FFF Friday: “What they spout as truth isn’t a blanket that covers all women…”

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 always urge the more judgmental folks I meet to think about what is behind some of the decisions they’ve struggled to make. Choosing how to feed a baby is often just as complex a decision process, and yet so many people see a bottle an assume that it was a fly-by-night choice. I’m sure for some it is, just as breastfeeding comes naturally to those who have been raised in breastfeeding cultures. But for many women who have been made well aware of the benefits of breastfeeding, deciding to use formula involves a rather involved backstory. And just as FFF Claire points out below, blanket statements aren’t really appropriate for complicated personal decisions. Those kind of blankets tend to leave some ice-cold toes sticking out of the ends.

Happy Friday, fearless ones.

Claire’s Story
My husband was exclusively breastfed, while my own mother had told me how difficult it had been to breastfeed my brother and she had switched to formula.  I was four weeks early and exclusively formula fed. Because of this I registered for bottles as well as a breast pump.  I wanted all bases covered, so to speak. 
During my last OB appointment I asked my OB what formula I should purchase. He seemed puzzled and asked, “Aren’t you breastfeeding?”  I countered with, “I’m going to try, but what if I get smacked by a bus? How will my husband feed the baby?”  My OB laughed, recommended some formula, and said, “In thirty years you are the first patient to be so thorough.” 
So, I tried nursing my son and it didn’t seem to work. I had three different nurses/doctors/lactation consultants tell me something different.  Our nursing sessions would last for two hours and I still had to top our son up with formula since he constantly cried. It was stressful and not the magical dreamy bonding experience I had read about. At a well baby visit I showed the staff my nursing log, and I was hooked up to a pump.
I was finally diagnosed with a short nipple and low supply. A militant doctor then handed me a sheet and told me I needed to drive thirty miles to get some supplements and admonished that “I should not stop breastfeeding!” In my mind I was thinking, if breastfeeding is important, why don’t they sell these magic herbs here? The militant doctor even made another woman cry in the room we were all sitting in.  She barked, “Do you know how many ingredients formula has?  Well, breast milk has more! Plus it is always changing!  It helps with IQ – you want a smart baby!”  (This woman whispered to her own mother, “He won’t eat, I can’t sleep.  I won’t be able pump enough when I go back to work…what am I going to do?”)
My husband drove us home, and I gave our son a bottle and had the wonderful maternal-gushy-awww-feelings of bonding.  This was good, since twelve hours later I would fall down the stairs with our son and break my leg in three places.
I had emergency surgery and was separated from my husband and baby for four days before I could go home.  Good thing I had bought that formula!  Three weeks later I had another surgery and between the blood thinners, painkillers and the fact I gave up eating, it became another win for the formula column.  I had no problem with formula feeding and neither did my husband.  I did have a couple of negative encounters, though.  One orthopaedic nurse was shocked that I wasn’t breastfeeding until I pointed to my external fixator and mentioned my medications, and then the light bulb went on.  One mother admonished that I could have pumped until I was off of my medications so our son could still have my milk.  Well, my last surgery was three weeks after our son turned one so that was a moot point.  Besides, my milk dried up after my first surgery.
My son thrived on formula and bonded with my husband and myself.  My injury and subsequent surgeries caused me to develop osteoarthritis, and I have since been put on medication so I can actually be a mom.  I went off of my medication when I became pregnant with our daughter.  When the question came up of feeding it was a resounding Formula! 
During her well baby check up, I had the same militant doctor from three years before!  I remembered her; she did not seem to remember me, however. Her rhetoric seemed to be nonexistent and I received no snide comments or evil looks for formula feeding our daughter.
Whenever I meet a woman who parrots, “Breast is Best.” Or some form of, “Any woman can do it, it just takes work,” I tell them what happened to me, and that more women encounter problems, obstacles, and sheer malice then what they believe. Some soften and others don’t.  I just hope that those that do soften will stop and take a moment to realize what they spout as “truth” isn’t a blanket that covers all women.
You know how the Beatles think happiness is a warm gun? For me, happiness is a good FFF Friday post. Spread some joy by contributing yours: formulafeeders@gmail.com.

Celebrity culture and infant feeding: Does breastfeeding need a makeover, or a makeunder?

There’s a startling disconnect inherent in the way our society views infant feeding. On a daily basis, I see vomit-worthy comments posted on Twitter disparaging mothers who are committing the mortal sin of nursing in public – some recent gems included a tweet from a guy who got his jollies waiting for a nip slip from breastfeeding moms, and several women taking cheap shots at “exhibitionist” moms who were “grossing them out” by feeding their babies in plain sight. Seeing this, I can absolutely understand the need for breastfeeding to get an “extreme makeover” in our culture; I can start to see why online discussions about the need for bottle-feeding support devolve into defensive diatribes about how we (FFFs) are in the majority, and have no comparable need for sisterhood.

And yet, my Twitter feed serves as a stark contrast to my other guilty pleasure – celebrity culture. We may live in a “bottle feeding society”, but breastfeeding has become a rite of passage among the pop-cultural elite. Just for fun, I spent a few days googling every single famous mom who had given birth in the past year or two, and almost every single one had a photo, interview, or online mention about how they were breastfeeding, or at least planning on it. The few who didn’t either adopted, or made it a point to explain why they weren’t (Tina Fey, Bryce Dallas-Howard). From hard-living rockstars like Pink, to pin-ups like Alyssa Milano, January Jones, and Beyonce, to girls-next-door like Sarah Drew, Alyson Hannigan, and Jenna Fischer, to the French first lady Carla Bruni... it seems as if everyone on the A, B, and C-lists were using their A, B and C cups (even the enhanced ones, a la Tori Spelling) for their evolutionary/biological purpose.

I’ve talked before about how important perspective and environment are in this discourse: two women in the same city could have markedly different experiences with infant feeding support, depending on their socioeconomic and cultural surroundings, as well as their individual peer groups. I live in Los Angeles, a stone’s throw away from Hollywood, so looking at this list of happily-lactating celebutantes clarifies why I felt so alone in my bottle-feeding days. But I realize my breastfeeding-friendly area is nothing like where so many women live, places where they feel ostracized every time they lift a shirt to feed a crying baby. I know this alienation is real; one look at Twitter proves that, and then some. I’m not sure what’s worse – enduring the threat of borderline sexual harassment each time you breastfeed, or having famous physicians tell you that you are harming your baby by not trying hard enough to give them their birthright of mother’s milk. I think it’s probably a toss-up, or at least depends on your psychological makeup and personal triggers.

However, I think lactivism needs to take a serious look at US Weekly before focusing more attention on “glamorizing” breastfeeding. It’s been glamorized. And yet, women are still experiencing ignorance and intolerance about nursing their babies (or toddlers). Celebrity culture has tremendous influence – the advertising industry capitalizes on this; think about how many famous folks endorse the products you purchase, directly or indirectly. Numerous articles have been written about how celebrity post-baby weight loss has a negative impact on our collective psyche; we supposedly watch them shrink in a matter of weeks and believe that’s how postpartum bodies should act (incidentally, most of them attribute their miraculous weight loss to breastfeeding).  If we see a Kardashian pushing a certain type of stroller on their insipid reality show, it becomes a hot seller the very next day. Depressing as it is, our society looks to the bobbleheads on the television for guidance on style and substance. So why isn’t it working with breastfeeding?

Seeing Victoria Beckham or Miranda Kerr or Hilary Duff breastfeed doesn’t make an impact, because of course these women are breastfeeding. They have the resources to do so – flexible and accommodating work environments, nannies, housekeepers, access to superior healthcare providers, support, and most importantly, they live in breastfeeding-friendly environments. How is this making breastfeeding look any more do-able to the average woman? It might make it look more attractive, but not more attainable.

So, maybe the focus should be less on giving breastfeeding a makeover, but rather a makeunder. Focus on making it more accessible and attainable to those who are struggling to make ends meet, to those who not only are lacking a nanny and personal trainer, but also a supportive partner; the ability to switch to a breastfeeding-friendly pediatrician; money to see a private lactation consultant, or a car to drive to see that consultant.

And from a formula feeder’s point of view, I want to make one last point: breastfeeding moms have their choice of role models. Maggie Gyllenhal, Marion Cotillard, Jennifer Gardner… Women who are opting not to breastfeed have Snooki, who recently was accused of saying breastfeeding is “kind of like you’re a cow” (although for the record, she was just talking about pumping, which she intends to do – she was scared of breastfeeding because her friends had experienced trouble…but I digress):

Source: http://www.hollywoodlife.com/2012/06/11/snooki-breastfeeding-cow-interview/

Speaking of makeovers….

FFF Friday: “If someone wants to judge me…that’s their choice.”

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.

D-MER, or Dysphoric Milk Ejection Reflex, is a problem that is seldom discussed in breastfeeding literature. It’s a tricky condition to diagnose, because other things can make breastfeeding a negative experience – postpartum depression, psychological responses to physical pain or sensations, associations with past abuse, body image issues…  D-MER, however, causes a “dysphoric” response (depression, anxiety, anger, negativity) with milk let-down, and it typically subsides as soon as that physiological process ends. In my opinion, this is a vastly under-diagnosed condition due to the perception that these feelings are shameful or “abnormal”, because we are told that breastfeeding should be a lovely, enjoyable bonding experience. Further, the vast majority of D-MER resources operate under the assumption that weaning is not an option, and that it can be resolved through medication. For those who want to continue breastfeeding, this is wonderful – but for those who do not feel comfortable taking certain medications while nursing, or at all, this advice may cause more frustration than comfort. 

FFF Andrea’s story, which unfolds below, demonstrates the conflicted feelings of a woman who wants to breastfeed, but also wants the happy, emotionally-attuned family life she so deserves. I hope that her willingness to share her journey will encourage other women living with D-MER to come out of the closet regarding their true feelings and experiences. This is a real problem, affecting real women, and it’s time we had some real, honest discussions about it – because in many ways, it is the most literal “booby trap” of them all.

Happy Friday, fearless ones….


Andrea’s Story
I formula fed my first and for the most part didn’t mind.  I knew he was turning out healthy and he was advanced for his age too.  I had no doubt that formula was a good alternative for those that didn’t want to or couldn’t breastfeed.  However a part of me always sort of wished breastfeeding worked out for me.  However I had depression only during breastfeeding and it just got worse as the days went on.  After a bit of research sometime later I found out that it was D-MER and was a bit relieved that I wasn’t abnormal and others experienced it too.
Fast forward a couple years and we had our second on the way.  I hoped that breastfeeding would work out and was determined off and on to exclusively breastfeed.  I researched D-MER and found out that if you had it before you would likely get it again.  That thought scared me quite a bit because I remembered how miserable I felt and the dread I felt before he latched on.  I found out that Wellbutrin had some good results with D-MER though and started researching the use of Wellbutrin while breastfeeding.  I took it for ADD already with great results, but had stopped before I got pregnant.  However, I just couldn’t find enough research to make me feel comfortable with that.  I knew only a little transferred through the milk, but I couldn’t help but wonder how much it affected a baby’s brain since they were so tiny and still developing quite a bit.  My education background made me wary as well.  To me, formula honestly seems to be a much safer alternative because it doesn’t have a drug in it that affects the dopamine levels in her brain.
Fast forward again and my daughter was born at a very healthy 7.11 pounds and 20.5 inches.  She had (still does have) the cutest chubby cheeks!  I decided to go ahead and let her latch on and she did, very fast and pretty good, too.  I remember telling the doula that we would take it one day at a time and wistfully stating that I hoped it would work out.  It was an experience I wanted to have.  I knew I’d bond with her just as well with formula; in fact it would be better than breastfeeding if the depression came.  We were in the hospital for 2 days and she breastfed really well; in fact I’d say she had a voracious appetite.  She had a wonderful latch, but she went at each feed so thoroughly that I got peeling and cracked nipples.  It only hurt when she latched on fortunately and sometimes that was because she’d just inhale the nipple.  On the third day I was pretty much couch- bound with a baby that was feeding pretty often for short cluster feeds.  If she wasn’t feeding she was using me as a paci or insisted on sleeping with her head right next to the nipple.  I could get up to maybe use the bathroom, but that was it.  My milk had started coming in and I began to feel those same depressing thoughts and I had some random bouts of anxiety as well.  Faint as they were at that moment, it was still undesirable.  I also found myself really hating the couch-bound aspect.  I couldn’t find a position that didn’t hurt since I had a couple stitches.  I also had a son that needed me.  My husband was helping out a ton, but my son insisted on having me help him go to bed at night and to pat him back to sleep if he woke up.  I wanted to be with him at bedtime and more as well, but with the way my daughter was feeding, it was very hard.  So midway into the third day we switched to formula.  Admittedly I felt relieved.  I wasn’t tied to the couch and my mood started improving with the slowly diminishing letdowns.  The more my milk dried up the better I felt.
A few days later though it was clear the formula wasn’t agreeing with her.  She was comfort feeding so much that she would drink about 6 ounces over a couple hours between fussing.  Then she’d cry and fuss herself to sleep.  We tried paci’s and all, but she wouldn’t take them.  I also noticed that she had silent reflux.  I decided to try Similac Sensitive since that was what my son was on.  I remembered that he didn’t do well on Enfamil Gentlease so maybe it would be the same with our daughter.  It seemed like she improved briefly, but she actually got worse.  So as a last option I bought a can of Alimentum and gave that a shot.  She started doing so much better.  It was an amazing improvement.  I fell in love with the formula, she is such a happy and calm baby now.  She does just as well on Nutramigen as well, which is a bit more affordable.
Part of me felt bad though.  I occasionally wonder if she’d have had this problem if she were breastfed.  I also wished a bit that breastfeeding had worked out.  I wanted that experience and the convenience as well.  I felt a bit guilty that I enjoyed holding my daughter more now that she wasn’t attached to me and voraciously feeding almost all the time as well.  She had such a high demand and was always tugging and pulling at me as well as feeding quite hard at times. 
I can’t help wonder if some of the guilt I feel is because all my friends breastfeed.  The only person I could talk to about the whole breast or formula dilemma while pregnant was with my mom, who had done both with my brother and me.  I tried talking to a friend, but she wasn’t very helpful.  I got some clear anti formula comments from another friend as well.  I laughed it off, but it did hurt a bit.  I know part of me feels envious because I did hope it would have worked out.  It’s just an experience I wanted to have that wasn’t tainted with depression or random bouts of abnormal anxiety.  At this current moment I’m trying hard to not get down that it didn’t work out.  It is so nice that my husband can help with feedings.  It’s nice that I don’t have a baby attached to me almost all day as well. It’s especially nice that my mood isn’t going downhill and that I won’t wonder someday if the Wellbutrin changed her brain at all.  I can help out more with our son too.  I do enjoy feeding her much more now.  It’s a wonderful bonding experience and as I say, since you need two hands for feeding with a bottle you can’t read a book or surf the web like you can while breastfeeding.  Sure you can watch TV, but I rarely pay attention to that, I love watching her and it helps keep me aware of her cues on when she needs to burp or is done. 
Overall, I know that this is better for me emotionally.  While most don’t understand DMER or why I won’t breastfeed while taking Wellbutrin, I know the truth.  If someone wants to judge me on my reason for not breastfeeding, that’s their choice.  I hope that someday moms won’t feel this huge push for breastfeeding and have more support for formula feeding.  We have enough to deal with as moms, how one chooses to feed their baby shouldn’t be one of those nerve-wracking issues that can be laced with guilt if the choice isn’t breastfeeding.
Share your own experience for an upcoming FFF Friday. Email me at: formulafeeders@gmail.com.

A study that has nothing (and everything) to do with formula feeding

A new study is making headlines this week. “Early full-term babies may face later school woes” warns HuffPo, explaining that in a study of 128,000 New York City public school kids,

…of the children born at 37 weeks, 2.3 percent had severely poor reading skills and 1.1 percent had at least moderate problems in math. That compares to 1.8 percent and 0.9 percent for the children born at 41 weeks…. Children born at 38 weeks faced only slightly lower risks than those born at 37 weeks… Compared with 41-weekers, children born at 37 weeks faced a 33 percent increased chance of having severe reading difficulty in third grade, and a 19 percent greater chance of having moderate problems in math.

This isn’t great news for those of us with babies born a tad early – one of my kids came at 39 weeks, and the other at 38 and change because I had an underachieving placenta in both pregnancies – and of course, the study is being used to basically blame moms for their selfish desire to hasten delivery or agree to scheduled c-sections which work in their OB’s favor. 
The study authors were more thorough than what we typically see in infant feeding research, controlling for confounding factors like smoking, lack of prenatal care, and poverty, as well as gestational weight, so on the surface, it is rather hard to explain away these results. 
And yet, since I can’t find the actual study (just the media reports), I’m unclear if the researchers factored in why the babies were delivered a bit early, and how their pregnancies were, in general. Were the moms on any medications? Did they exercise? What about prenatal stress? Depression during pregnancy? These are all factors which might be associated with preterm labor and delivery, and possibly could be affecting attention span or some other psychological or neurological characteristics. (Speaking of which – let’s remember that test taking skills have little to do with intelligence, and only matter for academic success, not lifetime success.)
But even if we take the findings as they are, and accept that being born a bit early may have an impact on your future academic success, we need to understand what this means in context. First of all, we’re talking about incremental disadvantages. 2.3 percent versus 1.8 percent. That means that even if you are in the group of kids born a few weeks early, you still only have a 2.3 percent risk of having “severely poor reading skills”. If we take 100 kids born between 37-38 weeks, this means only between 2 and 3 of those kids will be suffering from this adverse effect. 
Now, compare this to the risks shown with late-term delivery. A study back in May claimed that babies born at 42 weeks had “more than twice the risk” of developing ADHD.  Another study claims that the risk of stillbirth is 1/926 at 40 weeks,  1/826 at 41 weeks, and 1/760 at 42 weeks – in other words, with every week, the risk of fetal death increases. Ingesting meconium gets more likely the later your baby is delivered – there has been a 4-fold decrease in the amount of babies suffering from meconium aspiration syndrome since US doctors started inducing pregnancies before they went too far past-term. 
These stats are not meant to freak anyone out – I only cite them as a way of showing that we need to consider context when we look at statistics and studies. There are risks with delivering too late, and risks with delivering too early. The lesson should probably be that if you get to choose when your baby comes, your best bet is to plan for around 40 weeks, barring any medical issues that might make an earlier delivery a better choice. If baby decides to come early or doesn’t want to leave, then you and your doctor have to do some careful considering of your options, based on your individual case. Revolutionary idea, isn’t it?
Unfortunately, in the case of this study, rather than simply stating the facts and perhaps giving a bit of toned-down commentary that explained to women that inducing early may not be the best idea unless there is a medical reason to do so, the media pundits got alarmist and judgmental. A pediatrics professor/neonatologist interviewed for the HuffPo article lamented that “There are still a lot of babies who are being delivered more or less electively at 37 and 38 weeks, with people thinking, `This is no big deal – these babies are full-term.’ I think this is a big deal….I don’t want to panic moms whose babies come at 37 weeks…But those elective early deliveries really need to stop.”
This may be true. After having two babies induced early, I can attest that there are other issues that arise when a baby is forcibly evicted before the lease is up. But we also need to be careful about overstating things. A tiny little decrease in the ability to take tests is hardly a “big deal”, especially when I suspect most early deliveries are not “elective”. Many doctors do choose to induce or perform c-sections at 39 weeks, and maybe that should stop… but I don’t think it’s the moms who are making these calls. So maybe the focus should be on influencing the American Academy of Obstetricians and Gynecologists rather than engaging in subtle barbs towards these mythical moms who “can’t be bothered” to stay pregnant.
I know it seems odd that I’m posting about this, a study which has nothing at all to do with infant feeding, but think about it: you could easily sub out the term “elective early delivery” with “formula feeding” and the study would look and sound all too familiar. Without a strong understanding of relative risk and a healthy dose of perspective, it’s far too easy to use studies to scare women and create misunderstandings which will later be used to back up inflated claims. The more we learn to approach parenting science with a critical eye, the better off we will all be – no matter what our feelings about infant feeding.
A little post-script:
When I was looking for the actual study published in Pediatrics, I stumbled across another study in that same journal that we surprisingly (said with sarcasm) have not heard about in the parenting media. In the June issue of Pediatrics, researchers found that

…maternal cigarette smoking correlated significantly with the development of NEC (P = 0.02). There was no correlation seen between maternal gestational diabetes, maternal hypertension, formula feeding, and pathologic chorioamnionitis or uteroplacental insufficiency and NEC.
 “These data identified maternal cigarette smoking as the only risk factor that is associated with the development of NEC in premature infants,” the authors write. “Our data imply that smoking delivers toxins and nicotine to the uterine microenvironment that can affect microvascular development and may predispose the fetus to future NEC.”

Huh. I thought formula feeding was the BIGGEST reason babies got NEC. So finding no correlation between formula feeding and a higher risk is actually big news. More importantly, knowing that smoking is a major risk factor could actually help prevent infant death. Seems a bit more important than testing well in grade school, but maybe that’s just my own bias….
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