I want you to meet three women I know.
Mother A is a business woman, well into her thirties, who was bottle fed as a baby. She is a health nut who definitely wants her baby to get breastmilk, but doesn’t want to be tied down by the breast, so she hopes to do be able to do as much pumping as possible and to deliver the milk via bottle much of the time.
Mother B is an older woman who has finally conceived a long-awaited child with the help of a lot of scientific intervention. She has dreamed of being a mother for a long time, and wants to overcome her difficult childhood by showing her child the kind of unconditional love and care that she never received herself. She plans to breastfeed because she feels that it is the most natural way, and because she wants her precious bundle to get the antibodies from her milk that will help protect the baby from the ill winds of fate.
Mother C is a younger woman, an only child, who was breastfed herself but had no siblings. She has a history of depression and anxiety, and has found pregnancy difficult. She is determined to breastfeed because she doesn’t want to spend money on formula (money is a concern), because she values any boost she can give her kid’s IQ, and because she views breastfeeding as easier – no mixing formula, no bottles to sterilize… hell, you can even feed the baby while fast asleep.
Only one of the above women will be successful at exclusive breastfeeding. One will transfer exclusively to formula within a month and the other will feed primarily formula while supplementing with nursing sessions.
Which do you think is which?
Let me tell you more about them.
I visited Mother A shortly after the baby’s birth and her mother was there, putting together a bottle of expressed breastmilk for the newborn. The baby, born a couple of weeks early, was small and having difficulty latching, because she would fall asleep almost instantly at the breast. The doctors had suggested pumping and giving the baby the milk by bottle to make sure that she regained her birthweight in time.
Mother B’s baby was born bang on time – right on his due date – and he was enormous, nearly 11 pounds. By 10 days old, however, he had not regained his birthweight and the doctors were concerned about Mother B’s supply. They gave her galactogogues to stimulate her milk flow and on their advice she pumped regularly, only getting an ounce or two each time, which confirmed her doctor’s suspicions about her supply (after all, she WAS in her forties). In the mean time, they advised her to supplement with bottles of formula and the baby was weighed and weighed until he finally regained his birthweight at two weeks of age.
Mother C’s baby was born two weeks overdue and was 8 lbs. He had a lot of difficulty with latching on, which caused Mother C a great deal of pain. The doctor kept her in hospital for an extra day to give her time to work on the baby’s latch. Nurses helped her through each breastfeeding session, and her husband quickly learned how to help flange the baby’s lips, which relieved some of the discomfort. The nurses showed the mother how to manually express her breastmilk into a small cup, which could be tipped into his mouth – no bottle necessary. In fact, she was advised to avoid giving him a bottle until he was a month old, and that if nursing was too painful, tipping manually expressed milk into his mouth with the cup would help keep him hydrated without further messing up his latch.
Have you decided which is which?
Mother A quickly changed to formula and gave up breastfeeding entirely. It just hadn’t worked for her. She continues to advise pregnant women to try her long cherished plan of pumping all milk for the baby, so they can provide breastmilk without being tied down.
Mother B provided formula as the baby’s base nutrition, but continued to supplement him with nursing sessions – she never could get much milk from the breast pump. She is disappointed that she couldn’t nurse exclusively, and dislikes the dent that formula makes on her budget.
Mother C is me. I am still nursing 19 months later, with no discomfort. In fact, I had difficulty getting him to take a bottle later on, but eventually was able to leave him with friends for short periods of time. I never could get more than an ounce or two of milk out with a breast pump, either. My baby also had trouble gaining weight, but the public health nurse asked me questions about how many diapers my baby was producing (something Mother B was never asked) and I was told that my supply was fine. He was diagnosed with reflux and given antacids. Even now he eats solid food constantly and is still small – he’s a high metabolism child. My milk was, and is, fine.
Just like the first two women, I had difficulty getting started with breastfeeding.
Unlike the first two women, I was never told to supplement my baby with a bottle of either formula or breastmilk.
Unlike the first two women, my mother was there and supporting each breast feeding, and she never said “bottle” either.
Unlike the first two women, no one made me question my ability to eventually nurse my child, and no one made me feel like a failure when I didn’t succeed right away.
Unlike the first two women, I have an obsession with self-education and took out a copy of The Womanly Art of Breastfeeding from the library, which helped boost my confidence and explain my baby’s (and my breasts’) behavior.
I feel that Mother B especially was let down by her support medical staff. No one told her that the amount of milk she pumped did not reflect her actual capability to lactate when nursing. No one told her that milk is produced on a supply and demand system, and that supplementing with formula would ultimately reduce the “demand” from the child, reducing her chance of being able to produce sufficient quantities of milk to get him off of the formula when her milk came in. No one asked her how many diapers her baby was producing as a way of gauging her milk production. No one talked to her about supplemental nursing systems as a way to stimulate her nipples with each feeding. No one even told her that giving her baby a bottle might damage his latch at the breast.
So, when the researcher asked me how she could encourage women to breastfeed, I told her that Canada is barking up the wrong tree. We don’t need to be encouraged to breastfeed. We need to be told HOW to breastfeed.
(Stay tuned for Part 3 of Breast of Luck by our lactation guru, Carol @If By Yes.)
The image used in this post is credited to Guttorm Flatabo. It holds a Flickr Creative Commons attribution license.
I love The Womanly Art of Breastfeeding. Such a wise and useful book to have around! I too had problems with pumping, problems with latching number one, babies who bit and drew blood, incredible let-down pain while my uterus shrunk and still I fed. That lactation support is so important and beginning with the assumption that we can feed. Great post, again Carol.
I love the title. It IS an art!
Hi Carol, I can so relate to this post, and thankfully, I’m Mother C. Though the initial journey in breastfeeding had been full of pain due to engorgement, poor latching, cracked nipples etc., I’m so glad we (baby and me) persevered and with the help of very professional lactation consultants, a supportive husband, I get to experience the joy of breastfeeding.
I also feel that I was given the wrong advice and would probably have been able to nurse for far longer if I had not been told to supplement my breastfeeding with bottles of formula!
Thank you, Carol, for sharing this important knowledge. I wish I’d known this when I was struggling to get breastfeeding “right” with my 2 children! 🙁
I’m sorry you didn’t have the support you needed! Happily for all concerned, breastfeeding is just a small part of parenting.
How? That is the question. No one told me while pregnant with my first child that breastfeeding does not come naturally. It was a big struggle for me with our first daughter. Like yourself, we read books while my husband carefully watched my daughter’s latch and correct us. I also saw a lactation consultant. To prove to us that baby was getting milk, the consultant weighed the baby before and after a feeding. That way you can see on the scale that baby is now 2oz (or more) heavier.
In the end, I breastfeed exclusively for 6 months. At 6 months, I supplemented bottles of expressed milk since I was working at the time. At 9 months, we added formula. And then weaned around her first birthday.
The whole experience was much easier the second time around. Our second daughter latched on minutes after being delivered. Regained and surrpased her birthweight within days. There was less anxiety and it all flowed better.
I think education is the key. The How? is hard. Really hard. One of the problems I identified in the hospital that I delivered at, was that every nurse showed us a different way how to breastfeed. It was not consistent. We were suppose to be assigned a lacation consultant during our stay, but I don’t recall her doing much. I think if there is a bigger focus on the how during those early days, there would be a higher rate of success.
The weighing baby before and after is a brilliant idea! I had the different-ways to breastfeed issue with nurses, too, although I think that at least helped show me different styles. The biggest difference I noticed was that some women told me to press down my breast near his nose to help him breathe, while other women told me that doing this would pull the nipple out of his mouth… I still don’t know which is right…
Carol, I guessed Mother C — but only because I had read many times that a mother is likely to breastfeed if her mother had breastfed because of the support. Interesting post!
You’ll be thrilled to read this NY Times article about what hospitals in NYC are signing up to do!
Looking forward to part 3 of your post!!
I’m glad more hospitals are “baby friendly” now.
Most hospitals in Canada have long switched to that approach, although some think that it has swung too far – they are getting to the point where formula is pratically pronounced “poison” and is forbidden entirely. But what if the mother honestly COULDN’T breastfeed? Had had a mastectomy or something? The guilt tripping needs to stop!
Carol, I can so relate to this post! Thankfully, I’m Mother C. Though the initial journey in breastfeeding had been full of pain due to engorgement, poor latching, cracked nipples etc., I’m so glad we (baby and me) persevered and with the help of very professional lactation consultants, a supportive husband, I get to experience the joy of breastfeeding.
This is so well-written! Good to know that it really boils down to knowledge and homework, as well as support and the right advice. For my first child, I had a lot of discouragement from the older folks at home, who come from a generation that thinks that formula is better. But thankfully, I read up a lot, and found a terrific lactation consultant at the hospital who helped me clear the engorgement, blocked ducts, and gave me lots of helpful advice. It wasn’t a totally easy ride after that, but still glad that we managed to persevere till nearly a year. The hospitals here are really gearing up on their efforts to promote breastfeeding I must say. 🙂
Amen and Amen. Early in my career as a pediatric resident (and attending) talking with new moms in the hospital before I had children, I had no clue what to ask beyond “how is the breastfeeding going” and advise them to seek help from the lactation consultant in the hospital. After I had my first very difficult-to-breastfeed baby, my perspective was radically broadened and my self-learning had climbed so high due to my personal struggles. I actually ended up over time doing a fair amount of lactation support in my office as a result of my passion to help struggling moms who wanted to give it a go.
And yes, you can feed the baby while asleep but only after a good latch has been established!
A few other thoughts about the hospital support, in the US women stay mostly 48 hrs or so, and so it’s not long enough for them to develop terrible bleeding emacerated nipples, so they are lulled into thinking the feeding is going ok for another few days until they are screaming with every feeding. The baby’s weight can easily drop 5-10% in the first few days, so the doc isn’t really alarmed and it’s not an indicator of how well the baby is eating initially, in my opinion. It’s also very helpful for patients to know that they can go back and see the lactation consultant at the hospital even after they are discharged (in my case it was part of the hospital services so no extra fees) and get help when they really need it-between days 7-17 when the sleep deprivation is really setting in and the mom’s stress level is out of control, some babies are not gaining as nicely as you’d like to see, and the pressure to “just stop and give the bottle” is climbing.
Great post! Very insightful!
PS I really enjoyed the breastfeeding aspects of The Womanly Art of Breastfeeding” but feel like they went to the extreme in advising parents to not provide discipline in the form of rules or boundaries for their children.
Must have blanked that bit of the book out, soccernork (very big on boundaries here!) – but yes, the breastfeeding info is great!