Breastfeeding and Leukemia: Old news is no news

By the time you read this, many of you are probably already in panic mode.

 

The news outlets are probably heralding the news of a NEW study, PROVING that breastfeeding reduces a child’s risk of leukemia, or the unfortunate corollary, that formula feeding raises a child’s risk of developing this cancer.

 

Take a deep breath. This “study” is actually a meta-study. Meta-studies are often considered the highest level of research, since they are synthesizing data and ruling out certain study findings based on quality criteria, thus weeding out the “bad” studies and only showing us the ones with results worth caring about. They are very useful, because one study alone doesn’t tell us much; many high-quality studies, when looked at together, can give us a much better feel for what the reality of the research actually is.

 

But the same thing that makes meta-studies so useful can also be their fatal flaw. If the body of research they are considering “quality” is not actually that high-quality at all, then the results they get are far less impressive. As Joan Wolf has suggested, if you do the use the same poorly-designed study protocol one hundred times, you may very well get the same result. But that result comes from poor design.

 

That’s basically what’s going on in this study, Breastfeeding and Childhood Leukemia Incidence: A Meta-analysis and Systematic Review. Despite numerous references to controlling for “quality” in the studies they chose, there is no discussion of which confounding factors were controlled for in any of these studies:

 

Selection criteria for the present meta-analysis included articles researching the association between breastfeeding and childhood leukemia… Studies had to be case control for the purpose of the statistical analysis; have breastfeeding as a measured exposure and leukemia as a measured outcome; include data on breastfeeding duration in months, including but not limited to, 6 months or more (where relevant data were unavailable in the publication, the authors of the studies were contacted); and been published in peer-reviewed journals with full text available in English. Two investigators… independently searched the literature, reviewed and assessed the articles, and decided on inclusion. We identified 25 case control studies examining the relationship between breastfeeding and childhood leukemia risk, 7 of them were not included in any previous meta-analysis.

I looked up most of the studies they referenced, and they were pretty similar to the general quality of infant feeding studies (in other words, lacking a lot of necessary and relevant controls).  And sometimes, it wasn’t even the study authors’ faults – because the design of the study didn’t really allow for much control, or because they just didn’t focus that closely on breastfeeding. For example, one study they referenced as “high quality” had “never breastfed” as one of many factors they examined for correlation to leukemia. And yes, “never breastfed” had a moderately higher rate of leukemia- but so did “having eczema”.

 

On a positive note, since the study did not/could not control for exclusive breastfeeding, but rather just “breastfeeding to six months”, this might mean that the benefit could be conferred even for supplementing or combo-feeding moms, which is a type of breastfeeding more women are finding it possible to do. That also suggests, to me, that more research needs to be done into the mechanisms behind this benefit – for example, did they control for the type of formula used? Is it something in the formula, or simply something that the formula is lacking? Did they control for the reasons the babies stopped breastfeeding in the first place? Could introduction of solid foods have something to do with it (the six month aspect is intriguing – why not a great benefit at 4 months? 5 months? What is so important about that 6 month mark)?

 

It would be far more interesting and newsworthy to see a metastudy which really controlled for confounders – one that only used studies which did their due diligence in controlling for everything that can screw up infant feeding research, and discussed how they went about this.

 

And something else: remember the outrage when an interviewee on this blog hypothesized that there might be a association between insufficient feeding/brain injury in the neonatal period and autism? The consensus was that it was premature to even speak of a possible association – to even put the idea out there – which I fully understand (again, those were the physician’s views, not mine – I do not have a sufficient understanding of this particular body of research to even converse intelligently about it). Yet, some of the same people who have run this physician over the rails for merely suggesting her hypothesis, are the first to jump on the not-breastfeeding-causes-cancer bandwagon. And that’s just hypocritical, because you can’t be raging about scaring parents unnecessarily, and then in the same breath, scaring parents unnecessarily. Until we have a figured out exactly how breastfeeding until 6 months may prevent leukemia, there is simply no reason to believe it’s anything more than an association.

 

This science isn’t my biggest concern with this one, however (mostly because there was no science involved in this particular study – just an analysis of other people’s science). I’m far more interested in how the authors jump to the conclusion that breastfeeding is a “highly accessible, low-cost public health measure”, as quoted below:

 

The meta-analysis of all 18 studies indicated that compared with no or shorter breastfeeding, any breastfeeding for 6 months or longer was associated with a 19% lower risk for childhood leukemia (odds ratio, 0.81; 95% CI, 0.73-0.89). A separate meta-analysis of 15 studies indicated that ever breastfed compared with never breastfed was associated with an 11% lower risk for childhood leukemia (odds ratio, 0.89; 95% CI, 0.84-0.94), although the definition of never breastfed differed between studies. All meta-analyses of subgroups of the 18 studies showed similar associations. Based on current meta-analyses results, 14% to 19% of all childhood leukemia cases may be prevented by breastfeeding for 6 months or more.

CONCLUSIONS AND RELEVANCE

Breastfeeding is a highly accessible, low-cost public health measure. This meta-analysis that included studies not featured in previous meta-analyses on the subject indicates that promoting breastfeeding for 6 months or more may help lower childhood leukemia incidence, in addition to its other health benefits for children and mothers.

 

“Highly accessible”  is not exactly an accurate representation. As I said to reporter Tara Haelle for Forbes.com, “Women have clearly gotten the message that “breast is best” – in fact, reduction of leukemia risk is one of the benefits public health posters like to emphasize, as it packs an emotional punch. This is not “new” news.” And if women weren’t finding it easy of possible to breastfeed for 6 months before, despite being freaked out that their kids might get cancer because of it, this reiteration of old news isn’t going to change that.

 

I actually think it would be amazing if they did discover some factor in breastmilk that could reduce cancer. It’s certainly plausible; we’ve already seen evidence of cancer-fighting properties in breastmilk, via lab studies. But our goal should be isolating that factor in a way that we might recreate it, or at least mitigate the risks to babies who cannot receive their mother’s milk, rather than using it as a motivating factor for breastfeeding promotion.

 

Why? Because there always have been, and always will be, children who cannot  or will not get breastmilk from their mother for 6 months. We have always needed and desired alternatives. If we can focus on finding out why there is an association between breastfeeding and leukemia risk (and again- take a breath, because there have also been studies that showed no significant correlation between the two, so it’s certainly not an open and shut case), maybe we can mitigate that risk for those who are not breastfeeding. Now that would be something worthy of some juicy headlines.

Note: For some excellent reporting on this study, please see Forbes.com and USA Today. 

 

It’s Not About the Brelfie

For obvious reasons, I get excited whenever the media takes notice of how formula feeding parents are feeling.

That’s what happened yesterday, when the media (and my email, Twitter and Facebook feed) exploded with the news of a new campaign meant to fight back against breastfeeding pressure, using the hashtag “#bressure”. When I first read the articles about the movement, I noticed the positive (attention to the experience of “failing” to meet breastfeeding recommendations) and ignored the references to the “brelfies”, breastfeeding photos which apparently spurred the campaign in the first place. I even sent a letter to the creators, praising them and asking if the FFF community could contribute in some way.

But as the day wore on, red flags started popping up. First, a fellow blogger alerted me to the fact that the survey conducted by the Bressure movement alluded to breastfeeding selfies as “sexualized”. Then, every single article I read focused on how these (apparently sexualized) “brelfies” were directly causing pain and suffering to bottle feeders. Instead of talking about the systemic issues that create a cycle of guilt, fear, and competition, we were once again dragging the conversation down into the mommy-war gutter, pitting woman against woman, and continuing the seemingly endless divide between breastfeeding and formula feeding moms.

This is not progress.

I’ve run a modestly large international community of formula feeding parents for the past six years, and I know several truths:

1. Formula feeders are a diverse group, just as breastfeeders are a diverse group. There are militant, intolerant formula feeding parents who truly do believe that women shouldn’t breastfeed in public, just as there are militant, intolerant breastfeeding mothers who believe formula feeders are selfish, ignorant, and useless. I wish we could vote them all off the island, but alas, such is life. The problem is that we’re letting these factions monopolize the conversation. This is EXACTLY why we started #ISupportYou, to which there was a rather vocal backlash from the intolerant/militant faction, on both sides.

2. The media loves drama. It is so much more fun to blame “brelfies” for the pain we formula feeders endure, because then the extremists come out of the woodwork and create mile-long comment sections, boosting your traffic for the next few days. It is also easier to get inflammatory quotes when nuance is ignored. Nuance doesn’t get web traffic or media attention. Trust me on that one; I speak from experience.

3. Seeing breastfeeding photos is undeniably difficult for those of us who wanted to breastfeed and couldn’t, or feel conflicted about our choices. When we’re feeling vulnerable and judged, it can definitely feel like that model/celeb/Facebook friend’s breastfeeding selfie is intentionally meant to twist the knife a little deeper. But that shouldn’t stop a mom from posting a breastfeeding photo, any more than you should refrain from posting a shot of your newborn when your second cousin is struggling with fertility issues. Both of you have the right to your feelings – your pride, her grief. (That said, there’s the social media-era problem with all of us comparing ourselves to others, posting things we’d never say to someone’s face, and basically acting like insensitive jerks every time we hit “post”.)

4. The breastfeeding selfies themselves are not the problem, but the  ”#breastisbest #breastfeedingmomsrule #whatsyoursuperpower hashtags can be construed as an attack on formula feeding moms. That’s not me telling you to stop doing them, just explaining why the photos might hurt your best friend who switched to formula three weeks ago. That is not me telling you that the cause of normalizing breastfeeding isn’t important, just explaining why there might be better ways to achieve the same goals without adding to the conflict. Just like this latest “bressure” video series could have had a hugely positive impact, if the impetus behind it didn’t sound like bitterness and jealousy and a who-has-it-worse competition.

5. There’s enough anger, misunderstanding, and generalization on both sides of this debate to fill several football stadiums. When the media chooses to focus on something trivial (“brelfies” – for the love of god, who though of that term) instead of the real issues, we all lose. Personally, it makes me feel like I might as well jump in my DeLorean and head back to 2008, because what the hell have I wasted the past 6 years of my life on?

6. The top reasons that formula feeders are angry, based on my totally unscientific, not-peer-reviewed but at least peer-collected research, are the following:

We are made to feel like inferior mothers by medical professionals, websites, fellow moms, lactation consultants, mommy-and-me group leaders, and the media.

 

We get no guidance or education on bottle feeding from professionals, and when we seek it out, we get conflicting info peppered with constant reminders of why we really should be breastfeeding, so why even bother attempting to find the best type of formula, since they’re all crap, anyway?

 

The reasons that breastfeeding advocates and the media give for us “failing” to meet their recommendations are so far from our lived realities, it’s hard to believe we exist in the same dimension.

 

Everything having to do with babies these days – from conferences to books to radio shows – focuses on breastfeeding. If bottle feeding is mentioned, it’s typically in the context of Things To Avoid At All Costs Unless You Really Have to Go Back to Work In Which Case You Should Just Pump or At Absolute Worst Use Donor Milk.

 

Yes, there are many breastfeeding advocates who come to troll on our pages and provoke our anger. And yes, there are formula feeders who will do the same on breastfeeding pages. Ignore these people. They do not matter. There are more of us middle-ground, moderate folks than there are of them.

 

While mom-to-mom cruelty is certainly a part of the problem, we know that there’s a much larger battle to fight – the battle of scientific illiteracy and paternalistic advocate-physician/researchers who are blinded by a religious belief in breastfeeding. If the bullies didn’t have certain unnamed, infamous physicians leading their charge – people who encourage the shaming and ridiculing of formula feeding parents – they wouldn’t have so much power. If society had a better understanding of the reality of infant feeding research, and could acknowledge that correlation and causation are two different animals, it would take away the fear and guilt, on ALL sides.

We just want to be equal with you. Not better. We’re not even asking you to think that formula and breastmilk are equal – that’s a question of science, of risk/benefit analysis, and individual circumstance. All we are asking is that we do not equate the type of liquid going into our children’s bellies with how much we love them, or how bonded we are with them, or how strong/capable/dedicated we are as parents.

 

This is not about photos. This is not about who has it worse. This is not even about breastfeeding and formula feeding, anymore. It’s about how we view motherhood as a competition, how the powers that be monopolize on this competition, and how the media loves to encourage it. Instead of focusing on brelfies or bressure, let’s get the hell off Instagram and start making an impact in our own communities, with our own friends and fellow parents. Ignore the hype, and focus on the help.

A picture tells a thousand words. But they don’t have to be negative ones.

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A Mother’s Day Wishlist

As you’re all aware (provided you haven’t DVR-d past those jewelry commercials and avoided the card and party aisle at the drugstore), this Sunday is Mother’s Day.

Beyond the usual Hallmark cheese, our new digital age has ushered in a new wave of delights in honor of the occasion: viral videos showing (in a imperceptibly condescending manner) just how hard this mothering gig is; flowery status updates about the importance of motherhood clogging up your news feed; and, come Sunday, an onslaught of staged “Mother’s Day 2015″ photos from your friends, perpetuating the myth that all of us are perfectly coiffed, perfectly happy, perfectly perfect moms who are perfectly adored by our children.Mums-Jewelry-Gifts

Don’t get me wrong – I like it. My kids make me great gifts in school (like the card Fearlette brought home yesterday, which included her guess of my approximate age as “72″ and my height as 2 feet, which is totally accurate). Sometimes, I get to sleep until 8:30, which is heaven. I’m not kicking this holiday out of bed.

I just wish that, instead of overpriced flowers and jewelry, generic sentiments and hero worship, we could get what we really need for Mother’s Day.

Like subsidized maternity and paternity/partner leave, because having a newborn is hard, and being all alone with what amounts to a tiny terrorist (or several terrorists, if you have multiple children) is easier when there’s two adults around. Safety in numbers and all that.

Like a prenatal experience that actually prepares you for taking care of a baby, and doesn’t pretend that every woman has a supportive partner, money to burn, and the desire to breastfeed, birth naturally, and quit her job.

Like a hospital experience that respects your wishes to breastfeed or not to breastfeed, and is mother-friendly as well as baby-friendly, because pushing a baby out of your vagina/ having major surgery is kind of hard work. Not that being born isn’t hard, too, but why can’t we be friendly to both mom and baby? And while we’re at it, friendly to partner-parents, too?

Like a world that accepts that the term “good mother” doesn’t have one definition, and that what works for me and my child might not work for you and yours, and that’s a beautiful thing, because we aren’t robots. (At least not yet.)

Like more inclusivity for adoptive mothers, on this holiday and every day, because growing a child in your body isn’t a prerequisite for the title of “Mother”, nor has it ever been, or ever will be.

Like an Internet that gives us all the good stuff – support, information at our fingertips, a way to connect with the world even if we’re housebound, stuck inside with a immuno-compromised preemie in the dead of winter/having a hard time getting out of our pajamas, but leaves the bad stuff behind, like the judgment and smug pseudo-science and mommy-board trolls and my-way-or-highway bullies.

Like safe, clean, food-secure environments for all women and their children, because it’s so easy to forget that as we fight about feeding our babies, some women can’t feed themselves.

Like partners and/or family members and/or friends who are always there for us, and who have been given the tools to support us while we are breastfeeding but also respect when we decide not to.

Like care providers who acknowledge that postpartum depression and anxiety are real, and prevalent, and treatable, and worth prioritizing over general recommendations from the World Health Organization or the AAP.

Like accessible and judgment-free lactation assistance and bottle-feeding assistance, without having to take out a second mortgage to afford the help.

Like the realization that mothering extends beyond the first year, and that we will face all sorts of challenges as our kids grow which will give us an opportunity to be amazing or screw it up, and thank god for that, because too many parents have that ripped away from them, and we are so, so lucky to be able to screw our kids up for as long as we can.

Like health recommendation messages that are backed up by hard science but also humanized, because they are being delivered to a group of people who just got hit with a Mack truck of change and upheaval, and who are living in constant fear of all those .001% risks that you make sound like very real possibilities.

Like a magic solution to all the mother-on-mother competition and turmoil, because while it’s human to judge and question, our utterly inhuman method of communication has taken it to an insidiously harmful place where we hide behind screens and levy our judgments without ever having to endure the impact this has on those being judged. The jury of our peers is the least just.

Like a promise that we will stop pressuring women into using their bodies certain ways; assessing their strength and power by their bodily functions; and forcing them into narrow categories based on how they birth, feed, diaper, and transport their babies.

Like any of these things. Even just one.

Or you know. Something from Zales.

Happy Mother’s Day, fearless ones,

The FFF

 

 

 

FFF Friday: “No one is going to completely understand how difficult it is for you, except you.”

In the early days of Fearless Child’s life, I used to feel caught between a rock and a hard place. Or, more accurately, between a pump and a crying baby; between feeding my child, and caring for him. To keep up with his needs, I had to pump around the clock. This wouldn’t have been a problem, except that my husband went back to work a week after FC was born, and we had no local family, no help. So, when I was pumping, I couldn’t hold him. I couldn’t rock him, or walk with him in the sling, or do any of the things that would soothe him when he was inconsolable. I couldn’t even feed him, because I was too busy milking myself for his next meal.

The irony wasn’t lost on me, but I continued, because…. well, we all know why. Because we’re told that providing breastmilk is the most important job a mother has. Not loving your baby, or responding sensitively to his particular needs, but simply providing milk for him. And while there’s no doubt that giving him the “ideal food” is important, when every parenting decision is an exercise in risk/benefit assessment, it’s easy to see why some of us – like Whitney, who has written this week’s FFF Friday – decide the bad is outweighing the good.

Happy Friday, fearless ones,

The FFF

Whitney’s Story

When I was pregnant, I knew I was going to be breastfeeding my child. “Breast is best” is the slogan that a pregnant woman, and the public in general, sees everywhere. There are commercials, billboards, and internet ads dictating that breast feeding is the best choice for a growing baby. I thought that too. I knew there was no way my baby was going to touch formula. To me, formula was poison. It was what people who did not care fed their children, and I looked down on any woman who fed their child formula instead of breastmilk. It is so easy, natural, and FREE I thought. Then, I had my baby.

My daughter is perfect in every way. She was born 6 lbs and 19 inches with the tiniest mouth I had ever seen. When she opened her mouth to cry I noticed the thick attached upper frenulum, but did not think anything of it. She started breastfeeding well in the hospital, so well, in fact, that the pediatrician asked if I had other children. I felt awesome. I was rocking this breastfeeding thing. Then, we came home. Little one stopped eating. Completely. We came home at 11 am and she still refused to latch on until the following day when my mom ran out and bought me some nipple covers. She was able to latch a little better, but only for about 5-8 minutes, and then she was done. Then we would spend the next hour with her crying and me crying and frustrated trying to get enough milk in my daughter. We would take an hour break, and then we would start again. I went to a lactation consultant and she said that it possibly could be due to the frenulum attachment. I asked the pediatrician about cutting it, but she wanted to wait and see if it detaches on its own. Eight weeks this went by, and I was exhausted. I was angry at my baby. Why couldn’t she do this? Why did this have to be such a struggle. I envied the mothers posting happy breastfeeding pictures online, while I lived on the couch, an hour of feeding, an hour break. Every day. Something had to change, but I didn’t want to.

I started to exclusively pump and bottlefeed. I had bought widenecked bottles for Avie before she was born since they were supposed to be easier for breastfeeding infants. Of course, she could not use them at all, and I had to go out and buy standard sizes. At this time, I was also worried about having enough milk once she started daycare (more on that later). I started pumping and  freezing, and gave her formula occasionally. This was such a hard decision, but I wanted her to get some sort of breastmilk as long as possible, and I did not make enough to feed her and store extra. I had no clue about what formulas to try, or even how to prepare it, but through reading blogs and trial and error we learned. I felt like a failure. I had a friend, who does not have kids, tell me, “oh my sister had a hard time too, she had to use covers, her nipples were bleeding and cracked too, ect ect,” and she gave me “the look.” We all know what the look is.  The automatic judgement look of  ”I cannot believe that women is feeding formula to her baby! She is so lazy, and her baby is going to suffer for it.” My friend had no idea what my struggle was and how it affected me and my child.  I could care less about how breastfeeding was painful, but I did care that my baby wasn’t eating. No one is going to completely understand how difficult it is for you, except you.  What we should have, though, is empathy. From that point on, I internalized my feeding struggle. I was embarassed and did not want anyone to know my child had formula. However, things were better for my baby and me.quotescover-JPG-62

Once I started work, things changed. I have a job in which I work out of the car. I am a home health pediatric therapist and spend 30 to 45 minutes at a patients home, and then I drive 30 minutes to the next patient. It takes me an hour and a half in the morning from the time I leave my home, take my daughter to daycare, and then arrive at my first patients house. Then, I have 5-7 patients a day, driving over 100 miles, with my furthest patient being 50 minutes from my house in no traffic. Needless to say, it was hard trying to find time to pump. Usually it would be 5 hours between my morning pump and my next available time to pump. I pumped in the car on a daily basis. I even pumped while driving. I don’t recommend. I would massage myself if I could not pump, until I felt the let down. I took Fenugreek capsules, up to 10-12 of them a day. I did everything I could to keep milk production up.  Since my job does not involve being in an office, my company does not have to go along with the guideline of Obamacare stating that a breastfeeding  mom should be provided with a room with a sink and adequate time to pump. In fact, my company did not care when I told them I needed time to pump in the car. Instead, they told me I needed more numbers, and said I needed to start seeing two patients that were an hour away from the patient that was right before them.  I broke down and told them no. The alternative was for me to drive around with the just out of college male office recruiter. Yes, because I was really going to be able to pump that way. I felt like all they cared about was making money off me while sending me driving around unsafely trying to pump every free chance I had. I wonder how a company specializing in pediatrics can treat their breastfeeding mothers this way, but I have digressed. Needless to say, my milk production declined, and my stress about it rose.

When Avie was 6 months old, I had to undergo a minor surgery to inject cortisone and hyaluronic acid into my hip. I have avascular necrosis which is too far along for surgery, so this is my only option until I get a hip replacement. At 27 years old, I want to wait as long as possible. I did not realize that cortisone could decrease milk production. After the injection, I got 2 ounces out the rest of the day. I spent the next 3 days (it was a long weekend), pumping for 30 minutes every hour and a half except 6 hours at night until I brought my production up to 12 ounces a day. I was even more stressed about pumping as often as possible to maintain this production. A month later, I had a cortisone injection in my knee for the same complication as my hip. I had to go through the whole pumping for 30 minutes every hour and a half for three days situation again. I wish I was exaggerating. But, I am not. This time my production went up to 6 ounces a day. You may wonder why I would have gone through with another injection after the results of the first one. Well, I had hip surgery 4 years ago that never fully resolved. I always had some degree of pain. In the 9 months  prior to my injection, I was unable to walk without severe pain. I was unable to go up stairs or even the slightest incline. I could not take a single running step on my left leg, could not hop, and could not bear weight on just that leg. I walked via a step to pattern. This is not an option for a pediatric physical therapist, and I could not tolerate it any longer. Now my pain has decreased immensely and I am so grateful for my doctor.  I feel like I am trying to justify my decision to put my health needs over my babies breastmilk needs for all those women out there who refuse to acknowledge that formula may be a better option for certain women. I, nor any other woman, should have to feel this way, but so many of us do.

During this time, I started losing weight. I gained 24 lbs when I was pregnant. I went from 106 to 130. When my daughter was at 5-6 months I went down to pre pregnancy weight. Then, two months later I had lost 13 more pounds. I weighed 92.8 pounds. I had not changed my eating habits, albeit they were not the greatest. Since I don’t get a lunch break and I was pumping during free time, my lunch consisted of snacks in the car. The stress of trying to pump as much as I could, yet only getting .5 to 1 ounce every 30 minutes I pumped was taking its tole.  There is another slogan. “Every ounce counts”. When it takes you 30 minutes to make that ounce, 30 minutes that you could spend time with your child, or get work done, or just relax, I promise you, that ounce does not count. I had to do something. So, when my daughter was 9 months old, I had to quit.

Quitting pumping was one of the hardest decisions I have made. My mother, a pediatrician, was pressuring me to continue pumping even though I made so little. I felt like a failure when I stopped and I felt ashamed. I still am a bit ashamed, but I should not be. I live in a predominately white, middle to upper class, bubble of a city. A majority of the moms around me stay at home. I can feel the judging when I take out a water bottle and formula mix versus a boob when I am at a restaurant. I can see the judging on the face of others when they ask if my daughter is breastfeeding.  Apparently, that is a common topic among mothers. I know there will be plenty of people out there who probably think I did not try hard enough or think they would have kept going no matter what in my situation. If I did not go through this, I would probably be that arrogant too. Here I go again, trying to justify my decision for a group of women who no matter what the circumstance, believe that formula should never be given. (Yes, I read too many blogs where these women come out of the woodwork). They have no idea how hard I tried to give my daughter milk; how much my health and relationship with my child was sacrificed. But you know what? In the long run breastmilk vs formula does not matter. No one is going to care that my daughter received formula when she is entering kindergarten ( and if they do care, they have issues of their own). My daughter is happy. She is healthy. I am happy; the happiest I  have been since my daughter’s birth. In the month since I stopped, I have gained two pounds and I get to actually spend time loving on my child when I get home from work instead of fret while pumping.

I wish judgement of moms by other moms and women would come to an end. Wouldn’t that be a sight to see. All moms supporting each other instead of trying to prove they are better than each other.  If you choose to breastfeed: Great. If you choose to use formula from day one: Great. If you choose to breastfeed and it does not work and you try formula: Wonderful. You have chosen what is best for your family, and no one should make you feel less because of it.  I am sick of the breastfeeding campaign throwing stats down our throat, and people interpreting it to be if a child is not breastfed he or she will be dumb and sickly.  That is just not true.  I do not want anyone to have to go through the struggle and the feelings of inadequacy that I went through.  My child is being fed, I love her, and she loves me.  She is a happy, healthy 10 month old, and an incredible miracle. That, above all else, is what is most important.

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

FFF Friday: “Motherhood and martyrdom aren’t the same thing.”

The stories I receive for FFF Fridays tend to fall into three categories: those who never wanted to breastfeed, those who couldn’t breastfeed for physiological reasons, and those who ended up formula feeding due to situational and/or emotional reasons. 

I want to make one thing very clear: in my mind, they why’s shouldn’t make a difference to anyone but you. Choosing formula or having the choice made for you only matters because of how it affects your experience (ie, are you grieving the loss of the breastfeeding relationship, or do you feel relief after a traumatic experience with it). It does not in any way affect how I see you, or how anyone else should see you, or how you should see yourself. It does not make you a bad mother. It makes you a formula feeding mother. That’s it.

Still, I also think it’s important for people to voice their feelings and their personal truths. So if someone needs to explain how they “had” to choose formula, that’s okay. In a perfect world, no one would feel like they have to give an excuse. In a perfect world, like Kate says, no one would ever ask “why”.

But we don’t live in a perfect world, so there’s FFF Friday.

Happy Friday, fearless ones,

The FFF

***

Kate’s Story

To everyone who would like to know how I will feed my next baby:

Firstly, it’s good to know you’re interested. I worry about how you’ll respond to my answer, which might be delivered at you with a one-word sentence: “Formula.”

I might not say any more, because this is a hard one for me to discuss.

It’s a difficult decision to talk about because we live in an era where our choices as mothers tend to be driven by particular ideologies. As it happens, I do subscribe to the “Breast is best” ideology in theory. It’s a tired old aphorism which has often been quoted at me by well-meaning individuals oblivious to my own circumstances. Sure, perhaps breast is best in a scientific sense, or in a health and wellbeing sense. Very few would dispute this.

Unfortunately, due to the gap between ideology and reality, breast was not best for me. Breast was not even possible for me. Most importantly, it didn’t work for my baby, and probably won’t be for any future babies.

I started off wanting to breastfeed. Apparently, 97% of Australian women do begin this way. (This is possibly related to the way it is relentlessly promoted by grim Nazi-style midwives, and the cruel manner in which formula feeding is openly belittled. Am I a bad mum for ‘choosing’ formula? No, I’m not – but it wasn’t really a choice, as you’ll discover.)

Here’s what breastfeeding did: purely and simply, it starved my baby. Initially, she wasn’t even going to be allowed home from hospital because she had lost too much weight. My breasts bled each time I tried. Nurses alternately (and incorrectly) attacked me for not ‘latching on’ correctly and then suggested that my baby might have a tongue tie. (They were correct about this, as it happens. I have nerve pain to this day because of a problem that wasn’t diagnosed until it was much, much too late.)

So I saw a lactation consultant. (If breastfeeding is so natural, why are there so many professionals whose job it is to help us with it?) I didn’t get any answers. She was brusque and frustrated. “Just try harder” was her general advice. New mothers are in an incredibly vulnerable situation, and of course you want to take all advice on board. So I tried harder. I won’t bore you with the details, but it was both time-consuming and ultimately disheartening.

My baby couldn’t sleep because she wasn’t being fed. I couldn’t look after my baby because I was too busy hooking myself up to a breast pump. Night after night, every couple of hours, and I still couldn’t produce enough. I sat there, freezing and crying in the dark with shrivelled up, hideously bruised breasts – one on a pump, the other attached to an unhappy infant.

My baby cried constantly.  I couldn’t look after her – I didn’t even have the time to take care of her and be the inadequate labouring milk-producing machine I had reduced myself to becoming. I didn’t play with her. I didn’t even have time to eat properly. All was sacrificed to the ultimate goal of the “liquid gold” I had been promised. I was a mental wreck – I felt shivers of pure panic whenever she woke up, because waking meant feeding. There were nights where she would latch on for an hour and sleep for 15 minutes.

The milk bar was closed, against the wishes of its owner.quotescover-JPG-53

Later on, I was to realise that the combined effects of gestational diabetes, a caesarean birth, my baby’s tongue-tie and a condition called insufficient glandular tissue had all conspired against me. The fact that I feel compelled to give a medicalised explanation implies that I still feel defensive about the whole business. Well, you’re the one who asked about it.

I’m not sure why we all feel free to inquire about every mothering decision, especially given that, regardless of how I feed, I’m still Top Dog in my baby’s life. No one has as much of an interest in her as I do. I have the legal and moral right to make decisions about what works for both of us.

The first time I fed my daughter formula was possibly also the first time she slept properly. She didn’t look cross and anxious as she had before. She knew I cared about her enough to make sure she was nourished.

As opposed to putting myself first. Realistically, why was I breastfeeding? I thought it was expected. Most people I know could do it without too much worry. I didn’t want the judgements that came with formula feeding. The worst reason to do anything is to satisfy others. But, at the time, I thought I had to live in this miserable manner. I looked in the mirror and saw a tired, stressed martyr in those days.

Here’s the secret: motherhood and martyrdom aren’t the same thing. I’m Catholic, so I know a few things about martyrs. They all make amazing sacrifices for strong beliefs. They generally go against the grain of their times and are individual and counter-cultural in the way they live and die.

You can’t be a martyr to breastfeeding! Nor can you base your decisions on the expectations of others. The only person whose opinion I care about other than my own is my husband’s, and he supported me because he was the only one who saw and appreciated what breastfeeding was doing to me.

So, whenever I’m blessed with another child, it’s straight to the bottle. I hope my next child will smile and laugh as much as my little girl now does. She’s great. She’s never been sick. No one’s going to look at her in a year’s time and know how she was fed.

I am immeasurably angry that I live in a society which seeks to define my worth as a mother by how I can or can’t use my breasts.

For those who struggle with breastfeeding and don’t give up, I have only admiration. I wish them success, though not at the expense of their own health or their relationship with their baby. For my own sanity, I had to realise when it was time to put the whole experience in the ‘too hard’ basket.

I hope that answers your questions.

Most importantly, I hope it also makes you realise that you were wrong to ask questions in the first place

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

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