Of nanny states and nonsense

This is why I hate politics.

Earlier today, Jennifer Doverspike’s scathing indictment of Latch On NYC popped up on the Federalist website. By this evening, Amanda Marcotte had written a similarly scathing indictment of Jennifer’s piece on Slate. Both talked about hospital policies, formula feeder paranoia, and boobs. But in the end, what should have been a smart point-counterpoint between two passionate, intelligent women turned into a steaming pile of another bodily substance.

Yep, I’m talking about shit. 

Look, guys, I’m sorry for the language, but I’m done being classy, at least for tonight. Tonight, my Boston-bred, townie self is coming out, because I. Have. Flipping. HAD IT.

 

Doverspike’s piece does veer into political territory, mostly from the use of the term “nanny state”, a phrase that is undoubtably evocative (and apparently intoxicating) in today’s partisan climate. There were portions of her article that made me (a self-proclaimed, sole member of the Turtle party – our platform is that we just hide our heads in our shells whenever political issues arise. Anyone’s welcome to join!) a little uncomfortable, mostly because I worried that her important message would get lost by those on the Left. But I naively thought (us Turtles are naive about such things, considering we start singing “Mary Had a Little Lamb” whenever someone brings up Congress and prefer to our news from the Colbert Report) that she’d covered these bases with her final paragraph:

 

There are, of course, many laws the government issues for our protection and those of our children. Seatbelt laws, child car seat booster requirements, bans on drop side cribs and helmet laws. Regardless of whether or not these encompass valid risks (many do, some don’t), they do not encroach on personal freedom the way laws regarding parenting methods do. And don’t get me wrong; this goes in all directions. Infant feeding, and the personal freedoms associated with it, is not a liberal or conservative issue.

 

Apparently, it is a liberal or conservative issue, at least according to Marcotte, whose response to Doverspike felt far nastier than necessary. Marcotte accuses Doverspike of not doing her homework regarding the implementation of the WHO Code, for example:

 

What Doverspike fails to mention is why the WHO wrote out these regulations in the first place, something a quick Google search reveals. As reported at the time by theNew York Times, researchers had discovered that poor parents were stretching out formula by watering it down, which was leading to malnutrition in infants. In addition, places that lack clean drinking water are places where formula feeding is downright dangerous. There are substantial benefits, particularly worldwide, to creating a culture where breast-feeding is the go-to way to feed children, and formula is only viewed as a supplement for cases where breast-feeding isn’t working. Of course, that does cut into formula company profits, so if that’s your priority, by all means, bash the WHO’s efforts to keep babies healthy some more.

 

Huh. See, that’s odd, because I clearly remember reading something in Doverspike’s piece about this very issue… let’s see… ah, right:

 

Unlike the city of New York, the WHO  has valid reasons to be concerned with breastfeeding rates worldwide. After all, in less developed countries not breastfeeding may mean instead using cow’s milk for infants. When formula is used, the risks of it being prepared incorrectly and using contaminated water is rather high…The WHO should focus being on how to educate and support women in developing countries regarding the dangers of cow’s milk, the benefits of breastfeeding, and the importance of correctly mixing formula. Unfortunately, the WHO Code saves most of its energy in marginalizing formula companies, requiring hospitals to under no circumstances allow formula advertising and requiring that product samples only be given for research at the institutional level — “In no case,” it stipulates, “should these samples be passed on to mothers.” The WHO is also requiring labels stating the superiority of breastfeeding and warning to not use the product until consulting with a health professional.

True, she didn’t delve into the issues surrounding formula use in developing nations as deeply as she could have, but Marcotte’s take on the subject wasn’t exactly accurate, either. The Nestle controversy which she alludes to involved corporate subterfuge (women dressed as nurses convincing new mothers to use formula; these “health workers” then packed up and left, abandoning the moms with no established milk supply, no resources to procure more formula, and dirty water to use for what formula they did have), and this was what drove well-meaning individuals to create the WHO Code… but the problems that exist which lead women in these same countries away from breastfeeding are so much more complex than our Western understanding of “unethical marketing”. And to compare the risks of not breastfeeding in these countries to the risks in countries which are debating baby-friendly initiatives isn’t fair nor useful. These are two entirely separate issues.

Marcotte also dismisses Doverspike’s concerns that under Latch On, formula “must be guarded and distributed with roughly the same precautions as addictive and harmful narcotics” by citing a “sober-minded assessment” that she claims “shows that no such things are happening”. This “sober-minded assessment” is a CNN option piece from writer Taylor Newman, who repeatedly brings up her own breastfeeding experience in a hospital with piss-poor support. Newman engages in some of the most immature name-calling I’ve seen in a respected news source – those who disagree with her opinion of Latch On are “obnoxious”, “unhinged” they write “badly-written” posts that are just ‘kicking up dust”. (If this is sober-minded, hand over the vodka. This is mean-girl, bitchy, completely anti-feminist bullshit, is what it is. If a man called a fellow woman writer “unhinged” or accused her of being hysterical, I bet we’d see plenty of backlash from Slate. ) She also makes the fatal mistake so many reporters, pundits and advocates have made in this tiresome debate: she’s only seeing it through the lens of her own experience. It may not seem like a huge deal to someone who wanted to breastfeed (and ultimately did, successfully) that new moms will have to ask for formula each time a baby needs to eat, or that they will have to endure a lecture on the risks and intense questioning of their decision. But try living through that experience as, say, a single mom who was molested as a child. Imagine you don’t have anyone around to defend you, to demand that the nurses treat your decision not to use your body in a particular manner with respect. Imagine that you don’t feel like reliving your abuse and telling a total stranger – repeatedly – why the idea of letting a baby suck on your breasts makes you want to throw up.

I know I’m digressing here, and again, I’m sorry to be throwing my usual I-Support-You, let’s all hold hands and braid each other’s hair Pollyanna-esque, evolved FFF persona out the window. This is old school FFF, the angry one, the one whose claws come out when I see that women are being told their voices don’t matter, their concerns don’t matter, their choices don’t matter. The one who refuses to allow an important discussion – a women’s rights discussion, not a political one – get bogged down in right vs. left rhetoric.

Marquette’s choice of image to go along with her article is a baby holding a bottle with the caption “Freedom Fighters”. Again, I have to ask – really? Fine, be mad that the Libertarian Federalist invoked the Nanny State and beat up on poor old Bloomberg. Rage against that. But to belittle those of us who care about this issue is petty and cruel. And to ignore – once again – that what Latch On’s PR machine told the press was quite different from what was written in the actual materials used to implement the program; to ignore that no one has actually done a follow-up story since the initiative was announced which reports actual accounts from actual women who actually delivered in actual Latch On hospitals and used actual formula – this is just poor journalism.

Feminists, journalists, bloggers – I belong to all of your clubs, and I’m sure you’re about to revoke my membership, but I have to ask: Why are we rehashing the same arguments over and over, instead of discussing how we could come to a more beneficial, neutral ground? For example – couldn’t women be counseled on the benefits of breastfeeding before they enter the emotional sauna of the postpartum ward? Yes, I realize that not all women have access to prenatal care, but for those who do, this seems like a practical and  beneficial adjustment. If these issues are discussed beforehand, at least a mom who knows from the start that she doesn’t want to nurse can sign whatever documentation is necessary to tell the state s has been fully informed of the “risks” and “still insists” (Latch On’s term, not mine) on formula feeding. For those who change their minds while in the maternity ward – well, couldn’t we just agree that she gets one lecture on why it’s a bad decision, and then receives the education, support and materials she needs to feed her baby safely, rather than having to go through the whole rigamarole every time her infant begins rooting?

Or here’s another idea – take the hyperbole out of the initiative. Stop saying these things are “baby-friendly” or “progressive” or “empowering” because they aren’t necessarily so. And by saying that they are, you get people all riled up, politically. You start hearing terms like “nanny state” because some of us don’t want to be told how we should feel (or how our babies should feel, for that matter. If my mom couldn’t feed me and some nurses weren’t letting me access the next best thing, I’d be hella pissed, and that environment would become decidedly baby unfriendly. Especially when I punched the person refusing my mom the formula in the nose with my tiny baby fist). You start getting feminists shouting about second waves and third waves and whether women should feel empowered by their ladyparts or held down by them. It’s one big mess, is what I’m saying. So can we stop it, now? Can we start writing articles that are balanced reports rather than press releases for a particular administration or cause? Can we stop hurling insults at each other just because we don’t agree on what being a mother should mean?

Can we please, for the love of all things holy, just flipping stop?

FFF Friday: Breastfeeding doesn’t need to be an all or nothing proposition

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 feelings, and I hope we can all give them the space to do so. 

When Jackie sent me this FFF Friday submission, she was worried that her story “talk(ed) a lot about breastfeeding,” and that she would “understand if you think it might be too hard to read for those moms that are really struggling and not getting anywhere”.

This breaks my heart, not only because Jackie was empathetic enough to think about this while she was trying to speak her own truth, but also because I know she’s right: there WILL be moms for whom any mention of a working breastfeeding relationship is triggering. And not because they didn’t want to breastfeed, but because they did, and they are tired of being made to feel like they could have done more, or questioning their own truths. I know this, because I was one of those moms once.

But it’s not Jackie’s story (which is wonderful, by the way) that makes me angry. It’s the fact that I couldn’t come to the same conclusion Jackie did. It’s the fact that we’ve been presented this black-and-white scenario, where formula is the enemy of breastfeeding, in every damn sense.

Would I have had kept breastfeeding if someone had told me it didn’t need to be all or nothing? That a little formula (or heck, a lot of formula) would possibly be the key to a long-term nursing relationship that didn’t force me to sacrifice my mental or physical health? I have a feeling the answer is yes.

Jackie’s correct that this “hybrid model” wouldn’t work for everyone, but maybe it would work for more of us than the experts would have us believe. Perhaps this formula-breastfeeding dichotomy is a false one, and if we stopped seeing these things as all or nothing, not only would the infant feeding mommy wars cease to be, but more women would also find ways to incorporate breastfeeding (provided this was something they desired) into their lives without it having to be such a complex and identity-defining experience.

 Happy Friday, fearless ones,

The FFF

***

Jackie’s Story

With my first pregnancy I was like most women- determined to breastfeed.  My husband and both his brothers were breastfed into the toddler years so he was very much on board as well. My mother always swore she never produced any milk with me (I am an only child) so I was a bit concerned about that, but I noticed colostrum at around 35 weeks so I felt sure that I would be OK.

My first son was born at just over 40 weeks via a 37-hour, drug free, vaginal delivery.  He latched right away and everything seemed to be going great.  I had 2 lactation consultants visit us in the hospital and both of them thought his latch looked just wonderful.  My son was content if sleepy (another red flag we found out later), I had very little soreness, no redness or chapped nipples. I thought I had this breastfeeding thing down!  However, when he was 5 days old I decided to go to the breastfeeding support group at the hospital where he was delivered just to get him weighed and meet other Moms with babies around the same age.  The LC and I were astonished to discover that my son had lost a full pound – 12% of his birth weight.  That was also when we realized that the rusty, red pee diapers he’d been having were a sign of dehydration.  I had missed the “color of the urine” discussion in the baby care/breastfeeding classes it seemed.

While we planned to mention it to his doctor, we thought as long as he was peeing regularly that was all that was necessary.  Needless to say the LC shoved a bottle of formula at me and I rented a hospital grade pump (I hadn’t bought a pump figuring that would force me to be “good” and not tempt me to give pumped bottles of milk).  I started the classic supplementation cycle of breastfeed/give a bottle/pump.  When I started I was only getting drops of milk but about 10 days after birth my milk finally came in.  Still, I never was able to pump more than 2 oz total in a sitting (both breasts) and by that point I had lost confidence in my ability to breastfeed, plus I was dealing with postpartum anxiety, a form of PPD.  After lots of tears, discussions, and agonizing I ended up giving up on actual breastfeeding when my son was 3 weeks old and exclusively pumped for 5.5 months.  My son got what milk I could produce and formula for the rest.  He started gaining weight like a champ and is now a happy, healthy 20-month-old.

 

That experience erased any negative feelings I had towards formula, but I knew I wanted to give breastfeeding another shot.  I remembered how much I had enjoyed breastfeeding when I thought it was working and hoped that, armed with the knowledge I’d gained the first time around, I could make it work on my 2nd try.

 

18 months after my first son was born I gave birth to his little brother.  Unlike my first, average weight son, my second baby was a whopper, weighing in at 10 pounds 7 oz.  I had no medical indications for this (sugar, excessive weight gain, etc.) so we chalked it up to genetics – my husband and I were both big babies (8/14 and 9/9) plus big babies run in my dad’s family.  I ended up getting the epidural at the end this time around; the baby’s size made labor much harder and I couldn’t stay on top of the pain like last time. However it was another uncomplicated delivery – I actually got to lift my son up to my chest immediately after birth.  He latched right away and fed easily.

Right from the beginning the kid was hungry. We ended up waiting the “golden hour” to do any weighing/measuring by default because he spent the entire period nursing!  Determined to get my milk in, I nursed every 2 hours like clockwork (sooner if he wanted it which he frequently did) and my milk was coming in before we left the hospital.  I think some of this also had to do with the great support I had in the hospital this time around, including one amazing night nurse who must have answered a million breastfeeding questions.  I was much more on guard this time around, but again I was feeling good that things seemed to truly be going well this time.

Then we came home… and our first night back my baby decided to scream from 6:30 to 12:30.  I would put him on the breast, he’d eat until he unlatched himself, I’d switch and he’d nurse the second breast until he unlatched again. We’d try to put him down and 10 minutes later he’d be screaming his head off until I latched him again.  This time I’d armed myself with some ready-made formula and a feeding syringe (I wanted to avoid the dreaded “nipple confusion”) and we tried giving him 0.5 oz in the syringe but it didn’t do any good.  So back to the breast he went.  Finally at 2 or 3 in the morning I broke down and let my husband give him a bottle, which of course he gobbled up and went right to sleep.

Thank goodness his first doctor’s appointment was already scheduled for the next day!  There, my wonderful doctor told me to do what I secretly wanted to do anyway – let Dad give him a bottle overnight while I pumped.  As she pointed out, if my husband gave the baby a bottle while I pumped, we’d be done much sooner and everyone would get more sleep, which I needed to stay sane, stave off the return of PPD, and be able to care for both my boys.  My husband is a natural born night owl, thank goodness, so he’s never had a problem being up with me in the middle of the night.  In fact, it’s easier for him than for me, a morning person by nature.  My doctor also said that it was possible I just wasn’t making quite enough milk yet, especially with such a big baby.  So started my hybrid breastfeeding/formula feeding journey.  I would mostly breastfeed during the day and at night I would pump while my husband gave the baby bottles.  Even though I could feed my baby 95% at the breast during the day with no issues, just like the last time I was never able to get much milk pumping; even after trying many of the standard pumping “tips” such as staring at a picture of the baby or listening to baby cries.  I think I’m just one of those women who don’t respond to the pump.  I would typically save the small amount of milk I pumped overnight in case the baby really needed a little extra during the day, which was sometimes the case.

This time around breastfeeding has worked out for us, with the help of formula.  The baby gained weight slowly but steadily, ending up just an ounce shy of his birthweight at his 2-week check-up.  At first we had some gas/spit up issues and I had to play around with brands but finally found that Enfamil Gentleease worked best for us in terms of keeping him happy and keeping the milk inside (which is ironic because my older son couldn’t use Enfamil at all – it gave him the gas and spit-up problems, so he was a Similac baby).  I was off work for 6 weeks and during that time I breastfed whenever my baby was hungry, and boy was this kid hungry!  In those first weeks I was lucky if he went 2 hours between feedings, it was often more like 1-1.5 hours, and that was often after nursing both breasts for a minimum of 30 minutes (and many times it would be an hour or more).  I was lucky to have my mother-in-law staying with us to help take care of my big boy since I spent the majority of my time with the baby attached to my boob.  However, even with all that breastfeeding the baby would sometimes not be satisfied and the small bottle of pumped milk was not always enough, so I turned to formula.  Though he mostly wanted to always eat, at times he’d get into a deep sleep and wake up starving, then not want to take the breast because he wasn’t getting milk fast enough to satisfy him.  At those times an ounce or two of formula would get him just full enough to give him the patience to take the breast.  As he’s gotten older it’s not uncommon for him to take both breasts until he’s pulling off in frustration from lack of milk, take a big bottle of formula and then go back to the breast.  When I went back to work full time I was lucky to pump one 4 oz bottle of milk (from the same breasts that fed the baby who could take 13 oz of formula overnight!) so he gets mostly formula during the day.  I now breastfeed overnight since I’m not with him during the day.

What I learned from my experience is that breastfeeding doesn’t have to be an all or nothing proposition.  I do think my kid is one of those who just really loves the breast, which I’m sure helps my little hybrid model work (since he’ll latch and suck just for comfort or keep sucking even when he’s drained me dry, giving me stimulation I wouldn’t get otherwise), but formula allowed me to really enjoy my baby this time around.  It gives me sleep which I truly believe helped stave off the PPD (no depression for me this time around, yea!), it gives me a happy baby when he’s still hungry after I’m drained dry, it gives me nutritious food for him during the day when I can’t be with him and pumping fails me. Sometimes it just gives me a break or the ability to enjoy my older son, since dad can give my younger son a bottle when I need (or want) to do something other than breastfeed.

I think sometimes in the “breast vs. bottle” debate we lose sight of the fact that they can in fact work together to create an optimal experience.  In those first weeks I worried about my supply and would pump if the baby wasn’t interested in eating at the 3-hour mark (which was a rare occurrence but did occassionally happen).  Now I don’t worry about it, I figure he’ll eat when he’s hungry and if he’s still hungry after he’s tired of breastfeeding we’ll give him some formula.  I did find that it got easier at the 6-week mark like so many LCs and moms say it will; he latched more naturally, fed faster, and stayed fuller longer.  We still have some marathon sessions which I think have as much to do with comfort as nutrition, but I don’t sweat that either.  I’m mostly continuing to breastfeed because it’s enjoyable for both of us.  I feel that I could switch 100% to formula at any time and he’d be just fine.  Whenever he decides to wean himself (whether that’s next week or next year) I’ll be fine with that.  I know I’ve got an alternate source of food available that will keep him happy and healthy.  I know I have been very lucky and that my “hybrid model” wouldn’t work out for everyone, but what I would like to say to moms struggling with breastfeeding is to not be afraid of formula, but rather to see it as a helper and a nutritious alternate source of food.  I don’t know what I would have done without formula – 100 years ago would I have turned to goats milk or a lactating relative to supplement my babies, would I have just had unhappy, underfed kids, would my oldest have died from “SIDS” that was really undiagnosed starvation (I shudder to think!)?  All I know is formula saved me from all that and, I truly believe, saved my breastfeeding relationship.

 ***

Share your story: Email me at formulafeeders@gmail.com.

Is donor milk dangerous? Not as dangerous as hypocrisy.

Those of you who have been reading this blog long enough are probably well aware that I hate hypocrisy. I mean, I hate it. I hate it in politics, I hate it in religion, I hate it in the spats I have with Fearless Husband, and of course, I hate it in the breastfeeding/formula feeding debate.

But most of all, I hate it in myself.

That’s why I’m sitting here agonizing over how to report on a study that hit the news cycle tonight. According to NBC News,

…a new study finds that human milk bought and sold on the Internet may be contaminated — and dangerous…Nearly 75 percent of breast milk bought through the site OnlyTheBreast.com was tainted with high levels of disease-causing bacteria, including germs found in human waste…That’s according to Sarah A. Keim, a researcher at Nationwide Children’s Hospital in Columbus, Ohio, where her team purchased more than 100 samples of human milk last year, compared them to unpasteurized samples donated to a milk bank and then tested them for safety…what the researchers found was worrisome: more colonies of Gram-negative bacteria including coliform, staphylococcus and streptococcus bacteria in the milk purchased online, and, in about 20 percent of samples, cytomegalovirus, or CMV, which can cause serious illness in premature or sick babies. The contamination was associated with poor milk collection, storage or shipping practices, the analysis showed.

Here’s the problem: I look at articles which report on the dangers of formula with an intensely critical eye. It would be horrendously hypocritical for me not to do the same in this case – and I’m especially worried, because the people purchasing donor milk are in the same boat as many FFFs – people who wanted to breastfeed and couldn’t. I don’t want to turn my back on my audience and be a hypocrite in one fell swoop.

And yet.

Obtaining milk online is a new construct. We do not have several generations of humans raised on donor milk to examine and rely on for (admittedly insufficient, but oddly comforting) anecdata. We can’t define “donor milk” as clearly as we define commercial formula, because it isn’t a static product. Formula does not change based on a baby’s needs and age, or based on the diet or environment of the woman producing it; breastmilk does. There is not the issue of online, anonymous dealings when we discuss formula (well, unless you count the 16 cans of Alimentum my husband purchased on Ebay…I know, I know, but it was sealed. And that shit’s expensive if you buy it retail).

Discussing donor milk and the safety thereof is not the same as discussing formula, because there are so many more issues at play. This study is not about whether donor milk can nourish an infant better than formula can. This is about the biology of a live substance, and what happens to that substance once it leaves one person’s body and is transported to another’s. This is about body politics, and e-commerce. It is so much more complex than breast versus bottle.

So I hope I’m not being hypocritical when I look favorably at this study, because I do think it’s one worth taking seriously, as long as we acknowledge the limitations. Let’s review those, first:

1. It was a singular study. ONE study. Which used donor milk from one specific organization.

2. As the study is not yet available online, there’s still a lot we don’t know. NBC reports, “Of the 101 samples analyzed, 72 were contaminated with bacteria and would not have met criteria for feeding without pasteurization set by the Human Milk Banking Association of North America, or HMBANA.” I’m not sure how these criteria are set by HMBANA, and I don’t know exactly what the dangers of these bacteria are.

3. We don’t know that any of the babies who would have received this milk would necessarily have gotten sick. (This is one of the things we discuss with formula feeding studies, remember? For example, many people worry about the GMOs in formula. And yeah, most formulas contain ingredients derived from genetically modified corn, soy, and other foodstuffs.  But we have no evidence that babies fed these formulas suffer any ill effects from these tiny amounts of GMOs.)

Now, let’s talk about why this study is a little different than most of the breastmilk vs. formula studies we encounter.

1. The results were in vitro – aka, found in a lab. These were not observational or self-reported or marred by recollection bias. These were findings that were discovered from looking at samples under a microscope, in a controlled environment.

2. We do know that some of these bacteria are dangerous to babies.  20 % of the collected donor milk samples contained cytomegalovirus, which according to NBC “can cause serious illness in premature or sick babies.” 20% is a substantial amount.  The article didn’t give numbers for the samples which contained other disease-causing bacteria like coliform and staphylococcus, nor do we know if the amount of bacteria was sufficient to cause illness. (Please note: I think we do need to approach this with caution until we see more information, because there’s a chance the amount of bacteria wasn’t clinically significant.)

3. A large part of my ennui with formula studies is that most tell us the same thing: breastfeeding mothers are associated with healthier children. There’s not much variance in the theme of the research, or what can be done about it. This study is nothing like that. It is giving us actual information about the actual risk of bacterial contamination through donor milk. This is exactly why I started taking formula preparation rules so seriously when I saw in vitro studies on bacteria found in infant formula. It’s hard to argue with cold, hard science that has removed the human condition from the equation.

More importantly, this study offers us an opportunity. Not only does it allow us to improve milk sharing – something that can and should be a choice for moms who cannot or choose not to breastfeed – it reminds us that cold, hard science can be translated into better feeding options for families. Donor milk can and should be tested, to see how it needs to be stored and transported and screened. Formula can be compared with donor milk so that parents can understand the risks and benefits to both scenarios. Since one of the advantages of breastmilk is its ever-changing, adaptive personality, we could look at how the donor milk from a mom nursing a toddler might affect a newborn. We could even see if, say, the milk from women with higher IQs equates to higher IQs in babies fed their donor milk (oy, can you imagine the eugenic excitement over a finding like that? ::shudder::). You see where I’m going with this. When we’re discussing the substance rather than the behavior, a whole world of research will open up – research that can ultimately lead to improved formula, improved donor milk, and improved options for both babies and parents.

Lastly, it seems that defensiveness about negative press for one’s feeding choice is not exclusive to formula feeders. NBC quotes one milk sharing network’s founder as accusing the research of being “A blatant attack on women attempting to feed their babies”:

“..(It) is cruel and you should feel ashamed of yourself for spreading misinformation,” Khadijah Cisse, a midwife who founded MilkShare, a portal for connecting women cited in the new research, said in an email to NBC News. “Anyone can type up any bit of lies they want and make claims. Breast milk is supposed to contain bacteria.”

I feel bad for Cisse, as I know what it feels like to read research that denies my own lived experiences, or makes me feel judged for feeding my child in a specific manner. In her defense (and mine), it’s really hard to keep a lid on one’s anger when the media takes a 5k story and runs a marathon with it, without any consideration for context or nuance.

Imagine how much easier it would be to keep that proverbial lid tightly locked, if feeding choices were supported and respected. If the dialogue didn’t always involve universal bests. If we could make choices armed with more cold, hard science so that the choices themselves didn’t have to so damn cold and hard.

There’s a lot we could learn from this study.

Or, you know. It could die in an avalanche of hypocrisy.

 

 

 

 

 

 

FFF Friday: “No one told me about the possibility of this not working…”

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 feelings, and I hope we can all give them the space to do so. 

There’s a lot that bothers me about the way breastfeeding is presented to women (which I suppose is, erm, rather obvious), but the whole “only 1-5% of mothers can’t breastfeed” is definitely near the top. Not only is this statistic based on limited, shaky research, it is also completely misleading. Lou Gehrig’s Disease (ALS) affects .002% of the population, and there are telethons for it (as there should be, of course). Women with lactation failure are ignored, ridiculed, and told it’s all in their heads. I’m certainly not comparing ALS with lactation failure (please) but merely making the same point Lisa Watson of Bottle Babies did in her brilliant post about this issue: 1-5% of women is nothing to scoff at. 

As Karly writes in her beautiful, raw post below, “This was my baby and my body, and I knew them both best.”. It’s odd to me that this same sort of rhetoric is used to justify so much of the natural birth movement, but it is turned on it’s head when the subject is breastfeeding. Maybe some of us need to take a long hard look at our own hypocrisy, as feminists and maternal health advocates. 

Happy Friday, fearless ones,

The FFF

***

Karly’s Story

Now that my breastfeeding journey is coming to a close, I feel I finally have the emotional stability to tell my story. I never thought I would be writing something like this when Olivia was only 7 weeks old, but you know the saying, “the best laid plans are laid to waste.” And for me, this was no exception.

I’ll start out by saying that I truly believed that because I so deeply wanted to breastfeed, that I could just do it. I embraced the La Leche League belief system that all woman could breastfeed and that very few woman had actual supply issues that kept them from doing so. I threw out all the free formula I got in the mail, didn’t register for any non-Medela bottles on my baby registry, and did my share of breastfeeding classes, book reading, and research. I told everyone I knew that I wanted to breastfeed for accountability. I was so excited to partake in something so “natural.” I didn’t realize that there was much more to it than a willing heart and a pair of boobs.

My breast feeding journey didn’t start out the way I had planned, and since becoming a parent, I realize that not much does follow the way of our intentions! When Olivia was born, she had accelerated  breathing and was immediately whisked to the far side of my delivery room for monitoring. After she settled down, I was able to spend 10 minutes with her before she was taken to the transitional nursery for 5 hours. I desperately had wanted to nurse her right away, because that’s what everyone says you’re supposed to do to establish a good breastfeeding relationship. I was a little worried I wasn’t able to, but my maternal instinct was already rearing its head and all I was truly concerned about was her being healthy. When I was finally able to spend time with her, it was 10pm and there were no nurses around to help me. I buzzed my less than helpful and attentive nurse and she showed me the football hold and told me that Olivia wasn’t really nursing and couldn’t I tell? “See,” she said, “her cheek muscles aren’t really moving and you can’t hear any swallowing.” I was already starting to feel awful about my abilities to properly nurse. She told me a lactation consultant would come around the next day.

Around 11am the next day, a LC arrived and spent a reasonable amount of time with me. She ascertained that Olivia didn’t have tongue tie (good news) but that she had a high palette, which made it difficult for her to latch because her mouth was so small, and I have slightly retracting nipples.  She gave me a nipple shield and it seemed that Olivia was able to finally grab on to something. I tried nursing all day and it “seemed” to be going well, but I couldn’t really tell.

The next morning the pediatrician made his appearance and when we told him that Olivia wasn’t really producing that many diapers, he was concerned. He suggested supplementing with a 1/2 ounce of formula to prevent her from being dehydrated. I had to suck back my tears until he left. I was devastated. All the books and websites and avid breast feeders had “warned” me this might happen, and to not give in. When my newly on-shift nurse arrived, I cried with her. She was super understanding and reminded me that I needed to make sure Olivia was taken care of.

This was the first time I realized that a commitment to breast feeding can sometimes jeopardize your child’s health. If I hadn’t decided right then to make sure my child’s health came before my desire to only breastfeed, Olivia could have ended up hospitalized for dehydration (and I know this happens because I’ve heard first-hand about it). This is by no means a judgment on people who decide to take a different route than I did when listening to their doctor. However, I personally, could not justify it.

To abate my fears, my nurse showed me how to supplement the formula with a syringe and straw, so that Olivia would still practice her breast feeding skills and not be at risk for nipple confusion. She wouldn’t even notice what was happening. But I did- and no matter what I told myself, I felt awful. I hadn’t wanted to even touch formula, and here I was, supplementing in the first 30 hours of Olivia’s life. I felt inadequate and crippled. Everyone had told me that babies stomachs were the size of marbles and that the small amount of colostrum I had would surely be enough. But it wasn’t, so what was wrong with me? I had pumped what little colostrum I could relinquish, and it was about a 1/4 ounce (less than 8ML). It almost made me feel worse to actually see how little I had.

Everyone assured me that my milk would come in over the weekend, days 3-4, and not to worry.  I kept up hope, but still worried. As soon as it came in, I could stop supplementing. When I got home, the syringe and straw didn’t feel so easy anymore. It was near impossible to get it into Olivia’s mouth where she would do all the work and suck the formula out. After a few attempts, we started just squirting it directly into her mouth. I cried every time I had to attempt the syringe because she would unlatch when I accidentally poked her in the mouth. When she got frustrated she would bob her head and grab at my breasts, ripping off the nipple shield. I don’t think I’ve cried so much as I did those 4 days at home. The worst part was, I would nurse for an hour+ each time, and she would cry and root after each session because she was still hungry.

As the weekend ended, I knew something was amiss. There had been no change in my breasts at all- no engorgement, no let down sensations, no happy baby at the end of a marathon nursing session: only a hormonal wreck of a first-time mom who realized that her breasts were letting her down.

I signed up for a breast feeding workshop and was elated at the thought of some help and encouragement. The LC weighed Olivia before and after a 40 minute feeding and I was horrified to learn she had only taken in a 1/2 ounce in all that time. Add to it the fact that she had lost 9 ounces of her birth weight and had not gained any back in a week, meant I left the workshop in tears. My husband was so encouraging, but let me know that breast feeding was something I may have to just let go of. I wasn’t ready to hear it and sobbed the entire way to the health food store, where I purchased Fenugreek and Blessed Thistle supplements in hopes of increasing my supply. We committed that day to supplementing after every feeding to get Olivia’s weight up to par. Prior to that I fought every supplement because I had wanted to be enough for her alone.

When Olivia was 9 days old, we weighed her again at the Mother Baby Assessment Center in our hospital. She had only gained 1/2 an ounce in 2.5 days since we were last there. I was beginning to feel worse than a failure. I had been taking the supplements but wasn’t noticing much of a difference in Olivia’s satiation at the breast, or when I pumped.

The stress of even the idea that breastfeeding wouldn’t work was beginning to consume me. I spent hours on the internet trying to read other people’s stories of how they overcame supply issues, or how I could produce more. I couldn’t sleep well enough to feel rested, which I’m sure only made milk production worse. I knew that if I didn’t overcome this, I would be entering into postpartum depression. That day, I made a private appointment with a LC for the following Tuesday. But when I made it home, I didn’t even think I could make it that long. I wanted to quit, and quit right then. My husband wouldn’t let me, telling me he would be disappointed in me if I didn’t make it to my appointment, which was right around Olivia’s 2 week birthday. It hurt to hear him say that, because all I wanted was a way out. But I realize now that he didn’t want me to look back and regret quitting, but to do it when I was emotionally stable (as if that’s even possible in postpartum days!).

I reached out to a La Leche League leader in my area, who pretty much verbally vomited the same things I had read in the Womanly Art of Breastfeeding: very few woman have supply issues, just keep putting the baby to the breast, don’t supplement, feed on demand. She made me feel worse than I already did, because if “most woman don’t have issues,” then either something was wrong with me or I wasn’t trying hard enough. She couldn’t really say much when I told her that Olivia wasn’t even producing enough diapers- the tell tale sign that babies are getting enough breast milk.

I’m proud to say I made it to my appointment! I have to admit, I went with the intention of quitting as soon as it was over. The LC could tell I was on the verge of losing it. We nursed and weighed Olivia again and this time she took in 1 ounce, instead of 1/2 like the week before. Obviously, Olivia was growing and was only going to need more, and even this clearly wasn’t enough. The LC looked at me and told me that any milk Olivia got was good. It didn’t matter if I could exclusively breastfeed or not. She told me if all I could handle was nursing 1x per day then pumping, that was ok. She said it was my baby, not hers, and she wasn’t going to tell me to do something I couldn’t. She diagnosed me with a lactogenesis disorder, or a milk production problem.  She gave me a way out and made me feel like I could finally let go.

After that appointment, I felt a weight lifted. This WAS my baby and my body, and I knew them both best. I knew there was something wrong with my milk production, no matter what any La Leche League leader told me (which, coincidentally was to nurse EVERY HOUR. That’s not even humanly possibly as a new mother, and especially not emotionally possible for the wreck that I was at the time). Because the stress of exclusively breastfeeding was gone since I knew it wasn’t possible, I moved to only pumping.

Even then, I would pump 5-6x per day and still only get 5-6 ounces for the entire day, less than a quarter of what Olivia still needed. I started to walk down the road of depression again when my milk supply wouldn’t increase, no matter how frequently I pumped or how much fenugreek I took. Pumping made me feel almost embarrassed in a way, watching my ugly, not quite working nipples be tortured into giving up droplets of breast milk. When I found blood in my preciously stored milk (which is completely normal and not harmful for baby), I decided my days of breastfeeding/pumping were done. It was like the blood signified everything I was willing to put aside to just make it work- and it made me feel horrible. So I packed up my pump, bottles, and flanges. I put them out of sight and don’t plan on looking at any of it for a long while. It’s all over.

Formula feeding was never the issue for me. I don’t think its poison or that it contributes to obesity. If it was truly unsafe, it wouldn’t be on our shelves. It really wasn’t even about Olivia. I was mostly thinking about myself and what breast feeding was for ME. My sweet baby doesn’t care how I got the liquid in her bottle, only that I love her enough to give it to her when she needs it. And let’s be honest- when she’s in kindergarten I’m not going to be looking back and constantly thinking about how I couldn’t really breast feed. I needed a little more perspective.

The real issue is that I was truly uninformed about breast feeding. True, most women can breast feed in some form- but it’s not true that most women can exclusively breast feed. Many women have supply issues. Once I started having issues, all my girlfriends started coming out with the problems they had as well. Where were they all when I was standing on my soapbox, proclaiming my imminent success as a breast feeder, while secretly judging people who gave up? And on top of it, I had major guilt about all the breast feeding supplies we’d spent money on that would be useless to me. We had JUST bought a $250 breast pump! No one told me about the possibility of this not working! As my husband puts it, the books I read on breast feeding were selling something: an idea that sounds perfect, but that is rarely ever obtained. I dealt with feeling duped and stupid because I bought into it.

I ran the gauntlet of feelings the last 7 weeks. Emotionally, I had times of resenting my new baby, my body, and my husband. Physically, I was exhausted and bitter at my anatomy. I went through the stages of grief: denial, in that I never thought it could be happening to me; anger and bargaining with God; shameful depression; and finally today, acceptance.

I wanted to finish this post as I let my milk dry up. The physical pain is what I wanted from the beginning- to signal an imminent, successful breast feeding journey. Instead it’s a bittersweet end to something that I need to move on from. I started writing this in the throes of my post partum hormones. Now, 5 weeks later, I’m finishing it. When I went back to read what I started, tears started streaming down my face as I remembered the anguish I was feeling. I never want to feel that way again, and am so glad I am on my way to accepting God’s plan for motherhood, even though I’m still a little sad about it now and then.  I can finally put down the breast pump and spend time with my Olivia.

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Have a story you’d like to share? Email me at formulafeeders@gmail.com.

 

FFF Friday: “Caring for my baby doesn’t just mean breastfeeding him. It means being present to love him.”

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 feelings, and I hope we can all give them the space to do so. 

Gemma talks about feeling disconnected from her body while nursing her son in the story below. These sensations are in such contrast to much of the rhetoric we read about breastfeeding – how it is conducive to bonding; a way for mother and baby to connect. Obviously, for many women this rhetoric is reality – but for others, breastfeeding can provoke feelings of anger, isolation, pain, and sadness. This can be due to emotional reasons or conditions like D-MER, but it also can be provoked by the pain a woman experiences due to a bad latch, breast infection, or some other physical problem. There’s no doubt chronic pain can lead to depression. According to a 2004 Harvard Medical School Mental Health Letter, “Pain, especially chronic pain, is an emotional condition as well as a physical sensation. It is a complex experience that affects thought, mood, and behavior and can lead to isolation, immobility, and drug dependence…it resembles depression, and the relationship is intimate. Pain is depressing, and depression causes and intensifies pain. People with chronic pain have three times the average risk of developing psychiatric symptoms — usually mood or anxiety disorders — and depressed patients have three times the average risk of developing chronic pain.”

We can’t underestimate the effect of intense breast pain on a woman’s postpartum mental health, and vice versa. If this pain can’t be mitigated or conquered, it may very well be in the mother and baby’s best interest to end the breastfeeding relationship, so that a real relationship – one based on love, connection, and actual bonding – can develop.

Happy Friday, fearless ones,

The FFF

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Gemma’s Story

 

The birth didn’t feel traumatic at the time – baby was breech, planned c/s arranged but waters broke in middle of night with no prior contractions 2 weeks before he was due.

4 hours after waters broke I was 8cm dilated and had barely had gas and air for 15 minutes by that point. The spinal was then administered and he was born 5 hours after my waters had broken.

Let me be clear – breastfeeding had been a long held ambition, desire and belief. It was what I was most looking forward to in raising my baby. I knew it might be a bit toe curling to start and expected that.

I fed the colustrum with ease on first feed but every time after that seemed a struggle, and most of it had to be expressed. There was plenty of it which I thought boded well for the milk coming in and getting in with the real feeding.

We were discharged 36 hours after birth as I couldn’t stand it on the noisy hospital ward (this is not the place for a rant about the NHS) and I had to prove I could feed him alone with good latch and position. This box was ticked and tongue tie was ruled out.

Each day at home with the baby got progressively worse…I was being very well supported by my husband, mother, and extended family with all aspects, including the BF, whilst some feeds were slightly less painful than others as the week went on I dreaded the latch and feed, more and  more and more. The baby was being cared for by husband and mum so I could ‘rest’ but then being brought to me when he was so hungry it made the hell that was developing even worse.

All I could see was my husband bonding and loving the baby and I was disliking the baby, afraid of the baby and by the 9th day I was loathing the baby and devastated that I wasn’t loving him or having the relationship I wanted and intended.

Every feed was so incredibly painful at latch and then would only marginally reduce through each feed. The midwives who visited all reiterated that’s latch and position were correct and he was feeding correctly. I tried nipple shields, lanolin, breast shields, airing nipples, hydrogel dressings. It all made no difference. I became exhausted by conflicting information, it shouldn’t hurt, it will hurt, it improves after 10-14 days, it either works easily or it will always be a struggle…on and on with ‘information and evidence’…and I was sick of professionals looking at me and the baby, I felt, inspecting us which prevented me seeking the lactation consultants or other BF counsellors. . .

The pain on latch was worse than what I had felt in my labour, and I think I made more noise at times as he latched on than I did through most of the labour.

My husband helped me decide to stop BF our first born when he found me inconsolably sobbing over him while trying to get him to latch on at 9 days old. It was the third major breakdown over feeding in 3 days…and we had already been giving formula for two nights to help my nipples rest, which made me feel bad, but then the first early morning feed was less painful…so I accepted it thinking it would help the BF get better established.

He told me we had to use formula then and there. I resisted and we briefly fought before I relented.

After I slept for an hour I woke and realised I would stop loathing and start loving my baby as soon as he didn’t represent pain. I realised I had not been ‘present’ at all since I got home. I know the first week is said to be difficult but I had totally ‘checked out’ it didn’t feel like I was in my body at all.

The next morning I woke feeling my soul had re-entered my body. I loved my baby and haven’t stopped since. He is so calm with me, and is on a mix of formula and expressed breast milk (more F than BM, and still navigating this dynamic).

No doubt there are still storms to weather but now I know that caring for my baby doesn’t just mean BF him. It means being present to love him, being calm enough to take care of all his needs as well as feeding him with my soul and personality in tact.

 

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