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.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.


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10 thoughts on “FFF Friday: Breastfeeding doesn’t need to be an all or nothing proposition

  1. This is so important and something I wish someone had told me. It simply si not discussed in many cases! I am giving it a lot of thought in case I am lucky enough to have baby 2 🙂

  2. We had a pediatrician who was supportive of combo feeding, but I still had a lot of guilt. We combo fed until about 7 months and my daughter sort of lost interest in BFing and I put away the pump and we went to all formula. I had low supply that could not be resolved by any means as well as PPD and my girl took over a month to get back to her birthweight. I hope next time around, I can go into my feeding experience armed with the knowledge in my heart that however I nourish my baby is just fine, whether it is combo feeding or just FFing.

  3. This really hit a nerve with me, because I had the birth and postpartum period totally planned with my baby, and of course none of it worked out the way I had imagined. I wanted as close to a home birth at the hospital as possible and to exclusively breastfeed until the baby gave me cues that he was ready for solids, and then continue to breastfeed until he was 2. Well, I ended up finding out he was frank breech and 3 days afterwards my water broke, which didn’t give me enough time to figure out how to get him to turn. I ended up with a c-section and didn’t actually get to breastfeed my son until about 4 hours after his birth. By the time he was discharged, he had lost 10% of his body weight and was jaundiced. We ended up back in the hospital the following day because his bilirubin levels where dangerously high and the pediatrician ended up talking me into giving him formula to help bring down his bili levels. So while he was in the hospital, I alternated between breastfeeding and formula feeding. Once he was better and we went home, I took the bottle away and breastfed exclusively following his cues. He would always seem satisfied and would fall asleep a lot at the breast (which was the same problem you mentioned above). I went to see a LC because I didn’t feel like he was putting on weight and something just didn’t feel right to me. LC ended up telling me that I wasn’t producing enough milk, and he was underweight. So now I feel guilty for depriving my child of food thinking that I was doing what was best because that’s all I had read. I tried everything to bring up supply: mothers milk tea, lactation cookies, breastfeeding and pumping just about around the clock, until finally I just gave up. I’m at the point now where I breastfeed my son for on both breasts until he pops off prior to formula feeding and breastfeeding overnight when he’s sleepy, but wants a snack. He, like yours, seems to like the breast for soothing so when he gets fussy, I put him to breast and all is well with the world again, unless he’s really hungry and my breastmilk just isn’t enough. I’ve learned to read him well enough to know what to do and when to do it. I now love the feeding relationship I have with my son, and it works for us, even if at the beginning I though breastfeeding would be an all or nothing relationship. I actually remember telling my husband in the hospital after giving my son his first bottle, “well, that’s the end of breastfeeding my son” because I though for sure he wouldn’t want the breast again after having a bottle.

  4. Timely, but today Best For Babes published an article on the common Latina practice of deliberating combining formula and breastfeeding (“las dos”). http://www.bestforbabes.org/booby-traps-series-las-dos-and-other-cultural-barriers-to-breastfeeding
    One claim made is that combo feeding will cause problems with mothers’ supply. The trouble is, the actual evidence that “los dos” causes problems with Latina women’s breastfeeding is actually pretty weak. For one thing, Latina women’s breastfeeding rates in the US are the highest of all ethnic groups in spite of the common practice of supplementing; for another, although combo feeding is associated with a higher likelihood of BFing cessation for women overall, if you break the data down by race it appears that this association is only found for white women; among black and Latina women, it seems that those who combo feed are no more likely to quit BFing early than those who exclusively breastfeed.
    http://www.jpeds.com/article/S0022-3476(11)00154-5/abstract

  5. I laughed at my own reaction to this story – I got to the part where you said, ” hadn’t bought a pump figuring that would force me to be “good” and not tempt me to give pumped bottles of milk” and I instantly folded my arms and let out a deep sigh!!

    It is such a shame that we view anything other than exclusive breastfeeding as second best. There are multiple reasons this doesn’t always happen and so a happy feeding relationship that works for the family is the optimal standard and true success.

    You’ll be please to know my arms unfolded and I let out a happy sigh at the end!

  6. That’s such an encouraging story. I really don’t know why women aren’t told about this. I know in antenatal classes here in Australia, the whole ‘breastfeed exclusively, don’t give formula’ thing was drummed in, no one even mentioned mix feeding. It’s like they think women are children who can’t be trusted with the information because we will all immediately want to run off and give formula… I think it’s really patronising, it’s pretty insulting really. I hate those ‘breast is best’ posters, personally I’d like them to say ‘breast is usually best, but not always, and formula is way better than hunger’ but I guess it’s not as catchy!

  7. I combo fed too, more because my child had MSPI and was majorly fussy and distractible than out of any conviction, but it worked fine, and yes, guidance on how to space out supplementation and pumping so that you don’t lose supply is always very useful. I was also one of those who didn’t get much from pumping and didn’t find it possible with my work schedule (or worthwhile, given how painful it was + how much time it took to wash things each time). My child did self-wean at about 5.5 months, which may have had something to do with the fact that not being able to pump or feed often enough did bring my supply down a fair bit, but he was also so distractible and had had so many nursing strikes by that point that it’s difficult to tell. I wish LCs would work with combo-feeding women and support them in making it work, because there’s too much misinformation out there about virgin gut and similar nonsense, and women may either get scared off the whole BFing process if they feel it’s all or nothing. I would however caution anyone whose schedule is not their own or who doesn’t have great supply against the idea that one’s supply is infinitely adaptable – it may well dwindle, and one may end up supplementing more than one expected. But frankly if I had to choose between EBF and sanity, I know what I would choose.

  8. I have two boys. When I gave birth to my first one, I had complications right after he came out. I had a fever and was on antibiotics. Couldn’t hold him or feed him..While I was recovering, the hospital fed him formula. I didn’t mind. I just cared that he was taken care of. After I passed the fever and started to feel better, the nurses started to push the whole breastfeeding thing. My boy did not want anything to do with it. He didn’t latch on but the nurse forced him. I was so sad and frustrated.. I wanted to punch the nurse lol. We got home and we tried pumping but nothing. We ended up formula feeding.. I didn’t have a problem with it. I went to see my OB for my postpartum check up and he asked if I was breastfeeding.. and I said no. He said “Oh, I’m so sorry”. All I could think was “why are you sorry?”. My little guy is now 3 and he is healthy and normal!

    This June, I gave birth to my second son. He came out and he immediately latched on! I was excited! Maybe this time I could try out the breastfeeding thing! Well, while at the hospital, I would try feeding him and nothing. I felt like I wasn’t feeding him at all. I got all the nurses to check the latching and they said it was all good and not to worry. I was in so much pain..much worse than labour, believe or not. I tried pumping, nothing, I tried nipple cream and the nipple shield..NOTHING! Nothing was working. We went home and I kept going with the breastfeeding. I would burst out in tears from pain and frustration. It also didn’t help that he wasn’t pooping and he had orangy pee crystals. He was losing weight and was really dehydrated. At that point, I said SCREW IT and stopped. I went out and got formula and he started to do a complete 180. He pooped, he wasn’t dehydrated and he started to gain his weight back. Now at 5 months, he is growing so fast and he is a healthy boy.. Yes, to some it might seem like I gave up too quickly but you know what? They are my kids and I did what was best for them. Please just do what you feel is right. We as mothers have that instinct. I wish everyone out there would understand that and not make us formula feeders feel guilty.

  9. I can relate to your story. I combo fed my first daughter from day 3 to roughly 9 months when I decided to switch to 100% formula feeding. I was devastated that an exclusive breastfeeding relationship didn’t work for us, and I know many of the struggles we have and my ppd were in part related to my inability to have the relationship I wanted with my daughter. I, like many, never imagined that I’d have problems. After much research, I’m quite certain I have IGT. Anyways, I recently had my second daughter, and because of the circumstances of the pregnancy (no pre-e) and delivery (a planned section vs a traumatic emergency one), I was hopeful that maybe, just maybe I would get to have an exclusive breastfeeding relationship until my return to work. She is 2 1/2 weeks old, and we are supplementing and have been since day 3. I will admit that I am sad and am grieving again, but, I am in a much better place than with my first. I’m not sure that we’ll continue combo feeding for too long, but only time will tell. I remind myself that I am fortunate enough to make some milk, and that keep me going. I am also grateful that formula exists so that my child can get the calories she needs to thrive. When I start a new job in a few weeks, I don’t plan on pumping, so we may just nurse at night and for comfort during the day. It’s still a breastfeeding relationship, and it’ll be our special and unique one.

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