Author Topic: Evidence based breastfeeding for mustachians  (Read 15862 times)

Lagom

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Re: Evidence based breastfeeding for mustachians
« Reply #100 on: December 12, 2016, 10:45:51 PM »
Another thing about the breastfeeding classes, at least the one I took, was although it was at a highly respected/renowned hospital taught by excellent nurses who were also lactation specialists, there was ZERO coverage of possible medical issues that can come up with BFing and self care/prevention measures for them. Plugged ducts, mastitis etc. We took every single baby-prep class offered by our hospital, and I never once heard the word mastitis until I became very, very ill at 4 weeks and googled my symptoms. (I even checked our class materials because I thought surely they must have said something and I just missed it!) Had I been educated, I would have quite possibly been able to avoid a lot of misery by using self care and additional nursing/pumping when it was still just blocked ducts. Instead when it got painful I took a break from nursing on that side which is the exact opposite of what you should do, and ended up with a call to urgent care, a truly crappy several days, and 10 days of antibiotics that made both my daughter's and my digestive systems a little funky. (Which was when we finally tried formula for the first time, to give her a break from getting the drugs through me.) I just visited a friend who had her baby a couple weeks ago, and she said she actually did ask about mastitis in her BFing class because she had heard about it from a friend, and the teacher basically shut her down. Didn't want to discuss it, maybe to avoid scaring people but at what cost? This thread has reminded me I always planned to write to the instructors and encourage them to consider adding at least some basic information to their curriculum, or at a bare minimum put something for reference in the course materials you take home!

I honestly believe the classes shy away from discussing the risks/complications/problems because they don't want to turn off the audience from planning to BF.  So irresponsible IMHO!  It only makes things more traumatic when you do run into those issues yourself (and leads to a lot of internal dialogues along the lines of "is there something wrong with me because BFing isn't going perfectly smoothly??"). Good idea about writing in to the course instructors, I may do that myself!

Totally agree, but I also think it bears repeating that if you choose to use formula exclusively (even from day one. Even purely for convenience!) for a healthy full-term baby, there is little to no evidence to suggest there will be any qualitative difference in outcomes than if you chose to BF exclusively.*

*Note that for premature babies the evidence in favor of BF is much more compelling, although from what I can gather it's still equally important that the babies gain weight ASAP so supplementation is probably a good idea in low milk output scenarios.

KCM5

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Re: Evidence based breastfeeding for mustachians
« Reply #101 on: December 13, 2016, 06:20:29 AM »
Another thing about the breastfeeding classes, at least the one I took, was although it was at a highly respected/renowned hospital taught by excellent nurses who were also lactation specialists, there was ZERO coverage of possible medical issues that can come up with BFing and self care/prevention measures for them. Plugged ducts, mastitis etc. We took every single baby-prep class offered by our hospital, and I never once heard the word mastitis until I became very, very ill at 4 weeks and googled my symptoms. (I even checked our class materials because I thought surely they must have said something and I just missed it!) Had I been educated, I would have quite possibly been able to avoid a lot of misery by using self care and additional nursing/pumping when it was still just blocked ducts. Instead when it got painful I took a break from nursing on that side which is the exact opposite of what you should do, and ended up with a call to urgent care, a truly crappy several days, and 10 days of antibiotics that made both my daughter's and my digestive systems a little funky. (Which was when we finally tried formula for the first time, to give her a break from getting the drugs through me.) I just visited a friend who had her baby a couple weeks ago, and she said she actually did ask about mastitis in her BFing class because she had heard about it from a friend, and the teacher basically shut her down. Didn't want to discuss it, maybe to avoid scaring people but at what cost? This thread has reminded me I always planned to write to the instructors and encourage them to consider adding at least some basic information to their curriculum, or at a bare minimum put something for reference in the course materials you take home!

I honestly believe the classes shy away from discussing the risks/complications/problems because they don't want to turn off the audience from planning to BF.  So irresponsible IMHO!  It only makes things more traumatic when you do run into those issues yourself (and leads to a lot of internal dialogues along the lines of "is there something wrong with me because BFing isn't going perfectly smoothly??"). Good idea about writing in to the course instructors, I may do that myself!

This is interesting. I took one of those hippy dippy Bradley courses, and they spent a lot of time talking about breastfeeding challenges like low supply and mastitis. It was a long course (10 weeks, maybe?) but she covered almost everything. Pain relief, c sections, vbacs, nursing, supplementing with formula, newborn care, etc. 

I don't like it when information is withheld because some authority thinks the recipient (an adult) can't handle it or would make a different choice from their preference. Its unacceptable.

KS

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Re: Evidence based breastfeeding for mustachians
« Reply #102 on: December 13, 2016, 11:52:47 AM »
This is interesting. I took one of those hippy dippy Bradley courses, and they spent a lot of time talking about breastfeeding challenges like low supply and mastitis. It was a long course (10 weeks, maybe?) but she covered almost everything. Pain relief, c sections, vbacs, nursing, supplementing with formula, newborn care, etc. 

I don't like it when information is withheld because some authority thinks the recipient (an adult) can't handle it or would make a different choice from their preference. Its unacceptable.

To be fair, our breastfeeding class was only one 2 hour session so they did have a lot to cover in a short time. But I still think they could have briefly mentioned it or at least had something in the materials like a symptom chart and how to troubleshoot/care for it. They mostly just said "if there are any problems, talk to one of our lactation specialists ASAP to work it out." Which is fine when you're in the hospital and can push a button to see a nurse, but at home and overwhelmed I just wanted to look it up and not have to figure out how to get in touch with them since I'm not even sure they gave us a number to call that would reach their lactation people!

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #103 on: December 13, 2016, 12:11:48 PM »
This is interesting. I took one of those hippy dippy Bradley courses, and they spent a lot of time talking about breastfeeding challenges like low supply and mastitis. It was a long course (10 weeks, maybe?) but she covered almost everything. Pain relief, c sections, vbacs, nursing, supplementing with formula, newborn care, etc. 

I don't like it when information is withheld because some authority thinks the recipient (an adult) can't handle it or would make a different choice from their preference. Its unacceptable.

To be fair, our breastfeeding class was only one 2 hour session so they did have a lot to cover in a short time. But I still think they could have briefly mentioned it or at least had something in the materials like a symptom chart and how to troubleshoot/care for it. They mostly just said "if there are any problems, talk to one of our lactation specialists ASAP to work it out." Which is fine when you're in the hospital and can push a button to see a nurse, but at home and overwhelmed I just wanted to look it up and not have to figure out how to get in touch with them since I'm not even sure they gave us a number to call that would reach their lactation people!


Ah yes, the “call a lactation consultant” recommendation. This is thrown around any time a woman has a breastfeeding issue. Pain? Lactation consultant. Baby wont stop crying after nursing? Lactation consultant. Low supply? You guessed it. But as you so succinctly point out, there are serious flaws in this line of thinking because it is essentially saying "you can just wait it out until an expert tells you what is wrong and what to do."

Lactation consultants are extremely valuable, but they aren’t always immediately available to help parents trouble shoot. Breastfeeding is a 24/7 job, and it is not uncommon for parents to experience problems late at night or on weekends when lactation staff are not working. Parents often have to wait hours or days to speak to someone, or get an appointment…what are they supposed to do in the mean time? Grin and bear the extreme pain? Not feed their infant sufficiently?

Breastfeeding is a unique behavior in that unlike other health related questions, breastfeeding problems often can’t simply wait a day or two until you can see or speak to a clinician. Mere hours can mean the difference between a plugged duct and mastitis, or a hungry baby and an extremely ill one. Because of this, breastfeeding education has to be extremely proactive in educating parents on how to handle problems on their own until they can get help. That means providing detailed information on possible problems, how to spot them, and what parents should do until they can get an appointment. But too often we just resort to the “call a consultant” recommendation – yet another REACTIONARY measure, not a preventative one.
« Last Edit: December 13, 2016, 12:17:16 PM by little_brown_dog »

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #104 on: January 10, 2017, 11:27:09 AM »
Wanted to bump this up the forum because I know there are alot of mustachians who are expecting in 2017!

Here is a great review of that JAMA piece where the authors concluded that restrictive breastfeeding practices (withholding supplementation, pacifiers, etc) are not effective in improving breastfeeding duration, and in fact pose harm to infants.

Parents - when in doubt, supplement your nursing baby. You can absolutely supplement from day 1, until your baby is effectively nursing without it harming your nursing relationship. The idea that supplementation ruins nursing is outdated and based on studies of women who replaced nursing sessions with bottles...not on women who nursed on demand and supplemented afterward. Consider using a supplemental nursing system (SNS) or the nurse and top up method described earlier in the thread.

https://fedisbest.org/2016/10/new-guidelines-suggest-who-recommendation-to-avoid-supplementation-in-newborns-involves-risks-and-does-not-improve-breastfeeding-rates/

If you are due in the next couple of months and want to protect your baby from dehydration and starvation related complications, I highly recommend the Fed is Best feeding plan that you can bring with you to the hospital (like a birth plan). It lays out in detail how you want to feed, and what you want to do if your baby starts showing signs of trouble. It will give you all the language you need to advocate for your child to prevent them from deteriorating unnecessarily.

https://fedisbest.org/resources-for-parents/feeding-plan/

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #105 on: January 17, 2017, 06:02:51 AM »
I have a few breastfeeding resources that people might find useful:
The milk meg - she runs her own website, is an IBCLC, (it is the gold standard in lactation training) and has a blog and a book that covers pretty much every breastfeeding topic you can think of. http://themilkmeg.com
The ABA is the Australian Breastfeeding Association, anyone can access their information articles (and they cone with sources) and they have a 24 hour helpline which is free to Aussies (not sure what is avaialble overseas) https://www.breastfeeding.asn.au
Evolutionary parenting evaluates all the research regarding a wide range of subjects and has come to the conclusion, that due to the limitations and flaws in breastfeeding research, the harms of not breastfeeding are actually understated (think of groupings for example - there is no way to enforce them, and if you compare a baby who has a baby who has 1 bottle a day to a baby who only breastfeeds once a day, to those who are now exlusively breastfed, but for the first week of life was supplemented.) http://evolutionaryparenting.com/the-problem-with-breastfeeding-research/
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little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #106 on: January 17, 2017, 11:26:40 AM »
I have a few breastfeeding resources that people might find useful:
The milk meg - she runs her own website, is an IBCLC, (it is the gold standard in lactation training) and has a blog and a book that covers pretty much every breastfeeding topic you can think of. http://themilkmeg.com
The ABA is the Australian Breastfeeding Association, anyone can access their information articles (and they cone with sources) and they have a 24 hour helpline which is free to Aussies (not sure what is avaialble overseas) https://www.breastfeeding.asn.au
Evolutionary parenting evaluates all the research regarding a wide range of subjects and has come to the conclusion, that due to the limitations and flaws in breastfeeding research, the harms of not breastfeeding are actually understated (think of groupings for example - there is no way to enforce them, and if you compare a baby who has a baby who has 1 bottle a day to a baby who only breastfeeds once a day, to those who are now exlusively breastfed, but for the first week of life was supplemented.) http://evolutionaryparenting.com/the-problem-with-breastfeeding-research/

Thank you but I must point out a couple of your resources are highly questionable. Milk Meg and Evolutionary Parenting routinely peddle in formula shaming and pressuring moms into breastfeeding the “right” way (aka: exclusive). They engage in those exact scare tactics and twisting of evidence that I warned about in my original post. Evolutionary Parenting a while back was even mocking moms of infants with starvation related complications and those who need to use infant formula. Milk Meg is an IBCLC but is NOT a clinician - not a doctor, or nurse - and certainly not anyone who is qualified to weigh in on the medical necessity of supplementation to prevent neonatal starvation related complications. She has her degree in psychology. She was also a LLL counselor and believes in the "just one bottle" ideology - an outdated and clinically inappropriate understanding that believes mixed feeding or supplementing harms infants, destroys their guts, and dooms their breastfeeding. This has been debunked. She does have an adorable website however.

Fed is Best is the only organization I know that promotes breastfeeding while also taking a strong preventative stance against infant starvation. I wish there were more, but its really the only one I can recommend in good conscience. All the others are very laissez faire about the whole thing and seem to be in la-la land or flat out denial about the harms of breastfeeding pressure, even though dehydration/starvation complications from feeding problems are one of the top reasons otherwise healthy newborns are readmitted to the hospital after discharge. :(
« Last Edit: January 17, 2017, 11:28:45 AM by little_brown_dog »

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #107 on: January 17, 2017, 04:10:08 PM »
Hey! I didn't even link to the Alpha parent - now that has formula shaming. EP and MM are great resources for supporting breastfeeding, and I haven't seen any shaming there.
And Fedisbest ain't exactly unbiased either.
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Lagom

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Re: Evidence based breastfeeding for mustachians
« Reply #108 on: January 17, 2017, 04:14:52 PM »
Anything claiming that subjecting your child to starvation is better than not doing so automatically loses credibility as far as I'm concerned. No one is denying that breastfeeding is a great way to feed your baby, but there is no science behind the idea that supplementation impacts developmental outcomes and I wish this was communicated much better than it is.
« Last Edit: January 17, 2017, 04:31:42 PM by Lagom »

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #109 on: January 17, 2017, 04:38:30 PM »
Anything claiming that subjecting your child to starvation is better than not doing so automatically loses credibility as far as I'm concerned. No one is denying the breastfeeding is a great way to feed your baby, but there is no credible science behind the idea that supplementation impacts developmental outcomes and I wish this was communicated much better than it is.
Not sure if you are referring to the links I posted or not, but I haven't seen either of them suggest letting a baby starve. Usually I see more of 'try to exclusively breastfeed if you can, if you are having troubles, work with a lactation consultant to fix the underlying issues. This may involve using formula while you work through these issues."
What they do tend to advocate against is, giving formula unneccessarily, or 'just because'


And I didn't understand the problem with advising to go see a lactation consultant earlier - after all, they trained in infant feeding. Whether BF, FF, or mixed fed. If you are having a problem, they are the best people to go see. If you were having heart problems, you would go see a heart specialist yes?
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Lagom

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Re: Evidence based breastfeeding for mustachians
« Reply #110 on: January 17, 2017, 04:44:47 PM »
The problem is many (not all) lactation consultants are shockingly uninformed about the research on feeding and subscribe to the breast is best philosophy, pushing/shaming mothers into exclusively breast feeding even when it's clear they are not producing enough milk, etc. Some (but not most) even go so far as to blame the mother for not doing things correctly in those scenarios.

I mean, I liked the LC my wife and I chatted with fine, don't get me wrong, but this idea of "unnecessary" formula feeding is part of the problem. It implies that if you're using formula you are doing something bad, and that all other options should be exhausted first, which, as lbd has pointed out, has led to an increase in underfed babies. Using formula is not bad. It gives your child everything they need to grow and thrive. Sure, try breastfeeding to your heart's content, but if your baby is losing weight or gaining extremely slowly, you have extreme pain issues, stress around feeding times that's impacting your ability to bond, etc., etc., formula feed away. You are definitely making the best choice in those scenarios.

lazy-saver

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Re: Evidence based breastfeeding for mustachians
« Reply #111 on: January 17, 2017, 05:08:35 PM »
My favorite breastfeeding resource is http://balancedbreastfeeding.com/blog/.  This is a lot of useful information and it celebrates breastfeeding but is also positive about formula and doesn't try to pretend that breastfeeding is easy or the right answer for everyone.  I think breastfeeding is great for us personally and have trouble imagining wanting anything else, but I don't like people forcing their dogma on everyone, even if they approve of my choices.

The downside is that there is basically no organization.  I recommend either reading some posts and clicking the links to other posts, or putting balancedbreastfeeding and whatever topic you're looking for into google.  But I haven't found any other site whose content and attitude I like so well.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #112 on: January 17, 2017, 05:47:35 PM »
Anything claiming that subjecting your child to starvation is better than not doing so automatically loses credibility as far as I'm concerned. No one is denying the breastfeeding is a great way to feed your baby, but there is no credible science behind the idea that supplementation impacts developmental outcomes and I wish this was communicated much better than it is.
Not sure if you are referring to the links I posted or not, but I haven't seen either of them suggest letting a baby starve. Usually I see more of 'try to exclusively breastfeed if you can, if you are having troubles, work with a lactation consultant to fix the underlying issues. This may involve using formula while you work through these issues."
What they do tend to advocate against is, giving formula unneccessarily, or 'just because'


And I didn't understand the problem with advising to go see a lactation consultant earlier - after all, they trained in infant feeding. Whether BF, FF, or mixed fed. If you are having a problem, they are the best people to go see. If you were having heart problems, you would go see a heart specialist yes?

My issue with Milk Meg/Evo Parenting is they strongly push the idea that there are “right” ways and “wrong” ways to feed children - with exclusive breastfeeding being the only right way, and everything else just being different variations of inadequate. In this way, they cater to a type of feeding elitism that they seem to fail to recognize is hugely based on biological luck (having enough milk, having a baby that can nurse, etc). At least on their facebook sites, I have seen formula feeding likened to feeding children candy/soda/junk food which is not just bogus and cruel to the moms who rely on it, but also shocking, because as pro-breastfeeding sites, they should be aware that most breastfeeding moms use formula too (and for damn good reasons I might add). Sure, eventually they might concede some parents need formula, but only after putting the idea in people's heads that they should exhaust all options before choosing it - essentially the baby has to "prove" they need it by deteriorating first. For a subset of babies, exhausting all options puts them back in the hospital. That's what happened to me and my daughter.  This sort of "prove it if you need it" is a reactionary stance to infant dehydration, not a preventative one. If they were more encouraging of preventative supplementation and educating moms on how to do it in a way that protects nursing, I'd be far more supportive. If they were more open about all the new research showing that many moms can't safely exclusively breastfeed, I'd be thrilled.

You are right though, Fed is Best is biased, in that it is not designed to be an exclusive breastfeeding promotion site the way most other breastfeeding organizations are. It is meant to raise awareness about starvation related complications, who they are most likely to affect, and how parents and clinicians can prevent them. As a result, they are big supporters of preventative supplementation for babies with risk factors or those who appear to be deteriorating, weighted feeds, and erring on the side of a well-fed baby rather than an exclusively breastfed one. But as they clearly state on their website, they support all clinically appropriate feeding methods – exclusive nursing, bottle feeding with pumped milk or formula, or tube feeding formula/milk – as long as the method provides timely and sufficient nutrition/hydration for the child. They are totally for exclusive breastfeeding if it is monitored and the baby’s immediate safety is prioritized.

As far as the lactation consultant issue, you bring up a great point. I believe well trained lactation consultants who are IBCLC certified AND have medical training as physicians/nurses specializing in neonatology can be huge assets to mothers. Working with a great lact team helped me breastfeed for months despite extreme challenges. However, too often many IBCLCs are not medical clinicians and are not trained in starvation prevention. They can easily misdiagnose a deteriorating baby and give mom the standard "just keep putting baby to breast" advice. Others like Lagom mentioned, are so wedded to a certain image of perfect exclusive WHO-endorsed breastfeeding, they struggle to properly support moms in their own unique breastfeeding experience (in particular I'm thinking of low supply moms who are often pushed to try 90 million things to improve supply - including off label prescription meds). In addition, telling parents to wait to supplement their baby until an expert n"gives them permission", can be dangerous. Parents, like me, can go hours or days waiting for that lact appointment only to get there and be told "oh my god, yes the child is starving, they need supplementation, NOW!". By telling parents to just call a lact consultant, or get an appointment, too often we are implying their child can afford to wait that long. We aren't empowering them to make the choice to feed their child in a way they feel is safest/most appropriate for that feeding, that day, that week. Instead I want parents to be told "if you get worried, or nervous, or feel something isn't right, or your baby has any of these signs, please know you can and should supplement ontop of nursing until you can get to a lactation appointment. A few days of supplementing after nursing will not harm your breastfeeding if you do it correctly, but it could be the very thing that keeps your baby safe until you can get some breastfeeding help. Your baby's safety needs to be your first priority." To this day, I wish with all my heart someone had said something like this to me. Instead I got the standard "no bottles, no supplementation, exclusivity is best" education and resources, and I followed it perfectly....right back into the hospital.
« Last Edit: January 17, 2017, 06:09:03 PM by little_brown_dog »

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #113 on: January 17, 2017, 06:01:50 PM »
My favorite breastfeeding resource is http://balancedbreastfeeding.com/blog/.  This is a lot of useful information and it celebrates breastfeeding but is also positive about formula and doesn't try to pretend that breastfeeding is easy or the right answer for everyone.  I think breastfeeding is great for us personally and have trouble imagining wanting anything else, but I don't like people forcing their dogma on everyone, even if they approve of my choices.

The downside is that there is basically no organization.  I recommend either reading some posts and clicking the links to other posts, or putting balancedbreastfeeding and whatever topic you're looking for into google.  But I haven't found any other site whose content and attitude I like so well.

Wow thanks for this - I'm reading the "about" section and I'm seeing some stuff that sounds fabulous like....

"....there is no one right way to breastfeed, nor does it need to be done perfectly..."

"I'm not afraid to use formula..."

"You are not just a set of boobs or a milk making machine...."

There also seems to be an embracing of pumping and non-traditional styles of breastfeeding in the blog. Can't officially say I'm in love yet, but will definitely be digging through this one!!!

HappierAtHome

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Re: Evidence based breastfeeding for mustachians
« Reply #114 on: January 18, 2017, 07:49:39 PM »
little_brown_dog, I discussed this thread with some friends of mine who have a small baby and also happen to be a doctor and a very-well-informed-not-doctor :-) they were *so pleased* that I had heard the "formula is okay, supplementation is okay, exclusive breastfeeding is not the only good option" message given I'm pregnant, and were excited to discuss with me some of the specific research and facts you've posted.

Interestingly, the friend who has recently given birth was saying that with her first child, she felt a huge amount of internal and external pressure to exclusively breastfeed (breast is best!) and refused to supplement or switch even when exclusive breastfeeding was clearly not working. She said if she could do it over she'd supplement for sure, for her baby's best interests as well as hers. Second child, oddly enough, is a champion feeder and is getting all the boobmilk a kid could ever want, with apparently very little effort.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #115 on: January 19, 2017, 09:57:59 AM »
little_brown_dog, I discussed this thread with some friends of mine who have a small baby and also happen to be a doctor and a very-well-informed-not-doctor :-) they were *so pleased* that I had heard the "formula is okay, supplementation is okay, exclusive breastfeeding is not the only good option" message given I'm pregnant, and were excited to discuss with me some of the specific research and facts you've posted.

Interestingly, the friend who has recently given birth was saying that with her first child, she felt a huge amount of internal and external pressure to exclusively breastfeed (breast is best!) and refused to supplement or switch even when exclusive breastfeeding was clearly not working. She said if she could do it over she'd supplement for sure, for her baby's best interests as well as hers. Second child, oddly enough, is a champion feeder and is getting all the boobmilk a kid could ever want, with apparently very little effort.

Congrats on your little one! I am so glad you have flexible, supportive friends you can rely on. Seriously, the last thing new moms need are extremists pushing rigid and exclusionary ideas about what “good” breastfeeding looks like! And it is awesome that they have first hand experience with how fickle breastfeeding can be – with one baby it can be a nightmare, and with the next a complete breeze.  Ultimately a lot of it comes down to luck, so you just have to try your best with the circumstances you are given.

Knowing what I know now, I too wish that I had just supplemented my daughter (it could have prevented her hospitalization). However, I am hopeful that my next experience with future babies will be far healthier and more enjoyable, given that I now have a sane and knowledgeable approach to the whole thing.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #116 on: January 19, 2017, 12:41:18 PM »
Earlier in the thread there was a discussion about shame and stigma when it comes to not being able to breastfeed. I wanted to show people what the impact of such things can look like.

This is a recent story from a father whose wife seems to have committed suicide due to postpartum depression. In his heartbreaking plea to moms, he specifically calls out the obnoxious pressure to exclusively breastfeed. It is apparent his wife was suffering with anxiety and negative feelings about breastfeeding "inadequately". In his facebook post, he specifically calls out "breast is best" thinking, and the pressure from all the educational resources, hospitals, etc. He directly implores parents to remember that there is nothing wrong with supplementing.

http://www.cbc.ca/news/canada/british-columbia/florence-leung-husband-1.3940361

My heart is breaking today :(
« Last Edit: January 19, 2017, 12:42:59 PM by little_brown_dog »

brycedoula

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Re: Evidence based breastfeeding for mustachians
« Reply #117 on: January 20, 2017, 08:03:19 AM »
**Disclaimer: I was very fortunate in that I had very few issues relating to breastfeeding when my daughter was born.**

I agree that there is a fair amount of pressure (from care providers, family, friends, media, etc) to exclusively breastfeed. Most pregnant women are told, and read, "breast is best" from the moment they learn they are pregnant.

However, for a new mother who has decided that exclusive breastfeeding is how she wants to feed her new baby and is struggling, hearing phrases like "oh it's totally fine to supplement", "one bottle of formula won't kill him", "you don't have to do this" , "I was formula-fed & I'm totally fine" is EXTREMELY unhelpful and invalidating. That mother wants and needs support & resources to help her be successful (as SHE defines it), not what probably sounds like, to her, dismissal of her struggles.

Imagine if you had decided to start learning something, and when you first started there was a huge learning curve (as there is!), and when you admitted to a friend that you were struggling your friend said "Just quit! Don't be a hero..."

jezebel

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Re: Evidence based breastfeeding for mustachians
« Reply #118 on: January 20, 2017, 08:19:39 AM »
**Disclaimer: I was very fortunate in that I had very few issues relating to breastfeeding when my daughter was born.**

I agree that there is a fair amount of pressure (from care providers, family, friends, media, etc) to exclusively breastfeed. Most pregnant women are told, and read, "breast is best" from the moment they learn they are pregnant.

However, for a new mother who has decided that exclusive breastfeeding is how she wants to feed her new baby and is struggling, hearing phrases like "oh it's totally fine to supplement", "one bottle of formula won't kill him", "you don't have to do this" , "I was formula-fed & I'm totally fine" is EXTREMELY unhelpful and invalidating. That mother wants and needs support & resources to help her be successful (as SHE defines it), not what probably sounds like, to her, dismissal of her struggles.

Imagine if you had decided to start learning something, and when you first started there was a huge learning curve (as there is!), and when you admitted to a friend that you were struggling your friend said "Just quit! Don't be a hero..."

Supplementing is not quitting.  People viewing it as such is part of the problem.  It is totally fine and sometimes necessary.  Supplementation (with a supplemental nursing system) was only way I was able to establish successful nursing with my first child.  I really think that unless you struggled with breastfeeding and an underweight baby, you cannot fully understand the need for flexibility in the messages concerning feeding. 

Lagom

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Re: Evidence based breastfeeding for mustachians
« Reply #119 on: January 20, 2017, 10:13:30 AM »
I mean, I hear you @brycedoula, and I know this will be an even less helpful statement, but unless your child is premature and/or has other health issues, formula feeding exclusively because of the convenience is also just fine. I think it's laudable that you want to commit to BF only, but you don't need to if you feel it's causing hardship. Nothing will change for your child. If everything is going well, congratulations! It's good to hear that you find exclusive BF to be a personally rewarding experience.

I don't mean to invalidate your choices any more than you saying you want to exclusively BF invalidates the choices of those who choose to/have to supplement. Parenthood is all about making choices, often when there is no clear evidence which will be optimal. All any of us can do is inform ourselves to our best ability and choose accordingly. There is no need to judge others for choosing differently, and that applies to everyone.

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Re: Evidence based breastfeeding for mustachians
« Reply #120 on: January 20, 2017, 02:35:25 PM »
**Disclaimer: I was very fortunate in that I had very few issues relating to breastfeeding when my daughter was born.**

I agree that there is a fair amount of pressure (from care providers, family, friends, media, etc) to exclusively breastfeed. Most pregnant women are told, and read, "breast is best" from the moment they learn they are pregnant.

However, for a new mother who has decided that exclusive breastfeeding is how she wants to feed her new baby and is struggling, hearing phrases like "oh it's totally fine to supplement", "one bottle of formula won't kill him", "you don't have to do this" , "I was formula-fed & I'm totally fine" is EXTREMELY unhelpful and invalidating. That mother wants and needs support & resources to help her be successful (as SHE defines it), not what probably sounds like, to her, dismissal of her struggles.

Imagine if you had decided to start learning something, and when you first started there was a huge learning curve (as there is!), and when you admitted to a friend that you were struggling your friend said "Just quit! Don't be a hero..."

Supplementing is not quitting.  People viewing it as such is part of the problem.  It is totally fine and sometimes necessary.  Supplementation (with a supplemental nursing system) was only way I was able to establish successful nursing with my first child.  I really think that unless you struggled with breastfeeding and an underweight baby, you cannot fully understand the need for flexibility in the messages concerning feeding.
I can definitely see how annoying that is, brycedoula! It reminds me of other "helpful" advice that is really not - similar to "just eat more" to gain weight (or more relatable for most people, "just eat less" to lose weight). What's important is the right way to supplement, like Jezebel used to be able to continue breastfeeding her baby long enough to get the hang of it. It's not just "stick a bottle in baby", it's doing things that have been recommended up thread like: breastfeeding, then supplementing as part of the same feed so you are still stimulated to make more milk, baby keeps practicing breastfeeding, baby eats enough, and you're able to go through an improving cycle of events.

It sounds like it's really hard to want to exclusively breastfeed and not get any actual support.

Cognitive Miser

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Re: Evidence based breastfeeding for mustachians
« Reply #121 on: January 20, 2017, 03:55:33 PM »
For mamas interested in learning other ways to supplement, here's a great video showing four different methods of supplemental feeding:
http://www.queenbeelactation.com/single-post/2015/11/04/Favorite-Video-Alternative-Feeding-Methods

The deep latch and thumbs-up technique videos here are also pretty fantastic:
http://www.queenbeelactation.com/latch-videos

I had no issues whatsoever breastfeeding my first, other than some pretty painful nipples for a few weeks.  Whoever says that "it shouldn't hurt if you're doing it right" is doing more harm than good, I think.  It hurts for plenty of women whose babies have perfect latches.  If I had read all this great information before my first was born, I'm sure I would have given him formula occasionally to let my nipples heal.  But we went on to have a wonderful 15-month nursing relationship.

Because my first had such an awesome latch, it surprised me that things did not go well with my second baby, who is now four months old.  I haven't gotten to a point where I have considered giving her formula, for two reasons: 1. She's off the charts huge, so I knew she wasn't starving (went from 25th percentile at birth, gaining 1+ lbs a week, to 100th percentile at 2 months). and 2. She wouldn't take a bottle.  She really has a hard time latching onto... well, everything.  Pacifiers, bottles, me... Part of it has to do with my oversupply/forceful letdown, as she didn't really have to suck to get more than enough milk.  She's been in daycare for three weeks now and just started latching onto her bottles this third week...

Which is how I know about these alternative feeding methods.  I'm so glad our daycare was willing to give cup-feeding a try, or she might have gone hungry.  Formula vs. breastmilk isn't even an argument here.  Babies go hungry sometimes just due to ineffective supplemental feeding methods, and in our case she just wouldn't take a bottle regardless of what was in it.  I'm so glad to have such patient and competent childcare providers!

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #122 on: January 20, 2017, 05:13:14 PM »
For mamas interested in learning other ways to supplement, here's a great video showing four different methods of supplemental feeding:
http://www.queenbeelactation.com/single-post/2015/11/04/Favorite-Video-Alternative-Feeding-Methods

The deep latch and thumbs-up technique videos here are also pretty fantastic:
http://www.queenbeelactation.com/latch-videos

I had no issues whatsoever breastfeeding my first, other than some pretty painful nipples for a few weeks.  Whoever says that "it shouldn't hurt if you're doing it right" is doing more harm than good, I think.  It hurts for plenty of women whose babies have perfect latches.  If I had read all this great information before my first was born, I'm sure I would have given him formula occasionally to let my nipples heal.  But we went on to have a wonderful 15-month nursing relationship.

Because my first had such an awesome latch, it surprised me that things did not go well with my second baby, who is now four months old.  I haven't gotten to a point where I have considered giving her formula, for two reasons: 1. She's off the charts huge, so I knew she wasn't starving (went from 25th percentile at birth, gaining 1+ lbs a week, to 100th percentile at 2 months). and 2. She wouldn't take a bottle.  She really has a hard time latching onto... well, everything.  Pacifiers, bottles, me... Part of it has to do with my oversupply/forceful letdown, as she didn't really have to suck to get more than enough milk.  She's been in daycare for three weeks now and just started latching onto her bottles this third week...

Which is how I know about these alternative feeding methods.  I'm so glad our daycare was willing to give cup-feeding a try, or she might have gone hungry.  Formula vs. breastmilk isn't even an argument here.  Babies go hungry sometimes just due to ineffective supplemental feeding methods, and in our case she just wouldn't take a bottle regardless of what was in it.  I'm so glad to have such patient and competent childcare providers!
Has your second kid been checked for a tongue and/or lip tie ? They don't check for them in hospitals, and they can play havoc with a breastfeeding relationship. Some are really obvious, but others can be really hard to spot

Sounds kinda similar to my kid - I left hospital with him unable to latch onto me, and used nipple shields for 4 months. Despite the odds, I had a plentiful supply, and my son gained heaps and heaps of weight. His ties were eventually picked up when he was about a year old, and we had them cut, both because breastfeeding was sometimes painful, and because ties can have lifelong implications beyond breastfeeding.

I have attached a symptom list, please note that you do not need every symptom on there, or even many of them for bubs to have a tie - for examole, personally I ended up with an oversupply.
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KS

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Re: Evidence based breastfeeding for mustachians
« Reply #123 on: January 24, 2017, 11:48:56 AM »

I have attached a symptom list, please note that you do not need every symptom on there, or even many of them for bubs to have a tie - for examole, personally I ended up with an oversupply.

Interesting, thanks for sharing! The LC we finally had come to our house about 6 weeks in said she didn't find any ties, but my daughter and I went through a LOT of the symptoms on those lists! Too late now since she's a toddler and doesn't BF anymore but makes me wonder...

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #124 on: January 24, 2017, 05:02:01 PM »

I have attached a symptom list, please note that you do not need every symptom on there, or even many of them for bubs to have a tie - for examole, personally I ended up with an oversupply.

Interesting, thanks for sharing! The LC we finally had come to our house about 6 weeks in said she didn't find any ties, but my daughter and I went through a LOT of the symptoms on those lists! Too late now since she's a toddler and doesn't BF anymore but makes me wonder...
Actually, it's not too late to get her evaluated, and possibly have the ties revised if she has them and it is warranted.
Tongue tie in particular can have life long implications as it restricts the function of the tongue and can affect oral development - a high narrow palette is often a side effect of ties, which influences facial development - the sinuses can have less room which potentially affects the breathing. Snoring, sleep apnea, teeth grinding are not uncommon. My son used to grind his teeth before we had his ties revised, he doesn't now.
It can affect how well both breast and bottlefed infants feed too - there may be more difficulty latching,maintinga seal, and usually more air is gulped down, making them windy.
It can also affect the eating of food, and speech in some people.
I'm part of a tie support group and there are adult members on there, who discovered that they were tied when their kids were assessed and have shared their experiences of both the revision and how it has affected them.


I've added symptoms below and will come back to add some sources shortly (don't want to lose this post)
Notably another symptom is an increased risk of ear infections, which isn't listed below

ETA: this is a website by an ENT surgeon, so this link is to his blog, the specific page links to a study recently completed. Dr Ghaheri
This page is from a book regarding oral development and while it doesn't focus specifically on ties, it does mention them, and is well worth reading Mouth matters

« Last Edit: January 24, 2017, 05:41:36 PM by Flyingkea »
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onlykelsey

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Re: Evidence based breastfeeding for mustachians
« Reply #125 on: January 25, 2017, 02:17:08 PM »
For mamas interested in learning other ways to supplement, here's a great video showing four different methods of supplemental feeding:
http://www.queenbeelactation.com/single-post/2015/11/04/Favorite-Video-Alternative-Feeding-Methods

The deep latch and thumbs-up technique videos here are also pretty fantastic:
http://www.queenbeelactation.com/latch-videos

I had no issues whatsoever breastfeeding my first, other than some pretty painful nipples for a few weeks.  Whoever says that "it shouldn't hurt if you're doing it right" is doing more harm than good, I think.  It hurts for plenty of women whose babies have perfect latches.  If I had read all this great information before my first was born, I'm sure I would have given him formula occasionally to let my nipples heal.  But we went on to have a wonderful 15-month nursing relationship.

Because my first had such an awesome latch, it surprised me that things did not go well with my second baby, who is now four months old.  I haven't gotten to a point where I have considered giving her formula, for two reasons: 1. She's off the charts huge, so I knew she wasn't starving (went from 25th percentile at birth, gaining 1+ lbs a week, to 100th percentile at 2 months). and 2. She wouldn't take a bottle.  She really has a hard time latching onto... well, everything.  Pacifiers, bottles, me... Part of it has to do with my oversupply/forceful letdown, as she didn't really have to suck to get more than enough milk.  She's been in daycare for three weeks now and just started latching onto her bottles this third week...

Which is how I know about these alternative feeding methods.  I'm so glad our daycare was willing to give cup-feeding a try, or she might have gone hungry.  Formula vs. breastmilk isn't even an argument here.  Babies go hungry sometimes just due to ineffective supplemental feeding methods, and in our case she just wouldn't take a bottle regardless of what was in it.  I'm so glad to have such patient and competent childcare providers!
Has your second kid been checked for a tongue and/or lip tie ? They don't check for them in hospitals, and they can play havoc with a breastfeeding relationship. Some are really obvious, but others can be really hard to spot

Sounds kinda similar to my kid - I left hospital with him unable to latch onto me, and used nipple shields for 4 months. Despite the odds, I had a plentiful supply, and my son gained heaps and heaps of weight. His ties were eventually picked up when he was about a year old, and we had them cut, both because breastfeeding was sometimes painful, and because ties can have lifelong implications beyond breastfeeding.

I have attached a symptom list, please note that you do not need every symptom on there, or even many of them for bubs to have a tie - for examole, personally I ended up with an oversupply.

I am inehanded typing while breastfeeding but wanted to ask about your experience weaning your baby from using a nipple shield. I also started using one on day two because of tongue tie issues which have since been addressed.  Now my newborn is two weeks old and seems to need the shield to latch, which is a pain.  I have also been lucky in the supply department despite the shield use, but fumbling for a piece of rubber six times a night (haha) is getting old.

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #126 on: January 25, 2017, 05:38:31 PM »
For mamas interested in learning other ways to supplement, here's a great video showing four different methods of supplemental feeding:
http://www.queenbeelactation.com/single-post/2015/11/04/Favorite-Video-Alternative-Feeding-Methods

The deep latch and thumbs-up technique videos here are also pretty fantastic:
http://www.queenbeelactation.com/latch-videos

I had no issues whatsoever breastfeeding my first, other than some pretty painful nipples for a few weeks.  Whoever says that "it shouldn't hurt if you're doing it right" is doing more harm than good, I think.  It hurts for plenty of women whose babies have perfect latches.  If I had read all this great information before my first was born, I'm sure I would have given him formula occasionally to let my nipples heal.  But we went on to have a wonderful 15-month nursing relationship.

Because my first had such an awesome latch, it surprised me that things did not go well with my second baby, who is now four months old.  I haven't gotten to a point where I have considered giving her formula, for two reasons: 1. She's off the charts huge, so I knew she wasn't starving (went from 25th percentile at birth, gaining 1+ lbs a week, to 100th percentile at 2 months). and 2. She wouldn't take a bottle.  She really has a hard time latching onto... well, everything.  Pacifiers, bottles, me... Part of it has to do with my oversupply/forceful letdown, as she didn't really have to suck to get more than enough milk.  She's been in daycare for three weeks now and just started latching onto her bottles this third week...

Which is how I know about these alternative feeding methods.  I'm so glad our daycare was willing to give cup-feeding a try, or she might have gone hungry.  Formula vs. breastmilk isn't even an argument here.  Babies go hungry sometimes just due to ineffective supplemental feeding methods, and in our case she just wouldn't take a bottle regardless of what was in it.  I'm so glad to have such patient and competent childcare providers!
Has your second kid been checked for a tongue and/or lip tie ? They don't check for them in hospitals, and they can play havoc with a breastfeeding relationship. Some are really obvious, but others can be really hard to spot

Sounds kinda similar to my kid - I left hospital with him unable to latch onto me, and used nipple shields for 4 months. Despite the odds, I had a plentiful supply, and my son gained heaps and heaps of weight. His ties were eventually picked up when he was about a year old, and we had them cut, both because breastfeeding was sometimes painful, and because ties can have lifelong implications beyond breastfeeding.

I have attached a symptom list, please note that you do not need every symptom on there, or even many of them for bubs to have a tie - for examole, personally I ended up with an oversupply.

I am inehanded typing while breastfeeding but wanted to ask about your experience weaning your baby from using a nipple shield. I also started using one on day two because of tongue tie issues which have since been addressed.  Now my newborn is two weeks old and seems to need the shield to latch, which is a pain.  I have also been lucky in the supply department despite the shield use, but fumbling for a piece of rubber six times a night (haha) is getting old.
Lol @ rubber. And congrats on your little one!
I used nipple shields until he was approx 4 months old. At this point we were lying down together for each feed as that meant I could sneak away once he fell asleep. At this point his ties had not been revised, and I had no idea that they even existed. I had a really good supply too.
I had tried a couple of times to wean off shields, and hadn't been successful. The day we we weaned, it was actually cold turkey - every time I tried to feed my son, he would turn his head away and refuse to latch. It wasn't until either the next day or late that night (my memory is a little hazy) before I twigged to watch was going on.
I had done a few feeds previously where we started with the shield, then took it out part way through the feed - that's what I saw recommended online - start a feed so bubs isn't frantically hungry, then switch partway through. It will probably take a few goes before they are willing/able to latch, so don't push them if they protest.
The tongue tie will complicate matters somewhat in that your baby needs to relearn how to use their tongue again. Our mouths are formed very early in gestation, at approx 6 weeks, so they have spent their entire time in utero practising with a restricted tongue - it will take time for them to adapt to the new freedom of movement - in the tie support group I'm in, I've seen parents talking about it taking a few days to a few weeks to adjust.
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VeggieTable

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Re: Evidence based breastfeeding for mustachians
« Reply #127 on: January 27, 2017, 01:10:15 PM »
little_brown_dog, just wanted to thank you for this thread. I'm a long way from when I breastfed, as I had my son almost 2.5 years ago and only breastfed for 2 weeks. I swear, they were the hardest 2 weeks of my life. If this thread had existed back then, I would have felt SO much relief about stopping BF and starting FF. I have no idea if I was among the women who truly couldn't breastfeed, but I had a rough go. I lost a lot of blood during labor and while I have no idea if that contributed to a low milk supply, I do know that I was in bad physical shape and had a long, tough recovery. On top of that, my son clearly wasn't getting enough to eat and wanted to nurse constantly. I was an emotional wreck (PP hormones are SO much worse than pregnancy hormones, at least for me!). I felt like I was failing my son and like I should *want* to try everything possible to breastfeed, which led to a lot of guilt when we switched to FF.

Luckily it didn't take me long to get over that, especially once I realized my husband and I could trade off at night. Sleep gives you a much happier perspective on life :)  I was never shamed by anyone about choosing to FF, although when searching online for stories of moms who chose to FF or supplement, I could only ever find support for moms with medical problems who were physically unable to BF. I came to acceptance on my own and I fully support any mom who chooses to feed however she wants. But man, my journey would have been easier if I'd seen a thread like this :) So, thank you!

iowajes

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Re: Evidence based breastfeeding for mustachians
« Reply #128 on: January 27, 2017, 01:49:43 PM »
I got my breast pump this week.
I'm hoping if I can't exclusively BF/pump I can at least supplement FFing with pumping....

I wish I had gotten far enough along in the last pregnancy to qualify for my pump- I missed it by 1 week (need to be 30 weeks) as I'd really like to have a separate pump for work and home; lugging it back and forth seems like it will be a pain. The one I got sets up as a single or a double pump, so some people have told me that will be really nice to pump one breast while baby is feeding on the other if she doesn't regularly need both.

tweezers

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Re: Evidence based breastfeeding for mustachians
« Reply #129 on: January 27, 2017, 02:35:24 PM »
I got my breast pump this week.
I'm hoping if I can't exclusively BF/pump I can at least supplement FFing with pumping....

I wish I had gotten far enough along in the last pregnancy to qualify for my pump- I missed it by 1 week (need to be 30 weeks) as I'd really like to have a separate pump for work and home; lugging it back and forth seems like it will be a pain. The one I got sets up as a single or a double pump, so some people have told me that will be really nice to pump one breast while baby is feeding on the other if she doesn't regularly need both.

I tended toward oversupply and had a good amount of milk frozen when I went back to work (after 8 weeks leave).  Given that, once I was working I kept my pump at the office.  The hospital gave me an extra flange and membrane kit which greatly reduced the PITA factor of washing all the parts.  For me, it would have been worth purchasing it had it not been given to me.  Good luck!

Cognitive Miser

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Re: Evidence based breastfeeding for mustachians
« Reply #130 on: January 29, 2017, 02:04:24 PM »
I swear, they were the hardest 2 weeks of my life.

When I was pregnant with my first, my best friend told me that she had found breastfeeding much more difficult than actually giving birth. I agree. Even though I didn't have any true issues, it was no picnic to learn! She told me if I was truly committed, I should stick with it for six weeks, which was actually how long it took to get markedly easier.  Not with my second, though. That child took four months!

Has your second kid been checked for a tongue and/or lip tie ? They don't check for them in hospitals, and they can play havoc with a breastfeeding relationship. Some are really obvious, but others can be really hard to spot

Yep. That could be another thread on its own. I had five different professionals evaluate her, and while some thought she had a mild tongue tie, nobody thought she was in any danger if we took a wait and see approach, including the pediatric dentist who would have profited if we let him at her with his laser. She has since started latching well. I had some intensive latching coaching from the LC to whose website I linked. We approached the problem as if the main obstacle was my fantastic oversupply/letdown.

Since this is a thread with the phrase "evidence based" in the title, I would be remiss if I failed to mention that there is not a lot of scientific evidence supporting laser revision of tongue ties. I do not mean to say that tongue tie is not a significant problem for many infants (it is!), but that the data doesn't support laser revision at the rates it is being performed today.

Here is a source for that assertion, for those interested. I'm not an expert and don't care to debate about it, but reading this definitely led me to take the conservative approach regarding my daughter's latch.
http://www.alisonhazelbaker.com/blog/2015/9/1/modern-myths-about-tongue-tie-the-unnecessary-controversy-continues

Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #131 on: January 30, 2017, 07:10:53 AM »
I read that piece by Alison a while ago, I think it stirred up a lot of controversy in the tongue tie group that I am a part of.
The problem with research on ties is that there really isn't that much out there right now - there are ethical considerations that must be taken into account, for example withholding a frenotomy for baby that is FTT (no published evidence, but I have seen a lot of anecdotal about parents with FTT babies having a revision, and seen vast improvements.)
There is research starting to come out (like the link I previously posted) but it is slow.

If someone wants more links, I can dig them up, just let me know.
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Kitsune

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Re: Evidence based breastfeeding for mustachians
« Reply #132 on: January 30, 2017, 08:22:54 AM »
Others like Lagom mentioned, are so wedded to a certain image of perfect exclusive WHO-endorsed breastfeeding, they struggle to properly support moms in their own unique breastfeeding experience (in particular I'm thinking of low supply moms who are often pushed to try 90 million things to improve supply - including off label prescription meds). In addition, telling parents to wait to supplement their baby until an expert n"gives them permission", can be dangerous.

... It's like you were at the appointments with the lactation consultant I had when I had breastfeeding issues. For the record: those off-label drugs made me gain 20lbs but did eff-all for my milk supply. And even then I went back for one last appointment, and this person actually told me that instead of supplementing, what I needed to do was 'increase stimulation' and suggested (I shit you not) setting an alarm ever hour around the clock and trying to breastfeed every hour around the clock for a few days. And that then she would evaluate the situation and see if I had "permission" (eff youuuuuu....) to supplement.

And that's what made me take a step back and be like, wait. No. Lack of sleep to that extreme is a registered torture technique for a REASON. I can't be a good mother, bond with my (hungry!) baby, be a functional human being, and also not have a mental breakdown on no sleep at all. This is not something I can reasonably do. And then I asked my husband to go buy some formula and sat on the couch and cried. The pressure is real, y'know. And that's when I cancelled any further appointments with the lactation consultant because what she was pushing was clearly not in the best interest of either me or my child, and proceeded to breastfeed non-exclusively for 18 months.


little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #133 on: January 30, 2017, 11:31:46 AM »
Others like Lagom mentioned, are so wedded to a certain image of perfect exclusive WHO-endorsed breastfeeding, they struggle to properly support moms in their own unique breastfeeding experience (in particular I'm thinking of low supply moms who are often pushed to try 90 million things to improve supply - including off label prescription meds). In addition, telling parents to wait to supplement their baby until an expert n"gives them permission", can be dangerous.

... It's like you were at the appointments with the lactation consultant I had when I had breastfeeding issues. For the record: those off-label drugs made me gain 20lbs but did eff-all for my milk supply. And even then I went back for one last appointment, and this person actually told me that instead of supplementing, what I needed to do was 'increase stimulation' and suggested (I shit you not) setting an alarm ever hour around the clock and trying to breastfeed every hour around the clock for a few days. And that then she would evaluate the situation and see if I had "permission" (eff youuuuuu....) to supplement.

And that's what made me take a step back and be like, wait. No. Lack of sleep to that extreme is a registered torture technique for a REASON. I can't be a good mother, bond with my (hungry!) baby, be a functional human being, and also not have a mental breakdown on no sleep at all. This is not something I can reasonably do. And then I asked my husband to go buy some formula and sat on the couch and cried. The pressure is real, y'know. And that's when I cancelled any further appointments with the lactation consultant because what she was pushing was clearly not in the best interest of either me or my child, and proceeded to breastfeed non-exclusively for 18 months.

I am so sorry you had to go through that. Unfortunately your experience is not uncommon. I have seen many, many moms in breastfeeding support groups put on domperidone and reglan  for absolutely no medical reason other than the pursuit of improving supply. Many experienced bad side effects as well and were devastated when their milk supply didn’t improve.  I seriously think we have gone way overboard when we are prescribing off label prescription meds with very real side effects (some which are particularly dangerous for postpartum women, like depression!) to otherwise healthy women in order to force their bodies into breastfeeding the “right” way. To me, when someone says “you can go without sleep….you can take these meds that might make you really sick…you can keep triple feeding for weeks on end….exclusivity is worth it” what they are saying loud and clear is “YOU MOM, DO NOT MATTER. ALL THAT MATTERS IS HOW MUCH MILK WE CAN WRING OUT OF YOU AND HOW LONG YOU CAN KEEP IT UP.”

Low supply moms often use phrases like “dairy cow” and “just a pair of boobs” to describe how they were treated by the very staff and support groups who were supposed to be supporting them in their breastfeeding. The truth is, too many of the seeming experts in the lactation community are NOT supportive of any type of breastfeeding except exclusive breastfeeding. If they were truly supportive of all breastfeeding, we would see low supply moms celebrated for what their bodies CAN do, and not forced into “proving” that they can’t possibly do anymore. We would see combination feeding and supplementing moms celebrated for breastfeeding in a safe, healthy way for them and their babies instead of vilified as “ignorant” on breastfeeding, or “lazy”, or “selfish.” And we would see women educated on all the various ways to successfully breastfeed, instead of only educating moms on how to exclusively breastfeed.

To me, a person cannot claim to be pro-breastfeeding if they believe only in exclusive breastfeeding or if they believe that non exclusive breastfeeding is somehow inadequate or “less than” exclusivity. These people are pro exclusivity, not pro breastfeeding.

lazy-saver

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Re: Evidence based breastfeeding for mustachians
« Reply #134 on: February 11, 2017, 10:14:48 AM »
Some web browsing went far astray and I found this.

Apparently the whole "let's try to solve less than perfect breastfeeding rates by telling women that it's necessary for the baby, rather than addressing the reasons it's not entirely compatible with modern life" thing has been going on since at least 1915. There is a good chance it's been going on for hundreds of years, though I don't have direct references for that.  The reason I see this as relevant to this thread is that I think this is the sentiment that lead to breastfeeding-at-all-costs.

From https://archive.org/details/diseasesofnutrit00morsuoft :

Quote
The main reason why women do
not nurse their babies is that they do not appreciate its importance.
This is due to a considerable extent to the fact that they do not
receive proper advice from doctors, nurses and midwives, who,
unfortunately, are themselves in many instances ignorant of the
importance of breast feeding. The unwillingness to nurse among
the wealthier and fashionable classes is in part because they are
unwilling to sacrifice their own pleasure and convenience, in part
because it is not fashionable in certain circles to nurse, and in part
because of the opposition of their husbands, who do not wish to be
deprived of their wives' society. Many of them feel, moreover,
that on account of the great improvement in artificial feeding,
their babies will do well enough, even if they do not nurse them.
The unwillingness of women among the poorer classes to nurse
their babies is, in many instances, due to the fact that on account
of poverty they are obliged to go to work. Ignorance of the
advantage of breast feeding plays a greater part in their unwilling-
ness to nurse than among the better educated, as do also the
advertisements of proprietary foods.

Though another book published the same year https://archive.org/details/simplifiedinfant00dennuoft says this:

Quote
THAT mothers of the present day do not wish to nurse
their infants and are anxious to avoid this duty is a mistaken
idea. The author can think of only two cases where a mother
with a good supply of milk has been unwilling to nurse her
baby. The majority of mothers are not only anxious to
nurse their infants, but are extremely disappointed if they
find that they have not milk enough to properly nourish
them.

They were both kind of interesting to skim in terms of the things that have stayed the same and the things that are amazingly wrong, or just different.

lazy-saver

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Re: Evidence based breastfeeding for mustachians
« Reply #135 on: February 11, 2017, 10:42:51 AM »
However, for a new mother who has decided that exclusive breastfeeding is how she wants to feed her new baby and is struggling, hearing phrases like "oh it's totally fine to supplement", "one bottle of formula won't kill him", "you don't have to do this" , "I was formula-fed & I'm totally fine" is EXTREMELY unhelpful and invalidating. That mother wants and needs support & resources to help her be successful (as SHE defines it), not what probably sounds like, to her, dismissal of her struggles.

Imagine if you had decided to start learning something, and when you first started there was a huge learning curve (as there is!), and when you admitted to a friend that you were struggling your friend said "Just quit! Don't be a hero..."

I agree this is an important point too.  As someone who is making sacrifices in order to breastfeed (which I think can actually be said of almost anyone who continues breastfeeding after going back to work, and a number who don't) I am glad to know that formula is an option so I don't feel trapped, but if anyone even slightly suggests that I should "just" go with formula I'm not going to be happy with them.  It's just another way of trying to force one answer on everyone.

I am quite happy that the doctors we've seen have been really clear that both formula and continuing to breastfeed are good options.  A lot of people aren't that lucky.

lazy-saver

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Re: Evidence based breastfeeding for mustachians
« Reply #136 on: February 11, 2017, 11:03:31 AM »
my baby was allergic to a lot of foods (dairy, soy, corn, eggs, fish, wheat, etc).

Corn seems pretty random, how did you find that one?  I've just removed the last of the top eight allergens (there were a couple I never ate to begin with) and I'm hoping this will be it but also wondering what's next if it's not.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #137 on: February 11, 2017, 02:18:58 PM »
Some web browsing went far astray and I found this.

Apparently the whole "let's try to solve less than perfect breastfeeding rates by telling women that it's necessary for the baby, rather than addressing the reasons it's not entirely compatible with modern life" thing has been going on since at least 1915. There is a good chance it's been going on for hundreds of years, though I don't have direct references for that.  The reason I see this as relevant to this thread is that I think this is the sentiment that lead to breastfeeding-at-all-costs.

From https://archive.org/details/diseasesofnutrit00morsuoft :

Quote
The main reason why women do
not nurse their babies is that they do not appreciate its importance.
This is due to a considerable extent to the fact that they do not
receive proper advice from doctors, nurses and midwives, who,
unfortunately, are themselves in many instances ignorant of the
importance of breast feeding. The unwillingness to nurse among
the wealthier and fashionable classes is in part because they are
unwilling to sacrifice their own pleasure and convenience, in part
because it is not fashionable in certain circles to nurse, and in part
because of the opposition of their husbands, who do not wish to be
deprived of their wives' society. Many of them feel, moreover,
that on account of the great improvement in artificial feeding,
their babies will do well enough, even if they do not nurse them.
The unwillingness of women among the poorer classes to nurse
their babies is, in many instances, due to the fact that on account
of poverty they are obliged to go to work. Ignorance of the
advantage of breast feeding plays a greater part in their unwilling-
ness to nurse than among the better educated, as do also the
advertisements of proprietary foods.

Though another book published the same year https://archive.org/details/simplifiedinfant00dennuoft says this:

Quote
THAT mothers of the present day do not wish to nurse
their infants and are anxious to avoid this duty is a mistaken
idea. The author can think of only two cases where a mother
with a good supply of milk has been unwilling to nurse her
baby. The majority of mothers are not only anxious to
nurse their infants, but are extremely disappointed if they
find that they have not milk enough to properly nourish
them.

They were both kind of interesting to skim in terms of the things that have stayed the same and the things that are amazingly wrong, or just different.

Thank you for this! It is so interesting to see accounts of breastfeeding struggles/rates from different time periods, especially since most ardent breastfeeding advocates today like to pretend that "everyone" used to breastfeed. This romanticization of women from the past is completely absurd and woefully inaccurate, but it contributes to the guilt many modern mothers feel when they can't breastfeed - as if they are some weak, pathetic, abnormal, and unnatural woman/mother. Another great article on the history of breastfeeding difficulties is the following article. Bottles/cup feeding have been around since ancient times as well. There was never a "golden age" of breastfeeding, so we need to stop pretending like there was in an effort to guilt/shame mothers today. Articles like this were very cathartic for me because they showed me there was nothing abnormal or wrong about the fact that I needed to use a bottle and formula to keep my baby safe and healthy.

Was there ever a golden age of breastfeeding???
http://www.bbc.com/news/magazine-25629934
« Last Edit: February 11, 2017, 02:22:56 PM by little_brown_dog »

FinallyAwake

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Re: Evidence based breastfeeding for mustachians
« Reply #138 on: February 13, 2017, 10:49:07 PM »
like cranial bruising in the case of hyperbilirubinemia,

Well, this is fascinating to me.

My babies are older (teens and under) so I'm wondering if this is a pretty recent discovery, or if it's been known all along, but I/my docs never made the correlation.

I had four children, each one larger than the previous, and each labor/delivery longer and more traumatic.  So much so, that by the time #4 was baking and already measuring larger than the previous 3, we went ahead and just scheduled my first (and last!) C/S. 

The first three (all vaginal deliveries) all had bilirubin issues with extended treatment involving phototherapy both in and out of the hospital, hospital stays, trying to find a sunny spot in the house in the middle of a midwestern winter, and multiple, absolutely heartbreaking, heel sticks. 

My C/S?  Not a bili problem at all.

I always wondered why the first three had bili issues, but #4 didn't.  Your post has made a light bulb come on for me!  I probably have a slightly narrow structure that resulted in the increasingly difficult/traumatic births as the children got bigger, which probably resulted in bruising and the ensuing bili problems.  (Their cute little heads were humongous, BTW.)  Why, after all these years, am I just now realizing this? Also, child #4 appears to be the smartest yet of the kids.  Coincidence?   

I realize my narrow-birth-canal-possible-hyperbili-connection rambling is slightly OT, so I apologize for that.  If the mods want me to stay on topic, I could go on to tell you about my BF struggles, especially in light of trying to clear out the jaundice despite low milk supply, but I'd just be repeating what many other mommas before me have shared.  (Your story and mine are, in fact, very similar.)  Luckily, I realized very quickly that formula would be my friend on my new parenting journey. 

It took a lot of struggle and tears, but I finally realized that a healthy, well-fed baby and a healthy, well-rested new momma (well, okay, as rested as possible!) are two of the most important things for a new family to have.

Thank you, formula makers.  Truly.

And thanks, LBD, for the post!


little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #139 on: February 14, 2017, 10:24:05 AM »
like cranial bruising in the case of hyperbilirubinemia,

Well, this is fascinating to me.

My babies are older (teens and under) so I'm wondering if this is a pretty recent discovery, or if it's been known all along, but I/my docs never made the correlation.

I had four children, each one larger than the previous, and each labor/delivery longer and more traumatic.  So much so, that by the time #4 was baking and already measuring larger than the previous 3, we went ahead and just scheduled my first (and last!) C/S. 

The first three (all vaginal deliveries) all had bilirubin issues with extended treatment involving phototherapy both in and out of the hospital, hospital stays, trying to find a sunny spot in the house in the middle of a midwestern winter, and multiple, absolutely heartbreaking, heel sticks. 

My C/S?  Not a bili problem at all.

I always wondered why the first three had bili issues, but #4 didn't.  Your post has made a light bulb come on for me!  I probably have a slightly narrow structure that resulted in the increasingly difficult/traumatic births as the children got bigger, which probably resulted in bruising and the ensuing bili problems.  (Their cute little heads were humongous, BTW.)  Why, after all these years, am I just now realizing this? Also, child #4 appears to be the smartest yet of the kids.  Coincidence?   

I realize my narrow-birth-canal-possible-hyperbili-connection rambling is slightly OT, so I apologize for that.  If the mods want me to stay on topic, I could go on to tell you about my BF struggles, especially in light of trying to clear out the jaundice despite low milk supply, but I'd just be repeating what many other mommas before me have shared.  (Your story and mine are, in fact, very similar.)  Luckily, I realized very quickly that formula would be my friend on my new parenting journey. 

It took a lot of struggle and tears, but I finally realized that a healthy, well-fed baby and a healthy, well-rested new momma (well, okay, as rested as possible!) are two of the most important things for a new family to have.

Thank you, formula makers.  Truly.

And thanks, LBD, for the post!

Yes, it could very well be that your kids were at increased risk of jaundice/hyperbilirubinemia if they experienced bruising from a rough delivery. My daughter had the same thing. Newborns in general struggle to some extent to process bilirubin, which is why a substantial number of them develop jaundice (and why jaundice is considered common and “normal”). But if a baby has been bruised, their bodies not only have to cope with normal levels of bilirubin, but an increased amount produced by the healing process. If a baby is bruised AND dehydrated too, the odds of them developing the condition is greatly increased because now they have higher than normal levels of bilirubin due to the bruising, and less effective defecation and elimination of bilirubin due to their dehydration.

As far as intellect or long term outcomes goes, that data is still mixed/unclear or leaning more towards unlikely. As far as I can see, severe jaundice/hyperbilirubinemia can pose an immediate threat to the infant brain, but there have been studies that show little/no effect later in life as long as the jaundice was treated quickly and the infant improved with standard phototherapy and hydration treatment (did not require exchange transfusions), and did not experience any obvious neurological trauma from the event. Severe jaundice resulting in seizures, or other serious neurological damage (very rare) could certainly impact future cognitive abilities. The data on jaundice is also confounded by the fact that many infants who present with severe hyperbilirubinemia are also suffering from hypoglycemia, which on its own has been known to cause brain injury as well.

I take comfort in the fact that my daughter was treated quickly, responded rapidly to treatment, and has been reaching all of her milestones on schedule. However, knowing what I know now, I personally would never exclusively nurse a newborn with risk factors for hyperbilirubinemia until I was absolutely sure they were receiving plenty of milk at each nursing session. It’s just not worth the risk. All of my future children will be supplemented ontop of nursing sessions until my milk arrives.
« Last Edit: February 14, 2017, 10:32:40 AM by little_brown_dog »

Gin1984

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Re: Evidence based breastfeeding for mustachians
« Reply #140 on: February 14, 2017, 01:41:18 PM »
How did you guys use the shield?  It required me to keep a hand on it and I needed two hands for the baby. 

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Flyingkea

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Re: Evidence based breastfeeding for mustachians
« Reply #141 on: February 15, 2017, 07:27:16 AM »
How did you guys use the shield?  It required me to keep a hand on it and I needed two hands for the baby. 

Sent from my SPH-L710 using Tapatalk
When I used shields with my son, I would usually put him into position first, so that I just needed one hand to guide him that last little step. I used to put him on a pillow so that he was at the right height. Once he was in place, I would attach the shield with one hand, then pull my son closer with the other.

I learnt to Breastfeed lying down when he was a few months old, and had him lying on his back while I was next to him. Then, I just needed one hand to hold the shield on place (I used the upper breast for this.)
A kiwi in the land down-under, with 2 beautiful boys in her life.
Navigating through turbulence and toddlerhood

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #142 on: March 07, 2017, 12:02:35 PM »
I don’t know if any of you have seen this, but this story went viral last week. It was released by Fed is Best and is now all over the news websites and facebook. This is the original story, but you can go and look it up via google too if you want to see the news headlines.

https://fedisbest.org/2017/02/given-just-one-bottle-still-alive/#more-1453


It’s the story of the little boy who was born in a “baby friendly” hospital in the US, and whose mother was encouraged to exclusively nurse despite being told she was at risk for delayed/low supply due to her PCOS. In fact she had numerous risk factors for lactation problems: she was a first time mom, who had a csection, and PCOS (3 risk factors). He cried nonstop but mom was reassured it was normal, and the baby was not offered any supplementation nor was his mother told that he might need it. Instead, mom was told to go buy herbs to try to boost her supply. He went into cardiac arrest at home, only 12 hours after discharge, and died a couple weeks later when he was taken off life support in the NICU. His cause of death was hypernatremic dehydration and corresponding system failure.

This story is horrific for two reasons. The first is the obvious medical negligence. The child lost more than 7% weight before discharge and his diaper outputs were borderline/questionable. In addition, despite the fact that at least 1 staff member recognized the mother's risk of lactation problems, she was never recommended supplementation or even educated on how to do it.

The second reason is that this type of extremely questionable lactation advice/promotion is NOT uncommon, because many hospitals actually have policies and initiatives in place that demand "medical proof" of harm before they "allow" or recommend supplementation. In baby friendly hospitals, the policy is to discourage and avoid supplementation unless "medically indicated" and there are serious barriers to supplementation. If a doctor won't prescribe you formula, you have to request it yourself and often sign a waiver about how you are going against medical advice and breastfeeding advice by supplementing. The bar for prescribing formula for medical reasons is often high and requires obvious signs of clinical deterioration like excessive weight loss >7%-10%, hypoglycemia, moderate-severe jaundice, etc before babies will be "allowed" supplementation. Constant crying or nursing typically does not count as "proof" the baby needs more food. Once a hospital obtains the baby friendly certification, they are on the hook for keeping their supplementation rates as low as possible and there is often pressure on doctors, nurses, and lactation staff to not supplement unless absolutely obviously necessary. Staff with high supplementation rates are often reprimanded or "re-educated." In other words, their clinical judgement is often constrained and limited by policies. Obtaining baby friendly certification is presitigious, great for marketing, and very time consuming. As a result, hospitals want to do everything in their power to make sure they get to keep the certification once they receive it, and if they use formula too judiciously by baby friendly standards, they risk losing certification. In these hospitals, there is immense pressure to discharge as many moms exclusively nursing as possible, even if some of those babies aren't great candidates for exclusive nursing.  Sadly this means that these sorts of policies are REACTIVE to starvation, but do very little to actually prevent it. Johnson's experience is the most extreme case, but thousands of babies are hospitalized due to policies and pressures like this. In short, in these facilities, it is not unfair to say that breastfeeding exclusivity and adherence to the certification requirements is sometimes prioritized over the health and safety of an individual infant.

Parents…if your child ever shows any signs like this little one did….crying and distress even after nursing, nursing near continuously, etc…offer supplementation even if your providers are assuring you it is “fine.” Some BFHI hospitals are wonderful, but if you deliver in one of these, please be aware that your providers may be constrained by the policy and that you might have to be more firm and strong in advocating for your infant if you feel something is not right. You can always switch back to exclusivity once the baby figures out how to nurse and mom’s milk is sufficient. You can’t go back and undo starvation, illness, hospitalization, or severe harm.

« Last Edit: March 07, 2017, 12:12:53 PM by little_brown_dog »

seathink

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Re: Evidence based breastfeeding for mustachians
« Reply #143 on: March 07, 2017, 01:39:10 PM »
Thank you so much, LBD, and everyone here! I'm on this thread for a different reason → I'm part of the % who can't BF (medicine) and I read to find some comfort about doing formula. Everyone I know (even friends with my condition) has breastfed almost exclusively; it's the hip, cool, educated thing to do. But I'm glad to see options.
“Keep what is of no use at the moment, and later you will find what you need, one of her grandmothers had told her, the water in which you soak them will also serve to cook them, and whatever remains from the cooking will cease to be water, but will have become broth. It is not only in nature that from time to time not everything is lost and something is gained.” ― José Saramago, Blindness

The stockmarket is the worst place you grow your money passively except for every other alternative.

mm1970

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Re: Evidence based breastfeeding for mustachians
« Reply #144 on: March 07, 2017, 05:05:43 PM »
This is interesting. I took one of those hippy dippy Bradley courses, and they spent a lot of time talking about breastfeeding challenges like low supply and mastitis. It was a long course (10 weeks, maybe?) but she covered almost everything. Pain relief, c sections, vbacs, nursing, supplementing with formula, newborn care, etc. 

I don't like it when information is withheld because some authority thinks the recipient (an adult) can't handle it or would make a different choice from their preference. Its unacceptable.

To be fair, our breastfeeding class was only one 2 hour session so they did have a lot to cover in a short time. But I still think they could have briefly mentioned it or at least had something in the materials like a symptom chart and how to troubleshoot/care for it. They mostly just said "if there are any problems, talk to one of our lactation specialists ASAP to work it out." Which is fine when you're in the hospital and can push a button to see a nurse, but at home and overwhelmed I just wanted to look it up and not have to figure out how to get in touch with them since I'm not even sure they gave us a number to call that would reach their lactation people!
Yeah, I missed our 2 hour breastfeeding class (I was giving birth!)  It would have been nice to have some info.  The hospital room had a magnet with all of the important lactation phone #'s, so we took it with us.

Still, I had such problems, I had a hard time getting help.  There were a lot of babies that time of year, and best we could do is get help over the phone.  Which helped.  As did the book I borrowed from the library.  But I still struggled.

mm1970

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Re: Evidence based breastfeeding for mustachians
« Reply #145 on: March 07, 2017, 05:15:59 PM »
Thank you so much, LBD, and everyone here! I'm on this thread for a different reason → I'm part of the % who can't BF (medicine) and I read to find some comfort about doing formula. Everyone I know (even friends with my condition) has breastfed almost exclusively; it's the hip, cool, educated thing to do. But I'm glad to see options.
I BF exclusively with #1 for 13.5 months, through many problems (that I didn't recognize until way too late).  Like mastitis.

I was sure #2 would be easier, and it wasn't.  The first 6 weeks were rough.  Again.  I got through them.  But even though I tried to improve the process (worked shorter hours, pumped more frequently), I had the same plugged duct issues with #2 that I did with #1.

After a straight 6 weeks of getting a plugged duct every week, in desperation I finally called the doctor first thing on a Friday morning.  Nobody called me back.  I called FOUR TIMES.  Eventually, at 4 pm, I got a call back, with "well, try these things" (duh, I've tried them all) and "maybe we can squeeze you in on Monday".  MONDAY!!

Eff that, went home, had my husband to go the store and buy formula.  Started on Sunday, I started gradually decreasing my pump sessions by one.  (From 3 to 2, then 2 to 1) over the next 2 weeks.  The plan was to nurse at home and use formula when I was at work.  After about 6 weeks, he weaned himself to formula.  He was just not into nursing anymore (same thing with #1, six weeks to the day after I stopped pumping).

it was glorious, GLORIOUS.  I enjoyed the formula/ nursing combo, and would have been fine continuing (no more plugged ducts!)  But it wasn't in the cards, and I tell you - it was such a relief to no longer have the plugged ducts.

Once I started supplementing, I learned about all the other friends who did too.  It seemed like everyone was exclusively BF, but in reality, only a few actually did.

little_brown_dog

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Re: Evidence based breastfeeding for mustachians
« Reply #146 on: March 08, 2017, 11:25:31 AM »
Want to talk today about an important issue – donor milk - because there is alot of misinformation swirling around out there regarding this subject.

So we know a significant percentage of moms and babies need supplementation, but the question is, what should parents supplement with? To date, the AAP only recognizes 2 foods as safe for supplementation/infant feeding in the absence of mom's own breastmilk: 1) commercial infant formula, and 2) pasteurized/screened donor milk through a milk bank. The AAP DOES NOT RECOMMEND unscreened donor milk (sometimes known as peer to peer milk sharing). This means that informal milk sharing organizations like “Eats on feets” and”Human milk 4 Human babies” are in direct opposition to the AAP recommendations on donor milk. They specifically discourage the use of unscreened milk because of serious safety concerns, including bacterial contamination and the transmission of infectious agents like HIV.

It is critical to distinguish between pasteurized and screened milk from a milk bank and the informal peer-to-peer milk sharing networks because many new parents have been misled into believing that ANY breastmilk is superior and safer/healthier than formula, even unscreened/unpasteurized breastmilk from a stranger on the internet. This is absolutely not true, and is in no way supported by any of the major medical organizations. The AAP is specifically against peer to peer milk sharing, and recent research on milk sales over the internet confirmed that their fears are well founded. A study from 2013 in the journal Pediatrics found that 74% of samples were contaminated with bacteria. The authors concluded that their study demonstrates that infants who consume such milk could be at serious risk for illness. A study in 2015 found that some sellers online were mixing cow milk into breastmilk and selling it to parents. And a brand new study that just came out of Florida found that while most parents tried to follow safe food prep practices when donating breastmilk informally, the majority of the sample did not follow all 5 of the safety precautions listed in the survey (meaning, while the donors were trying they were not following ideal practices). Only 36% of the sample reported following all 5 procedures, and only 40% of the sample followed at least 4...meaning that over half of the sample were routinely missing out on 2 or more important procedures for ensuring the safety of the breastmilk in terms of bacterial contamination. The studies are listed below:

http://pediatrics.aappublications.org/content/early/2013/10/16/peds.2013-1687

https://www.sciencedaily.com/releases/2015/04/150406071040.htm

https://www.sciencedaily.com/releases/2017/02/170217095910.htm

Milk bank screening procedures also highlight the pitfalls of peer to peer milk sharing. Large numbers of potential donors to milk banks are turned away for failing to pass their rigorous safety qualifications which includes screening out people with substance use, sexually transmitted infections, medication usage, herbal supplement usage, among other things. In other words, many of the women who want to donate breastmilk cannot pass the milk banks’ safety checks and their milk is currently viewed as potentially unsafe for donation. If these women turn around and donate over the internet, the parents will be receiving milk that is not deemed safe by milk banks. Scary.  If you are interested in what a milk bank's screening process is like, the following link provides some information.

https://www.milkbank.org/milk-banking/milk-banking-faqs

Here are the official AAP guidelines on the use of donor milk. They focus predominantly on its clinical prep and usage for infants in the hospital setting. You will notice at the bottom that clinicians are instructed to actively discourage peer to peer milk sharing due to the safety concerns.

http://pediatrics.aappublications.org/content/early/2016/12/15/peds.2016-3440

There are currently only 20 milk banks operating in the US. Most milk banks do not provide milk to the public and instead reserve their milk for preterm and ill infants in area hospitals, as these infants are the ones who are most likely to benefit from extra breastmilk. Some milk banks may have extra milk you can purchase, but they tend to be very pricey ($4-$5/ounce).  Depending on your circumstances and how important it is to you that your child avoid formula, some parents might find the price worth it (if they can access it). However to date, there is absolutely no evidence that full term babies supplemented with donor milk do any better than those supplemented with formula. If you do not have access to a milk bank or otherwise cannot reasonably obtain donor milk through this route, the AAP recommends that you use commercial infant formula for your child as it does not pose the same safety risks as unscreened breastmilk.
« Last Edit: March 08, 2017, 11:45:11 AM by little_brown_dog »

Freedom2016

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Re: Evidence based breastfeeding for mustachians
« Reply #147 on: March 09, 2017, 08:05:35 AM »
lbd, this thread is an amazing public service - thank you! I wish it existed when I had my first child back in 2012. :)

I'm a well educated, sane, thoughtful person who logically understood that FF is fine for babies, but when it came to my own child I fell hook, line, and sinker for the exclusive breastfeeding line of thinking. I had supply problems with #1 and felt guilty and like a failure that I had to supplement almost out of the gate.

I went whole hog into everything the LC's recommended (we saw more than one and I can say the conflicting advice was incredibly confusing!) -- pumping around the clock (omg the 4am alarm was the worst), using a nipple shield (was never able to wean him from it), avoiding bottle feeding b/c of the dreaded "nipple confusion", taking fenugreek (I smelled like syrup!), lactation cookies (yuck), domperidone, weighted feedings. There was so much unnecessary stress, guilt, and anxiety throughout. And despite all those efforts my supply was never fully adequate for DS. I eventually made uneasy peace with that (that stat of ~5% of women actually having low supply haunted me, making me feel like it must be my fault).

I was prepared for the same problems with #2 (I even ordered domperidone in advance) but, incredibly and inexplicably, my supply was over-the-top with DD (case in point: one day I pumped 14 oz from one breast in one pumping session. 14 oz. I actually googled to see if that was some kind of record. There were no matching results LOL). I had so much supply that I got plugged ducts and mastitis repeatedly with her (which was possibly worse pain than childbirth). I took a lot of warm showers and wore a lot of cabbage leaves (look it up) and took a lot of antibiotics, and even saw a doc to rule out inflammatory breast cancer b/c of persistent redness. Even apart from that, there were a lot of tears feeding her too - as others have said the idea that if it's painful you're doing it wrong is complete horse shit and very worry- and guilt-inducing. Having said that, we introduced bottles early for her (I think the idea of nipple confusion might be horseshit too (?), at least it was for my kids - #1 simply learned how to suck on the end of a syringe instead of a bottle, until I wised up and ditched the syringe feeding; #2 was fine with either breast or bottle). In the end I did feel some personal pride that DD was fed only breastmilk for the first seven months of her life. After that we introduced FF.

Both kids were fully weaned from breastmilk by 11 months - for health reasons for me. I lost a breast to cancer prior to #1 so I had check-ups where I needed to not be lactating in order to read mammo/MRI results accurately. Hence the shorter BF timelines.

So I fed him, and then her, with one side only. It was a bit of a personal mission for me to be able to "prove" that my body was still capable of feeding a child -- I felt like my body had betrayed me w/ the cancer so it was a personal triumph to be able to do it at all. Even so, like I said earlier, I was very prone to feeling guilty when I couldn't manage to exclusively BF our son. And it was still a struggle with our daughter.

If this thread had been around back then, I like to think I would have been able to make more freeing decisions about how to feed our kids in a way that acknowledged that I had needs too. Even more importantly, like lbd and others have said, to celebrate what I WAS able to do instead of berating myself for what I couldn't do.

I forwarded this thread to friends who are expecting their first child in a few months. Again, thanks for these great resources lbd, and everyone else who has contributed here.

Edit: Funny/not funny joke from my physician brother-in-law during the throes of my breastfeeding challenges: "Hey, you know there's a cure for that, right?" "No, what is it?" "Formula."
« Last Edit: March 09, 2017, 08:07:16 AM by Freedom2016 »

moof

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Re: Evidence based breastfeeding for mustachians
« Reply #148 on: March 09, 2017, 11:47:57 AM »
I don’t know if any of you have seen this, but this story went viral last week. It was released by Fed is Best and is now all over the news websites and facebook. This is the original story, but you can go and look it up via google too if you want to see the news headlines.

https://fedisbest.org/2017/02/given-just-one-bottle-still-alive/#more-1453

I read it, and it rings way too familiar.  It took my wife a lot of crying and many weeks to forgive herself for feeling like a failure as a woman for not being able to make breast feeding work.  WTF?  I could easily see that with even slightly more pushy nurses, or a slightly more militant lactation consultant we could have ended up in her position instead of having a great 4 year old.  Our kid was tongue tied, and my wife's family has a history of production issues (mom, both sisters as we later found out), but the guilt and shame for giving your kid anything short of "the best" is horrible these days, especially when coming from health professionals.

Doctors and nurses in the hospital should make the following clear:
1)  What a "wet" diaper means in weight.  No one told us how hefty it really should be.  Our kid was making urine, but about 1/4 of what he should have.  I wish we were told ounces per day so we could weigh the diapers and realize sooner that things are not going well.  Or at least share props to a dry and wet diaper so you are calibrated to what realistic heft there should be.

2)  Nurse for 20 minutes and bottle supplement should explained as a strategy as a way better determine if your kid is getting enough, or just tiring out and giving up.

3)  Most health benefits claims disappear when you account for income, formula is just fine if it becomes necessary.  Modern formula is quite good.  More well off folks can be stay-at-home and breast feed, so the straight statistics are heavily tilted by income, which also affects health of kids.  Factor out income and most of the breast feeding advantage goes away.  I wish this was shared with us instead of tales of lower IQ's and degraded immune systems that equate anything short of breast feeding with near child abuse.  After the fact I found some decent write-ups that dug that little bit extra deep.

End rant.

seathink

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Re: Evidence based breastfeeding for mustachians
« Reply #149 on: March 10, 2017, 12:07:41 PM »
Want to talk today about an important issue – donor milk - because there is alot of misinformation swirling around out there regarding this subject.


Appreciated!!
“Keep what is of no use at the moment, and later you will find what you need, one of her grandmothers had told her, the water in which you soak them will also serve to cook them, and whatever remains from the cooking will cease to be water, but will have become broth. It is not only in nature that from time to time not everything is lost and something is gained.” ― José Saramago, Blindness

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