Why THIS mom didn't meet her breastfeeding goals.

I just read a post over on PhD in Parenting that has me kind of fuming. My thoughts are far too long to include as a comment, so I’m writing about it here instead.

I have resolved a lot of my feelings about this over the last four years, but I’ve had this come up a couple of times recently and Annie’s post was enlightening in a way that no other breastfeeding information ever has been. This list of reasons (that are identified as myths in Annie’s post) why women are encouraged to supplement with formula in hospital that reopened the frustrated wounds of my failed breastfeeding experience:

  • Your baby is hungry
  • You were sleeping and I didn’t want to wake you, so I just gave him a bit of formula.
  • Your milk hasn’t come in yet. We’d better get him on a bottle.
  • Your baby has low blood sugar.
  • Your baby is crying a lot.
  • Colustrum has no nutritional value.
  • It will cure jaundice.
  • Maybe if he has a bit of formula, he’ll know what it feels like to have a full tummy and that will make him interested in nursing.
  • Your baby’s blood sugar is too low.
  • Since English isn’t your mother tongue, you should really just formula feed.

The three that are bolded? Those are all things that I was told or led to believe. Let me back up and tell you a bit more of my story interspersed with information I have learned since giving birth.

I have polycystic ovarian syndrom (PCOS). I was diagnosed 10 years ago after miscarrying my first child. (Wow…I would have a nearly ten year old this year if that hadn’t gone the way it did.) My GP who was caring for me until I got to 30 weeks should have been closely monitoring me for signs of gestational diabetes, including ordering the GD testing early - at 24 weeks or earlier instead of the usual 28/29.

I entered the diabetes clinic, was monitored for blood sugar regularity and size of the baby. At 37 weeks, when an ultrasound estimated that Brandon was about 9 pounds, I left the ultrasound clinic in tears, knowing that my doctor was going to recommend c-section. She scared me into it and that’s all I’ll say about that. Yes, my son was 10.5lbs at birth, but women CAN give birth naturally to large babies - it’s not the end of the world. I did not want a section. I was (and still am) terrified of surgery. Should we decide to have another, I will go for VBAC - no doubt in my mind.

Prior to giving birth or even being pregnant, I did a significant amount of reading about PCOS, the symptoms and effects on my body/life and how to manage it. Not once did I ever read anything about low milk supply. I have no idea how that significant and frustrating fact escaped me. It wasn’t until my pre-op, 5 days before my surgery that the nurse (also a lactation consultant) raised the red flag to me. 

I went home in tears. I was having a c-section, which is known to complicate breastfeeding AND I had a broken body that may not work right. Talk about stress and frustration and bad timing!

Fast forward to nearly a week later. I’m blissfully unpregnant, staying as still as possible so as not to disturb my incision and my Friday night nurse makes a helpful suggestion. Brandon really isn’t getting enough to eat from me. He’s wanting food more often than every three hours (no mention of the possibility of breastfeeding on demand). She offers to help me with lact-aid. Brilliant! I can supplement and still get the benefits of breastfeeding. 

We did this Friday and all day Saturday until the night nurse arrived in my room just after Matt left for the day for the regular feeding. She immediately started to tell me that I needed to decide what I was going to do when I got home because we couldn’t do lact-aid at home. Oh, did I mention that this was about 11:00pm? Yeah, her timing was awesome. Not to mention that she didn’t once tell us WHY we couldn’t do it at home.

She delivered this news while she also informed me that I was doing everything wrong, despite the fact that my son had latched like a champ for two days with no problem. She proceeded to put her hands in front of his face so I couldn’t see what I was doing to get him latched on. This resulted in repeated failure to get him situated. She even shoved the lact-aid tube so far into his mouth that she choked him once. He had his first screaming fit that night thanks to the nurse from hell. And I had my first breakdown. 

After she left the room and Brandon was settled, I called Matt in tears. He returned to the hospital and found said nurse to have a little talk with her. Then he stayed with me until 2:00am when we were to do the next feeding so that he could handle the lact-aid without needing the nurse from hell to help. This didn’t stop her from barging in my room and delivering pamphlets on how to bottle feed and the process to sterilize bottles. I refused to say a word or even look her in the eye, I was so angry. Her audacity still amazes me. If I had a baby in that hospital today and she walked into my room as my nurse, I would tell her to go switch with someone else. I can’t believe someone like that is allowed to work in a birth unit.

The day after, shift change brought a kinder more level-headed nurse who gently explained that lact-aid had to be used with the supervision of a certified lactation consultant. Ah. Okay. She helpfully provided some formula samples and we packed up and left the hospital and made a trip to the drug store to rent a breast pump and purchase bottles and formula, which I hadn’t bought before because I hadn’t planned to use them.

Five days post-partum (and the day after we were released), I attended the hospital’s breastfeeding clinic where the LC recommended that I obtain some Blessed Thistle, Fenugreek and ask my GP for a prescription of Domperidone. I stopped at the health food store on the way home for my herbs and called my doctor right away. Her nurse practitioner called me back to say that she wouldn’t give me the prescription despite the fact that all eight OB/GYNs at the hospital I where I gave birth recommend it for helping with low milk supply. I never went back to that GP again. 

I was able to obtain a prescription from my OB for domperidone, but not until a full two weeks post-partum. The herbal supplements had already helped, and I saw a difference with domperidone, but no one ever told me to just let the baby nurse as much as possible or feed on demand. I was told to feed him for 15 minutes on each side, then pump for 15 minutes. The process was exhausting and it really didn’t help my milk supply improve.

Little chronological side note: At my six week checkup, my OB saw something made her question me - it’s a symptom of my PCOS and I told her I had it. My GP had not informed her when she referred me to the OB. That cemented my decision to never go to that GP again. Lesson learned, though: Do not assume your doctor is doing their job well - they could be missing key steps that have a big impact. My OB needed that information while I was pregnant, not after.

I took domperidone for eight weeks. I didn’t risk asking for more than that because my OB was annoyed that she had to be the one to prescribe it. We rented the breast pump for eight weeks. But because we were buying more formula all the time, and the domperidone had run out, I returned it. I’d continue giving Brandon breast milk as long as it lasted and let nature guide me.

At just shy of three months, Brandon turned away from me for the last time, refusing my milk because there just wasn’t any there. The drip, drip of that faucet was quickly silenced and as much as I tried to tell myself I did everything I could, I knew there was probably more I could have done.

I wasn’t wrong, as I’ve learned in the years since. I may never have been able to build the milk supply needed to breastfeed my son exclusively, but I think the system failed me in a number of ways. It’s been a learning experience that will inform my decisions in future should we have another child, but it frustrates me to no end that I could have and should have had a better chance.

Maybe by sharing my experience other moms can learn from the mistakes I made in ignorance. But most of all, follow your gut. First time moms should have a voice that is every bit as loud and confident as second, third, etc. moms. If something is bothering you or you disagree, speak up. If your doctor or other caregiver isn’t giving you rational reasons for their recommendations, find another opinion and don’t put it off. Do your research, because you have to be your own biggest advocate in all areas of health - for you and for your child(ren).

Formula marketing practices are wrong - no need to take sides

Recently, someone I know said something to me about hating formula.

Really? Why?

Formula is an inanimate object. A food. It keeps many babies alive. Including this one:

Yes, my son was formula-fed and it was pretty much our only option for feeding him. I never planned to use formula. We had to buy bottles and formula on the way home from the hospital, in fact. My mother used to share stories of how special she felt her time breastfeeding was and I wanted that too. However, less than a week before Brandon’s birth I was told by a nurse/lactation consultant in my pre-op appointment that having PCOS could mean I’d have problems with low supply.

This is why the “I hate formula” attitude rubs me the wrong way - it feels so superior. I’m tired of the formula feeders versus breast feeders debate. As someone who had no option other than to give my child formula, it’s deeply disturbing to me to see the comments that some women make about moms who feed their children formula and the risks expose their children to for “convenience”. (Sorry, paying $30 a can wasn’t at all convenient!)

For well over a year of Brandon’s life, I didn’t know that there was a boycott of Nestle products that had been (and still is) going on for decades. I only found out when I saw this post go up in September 2009 and watched the flurry of tweets, comments and commentaries. Back then, I didn’t really understand the issue and it prompted a lot of questions - many that had to do with some of the things that were being said by some of the more militant supporters of the boycott - particularly when people like me raised questions. Fortunately, in addition to Annie, there are many cooler heads who will answer questions and concerns with patience.

Even after reading post after post about this issue on Annie’s blog for nearly two years, I still couldn’t bring myself to fully embrace the boycott. Though I used Nestle formula only once - when the grocery store didn’t have our regular brand - I still had the overwhelming feeling that this was a formula feeders versus breast feeders issue and I didn’t want any part of that. It was just too emotional for me, given that breastfeeding wasn’t even an option for me. I didn’t want to feel like an inferior mother.

When Annie wrote this post last fall - Is shame a barrier to social change? - it changed my view completely (and immediately). I knew I needed to read carefully after the first paragraph:

I’ve had a lot of interesting conversations over the past few days about shame, guilt, and social change. Without going into excruciating detail, I heard a lot of people say that calls for formula marketing to be restricted makes formula feeding moms feel shamed because if formula marketing needs to be restricted, then that means that formula is bad, which means that formula feeding moms are doing something wrong.

I can hardly begin to tell you how well I identify with this line of thinking. It’s how I felt for nearly 2 years.

Annie goes on to say:

We live in an imperfect world. We all make choices, on a daily basis, with imperfect information and in imperfect conditions. Every single day, I make choices that I wish I didn’t have to make. Every single day, I try to make better choices. It is a balancing act between progress and reality. No one is perfect. No one should be expected to be perfect. No one needs to feel guilt or shame for being imperfect.

So, here’s the revelation that I had when I read Annie’s post about shame being a barrier:

PhD in Parenting | Why I Protest Nestlé’s Unethical Business PracticesFORMULA isn’t bad. It isn’t the evil culprit it gets made out to be in so many posts that are advocating for better breastfeeding support or boycotts against Nestle for its marketing practices (usually in the comments - that’s where it can get really ugly).

Is formula the best thing to give your child? No - we can all agree on that and set aside the whole “breast is best” argument.

BUT I did what I had to do to keep my son alive, healthy and growing. Just like every other mother out there, I want what’s best for him. I want what’s healthy for him. In our circumstances, that turned out to be food from a can, whether I liked it or not. I felt a lot of guilt and shame for a long time after Brandon’s birth. He’ll be four years old this year and I still have trouble accepting what occurred.

My hope is that more breastfeeding advocates and formula marketing critics will use greater care in how they get the message out about their cause - much like Annie and Amber (and I’m sure many others as well). Hearing that breast milk is best for a child isn’t objectionable. Having the worst-case scenarios (low IQ, obesity, death, etc.) of feeding a child formula is highly objectionable. It also muddies the issues around formula marketing and leads to the question: Is formula bad or are the formula marketing practices unethical?

It has taken me over two years to get past the inner conflict of being a formula feeder to see that boycotting Nestle doesn’t mean I’m condemning my own actions.