FFF Friday: “It’s not okay.”

I’ve been looking deeper into the issue of how formula-requesting moms are treated in the maternity wards of breastfeeding-”friendly” hospitals, and some of what I’m hearing is beyond comprehension. Don’t get me wrong – there are many hospitals that are doing this well, managing to support and promote breastfeeding while still respecting the individual needs and desires of mothers.  But the ones who are messing up are doing so royally.

Jessica’s experience would fall into the latter category. After a tough pregnancy and birth, what she needed was support and sensitivity. Instead, she got… well, I’ll let her tell you. 

And Jessica is right. It is in no way, shape or form “okay” for women to be treated like this at one of the most life-altering times of their lives. We can’t let it be okay. We have to speak up, and demand better… for ourselves, for our friends, for our wives and partners, and for our daughters. 

Happy Friday, fearless ones,

The FFF

***

Jessica’s Story

Dallas was born on May 14th, 2014 at 9:31 pm after being induced on May 13th.  I was 39 weeks pregnant, had gained 80 pounds despite staying active and eating healthy.  I had been admitted to antenatal three separate times for kidney stones, tachycardia and high blood pressure before I was induced.  My pregnancy had taken a toll on me physically and emotionally and labor wasn’t a stroll in the park either.  I got no sleep, and when I say no sleep, I mean NO sleep, and my son was facing the wrong way and wouldn’t come down far enough for them to break my water.  After 35 hours he had finally made his way down and they broke my water, he was born vaginally two hours later.

 

I ripped since he was facing the wrong way so once the epidural wore off I was in a lot of pain, of course.  When I was rolled back to recovery I had close family waiting to meet my son.  He was sleeping soundly and I was exhausted and in the middle of having visitors a lactation consult barged in and said it was time to start breast feeding and that it was so important to get the colostrum NOW.  I asked them politely if they could wait until my guests left or my baby woke up but they said I just had to start now!  I was so confused and exhausted and on top of that, I didn’t want to tell my parents to leave but I also couldn’t breast feed in front of them, it was too uncomfortable.  They left on their own and the lactation consult put my sleeping baby on my breast which woke him and made him absolutely furious.  He didn’t get one drop because he refused to latch but he went back to sleep shortly.

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We got four hours of sleep that night when a different lactation consultant made her way in at 5:00 am saying that she heard my attempt at breastfeeding the night before was “unsuccessful”. Really?  That’s encouraging.  Moving forward, she also woke my baby up and tried to force my baby to feed and once again he refused, got angry, and she left me with a screaming, hungry baby.

This pattern continued throughout the day and by that night I begged my nurse for a bottle. She called my wonderful lactation consult who came in, sat on my bed and tried to explain to me that formula was so inferior and I quote: “if your baby could talk, he would say toughen up, mom, I need your breast milk.”  The whole time I was thinking, you crazy lady, he just wants to eat and you crazy people won’t let me give him a bottle!  She continued to explain that women have been doing this since the beginning of time.. It just made me feel like, if the Neanderthals could do this why can’t I?  I never felt like such a failure.  I had only been a mom for 24 hours and they had me convinced my baby hated me and I was being selfish for wanting to ACTUALLY feed him when he was literally starving.

 

By the next morning, my baby was jaundiced from not receiving enough food to make another bowel movement.  His jaundice almost reached high enough levels to have to undergo phototherapy.  As soon as we got home, I did what I think any sane person would have done and gave my son a bottle.  He went to sleep shortly after and had his second stool since birth a few hours later.

 

Once my milk came in I pumped for my son (he never would latch) and supplemented formula.  After eight weeks my milk supply was so low I just switched completely to formula feeding.  Now my son is four months old, in the 98th percentile and hitting all his milestones a month ahead.

 

I never wish the terrible experience with forced breastfeeding and the disapproving looks from the lactation consultants and doctors I had on any mother.  Delivery is a time of celebration and helping a mother feel comforted and giving her all the emotional and physical support she needs.  I hope one day the stigma of formula feeding goes away and we’re not seen as second best or weak women.  We are warriors and we are still WONDERFUL mothers!  We carried our children for nine months, gave birth to them and love and care for them unconditionally.

It’s not okay.

 ***

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

FFF Friday: “Each day I try to move past my own body anger and mommy guilt…”

These days, it seems like everyone wants simple messages. Everything needs to be packaged into 140 characters, turned into a meme, posted with a hashtag. 

But maybe that’s the problem with all this parenting stuff. Things are rarely so glossy or clear. There’s a lot of shades of gray; a lot of exposition. By limiting ourselves to the messages we see on social media, we are limiting our ability to understand, connect, and evolve.

Stacey’s story has many layers. She expresses them beautifully, but this isn’t a story I can tie up with a pretty bow. Like so many of us, she has mixed feelings about her feeding experience. Her voice – and others like it – get lost in this world of absolutes and told-you-so’s and this-is-how-it-is’s. 

These are the quiet voices, ones that seldom get heard, but should be heard. They add the color and nuance to our conversations. 

I hope we can take the time to listen. 

Happy Friday, fearless ones,

The FFF

***

Stacey’s Story

I think its time to tell my story.  I have a love-hate relationship with feeding my children.  I love feeding them.  I loved breast-feeding them, having them at the breast and snuggling them, and providing what I was able to make.  I hated breastfeeding because never have I felt so inadequate, out of control, and just a sense of anger towards my body and my disease in my life.  I love bottle feeding because I love snuggling my children and seeing them be satisfied and grow.  I hate bottle feeding because it represents what my body has been unable to do for me, and what I feel my disease has stole from me.

 

Since the age of 14 I have struggled with a variety of autoimmune diseases, which over the course of the following 7 years would each come to be diagnosed.  It was extremely difficult being a “sick” teenager.  However, once I was into my 20s I really came into my own, managed my health, and lived “normally”: traveling, finishing graduate school, working, getting married & pregnant.  My pregnancies were each managed by the Special Pregnancy Program at a University hospital, and my first was born extremely healthy by induction at 39 weeks. I had a very quick labour, no painkillers, and put my son to my breast within seconds of his birth.  It was so “natural.”  And those first few days went very well.  No breastfeeding issues were identified at the hospital.  Everyone commented on how naturally I took to breastfeeding my son.  He had a good strong latch, and I was able to relax.  I was confident I had it down.

 

Fast-forward 2.5 weeks- little man was constantly at the breast, when he wasn’t at the breast he was crying, and he was a really skinny baby.  We go to our 3 week healthy baby check up and little man has not returned to birth weight.  I get the name of a lactation consultant and she can come to our home that night.  When she observes, apparently my son had to suck 8 times for each swallow.  I’m not producing enough.  I need to supplement immediately.  She provides me with supplemental nursing system that I can try, and recommends 20 mins/side breast feed, followed by supplementing 2oz formula, and also pumping for 10 mins each side.  I am to put him to the breast every 2 hours, even at night if he’s sleeping.  I do this religiously for the first week, and my disease begins to flare thanks to lack of sleep and stress.  My boobs hurt.  I hate the damn pump.  I’m eating galactagogues and herbs and disgusting tea.  I’m doing everything I can.  But my production is not increasing.

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My dad, a wise farmer, advises me: put baby to the breast, he gets what he gets, and then top him off.  Forget the rest, you’re killing yourself and you can’t make milk if you’re dead.  I retire the pump & the tea & the waking the baby to eat.  I keep taking the herbs but I quit stressing about the food.  I focus on resting and eating foods I can digest easily to get my health back.  I manage the breast feeding and topping off for the next 3 months.  It goes smoothly. It’s our thing.  In public, I alternate between feeling embarrassed about exposing myself, my body, and exposing my inadequacy when I get out the bottle to finish off.  When people see the whole scenario play out, you can see the puzzlement.  Some make comments… “why don’t you just bring a bottle to a restaurant,” Others feel it’s their job to inform me, “you’ll never make enough if you keep offering the bottle.”  eventually I cave, and just bring the bottle out in public.  It seems easier, but then I feel the glare from the breast feeding mammas at the cafe… obviously I don’t care enough about my baby to give it the breast, since it’s the best.  Eventually, following another flare of my digestive system I totally dry up.  Simultaneously my son was rejecting me and he was hit by a head cold which made breast feeding that much harder.  I had no painfully engorged breasts from weaning.  They just stopped producing completely.  My son became exclusively bottle fed at around 4 months of age.  I was sad, but I accepted it.  Next time I would get off to a better start and hopefully I wouldn’t flare.  Then things would go better.

 

Next time rolled around faster than any of us thought it would.  Our gorgeous girl was born 3 days after our son turned 19 months.  I was armed and ready for my breastfeeding battle.  I was a seasoned veteran returning to the front.  My herbs and breastfeeding tea were packed in my hospital bag.  I had a lactation consultant on speed dial, along with my naturopath and my birthing doula.  I had hired help for the entire postpartum season lined up.  And then the day after my daughter’s beautiful, natural birth, I was officially diagnosed with insufficient glandular tissue and my daughter had a tongue tie.  Apparently this might be a fight I would not win.  I was angry because I’m a Type A who usually wins.

 

Within that first postpartum week, I do some serious soul searching at 2am… We decided to fix the tongue tie to give me the best shot.  I decided not to pump after feeding.  We decided to supplement 2oz each night before bed so I could get some rest.  We said, let’s see where we are in six weeks.  Then eight weeks.  We had spent hours upon hours breastfeeding every day, typically 15 hours.  We went in for extra weigh-ins and she was consistently gaining, but only about 3 oz/week.  We never put her health at risk- she always made enough wet diapers, was consistently alert and strong, and very happy.  However, at eight weeks my daughter was not yet 9 lbs (she was born at 6 lbs) and we didn’t feel she was hitting her development milestones.  It was pretty clear she needed more.  And so we began to supplement after each feed.  Our feeding began to schedule itself- every 2-3 hours we would breastfeed and then top off.  We managed this for 2 months.  It was a comfortable 2 months.

 

At about 16 weeks she began to push me away.  Breastfeeding is a lot of work for baby and bottles are easy.  That was the hardest part.  She preferred the bottle.  When I lost my postpartum help at the four month mark, her rejection had already brought on the wean.  So we let things naturally finish.  It’s been 1 week since her last feed at the breast.  It was only 5 minutes.  I was sure it would be the last.  It had been 2 days since she had last latched.  I gazed at her and pet her forehead as we finished our special moment.  Like all things in motherhood, when one stage and need ends, another becomes more pressing and my motherhood only evolves.  And each day I try to move past my own body anger, and mommy guilt, and be thankful it grew 2 beautiful healthy babies despite its challenges.  Sadly, I’m still not able to embrace my identity as a “fearless formula feeder.”  I hope to before the journey concludes.

 

As I finish my breastfeeding journey, and come to embrace bottle feeding, I believe strongly that mothers need to be supported fully in their journey to feed and nurture their children, however that happens.  I really felt that support lacking with my son.  My experience with my daughter has been somewhat better.  We moved cities and our care-team seems much more open and supportive of us.  I am so grateful for this support from the medical world.  In larger society I still hear critics, and feel that some don’t think I’ve tried hard enough or others that feel I shouldn’t have even tried.  Neither feels “good”.  What I’ve come to see is that support means embracing with openness. The breast or bust mentality doesn’t help when you’re struggling and CANNOT PRODUCE; but for me the “well just give her a bottle already” attitude really didn’t help either.  I just wish society as a whole could embrace mothers and say- “wow, you’re really doing your best!” Whatever that “best” may be.

I also feel like I couldn’t have followed this path of both/and to this point without amazing support.  My husband really is clueless about parenting, but his unwaveringly trusts me and provides me with what I say I need, when I need it.  My dad, the wise retired farmer, really provides an emotional counterweight for me.  My in laws do their utmost to support our family by providing love, babysitting, date nights, and shower time.  My Manny this summer really allowed me to give my daughter as much attention as I gave my son in the early days, while knowing he was totally and completely happy & looked after.  I didn’t have to sacrifice one for the other at all and I maintained my health.  My care team provided me with education and support in a respectful, validating way.  Despite what has not worked out perfectly, I’ve really been lucky.  Many other Mommas do not have this kind of postpartum circle of care.  I hope that as a society we can acknowledge, love, and embrace women as they struggle on the journey through the maze of choices and non-choices of motherhood each day.

***

Want to share your story? Email me at formulafeeders@gmail.com

 

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: “There isn’t just one way to do things right.”

I don’t think I tell you guys this enough, probably because unlike the rest of the world, I still find myself immersed 24/7 in infant feeding issues – but it really, honestly does get better. And worse. And better. And so on. That’s what parenting is: a series of near-misses, celebrations, mistakes, and rewards. To put so much stake, so much blood/sweat/tears into one tiny part of a lifelong journey…. it’s really ludicrous, when you think about it. 

So, stick with me, until your kids are a bit older, until you’re out of the formula/breastmilk stage and your worries shift to preschool choice and behavior issues, and then forget me. Stop checking this blog. Erase my Facebook page.  Forget this ever happened. Forget you even cared. Because you are more than how you feed. You are the sum of an intricate, complex, messy, wonderful equation. Don’t limit yourself to the simple arithmetic of breast + bottle.

If you don’t listen to me, listen to Lilia. Her short but incredibly sweet story is below. I hope you enjoy it as much as I did.

Happy Friday, fearless ones,

The FFF

Lilia’s Story

Seven years ago I had what I thought would be the biggest disappointment as a mother.  Despite a deep desire to breastfeed, I was not able to do it. For years I tried to find the reason, I thought knowing “why” would give me peace of mind and take away the terrible guilt I felt. I read many articles, talked to doctors and lactation consultants and no one could give me a reason or explanation.  In my mind, if no one could tell me why I couldn’t breastfeed it had to be because I wasn’t trying hard enough.

I didn’t want to be the bad mother, the only mom pulling out a bottle in a room full of judging eyes. The pain I felt was not only emotional, my breasts were so bruised from pumping  so much that having my baby latch was a nightmare. It was mental and physical torture. Eight weeks (with a terrible case of thrush) went by until I realized this wasn’t a battle worth fighting.  Yes, I “gave up” and I was so relieved.  At last I was able to hold my baby, look at her and admire the big miracle she was. I would hold her for hours and just make a bottle when she was hungry.  No more fear and pain for either of us, just the certainty that we both finally had what we needed. quotescover-JPG-54

The physical pain was gone, for both of us, but the emotional pain lingered for years.  I had let the ability to breastfeed define me as a mother. I had given all my power to those who told me I should breastfeed. For a while I was furious for allowing this to happen.  But mostly, I mourned those first days and weeks I missed, pumping instead of holding my baby, living in fear of her being hungry instead of feeling the joy of being a new mom.  I just felt sadness because I knew I would not get that time back.

Despite my experience, I was willing to try again with my second child, but it didn’t work out either.  This time I tried for a total of one feeding, I would not put this baby through any pain, her sister and I had endured enough for her. Tears still come out as I read these words and those of the moms going through the same struggle, but seeing my babies grow up healthy and happy and the loving relationship I have with them confirm every single day that the way I fed them had absolutely no impact on who they are today or who they will become.

I know I will have many setbacks and there will be many disappointments as I try to raise healthy, happy, productive human beings. There will be many times in which I will feel like a failure, but looking back, the inability to breastfeed has become a tiny speck in a world of possibilities for me to mess up as a mom.

After all these years and one more baby, who was formula fed from the start, I have learned that the “failures”, setbacks and disappointments only make me a more resilient mother. I realized that the guilt didn’t come from giving my child formula. It came from what I thought people would think of me for pulling out a bottle instead of my breast to feed my child. But as painful as this experience was for me, I am thankful because I learned to see every situation as unique, there isn’t just one way to do things right.  I learned to do what is best for me and my children. I learned to dodge the bullets of judgment that will come my way for one reason or another.  And finally, I found the people who are on MY side, and this is priceless in the dangerous world of parenting.

***

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

 

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.

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