FFF Friday: “I made a choice and it was the right choice.”

There’s something so quietly profound about the quote I pulled out of Sarah’s story. “I wasn’t going to stop myself from being able to look after him in every other way in order to give him (breastmilk),” she says. That’s really the crux of our argument, isn’t it? That sometimes, you have to choose something that seems less than ideal in order to have what is truly ideal: a bond with your child, a healthy body, a functioning mind.

When you make those kinds of choices, you thank whatever deity you believe – God, Jehovha, Allah, Buddha, Science- for the invention of viable substitutes, that can fill in when the ideal is not ideal. And you know what? I thank him/her/it every time I look at my children’s ideal faces, marvel at their ideal minds, and treasure our ideal bond.

Happy Friday, fearless ones,

The FFF

***

 

Sarah’s Story

When I fell pregnant for the second time (first pregnancy was a miscarriage), I was asked by every health professional whether I planned to breastfeed. I was all for it, it was everything I wanted to do. I thought it would just happen naturally so I didn’t go to any classes and didn’t do much research on it at all.

My son measured big throughout my whole pregnancy and at 38 weeks he was estimated to be about 4.5kg. The doctor decided It was best to be induced which I really didn’t want but I agreed anyway. We had a date within the week and I went into hospital at 39 weeks and 1 day to be induced. Things did not progress overnight with a catheter inserted so I was put on the drip the following morning. I did not cope very well with the pain and I had an epidural which I was adamant I wasn’t getting before labour started! Baby was sitting funny so the pain of the contractions was gone, but I had back pain which lasted the entire time I was in labour. I was so exhausted I spent he whole day drifting in and out of consciousness. By 10pm the midwife told me I had fully dilated but baby’s head wasn’t descending as he was very big. I was terrified of the idea of a cesarian but I agreed. I was taken to theatre at around 12am I believe, I don’t have much memory of the day at all. I was hysterical with fear and exhaustion.

Finally at 1:30am my son was born. He was weighed at 4.9kg and wrapped in a towel and my partner held him on my chest for a few minutes. Suddenly I was passing out again, my baby was taken to nursery and my fiance kicked out of the OR. I don’t remember much except the anesthetist telling me I may need to be put to sleep. I came in and out of consciousness and at one point I was in recovery with nurses all around doing things. I was taken to the adult special care unit and I could barely move my limbs. I had oxygen tubes in my nose, three different canulas with lines going into my arms and i was so tired. My baby was no where to be seen but my fiance assured me he was okay, but hypoglycemic. He had already given him his first bottle in the nursery and while i was disappointed it wasn’t me, I understood why and I wasn’t upset. I was glad it was him that fed him.

The next day I found out I had lost 4 litres of blood when my tired uterus didn’t contract after my son was born. I was very anaemic and that was why I was so tired.  It had also tore bigger than the incision site and I wasn’t allowed to try for more babies for well over a year.  I was encouraged to attempt breastfeeding with the help of the nurses. I felt so overwhelmed with random people touching my breasts, telling me what to do and it was so painful. We didn’t have much success feeding and it was always painful despite being told it would get better it never did. We gave him formula bottles in the hospital after attempting to feed and he took to them very well. They told me because of the large blood loss my body was focusing on producing blood rather than milk. I was sent home on the 5th day after my son was born, still barely able to walk from cesarian pain. It took a week for my milk to come in and it was a very small amount, I tried pumping and I got less than 40ml from both breasts. I discovered I have flat nipples and it was very hard for my son to latch on and the whole experience was very frustrating leaving us both in tears. I began to resent my baby for the way I felt when feeding him. I then got an infection in my wound site and had to take pain medication which was unsafe for breastfeeding. I pumped the whole time I was taking them with the intention of trying again after I was off them.

quotescover-JPG-78

Afterwards I sought out the help of a lactation consultant at the hospital where I gave birth. I went in for weekly appointments and we discovered he was getting less than 30ml from each breast. He also had a terrible latch but we had most of this corrected. I tried nipple shields, I even borrowed a hospital grade pump from them and I was about to start taking drugs to increase my supply. I tried a SNS which was too fiddly for me and I couldn’t see myself using it in public. We were giving him bottles this whole time after every feed and I wish i had just stuck with them earlier.

The final stroke happened when my son was just under five weeks old. I was taken to hospital in an ambulance with severe abdominal pain. It was diagnosed as pancreatitis caused by gallstones blocking a duct. It was the worst pain I have ever experienced and I spent a whole night hooked up to morphine just to make it through. I was away from my baby for a week in hospital waiting for surgery to have my gallbladder removed. I missed him so much. By the time I got home my milk was completely gone and I was barely able to pick him up without pain, let alone feed him. I made the call to switch him to full formula feeds.

I struggled for many weeks with the guilt. I cried and cried about my traumatic labour experience, my inability to breastfeed, everything. I still don’t know what it took to realize that I had done nothing wrong. That I’d done my best for him and done the best thing for both of our health and sanity. My partners mother told me that she had formula fed all four of her children from birth, by choice. I don’t feel now that I was unable to breastfeed and was forced into formula feeding. I made a choice and it was the right choice. A stressful breastfeeding relationship was damaging my ability to bond with my baby, and health concerns meant I’d have to put my own health second, keep myself in pain just to give him breastmilk. I wasn’t going to stop myself from being able to look after him in every other way because I was sick, to give him that when it wasn’t benefiting either of us.
I wish there was more information and support out there for mothers who choose to formula feed. Bottle safety, how to prepare a bottle, etc. I have been lucky to not receive judgement from anyone except myself. Even the LC was very supportive with bottle feeding. Mothers, please start supporting each other and your choices. It doesn’t matter whether your baby is formula fed, breast fed or fed with expressed milk, as long as it’s done with love and care. My son is now a happy and healthy 4.5 month old who benefits from having a mum who isn’t stressed to the max while trying to feed him, and we have a beautiful relationship.

FFF: Furious Formula Feeders?

“The community of women who choose to formula feed, and the moms who have so many challenges with nursing that they formula feed, tend to feel that the lactation professionals are insensitive, pushy and overstate the amazing-ness of nursing a baby. And they are ANGRY!! Check out the Fearless Formula Feeder page and you will get a massive dose of angry. They seem to take so much personally and cannot seem to see the broader cultural ramifications of the formula companies’ marketing campaigns. They also do not seem to understand that successful nursing is time sensitive. It has to be initiated early after birth or there is really no going back.”

 

After seven years of working in the infant feeding space, I’ve become rather immune to criticism. There are people who will never understand why a site like this is needed; people who think what I do “promotes” formula feeding; people who don’t think there should be any sort of choice in how babies are fed. Recently, my Facebook readers were threatened by someone claiming they would be reporting them to social services for child endangerment, due to their feeding method. It happens. People suck, and all that.

But last night, I saw the above comment on the page of someone who claimed to be all about female empowerment, empowered choice, and sisterhood. This was someone I collaborated with – or, rather, allowed to use my image and words in a way that resulted in no financial compensation, favorable publicity, or support for my own cause (the exact opposite, actually – it was a film which portrayed formula as the devil and romanticized mostly white, upper class, celebrity women and their breastmilk). Someone I welcomed on the FFF page. Someone, I assumed, who respected that our opinions were different, but whose goals were ultimately the same: ensuring that mothers were informed, autonomous, and supported in their choices.

Seeing her comment did, indeed, make me “ANGRY!!”

Then, I started thinking… maybe she’s right. Maybe we really are ANGRY!!. For a moment, I felt self-conscious and defensive, wondering if I should post something sweet and positive to counteract this negative portrayal.

But then I stopped myself, because damn straight, I’m angry.

I’m angry that despite sharing hundreds of stories of what the “breast at all costs’ mentality does to women, the people who are responsible for perpetuating this culture refuse to listen.

I’m angry that these same people spend so much time and energy hating the formula companies, when the formula companies are not the ones mishandling women in the hospital, leaving IGT and other potential breastfeeding complications undiagnosed, ignoring the mental health needs of new parents, or forcing women to go back to work after a few short weeks in order to support their families.

I’m angry that they can’t see the difference between “anti-breastfeeding” and “anti-breastfeeding-extremism’. These are not the same things. quotescover-JPG-32

I’m angry that they continue to gaslight the women who come to me for help, sometimes suicidal, over their perceived “failure” to breastfeed.

I’m angry that they are allowed to be angry at anyone and everyone who doesn’t think the way they do, but insist on absolute complacency and infinite patience from us.

I’m angry that they think we are uninformed about breastfeeding, when the most common reason parents come to my page is that they were blindsided by formula feeding; they had read books and taken classes on breastfeeding, but never even thought of using formula. These women know more breastfeeding than most. They know about jaundice protocols, Thomas Hale, SNS feeding, galactogogues, tongue ties, lip ties, skin-to-skin, the magic hour, the breast crawl, good latches and bad latches, exclusive pumping, power pumping, and more. They know how important it is to breastfeed immediately after birth. There’s a reason nearly every FFF Friday starts with a scene in the delivery room.

I’m angry that some of the “new voices” in this debate are doing more harm than good, making claims that can’t be supported, confusing the issues, and making it harder for the rest of us.

I’m angry that my community members are told that they are victims when they don’t feel like victims. I’m angry that when they do feel victimized, they are dismissed, brushed off as unfortunate casualties in the War Against Big Bad Formula.

I’m angry that the formula companies continue to make stupid marketing moves, adding fuel to a fire that should’ve been extinguished back in the early 1980s.

I’m angry that “celebrating moms” always means “celebrating breastfeeding”. Moms should not be celebrated for feeding their babies. They should be celebrated for doing a job that is often hard and thankless, for bringing home the bacon, frying it up, and cleaning all the dishes afterwards before putting the kids to sleep and working on tomorrow’s quarterly reports. I’m angry that this myopic focus, this fetishizing of what should be a perfectly normal act, marginalizes adoptive parents, primary caregiving fathers, and anyone without working mammary glands.

I’m angry that moms can’t nurse in public without it being a fucking federal case. Literally.

I’m angry that moms don’t get sufficient support in the hospital for breastfeeding – especially if they are young and/or non-white.

I’m angry that parents get no support whatsoever about formula feeding, and that parents in the UK need to preemptively bring their own supplies if they think there’s even a chance they might need or want to supplement. (Has anyone else thought about how this might be more self-sabotaging than having formula available in the hospital? Not that I think either is actually self-sabotaging, but for those constantly making that argument… let’s use basic logic for a minute.)

I’m angry that my use of formula is somehow threatening to your efforts to encourage other women to breastfeed.

 

I’m angry that women insist on battling each other in these snarky ways, like life is just one big junior high school. Grow up. Grow. The. Hell. Up. There are so many problems in the world – you really want to spend time arguing about whether we feed babies breastmilk or a perfectly viable substitute? Is live and let live really that hard a concept? Do you really have nothing better to do than tell random women on the internet how they are Doing It All Wrong? And formula-feeding moms who hang out on breastfeeding sites to cause trouble – I’m talking to you, too. You’re part of the problem. Making shitty comments about breastfeeding moms, who have just as much right to community and support as you do, is hypocritical and mean. Mean girl behavior is not “venting”.

I’m angry that comments like the ones above leave my community no choice but to stay silent. If they respond, and say what they want to say, they sound ANGRY!! If they don’t respond, they are silenced. Neither is an attractive or empowering choice.

I’m angry that I still feel the need to write posts like this, when my kids are in elementary school. I am angry that I care. I am angry because it doesn’t change anything, and I’d probably be a much happier person if I never said the word “lactivism” again.

So yes, I am angry. In fact, I am ANGRY!! And I’m sure much of it is self-imposed, because I could be focusing my own efforts on something more important, like the Syrian refugee crisis, the poverty and inequality in my own city. I could be focusing this energy on my children – sometimes I think that formula feeding made me a better mom, but Fearless Formula Feeder made me a pretty crappy one.

As for the FFF community? Sure, I suppose they are ANGRY!!, too. But no more than they should be. And if they are talking and venting and crying and supporting each other on my page, they are handling that anger appropriately. They have a safe space to work through that anger – but there are many people who want to take that away from them. “Concern Trolls” who repeatedly post inflammatory pieces (and if you’re going to argue that “information” isn’t ever inflammatory, ask yourself: would you post a piece on how easy it was for you to get pregnant on an infertility support page? Or an article about a plane crash on a Fear of Flying support group?), “experts” who try to school them, people who don’t believe they have any right t feel bad because formula feeding is so prevalent. (So is obesity. Doesn’t make the kid who gets relentlessly teased in school for their weight feel any better.)

Most of my readers work through their anger, and move on. Many go on to breastfeed future kids, armed with the knowledge they now have that there’s no such thing as failure. They understand relative risk. They know how to spot problems, and what can and can’t be done about them. They aren’t trapped in the sticky spider web of dogma. They know they have a soft place to land, should things not go as planned.

ANGRY!! isn’t a bad thing. ANGRY!! is what makes us act up, speak out, and create change. ANGRY!! is a healthy, justified emotion when you’ve been shamed, mistreated, embarrassed, ignored, and insulted. ANGRY!! is empowering, as opposed to sad, depressed, lonely, ashamed.

So yes, you’re right. We are ANGRY!! We don’t enjoy it. We don’t want it. We want to move on and be HAPPY!! CONFIDENT!! ACCEPTED!!

Maybe if you could just let us be, you could let us be.

_______

The following are some additional comments sent to me by FFF members, reacting to this piece.

“Well yes I am angry. I am angry for being bullied into breastfeeding even though it was clearly not the right path for me. I’m angry my sons were left to go hungry and get sick because nobody would believe I wasn’t producing breast milk. I’m angry my midwives believed in breastfeeding at all costs. I’m angry there were entries in my post natal notes essentially calling me lazy and not trying hard enough to breastfeed. I’m angry that “normalise breastfeeding” has caused the vilification of formula feeding. I’m angry that I have been made to feel like a second rate mother who is poisoning her children and condemning them to a life time of low intelligence and obesity. That is, of course, if they survive child hood at all. I’m angry that I am supposed to laud and bend over backwards to accommodate breastfeeders but the courtesy is never returned. I’m angry that twaddle like “only 2% of women can’t actually breastfeed” is bandied around and taken as gospel, despite there being no respectable scientific research into such a claim. So yeah, I am angry. But as I usually say, if you kick the dog long and hard enough, sooner or later it will bite back.” – Emma

“What it comes down to is that unless you agree with the lactivist mentality that breastfeeding is a child’s “birthright” and that it’s the “end-all, be-all” of infant nutrition, then you wrong, misguided and angry. In reality, we are standing up for what we believe in just as much as they are standing up for their beliefs. However we believe in a women’s right to choose, to keep her bodily autonomy while still nurturing her children. And above all we lift one another up as mothers. I’m proud to be a part of the latter side.” – Deanna

“Being angry about having your body policed and having your parenting choices judged and shamed is a completely legitimate feeling/thing. Or are we as women only allowed to ever be happy or sad and anger is never ever appropriate?” – Nikki

“I wonder what the end game is if they actively alienate women who chose to, or had to, formula feed. I wonder, do they really care if we breastfeed? If so, do they think this kind of hurtful rhetoric will be a useful tool in convincing women to try breastfeeding again with the next child? Or are they just turning women off to their agenda through causing them pain? I for one have found the most support and kindness in caring for my child in the ff community, so I’d stick with what worked to keep myself and my family healthy and safe. It just seems so disingenuous that they are trying to “help” through hurting people. I don’t think they give a fig in the long run what I or any of you do, or for the health of our children. They just want to stare into their own reflections in solipsistic fantasy.” – Jessie

“I’m not angry that I couldn’t breastfeed. Not anymore, at least. You know what DOES make me angry though? A bunch of sanctimonious women (and men too, I guess) telling me how wrong I am for feeding my children formula. You know what? Formula saved BOTH of my kids’ lives. And it saved my sanity! My kids are happy, healthy, and thriving.” – Tasha

“I’m not angry or disappointed that BFing didn’t work out for us. I really don’t care anymore. Shit happens. I’m angry about the way moms are treated and babies put at risk for something that doesn’t really matter.” – Amy

“It’s funny because I’m not angry at all. Formula helped my son’s life from the beginning and formula helped me through PPD and other issues with my two girls. Not angry, grateful.” – Shannon

” I honestly think we are entitled to stand up for ourselves. All of us have at least one, if not many more, stories of being shamed for feeding our healthy and beautiful babies. The whole reason we’re here is to receive support from each other, that we are amazing mothers and parents, regardless of how we feed. We aren’t here to just bash breastfeeding, we are here for each other when everyone else is bashing us. were an amazing group of women who need support. We may come off as angry, but if these individuals who bash were in our shoes, they would see just how wrong their opinions of us are.” – Alexis

“They don’t even get *why* I’m angry. It’s not about me, I don’t give two shits I’m angry for two reasons. 1-All of the lovely ladies and GOOD MOMS who come here with broken hearts because of how the lactivist community has treated them and 2- Because their judgement doesn’t end with their side eye and snarky comments, they are changing public policy (think BFHI and all the horror stories from WIC offices) and that affects all of us. I don’t care if you sit there and comment about my bottles til the cows come home, but when you’re changing policies based on bad info that’s dangerous.” – Maria

“As someone who had no desire to BF whatsoever I have never gotten used to the opinion that we’re not allowed to decide what we want to do with their bodies and we’re not allowed to get angry when people tell us we’re not allowed to decide– or act as if we are stupid or misled when I KNOW we are some of the most informed women when it comes to this issue.” – Nicole

 

“How can they read the stories of what the mothers and babies went through to establish breastfeeding, and still blame women and claim everyone can Bf!!. DARN RIGHT I am angry!!!!!. I bought the “everyone can breastfeed” BS. None of those brilliant nurses (who were also licenses LCs) managed to help my baby latch. My baby had hypoglycemia, jaundice and lost 10% of her birth weight within two days, under their ‘watchful eye’.” -Bahan

“The justification for why why “should not be angry” is both condescending and misdirecting. Also, I’m pretty sure a lot of us are way more educated on formula and breastfeeding, and have given far more thought about the rhetoric surrounding it and it’s implications than most people.” – Bethanny

“They’re silencing us, undermining our autonomy. ‘They make X choice because they’re angry and stupid so X isn’t valid'” – Stephanie

The FFF Database of Feeding Choice-Friendly Hospitals (and Choice-Unfriendly Hospitals)

The following is an international list of hospitals that have been recommended by parents who used formula, organized by country and state.

 I originally called this list “formula friendly”, but they are really just “choice friendly”. These hospitals get good reviews because they respect maternal autonomy and choice, and offer support no matter how a family decides to feed.

Please note that hospital policies change periodically, and these reviews may no longer be relevant. I always suggest asking about their infant feeding policies on the hospital tour, and making sure you write your desires for feeding in your birth plan. For more advice on handling breastfeeding/baby-friendly initiatives, please click here.

Glossary: 

“Baby-Friendly” or BFHI = hospitals that have received accreditation from Baby Friendly USA, a breastfeeding initiative. BFHI hospitals are required to promote and protect breastfeeding by following “10 Steps to Successful Breastfeeding“. 

RTF = Ready to Feed formula. In this context, this usually means the hospital provides sterile, ready-to-feed “nursettes” which are the considered to be the safest, easiest way to formula feed a newborn. 

BF or EBF = Breastfeeding or Exclusively Breastfeeding

EFF = exclusively formula feeding

Formula-Friendly Hospitals, by State and Country

These hospitals received positive reviews from formula-using parents

UNITED STATES

ALABAMA

Grandview Medical, Birmingham, AL – “The LC even offered to go get me formula when she could tell how upsetting and stressful breastfeeding was for me. They always ask my choice before I have the baby and have never made a negative comment about formula.”

Brookwood Medical Center, Birmingham, AL – “They had excellent lactation specialists who were happy to help, but I caught zero judgement for supplementing with formula and they sent me home with tons of samples.”

 

ARIZONA

Banner Thunderbird Hospital. Glendale, AZ

Mercy Gilbert Medical Center, Gilbert, Arizona-  “Tells you on the tour that they are a breastfeeding hospital, but I went in and had my son and said we wanted formula right from the start, no questions, no guilt. I think the nurses are on the “as long as you’re feeding the baby” bandwagon.”

Abrazo Health Scottsdale Campus, Phoenix, Arizona. “Helped me breastfeed and willingly gave me formula when I asked for it; had no issues.”

Banner Estrella Medical Center, Phoenix, AZ. – “They asked during delivery if I wanted to breast or bottle feed. I answered, they wrote it on the board, and that was it. I loved that they didn’t pressure me in any way, and they kept my room stocked and answered all of my questions. No guilt at all. Totally supportive and I’m so appreciative for that.”

Del E Webb Medical Center, Sun City, AZ. — “They didn’t give me any trouble about formula feeding and even gave me a ton to take home… they were super sweet and supportive about it.”

 

ARKANSAS

Sparks Regional Medical Center, Fort Smith, AR – “When I said formula they gave me a case of 12 RFT bottles, and put it in the bassinet drawer. They gave me more cases on demand when I ran out. They gave me feeding tips. They had no problem taking my daughter to the nursery at night so I could sleep. When I was being discharged, they asked me if I had some formula at home, and gave me a couple cases to take home with me (along with three large packages of diapers, six pacifiers, and a digital thermometer.)”

Willow Creek Women’s Hospital, Johnson, AR – “Once I stated my preference, they were great. Kept us stocked with the ready to feed nursettes.”

CALIFORNIA

Scrips Memorial Hospital, Encinitas CA – “Was a “baby friendly” hospital meaning they were very pro-breastfeeding to the point they did not accept free formula from formula companies. I had to ask for every single bottle I fed my baby and didn’t get any extra formula sent home with me because they kept their formula held tightly but they were very respectful of my decision to formula feed from the start without insisting I give them any sort of explanation and there was no pressure to feed my baby another way and I never felt judged by any of the nurses or drs.”

Scripps Memorial Hospital La Jolla, La Jolla, California (San Diego County) – “All three of my children were born here and all three had to be supplemented with formula pretty soon after their births. The nurses and lactation specialists were incredibly supportive and also sent me home with plenty of formula. About 24 hours after the birth of the my third child, I told them I needed an SNS (Supplemental Nursing System) and formula and I had both within 10 minutes. Then I did my thing, taped the tube to my nipple and fed my baby. The nurses just laughed and said “Looks like this isn’t your first rodeo!” I felt incredibly supported and cared for. I stopped pumping at 10 weeks and never looked back.”

Los Alamitos Medical Center, Los Alamitos, CA – “Asked how we were planning to feed, asked if we had a brand preference, gave some tips/instructions on timing and amount, checked in to see how it was going … no issues, no pressure whatsoever.”

 St Joseph’s Hospital in Orange CA

Kaiser Permanente Santa Rosa Medical Center, Santa Rosa, California –  “With my son I hadn’t specified what I wanted to do so they were pretty pushy with the breastfeeding but after telling them I was formula feeding my daughter, no ifs ands or butts, I didn’t hear anything else. They even sent in a lactation consultant to advise me on proper bottle feeding.”

Santa Rosa Memorial Hospital, Santa Rosa CA –  “Very respectful. I went in with a ‘we shall see what happens’ attitude and they didn’t give me any grief for supplementing early on. The asked if I wanted to see a LC and when I said no they didn’t push the issue.”

 

COLORADO

Avista Adventist Hospital, Louisville, CO – “Fantastic nurses and doctors, everyone was completely supportive of my choice to formula feed from the start with my second baby.”

 

CONNECTICUT

Danbury Hospital, Danbury, CT –  “No questions at all about why I was exclusively formula feeding.”

St Mary’s Hospital, Waterbury, CT – “They still had to do the BFHI survey but if you were forthright about FF from the get go, zero pressure.”

DELAWARE

Nanticoke Hospital, Seaford, DE. “They didn’t shove anything down our throats, offered whatever we needed. Did they encourage breastfeeding? Yeah. But did they also give her formula when she needed it? Yes.”

 

FLORIDA

Mease Countryside Hospital, Safety Harbor, FL  “It’s actually a baby friendly hospital (BFHI), but I formula fed both my sons and never got any pushback or comments from the nurses. Once I told them I was formula feeding, the LC didn’t even visit my room.”

General Hospital, Tampa, FL

University Community Hospital, Tampa, FL

 

GEORGIA

St. Mary’s Hospital, Athens, Georgia –  “Provided balanced infant feeding support both in breastfeeding initiation and postpartum infant feeding support. Formula was offered when it was clear we were having feeding difficulties. While there was a heavy emphasis on trying to help moms ‘make it work’ in the breastfeeding department, formula was not verboten. I very much appreciated that from their LC.”

Trinity Hospital. Augusta, GA.

Winn Army Hospital, Fort Stewart, Georgia – “They are Baby Friendly (BFHI), but when my oldest was hungry and my milk hadnt come in, they had formula on hand, pacifiers as well, and recommended a little formula to help with her jaundice as well. It is an Army hospital, but for any military wives that might end up delivering there, I was very happy.”

Emory Johns Creek Hospital, Johns Creek, GA – “Formula fed by choice from the start, no problems, in both 2012 and 2015. They also have a level 3 NICU.”

Southern Regional Hospital Women’s Center, Riverdale, GA.

 

HAWAII

Tripler Army Medical Center (TAMC), Honolulu, HI

Kapiolani Medical Center for Women & Children, Honolulu, HI

IDAHO

Kootenai Health, Coeur’d Alene, Idaho – “They never acted differently with me weather it was breast feeding or formula feeding and they even kindly suggested formula while my son was in the NICU so we could get some sleep rather than drive to the hospital every two hours at night.”

 

ILLINOIS

Prentice Women’s Hospital (Northwestern), Chicago, IL. While I can’t speak for everyone’s experience, mine was stress free and no one batted an eye with my choice to exclusively formula feed. Excellent nursing staff.” (FFF Note: I have heard mixed reviews of this hospital – they are staunchly BFHI, and some say the nurses were extremely pushy. Most likely depends on who is on shift!)

Advocate Good Samaritan, Downers Grove IL – “I wanted formula from day 1, my room was always stocked up, baby NEVER starved. They actually would not release us until he regained his birth weight! Amazing hospital and staff! I had two babies there and formula was readily and easily available 24/7! You could have the baby in the nursery all night or in your room. Amazing hospital!”

Evanston Hospital, Evanston, IL – “One OB resident gave me a hard time before the baby was born about my choice to formula feed. After she was born, the nurses could not have been more supportive.”

Little Company of Mary Hospital, Evergreen Park, IL – “Although I had planned to BF, when the nurses and my pedi saw me struggling, they suggested supplementing and provided RTF formula, cups (because I was only supplementing at the time they suggested to avoid nipple confusion), etc. When I decided during my extended stay to exclusively formula feed, they grabbed the nipples and restocked frequently. I was sent home with lots of formula as well. It is a Baby Friendly hospital but I couldn’t have been more pleased. No pressure either way. The nurse kept telling me to feed my baby the best way for us and not to listen to what anyone else said.”

Delnor Hospital (Northwestern), Geneva IL –  “They provided all of the ready to feed formula as soon as he was born. He stayed in the NICU there and the Lury Children’s neonatologist that treated him didn’t say anything. They supplied almost a week worth when we went home.”

Advocate South Suburban Hospital, Hazel Crest, IL – “I started off trying to breastfeed exclusively, but before I was discharged hubby and I asked about supplementing with formula. The nurse handling my discharge told me that supplementing could work out (absolutely no discouragement) and how to proceed to do so. The nurse gave us a pack of nursettes without any issues. There was also a formula sample pack at the bottom of the hospital bassinet that we were able to take with us.”

Anderson Hospital, Maryville IL – “They were open to my feelings and very supportive when I wanted to start supplementing.”

Memorial Medical Center, Springfield, IL – “Exclusively formula fed both my now 2 year old and newborn son and no one batted an eye. Love this hospital for multiple reasons!”

Carle Foundation Hospital, Urbana, IL

Central DuPage Hospital (Northwestern), Winfield, IL – “Amazing hospital, supportive staff. LOVE.”

 

INDIANA

St Vincent Carmel Hospital, Carmel, IN – “When we took out tour we got to sit down and do our birth plan. They asked about breastfeeding and if I would need a LC. I said I wasn’t planning on breastfeeding because I wasn’t comfortable. They said not a problem and marked that I didn’t need a LC to visit and what brand of formula I wanted. During my actual birth after my daughter arrived one nurse did ask if I wanted to try and breastfeed; I said I was planning to formula feed. She said not a problem and said she was sorry for not looking at my chart and got me the formula brand I wanted to try. Overall it was a great experience the whole time the nurses were great at making sure we had plenty of formula and never once pressured me into trying to breastfeed.”

Dupont Hospital, Fort Wayne, IN –  “When we decided to formula feed, no one tried to convince us otherwise. Provided everything we needed and helped when I had questions.”

Lutheran Hospital, Fort Wayne, IN –  “I planned from the very beginning to do a combination of breastfeeding and formula feeding. They asked if I wanted to speak to a lactation consultant, instead of just assuming I would want to. When it came time to request formula, I was able to talk with a pediatrician about which type might be best. Great experience!”

Parkview Hospital, Huntington, IN. “They asked me if I planned on formula or breast feeding. When I told them formula, they didn’t question or even try to talk me into it. They just brought us some Enfamil Newborn nursettes. I actually had a nurse ask if she could feed her in the nursery while I ate.”

IU Health/Methodist Hospital, Indianapolis, IN – “From the moment I checked in, they asked in a very non-judgmental way whether I would be breast or bottle feeding. After that, I was given bottles, formula and pacifiers without issue. I never felt bullied by anyone.”

IU Health Arnett Hospital, Lafayette, IN

 

IOWA

Iowa Methodist Medical Center, Des Moines, IA

Mercy Hospital, Dubuque, IA –  “Amazing staff, were very supportive of my decision to formula feed and provided answers and help with breastfeeding and pumping without being pushy.”

KANSAS

Shawnee Mission Medical Center, Merriam, KS (Kansas City area) – “I had two very dangerous, complicated births and both my babies and I were cared for by top-notch professionals. During my pre-labor paperwork appointments, I stated formula was my choice and specified my brand and both times, it was loaded up on our bassinet carts and ready immediately when the babies were born. Nobody said a single word and the nurses were nothing but loving, helpful, and supportive. My births were 21 months apart and I received the same standard of care.”

 

KENTUCKY

Owensboro Medical Health System (OMHS), Owensboro KY

 

LOUISIANA

Women’s and Children’s Hospital, Lafayette, Louisiana – “Asked which option we wanted. Lactation consultants were wonderful, supportive and helpful when we tried breastfeeding, and even gave tips when we had to switch to formula.”

Lake Charles Memorial Hospital for Women, Lake Charles, Louisiana –  “While they do have very good resources and lactation consultants for those who wish to breast feed, never once was I harassed or made to feel bad about my decision to formula feed. They even respected my wishes to not have a lactation consultant come by my room. It was a very good experience and I left feeling confident and well taken care of, as well as my son getting the nutrients he needed that I couldn’t provide, without being made to feel less than.”

 

MAINE

Inland Hospital Birthing Center, Waterville, Maine – ” I had wanted to breast feed but my son was born with low blood sugar so they had to supplement immediately after birth. They used a syringe and small tube to give him the formula so that it wouldn’t upset breastfeeding. The LC came into see me once while I was there and was very helpful and supportive. The nursing staff was wonderful. They were very encouraging. They were more than willing to help me to get my son to latch etc. When he just wasn’t taking the breast or I seemed too exhausted they offered formula. They were never condescending or condemning about it. When I went home I still was supplementing a lot because breastfeeding just wasn’t working out. I made an appointment with the LC. She was very supportive of us supplementing. She showed me how to pump to help build up supply. She also suggested using a bit of formula to satisfy the baby so getting him to latch would be easier. She stayed in contact with me and when I told her that I had pumping around the clock and getting 1/2 an ounce a day she said “You can stop if you want to.” She then went over safe preparation of formula with me. This birthing center is truly all about healthy babies and moms. I am looking forward to having my baby there next summer.”

 

MARYLAND

Anne Arundel Medical Center, Annapolis, MD – “No pressure, no guilt. FF from the beginning with my 2nd & 3rd babies there. I felt totally comfortable and was supplied with everything needed. Great experience both times (my third child was born last month).”

Johns Hopkins Hospital, Baltimore, MD – “I supplemented both of my babies starting shortly after birth, no problems!”

Mercy Hospital, Baltimore, Maryland –  “I can’t breastfeed (IGT)… When I explained to the very nice LC that visited, she was so supportive and went and brought extra formula for me to keep in the room so I wouldn’t have to worry about asking the nurses when I ran low. She even propped some pillows for me to be comfy in a bottle feeding friendly way! Not one nurse said anything or acted negatively when I said I wouldn’t be breastfeeding (even though it’s a very BF friendly hospital).”

St. Agnes Hospital, Baltimore MD – “Absolutely no pressure or questions about my decision to formula feed from the beginning.”

Howard County General – Columbia, MD – “Every nurse and doctor asked/assumed I would breast but when I said no I didn’t get any push back/harassment.
My son’s bassinet shelves were stocked with RTF formula and nipple and I was given a feeding schedule ,and a booklet to track his input and out put. The LC came around each day and (slightly annoyingly) asked each time if I was BFing. Each time I said no and never got a lecture or anything. Each no was followed with asking if I had any questions about drying up my milk. Every one was very nice.”

Greater Baltimore Medical Center (GBMC), Towson, MD

 

 

MASSACHUSETTS

Beth Israel Hospital, Boston, MA

Massachusetts General Hospital, Boston, MA – “Had a great experience there in 2014. I made my wishes clear in advance (exclusive formula feeding from the start, no visits from LC, and baby would spend nights at nursery while I got Benadryl and slept) and everyone honored them.”

Newton Wellesley Hospital, Newton MA – “With baby #2 there was no pressure, no forms to sign, no questions. Lots of support and assistance. And with my first pregnancy when I wanted desperately to breastfeed and baby was in special care nursery extensive support with all my questions and concerns (plus plenty of formula for supplementing).”

Norwood Hospital, Norwood Massachusetts – “Formula fed from the get go with both kids. While they are baby friendly (skin to skin right after birth, room in with mom not nursery) I was never once questioned why or pushed towards breast feeding.”

Berkshire Medical Center, Pittsfield, Massachusetts –  “They support all feeding choices, no forms or harassment. They also have a nursery that all new moms are welcome to use as well as the option of rooming in if that’s what people prefer!”

Winchester Hospital, Winchester, MA – “Never felt any judgement about my choices!”

 

MICHIGAN

MidMichigan Health Center, Alma, MI  –  “I had a wonderful experience there. No judgement when breastfeeding didn’t work for us.”

Beaumont Hospital, Dearborn, MI – “They ask how you are feeding and that’s the end of it. Even provided tons of ready made to take home.” Another reviewer: ” I had a phenomenal experience combo feeding with my second son at the hospital. No guilt, no pressure to exclusively breastfeed. It was my choice and they were supportive of that choice.”

University of Michigan Hospital, Ann Arbor, MI – “Said I was doing formula and no one bugged me.” (Note– another mom said:  “I didn’t have such a good experience. There is no nursery for moms to recover from a tough birth and I was told that if I had help at home to vacuum, I surely could breastfeed. (She thought I was just overworked and not diagnosed with a major depressive disorder.) UM is working towards baby friendly.”)

Spectrum Health Butterworth, Grand Rapids, MI.

McLaren Greater Lansing, Lansing, Michigan – “They ask you how you plan to feed your baby and support you whatever your choice. They have a traditional nursery where my baby stayed the first couple of nights after my c section when it was difficult for me to get out of bed, and when my milk didn’t come in right away they gave me formula and bottles to feed my hungry baby while at the same time offering me a lactation consultant to help me keep my baby latching and keep me hooked to a pump every day to get every last bit of colostrum for him too and encourage my milk to come in. But feeding a hungry baby was priority number one no matter how it happened and that’s the way I think it should be!”

 

MINNESOTA

Maple Grove Hospital, Maple Grove, MN.

St Cloud Hospital, St Cloud, MN  – “Just asked me how I wanted to feed the baby. I said formula and that was it. They kept nursettes stocked in the room and brought more when necessary. No comments whatsoever. All the nurses,etc were so attentive to making sure I was ok, too. Great experience.” Another reviewer: “My nurse was wonderful after my first i tried to bf and she over heard me bawling to my husband because it wasn’t working. I am so thankful to that nurse who took time to talk to me about formula. My second babe straight to ff…no issues.”

 

 

MISSISSIPPI

Merit Health River Oaks Hospital, Flowood, Mississippi

 

MISSOURI

Centerpoint Medical Center, Independence, MO

Mercy Hospital, St. Louis MO – “The nurses and staff was amazing and they never judge me. A lactation consultant actually helped me and told me how to dry up my milk faster. She was awesome. I will never forget her or my experience.”

 

MONTANA

St. Vincent’s Hospital, Billings, MT – “Everybody was really kind and supportive about my decision to formula feed my baby.”

Community Medical Center, Missoula, MT – “They provided me with formula right away because i told them that I had no interest in even trying to breastfeed with #2. They gave me individual prepackaged bottles of formula, and the nurse walked us through how much formula to provide at each feeding and how often to feed it to her. My daughter didn’t love the formula they had, and I ended up breastfeeding her the one night we were there anyway, but the nurse packed the rest of the formula they had provided for us to take home, just in case.”

 

NEBRASKA

St Elizabeth Hospital, Lincoln, Nebraska – “I discussed with my midwife how I wasn’t going to breastfeed. I wrote in my birth plan that I was going to formula feed. Not one time did a doctor or nurse try to get me to change my mind. They never sent lactation in to talk to me to try to get me to change mind. It was awesome and made me feel supported in my choice to formula feed.”

 

NEW HAMPSHIRE

Littleton Regional Hospital in Littleton, NH – “Formula feeding my second child was so easy right from the start.”

 

NEW JERSEY

North Shore LIJ (multiple locations across NY and NJ)  – “Very formula friendly – I was having some trouble getting the hang of bottle feeding my son – a really helpful nurse came in and helped me through it – not one person batted an eye about me not breastfeeding.”

Clara Maas Medical Center, Belleville, NJ – “They were perfectly open to combination feeding or exclusive formula feeding, but I needed and wanted to be told HOW to supplement my baby and how much he actually needed, and was pretty much on my own. If you’ve got your own feeding plan and stay on top of it, it should be OK, though.”

Englewood Hospital, Englewood, NJ

Hackensack University Medical Center, Hackensack, NJ

Christ Hospital, Jersey City, New Jersey –  “I asked through sobs for formula and the nurse said “oh sweetie I thought you’d never ask. It’s going to be okay,” then all the nurses gave me about 2 week’s worth of samples when I left. It was such a relief.”

Virtua Memorial, Mount Holly NJ – “When I was exhausted from breastfeeding they were so helpful and gave my baby formula when I asked them to so I could have a break.”

Capital Health, Pennington, New Jersey. “I did end up nursing, but they brought me formula for my little guy when I couldn’t get him to latch when he came out of the NICU. Actually, I think the nurse suggested it. It took a lot of pressure away. They sent me home with all kinds of goodies for both types of feeding.”

Riverview Medical Center, Red Bank, New Jersey – “Lactation consultant was a horrid wench who gave me a superior attitude despite admitting immediately that she had never even HEARD of my medication, but the nurses were very supportive. The second time around, they ensured an LC didn’t come near me.”

Valley Hospital, Ridgewood, NJ – “Good, but I made it excessively clear I wasn’t going to breastfeed”.

 

NEW YORK

 

Glens Falls Hospital, Glens Falls, NY

Mount Sinai Hospital, New York, NY – “Specifically the NICU. Amazing experience with neonatologists who encouraged formula for my IUGR preemie, told me I could pump and they would give her breastmilk if I wanted, but to know that the calories in formula were necessary. They were also really gentle and kind about telling me this and thrilled when I said I love formula, think it is great and my goal is to feed my baby and formula is a great way to do that. My nurses and my baby’s nurses were equally as supportive of all of my choices. LC was annoying but not offensive.” Another review: “No questioning of my choice. All matter of fact. The lack of pressure or questioning was support enough for me!”)

South Nassau Communities Hospital, Oceanside, NY.

St Joseph’s Hospital Health Center (NICU), Syracuse, New York. – “Great experience! They let me take a hospital grade pump home when I was trying to boost my supply AND they also gave me a thorough and much-needed education on formula feeding (which water to use, how to properly mix, how to store, how to sterilize bottles … NOT what brand to use, contrary to popular opinion). I never felt pushed or judged.”

Samaritan Medical Center, Watertown, New York – “My daughter was born 5 weeks early and spent a week in the NICU. Once she was born, they asked if I’d be formula feeding or breast feeding, and I replied formula:) that was the end of it! They even noticed the formula she was on was affecting her, and switched her to a soy formula, which literally made the world of a difference. She had blood work done and had a milk sensitivity. They were nice enough to even send me home with the formula my daughter was currently on:) never pressured me to breast feed!”

 

NEVADA

Mountain View Hospital, Las Vegas, Nevada – “When I had my twins they were making it rain RTF Enfamil. It was awesome. Always gave us more if we asked, and let me get it myself from their storage once I was walking around.”

 

NORTH CAROLINA

Duke University Hospital, Durham, NC – “Good all around. I combo-fed, and the nurses were very helpful. Like Danielle Suarez said above, their main concern was that your baby was fed. The LC who visited me was also really sane about formula. Also the LC only came because I asked her to, not because she was haunting the L&D wing rattling a Medela.”

 

OHIO

Dublin Methodist, Columbus, OH – “With my first I hadn’t even considered that my milk would never come in. From the second day when it was decided I should be pumping and supplementing I had all the formula I needed. The nurse also provided me with proper formula feeding instructions. With my second I chose to formula feed from day 2. They brought me formula and never batted an eye. I had a great experience both times.”

Grant Medical Center, Columbus, OH – “They simply asked how we were feeding and that was that. We had unlimited formula while there and everyone was very supportive.”

Ohio State Univ Wexner Medical Center, Columbus, OH – They asked when I was admitted and were respectful and helpful. I had support in FF when I needed it and BF support when I needed that (two different births). My discharge booklet had info on both. They provide formula, as well, no questions asked.

Mercy Fairfield, Fairfield, OH – “When I checked in they asked how I planned on feeding and I said bottle. I never heard another question about it from anyone. They provided ready to feed bottles with no fuss and asked if I would like to take some home.”

Highland District Hospital, Hillsboro, OH –  “They were helpful but not pushy when we wanted to try and gave us formula without a fuss when it wasn’t working.”

Kettering Hospital, Kettering, OH.

Fairfield Medical Center, Lancaster, Ohio –  “Asked me how I was feeding I said formula they said Ok and made sure I had enough. My nurse also explained about how long it was good for and some formula information.”

Marion General Hospital, Marion, OH – “They were completely fine with my choice of formula feeding, they asked me my choice at arrival and that was the end of it. At discharge my paper work had info on both.”

South View Hospital, Miamisburg, OH – “Asked once how I was feeding my baby the LC came by with a paper on proper formula use mixing, how long it is good for, storage, how much to feed.. Etc. Baby bassinet was fully stocked with formula.”

 

OKLAHOMA

Integris Baptist Hospital in Oklahoma City, OK –  “Baby friendly and gave educational info on breastfeeding, but also no judgement at all on our choice to FF (and the judgement was what I feared the most- I had an awesome nurse who picked up on my nerves and was very sweet and reassuring!)”

Children’s Hospital, Oklahoma City – “They encourage breastfeeding, but they didn’t question when I asked for formula to supplement.”

St Francis Hospital, Tulsa, OK – “Great experience in October 2013. No pressure, let them know up front I was EFF, no unnecessary LC visits, and when requested I got some RTF to take home!!”

 

OREGON

Mid-Columbia Medical Center, The Dalles, Oregon – “They are pro-breastfeeding, but when my daughter had jaundice and wasn’t gaining weight, they helped me supplement until she was thriving. And they sent me home with so much formula!”

 

PENNSYLVANIA

Holy Spirit Hospital, Camp Hill, PA – “They asked my preference, marked him as formula only, asked for a brand preference, and never batted an eye or made me feel bad.”

Saint Vincent Hospital, Erie, PA – “They asked me my feeding preference when I was registering and when I said formula, that was the end of it. Nobody pressured me to breastfeed or lectured me about it. They provided ample amounts of formula for my baby while we were there and they sent me home with a bunch of the nursette bottles. I appreciated the fact that they respected my decision to formula feed. It helped make that decision a little easier for me.”

Harrisburg Hospital (Pinnacle Health), Harrisburg, PA – “Baby friendly, but totally chill with my decision to EFF from the beginning.”

Women’s and Babies Hospital, Lancaster, PA

Good Samaritan Hospital, Lebanon, PA – “With my second baby, I said from the beginning I would be formula feeding due to issues breastfeeding my first. All the nurses were supportive and other than a casual remark that it might be easier the second time around if I wanted to try again, the doctors were too. The lactation consultant mistakenly came in once, thinking I was nursing. When I explained that I wasn’t, she never pressured me at all and even said, “Mothering is more than milk.” I loved that!”

Magee Hospital, Pittsburgh, PA –  “I wasn’t planning to FF but one of my preemie Twins had glucose issues so they immediately recommended formula. Both my twins were on formula in the NICU (and there was also a breast pump available for me to use) and in the nursery, and when the boys were in my room they gave me formula for free. They showed us how to feed them, how to safely handle and store bottles, and told us how much they should be eating. Before they sent us home they made sure to get both boys on the same kind of formula to make feeding easier for us.”

West Penn Hospital, Pittsburgh, PA – “My son was born extremely premature at 25 weeks. While I chose to pump for him in the beginning, the stress of it all was too much for me. One of the nurses actually sat me down and told me that if I was miserable pumping, then I needed to stop. That formula would be just fine for my little guy. I took her advice, and she was right. The entire staff there made me feel so comfortable when I decided to transition my son to formula. I am so grateful for that.”

Heritage Valley Sewickley, Sewickley, PA – “Was asked breast or bottle, and then what brand I preferred.”

Lankenau Medical Center,  Wynnewood, PA – “They asked me if I was going to FF or BF. I said formula, they asked which kind I preferred, and nobody said another word about it. They just brought it to me.”

SOUTH CAROLINA

Hilton Head Hospital, Hilton Head Island, SC

 

TENNESSEE

Fort Sanders Regional Medical Center, Knoxville Tennessee

 

TEXAS

Arlington Memorial, Arlington, TX –  “Awesome –  they encouraged me to supplement when she was hungry were supportive for rooming in or sending to the nursery. I felt lactation was great and supportive for both formula and breastfeeding. One the nurses told me as long as the baby is fed and happy that’s all that matters! they sent me home with lots of formula samples too.”

Baptist St. Anthony (BSA), Amarillo Texas – “Because of my breast reduction breast feeding was difficult. They were more concerned about my babies nourishment. They provided formula right away with out asking and supported me as I breast fed and supplemented. I couldn’t have asked for a better experience. They were so supportive when I was breast feeding and also helped me understand all the ins and outs of formula. They also gave me a bunch to take home!!”

St. David’s North, Austin, Texas –  “I had supportive nurses when I tried to breastfeed, but they also INSISTED he receive formula since he was so early and his blood sugar was so low. I discussed formula feeding with nurses in L&D and they were immensely supportive. Our pediatrician there was also both firm and supportive about both mom and baby’s health no matter what form the food took… Which for us meant a 100% switch to formula very soon after birth. The entire staff at St. David’s North is EXTREMELY respectful, knowledgeable, and kind. They handled my incredibly complicated pregnancy and delivery, as well as our feeding stuff, with grace and compassion.”

Medical City Hospital, Dallas Texas

Memorial Hermann Hospital, Sugar Land, TX  – “We had adequate help from the lactation consultant but needed to supplement a few feedings with formula due to baby’s low glucose. They sent us home with both formula and lots of bf resources. I remember nurses asking if we were bf or ff and they seemed respectful of both options.”

Mother Frances, Tyler, TX – “They obviously support breast feeding but they do not judge you. They simply ask how you’ll be feeding, you say formula, they walk off and bring back a bottle. Simple. Had all 3 of my kiddos there. I love them!”

Clear Lake Regional, Webster, TX – “Noted both breast and formula on baby’s label. Had formula standing by when newborn refused to latch. LC gave options on how to combat nipple refusal and how to properly mix formula and BM together, if needed. No questions asked from the nurses and left with newborn nurser bottles.”

UTAH

Orem Community Hospital – Orem Utah USA

 

VIRGINIA

Spotsylvania Regional, Fredericksburg, VA –  “Was excellent about bringing formula stock and putting it under his bassinet.”

Sentara Norfolk General and Sentara Leigh Memorial, Norfolk, Virginia – “Never questioned formula use and the Special Care Nursery at Norfolk General actually encouraged formula use in December 2014 with my 2nd child who had a milk protein allergy.”

The Portsmouth Naval Hospital, Norfolk/Portsmouth VA – “Was wonderful with my second. When I asked for formula, it arrived, no one questioned my authority and combo feeding was encouraged as PART of their breastfeeding support system. Genuinely placed infant/maternal heath as a priority over theoretical “baby friendly” doctrine.”

Bon Secours Maryview Medical Center, Portsmouth, VA –  “I formula fed from the start and never had anyone push breastfeeding, and they never offered a lactation consultant or had one come in anyway. They accepted it as my choice and moved on!”

Reston Hospital, Reston, VA –  “Baby friendly, but did not ask questions or send in the lactation brigade when I said formula from the start with my second baby. They only asked one time how I was feeding. Only one nurse didn’t want to bring formula, but otherwise all were very helpful and supportive. With my first baby, same hospital, they provided breast feeding help, pump, bottles, LC, and information to take home. So I’d say they are friendly to either option.”

Roanoke Memorial Hospital, Roanoke, VA – “They asked how I planned to feed and I said bottle. They just asked if I had a particular reason but weren’t pushy about it…they were fine with the answer “personal reasons/choice” but did let me know they had a lactation consultant available if I wanted it. They provided plenty of formula and some to take home. They gave me a handout on what to do when my milk came in, mostly about putting cabbage in your bra haha. I have heard other stories though about women who attempted to BF and it wasn’t working out, and the LC got a little pushy/rude. Of course I never even saw the LC so I didn’t have that experience and can’t verify if it would be that way for everyone.”

Stafford Hospital Stafford, VA – “Offered lactation consultant services when requested, and formula when BF didn’t work out – no questions asked.”

Princess Anne Hospital, Virginia Beach, VA – “Never got a “boo” or a “hoo” about not attempting to breastfeed my son, and the nurses kindly kept him in the nursery overnight so I could get plenty of sleep before going home. It was heavenly.”

Sentara Northern Va Medical Center, Woodbridge, VA – “Had all 3 of my babies there- never ever felt pressured- their staff is phenomenal.”

 

WASHINGTON

Legacy Salmon Creek, Vancouver, WA –  “Baby-friendly, but open to all forms of feeding as long as mommies are feeding.”

 

WEST VIRGINIA

Raleigh General Hospital, Beckley, West Virginia

 

WISCONSIN

Aurora Medical Center, Oshkosh, WI – “Offered formula to help satiate babe while I got a good night’s rest. Nurse Kendra and LC Rachel listened to my anxieties and uncertainty about breastfeeding and suggested pumping and supplementing as an alternative that might work for us. No shaming, nothing but support and resources, and the LC even said, “Breastfeeding is not more important than sane parents.” ”

Ministry Saint Clare’s Hospital, Weston WI. Sent us home with a bunch of formula for supplementing (my son was very jaundiced). Gave me no flack at all.

 

WYOMING

Memorial Hospital of Converse County, Douglas, WY

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AUSTRALIA

Angliss Hospital, Melbourne –  “They had a bottle room ready with bottles sterilised and formula ready to go (or you could BYO formula if you didn’t like their brand). They strongly encouraged me to FF as my son had low BSL due to GD and ended up in special care. Never once saw a lactation consultant and was never told during my pregnancy to express pre labour to build up a stockpile (which is what they do to ensure you can BF post birth with a low BSL baby). I was in a GD forum during my pregnancy listening to women try desperately to express in their final weeks and was glad my hospital never put that pressure on me before or after birth.”

Nepean Public Hospital, Penrith, NSW

Westmead Public Hospital, NSW – “I attended a birth as a birth photographer for a mum who was having her 3rd baby. After Bub was born, the midwives asked if she wanted to breastfeed. Mum said no. There was no further discussion and a midwife came in with a bottle and helped dad give it to Bub while still in the birthing suite.”

Wollongong Hospital AustraliaWollongong, NSW –  “I told them i was feeding my baby formula and they were amazing! They gave me different types to try and even gave me a booklet on how to clean and sterilize. No forms to sign. Brilliant. However they continually lost my paperwork and kept delaying my discharge… Formula consultation amazing-wouldn’t recommend it for anything else.”

Glengarry Private HospitalDuncraig, Western Australia –  “Supported my choice to bottle feed my daughter completely and didn’t judge me at all.”

 

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CANADA

Alberta

Surgeon Hospital, St. Albert, Alberta

Red Deer Hospital, Red Deer, Alberta, Canada. “Very pro-breastfeeding, but had to supplement with formula and nobody asked twice, just kept bringing bottles.”

British Columbia

Surrey Memorial Hospital, Surrey, BC –  “Were very supportive of making formula available and offering instructions on how to use it. They even gave me some RTF bottles to take home.”

Cariboo Memorial Hospital, Williams Lake, BC.

100 Mile District General Hospital, 100 Mile House, BC

Nova Scotia

The Aberdeen Hospital in New Glasgow Nova Scotia – “Actually provides you with formula while in their care and sends you home with samples.”

Ontario

Royal Victoria Hospital, Barrie, Ontario – “I was struggling with breastfeeding and my daughter was losing too much weight. They offered me formula and were extremely helpful and supportive when I found myself very emotional about the situation.”

Joseph Brant Hospital, Burlington, Ontario – “Had no problem giving me formula. I had been trying to breastfeed and it wasn’t working so they offered formula with no judgment.”

General Hospital, Ottawa, Ontario.

Queensway Carleton Hospital, Ottawa, Ontario – “Not one negative experience. The lactation consultant was even asking around about easiest to digest brands and checked if lactose free formula was available for me.”

Civic Hospital, Ottawa, Ontario –  “I had to supplement with my son. When I asked for formula my nurse ran and got it for me, no questions asked besides if I was ok. I was very impressed with how I was treated when I needed the formula.”

Oakville Trafalgar HospitalOakville, Ontario – “Asked how I planned on feeding my son and when I asked for formula they gave it to me. No questions asked!”

Montfort Hospital, East Ottawa, Ont.-  “I went in saying I didn’t want to even try Breastfeeding and they did not give me any problems. They supplied me with formula.” Another review:  “I went in saying I didn’t want to even try Breastfeeding and they did not give me any problems. They supplied me with formula.”

Victoria Hospital of the London Health Sciences, London, Ontario –  “Designated Baby Friendly but did not give me any trouble with formula. I wrote on my intake form ‘no lactation consulting AT ALL; exclusive formula use’ and no one even questioned the choice. Hospital provided formula and nurses helped ‘some’. They sent me home with tons of breastfeeding info pamphlets and booklets, not a damn thing re: formula. The Health Unit was also only interested in BF support, not formula. So if you’re prepared to go it alone with zero advice on bottles, formula types, feeding frequency, stool consistency, reflux….. Victoria Hospital will let you.”

Peterborough Regional, Peterborough Ontario – “Staff were super helpful with formula. Didn’t make me feel guilty, provided me with formula and told me the stuff I needed to know regarding feeding.”

Hospital Montfort, Ottawa, Ontario –  “Great with both my kids and my choice to not breastfeed. They provided a package with instructions and how to safely prepare,store etc and also provided the ready made formula for us during our whole stay (4 days for both, as they were sections) They asked when I got admitted, I told them I was going to FF, and that was that. Only had 1 nurse make a comment, and try to “change” my mind.”

Quebec

Lasalle Hospital, Lasalle, Quebec –  “I wanted a pump they gave me one, I wanted formula, they gave me that too, no questions/no arguing. Very happy with my experience there.” Another review: “”Very formula friendly. I combo fed and no questions were asked beyond which was my preferred brand.”

Pierre-LeGardeur Hospital, Terrebonne, Quebec – “They asked if I wanted to breastfeed, I said no and they brought me nursettes. That was it. No questions, no judgement.”

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FRANCE

Auch Hospital, Auch, Southwest France – “My first three kids were born in the States and I faced tremendous pressure to breastfeed despite having zero success each time. The fourth time around was so much more pleasant! I really wanted to try to BF but his weight kept plummeting and he needed to heal a broken collarbone. Less than two weeks after he was born, after teas and oatmeal and Gatorade and cookies and then some – even a prescription! – my midwife put her hands on my shoulders and looked me right in the eye and said, “You tried. You really, really tried!” Her reassurance that my inability to breastfeed wasn’t because I hadn’t pushed hard enough or that I’d been too selfish allowed me to let go of (some of) the guilt that had been compounding since my first was born. For that I will be forever grateful!”

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ISRAEL

Haddasah Ein Karem, Jerusalem

Hadassah Mount Scopus, Jerusalem –  “Sat down with the head nurse about making the decision not to breast feed, within a day or so after my c-section. She was supportive of my decision. Another nurse recommended that if my decision was final then to take a little pill to dry up the milk (which hadn’t yet come in) to avoid unnecessary discomfort.”

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ITALY

Ospedale Vittore Buzzi, Milan – “Although i don’t think you can find a real formula-friendly hospital in Italy, at least they are neutral, once you ask to switch to formula.
It’s up to the mother going to the nursery and ask for a bottle when the baby is hungry, but i am pretty sure nurses would bring it directly to the bed of patients that cannot walk.”

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JAPAN

Miura OB-GYN and Birthing Center, Nishisonogi-gun, Nagasaki, Japan. – “Before giving birth I made clear my plans not to breastfeed, and every single nurse and Doctor there were respectful of my decision, did not try to guilt me into changing my mind, and promptly prepared me formula for the entire week I was there in recovery. Absolutely lovely experience.”

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UNITED KINGDOM

William Harvey Hospital, Ashford, England

Royal Derby Hospital, Derby, England – “They promote breast feeding, but after my daughter refused to breast feed for over a day, and myself being hand expressed like Betty the milking cow (I had a 4 day stay in hospital) I just wanted to feed my uy89tbaby so I asked for formula. The midwife gave me a relieved expression and said “thank god you’ve got some common sense, if only other women did” they were very supportive of my decision to make sure my baby was fed, no matter what. Obviously, with it being the NHS they provide the formula free of charge, I’m guessing all NHS ran hospital’s do.”

St Georges, Tooting, London – “Took charge when needed and suggested I fed my jaundiced, starving baby formula.”

Queen Charlottes Hammersmith, London UK

St Thomas’ Hospital, London, UK- “Have been great this far, even with choice to FF.”

Wrexham Maelor, North Wales, UK – “They provide 2 brands of formula & give out teats out to parents that need them & I was even given help with getting a very sleepy, disinterested baby to bottle feed. I was never made to feel bad for my choice & experienced no pressure to breastfeed whatsoever (apart from the posters advocating breastfeeding that covered almost every available space of course!)” Another review:  “The breastfeeding support could have been better but they provide mums with formula free of charge for as long as they are in hospital, in a variety of brands, rather than expecting the dads to go out and buy it.”

Wishaw General Hospital, Scotland –  “I had excellent support from their breastfeeding support team, but as soon as baby showed signs of dehydration he was topped up with formula. When it just wasn’t working for me and I was exhausted they asked me what I wanted to do. Without question or judgement they brought be a bottle. The next morning a few midwives came in to tell me their story and reassure me that I had made the right choice for me and my baby.”

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Hospitals to Avoid

These hospitals received poor reviews from formula-using parents, either because their choices were not respected, or they were not given guidance or support.

CALIFORNIA

Kaiser System Hospitals, All Locations, California (note: Kaiser was also mentioned positively by some FFF members – while they do have a stringent Baby-Friendly policy in place, many nurses were helpful once the decision to formula feed had been made.)

Barstow Community Hospital, Barstow, CA. “They’re very Baby Friendly, no pacifiers are on the floor, formula only if you get pushy about it, and we had to sign several forms that said we understood breast was best and formula was not as good. It wasn’t overall horrible, and I am stubborn enough to not let a nurse make me feel bad, but I can see where a Mom could be bullied.”

Northbay Medical Center, Fairfield, CA – “They are “baby-friendly” and after OB cleared me for discharge the nurse demanded she saw my son latch again before I could leave. She manhandled me and my son, I told her I just wanted my son to be fed, regardless of how and that I didn’t want another aggressive lactation consultant to come in and “counsel” me. She snuck out of the room and got one anyway and basically held us hostage there telling me that I wasn’t trying hard enough and needed to come see the lactation clinic days later. Meanwhile I’m in tears and traumatized and my 3 day old son was hoarse from all of the hunger screaming. I ended up refusing all lactation care and had to demand formula and was made to feel like I wasn’t trying to help my child. They were very quiet and condescending after that. A beautiful experience up to that point was soured by their hostility. And it ends up my milk never came in due to previous fertility issues. So it wouldn’t have mattered what they did, my body wasn’t going to cooperate.”

Kaiser Permanente Medical Center, San Francisco, CA “The delivery was amazing, but the post maternity care was awful. They really push breastfeeding and rooming in. After my delivery I was in a ton of pain and put on serious pain meds, which I appreciated, but no one mentioned that the pain meds might make it hard for my milk to come in. I also could not sleep with my daughter in the room so after 4 days of pretty much no sleep I was also falling asleep while feeding her. It was horrible and it so did not have to be that way.”

Los Robles Hospital, Thousand Oaks, CA –  “After I made it clear I was not bf (and they kept pestering me as to why), I was put into a room far from the other patients and the nurses station, near the exit, like a pariah after my c section. Even my sister, who is a nurse, was concerned how isolated I was and how lax security around baby was. I had to chase down nurses to get adequate pain meds. It seemed like they didn’t want anything to do with me. In an effort to be a more ‘baby friendly’ hospital, they cut their nursery hours down to 11pm to 6am. I was on heavy narcotics and my husband had to leave earlier to take care of our other two kids. I barely made it to the 11 pm time and fell asleep feeding him. Even at 11, on one night the nurses didnt show up. I had to drag myself out of the hospital bed, in pain and doped up, attempting to roll him to the nursery myself. One nurse stopped me and loudly chastised me for trying to cut through the nurses’ station instead of helping me, even though I was not trying to cut through but simply ask where nursery was. On another occasion, a different nurse rolled my son back in from the nursery, barked “he needs fed” and left. My husband was not back yet and I had to roll myself out of bed in pain, set him in the hospital bed, and roll back in, hoping I did not roll on top of him. When I finally reached his chart, I saw the nursery nurse had noted feeding him 15 minutes prior, but there was no one to ask. The worst part was because the nurses continued to ignore me, they did not pay attention when I complained that the shortness of breath and nausea was not getting better. I ended up back in the hospital within the next week with post partum preeclampsia and put on an iv drip. I am only alive because my father, a retired ob, happened to recognize the signs and sent me to the er. This hospital is not fit to care for anyone, let alone bottle feeding mothers.”

FLORIDA

Winnie Palmer Hospital, Orlando, Florida. “Great hospital but they are really annoying with lactation consultants and making you feel like you are making a bad choice.”

 

GEORGIA

Northside Hospital, Atlanta, GA – “I got some pressure to breastfeed even though they provided formula. They forced me tho BF if i wanted my baby to eat the first hour. That was not my plan. I love my dr and most nurses, but i planned on pumping tyre first two days of colostrum and then using all hypoalergwnic formula. They didnt get me bottle feeding supplies and said they couldn’t get a pump in labor and delivery. They pushed me into breast feeding during their golden hour. Then some nurses continued to be pushy as well as the in house pediatrician. Only when i explained a lot of personal reasons and medical for not wanting tho breast feed did one nurse finally admit she had bottle fed her kids…thats after she made me feel bad two days. It was like all the staff had to make you try it whether they wanted to or not.”

HAWAII

Vera Zibler Birth Center, Kailua, HI

MASSACHUSETTS

Mount Auburn Hospital, Cambridge MA – “When I asked about what formula might be considered “the best” to try, the LC said, “well swamp water is swamp water.” That kept me from going fully formula fed for way longer than was healthy for me.”

St Elizabeth’s Medical Center, Brighton, MA – “I asked for formula and it was no big deal. But nobody told me how to use it. There is no support for formula feeding moms.”

 

NEW YORK

Jack D Weiler Hospital, Bronx, NY – “Horrible formula feeding experience. After giving birth I was asked multiple times an hour by every nurse, each day I was there, if I was breastfeeding and when I said no they asked why and kept telling me how much better it would be for my baby if I did, instead of just respecting my choice. They would not supply me with formula (which would have been great to know on the tour I took before I gave birth there) without me asking and when I did they only gave one bottle at a time and took a long time to bring it, while my baby was crying in hunger. This left me with a crying and hungry baby at 3:00am for over ten minutes until they could be bothered to give me a bottle of formula and then the process was repeated at 6:00 am. They did not talk to me about best quantities for a baby to drink, how often, how long the milk is good for, sterilization, how to get the baby to properly latch on to a bottle (to avoid sucking in air or creating a milky mess) how to spot allergies or anything important for a formula feeding mother to know. They didn’t give me any information on how to dry out my milk safely, how to relieve pain, and how to avoid complications. They left me to my own devices and were very rude about formula in general, yet had lactation consultants available for breastfeeding mothers and very enthusiastic about giving breastfeeding information. It was a horrible experience.”

 

OKLAHOMA

St. John’s Hospital, Tulsa, OK – “Very pushy with breast feeding, sent in LC to “pep talk” when I requested formula to supplement. Then told that formula required Doctor request. Since baby was born over Labor Day weekend, I could not find a Pediatrician that would file the request. Baby lost 1 lb before we were released and able to get formula on our own. Not Formula Friendly at all!”

 

TEXAS

Texas Health Presbyterian, Dallas, TX. “They went “baby friendly” a couple years ago and wow. Not good.”

 

WISCONSIN

Aurora Medical Center, Kenosha, WI – “I had a nurse who hid the formula bottles I had out on my bedside table in a drawer under a bunch of receiving blankets.”

St. Mary’s Hospital, Madison, WI – “I wouldn’t say avoid this hospital at all costs, because their birthing floor is fantastic, but I had a negative experience at St. Mary’s in Madison, WI. They make it clear that you must put the baby to breast before you are released to the recovery floor. I wanted to breastfeed, but my baby was preterm, and I had several issues that ended up making it impossible to EBF. I had a lactation consultant click her tongue at me when my milk hadn’t come in by day 3. She manhandled my screaming baby and my breast while barking at me about how I was “doing it wrong.” When my daughter’s blood sugars were plummeting, donor milk was the only option presented to me. If you deliver here and plan to give formula or are open, be aware that you may have to be pushy and firm about your choice.”

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AUSTRALIA

Royal Prince Alfred Hospital, Sydney-  “Is pro breastfeeding (as per state health mandate). There is no nursery – baby is kept with you at all times (I don’t know if this is now a state wide policy) If you ask for formula, you are encouraged to keep trying and they’ll get a lactation consultation happening. If you insist on formula you must sign a form every time is given (again state regulation – or so I was told) This form stops applying only when it is deemed medically necessary for formula to be administered.”

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CANADA

BC Women’s Hospital, Vancouver, BC, Canada –  “They’re a “Baby Friendly” hospital. When my first was born, they had someone show up to show me how to breastfeed in surgical recovery, and… that was it. No help other than that. I tried paging them twice with the call button my first night there because I thought he was having trouble breathing, and they told me someone would come “later.” No one came until morning rounds. I ended up giving him some whacks on the back (having no idea how to do this with a newborn and recovering from surgery), and he spit up a large wad of mucus. He was crying and crying, and the second night, the only time a nurse came was to tell me to keep him quiet because other moms and babies were trying to sleep. I tried leaving AMA after the second night because I hadn’t slept and kept falling asleep while holding him. They said I could leave, but my baby couldn’t because he hadn’t been checked by a paediatrician. They brought the paediatrician in, and they weighed and checked him for the first time since he was born. He had lost more than 10% of his weight, so they showed me how to pump and said I was only allowed to take him if my partner ran down to the milk bank and got donor milk before they closed in 20 minutes because they didn’t want him to drink formula. I was told that I couldn’t use a bottle or it would ruin breastfeeding and to call the breastfeeding clinic the next day for an appointment. I did, and it was a two week wait. Overall, horrible experience. My doctor and the surgical team was fantastic, but they just dump you in a room after and make you feel like a failure. I still remember those two days as the worst of my life.”

Fraser Health Hospitals, British Columbia – “They will give you formula, but will dispense it in plastic medicine cup since newborns only need 30 ML at a time.”

Mt Sinai Hospital, Toronto, Ontario –  “They refused to talk about formula feeding at their birth class, and they gave out infant feeding literature that stated that formula consumption is associated with an increased risk of infant death…The nurses ranged from very rude when I couldn’t get my baby to latch to kinder-yet-uselessly-incompetent in terms of breastfeeding (“nurse from the very tip of the nipple.” Etc.) One of them made my hand bleed around an IV because she was twisting it while ostensibly showing me how to hold my baby, and snarled when I pointed out the blood that breastfeeding was supposed to hurt, and did I want to do it or not? Eight out of ten times I went to see their lactation consultants, they refused to talk about supplementation (the other two times I got great, non-judgmental lactation consultants, but I was still trying to EBF, and at least one of them was visiting from another hospital and only there for the day). They pushed hand-expressing when I asked them what I could do about my serious pain from “mommy thumb,” because it was “what women have been doing for thousands of years.” They insisted that only 1% of women have true low supply and I was not among them. They told me that it was normal that my son be at the bottom of the chart for weight and at the top for height and cluster-feed for 24 hours at a time. They did not have the knowledge to address physiological challenges related to breastfeeding with large breasts and indicated that trying to get said issues resolved amounted to humblebragging. They pushed me to take domperidone and fenugreek supplements (the latter may decrease supply further in hypothyroid patients) without asking about my medical history.”

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ISRAEL

Ichilov-Lis Maternity Hospital, Tel Aviv, Israel – “They seemed to be okay if you knew from the start you wanted to formula feed, but if you wanted to breastfeed, they were going to make sure you didn’t supplement, even if that meant bullying patients, letting the babies get dangerously dehydrated, and refusing to feed babies whose mothers weren’t feeling well enough to walk to the nursery.”

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UNITED KINGDOM

Croydon University Hospital (formerly known as The Mayday Hospital), Croydon, UK. “Their policy was not breastfeeding, (then) no food, drink or pain relief.”

Great Western Hospital, Swindon, Wiltshire, UK – “I planned a home birth and ended up there for c-section. Didn’t even know I could bottle feed, they were so pro breast. Found out I could have bottles about half an hour before I went home. Furious doesn’t even begin to describe how I felt. The way I was dealt with still upsets me now (9 weeks on). I even told one of the midwifes I was planning to bottle feed when I got home, I’d used a carton of formula in my bag to feed her a little with a syringe, it was on the table In front of her and she still didn’t go and get me bottles!! I don’t know if I’m angrier at the hospital for not helping or me for not speaking up. Currently awaiting a reply to the complaint letter I sent their chief exec.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Begging for Balance Before Banning the Bags

Last month, Maryland became the fourth state to eliminate the practice of handing out formula samples at hospitals. This was heralded as an important move in ensuring the health and welfare of the state’s newborns, as these sorts of initiatives always are. Reporters quoted breastfeeding advocates and nurses talking about how hospitals should be “marketing health”:

“This move allows Maryland hospitals to put their smallest patients’ health first,” said Dr. Dana Silver, pediatrician at Sinai Hospital and vice president of the (Maryland Breastfeeding Coalition), said in a statement.

From The Baltimore Sun

While the ban was officially a voluntary decision from the state’s 32 birthing hospitals and not a ruling from the state government, there were an awful lot of comments coming from state officials about the new policy:

“With changes like ‘banning the bags,’ we expect to see more mothers to try to exclusively feed their infants through breast feeding,” said Dr. Howard Haft, deputy secretary of public health services, in a statement. “This provides better overall health outcomes for Marylanders and brings us closer to achieving national goals in this area.”

The move was proposed three years ago by state health officials as part of a package of steps hospitals could voluntarily take to support breast feeding, which studies show may provide health benefits to the infants and mothers

The Baltimore Sun

Supporters of the “Ban the Bags” movement claim that mothers who get the formula samples are less likely to exclusively breast feed and stop breast feeding before mothers who don’t get the formula.. They are absolutely correct. There are many studies showing this result, and I am in absolute agreement with them that the bags should NEVER be indiscriminately handed out upon hospital discharge.

Further, I agree that there’s no need for any marketing to be allowed in the maternity ward. As long as we all agree that this really means NO MARKETING. That includes free samples of Medela breast pads. I would also argue that posters ‘advertising’ the benefits of breastfeeding – often with slogans that are inherently shame and anxiety-producing – have no place in the maternity ward.

And lastly, there’s a valid argument that allowing formula companies to provide samples drives up the cost of commercial formula. But this is a bit of a straw man, because the marketing budgets of large pharmaceutical corporations are built in well-thought-out, specific ways; I suspect that Enfamil will find a way to use whatever money was going into the hospital discharge packs and spend it elsewhere. The cost of brand-name formula isn’t going down anytime soon, which is why it’s a wonderful thing that we have high-quality generic options on the market.

All of these arguments in favor of the Ban the Bags movement are valid. But there are other, equally valid arguments opposing it, that are being uniformly ignored by those in power:

What if mothers actually want the samples?

What if these samples allow parents to feed their babies the safer but far more expensive ready-to-feed nursettes, which reduce the risk of bacterial infections and exhausted, new-parent errors in preparing powdered formula?

What if the formula-sponsored discharge bags are the only real source of formula “education” parents are receiving?

Granted, these three questions all have other solutions than “give everyone formula samples”. For example,

– Formula samples could be on hand but only given upon parental request.

-These samples could be generic RTF newborn nursettes, pre-measured into small amounts that would prevent overfeeding (since everyone is so concerned about formula-using parents force-feeding their babies until their thimble-sized tummies expand, cursing them to a lifetime of morbid obesity)

-Samples could be outlawed, but all parents could instead receive a pre-discharge tutorial on safe formula feeding, what to look for in terms of insufficient breastfeeding and/or jaundice, and also a pamphlet or book with unbiased, easy to understand instructions for all safe feeding methods (breastfeeding, pumping, donor milk, formula feeding), as well as a local resource list for breastfeeding, formula feeding and postpartum mental health support.

Advocates for Ban the Bags can claim that these policies are put in place to protect babies, rather than to shame mothers or take away their options, but they need to understand that this is indeed the perception. I conducted a simple survey, composed primarily of the Fearless Formula Feeder audience, to explore what formula-using mothers thought of these initiatives. Of course, this is a biased group – most started out breastfeeding and switched to formula within the first 3 months, and some formula fed from the beginning (although I did open the survey up to anyone, and we did have 17% who exclusively breastfed, and 15% who breastfed and switched to formula between 3-12 months). But I’d posit that their bias is what makes their opinions so powerful. These are the moms who didn’t end up exclusively breastfeeding. If they felt that formula samples were at fault for this result, we would see that on the survey. Instead, this is what the survey found:

Chart_Q4_151104

Hurt your breastfeeding efforts= 2.26%

Help you in some way = 22.56%

Neither= 32.83%

Some of the open-ended responses included:

“I was offered a bag but refused it.”

“It was an absolute blessing- i needed to supplement while my breast milk came in, and it meant that i didn’t have to run to the store while recovering from 2 c-sections.”

“It did not influence my decision to switch to formula after 4 weeks, but it was so helpful to have the formula sample to try and see if it helped before buying expensive formula at the store.”

“Gave it away or threw it out.”

“It helped tremendously. I could only produce enough breastmilk for one baby, but I had two. Formula is expensive (as are babies, and we had two!), so the formula that the hospital sent us home with was invaluable. We wouldn’t have bought the nursettes on our own (we’re too cheap), so the ones that the hospital gave us made the first few weeks of parenthood a little bit easier. We weren’t having to mix formula after not sleeping.”

“I had a stack of breast feeding information given to me, a breast feeding class to attend, and a formula bag with some info and a small can of formula. The bag was just a nice gesture to formula being a choice for me and my babies.”

“I wasn’t as stressed about breast feeding bc I knew I had some formula to use if needed.”

There were some responses suggesting that the formula samples were detrimental to breastfeeding success, supporting my assertion that these should be clearly called Formula Bags, and only given upon request:

“It made me feel like the only option was failure… Here are samples and coupons so you can hand your life over to the formula companies.”

“… I forgot about it and when I found it the formula was expired. It was wasteful.”

“I felt like thenurses had no confidence in my ability to breastfeed. When I was given the bag I felt like I was destined to fail and everyone knew it except for me. My sister helped me to overcome the initial obstacles and I was successful meeting my breastfeeding goals, but without her I’m not sure I would have continued past two weeks.”

For those respondents opposing Ban the Bags, the most common impression was that it shamed formula feeding parents:

Chart_Q5_15110467% of respondents felt that the initiative “shames parents who choose formula”; 60% didn’t like banning the bags because the samples came in handy; 31% said that the bags were “the only source of formula education I received.”

Open-ended responses included:

“Because it’s paternalistic and undermines a parent’s right to choose how to feed her baby”

“I don’t think it should be banned altogether, samples should be available to women who choose to formula feed or combo feed, but I don’t think formula companies should be targetting women who intend to breastfeed exclusively any more than Lansinoh or Medela should target women who intend to formula feed.”

“Because it should not be the government’s business to create a culture of shame around a product that many new parents need. I think it would be fair to educate new parents that supplementing may interfere with their milk supply if they express a desire to breastfeed exclusively. Beyond that, they should leave it up to the parents if they wish to receive them or not. If a company wishes to provide a sample, their client base should be allowed to receive it…the samples are helpful as parents make decisions around what is best to feed their child.”

“Because it implies a qualitative judgement on formula use. Parents have a right to choose their feeding method and the hospital does not have a right to attempt to manipulate that choice. With both of my children, I was offered only pampers brand diapers in the hospital. Why does pampers get the opportunity to push their brand name but not a formula company?”

“Because it is completely, 100% disingenuous and insulting to insinuate that a promotional bag has more power over me than my own well-reasoned decision-making processes.”

“It implies parents aren’t capable of making a choice. That we women are so weak willed that if we see a formula sample we’ll throw our breastfeeding goals away for a few samples. It laughs in the face of informed consent. If one is going to make a choice human milk or formula then they should be given ALL of the information. The only information parents are given at appointments and from the hospital is about breastfeeding. Yet if a formula company gives formula information it’s decided it’s only for marketing. Sure formula makes formula companies money but if the hospital offered unbias formula information about it instead of 10 risk of formula feeding lists we wouldn’t be seeking it from the formula companies.”

“Much like banning condoms & birth control doesn’t prevent sex, banning formula samples & literature doesn’t prevent parents from using formula. It’s dangerous – parents need ALL the info about infant feeding. “Ban the Bags” initiatives are tantamount to sticking your fingers in your ears, closing your eyes, and saying “na na na I can’t hear you it’s not happening.” Childish and completely ineffective.”

The most attractive solutions for most respondents were to hand out the sample bags only upon request (73%), or to give an unbiased book/pamphlet talking about all infant feeding options (62%)  as an alternative:

Chart_Q7_151104(Interestingly, 19% chose “parents could receive sample bags of breastfeeding-related products”. I find this interesting, as it does negate the more palatable argument (at least in terms of feminism and bodily autonomy) that the reason to ban the bags is to take corporate interests/marketing out of healthcare settings. Apparently, predatory marketing on postpartum women is perfectly okay, provided it comes from Lansinoh rather than Similac.)

Many respondents mentioned feeling like the gift bags “normalized” formula, saying that it was the only time formula was mentioned or seen during their hospital stay. For those choosing to formula feed or combo-feed from the start, this can be disheartening. If formula were discussed as an option, without the scare tactics or patronizing language used in most healthcare settings, perhaps getting rid of the bags would meet with less outrage. In a space left for respondent comments, a sense of feeling marginalized and that there was only one “right” choice for infant feeding was clear:

“I had zero information about the right way to formula feed. I had no idea how good formula was good for, how to properly store it, the right amount to give, etc– I only learned from formula containers. Information about this in a pamphlet would have been very helpful.” 

“The lack of free formula is not my concern. I am concerned that regulating this shames formula feeders (i.e., the message is that formula is so awful it should not be given out by a hospital). I am also concerned about the total lack of education in hospitals about when and how to supplement or EFF.”

” These are often the first times mom and dad are presented with formula, and the only “education” and information they may receive about it. Yet breastfeeding info and help is available in quite a widespread manner. Again to take this away would do a great deal of harm for parents who may exclusively formula feed, as they could certainly use whatever educational info they can get about formula feeding.”

“Parents should be given accurate, and unbiased info about ALL feeding options. Denying info about a healthy, and nutritional feeding choice merely due to zealotry does nothing to help women, or children.”

“Formula information and samples should always be available on request – no questions asked. Also safe and clear information for both feeding methods needs to be made to all parents. Breastfeeding, pumping, bottle feeding, sterilising equipment, post partum depression, maternal health, and safe practice for storing formula and breastmilk.”

Although there’s been a recent backlash against breastfeeding pressure, this is not an issue of questioning breastfeeding’s benefits. Of course hospitals should be protecting and supporting breastfeeding, provided it is something a woman is not opposed to doing, but we also have to be realistic: formula is here to stay. It is going to be used, and the way we’re going about things now, it is going to be used incorrectly, with shame and guilt and fear. Of course direct marketing to patients has no place in the healthcare setting, but in a climate where formula is being kept under lock and key and treated like tobacco or alcohol, we need to be aware that the formula companies are often the only ones discussing their product with new parents. If we truly care about “putting the health of our smallest patients first”, then do exactly that, because leaving their parents without proper info on formula use is putting their heath in danger. Making their mothers feel marginalized simply because their breasts don’t work how they are supposed to, or because they have personal, valid reasons for not wanting to feed a child from a culturally, emotionally-loaded part of the female anatomy, puts the mothers’ health in danger, which can obviously affect infant health as well.

These are not simple issues, so let’s not oversimplify them by insisting that taking away a bag – a bag that can be taken or left, like the jello on the hospital tray – is going to make a huge impact on breastfeeding rates, while ignoring the impact it may have on the experiences of formula-using parents.

Balance before bans. That’s all we ask.

 

 

 

 

 

News Bites: Lack of support for breastfeeding moms; Organic formula hyperbole

My blood pressure is rising, and I’m mid-tirade directed at my poor, innocent husband when it hits me: It must be time for a good, old fashioned, FFF news roundup.

Those of you who’ve been with me for awhile probably remember that I used to do these frequently, especially when something in the news cycle gives me a bout of psychologically-induced hives. So it may come as no surprise that I felt the urge this morning, when not one, but two frustrating pieces popped up in my news feed.

First up, we have coverage of a new study in the aptly titled “Morbidity and Mortality Weekly Report”, claiming that women are still not getting sufficient support in American hospitals for breastfeeding.

According to NPR:

Most hospitals around the country aren’t doing a good job of helping new moms who want to breast-feed, researchers report Tuesday..Several common practices at the institutions may actually prevent moms from sticking with breast-feeding for six months — the duration thought to be most healthful for babies.

 

Epidemiologists at the CDC surveyed more than 80 percent of the birthing centers across the country about the support they give new moms trying to breast-feed. About half of those surveyed said they implement five of the 10 practices recommended by the World Health Organization. By comparison, only a third of hospitals were hitting that mark in 2007.

Looking at the study itself, the news is far from dire. In fact, according to the CDC report of the evidence, “nationally, hospitals implementing more than half of the Ten Steps increased from 28.7% in 2007 to 53.9% in 2013.” That’s a pretty significant jump, but the media decided to go with the story that “hospitals aren’t doing enough to support women in meeting breastfeeding goals.”

This is me, reading these articles. Not really. But it SO could have been.

This is me, reading these articles. Not really. But it SO could have been.

But what is the real story, here, and how come no one is talking about it? What this study tells us is whether hospitals are following what they are ‘supposed’ to do to help improve breastfeeding rates. These are things like providing mandatory breastfeeding classes, holding breastfeeding support groups (or referring out to La Leche League, etc.), making sure no pacifiers are given to neonates, and outlawing the use of “unnecessary” formula supplementation – something which the NPR piece gives ample air time:

And, too often, that’s not happening. For example, about 75 percent of hospitals still give healthy babies some formula in the first days of life, even when moms say they want to breast-feed.

 

“Even a little bit of formula may undermine a strong start to breastfeeding,” Frieden says.

Again, let’s go back to the actual study. All it tells us is that “less progress occurred in limiting non–breast milk feeding of breastfed infants (20.6% to 26.4%)”. “Breastfed infants” means infants who start out breastfeeding, presumably. But many, many parents end up supplementing by choice or by necessity – and the study does not differentiate between these situations and the type of scenario the media is imagining, where innocent breastfed babies are stolen from their parents in the night and force-fed Enfamil.

This study is not news. This study is not, in fact, telling us anything about whether women are getting “support”, at all. It is telling us whether the number of hospitals following government guidelines for raising breastfeeding rates is going up (it is). It does not correlate that number with any increase in actual breastfeeding rates. It does not survey women and ask if they felt supported in achieving their breastfeeding goals. And it certainly does not factor in the needs or experiences of women who do not want to breastfeed, or physically can’t.

But it’s not the study I’m worried about – it’s the media’s insistence on sticking to one stale, tunnel-visioned narrative, insisting that what women need is support, but defining “support” as more control over their decisions and bodies; deciding that “supporting breastfeeding” means what one group decided it means, rather than listening to women, and asking them what would really help them achieve their goals. We end up exactly in the same place we were before: with hospitals implementing pro-breastfeeding policies and then wondering why their patients and nurses are making them so difficult to carry out. (Maybe because they aren’t the right policies, or they aren’t being implemented in the right way.)

Moving on… to a piece that could have been a nice little gift to formula consumers, something that actually made a case for better transparency in the formula industry, in the popular New York Times “Motherlode” column. If you’re not familiar with Motherlode, it usually features well-written personal essays on parenting, with the occasional news, book review, or opinion piece. Today’s column, “What Does ‘Organic’ Mean For Baby Formula”, was none of these, but rather a bizarre bit of “investigative reporting” that would have fit better over on Food Babe’s blog. The author of the piece writes:

…I began to question what, exactly, were the unexpected and confusing things I was reading on the ingredients lists.

The biggest surprise was that in many of the formulas, the main ingredient was not milk, but highly processed, refined sweeteners (often listed as organic glucose syrup solids). I generally avoid feeding refined sweeteners — even organic ones — to my children. I was even more taken aback to see how many also included ingredients one wouldn’t typically expect to find in organic food — like synthetic preservatives.

I won’t bore you with all the specifics of why formulas contain sweeteners, synthetic preservatives, and “confusing” ingredients, except to say this: companies have done their R&D to make the healthiest product possible for the lowest possible price. There may indeed be less processed or more premium ingredients available, but we don’t have any research proving that more expensive or organic formulas are any better for a child’s health, so there doesn’t seem to be justification for using materials that would raise the cost. (Note: If you do want more info on formula ingredients, visit Dr. Chad Hayes’ fantastic website).

Now, to be fair, I understand the author’s confusion; if you’re used to buying high-end organic food, the back of a formula can – organic or not – is going to be super intimidating. But it’s important to remember that the definition of organic food is simply about the sources of the ingredients:

“What is organic food? Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations.  Organic meat, poultry, eggs, and dairy products come from animals that are given no antibiotics or growth hormones.  Organic food is produced without using most conventional pesticides; fertilizers made with synthetic ingredients or sewage sludge; bioengineering; or ionizing radiation.  Before a product can be labeled ‘organic,’ a Government-approved certifier inspects the farm where the food is grown to make sure the farmer is following all the rules necessary to meet USDA organic standards.  Companies that handle or process organic food before it gets to your local supermarket or restaurant must be certified, too.”

-Consumer Brochure, USDA National Organic Program, http://www.ams.usda.gov/nop/Consumers/brochure.html

To clarify, in organic foods, the ingredients used can’t be derived from sources using GMO, pesticides, antibiotics, and so forth. It doesn’t mean that the food is healthy or whole. You could make an organic version of a Twinkie, but it would still be a Twinkie.

Now, in the case of formula, we are talking about something healthy – but also highly processed. This is chemical food, and it should be chemical food. It is a substitute for human milk; hence, the only way it can come close to human milk is by being recreated in a lab. Every mammal creates milk specific to its species; having the primary ingredient of human infant formula be cow’s milk has to do with cow’s milk being cheap and readily available, and easy enough to alter to be suitable for human consumption; it’s not because cow’s milk is particularly good for humans, whether it comes from the udders of grass-fed cows or not. 

I honestly do not want to criticize the author of the NYT piece. She sounds like a very well-intentioned mother. But I do think that an article which seems on the surface to be investigative journalism instead of an opinion piece, could be misleading to other well-intentioned parents, who will now feel that they have to pay exorbitant amounts of money to feed their children “healthy” formula: 

On a friend’s advice, I began to research two formulas made in the European Union, HiPP and Holle. It seemed pretty clear: these formulas came closer to what I would expect in organic baby food. No refined, high-concentrated sweeteners. No synthetic DHA or ARA. No synthetic preservatives. HiPP says it analyzes all its agricultural projects for traces of over 1,000 different substances. The main ingredient in Holle’s formula is milk that comes from pasture-fed cows raised on biodynamic farms.

 

Holle and HiPP are great products. And the author’s assertion at the end of her article, that parents need better options, is spot-on. I want there to be more communication between formula manufactures and parents, so that we all understand why certain ingredients are in our babies’ food. I want there to be ample options for kids with all sorts of food sensitivities; formulas for vegans; formula for parents who care about grass-fed cows. Because that’s the beauty of using a manufactured product – it can be altered. It can evolve.

What I don’t want is fear-mongering or confusion running around, when parents are already stressed and scared about formula use. I want parents to know that while DHA/ARA is indeed hexane-extracted, that does NOT mean that any hexane remains in the DHA/ARA. I want them to know that the reason many companies don’t use lactose is not because it’s expensive, but rather because cow lactose is different than human lactose, and many babies have a hard time tolerating it. I want them to know that yes, ingredients matter, and it’s absolutely okay to care about what goes into your body and your baby’s body (not that you need my permission or anyone else’s to feel how you’re going to feel, but you know what I mean), but the formulas on the market now have been tested, highly regulated, and proven to work beautifully for the majority of babies.

Insisting that we have more choices and better consumer knowledge does not have to mean throwing the generic brand-fed baby out with the bathwater. Let’s stop and talk to the people who are creating these formulas, and not just stop at the Cornucopia Institute (because both sides are affected by very strong bias, and you need to balance one extreme with the other), as well as some totally independent, science-minded folks. Let’s aim for truth and nuance rather than absolutes and middle-class food politics.

And now, I’m going to go celebrate the Cubs securing their place in the post-season, because that’s the only news really worth talking about, anyway.

 

***For a great breakdown of the organic formula options currently available in the US, visit the Incredible Infant’s Guide to Organic Formula.***

 

 

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