Fun and games with Kaiser’s new breastfeeding policy

This image was used in conjunction with this story, about how Kaiser Permanente (an American health system which prides itself on being Baby Friendly) is now promoting breastfeeding as a means to fight obesity.

For our first game, I’ll give you two guesses as to where I am heading with this one.

The article states that “The breastfeeding-obesity link is now recognized by key government agencies such as the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP).” True dat, as they say. The LINK between reduced chance of obesity and breastfeeding is certainly recognized by the CDC and AAP (although last I checked, the AAP was not a “government agency”, but rather an independent association of pediatric physicians). But, um, a link is not a cause or cure. It’s a link.

The CDC’s own document on the breastfeeding/obesity link states:

…Breastfeeding is associated with a reduced odds of pediatric overweight; it also appears to have an inverse dose-response association with overweight (longer duration, less chance of overweight). While more research is needed, exclusive breastfeeding appears to have a stronger effect than combined breast and formula feeding, and the inverse association between breastfeeding and overweight appears to remain with increasing age of the child. The three meta-analyses reported in these review articles suggest a 15% to 30% reduction in odds of overweight from breastfeeding.

If you read the entire report, you’ll see that several of the studies in question reported a reduced risk of obesity with breastfeeding initiation – meaning that if women just breastfed in the hospital, there was less of a chance that the child would be overweight. And all studies were observational in nature, as the report authors go on to explain:

There are several possible explanations for why breastfeeding appears to reduce the risk for overweight, but conclusive evidence is not yet available. The studies presented in this brief are limited in that they are based on observational studies and cannot demonstrate causality. One possible explanation for why the literature indicates that breastfeeding reduces the risk of overweight is that the findings are not true but instead are the result of confounding. It may be that mothers who breastfeed choose a healthier lifestyle, including a healthy diet and adequate physical activity for themselves and their children. This healthier lifestyle could result in a spurious relationship between breastfeeding and reduced risk of overweight. The results of Arenz et al. and Owen et al.,however, suggest a true relationship between breastfeeding and reduced risk of overweight, because after adjusting for potential confounding variables, significant inverse associations remained. For example, Arenz et al.reported a significant adjusted OR of 0.78 (95% CI: 0.71, 0.85) among nine studies that adjusted for at least three of the following confounding or interacting factors: birth weight, parental overweight, parental smoking, dietary factors, physical activity, and socioeconomic status/parental education. Similarly, when Owen et al.30 conducted a subanalysis of six studies that controlled for possible lifestyle confounders, the significant inverse association between breastfeeding and pediatric overweight remained, but it was smaller than in the unadjusted analysis. While randomized clinical trials are required to adequately test this relationship, it is unethical to randomize infants to a group with no breastfeeding because of breastfeeding’s known health benefits…

Fair enough. But then the paper launches into a slew of hypotheses about why breastfeeding confers a protective effect against obesity (none of them proven, or even studied, in some cases) and continues with a lengthy discussion about how to improve breastfeeding rates. So what can we gather from this paper?

1. Breastfeeding is associated with a lower risk of obesity.
2. We don’t know why.
3. Breastfeeding rates are low.

Hardly evidence-based proof that we should be promoting breastfeeding as a means of reducing obesity, and yet, here we are again, beating the same dead horse. Somebody should probably call PETA.


Time for the next game… going back to the image at the top of this post… can you spot the misleading or outright false claims?
First of all, breastfeeding does not “prevent” asthma. In fact, several studies (like this one and this one) have suggested that longer breastfeeding may increase the risk of asthma in babies whose mothers have the disease. One meta-study recommended that short-term breastfeeding (4-6 months) was optimal for asthma prevention, but that breastfeeding longer than that may have a reverse effect; another, published in 2011, “(did) not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over.”
Breastfeeding also does not “prevent” postpartum depression; this particular claim is outright dangerous. If women believe that breastfeeding protects them from getting PPD, they may fail to seek treatment when symptoms arise. The only studies I’m aware of show an association between breastfeeding cessation and PPD; all this proves is that women who already are showing symptoms of PPD are more likely to quit breastfeeding (another plausible theory is that breastfeeding failure may be a risk factor for PPD).
I’m not sure how this image is being used, but it concerns me…. this is exactly how misleading information spirals out of control. If policymakers and physicians do not have the good sense to differentiate between “links” and causalities, what hope do we have for the general public having a decent understanding of what will impact our health?
Breastfeeding may be good for baby, and good for mom. But please, can we stop with the false advertising? It’s not fair for the formula companies to do it, but it’s just as unfair for the government or health authorities to make unsubstantiated claims. Maybe even worse – we are taught to be skeptical of big corporations, but most of us still have a blind faith that doctors and health organizations are 1) honest and 2) out for the common good. I still believe #2 but I am highly doubtful of #1. And I’d still prefer the truth, even if does make for a less convincing “sell”.

One more little postscript…. my friend J is exclusively breastfeeding, and is a member of Kaiser. Despite the fact that you can’t go two feet in a Kaiser hallway without seeing a breastfeeding promotion poster, she was recently prescribed an allergy medicine that killed her milk supply. She couldn’t understand why her son seemed fussier all of a sudden, until she tried pumping first thing in the morning (her son sleeps through the night, so she hadn’t nursed for over 6 hours and should have been full) and only got a few drips. When she called Kaiser to inform them of this development, they told her that since the meds she was given weren’t contraindicated for breastfeeding, they were deemed “safe” even though she was a nursing mom. She asked what was safe about not having enough milk to satisfy her baby, and the nurse on the phone told her that “she could always just give him formula.”
Interesting. I guess she can blame that nurse if her son is chubby at the age of 5, huh?

Blasts from the past: Best of FFF, 2009-2011

As 2011 comes to a close, I thought it might be fun to go back and revisit some posts. The FFF community tends to be rather transient… once people are out of the formula/ breastmillk era, they don’t stick around. Makes sense – there are far more pressing things to worry about in the toddler years, like potty training, tantrums, etc. And of course, there’s (unfortunately) always a new crop of stressed, isolated new moms stumbling upon this page after a failed 3am feeding….

Point being, I think there might be a lot of folks who are searching for posts on a specific issue that we’ve already covered at some point in the past 2.5 years. So, in your honor, newbies – here are some oldies but goodies you might find useful:

Dealing with formula feeding fear, guilt, and hate:

What do formula, IVF, pregnancy after 30, and working moms have in common? – Examples of other maternal “choices” which carry some degree of risk, to show that we make decisions every day which might not be the most ideal, but which work best for our individual situation.

A public health threat, of the male persuasion- In response to an ongoing tirade of comments from a male lactivist, I wrote this post, comparing the “risks” of older men fathering children to formula feeding. It’s written with my tongue firmly lodged in my cheek, but I think it’s actually a good example of relative risk.

Formula is the 4th best choice and other fallacies – Some thoughts on WHO’s hierarchy of infant feeding

The Top 5 Formula Feeding Myths Debunked

A collection of the top formula-related insults and misconceptions

For those considering bottle feeding from the get-go

The Giant Misunderstanding Behind Breastfeeding Guilt- If you’re sick of people whining about how they can’t talk about breastfeeding without some formula feeder telling them they are making her feel guilty, send them this link.

….But if you DO feel guilty, check this one out: On letting go of guilt

About the FFF

Nursing old wounds: my story – The tale of Fearless Child, or, How I Became The FFF

The Big Reveal – Fearlette’s story

FFF Musings on Breastfeeding

Why we should support (positive) lactivism

Public displays of affection – nursing in public

Extended breastfeeding

Breastfeeding promotion tips from a formula feeder

Milk sharing

Random thoughts, studies, and current events

Quick thoughts on the Similac Recall – Remember Buggate 2010? Ah, memories.

WHO Code, Old Navy, and the Case of the Renegade Onesie -My opinion on WHO Code, in response to the mass freak-out over a cute little onesie.

Stress and breastfeeding failure: related or not?

Feminism and lactivism – why the two -isms have such a crappy relationship

Formula feeding and obesity: a big fat lie

The Bottlefeeder in Room 1 - a personal account of a woman who gave birth at a baby-friendly hospital, which led me to write this:
Surviving the baby friendly hospital: tips for those planning to formula feed


Formula feeding logistics

Bonding on bottles

Nipple Confused? Here’s some “supplementary” info – supplementation and the reality of nipple confusion

Bottle weaning

Night weaning

Homemade formulas: recipe for disaster or interesting alternative?

Hyping hydrolysates: All about hypoallergenic formulas

Are soy formulas safe?

Toddler formulas

Choosing the right bottle for your baby

Changing formula and nipples as your baby grows

Formula feeding and reflux

Tips for drying up breastmilk

The two-hour rule: part one and part deux – why you shouldn’t leave a bottle out longer than a few hours (I got properly schooled on this one….)

The FFF Documentary: Message in a Bottle

This was a little film I made a few years ago, attempting to give the FFF Friday voices another medium….it’s long, so it’s in three parts….
Part 1
Part 2
Part 3

FFF Friday: “Surely we should all be a bit more understanding?”

It kills me that FFF Shane still feels “slightly guilty” about her choice to formula feed, even though her son is thriving, happy, and healthy. Today, Fearless Husband and I were talking about some very dear friends who are going through their own 3-days-postpartum struggle with feeding. I confided that while I wanted to give this new mother the support she needed to switch to formula, I also worried that in the long run, she’d have an easier time breastfeeding – because the guilt you have to live with as a formula feeder (especially if you decide to stop when your body and baby are still allowing breastfeeding to be a possibility) cancels out the relative “ease” of it in the beginning. Fearless Husband thinks I’m nuts… what do you guys think? If a friend of yours was struggling with breastfeeding and wanted to switch to formula, would you encourage her to “persevere”, or throw in the nursing cover? How do you meet a woman where she is at, if you can’t really know where she is at due to the enormous pressure put on mothers these days, coupled with those postpartum hormones and the transition to new motherhood? I think these questions matter, because Shane’s point about the sisterhood of women being mucked up by the breast/bottle war is excellent, and maybe we should start thinking about how best to support our friends and fellow moms. Start the revolution that way, rather than just railing against the powers that be.

Regardless – I hope Shane’s guilt will fade… she made a decision which put an end to a great deal of stress for her and her family, and all three members of that family are happy, fed, and loved. Full stop, as they say in her neck of the woods…

***

I have 3 sisters who all have children – and who have all breast fed successfully. My mum had five kids and she breast fed too (apart from my little brother – she gave up after two weeks as ‘he was a greedy bugger and I couldn’t keep up with him’.) I naturally assumed that breastfeeding was the way forward for me – hell if all my sisters could do it why couldn’t I?

Throughout my pregnancy I was bombarded with breast feeding info from the NHS and Bounty packs which I read up on, I attended a breastfeeding class, read books, the internet and quite frankly I thought I had it sussed.

So when the happy day arrived (when England was rioting – I was in labour when all hell was kicking off 5 minutes down the road..) I ended up having an emergency c-section which I think may have played a part in why I really struggled to feed him,(As an aside – could
emotional stress affect the production of milk? I was still grieving for my dad who had passed away a couple of months earlier from a sudden illness).

Everytime I voiced my concern to the midwives I was told to keep persevering. I had midwives shoving my boobs into his mouth and pulling me into different positions. When I got home my delicious son was starving. After the 2nd sleepless night my husband and I bought formula with heavy hearts. It felt like I had failed at parenting at the first hurdle.

But the joy of knowing our son was eating overwhelmed us – but I was still ridden with guilt and desperately tried to feed him – I tried pumping (by hand and electronically). I was still encouraged by the home visiting midwives to persevere (and not one piece of advice about
alternatives!) which I tried to do but I was producing so very little after two hours it really wasn’t worth it. So after a week of struggling my husband and I switched onto formula. It did help that I had my mum visiting from Scotland at the time who was an excellent
voice of reason.

I went through periods of feeling fine about the formula (My husband could feed him! We could go out and about! I wouldn’t have to wear maternity bras! I could have that extra cup of coffee/bar of chocolate/glass of wine!) and then an overwhelming sense of guilt burbled up from my stomach to my heart (Is he going to be plagued with illnesses throughout his childhood? Is he going to be the dunce of the class? Will he be a mutant?).

I’ve talked to my friends about it and they have all been very supportive – some even admitted that they wished that they had gone onto formula sooner after they spent months struggling with breastfeeding.

3 months down the line I still feel slightly guilty about it but my beautiful baby boy is healthy and content. He sleeps well, he eats well and is a happy and healthy boy.

My concern is at a time when mums and mums-to-be should be supporting and understanding each other, there is this one-up womanship regarding feeding our children – surely we should all be a bit more understanding?

***


Thanksgiving may have come and gone, but you can still give thanks to all the brave women who’ve shared their stories by sharing yours (and if you aren’t American and therefore could care less about Tofurky Day, well, you get the point) – email me at formulafeeders@gmail.com.

Bottle Holding is Not Bottle Propping (and neither is the end of the world)

I won’t lie to you guys – there were many, many times in FC’s babyhood when I would have killed for a device like this. Judge all you want, but when stuck in Los Angeles traffic on the 405 and your kid is screaming in hunger and you know all he needs is a little formula…

Anyway. I never did bottle prop, but I can’t say I wasn’t tempted. And I rejoiced when he started holding his own bottle around 5 months of age; it made those long car rides exceedingly easier.

(This is one of the rare cases where I didn’t envy my breastfeeding friends, by the way. At least if Fearless Husband was driving, I could sit in the back and hold a bottle for FC. Considering you can’t take the baby out of the carseat while driving, I’m not sure there would be any way to breastfeed on the road without pulling over. In LA, this isn’t always the easiest thing to do… there are long stretches of my commute where pulling over would mean putting myself at major risk, what with being a woman alone with a baby and the violent crime statistics of the neighborhoods. Obviously not a huge problem as you can always just feed your baby before you begin your journey, but if you get stuck on the 10 freeway for two hours – a daily occurrence here – and you have a newborn in the car…. you can imagine why I felt a bit less bitter about bottle-feeding during those times.)

Now, when FC started holding his own bottle, it was pure awesomeness, because he would still let me hold him and snuggle him while he ate. It was the best of both worlds – since I didn’t need to hold his bottle, I had both hands free to play with his feet, hug him tight, or even read him a story while we cuddled.

My fearless, feisty little Fearlette is a whole other can of tomatoes, though. She started holding her own bottle around five or six months as well. Fearlette loves to be held, but only on her terms; she has to look out into the world, has to be in control. And when it comes to her bottle time, that is hers and hers alone. She can’t really be bothered to drink a whole bottle anyway (which has made the whole weaning onto sippy cup thing disgustingly easy this time around), so she’ll grab it from me, crawl or cruise away into a corner, take a few sips and throw the bottle on the floor, usually face-down (I have Stanley Steamer on speed-dial). I’ve tried in vain to make her let me hold her – waiting until she’s ravenously hungry to offer her a bottle, as if I could lure her into my arms via her gurgling stomach…. but she just wiggles her way out.

I miss those warm, snugly feeding sessions. Oh god, do I miss them. And yeah, I suppose if I were breastfeeding, I’d still have them, because she’d be forced to have physical contact with me while feeding.

But on the other hand, I get sort of a kick out of her independence. Forcing her to be close to me isn’t going to make her bond with me; if anything, it’s going to smother her. We have plenty of snuggle time, just not while she’s eating. Food and comfort do not need to be one and the same, at least after you get through the newborn stage.

Bottle holding is not bottle propping, at least in the psychological sense. You are not depriving your child of bonding time or physical proximity just because his hands are holding the food-dispensing apparatus. If he still lets you hold him while he eats, then there is no difference at all between feeding a child who does not hold the bottle and one who does. If he doesn’t want you to hold him, and has the ability to a) hold the bottle and feed himself and b) physically move away from you so that he is eating somewhere other than your arms, it’s okay to allow him this freedom. Considering no newborn on earth can feed herself, we are talking about older babies, here; ones who are learning to crawl, figuring out their own place in the world, and at least in the Fearless Chidrens’ cases, becoming their own little hard-to-please individuals. Fostering autonomy is just as important as cementing bonds that are most likely already set in stone, by the time a baby is capable of holding his own bottle.

Physiologically, however… it’s a bit of a trickier distinction. Fearlette only wants to drink her bottle lying down, flat on her back. I have no freaking clue why this is; I always held her with picture-perfect bottle-feeding posture, fancying myself a formula feeding “expert” and all: close to my chest, slightly elevated, right at boob level… the whole shebang. And yet the minute she was able, she grabbed the bottle from me, sprawled out on her back, and went to town. For months, I tried to amend this behavior, even attempting another kind of “propping” – baby propping, where I’d prop her up on some pillow so her upper body was appropriately elevated. She’d have nothing of it. It was either eat flat on her back, or not eat at all.

I was – and still am – less than thrilled about this situation. According to one anti-bottle-propping brochure from Intermountain Primary Children’s Medical Center:

If you bottlefeed your baby while she is lying flat, she will be more prone to ear infections. Your baby has little openings from the back of her throat to her ears called a Eustachian tube (pronounced you-stay-shun tube). Adults have these tubes, too, but your baby’s Eustachian tubes are shorter, wider, and flatter. When you feed your baby with a propped bottle, the liquid pools in the back of her mouth. The liquid can then back up into her ears through the Eustachian tube. This is bad because bacteria can then enter through the tube into the ear, and cause an ear infection.

This sounds plausible. I’ve said before that I believe the correlation between ear infections and formula feeding is due to the mechanics of formula feeding, not the lack of breastfeeding. I would like to have research done on babies fed breastmilk in bottles versus babies fed formula in bottles, to see if there is a significant difference in the number of ear infections between the groups. My own purely anecdotal evidence, the Fearless Family Sibling Study, found that the baby who did not insist on drinking all bottle flat on his back has had no ear infections in all three of his years on this planet, while the baby who prefers drinking while supine has had three in her not-quite-one.

And then, there’s this, from a guide for WIC professionals dealing with infant feeding:

It is not advisable to give infants a bottle (whether propped or not) while the infant is lying down at nap or bedtime or while the infant is lying or sitting in an infant car seat, carrier, stroller, infant swing, or walker. In addition to possibly causing choking and ear infections, these practices can lead to dental problems if there is milk, fruit juice, or a sweetened beverage in the bottle.

Aw, crap. Really? The highlighted part pretty much outlines the only places my daughter will drink a bottle.

But a closer look at this passage – one used to inform “professionals” about counseling bottle feeders – finds some incongruities. First of all, why does a baby holding her own bottle and drinking in a swing, carseat, etc, have more of a risk of dental problems than that of a baby whose mother is holding her during a feeding? Only one citation is used for this passage, and it is a manual from the American Dietetic Association. No studies of note.

In fact, I couldn’t find any studies specifically looking at the dangers of bottle propping or bottle holding, except for one from 1968 (oh and if anyone can get the full text of the study without paying exorbitant fees, let me know… I’d be curious to read it).

So I’m a little confused. Where is the evidence that bottle propping actually causes choking, dental disease, or ear infections? I’m not saying it doesn’t, because some of the theories and hypotheses out there sound perfectly reasonable, but until we have research, that is all they are: theories and hypothesis.

Look. The only people I actually know who bottle prop are a) daycare providers and b) moms with multiples. If I had to take care of more than two infants at one time, I’d be wanting more than just a bottle propper. (Like a bottle of Jack Daniels and some Valium.) These women are using actual bottle proppers, designed to keep the bottle at the proper angle. I would assume that this would help with the choking and ear infection risk, as long as the baby was being properly observed – not just left unattended with a propped bottle. That would be child endangerment, not poor feeding technique. I can’t see why using an apparatus that allows for hands-free feeding would be physically dangerous in the hands of a responsible adult, so the only thing left to worry about is that elusive “bonding” aspect. Considering we can’t really do a study which measures the effect of occasional bottle propping on the emotional state of infants, I’m not sure there is empirical evidence to back up these warnings.

As is the case with most infant-feeding-related stuff, these recommendations are so mucked up by the moralistic tone of parenting advice, that it’s hard to discuss them without people getting defensive or judgmental. Bottle-propping needs to be discussed and studied on a purely logistical level, as does bottle holding. Framing these recommendations as “good parents do this” and “bad parents do this” helps no one; neither do vague admonishments about ear infections, choking, and obesity; and it certainly isn’t helpful to use the two terms interchangeably.

Until I see some good, clinical research about why bottle propping is dangerous, I’d approach these recommendations a little more realistically. Yes, it’s better to hold younger babies while you feed them, if and when it is possible. If you’re a mom of six kids, or a babysitter of triplets, or in some situation where this might not be possible all the time, go ahead and prop a bottle when necessary – just do it safely. Make sure the baby is old enough and strong enough to turn away from the bottle when he’s finished, and keep a close eye on him to make sure he’s not choking (or use a slow-flow nipple – it takes like seven minutes for a drop of formula to come out of the newborn Avent nipples, for example. It’s not like buckets of formula are going to be pouring out of one of those bad boys).

As for those with older, independent bottle holders, if they let you hold them once in awhile, more power to you. Otherwise, hug, love and cuddle your kiddo in every other way possible. It’ll be okay.

Seriously, though, it will.

FFF Friday: “The balance around talking about infant feeding is completely off-centre…”

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.


This contributor asked to remain anonymous, but I seriously wish I could shout her name from the rooftops, in Streetcar Named Desire-esque fashion. Her sentiments are exactly what I want FFF to be about – finding a modicum of practicality, honesty, pathos and humor in the breast vs bottle conversation.

I think after all the seriousness and academic discourse of the past week, we all deserve a little levity. It’s rainy and gray here in LA today, but reading this makes me feel like the sun is shining and there is hope for humanity. Dramatic? Yes. But well deserved.

Happy Friday, fearless ones,

-The FFF

***

I’ve started to write this so many times, and every time I did it started well but almost immediately became long and boring, which isn’t my style…the long bit anyway, I’m averagely short; my husband will confirm that I’m an incredible bore. I want this post to be a light hearted account of triumph over zealous lactivists, and an ode to my superb family and all the stuff I love about them.

I thoroughly enjoyed my pregnancy; it was easy and fun. I got to be fat and not care, my boobs were enormous, I was a little spotty but hey ho, my stomach moved of its own accord! I planned to breastfeed and read up on it, went to support groups (where they had knitted boobs no less!), but I wasn’t actually all that fussed. This is where my Mum comes in; she’s always said about the whole pregnancy/childbirth/breastfeeding thing (paraphrased):

“50% of the population are going to do it at some point, you’re not special, people survive, get on with it try not to have Pethodine and breastfeed if poss. If it’s not possible don’t whinge, you weren’t, your sister wasn’t but your brother was and he’s got all my allergies, oh and you’re the cleverest one [thanks Mummy, no favourites then!]”

She’s actually right about my brother, he turns into The Gruffalo at the mere mention of a hamster but otherwise he’s a very nice individual. I can’t offer any insight into the comparative states of our various tracts, nasal passages, earholes etc. but I’m assuming his are OK because he hasn’t mentioned them to me of late. Currently, he’s more worried that I’m going to get a PhD., that would bring us to a whole new level of sibling rivalry and one he’s not sure he can entirely be bothered with. Maybe I should just tell him that Mummy already thinks I’m the cleverest and it’s a lost cause? Anyway, that’s a whole other story and I digress.

DD was born after a text book, but long labour. The high point was when I turned into the girl off The Exorcist when my husband came into the room with a bowl of cornflakes. The low point was the two times I got sent away from the hospital because I just wasn’t ready to be in there yet. Once DD was (finally!!!!) born she was put straight onto my chest and there wasn’t a peep out of her, she just looked at me like a tiny alien. I was absolutely ecstatic and more proud of myself and our new family than words can say.

After I was put into the bed and given tea and toast someone popped into the room and told me that she might quite like to be fed now. I thought that was about right and so my beautiful, wide-eyed, 7lb 5oz baby girl was manhandled into getting her tiny mouth around my enormous boob. The midwife looked momentarily pleased with her effort, said “there you go!” ticked a box on my chart and left. We got the camera for the obligatory photo continued with our ecstatic daze. I suspect the midwife was momentarily chuffed because the simple tick of the box added another stat to the ‘initiate breastfeeding’ rates, job done.

Things got a bit trickier when we got home, mainly because I had no idea whatsoever of what I was doing and despite the classes, research, and midwife; I had not heard a single realistic account of what it’s like to breastfeed. The first four days went something like this: she woke up, I sort of managed to stick it in, and she went back to sleep. In fact, she slept for almost a whole three days on my husband’s chest whilst I sat next to them twiddling my thumbs and waiting for the whole ‘Motherhood’ thing.

By the fourth day, DD woke up and was starving. I mean STARVING. She wouldn’t stop crying and I didn’t know what to do, my milk wasn’t in. A midwife came round to check on us and responded to my exhausted and tear-puffed face with: “They only need a teaspoon-full at the moment; you’ve got all she needs, keep going”. The moment she left my husband was dispatched in search of a box of Cow&Gate. I already had the bottles in (naughty naughty!) because I’d listened to my Mother, she’d also firmly informed me that “Cow&Gate babies are happy babies” (she says the same thing about Marmite and Fishfingers and sleep). DD downed 4oz immediately, it didn’t touch the sides. I was incredibly relieved that I had ignored the midwife and my baby was now able to sleep peacefully whilst my scabby nipples recuperated before the next onslaught.

On the fifth day my milk did come in and my breasts were incredibly painful, it was worse than labour itself. I think Hugh Heffner would have marked me highly for the enormous ball shaped protrusions on my chest but I may have lost marks for the diagonal, puss-filled, bleeding scabs across each nipple. A little off-putting I imagine. I started with the pumping, I gave bottles, I cried a bit, I kept trying to get her back on again, I cried a bit more, I did it in private, I had a go in public, I did cabbage, I did hot water bottles, I did ‘on demand’, I did timed and anyway, eventually, it’s all a bit of a blur now, I got the latch, or whatever it was that was difficult, right. By that point the EBF ship had sailed.

There were points where I was furious with myself for giving her bottles, to points where I felt defensive about using bottles to points where I would claim to be fine about it and then internally beat myself up and get depressed about how thick and fat I was going to make her. I called myself possibly every name under the sun and then some. However, after a while I noticed that everyone was seeing how beautiful DD was (is!), and telling me how relaxed and happy we both seemed and that I was a ‘natural’ mother…yeah, natural and only 80% of the nipple time! Finally, I stopped growling stuff containing the words ‘misogynist’ and ‘testicles’ and ‘sandpaper’ and ‘vinegar’ to my husband and our marriage started to get that twinkle back. From that point I quit with the naval gazing (Mother’s advice again) and accepted that I mixed fed, that DD was happy and that we had an awesome little family thing going on.

I actually consider myself to have been really successful; I managed to breastfeed for over a year and really genuinely enjoyed it. I supplemented with bottles and DD thrived. I don’t think this would have been possible had I not had a superb midwife (day six) who was superbly pro-choice. She told me everything I needed to know about bottle feeding, gave me the number of my local breastfeeding support group for when I was ready and wrote “sore ++” and “discussed” in my medical notes so that other midwives wouldn’t give me any stick. I wish there were more midwives like her and think that FFF and books like Joan Wolf’s “Is Breast Best?” are superb resources for women and should be required reading. The balance around talking about infant feeding is completely off centre and that’s why we need to be talking about our experiences and engaging with research positively, that means with constructive criticism as well as praise.

On account of my success I would also like to thank my superb family, especially my Mum for her fantastic advice. Her body is similar to mine and she’s done it three times before, she was so right and so supportive (although not ‘supportive’ in the way lactivists would like). Seeing her face when she was able to give DD a bottle herself was beautiful, she was full of pride and love and that is a priceless memory.

My Dad deserves thanks for never failing to make me laugh, intentionally and unintentionally! He gagged when he saw bottles of expressed milk in the fridge (unintentionally hilarious) and thoroughly enjoyed shouting ‘BITTY’ whenever he liked (inappropriately, but intentionally hilarious). We never made breastfeeding into some sort of sacred act of Motherhood to be worshipped and revered, it just happened sometimes and was funny because it’s a bodily function with wobbly bits involved.

I would like to spare a thought for my fantastic husband who put up with a lot of breastfeeding nonsense from me. I would also like to say that I loved watching him feed our baby and love that he still enjoys feeding babies now; he’ll give any baby going a bottle he really will. I’m very proud of myself for letting him discover that pleasure. I’m also really proud of the way he approaches the whole “breast is best” debacle with a healthy dose of cynicism. He went from being a staunched “breast is bester” to a more moderate, “thank you for trying your hardest”. I love that he appreciates my efforts and that we’ve started this journey together (can I have DD/DH 2 now pleeeaaaase?).

Finally and most importantly, I’d like to thank my wee girlie. I’ve been hugely fortunate in seeing DD grow stronger, funnier and more wilful every day and I have the privilege being able to love her with all my heart. Just some of the more random things I love about DD are that, she’s almost phobic of yoghurt, not allergic, just extremely hateful of it. She LOVES swimming, but not on her back because, try as she might, she can’t open her eyes when she’s on her back in water (not even in the bath). Her favourite song it Regina Spektor, Fidelity, she listens to it on repeat. She’s superb at baking. She loves all animals, even snakes! If I go out without her, even to the shops, I get greeted with an enthusiastic “Mummy! You’re BACK!” as though I’ve been to the moon. She says ‘Hopigus’ instead of Octopus and thinks Batman is called Fatman (she also suspects that her Daddy actually is ‘fatman’ on account of a t-shirt bearing a certain bat-shaped logo). Oh, and she’s not fat, she’s top of her class, she’s got perfect teeth and she’s rarely ill (although I would still love her with all of my heart if she weren’t those things).

My hope is that should someone stumble across this post in their darkest breastfeeding hour, they can take comfort from it. Breastfeeding is awesome, it’s cuddly and warm and once you get the hang of it, very handy when you’re out and you realise that you’ve forgotten the baby’s drink (I have an almost 100% record for that), it can also mean that you don’t have to get out of bed at night. However, bottle feeding is also awesome, your significant other, Grandparents and friends can all enjoy feeding your tiny one, it gives you a well earned break whenever you like and it feeds your baby when you simply feel like you can’t. Supplement or no supplement, just find a balance that suits you and your growing family.

My biggest boob related hope for the future is that we all find some sort of middle ground and realise that boob, bottle or both, we all just want the same thing, the best for our babies. I also never want to hear “breastfeeding is free” or “breastfeeding is the most natural thing in the world” or “only 1% of women don’t have enough milk” or “breastfeeding causes obesity” or “breastfeeding reduces crime” etc. ad infinitum/nauseam….might that be asking too much?

To finish with, if any pregnant Mother asks me for my breastfeeding advice I now say:

“Do your best, but don’t beat yourself up. Breastfeeding can be amazing, but that doesn’t make it easy and sometimes it won’t feel natural at all. Listen to, and don’t dismiss the advice you’re given, if the shoe fits you can try it on, if it doesn’t, say Thank you and leave it there. The most important thing is that you give your baby your love and attention and make a happy home, whatever form that may take.”

From the bottom of my bosom, thank you for reading this.

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Feeling in inspired to share your story? Email me at formulafeeders@gmail.com. Come on…all the cool kids are doing it….

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