FFF Friday: “Why I am suggesting my wife stops pumping.”

Lately, I’ve seen more discussion about the roles fathers (and partners) play in supporting breastfeeding. But I fear that there’s something missing in this discussion, a rather large elephant in the room that everyone is stubbornly ignoring despite the odor coming from the large pile of elephant dung in the corner. 

Having a supportive partner is absolutely fantastic when you’re trying to breastfeed. But what does being supportive really mean? Does it mean being a breastfeeding cheerleader, reminding your partner of the benefits and imploring her to keep going? Or does it mean stepping in when you see her emotionally disintegrating before your eyes? How do we help our partners truly support us – by indoctrinating them on the importance of exclusive breastfeeding, or by educating them on postpartum mental health, and the importance of the emotional stability of the family? 

My husband struggled with this. It’s something I’ve talked about before, but probably not to the extent that I should have. In our case, he took the breastfeeding classes and was entirely convinced that formula was NOT an option for our family. Plus, I’d told him I wanted to breastfeed. This meant that he believed his role was to keep reminding me of these things; every time I burst out in tears, wanting to quit, he’d say “this is what we decided” or “I have to think of FC, and what’s best for him.” As I was already halfway down the rabbit hole of PPD, these were not helpful statements. I resented him, and felt even more like a failure when things didn’t work out. 

Six years later, Fearless Husband can’t even discuss what I do for a living. He’s still drowning in anger about it all; he feels like he was manipulated, which led him to put his wife’s emotional health (and his son’s physical health) at risk because of what society and the “experts” told him was absolute truth. I can look at my own experience with perspective; the passion I feel about this topic is no longer personal, but about feminism and justice and truth. For him, it’s still personal. 

Our partners can be part of the solution, or part of the problem. They can’t win. They are doomed if they push us to keep going when we really need to stop, or if they push us to stop when we want to keep going; when they don’t have an opinion either way, or when they have too strong an opinion. So what can we do to help them help us? 

I’d love to hear your ideas, and to collect them in a post that can be shared with concerned fathers and partners. Leave them in the comments below, or on the FFF Facebook page. 

To start this conversation, I want to share a unique submission I received from Jeff, a father who is dealing with this exact Sophie’s choice of a situation. I am grateful to him for sharing his thoughts, and for supporting his wife in the best way he can. 

Happy Friday, fearless ones,

The FFF

Jeff’s Story

We wanted to breast feed our baby for six months. We were committed to it. In fact, I was worried that as the dad, I wouldn’t have enough to do in the first months to care for our baby. And it hasn’t worked out that way…

I am completely fed up with what breastfeeding – exclusive pumping – is doing to my wife. Some background – our baby is 7 weeks old. We had a normal, uneventful delivery, and she’s healthy, gaining weight, and a perfect angel! But she just won’t latch. Let me tell you – we have tried. For hours, doggedly and desperately. Nipple shields, syringes and tubes, pillows, massage, hand expression, “lactation cookies”, lecithin, goat’s rue, countless cups of tea, rain dances and magic invocations… The few times she did latch, she did not get enough milk to satisfy her. After weight loss, dry diapers, and a lethargic baby, we started supplementing with formula. Our stress level went down, and our baby sprang to life!

We have seen four lactation consultants (two in the hospital, and two since we got home). They gave us terrific support – hours of individual attention and lots of moral support. They are wonderful, encouraging, and compassionate people – and I would not say we’ve felt bullied into breastfeeding. I’m very thankful to our insurance (Kaiser Permanente) for providing the support, because we didn’t want to give up. Our pediatrician and an ENT specialist checked for tongue-tie, and found nothing amiss. They also worked with us on the pump, so we’ve really given this an honest effort. We just don’t know where the issue is.

Both baby and mom have been in tears after attempt after attempt – robbing them of pleasurable bonding time. I’ve watched my wife in tears over the pain of engorgement and plugged ducts, a bout of mastitis, and the frustration and embarrassment of being hooked up to a pump while I get the pleasure of holding and feeding our baby. We haven’t had to supplement with formula much after the first week, but it’s come at a huge personal cost.

So, my wife became an exclusive pumper. Maybe our experience is atypical, but pumping takes forever. She spends close to an hour per session, many hours a day, just to keep abreast (pun intended) of the demand. It takes at least half an hour before she gets any flow. There simply are not enough hours in the day for her to pump, sleep, and hold the baby. So in the name of “breast is best”, our baby is being deprived of the comfort of her mother’s arms.

We blindly subscribed to the “breast is best” philosophy. Since these problems stated, however, I went back and read the primary literature on breast milk versus formula (I have a PhD in immunology, and my wife has a MPH and worked for the World Bank in the nutrition hub). I was surprised at how weak the evidence for breast milk over formula was! The most convincing evidence I can find is that breast milk protects babies from GI infections, which makes sense if you don’t have a clean water supply as a basis for your formula. That’s not a significant concern in the developed world, however. For nearly every study I read, the differences in IQ and every other measure are less than the test-to-test variation seen in individual children. (i.e., the difference seen between a breast fed and a formula fed baby is less than the difference seen if you tested the same baby twice.) Even if you believe those differences, the link between intelligence and breastfeeding is confounded by the many other variables that cluster with extended breast feeding, especially socioeconomic factors.

I’ve reached the conclusion that this is not serving my wife or our baby’s best interests. So, I am going to tell my wife tonight that I think she’s done a fantastic job giving our baby nothing but breast milk for the first 7 weeks, but that I am concerned that “extraction” of breast milk is dominating their relationship to the detriment of both of their health. I would rather see my daughter held in the arms of her happy mother drinking formula than look across the room at my wife’s teary eyes while I feed the baby breast milk sucked from her body.

I still support efforts to encourage breast feeding, but we have to be wise enough to recognize when it isn’t serving the best interests of the mother or baby. Public health recommendations are based on large groups of people – they cannot (nor do they try) to predict the best action for all people in all situations. If breastfeeding works for your family, that is wonderful and I’m genuinely happy for you. Please respect that it does not always work, despite desperate desires to the contrary. We didn’t want or choose this outcome, but I don’t feel bad for making a decision that protects my family’s physical and emotional health.

That’s why I think it’s time to support my wife and baby by suggesting she’s done enough, and that it’s time she put down the pump and picked up the baby.

***

Want to share your thoughts or story about infant feeding? Email me – formulafeeders@gmail.com. 

Father Knows Breast: Men have breastfeeding angst, too

I’ve been re-reading Joan Wolf’s book, Is Breast Best: Taking on the Breastfeeding Experts and the New High Stakes of Motherhood. The first time I read it I was doing so in order to review it for this site, and also as research for my own book; this second reading is simply for enjoyment. And I have to say, it is a damn good study. If anything, its downfall is that it is too comprehensive; she covers so many issues so thoroughly that it almost gets overwhelming. But that’s a pretty good fault to have, kind of like when an recruiter asks you what your faults are and you say “Huh…well, um, I guess I’m a perfectionist…”

Anyway, one of the (many) arguments she makes is about the gender-specific nature of the breastfeeding-begets-bonding rhetoric. How come we never consider the “bonding” behaviors of fathers in regards to infant feeding? It got me thinking… we seldom discuss the male POV here on FFF, and maybe it’s time we did.

On the few male-written blogs on breastfeeding I’ve seen, the blogger always refers to the “myth” that breastfed babies can’t bond with their fathers, and how this wasn’t true for him/didn’t matter if it was true for him because nature designed it that way and it was all worth it in the end. These guys usually talk about how it makes them even more in awe of their wives; how they were able to help out in other ways (diapering, cleaning the house, bringing the baby to their wives in the middle of the night); how “real men” support breastfeeding.

Most of these sentiments are really beautiful, and I don’t doubt that all of them are 100% true. For some men. But just as with women, I think it’s unfair to assume that every man’s experience with breastfeeding is going to be identical.

I’m sure there are men who do feel left out, when only their wives can provide the comfort and food to their new infants. Babies don’t do much but eat (and poop, but changing a diaper isn’t much of a bonding activity) at the beginning; with first babies, most willing and able dads will be involved in breastfeeding because it takes time for their wives to get the hang of it (I know my own Fearless Husband was quite adept at maneuvering my nipples into my son’s mouth by the end of the first week). But after breastfeeding is established, dads don’t really get to do much in the way of feeding unless pumping and bottles are involved. I’m not saying this is a “reason” to bottle feed, or an indictment of breastfeeding, but I also believe we should feel free to voice any and all feelings about individual experiences with breastfeeding. It is an intimate experience, like birth, and sometimes it helps to tell our stories- even if that means saying things that are politically incorrect.

These are tricky subjects, in even trickier situations. We can’t censor ourselves for fear of appearing anti-breastfeeding. I actually think that in some ways, doing so is anti-breastfeeding – because if we aren’t honest about our experiences and feelings and challenges and concerns, how the hell will breastfeeding ever become the “norm”? “Norm” meaning normal, right? Normal things can be made fun of; looked at analytically; debated. Normal means that we can talk about the uncomfortable truths.

So, just in case anyone with a penis should ever stumble across this blog, I want to make a few things clear, since it’s highly unlikely anyone with actual authority will have the balls to do it:

  • It’s okay to feel left out.

  • It’s okay to feel a bit squeamish that a body part which was once an integral part of your intimate, sexual relationship with your wife is now simply a feeding tool /public domain, being seen, discussed, and manhandled by a myriad of medical professionals and lactation consultants.

  • It’s okay to wish that you could do “the most important thing for your baby”, that you could shoulder some of the responsibility for his/her future health and intelligence.

  • It’s okay to question whether this “most important thing” is really all that important, and if it will have that much impact on your child’s future health and intelligence.

  • It’s okay to feel confused about how best to support your wife when she is crying over bleeding nipples/insufficient supply/frustration/pain/mastitis/spilled milk, when part of you just wants to give the kid a damn bottle and tell her to quit already, she’s been through enough; it’s okay that you aren’t sure whether she really wants to quit or needs you to be the rock and push her through this roadblock.

  • It’s okay to feel concerned about your baby’s welfare if your wife is having trouble breastfeeding or is telling you she simply doesn’t want to do it. When every parenting book and birth-prep class you took has informed you that formula fed babies are sickly, emotionally stunted and stupid, how could you not worry?

  • It’s okay to feel uncomfortable when you see your wife’s friends nursing. Two months ago if you’d seen their boobs it would have been a federal case; now you’re supposed to think nothing of it…?

  • It’s okay that you can’t understand why your wife cares so much about what other people think of her and what she is or isn’t doing with her breasts.

  • It’s okay that you feel resentful that fathers are barely acknowledged in all the talk about infant feeding and early development, especially if you are a gay, single, or primary caregiving dad. It’s not right, it’s out-and-out sexist, and it just sucks.

We can’t leave fathers out of the conversation, because they inevitably become part of the conversation. Yes, breastfeeding is a woman’s issue, but it has become a social and medical issue revolving around babies. Babies who often have both a male and a female parent, and sometimes only a male parent, or two male parents. The physiological act of lactation is exclusive to women; feeding babies is in the purview of both genders. I hope more fathers start to weigh in on how the pressure to breastfeed is affecting them, as well.

Oh – and also – while writing this, I couldn’t help but think: First we ask men not to fixate on our breasts as sexual objects; then we ask them to fixate on our breasts as a means to a healthier, wealthier child; a healthier, wealthier nation. Either way, the attention is all on the breasts.

Paging Dr. Freud….

The Daddy Dilemma: How much say should fathers have about breastfeeding?

As I mentioned previously, I recently suffered some minor complications with my pregnancy that rendered me unable to travel to my dear friend’s wedding. The reasons were twofold – first, because I was diagnosed with a condition that put me in a “high risk” category; and second, that I started bleeding and cramping a day before I was supposed to leave. The first reason, in my mind, was not enough of one to miss my oldest friend in the world’s most important day; Fearless Husband (FH) disagreed. We argued for a week, him siding with the alarmist perinatologist who advised me to cancel, me with our lacksadaisical obstetrician who said I should absolutely go. Ultimately, my body made up my mind for me; once the more emergent (and painful) symptoms occurred, my mommy instinct kicked in and told me I’d be a complete moron to travel across the country under the circumstances (actually, it wasn’t just mommy instinct that told me that – so did the OB on call, who seemed like a straight shooter and broke the tie between my battling healthcare providers).

I’m rehashing this to illustrate a point about fathers and the relationship they have with their pregnant wives and unborn children. In my non-pissy moments, I realized that the situation must be scary and frustrating for FH. Our daughter is in my belly, not his. It may not be politically correct., but it is a visceral reaction – someone else has responsibility for taking care of his child, and he has little to no control over what that person does or doesn’t do. Even for the most evolved, post-feminist era man, that’s gotta sting. At one point in the week of should-I-stay-or-should-I-go arguments, FH said, “It’s not my decision; it’s not up to me. I guess I don’t even have a say in it. I’m just telling you how I feel.” Although we were mid-fight, I immediately softened. “Yeah, actually, you do have a say. This is your kid too. If you really, truly feel I am putting our child in danger, then of course you have a say,” I told him, feeling like the most selfish person on the planet for even considering taking the trip.

I think that the frustration modern dads feel about where they should draw the line between “controlling” their significant others’ physical lives in regards to procreation, and taking a true and equal part in co-parenting, affects the issue of breastfeeding. We hear talk about how fathers can support the breastfeeding mom (doing other tasks so that she can focus on feeding –  bringing her water, changing diapers, etc); on the flip side, there are stereotypical horror stories of how men can feel “left out” from, resentful of, or “turned off” by the nursing relationship. But this is oversimplifying things, I think. The question remains: what rights do male partners have in dictating whether a mother breastfeeds? If they believe that formula really does carry risk, then can we blame them for taking a strong stand on breastfeeding?

In my case, FH started out being the ideal breastfeeding-supportive father. But as things went from bad to worse, his (well-intentioned) Pollyannic attitude began grating on me. He claimed he was being supportive by not letting me give up, but in my dark days, that’s not how I saw it. I recall a message board friend (one who was a staunch breastfeeding advocate, no less) telling me that “until he feeds your child with the most sensitive part of his body, he has no right to tell you how to feel or what to do.” I agreed at the time, and it fueled my anger. What kind of misogynist shmuck had I married? If I wanted to give up, I could give up. He had no say.

But that’s not entirely true, is it? FC was his child; at the time, he 100% believed that by switching to formula, we were putting his health and welfare at risk. In this context, can I blame him for feeling angry at me for considering “giving up”? Didn’t he have a right? Didn’t he have a say? FC is as much his child as mine, after all.

Months later, the man I had dubbed “La Leche Lackey” had done a complete 180. He read the research, looked at the issue with open eyes, and saw how different our lives became once we listened to our child’s needs rather than the alarmist voices that guilted, scared, and divided us. He got angry; he felt cheated.

Still, I don’t think he feels any remorse about acting the way he did. The way he sees it, he thought he was being supportive of what I wanted, deep down; that I was too depressed and frustrated to see clearly. He also thought he was protecting FC, which was his job, as a dad.

I’m not sure what my point is here. I guess it’s simply to say that a dad’s role in breastfeeding is complex, and we need to consider it carefully. As a feminist, this issue is a toughie for me; it’s a slippery slope from what I’m expressing here to a confusing, conflicted conversation about reproductive rights. As a mother and part of a loving, committed, equal relationship, though, I have to hesitate. How can we ask men to be equal partners in childrearing while not allowing them a say in how those children are fed? And yet, if the manner of feeding requires significant embodied commitment on the part of a woman, it does delve into dangerous territory.

This is one of the reasons why I believe that formula is an important option to keep in our society. Breastfeeding is inherently female work (although men can and do lactate – I’m still waiting for some research to be done in that department; that would really be progress. If breastfeeding is all it’s cracked up to be, then how cool would it be for the other half of the population to be able to contribute to our milk supply?); formula allows us to have equal footing. Of course, many women find breastfeeding extremely rewarding; a gift, if you will, that women are given, much like the ability to grow life in the first place. But for those who don’t, it sure is nice to have a way that men can be true co-parents, in every sense of the word.

See? It’s a toughie. Let’s just call it a wash and get to work on the whole male lactation thing, shall we?

The Call to Action on Breastfeeding: What it means to formula feeding parents

The CDC, Department of Health and Human Services, and Office of the Surgeon General have recently initiated a Call to Action on Breastfeeding. According to the HHS website, “life in America often creates barriers to breastfeeding and makes it hard for women to breastfeed. It is time for our society to get serious about giving families the support they need to be successful with breastfeeding. For this reason, the U.S. Department of Health & Human Services (HHS) would like to open up a national dialogue on how to make breastfeeding easier in this country.”

The rest of the website is committed to suggestions, received through an anonymous online comment form, from people identifying themselves as “concerned citizens”, “health care workers”, “breastfeeding coalition members” and so forth. These suggestions run the gamut; most are excellent, offering concrete and logical ideas, about such things as pumping rights for working moms, on-site daycare options, free lactation consultant home visits, and longer paid maternity leave. There’s also a lot of concern about normalizing breastfeeding in our society, which is so important, in my opinion… some of the crap I see on Twitter, and the whole Facebook debacle (not allowing women to post photos of themselves breastfeeding), let alone the insanity of nursing moms being kicked out of public places like Target…it is truly sickening. So if that is the goal of this “call to action”, I support the initiative fully.

However. (Isn’t there always a “however”?)

Some of the other comments – a large enough number to make me break out in a cold sweat – hint at a not-so-distant future where our rights as formula feeding parents (and I say parents, not moms, because I don’t want to alienate single dads, primary caregiver fathers, or gay partners who adopt, because they are a welcome part of our FFF group too) are in jeopardy. It took me the better part of an hour to just get through the first few pages of comments, but there were a few in that small sample that I want to bring to your attention, along with my take on the inherent dangers in these specific suggestions (all are copied directly from here, so don’t blame me for the grammar or spelling):


Formula supplementation should be treated as a pharmaceutical intervention and should only be allowed under certain medical conditions at the direction of a health care provider who can write orders for pharaceuticals. Formula supplementation should only occur with expressed permission of the mother. 

 I have been involved in lactation since its inception as a clinical area. We would go a long way towards human milk as the only human infant food if infant formulas were available to the general public only by prescription. This forces the HCP as well as the infant’s caregivers to think twice about using infant formulas instead of mother’s milk

I find this concept (expressed by two separate posters) particularly frightening. Formula as a pharmaceutical, available by prescription only? This would mean that your doctor would have to deem your situation “sufficient” for formula. Let’s say a woman was sexually abused and has emotional reasons for not wanting to nurse. Is this a legitimate “medical reason”? What if a woman has postpartum depression and does not want to take the risk of nursing while taking needed antidepressants (and until there is more long-term research done on the effects of certain newer medications on nursing babies, she would have every right to feel that way)? Or what if she just doesn’t feel comfortable sharing her emotional problems with her pediatrician or, for that matter, her insurance company?

Establishing breastfeeding guidelines that would require a home visit within 24 hours to check on the family and breastfeeding by a trained lactation specialist, as well as an increase in post-delivery visits with the pediatrician and a lactation specialist in order to provide the mother, child, and family with continued support in breastfeeding.

I love the idea of more professional support for those who want to breastfeed – but a “mandatory” check on breastfeeding? Umm, sorry, but that seems like a crazy invansion of privacy. Plus, I was a mess when I first came home from the hospital. The last thing I would have wanted was some stranger butting in to my private affairs, especially after having to get my hoo-ha checked by random nurses and doctors every 5 minutes for three days straight.

There is a major disconnect between OBGYNS,Pediatricians, nurses and new mothers in the hospital and before birth. There must be pre-birth dialogue between these practitioners and the patient/client about the benefits of breastfeeding and the shortcomings of formula. The government needs to do more and make these conversations mandatory.

Again, the concept of government intervention in my private medical interactions makes me queasy. (And Dad, if you’re reading this, I know you’ll use that comment against me in a debate about health care reform. Please don’t. 🙂 ) And the “shortcomings of formula”? The science is NOT clear on this. It really isn’t, guys. There are definitely studies proving the benefits of breastfeeding, but as we’ve discussed before, this is all about calculated risks. The benefits of a happy mom outweigh the statistically minimal “shortcomings” of not breastfeeding (and for many of us, there are health benefits to this as well, considering our babies could not tolerate breastmilk, or were unable to nurse).

Companies or the government should offer some sort of pay for maternity leave. If a woman is breastfeeding, FMLA leave should be extended to 6 months (does not all have to be paid) as this is the recommendation by AAP and WHO when babies should have SOLELY breastmilk.

This one is tricky. I would love to see women getting paid maternity leave. But I’m really not sure this would help raise breastfeeding rates.Most of the women I’ve heard from didn’t stop nursing because they went back to work – there were much more specific and troubling issues going on. And on the flip side, I know plenty of women who went back to work after 6 weeks, but have faithfully pumped for the recommended year and enjoyed a wonderful nursing relationship on weekends and in the evenings/mornings. I wish we could support paid and extended maternity leave simply because it is better for all primary caregiver parents and all babies in every respect, not just for feeding. A bottle-fed baby still needs it’s mom or dad around, you know?

Breastfeeding saves employers sick days, saves the parents money, saves the environment because there is nothing that goes into manufacturing it. Breastfeeding mothers should be offered a tax credit by the government.

That’s all well and good, but considering my child has a medical reason why he needs hypoallergenic formula, could I get a tax break too? Breastfeeding is free, at least according to the person who made the above comment… special formula is expensive. I could really use some extra cash from Uncle Sam to pay for it…not to mention the thousands of dollars I spent on lactation consultants, pumps, etc. when I was struggling to nurse.

When doctors give free well baby visits to those who are breastfeeding exclusively, that will increase the rates, too! I knew a doctor who did this in southern California many years ago..

Wow. I’m not even sure what to say about this one. Can we at least include children whose parents had a legitimate reason to feed formula in the mix? Oh yeah… then we’re back to that other sticky wicket: who determines what makes a “legitimate” reason?

A recent journal article showed that more pediatricians now have negative attitudes about BF and a lack of faith in women’s ability to effectively BF than in 2004. Women turn to their baby’s pediatricians for knowledge and support. We must provide better education to them and skills training regarding human lactaion & supporting BF.

Umm… could this be that pediatricians, the EXPERTS on child health, might not be entirely convinced that breastfeeding is the magic elixir it has been made out to be? (Again, I am not saying that breastfeeding doesn’t have many wonderful benefits…but I believe people should do it because they want to, not because they are scared or guilted into it, and I’d bet that a lot of pediatricians feel likewise.) They should support breastfeeding, without a doubt – I know there are doctors out there who make things hard on nursing moms, and that is inexcusable – I would suggest finding another doctor if you’re in this situation – but the fact that many have “negative attitudes and a lack of faith in a women’s ability to nurse” could just be a result of seeing too many women struggle, with negligible results for their children’s health. As my pediatrician said, “Nearly all my patients are or were breastfed for at least a year, and let me tell you, we get PLENTY of sick kids.” She believes that daycare is more a problem than what the kid is eating in that first year.

Using that logic…we’re back to longer, paid maternity leaves for all parents – gay, straight, formula feeding or breastfeeding… wouldn’t it be nice to see that as a “Call to Action”?

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