Monthly Archives: May 2012

Soy formula safety study puts (some) fears to rest

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Remember back in the old days when I used to grab whatever infant feeding study was in the news and dissect it just for the hell of it? That was fun. So much more fun than the mommy war stupidity. Statistical methods and confounding factors are way easier to understand than the intricacies of parenting-blog politics.

Let’s get back to those stress-free basics for a minute, by examining a study in this month’s issue of Pediatrics (Developmental Status of 1-Year-Old Infants Fed Breast Milk, Cow’s Milk Formula, or Soy Formula, Pediatrics, May 28, 2012) which compares the mental, motor and language status of infants fed with soy formula, infants fed with milk-based formula, and breastfed infants. Contrary to the typically sensationalist, breast-is-best portrayal the media gave of this study, it actually seemed to come from a place of real concern for infant development and feeding choice. There’s been a fair bit of scaremongering regarding soy formula in recent years; the concern is that feeding a tiny human so much soy (soy contains isoflavins, which according to the study authors, can “raise the possibility of potential estrogenic effects”) will affect that baby’s development in a negative way. It’s not clear, exactly, what these negative effects may be – man boobs? Reproductive problems? Poor neurological outcomes? Two heads? Zombie behavior? (Okay, that was probably uncouth, considering this past weekend’s bizarre news out of Miami…) Regardless, parents have been warned not to use soy formula unless their babies cannot tolerate dairy-based formula or they are vegan (which, I’m sad to report, is misleading – there is no such thing as a vegan commercial formula – there are animal-derived ingredients in every formula on the market). The authors of this study (one of whom does belong to an organization called the Soy Nutrition Institute, so there is some conflict of interest – a fact which is clearly stated at the top of the article, for the record) hypothesized that the milk-based formula-fed babies and the soy formula-fed babies would have similar development, and that the breastfed babies would score slightly higher.

Women were recruited to the Arkansas-based study during pregnancy, and all had decided prior to birth whether to feed their babies breastmilk, milk-based formula, or soy formula. The researchers followed these women and their offspring for one year, testing the babies with developmental and language assessments at 3, 6, 9 and 12 months. Their findings matched the original hypothesis – all three groups had similar scores, with the breastfed babies scoring slightly higher.

Now, the point of this study was to see if soy formula supported development as well as milk-based formula, so I’m a little confused about the inclusion of breastfed babies. I suppose one could argue that since breastfeeding is considered the biological norm, it is important to have a baseline for which to compare the different formulas… but it’s not that simple. The researchers controlled for maternal IQ and SES (socioeconomic status), as well as maternal age. However,  this is just the tip of a very large and foreboding iceberg when it comes to the factors which confound infant feeding studies. There’s a table in the Pediatrics article showing the mean IQ and SES of the three groups, and these are significantly different. The mean IQ of breastfeeding mothers was 109.8; milk-based formula moms scored 106, and soy formula mamas scored the lowest at 103.8. As for SES, the moms were assigned a “score” based on highest level of education and occupation; for this category, the breastfeeding, milk-based, and soy-based mothers had scores of 49.8, 45.6, and 45.9, respectively.

These factors were controlled for, of course, meaning that the scores of the babies were “weighted” in ways which (theoretically) factored in the impact of IQ and socioeconomic status. But even within those parameters, there are important caveats: what about paternal IQ? What about childcare status: home with mom or dad, private nanny, grandparent, or daycare? What about maternal emotional state, or parenting style? What was it that made some of these women choose breastfeeding, some choose soy formula, and others choose milk-based formula?

Obviously, researchers can’t control for everything, and in the case of this particular study, in the end it didn’t really matter. The study authors explain:

In our cohort, standardized mental, psychomotor, and language development scores were very similar among the 3 feeding groups, with averages falling within the clinically normal limits….BF infants scored slightly better than formula-fed infants…These results are consistent with a large body of literature demonstrating advantages of breastfeeding on cognitive function later in life.  However, it is important to point out that developmental test scores of all 3 diets groups were within the standardized norms, and differences between BF infants and formula-fed effects were quite small in magnitude and thus difficult to interpret in terms of potential clinical relevance. Previous studies have shown lesser advantages when taking into consideration confounding factors or segregating for variables such as being small for gestational age. Here, results were similar after adjusting for confounding factors and controlling for other variables of concern. Thus, our results demonstrate a potential beneficial effect of breastfeeding on cognitive function.

To reiterate, the researchers are acknowledging that the differences were statistically significant, but nothing to get overly excited about. It did seem that the breastfed babies had a slight advantage, but it’s hard to know if this benefit will carry over to later childhood, or if it was even due to the breastfeeding itself.
But, um.. did the study prove all that much about soy formula, either? The confounding factors should be less of an issue when comparing the two groups of formula fed infants (although it’s interesting to note that the mean IQ of the moms who chose soy formula was significantly lower than that of the milk-based group), but the study focused on such a limited period of time, albeit one of tremendous growth. Like the majority of infant feeding studies, we only have a hyper-focused snapshot of these babies for one year of their lives. I’d be very interested to see the development of these three groups over time (provided the authors could work a little on their controls, and get a bit more nuance-y with their bad selves). How do the different types of formula affect psychosocial development at the preschool level? Age of onset for puberty? Fertility issues later in life? If the concerns over soy revolve around estrogenic effects, we’re talking about irregularity in menstrual cycles, reproductive problems, and abnormal breast cells, as well as the aforementioned vague worries about brain development. (Please note: I do not believe that soy formulas are inherently unsafe. I think, like every other decision in infant feeding, every family needs to perform a risk/benefit assessment. If your baby can only tolerate soy, feed them soy. There have been enough studies searching for reasons to avoid soy formula, and only one which found a long-term negative outcome, which was longer menstrual periods – not the biggest deal in the world, although don’t tell your daughter I said that in about 13 years. My point is only that this particular study does not comprehensively address the concerns which make the internet peanut gallery skeptical about the safety of soy formula.) 
My final assessment? The study gives decent evidence that babies fed on either soy formula, milk-based formula, or breastmilk will thrive and develop normally, within similar ranges. In other words, it doesn’t seem to matter all that much how your baby is fed, at least in terms of motor and mental development for the first year. 
You know, come to think of it, I kind of like this study…

FFF Friday: “I couldn’t discern rhetoric from sound breastfeeding advice.”

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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 also are 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.

In this week’s FFF Friday, Lindsay eloquently dissects the “dichotomy that exists between the social and political messages aimed at promoting breastfeeding and touting it as ‘best’, and the complete and utter lack of meaningful support provided to many women when they experience problems breastfeeding.” 

I recently got named to a “best pregnancy blog” list, and my immediate, panicked reaction (after being sincerely flattered) was that if I’m considered to be writing a pregnancy blog, couldn’t the discussion here frighten prospective mothers out of nursing? But reading Lindsay’s post reminds me that sometimes, being forewarned is forearmed. There are plenty of sites out there that offer inspiring, positive stories of blissful breastfeeding experiences, but hardly any talking candidly about the problems  - however rare – that women may encounter. If a physiological problem is going to impede your breastfeeding goals, wouldn’t it be better to know beforehand, to either a)prepare yourself emotionally for what lies ahead b) investigate various remedies or possible solutions, or c) perform your own informed, risk/benefit assessment and make a decision about how far you are willing to go, before the postpartum hormones and newborn craziness set in?

I don’t think the answer is the same for everyone. Some prefer to go into new experiences with blind positivity, and that is absolutely okay. But it’s also okay to be the type who wants to be aware of all the potential roadblocks before getting on the road. Going with that analogy, I hope this blog is sort of like the Sig Alert of infant feeding.

Happy Friday, fearless ones…

The FFF

***
I flinch whenever I’m asked the question, “Are you breastfeeding?”  It’s almost imperceptible, but somehow the truthful response makes me feel inadequate, selfish and less of a mother than those who breastfeed their children.  Intellectually I know none of that is true, but I’ve had a hard time reconciling my truth with the many well intentioned but often insensitive pro breastfeeding messages women are faced with every day.  It’s hard not to be bitter.
Truthfully, I don’t feel like formula feeding was any more of a choice than my initial goal of breastfeeding was.  While pregnant with my first daughter an enthusiastic, “But of course!” was my standard response when asked if I planned to breastfeed.  Having inverted nipples did nothing to dampen my resolve.  I spent countless hours reading about breastfeeding, studying diagrams that showed various infant holds, and watching videos that differentiated between an infant that was drinking from the breast versus one that was just sucking.  A simple internet search of “inverted nipples” yielded hundreds of articles written by professionals who confidently proclaim that most women with this anatomical imperfection can indeed breastfeed.  This was assurance enough to convince me and I never gave it a second thought.
While in the hospital after the birth of my first daughter it appeared she was latching relatively well and able to draw my nipple out when she fed.  I tried to disregard the searing pain I felt each time she took my nipple in her mouth because the nurses told me that her latch looked good.  No one seemed to feel it was a problem as long as she was spending the requisite 15 minutes attached to my breast every three hours.  I asked to see a lactation consultant but was told there were none employed by the hospital.  I looked at the posters on the hospital walls that listed the many ailments and diseases my daughter would be at a reduced risk of developing if I breastfed her, and I smiled because I thought we were on our way.
The day after we brought her home is when my milk came in and the problems started.  If it was challenging for my daughter to latch onto nipples that would only stubbornly emerge when my breasts had been empty of milk, it was near impossible now that they were full and becoming increasingly engorged as the hours ticked by without a successful feeding.
I turned to hot water bottles and the pump to relieve discomfort from engorgement and soften my nipples in preparation for feedings. My nipples are inverted to such a degree that upon removal of the pump suction they immediately invert.  Timing it so that my breasts were ready when she was ready for a feeding was dicey.  If I miscalculated, and I often did, I was left with a frantically hungry baby that had no patience for stubborn, slow-to-emerge nipples.
Somewhere in the fog of those first days at home there were failed attempts to use nipple shields which had been recommended by nurses at the hospital.  They were quickly discarded along with the breast pillow and lanolin cream as I spent more and more time with the pump and less with my daughter at my breast.  After a week she was being fed almost exclusively expressed breast milk, often by my husband as I kept to a strict pumping schedule and lamented the breastfeeding relationship I’d imagined and which was quickly evaporating before my eyes.
By this point I was emotionally exhausted and despite needing help, I had grown increasingly wary of health professionals and any so-called lactation experts.  I felt that all of the advanced preparation I had done to ensure we were able to breastfeed was a waste, and most frustratingly I couldn’t discern rhetoric from sound breastfeeding advice.
My family doctor and obstetrician hadn’t bothered to examine my nipples during pregnancy; the nurses in the hospital had all given me conflicting information; the public health nurse that followed up at home was only able to look at me with sorrowful eyes and repeat over and over that babies “breastfeed, not nipple feed”; and most of all, I felt let down by the literature – where was all of the truthful information on the realities of breastfeeding with what I now know to be severely inverted nipples?  By the time I reached the point that I should have called a lactation consultant I was so guarded and apprehensive about receiving bad advice or worse, being judged, that I couldn’t even bring myself to make the phone call.  Emotionally I had reached rock bottom.
I exclusively pumped for my first daughter with a single electric pump until 8 weeks when I switched to formula.  It was during those weeks that I first began cringing when asked if I was breastfeeding.  Exclusively pumping was like an indeterminate state somewhere between breastfeeding and formula feeding.  I didn’t belong in either camp.  My family doctor thought I was crazy – she knew that exclusively pumping was much more time consuming and couldn’t understand why I didn’t just breastfeed.  Very few people understood that I couldn’t stand the heartbreak of trying and failing, even just one more time.
My second daughter is now 5 months old and with her I exclusively pumped for 12 weeks before switching to formula.  Our time in the hospital and first days at home were similar to the experience with my first daughter with mind-numbing pain each time she fed despite assurances that she was latched on correctly, and complete failure to get her latched once my breasts had any amount of milk in them.  Once again fear of judgement prevented me from reaching out to lactation professionals.  This time, however I was much more prepared emotionally and resigned myself by day four that a hospital grade double electric pump and I were going to be spending a lot of time together.
I know that I tried as hard as I could.  I also know there are many other options that women can explore when they experience problems breastfeeding such as cup or syringe feeding, lactation consultants, breastfeeding support groups, and so on.  None of those options made sense for me or my family, and I feel no regret over my decision not to attempt any of those measures.  I am completely secure in my belief that formula has provided my children the nutrition then need, and then some.
But what does occasionally keep me up at night is the dichotomy that exists between the social and political messages aimed at promoting breastfeeding and touting it as “best”, and the complete and utter lack of meaningful support provided to many women when they experience problems breastfeeding.  To add insult to injury, when women inevitably turn to formula after breastfeeding fails they are made to feel ashamed of their “decision” because in our society acknowledgement that formula is a healthy means of nourishing an infant is viewed as a threat to breastfeeding. 
I often recall three years ago when I tearfully offered my four day old daughter her first bottle of expressed milk and felt like I had already failed her.  The sadness has faded and the part I now recall, and which escaped me then, is the look of contentment and satisfaction she had after that feeding, and each one that followed it.  Breast milk or formula – I’ve learned that a healthy, satiated baby is what’s important, and both can do the trick.

Mammary Mania: Podcast approaches lactation science as the science it should be

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I just listened to a podcast of a fascinating interview about breastmilk, courtesy of Skeptically Speaking. Interviewer Desiree Schell spoke with Dr. Katie Hinde, an Assistant Professor of Human Evolutionary Biology and the Director of the Comparative Lactation Laboratory at Harvard University. The newest of my internet crushes, Hinde offers a unique perspective on the science behind breastmilk with a level of sensitivity and realism that is unparalleled, as far as I’m concerned.
Take a listen for yourself – it’s well worth the 15 minutes. But in case you just want the Cliff’s Notes, here are the FFF-related highlights:
  • Hinde points out that while there is a good deal of lactation research going on in the world, much of it is agenda-driven. The science is mainly coming from three areas: breast cancer research (which tends to focus on rats, who have similar mammary development to humans), the dairy industry (fixated on how to maximize milk production in cows) and from the infant feeding world (looking at tiny humans and their mothers).  Within the last category, Hinde notes that both sides have clear agendas – one is trying to increase formula sales, and the other has “anti-formula aspects, that no matter what, breast is best.”  “Both ends of these spectrums are limiting,” she says. (To which I say, word. WORD.)
  • Research has shown that milk varies dramatically between women. Some mothers make high fat, low sugar milk; some have more cortisol (a beneficial hormone) in their milk; and so forth. Hinde explains that our milk is affected by what we’ve eaten and been exposed to for years prior to pregnancy and actual lactation, and that these lifestyle factors may create these differences in milk. Even the lactation process can vary across populations – Hinde notes that in America, studies have shown that many women do not have “copious milk production” until 72 hours postpartum, whereas in the less-developed world, the average time is much shorter. Considering doctors often step in at that 72-hour mark and recommend formula supplementation due to fears of dehydration or neonatal weight loss,  it would be highly beneficial to find out why this delay occurs. Hinde questions why there hasn’t been more research on these differences in lactation process and milk constituents among women.
  • While Hinde speaks about the power of breastmilk (and gives a really interesting explanation of just why breastmilk is so miraculous, absent of the usual hyperbole and backed by actual science), she also acknowledges that the decision to breastfeed is not made in a vacuum. And in what is probably one of the bravest statements I’ve ever heard made in a public forum about these issues, she argues that by finding out more about breastmilk, we can then create a better formula. “This is an important goal,” she states, because if women are unable to lactate, or have contraindications like HIV, “we need to make sure that the intervention (formula) is as representative as it can be for what (babies would be) getting from their mothers.” Now, obviously Hinde would argue that breastmilk is a superior nutritional choice, but the fact that she acknowledges the reality that some women are going to need formula, and that we owe these women and their children a better product…. well, let’s just say it made me tear up.
  • On the topic of breastfeeding support, Hinde muses that there is this idea that because lactation has evolved over millions of years, it should be effortless and natural. But “so is sex”, she says, and a lot of us aren’t so great at that to begin with, either. She suggests that by openly discussing the physiological problems so many mothers face when attempting to breastfeed, we could actually increase the amount of women successfully meeting their breastfeeding goals, because we would feel less overwhelmed and lost when these issues arise. (I like to think all of your FFF Friday stories are doing this, in some small way; that they not only make formula feeding moms feel more empowered, but also help women dealing with breastfeeding challenges find answers, solace, and community, as well.)

Dr. Hinde is exactly what is needed in the world of lactation science – a true scientist, able to approach her research with nuance and a wider perspective.  Check out her blog, Mammals Suck…Milk and take a listen to the Skeptically Speaking podcast (Schell, the interviewer, is also pretty darn rad, and manages to guide a potentially science-y interview into a very accessible and entertaining listening experience) to gain a far more thorough understanding of mother’s milk that makes you think instead of wanting to hurl your computer at the wall.
Speaking of thinking, this interview made me ponder about the types of studies that would be truly helpful for infant feeding research. How about a large study examining differences in children of non-breastfeeding mothers, randomly and blindly assigned only expressed donor breastmilk from bottles or a DHA/ARA containing, partially hydrolyzed formula (since this type seems to be the one that fares best in the studies which have been done), essentially ruling out all confounding factors? Or, what if we did intensive interviews and examinations with women who suffer from insufficient milk or delayed milk production, compared to controls that have no problems? Looked into their social, emotional and physical histories, and tried to find a common thread. I’d also love to see studies of breastmilk composition from women on severe elimination diets compared to those with healthy diets. And the list goes on…
So, let’s play scientist. What types of studies would you like to see in the field of lactation science? What do you think would actually help women to breastfeed, or to make formula a better substance?

FFF Friday: “I have no regrets about using formula…not a one.”

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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 specifically chose this FFF Friday submission from Liz for this week because, with all the discussion over the attachment parenting TIME spread, there’s been a renewed conversation about personal choice within the parenting realm. Choosing to bottlefeed from the start is (at least for now) a choice we are allowed to make, and I find it tremendously refreshing to hear that some women don’t get all that bothered by the pressure to breastfeed. (On the other hand, it sort of negates the need for my blog and book, but whatever. I’d much rather be the Fearless Famine Fighter, or the Fearless Fairness Forger. Early retirement would be fine.)

I’m kind of in awe of Liz’s ability to focus on what’s important and block out the rest, and I hope you all enjoy her unique perspective.

Happy Friday, fearless ones…

The FFF
***
My experience thus far has (fortunately) been fairly free of bullying and drama but I notice that every now and then there will be a comment indicating that there wasn’t a whole lot of perspective from moms that were on the formula feeding wagon from the start.  So I thought I might offer my own story regarding How I Learned To Stop Worrying and Love the Bottle…which is probably too strong a statement.  Like I said I’m hardly a casualty of the Mommy Wars…yet.
I grew up in a formula feeding family.  My mom was formula fed.  I was formula fed.  All four of my younger siblings were formula fed.  My baby doll was formula fed.  Looong before I learned how to change a diaper I learned how to bottle feed a baby.  I wasn’t visually exposed to breastfeeding until I was a teenager and that was through a video I saw in biology class. 
Sad?  Maybe.  But if you’re feeling sad reading this, it’s more sadness than I’ve ever felt over it.  When I first saw that video I was staring with all the fascination of a five year old boy who discovered that snakes are not slimy.  I didn’t feel uncomfortable and intrusive with it.  But I wasn’t taken up in things like “how beautiful and natural!” either (“beautiful” really isn’t a word I use to describe most bodily functions..).  I was watching a mom feed her baby in a way I had never seen before and it didn’t weird me out.
What was I talking about?  Oh yeah!  Bottle feeding!  So being that I was brought up in this world of babies and bottles, of course I was going to formula feed my kids should I have any.  It’s only natural to do what you know how to do…right?  Well that was how I saw things.  For many many years I was blissfully unaware of this whole Mommy War that was raging on behind the scenes that my own mother already had to deal with and she didn’t have the the internet.  
A couple of months after I got married I was finally diagnosed with PCOS.  Instead of being devastated I was leaping for joy.  It’s a very frustrating experience watching your periods get farther and farther apart after you’ve long passed the age when cycles are supposed to be regular.  Now instead of being a freak I had a name!  An answer!  Something that could explain everything from the 6-9 month cycles to my tenor voice! (Though between you and me I think my voice is actually kind of sexy)  But eventually I had to face the realization that the bottle or breast issue might not be something I’d have to consider ever. It’s possible for us PCOS ladies to get pregnant but it’s not that easy.  So imagine my very happy and terrified shock when two months after having a period I see that BFP.
Now I’m not a very crunchy person and my husband is only crunchy when it saves money.  So two things that were a point of contention were diapering and feeding.  A very pro-cloth diapering FAQ was enough to turn him off to the idea. But breast feeding…  See, he comes from a breast-feeding family.  He was breastfed.  All three of his younger siblings were breastfed.  This was the world HE grew up in and I guess it never occurred to him that his wife wouldn’t be so hot on the idea.
Oh we talked about the statistics but that can only go so far with me when strong personal experience says otherwise.  Ye,s my husband was a gifted child but he’s the son of gifted parents (genetics?) and had their undivided attention for the first few years of his life to cultivate that gift (nurture?).  My siblings and I are no intellectual slouches either and I was also able to read at a more advanced level for my age because my parents were able to devote more time to me.  Bonding?  Emotional development?  Sorry, but I don’t think method of feeding isn’t the be all and end all of bonding when there are so many other hours in the day to spend with your kid.  Obesity?  Yeah I’M fat but my sibs are not.  I have a couple of ideas as to what led to that and formula isn’t one of them.  In the end the only thing I could see eye-to-eye with him on was that it was free and convenient…well, if things were ideal, of course.  I already knew of one friend of the family who went through a breastfeeding horror story because she was unable to produce enough milk.
In addition to the encouragement from my husband there was some additional encouragement from a group of ladies from my book club.  I didn’t get jumped on about breastfeeding or anything.  The topic just came up eventually.  “Are you going to breastfeed?”  “We’re talking about it but I’m leaning towards ‘no’.”  And well…there went the conversation.  It was a pleasant conversation and it was clear that for at least two of these women, the experience was nothing short of amazing.  It was quick, it was convenient, it was free, and they seemed so happy to talk about it.  They were so positive about it I…thought about breastfeeding.
In retrospect I think on some level they took how easy it was for them for granted.  In the midst of our conversation I did bring up the concern about my friend and how I think I would feel more comfortable knowing how much my child was eating at every feed.  They were very quick to sweep it aside.  “Don’t let that discourage you.” (Fair enough)  “She was probably doing something wrong.”  (Whoa…you don’t know this lady)  “Everyone can breastfeed if they try hard enough.”  (She was trying for two MONTHS)
Well like I said before…the conversation got me to think about it.  And I told my husband I would THINK about it (opportune word being “think” here).  And so I thought about it and thus began one of those nasty “mental” conflicts.  I could see myself forgetting to pack a bottle while on the road.  Having a method of feeding hard-wired into you sure sounded nice.  But would I like the feeling of having my boobs sucked on?  Bottles would have to be introduced eventually anyway.  Even though I’m a SAHM, my sister was getting married six weeks after my due date and I was her maid of honor.  SOMEONE besides me has to be able to feed this baby whether it’s hubby, or uncle, or grandma.  I don’t want this baby to be insistent on my boob.  Would my husband be willing to splurge for a pump to get the job done quicker?  Well breastmilk is natural…but am I really doing this because I want to or because I’m being pressured to?  I knew in the pit of my gut my heart was not in this breastfeeding thing but my head kept pounding on me and making me second guess myself as a new mom.  Even though I accepted formula now…would I feel one day guilty about not giving breastmilk?  One day I was checking out nursing tanks and reading pump reviews.  The next I was grumbling something about everyone sticking their nose a little too far into my boobies and if my husband wanted this baby breastfed so badly he better start lactating.
I eventually thought myself into a hole and ended up turning to my mother.  She was so wise that even when I was a teen I thought she was the wisest woman I knew.  So one day over the summer while I was visiting for lunch and we had a talk.  As soon as I said the words “I’ve been thinking about the possibility of breastfeeding” there was a shout of “Oh god WHY?!” from the other room.  My sister was the closest out of all of us to said family friend and was quite traumatized watching her go through whatever experience she had.  My mom kindly told her to butt out.  So we began to talk. 
Mom is the best.  She had her way of doing things but is definately on Team Fed Baby all the way.  Both methods come with their benefits and burdens and a lot of that balance will rely on your body and the baby’s body.  The issue really isn’t black and white.  Whatever you choose to do, it has to be the one you feel the most comfortable with and not the one that other moms are pressuring you to do.  You can’t do everything in order to please all those moms.  So just stick with what’s best for baby…and you too.  A miserable mom won’t be as effective as a happy one.
“But I will say this…there was not a single day where I regretted feeding all of you formula.  Not a one.  And I couldn’t ask for 5 better kids.”
I realized that until now I had never before met a woman that was so…positive…with her formula feeding decision.
With renewed confidence that it was okay to go with my gut, my husband and I had the penultimate discussion.  THIS baby was going to be formula fed.  I wanted to get back to treating my PCOS without worrying that my meds would be mixed in the milk.  I wanted to return to preparing for that “run a marathon” bucket list item (I’m still a few years away from that).  But most of all this whole mom thing was so new to me, I ‘d like to have at least ONE aspect of babycare be something I already knew how to do.  It’s not like he was going to do the majority of the feeding anyway so at least let me feed this kid the way I already know how.  Maybe if we have a #2 I can give breastfeeding a shot with that one.
Speaking of PCOS, it was this very blog that opened my eyes to the possibility that breast-feeding has a high chance of not being sunshine and rainbows for me.  I feel so stupid for having gone so far into this discussion and not once considering how PCOS might affect a breastfeeding experience.  After all, it mucks up with so many of my other womanly functions why shouldn’t this be any different?  When our daughter was born, I braced myself for engorgement and breast pain as I waited to dry up.  But except for some slight leaking from one boob that almost went entirely unnoticed if it wasn’t for a small bra stain and pain that was only noticeable as I was lying in bed free from distractions…nothing.  No cabbage leaves.  No ice packs.  Nothing that really needed a pain reliever.  Nothing.
We returned to the topic about a month after we returned from the hospital.  I was giving our daughter her final feeding for the day and he was watching us from the couch.  She was already able to hold her head up and just wanted to look at the world around her.  She was also sleeping through the night and no colic.  She’s never had a moment where she was completely inconsolable and was very healthy…further cementing in my mind that how you feed is a much smaller piece of this parenting pie than we all make it out to be.  She was able to drink a generic brand of formula that we could get at a wholesale price as opposed to what could have been a very stressful and expensive breastfeeding experience.
It turns out most people I’ve come across respect that.  The ladies in my book club have let me be.  I raised an eyebrow and couldn’t help but giggle on the inside when the newcomer said “Oh she’s beautiful!  She looks GREAT for a formula fed baby!” (in a twisted way I love it when well-meaning people are so innocently ignorant of their blatant disregard for tact).  Her pediatrician, though I could tell he doesn’t agree with our choice, was able to put biases aside to help us.  If anyone is giving me stink-eye when we have to feed in public, I haven’t really noticed.  I stopped being aware of everyone around me once I realized how dang cute she was.
Feeding her is an absolute joy.  I try not to take that for granted.
With a new perspective now that we were actually feeding a child, we were both able to be at peace with the situation.  In spite of a discouraging dry-up period I’m still thinking about breastfeeding a second baby.  But I will not put that kid, or myself, through a hard time while we wait for my boobs get their act together, something that may or may not happen.  Not when I have no regrets about using formula…not a one.
***

Make my day. Send me your story – formulafeeders@gmail.com – to be used for FFF Friday. 

Hey TIME (and everyone else): There is a mommy war, but this isn’t it.

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People have been asking my opinion on the TIME magazine “scandal” for the past 48 hours. Every time I respond, I feel a little dirtier. Giving my opinion suggests that I should have an opinion, and that infers that the TIME issue has something to do with formula feeding; that a story on attachment parenting must, by default, be inflammatory to those who do not breastfed.

But in my opinion, this media frenzy has nothing to do with the breast/bottle battle.

Well, for the most part it doesn’t.  The TIME cover story is actually about Dr. Bill Sears, whom I feel has everything to do with the topics I cover. I could critique his methodology all day long (and I would love to, should anyone care to give me the editorial space to do so). Unfortunately, no one is really talking about Sears, except in the most cursory of ways. The other 99.99% of the focus is on the cover image, and the fact that some families choose to continue breastfeeding longer than our society has deemed acceptable.

In my 2010 post on extended breastfeeding, I mused that

{extended breastfeeders} are probably…pretty sick of being judged, just like we formula feeders are. It seems that in this country, at least, you can only win the Good Breastfeeding Mom Award if you nurse for the standard year. Any less, or any more, and you’re made to feel like a selfish, negligent parent – for different reasons, of course, but the end result is the same. I’ve seen people comparing breastfeeding an older kid to child abuse; formula feeding moms have dealt with the same accusation. I’ve heard people call extended breastfeeding “selfish”, saying that the mother is trying to infantilize her growing toddler. And as we all know too well, formula feeding is synonymous with self-serving behavior in many people’s minds…being an FFF is not just about defending formula feeding. It’s about defending the right for ALL mothers to feed their babies (or toddlers) in the best way they see fit. Don’t get me wrong; it’s understandable to feel uncomfortable seeing something you’re not used to seeing. We don’t see many walking, talking, kids still nursing in this country; it’s just not the norm. I doubt it will ever be. But that doesn’t mean it’s not a good choice for certain families, and hey, if it works for them, then that’s all that matters.

Since writing that article, I’ve become quite close with several “extended” breastfeeders (I hate that term, because why is it “extended”? Because some women continue nursing after the AAP recommendations state is necessary?) and I feel even more protective of those breastfeeding-longer-than-our-society-thinks-is-normal. Frankly, some of the most compassionate, non-judgmental breastfeeding advocates I’ve encountered fall into this category. 
The problem is that the “experts” who advocate for “full-term breastfeeding” are often the same folks who are constantly berating those who formula feed; the same folks who are holding one type of parenting up as “the best” and all others as sub-optimal. This puts people on the defensive, and it leads to the kinds of comments I’ve seen in the last few days, the kinds of comments which make me feel like everyone is Missing. The. Point. The hurtful comments about formula feeders that I see make my blood boil, but the comments I see from mothers disparaging breastfeeding as a practice embarrass me. I don’t want to be associated with those who make these comments, and yet I feel a responsibility to provide a safe place for all formula feeding moms, especially those feeling disenfranchised and tired of defending their feeding method. I have to believe that these comments come from that negative space, rather than a true belief that breastfeeding is “dirty” or “selfish”. 

And yet, taking this a step further, one could easily argue that the cruelest lactivists on the internet are motivated by similar feelings of disenfranchisement and resentment. So what is the difference?

When it comes to most breastfeeding-related media blitzes, the difference is that one side has authoritarian voices joining their catcalls. When representatives of the AAP are making snarky statements about formula feeding and obesity, the comments of the virtual peanut galley become far more potent. It is no longer a mommy war. It is just one group getting bullied by a much stronger opponent.

In the fallout from the TIME examination of attachment parenting, the extended breastfeeders have become similar victims. Their choice is no longer valid because the medical authorities have not dragged out a large body of evidence supporting it as a health-enhancing act. Therefore, it becomes a choice, and within the realm of infant feeding, choice is a myth.  Choice is like a screwed up version of Tinkerbell. It doesn’t have a right to exist unless enough people are clapping their hands in support of it.

There is a Mommy War, and anyone who says there’s not is either a) tremendously confident in their parenting skills b) a Luddite with no internet connection or c) someone who is far enough away from the baby years to have selective memory of how competitive and hard the first years of parenting can be. There is a very real, and very dangerous Mommy War going on surrounding infant feeding, and it is a war provoked by parenting experts, medical professionals, and (in my opinion) misogynist jerks who feel it is their male privilege to tell a woman what it is to be a mother.  But extended breastfeeding is not part of this Mommy War; in fact, in many ways, the Mommy War only lasts for the first year or two, when the (supposed) “critical” period for attachment and foundational health is happening. A mom who has spoken out against judgment and whose only crime entails feeding her son from her breast while looking like a hipster fashion model (because seriously, my only issue with this woman is that I am disgustingly jealous of her physique and the confidence she’s mastered at tender age of 26) is not a solider in the Mommy War, and I sincerely hope she doesn’t become a casualty of it.

The Mommy Wars are not about parenting styles. The Mommy Wars are about experts – and consequently the mothers who are looking to these experts for guidance during a fragile and intimidating time in their lives – attempting to validate parenting choices/philosophies by marginalizing or insulting others. (For proof of this, check out AP guru Kathy Dettwellyer’s comment on this particular piece from the TIME issue). Heck, a lot of the time, those perpetuating the Mommy Wars aren’t even mothers.

Attachment parenting is not limiting to women; making attachment parenting the superior choice is. Extended breastfeeding is not extreme; claiming that it is necessary for emotional or physical health is. Formula feeding is not anti-breastfeeding; claiming that formula feeding is better because you think breastfeeding is “gross” or “weird”, is.

I believe that for the most part, mothers are too busy to wage wars. Instead, we are trying to survive the often klutzy dance that is modern motherhood. But I think we all need to try a different dance for awhile, and it involves some artfully placed kicks to the posterior regions of those who capitalize on our need for validation. That would be a skirmish worthy of a TIME spread, wouldn’t it?

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