There’s a fine line between acknowledging that feeling of failure and guilt are normal parts of the formula feeding experience, and accepting that it has to be this way. I personally despise the sentiment that “no one can make you feel guilty” because guilt is a real and valid emotion. The guilt may indeed come from within ourselves, but it stems from a deep desire to do the best for our children, and when there’s such a limited definition of what “the best” is, it doesn’t leave much margin for error.
I really want to reassure FFF Diane, the writer of the following story, that she DID try hard enough. That doesn’t mean that we should have a scale for such things; that some women are “excused” because they tried to breastfeed for a certain amount of time, or with a certain level of perseverance. I don’t believe that Diane should have had to feel like there was so much at stake, but I fully understand why she did… because I’ve been there myself. And until we see sufficient, systemic change which allows for individualized narratives of “good mothering”, we need to support women like Diane as much as we possibly can. I want her to know that she is an amazing mom no matter how or what she feeds her child; that she did not “fail” at anything, and that she is doing a tremendous service to other women by being open about her experience. This goes for all of you who have shared your stories here – you should be proud, and you should be thanked, a million times over.
I’ll start: thank you. 999,9999 to go.
Happy Friday, fearless ones,
The FFF
Labor, on the other hand, was a whole different ballgame. I was scared to death of labor. I vehemently did not want to be induced because I was afraid of it resulting in a c-section. In addition to being scared of the pain associated with a c-section, I had heard it was much more difficult to breastfeed after one, and I wanted to get started on the right foot. My 40 week appointment came around one day after my due date, and much to my disappointment, there was absolutely nothing going on. I was set up for an NST and BPP the following Tuesday and was told if anything did not look right, I would be induced that day, if everything was okay, they would let me go until Friday, which was 8 days past my due date. I went home and cried for much of the evening. At midnight, just as I was about to go to bed, I stood up and my water broke. We rushed to the hospital and I had a perfect labor. 12 hours from start to finish and only 30 minutes of pushing. It was no where near as bad as I had thought it would be. I made it known to the doctor, nurses, and my husband that as soon as my daughter came into the world, she was to be placed on my chest for kangaroo care and the beginning of our breastfeeding relationship.
Here are where the problems started. The doctor complied and immediately placed my beautiful 7 lb 11 oz daughter on my chest. I opened my gown right away to breastfeed. This is when newborns are supposed to be eager and alert, right? They are supposed to want to nurse right away from everything I had researched. She did not seem interested. She took a few lazy sucks at the breast and then broke away. I alerted the nurse who told me that her stomach was the size of a marble and not to be concerned. She fell asleep and we were transferred to the postpartum unit.
I told every nurse that came in my room that I felt like breastfeeding was not going right and requested a visit from the LC. They all told me the same thing – as long as she was having dirty diapers she was fine. After all, her stomach was only the size of a marble and she didn’t need much. I, on the other hand, couldn’t shake the feeling something was wrong. She would suck a little when I put her to the breast, but it didn’t feel like anything was coming out. Although, she was having dirty diapers, so my husband said he thought everything was fine. Being first time parents, we did not realize that all she was passing was meconium – there was no urine or stool in any of those diapers.
The LC finally came to see me 27 hours after my baby was born. After 2 minutes of observing me, she quickly realized that my daughter was getting absolutely nothing from me because I have inverted nipples and her suck was not strong enough to get anything out. She suggested that at each feeding, I should try to get her to latch for 15 minutes, supplement with formula, and then pump for 15 minutes. She also gave me a nipple shield. Even with the nipple shield on and some formula dribbled on it, she could not get my daughter to latch. When I pumped the first time, I literally had 3 drops of colostrum. Still, I used a glove to coat it on my finger and fed it to her off my hand. In the early hours of the morning, the night nurse came in to tell me that my baby had jaundice. She was starving because I wasn’t able to produce enough to feed her. She had been in the world less than 48 hours and I was already failing her. The next morning, the NICU doctor came in and told me that if we did not feed her formula, she would be admitted to the NICU while I was discharged to treat the jaundice. I could not fathom leaving the hospital without my little girl. I expressed concern that giving her a bottle would interfere with breastfeeding. He told me that once my milk came in, she would latch and drink, and there would be no harm done. I followed his advice and gave her formula so she could come home with me.
For the next two weeks, I tried to get her to latch at every feeding and pumped every 3 hours around the clock. I waited for my milk to come in. I waited to feel engorged. I waited for something to happen. It never did. She never latched. I never got engorged. I never got more than a slight coating at the bottom of the bottle when I pumped. This led to many tears and feelings of failure. I was so afraid of being judged by others for not trying hard enough. A friend told me to just throw out the bottles and eventually she would get the hang of it. I could not do that. I could not starve my daughter. It got to the point that I literally cried at every single feeding. I told my husband that I wasn’t doing the best for our daughter and she deserved a much better mother. I was not enjoying my time with her and I was resentful of the pump. Finally, after two weeks, my husband came home after work and night class to find me with the pump, with a few drops gathered in the bottom of the bottle. He asked how long I had been pumping and I answered 30 minutes. He gently told me it was time to give it up. I remember feeling so relieved that someone finally had given me permission to stop.
Today, my daughter is a strong, smart, healthy 7 month old. She has never been sick and is hitting all of her milestones early. In the scheme of things, what she is fed the first year of her life means so very little. I dare someone to tell me that my daughter is any less perfect or our relationship is any less strong because of the manner in which she is fed. I would like to say I will try to breastfeed my next one, I still feel like I didn’t try hard enough. I do believe there were underlying problems with her latch/ sucking reflux. For the first month of her life, she did not even have a good suck when taking a bottle. However, I don’t know if I will be able to take trying and failing again. Time will tell, but in the meantime, I will enjoy every minute with my darling girl.
About the Author:
Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.
Suzanne Barston – who has written 428 posts on Fearless Formula Feeder.
I am in tears. I have a similar story. After six weeks of pumping, my husband too was gentle and reassuring. My baby is now 13 months old and I STILL mourn the loss of breast feeding. Especially after being successful with my first son. Thanks for sharing!
I don't believe for a minute that you 'didn't try hard enough.'
It sounds like you didn't receive good support or information, though, beginning antenatally. I know that before I had babies, I wouldn't have had a clue what an inverted nipple was. In fact, once I did find out about them, I was surprised that the three different midwives I've had over four births have never mentioned them antenatally. I have not had them personally, but it seems odd that health professionals are not determining *before* birth whether or not Mum has any physical problems that might make bf difficult so as to help make a plan about how to deal with it. Instead, like you had to, Mums are left dealing with everything 'on the fly' which is very difficult indeed.
I remember the feeling of resentment of being tied to a pump for a week and not really feeding my ds because I was pumping during feed times. And I remember feeling very sad about my fourth (and last) baby's first six weeks passing in a blur because of his latching problems meaning I had to pump and supplement him with EBM in a bottle.
Everyone's 'try hard enough' is different, and nobody can place a judgement on where that point is for someone else. It will all be influenced by circumstances, personality, state of mind, physical discomforts, family dynamics, support networks … the list goes on. I know that the outcome of my experience with baby #4 would have been very different if he had been #1.
All the best to you – you are doing a great job!
The current thinking seems to be “don't worry mother,” and I've seen mentioning things like inverted nipples be actively discouraged. The thinking goes, “Most inverted nipples correct themselves with baby's sucking, so it doesn't do to cause worry by mentioning it ahead of time.” See here for an example: http://www.askdrsears.com/topics/breastfeeding/common-problems/flat-or-inverted-nipples
What none of the books or resources ever mention is that there are actually multiple grades of inverted nipples. Grade 1 come out easily with stimulation or when it's cold (and tend to stay out for a while). Grade 2 take more stimulation to get them to come out, and they invert again pretty quickly. Grade 3 are more severely inverted and it can be very hard to get them to come out manually. So the “most inverted nipples correct themselves with baby's sucking” is usually true for Grade 1 and most Grade 2 nipples. You may not have to do anything differently if you have Grade 1 nipples, and the advice to manually stimulate them or pump for a couple minutes before nursing is probably all you need for Grade 2. But Grade 3 nipples can be much more difficult. After 2 months of pumping and nursing, mine were flat at best. Even with a nipple shield, there was barely anything for my son to latch onto.
Honestly, I think more OBs and midwives should do a breast exam at the first prenatal appointment and again sometime in the 3rd trimester to identify any possible problems. That way pregnant women could start seeing an LC even before their baby is born if there are signs of a Grade 2 or Grade 3 inversion or signs of IGT or something. Before I started learning about breastfeeding, I sort of intuitively knew that it would be harder to breastfeed with inverted nipples that never come out. Then I read all the books and websites that say most women with inverted nipples have no problems nursing. If I had known that it really could be a problem, I think I wouldn't have been so hard on myself when we struggled.
I am so glad you eventually got through your ordeal but I am still trying to understand the trauma us women put ourselves through to breastfeed. I will admit, after taking all the classes, buying the pumps, etc, my husband lost his job two months before our first was born. Knowing I had to return to work early and that my husband, not myself, would be her primary caretaker I bought formula and a good sports bra. When she was born I bound up and gave her formula. Never once even had her on my breast as I heard it would stimulate production and increase the odds of mastitis. I wasn't going to breastfeed so why deal with that? It went so well and we are all so happy with it that I plan on doing the same with my second even though my husband is working again.
Seriously, breastfeeding has a slight nutritional value over formula but the difference is so slight that I actually think that formula feeding is better once you factor that babies are well fed, sleep better, and can bond with both parents, not just mom. (I know, the horror, right? Maybe I am just a freak of nature as I also loved my quick and painless planned c-section, had a super easy recovery and chose a second one with baby #2. Nobody has ever accused me of being crunchy.) Not that I discourage breastfeeding, but I really don't see what the big deal is.
Statistics show that babies do best in families that are financially secure and emotionally stable. Breast or bottle really doesn't factor into this. Yes, breastfed babies are more likely to come from families that are financially and emotionally secure due to it being a high class thing to breastfeed now, but did you know back when formula feeding was considered high class and breastfeeding was something poorer families couldn't afford (pre-WIC) that formula fed babies did better than breastfed ones?
(And don't get me started on the “reducing breast cancer” scare. Breastfeeding only reduces your odds of breast cancer IF you have the breast cancer gene and IF you breastfeed at least a year, preferably twice, ie. two kids).
You are a great mom and I encourage you to breastfeed your second if you wish but please don't fret if it doesn't work out or if you just don't like it. Really, it makes little difference.
“did you know back when formula feeding was considered high class and breastfeeding was something poorer families couldn't afford (pre-WIC) that formula fed babies did better than breastfed ones?”
Do you have a source for this?
I agree that breastfeeding is not the be-all and end-all of parenting, but there is evidence that it has real health benefits. Some people may exaggerate those, but I don't think the best response to that is to minimize the benefits.
Google doesn't carry much but “formula feeding is poison” anectdotal stuff and I don't feel like going to to library right now, but my aunt is a pediatrician and she told me formula feeding was the norm back in the day and my own mother was told, back in 1973, that she was putting my brother's health at risk by breastfeeding. Formula was considered a perfect food as all the nutrients were added and you could measure out exactly how much a baby was supposed to get. Only bad mothers put the baby to the breast and let quality and quantity go to chance. Of couse, we know that's all hogwash now, but it's interesting how things change.
The benefits to breastmilk include slightly fewer ear infections and slightly fewer stomach upsets. Period. There are a long list of medical resources for this.. the book “Is Breast Best?” by Joan Wolf has an exhaustive list of them. (Sorry for being so lazy, really I have a toddler and a new baby at home right now and don't feel like backtracking my research right now.) For third world babies of course, breastfeeding is lifesaving, but not for first world babies. It's slightly better nutritionally and I will readily admit to that, but when you factor in the difficulties, in my opinion, formula feeding is better.
Again, it's great if you want to breastfeed and I support choice, I just hate this whole having to pretend to really try and self-shaming when you choose formula. Even here on this blog supposedly supporting the formula feeding choice there is a sense that you are still a bad mother if you choose to formula feed without trying. I've felt pressure to make up a mastitis or medication horror story to justify my choice even though I know darn well formula is not hurting my child. I'm done with it.
This is an interesting hypothesis (if correlation/class is indeed what the BFing advtg is about) but I doubt it's true because formula was not as well, uh, formulated back when it was correlated with elite use. And I doubt there were proper studies comparing the health outcomes of both infant populations…
A brief Google Scholar search showed many older studies. This article from 1948 provides a synopsis of what was known or thought at that time: http://www.jpeds.com/article/S0022-3476(48)80281-7/abstract
And you are very right that our formulas are much better now.
I wish that breastfeeding “success” wasn't treated as identical to loving and responsive parenting, especially because so often it is not under the mother's control. Breastfeeding has immunological benefits, but it isn't an essential part of parenting, and one can be loving and nurturing without it. There is just so much more to good parenting.
Yeah, but that one compares human milk and cow's milk rather than human milk and formula…
True, but most formula at that time was a homemade mixture of diluted, sweetened milk. That is why it is called “formula,” because your doctor would give you a formula for making it. By the time proprietary formula was the only accepted option, breastfeeding was already being heavily promoted again and was on the rise.
By the 1970's formula was “formulated”, although not as good as formula now. I readily admit that evidence shows breastmilk to be better than even modern day formula. My point is that there are so many other factors in raising a healthy infant that the difference isn't all that important in the big picture.
Becky05, I posted a link with some references in response to you and it's not showing up. I'll give it a little longer.. I didn't make a copy of it and it was longish!
“My point is that there are so many other factors in raising a healthy infant that the difference isn't all that important in the big picture. ” I absolutely agree with that! I was under the impression, though, that breastfeeding had always been shown to be somewhat better than artificial feeding, even when breastfeeding was what “poor people” did.
Ah, didn't know that – interesting!
Diane, thank you so much for telling your story! I feel like we are sisters in this, as so much of your story is just like mine, preparing and expecting to breastfeed, trying beyond what was probably reasonable because of desire to do what is best for your baby, but not being able to enjoy her during that time as a result and both the guilt and relief at finally being able to stop that “trying” madness. I also share the mixed feelings about whether or not to try with the next one. No matter what you decide next time, I know that you are a great mom! You are a great mom because you cared enough to think ahead of time about what might be best for you and your family and child, and try your darndest to make that happen. So even if next time you do the same, and the answer is to use formula from the start, you're still being a thinking, caring mom, working hard to make decisions that will work the best for everyone. This characteristic that you have will follow you and your daughter through your whole relationship and have so many wonderful ripples! It is your good intention for her, and your effort to see that through that matters, not the details of what was on your side at any particular moment, including breastmilk coming in, or her ability to latch! Just remember you have so so much more to offer that little one than your breastmilk, and it sounds like you are giving it to her in abundance!!!–best wishes for you! Sarah Picking
“Honestly, I think more OBs and midwives should do a breast exam at the first prenatal appointment and again sometime in the 3rd trimester to identify any possible problems. That way pregnant women could start seeing an LC even before their baby is born if there are signs of a Grade 2 or Grade 3 inversion or signs of IGT or something. “
^ This. This is what TRUE breastfeeding support looks like. Not sweeping potential problems under the rug for fear we're too delicate to hear them and still decide to breastfeed.
Wouldn't it be wonderful if we ditched the whole idea that “breastfeeding is natural and therefore easy” attitude that is subtly and overtly espoused by breastfeeding websites, and instead if organizations like Best for Babes lobbied for changes in the standard of pre-natal care to include stuff like this? Wouldn't it be wonderful if so many moms didn't have to resort to the internet to self-diagnose with inverted nipples, IGT, thyroid problems, etc.?
Wouldn't THAT be how to get more babies to the breast, instead of yet another webpage shoving “breast is best” in our faces?
I agree. If moms-to-be know they're at increased risk for BFing difficulties, they have a better chance at troubleshooting, in my unprofessional opinion. And yes, they have time to get used to the idea that they might need to pump, supplement or even go to exclusive FFing. Perhaps a best and worse case scenario and the likelihood of each would be helpful. (i.e., “You have first degree inverted nipples and a 10 to 20 percent likelihood of latching problems. There's a small chance you'll need to use a nipple shield or even pump exclusively” or “You have severe IGT and have a 10 percent chance of being able to supply all the milk your baby needs and a 30 percent chance of being able make half or more of what your child needs. Some patients like you produce very small amounts of milk [only a few ounces or even drops per day].” Note: I have no idea what the actual statistics in these situations are– these are more examples of formats doctors might use.) They can get instructions how to bottle feed safely before the baby comes, just in case. And they can decide whether or not to keep formula and bottles in the house. Maybe they could stake out nearby stores that carry bottle feeding supplies and are open 24/7 if they decide not to get them before Junior arrives.
I suppose some health care professionals shy away from doing this, because it may add to the stress of pregnancy, and some may decide not to try nursing at all. Also, the human body can be unpredictable. So they might misjudge a body's capacity to BF. I'll admit that I don't have any kids yet, and there are several health issues that might cause me nursing problems. I might get physically worse for a few months after my babies are born, too. I'm glad I know. I can pepare myself that way. But I may decide to go straight to exclusive FFing because of it. I realize that's the last thing some of the more extreme lactivists want. But I will have to to weigh my feelings about not knowing what might have been in terms of BFing and maybe having really hard time trying to nurse… and wondering whether I might have enjoyed my newborns more and had a smoother transition into motherhood. Not an easy decision. But I'd rather go into the whole thing eyes wide open. Not telling me and perhaps letting me be blindsided by a hungry baby, hours of pumping, pain, difficulty with all the holding and a lack of information on how to bottle feed– all while trying to recover from a c-section, get my hypothyroidism and fibromyalgia under control again and oh yeah, learn to be a mom– would not be doing me any favors, IMHO.
Lactivists commonly rail against the 3 a.m. formula sample can in the house. How about, instead of freaking over a woman's choice to have that backup, lactivist organizations start rallying for things like nipple shields passed out to women in their hospital take-home bags? Or how about, when you rent a pump at the hospital or through a lactation consultant, you're told from the outset you have to choose the size of the flange–the ones provided by default will NOT work for a lot of women (three different LCs and the militant lactivist pediatrician couldn't be bothered to tell me this)? Wouldn't that be so much more helpful than statements like the AAP's?
You make a great point about how not telling you what to truly expect is a booby trap–and a big one–all on its own. That is only amplified when you have an underlying medical condition. If the goal is to truly work toward better health for moms and babies, it's time start offering REAL support, instead of the one-size-fits-all, impractical propaganda that passes for breastfeeding advice these days.
V true. It also occurs to me that perhaps there's a self-selection among lactivists re: perception of barriers – on Kellymom they once asked people what barriers they had faced to BFing and most people mentioned external ones like mothers/MILs pressuring them to start solids early, unsupportive hospital staff, “uneducated” people around them and so on, rather than real physical difficulties…where there were physical or work-related challenges mentioned, it was always in the context of “I overcame this and anyone can.” I get the impression that many who are very rah-rah about BFing as the only responsible choice, public health issue, etc. have had a limited set of barriers to face…so their sense of the help others need may be similarly limited to making hospitals BFing friendly etc. I always bang my head on the wall about this but why the **** doctors don't pool their data on women who stop BFing and the reasons why they stop, so that we can have good data on real challenges instead of extrapolating from the experiences of the self-congratulatory militant few, I will never understand…
Um, YES.
Except then they might end up with a study which could actually help women who want to breastfed. God forbid.
Well said. Every family's situation is different. My potential physical barriers to BFing are greater than the average person's. Work and any number of other issues, including poor information/ advice and lack of support, can definitely stand in the way of breastfeeding as well. Sometimes formula is the responsible thing to do. Do these crunchaloons really think that an underfed baby, older sibling who's not getting enough attention, a basket case mom, not being able to pay the bills, a generally stressed environment, etc. are best for the child? Research on what led moms to stop BFing/ not BF and how those obstacles might be overcome would be far more helpful than stating “Breast is best/normal” for the billionth time or declaring BFing a “public health issue”. And calming down about the use of formula, whether in conjunction with breast milk or exclusively, would be good too.
I think the anti- formula sample sentiment stems from the opinion that formula is bad. Not a view I share… I think it's a perfectly acceptable way to feed a baby. I can see how someone who was trying to BF might cave at 3 a.m. if nursing was going very going badly. That (relief) bottle might be just what the family needed– a square meal for the baby and a few hours of sleep for everybody. Then they can try again when they're all more refreshed. On the other hand, a bottle could lead to nipple confusion and supply problems. If you think formula is the devil incarnate and BFing is some sort of cure-all/ prevent all, you're probably sitting there thinking, “No! Don't do it!” I don't object to FFing. So if a mom who was trying to EBF gets desperate enough to give a bottle and ends up FFing, combo feeding or pumping, maybe it’s for the best, IMO. I’m at such high risk for BFing difficulties that methinks I better have a back-up. But everybody is different. Moms-to-be have to make a judgement call on that one.
Sorry nobody told you about pump flanges. Talk about poor/ lacking advice. Grr.
There are some hospital gift bags for BFers (that are not sponsored by formula companies), but I don’t know how widely distributed they are. Contents vary.
http://www.llli.org/llleaderweb/lv/lvdecjan03p139.html
http://blogs.orlandosentinel.com/features_momsatwork/2010/09/breastfeeding-gift-bag-touted-for-new-moms-alternative-to-traditional-hospital-bag-from-formula-makers.html
http://www.motherof7.com/breastfeeding-kits.html
I’m really glad to see these. Offering an alternative is much more positive than complaining about the evil formula companies and their “goody bags”, if you ask me.
Yes! Thank you so much for sharing this. Breastfeeding both my babies was a total nightmare (3 months of hell with the first and 6 weeks with the second). If my husband and I decide to have a third, I'm not going to put us through it again. Stay strong and don't let anyone tell you to ignore your instincts sista!