FFF Friday: “I had come to believe that formula was poison…”

If I could nail down one thing to blame for the pain formula feeding parents feel, it would be the nature of infant feeding literature. The words they use, the images, the phrasing…. it’s not the “facts” that are given but the bastardization of those facts; not the purpose of the public health campaigns but the insidious ear-worms they become. Those words haunt us, and taunt us.

Changing the way we support and inform new parents could make all the difference. And it’s so freaking easy. It doesn’t need to be researched or number-crunched. You wouldn’t even need particularly smart copywriters. Just be honest, emotionally neutral, and understanding that people are people, not statistics. Done and done.

Happy Friday, fearless ones,

The FFF

*** 

Emily’s Story

In December 2012 we decided we would come off the pill and try for a baby. Two years and two miscarriages later our son came into the world, on 9 December 2014.

I was always unsure about breastfeeding. I’d heard a few stories about it being hard and painful but I decided I would go for it and see what happened.

I was very casual about the whole thing. I knew that breast was best, I had been given countless leaflets and advice leading up to the birth to tell me so, but I wasn’t going to put any pressure on myself. Oh no, I was cool, calm and well in control of the notion.

Until my son arrived.

It was a tricky birth, natural, with an early dose of pethidine, more gas and air than you could shake a stick at and a helping hand from a ventouse cup, but he came out alive and screaming.

It was amazing. He was perfect. The most perfect little thing I had ever seen and I immediately fell into mother mode. I wanted him on my skin straight away and I never wanted to let him go.

When we were moved into our room the midwife came in and told me it was time to try feeding him with my breast. No one asked me if I wanted to use a bottle, I was just guided through what to do. He latched on perfectly and I was told I was a natural.

I sat there, with my son feeding away off me and I felt like this made up for all the hard work I had to get him here. The miscarriages and the traumatic pregnancy (I had severe SPD and was in a wheelchair for the last few months) were all worthwhile, as now I was giving my son the absolute best start in life.

Because the birth was a little tricky I was kept in for a few days and as such my son was more closely monitored. His sugar levels were low and he needed a lot of heel pricks, he became jaundiced and slept, a lot.

At no point did anyone suggest I try a bottle to top him up. I just kept being told that I was doing a great job. They even sent in their breastfeeding expert to sit with me, who confirmed this.

It was at this point I noticed he had tongue tie. I had heard about this from a friend so I knew what to look out for. I pointed it out to them and they arranged for him to have a snip that day, day two.

He came back having apparently not even noticed it was done and I clamped him to me to try it out. It felt different and yes, I nodded that this should be it. I had convinced myself it was better.

We were discharged on day four and I went home, carrying on feeding my son from my breast, believing that everything was OK. By this time I was becoming determined to breastfeed my baby. The message I was reading on all the sites I googled to help me was that if I didn’t breast feed him he would likely become obese, suffer allergies and even a higher risk of cancer! There was no way I was going to allow that to happen to my precious bundle.

The community midwife came to visit the day after and we were sent back to hospital on day 7 as he had lost 11% of his birth weight and he was severely jaundiced. It was absolutely horrific.

My son spent the whole night in a UV incubator by my bedside. I was only allowed to pick him up to feed him. I wasn’t even allowed to hold him if he cried.

I spent the 24 hours we were in hospital on a strict routine of hourly pumping and feeding. I was distressed, convinced I had starved my son by not being able to feed him properly. I felt like I had already failed him as a mother.quotescover-JPG-67

I wasn’t pumping enough milk. The staff told me that that was probably the issue and that I needed to calm down and wait for my milk to come in. It was probably delayed from the birth. In the meantime it was suggested that I top up with formula.

I point blank refused. I had been told by breastfeeding supporters that I mustn’t do this as it would affect my supply. I had read all of these messages from government campaigns. I had a close group of friends who had all had babies around the same time, who were breastfeeding advocates. I had come to believe that formula was poison and I was not going to give up without a fight.

The UV lamp did the trick and all the pumping and feeding meant that he gained a little weight. Enough for me to be allowed to go home, with the agreement that I would see the community midwife daily.

On one of these visits she pointed out that he was still tongue-tied. I hadn’t realised, but it was actually pretty bad still. He was booked back in for another snip at two weeks old and we all felt sure that this would be the end of it.

I spent the next few weeks desperately reaching out to everyone to get help to feed him. Friends, peer suport, midwives etc. Everyone praised me and encouraged me to keep going, even though Hugo’s weight gain was very slow.

My husband, normally a placid, gentle man was determined I keep going and during one conversation we had about possibly stopping he became quite cross and insisted I continue to breastfeed our son. He had also been made to feel as if breast was best.

On Hugo’s four week birthday I went into clinic to weigh him. I had previously been given another week to get some weight on him or my midwife was going to insist I switch to combi or formula. I was a wreck that morning. I knew that this journey was going to come to an end and I was right. He had hardly gained a thing that week and I broke down in hysterical tears.

I was led to a private room and she asked if I had a bottle and some formula. I had come prepared and she made the bottle up for me to feed to my son. As I held him in my arms and looked down at his face, I realised that this was the first time in weeks I had properly ”looked” at him. I watched his little lips work around the teat of the bottle and saw him gulping up this golden liquid that was going to make my son get fat and healthy and I felt euphoric.

I felt uncontrollable love for him and right then, as I fed him this wonderful stuff, I knew I was the best mother in the world because I was finally able to put my son before me and do what is best for my son. All the stresses and worries of the first few weeks just washed away and I felt amazing! Breast is not best, a well fed, happy, healthy baby is best!

I don’t disagree with promoting breast feeding. What I disagree with is the wording of these campaigns and the pressure they put on a mother to breastfeed. There is something very wrong with our world if we are not able to support a woman, no matter what her choice of feeding is, who just wants to feed her child!

***

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

FFF Friday: “The best choice for us was actually formula.”

As Emily has observed, many of the FFF Friday submissions start with the words “I always wanted to breastfeed.” I know I’ve personally said those words too many times to count. 

But that’s not the only story out there. There are many women who feel as Emily did, and that is just as important and valid to talk about – perhaps more. There’s this idea out there that as long as a mom “tried to do her best”, she should be immune from judgment. This is, in many way, just as judgmental and limiting a script as any other uttered in the infant feeding discussion.

What is “doing your best”? Is it martyring yourself, like so many of us have, in the name of exclusive breastfeeding? Is it having a medical excuse? Being *this* depressed, *this* sick, *this* abused?

Or is doing your best really doing the best you can as a parent, in the best way you – as an individual – think you can?

I prefer the latter definition. By that logic, we’ve all “tried to do our best”. Sometimes our best does not mean breast.

Happy Friday, fearless ones,

The FFF

*** 

Emily’s Story

I’ve heard a lot of formula feeders start off by saying “I always wanted to breastfeed.”   My story starts with “I never wanted to breastfeed.”  I remember not being comfortable with it when I was a child and never did feel comfortable about it, even when I considered it as a logical adult.  The thought of having a baby or machine sucking on my nipples just made me cringe.  Some have made assumptions that I was sexually molested or have daddy/mommy issues (I wasn’t and my parents are awesome, thankyouverymuch), but there really isn’t some reasonable answer to why I feel that way.  And no, I don’t consider boobs to be only sexual objects.  It just is what it is.

My son had been an unexpected surprise.  I was still waffling about if I wanted to have kids at all when I found out I was already pregnant, and up until he was a couple of days old I was unsure how I felt about him (and then, of course, I fell madly in love with him).  When I was reading about how freaking amazing breastfeeding is I was filled with dread.  I deeply feared that I’d have to endure it, but then as I was considering the bonding aspect of it, it occurred to me that with being already unsure about him the last thing I needed to be doing was giving myself more of a reason to experience negative feelings for him.  Whatever else I felt, I had determined that I was going to do right by him.  Nothing I read in true scientific studies suggested that he wouldn’t be perfectly fine on formula, and I was truly terrified that I’d end up hating him if I made myself breastfeed him.  That’s not doing right by a child, I don’t care if breastmilk really is all that and the cure for the common man-cold.  It made sense to me that the best choice for us was actually formula.

recite-mk563q

People I know and encountered in real life didn’t give me any grief about it- in fact the nurses at the hospital asked me which way I was going just so they’d know to send me either a lactation consultant or some of those spiffy 2 oz. premade nurser bottles.  They even gave me a few extra packs of those to take home.  It was only when I got online that I was immersed into the dreaded mommy wars.  You go on to these mommy communities because, let’s face it, it is possible to get a lot of really good advice about everything from getting those darned teeny socks to stay on a baby’s feet to a plethora of breastfeeding info.  It is my habit to research the heck out of things, especially when it comes to my children.  Seriously, it took me two weeks to decide on a convertible carseat when my son was outgrowing his infant carrier.  I’d already researched breastfeeding on my own for well over a month during my pregnancy, but with these communities I know way more about it than I really ever needed to.  The most insulting assumption was people saying I must be one of those moms who doesn’t give enough of a damn to educate herself, if I chose formula from the get-go.  The very idea was just unfathomable to them.  2 and 2 do not go together, you can’t love your baby if you never even tried.  The only time I ever felt regret for not breastfeeding was from these women.  It was not all of the moms there, but just a handful were more vocal about how strongly they believe in the importance of breastfeeding.

Sometimes, for an hour or two, I’d fall into their trap about not loving my son enough to sacrifice my feelings on the altar of motherhood and do it for his sake.  Then my son would low-crawl over to my stack of magazines and giggle as he happily shredded them, and I’d move on to the next topic.  Something like, “What solids have you done so far?”  Every once in a great while I’d read how a mom who felt as I did succumbed to the pressure to do it, and what she’d describe is exactly what I knew my experience would have been.  Resentment of her child every time she had to lift her shirt up, the cringing, discomfort, distaste, and dread in between feedings- in other words, she was almost completely devoid of the joy of having a baby.  The joy that that was always there in my own breastfeedingless experience.  It makes me immeasurably sad that there are those who would say that breastfeeding is more important than that, and if you really love your baby those terrible feelings are just something you’ll live with.  Why the hell do we lend any credence to people like that, anyway?

These days both of my kids are too old for me to care about what people think of my choice.  I do still get to enjoy the occasional shock and outrage when I answer The Question simply with “I didn’t want to.”  No remorse.  No trying to explain it away.  I really don’t give a crap anymore about what my kids ate the first six to twelve months of their lives.  They are alive and vibrant, and they know that they are fiercely loved.  My son just started tae-kwon-do and my daughter is trying out preschool ballet and her first fall soccer this year.  He is sweet as can be and she is my diva.  He loves video games and is fascinated by his father’s military career, and she will throw on cowboy boots with her princess dress and go ride their Powerwheels 4-wheeler.  We are taking him to an air show two states over just to nurture his dream of becoming a jet fighter pilot.  To bystanders they are the same every day kids as every other kid, and everything, all that truly matters in my world, to me.   I am not usually one to be able to not care what people think of me, but the happiness my kids bring me enables me, in this case, to rise above it.

 ***

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

 

FFF Friday: “I will give you the moon, but I can’t give you my milk.”

Those of you who’ve submitted FFF Friday stories may have noticed it can take a looooong time for them to be published. It’s just a matter of the queue being ridiculously long; there is no shortage of hurt, anger, or conflict about infant feeding. But every story is equally powerful and important to share, no matter how long ago I received it. 

Today’s post is one of those stories that has been sitting in my inbox for awhile now. When I re-read it today, I was struck by how palpable the love the author has for her daughter is. The description she gives of their bottle-feeding times made my heart skip a few beats. THIS is #bottlebonding. It’s beautiful, and it’s real, and I wish more parents were told that it is possible. For those of us who’ve done it, this seems like an obvious truth, but the negativity about formula feeding has convinced parents that they will miss out on an essential connection if they do not or cannot breastfeed. So if you feel that way, read this. 

Happy Friday, fearless ones,

The FFF

***

Rebecca’s Story

Today my baby girl turned 18 months old. A while back, her pediatrician had said in passing that he likes to see toddlers weaned off bottles by 18 months. At that time, it was a finish line and a time I would look forward to. I have hated those plastic bottles on my kitchen counter with a vengeance.

I was meant to breastfeed.I grew up with a La Leche League Leader, my mom. I remember those noisy meetings in our living room as I was trying to fall asleep down the hall as a little kid. I knew I was going to breastfeed. When I was pregnant, I had dumped out the cans of formula samples that had arrived in the mail swearing I wouldn’t give my baby that artificial stuff. My husband and I attended a breastfeeding class taught by the hospital’s lactation consultant. I remember asking the teacher if she would recommend purchasing a breast pump before the baby arrived or if it made sense to wait. Her response was that if you want to make breastfeeding work, you can. Go ahead and purchase one. I went ahead and ordered the pump through our health insurance and signed up for a few weekly calls from their own lactation consultants. It was ingrained in my head: breastfeeding was obviously the only choice if you had any desire at all to raise a healthy child. And then, 18 months ago, my body and my baby had other plans.

My daughter was delivered by C-section at the end of 37 weeks after a routine OB appointment. I was given 6 hours to pack my bag and meet the doctor at the hospital. I was really counting on those 2 or 3 more weeks to prepare myself for the baby. One item on my list was to read The Womanly Art of Breastfeeding. Of course I didn’t get to it. In the recovery room, when the baby was first put to my breast she rooted, bobbed her head and nuzzled. But, she never latched on. The nurse was excited and said, wow- when she gets it, she’s going to be a good nurser! Well, we never got it. I had visits from the hospital’s lactation consultants who were just too busy to stay and help. Both implied that there was something wrong with my breasts and never questioned whether something was going on with the baby. I remember a stressful visit from a technician who shoved the baby’s face into my breast and handled me in a way that was extremely uncomfortable and very stressful. I was afraid to ask anyone else for help after that.

After the addition of a nipple shield given to me by the hospital’s lactation consultant, the baby finally latched and achieved some suction. However, the nipple shield restricted the amount of milk flow due to the limited number of holes. The baby had some wet and soiled diapers that we tracked consistently on the hospital’s clip board. However she continued to lose weight and when questioned, the pediatrician said it was still within normal range and keep trying to breastfeed without the nipple shield. “You’ll get it. It just takes practice.” No one else seemed concern, but I still knew that something wasn’t right.

We had some very long nursing sessions, with the nipple shield, in the middle of the night at the hospital. When a nurse came in to check on me, I told her that the baby had been sucking for about an hour and was still going. “Oh, she’s just using you as a pacifier. Let me take her to the nursery so you can get some sleep.” Yet, an hour later, around 2AM I was pacing the maternity ward halls because I couldn’t sleep and really missed the baby. I wish the nurse had asked me why I couldn’t sleep rather than just trying to tell me the baby was fine and I should go back to bed. We were discharged from the hospital with no real suggestions or advice about how to eliminate the nipple shield. Just keep trying.

I spoke to my mom who insisted I call a La Leche League volunteer and looked up the number of someone in my area, picking her out by her pretty name. This LLL leader was extremely patient with me and asked me what the baby’s tongue looked like. Did it make a little heart shape when she cried? Well, sort of. As a speech language pathologist, I had studied the anatomy of the mouth and knew what short lingual frenum would look like on a toddler who was having speech problems. I never really knew what an infant frenulum should look like, nor did I look at her lips.

The next day at the pediatrician’s office, I mentioned the tongue tie to which he said the baby’s tongue looked fine, but she was still losing weight. He said we could continue to breastfeed without supplementing, but return the next day for a weight check. And of course the next day she had lost even more weight and was now a shade of peachy yellow from jaundice. The pediatrician instructed us to supplement with expressed breast milk after each breastfeeding session. And he sent us home with some formula samples, “just in case your milk dries up in the middle of the night.”. He also put us in contact with a lactation consultant who generously came out to our house that evening. I don’t remember whether she held the baby or examined her mouth in any way, but she stayed for a long time and showed us some techniques to help the baby latch. We were able to do it (and by ‘we’, I mean me, my husband, the baby, our recliner, 13 pillows and a bunch of rolled up blankets.) We kept up the new techniques and the baby fed without the nipple shield for the whole night which was both exhausting and overwhelming. I’m not sure anyone slept.

By this point in the game, I was beyond anxious. While I was on the look out for post partum depression, the anxiety piece wasn’t in the forefront of my mind. I believe it started with the surprise delivery and just continued to mount. I couldn’t relax enough express any milk with the pump and it just became a vicious circle. The baby needed to be supplemented after each feed, but I couldn’t produce any milk.

My husband called my mother who came immediately from Connecticut. A lot of that is still a blur- I didn’t know it was that bad. Finally, in a way that I don’t really remember, I was sent to bed with some medication and my husband and mother, armed with bottles and formula, fed the baby through the night. I think it was the first time I had slept for more than 30 minutes at a time for the past week. I was told that I should not feed the baby any of my breast milk because of the anti anxiety medication that was starting to help.

Slowly I lifted out of the fog and the baby began to thrive, regaining her weight and returning back to a healthy shade of pink. I think I cried every time I had to prepare a bottle for at least a week. The reminders of “breast is best” is EVERYWHERE. It just kept stabbing at my heart- on the formula container, on the coupon from Target (!), every other line on Facebook and in every baby/parenting book out there. I continuously recalled the lactation consultant who told me after class that if I wanted to breastfeed, I could. Well, I’m not sure I’ve tried that hard or wanted something to work that badly ever before. I just felt like my body had failed me and I had failed my daughter.

For some reason, I didn’t feel that I should keep seeking answers after 3 lactation consultants and a pediatrician told me that there really is no reason for the baby’s inability to latch (without the 4 adult hands and acrobatics that ensued). The pediatrician assured me that the baby was going to be ok when I questioned him (between sobs) about the differences in her life growing up on formula rather than breast milk. The psychiatric nurse practitioner that was helping me with medications for the post partum depression/anxiety, just couldn’t understand why it was so important to me to breast feed my daughter. “What’s the big deal?” she said. She doesn’t have children. At my 2 week check up with the OB, when I asked about ways to increase my milk supply, she said that pharmaceuticals don’t work well. And besides, she was raised on formula and she’s done pretty well for herself! This was not helpful advice.

Slowly, our family was establishing a routine. My husband returned to work and I began to venture out with the baby. The first event I remember going to on my own was a local babywearing group meeting. If I wasn’t going to have my daughter on my breast for feeding, I was going to have her as close to me as possible. I met some wonderfully helpful women and borrowed a wrap from their lending library. A few of the moms and newborns that I met through my prenatal exercise class were at the meeting as well. At one point I remember looking up and seeing at least 5 women nursing beautifully next to each other at the same time. I just held back tears. My daughter began to get hungry while we were at that meeting. Instead of mixing up the bottle of formula there and continuing to visit with other new moms, I said quick goodbyes to everyone and drove down the street to an empty spot in a parking lot to feed the baby. How ironic that some moms feel they need to find discreet places to nurse in public. I was afraid to bottle feed in front of my peers. Every where we traveled, when it was time to feed, I apologized to everyone as I mixed the formula. I spent so much energy trying to hide that we were bottle feeding- always aware when someone was taking a picture, I would do my best to get the bottle out of the shot. Instead of spending so much energy being embarrassed, I wish I had directed that energy at seeking answers from other lactation experts.recite-1owp3jx

At some point during the first month, I looked up re-lactation on the internet. When we were home alone on a quiet calm afternoon, I put the baby to my breast, watched her bob her head as she unsuccessfully tried to grasp me with her mouth. The feelings of overwhelming sadness and anxiety came flooding over me. I guess this is it, kiddo. I will give you the moon, but I can’t give you my milk.

Eventually bottles just became a way of life, although I complained every time I had to spend money of formula. As I learned more about nursing from friends and lots of questions about tongue ties and lip ties circulated on Facebook, I was more alert when I looked in the baby’s mouth. Somewhere around 5 months of age, I noticed her lip tie. At her 6 month well visit the pediatrician said it wasn’t an issue and we’d wait to see what happened when her teeth grow in. (Soon we will return to the pediatrician for her 18 month well visit. It will be her first visit with both front teeth grown in with the tell tale gap between the teeth. I am already a bit anxious for the doctor’s take on that.)

Somewhere around 11 or 12 months of age, when she had a diet full of solid foods, the baby stopped taking bottles from my husband or her grandmothers. Somehow she had equated bottle with mommy as I was the primary feeder being at home during the day. At 12 months we changed over to cows milk and I rejoiced at never having to buy formula again. I figured we would slowly make the transition away from bottles to sippy cups. But then I realized that something strange had happened and I was starting to enjoy our snuggle time with the bottles of milk. She would have one before each nap and one before bed. It was our special time. It wasn’t that I didn’t enjoy feeding my daughter before this, but something started to feel different. Over the past few months, I have really started to pay attention to what was happening when I gave her milk in her bottle. She always sits in the same position on my lap, with her cheek against my breast. Sometimes she nuzzles in. She often takes my hand and puts it on her leg so I will gently rub it. She holds my fingers with one hand and twirls her hair with the other. She has never tried to hold the bottle herself (despite all those other acts of independence that come with toddlerhood). She will pause sometimes to say something to me and when she wants to drink more, she raises my hand that holds the bottle, never reaching for the bottle itself. It’s become a very special time for me to spend with her. I consider it an amazing gift that she has given me that I will always cherish.

Motherhood is far from an easy journey. I really worried about my daughter’s future without being breastfed and those fears still creep into my thoughts periodically. But then I look at her in awe of what an amazing little girl she is.  To think, a child that has been on earth for exactly 18 months could teach a grown woman so much about love, making choices and finding the beauty in a challenging situation.

 ***

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

Experiences of Formula Feeding: Results of a survey of 1,120 formula-feeding parents

We talk a lot in the Fearless Formula Feeder community about the negative experiences we’ve had with medical professionals, media outlets, and our peers. And this is good, and healthy – we need a place to chew on these bitter feelings, and hopefully digest them so we can move on with our lives. Still, I want to go a step further this year, and really think about (and act upon) what could be made better. I think the time for some positive, real change is now, don’t you?

Considering how much the infant feeding world likes research, I think some data is a good place to start. Mind you, what I’m about to talk about isn’t peer reviewed or even professional compiled data; it’s merely a Survey Monkey study, which any Joe Shmoe can do at any time. This one was written by me, and I am by no means an epidemiologist (although I like to pretend I am, and probably would have tried to be if I could wrap my mind around simple algebra, let alone statistics) or PhD or anything of the sort. So it’s important to take this data with a grain of salt; it’s simply anecdotal, self-reported data crunched by a website to give us some idea of what’s going on for a particular, self-selected group.

Let’s talk a little about what this all means. Basically, I posted this site on the FFF Facebook page. It was shared and spread around a fair amount, but it’s safe to say that the majority of the respondents were FFF members. Which means something, because as a group, we tend to be a few things: educated, interested in parenting, mostly white, mostly lower-middle to middle class, mostly English-speaking (although the respondents included people from the U.S., Canada, the UK, France, United Arab Emirates, Australia, New Zealand, the Netherlands, Bulgaria, South Africa, Russia, and Mexico), and people who read a lot and care a lot about formula feeding issues. Because of this, we can’t necessarily assume that our experiences are typical of ALL formula feeding parents, but considering we have a pool of 1120 people, from a variety of geographic areas who formula feed for a number of different reasons, we can infer some things from the data we have here.

That said, I think it’s interesting and helpful to at least collect our experiences in a way that can help us talk about them more clinically, to understand the experience of some formula feeders, who tend to be parents who think a lot about parenting. That’s important, I think, because it suggests that these answers are relevant for care providers who are trying to serve this market.

With no further qualifications and hemming and hawing, I’d like to present you with the results of the first ever Fearless Formula Feeder/I Support You Survey on Formula Feeding Experiences. 

 

Question 1: When did you begin formula feeding?

Screenshot 2015-01-27 at 12.13.32 PM

Screenshot 2015-01-27 at 12.14.01 PM

 

The majority (32%) of respondents began using at least some formula shortly after birth, although breastfed at least once. But those who began using formula after one month were a close second, at 25%, and 19% formula fed from birth.

Real-world implications: If most of these respondents were formula feeding a one-month infant or younger, their responses on the degree of instruction they received carry particular relevance. In completely unscientific terms – we’re talking about tiny babies and brand new, very sleep deprived parents. If anyone needs explicit guidance on something which can, at times, resemble a junior high chemistry experiment, it’s these folks.

Question 2: What were your reasons for choosing formula?

Screenshot 2015-01-27 at 12.16.33 PM

Screenshot 2015-01-27 at 12.16.50 PM

Respondents were able to select more than one answer here, so please note that there was often a combination of reasons that led an individual parent to formula feed. The most common answers were “I couldn’t produce enough milk” (44%); “My child wasn’t able to breastfeed successfully” (33%); and “Breastfeeding contributed to my postpartum depression” (22%). 17% of respondents chose “I did not want to breastfeed.” As respondents could elaborate on their reasons via a text box, some of the comments received were as follows:

“I am a survivor of childhood sexual abuse, and both childbirth and breastfeeding were intensely triggering.”

“I stopped because it was straining my mental health and I felt like I was missing my daughter’s life because I was so consumed with trying to make breastfeeding work.”

“When they tested my milk with my 2nd child (32 weeker preemie) it was as fatty and nutritious as tap water.”

“Doing all of the nightfeeds by myself was never a realistic option for our family because I earn most of our income, I can’t show up to work massively sleep deprived and I have no opportunity to pump during the workday. This little detail was glossed over in all our prenatal breastfeeding education. When I caught on to it in the first week postpartum my husband and I jointly decided that breastfeeding was not for us.”

“I had mastitis so severe I was hospitalized. It turned into an abscess that they tried 3 times to drain with a needle but it didn’t work. They eventually had to do surgery to remove it. I tried to breastfeed through all that up until the second time they tried to drain it with a needle when I finally decided to stop trying because it was killing me.”

“Child ended up hospitalized due to dehydration.”

“I had postpartum thyroiditis. Only ever… produce(d) 2 ounces of milk per day. It also triggered devastating insomnia that lasted for 12 days. I decided it was killing me, so i stopped.”

Real-world implications: The responses on this question are obviously all self-reported, and there’s no way to verify the validity of medical reasons such as an inability to produce milk. However, I’m in the business of believing moms when they tell me things, so I’m assuming that there was a valid reason each of these moms felt that breastfeeding did not work for them. The point of including this question, for my purposes, was to see the variety of reasons parents chose formula and to get an idea of what would be best discussed prenatally. For example, there are visual cues for Insufficient Glandular Tissue, which physicians could be trained to notice during prenatal exams. Or, for women with histories of depression or sexual trauma, it might be helpful to be more open about the effect breastfeeding may have on them in an individualized, sensitive way – because what is empowering and healing for one woman might be damaging and re-traumatizing to another.

Question 3: When you first began formula feeding, were you given instruction/guidance from medical/hospital staff?

Screenshot 2015-01-27 at 12.19.58 PM Screenshot 2015-01-27 at 12.20.15 PM

55% of respondents said that were not given any formal instruction or guidance on how to use formula. While 33% of the rest of the group did get some sort of verbal guidance from a medical professional, only 12% got a pamphlet or written material.

Real-world implications: This seems like a no-brainer – how hard is it, really, to give new parents a brief one-sheet on formula prep, with resources listed for further help?

This leads me to….

Question 4: Where did you receive most of your guidance on using formula?

Screenshot 2015-01-27 at 12.21.59 PM Screenshot 2015-01-27 at 12.22.09 PM

53% – just over half- said that the main source of instruction was from the back of a formula can.

Parents are also getting help from other sources – nearly 30% did cite their pediatrician/other medical professional as a resource, so that’s promising. Another 33% said that websites were helpful, and 23% got assistance from friends or relatives.

Real-world implications: Considering pediatricians typically give verbal or written instructions on how to administer baby ibuprofen, and discuss things like television use, potty training, and sleep training with patients, I think it’s odd that we assume the instructions written on the back of a can are sufficient for safe formula prep. Not all parents are native English speakers or fully literate. Not all parents can read tiny print on the back of a can at 2am, when they are sleep deprived and worried about a newborn.

 

Question 5: Do you feel you received adequate information about formula feeding safety and use?

Screenshot 2015-01-27 at 12.23.22 PM Screenshot 2015-01-27 at 12.23.31 PM

While 40% said yes, 34% said “no” and another 22% said “I’m not sure”.

Real-world implications: This suggests more than half of parents using formula aren’t convinced that they were given enough information to feed their babies safely. Not acceptable.

Some additional responses:

“Too many people I spoke to IRL seemed to be compelled to remind me that breast was best. That shaming did not help me during a time when I was very vulnerable and wanted information”

“Eventually, after I did my own research. The nurse in the hospital almost yelled at us for leaving the half consumed bottle of ready-to-feed out at room temperature. We had no idea as new parents what we were supposed to do with formula, and no one had taken the time to explain it to us. So any information I got was from my own research.”

“I feel I had to ask too many questions to the pediatrician that should have just been told to me. For example, in the hospital they gave him 2oz every 4 hrs. When we went home no one told us to change that so he dropped a lot of weight…”

Question 6: If you could choose the way you received info on formula, how would you like it to be given?

Screenshot 2015-01-27 at 12.24.37 PM Screenshot 2015-01-27 at 12.24.47 PM

Respondents could choose more than one answer here, but there were two methods which received the vast majority of responses: “a nurse or doctor to talk to you about it” and “a pamphlet or written materials.”

Real world implications: Medical professionals need to be informed on formula feeding safety and practicalities, and be allowed to impart the information in a judgment-free manner. Written materials should also be created to be given to parents at discharge. Since 18% and 16% responded that they’d like to learn about formula via a peer support group or websites/books respectively, it also may be helpful to offer a resource list to all expectant mothers that is truly comprehensive, and not just helpful for those planning to breastfeed.

Question 7: What was the hardest thing you faced when you began using formula?

Screenshot 2015-01-27 at 12.26.30 PM Screenshot 2015-01-27 at 12.26.42 PM

This was one of the most interesting questions on the survey, in my opinion; 65% of parents responded that “my own feelings about formula use (guilt, shame, fear, etc.)” was the hardest aspect. The other two popular answers were “the lack of social/emotional support from fellow parents” and “the lack of information on safety, choosing a formula, bottle feeding, etc. (practical issues).”

Real-world implications: Formula feeding parents need a safe space where they can access peer support, work through feeling of guilt/shame/fear, and learn about practical issues of formula feeding. To me, the simplest answer is that we need peer support groups, our own version of La Leche League. Kim Simon and I have been developing a platform for these peer groups through the I Support You organization, and I am really excited that two FFF members have already started their own local chapters (Atlanta and Baltimore). I hope that we can grow this movement so that every major metropolitan area has a resource for formula feeding/combo feeding parents, because as these numbers show, it is desperately needed. Need more proof? Here are some of the open-ended responses to this question:

“I became very depressed and felt worthless as a mother and human being. Luckily, my husband caught me in the middle of writing a good bye letter to my daughter as I had planned to end my life.”

“felt like a failure for not giving the “liquid gold.” I really had to search for good evidence. I remember finding a paper by 3 biostatisticians who had all breastfed. They dug into the evidence. Reduced mortalitly? One study had one infant death in the formula fed group, but the baby fell off the counter!!! Finding unbiased, easily accessible info would have been great. “

“The NICU lacation consultants were relentless. My doctor told me that I most likely would not be able to successfully pump. The NICU nurses understood that it didn’t work out. My baby’s doctor made arrangements for donor milk. However, the lactation consultants hounded me and made me feel like it was my fault it wasn’t working. They added unnecessary stress to a situation that was already a nightmare.”

“I didn’t know any other formula feeders. It wasn’t that my fiends/peers were unsupportive… but they were all breastfeeding and could not relate to formula feeding.”

Question 8: Did you have any trouble with the technical aspects of formula feeding?

Screenshot 2015-01-27 at 3.12.30 PM Screenshot 2015-01-27 at 3.12.41 PM

43% of respondents said no, they hadn’t had any issues in this regard. Of the remaining respondents, the most commonly-faced issue was reflux/other GI issues, followed closely by “I had trouble finding a formula that worked for my child.” A small but significant amount (14%) “(were) confused about formula or supplementing and felt lost on where to go for help.”

Real-world implications: More than half of those surveyed endured some sort of struggle with the technical aspects of formula feeding, suggesting that using formula is not as simple as “add powder and water” for many parents. I hear this excuse a lot from those who deny the importance of formula feeding education and support – that it doesn’t have a learning curve, that doctors don’t need to know much about it because every formula is the same, etc., etc. And that is certainly true for some people, but not for all. Not for over half of us.

Question 9: Did you experience any emotional challenges due to your choice to formula feed?

Screenshot 2015-01-27 at 3.15.24 PM Screenshot 2015-01-27 at 3.15.48 PM

Only 18% of respondents said no, that they hadn’t experienced emotional challenges. The rest (who were allowed to choose more than one answer) mostly struggled with their choice or need to use formula (58%), and worried what others would think (55%). 35% felt “left out by other moms” and a quarter of respondents (26%) felt that the emotions around infant feeding contributed to postpartum depression and/or anxiety.

The open-ended responses included:

“I would have felt very comfortable in my decision to formula feed from the start if I had not been pushed into breastfeeding by the hospital, and also my mother and stepmother made me feel incredibly guilty. I had asked for info on bottle feeding while in the hospital and was snubbed. These issues contributed to my emotional challenges. It took almost 4 months for me to realize everything was okay.”

“I felt guilty for not feeling more guilty. Also felt like I didn’t try hard enough and that subconsciously maybe I was using PPD risk as an excuse. Oh, and I ended up with PPD anyway.”

“I was worried that all the negative health outcomes would come true- it’s pretty dirty to scare a mom into thinking that one choice could make her child overweight, less intelligent, and generally unhealthy. Happily, none of these things have come true in 3 years!”

“Despite knowing better, I felt guilty that I wasn’t giving my baby “the best.” That I hadn’t “tried hard enough” for her. The pediatrician at the hospital compared bottle feeding to “taking your baby to the drive through.” Thankfully her actual pediatricians were wonderful and told me it absolutely makes no difference either way.”

“I did feel some guilt about not breastfeeding, though I got over it rather quickly. What resonates more with me, though, is the fact that I didn’t want to breastfeed in the first place, but felt pressured friends, my community, the hospital, etc. to do it. And while it’s true that my kid had serious reflux, allergies, etc., and I had production problems, I also just HATED breastfeeding. And even sites like FFF sometimes make it sound like it’s only ok to FF if you tried to breastfeed and couldn’t. I’d love for women to have permission to just chose not to breastfeed in the first place.”

“I knew that there was no way that I could carry on attempting to BF and pump while still taking care of myself and my child (literally I would feed, attempt to pump, and he would be ready to eat again). But I could not relay that kind of feeling of desperation and failure to other moms who had no problems BF. I thought I was doing something wrong.”

“…I was confident in my decision about FF from birth, well educated and versed BUT still got side-eyed and looks from some people. No matter how confident you are when there are people who truly believe formula is poison and if you don’t BF you don’t deserve to have children (even when you fought with infertility to get said child) it’s disheartening. The lack of correct info on FF and the slew of misinformation on the benefits BF make it difficult to even the playing field.”

Real-world implications: Mothers are hurting. When over 80% of formula feeding parents are talking about the emotional ramifications of their feeding method, we need to sit up and listen. We have a large body of breastfeeding research now, but an abysmally small body of research on the effect of postpartum depression and adjustment difficulties on both mother and baby (not to mention other children, partners, employment, future relationships, etc.). If the way we approach infant feeding is contributing to emotional duress in a generation of parents, it seems worthwhile to reassess the risk/benefit of promoting breastfeeding in the way we currently do.

If we insist on continuing down the same path, then we need to also make sure that the negative experiences of formula feeding parents are tempered by appropriate measures. This means ensuring that they are treated with respect and with regard to personal autonomy; setting up social support systems like peer groups or pre/post-natal classes which address other methods of infant feeding; and perhaps providing sensitivity training for those dealing with newly postpartum or expectant parents so that they learn to impart the benefits of breastfeeding in a manner devoid of shame, guilt, or fear-mongering. It is possible, and it is well worth it.

Question 10: What country do you live in?

Most respondents were from English-speaking countries: the United States, Canada, the UK, Australia, and New Zealand.

Real-world implications: Not sure we can take much away from this, except that the reach of FFF (which is how respondents were recruited) is mostly in the English-speaking world. But while we’re on the subject… let’s address the need for culturally-specific infant feeding recommendations and policies. Even within the countries we’re discussing here – which on the surface have many similarities – there are demographic, socioeconomic, religions, cultural, and political differences. People cite the World Health Organization as a good source for formula feeding best practices, but it’s rather simplistic to try and make this issue universal. Mixing formula in a place with unsafe water and hygiene issues is quite different than doing so in a Lysol-happy kitchen using filtered, purified, boiled water and a dishwasher with a “sterilize” cycle. And that’s not even mentioning the impracticality of assuming that genetic, lifestyle, and dietary factors do not affect biological processes; to say IGT only affects 1% of the Swedish population, for example, means nothing to a demographic of Eastern European Jewish women in Manhattan. There are higher rates of breast cancer and Crohn’s disease in some ethnicities; higher rates of genetic diseases in others. Why should breast tissue be immune to these same factors?

I know I’m going off into tangents here, but the point is: it is time to think of infant feeding with more nuance, even in seemingly homogeneous populations. At the same time, we need to recognize that feelings of guilt, shame and fear are common in Western, relatively privileged demographics, regardless of breastfeeding rates and months of paid maternity leave. This is complicated stuff, and requires far more complex analysis than we’ve been given it. It’s time to step it up.

Question 11: What would have helped your experience with formula be more positive?

Screenshot 2015-01-27 at 3.16.57 PM Screenshot 2015-01-27 at 3.17.39 PM

The highest amount of responses went to the following (again, respondents could choose multiple answers): more support and guidance from medical professionals (50%), more support and guidance from peers (45%), prenatal preparation for formula feeding (50%) and a peer support group for bottle feeding or combo-feeding parents (44%).

Real-world implications: All of this would be so simple to accomplish. If medical professionals were not scared to discuss formula, lest it be considered giving women “permission” to not breastfeed; if formula could be discussed in prenatal classes in an honest, clear, factual way; if we could stop making it “breast vs. bottle” and just make it two different, sometimes compatible, ways to feed a baby…. just imagine what could happen.

When La Leche League began, it was due to the inadequate support for breastfeeding mothers from society and physicians. While there are still battles to be fought, we are seeing more and more support for breastfeeding (as long as its done within the parameters of what is deemed “socially acceptable” – ie, for no more/no less than a year or two – which is most definitely a problem we need to address), if not from society as a whole, at least from the medical establishment, the government (at least in lip-service and funding for Baby Friendly and corporate lactation programs) and the parenting community. Now may be the time for a formula-feeding equivalent of LLL to do the same noble work – ensuring that moms (and dads – formula feeding is not gender-specific, and dads need to be included more in this conversation, especially those that are primary caregivers) are getting the support they need, when the powers that be cannot provide it themselves.

I will be following up with another survey soon, which will examine if there truly is a need for more “education” about formula feeding, or if it really is simple enough to merit the lack of focus given to it in prenatal and postnatal settings. But until then, I want to leave you with a few more of the comments left in the open-ended sections of this survey. My hope is that this will inspire those with the money and resources to conduct actual, peer-reviewed research on these topics to do so. At the very least, I hope it gets us thinking. Because we need to be thinking, and not just shouting at each other, endlessly, about who knows best.

 

“I just wish that they would give better instruction at the hospital to moms who choose to formula feed about mixing, feedings and choosing the right formula for your child. They send lactation consultants for breastfeeding moms. Why can’t they teach formula feeding moms a few pointers about formula feeding? We are all feeding babies. Why give one method so much attention and neglect another entirely? All that matters is babies get fed. Is that not the most important objective?”

“If there was more support (from) medical practitioners perhaps breastfeeding mums would be less critical.”

“I took a breastfeeding class, but looking back I wish it would have been a general baby feeding class. To learn about pros and cons of breastfeeding, formula feeding, using bottles, and starting solids. Because although not everyone will breastfeed, everyone will at least need to learn about several of these options.”

“I  had no idea what I was doing and didn’t even know where I should look to find the information. It’s hard to find good formula info online and I didn’t know what to trust, especially when I was emotionally and physically exhausted and felt judged by others as well as by myself.”

“Can you fix the world and let everyone know that formula feeding isn’t bad? As long as you feed with love. This is such a touchy topic and I just wish everyone would let it go bc they only make it worse for moms. I also hate the attitude that formula feeding is okay IF you tried to breastfeed or IF you have low supply. I really want the attitude to be that there is nothing wrong with a mom who chooses to formula feed from the get go. Essentially if you could fix the whole attitude about how we feed our babies that would be great.”

 

You’re Proving the Point

There’s this video that’s been making the rounds on the parenting pages for the past few days. If you haven’t seen it yet, feel free to do so now.

 

Yes, it was made by a formula company. Boo. Hiss.

Now that we have that out of the way, can we get to the real discussion?

Spoiler alert: no, we can’t. Because it was made by a formula company, and therefore anything the video stands for is nothing more than a cleverly crafted marketing message meant to scare women off breastfeeding by convincing them that their milk is made of Ovaltine and if they breastfeed even once, they will instantly be turned into a newt.

What, you didn’t see that? That’s because you’re naive. You don’t understand. Obviously haven’t read (fill in the blank with any blog or breastfeeding politics books here), because if you had, you’d understand that this is ALWAYS what formula companies do, because FORMULA=PATRIARCHY. Duh. Choice as feminism? That’s about as last century as Debbie Gibson.

But wait – if the problem was simply that this is a marketing tool (which it is, no doubt; formula companies – scratch that, all companies – are not in the business of throwing massive advertising dollars into PSAs about mommy wars if they didn’t think it would do them some good in the long run), I wouldn’t be writing this late-night post, my fingers shaking so hard from frustration that I’ve had to retype this sentence three times. I mean, being skeptical about advertising, I get. I personally hate Luv’s diapers, I think they suck donkey balls and leak like my junior year apartment’s jinky kitchen sink, but I love their “second time mom” commercials. Hell, I’ve cried at McDonald’s ads and I’m a card-carrying lifelong vegetarian. But if your morals are strong enough to temper your taste in entertainment, you’ve got my respect. It’s healthy and smart to analyze the endless array of shit that passes over our news feeds and DVRs.

The problem is that now, people have turned what could have been a great statement on being media savvy and critical of marketing messages into the same old, tired argument about why the mommy wars don’t exist, and why breastfeeding is a public health issue and therefore can’t be considered a choice in the same context as cloth diapering, or choosing to work rather than stay home, or even abortion.

But, see, you’re proving the point.

You’re proving that the perceived judgment among women isn’t all in our heads; that it isn’t something the formula companies and media have created, but rather capitalized on. Those are two very different animals. Of course formula companies are going to talk about judgment and choice and empowerment and all those other triggering terms in the infant feeding debate. Because it resonates. It’s simple advertising theory 101: inventing the need versus serving the need. This is a case of serving the need.

Formula companies see the need, because women who formula feed are made to feel ashamed of their choice. If you don’t believe this is true, and you happen to be a parent, for one second, close your eyes, clear your mind, and think: If your entire Facebook feed was full of memes about how gross (fill in the blank with something you feed your child, or a method or parenting you employ) was, or some study came out that suggested kids that (fill in the blank with something you do as a parent and feel strongly about, whether it be breastfeeding or time outs or co-sleeping or taking them to church) who did this have higher rates of obesity/attachment issues/lower IQ, how would you feel? How would honestly feel, in your gut? Forget about the reality or perception of the current research, forget about societal norms, forget about all of it – just think about how you would feel.

You feel it? In your stomach? That queasiness? The feeling that while everything you see in front of you says one thing – that your healthy, gorgeous child has no attachment issues, is smart as a whip, and is this amazing creature you have nothing but awe for – the rest of the world is entirely convinced that your lived reality is false, based on purely associative data that has nothing to do with your family or your child? That is how formula feeding parents are made to feel every day. Not by “breastfeeding moms”, which many of us have been/are/would like to be/are best friends with. This isn’t about breastfeeding moms vs. formula feeding moms. THAT, my friends, is a made-up mommy war. But formula feeding parents are being made to feel this way: by the media, by their physicians, by ads on the freeway, and by you. Yes you. The ones on the parenting pages, pretending to be so accepting of alternative choices; who rage on about how being able to choose how/if you vaccinate is a parent’s choice, science be damned, and then in the same breath tell parents that formula feeding is a public health issue, because the poor, sick formula fed babies will be messing up your gene pool 20 years down the line.

You’re right about one thing though. This isn’t a mommy war, not at all. It isn’t the mom at the park versus the other mom at the park. (Moms at the park are usually pretty nice, actually, in my experience. If anything, they judge you more for how your kid is behaving in the sandbox than what you’re feeding him.) This “war” is run by those with power – the ones running websites, hospitals, initiatives; the ones authoring books and selling their wares under the impenetrable armor of a PhD or MD (because no one with a PhD or MD could ever be wrong, or biased. Unless they work for Big Pharma, of course). Not because of the information they are sharing, but how they are choosing to share it. Not because of the research they do, but because they only deal in absolutes, refusing to see nuance or entertain other findings or beliefs.

This isn’t a war, even, because that implies some sort of mutual disagreement. It’s one side bullying another, refusing to hear the other side’s point of view, denying the other side’s right to exist. For that side, the only peaceful resolution involves accepting a totalitarian regime, no middle ground. And since there’s no way to argue against someone when they shut down your right to be heard, it’s a losing battle.

So let’s just say we give up. We’re waving the white flag. YOU WIN.

Go on – keep shouting from the rooftops that breastfeeding will save all of us from certain death and that formula will turn our children into baby seals. Go on – tell us we have no right to feel judged, and that we can’t be mad at you, we need to be mad at the formula companies because they provided food that kept our babies thriving fooled us into thinking our IGT was real, our depression was truly only helped by ceasing lactation, and that our history of sexual trauma would be exacerbated by nursing.  We hear you. We’ve heard you. Keep it going, because maybe you haven’t made that mom over there sufficiently remorseful.

But don’t sit there and tell me that the feelings Similac capitalized on are not real. That they don’t matter. That our experiences don’t matter. Don’t post sanctimonious rhetoric about feminism and scoff at anyone who dares to question your point of view, because last I checked, that seems a helluva lot more patriarchal than a can of baby formula. And you have a vagina, so that makes it worse. Formula cans don’t have vaginas. (Again, last I checked. Who knows. It’s been awhile since I had a formula-feeding infant.)

Or you know what? Go ahead and tell me all of that. I’m all for free speech. Who the hell am I to tell you what you can’t and cannot say?

Just don’t expect the rest of us to listen. We’ll be over here watching some kitten get rescued by a fireman and yelling about how it must just be a ploy for us to give money to the fire department. Because… patriarchy. Or something.

 

 

 

Related Posts Plugin for WordPress, Blogger...