FFF Friday: “This whole breastfeeding mommy war…is just a bunch of sound and fury.”


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.




I’ve been thinking of how to respond to another blogger’s post about how women who claim to have “failed” at breastfeeding are just lazy liars; that we simply weren’t up to the challenge, or that we prioritized other things in life ahead of our newborns’ health and nutrition. It’s actually kept me up the last few nights, this conundrum of how to answer the battle cry: do I engage? Or chant a slow and steady stream of “bricks and bones” and take the high road?

Ultimately, I think the best way to counter these claims is to present FFF Katie’s post. This mother of 5 has the gift of perspective, something many of us in the breast/bottle debate do not. She has succeeded at breastfeeding, and “failed”. She has made decisions on infant feeding based on her own health and mental state, as well as that of her other children. And she’s done it with pride, and a sense of self that those who take pleasure in judging others will likely never experience. 

Before I hand it over to Katie, though, I do want to say one thing. Please, for the love of god, do not let the asinine opinions of extremists (of any sort) cause you consternation or anger. Let me take on that anger for you (because believe me, I do); you just focus on yourself, your sanity, and your family’s well-being. In the end, any self-proclaimed lactivist who insists on telling women they are lying about physical impediments to breastfeeding, or that their own mental health or the needs of other children do not matter, is doing more of a disservice to the breastfeeding cause than a million booby traps. Those that truly care about the health and happiness of mothers and babies take this stuff seriously. In the end, it doesn’t matter if insufficient supply was caused by physiological malfunctions, or emotional stress. It doesn’t matter if your neighbor was able to withstand a case of mastitis and you weren’t. Motherhood isn’t a contest. Womanhood isn’t a contest. You shouldn’t have to defend your choices to anyone. Least of all here. 

Lastly…I know that having someone judge our experiences can make this feel like less of a safe space. But it is safe, and it will remain so. If I need to, I will make FFF Friday posts the one place where I do censor comments.  I will fight tooth and nail for each and every one of you. I may be small, but I’m scrappy. And I will fight dirty, if need be. Okay?

Happy Friday, fearless ones…

The FFF

***

Katie’s Story:

If you want to apply labels to me based on what I do every day, you might want to call me an attachment parenting, unschooling/relaxed homeschooling mom of 5 kids who, no matter how splattered I am in baby drool, will insist of wearing a full face of makeup to leave the house. 

Despite the above, I am also an unapologetic breastfeeding failure.  I also failed algebra in high school – twice – and I feel as bad about the latter as I do the former.  Despite them both being part of a balanced diet, they just don’t agree with me.

What makes my breastfeeding failure so complete is the fact that of my five children, I successfully breastfed one of them.  The problem is that this one moment of glory was not with Baby 5, which would have been redeeming in the eyes of my AP sisters, but rather was with Baby 3. We functioned in happy nursing bliss for almost 2 years before it was time to call time on the milk bar.

And somehow, despite this success, I couldn’t do the same for my last two babies.

Epic. Fail.

To understand how disturbing this turn of events was at the time, one must understand my journey.  If there is a breastfeeding problem, I have probably experienced it, and probably more than once. 

Me and breastfeeding go way back.  I gave birth to Baby 1 in 1991 at the grand old age of 20.  I was a single parent and breastfeeding was part of my plan.  For those too young to know, the internet wasn’t a household utility until some 7 or 8 years later, so this desire to breastfeed stemmed not from an overload of internet information but rather on my desire to live as simply and as naturally as I could. 

Plus, breast milk is free and that is a bonus when you have no income and are staring down the barrel of a welfare check.

When I brought Baby 1 home, like many women, I felt like I’d been hit by a tractor trailor.  Despite this, I dutifully waited for my milk to come in.  So began my first Descent into Boob Hell.  When it came, it arrived like a tsunami – wild, abundant and totally out of control. Milk flowed everywhere, all the time.  Breast pads were useless.  At night I would soak through my bra, my pajamas, and my sheets – time and time again.  My baby was so overwhelmed, he would choke at my breast.  It was like someone had turned on the faucet full force then just walked away while the house flooded.

To pile insult onto injury, my nipples started to crack.  Then, at 10 days post partum, I developed a uterine infection which required me to be hospitalized so I could receive IV antibiotics.  They would not let me bring my baby with me, and despite my efforts, the hospital pump they gave me produced…nothing.  This may have been due to the fact that I didn’t use it – I tried it a couple of times but each time I felt like some robotic demon was trying to suck off my entire aereola.  Not good.

After my stay in the hospital, I emerged feeling much better. The feeling of having recently survived an accident with large industrial equipment had passed but I was afraid that since I had to handle everything on my own, I could not cope with the extra demands– physical and otherwise – breastfeeding placed on me.  So I made the decision to continue feeding my son formula, which he had been receiving during my hospitalization.  I knew he needed a healthy and happy mamma; breastfeeding was getting in our way. 

So I made the call and didn’t look back.  Since there was no internet in those days, no message boards, or Facebook feeds, or anything else entertaining for that matter, I felt very little guilt and there was no one around to suggest that I should. 

I am happy to report that Baby 1 is now 21 years old, a musician, and the picture of health. 

And he aced math in high school, so no worries about his IQ. If formula did kill off a few brain cells, he hasn’t suffered for it.

It was another 9 years before I’d step into the ring to nurse another baby.  By this time I was married and working as a teacher but I wanted to try breastfeeding again. I honestly believed my first four had been a fluke, probably because of my age, and that with the benefit of added years and wisdom, I was sure to have no troubles the second time around.

I had no idea what I was in for.

Baby 2 was born in 2000.  At the time, my husband, son and I had just moved to the United Kingdom (where my husband is from) and were living in my in-laws RV while we waited to get our own place.  We brought Baby 2 home to a tiny space which we all inhabited together and I did my best to breastfeed.

Within days my nipples were cracked and bleeding.  I had plenty of professional support thanks to the UK healthcare system – a nurse called a health visitor (who specializes in maternal and baby care) came to visit almost every day and could find no reason why I was cracking so badly.  Despite the agony, I persevered, in no small measure because I was so depressed at being so far from home and I wanted to have one thing that only I could do for my son.  Breastfeeding him was my way of holding on to my independence.

Four months I carried on.  In that time my nipples never completely healed.  On top of that I developed a case of mastitis so bad that my breast felt like a chunk of wood – you could actually knock on it and it sounded like a door.  Despite following all the advice surrounding mastitis, I developed a fever and again had to be hospitalized.  I was close to requiring surgery to remove the mass that had formed.  It was a lucky escape.

Finally, at 16 weeks, my husband begged me to see reason.  I had been so focused on nursing this new baby that I’d neglected both my health and the well-being of my first son, who was now 9, living in a new country, and in need of some maternal support.

Again, I made the call and never looked back. 

Baby 2 is almost 12 and is a certified genius as far as his IQ goes. 

Neither boy has ever been seriously ill a day in their lives.

Two and a half years later, my daughter was born.  I was bound and determined that she would be exclusively breastfed. I was determined not to let my nipples crack and bleed.  I bought some Lansinoh cream and it worked a treat!.  I had one small bought of mastitis, but with the help of prescription antibiotics, it cleared up after a few days.

Once I hit 6 weeks, Baby Girl and I were cruisin’!  Breastfeeding her was a revelation!  The milk was always ready.  There were no bottles to clean and no sterilizer to mess with.  Her latch was perfect and I never cracked or bled.  My milk production was not over-abundant nor was it inadequate.  It was just right.  And my little Goldilocks loved it!

After successfully nursing for almost two years, I became one of the converted.  Anyone who even considered bottles for any but the most serious of dilemmas, was nuts. I was probably quite evangelical about it, and quite annoying.

Karma must have been waiting for me. When I had Baby 4, I never considered anything but breastfeeding.  That’s why the entire debacle of feeding him came as such a shock. 
Baby 4 had a voracious appetite.  Tipping the scales at 9 lbs 14 oz at birth, he required a lot of sustenance.  Right from the start, however, I could tell something was not quite right.  I couldn’t get him to latch properly.  I asked for help from the midwife before I left the hospital but, despite her belief that she knew what she was doing, she didn’t. I’d breastfed a baby long enough to know I was doing it right.  She’d never breastfed anything in her life.

When my milk finally came in, I noticed straight away that something was off.  Milk production with Babies 2 and 3 never returned to the flood levels of my first Baby but had at least been sufficient.  When a baby has sufficient milk supply, your breasts drip mildly during let down and you can see and hear your baby taking long, satisfying swigs in the first few minutes as that first rush of milk quickly eases the harsh pangs of hunger. Their jaws drop and their ears wiggle. 

You know when it’s going right because there really is no pain.

And you know when it’s wrong.

I was producing next to nothing. There was no dripping and no satisfied gulps of relief when my baby nursed.  This made his suck that much harder, as if he was saying, “I know it’s in there, damn it!”  This led to, you guessed it, cracked and bleeding nipples that no abound of medical grade lanolin cream could prevent.

Oh. Joy.

Then we developed thrush.  This painful little demon was my undoing.  It’s athlete’s foot in your boob and in your baby.  Getting rid of it is next to impossible.  I knew the signs and went to the doctor straight away.  There are holistic remedies, but they are time consuming to produce and involve purple stuff on your boobs which will stain your clothes and the recommendation is that you go topless for a while.  With two sons in the house – one 20 and one 10, that sure as hell wasn’t an option.  So to the MD I went. He gave me two tubes of cream – one for me and one for baby – but I saw no improvement.

To make my misery complete, the thrush developed into something even more horrific – Deep Thrush.  This is when the thrush has travelled down the milk duct.  Between feedings (when a poor suffering mother should be blessed to feel nothing) I now had stabbing pains – like someone was trying to extract shards of glass from my breast.  One minute I’d be fine, just sitting there watching the Oprah show, and the next – BAM! I’m clutching my chest and gasping for breath.  Not a good look, let me assure you.

On top of all this, Baby 2 has Asperger’s Syndrome – he’s on the autistic spectrum.  He is particularly sensitive to emotional upheaval in his life and he was becoming a wreck watching me sacrifice my breasts on the alter of motherhood.  He was becoming increasingly anxious and seriously sleep deprived.  He become more rigid in his thinking and there were days where the stress of a new baby and an agonised mother left him unable to function. 

At 5 weeks, I decided I could go on no longer.  Feeding this new baby was taking up too much time and way too much energy.  I had three other children and a husband to worry about.  Everyone needed me to bring my A game and I wasn’t even out of the locker room.  Something had to change.

I won’t lie – I couldn’t even be in the same room when my husband gave the baby his first bottle.  The smell offended me.  My failure to do something I had done so easily just a few years before was gut wrenching. 

It. Totally. Sucked.

After a few days I put my Big Girl pants on and took back responsibility for feeding the baby.  There is an Attachment Parenting methodology to bottle feeding and it involves mom doing most of the feeding and lots of skin to skin contact in order to mimic the breastfeeding experience as closely as possible.  So that’s what I did.

I also refused to wallow in guilt or self-recrimination.  The situation was what it was.  I made the call to end breastfeeding, not anyone else.  Feeling bad about wasn’t helping anyone.  I took one for the team and now I had to suck it up and move on.

Truthfully, that baby was super happy to get that bottle of formula.  He loved having a full belly.  I enjoyed feeding him pain free.  He continued to grow and thrive, as had his brothers who had been fed formula, and after a few days of adjustment, I began to enjoy our new “nursing” relationship.

At the end of the day, that’s what feeding is – nursing.  Whether it comes from a breast or a bottle, if it is done with love, care and attention, baby will be happy and well nourished.

Baby 5 came along just 3 months ago.  I gave breastfeeding a trial run but the problems of Baby 4 – lack of milk production and thrush – were present from the start.  Again, my nipples were not up to the challenge of a baby who had to suck too hard and in discomfort and they cracked and bled almost immediately.  I tried the medical remedies, consulted with my midwife and my health visitor and they tried to help but it was no use. 

At two weeks, I made the call.  At his 2 week weigh in, the health visitor determined that the baby was not gaining enough weight (yes, they used a breastfed baby chart).  He was failing to thrive.  With a 15 month old nipping at my heels – on top of everything else – I simply did not have the time to make this work.

He is now 3 months old and doing great. I practice Attachment Parenting in other ways – such as co-sleeping and baby wearing and we are both happy and healthy.  My son with Asperger’s is also doing well.  He went through a period of anxiety right after the baby was born, but once I started formula feeding, everything calmed down. 

Calm is what I need.

There has been more public pressure to breastfeed this final time.  No one says anything directly, but I can tell.  Most women I know breastfeed.  I am the only AP parent I know who does not.  For AP parents, breastfeeding is our not-so-secret handshake. Do it and you are in The Club.  Don’t do it and you are treated like some kind of half-caste alien.

Never mind.  Twenty years ago when I had my first son, the debate at the time was about working vs staying at home.  Study after study was digested by legions of women who wanted proof that their decision was going to result in the smartest, happiest, most successful adults.  These days, no one worries too much about it.  It’s a personal choice each woman makes based on her own circumstances.  There are good and bad points for each.

Live and let live, right?

That’s how I now see this whole breastfeeding “Mommy War” story.  It’s just a bunch of sound and fury.  

In 20 years of trying to get it right, I have learned a few lessons.  First and foremost is that your relationship with your child does not begin and end with how she was fed as an infant.  Even if you breastfeed, there are loads of ways to screw up your relationship.  Navigating adolescence is one of them.  If I could tell new parents one thing it would be this: feed your child in the way that works best for you.  It doesn’t matter.  But when that gorgeous little baby turns in to a difficult 15 year old, and out of the blue that 15 year old asks if you want to watch a movie together, or go shopping, or if you have to invent ways to hang out – for the love of God, DO IT!  That is how you keep the family bonded.  That is your best protection against drugs and teen pregnancy and all of the other bad things that can happen as your child moves ever closer to adulthood.

It’s not about the boob.  It’s about communication and love and nurturing.  Get that right and you have half the battle won.

The other half? Sheer luck if you ask me, and despite what some might say, boobs are not some kind of lucky rabbit’s foot.  Your teenager can’t walk around with them in their pocket to ward off evil influences.  Sorry for anyone who thought they could.  I hate to bear bad news.  Sometimes the truth hurts.

Feeding your baby should not.  

***

Take a stand. Send your story in today, and let the world know that parenting amounts to more than lactating breasts: formulafeeders@gmail.com

FFF Friday: “I have given my son the best start in life that I could.”


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.

Here in the States, you see a lot of bumper stickers and signs on the highway reading, “I am the 99%”. This is alluding to the idea that only the top-earning 1% of our population is living the American Dream; the rest of us are in deep doo-doo. 

Sometimes, I feel like we should have FFF bumper stickers made up that say “I am the 2-5% (or by some more conservative estimates, the 1%)”. These are the percentages given for the number of women who are physically incapable of producing enough milk. Considering the lack of quality research that proves these statistics are accurate, I suspect the percentage is significantly bigger… but even if it isn’t, that 2-5% is made up of real, flesh-and-blood women, who deserve to be heard. 

FFF Jo is one of those women, and her story unravels below. I hope Jo will be heard, and that this guest post will serve the same purpose as bright red graffiti on a highway underpass. These are the 2-5%, and they matter.

Happy Friday, fearless ones…

The FFF

***
At no point during my pregnancy did I ever consider formula feeding. It wasn’t that I was against it, or even particularly passionate about breastfeeding, it was just that it seemed the most natural and straightforward thing to do, all you need are boobs and a baby right?

I live in the UK. From what I understand from reading this blog, things are a bit different here from the US. Formula is not allowed to be advertised or promoted. During my antenatal classes formula was never mentioned, and it is not ever offered in hospital unless medically necessary (or requested by the mother).

I had a very easy pregnancy. At about 30 weeks I was told that my son was lying breech and if he didn’t turn head down it would be safer for me to have a c-section. Despite a number of attempts to turn him he stubbornly remained where he was! So one Monday morning, 3 days before my due date, I went into hospital. My beautiful son was born at about lunchtime in what was a very stress free way. Straight after birth he was placed on my chest and breastfed very soon after.

All that night and the next day I continued to breastfeed. My son latched on beautifully straight away and seemed to feed well. I was slightly concerned that my breasts didn’t seem to be very full or hard, but I was told that this was perfectly normal and that ‘In a few days I’d be looking like Dolly Parton’!
When my son was 2 days old we were discharged and my husband and I took him home, ready to live happily ever after … that was when things started to fall apart.

The midwife came to visit me at home the day after I was discharged. As part of her routine check she weighed my son and told me that he had lost 11% of his birth weight. I was obviously worried, that sounded like a lot! She told me to breastfeed as much as I could over the next 24 hours, but that if he lost any more we would have to be readmitted to hospital. My son spent much of the next 24 hours on my breast, but the next day I was told that he had lost nearly 20% of his birth weight and we needed to go back to hospital immediately. I was very frightened – why hadn’t I been able to care for my son?
Upon our return to the maternity ward the midwives checked my son. He was jaundiced and dehydrated one of the midwife asked if I would consent to her giving my son some formula. Of course I said yes. It broke my heart to see the gusto with which he guzzled every drop of formula he was given – the poor thing must have been starving.

Over the next week I breastfed for as long as my son would stay at the breast, then pumped, then supplemented with formula. I repeated this process every three hours day and night. We had to give the formula using a cup as the midwives said that using a teat would make breastfeeding harder – It is a real skill giving a newborn formula from a cup!

During our stay in hospital the change in my son was amazing – he began to put on weight and fill out. He seemed so much happier and relaxed. I kept waiting for my milk to come in, but it never did. I was prescribed medication to increase my milk supply which it did, to a point (It took me 40 minutes to pump 1/3 of an ounce). After a while I couldn’t see the purpose of staying in hospital – Both my son and I were healthy and on a ward with babies with severe feeding difficulties. I asked the midwife if we could try feeding my son formula from a bottle. She agreed and he took to it well. We were discharged and agreed to continue breast, pumping and supplementing for as long as it took.

One month later, and we were in the same position. My milk supply had not increased. I was struggling to bond with my son as feeding him was such a trial. I was emotional, stressed and physically exhausted. My nipples were cracked, I had developed mastitis and was still producing so little. After watching me go through this for a few days, crying my way through every feed, my mum said to me ‘Why are you doing this? It might be time to stop’. I agreed, and over the next week my son became a fully formula fed baby. I was prepared for the pain as my milk dried up, but the pain never came, and I never leaked a drop (nothing to dry up I guess!)

My son is now a healthy, happy 3 month old baby, who I love with all my heart. I feel so blessed to be his mum. My heart still hurts, knowing that he didn’t get the best start in life. But in my head I know that I made the right decision. Without formula my son would have starved.

There does seem to be a common assumption that mum’s who give their babies formula (along with those who don’t co-sleep, baby-wear, etc.) are lazy, uninformed women who are looking for an easy option, but I know better than that. I did what I had to do to ensure my son was healthy and grew well – I believe that anyone else would do the same. The vitriol which some people direct towards formula feeding mothers astounds me. Just this week I have read articles saying things like ‘Formula is a starvation diet’, ‘Formula kills babies’, ‘If you couldn’t feed your child yourself then they were meant to die’. Reading such things brings me to tears, even though I know that my son is thriving.

I felt, and still do feel, incredibly guilty about my decision to formula feed, but my health visitor said something that made a lot of sense. I am a primary school teacher, and she asked me this question: ‘Can you tell which children in your class were formula fed? Can you tell which come from happy, stress-free households?’

 I believe that I have given my son the best start in life that I could. He is loved by two happy, relaxed parents, and has a mother who is determined to do her level best for her son. This goes way beyond the way that he is fed.

***

Whether you’re in the 1%, the 99%, or don’t even know what the fruck that means, you are welcome to be part of the FFF Friday contributor “club”. Simply send your story to formulafeeders@gmail.com,  and  help support other parents dealing with confusion, fear or conflict over their feeding method.

Bottle-feeding and weight gain in infancy: Does it matter what’s in the bottle?

This baby looks delicious (http://nomnommonster.com)

Fearless Husband and I have embarked on a 2-week “cleanse”, meaning we are only eating whole, organic, mostly raw foods. Meaning mommy is without her little helpers, Sugar and Caffeine. Meaning mommy is ornery.

Thus, I hope you’ll pardon the snarkiness which I’m sure will creep in to the following post. I’ve been trying to hold back lately, in the spirit of creating a kinder, gentler, more “professional” FFF, but the lack of food is bringing me back to my obnoxious roots. And it certainly doesn’t help that the study I’m about to dissect is about weight gain in babies (chubby, delicious babies… not that I’d ever eat a baby or anything, being vegetarian and, you know, not a cannibal. Unless the baby was dunked in chocolate… or rolled up in a nice fluffy tortilla….oh my god, I need sugar….) which is one of my biggest pet peeves.

I stumbled upon the study in question via this article, Bottle Feeding Linked to Rapid Weight Gain in Infants, Possible Obesity Risk. Great title, right? The article is correspondingly anxiety-provoking:

In a surprise twist to the “breast is best” debate, bottle feeding, and not just formula feeding, increases the risk of rapid weight gain in infants, leading to an increased risk of obesity later in life, says a recent study published in the Archives of Pediatrics & Adolescent Medicine...The results of the study indicate that breastfeeding, and not just breast milk, is best for babies. Infants who were exclusively formula fed by bottle gained only between 71 and 89 grams more per month than infants who were exclusively fed human milk by bottle. Furthermore, weight gain was negatively associated with the proportion of breast milk feedings but positively associated with proportion of bottle feedings among the infants who received mostly human milk…. In other words, bottle feeding, and not just formula feeding, puts children at an increased risk for rapid weight gain during infancy and for obesity later in life. Breastfeeding, and not just breast milk, is best in terms of maintaining a healthy weight.

Okay, so reading this, I felt conflicted: on the one hand, I am pleased as punch that researchers are looking at differences in the types of milk fed by bottle, and comparing human milk fed by breast to human milk fed by bottle – these are the types of studies that can potentially help us figure out if it something in breastmilk (which could then possibly be recreated to make a better formula) conferring certain benefits, or if it is the act of breastfeeding itself. If it is the latter, then this has obvious implications for working women, and exclusive pumpers, many of whom go to extreme lengths to provide the health-enhancing benefits of breastmilk for their babies. But on the other hand… if this was yet another study linking bottle-feeding to obesity, it wouldn’t really be doing much more than creating more stress and pressure on mothers who were unable to exclusively breastfeed – especially if those who were combo-fed fell prey to the same dreaded weight gain as formula-fed babies.
A quick jump over to the actual study (which is available to the public, free of charge, so I highly recommend taking a gander. It’s always better to go directly to the source. Kind of like my current diet…did I mention I was hungry?) quickly put both my excitement and my fears to rest. And here is why:
1) The study was based on phone surveys done with mothers, who reported both the mode of feeding and infant weight gain. Self-reported information is pretty much the bottom of the barrel when it comes to solid scientific data. It’s notoriously shaky as evidence goes, and especially with something like infant feeding where there is a strong, socially-induced morality/pride factor (especially considering the majority of the women involved were white, middle class, and college educated –  the group mostly likely to initiate breastfeeding and be well versed in the benefits), what someone tells you and what they actually do might be two entirely different things. Point being, this isn’t exactly hard data. Even the weights may have been misreported. The researchers could have asked for physician records to back up their results, but they didn’t.
2) More importantly – the study had fudge-all to do with childhood obesity. All it looked at was the rate of weight gain in the first year. Now, one could take these results and merge them with other studies which associated faster weight gain in infancy to later obesity, but then you’re just taking two observational, intricately confounded studies and throwing them together like a Glee mashup: same old songs, dressed up in a fancy arrangement. This study did not discuss whether the babies were gaining appropriate amounts of weight; we don’t know if the exclusively breastfed babies on the lower end of the curve were underweight or normal, or if the exclusively formula-fed or mixed-fed babies (on the other end) were overweight. All of these babies could have been within normal limits – we’re talking grams here. 

I think it’s a rather daring leap to take self-reported data that shows differences in the rate of weight gain in the first year of a child’s life, and use it to justify the message that “Feeding at the breast needs to be the first feeding choice for babies. When feeding at the breast is not always feasible, supplementing breastfeeding with expressed breastmilk is a good alternative, but special attention is needed for infants’ internal feeding cues while bottle-feeding,” which is exactly how the study authors capped off their conclusion. Where is the discussion of why weight gain in the first year is bad?

Interestingly, the researchers also found that “Infants categorized as consuming ‘human milk by bottle only’ and ‘nonhuman milk by bottle only’ gained more weight than infants fed at the breast only, but there was no such bottle effect observed among infants categorized as consuming ‘human and nonhuman milk by bottle.’” They hypothesize that:


“…(t)his might be owing to the fact that infants in this mixed feeding category were more likely fed at the breast previously than the other 2 groups (data not shown). Our previous study suggests that infants fed at the breast develop a better self-regulation of milk intake, which may be carried over even after feeding is transitioned from breast to bottle. Similarly, mothers who previously breastfed might better recognize infants’ cues of hunger and satiety, which may last even after they stop breastfeeding.”

I view this as a prime example of the Achilles heel of infant feeding research. When your internal bias is strongly in favor of one outcome, it’s too easy to extrapolate. First of all, how did they come to the conclusion that the women feeding both breastmilk and formula by bottle breastfed longer than those feeding exclusively breastmilk by bottle? Perhaps this came from additional survey findings, but since we don’t see this data, I’m going on the assumption that this was simply the authors’ hypothesis.  I think it is an equally plausible explanation that women who are feeding both breastmilk and formula by bottle (this is a group with no physical breastfeeding, remember) were exclusive pumpers, just like the other group, who decided to add formula in at some point. As a former exclusive pumper, every drop you pump is worth it’s weight in gold. If anyone’s going to be “encouraging” a baby to finish what’s in his bottle, wouldn’t it stand to reason that it would be the woman who worked her ass off to provide it’s contents? Perhaps the mixed-feeding group didn’t feel as much pressure to make sure that their babies got every last drop, which helped reduce the risk of overfeeding. (PLEASE note that I am in NO WAY insinuating that all exclusively pumping moms overfeed their kids. I don’t think this, at ALL. I am simply providing an alternative hypothesis that I believe is equally plausible to highlight the tunnel vision so prevalent in this area of research.) Alternately, maybe the act of exclusive pumping makes milk less “filling” in some way (the researchers do briefly discuss hindmilk versus foremilk, which can get a bit screwy with pumped milk, especially if you are combining milk from different pumping sessions) and adding a bit of formula helped the mixed-fed babies feel more full. Regardless, my point is that there are other rational (and perhaps more interesting, in terms of future research) explanations than the one provided by this study’s authors.

You’ve all heard my rants on this before, but I am seriously sick of studies that examine weight gain in babies and attempt to use it as fodder for the childhood obesity hysteria. I read another article about a separate study today, which correlated c-sections with later obesity in infants, and felt the same frustration. This article questioned why, as the rates of c-sections have gone up, so have the rates of obesity. I think this is like asking why the rates of autism have gone up along with the rates of breastfeeding. It’s ridiculous. Childhood obesity is high in this country because our kids eat like crap and sit in front of screens all day. It’s hard to change these behaviors, when you’re on a limited budget, living in areas with poor food options, and working all day to keep a roof over your kids’ heads. And being a little heavy isn’t even a bad thing, as long as you are eating healthfully and moving your body – some folks are genetically predisposed to being a little more fluffy. It’s about overall health, not body weight, and much of the conversation around weight gain and body size seem to ignore all of these considerations in favor of overreaching studies that attempt to pin blame on individuals, while refusing to see them as individuals.

And speaking of that, I’m about to shut down my screen, go drink a glass of spinach and kale juice, and dream about eating crap. Crap is delicious. Which is why is is so much fun to blame our propensity towards pudge to the way our mothers birthed and fed us.

FFF Friday: “I would dread having to hold her and feed her…”

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.


You know what I want to put on a bumper sticker? “Motherhood is not spelled Martyrhood.” It needs to be said, because a lot of people seem to be confusing the same terms.
Tonight’s FFF Friday post, courtesy of FFF Karen, highlights this syndrome in her astute assessment of how many feel you need to go to extreme lengths to earn the title of “good mother”. This has absolutely nothing to do with breast over bottle, but rather a pervading trend of glamorizing pain, sacrifice, and the relinquishing of one’s own needs and desires. Obviously, your priorities change when you become a parent – but a) it takes two to tango, and I’m sick of men being left out of the equation of what it takes to raise a happy, healthy child; and b) being willing to sacrifice and lay down your life for your child (which I bet most of us would do in a heartbeat) is not the same thing as craving the opportunity to prove your worth by glorifying pain and suffering.
Anyway. Off my soapbox, and onto Karen’s (which, of course, isn’t actually a soapbox but rather an impressively honest, laid-bare account of her experience….
Happy Friday, fearless ones,
The FFF
***
I was one of those women who was completely obsessed with breastfeeding when I was pregnant. I didn’t buy or register for any bottles or order any formula samples. When I had my daughter,via c-section after a marathon pushing session and long labour, She was a big, healthy girl (9lbs 12oz and almost 22 inches long). I asked to breadfeed her right away. She latched beautifully and I was so happy – even though my legs were still numb from the surgery. I stayed in the hospital for three nights following the surgery and it was an emotional rollercoaster. Each nurse who visited us reassured me that the baby and I were doing everything right when it came to feeding her. And we fed, like clockwork, every three hours. I would have to wake the baby up to feed each time, though, and often undress her or use a wet washcloth to get her interested in feeding. Then, after a few minutes of suckling she would usually fall asleep on my chest. On the fourth day, before I was discharged, I asked to see a lactation consultant because I felt something just wasn’t right plus I had a lot of nipple pain and burning.
The LC said that it shouldn’t hurt if done right but that the baby and I could be in a book – the latch and hold were perfect. She assured me things would get better. But the baby had lost a significant amount of weight and was still very lethargic. She was also jaundiced and not seeming to get better. We started supplementing with formula though a tube system so the baby would be on the breast but also getting formula without knowing it. We continued that at home every three hours. I was in a lot of pain and was stiff from the surgery so slept on the couch for the first week after we took the baby home. My husband would take the baby upstairs to bed and set an alarm to wake her up to bring her back to me for feeding. It was so exhausting and the pain was getting worse. It took two of us to feed her – to set up the tube system and then I held his hand and squeezed as the pain intensified as she sucked. I was starting to dread my little girl waking up and hated feeding her.
I saw the LC again and she said my milk was not coming in and that my breasts were still soft and not showing any signs of milk. She said a pre-existing condition I had, Polycystic ovarian syndrome, may have something to do with low milk supply. I saw several nurses, went to two breastfeeding clinics (incl. Le Leche League) and talked to my doctor. All gave me suggestions to try to increase my milk supply while I supplemented my baby with formula. I tried the herb fenugreek, drank beer, nursed more often and for longer periods of time, and finally took a prescription drug which was supposed to help with supply. Nothing seemed to help. Our little girl was growing faster than my supply. And my nipples were starting to look and feel like they would fall off. At one point, I told a public health nurse i had cracked nipples so bad that they were bleeding. She boasted that she had the same thing and that feeding my baby milk with blood in it was not anything to be worried about. This seemed like a crazy comment to me and it felt as though she (and others I had met at the clinics) was proud of the battle scars she had from the trials and tribulations of breastfeeding. It was almost like, if it was easy then it wasn’t worth doing. I felt like, if I hadn’t tried everything humanly possible then I was a bad mother.
About two weeks in to my daughter’s life, I was up for a late-night feeding and just started to cry uncontrollably from the pain of my baby at my breast. By this point I was convinced she wasn’t getting anything from me other than the formula in the tube. When I pumped, I was able to get just under one ounce from both breasts – even after all the herbs, drugs and tricks. My husband walked in on me sobbing and said “enough is enough”. We bottle fed our baby for the first time at the next feeding and she was a champ. I felt like dirt but she sucked back all the formula happily. I still pumped whatever I could and added it to her bottle. But after a few weeks, my daughter’s bottle was still 95% formula and just a tiny amount of breastmilk. So eventually, with a heavy heart, I gave up altogether.
Now, my baby is almost four months old and she’s big, strong and happy. She’s been sleeping through the night since just shortly after we started giving her the bottle and she’s growing like a weed. I look back at those hard weeks in the beginning – and all the guilt I still sometimes feel – and wonder if it was worth it. I do believe breastfeeding is best but my baby was sucking on dry breasts. We were both stressing out and there was little benefit. I cringe when I think of how I would dread having to hold her and feed her. I had thought it would be a beautiful was for us to bond but it turned out to be nothing of the sort.
I proudly bottle feed now and wish there were more resources out there for bottle feeding mothers and families.
***
Like Karen, I wish there were more resources for bottle feeding families. By sharing your story for an upcoming FFF Friday, you’ll contribute to one important resource – one which helps new parents feel less alone in their struggles. Send yours to formulafeeders@gmail.com.





The FFF Quick-and-Dirty Guide to Formula Feeding: Recognizing Sensitivity, Intolerance or Allergy to Formula

Those of you who haven’t been following this blog since the beginning may not know this, but my son Fearless Child (FC) has a dairy allergy, which went undiagnosed for the first few months of his life. Having his insides assaulted on a daily basis made him grumpy – so grumpy that he screamed bloody murder for about 20 hours a day. And yet it took us over a month of elimination diets, doctor visits, and late-night consultations with Dr. Google to figure out what was going on. This was partly because FC’s symptoms were slightly atypical, but more so because as new parents, we were utterly confused as to what was “normal” newborn behavior and what necessitated medical intervention.

There’s a good deal of information on dairy intolerance in babies on the Web, but not much specifically geared towards bottle-feeding parents. This is unfortunate, as those of us feeding our kids in this manner actually have a really simple way of figuring out if food issues are at play – and yet so many of us struggle for months, feeling increasingly frustrated and hopeless with our inability to comfort or feed our children adequately.

I always hesitate to offer what might be construed as medical advice, since there’s far too many hacks out there doing just that. So before I continue with this post, let me reiterate: I am not a doctor. I haven’t even played one on t.v. (Does anyone still get that reference? Or does it make me sound old?)  The following information is what I have culled from my own research, talking to pediatricians and pediatric GIs, and from my own experience as the mother of two kids with feeding issues.

Oh, and one more note: I am going to use the terms “intolerance”, “sensitivity”, and “allergy” interchangeably here, even though these three things are entirely different. This is because until you see a physician, you won’t know which of the three you are dealing with. My purpose with this post is to help you realize when something is amiss, and to assist you in navigating a medical system which often ignores the power of parental intuition and knowledge of one’s own child. You’ll have to see an actual MD to get a true diagnosis… and I don’t meant Dr. Google.

 

Behavioral Symptoms of Formula Intolerance or Allergy in Young Babies

Newborns are complicated creatures. Some are calm and sweet (this is the kind of baby everyone else seems to get at least once, but apparently my and my husband’s genetics do not morph in a manner conducive to a docile temperament), others are generally chill except for a bout of colic between weeks 2-8, and others are fussy all.the.time. This last group is the one that we need to worry about. Typically, a calm, contented baby is a well-fed and happy one. This is not to say that food allergies will not strike later in life, once solids are introduced, but a newborn who is sensitive to something in formula will usually express discomfort in a pretty vocal way. Watch out for:

- Extreme fussiness. Colic is defined as crying for a period of 1-3 hours, at least 3 days a week, typically in the evening. A baby who is sensitive to formula will cry constantly, throughout the day. They can sometimes be comforted, but only by extreme measures like continuous movement (we had to bounce FC so vigorously that once, while shopping for a new car, a man came up to us in horror and told us we should stop shaking our baby; a friend’s dairy intolerant breastfed baby was only comfortable while being vibrated in his bouncer – all night long), specific holds (the Harvey Karp /Happiest Baby hold is magical for babies with tummy issues). The difference between a “normal” fussy baby and one with potential allergy or intolerance is that they have 2 settings: sleep and screaming. The fussiness is the default, rather than the exception.

- Trouble sleeping. While many young babies sleep erratically, they usually sleep a lot cumulatively.  A newborn with a formula intolerance will often be too uncomfortable to sleep.

- Trouble eating. This one gets tricky, because other issues can cause trouble with feedings – sensory issues, reflux, dislike of the type of bottle or nipple you are using… but one common symptom in babies experiencing formula intolerance is fussiness around eating. They may pull away from the bottle and scream; or eat only small amounts at a time. Reflux can also be associated with formula intolerance, so spitting up an excessive amount after every feeding (especially if there is curdled formula or blood in the spit up) might signal a problem. Some babies might develop an aversion to eating, associating the formula with pain, and refuse the bottle altogether. Others may “comfort feed” and want to eat constantly (more on this later).

- Inability to connect or bond. Again, this can signal a far more serious issue, but it should be noted that babies who are in constant pain have a rough time chillaxing enough to focus on their parents or begin engaging in social interactions. I’ve had numerous parents tell me that they had secretly worried their baby “had no soul” or “wasn’t all there” prior to diagnosing and solving a severe allergy or intolerance. If your baby is screaming constantly or is noticeably stiff, writhing, or doesn’t seem to be comforted by touch, see your doctor.

 

Physical Symptoms of Formula-Related Food Intolerance or Allergy

The physical manifestations of a formula intolerance are more straightforward, but they also tend to suggest a more serious problem (i.e., clinical allergy versus sensitivity). In terms of getting a diagnosis, they do make life easier, but they can also be scary when first encountered. These include:

- Weight loss, or extreme weight gain, from comfort feeding.  I’ve heard of more than a few cases where babies who are overeating are misdiagnosed with the excuse that “milk protein intolerance causes failure to thrive”. This is true; many kids will have aversions to formula or breastmilk caused by associations with pain, and refuse to eat; these conditions can also cause malabsorption, so the baby isn’t getting the necessary nutrients to grow. But some babies find the liquid comforting as it goes down (especially those who have reflux associated with the intolerance or allergy), or like the sucking action, and want to eat constantly. The offending food causes more distress, which then creates a need to comfort feed more… and suddenly you’ve got Jabba the Hut, Jr. on your hands. Their girth may cause doctors to dismiss discomfort and symptoms as “overeating”(which can certainly cause a whole list of problems, but my point is that sometimes, the overeating is a symptom, not a cause).

- Blood in the stool – this can appear looking like strawberry jelly (red) or like coffee grinds (black). If you see blood, drop everything and call your pediatrician.

- Mucous in the stool – this is a biggie, because often the blood will be invisible to the naked eye, but mucous is easy to spot. Mucous looks like stringy, gelatinous strands, usually white or clear in color.

- Rashes – these can appear in a variety of forms, and may be hard to differentiate from normal newborn skin issues like diaper rash or infant acne. Sometimes the rashes might look like hives, but they can be atypical. FC would get petechia-type red dots on his cheek, right next to his eye, and down his cheek. (This same reaction continued as he grew into toddlerhood, and was a great way for us to know we’d screwed up and allowed for accidental exposure). Other parents have told me that the rashes congregate near the joints, or as a red ring around the anus. All lovely and comforting things to see on your precious newborn, right?

- Vomiting up blood. Again, this merits a panicked call to the doctor. Stat.

Something you should also know is that milk protein allergies come in two forms: rapid onset (immediate reaction) or delayed onset (reaction within 7-10 days of ingesting milk). This may explain why some babies don’t start reacting to formula until a week or so after birth/switching over from breastfeeding. Rapid onset looks more like a “classic” food allergy – hives, wheezing, bloody diarrhea. The rapid onset form is far more dangerous, as allergies can worsen with every exposure, eventually leading to anaphylaxis, so if you see these sort of symptoms, do not pass go, do not collect $200, just dial your pediatrician.

Which brings me to….

Seeing Your Doctor

There are a lot of fabulous pediatricians out there. There are also some really crappy ones. And in the middle, there are doctors who have seen thousands of neurotic new parents who freak out at the first sign of slight fussiness in their babies, and also a slew of legitimately concerned parents dealing with the untreatable hell that is infant colic. Considering that in the majority of cases the babies they see are either healthy and just waking up to the world (it’s normal for a baby to be impossibly easy and sweet for the first few weeks and then wake up one day with an attitude. Think of it as good practice for the teen years), or are unfortunate victims of colic and just have to wait it out (excuse my tangent for a moment but I cannot for the life of me understand why no one has figured out this colic thing. Seriously? We can clone sheep and we can’t figure out why some babies cry inconsolably for exactly 3 hours at the same time every night??!), it is understandable that some pediatricians have dismissive or patronizing attitudes towards those complaining about fussy babies.

I have seen parents who do overreact to sudden onset of mild spitting up, fussiness, or constipation- it’s hard not to, considering the lack of sleep, the hormones, and the lure of the Internet (Dr. Google is an alarmist). But for the most part, every parent who has emailed me with a laundry list of weird symptoms and a general, foreboding sense that something is “not right” with their newborn, has later followed up to confirm diagnosis of an allergy or intolerance. I’m a big believer in mommy/daddy “gut” when it comes to your baby’s gut.

So, here’s what I would suggest: before you go in for your child’s appointment, write down a list of every symptom you have observed. If you’ve been noticing mucous or blood, collect a stool sample, and show your doctor the craziness that is coming out of your kid’s tush. If your doctor starts talking about colic, explain to him/her that you are well aware of what colic is, and colic does not explain the other symptoms you are noticing (you might also want to mention if your child’s crying doesn’t follow a colic-like pattern – meaning that it is not sustained crying for a specific period of time, but rather constant fussiness throughout the day).

It is also well within your rights to request allergy testing, but here’s the thing: with this sort of testing, only a clinical allergy will show up. If your baby has an intolerance or sensitivity, the testing will probably come back as inconclusive or “normal”. Additionally, there is some controversy on whether allergy testing in young infants is even accurate.

Luckily, there is another, non-invasive way to see if the formula you are using is the problem, which is what I like to call…

The Miracle Cure

I could write a Shakespearean sonnet for hypoallergenic formulas, and I’m sure the folks who like to think I’m paid off by formula companies will find fodder for this conspiracy theory in how often I hawk Alimentum on here. But I just love the stuff. And not just Alimentum. Nutramigen, and Neocate, and whatever comparable product is on the European/Asian markets. The stuff is stinky, expensive….and utterly lifesaving.

If you suspect that your baby has a milk protein sensitivity, and the symptoms are not severe enough to necessitate medical intervention, you might want to consider doing a 48-hour hypoallergenic challenge. This is a 4-step process:

1. Get thee to thy nearest drugstore/grocery store

2. Purchase a commercial hypoallergenic formula (please read my post on types of hypoallergenic formula to ensure that you are choosing a true hypoallergenic and not simply a “sensitive” brand)

3. Serve said formula to thy infant, and observe for the next day or two

4. Thou shalt be singing high praises to the heavens by yonder morning, otherwise the formula probably wasn’t the problem in the first place.

While milk and soy protein allergies are the most prevalent in young infants, there are some kids who are sensitive to corn or other ingredients in formula. And for children with severe milk protein allergy, a commercial hypoallergenic isn’t going to cut it – they will need an amino acid-based formula, which is available by prescription only. But for most babies suffering from mild to moderate sensitivities/intolerances, a hypoallergenic formula is truly a godsend. You should see a marked improvement within 2 days if the problem is food related and not due to some other underlying medical condition (cough*call doctor*cough) or- and I seriously hate to say this – if it’s just colic or fussiness, in which case you really do just need to give it time, and start drinking heavily to get through the next few months. Kidding. (Maybe…)

If you are dealing with colic or normal infant fussiness, the good news is that you can skip the following section, and not have to worry about a childhood without ice cream and birthday cake. But if the formula does make a dramatic difference, you may want to consider….

What the Future Holds

If the hypoallergenic works wonders, you can continue to use the formula and try re-introducing a normal or sensitive formula at about 6 months, once your baby’s system has developed a little more. If symptoms return, then you simply return to the hypoallergenic.

That said, hypos are quite costly, and if your child does have a true milk protein allergy, you might be able to get the formula covered by your insurance. You’ll need to see your pediatrician to get the right paperwork filled out in order to do this.

I’d also suggest that you do ask for a referral to an allergist and/or pediatric GI, just so you will have someone in your corner when you start solids. While most children outgrow a milk protein allergy or intolerance as they become toddlers, some take longer than others. It gets really difficult to figure out a delayed-reaction allergy once they start solids, because the exposure could have been anytime in the week or so prior to the reaction. Also, weaning off formula looks a bit different in a dairy intolerant/allergic child. Sometimes, pediatricians will want you to stay on formula a little longer since it’s harder for kids to get the nutrition they need when they can’t eat or drink dairy products. In other cases, using a milk substitute like soy (unless your child is sensitive to soy as well, which many milk protein intolerant kids are), rice, almond (as long as you’ve seen an allergist and been tested for nut allergies), oat. or hemp, can be a perfectly acceptable option. My kids have both thrived on unsweetened almond milk, which is fortified with so much stuff nowadays that the only thing milk trumps it on is protein content and fat (and we incorporate other foods into their diets that compensates for this).

You’ll get very good at reading labels, and creative with recipes, and become a master at surreptitiously pulling vegan cupcakes out of your diaper bag at birthday parties so your kid won’t feel left out. You’ll probably do “challenges” with your kid every so often to see if his or her body has decided to make friends (or at least frenemies) with dairy, and when that day comes, you may even get to see a face like this:

Fearless Child’s first time eating cake & ice cream at a friend’s birthday. And yes, I cried.
Until then, remember- you are the expert on your child. You are also your child’s best advocate. Formula can be changed at any time, so there is no reason to suffer stoically if you suspect an intolerance or allergy to the one you are using now.
Great Links/Sources
http://kidshealth.org/parent/medical/allergies/milk_allergy.html
http://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy
http://foodallergies.about.com/od/dairy/a/babymilkallergy.htm
http://adc.bmj.com/content/92/10/902.full.pdf
http://www.kidswithfoodallergies.org/resourcespre.php?id=140&
http://www.medscape.org/viewarticle/563463
Related Posts Plugin for WordPress, Blogger...