Special Feature: Excerpt from the new book, “Becoming Mother”

I am so thrilled to bring you a free preview of Sharon Tjaden-Glass’s new book, Becoming Mother: A Journey of Identity, which came out just today. Becoming Mother is “a reflective memoir that spans from pregnancy through the end of the first year postpartum. It follows the author as she resists, denies, copes with, and ultimately embraces her identity as a mother.” I love how Tjaden-Glass blends introspection with reflection on larger social issues, and I especially enjoyed her chapter on feeding her daughter, which you’ll find below. If you’d like to read more, the book is available on Amazon (Print and Kindle), or you can visit her website. 

- The FFF

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Why did my inability to breastfeed cause me so much devastation? Was it perhaps because I still felt so connected to Felicity? Certainly, this presented a paradox: How could our needs be in such conflict while we were still so attached? She needed food, and I couldn’t provide it. It seemed impossible.

But there was another, deeper layer to my devastation—the devastation of a wounded identity, one that was still a newborn itself. That fresh identity as a competent mother—hero of my own story, defender of my newborn baby—was now at risk. I was becoming some breed of mother who didn’t neatly fall into one category or another. How could I have had an unmedicated childbirth and now be formula feeding my baby? What kind of mother was that?

Mothers like me didn’t seem to exist in mommy blogs or on-line forums. Mothers who gave birth without medication always breastfed their babies! They endured the pain so their babies would be alert after birth and latch with no problems. If they could stand the pain of childbirth, the pain of nursing cramps and chomped nipples and mastitis would be child’s play.

This is what I thought.

But again, these thoughts emerge from living in a society that emphasizes choice. When our concerns are not simply feeding our children, we can refocus our concerns on how we are feeding them. And when those feeding choices are presented on a continuum of “good, better, and best”, it’s fairly easy to jump to the conclusion of “good, better, and best mother.”

Even after I reassured myself that I was a competent mother, I knew the stereotypes that follow mothers who formula feed today. Our identities are not solely composed of what we think about ourselves. They also include—whether we like it or not—what others think about us. We may not care what some people think about our parenting, but we want those whom we respect to see us at least as good parents, if not great parents. And so this was a major psychological blow at a time when I was already bottoming out because of the fluctuations in my postpartum hormones.

So when I was unable to breastfeed, I had to reconcile many truths. I had to surrender my commitment to breastfeed. I had to accept that my baby wouldn’t be eating what everyone was calling “the best.” I had to reconcile what this decision said about my new identity as a mother. And I had to accept a very definite separation from my baby at a time when I wasn’t ready to let go.

Until I decided to wean Felicity, I had relied on evidence-based research to make decisions about labor, birth, and feeding. And while all of this knowledge helped me to avoid an unnecessary labor induction, it was not the definitive authority that I had imagined it to be during pregnancy. Because I lacked confidence in my own instincts as a woman and a mother, I placed all of my trust in this research, believing that it would provide me the best counsel about how to solve any problem that I could encounter as a new mother.

In fact, Davis-Floyd (2003) explored this tendency of American mothers to grant more authority to scientific knowledge than their own intuitive and bodily knowledge. She asserts that this tendency arises from American cultural beliefs that possessing, “scientific knowledge about medical birth” gives mothers power and control in a culture where, “knowledge… is respected… (and) enables one to be a competent player of our cultural game” (p. 31). Not only does her cultural observation explain my intense desire to read and research during pregnancy, but it helps me understand my own distrust in my body’s signals.

But if I had been able to listen to my body and trust my instincts more, I would have probably stopped breastfeeding around eight days postpartum. It was at this time that I knew my milk supply was not going to increase. My daughter was already eating mostly formula despite my constant pumping and nursing. I had done all of the interventions that I could try and the outcome was the same—one to two ounces of breast milk per day. At this point, I had to start denying what was happening to me in order to keep going. Every time I nursed her, I reminded myself that breastfeeding was best and that I was doing the right thing. I refused to let myself focus on the fact that she could only draw half an ounce of breast milk during a feeding. Instead, I allowed statistics and the results of scientific studies to overshadow my own personal experience.

 

But it wasn’t just research that fueled my self-denial.

It was also my own pride.

 

I shared in today’s breastfeeding enthusiasm to the point of sacrificing my own health. I had read about the dangers of infant formula. I didn’t want processed food going into my baby’s body. Unlike women of my mother’s and grandmother’s generations, I live in a time when breastfeeding is now heralded as the best decision that mothers can make for the health of their babies. It supports their immune systems. Breast milk is more easily digested, so babies have fewer cases of constipation and diarrhea. It makes them smarter? It decreases their chances of developing obesity? Okay, those findings seemed like a stretch, but I was willing to believe them—since I was going to breastfeed.

 

But ultimately, it was my own pride that kept me nursing and pumping until I literally had nothing left to give.

 

I didn’t want to be criticized. But I also didn’t want to be wrong.

 

I realize now that in those early months of her life, whenever nursing came up as a topic, I found myself trying to convince people that I didn’t choose to formula feed. Instead, I was forced to formula feed. I thought about all the assumptions that someone might have about me if they thought that I had chosen to formula feed. Assumptions that I had gathered from the hospital’s breastfeeding class, from popular breastfeeding books, and from on-line forums about breastfeeding. Through the postpartum fog, I could almost hear their thoughts.

 

Maybe you should have pumped more. Nipple shields slow the stream of milk. You should have taken more herbal supplements or tried this medication that I took. If you slept more, your milk would have come in. Are you sure her latch was good?

 

For the first few months of Felicity’s life, nearly every conversation with another mother started with the presumptive “So how’s the nursing going?” or the kinder “Are you nursing?” I never started these feeding conversations, but they came up in every conversation with a visitor who came to our home in those early months.

 

“I’m not breastfeeding anymore,” I would say.

 

The long pause. The nod. The silence, as if waiting for more.

 

Every time, I tried to figure out how to get out of the conversation without breaking into tears. I found myself answering questions that they hadn’t even asked. I launched into explanations of how hard I tried, how often I nursed her, and the types of interventions we used. The two weeks of devastating insomnia, the miniscule yield from pumping sessions, her weight loss, my descent into hell.

 

And then I would end with, “But really, medically there’s a problem with me. My milk never really came in. Really, I didn’t have any engorgement. I have thyroid issues, so that’s probably what caused it.”

 

But no matter how convincing I thought I was, I was embarrassed to even talk about the issue because of an oft-repeated statistic about how nearly every healthy woman can produce enough milk for her baby. Only one to five percent of women are not able to produce enough milk for their babies, I had read over and over again in breastfeeding literature.

 

And that was how I was asking others to view me—as a person as uncommon as someone who grows scales instead of skin.

 

Me. The person who believed in the power of her own body. Who had just given birth without medication. Who believed that if she just listened to her body, that it would do what it needed to do.

 

Me. The person who was convinced that all problems with breastfeeding could be solved with knowledgeable interventions and perseverance.

 

Me. The person who was disciplined and persistent enough to kickbox and portion-control her way to a size six.

 

Me. That person.

 

Suddenly, it seemed that all of those qualities that I had spent a lifetime practicing were not true anymore. That freshly crafted identity as a strong, capable mother was now unraveling fast.

 

So underneath my explanations for why I wasn’t breastfeeding, my tone was desperate. It screamed: Please, please, everyone! Please just believe that I’m a medical anomaly, defective on the inside. I’m not stupid, or uninformed, or lazy, or selfish. I’m just broken, everyone. That’s why I’m formula feeding, not because I chose it!

 

When we made the switch, I prepared myself for the worst. A sick baby. A colicky baby. Diarrhea. Constipation. Blood in the stool. But none of that happened.

 

What did happen was much more positive. Formula feeding helped me expand my understanding of what it means to be a mother. Before I stopped nursing Felicity, almost all of my interactions with her revolved around marathon feedings and pumping sessions. My sole role was nourishment. There was no room in my mind to be anything else to her. When I wasn’t nursing, I just wanted to be alone. I just wanted to sleep. I just wanted to feel better. But I couldn’t sleep and I didn’t feel better. Near the end of my time breastfeeding her, I would tear up at the sound of her hungry cry and think, Not again. I can’t. But then, I would get up and do it.

 

But once the pumping sessions and the marathon feedings were gone, once the sleep returned in increments of two hours, I started to look at her. Just look and look at her. Listen to her. Talk to her. Play with her. Here was this person whom I felt that I already knew, and yet I still had everything to learn about—what her voice would sound like some day, what activities she would like to do, and how it would feel for her to hug me. For the first time, I started to look into the future a bit and get excited about helping her pack her bag for her first day of kindergarten or helping her learn to tie her shoes. I was finally able to imagine what kind of mother I wanted to be.

 

And then I started to wonder, Why does it matter how I feed her? And why is this topic open for public discussion?

 

And finally: So what if I did choose to feed her formula? Does that make me a bad mother? Don’t we value choice in our culture anymore?

 

All those breastfeeding books had presented formula as a choice for mothers who weren’t dedicated to the sacrifices and challenges of breastfeeding. Was I dedicated? Did I care about the health of my child?

 

Why, yes, I did. So that meant that I would breastfeed.

 

The decision to breastfeed wasn’t framed around the starting point of what was healthiest for me. Instead, the decision was framed around what was healthiest for my baby. And breastfeeding can be incredibly healthy for many mothers. But breastfeeding literature never mentions that it can be unhealthy—either physically or emotionally—for others. So the message is clear. I should be more concerned about what is healthiest for my baby because I’m a mother now. And mothers sacrifice. Everything, if need be.

 

And I did.

 

But when the herculean attempts to eat enough, pump enough, and nurse enough had worn me down into a sliver of a human being—no longer able to make rational decisions, no longer able to feed myself, no longer able to walk to the bathroom without assistance, no longer able to recognize my own face in the mirror—I started to wonder, How much more do I really have to give before I’m dead?

Still, it was tiring and it hurt to feel the need to defend how I fed Felicity. Feeding is part of the public sphere, a topic suitable for conversation with others. Everyone could figure out how I fed her and, with that knowledge, a host of assumptions were already in place about why I fed her this way. Maybe I thought breastfeeding was repulsive. Maybe I lacked confidence that I could do it. Maybe I had fallen victim to the hospital procedures that often interfere with the breastfeeding relationship. Maybe I didn’t know all the medical studies about the benefits of breastfeeding. Or maybe I was misinformed and thought that breastfeeding would ruin my boobs. Or maybe I was just selfish and wanted someone else to feed her while I got some decent sleep.

How did I know about these assumptions? They belonged to me. They were my thoughts before I gave birth.

In fact, I can attest to the fact that as a first-time mother, I greatly appreciated the cultural divide over breastfeeding because it made my choice much easier. I read books about breastfeeding. Then, I looked within my own educated, upper-middle class, white community and I saw that breastfeeding was valued and widely practiced, and that—as far as I could tell—everyone had been successful at it. I wasn’t looking for a reason to be different from everyone else.

 

But perhaps the most convincing evidence for my decision to breastfeed was the testimony of the nurse who taught the hospital’s breastfeeding class. As I reflect on that class, I can now see how the nurse’s own personal experiences regarding breastfeeding shaped her response to that question about the possibility of not producing enough milk. From her position as a medical professional, she advised, “Feed your baby.” From her position as a lactation consultant, she stated that, “Ninety-five percent of women can breastfeed their babies.” From her position as an experienced breastfeeding mother, she claimed, “If you stick with it, it will get easier.”

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She had given me exactly what I wanted to hear—a positive view of breastfeeding, approved by both a medical professional (to meet my husband’s criteria for credibility) and a mother of four (to meet my criteria).

 

As a new mother, advice based on personal experience was often compelling to me, even if it varied so much from person to person. I simply listened to the voices whose advice matched what I wanted to hear and ignored or discounted the voices that I didn’t. I didn’t want to hear about women who had epidurals, or C-sections, or formula fed their babies. That wasn’t going to be me. They had made bad decisions that had put them in those positions, so I didn’t want to listen to their stories.

This way of viewing the world didn’t pose a problem until I found myself on the other side of the line that I had drawn. Instead of a breastfeeding mother, I was a formula feeding mother. And all those silent judgments that I had once pronounced in my thoughts—never once out loud—were now heaped upon me. I hadn’t even realized how harshly I had judged formula feeding mothers until I had become one. The pressure was more than I could bear. I was forced to mentally confront each stereotype that I had about formula feeding. I was not lazy. I was not selfish. I was not a quitter. I was not stupid or uninformed. I was not pro-corporate America.

It helped to talk with friends about how difficult breastfeeding had been for me and to read stories of women who had traveled this road before me. It took months of reflection to create a mental space where I could be confident in how I fed Felicity.

 

I remember the day that I realized that I had this confidence. Felicity was six months old and one of Doug’s cousins was visiting. She was a single woman in her mid-twenties. She had never met Felicity before. When I started mixing a bottle of formula, she asked if I had ever breastfed Felicity. It didn’t sound like an accusation. I doubt she realized how emotional that question could be for a new mother.

 

I said, “I did. For twelve days. And then we had to switch to formula. I wasn’t making enough milk, so that’s what we had to do.” She didn’t push the issue, and finally I didn’t feel compelled to explain myself further.

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- Excerpted from Becoming Mother: A Journey of Identity by Sharon Tjaden-Glass (Lucky Frog Press, August 1, 2015). Reprinted with permission from the author. 

Forget “baby friendly” – why not “family friendly”?

More and more hospitals are adopting the Baby Friendly Hospital Initiative, based on the 10 Steps To Successful Breastfeeding. For women who want to breastfeed, this can be fantastic news – especially in areas where breastfeeding is not the societal norm. It also is positive news for mothers who want to room-in with their babies.

The problem is, though, that these initiatives are billed as good news for everyone; something that is being done for the benefit of all babies and mothers. Framing them this way eliminates any chance of individualized healthcare, often putting the baby’s needs above the mothers, or some mothers’ needs above other mothers’ needs.

It doesn’t need to be this way.

Breastfeeding support is crucial. But so is maintaining personal autonomy. So is support for postpartum mental health. So is a mother’s physical health. So is support for adoptive families. So is support for fathers, so that they are rightly made to feel they have equal responsibility in this child-rearing game, from day one. Until then, parenting will remain an undeniably gendered activity.

I do not believe that Baby-Friendly has to mean mother-unfriendly. I think there are many wonderful things about the 10 Steps. But to put breastfeeding first, instead of on the same level as other aspects of infant care, is misguided.

I asked the women of the Fearless Formula Feeder Facebook community – one that spans over 50 countries, and over twelve thousand people from all walks of life- to answer a question: “What would a truly family-friendly hospital look like?” The responses are below, and I hope that care providers, nurses, politicians, and especially hospital administrators will read these. They range from general policy suggestions, to personal experiences of what works, and what doesn’t, when it comes to maternity care.

Some of these suggestions are cost-prohibitive, of course, or may not apply in certain medical/insurance-based situations. But overall, these are simple requests. Respect. Autonomy. Kindness. A plea for care providers to truly do no harm.

I know we can get there. Many hospitals are already doing this, and doing it well. It can’t be about exclusive breastfeeding rates, and losing funding if you don’t have a specific number of babies leaving without receiving supplementation. It has to be about patient care. Long-term outcomes.

Do no harm. That’s all these mothers are asking.

 

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WHAT WORKS

 

“I experienced a truly baby and family friendly hospital. The nurses educated me and hubby each day on how to do things to care for our son. Including how to formula feed safely and correctly.”

 

“My experience was great. The nurses were so helpful and friendly and kind and always willing to help with my latch, etc. I had a hard time meeting with the LC because I was often in the NICU when she made her rounds. but they made sure I got to see her right before I checked out. I did not feel judged with my right off the bat combi-feeding and they were very open to having my husband come into the NICU and feed baby boy when I was too wiped out. I felt like they took care of me and the baby.”

 

“I gave birth at a ‘baby friendly hospital’ and I was extremely pleased with my experience. The hospital staff made the biggest difference for me. I was given options, and I was never once questioned on my choices nor did the staff feel compelled to “educate” on my decisions. I told a nurse I was struggling with breastfeeding. Her response was a simple and kind ‘Would you like some formula? Or to see a lactation consultant?’ One nurse noticed my son was extremely fussy, and asked if they would like me to take him to the nursery so I could get some rest. Being helpful yet respectful, that’s what a baby friendly hospital should be about. A little bit of tact goes a long way.” 

“The hospital that I delivered at… allowed two support people to stay 24 hours a day, and had fold-out chairs provided for them to sleep on. This allowed both my husband and mother to be present before, during and after birth. The number of guests is restricted, and all visitors must be pre-approved by mom. Nurses were amazing – supportive and knowledgeable. We also had access to a lactation consultant. Baby stays in the room with mom at all times, and you are given as much or as little support as you need. Once home, I was visited by the public health nurse, who checked in regarding both the baby’s health and my own, including my mental health.”

“I found both of my experiences to be family friendly. I had the privacy of a private room without extra costs, respect for my decisions, especially with feeding. They were ready to assist with breastfeeding, and when that wasn’t working out, had formula ready and waiting. They encouraged both options without judgment, and made me feel that baby having a full tummy regardless of the method was what was important.”

 

WHAT DOESN’T WORK

“After baby was born.. it was like I didn’t exsist.. even though I was having medical problems like clotting and depression.. I think there should be a team of nurses that still “make sure your ok.”…He’s got to go home with me.. and I am a hot mess. I had a high grade fever for 2 days…I told them I thought I was and they didn’t check till I was almost released and then I got a big IV of antibiotics.. not to mention, crying all night.”

“I made it very clear when my son was born that I wanted him breastfed, but supplemented as needed. No one gave me any idea how to do so, or saw fit to tell me what he needed, even when he lost 11% of his body weight.”

 

“I just generally felt like I had no idea what I was supposed to do. I was tired and confused and the only solution I had for anything was check the baby’s diaper, then attach him to the breast to see if that helped. It did, and my OB said it was fine when I saw her in the morning, but I spent all night going, “Oh god am I doing this wrong? It’s 2 AM and I have forgotten what sleep feelings like and I can’t find the light switches to turn out the lights.” And the thing is — I had overall a very positive birth experience! But I felt left alone a lot when I wish someone had been able to offer a bit more general guidance overall. And I don’t know that it’s really possible in current US medical settings, which generally assume your family can step in and be that role.”

“Allowing c-section moms to send their babies to the nursery for a few hours at a time. With baby #3, my hospital started a “rooming in” policy, which they claimed was to enhance bonding, but really it was b/c they are short staffed with budget cuts. My husband had to be home with our girls, so I was left on my own, the same day/night as a major surgery, to try and get in and out of bed, care for the baby, and try to pump. By the second or third night, one of the nurses saw how completely exhausted I was and offered to take the baby to the nursery so I could rest. I am still grateful for her kindness and foresight.”

 

“Family-friendly means being heard. My daughter refused to feed her first day. I kept saying something was wrong, nurses kept telling me it was normal. She was lethargic from blood type incompatibility jaundice. My boobs were handled by more people than I could count. They had me hand expressing for droplets. It was awful. They found the jaundice at her 24 hour tests and nobody explained it- just stuck her under lights and left us alone. Because I was a first time mom I wasn’t listened to, I was brushed aside.”

“The ability for support people to ‘tag out.’ When our kids were born, Dad got an ID bracelet in the delivery room. Awesome – it meant they knew which baby belonged to which grownup. Great idea. But once that band went on, it meant he was the ONLY person allowed to stay past 8pm (when visiting hours ended). So his choice was either stay to be able to help me, or go home and put the other kids to bed and retain some semblance of usual in their world. It would have been awesome if someone else had been able to come for a couple hours while he did bath and bedtime (even just until 10 or 11) and maybe caught a nap himself.”

“Kangaroo care. Yes, I understand the benefits. But for me, someone who is painfully modest, it was a bit alarming when a nurse ripped open my grown and exposed my body to a room full of students (no warning!) I would have rather swaddled my newborn and shared him with my husband, rather than lying there in the hospital bed for an hour (because it was required, I mean *suggested*) while listening to my new baby cry. They didn’t listen to me when I told them that he needed an immediate bottle for low blood sugar, though they knew I had gestational diabetes….Too many mothers are treated like second class citizens with no apparent needs. This must do wonders for those who will experience postpartum depression.”

“I was told during my birthing class that the hospital highly encouraged rooming in as mother and baby sleep better that way (not true in my case). Even walked us past the empty nursery to show us that most people don’t send the baby to the nursery, so I felt very guilty asking for them to take her for a few hours.  I only got 2 hours of sleep a day while in the hospital.”

“Avoiding passive aggressive comments regarding decisions parents have made (I just got a lot of “Well, at least she’s still getting breastmilk” comments from my hospital when I told them I’m pumping instead of breastfeeding her – and she’s in the NICU and can’t even breastfeed yet!). Being able to deviate from a policy when it’s deemed appropriate – I had to watch a video before being discharged about how to care for my newborn. My newborn has a heart defect and is in the NICU and is in fact NOT coming home with us. Having to watch a video about caring for the baby I’m not bringing home kinda sucked. It would have been nice if the nurse could just note that I didn’t watch the video cause it didn’t really apply to me. Plus it was a really outdated and stupid video in general.”

“A true baby friendly hospital experience would not involve nurses or doctors pressuring a new mom into breastfeeding. I spent the first 48 hours of my child’s life listening to nurses telling me that “breast is best” and crying because it wasn’t working for us. I felt like a huge disappointment to my baby. You are celebrating a new life! It should be a joyous time, not a depressing one.”

“I would love to see a hospital that gives a detailed tutorial on how to supplement and when. I had planned on exclusively nursing with my first but when that did not work out I was told to supplement. Well what does that actually mean? I didn’t know and I was so exhausted I didn’t even feel up to researching it so I ended up moving straight to formula. If I had had more help then perhaps I could have nursed longer.”

“I felt pressured to make breastfeeding work and then felt guilty when I requested to start supplementing with formula while in the hospital. They made me sign a form for documentation purposes saying I was educated in the benefits of breastfeeding and only 1 nurse out of my entire 3 night stay post c-section (and she just so happened to be the very last nurse I had prior to discharge) made me feel truly supported & told me it was ok to do whatever I chose and baby would be fine regardless. I think a truly baby/family friendly hospital would be supportive and accepting no matter what feeding method you choose.”

“I would have loved to get some sleep and not have nurses wake me up every two hours. That just gave me such a rough start to parenthood. We actually left the hospital early to get some sleep at home.”

 

“I would have liked more information on nursing and what that would look like over the first few weeks, as well as things like weight gain and how that was supposed to look. I read a lot about breastfeeding beforehand, and I also went to a breastfeeding class, and they all seemed to emphasize the number of diapers thing but not the normal weight gain range, so it took me a while to realize that my supply wasn’t sufficient. It wasn’t until my SIL, a nurse, told me that my kid should be gaining an ounce a day, not an ounce or two a week, that I realized we had a real problem, not just something that would go away if I nursed constantly. I don’t know how I missed that information when I was weighing her weekly at the public health unit to check on her weight gain, but I did. So more information on supplementing, and when it’s a good idea, and more support for that would have been helpful. Also, not having the doctor who delivered my daughter try to squish my nipple into her (the baby’s) mouth roughly in an attempt to show me how to latch would have been good.”

“(I wish they’d had) an explanation on why they’re encouraging you to do certain things. The reason being, I had preeclampsia so my daughter was born a couple weeks early. I was very sick and had a very hard induced labor. So I was extremely out of it even a day or two after she was born and staying in the nicu. The nurses brought a pump in the room and kept telling me I had to pump but I didn’t understand why I had to do it so soon. I understand it now but at the time I would’ve appreciated an explanation instead of just being given a pump and a deadline.”

 

 

WHAT MIGHT WORK

“ I think a family-friendly hospital initiative service would entail 1) LC’s that provide support and education in both breast and safe formula feeding practices minus any rhetoric or ideology promoting one over the other, 2) allowing parents to either room-in with their new babies, or send them to a fully-staffed nursery in case they need some uninterrupted sleep during their hospital stay, 3) provide support and education to new fathers on what to expect, how to become involved in the early days, etc., 4) will provide genuine evidence-based care before, during, and after the birth, 5) supplying parents with resources regarding feeding concerns, emotional support, and physical care for the post-partum stage once the family is sent home.”

“Recognize that mom is also a recovering patient… especially if she’s had a traumatic birth. Babies require a healthy, happy mom to thrive so make sure mom is getting her pain meds on time, help with showering/self care, checks for infection etc….If a mom has decided she is NOT nursing (for whatever reason) don’t continue to send in LCs. It’s already a hard decision. Don’t make it harder for her. Women are smart. Trust that they’ve made the choice that’s right for them.”

“Treating mom like she’s just as important as the baby, especially after delivery (you deliver the baby and suddenly don’t matter at all anymore sometimes). That means factoring in what’s best FOR HER as well as for baby. Providing unbiased information and help for whatever mom (and the family) decides to do. Answering any questions in an unbiased way. Asking questions in an unbiased way (“How are you planning to feed?” rather than “Are you breastfeeding?”). Realizing that giving birth is really hard on your body and that there is a recovery process involved regardless of how you delivered (vaginally, c-section, epidural, natural, etc.) and treating mom like she is in recovery – not expecting her to 100% parent the newborn immediately if she doesn’t feel up to it. Treating moms as individuals – what’s best for one isn’t best for another.”

 

“Respecting the parents decision on how to feed their baby. No pressure or guilt, the priority should be that the baby is getting fed and thriving, no matter how that gets done.”

“It would involve postpartum nurses being qualified as a lactation consultants and/or having lactation consultants available all the time — including nights and weekends. Formula should absolutely be available if people want it but not if people don’t — respecting people’s choices goes both ways. I firmly believe that if I had had better BFing assistance from the beginning, my child would not have been fully on formula within 2 weeks of birth.  I did not appreciate the way an allegedly baby-friendly hospital was actually not particularly helpful with feeding.”

“Support for parents who want to REST, be that a nursery, less intrusions. Formula support as well as breastfeeding support. To be offered formula as an option even if you plan to breastfeed. Have all your care providers be on the same page (no conflicting information). For everything to not be so RUSHED. Help for first timers, be that showing you how to do something or offering guidance/reassurance.”

“A truly friendly baby hospital would start out by asking you what your plan or goals are without injecting their own opinions or tone. If you ask for advice, they would then tell you pros and cons, but again remain neutral. After all, how can a hospital be baby friendly if a mother feels ridiculed or intimidated when stating what she wants? A happy mother equals baby friendly.”

“I think it would allow more than two hours of sleep for a mother who has just given birth, and options for the mother rather than mandated rooming in or nursery. It would offer services such as a kind LC if desired, and if not, training in the use and preparation of formula. It would offer services to new moms such as explaining postpartum depression and when to see someone for it. it would offer rooming in for both parents…”

“Basically it comes down to respecting the family concept and allowing mom and baby to bond while recovering from the rigors of birth offering preference-based options. I think they should educate when a mom seems unsure and ask if they can help clarify with some information to make a decision on. Pushing breastfeeding as hard as they do comes across as hostile to those of us who have no option, and it’s rude. If care providers could have their third trimester patients fill out some preferences ahead of time it would save a lot of trouble. I would much prefer to be asked ahead of time what my plans for infant feeding were, and do I need any additional information on either option, and if I was firm in my decision – not to be preached to by the hospital staff, but rather receive instruction about the choice I made if I indicated such. “

“I avoid “baby friendly” hospitals because they end up being very hostile to women who cannot breastfeed like me, and even more hostile to women who choose not to breastfeed. They need to realize that this woman has just given birth. She needs rest, and she needs to bond with her baby regardless of method of feeding. If she’s a new mother she may need more instruction on caring for baby, but otherwise the constant vitals checks in the middle of the night make for a sleep deprived and exhausted mother upon leaving the hospital. Why can’t they just attach some monitors for the night and let us sleep rather than waking us up every couple of hours?? That has mind boggled me for the longest time.”

“Feeding specialists for both feeding choices. Nurseries where the baby can actually stay for a few hours so parents can rest. Services for mothers who need or want information on PPD.”

“Hospital workers that actually sit down to explain things to you, and give you options instead of scare tactics.”

“Respect and support for new parents. Regardless of their feeding or birth plan choices. Offer information and resources to help them make informed choices that best fit them and their family’s needs.”

“Ask the parents questions: what are their feeding goals? What do they have questions about? Are there areas where they feel like they need support? Take the lead from parents as to where to offer support. Provide unbiased information and support on infant feeding. Check in on mom and baby regularly, and more information provided on postpartum mood disorders and how to get help.”

“There’s so much information on breastfeeding. Yes, it is absolutely wonderful to educate new parents on proper feeding. So where’s the information on formula? There’s nothing (other than “feed him an ounce”). What does that do? Where’s the reading material….well, guilt free reading material. Have these hospitals considered women who have gone through breast cancer? Rape and molestation survivors? Mommies who suffer from depression and need certain medications? Hell, mommies who are in need of many different medications! Or- crazy thought- women who just choose formula? They need information too, for their babies’ sakes. There should be something with answers to frequently asked questions. Burping, dairy allergies, acid reflux, how much, when to increase your child’s formula, generic vs name brand, etc.”

“Respect the mother as both a grown up able to make decisions about her body and her care, and a patient in her own right. BFHI has a nasty tendency to view baby as the only patient and mom as the adjacent milk production unit. What does that mean in practice? A mothers informed choice to formula feed must be respected. Currently FF moms have to fight epic battles with staff to obtain formula and be spared intrusive and unwanted lectures about breastfeeding from every new staff member that enters the room.”

“Mandatory rooming in for all mothers must end. Not giving exhausted mothers any opportunity to sleep at night even if they ask for it is abusive, paternalistic and dangerous to both mom and baby. No sane person would order a day zero surgical patient to look after a baby regardless of the patient saying he can`t cope. Exactly that is standard BFHI procedure for cesarean moms. Things have come so far that maternity ward nurses no longer consider baby care part of their job description. This insanity needs to stop.”

“A truly baby friendly hospital would respect the wishes of the parents in regards to how they want to feed their baby. I went to a hospital where they are exclusively a breastfeeding hospital, they almost yelled at us when we brought formula in for our first son. Offer choices and information to all new parents, and have them decide.”

“Respecting the parents right to choose. Understanding that the parents\family of the new baby might have different beliefs\goals than the hospital\nurse\doctor. The way things are worded in literature from the hospital even if they claim to be supportive it’s really clear what the hospital really thinks.”

“A baby and family friendly hospital would make it a priority to understand what the goals and needs of each family are either before, during, or directly after birth. They would offer education, support, and guidance at ALL times. Trained nurses, doctors, and midwives should value the fact that not every baby, mother, or family is the same, with the same resources, support, and goals. Every mother should leave the hospital feeling like they were given the information, support, time to heal, and time to bond with their baby that they needed. It’s not about breast VS. formula. It’s not about natural VS. medicated. It should be about helping create healthy babies, healthy mothers, and healthy families in every sense of the word.”

“ASKING what your needs and goals are – NOT just slamming what is BEST in your face. Weighing OPTIONS with you (delivery, drugs, feeding, sleeping, etc) in a ‘we offer x, y, & z’ manner instead of ‘our policy is x’ without telling you everything. Covering ALL medical needs -making sure that maternal mental health is JUST as noted and prevalent as physical.”

“The word “mandated” is not part of its vocabulary. Nursery is an option after a difficult birth or c-section, no mandated lectures about breastfeeding, options for early discharge exist for those who feel great and are ready to leave, and the family remains the center of care. Finding out what the family wants/needs is the driver of nursing care and those choices are supported.”

“Allowing a mother to rest after hours of exhausting labor and delivery. You go through the biggest work out of your life, on little to no sleep. So, of course a nap would go a long way. And think of the huge hormonal drop a woman goes through once the baby is born! Hello baby blues!”

“More after care is required. Sending new Mum’s home with planned health worker visits to support breastfeeding or proper instruction on formula as well as looking at Mum’s mental health and Bub’s overall well being.”

“A place where you are listened to. Where fathers are always welcome. Where lactation consultants are available 24/7, and formula freely given upon request – no questions asked. Babies allowed to room in with mums, but a nursery available if requested if mums need sleep.”

“A hospital where the parents are asked what they have chosen instead of “educated” about what the hospital policy says is best. Also, an emphasis on mom’s self care during recovery would be beneficial to the whole family. And last but not least, consolidated room visits by hospital staff so that families have uninterrupted time to rest and bond together. This would mean that the Drs, nurses, administrative, housekeeping, kitchen, and any other staff coordinate their visits into a room within a specific time period. With my first baby I had visitors at every hour of night and day. One woman even refused to leave and demanded that my husband wake me up after he explained that I was sleeping for the first time in over 72 hours and asked her to return later. With my second baby, I kept track of the interruptions and the longest we had alone was 45 minutes. So to summarize that is three things: ask more questions and respect the parents’ answers (instead of trying to educate them until they comply with the hospital standards), help mom take care of her body post delivery, and let the whole family have adequate private time to rest together by limiting the number and duration of room visits.”

“Remember although you’ve dealt with 1000′s of mothers and babies this could be this mother’s 1st experience of all this. Be kind and treat each parent as you’d want to be treated, with kindness, respect and patience.”

“A place where parents can feel supported and receive non-judgemental/unbiased education about baby care including all feeding options. As health professionals we want women to feel empowered to have their own, unique birth experience and be in control of their bodies but after baby is born that seems to go away and we start preaching about what is “best” . To me, we would use the same thinking as we do during labor in a family/baby friendly hospital– have a “baby plan” similar to a birth plan; what are your goals, preferences and concerns as a parent? If you choose to bf, ff, cloth /disposable diaper, room in/ send baby to the nursery for a few hours, love/hate the idea of skin to skin etc we would tailor your plan of care to those preferences so you can get the best care, hospital stay, and education to prepare you for YOUR life at home with a new baby. Smaller nurse to patient ratios so you get that personal care and don’t feel rushed or pressured. Overall, a place where you can feel comfortable and supported without feeling judged so when you are discharged you feel confident and ready to take baby home.”

“Guilt free choices. Offer room in and a nursery, formula and lactation support. A pressure free environment focused on helping new families bond in a way that suits them best.”

A hospital that practices safety first and not based on surveys. A hospital that respects patient choice as long as safety is maintained. No more lying about not having formula, insane contracts to induce guilt and fear over using formula, following APA guidelines for the use of pacifiers, allow moms to sleep through the night unless they just don’t want to, a space for partners to sleep and care for the baby when mom needs rest. And..stop passing off propaganda flimsy “science” as truth just to boost breast at discharge numbers. The biggest thing? Put their money where their mouth is. If breast is so great that it is forced on every mom then offer out-patient follow-up on every delivery with free lactation support as well as newborn care. Call moms to ask about depression, engorgement, infant dehydration and jaundice…the list is long. Forcing people into buying breast is best then when they get home not giving one care if they are ok is just despicable.”

“Family friendly means baby friendly AND mother friendly. It means remembering that the mother is a patient in need of care and support even after the baby is born, and not just a vessel for birth. The mom doesn’t cease being a patient at the moment of delivery. This means that the needs of the mom are honored, from respecting her choice about feeding to giving her adequate medical care and support after delivery. This requires hospitals to do the very things they are currently moving away from: providing formula, cease hassling the mother if she states she does not want to breastfeed, and offer nursery hours to mothers who have undergone c sections or grueling labors and/or those who do not have family or friend in-hospital support. The fact that these simple fixes have been lost in a frantic effort to promote breastfeeding above all else should be a concern to us all.”

“Unbiased informed consent, then respect and support for the choices made after such informed consent. Seems like it should be so simple, but the “unbiased” part seems all but impossible.”

“A place that respects moms choices. A place that allows her to choose times to room in with her baby while giving her the guilt-free option to sleep all she wants and recover. A hospital that makes formula available without a waiver at the choosing of a mother. A hospital that informs a mother of the benefits as wells as the risks of exclusive breastfeeding before lactogenesis and prioritizes the feeding of newborn babies over exclusive breastfeeding. A place that encourages staying at least 72 hours because discharge at 48 hours increases risk of readmission but more importantly increases the risk to the child. A place that doesn’t wake you up every 4 hours for vital signs that you don’t need, time and effort than can better be used weighing your child that is fasting from colostrum-only feeding at least one more time a day. A place that respects the rights of a mother to feed her child however she wants and respects the rights of a crying baby to be fed.”

“Actual accurate information about how to supplement or combo-feed. There is more than one form of combination feeding that works, there are also combination-feeding models that don’t work so well. “

“A place where nothing is ever presented as the “right” way of doing something, but rather for every decision multiple options are presented, with info on the pros and cons of each choice to support informed decision making. Families should be supported in any informed decision they make. The presented pros and cons should be based on established medical research, and if none is available, parents should be told that it’s not yet clear what the exact pros and cons are.”

“Respect for the mother, respect for her choices, compassion and understanding with education if the mother requests it. A family/baby friendly hospital experience would make a new mother feel confident and heard, not made to feel like a failure before she even gets home with her baby. The push for breastfeeding causes significant distress for new mothers who do not want to do it, who can’t do it, and who do not know how. I would like to see all feeding options outlined and explained (without judgement) kind attentive staff to answer questions and concerns and honestly a chance to get a bit of sleep.”

 

FFF Friday: “That First Bottle: Nine Years Later”

If you follow me on Facebook or Twitter, you’re probably well aware of the #FacesOfFormula campaign. The following essay was submitted along with the author’s photo. She preferred to have her name changed for publication, but I wish I could tell you her real name simply because I want to thank her personally and publicly for these words; for explaining why this campaign is important; for being so insightful and honest.

For now, though, my private thanks will hopefully suffice. THANK YOU.

Happy Friday, fearless ones,

The FFF

****

That First Bottle: Nine Years Later

by “Karin”

New moms are often told that offering just one bottle of formula will trigger a domino-chain of dire consequences.

momthejunglegymI’m not a new mom anymore. I have two great kids, both in elementary school. I’m here to tell you that my firstborn’s first bottle of formula was indeed the start of something bigger, with many long-term implications.

That first bottle was the start of me accepting the most effective treatment for my postpartum depression– an illness that, left unchecked, had a 100 percent chance of harming the mother-child bond.

An illness triggered by my rigid, near-delusional belief that only breastfeeding made me a real mother.

 

That first bottle was the start of me respecting my own maternal intuition, instead of letting “experts” who didn’t even know me dictate how I should think and feel about breastfeeding. Or anything else. (Ironically, the experts will often tell moms to “trust your intuition,” when they really mean “only if it agrees with my theory.”)

 

That first bottle was the start of me thinking critically. I began to question a supposedly first-world society that sentimentalizes mothering beyond reason, while failing to actually support it. A society that puts all the pressure on individual women to meet increasingly impossible ideals.

 

I began to wonder about the ideological agenda behind bombarding mothers with “science” that is oversimplified, hastily published, or just plain wrong. Whose sole purpose seems to be scaring us, shaming us, and reducing us to our bodily functions.

 

I began to ask why the concept of the “good enough mother” was now being replaced by the “optimal mother” who, beginning with her preconception diet, is all about controlling her child’s every outcome.

 

As if this were possible, or even desirable.

 

That first bottle ignited my feminism and made me a radical advocate for both moms and kids– just as breastfeeding did for many of my friends.

 

That first bottle helped me realize that me and my close friend who nursed and co-slept for 4 years, were more alike than different. I observed that exclusive breastfeeding did not magically relieve my friend’s insecurity and self-doubt about her parenting.

 

That first bottle was the start of me coming into my own as a mother. It brought me back to myself– someone of infinitely more value than two breasts and a uterus.

 

As my mood lifted and I got some therapy (and sleep), I began understanding things about my own childhood experiences that I didn’t want to repeat. I even ended some hopelessly toxic family relationships, for my kids’ sake as well as mine. It was terrifying and exhilarating.

 

That first bottle gave me the strength to have another baby, four years and 3 devastating miscarriages after the first. I formula-fed from the start so I could take the best medications for me. No PPD this time, just the standard-issue fatigue/marvel/gratitude.

 

(By the way, my little dude had reflux and woke up every 90 minutes for six months. If I hadn’t had help feeding him I would have hallucinated!)

 

That first bottle made me realize, as the years went by, that my previous guilt about not being a “good mother” would never have been transformative or beneficial to anyone. In fact, it would have cast a pall over our family life. And we’re too busy doing dinnertime lip-syncs to Queen’s Greatest Hits to bother with that!

 

That first bottle helped me to appreciate that as my children get older, their needs become more complex and their individuality more apparent, and they need a fully present and attuned mother more than ever.

 

That first bottle helped me not to give a crap what people think.

 

Not giving a crap came in very handy when my older child developed motor delays and unusual behavior, and was eventually diagnosed with autism. We were devastated at first. But then we realized we now had the gift of understanding, and some real help for our child. On a regular basis, though, things can get pretty raw in public.

 

Imagine a school-aged child on the floor at Costco, screaming and throwing her shoes. Or, blowing a Bronx cheer in some random adult’s face. I can’t tell you the kinds of stares and comments I’ve had to learn to slough off.

 

Those strangers don’t know the incredible gains my kid has made in four years– and that, far from being “in her own world,” she has an acute and nearly telepathic sensitivity to others’ emotions. How I work third shift just to pay for her therapies. They don’t know that raising a child with autism involves discipline plans that must always be followed, no matter how tired the parent. How challenging and counterintuitive it all feels some days. How many times I have nonetheless stayed calm while my child yelled at me and raked her nails into my arms.  Because she is not being “bad,” and scoldings don’t help.

 

That first bottle helped me show her, by example, that it’s okay to struggle and to be different. It helped me have faith in my ability, and hers, to survive and thrive together. It helped me to fall in love with her, to understand her, and to feel blessed that she is in the world and in our family.

 

And finally, first bottle helped me care for myself so I can now be present for people in crisis, as an ER social worker. It set a foundation for me to make room for other people’s experiences, and to create a safe space for them.

 

I have met many patients who feel that their mental health isn’t worth much, or that they should just tough things out without help. I’ve been there, I get it, and I can offer a way out of that hell.

 

So yes, that first bottle started something. It gave me guts, and then it gave me wings.  It gave me two children who are cherished and secure. And I’ll be forever thankful.

Breastfeeding and Leukemia: Old news is no news

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

 

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

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

 

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

CONCLUSIONS AND RELEVANCE

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

 

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

 

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

 

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

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

 

It’s Not About the Brelfie

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

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

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

This is not progress.

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

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

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

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

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

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

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

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

 

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

 

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

 

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

 

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

 

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

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

 

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

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

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