FFF Friday: “The goal I’m working on”

There’s so much talk of “goals” in the breastfeeding world. Reaching this goal, not giving up on that goal. So when I received Elise’s submission, I thought it was really interesting that her “goal” was to formula feed. It’s like the reverse of so many FFF stories: she can breastfeed, but she can’t seem to make formula feeding work. It would be funny, if I wasn’t so frustrated on her behalf. Because she’s right: why should she feel guilty? Why isn’t “I hate breastfeeding” reason enough to switch? 

Happy Friday, fearless ones,

The FFF

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Elise’s Story

“The Goal I’m Working Towards”

I hate breastfeeding.

I can do it; I am one of those “lucky” women whose milk flows like honey. I’m on my third baby and struggling with the desire to formula feed.

With baby #1, my birth went terribly awry. I saw midwives my entire pregnancy and was supposed to have a water birth at a free standing birth center. Instead my son went post term and was delivered via c-section after a failed 30 hour induction. I never saw my midwives after they dumped me because I became high risk (baby being 2 weeks late). My cervix failed me but my breasts did not. I couldn’t give birth but I could breastfeed! Cracked and bleeding nipples did not stop me. I got my nipple shield training wheels and within a month my firstborn was EBF. This went on F.O.R.E.V.E.R. After his weight went to the 65th percentile from his consistent 90-95th percentile between his 12 and 15 month well-baby appointments, his pediatrician asked me how much milk he was drinking. “Eight to nine times a day,” I replied. He looked at me sternly and said, “He should be getting milk no more than THREE times a day.” “Do I have to keep nursing?” I asked, with a note of desperation in my voice. “No!” he exclaimed, and I happily went home and weaned, thrilled to be getting my body and breasts back. Within a month I lost 10 pounds.

Three years later, baby #2 arrived via planned c-section (I had to keep defending why I wouldn’t try for a VBAC). It was even easier to nurse the second baby. No nipple shield and only minor cracked and bleeding nipples that quickly healed. When she was eight weeks old, I noticed a bug bite on my right breast. Fast forward a week and this “spider bite” was almost the size of an egg and causing a tremendous amount of pain – so much pain that I drove myself to urgent care at 2am where the throbbing lump on my breast was lanced and stuffed with gauze. I was given orders to return 24 hours later to have it reexamined. By the time I arrived the second night (having already started antibiotics), red streaks formed across my breast. I had MRSA and started IV antibiotics immediately. I had to keep returning to urgent care at 2am to receive IV antibiotics for the next several nights and go on ten day course of antibiotics so strong I had to stop nursing. Suddenly the milky breasts that had been my salvation with my first born were now threatening to kill me. Post-partum anxiety set in and I lost my best friend because of my diagnosis (she was paranoid she or someone in her family would contract MRSA).

So for two weeks I pumped and dumped and succumbed to formula feeding my baby girl. By the end of my nursing “vacation,” I realized we were on a schedule and I was sleeping better (even with all that anxiety!). But once the course of antibiotics was over, I started nursing again and was back to exclusively breastfeeding within a few weeks. I couldn’t let my breasts fail me when my cervix was still broken and I wasn’t going to let that damn flesh eating staph infection stop me. I weaned her “early” at 10 months because I wanted my body back and was starting to feel the drag of always having a small human attached to me. Within a month of stopping, I shed those last 10 pounds.

Five years later and now I’m on baby #3. My breasts have swollen to a 36J/K cup from their pre-pregnancy 34H, and pregnancy 36I, the largest they’ve ever been. In the hospital I confidently supplemented with formula and had no problem politely telling the lactation consultant to shove it after she raised her eyebrows at the pre-mixed formula in my room. I told her I exclusively breastfed my older two children but that my nipples/breasts/self need the break only a bottle or two of formula can give in those early days but that I would get around to EBF within a month. Since I’ve given birth, I’ve pumped at least once a day and have publicly stated “I’m not going to feel guilty for feeding my baby” when given questioning looks for why I’m ordering my husband to go make a bottle of formula. quotescover-JPG-96

Except… I feel guilty as hell.

My baby boy is now a month old, five weeks tomorrow. I’ve had the EASIEST time breastfeeding this lil’ guy. I’ve had no cracked nipples, no blood, no sores, no plugged ducts, no supply issue, no MRSA. I can pump over 3 ounces in less than 10 minutes. He’s gotten at least a bottle a day; sometimes breast milk, sometimes formula. Mostly though, he’s been latched to me.

And. I. Do. Not. Like. It.

I shudder and grimace when he latches on; it’s not the pain. There is no pain. I dislike the feeling of the suckling, of the letdown. I absolutely cannot stand it when my nipples become pacifiers. When he nurses, I want him OFF my body. I can’t stand that while my belly has shrunk, my breasts have not and I have to buy plus sized shirts to get them over my gigantic breasts.

I’m a stay at home mother. I have the “time.” My older two are in school five days a week. I’m white, college educated, and live in the Bay Area, home of all things natural and attachment parenting. I’m SUPPOSED to breastfeed.

And I don’t want to.

Here is my list of reasons why formula feeding is awesome:

1) Your boobs can go back to being sex objects. Yup. Having to smack away hub’s hands every time they come near you gets annoying hella fast.

2) You know how much baby is eating!

3) Even for the uninhibited, it’s nice not having to whip out your tits several times a day.

4) No more Heave Wheeze Heave Wheeze Heave Wheeze sound of the pump.

5) No more pump parts to clean!

6) Daddy gets to share in feeding.

7) Mommy’s nipples can go back to normal. Er, “normal.”

8) You will feed on some kind of schedule.

9) For me, I will lose 10 lbs in one month (unlike every other woman whose weight just “melts” off while breastfeeding, I hang onto at least 10 lbs until I’m done nursing)

10) You can wear a REAL bra – not some shitty, ill-supporting bra with clasps.

11) wearing a bra to bed sucks

12) Wearing disposable nursing pads 24/7 gets old fast. Because I’m a squirter, I wear then however long I nurse.

In the most perverse way, I wish I had issues breastfeeding so I GET to formula feed, so I have an  “excuse” not to breastfeed.

But really, why do I need an excuse? Why must I tell people why I prefer bottle feeding? Why do people care how MY baby is being fed? He’s well fed, isn’t he? He’s healthy, is he not? His pediatrician used the exact words, “Super Duper” to describe my thriving son. If my son is super duper and *I* am okay giving my baby formula, then why can’t I let go of this gnawing guilt and just feed my baby that way *I* want to?

I’m phasing out the breastfeeding as of yesterday. It’s not that I can’t, it’s that I don’t WANT to breastfeed. It’s not a bonding experience for me, it’s something I dread. Currently I’m pumping several times a day because I’m scared of mastitis but I know that will fade in time. This baby WILL be formula fed. It’s the goal I’m working towards.

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Feel like sharing your story for an upcoming FFF Friday? Email me (the FFF, aka Suzanne) at formulafeeders@gmail.com.

 

Breastfeeding, IQ & Success: A few thoughts on the newest study to cause unnecessary worry for parents

“The longer babies breastfeed, the more they achieve in life,” proclaimed an article in The Guardian this morning. And around the world, millions of parents felt their stomachs lurch. Not because of what the study this article referenced actually said, but because they know, from experience, what this study means.

It means that we will continue to be beat over the head with “breast is best” proclamations that have fudge-all to do with our individual realities.

It means that we have to avoid social media for the next few days, unless we want to silently endure smug status updates, or be labeled “defensive formula feeders” if we dare offer an alternative point of view.

It means that those of us who are newly minted moms and dads, still anxiously watching our babies’ chests rise and fall and worrying about the color of their feces and every ounce they gain, will wonder if they should have tried harder/could have done something differently/might have chosen another path.

It means we will witness another media cycle where reporters regurgitate the same mommy-war bullshit, throwing in condescending caveats about how it’s “still a mother’s choice” whether or not she nurses her child.48fc15010a26b03f8586826f99699143

It means that society is still, as always, missing the damn point.

As for the study itself…. what it means is a lot less obvious. Here is the summary:

Methods

A prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula.

Findings

From June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20–5·33), more years of education (0·91 years, 0·42–1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8–588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income.

Interpretation

Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.

 

In laymen’s terms, these researchers interviewed a large group (3493) of 30-year-olds who were part of a larger study which began in 1983, when these folks were born. They chose these subjects based on the fact that they had a significant amount of data on their infant feeding patterns and follow-up data, and because they agreed to be interviewed for the project. They gave them IQ tests, and found that those who had been at least “primarily” breastfed for 12 months scored about 3 points higher, on average. (This doesn’t mean that every single formula-fed subject scored lower, or that every single breastfed subject scored higher – we are talking about aggregates here, not individuals.) The breastfed subjects also tended to have a little under a year more schooling and make a bit more money per year.

The researchers (and the media) claim that this is the first study to so clearly show a causal (and dose-related) relationship between nursing and intelligence/success in later life.

The critics claim that because they did not control for maternal (or paternal, for that matter) intelligence, the results are not so convincing. I agree that parental IQ is far more important than most of what they did control for, but they did at least control for a fair number of confounding factors, like socio-economic status, parental education level, income, birth weight, and so forth. They also had the advantage of using a cohort for which breastfeeding wasn’t associated with class; in other words, people across all socioeconomic groups breastfed and didn’t breastfeed, ruling out the concern that some of these positive effects would merely be associative (rich people breastfeed, rich people have better opportunities/resources, etc.).

There could very well be a correlation between those in this study who were breastfed and better outcomes in terms of IQ and success. I do have some questions, though:

1. What were the formulas like in Brazil, circa 1982?

I couldn’t find anything regarding the types of foods used as breastmilk substitutes in Brazil in 1980-1983. At best, they were the same or similar to American brands, which were somewhat different than how they are now. Not vastly so, but enough that it could potentially make a difference. (Then again, most of us were raised on these formulas and don’t seem too damaged because of it, so…. make of it what you will.) The study did not specify what these babies were eating in place of the breastmilk: properly prepared, commercial infant formula? Homemade formulas? Animal milk? This does matter. We need this info before we can begin to make assumptions about the risks of formula, because for all we know we may not even be talking about formula.

2. What, exactly, were the politics of breastfeeding in Brazil, circa 1982?

The authors talk about breastfeeding not being associated with SES in this cohort, but what did cause women to choose formula over breastfeeding, and vice versa?

According to a 2013 paper in Revista de Saude Publica, “Campaigns promoting breastfeeding began in Brazil in 1981 with the National BF Promotion Program. The 1980s was marked by significant advances in legal protection for BF, with the approval of the Brazilian Code of Marketing of Breast Milk Substitutes and the inclusion of the right to 120 days maternity leave in the Constitution.” I also found references to a Brazilian television campaign which promoted breastfeeding, initiated in the early 1980s which featured spots aimed at various demographics, using language, images and celebrities that would appeal to these specific groups. This implies that the author’s assertion that their study was able to negate possible confounding factors might be overstating it a bit. Socioeconomic status is not the only thing that could give a child a slight bump in advantages associated with success later in life. If there were fundamental differences in the mothers who chose to breastfeed back in 1983 Brazil, those differences would matter for the purposes of this study.

3. Why is a 3-point bump in IQ and a slightly higher income so important for public health, anyway?

The authors state that these findings are important on a public health and economic level. But let’s get Orwellian here, for just a second: if everyone is breastfeeding, then everyone is getting the 3-IQ point and 1-more-school-year advantage. Everyone is making more money per year.  The playing field is even. I nearly failed Econ, so correct me if I’m wrong, but don’t you need “have-nots” to have “have’s”? If the whole country is smarter, then I guess you’d have an economic advantage… but the breastfeeding research world is quite international in scope. After all, our recommendations come from the World Health Organization, not the Every-Country-For-Herself Organization. If we all are smarter from breastfeeding, that’s great – but it’s not much of an economic argument, is it?

Obviously, I am being entirely facetious with the a paragraph. I am far from convinced that breastfeeding makes you smarter or more successful. But I want to point out how convoluted these arguments in favor of breastfeeding truly are. How offensive they are. The implication is that our life’s worth is measured in IQ and financial reward. How about a study showing how traits like patience, kindness, acceptance, creativity, ingenuity are tied to infant feeding?

This study was funded by public health agencies, so these questions are important. When we confuse public health messaging with messaging about IQ and “success” (a quite narrow definition of it, incidentally), we are heading down a very slippery slope.

4. Why aren’t we asking why and how, instead of droning on about the same old tired shit?

If – and this is a strong if – the author’s hypothesis that the fatty acids in breastmilk may be the cause of this bump in IQ (which they imply is what provoked the longer time in school and the greater income – again, sort of a sloppy connection, considering there’s many people with incredible IQs and low levels of education and career success), then why is the take-away “see, everyone should breastfeed!” and not “how can we improve breastmilk substitutes so that all babies get this advantage?”

The study itself is only noteworthy because it followed a lot of people over a lot of years. But remember: associative data is always associative data. Sure, larger groups make for more dramatic assumptions, but at its core, this is just like any other infant feeding study: it shows that there is a slight advantage for people who were breastfed. It doesn’t show how, it doesn’t show why, and it doesn’t tell us squat about anything on the individual level. It does not in any way prove that tour brilliant formula-fed child would have been 3 points more brilliant if you’d managed to breastfeed her. And even if it did prove without a doubt that breastfeeding added 3 points to every single baby’s IQ, it would not tell us how many IQ points a baby might lose if she was starving for the first 6 months of her life, or if her mother was crying and absent all the time, hooked up to a pump, instead of interacting with her. Or if the breastmilk she was getting was laced with any number of substances. Or if her mom didn’t eat enough kale. Or too much kale. Or if her mom ate dairy and she had an undiagnosed MSPI. Or if her dad was an asshole. Or if she was abused and dropped out of school and did drugs that dulled her senses, rendering her unable to even take the bloody IQ test.

My point is, no matter what this study tells us (and it doesn’t tell us anything we hadn’t already heard), the more important thing is what it doesn’t tell us. Life is about so much more than what you eat in the first few months of your life. That doesn’t mean it doesn’t matter – otherwise I wouldn’t be so crazy about making sure research is done to improve formulas and make sure they are as safe and healthy as possible – but provided your child us getting adequate nutrition, there are just so many other things that can help them along or trip them up.

And don’t hate me for saying this, but you are only one of them. Sure, you’re who they are going to be talking about on the therapists’s couch in 30 year’s time, but they aren’t going to be mad at you for not breastfeeding. They are going to be mad that you missed their school play, that you embarrassed them in front of the cool kids in the parking lot of the mall, that you didn’t support their life’s dream to be a potter specializing in tiny, thimble-sized pots.

So do yourself a favor: throw out the newspaper screaming about breastfed babies “growing up to smarter, richer adults”, turn off the Today Show with its smug newscasters, and talk to your child. Because that’s they want. Not your breastmilk. Not 3 IQ points. They want you, and all your imperfections, and all your concerns for their welfare and your anxieties and your dorkiness and your dysfunction. They just want you.

Until they turn 13. But that’s another story.

 


 

 

 

FFF Friday: “It’s like I can breathe again.”

Abigail’s story (below) beautifully illustrates how each and every experience with feeding babies can be different, even for the same mom. Aside from being an important concept to share with moms, it also highlights the inherent flaws in universal recommendations for what is “best”. Even within the same family, “best” can be subjective; it can change and shift.

Not everyone has the strength and perspective that Abigail did, the courage to say that the universal “best” isn’t the personal best. So it’s up to the rest of us to make sure moms receive this message: you do YOUR best. You love the way YOU love. The rest is just, well… it’s like oversupply. It’s extraneous; it complicates things. It can feel like too much, and that’s okay.

Happy Friday, fearless ones,

The FFF

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Abigail’s Story

Like many moms out there struggling with nursing, I came across your website after Googling something like “how to switch from nursing to formula”.  I have read a number of the mom’s stories on your blog, but have not yet come across a story like mine.  Mind you, I don’t think I’m necessary special, but I would love to share with you my Formula Conversion story, just in case there is someone else out there like me who needs encouragement.

I’ve known and read about many moms who switch to nursing because of lack of supply, but what if a mom makes too much milk?  I can’t tell you how many times I’ve been told how ‘lucky’ I am that I produce so much milk.  It’s a curse!  My body has always overproduced milk, when I was nursing both my son (now 2) and my daughter (now 8 weeks today).  I nursed my son for 7 months, which was not the easiest, and I guilt-tripped myself into it most days… but we persevered.  I had an overactive letdown and oversupply, but he was able to handle it.  I did turn to formula after 7 months, and then whole milk at 11 months.  So, when I found out I was pregnant with our daughter, I was excited to nurse again.  This time, I told myself, I can do it!  I know how to do it, there will be no excuses.  I assumed, correctly, that I would have an overactive letdown and oversupply again, but she would be able to handle it in a few weeks postpartum as my son did.  Boy, was I wrong.

Over the first 7 weeks of her young life, I watched my daughter choke, gag, burp, spit-up so badly… I went to La Leche League online forums, desperate for help, because I really wanted to nurse her.  They gave me all the same tips that I already knew – lean back, block feed, etc. etc… I talked to a number of lactation consultants, too… meanwhile, my marriage was rocky, as my husband and I fought about my nursing anxiety.  I know I was stressed when I was nursing my son, but I absolutely was not stressed like I was this time – pacing for hours until my feet and back ached, no appetite, afraid to hear my daughter’s cry because I just didn’t want to nurse her.  Not only did we have these letdown issues, but her latch was just awful.  I know EXACTLY what to do to get a baby to latch, but she only wanted my nipple. I just couldn’t get her to latch correctly, the poor thing.

One day, my friend came over with her 4 month old baby, who has been formula fed for most of her life.  I watched her feed her baby… she was so calm, so peaceful… my little girl has never been at peace while nursing.  A few nights later, my husband and I had another big blow-out about nursing vs. pumping vs. formula… and I knew something had to change.  He just doesn’t/didn’t understand my nursing anxiety, so I had to make a decision.  Either I continue nursing and drive myself and my family crazy, or I switch to bottles.  The next morning, I made my decision: I’m making the switch.  And it was absolutely the best decision I’ve made in the past 8 weeks.  How so?

I can’t fully explain why, but my daughter is almost like a new baby.  The day she started taking bottles, she’s been more relaxed, happier, and just overall content.  In fact, her schedule finally fell into place, which I’ve been working so hard on since she’s going to daycare in four weeks.  I did try pumping and putting my milk in bottles, but I was still having anxiety with the pumping.  So a few days later, I switched to formula.  I will admit, I don’t think it was the formula per se that makes her happy – the bottles themselves are a major factor.  But, La Leche people, and many other nursing extremists still frown upon bottles, even if they contain breastmilk.  Judging by my interactions with them, nothing will be good enough unless I am shirtless and nursing on demand.

At the end of the day, I truly believe that I was feeding her my anxiety through nursing – and its the nursing that made her so unhappy and ‘refluxed’.  I thank God for intervening, and showing me the way to peace… nursing is a deeply emotional issue, and this decision I made to switch to bottles/formula was gut wrenching.  But, I feel like my old self!  I really do.  It’s like I can breathe again.quotescover-JPG-47

Anyway, I just wanted to share this with you, because having too much milk is also a cause a great grief and stress to a mom and baby.  If there are any other moms that are suffering as I did, know that there are more options than ‘just lean back’ or ‘pump the extra milk’.

I’ve been told, point blank, that if I don’t nurse my baby, I don’t love her. No.  I love my baby so much that I am willing to sacrifice nursing in order to give her all of my heart without the heaviness of postpartum anxiety.

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Feel like sharing your story? Email me at formulafeeders@gmail.com.

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