not to get too caught up in these worries, reminding myself that it would only be that way for a few weeks and we have the rest of our lives to be egalitarian parents. I knew that women with thyroid conditions sometimes have problems making enough milk due to hormone levels. I reminded myself that I was on medication for my hypothyroidism, therefore putting my hormone levels where they should be. I tried to focus on preparation and education instead of worry. I read articles, blog posts, and book excerpts; Rusty and I attended a couples’ breastfeeding class (where I was disappointed that much of the class was a sermon against formula feeding rather than a practical how-to session, and where one of the instructors compared not breastfeeding to not using a car seat); I attended a La Leche League meeting; I talked with friends who had breastfed about their experiences, including getting a run-down from my friend and coworker Rochelle about the quirks of the “new moms room” (aka the Lactation Cell!) at work.

My dreams during pregnancy included a lot of anxiety-based dreams about “forgetting” the baby and leaving him/her somewhere for hours; but despite my low-level anxiety about breastfeeding during my waking hours, in all my dreams about it (and I did dream about it quite a few times), breastfeeding was going really well and was remarkably easy. As someone who has had prophetic dreams before, I took this as a good sign.

Fast forward to May 1. Fitz was born at home. He had a drug- and intervention-free birth and postpartum period. He was placed skin-to-skin with me immediately after birth and lay draped across my chest as I was getting stitched up. Theoretically, the stage was set for a positive nursing experience. I don’t remember exactly how long it had been after his birth the first time I tried to nurse him, but it wasn’t long. He didn’t seem interested. The midwives said not to worry and to just keep offering. When they left a few hours later, he still hadn’t nursed for more than a few minutes at a time, and something just seemed “off” to me, even though everyone was telling me not to worry.

When the midwife came back the next day for the first postpartum visit, Fitz had nursed a total of six times. We’d had two “good” nursing sessions, about 45 minutes each, where I could tell a difference in his suckling – instead of feeling nothing and being unsure that he was actually latched on at all, I felt an uncomfortable tugging, slightly painful. I told myself that I just needed to get used to the feeling of breastfeeding. People on Facebook told me he’d start eating more in the next few days. Still, my gut was telling me something was wrong.

On day 3, I crashed. I know now it’s a textbook case of the onset of postpartum depression, when the hormone levels plummet by something like 10,000% at 48 hours postpartum. Attempting to breastfeed was becoming increasingly painful. Fitz was popping on and off the breast, arching his back and screaming. I knew PPD had gotten ahold of me and I was downing placenta pills as often as I could but it wasn’t helping. I was following all the latching techniques from the breastfeeding class but still Fitz was a screaming banshee. I thought there must be something wrong with me, or I wasn’t trying hard enough, or somehow I was a failure no matter all my best efforts. Rusty called our postpartum doula. She came over that night and I broke down sobbing and told her I hated breastfeeding and wished I didn’t have to do it, I shouldn’t have had a baby, I wanted to run away and leave Fitz with Rusty. She helped me have our one good nursing session, propped in the glider with a million pillows and rolled towels and the Boppy and Fitz and I both stripped nearly naked. I thought there was no way I could go through this production every time, but I at least felt a little more confident that maybe things could turn around.

The next time Fitz was hungry, I tried everything she had shown me. But it didn’t work this time. I dreaded having to feed him and tried to delay it as long as possible with the pacifier. I began to have panic attacks when bringing him to the breast. I cried constantly. That night, I was done. I couldn’t take it anymore. Fitz wouldn’t stop crying and I couldn’t get him to stay latched on. My mom was still in town and she walked around the house with my screaming baby as I begged Rusty to go to the 24-hour Kroger and get some formula. I went to take a shower and collapsed in the bath tub, heaving with tears.

On the morning of day 4 we took Fitz to the pediatrician and in the waiting room, I met Anna, and I am so grateful for that chance meeting and our now friendship. She started talking to me and asked if I was breastfeeding and I broke down crying and said it wasn’t going well. She said that she and her son had a lot of problems with breastfeeding but were able to do it thanks to working with a wonderful IBCLC, whose name and number she gave me. We were called back into the exam room and while waiting for the doctor, Fitz wanted to eat again. I tried but it was still painful and didn’t feel right. When the doctor came in and saw us, she said, “That looks good!” and I broke down crying again. Like everyone else (except Anna), she said not to worry, it would get better. But we found out Fitz had lost 10% of his birth weight (and since I didn’t have IV fluids in labor, that’s an accurate number) and I did worry.

When we got home I read an email from someone purporting to help, telling me that giving Fitz a bottle was the best way to ruin a breastfeeding relationship and I should feed him with a syringe. That seemed so outside the realm of possibility that I felt completely abandoned. I had Rusty call Ann, the lactation consultant. When she called back, I sobbed on the phone with her and told her I hoped she wouldn’t be disappointed in me for giving Fitz formula. It was such a relief to hear her say that of course she wasn’t disappointed, and that she was glad I had done it, because the most important thing is that the baby has to eat.

She came out the next morning. Looking back, I don’t know what I would have done without her. She was the perfect combination of compassionate and professional. She had no judgment. Maybe after being in her field for over 40 years, she’s past the judgment and just wants to help. She presented information clearly and completely. She examined Fitz’s mouth and told us he had something called type 4 tongue tie. I felt such relief; I wasn’t crazy, something was wrong, and it wasn’t that I wasn’t doing everything right, it was that my baby had an actual physical impediment to breastfeeding! Ann said this kind of thing runs in families. She found that I had it too, but no one had ever caught it with me, because I was never breastfed. (Some babies with this type of tongue-tie have no problems with bottle-feeding, but Fitz had trouble with a bottle, too.) She explained the frenotomy procedure. She explained the possible effects if we decided not to do the frenotomy. She taught me how to hand-express. She showed me how to nurse with nipple shields. She found the correct size flanges for me to use with my pump, showed me the best way to pump to increase my supply, and sat with me while I did it. She taught Rusty and me the best way to bottle-feed Fitz. She presented cup feeding and syringe feeding as options and described each. She left photocopied articles about tongue-tie and frenotomy, and written instructions covering everything we had discussed. She held my hand as I sobbed and asked, “What if I just don’t want to breastfeed?” and answered that whatever I decided, she would support me and help me do it safely.

That morning with Ann was the last time I fed Fitz directly at my breast. The mere thought of breastfeeding had become too much of a trigger for me. I turned my attention to pumping. I pumped every 2-3 hours using the techniques Ann had taught me, and sure enough, just like she had said, my supply increased overnight. For the next three weeks, I pumped enough milk that we didn’t have to give Fitz any formula. I borrowed a huge trash bag full of milk storage bottles from a friend because I was rapidly using up all the ones we had. I started freezing milk. I was really good at pumping and my body responded really well to the pump. Even though these were my absolute darkest days of PPD and most of the time I felt like a worthless mother, pumping was the one concrete thing I was able to do for my baby.

With Rusty’s return to work looming on the horizon, though, I knew something was going to have to give. I knew I couldn’t keep up this pumping schedule while home alone with Fitz. I decided to wean off the pump. With Ann’s help, I came up with a plan for a gradual weaning process. It took me seven weeks to wean off pumping. I also started seeking donor milk through the peer-to-peer milksharing networks Human Milk for Human Babies and Eats on Feets. I pumped for the last time on July 17. It was a bittersweet moment. For several weeks afterward, I still leaked milk, especially in the shower. I thought of all that milk going to waste. A few times on “good days” I considered starting pumping again, but reminded myself of all the reasons I had stopped and how it was helping speed my recovery from PPD.

I feel like I should close with some grand statement, but now that I’ve written this all out, I’m emotionally exhausted. In my heart of hearts, I feel with 100% certainty that I made the right decision. The guilt and doubt creeps in when I see the ceaseless posts about breastfeeding being best, from people who probably have good intentions but don’t realize how hurtful and alienating they are being. I still don’t know how to handle those situations. It wears me out to constantly “speak up” when I see thoughtless comments. My therapist says maybe the reason this was so traumatic for me is because I didn’t have a plan B. I had a backup practice and hospital in case the home birth didn’t work out, so that was my plan B for the birth; but we had no formula in the house. I don’t think that’s it, though. We also didn’t have any disposable diapers in the house but I can’t see myself being such an emotional wreck about it if cloth diapering hadn’t worked out.

I fed my son directly at my breast for five days. I gave him my milk for two and a half months. But what I’ve come to realize is none of that matters nearly as much as the fact that on a daily basis I give him my love in the unique way that only I can, because I am his mama. My baby needs a healthy mom more than he needs my milk. I am inching toward recovery, even though I still have days where I feel like a worthless mother. On those days, I try to remember these words from a recent Daily Hope email from Katherine Stone of the blog Postpartum Progress:

“Use what talents you possess; the woods would be very silent if no birds sang except those that sang best.” ~ Henry Van Dyke

Your baby would have very little without his or her mama. You are SO important, even if you feel like you’re blowing it. You have talents — you are feeding and clothing and speaking or singing or rocking or strolling or reading or bathing or whatever it is that you have done or will do. Keep on doing whatever you can do to the best of your ability. To you the things you are doing may seem like they don’t measure up, or they aren’t enough or you don’t have the right thoughts in your head when you’re doing them. To your baby, they’re like birdsongs in the woods.

***

Share your story for an upcoming FFF Friday: email me at formulafeeders@gmail.com.
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