FFF Friday: “I was resentful of the pump and my physical experience with motherhood.”

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. 

We’ve been discussing the relationship between breastfeeding and postpartum depression over on the FFF Facebook page, and it’s been intensely triggering for me – and for many of you as well. The thing is, people just can’t wrap their heads around the fact that women are complex, varied individuals. While it may be true that breastfeeding is the biological norm, that does not mean it is emotionally or physically easy or rewarding for all people. And we’re not just talking about women who have been diagnosed with IGT or some other physical impediment to lactation. In Jennifer’s case, there were a variety of situational factors (and boy, did she hit the shit jackpot with her birth experience) that may have contributed to her breastfeeding problems. On paper, one might suggest (as an OB/GYN who engaged in a twitter conversation with me did, just this very morning) that the problem here is not breastfeeding but a lack of adequate breastfeeding support. 

But that would be ignoring the stark reality of Jennifer’s experience. How many women went through exactly the same crap that she did, with exactly the same history, tolerance for pain, and breaking point? I’m betting she’s unique (in many other more positive ways, too – she also sounds like a fantastically smart and insightful person). We are all unique. There is a certain sameness to many of these FFF Friday tales, but each one is told through a different lens. And this is what is missing in ivory tower conversations about breastfeeding and formula feeding and the decisions mothers make: the admission that what is right for one woman may not be right for another. That what causes depression in one may cause elation in another. We are not just our biology. And that’s okay. Evolution and a modernity that allows us options doesn’t have to be a negative thing. 

And regardless, when the decision is between a mother who cannot bond with her child – one who is physically and emotionally faltering – and a can of formula, I will choose the formula every time. It may not be the biologically appropriate choice, but it can still be an appropriate choice. Funny how so few people can make that distinction. 

Happy Friday, fearless ones, 

The FFF

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Jennifer’s Story

Sometimes I don’t know where to begin with telling my FFF story. I’m not entirely sure what exactly caused my problems, though it could be any number of things.

I had wanted to breastfeed. I really, really did. I’d read everything about its benefits, my late mother had breastfed me when I was a baby and I wanted it to be part of my overall plan: midwives, doula, home water birth, breastfeeding, cloth diapers. I have a crunchy side to me and my pregnancy really brought it out.

I believed the hype, that all women can breastfeed. I doubted women who claimed otherwise and had all my bras and nursing tops ready.

My pregnancy stunk. I was in good health, but plagued with heartburn from start to finish, and developed acid reflux. My small breasts, although sore and slightly swollen at first, never really grew, much to my disappointment. Apparently pregnant women experience leaky breasts, something that never happened to me.

Something else that never happened was labour. I went 43 weeks without a sign labour was forthcoming. My cervix was tightly shut and eventually I had to throw in the towel. It was sucking the damn life out of me. I had long ago stopped being able to lie down without vomiting and my baby was getting incredibly large inside of me.

I wanted a C section, convinced an induction wouldn’t work. Inductions seemed to be for women on the verge of labour, not those nowhere near it. I was denied my C section by the OB I was transferred to, and was started on Cervidil, supposedly very gentle. I burned internally for 12 hours. 0 cm dilated.

Four hours after the Cervidil tag was pulled out (and having to repeatedly decline an internal check due to pain, telling the resident to wait until the burning stopped), I was given a Foley catheter, and morphine so that I could sustain a new pain. Well, that got me to 4 cm, so they broke my water.

They wouldn’t allow me to walk around to kick start labour, preferring to keep me in bed and hooked up to fetal monitors (and check my vitals every 20-30 minutes. They woke me up to do this. I was very sleep deprived.) The whole time the nursing staff was freaking out due to my advanced gestation, despite all ultrasounds and non-stress tests showing excellent health.

I was then given oxytocin against my wishes. I needed an epidural after three hours of terrible pain. By morning, I’d been induced for two days and they wanted to insert internal monitors. No effing dice. So over it. I asserted I wanted a C section and it was granted.

The procedure was scary, but I had my baby in under an hour. His health was perfect and he was 9 pounds, 13 ounces. After the shakes were over, I held my baby skin to skin and he latched immediately. I was overjoyed with this one thing finally going right.

I fed him like clockwork, and he was getting plenty of colostrum. I was exhausted, but never allowed to sleep. If my baby didn’t want to nurse, then the nurses were coming in to wake me and take my vitals. I soon developed hives and no one knew why. Benadryl helped, but I had to keep taking it.

My son was losing weight, but my midwives were okay with it because they’d be checking up with me at home. He was down 10% when we left the hospital. My milk hadn’t come in.

The next visit, I was emotionally wrecked, and he was down 12%. There was something reddish in his diapers, signalling dehydration. They recommended formula and said to keep him on the breast to ensure my milk would still arrive. At home I drank Guiness and took tincture and did my best while still trying to recover from surgery, pregnancy and exhaustion.

I soon developed chills and a fever, so I was told by my midwives to go to the ER. I was examined and scheduled for an ultrasound before I was thankfully sent home to sleep. I could have stayed in the ER till morning and have the ultrasound bright and early, but I’d had enough of hospitals, was out of my mind with how tired I was, and there was a woman dying beside me. We had listened to her Last Rites. All the while my baby was at home being fed formula by my aunt who had come to stay with me.

The ultrasound that afternoon showed a uterine infection. I was admitted to the hospital, told my baby could come, that we were going back to labour and delivery and I’d be put on IV antibiotics for a couple days. A low and desperate “No….” escaped me. I was devastated. The week my son was born was turning out to be the worst week of my adult life. I kept thinking about how I was going to care for my baby back in L&D during the day while my husband was at work.

We didn’t go to L&D. We were instead sent to a post-op recovery wing that was built in the ’30s. No room for my baby, or a companion. I freaked out. I was five days postpartum and post-surgery. Now I would be left alone in a scary hospital room with only a communal bathroom and most importantly, away from my son.

The nurses were terse at my horrified reaction. I was sobbing. My husband battled the staff to at least give me a private room, and he and his father brought me what I’d need, including nursing tincture and an electric pump.

I wasn’t as diligent with either of those things as was recommended because I was so frazzled and depressed. But I still went at it, and realized that my milk had unceremoniously come in. No engorgement, no real amount. Maybe two ounces in one day’s worth of pumps. My left breast was especially pathetic. Most of the milk came from the right.

My time in the hospital was surreal. I had just had a baby and was alone most of the day. I had a friend visit me, letting me know formula was totally fine. I wasn’t ready to face that yet. My husband brought the baby to see me and I had mixed feelings. I didn’t feel like a mother. I wasn’t feeding him, I hadn’t seen him in over a day and he was only 6 days old at that point, so a sixth of his life had gone by without me. My midwife was very worried about me developing depression. So was I.

When I was discharged, my son was eating 4 ounces a feed. I was put on Domperidone and given a tube to insert into my son’s mouth while he nursed, to teach him that my breasts were in fact a food source and not the empty things he’d grown used to. It worked, sort of. He would sometime nurse, sometimes hold out for the bottle. And then I’d pump. It was a slog. Thank god for my aunt, who stayed on an extra week to help me. Without her, I surely would have developed PPD.

The feeding/pumping cycle went on for months. I added Fenugreek and Blessed Thistle to my routine. I got up to about 7 to 10 ounces of milk pumped per day, with one successful morning breastfeed. The rest was formula. I wasn’t bonding with my son. I was resentful of the pump and my physical experience with motherhood. Despite the fact he started sleeping through the night at eight weeks, I didn’t look forward to each new day.

Then he started rejecting my pumped breast milk. Even though I stored it correctly, it would occasionally go off and I’d have to dump what amounted to a full day’s efforts. If it smelled fine, I’d hide it in his formula so he’s still get it. Nope. He caught on and started rejecting those bottles too. Turns out if it’s not straight from the tap, he wasn’t interested. And he was only interested in the tap in the morning.

Having your baby not even want your pumped milk is a new level of rejection. That’s when I said no more. Screw this. I stopped pumping. I had hit my brick wall. I was ready to cede to the inevitable: formula feeding. I finally experienced engorgement, at the end of the first day off the pump. It wasn’t painful, but I leaked and there was definitely firmness and fullness. It was like a cruel joke, to at last know what it meant to have enough milk in my breasts to feed, only through the process of saying goodbye to it. It had taken almost a whole day for my breasts to fill and that was the best I could do after everything I’d gone through. I decided to keep the morning feed for as long as my body would allow it.

Since I stopped pumping I’ve started loving my son more. I see things now that I was missing while pumping away. He is an amazing baby! Every day is getting better. I’m happier, my son is calmer, and my maternity leave no longer feels like a prison.

I don’t know how long the morning feed will last. Eventually his needs will go up and my body may well not adjust to them. But oh well. Despite having been breastfed, myself, I had four ear infections in my first year of life, followed by tonsillitis. I had double pneumonia in my childhood, and kidney stones in my teens, and appendicitis in my early 20s, and I have IBS. So I’m pretty sure you can’t breastfeed your baby to a life of good health. Like so much else, life is luck of the draw.

I’m not having another baby. I hit the jackpot with the one I have and he is my dream child. I’m also selling the pump. How very therapeutic that will be.

So, out of my plan (home water birth, breastfeeding, cloth diapers) I got 1 out of 3. I accept this. And what caused my problems? Was it the C section and infection? Was I too exhausted from the experience? Do I have hormonal problems that A. Didn’t allow my breasts to change and B. Didn’t send me into labour? I have no idea. I just know it didn’t work and it’s not my fault.

I’ve had to weather a little subtle criticism over the formula, but whatever. Kid’s gotta eat.

***

Want to share your story with the FFF audience? Email it to me at formulafeeders@gmail.com. 

Introducing the Family-Friendly Hospital Initiative

My first experience with a baby friendly hospital was far from pleasant….because no one had really showed me how to attach, just pushed and shoved my breast, my nipples became blistered and bloody…As day 3 approached it was clear my son was having a few issues.  He was becoming jaundiced, he still hadn’t passed any sort of wee.  This was when the contradictory advice began.  One told me he was a lazy sucker and that I had to watch for Nutritive sucking, where his whole jaw was moving, all the dummy sucking was not getting him any milk.  Another midwife told me that was nonsense and any sucking was getting him milk.  One told me my latch was good, another told me it was rubbish.  It seemed with every shift change I got another piece of different advice.  I was more confused than I had ever been in my life and I had absolutely no idea what I was doing.  They had me constantly hooked up to the breast pump, hoping to encourage my milk in but I never got even a drop out…he had lost nearly 30% of his body weight in 3 days, they aim for 10% at the most.  I felt angry,  I had told them my baby was starving.  Any time I had asked for formula I was told it would affect my milk supply and refused…I had to sign a form allowing him to have the bottle.  He gulped it down and went straight to sleep.  The first time really since he had been born.  The next morning when with a new midwife when I asked for another formula top up I was given a spiel on how ridiculous it was to have given it too him in the first place and I would destroy any chance of ever having any milk.  When my husband asked which formula they recommended if we decided to go that way because he could see how thoroughly overwhelmed I was he was told they don’t recommend formula.  Those two bottles allowed his weight to go up enough however to allow us home after another night so we finally got out of there.  I left exhausted, nipples absolutely shredded, confused, overwhelmed and violated….Baby friendly maybe, mother friendly most definitely not. – Courtney

“My local hospital is “baby-friendly”…  My own opinion of this implementation is that it was distinctly “mother unfriendly” – to the point I’m still traumatized by what went on now and regularly cry myself to sleep over it all. My daughter came prematurely, was sent to NICU, while I was sent to the post-natal ward… I had a leaflet on breastfeeding slung at me, and when I pointed out it was a tad insensitive- I had a premature baby in an incubator not even on the same floor in the hospital as me, and I couldn’t do anything since she wasn’t even WITH me (none of the staff had broached expressing or pumping at this point) – I got snarled at that “breastfeeding is really important you know” and the nurse flounced off…After about a week and a half, when I was truly at the point of crumbling, when we’d made no progress at all with breastfeeding and latching, one wonderful nurse put her neck on the line and broached the taboo (bottles, formula and teats were very much the elephant in the room everyone was too scared to mention) and told me that basically I would be looking at extending our time in hospital by another 2-3 weeks in order to be able to go home breastfeeding… I asked to try her with some of this expressed milk in a bottle to see what she would take… From there she really turned the corner. However because of being “baby friendly” – the bottles, teats and formula were hidden away behind the nurses’ station (very similar to the NYC proposals) – you had to do the walk of shame, akin to being on the Weakest Link, to go and collect them… it was literally a matter of a few days from that first bottle feed to her being able to take her full feed requirements and maintain/gain weight and have her feeding tube removed – the hospital would have let me plod on in ignorance that this was possible to sacrifice my mental health on the altar of their baby friendly status quite happily. The prolonged stressful nature of our hospital stay has left me with an anxiety disorder requiring medication, sleep problems and I cry myself to sleep on many many nights over the trauma we went through – this is after counselling as well. I switched to formula feeding as my supply dwindled and my breast pump motor died in the end.” -F.T.

A colleague said something to me last week that really knocked me on my ass. She asked if I had lost my passion for this blog, and for the cause in general; she told me that FFF “wasn’t what it was” a year ago. I’ve reflected on this for the past 5 days, and I started wondering if maybe I was the Internet equivalent of an aging beauty queen, hanging out at the local cougar bar and wearing pants that were more appropriate for my 14-year-old daughter. It was a scary thought. (And a little too close to home, as I still shop in the Juniors department, on occasion.)

On further reflection though, I don’t think I’m old, or tired, or lacking passion – I’m just a little jaded. I’m jaded because I realize that blogs can only go so far; that the time has come to take FFF to the next level and begin forming concrete advocacy efforts and fighting for real, practical change that can lead to flesh-and-bones support, rather than just the virtual kind.

This advocacy will begin with an endeavor I am calling the Family Friendly Hospital Initiative (FFHI). I originally planned to call it the “Mother-Friendly” initiative since the mothers are the ones physically engaged in breastfeeding, but ultimately chose the name “Family Friendly” to reflect the fact that families are made up of not only babies and mothers, but also biological fathers, adoptive parents, gay and lesbian spouses, and siblings with their own specific needs. We need to approach all types of famiIies in a holistic manner, recognizing that the health, happiness and economic stability of the entire family is vitally important to emotional and physical health of a growing infant and to our society as a whole.

I plan to approach hospitals, local media, and government officials to encourage adoption of the FFHI, a program that can work in conjunction with the BFHI Ten Steps, taking the best parts of that program and clarifying the aspects that could potentially infringe on a woman’s right to choose how to use her body. I am going to fight, tooth and nail, for hospitals to start offering bottle-feeding classes, or if this isn’t a possibility, perhaps giving access to a hotline to connect new moms with trained peer advisers who can walk them through safe formula preparation, outline the best pumping and milk storage practices, offer suggestions to common formula concerns and complaints, and hopefully provide peer support groups which can meet, much like breastfeeding support groups, but for formula-feeding, pumping, tube feeding and combo-feeding mothers.

There is no reason that supporting and promoting breastfeeding has to mean punishing the women who either choose to formula feed, or end up doing so for any number of valid reasons. The Family Friendly Hospital Initiative will promote breastfeeding as the healthiest choice, but will frame it as a truly informed choice, giving concrete, real-world statistics in contexts that any parent can understand, not just the ones with a degree in epidemiology. It will adhere to practices shown to improve breastfeeding rates, but make the ultimate goal a healthy, fed baby and a confident, emotionally healthy mother and/or father. The FFHI will reach out to postpartum mental health professionals and organizations and attempt to make maternal postpartum health a significant priority. It will encourage researchers to engage in studies which will learn from women who are not breastfeeding, rather than dismissing them; studies which will make bottle-feeding (whether it be formula, donated milk, or expressed maternal milk) safer; studies which will help us determine how our societal evolution has affected breastfeeding, and how to merge a woman’s innate desire to feed her child naturally with the reality of an incredibly unnatural world.

Take the good….

“…Every nurse who came to check on us was extremely respectful. They all asked before touching me and gave great advice about how to get him latched and how to take care of myself while breast feeding. Once we were discharged, we received follow up care from community health nurses. They check on everyone by phone, but came to visit us in home after hearing about the number of times my son had been up to feed. They weighed him and provided a lot of encouragement. When the jaundice was getting worse, not better, it was a community health nurse who was also a lactation consultant who said, ‘How do you feel about formula supplementation?'” – Lisa

“Baby 3 was born in a baby friendly hospital and was my best experience.  The LC came in just to see how I was going to feed and offered support with breastfeeding or formula feeding.  She just wanted to see mommy and baby happy.  She even checked on me knowing full well my baby was receiving a bottle just to make sure she wasn’t having any issues with the formula.  I breastfeed baby girl enough for the colostrum like son 2- but I didn’t feel judged at the hospital at all- in fact I felt fully supported.”   -Betsy 

 

When I asked my Facebook followers to share their experiences of “baby friendly” hospitals, I was shocked – and not for the reasons you might think. I was expecting tales of shaming, mistreatment, and inferior assistance with the actual mechanics of breastfeeding. But instead, the majority of the stories posted on my Facebook wall were positive. “I went in planning to use formula. I was so nervous,” says Amy. “Every single person was supportive, did not say one single word about it, and several actually expressed relief for me! …They didn’t have much advice on stopping my milk but they tried. My pediatrician seemed thrilled too. I went in ready to defend and they were all SO fantastic.” Natalie reports that the “hospital staff were all very kind. Every time they asked if I was going to try breastfeeding, I would start with my big long explanation, and they’d stop me right away and say ‘it’s your choice, you don’t need to explain'”. A few readers had given birth in both baby-friendly establishments and hospitals that hadn’t adopted the initiative, and they gave much higher marks to the baby-friendly ones. Allowing babies to room in, experience skin-to-skin immediately after birth, and having more lactation consultants or breastfeeding-educated nurses on staff are changes most new mothers would applaud. Obviously, there are elements to the baby-friendly program that should be commended and implemented worldwide.

…But Leave the Bad

I delivered at a baby-friendly hospital. I had intended on giving breastfeeding a try but was not sure I wanted to do it long term…When I delivered, a nurse helped me initiate breastfeeding…He was not latching well, which I assumed the LC would have told me. I now found out that it is against their policy to use prosthetics (shield), which would most likely have saved our nursing relationship and helped my sleepy baby latch… They checked his bili levels and they were sky high. I told the night nurse she could feed him formula and I was fine with that. She fed him 25ml through a syringe. The next morning I was told the machine used to check the levels was malfunctioning and he was actually fine. The LC berated me for allowing my baby formula. After our release he became too tired to latch and would scream. The pediatrician told me I should supplement. I gave him a bottle, and he refused to nurse. By the next day, he had gained 4oz and changed color. I stopped after that for my own sanity and recovery. My experience wasn’t horrible at the hospital, but when I was looked down upon for allowing him formula I felt as though it wasn’t so much about me making a decision I thought was best, but them not being able to check off that ‘exclusively BF’ checkbox.” -Sara

“Because of my problems with (my first child) I was leaning towards formula but still wanted to attempt the breast or at least get the colostrom benefits.  When the lactation consultant came in, she was rude.  So rude.  I explained my troubles with my first son- where she informed me that the problems I experienced were impossible, she isn’t there to convince me to breastfeed, and I am sabotaging my efforts with son 2.  By the time she left the room, I was crying. Literally crying.  I told the nurse to get my son a bottle of formula so I would never need to see that woman again.  Turns out son 2 tongue sat back in his mouth a little too far and needed a preemie bottle nipple.  LC might have caught that and offered me a shield or something if she hadn’t been there to just berate the hell out of me. – Betsy 

Despite the numerous positive experiences voiced in this small sample, adopting procedures which focus on an end goal (having most babies exclusively breastfed upon discharge from the hospital) can lead some care providers to fall prey to human tendencies of fear, selfishness, and bias. It is evident that so much depends on the individual care providers and administrators of each hospital; the Baby Friendly Hospital Initiative (BFHI) is based on the organization’s Ten Steps to Successful Breastfeeding, which are meant to “promote, protect, and support breastfeeding”. Yet, the program is often simultaneously promoted as a way to improve maternity care in the United States, to bring hospital birthing to a more personalized, less sterile level. And while these two goals might seem to work in tandem, there’s too much left to interpretation in the Ten Steps to ensure that they really do. In fact, in some cases, it seems that the emphasis on exclusive breastfeeding for the good of the babies is subjugating the needs, autonomy, responsibility, rights and desires of the mothers.

Still, I do believe that things must change in our hospital system so that women will be supported in their efforts to breastfeed. New mothers shouldn’t be sabotaged or bullied, no matter if the substance in question is formula or breastmilk. And the early days of breastfeeding are incredibly vital – both physically and emotionally. I simply want to make sure that women are supported in both the former and the latter respects.

Engage the professionals

“My son was born in a “baby-friendly” hospital. In theory, it’s all very good and helpful, but I feel the nurses need to be given a reminder about personal boundaries and coherent advice. I was pretty upset that they wouldn’t let my husband hold him after the birth and that they manhandled my breasts (without asking first) to try to painfully extract some colostrum (which I didn’t have at all) because my son apparently needed to have some *right now*. I was exhausted and just wanted to be left alone. I wanted my husband to take the baby so I could sleep. There was a lot of manhandling and nipple-pinching during the next feeding attempts, which was very painful and disturbing…Also, my son slept for most of his 48-hours hospital stay. I went to the nurses station to ask them if I should wake him to feed him and I was told “no”, but when I was discharged, a nurse scolded me for not attempting to nurse every 3 hours. I felt confused and misdirected. I was happy to leave!”  Roxane

I believe that most people go into the medical field – a care profession – to help others. We cannot ask nurses and physicians – professionals who carry the credo do no harm close to their hearts – to subjugate the needs of one patient for that of another. We should be asking these professionals to work with us to improve infant feeding practices, rather than demanding they behave in certain ways (ways that may be in direct conflict to their instincts as caregivers) in order to meet government goals. Therefore, I hope that medical professionals – especially maternity care specialists – will join me in urging the adoption of this initiative. Perhaps it will also be more palatable to hospitals who have shied away from becoming baby-friendly; if the goal is to end practices which sabotage breastfeeding, it shouldn’t matter whether we do it via WHO/UNICEF-endorsed methods or our own modified American version.

As I’ve been researching the BFHI, another realization I’ve had is that despite all intentions, women are still being given atrocious advice in baby-friendly hospitals- advice that would make most experienced LC’s cringe. A friend recently gave birth at a Kaiser hospital here in California, one that prides itself on being Baby Friendly. She told me the most curious tale of how, when her newborn didn’t latch right away (and I’m talking like 3 minutes into the first skin-to-skin, right after the cord had been cut), a nurse dribbled formula all over my friend’s chest, apparently to encourage the baby to latch. Considering step 6 of the BFHI is “Give newborn infants no food or drink other than breastmilk, unless medically indicated” and my friend’s baby was born perfectly healthy, I have no flipping idea why this would have been done.

I suspect that when the focus is solely on having women leave the hospital breastfeeding exclusively, rather than on encouraging long-lasting, healthy, happy breastfeeding dyads, bizarre and contradictory actions will continue to occur. By talking with healthcare professionals rather than treating them as the enemy, or assuming they are all pawns for the formula industry, we can hopefully come up with better protocols that lead to better outcomes overall.

Encourage individualized patient care

“My baby latched perfectly and all was great. Except that I hated it. No matter what the hospital does, I believe women will quit breastfeeding for all kinds of reasons. I hate calling it “succeeding” at breastfeeding because I think success is determined by a happy healthy baby and mom, which isn’t always breastfeeding.” – Erin

“I have 2 sons, now 2 and 4.  I also have PCOS and hypoplastic breasts.  I tried to breastfeed my first, didn’t work.  Didn’t even try with the second (with the blessing of the same LC who was at the same hospital and remembered me!  Took one look at me and said, “nope, don’t bother.”).  By the time I had my 2nd child, the hospital had become “breast friendly”, in their words.  So they were not giving away the formula bags and samples any longer.  Nurses told me that they actually had to THROW THEM AWAY.  Since I had been expecting these items, I was shocked to hear this.  When the director of nursing stopped by to take a little survey on my stay, I really let her have it.  “But we’re BREAST FRIENDLY” she kept repeating.  My response?  ‘Well guess what honey, my breasts aren’t very friendly, and they don’t make milk'”.-Rebecca

I actually believe that most of the 10 Steps outlined on the BFHI website are perfect for encouraging breastfeeding, and seem to reflect the research that has been published on this issue. But I think that there is a fundamental flaw in the program: it does not give sufficient attention to the needs of bottle-feeding parents. Mothers have different birth experiences, different socioeconomic backgrounds, different ethnicities, different emotional makeups, different physical impediments. Mothers are different. Treating all American mothers as one homogeneous, uniformly-lactating group is a recipe for disaster. There’s a movement afoot to change the face of maternity care in this country – homebirths, or hospital births assisted by doulas or performed by midwives are becoming more popular. We seem to be having two parallel conversations – one that says “treat me like an individual, not as a medical case to be managed” when it comes to birth, and one that begs for overly-monitored, medicalized, one-size-fits-all treatment when it comes to breastfeeding.

There is no reason we can’t follow most of the BFHI steps, and still provide resources, emotionally neutral education, and equal support for those who opt to combo feed or formula feed.

Education, Not Indoctrination

“No discussion of challenges in our BFing class, just all the joys and benefits. Frankly, I think it’s much better to discuss potential problems even if they affect only 10% or so of mother-baby pairs. Knowledge is power, and you aren’t blindsided by pressure or bullying or confusion either way in the days immediately after birth if you know what to expect. I seriously don’t understand why anyone would think it wasn’t important to discuss potential problems. It would be so much better for getting people to know when to get help.” Sumita

“In fairness breast feeding wasn’t really covered either – it was more here are the benefits this is why you should – and this is briefly how it’s done- we will show you when you have your baby. Formula wasn’t even mentioned at all. – Kate 

I took a breast feeding class at the baby friendly hospital I have birth in. They never talked about any problems that could come up. Only the benefits and good things about breast feeding. I spoke to a nurse while I was in the hospital and asked her how come I wasn’t told about flat nipples, latching issues and such and she said that they don’t discuss negative things in the breast feeding class so that women aren’t discouraged. In my case it would have been very helpful to know about issues like that because it would have avoided me getting depressed about not being able to breast feed my premature baby.” –Rosella

“We are set up for failure and every real life mom I know knows it. SO many women I talk to NOW commiserate with how hard it can be, but all the literature, all the websites give such an opposite impression. Like, why WOULDN’T you breastfeed if its beautiful, bonding and almost everyone can do it? If everything they said was true, everyone WOULD breastfeed. But its not true for everyone.– Rachel 

The number of mistakes I made formula feeding my first born because of the lack of info frightens the hell out of me to this day. I called a nurse hotline once to ask some questions and got a lecture about how I should try to re-induce lactation.” – Mina 

Regardless of what happens in the 48 hours after delivery, the education parents are receiving about infant feeding is downright embarrassing. Classes drill the importance of breastfeeding into our heads without giving us much practical information on how to actually nurse; this is somewhat understandable as it’s the kind of thing you can’t really learn without doing. However, a brief acknowledgment of some of the more common complications would be an easy thing to add to prenatal curricula – latching issues, flat or inverted nipples, tongue ties, commonly used drugs that may be contraindicated, health conditions such as diabetes or PCOS which could potentially complicate breastfeeding – and doing so would prevent many women from feeling like failures when breastfeeding doesn’t come easily. Considering the emphasis on avoiding nipple confusion and establishing milk supply in the first few weeks which permeates the canon of breastfeeding advocacy literature, it seems logical that we should do whatever we can to ensure that women are not blindsided by these issues – forewarned, they could come up with a solid plan with a lactation professional which could prevent actions made in moments of confusion and panic.

Additionally, the lack of education about formula feeding is a travesty. I have written about this many times before, but I will reiterate: if only 36% of American mothers are breastfeeding exclusively at 3 months, that means a majority of babies are being fed formula. It is IMPERATIVE that they are properly supported in doing so. Ignoring the fact that formula is a reality in the lives of many parents doesn’t just punish the parents- it affects the babies. True, formula feeding isn’t brain surgery – but it could be argued that breastfeeding is an instinctual act for humans. Formula feeding? There’s nothing instinctual about it. There is a huge margin for error. I personally suspect that many of the subtle health disparities we see in the aggregate between formula fed and breastfed babies are due to avoidable and common mistakes in formula preparation and selection. Most parents have no idea what the difference is between a “sensitive”, “hypoallergenic”, or “lactose-free” formula. They don’t know that the angle of the bottle, the flow of the nipple, and the type of formula (powdered, liquid, concentrated) could affect their baby’s digestive system. They don’t know what water to use, how often they really have to sterilize bottles, or what formula to choose. They must rely on friends and the internet for advice about something that should be – unlike breastfeeding – a regimented and meticulous process (sadly, it seems our society has this flipped. Breastfeeding is treated like brain surgery, and formula feeding is seen as something we should inherently know how to do…). Medical professionals may be used to the “formula feeding model” for things like weight gain and feeding schedules, but even this is more true of the “old guard” (those who have been practicing for a long while, before breastfeeding’s resurgence) and these same folks might not be aware that there’s been research and new thought on the bottle-feeding front since they got out of med school in 1963.

I propose that breastfeeding education be altered to reflect some of the realities of breastfeeding – common challenges, medications, diet, and pumping – the same things discussed on KellyMom, Mothering.com, and The Bump. I also want to see hospitals offering bottle-feeding classes and resources once a mother has voiced a desire to either supplement or completely formula feed.

The “Parent-Friendly” Manifesto

I am not sure what form this “initiative” will take just yet, but I am hoping that FFFs across the country will join me in advocating for positive change. It is healthy and necessary to mourn the loss of breastfeeding, or rage against the current atmosphere of shaming and belittling formula feeding moms – but we can turn that anger and grief into positive change. I know we can. Let’s work on this, together, so that no new moms have to go through what we have gone through. Let’s make it so  FFF Fridays become obsolete, because there will be so few people who feel bullied, abused, or let down by their experiences. Let’s make my friend’s comment a reality – make it so that I have lost my passion, because there will be nothing left to get fired up about.

Who’s with me?

FFF Friday: I placed my mental health above what my son ate…”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts, and I hope we can all give them the space to do so.



I honestly don’t know what more I can say to introduce this piece, because the title says it all. 


Thank you, FFF Abigail, for illustrating how individual circumstances are far more important in what determines a woman’s feeding choices than formula bags, societal barriers, pacifier use, sub-par maternity leaves, or any other “booby trap”. Sometimes, a family’s decision is less about confronting barriers to breastfeeding, and more about confronting – and overcoming – personal barriers to health and happiness. 

I feel stupid saying my usual “happy Friday” today, since everyone in the US knows it is anything but. So instead, let me close with this:

Stay safe and happy, fearless ones,

The FFF
***
Abigail’s Story
My mom died during my birth from poorly managed pre-eclampsia that was detected at a routine prenatal appointment.  I was born via c-section, after she was clinically brain dead, at 32 weeks.  In 1980, my chances of survival at 3 lbs., 3 oz. weren’t so good.  Fortunately, I inherited the family’s stubborn gene, and I persevered!  Obviously, I wasn’t breastfed; Similac was the drink of choice.  Despite being premature and being deprived of oxygen for some time while my mother was comatose (long story here), I thrived.  I had a normal childhood, was rarely sick, excelled in school, and got my PhD when I was 25.  Not too shabby given the fact that I was raised sans breast milk!
When I got pregnant with my son, I was elated!  But, pregnancy was a terribly nerve-wracking time for me.  I worried about pre-eclampsia and pregnancy complications as well as miscarrying, birth defects, etc., all while dealing with my husband’s crazy, special-ops military schedule.  I’ve always dealt with anxiety and mild depression, and I could make a profession out of worrying,  but my OB felt that it was better for the baby for me to go off my medication while pregnant, and so I did.  In hindsight, that might not have been the best decision, but I wanted my pregnancy to be “clean.”  I did a lot of reading and researching during my pregnancy…birthing options, feeding options, etc.  Reading about breast feeding nearly sent me into a panic attack…thinking about having supply issues and mastitis and cracked nipples and having a baby attached to me all the time and having issues forming a nursing relationship.  The more I read on the subject, the more anxious I got about the whole notion.  And, after a lot of discussion, my husband and I decided it was probably best if I formula fed…he could share some of the feedings and take some of the burden off of me…it would give him some quality time with our son since his career takes him out of the country very frequently…AND, most importantly, I could go back on my anxiety medication after giving birth without worrying about how it might affect by son via breast milk.  To us, formula feeding made sense.  And, since I wasn’t breastfed and turned out just fine, I never thought of formula feeding as something detrimental.
Fast forward to my son’s birth…an uncomplicated induction…an uncomplicated vaginal delivery…a beautiful baby boy…and my worst fear…less than 18 hours later, we learned that something wasn’t right.  My son had a rare craniofacial birth defect that would require surgical correction.  Craniosynostosis, a skull anomaly that occurs in one out of every 2000 births, occurs when one or more of the sutures (fibrous material that hold the bones of the skull open while the skull grows), fuse prematurely.  In our son’s case, two sutures had fused in utero.  Left uncorrected, he would have an abnormal head shape, the brain couldn’t grow properly, and he would likely suffer intellectual and developmental delays.  We met with a craniofacual surgeon when my son was 8 days old and surgery was scheduled for three months later.  The surgical correction involves an ear-to-ear scalp incision, breaking of the sutures, stabilizing the breaks with plates and screws that will dissolve over time, and, in my son’s case, re-shaping the forehead and the eye sockets.  The news was DEVASTATING.  I went back on medication immediately, and the 12 weeks we waited for H’s surgery were AGONIZING.  Though we knew the surgery was necessary, it’s horrible to contemplate something so major happening to your tiny son, and I am SO GRATEFUL I was using formula!!!  Had I not been on medication, I wouldn’t have been able to be a good mother during those weeks of waiting…and had I breast fed while on medication, my anxiety would have been unmanageable.  It might not make sense to those not in my shoes, and that is OK.  I’ve been told I shouldn’t have had a child if I wasn’t willing to breastfeed…that I was selfish…that I was harming my son…but I beg to differ.  Because I formula fed and because I placed my mental health above what my son ate, I was able to be the BEST mother possible to my son.  The mark of a good mother is not found in how she feeds her child…it’s in how she loves and cares for her child.  I’m his number one advocate…and now…a year post-op, to look at my brave little hero, you’d never know what he’d endured.  He’s a happy, healthy, thriving 16 month-old.  Breast may be “best,” but it wasn’t best for us!
***
Share your story for an upcoming FFF Friday. Email me at formulafeeders@gmail.com.

Diamonds are a girl’s breast friend

Last night, I came across some web chatter regarding a new jewelery commercial that some women found offensive. I assumed the ad in question was that insufferable spot where the woman gets scared by a little thunder and jumps into her man’s arms, whereupon he assures her, “I’m here…I’ll always be here,” and hands her something sparkly.

Gag.

But no. Unfortunately, I seem to be the only person who finds this sexist and dated commercial so despicable. The controversy is actually over a Zales ad that has a bunch of people saying “I love you” in different scenarios. One of the vignettes shows a dad bottle-feeding a baby as he tells his wife he loves her. Apparently, this is anti-breastfeeding…”I was outraged within seconds when it showed a mom leaning over an empty crib while dad bottle fed a baby in the background,” said blogger BirthActivist. “I mean come on, wouldn’t it be better to give mom a diamond for breastfeeding?  Or even as a push present?  But this was just sad.  If you’re as outraged as I am, you can write them online or call them…”

While she certainly has a right to dislike the commercial, I am utterly confused at why she would be “outraged”, or how this imagery is at all anti-breastfeeding. First of all…we don’t know what’s in the bottle. It could easily be pumped milk. Maybe the mom pumps once a day so that the father can take one feeding, you know?  I take a completely different message from the ad. I think it just shows a lovely moment, where the dad is bonding with his new baby, and wants to tell his wife how much he loves her for bringing this precious gift into his life. According to many breastfeeding advocates, feeding your child is an act of bonding- so without the ability to bottle feed, fathers are robbed of this amazing opportunity. I was adamant about nursing before my son was born, but I was equally sure that I wanted to pump occasionally so that my husband could take part in the feedings. My dad once told me that his favorite part of fatherhood was those midnight feedings (I was a formula fed baby); that stuck with me. As strongly as I wanted to breastfeed, the image of a dad feeding a newborn was an evocative one for me; I don’t think this is a bad thing. Exclusive breastfeeding has many, many benefits, but I do think it leaves fathers out in the cold in this one respect. We have evolved into a culture (thankfully) where co-parenting is becoming more prevalent; some dads are even taking on the role of primary caregiver, which I see as a huge step for gender equality. But unless they can occasionally give the baby a bottle, they never get to enjoy this heralded “bonding”. And that sucks (no pun intended).

When my son wants comfort, he usually comes to me, but I think that’s more a matter of my being the primary caregiver; other than that, he is equally bonded to both my husband and myself. I love that. I love that he sees me as more than a food source; that the comfort I give him is something that I have developed as I’ve gotten to know him as an individual, something that I had to learn and work at. I love that his eyes light up when he sees his dad, that we’ve never had that issue of him wanting mommy more than daddy… I love that we are an all-powerful, seamless family unit, with interchangeable roles…

I certainly don’t think this is an argument against breastfeeding, but more of a nice little consolation present for those who are formula feeding or pumping. And feeling this way, I just can’t see why that image in the Zales commercial would offend anyone… if it were a mom standing there bottle-feeding, then I could obviously buy the argument that this is yet another subliminal message feeding a formula-centric society, but guys, how else is the man in this commercial supposed to feed the baby? And maybe that was integral to the point they were trying to get across in the 0.2 seconds that this image flashed on the screen – a lovely moment between father and child which provokes him to profess his love for the woman who made it all possible.

And hey. There ain’t nothin’ wrong with giving her some bling for her efforts. I think we can all agree on that.

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