FFF Friday: “I don’t think I have ever felt quite so judged about any other parenting choice.”

So much of the conversation on infant feeding focuses on first-time mothers and their breastfeeding experiences, for understandable reasons. But that also makes it easy for some to dismiss these experiences as simply “misconceptions”, “nervousness” or “inexperience with breastfeeding”.

But what happens when a third-time mom has twins, and despite the fact that she breastfed successfully twice before, she finds herself dealing with unexpected complications? Turns out, in Michelle’s case, that mother ends up dealing with the same emotional turmoil, conflict, and confusion as the first-timers. Because breastfeeding problems are not the sole property of any “type” of mother, of any age, socioeconomic group or ethnicity, or parity. These problems can strike any mother – and when they do, each and every one of us deserves support, respect, and the opportunity to make the best decision for our families. 

Happy Friday, fearless ones,

The FFF

***

Michelle’s Story

When I found out that baby #3 was going to be baby #3 and #4 I was understandably excited and nervous. One one the first things people commented/questioned me about was whether i was going to try to breastfeed them. My answer was always that I would play it by ear and see how it went.

The twins developed something called TTTS (twin to twin transfusion syndrome, which can happen when identical twins share a placenta) and I was hospitalized for 6weeks with daily ultrasounds and monitoring, to make sure the babies were still okay. Every day I worried that one or both babies had died. It was not a relaxing pregnancy.

My babies were born at 31 weeks….tiny but perfect. They spent 6weeks in the NICU and I spent those six weeks pumping every 3-4 hours and making trips back and forth to the hospital while also trying to care for my other two kids who were not quite 2 and 6. I was generally NOT at the hospital for feedings, but the girls were getting my milk, first through an NG tube and then when they got better at suck/swallow/breathe, through a bottle. When they were getting close to discharge, the nurses told me to buy bottles and I was clueless and overwhelmed because I had always breastfed my others and had never used a bottle. I had requested a lactation consultant to help me transition them from bottle to breast, but she told me to nurse them and give them bottles afterward if they still seemed hungry. Prior to their discharge, I had attempted putting them on the breast exactly one time and it was not what in would call a rousing success.

They were discharged at 37 weeks and they were still incredibly sleepy and not interested in working for their food. I continued with nursing, bottle feeding, pumping every 3-4 hours. I was attached to the pump. I was miserable . I got in touch with a different LC who was more helpful and over the course of a week or so, I got the girls to latch and eat and finally I could be rid of the infernal pump.

Around 40 weeks the girls woke up. And they screamed. They screamed and they screamed and they screamed. They were miserable. I contacted the same LC again and she thought maybe I had oversupply. I worked on that. The babies continued to be miserable. I took them to the pediatrician who said some babies are just miserable and despite the fact that I had experience with two other babies, I had not had experience with twins. The girls still screamed. Finally when they were around three months old I read about milk protein intolerance and decided to eliminate dairy from my diet. There was much less screaming. There was still some though, and their stools were still showing signs of further intolerance, so I stopped eating soy also. That seemed to be the magic thing. Finally, I had happy babies (their bowel movements still seemed weird, but they were happy, I was happy…everything was finally good in our world). They were five months old at that point and I was finally enjoying them.

Fast forward to their weight checks. The older they got, the less they were gaining. They started out at three pounds, were almost five pounds when they came home at 6weeks old, and at five months were eight pounds. At six months they were up a couple more ounces each. We were going to the pediatrician for weight checks weekly and they were gaining, but slowly. Nobody suggested formula (I had on occasion used nutramigen when I got too touched out and needed a break. They also suffered from pretty severe reflux and wanted to nurse ALL THE TIME. I had tried a “gentle” formula once and it had resulted in immediate screaming that lasted two days, so that solidified my belief that these babies could not tolerate any dairy).

At their NICU developmental follow up appointment at almost 8months, the neonatologist was very concerned about their weights. At first they were recommending physical therapy, but he thought that if they started growing that it would not be necessary. They were 8 and 9 pounds and had been within 6 ounces of that same weight for at least 10 weeks. He suggested me doing an elimination diet and also supplementing with puramino formula 2x a day to see if that would help. I was already struggling without dairy/soy and feeding the rest of my family, so I was not thrilled about an elimination diet. I was not thrilled about the prospect of formula either. I thought long and hard about it, and decided to give them the formula and go back to eating what I wanted. I continued to pump just in case, for about three weeks. I watched my supply dwindle. I initially struggled with guilt, despite the fact that in the month they have been on the formula, they have each gained THREE pounds. There are rolls of chub on their legs! They are finally thriving and I love seeing them grow (they are almost 9months old now).

Nobody says “Good for you for feeding your babies!”. People insinuate that I didn’t try hard enough, that if I were a really good mother I would have gone on the elimination diet. One lady told me that I finally gave in to the evil medical establishment and that I should go back to breastfeeding. I don’t think I have ever felt quite so judged about any other parenting choice. I hate that I feel like I have to explain how we got to this point and despite me resolving NOT to explain, I feel oddly compelled to anytime anyone comments (which they all do immediately upon seeing a bottle).

One thing these babies have taught me is empathy. I never really understood empathy like I do now. I am much better able to put myself in someone else’s shoes and not be judgmental (secretly or otherwise).

I am so incredibly grateful that i found FFF when I did. My healthy thriving babies are glad also!

***

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

FFF Friday: “Why is it giving up? Why isn’t it just stopping?”

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.

FFF Sara sent me this excellent post, which was originally published on her own blog. I felt it was worth re-posting here, especially in the wake of some of the recent conversations on the Facebook page. Like recently, when I asked why so many of us felt the need to preemptively justify our choices (or lack thereof), explaining why we were bottle feeding every time the subject arose. Your responses, as always, were brilliant. And I’m working on a post about this very topic as we speak. In the meantime, though, I think Sara’s post illustrates one of the fundamental reasons we might seem defensive: if you have tried to breastfeed, and stopped, you may be feeling how Sara felt – that you are seen as a “quitter”, someone who “gives up” rather than  someone who simply tried something, found it didn’t work, and stopped. The implication that we have “given up” leads to justifications and narratives focused on how hard we tried.  

Ultimately, there will always be someone who feels they were a bigger martyr, or someone who feels because they got over something similar, you should have been able to as well. The people who will judge will judge, and if they’re not judging you, they’re using your words to judge someone else – how many times have we heard “well, it’s okay because you tried,” as if we get a free pass to the Good Mother Club? Respecting choices means we need to stand up for women who choose to formula feed for any reason, even if we don’t personally understand those reasons. Otherwise, we’re just paving the way for more drama for future generations of mom, and that- well, that just sucks donkey balls.

Happy Friday, fearless ones,

The FFF

*****

Sara’s Story

The longer I’m a mom the more perspective I get on how things went for us and the delivery and first few months. It’s no joke that your in the haze of emotion and trying so hard to do the best you can, when you really don’t have a clue what to do at all. And, one of the areas I find that I’m still most sensitive about is breastfeeding and all the “advice” I got while trying to be successful.

I wasn’t successful, but I’m okay with it because I feel like so very much of it was things I could not avoid or foresee.

Most of you know that Julia was premature. Not by a lot (in terms of prematurity), but by enough to matter. What I’m saying is I didn’t get to attend the classes I wanted to (I was actually still a patient myself) and read the books I had planned. Instead I pumped for two and a half weeks until she came home. We thought she was nursing well in the NICU, but it turns out she wasn’t. She had a tongue tie, but we didn’t know that until she was almost six weeks old.

And, all the while we supplemented (which, of course, was started in the NICU once she began eating). And, I pumped. I pumped at every feeding for two months. I pumped after nursing. I pumped when I missed a feeding. I pumped when I would be away from her during a feeding. I felt like I was strapped to the pump. Which is exhausting.

But, my point is this: It’s okay to stop nursing or to never start. Looking back, I wish I hadn’t spent so much time/ money/ effort/ emotions on the whole process. There’s so much that screams, “this is the best for your baby and you aren’t doing all you can if you give up”. Give up being key words. Why is it giving up? Why isn’t it just stopping?

I mean, doesn’t all of parenting just come down to choices we make. My husband let me make the choice about when to stop, but he was supportive of whatever I decided to do. And, don’t we all try to make the choices we feel are best? Does any parent make a choice thinking it’s harmful in any way?

I write this because I’ve had more strangers than I’m comfortable with ask about how I (we) feed her. It’s none of your business!!!

I’ll say it again just to drive the point home. It’s okay to feed your baby formula. And, I’ll be the second (my husband would be the first) to say that breastfeeding is not free like books and people would have you believe. Ha! On the contrary, we spent a lot of money trying to be successful. When you add up the pump, the supplements, the lactation consultant, the surgery, the hospital pump rentals, the creams and pads and bras, etc. it was a lot of money.

I now know in my head the reason I was so hell bent on being successful was because I felt like in some way I should have stayed pregnant longer so she would have been full term. (Like I had any control over that.) Or that pumping was the only thing I could do while she was in the hospital. But, now that I’m on the other side of it I know I just couldn’t keep up due to other circumstances. That I have no control over.

I hope that hospitals continue to be baby friendly and promote breastfeeding. But, I also hope that we’ll all be a bit more mom friendly and not make new mothers feel like they are somehow failing if they choose not to. It’s a choice. Let’s support each other in those choices. Please?

***

Share your story with the FFF community: email me at formulafeeders@gmail.com.  

Ready-to-feed formula may prevent Cronobacter infection in babies

I love when I’m right. I mean, it happens so infrequently (at least according to Fearless Husband).

Even before the Cronobacter scare of 2011, I’d dramatically changed my tune about formula preparation and safety. The research I read surrounding bacterial infection in babies due to formula or bottle use made me see just how piss poor our education on bottle feeding truly is; this is what spurred my interest in starting some sort of pre or post-natal educational workshop/literature for bottle feeders, and also made me suspect that there was an astonishingly simple – albeit prohibitively expensive – solution to the bacteria problem.

Safety, thy name is Ready-To-Feed.

Until now I’ve merely been able to suggest that my personal belief is that ready-to-feed nursettes are the safest bet for newborns, and especially for late pre-term babies or those with any sort of compromised immune system. Now, a study published in Pediatrics gives scientific credit to my completely unscientific gut feeling.

I’d say squeeeand do a little dance of egotistical joy,

but unfortunately I can’t. Because we are talking about infant safety here, and the solution which this study is suggesting is not going to be feasible for many parents due to the cost involved. This is turning my happy ego dance into a sad waltz. Which sucks, because who doesn’t enjoy a good happy ego dance?

The study, Prevention of Invasive Cronobacter Infection in Young Infants Fed Powdered  Infant Formulas, looked at the records of 68 babies infected with invasive cronobacter between 1958-2003, and 30 babies between 2004-2010. A couple of things to note before we get into the nitty-gritty of the study:

1. Invasive Cronobacter infection is extremely rare, and usually affects pre-term babies and very young neonates (all of the infants reflected in these records were under two months old).

2. This study had some significant limitations, considering that it was conducted using records from a variety of international organizations (CDC, USDA, WHO, as well as “personal communications” and “publications”. Definitions might have varied, as well as the quality of the information. This might explain the shocking disparity between the cases reported in the older batch (1958-2003) and the newer batch (2004-2010).

Now that the caveats are out of the way, let’s continue. The study found very different statistics in the two chronological batches. In the older batch, only 24% of the babies were full term; out of the more recent cases, 58% were full term. That’s a radical leap. Plus, while in the 1958-2003 group only 21% became symptomatic at home, that percentage jumped to 52% between 2004-2010. This may have something to do with the fact that there were half the number of cases in the more modern group versus the older one; if bacterial contamination was becoming more rare, then perhaps we’re dealing with a newer or more virulent strain in the new millennium. But I also wonder if part of the disparity between the characteristics of the cases has to do with the lack of formula feeding guidance. The resurgence of breastfeeding since 2000 has led to many fantastic outcomes, but the downside, as we’ve discussed before, is a refusal to address the needs of formula feeding parents. Historically, concerns about bacterial infection were focused on NICUs; the tubing used to deliver food to the tiniest babies could easily become contaminated if the utmost care wasn’t taken, and given the fragile systems of premature or sick infants… well, it wasn’t a great combination of risk factors. But looking at the statistics used in this study, it seems that in the past 12 years, full-term babies in their parent’s care – at home – were equally at risk. I think it merits further reflection, at least, to consider if these cases might have been due to parents being given no guidance or support with formula feeding. We know from our numerous conversations here, and on the FFF Facebook page, that most of us were given ample education on breastfeeding (even if we didn’t get much practical support); very few of us were instructed on how to formula feed safely, sometimes with the excuse from more intolerant healthcare professionals that there was no “safe” way to formula feed.

Regardless, even if we were given better instruction on safe bottle feeding practices, very young infants fed powdered formula are at significantly higher risk of becoming ill from invasive cronobacter. The Pediatrics study found that out of all infected infants studied, 26% had received breastmilk, 23% had received RTF, and 90% had received either powdered infant formula or human milk fortifier (which is another caveat I forgot to mention – powdered human milk also posed a significant risk, not just powdered formula. Apparently Cronobacter loves powder of any sort).

Okay- just so we are crystal clear here – the lowest percentage of infected babies came in the group fed ready-to-feed formula only. It even beat breastmilk (not by much, but I think it should be mentioned, since it would be if it were the opposite). So it’s a no-brainer that the study’s author then recommends the following:

Invasive Cronobacter infection is extremely unusual in infants not fed powdered infant formula/Human Milk Fortifier. RTFs are commercially sterile, require minimal preparation, and are competitively priced. The exclusive use of breastmilk and/or RTF for infants <2 months old should be encouraged.

I’ve been advising that newborns use RTF whenever possible for awhile now, but every time I do I feel like a classist a-hole. Because let’s be honest – the stuff is expensive. Even if you buy the 32-oz containers rather than the more costly (but sterile) nursettes, you’re still talking a major difference in cost for the recommended two months of use. And those first 2 months, there is a lot of wasted formula – babies are erratic, not on a schedule, parents are still figuring out hunger cues… it takes a few months before you know Junior will take exactly 4 oz every 4 hours. Powdered formula is significantly cheaper. And god help you if your baby ends up on a hypoallergenic – buying the RTF version of that stuff will seriously kill your bank account.

The big elephant in the room, of course, is that the formula typically given away in those controversial hospital swag bags is ready to feed – often in the form of sterile nursettes. Not that the amount in the bags would feed a baby for the entire two month window of risk, but the bags I received – generously “supplemented” by the maternity ward nurses since our breastfeeding-friendly hospital didn’t have many formula feeding mothers and there were plenty of leftover bags – gave me enough formula to get us through the first few weeks. Every little bit counts.

Now, I’m not naive enough to believe that the formula companies are giving away RTF out of the kindness of their hearts. But considering that the Ban the Bags movement has grown in popularity, and hospitals are going Baby-Friendly right and left – they are going to need an alternative way to market their products. Why couldn’t we set up a program which would give parents that have chosen to formula feed (or supplement) before leaving the maternity ward to request a “gift” of ready to feed formula? Formula companies could still reap the rewards of brand loyalty, and look somewhat altruistic in the meantime. The parents who receive these samples could be the same ones who already were forced to sign documentation which labeled them as formula feeders, so what would be the harm?

There needs to be a way to provide supplementing and exclusively formula-feeding parents with the safest breastfeeding substitutes possible. In the first two months of life, ready-to-feed formula is the safest commercial alternative. If the formula companies would be wiling to provide at least a few weeks of RTF to take the financial edge off, it might help parents afford RTF for the subsequent 6-7 weeks.

Seems like a no-brainer to me, but then again… you know what Fearless Husband says. I’m hardly ever right.

 

 

A couples therapy session for Science and fed-up parents

You know how I’m always harping on and on about how we could be doing studies that actually help us protect infant health, rather than guilt-tripping mothers? My fairy godmother must’ve been listening, because today I stumbled upon an interesting article, courtesy of Mammals Suck (maybe she is a fairy godmother? Scientists can be fairy godmothers, can’t they?)

Featured on Nature.com, the article described two findings about the sugars in breastmilk. The first discovery was that one of the human milk oligosaccharides (HMOs) – the sugar molecules present in breastmilk –  can actually increase the chance of mother-to-child HIV transmission.

The molecule, called 3′-sialyllactose (3′-SL), is found in varying concentrations in the milk of different women. In a study in Zambia, HIV-negative newborns breastfed by HIV-positive mothers are twice as likely to catch the virus during their first month of life if the mother’s milk has an above-average level of 3′-SL1.

Doesn’t sound like the most positive news, but wait: only certain women’s milk contains significant enough levels of the sugar to place their babies in danger. Plus, other sugars have a positive effect:

The same study in Zambia found that five more of the 150-odd complex sugars in breast milk seem to have a protective effect. HIV-negative infants who consumed these sugars had a better chance of reaching their second birthday than did HIV-negative babies who drank breast milk lacking those sugars irrespective of their mothers’ HIV status. (Once a baby had caught HIV, however, breast-milk sugars had no influence on survival.)

 

The second part of the article described research into why some babies are not able to fight off necrotizing enterocolitis (NEC), despite being fed human milk. Breastmilk contains oligosaccharides that fight off this deadly infection – but as it turns out, not all women produce these sugars:

 (A team) reported an association between a dangerous gut disease in babies called necrotizing enterocolitis (NEC) and the inability of affected infants to secrete a suite of oligosaccharides in their mucus. These babies are considered particularly likely to benefit from drinking the sugars via breast milk, but about 10% of European women cannot make them in their milk…

 

Okay, so this is where it gets really interesting. Both of these examples suggest that depending on the composition of a particular woman’s milk, the health benefits of breastfeeding may not be identical across populations. A researcher quoted in the article hypothesized that “(t)he often confusing literature on breast feeding’s impact on disease will be largely explained by this underestimation (of the variation in human milk).” The article also explains how “(s)everal labs are trying to identify how variation in the prevalence of the large sugar molecules in breast milk… influences infant health. Once clear links are established, clinical trials to test HMOs as health-boosting additives in infant formula milk can be drawn up.”

Say WHAAAAAAAAT??

Yep, you read it correctly, FFFs. And I think we can all take a moment for a collective sigh of relief. Not all researchers are so entrenched in their  public policy advocacy efforts that they forget to see the forest for the trees! Not all lactation scientists are lactation consultants! Some are – dare I say it – scientists.

I fear that this is the type of research that gets pushed under the rug, because it requires critical thinking. There isn’t an easy soundbite that can appeal to the masses – in the first example, the answer is not to tell HIV+ women in developing countries to use formula until they are tested for the specific HMO, because formula feeding in resource-poor countries with contaminated water is a high-risk activity. But perhaps more research could lead to some sort of treatment which would help these women lower their levels of 3′-SL and increase the beneficial HMOs.

Similarly, what if a preemie’s mom wanted to get her breastmilk tested to see if it contained the necessary HMOs to protect her baby? And if she found that she was part of the 10% who didn’t produce these beneficial sugars, perhaps that could allow her to make an informed decision about using donor milk, while either pumping to keep up her own supply, or deciding to switch to formula once the baby was older.

Research like this allows for progress. It allows us to understand exactly what it is about breastmilk that makes it so beneficial, which might lead to better, more biologically “equivalent” options for women who can’t or choose not to breastfeed. But even taking it away from the infant feeding choice powderkeg for a minute, I think it’s an interesting thing to ponder why certain people are so uncomfortable with the suggestion that not all breastmilk is perfect milk. I mean, I understand it – who the hell is science to tell a woman that her milk isn’t “good enough”?

But people – this is exactly why we can’t be wishy-washy about whether breastfeeding is a personal act or a monitored, medicalized event. If we are going to pitch it to women based on statistics, telling parents that science has proven the medical necessity of nursing our young, then we must accept the risk that science could turn around and say “erm, you know what? I messed up. That’s only true for some women. Some gals just produce inferior milk.” While we might want to say screw you, science, and the horse you rode in on, we can’t. Because we used science in some very dirty ways when it suited our needs, and now it is hanging around like a rebound boyfriend who just doesn’t take a hint.

On the other hand, if we don’t allow medical authorities to lay down moral indictments based on the way we feed our babies, then we can easily kick science to the curb when it tries to tell us that our milk may not be all it’s cracked up to be.

Personally, I don’t think either scenario is great. As that Facebook group with the funny memes says, I f**king love science. Because I don’t think it’s true science that is messing things up for women. I think it is zealotry dressed up as science – people who are so committed to a cause that they are unable to come into research with the open, curious mind so integral to the scientific process.

So, I think as women, as mothers, it is safe for us to applaud research like this. We have to trust that knowledge can be power, as long as it is handed to us free of extrapolation. It’s not scary to hear that formula fed babies aren’t protected from NEC if donor milk is made available to preemie parents, or if we know that good old science is doing its best to create a supplement that could offer our tiniest babies protection regardless of the quality or quantity of a new (and often highly stressed, given the circumstances) mother’s pumping efforts. It’s not guilt-inducing to hear that breastfed babies have a higher IQ if we know exactly why this is – if it is an association, or something about the physical closeness during the act of nursing (which could easily be recreated by a bottle-feeding parent using a bit of imagination and less clothing) or something specific in the milk (in certain milk? Do some women increase their baby’s intelligence, and some women decrease it? Who the heck knows until we look into it?).

We can’t be scared of science, and we can’t abuse it. And scientists can’t be scared of staying neutral, and can’t abuse their power. If we can give each other this mutual respect, maybe we can turn this into a beautiful relationship. Even if it did start out as a rebound…

 

 

FFF Friday: I still feel a sense of shame…but I’m strong enough now to challenge it.”

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.

You may recognize elements of Fay’s story – she shared her experiences as part of the Baby Friendly informal poll earlier in the week. There’s a rawness here that might be painful to read, but it’s so incredibly brave of Fay to share her feelings, even when she hasn’t fully processed them. I think that for those in the thick of infant feeding hell, hearing triumphant tales from those who have risen from the ash can inspire hope; but just as importantly, the stories of those with one foot still caught in the postnatal version of Hades can offer solace, and the reassurance that they are not alone. I know that when I was going through my own struggle, reading something so powerful and brutal would have given me the gift of camaraderie, and the permission to feel whatever I was feeling. That’s an integral part of the healing process, too.

Also- I have to get political for a second here, and say that Fay’s story reiterates why posting warnings on formula cans is a damaging, ridiculous, and dangerous idea – and there’s a movement happening, right now, to make that idea a reality in Australia and New Zealand. Our friends down under at Bottle Babies are working hard to give voice to women who oppose this movement, and you can help them by taking a survey found here. As Fay says, “I was so, so scared of the formula tins – because they’re painted out to be so utterly utterly dangerous.” But what is far more dangerous is what this unfounded and ridiculous fear did to Fay’s mental health. We cannot allow this to happen to more women, over “facts” based on observational studies and rife with caveats. 

Happy Friday, fearless ones,

The FFF

**********

Fay’s Story

When I deal with (ok, so it’s normally more of a verbal fight if we’re honest) militant pro-breastfeeding women, it always seems that they have some kind of mental ranking of “acceptable” reasons to bottle-feed. I tend to find that quite quickly, when they hear my story, they start to backpedal and slot me into one of those reasons. That doesn’t comfort me – I don’t need the approval of women who get their own sense of validation by belittling other women to make themselves look good – but I mention it because it continues to make me raise an eyebrow, and gives me a wry sense of amusement.

Although I intended to give breastfeeding a good go – I never got into the full-blown adulation of breastmilk as some kind of wonderful force of amazement that could cure all ills. I sat with a degree of scepticism through the breastfeeding part of my ante-natal class as they proclaimed it as guaranteeing immunity from eczema and asthma (my breastfed younger brother had the worst case of childhood eczema his consultant had ever seen) and told us how we wouldn’t die from ovarian cancer if we breastfed (my grandmother, having breastfed five children, died from a tumour there the size of a watermelon). When they got out the knitted breasts and they’d used the remains of whatever wool they had to hand – and mine was blue – I couldn’t really keep a straight face… then they didn’t have sufficient baby-sized dolls to practice good positioning – so I got this tiny thing – cue the jokes about premature babies, and the oh-so-helpful comments about “well you can’t really practice positioning on something that sized as babies aren’t that small”… I shall return to that point later.

Anyway – I planned to breastfeed because, well – they’re easily portable, not something I’m likely to forget when sleep deprived and trying to organise getting ready to go out for the day (even in my most un-caffienated state ever I’ve not managed to forget my boobs yet), and I didn’t fancy the faff of making up bottles at 4am. Add in the fact that the guidance seemed to have been set to make formula feeding as utterly inconvenient as possible – and it wasn’t so much a reverence for breast being best – but breast being easiest that was pulling me in. I thought I’d have a healthy attitude to it, and be able to roll with whatever fate handed me… I was wrong.

Week 33 of my pregnancy, Easter Sunday to be exact, and I’m sat there happily tucking into an excessively large chocolate Easter egg from hubby – and I start to get cramping pains in my stomach. I dismiss it, in a “woo hoo I finally have Braxton Hicks” kind of way and continue chomping (hey – it was nice chocolate – these things MUST be done!). Then I realise these pains are coming every five minutes, dither for a bit, and we go into the hospital – assuming I’ll be checked out, monitored for a few hours and then we’ll be on our way home.

I didn’t leave that hospital for a good couple of weeks.

To cut a long epic saga short – my waters had begun to leak, I was kept in to get the steroid injections to mature the baby’s lungs and, after a very traumatic, badly handled birth on the part of the hospital which isn’t really relevant here but included such noteable highlights as me being denied pain relief for 3 1/2 hours – but offered aromatherapy – which didn’t go down very well, and me doing almost all of my dilating on two paracetamol (which I think carries me bonus “mummy points” for being well-hard)… my daughter arrived at 33 weeks gestation, as a 4lb tiny little blue thing.

We were set up to fail from the start.

No skin-to-skin, no warm fuzzy fresh baby time – I didn’t even get to see her as she was rushed past me to NNICU. When they’d finished repairing the scene of devastation that was formerly my womanly bits, I was wheeled into the neo-natal unit, still completely numb from the waist down – and they pointed at her incubator… then kicked me off the unit and up to the ward for the night. No chance of bonding, no chance of even mentally processing that this was my child.

I was dumped on a darkened maternity ward and the Government leaflet on breastfeeding slung at me. When I pointed out that, since my baby was currently in an incubator, wired up to god-knows-what, and nowhere near me, that this might NOT be the opportune moment to be giving me this leaflet – the verbal barrage started and the leaflet, accompanied by the nurse, flounced out of the room. I just lay there – not quite able to deal with everything that had gone on – and kind of wondering what exact use the breastfeeding leaflet WAS to me, that night at 1am, with my baby nowhere near me, and no one looking much interested in helping me start to see if I could express some colostrum. Surely they didn’t expect my boobs to reach down the corridor, take a lift and get through security onto the ICU?!

The night, the worst night of my entire life, passed eventually and I was wheeled down onto the NICU and allowed to hold this tiny tiny creature. Remember the comment about the tiny doll at ante-natal… where it was dismissed as “babies don’t come in that size”… well mine apparently did. No one had prepared me for how to handle something so small – let alone manouver her onto my very large at the best of time breasts. Someone on the unit took pity on me and helped me try to express some colostrum – but then I was put into the first impossible position… “We’re going to put a feeding tube down your baby’s nose, your milk hasn’t come in yet so we’re going to give her formula… which brand?” Utterly numb from it all – I just let them choose and then had the horrible experience of watching them fit what would be the first of many NG tubes. They sorted me out with a breastpump nozzle and a steriliser – did a little bit of token helping me to try to get her latched on – but it was very much a “throw breast in vague direction of baby and hope it sticks” type of help. When you’re dealing with a tiny baby, with wires everywhere and this huge long tube dangling out of her nose – everything is about a hundred times harder to handle anyway… she couldn’t latch – she’d lick at the nipple like a kitten lapping milk – but that was it.

Time passed, I pumped and my milk came in (but weak in supply) – I fed what I could pump down her nasal tube, topped up with formula, but despite trying and trying and trying – she couldn’t latch, or when she could, she couldn’t maintain the latch – she was too small, too weak, too sleepy to do so. Add in the incessant interruptions of hospital life when you’re lying there half-naked fumbling away trying to get a large breast into a tiny baby, and the fact that ALL our breastfeeding lessons had been totally ignorant of the possibility of premature babies and how different it is handling them – and we were getting nowhere.

Because of various other circumstances surrounding the birth, and the fact that I was having to live on the maternity ward from hell, with no option to leave the hospital – and my mental health was starting to suffer. Trying to get her to latch every feed with no luck, having to do all her NG tube feeds, and pumping every two hours was absolutely destroying me. The tipping point came one night when I was talking to one of the staff whom I’d got very close to (she’d had a premature baby herself) and mentioned I had no idea how long we were going to be prisoners on the ward for, and she mentioned it was going to be an additional 2-3 weeks MINIMUM for us to be allowed to leave breastfeeding. Since we STILL had no sign of any progress with her being able to latch on, I asked for a bottle to try to feed her some of the expressed milk that was going down her feed tube… and she took, and I can still remember the figure now, 12 mls of the 34 mls she was taking at that point in time – and I cried. I cried with relief that I’d seen her ACTUALLY feed, by mouth, like a normal baby. And I cried because it was the first sign I’d had of any tangible progress, and because I’d been able to hold her close and provide that for her, rather than lie her down and hold a tube up in the air after a few fumbled breastfeeding attempts each feed.

Yes, I sold her out in that I took the “easy” route. I regret deeply that her mum wasn’t strong enough to stick out trying to get her to latch but I figured at least if we went home with me expressing, I’d possibly keep my options open and be able to get her to latch on when she got nearer being full-term. The amount she took by bottle rose steadily each feed and within a few days they were talking about removing her tube and sending us home. By this point I was taking domperidone and sniffing aromatherapy oils to try to increase my supply – but I was doing it, and she was feeding, actually feeding, and they took the tube out, and she did it all on her own!

So they let us go home, and I pumped, and I pumped, and I pumped… and dad did all the feeds, cuddles and being a parent thing… and I pumped, and I pumped… and we didn’t go out because I always needed to get home and pump… and I spent hour and hour and hour cleaning and sterilising breastpump parts.

I tried to get her to latch – with no luck. I tried nipple shields – no luck. All anyone gave me in terms of advice was “more skin-to-skin”… so I added that in among the interminable pumping. By now, my breastpump motor was starting to fail, as was my supply – but I kept going. In addition to it feeling like the ONE bit of my “mummy” hopes and dreams that HADN’T gone to hell because of her prematurity – the pro-breastfeeding camp, the propaganda about formula being akin to cyanide, the fear of how on earth did I make up feeds correctly (because they don’t give you that information easily any more for fear that it makes formula feeding “normal”) kept me going.

And I hit a wall – as she hit full-term, and STILL couldn’t latch properly – my supply was gone, my pump was really almost dead and my freezer stash had run out. We bought formula, and I sobbed so hard when we fed her it. I felt as though I’d sold her out by not sticking out the hospital – but I know if I had done, the toll it was taking on my mental health was so bad I would have attempted suicide soon, and I felt as though I’d failed her so badly as a mother – that my body had failed her and she’d been born too soon, and that my willpower had failed her in that she wasn’t breastfed. And I was so, so scared of the formula tins – because they’re painted out to be so utterly utterly dangerous. I remember once wailing to my husband that “I’m feeding her POISON!!!”

But I didn’t have a choice – circumstances had made the choice for me – she HAD to be fed.

And this 4lb little girl, sleepy and jaundiced who never woke and just lay in her cot… she’s thriving. She’s a ball of funny little baby who’s doubled her weight and is about to hit appearing on the growth charts and is catching up with her full-term peers fast. She’s not hitting milestones on schedule for her actual age (which she wouldn’t be expected to) – but she IS ahead of them for her age adjusted for prematurity.

Her mum’s doing somewhat less well, has PTSD from all we went through at the hospital in the NNICU, still feels guilt over it all, but is dealing with that – but does take pleasure every day in the biggest grins from the evil genius in training (she’s got the maniacal giggle down already) that is her little girl. I still feel a sense of shame if I have to bottle feed her in public, I still feel that I need to justify how she’s fed. I feel sadness and anger at how the hospital failed us in terms of their provision for preemie babies – but I’m strong enough now to challenge it.

And it isn’t the horrific faff and hazard that they made it out to be.

It’s not 100% positive, it’s not a choice I’m fully come to terms with – but there you go – my story.

******

Doesn’t matter if you’re still in the midst of your story, or ten years past it – telling it is important. If not to you, then to some random other parent on the internet. E-mail me at formulafeeders@gmail.com if you’re ready to share.

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