The Money Mustache Community
Learning, Sharing, and Teaching => Mini Money Mustaches => Topic started by: little_brown_dog on November 08, 2016, 10:43:32 AM
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There was some discussion on another thread (http://forum.mrmoneymustache.com/mini-money-mustaches/tips-on-saving-money-on-a-newborn/) about the objective risks/benefits of breastfeeding. I wanted to start a new thread here because I didn't want to derail the OP's topic, and because there seems to be quite a bit of interest in this subject as well as alot of pushback. There is a shifting tide in public health right now surrounding breastfeeding. Old dogmas, such as those that preach no supplementation, or assume that almost every woman can breastfeed exclusively, are being debated and challenged in the medical and public health realm, but it will probably be a few years until these new understandings arrive in most breastfeeding classes, educational packets, and in-person discussions with front line OBs/midwives, lactation consultants, and pediatricians. It has come to my attention through my own breastfeeding struggles and my daughter’s subsequent hospitalization, that parents are not receiving the most up to date information regarding the benefits and risks of exclusive breastfeeding. I know this for a fact because I was one of these parents.
About me: I am the mother of an infant that suffered hyperbilirubinemia and dehydration due to ineffective breastfeeding in the first few days of life. I took breastfeeding classes and sought advice from well trained CNMs and lactation consultants, breastfed on demand, etc, so I was completely shocked when this happened to me of all people. I continued to breastfeed after battling back from the extreme challenges we experienced, so I know what it is like to be very committed to breastfeeding. I am not a medical professional (nurse/MD) but a researcher in women’s issues and pediatrics. All of my analysis is viewed through that public health lense.
Currently, breastfeeding is presented in classes and OB offices as a near perfect good. Benefits are touted left and right, and women can attend frequent classes and support groups to learn the mechanics of it. But very little information is provided on the risks of breastfeeding- and yes, there are documented risks, namely starvation related complications due to dehydration/not eating enough. If you doubt this, I encourage you to attend a class, or pick up a breastfeeding packet and see if any of the following information is presented at all, let alone in detail.
The bottom line is, every day there are newborns in the US who are re-hospitalized after initial discharge (or have their original stay extended) because they are essentially starving while breastfeeding. Starvation manifests through different physiologic conditions such as hyperbilirubinemia (high bilirubin), hypoglycemia (low blood sugar), hypernatremia (high sodium), and excessive weight loss breaching the new 7% threshold set by the American Academy of Pediatrics in 2012. This threshold is lower than the old standard 10% weight loss target previously accepted as normal/safe, as it was discovered that many babies were experiencing complications at or around 10%. These conditions can be due to other factors, like cranial bruising in the case of hyperbilirubinemia, or gestational diabetes in the case of hypoglycemia, but they can also be caused, or greatly exacerbated, by dehydration. And they are deadly – when left untreated for too long, starvation results in widespread brain injury and eventual death. An infant can experience brain damage and seizures by day 3-4 of life if they have not had anything to eat. Hyperbilirubinemia is particularly prevalent and very confusing for parents to effectively navigate because jaundice (the red flag symptom of potential hyperbilirubinemia) is often downplayed as "common" or "normal" in infants.
The estimated prevalence of readmission for starvation related complications is 1-2% of all infants, but this does not include those infants who are not yet so severe and can be managed in the outpatient setting. Many infants require frequent weight and bilirubin checks, supplemental nutrition, and repeat lactation consultant evaluations at their pediatrician offices but who do not qualify for emergency readmission. My daughter was discharged with mild jaundice only to be readmitted the following morning because her seemingly normal jaundice had overnight turned into a full blown emergency - hyperbilirubinemia and was starting to demonstrate the symptoms of very early stage bilirubin encephalopathy (http://neuropathology-web.org/chapter3/chapter3eBilirubinencephalopathy.html).
The old dogma is that these conditions in otherwise healthy babies are due to a mother’s lack of breastfeeding education, and that if she would just see a consultant, or take a class, or breastfeed the “right” way, the problem would never have happened. This is true in some cases, but new research demonstrates that we have underestimated the prevalence of lactation problems that are not within a woman’s control. In other words, there could be an awful lot of women out there who through no fault of their own are accidentally starving their infant in the first week of life. Research has estimated 20% of first time moms experience delayed lactation (https://www.ncbi.nlm.nih.gov/pubmed/12949292) right after giving birth, where their milk doesn’t arrive within the normative 48-72 hours. The authors specifically conclude that effective lactation post birth is "strongly influenced" by parity. 72+ hours is a dangerously long time for an infant to go without milk as I just discussed, and if mom is discouraged from supplementing, or pumping to bottle/syringe feed, she can easily go three days just putting a baby on a virtually empty breast over and over again while the child deteriorates. And while many advocates claim that only 5% of women can’t breastfeed, this statistic is highly questionable. It generally references women who truly cannot breastfeed due to insufficient glandular tissue or other breast problems, but does not account for women who simply have suboptimal supplies or those women who have normal supplies but experience delayed lactation at first. We don’t have clear numbers on just how common general insufficient milk production for exclusive breastfeeding might be, but an interview with a breast milk researcher at Penn State suspects from her research that it is much higher than previously thought (https://themomivist.com/2016/08/02/moms-dont-feel-ashamed-about-your-breast-milk-supply-even-scientists-are-still-searching-answers-for-why-it-isnt-consistent/).
UPDATE: New research released this year showed that anywhere from 1/3-2/3 of mothers did not produce the minimum amount of milk necessary for optimal nutrition within the first month of life, further strengthening the research showing that our previous assumptions about the "rarity" of insufficient lactation are incorrect. It is becoming more apparent that insufficient milk production, particularly in the first month postpartum, is not rare, but actually a surprisingly commonplace phenomenon. https://www.ncbi.nlm.nih.gov/pubmed/27897979
If you are particularly interested in starvation related complications, I highly recommend FedisBest.org. It is an evidence based organization founded by a physician and NICU lactation consultant, and they offer a bunch of great resources and information on how to breastfeed while also taking a proactive, preventative stance against starvation.
So what to make of all this? How do we support breastfeeding without putting babies at risk for starvation complications? A great read if you can access it, is a recent editorial in JAMA (http://jamanetwork.com/journals/jama/article-abstract/2571222). It discusses the newest findings by the US Task Force on systemic breastfeeding initiatives like the renowned Baby Friendly Hospital Initiative, which prides itself on strict feeding rules like no bottles, pacifiers, or supplemental formula. The task force found that these sorts of policies DO NOT HELP improve long term breastfeeding duration, and that instead providers should focus on tailored individualized breastfeeding plans that fit a mother and baby’s unique needs. The editorial writers also worry that these rigid policies are harming infants by withholding pacifiers (associated protective factor against SIDS) and contributing to those starvation related complications in newborns. Instead, the new recommendations are for hospitals to tailor their breastfeeding education and recommendations to individual mothers. Hopefully as more research comes out, these recommendations will include more information like I provided here so mothers or babies at particular risk (first timers, early term babies, babies with other risk factors for hypoglycemia/hyperbilirubinemia) can take a preventative approach to dehydration/starvation through supplementing, combo feeding, or being particularly vigilant when exclusively nursing. Lastly, I want to point out that the fact that the US Task Force found that the BFHI was not effective is HUGE. And the fact that this editorial appeared in JAMA is also very notable, and just one of the little breadcrumbs we are finding sprinkled throughout the field regarding this shift in breastfeeding dogma and policy.
Update: More research questioning and challenging the rigidity of exclusive breastfeeding promotion. New research shows that breastfeeding mothers who fail to meet exclusivity guidelines are experiencing negative emotional impacts like guilt and disappointment, even if only supplementing a little bit for necessary reasons. The paper authors conclude that "it is important that future recommendations recognize the challenges that exclusive breastfeeding brings and provide a more balanced and realistic target for mothers." http://onlinelibrary.wiley.com/doi/10.1111/mcn.12364/full
Happy to provide more resources and sources if needed/interested!
Edits made on 9/29 - I updated the weight loss threshold information here to the AAP 7% guidelines and why the AAP does not recommend the 10% guideline anymore. Many providers today still follow the 10% rule, but this is in opposition to the AAP guidelines as it is not conservative enough to effectively prevent underfeeding in many infants.
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We struggled with breastfeeding. It took a couple weeks to get a diagnosis that he was tongue tied and could not easily nurse correctly. My wife's milk also did not come in very well, so a one-two punch. We settled on pump and augment, saving a fair amount in the freezer before things dried up. He got one bottle a day of breast milk through 6 months old to get the antibody exposure, but the rest was formula.
My basic conclusion is that the current arm-twisting of "anything short of breast feeding is almost child abuse" has gone way too far. My wife ended up beating herself up, crying a lot, and feeling like a failure for not being able to make it work. Formula is quite good these days, and studies we dug up at the time that properly corrected for income and other factors showed outcomes within the error bars. My personal advise is to give it a good shot if you can, but to realize that your kid will be just fine on formula
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LBD- thank you for this. I think this is really important information for people to have, and you appear to be taking an incredibly balanced and evidence based approach. I read, and learned from, all the articles you linked.
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We struggled with breastfeeding. It took a couple weeks to get a diagnosis that he was tongue tied and could not easily nurse correctly. My wife's milk also did not come in very well, so a one-two punch. We settled on pump and augment, saving a fair amount in the freezer before things dried up. He got one bottle a day of breast milk through 6 months old to get the antibody exposure, but the rest was formula.
My basic conclusion is that the current arm-twisting of "anything short of breast feeding is almost child abuse" has gone way too far. My wife ended up beating herself up, crying a lot, and feeling like a failure for not being able to make it work. Formula is quite good these days, and studies we dug up at the time that properly corrected for income and other factors showed outcomes within the error bars. My personal advise is to give it a good shot if you can, but to realize that your kid will be just fine on formula
Hear, hear.
I had unexplained nipple pain for 3 months. That felt like an eternity. I kept going. Some weeks was just pumping, other weeks pumping was too painful and I supplemented with formula. The amount of guilt I felt about the supplementation was crazy. I am a well educated, rational person who would never judge a woman in my situation for supplementing or indeed changing to formula (I don't want to say 'quitting' as it feeds into the guilt) and yet I could not talk myself out of that guilt.
In my case, the pain resolved at around 15 weeks. But there are some women for whom the pain never resolves. That is just one of many reasons why B/F will not work for everyone. To anyone who is pregnant and hopes to be able to exclusively B/F: good for you! Do some research, talk it through with experienced friends, and relax - chances are good that you will be able to, but you need to be relaxed about the possibility of trying alternatives if you need to.
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LBD- thank you for this. I think this is really important information for people to have, and you appear to be taking an incredibly balanced and evidence based approach. I read, and learned from, all the articles you linked.
Thanks! This topic is very near and dear to my heart after living through it personally. The situation is heartbreaking in its irony – conscientious, well informed mothers withhold formula or even their own pumped milk from their babies because they and their providers genuinely believe that is what is “best” for the child. They are trying to follow the “rules” perfectly, because they love their babies so much, that they end up actually hurting the child unnecessarily. Then they spend weeks, months, or even years beating themselves up over their failure - failure to protect the baby, failure to breastfeed the "right" way, failure to meet those all holy strict guidelines and expectations. I never want another parent to go through this ever again, so I keep blathering on about it. Thankfully, we have the information, it is just a matter of getting it out to parents and pushing back against the inertia created by old breastfeeding attitudes and policies :)
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Thank you for your post!
I fell into the 20% of first-timers with delayed lactation. My son got formula, since he had major surgery 36 hours after birth and needed the nourishment. I pumped for 6 months, but we still had to supplement.
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little_brown_dog thanks for this thread and the information you provided! Breastfeeding didn't work out for me and making the decision to switch to formula was heartbreaking. But ultimately it was the best option for our family. As you know, babies are supposed to regain or surpass their birth weight by two weeks old. At his two week checkup, our son was still underweight. The doctor let us give it another week to try with exclusive breastfeeding. The day before the appointment to see the doctor again (one week later) I finally called a lactation consultant. She'd had a cancellation and we were able to get in to see her that day. She weighed our son and he weighed one entire pound less than his birth weight. And he only weighed 7 lbs 10 oz at birth. So yeah. She sent my husband to the store during the appointment to buy formula to feed our son. If I could go back in time and do it all again, I would have started formula as soon as we came home from the hospital and it became obvious that even though my milk came in, it wasn't nearly enough volume to sufficiently feed him.
That statistic about only 5% of women being truly unable to breastfeed is so frustrating to me, because the unspoken implication is that if breastfeeding's not working for you then you just aren't trying hard enough. That's BS, in my opinion. Anecdotally, I know WAY too many women who struggled to breastfeed, who tried and tried and tried to make it work, and in the end, it just didn't. There is no way 5% is an accurate figure (the materials I read actually had it at 3%). Even if it is accurate, it's not helpful information for women who are struggling.
Yes, breastfeeding is free IF IT WORKS. We spend so much money trying to make it work. We bought different breast pump flanges that the lactation consultant recommended, hoping the shape would work better. We bought a natural herbal intinction that was supposed to increase milk production. We bought brewer's yeast (a giant jar because that was the only size the store sold) to make lactation cookies to increase milk production. We finally stopped the insanity when the lactation consultant said our last option was to order pharmaceuticals from Canada. Pharmaceuticals whose intended use are for nausea but have a potential side effect of increasing milk production. It seemed like a grey area whether this is even legal to do in the US. Anyway, that's where I drew the line. I'm not all that comfortable with taking pharmaceuticals while breastfeeding, not all that comfortable with doing some thing that seemed to be in a legal grey area. Plus no guarantee it would actually work. With all the money we spent, we could have funded a month's worth (or more) of formula. And of course, we were already buying formula anyway because I never did produce enough to provide his daily need.
Fortunately my son didn't have any complications from basically starving for his first 3 weeks of life. He's almost two now and is really thriving.
So, thank you for sharing that new research is coming out about this and that hospitals and doctors are paying attention.
For anyone going through the agony of deciding whether to use formula, here are some resources that helped me out:
http://www.fearlessformulafeeder.com/category/fff-friday/ - collection of stories from women who use formula. Reading through the archives helped me feel less alone as I made the decision to use formula. And I love the name Fearless Formula Feeders because I had a lot of fear about being judged for my decision.
https://newrepublic.com/article/105638/amy-sullivan-unapologetic-case-formula-feeding - one of the few articles in support of formula that I found through a google search
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I read through the other thread and thought I'd comment here on something you wrote over there, quoted below. I so wish I had known that topping up with a bottle of formula was an option. It would have saved us a lot of grief and possibly done more to save my breastfeeding attempt than anything the lactation consultant suggested. I didn't want to use bottles for fear of nipple confusion but if I could do it over, I'd use the technique below and not worry about it.
If there are any new parents to-be reading this, here is an easy litmus test to figure out if a newborn is receiving enough nutrition from the breast (great for anxious parents at home after discharge who can’t see a professional within a few hours): nurse baby until baby seems done/sleepy/pops off, then right after offer a bottle or syringe of a ˝ oz pumped milk or ready-to-feed formula. If baby chugs it back and finishes it all, there is a really good chance baby is not eating to fullness/receiving enough at the breast yet. Offer an extra ˝ ounce if needed. You can keep up with this nurse and top up system until baby refuses to take the extra food, or until you get professional help at your next appointment. This is basically a nurse on demand practice with a safe guard built in. If baby is truly not nursing effectively for whatever reason, the top ups will keep them hydrated and safe until you can get some help without compromising your breastfeeding. This is what we were taught to do in the hospital after my daughter was hospitalized for starvation related problems due to our inability to breastfeed sufficiently. I so wish someone had told me this BEFORE she deteriorated.
On a financial note - it is FAR more cost effective to prevent infant deterioration in the first place than wait for a baby to lose too much weight or get too dehydrated before you intervene. Formula supplementation for a couple days will set you back maybe 10 bucks and has been shown to actually improve your chances of successfully breastfeeding into the future, while blindly avoiding bottles and formula in an effort to preserve breastfeeding can land you with hundreds of dollars in medical bills, a sick baby, and a much more difficult time trying to get the baby back on the boob. Basically, when in doubt at all (especially when you are at home and not in the immediate care of a hospital), feed the baby an assured amount of nutrition first (ex: pumped milk or formula) and THEN worry about breastfeeding the so called "right" way. I learned this lesson the hard way, as have many other parents.
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Thanks for all of the information. I'd already decided we needed to have a tub of formula at home in case breastfeeding didn't work, but I had no idea how to know if it wasn't working!
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Thanks for all of the information. I'd already decided we needed to have a tub of formula at home in case breastfeeding didn't work, but I had no idea how to know if it wasn't working!
This might help you, too, Anatidae V:
https://www.breastfeeding.asn.au/bfinfo/my-baby-getting-enough-milk
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Large babies should not lose a lot of weight within the first 6 weeks. My sister was very committed to breastfeeding until she saw (at a doctors visit) how fast my always- crying nephew drained a full bottle of formula then fell to sleep. like, 10 minutes and done drained the bottle. She thought he had tummy troubles, not milk supply troubles.
I too, had challenges. Tongue tied baby with my first (diagnosed), and then an extra- extra large baby (and admitted to ICU initially where nurses fed by bottle because, really, a new mom does not have a lot of milk to pump to feed an 11lb baby...) with my second.
At least after seeing my sister struggle so much, I was willing to top up with formula earlier than her, and without guilt and rather real satisfaction for being able to breastfeed as much as I did.
So I think we have it wrong -- we should celebrate how much we can breastfeed, and the attempts, rather than guilt for slowing down or stopping.
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I read through the other thread and thought I'd comment here on something you wrote over there, quoted below. I so wish I had known that topping up with a bottle of formula was an option. It would have saved us a lot of grief and possibly done more to save my breastfeeding attempt than anything the lactation consultant suggested. I didn't want to use bottles for fear of nipple confusion but if I could do it over, I'd use the technique below and not worry about it.
If there are any new parents to-be reading this, here is an easy litmus test to figure out if a newborn is receiving enough nutrition from the breast (great for anxious parents at home after discharge who can’t see a professional within a few hours): nurse baby until baby seems done/sleepy/pops off, then right after offer a bottle or syringe of a ˝ oz pumped milk or ready-to-feed formula. If baby chugs it back and finishes it all, there is a really good chance baby is not eating to fullness/receiving enough at the breast yet. Offer an extra ˝ ounce if needed. You can keep up with this nurse and top up system until baby refuses to take the extra food, or until you get professional help at your next appointment. This is basically a nurse on demand practice with a safe guard built in. If baby is truly not nursing effectively for whatever reason, the top ups will keep them hydrated and safe until you can get some help without compromising your breastfeeding. This is what we were taught to do in the hospital after my daughter was hospitalized for starvation related problems due to our inability to breastfeed sufficiently. I so wish someone had told me this BEFORE she deteriorated.
On a financial note - it is FAR more cost effective to prevent infant deterioration in the first place than wait for a baby to lose too much weight or get too dehydrated before you intervene. Formula supplementation for a couple days will set you back maybe 10 bucks and has been shown to actually improve your chances of successfully breastfeeding into the future, while blindly avoiding bottles and formula in an effort to preserve breastfeeding can land you with hundreds of dollars in medical bills, a sick baby, and a much more difficult time trying to get the baby back on the boob. Basically, when in doubt at all (especially when you are at home and not in the immediate care of a hospital), feed the baby an assured amount of nutrition first (ex: pumped milk or formula) and THEN worry about breastfeeding the so called "right" way. I learned this lesson the hard way, as have many other parents.
I'm not sure this is true though. It's pretty hard for a baby to not suck on a bottle or to stop the flow of milk from one.
I would suggest taking a breastfeeding class before baby is born and make sure to see a lactation consultant in the hospital a few times before you go home, and probably have the number of one on hand in case you need help after getting home. Find someone who is certified with IBCLC after her name.
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I read through the other thread and thought I'd comment here on something you wrote over there, quoted below. I so wish I had known that topping up with a bottle of formula was an option. It would have saved us a lot of grief and possibly done more to save my breastfeeding attempt than anything the lactation consultant suggested. I didn't want to use bottles for fear of nipple confusion but if I could do it over, I'd use the technique below and not worry about it.
If there are any new parents to-be reading this, here is an easy litmus test to figure out if a newborn is receiving enough nutrition from the breast (great for anxious parents at home after discharge who can’t see a professional within a few hours): nurse baby until baby seems done/sleepy/pops off, then right after offer a bottle or syringe of a ˝ oz pumped milk or ready-to-feed formula. If baby chugs it back and finishes it all, there is a really good chance baby is not eating to fullness/receiving enough at the breast yet. Offer an extra ˝ ounce if needed. You can keep up with this nurse and top up system until baby refuses to take the extra food, or until you get professional help at your next appointment. This is basically a nurse on demand practice with a safe guard built in. If baby is truly not nursing effectively for whatever reason, the top ups will keep them hydrated and safe until you can get some help without compromising your breastfeeding. This is what we were taught to do in the hospital after my daughter was hospitalized for starvation related problems due to our inability to breastfeed sufficiently. I so wish someone had told me this BEFORE she deteriorated.
On a financial note - it is FAR more cost effective to prevent infant deterioration in the first place than wait for a baby to lose too much weight or get too dehydrated before you intervene. Formula supplementation for a couple days will set you back maybe 10 bucks and has been shown to actually improve your chances of successfully breastfeeding into the future, while blindly avoiding bottles and formula in an effort to preserve breastfeeding can land you with hundreds of dollars in medical bills, a sick baby, and a much more difficult time trying to get the baby back on the boob. Basically, when in doubt at all (especially when you are at home and not in the immediate care of a hospital), feed the baby an assured amount of nutrition first (ex: pumped milk or formula) and THEN worry about breastfeeding the so called "right" way. I learned this lesson the hard way, as have many other parents.
I'm not sure this is true though. It's pretty hard for a baby to not suck on a bottle or to stop the flow of milk from one.
I would suggest taking a breastfeeding class before baby is born and make sure to see a lactation consultant in the hospital a few times before you go home, and probably have the number of one on hand in case you need help after getting home. Find someone who is certified with IBCLC after her name.
Thank you for mentioning this, as it brings up some misconceptions I hear all the time.
Even parents who see lactation consultants and take classes in the hospital can and do find themselves struggling after discharge. I am a perfect example. Just because you appear to be doing well in the hospital does not mean that the baby is definitely breastfeeding effectively. Most will be, but some like my daughter, are tricksters. They latch well, nurse for 20 min, etc but barely get anything out. As they nurse and nurse trying to get milk out, they tire out and pop off/fall asleep after 15-20 min, appearing satisfied when in reality they are simply fatigued. It should also be noted that babies can and do often continue to wet and soil diapers appropriately even when they are slowly becoming dehydrated. My daughter continued to poop and pee normally according to schedule even though she was slowly deteriorating.
The described protocol is designed to prevent accidental underfeeding, not to prevent possible overfeeding which as far as I know, is much more difficult to do and does not pose the same immediate safety harms to the infant. The 1/2oz-1oz at a time rule also prevents the baby from drastically overfeeding, because it is tightly controlled by the parent. If baby eats a full oz of supplemental food after breastfeeding, then no more until the next nursing session. It was designed and told to me by a certified IBCLC, but I do recommend that all parents really try to get their own information about how to properly supplement their baby while nursing, as their own circumstances may require modifications. If a consultant poo poos your concerns or requests for this type of education, find someone who is more supportive and flexible.
For concerned parents who are up at 3am suspecting that something may not be right, this protocol is the appropriate feeding style to attempt if they want to ensure baby is eating while also still breastfeeding on demand. It is a way to ensure the baby is well fed and safe until they can get to that lactation appointment during the day. It is NEVER the best option to simply hope or wait and see with extremely young infants. Ensuring the baby is getting at least something at every feeding has to be prioritized first and foremost. Parents should NEVER be discouraged from supplementing their infant if they even have the slightest suspicion that something is wrong, because if the baby is truly struggling, they are at real risk of becoming very sick. Giving your baby a couple ounces of pumped milk or formula by bottle/syringe until you can get to an appointment will not harm the baby in any way, but withholding that food certainly might if they are truly in distress.
Please parents, never withhold food from your infant if you are worried just because someone told you to. The guidelines and advice provided in most breastfeeding packets and materials are generalizations - they talk about what works for most babies, and do not take your own baby into account. I was worried about my daughter the night we were discharged home, but all the old school advice in the classes and manuals said to avoid supplementing and just keep putting her on the boob, so I refused to even pump and give her that. It is a mistake I still regret to this day because even though I was doing everything right according to standard breastfeeding education, my refusal to think for myself, trust my gut, and ensure my baby was eating something actually put my daughter at risk.
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Some more info if parents are interested:
Clinical signs of potential early stage starvation related complications in exclusively breastfed newborns:
1. Yellowy skin or eyes (jaundice)
2. Lethargy – newborns typically wake up every 1.5-2.5 hours to feed (give or take). If an extremely young newborn (<1 week old) is sleeping 3 or more hours at a time, lethargy may be setting in. We saw this with my daughter – by the early morning hours of our first night out of the hospital, she was sleeping deeper and longer as time went on. Thankfully, despite my exhaustion some mama intuition told me I HAD to keep trying to feed her, and I dutifully woke her to try to nurse every 2 hours even if she was still sleeping. Watch for this sign in out conjunction with others.
3. Deterioration of latch/sleepiness at the breast – a baby that seemed to be doing well for the first day or two, but is now constantly popping off, struggling to latch, acting disoriented, or falling asleep repeatedly during feedings may be struggling. Deteriorating infants due to fatigue may show worsening ability to nurse.
4. Excessive nursing/non stop nursing – some babies will attempt to nurse near continuously if they are not receiving enough. Babies that are constantly on and off the boob without about an hour or so of downtime between may be trying to tell you that they are extremely hungry.
5. Inconsolable crying – at some point agitation may take over and babies may cry constantly. They may pop off the breast to cry, or cry continuously even after a nursing session due to extreme hunger. Crying may be interspersed with bouts of rooting and attempts to nurse.
6. Decreased urine/stool output – There is a misconception that plenty of wet/dirty diapers = plenty of food. Not always true. Some babies will continue to wet and poop on schedule even while they are slowly deteriorating. Output may only plummet once the child is very dehydrated, which by that point they may need serious intervention. Counting diapers is useful, but it will not do anything to prevent the baby from dehydrating in the first place (it only alerts you to a serious problem once it has developed). Make sure baby is wetting/pooping on schedule as a safety check, but do not rely on this as unequivocal proof that everything is okay.
7. MOM – moms, if you can’t detect the presence of colostrum on your nipples, in baby’s mouth, or when hand expressing, you might have a problem. If you do not experience some swelling/engorgement or other signs of actual milk arrival by 72 hours post birth, you may be experiencing delayed lactation (note: you can certainly have colostrum and still experience delayed lactation). Be sure to stay mindful about your own body as well to make sure you are in working order. As a first time mom whose baby was not nursing effectively, my milk did not arrive until 5 days post birth despite the fact that I had plenty of colostrum.
If your baby is experiencing some of these, and you can’t get to a non emergency appointment with a doctor or lactation consultant within a few hours, then definitely offer supplemental nutrition ontop of nursing attempts (pumped milk or formula) until you can get some help.
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[redacted for irrelevance] I know its anecdata, but there is so much mommy-shaming around the middle classes these days and no-one should believe a word of it. Yes there are studies to say breast is best, but they are at such large numbers that it is impossible to demonstrate individual effect.
Keep calm and carry on, I say.
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So I think we have it wrong -- we should celebrate how much we can breastfeed, and the attempts, rather than guilt for slowing down or stopping.
+1 times a million. This is actually where we are heading it seems given the new rumblings around tailoring breastfeeding education to a woman's unique circumstances. My sincerest hope is that within the next few years we will see a more inclusive and flexible understanding of breastfeeding, instead of the over zealous push for absolute exclusivity from the get go.
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Posting to follow, as I'm due in 6 weeks (!!)
Thanks for taking the time to post this, little_brown_dog!
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Research has estimated 20% of first time moms experience delayed lactation (https://www.ncbi.nlm.nih.gov/pubmed/12949292) right after giving birth, where their milk doesn’t arrive within the normative 48-72 hours. The authors specifically conclude that effective lactation post birth is "strongly influenced" by parity.
In this context, what does 'parity' mean? Primiparity refers to a first-time mother, but I can't figure out the 'parity'. (I checked the source and it shows up there too as simply 'parity').
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I think the problem is that for most upper middle class women who can easily afford to supplement, its easy to say "do what you can, if you need to supplement, no big deal!" ***BTW I agree with this sentiment, and my 2nd kid ended up supplemented at 7 months, and a month later 100% formula fed, about which I have no guilt and could easily afford! And also I know that is not what everyone here is saying, but I see it a lot***
When you look at poor women, though, it is trickier. On one hand, if they return to work, probably at 6 weeks, it is highly unlikely they will be able to pump and maintain 100% BF. And we shouldn't make them feel guilty for that. OTOH, if they don't work, we are talking about a cultural shift (which I assume is part of why they have pushed BF so hard in the last ~20 years) and we are also talking about women who may not be able to afford formula. I see ISO formula posts all the time on my local pay it forward groups, and it is heartbreaking. The reality is that WIC does not offer enough formula for a 100% FF baby.
So I am really torn when us UMC women are all "tra la la if it doesn't work out, just supplement!". No. We need better nursing education and support- not just "you should nurse" from the delivery nurse, but IBCLC support, weighted feedings, etc, and we need better maternity leave, because with that the vast majority can nurse (if they want to).
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Research has estimated 20% of first time moms experience delayed lactation (https://www.ncbi.nlm.nih.gov/pubmed/12949292) right after giving birth, where their milk doesn’t arrive within the normative 48-72 hours. The authors specifically conclude that effective lactation post birth is "strongly influenced" by parity.
In this context, what does 'parity' mean? Primiparity refers to a first-time mother, but I can't figure out the 'parity'. (I checked the source and it shows up there too as simply 'parity').
I can answer this one! =)
https://en.wikipedia.org/wiki/Gravidity_and_parity (https://en.wikipedia.org/wiki/Gravidity_and_parity)
Parity, or "para" indicates the number of pregnancies reaching viable gestational age (including live births and stillbirths). The number of fetuses does not determine the parity.[4] Twin pregnancy carried to viable gestational age is counted as 1.
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aha.
Parity is the number of pregnancies carried to viable gestational age.
Thanks!
Following with interest. In a lot of the natural/crunchy circles medical providers are portrayed as the enemy who will force formula down your babies throat! This is pretty much how my Bradley teacher represented things anyway. =) It's easy to say that is ridiculous, but I have been shamed and yelled at by a provider who wanted us to supplement without knowing any of our history or even listening to what we were saying (and in my case it was very unnecessary) So I can understand there are some valid roots to the animosity that some subgroups feel towards medical providers.
On the other hand someone close to me went through a similar experience to yours. Years later she still feels guilty for 'starving her child' (her words) and wishes that the medical providers she was seeing every day would have pushed formula more strongly.
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My wife felt so pressured to breastfeed even though she clearly wasn't producing enough. At our older son's four-month appointment, his first in a month, he had gained absolutely no weight. Not an ounce. I was a walking zombie, having not slept for more than four hours at a clip in a month. He clearly wasn't getting enough to eat. I was begging my wife to supplement but she would not. Such is the breastfeeding culture we have in this country. (Looking at photos from this period, he looks like skin and bones at 4 months.)
Thankfully the doctor told us to supplement. I drove right to Costco and bought a canister of formula. Our little guy sucked down three and a half bottles, belched with the gusto of a grown man, and slept for 12 hours -- as did we.
Breastfeeding is wonderful if it works. But it's not for everyone. Our son is now almost 14 and small for his age -- even small considering the height of his parents. Maybe this lost month of growth didn't matter. Maybe he'll have a massive growth spurt or two yet to come.
But if he levels off at three inches shorter than me, I'll always wonder. His younger brother, whom we supplemented with from day one, is projecting to be much taller.
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little_brown_dog, thank-you for starting such an interesting and informative thread. In my own experience there is a wealth of shitty information out there in regards to infant feeding. When you are in the hospital you will be exposed to vastly difference advice/information within a span of minutes. For me, what worked was arming myself with decent information before hand, ignoring what I thought was crappy advice, and following my motherly intuition (it's a thing).
Some anecdotal info: when I was in my late teens/early twenties (well before I was thinking of kids), I was told two different doctors that I would never be able to breastfeed due to my nipples being inverted. I solidly filed this into the "crap" pile. IMO Breastfeeding continues to be regarded as a mysterious process by the medical establishment. It seems to be a consensus that "breast is best" (stupidest slogan ever), but finding decent breastfeeding advice is like navigating a minefield. If I have learned anything, it's that breastfeeding EVERY child is different, and to expect your breastfeeding relationship to perfectly align with the ever changing breastfeeding guidelines is unwise.
I wrote a lot more anecdotical details about shrugging off the "no you can't" and successfully managing to breastfeed two very different children. I decided against hijacking the thread, and deleted this information. I anyone is interested please pm me.
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little_brown_dog, thank-you for starting such an interesting and informative thread. In my own experience there is a wealth of shitty information out there in regards to infant feeding. When you are in the hospital you will be exposed to vastly difference advice/information within a span of minutes. For me, what worked was arming myself with decent information before hand, ignoring what I thought was crappy advice, and following my motherly intuition (it's a thing).
Some anecdotal info: when I was in my late teens/early twenties (well before I was thinking of kids), I was told two different doctors that I would never be able to breastfeed due to my nipples being inverted. I solidly filed this into the "crap" pile. IMO Breastfeeding continues to be regarded as a mysterious process by the medical establishment. It seems to be a consensus that "breast is best" (stupidest slogan ever), but finding decent breastfeeding advice is like navigating a minefield. If I have learned anything, it's that breastfeeding EVERY child is different, and to expect your breastfeeding relationship to perfectly align with the ever changing breastfeeding guidelines is unwise.
I wrote a lot more anecdotical details about shrugging off the "no you can't" and successfully managing to breastfeed two very different children. I decided against hijacking the thread, and deleted this information. I anyone is interested please pm me.
During nursing school, I did a rotation with a lactation consultant. Not only did I see a woman with inverted nipples successfully BF, one of her nipples had everted as a result of feeding her previous baby! But even though only one everted, she could feed on both sides. Anyway, it definitely seems like things said on either side- you def can BF or you def can't BF- often need to be taken with a grain of salt.
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My wife felt so pressured to breastfeed even though she clearly wasn't producing enough. At our older son's four-month appointment, his first in a month, he had gained absolutely no weight. Not an ounce. I was a walking zombie, having not slept for more than four hours at a clip in a month. He clearly wasn't getting enough to eat. I was begging my wife to supplement but she would not. Such is the breastfeeding culture we have in this country. (Looking at photos from this period, he looks like skin and bones at 4 months.)
Thankfully the doctor told us to supplement. I drove right to Costco and bought a canister of formula. Our little guy sucked down three and a half bottles, belched with the gusto of a grown man, and slept for 12 hours -- as did we.
Breastfeeding is wonderful if it works. But it's not for everyone. Our son is now almost 14 and small for his age -- even small considering the height of his parents. Maybe this lost month of growth didn't matter. Maybe he'll have a massive growth spurt or two yet to come.
But if he levels off at three inches shorter than me, I'll always wonder. His younger brother, whom we supplemented with from day one, is projecting to be much taller.
I am so sorry your son had to go through that. Your wife is certainly not alone...there are so many of us who accidentally starved our little ones out of the best intentions, but no one ever talks about it. Parents are terrified of doing something wrong, which makes us very vulnerable to the overgeneralized advice or out of date information that is peddled in many breastfeeding classes, manuals, support groups, or even physician offices. That is why I started this thread. I never want another baby to accidentally starve due to biased propaganda-esque breastfeeding "education" or lack of up to date information on the prevalence of lactation problems.
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Can you explain how a newborn can have an appropriate number of poops even if they are dehydrated? I'm due with my second and have been reading up again on bfing and everything says to go by poops & weight.
Thank goodness in my area we have public health nurses (some are LCs) that come to your house a couple of days after birth and check on you and your baby. Then they keep coming if you are having issues! This is apparently only with your first baby though, so this time I have a midwife who will do the same thing.
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Can you explain how a newborn can have an appropriate number of poops even if they are dehydrated? I'm due with my second and have been reading up again on bfing and everything says to go by poops & weight.
Thank goodness in my area we have public health nurses (some are LCs) that come to your house a couple of days after birth and check on you and your baby. Then they keep coming if you are having issues! This is apparently only with your first baby though, so this time I have a midwife who will do the same thing.
Sure. Infants who are mildly dehydrated can continue to eliminate more or less normally, just like adults. This is because waste elimination is an essential function in the body, so the body prioritizes it for as long as reasonably possible. So while checking the amount of wet and poopy diapers is definitely important, it will not clue you in to a problem until after the baby is already getting quite dehydrated. In other words, it is not a tool that can help prevent you from under feeding your baby in the first place. There was actually a study done that showed that even infants who were losing excessive weight continued to produce the expected minimum of wet/dirty diapers for the first few days of life. It was only around day 4 that a decrease in output indicated breastfeeding inadequacy. http://jhl.sagepub.com/content/24/1/27.abstract
It should also be mentioned that the urine/poop guides handed out are often conservative numbers, and do not necessarily reflect optimal elimination for your infant. For example, my daughter was meeting the minimum requirements for daily poops and was over the minimum requirements for pee on days 1 and 2, but she was slowly becoming dehydrated anyway. Her output only dropped on day 3, the day we were rehospitalized anyway. Her diaper checks had looked fine, but her super yellow skin, lethargy, and disorientation while feeding told another story. Once she was rehydrated in the hospital with pumped milk and formula, her elimination went way up, way past the minimum requirements on the guide we were given. She was still passing lots of meconium almost 4 days postpartum, which indicated that even though she had been pooping prior, she was not eliminating effectively.
Personally, when we hopefully have baby #2, I plan on asking to have the baby weighed before and after a nursing session (pre/post weights) a couple of times before discharge to make sure the baby is getting enough. We didn't do this with my daughter. They are not a perfect measure, but they are easy enough to do, and unlike diaper checks, might be able to alert you to a problem before it develops.
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I had no issues with breastfeeding, but think its shameful that women are made to feel like they're failing if they choose or need to feed their baby formula. Those feeling guilt/shame over formula-feeding may be interested in research showing that selection bias inflates breastfeeding benefits (i.e. when children from different families were compared, the kids who were breastfed did better on various measures than kids who were not breastfed). When children fed differently within the same family were compared (i.e. one child breast-fed and another formula-fed), there was no statistically significant difference in any of the measures except for asthma, with breastfed children at a higher risk for asthma than children fed formula.
http://researchnews.osu.edu/archive/sibbreast.htm
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Honestly, just the fundamental idea that BFing vs formula is not a dichotomy is a revelation. You can top up, you can supplement feedings, etc. Honestly never even occurred to me. Talk about a paradigm shift.
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Posting to follow. I'm 6 months pregnant and breastfeeding is one of the things I'm most apprehensive about.
Of my friends who have had children, approx half have really struggled to breastfeed, so although I'd heard about the 5% number, it always seemed like crap to me.
I'm hoping that having an open mind, support, and planning for any outcome will help make feeding (however it happens) successful.
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Absolutely loving this post. I haven't seen this link shared yet, so here it is: www.fearlessformulafeeder.com This woman is a godsend.
Here's my story. When I first found out I was pregnant (my son is now 5), literally the first book I read was "The Womanly Art of Breastfeeding". I was obsessed from the start. There was no way this was NOT going to happen for me and my baby. I had a picture perfect pregnancy but an absolutely horrible delivery. Failed vacuum extraction, tons of meconium (the worst my midwife had ever seen in 50 years of practice, she later told me), which resulted in my son being transferred to the biggest NICU in the city upon delivery. He had severe respiratory and neurological complications. I didn't even get to hold him until he was a week old, let alone breastfeed.
Still, I focused whatever energy I could on pumping. I pumped like it was my job, and it kind of was, seeing as how I could do nothing else for him. In the NICU pumping room, I would see women labeling their jars "1 of 4, 2 of 4" and I could barely produce an ounce. The amazing lactation consultant examined me and thought I had hypoplasia (underdeveloped breast tissue, which was later confirmed by an MD).
Within days of my son's birth the nurses started supplementing him with formula. I just couldn't pump enough for him. Thankfully I was able to see past myself far enough to recognize that formula was the least of my son's problems, but I honestly think that had he had a normal birth, I would have absolutely been one of those women who nearly starved her baby trying to feed him breastmilk alone. In fact, years later I picked up "The Womanly Art of Breastfeeding" again and searched for references to hypoplasia. There was only one, and it was in a footnote stating that it is extremely rare and (of course) most women are able to produce enough milk for their baby.
Once I was able to hold my son, he did breastfeed and it was wonderful. He came home 2 weeks later with a miraculously clean bill of health, and I successfully combo fed him for 6 months until he got wise and realized that bottle feeding was way easier. My daughter who came 3 years later made it to 8 months.
Today I try to be an advocate for women and how they choose to feed their babies. Breastmilk is great, but so is formula. My children thrived on it and I am so thankful that we live in a country where safe formula and clean water is available.
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Happy to see there are so many others who found themselves in a similar boat, where breastfeeding was unique to their own bodies and babies!
Some more info to fight common breastfeeding myth...
Newborn stomach size - there is this weird obsession in the crunchy community regarding overfeeding newborns, and many moms refuse to supplement because they are told that it will result in overfeeding due to a baby's extremely small stomach size. As a result, some moms may not be feeding their babies enough. This fear of overfeeding is very odd and stems from misunderstandings about how much a baby should be expected to eat in one sitting.
Here is a great article about newborn stomach size, including hospital feeding guidelines. As you will see, hospitals routinely offer brand new newborns only 1-2 days old up to a solid ounce of formula or colostrum/milk every couple hours for optimal hydration/growth and to prevent excessive weight loss or dehydration. Yet the breastfeeding community keeps telling mothers that a newborn baby only needs or "should have" 7-10ml per feeding (an extremely small amount, less than 1/2 an ounce!) based on outdated advice. This leads to the misconception and assumption that whatever mom is producing is probably more than sufficient when in reality it may not be. It also leads to overblown fears that top-up supplementation is akin to force feeding an infant.
https://themomivist.com/2016/10/10/the-newborn-stomach-size-myth-it-is-not-5-7ml/
When in doubt, feed to satiety (follow baby's cues) or supplement up to 30ml (1oz) after a nursing session if you suspect baby is not getting enough at the breast.
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Here's my story. ----- I had a picture perfect pregnancy but an absolutely horrible delivery. Failed vacuum extraction, tons of meconium (the worst my midwife had ever seen in 50 years of practice, she later told me), which resulted in my son being transferred to the biggest NICU in the city upon delivery. He had severe respiratory and neurological complications. I didn't even get to hold him until he was a week old, let alone breastfeed.----
Within days of my son's birth the nurses started supplementing him with formula. I just couldn't pump enough for him. Thankfully I was able to see past myself far enough to recognize that formula was the least of my son's problems,
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Wow, sounds like my story with my second, except that the NICU was in the same hospital as delivery, I did not even see him for 24 hours after the birth, and when DS finally came home, he was on supplemental oxygen for another 6 weeks. Yep, tube in nose, O2 meter on toe, and a tank to lug around with the newborn everywhere we went. If you think a diaper bag is heavy....!
All of that equipment definitely puts a damper on breastfeeding, he was a large baby and voracious feeder, and we did not even try past 4 weeks.
When I saw the moms with 2 month old premee's in the NICU, I could not believe how well groomed, happy, fed, slept, and able to socialize they were! Then I realized that they did not have a baby at home, nor a 2 year old, and all they had to do was pump, get dressed and come to the hospital for a few hours, buying coffee on the way. (on Mat leave for a year here, so even working moms were not working). Not saying that they did not have hardship, just very different form of it.
It is a lot easier to pump when you don't have other toddlers or medical equipment getting in your way..
Good for you for making it work despite the NICU stay.
..
Oh -- and although DS was diagnosed eventually with a learning disorder, which I blame partly on the oxygen at birth issues, he seems to be adapting / outgrowing it now that he is 14...
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My first daughter had to be re-hospitalized due to severe jaundice. I was breastfeeding around the clock but my milk hadn't come in yet (until day 5). Everyone had kept telling me that it was fine and natural and the baby wouldn't starve, but she did. With my second baby, I was more prepared and pumped from the first day to help stimulate my milk. She still had to go back to the ER for jaundice but it wasn't quite as severe. With my third baby we finally got it right. He was born at 36 weeks and had low blood sugar so I had to supplement right away. The lactation consultant brought us an SNS to use while breastfeeding (a little tube that drips formula into the side of the baby's mouth while nursing) and I used it for 4 days until my milk came in. It was amazing and he was my only child to not have to go into the ER on our first night at home.
Like you, I am an educated women and couldn't believe that this happened to my children and that no one seemed to ever mention it.
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I thought about this thread and what I should do to prepare for my New Year's baby, and what I've come up with is:
-get breastfeeding stuff
-get ~5 samples of formula (one non-lactose, although I don't think my kid is likely to be lactose intolerance given its parents and heritage)
-get a couple bottles
-plan to breastfeed
-do a satiety check a couple times, especially if the kid isn't peeing/pooping much
-have a list of LCs/post-partum doulas/etc to ask questions of
That seems reasonable, right?
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Wise mustachians, I appreciate your thoughts on this thread very much and am very sorry to hear of the challenges that some of you have faced. I exclusively breastfed my first baby and am pregnant with another. While I don't think I or the baby had any serious issues (despite my milk not coming in until around day 3 as I recall), breast feeding was extremely painful for the first several weeks and I had extremely unhelpful lactation consultants. They were all concerned about how he was doing - he was fine - but no one gave a damn (it seemed) about me despite the severe pain I was in. On my own I figured out a solution to my problem and was able to nurse and pump successfully. A few thoughts about breastfeeding. One, everyone warns about the dangers of nipple confusion if you give the baby a bottle. Well, the flip side to that is that mine developed a strong aversion to the bottle, especially when he was sick. There were a few horrible times when I had to go to work when he was sick and he refused bottles and basically starved himself all day, leading to dehydration that required hospitalization. That was just awful. Also, exclusively breastfeeding had the effect (in my experience) of creating a STRONG preference for me ALL.THE.TIME, especially as an infant. It was very hard on all of us when I needed a break and my husband so wanted to help, but the baby just wouldn't settle down unless I was holding him.
So. Anyway. Looking ahead to the next baby, I want to approach things a bit differently. My goals are (1) to recognize that I will have way less time, energy, etc. given that I have a toddler to care for in addition to the baby and (2) to involve my husband more in the care of the new baby. First, I plan to supplement with formula from the beginning, even if it is just a bottle a day. Other than that, I have no idea what I want to do. Despite the hardships, I really did love nursing itself much of the time. On the other hand, pumping was a pain. Does anyone have experience and/or recommendations for doing a mixture of both? I will be going back to work after about 3 months BTW.
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Wise mustachians, I appreciate your thoughts on this thread very much and am very sorry to hear of the challenges that some of you have faced. I exclusively breastfed my first baby and am pregnant with another. While I don't think I or the baby had any serious issues (despite my milk not coming in until around day 3 as I recall), breast feeding was extremely painful for the first several weeks and I had extremely unhelpful lactation consultants. They were all concerned about how he was doing - he was fine - but no one gave a damn (it seemed) about me despite the severe pain I was in. On my own I figured out a solution to my problem and was able to nurse and pump successfully. A few thoughts about breastfeeding. One, everyone warns about the dangers of nipple confusion if you give the baby a bottle. Well, the flip side to that is that mine developed a strong aversion to the bottle, especially when he was sick. There were a few horrible times when I had to go to work when he was sick and he refused bottles and basically starved himself all day, leading to dehydration that required hospitalization. That was just awful. Also, exclusively breastfeeding had the effect (in my experience) of creating a STRONG preference for me ALL.THE.TIME, especially as an infant. It was very hard on all of us when I needed a break and my husband so wanted to help, but the baby just wouldn't settle down unless I was holding him.
So. Anyway. Looking ahead to the next baby, I want to approach things a bit differently. My goals are (1) to recognize that I will have way less time, energy, etc. given that I have a toddler to care for in addition to the baby and (2) to involve my husband more in the care of the new baby. First, I plan to supplement with formula from the beginning, even if it is just a bottle a day. Other than that, I have no idea what I want to do. Despite the hardships, I really did love nursing itself much of the time. On the other hand, pumping was a pain. Does anyone have experience and/or recommendations for doing a mixture of both? I will be going back to work after about 3 months BTW.
I am due with my first soon, so I have no first-hand experience, but several other women have said that pumping or supplementing with formula early is helpful in that it allows the kid to associate soothing and food with dad/second partner, and not just mom. They recommended that my husband take several of the feedings, including one at night, which makes sense to me. We'll see how this plays out.
I was planning on just breastfeeding for the first few weeks or so (assuming everything is working) and then introducing a bottle, even if it's full of my own breastmilk. I was told that 3-6 weeks is a good time to introduce a bottle, but I haven't really seen any science backing that up. Maybe the thought is that you won't scare the kid off of breastfeeding if it's used to that by then?
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Here's my story. ----- I had a picture perfect pregnancy but an absolutely horrible delivery. Failed vacuum extraction, tons of meconium (the worst my midwife had ever seen in 50 years of practice, she later told me), which resulted in my son being transferred to the biggest NICU in the city upon delivery. He had severe respiratory and neurological complications. I didn't even get to hold him until he was a week old, let alone breastfeed.----
Within days of my son's birth the nurses started supplementing him with formula. I just couldn't pump enough for him. Thankfully I was able to see past myself far enough to recognize that formula was the least of my son's problems,
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When I saw the moms with 2 month old premee's in the NICU, I could not believe how well groomed, happy, fed, slept, and able to socialize they were! Then I realized that they did not have a baby at home, nor a 2 year old, and all they had to do was pump, get dressed and come to the hospital for a few hours, buying coffee on the way. (on Mat leave for a year here, so even working moms were not working). Not saying that they did not have hardship, just very different form of it.
It is a lot easier to pump when you don't have other toddlers or medical equipment getting in your way..
Good for you for making it work despite the NICU stay.
Canadian here too, so yep, that had a huge part of enabling me to "make it work". I didn't have to worry about going back to work in a few weeks. And yep, since he was our first child, we were able to focus exclusively on him. I distinctly remember feeling so guilty when I woke up every morning at home, completely well rested. I would have traded anything to have been a sleep-deprived, un-showered new mom with a baby at home. But alas, those were not the cards we were dealt!
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I thought about this thread and what I should do to prepare for my New Year's baby, and what I've come up with is:
-get breastfeeding stuff
-get ~5 samples of formula (one non-lactose, although I don't think my kid is likely to be lactose intolerance given its parents and heritage)
-get a couple bottles
-plan to breastfeed
-do a satiety check a couple times, especially if the kid isn't peeing/pooping much
-have a list of LCs/post-partum doulas/etc to ask questions of
That seems reasonable, right?
Sounds like a great plan. I also recommend talking to your partner (if applicable) about your feeding plan/breastfeeding goals. Make sure that you are both on the same page and that he/she knows that you want them to step in when things are getting out of hand with either your well being or the baby's.
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Wise mustachians, I appreciate your thoughts on this thread very much and am very sorry to hear of the challenges that some of you have faced. I exclusively breastfed my first baby and am pregnant with another. While I don't think I or the baby had any serious issues (despite my milk not coming in until around day 3 as I recall), breast feeding was extremely painful for the first several weeks and I had extremely unhelpful lactation consultants. They were all concerned about how he was doing - he was fine - but no one gave a damn (it seemed) about me despite the severe pain I was in. On my own I figured out a solution to my problem and was able to nurse and pump successfully. A few thoughts about breastfeeding. One, everyone warns about the dangers of nipple confusion if you give the baby a bottle. Well, the flip side to that is that mine developed a strong aversion to the bottle, especially when he was sick. There were a few horrible times when I had to go to work when he was sick and he refused bottles and basically starved himself all day, leading to dehydration that required hospitalization. That was just awful. Also, exclusively breastfeeding had the effect (in my experience) of creating a STRONG preference for me ALL.THE.TIME, especially as an infant. It was very hard on all of us when I needed a break and my husband so wanted to help, but the baby just wouldn't settle down unless I was holding him.
So. Anyway. Looking ahead to the next baby, I want to approach things a bit differently. My goals are (1) to recognize that I will have way less time, energy, etc. given that I have a toddler to care for in addition to the baby and (2) to involve my husband more in the care of the new baby. First, I plan to supplement with formula from the beginning, even if it is just a bottle a day. Other than that, I have no idea what I want to do. Despite the hardships, I really did love nursing itself much of the time. On the other hand, pumping was a pain. Does anyone have experience and/or recommendations for doing a mixture of both? I will be going back to work after about 3 months BTW.
Yes, the ability for mom to take a break is a hugely undervalued benefit to formula feeding. I loved being able to leave my son when I needed or wanted to without worrying about whether or not he would eat. And my husband loved being able to feed him too. Obviously there are many ways to bond with a baby, but in those early days, feeding is a big one.
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Nicely written post! I tried to EBF my first, which I did for 6 weeks or so. Gradually switched to 100% formula BT the time I went back to work at 11-ish weeks. I wasn't about to pump at work. I may have tried for longer, except my SMIL pushed me to switch earlier than I might have. That was probably for the best, as I have severe issues with interrupted sleep. I am unable to go back to sleep, and unable to nap during the day. I was a zombie.
My 2nd born was born 2.5 weeks early and just under 5 pounds. He would not latch due to his tiny size (and possibly my engorgement). At that weight, combined with some blood sugar issues of his in the hospital, I was not about to let it drop any more when we got home. I used the pump at the hospital and supplemented from day 1 or 2. I was going to rent for a couple months, but insurance covered purchase and not a rental, so I pumped as well as gave him formula for 6 months. (I never had quite enough supply.) The pumping added a lot of complication to our family lives, so I quit earlier than I might have with more free time available to me.
Over the last 6+ years since my first, I've seen more and more pressure put on new moms to EBF. It has always seemed too extreme to me to push so hard for never using a bottle or formula. The benefits of BM aren't that much greater, really, and formula isn't poison.
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...and formula isn't poison.
Hmm, new marketing pitch? LOL
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I thought about this thread and what I should do to prepare for my New Year's baby, and what I've come up with is:
-get breastfeeding stuff
-get ~5 samples of formula (one non-lactose, although I don't think my kid is likely to be lactose intolerance given its parents and heritage)
-get a couple bottles
-plan to breastfeed
-do a satiety check a couple times, especially if the kid isn't peeing/pooping much
-have a list of LCs/post-partum doulas/etc to ask questions of
That seems reasonable, right?
I would add: get a breast pump (free under ACA in US, not sure where you are), take it out of the box, sterilize the components and make sure you know how it works. On my second night home from hospital, I was painfully engorged and even though pumping is kind of a catch-22 in that situation (stimulates more milk production, which you don't want when you're that massive already!) I decided to pump because baby was too little to latch onto my engorged boobs, getting frustrated, seemed hungry, I was in so much pain and I was so worried she wasn't getting food. Pumping and being able to SEE that milk go into her, and know how much she drank, was so good for morale, and so good for engorgement. But of course being all "I'm gonna exclusively BF!" prior to the birth, i hadn't even gotten the pump out of the box and that added a lot of stress.
*Note: so many people mentioned nipple confusion to me as a reason not to pump/formula feed. Ignore them. If your baby is hungry and you have any inkling that she's not getting enough from the boob, FEED FIRST, worry about nipple confusion later. As my pediatrician told me - if it happens (and it didn't, and it often doesn't...would be curious if anyone has scientific research on this?), that's next week's problem! Today's problem is getting her fed.
Fed is best :)
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...and formula isn't poison.
Hmm, new marketing pitch? LOL
Lol, some extremists act like it sort of is.
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When I was in extreme pain and asked a lactation consultant if I could give my newborn a bottle of pumped milk, she replied "Well, that's YOUR choice to do that . . ." as though I had indeed suggested giving the baby poison.
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When I was in extreme pain and asked a lactation consultant if I could give my newborn a bottle of pumped milk, she replied "Well, that's YOUR choice to do that . . ." as though I had indeed suggested giving the baby poison.
So when they say "breast is best"- they mean as a delivery method, not as in where the milk is from?
My gosh...
(I'm 21 weeks right now and my midwife just checked me for inverted nipples to see if I would need an early lactation consultation. It was weird, because it seems like she could have just asked, rather than looking... She also recommended getting a pump and starting pumping before the baby is here to stimulate production. She didn't say when to do that, though now is still too early. I'd never heard that before. Last time since the baby was stillborn it was all about tricks to make the milk go away as quickly as possible because man that hurt.)
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(I'm 21 weeks right now and my midwife just checked me for inverted nipples to see if I would need an early lactation consultation. It was weird, because it seems like she could have just asked, rather than looking... She also recommended getting a pump and starting pumping before the baby is here to stimulate production. She didn't say when to do that, though now is still too early. I'd never heard that before. Last time since the baby was stillborn it was all about tricks to make the milk go away as quickly as possible because man that hurt.)
You may want to question your midwife on this because she doesn't seem to understand the biochemistry of milk production. Lactation is driven mostly by the hormones prolactin and oxytocin. Prolactin concentrations increase during pregnancy, but it is the sudden drop in estrogen and progesterone levels following delivery that stimulates milk production (along with insulin and cortisol). Oxytocin stimulates contractions needed for release of milk (let-down), but it is also the key hormone that causes uterine contractions during labour (pitocin is the artificial form of this hormone). Use of breast pump while pregnant can essentially cause premature labour/delivery by causing uterine contractions (which is why women are sometimes advised to stimulate nipples in early labor because it causes the body to release oxytocin). At best, use of a breast pump won't increase milk production prior to baby's both because the maternal hormone conditions aren't conducive to milk production. At worst, it triggers premature labour and delivery.
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An important point that I don't think anyone has mentioned: if you're supplementing because of low milk supply and you'd like to reach exclusive breastfeeding, you should also pump to signal to your body that it needs to make more milk.
ETA: Or supplementing for any other reason.
I also want to be clear that I think that it's perfectly reasonable to feed your baby breastmilk or formula or any combination, I just wanted to make sure that people knew that if you feed formula for any reason it can be temporary but only if you pair it with the work to keep up / increase supply. Do some research / ask a supplementing-friendly LC to find out more precisely what's needed.
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(I'm 21 weeks right now and my midwife just checked me for inverted nipples to see if I would need an early lactation consultation. It was weird, because it seems like she could have just asked, rather than looking... She also recommended getting a pump and starting pumping before the baby is here to stimulate production. She didn't say when to do that, though now is still too early. I'd never heard that before. Last time since the baby was stillborn it was all about tricks to make the milk go away as quickly as possible because man that hurt.)
You may want to question your midwife on this because she doesn't seem to understand the biochemistry of milk production. Lactation is driven mostly by the hormones prolactin and oxytocin. Prolactin concentrations increase during pregnancy, but it is the sudden drop in estrogen and progesterone levels following delivery that stimulates milk production (along with insulin and cortisol). Oxytocin stimulates contractions needed for release of milk (let-down), but it is also the key hormone that causes uterine contractions during labour (pitocin is the artificial form of this hormone). Use of breast pump while pregnant can essentially cause premature labour/delivery by causing uterine contractions (which is why women are sometimes advised to stimulate nipples in early labor because it causes the body to release oxytocin). At best, use of a breast pump won't increase milk production prior to baby's both because the maternal hormone conditions aren't conducive to milk production. At worst, it triggers premature labour and delivery.
Seriously. That seems like very dangerous advice for your midwife to be giving. I've only ever heard of using a breastpump while pregnant to stimulate labour well after the due date.
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Seriously. That seems like very dangerous advice for your midwife to be giving. I've only ever heard of using a breastpump while pregnant to stimulate labour well after the due date.
I didn't really question her on it. Since I wasn't referred to the hospital lactation consultant (she's an MSN, ARNP, CNM, who works out of a major hospital and teaches at the medical school- not a lay midwife) we didn't talk about it further. Maybe I misunderstood her, but I'm almost certain that's what she said to do- because I said something about my insurance not covering a pump until later in pregnancy and she said "it's too early to get started just yet anyway"
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So. Anyway. Looking ahead to the next baby, I want to approach things a bit differently. My goals are (1) to recognize that I will have way less time, energy, etc. given that I have a toddler to care for in addition to the baby and (2) to involve my husband more in the care of the new baby. First, I plan to supplement with formula from the beginning, even if it is just a bottle a day. Other than that, I have no idea what I want to do. Despite the hardships, I really did love nursing itself much of the time. On the other hand, pumping was a pain. Does anyone have experience and/or recommendations for doing a mixture of both? I will be going back to work after about 3 months BTW.
My son is 5 months old and I have been back to work for about half of his life (wow that's weird to say it that way!) I am breastfeeding him from 5pm-6am and he gets formula while I am at work- I decided before he was born that I was not going to pump at work.
We gave him a bottle from his first day home. It was a bottle of RTF formula first- I was panicking about my milk coming in and I'm glad we did because he scarfed it down and passed out. For about the next two days I exclusively pumped and he had 95% breastmilk. This allowed me to get lots of rest which was so important. I tried several times each day to get him to latch but there wasn't any pressure because we had bottles of breastmilk ready to go. It wasn't until he was about a week old that everything "clicked" and he got a good latch.
After that first week I breastfed him and found 1 time to pump each day- I was fullest usually after his first morning feeding around 6am. Whatever I pumped, my husband would feed our son at his 10-11 pm feeding. If he was still hungry after that, he got formula (I was really lucky with a good supply so this rarely happened). Again this was HUGE because I could get a 5 hour stretch of sleep. This is what our routine looked like while I was on maternity leave (12 weeks FMLA). My son also got formula about one bottle a week- this was when I went out during the day without him or we were out to lunch/dinner.
Starting around week 8 postpartum, I started introducing one bottle per day of formula. I added an additional bottle each week so that by 11 weeks my son was having formula during the hours I would be at work. I did it gradually so that I had minimal discomfort.
When I went back to work my son did have a problem with taking the formula- but I think really it was a problem being away from me. I managed to pump & freeze about 50 ounces of breastmilk that helped us get through the transition of me going to work- it took about two weeks for him to be back to his normal eating habits during the day.
I am so glad that we gave my son bottles AND formula from day 1, since I knew I was going back to work. Apparently there is a difference in taste between formula and breastmilk. My son never had "nipple confusion" and still loves breastfeeding.
I wish the cultural mindset was that every ounce of breastmilk is "good" for the baby and not every ounce of formula is "bad". I wholeheartedly believe that the reason I am still breastfeeding is because I never wanted to EBF. I wish there were more examples for women of combination feeding. The only example I had was my mom, all of my mommy friends either exclusively BF or FF.
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Millenialworkerbee, thank you so much. This is exactly the type of information I hoped someone could share. I totally agree with you that the focus needs to shift to celebrating the presence of breast milk (however much or little, if any at all) rather than denigrating the amount of formula given.
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Seriously. That seems like very dangerous advice for your midwife to be giving. I've only ever heard of using a breastpump while pregnant to stimulate labour well after the due date.
I didn't really question her on it. Since I wasn't referred to the hospital lactation consultant (she's an MSN, ARNP, CNM, who works out of a major hospital and teaches at the medical school- not a lay midwife) we didn't talk about it further. Maybe I misunderstood her, but I'm almost certain that's what she said to do- because I said something about my insurance not covering a pump until later in pregnancy and she said "it's too early to get started just yet anyway"
I would definitely ask for clarification, as I have never heard of mothers being instructed to actively pump days or weeks before their due date. If she confirms that this is what she wants you to do, you might want to seek a second opinion from an OBGYN to get a different medical perspective on the subject. Perhaps she meant that you can pump a little the day or two before your due date or if you are overdue, but even that is pretty unusual/atypical advice as far as I know. I have however heard mothers of early term or preterm babies (or those with history of lactation problems) being instructed to use the pump in addition to nursing attempts in the first week after delivery to help bring milk in faster or promote a strong supply (preterm and early term babies are notorious for being weak nursers, which can impact the supply/demand cycle). However, it should be noted that if you do have a little one that does nurse well, pumping ontop of on-demand nursing can create oversupply, which can be just as much of a headache and struggle as undersupply.
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Yes thanks Millennialworkerbee, and all others who have posted here. This is such a helpful thread!
I am returning to work 3 days/week in January. You've all got me thinking about whether maybe for my own mental health (in terms of not being so stressed at work about finding time to pump) that maybe it wouldn't be such a bad idea to transition DD to formula for her daytime feeds.
I would be dropping her off at 8 am, so she'd have her breakfast on the boob. I'd pick her up around 4 pm so in plenty of time for her evening feeds (currently 5 pm and 10 pm. not sure when she'll drop the 10 pm one). That would be two out of five feeds a day of formula. I assume that my supply would drop and so I would also need to give her formula on the days that she's at home...there are some cost implications to that. Health implications. Simplifying life implications. I'm just thinking out loud here but appreciate hearing all the different perspectives on this thread.
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Yes thanks Millennialworkerbee, and all others who have posted here. This is such a helpful thread!
I am returning to work 3 days/week in January. You've all got me thinking about whether maybe for my own mental health (in terms of not being so stressed at work about finding time to pump) that maybe it wouldn't be such a bad idea to transition DD to formula for her daytime feeds.
I would be dropping her off at 8 am, so she'd have her breakfast on the boob. I'd pick her up around 4 pm so in plenty of time for her evening feeds (currently 5 pm and 10 pm. not sure when she'll drop the 10 pm one). That would be two out of five feeds a day of formula. I assume that my supply would drop and so I would also need to give her formula on the days that she's at home...there are some cost implications to that. Health implications. Simplifying life implications. I'm just thinking out loud here but appreciate hearing all the different perspectives on this thread.
My supply definitely dropped during the day, but I am still able to breastfeed my son 1-2 extra times a day on the weekends- and I definitely try to encourage it to keep production up! Since you would only be gone for 6 feedings out of 35 in a week I don't think you would have as much trouble keeping your supply up. I lucked out with a pretty good supply though I think.
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Millenialworkerbee, thank you so much. This is exactly the type of information I hoped someone could share. I totally agree with you that the focus needs to shift to celebrating the presence of breast milk (however much or little, if any at all) rather than denigrating the amount of formula given.
You're welcome! If you or anyone else that reads this wants to know more I'm an open book. I just kind of went with the flow and I'm grateful that it is still working for us.
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Within days of my son's birth the nurses started supplementing him with formula. I just couldn't pump enough for him. Thankfully I was able to see past myself far enough to recognize that formula was the least of my son's problems.
I had a similar experience with my second child - apparently when you have a preemie, the nurses are all about the formula! The experience really drove home to me the fact that you can supplement early on and go on to breastfeed long term. If your body is up to it, you can even go on to breastfeed exclusively! My son got formula for about 5 days, then switched to exclusive breastfeeding, and hasn't missed a beat since. I pumped during those 5 days to keep my supply up, and then spent another 2 weeks supplementing with pumped milk after half of his feedings (which had the added benefit of showing me that I was actually producing enough milk).
I'm not planning on any more kids, but if I were, I would absolutely err on the side of supplementing in the first few days. If properly managed (ie, you let the baby nurse before supplementing, or you pump to replace a nursing session), it's no impediment to successful long term breastfeeding.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
I know 6 or 7 people that didn't breastfeed because they were lazy, it's gross, or they didn't want to take the time to learn. These are the people the pro breastfeeding campaigns are after.
The people with actual medical conditions? Different story and of course you can't exclusively breastfeed.
What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
It's a very hard problem, trying to shame those moms that can and do not, while not trying to offend those that want to and can't. I can't honestly think of any way to do that.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
I know 6 or 7 people that didn't breastfeed because they were lazy, it's gross, or they didn't want to take the time to learn. These are the people the pro breastfeeding campaigns are after.
The people with actual medical conditions? Different story and of course you can't exclusively breastfeed.
What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
It's a very hard problem, trying to shame those moms that can and do not, while not trying to offend those that want to and can't. I can't honestly think of any way to do that.
Here's the thing though, shaming moms that can and do not is completely unnecessary. There's very little evidence that breastfeeding a healthy full term baby in a first world country with clean water and safe, easily available formula is objectively better for the baby that formula feeding.
I say this as a mother that exclusively breastfed my baby.
Obviously we should disseminate information about the benefits of breastfeeding. But shaming mother's into breastfeeding their babies, which can be stressful, incredibly painful, time consuming, as well as enjoyable and frugal, depending on your perspective, is wholly unnecessary.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
I know 6 or 7 people that didn't breastfeed because they were lazy, it's gross, or they didn't want to take the time to learn. These are the people the pro breastfeeding campaigns are after.
The people with actual medical conditions? Different story and of course you can't exclusively breastfeed.
What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
It's a very hard problem, trying to shame those moms that can and do not, while not trying to offend those that want to and can't. I can't honestly think of any way to do that.
I can't say this strongly enough: No one is mandated to breastfeed, and no one should be shamed if they elect not to; regardless of the reason.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
I know 6 or 7 people that didn't breastfeed because they were lazy, it's gross, or they didn't want to take the time to learn. These are the people the pro breastfeeding campaigns are after.
The people with actual medical conditions? Different story and of course you can't exclusively breastfeed.
What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
It's a very hard problem, trying to shame those moms that can and do not, while not trying to offend those that want to and can't. I can't honestly think of any way to do that.
I've never done it (pregnant right now), but I understand breastfeeding is tough for a lot of moms, even without factoring in the sleep loss. Moms who choose not to breastfeed are not "lazy" and being characterized as such likely isn't encouraging them to try/continue to try. After hearing I intended to try, my own mom recently told me how "easy" breastfeeding was and all I needed to do was decide to do it. (She's the same person who told me she though vomiting in first trimester was a "waste of time" so she decided not to do it. Been super great support during the pregnancy as you can tell.)
There is so much shaming of moms. People judge what you eat while pregnant, whether you breastfeed, your disciplining style, later eating habits of your kid, and so on. I daresay there is no other area of life where this type of interfering behavior is seen as acceptable. My coworkers report that when they split pickup/drop off, the daycare workers try to shame them if their husbands aren't bringing in the right items at dropoff, rather than talking to husbands who the ones doing it differently than the daycare workers want. Because even that is the fault of the moms. This is not right and it's not acceptable.
Encourage and educate yes, but stop the shaming and let people make their own decisions.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
I know 6 or 7 people that didn't breastfeed because they were lazy, it's gross, or they didn't want to take the time to learn. These are the people the pro breastfeeding campaigns are after.
The people with actual medical conditions? Different story and of course you can't exclusively breastfeed.
What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
It's a very hard problem, trying to shame those moms that can and do not, while not trying to offend those that want to and can't. I can't honestly think of any way to do that.
I agree that it's a hard problem, but honestly, you have to trust the mom to do what's right.
My first son never had formula, and I nursed him for 13.5 months (also: my milk didn't come in until day 5, like fully come in. But he didn't have issues with losing too much weight those first few days.) I had a freezer stash that was huge.
I had friends who:
- nursed twins and built a freezer stash
- tried breastfeeding and couldn't and were heartbroken and sobbing (as in: they went to the local expert LC, who was so busy the best I could do is get her on the phone. Herbs, drugs, pumping, and still the baby lost too much weight and they eventually had to supplement)
- tried breastfeeding and couldn't (no supply) and shrugged and went to formula
- did a combo of formula and breastmilk from the start
- exclusively pumped
I've got friends who are members of LLL and they always have good intentions. "Did you do X? Did you do Y?" Always with the intention of helping.
Some people just give up too soon! Or do they?
Fact is, it's hard. I got plugged ducts and mastitis. With #1, I worked FT, rarely slept, was sick all winter, and then with the mastitis. First six weeks I sobbed in pain (though the phone info from the LC helped.)
With #2, I figured it would be easier. Nope. I was shredded within days. Eventually got past that at 5 weeks. But man, still with the plugged ducts (even though I pumped more often and worked less). I reached out for help and got nothing. So at 8.5 months I said "eff it" and stopped pumping and bought formula. With the idea of combo-ing. Combo-ing lasted 6 weeks till my kiddo was over nursing.
Honestly, it's entirely up to the woman who has to nurse, and pump, and work a job, and take care of other kids, and deal with the emotions and hormones and plugged ducts and cracked nipples, and night time wakeups and mastitis to decide when they've "done enough". Not you, not anybody else.
I can't imagine that you'd want to "shame" anyone.
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I thought about this thread and what I should do to prepare for my New Year's baby, and what I've come up with is:
-get breastfeeding stuff
-get ~5 samples of formula (one non-lactose, although I don't think my kid is likely to be lactose intolerance given its parents and heritage)
-get a couple bottles
-plan to breastfeed
-do a satiety check a couple times, especially if the kid isn't peeing/pooping much
-have a list of LCs/post-partum doulas/etc to ask questions of
That seems reasonable, right?
I wish lactose intolerance can be determined by genes alone. Neither my husband nor I (or anyone in the family) have any allergies but my baby was allergic to a lot of foods (dairy, soy, corn, eggs, fish, wheat, etc). As a result, I was on a super restricted diet and had to EBF since she hated the allergen-free formula taste. The first six months were super hard and things got better once she started solids and reduced dependence on my milk alone. Now thankfully she is out of most allergies, but it took time.
We are gearing up for baby#2 which hopefully should be less stressful.
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My wife felt so pressured to breastfeed even though she clearly wasn't producing enough. At our older son's four-month appointment, his first in a month, he had gained absolutely no weight. Not an ounce. I was a walking zombie, having not slept for more than four hours at a clip in a month. He u clearly wasn't getting enough to eat. I was begging my wife to supplement but she would not. Such is the breastfeeding culture we have in this country. (Looking at photos from this period, he looks like skin and bones at 4 months.)
Thankfully the doctor told us to supplement. I drove right to Costco and bought a canister of formula. Our little guy sucked down three and a half bottles, belched with the gusto of a grown man, and slept for 12 hours -- as did we.
Breastfeeding is wonderful if it works. But it's not for everyone. Our son is now almost 14 and small for his age -- even small considering the height of his parents. Maybe this lost month of growth didn't matter. Maybe he'll have a massive growth spurt or two yet to come.
But if he levels off at three inches shorter than me, I'll always wonder. His younger brother, whom we supplemented with from day one, is projecting to be much taller.
I am not sure how to politely say this but just because your boys aren't the same size does not make breastfeeding inferior. I have two male cousins with the same parents one is 6-5 the other 5-10. That's a genetic differance not diet. My sons are not the same size either. We are trying to raise healthy humans not getting cattle to market weight.
I have struggled with this thread and I suspect that our cultures over medicalization of birth is part of the supply problems woman experience. We get so antsy the second anyone goes past her EDD. We have very high section rates and have made VBAC just about impossible. Epidural rates are high. Maybe my LLLI meetings in the early 2000's were a bit pie in the sky. But lots of people just need encouraging not bottles and formula. I think many of the health consequences to formula feeding or advantages to breastfeeding are not apparent until the second or fourth or seventh decades of life.
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My wife felt so pressured to breastfeed even though she clearly wasn't producing enough. At our older son's four-month appointment, his first in a month, he had gained absolutely no weight. Not an ounce. I was a walking zombie, having not slept for more than four hours at a clip in a month. He u clearly wasn't getting enough to eat. I was begging my wife to supplement but she would not. Such is the breastfeeding culture we have in this country. (Looking at photos from this period, he looks like skin and bones at 4 months.)
Thankfully the doctor told us to supplement. I drove right to Costco and bought a canister of formula. Our little guy sucked down three and a half bottles, belched with the gusto of a grown man, and slept for 12 hours -- as did we.
Breastfeeding is wonderful if it works. But it's not for everyone. Our son is now almost 14 and small for his age -- even small considering the height of his parents. Maybe this lost month of growth didn't matter. Maybe he'll have a massive growth spurt or two yet to come.
But if he levels off at three inches shorter than me, I'll always wonder. His younger brother, whom we supplemented with from day one, is projecting to be much taller.
I am not sure how to politely say this but just because your boys aren't the same size does not make breastfeeding inferior. I have two male cousins with the same parents one is 6-5 the other 5-10. That's a genetic differance not diet. My sons are not the same size either. We are trying to raise healthy humans not getting cattle to market weight.
I have struggled with this thread and I suspect that our cultures over medicalization of birth is part of the supply problems woman experience. We get so antsy the second anyone goes past her EDD. We have very high section rates and have made VBAC just about impossible. Epidural rates are high. Maybe my LLLI meetings in the early 2000's were a bit pie in the sky. But lots of people just need encouraging not bottles and formula. I think many of the health consequences to formula feeding or advantages to breastfeeding are not apparent until the second or fourth or seventh decades of life.
Laura Ingalls, LiveLean wasn't saying breastfeeding doesn't work, but it wasn't working for their son and wife. I think sharing breastfeeding one baby between multiple women may have been a little more common historically, and i understand supplementing with all kinds of things may have occurred a lot as well.
I agree the son's height has little to do with breastfeeding vs formula, I'm also inches shorter than any of my siblings and every one of us was fed the same way. LiveLean, I think you can relax that this one decision hasn't affected your son that much.
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The wife was able to 100% breastfeed. Many people CAN feed without problems.
....What % of moms are able to exclusively breastfeed? I would wager it is much higher than the amount that do.
Based on everything I have read about different breastfeeding problems, I would conservatively estimate that approximately 75-80% of mother-baby pairs can exclusively breastfeed at the breast (nursing) in a manner that is safe and nutritionally adequate for the infant from day 1 of life, in accordance with the recommended feeding guidelines put out by the American Academy of Pediatrics and World Health Organization. Note that exclusivity means absolutely not one drop of formula or donated milk – mom is the only source of nutrition – and the guidelines also recommend exclusive nursing (no pumping or bottles). While that is certainly a strong majority, it is absolutely not an overwhelming majority. The good news is, most mothers will be able to exclusively breastfeed if they have the education, time, resources, desire, and support to do so. They have biological luck on their side, they just need the resources and time to put in the legwork if they want to do it. But this thread isn't about those lucky moms whom biology and nature has graced with plenty of milk and the ability to nurse, it's about those other mothers and babies that no one ever talks about.
Those mother baby pairs that fall into the remaining 20-25% or so can be affected by a number of problems that are not necessarily preventable or fixable. Moms and babies in this unfortunate group can be there for any number of reasons such as delayed lactation (22% of first time moms), chronic low supply (est 5-15% of women), insufficient glandular tissue (<5% women), ineffective milk transfer due to poor suck/swallow coordination (common in early or pre term infants), inability to appropriately latch due to mouth structure of baby (tongue/lip tie), etc. It is critical to note that most of these are not something a mother can know about or prepare for in advance, regardless of how educated and committed she is. So it is absolutely vital that we recognize the possibility of these things and plan for them, rather than just continue to let a subset of babies starve for a few days before we start feeding them appropriately.
To answer the 2nd part of your question, the CDC 2016 breastfeeding report card indicates that 81% of moms have ever breastfed their babies, suggesting that a majority do initiate or attempt it, and at 6months postpartum a slim majority (51%) are still breastfeeding. So in fact, the majority of US women do breastfeed, and keep it up for an extended period. However, it is critical to note that exclusive breastfeeding (absolutely no formula whatsoever) rates are dismal, with only 44% of moms exclusively breastfeeding at 3mo, and 22% at 6mo. Before we assume moms are lazy and just not trying hard enough to exclusively breastfeed however, we must remember that exclusive breastfeeding is 1) not possible for up to 20-25% of mothers as discussed above, and 2) that most moms in the US work, and have to return to work at or prior to the 3mo mark (possibly explaining the huge drop from 44% to 22% between 3 and 6 months). Exclusive breastfeeding is a full time job and requires a baby to have near constant access to mom during the day. Unless a mom has a very flexible workplace for pumping, and has a milk supply that is pretty forgiving of pumping delays and stress, there is a huge chance that exclusive breastfeeding will simply not be feasible once she returns to work. I suspect that the low rates of exclusivity are due to a combination of very real breastfeeding challenges in that 20% subset of women, as well as the sheer difficulty of actually making exclusivity work around a life that involves other responsibilities and time constraints (most women just don't have the luxury (both financially or emotionally) of sitting at home for 6 months to nurse on demand). Finally there are the mental health costs - by 3-4 months, many women just don't like feeling like a dairy cow anymore. They want to be able to diet/exercise without worrying about their supply, or they just want to get a bit more sleep, or maybe they just really really can't stand breastfeeding period. There are many valid reasons that women do not exclusively breastfeed. I have personally talked to many women who could not or did not exclusively breastfeed, and sheer laziness or incompetence has never been a factor.
And what about those 19% of moms who never breastfed? Before we write them off as the lazy ones, it is important to consider who these moms might be:
Women who KNOW they can't breastfeed due to breast surgeries like mastectomies
Women with a history of sexual abuse, for whom the physical discomfort of nursing can be traumatizing (particularly if their breasts were involved in the attack)
Women on medications or with conditions for which breastfeeding is contraindicated (psychiatric medications, HIV+ women, etc)
Women in unique socioeconomic situations (teenage mothers, women who know they will have to return to work within a couple weeks of giving birth)
Women with a history of mental health problems like depression and anxiety for whom breastfeeding may cause excessive stress
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My wife felt so pressured to breastfeed even though she clearly wasn't producing enough. At our older son's four-month appointment, his first in a month, he had gained absolutely no weight. Not an ounce. I was a walking zombie, having not slept for more than four hours at a clip in a month. He u clearly wasn't getting enough to eat. I was begging my wife to supplement but she would not. Such is the breastfeeding culture we have in this country. (Looking at photos from this period, he looks like skin and bones at 4 months.)
Thankfully the doctor told us to supplement. I drove right to Costco and bought a canister of formula. Our little guy sucked down three and a half bottles, belched with the gusto of a grown man, and slept for 12 hours -- as did we.
Breastfeeding is wonderful if it works. But it's not for everyone. Our son is now almost 14 and small for his age -- even small considering the height of his parents. Maybe this lost month of growth didn't matter. Maybe he'll have a massive growth spurt or two yet to come.
But if he levels off at three inches shorter than me, I'll always wonder. His younger brother, whom we supplemented with from day one, is projecting to be much taller.
I am not sure how to politely say this but just because your boys aren't the same size does not make breastfeeding inferior. I have two male cousins with the same parents one is 6-5 the other 5-10. That's a genetic differance not diet. My sons are not the same size either. We are trying to raise healthy humans not getting cattle to market weight.
I have struggled with this thread and I suspect that our cultures over medicalization of birth is part of the supply problems woman experience. We get so antsy the second anyone goes past her EDD. We have very high section rates and have made VBAC just about impossible. Epidural rates are high. Maybe my LLLI meetings in the early 2000's were a bit pie in the sky. But lots of people just need encouraging not bottles and formula. I think many of the health consequences to formula feeding or advantages to breastfeeding are not apparent until the second or fourth or seventh decades of life.
Laura, the idea that supplementing ruins breastfeeding has been debunked. In fact, newer studies now show that when done appropriately, supplementing in the first few days/weeks of life is associated with improved breastfeeding outcomes months later. Will find the studies and will post them later (on my way to bed now). These outdated recommendations are the exact thinking that landed babies like my daughter in the hospital. I was worried about her the night after discharge, but over and over again the manuals and guidelines and support websites just kept saying no bottles, no supplementation! I wanted to succeed so badly, I followed this advice and it was a terrible mistake. Mothers need to be encouraged to FEED THEIR BABIES, not encouraged to strive for an ideal version of infant feeding that may or may not be working. Perhaps if we empowered mothers with knowledge and education on how to supplement while breastfeeding before they even deliver, we would have fewer starving babies and more successful breastfeeding relationships.
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As someone who strongly follows science, read extensively on the topic, and would never do anything to remotely jeopardize my daughter's health, I have no issues with the fact that at one month, we switched completely to formula. We were going to wait much longer, but early latching issues led to severely damaged nipples (hunks of skin missing, extreme pain and constant bleeding, high levels of stress and anxiety around feeding time for my wife), which led to several weeks of religious pumping so she could heal, with the milk production nevertheless dwindling to no more than a couple ounces/day. This was unsurprising given that my wife, god bless her, soldiered on through the pain and breast fed the whole first week but the baby still lost around 12% bodyweight due to low milk production. By the end of the entire ordeal, we were forced to feed our baby 80-90% formula anyway so we decided it wasn't worth the effort to continue.
Anyway, if I thought there would be significant benefit to soldiering on with the paltry pumping output, I would have still pushed for it, but I have seen no credible evidence whatsoever that breast milk meaningfully does anything better except maybe slightly reduce illness, which is by far the most apparent in premature babies (not applicable to our situation). Other supposed benefits like slightly higher IQs, etc., are pretty much entirely attributable to demographic correlations with populations that tend to breast feed more. This whole breast is best mother shaming movement is deplorable, if you ask me. Not only is it offensive, but it's also not even based on any actual evidence, much like, for example, the anti-vaccine movement.
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Here is a 2013 study showing that limited supplementation in the first few days of life (before mom's milk arrives, typically by 72hrs postpartum) can actually improve breastfeeding rates at 1 week and 3 months in those infants who have already lost >5% of their body weight. The sample is small, but it was a randomized trial (the "gold standard" for scientific inquiries) and was reviewed and published by a prestigious and rigorous peer reviewed journal, Pediatrics.
http://pediatrics.aappublications.org/content/early/2013/05/08/peds.2012-2809
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Interesting to see different approaches. Our experience in Canada was pretty awesome.
With my two babes the hospital conducted repeat bilirubin tests before discharging. The first babe did not get discharged for 5 days as her bilirubin levels did not decrease in a normal manner. The second had normal bilirubin and was discharged at 24 hours. A week later the public health nurse came to our house and repeated the bilirubin test as a standard home check. At the time they also weighed the babes again to check for weight gain; if the babes hadn't gained weight you get assigned follow up visits (repeated until the nurse is satisfied that everything is normal).
The Lactation Consultant (LC) set us up with formula for our first due to the high bilirubin on day 2. The instructions were to do both (BF for bonding/food and Formula), as well as we kept a log of all diapers and feedings. We didn't see it as a shame thing, we saw it as everyone was working for the child's best interest.
For those who feel shamed, it takes a community to raise a child. We are all the products of our friends and families and that includes being shamed. I was shamed when I picked my nose, didn't wash my hands in the bathroom, didn't comb my hair (kids do disgusting things, get use to it) etc. This is a normal part of society, encouraging us all to achieve something better if possible.
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Interesting to see different approaches. Our experience in Canada was pretty awesome.
With my two babes the hospital conducted repeat bilirubin tests before discharging. The first babe did not get discharged for 5 days as her bilirubin levels did not decrease in a normal manner. The second had normal bilirubin and was discharged at 24 hours. A week later the public health nurse came to our house and repeated the bilirubin test as a standard home check. At the time they also weighed the babes again to check for weight gain; if the babes hadn't gained weight you get assigned follow up visits (repeated until the nurse is satisfied that everything is normal).
The Lactation Consultant (LC) set us up with formula for our first due to the high bilirubin on day 2. The instructions were to do both (BF for bonding/food and Formula), as well as we kept a log of all diapers and feedings. We didn't see it as a shame thing, we saw it as everyone was working for the child's best interest.
For those who feel shamed, it takes a community to raise a child. We are all the products of our friends and families and that includes being shamed. I was shamed when I picked my nose, didn't wash my hands in the bathroom, didn't comb my hair (kids do disgusting things, get use to it) etc. This is a normal part of society, encouraging us all to achieve something better if possible.
It sounds like you had awesome supports! I so wish combination feeding/supplementing with formula was recommended to us when it was clear my daughter was at risk for hyperbilirubinemia, but we were just encouraged to see what happened with exclusive breastfeeding (even though that was a much more risky feeding approach for my daughter). When she deteriorated, only THEN were we encouraged to supplement (but you know, by that point she was re-hospitalized because she was so sick). It was a completely reactionary approach to deterioration, not a proactive/preventative one.
As far as shame goes however, shaming and stigmatizing formula use is not the same thing as stigmatizing completely optional/voluntary behaviors like picking your nose or trying recreational drugs for the first time. You do not need to pick your nose or take drugs, but babies must eat a certain minimum amount of food to stay healthy and safe. As I mentioned in my post, approximately 20% of mothers might not be able to safely produce enough milk for their babies at some point (either in the first week after delivery, or longer term). The ability to exclusively breastfeed safely is not 100% in a woman’s control, so encouraging widespread public health pressure to push women to meet ideal standards as if it IS 100% in their control is just flat out dangerous for a subset of babies. When we stigmatize formula and shame women for not exclusive breastfeeding, we create an environment where 1) we perpetuate the myth that practically everyone can exclusively breastfeed if they just try hard enough, which then results in 2) women and providers being more likely to wait and see rather than proactively seeking to prevent deterioration in the first place.
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Interesting to see different approaches. Our experience in Canada was pretty awesome.
With my two babes the hospital conducted repeat bilirubin tests before discharging. The first babe did not get discharged for 5 days as her bilirubin levels did not decrease in a normal manner. The second had normal bilirubin and was discharged at 24 hours. A week later the public health nurse came to our house and repeated the bilirubin test as a standard home check. At the time they also weighed the babes again to check for weight gain; if the babes hadn't gained weight you get assigned follow up visits (repeated until the nurse is satisfied that everything is normal).
The Lactation Consultant (LC) set us up with formula for our first due to the high bilirubin on day 2. The instructions were to do both (BF for bonding/food and Formula), as well as we kept a log of all diapers and feedings. We didn't see it as a shame thing, we saw it as everyone was working for the child's best interest.
For those who feel shamed, it takes a community to raise a child. We are all the products of our friends and families and that includes being shamed. I was shamed when I picked my nose, didn't wash my hands in the bathroom, didn't comb my hair (kids do disgusting things, get use to it) etc. This is a normal part of society, encouraging us all to achieve something better if possible.
The key is that no one should be shamed for how they choose to feed their baby, regardless of why/how they come to that decision. Mothers may choose formula for a number of reasons (medication not compatible with breastfeeding, work environment that doesn't readily allow pumping, not producing enough milk, they don't like it, whatever), and that is their decision. It might not be the choice you would make, but to feel like it is your place to judge/shame them for it is offensive. For the record, both of my children were exclusively breastfed. Interestingly, I was judged/shamed because of how long they nursed (they self-weaned at 2.5 and 3.5 years, respectively), which is also offensive.
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Interesting to see different approaches. Our experience in Canada was pretty awesome.
With my two babes the hospital conducted repeat bilirubin tests before discharging. The first babe did not get discharged for 5 days as her bilirubin levels did not decrease in a normal manner. The second had normal bilirubin and was discharged at 24 hours. A week later the public health nurse came to our house and repeated the bilirubin test as a standard home check. At the time they also weighed the babes again to check for weight gain; if the babes hadn't gained weight you get assigned follow up visits (repeated until the nurse is satisfied that everything is normal).
The Lactation Consultant (LC) set us up with formula for our first due to the high bilirubin on day 2. The instructions were to do both (BF for bonding/food and Formula), as well as we kept a log of all diapers and feedings. We didn't see it as a shame thing, we saw it as everyone was working for the child's best interest.
For those who feel shamed, it takes a community to raise a child. We are all the products of our friends and families and that includes being shamed. I was shamed when I picked my nose, didn't wash my hands in the bathroom, didn't comb my hair (kids do disgusting things, get use to it) etc. This is a normal part of society, encouraging us all to achieve something better if possible.
In addition to what lbd said, there is also no evidence that promoting breast feeding no matter what is categorically in the child's best interest, and often it very much is not (e.g. mother physicially can't produce enough milk). To repeat the above, any serious research into the issue will reveal that with the exception of premature or extremely low birth rate babies, there is no credible evidence that exclusively formula feeding from day one will have any negative impact except maybe slightly increasing the rate of colds, ear-infections, etc., something that seems most prevalent in lower birth weight babies. The village in your analogy is more akin to a mob that doesn't actually know why it is trying to force a particular behavior but does so anyway.
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Anyway, if I thought there would be significant benefit to soldiering on with the paltry pumping output, I would have still pushed for it, but I have seen no credible evidence whatsoever that breast milk meaningfully does anything better except maybe slightly reduce illness, which is by far the most apparent in premature babies (not applicable to our situation). Other supposed benefits like slightly higher IQs, etc., are pretty much entirely attributable to demographic correlations with populations that tend to breast feed more. This whole breast is best mother shaming movement is deplorable, if you ask me. Not only is it offensive, but it's also not even based on any actual evidence, much like, for example, the anti-vaccine movement.
You are correct – the most robust evidence for the benefits of breastfeeding healthy, full term infants are a mild-moderate decrease in the incidence of certain low level illnesses (respiratory etc), but even this is not earth shattering.
All of the other associations (obesity, diabetes, etc) are overwhelmingly confounded with socioeconomic status. Guess who uses more formula? Poorer, less educated mothers. Who is more likely to be obese/diabetic/etc regardless of breastfeeding status? Yup, you guessed it. In fact, a study by Ohio State breastfeeding researchers found that when you compare breastfed and formula fed siblings to eachother (within the same family) there was no difference in health outcomes. Only when they opened the analysis up and compared breastfed babies to formula fed babies from different families did they see those highly lauded positive associations between breastfeeding and better health. In other words, it doesn’t seem to matter if you breastfeed, mixed feed, or formula feed as long as you ARE SIMILAR TO THE TYPE OF PARENTS/FAMILY THAT IS MORE LIKELY TO BREASTFEED. And who is more likely to breastfeed? Well off, highly educated, health conscious people – the healthiest subgroup around to begin with. This group is the one who is likely to practice pre-conception self care, time their pregnancies, attend all prenatal appointments, have decent maternity leaves, follow healthier diets, exercise more frequently, live in safer locations, and generally experience less physical and emotional stress than their lower SES counterparts.
So why is there so much ado about breastfeeding if science is showing us that we have overstated/exaggerated the benefits to babies? Well, there are a couple reasons. First, is that breastfeeding is truly very important for a subset of babies, like premies in the hospital. These infants tend to have lower rates of necrotizing enterocolitis and clearly do better on a breast milk diet. But while this is very important, too many people have erroneously assumed that the same level of benefit would extend to full term babies. The research however has simply not shown this to be true. Another reason is that healthy formula use is really predicated on safe water supplies and access to well regulated formula. In developing nations where women do not have these things, formula use can be deadly (due to mixing with contaminated water, or due to formula rationing and inappropriate usage). So once again, people saw the devastating effects of formula in impoverished countries and assumed that meant formula would also be bad for women in industrialized nations. Another erroneous assumption.
But perhaps most importantly, it turns out that breastfeeding is great for MOM. Yup – mom seems to reap more benefits from breastfeeding than baby. Breastfeeding can help improve postpartum recovery, and is well known for delaying a woman’s return to fertility. Breastfeeding women on average get their periods 3-4 months later than women who formula feed. This prevents mom from getting pregnant again too quickly, which can wreck havoc on her body and/or result in poorer outcomes for the new fetus/baby. Reduced fertility also has been shown to have longer term benefits for moms, with women who experience fewer menstrual cycles in their lifetime being at lower risk for certain reproductive cancers. Other studies have shown that breastfeeding women are more likely to lose their baby weight more rapidly. And a few have shown that longer term breastfeeding (having breastfed for more than a year of your life, either with a single baby or across different babies) is associated with lower breast cancer risk. But of course, this could also be confounded by socioeconomic status as cancer rates are notoriously higher in more vulnerable populations anyway. It is important to know though, that these benefits are not limited only to mothers who manage to exclusively breastfeed! Any breastfeeding can result in health benefits for mom, even if baby is not 100% breastfed.
In short, there is no clear evidence that exclusive breastfeeding by itself will result in a healthier, smarter baby. But there is good evidence that it might be beneficial to mom. Moms should not obsess about exclusivity but instead focus on enjoying breastfeeding, even if that means accepting a bottle of formula every now and then. And parents should strive to adopt and encourage the other more critical healthy behaviors in their families if they want to make a big impact on their kids' health.
Can post resources/sources if people want…just figured I’d hold off unless people were interested.
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LBD, thank you for sharing your professional knowledge here. I'm due with my first next May and I'm feeling more empowered around breastfeeding now that I've decided to have formula in the house as a backup and I know I can supplement without worrying about ''nipple confusion'' etc.
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LBD, thank you for sharing your professional knowledge here. I'm due with my first next May and I'm feeling more empowered around breastfeeding now that I've decided to have formula in the house as a backup and I know I can supplement without worrying about ''nipple confusion'' etc.
Happy to hear that you are feeling good about breastfeeding! The best advice I received (after the fact of course) was this:
1. There is no "right" or "best" way to breastfeed - it looks different for everyone. Some moms can do it exclusively, some moms only nurse, some moms nurse and pump, some nurse/pump/formula feed, some just nurse and top up with formula, and others do a mix of all of these at different points based on changing circumstances. Know that whatever works best for you is the right way to breastfeed, and enjoy your successes as defined by your own experience (not someone else's standards).
2. Find flexible, openminded breastfeeding support BEFORE you have the baby - Too many women are only exposed to ob/gyns, midwives, breastfeeding classes, and breastfeeding resources that push a singular, "ideal" vision of what breastfeeding should be. Then when they struggle or don't breastfeed the "right" way, they feel like a failure or abnormal, or worse (like me) end up putting their baby in harm's way. Make sure your providers, your hospital, and your breastfeeding support network have an inclusive understanding about breastfeeding before you actually have the baby. Look for providers who are absolutely willing to show you how to supplement while breastfeeding, and support groups that encourage and empower mothers who mixed feed. If you ask for mixed feeding resources and people just lecture you about the importance of exlusivity, or assure you that you "won't need" anything other than your milk, find someone else who is more compassionate, openminded, and evidence based. The Fed is Best page on Facebook is a great little support network/resource that you can immediately tap into/locate.
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Interesting to see different approaches. Our experience in Canada was pretty awesome.
With my two babes the hospital conducted repeat bilirubin tests before discharging. The first babe did not get discharged for 5 days as her bilirubin levels did not decrease in a normal manner. The second had normal bilirubin and was discharged at 24 hours. A week later the public health nurse came to our house and repeated the bilirubin test as a standard home check. At the time they also weighed the babes again to check for weight gain; if the babes hadn't gained weight you get assigned follow up visits (repeated until the nurse is satisfied that everything is normal).
The Lactation Consultant (LC) set us up with formula for our first due to the high bilirubin on day 2. The instructions were to do both (BF for bonding/food and Formula), as well as we kept a log of all diapers and feedings. We didn't see it as a shame thing, we saw it as everyone was working for the child's best interest.
For those who feel shamed, it takes a community to raise a child. We are all the products of our friends and families and that includes being shamed. I was shamed when I picked my nose, didn't wash my hands in the bathroom, didn't comb my hair (kids do disgusting things, get use to it) etc. This is a normal part of society, encouraging us all to achieve something better if possible.
In addition to what lbd said, there is also no evidence that promoting breast feeding no matter what is categorically in the child's best interest, and often it very much is not (e.g. mother physicially can't produce enough milk). To repeat the above, any serious research into the issue will reveal that with the exception of premature or extremely low birth rate babies, there is no credible evidence that exclusively formula feeding from day one will have any negative impact except maybe slightly increasing the rate of colds, ear-infections, etc., something that seems most prevalent in lower birth weight babies. The village in your analogy is more akin to a mob that doesn't actually know why it is trying to force a particular behavior but does so anyway.
I'm not sure I'd call family and friends a mob, they genuinely care about the child. I stand by the village analogy, I have a village around me raising my children (including teachers, friends, doctors, and hundreds more). I think I'd be ungrateful to think I was doing it all on my own, even strangers play a part.
Most people are responding to what they learned from professionals; my MIL was taught formula was best, SIL was taught BF was best (30 years apart); we discussed this in the hospital. The historical context is important to remember, both people were taught by Doctors and professionals (like LBD) with contradicting advice. Can you blame them for being confused and offering advice they heard from a doctor when they delivered? They were indoctrinated with professional advice, generally I trust doctors and will do exactly what they tell me to do and pass it on because I want everyone else to be healthy too. Its not shaming when people repeat stuff they heard from Doctors is it?
I'm not attacking LBD, just pointing out the different approaches in the past 50 years. People are actually trying to help by repeating professional advice. If you want to be taken seriously, you have to acknowledge that this issue was created by doctors and now we have other professionals standing up and telling them they're wrong and we're right. The average person doesn't want to research, they want the professionals to get a consistent message and tend to trust the professional in the room and not on the internet.
I think some people need to step back and instead of feeling ashamed they should try to empathize and see the other person for being helpful. Sure some people deliver the message poorly, not everyone communicates well. The intent is still the same, they want you to raise your child to be happy and healthy, that's the point of them repeating messages they were told. I'm grateful people like LBD helped at the hospital, I'm also grateful the MIL told us contradicting information. I'd rather have that then silence from disinterested relatives, its a sign of caring and not shaming.
LBD; I think we had standard care for Canada, when you take out the costs of keeping babies in the hospital most people tend to be more cautious.
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I'm not disagreeing with you. But the breast is best "movement" (if you will) goes well beyond friends and family members. Many nosy strangers will happily insert themselves into your life if they know you're formula feeding. Most damagingly, this includes many (dare I say most?) health professionals, who should definitely know better. I suppose I can't blame aunt Sally for believing the lactation consultant, but I can definitely blame the lactation consultant or pediatrician for spreading misinformation.
Sure, breast feeding in public has its own negative connotations to some, but that's primarily based on squeamishness (I do acknowledge there is still plenty of judgement on things like how long you breast feed and so forth). There are many out there that will tell you that you are severely harming your baby by formula feeding. They will often do so in extremely nasty terms. These people are ignorant and mean and in no way helping raise the child they purport to "protect."
The thing is, professionals change their mind all the time based on the current best evidence. Look at sleeping position for another easy example. If you want to be taken seriously, you have to acknowledge that your opinion might be based on outdated information and you shouldn't jump to criticize and insult someone who may know more about the topic than you do and/or be facing circumstances you don't understand. to be clear, I'm not saying you are doing this specifically, but I don't see why I should be the only one held to a standard of trying to understand other people's perspective while they get a pass because they can't be bothered to research an issue.
It sounds like you and your family had friendly and open discussions on the topic. Good for you. Many many others are not so lucky and are shamed and insulted for those choices, often by their own "village," which as you can probably imagine makes the whole ordeal much more emotionally difficult. Families facing that situation should know that they are not alone and that many of us know that they are making good choices in the best interest of their baby, regardless of what some ignorant busybody tries to tell them.
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I don't have time to read the whole post right now bc am the working parent of an infant, but, yes to LBD's originating post.
I had a similar experience - baby lost 10% of birthweight, got dehydrated and billi levels spiked. He wasn't rehospitalized but we got close. B Even though we had a straightforward vaginal delivery, immediate skin, lactation support, baby on the tit 24/7, none of that changed the fact that my milk didn't arrive until 5 days pp. ecause I was induced at 42 weeks, I had been pumping antenatally for 2 weeks and I saved all that colostrum. Fed it to him in bottles and that was enough to turn things around, but formula supplementation was the next step.
He's still exclusively breastfed at 3 months but his weight gain is a litttttle on the low side, so if he doesn't catch up I may reconsider supplementing. Plus, now I'm working p/t and don't have a fixed office so it's really hard to find enough pumping opportunities.
As for "breastmilk is cheaper"--- given how much more food I'M eating, I just don't think this is true at all.
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I'm not disagreeing with you. But the breast is best "movement" (if you will) goes well beyond friends and family members. Many nosy strangers will happily insert themselves into your life if they know you're formula feeding. Most damagingly, this includes many (dare I say most?) health professionals, who should definitely know better. I suppose I can't blame aunt Sally for believing the lactation consultant, but I can definitely blame the lactation consultant or pediatrician for spreading misinformation.
Sure, breast feeding in public has its own negative connotations to some, but that's primarily based on squeamishness (I do acknowledge there is still plenty of judgement on things like how long you breast feed and so forth). There are many out there that will tell you that you are severely harming your baby by formula feeding. They will often do so in extremely nasty terms. These people are ignorant and mean and in no way helping raise the child they purport to "protect."
The thing is, professionals change their mind all the time based on the current best evidence. Look at sleeping position for another easy example. If you want to be taken seriously, you have to acknowledge that your opinion might be based on outdated information and you shouldn't jump to criticize and insult someone who may know more about the topic than you do and/or be facing circumstances you don't understand. to be clear, I'm not saying you are doing this specifically, but I don't see why I should be the only one held to a standard of trying to understand other people's perspective while they get a pass because they can't be bothered to research an issue.
It sounds like you and your family had friendly and open discussions on the topic. Good for you. Many many others are not so lucky and are shamed and insulted for those choices, often by their own "village," which as you can probably imagine makes the whole ordeal much more emotionally difficult. Families facing that situation should know that they are not alone and that many of us know that they are making good choices in the best interest of their baby, regardless of what some ignorant busybody tries to tell them.
I'm glad you researched. Are you feeling shamed? Is shame inherently bad? Why was Aunt Sally or the LC wrong, she was repeating the best scientific knowledge as told to her 20 years ago? the LC never spread misinformation, it was later changed to current scientific knowledge.
Stepping back from BF and using an analogy here. We have a court case coming up in Canada. Public shaming of the parents has already started because they "believed" that holistic medicine would cure their child of pneumonia. I absolutely believe these people should be ashamed of their actions, their belief's had tragic consequences (a round of antibiotics would have worked). Its worth noting, they don't feel ashamed and would do it again based on their scientific research, unfortunately they have other children and its a possibility. The shame cycle exists to discourage anyone else from not treating sick children, hopefully we can all see shame is warranted here.
Shame is just a societal tool to pressure better behavior from all of us. I don't think its wrong to feel ashamed at times, we all should at times. Viewing shame as a horrible emotion is detrimental, shame exists to encourage us all to research, learn and improve. People without shame are also known as psychopaths (clinical sign of a psychopath is no shame), nobody wants that.
What you're espousing is that nobody should ever shame or feel ashamed by their actions. Can you imagine the consequences if people didn't discuss the best techniques to raise their children? its precisely because of shame that this conversation happened, the fear of shame spurred the conversation for me as well. Pretty much everyone I know who feels shame either corrects their actions or finds out why they're correct and stand their ground (in general, not just breastfeeding and formula).
As the parent you don't ever get a pass, I know what you meant but its not a good argument to equate yourself with strangers in your child's life. In the spheres of influence you're number one to the child. You're held to a higher standard precisely because you are the most important person, why would you compare yourself to a stranger in your child's life? Who better to have final say on your child's upbringing than you? Its definitely not myself, some random from the internet. You have a vested interest in the topic, strangers don't.
What I like about the shame cycle is that it encourages important conversations. Instead of seeing it as a negative how about we discuss the positive implications; like this thread that spread knowledge.
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Huh? Not sure how you got all of that. All I'm espousing is that ignorant people not shame other people based on that ignorance. I never made sweeping statements about shame as a legitimate social tool, at times. Shame is an important way to combat racism, for example. But shaming a mother for using formula, no matter how "well-intentioned" is not remotely comparable to that.
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What if I told you that for my second kid I'm PLANNING to supplement breastfeeding with formula purely for the convenience of it??
I exclusively breast-fed my first-born until I had to go back to work at 4 months. Then I became a pumping martyr at work and life was untenable. I produce exactly enough milk for a baby who breastfeeds, but pumping doesn't really cut it. I was pumping for hours at work, unable to get any work done, taking work home, sleeping was a nightmare...and at daycare they were giving my son formula anyway because there wasn't enough breastmilk for him.
Not worth the stress. Not at all. I remember the blissful joy I felt when I put the pump on the shelf, gave my son formula at daycare, and breast-fed him at home.
This time my daughter (due Christmas Eve) is going to get formula in addition to breastmilk right from the beginning, even if I have the same experience as with my son (no big problems nursing). I want to be able to leave the house for an hour or two. I want my husband to be able to take a night-feeding. A little formula never hurt anyone. Both my husband and me were exclusively formula fed!
Just got JUDGED by one of my midwives for bringing this up at my last prenatal appointment! I'm giving birth at a pretty militant baby-friendly hospital (because I watched the stupid "Business of Being Born" and wanted to be a crunchy mom the first time around, before reality hit, and I don't want to go to a different hospital even though I disagree with the baby-friendly thing). Whatever. It took parenting my first kid to realize that avoiding judgment as a mom is impossible. You just have to do what's right for your kid and your family and be confident that you do indeed love your kid and people have indeed been doing this for millenia and everything is indeed going to be fine.
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What if I told you that for my second kid I'm PLANNING to supplement breastfeeding with formula purely for the convenience of it??
I exclusively breast-fed my first-born until I had to go back to work at 4 months. Then I became a pumping martyr at work and life was untenable. I produce exactly enough milk for a baby who breastfeeds, but pumping doesn't really cut it. I was pumping for hours at work, unable to get any work done, taking work home, sleeping was a nightmare...and at daycare they were giving my son formula anyway because there wasn't enough breastmilk for him.
Not worth the stress. Not at all. I remember the blissful joy I felt when I put the pump on the shelf, gave my son formula at daycare, and breast-fed him at home.
This time my daughter (due Christmas Eve) is going to get formula in addition to breastmilk right from the beginning, even if I have the same experience as with my son (no big problems nursing). I want to be able to leave the house for an hour or two. I want my husband to be able to take a night-feeding. A little formula never hurt anyone. Both my husband and me were exclusively formula fed!
Just got JUDGED by one of my midwives for bringing this up at my last prenatal appointment! I'm giving birth at a pretty militant baby-friendly hospital (because I watched the stupid "Business of Being Born" and wanted to be a crunchy mom the first time around, before reality hit, and I don't want to go to a different hospital even though I disagree with the baby-friendly thing). Whatever. It took parenting my first kid to realize that avoiding judgment as a mom is impossible. You just have to do what's right for your kid and your family and be confident that you do indeed love your kid and people have indeed been doing this for millenia and everything is indeed going to be fine.
Thanks for posting this. And thanks to the OP for starting this thread and for all the wonderful information. It's refreshing.
I'm planning to do the same thing when I go back to work at 6 months (hmm, maybe have already mentioned this upthread). I teach and my days are packed with lectures and student meetings, I barely get time to eat lunch let alone pump. My priority will be getting back to DD as soon as possible (don't have set hours) and I can power through my work more quickly if I'm not fitting pumping in. I'm also dealing with some postpartum anxiety and feeling very overwhelmed at the thought of going back to work and putting DD in daycare. Planning in advance how to simplify my routine by giving myself permission to half-wean her has been helpful for my mental health. I asked my pediatrician if she thought there would be any negative effects to switching to around 40% formula (two daytime feeds formula; breakfast/dinner/dream feeds from the boob). She was wonderful and reassuring that this will be fine! Very encouraging and said she did the same thing when she went back to work at 4 months and that it sounded like a great plan to her. Now I'm feeling very lucky to have such an understanding, no-pressure pediatrician.
[Man but those norms in favor of BF no matter what are strong...even as I write this I feel defensive, even though I would never judge another mum for doing the same...]
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I'm glad you researched. Are you feeling shamed? Is shame inherently bad? Why was Aunt Sally or the LC wrong, she was repeating the best scientific knowledge as told to her 20 years ago? the LC never spread misinformation, it was later changed to current scientific knowledge.
Stepping back from BF and using an analogy here. We have a court case coming up in Canada. Public shaming of the parents has already started because they "believed" that holistic medicine would cure their child of pneumonia. I absolutely believe these people should be ashamed of their actions, their belief's had tragic consequences (a round of antibiotics would have worked). Its worth noting, they don't feel ashamed and would do it again based on their scientific research, unfortunately they have other children and its a possibility. The shame cycle exists to discourage anyone else from not treating sick children, hopefully we can all see shame is warranted here.
Shame is just a societal tool to pressure better behavior from all of us. I don't think its wrong to feel ashamed at times, we all should at times. Viewing shame as a horrible emotion is detrimental, shame exists to encourage us all to research, learn and improve. People without shame are also known as psychopaths (clinical sign of a psychopath is no shame), nobody wants that.
What you're espousing is that nobody should ever shame or feel ashamed by their actions. Can you imagine the consequences if people didn't discuss the best techniques to raise their children? its precisely because of shame that this conversation happened, the fear of shame spurred the conversation for me as well. Pretty much everyone I know who feels shame either corrects their actions or finds out why they're correct and stand their ground (in general, not just breastfeeding and formula).
As the parent you don't ever get a pass, I know what you meant but its not a good argument to equate yourself with strangers in your child's life. In the spheres of influence you're number one to the child. You're held to a higher standard precisely because you are the most important person, why would you compare yourself to a stranger in your child's life? Who better to have final say on your child's upbringing than you? Its definitely not myself, some random from the internet. You have a vested interest in the topic, strangers don't.
What I like about the shame cycle is that it encourages important conversations. Instead of seeing it as a negative how about we discuss the positive implications; like this thread that spread knowledge.
OR we could have the conversations in a nonjudgmental manner, as we seek to encourage and support mothers who are struggling to do what they believe is best for their baby, themselves, and their families.
I personally wonder if mothers didn't face so much judgment, whether that would reduce postpartum depression rates. Have you ever considered the negative effects of using shame as a behavioral tool, rather than a more positive focused method?
Why do strangers assume they know what is best and further, that they have a right to intrude into the personal life of others to interject their opinions, when they have no idea:
- if the mother can breastfeed (medications? illness? insufficient milk? etc.)
- if the mother has sufficient support (time off work? a pump that works, rather than a cheap one covered by ACA that breaks/works poorly?)
- if the mother is getting enough sleep/rest so she is not a danger to herself and others.
- if the mother is uncomfortable breastfeeding in public by others seeking to shame for that behavior (despite it's legality, it happens)
- if the mother is uncomfortable breastfeeding because of prior sexual assault, etc.
I'm now envisioning your world, where people go around shaming each other for anything they deem bad. A few thoughts:
1) That sounds perfectly horrid place to live where everyone is mean to everyone else rather than supportive. This trains up bullies of our children as well, who perpetuate this negative-focused cycle.
2) I expect the behavior to go underground rather than change. No reason to tell the lactation consultant you're still having issues - just tell her that you're all set, and buy formula online. Stop visiting and seeing the preachy friends. etc.
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What if I told you that for my second kid I'm PLANNING to supplement breastfeeding with formula purely for the convenience of it??
I exclusively breast-fed my first-born until I had to go back to work at 4 months. Then I became a pumping martyr at work and life was untenable. I produce exactly enough milk for a baby who breastfeeds, but pumping doesn't really cut it. I was pumping for hours at work, unable to get any work done, taking work home, sleeping was a nightmare...and at daycare they were giving my son formula anyway because there wasn't enough breastmilk for him.
Not worth the stress. Not at all. I remember the blissful joy I felt when I put the pump on the shelf, gave my son formula at daycare, and breast-fed him at home.
This time my daughter (due Christmas Eve) is going to get formula in addition to breastmilk right from the beginning, even if I have the same experience as with my son (no big problems nursing). I want to be able to leave the house for an hour or two. I want my husband to be able to take a night-feeding. A little formula never hurt anyone. Both my husband and me were exclusively formula fed!
Just got JUDGED by one of my midwives for bringing this up at my last prenatal appointment! I'm giving birth at a pretty militant baby-friendly hospital (because I watched the stupid "Business of Being Born" and wanted to be a crunchy mom the first time around, before reality hit, and I don't want to go to a different hospital even though I disagree with the baby-friendly thing). Whatever. It took parenting my first kid to realize that avoiding judgment as a mom is impossible. You just have to do what's right for your kid and your family and be confident that you do indeed love your kid and people have indeed been doing this for millenia and everything is indeed going to be fine.
Thanks for posting this. And thanks to the OP for starting this thread and for all the wonderful information. It's refreshing.
I'm planning to do the same thing when I go back to work at 6 months (hmm, maybe have already mentioned this upthread). I teach and my days are packed with lectures and student meetings, I barely get time to eat lunch let alone pump. My priority will be getting back to DD as soon as possible (don't have set hours) and I can power through my work more quickly if I'm not fitting pumping in. I'm also dealing with some postpartum anxiety and feeling very overwhelmed at the thought of going back to work and putting DD in daycare. Planning in advance how to simplify my routine by giving myself permission to half-wean her has been helpful for my mental health. I asked my pediatrician if she thought there would be any negative effects to switching to around 40% formula (two daytime feeds formula; breakfast/dinner/dream feeds from the boob). She was wonderful and reassuring that this will be fine! Very encouraging and said she did the same thing when she went back to work at 4 months and that it sounded like a great plan to her. Now I'm feeling very lucky to have such an understanding, no-pressure pediatrician.
[Man but those norms in favor of BF no matter what are strong...even as I write this I feel defensive, even though I would never judge another mum for doing the same...]
Formula for success, I call it! The reality is that if you're a working mom it's just really hard to sustain pure breastfeeding, and in my opinion, instead of being looked at as poisonous junk food, formula is a tremendous liberator!
And...totally! Breastfeeding propaganda is so ingrained into me it's taking all I have as a rational person to overrule my emotions and feed my kid formula with no guilt, no apologies, and no second-guessing myself.
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I'm glad you researched. Are you feeling shamed? Is shame inherently bad? Why was Aunt Sally or the LC wrong, she was repeating the best scientific knowledge as told to her 20 years ago? the LC never spread misinformation, it was later changed to current scientific knowledge.
Stepping back from BF and using an analogy here. We have a court case coming up in Canada. Public shaming of the parents has already started because they "believed" that holistic medicine would cure their child of pneumonia. I absolutely believe these people should be ashamed of their actions, their belief's had tragic consequences (a round of antibiotics would have worked). Its worth noting, they don't feel ashamed and would do it again based on their scientific research, unfortunately they have other children and its a possibility. The shame cycle exists to discourage anyone else from not treating sick children, hopefully we can all see shame is warranted here.
Shame is just a societal tool to pressure better behavior from all of us. I don't think its wrong to feel ashamed at times, we all should at times. Viewing shame as a horrible emotion is detrimental, shame exists to encourage us all to research, learn and improve. People without shame are also known as psychopaths (clinical sign of a psychopath is no shame), nobody wants that.
What you're espousing is that nobody should ever shame or feel ashamed by their actions. Can you imagine the consequences if people didn't discuss the best techniques to raise their children? its precisely because of shame that this conversation happened, the fear of shame spurred the conversation for me as well. Pretty much everyone I know who feels shame either corrects their actions or finds out why they're correct and stand their ground (in general, not just breastfeeding and formula).
As the parent you don't ever get a pass, I know what you meant but its not a good argument to equate yourself with strangers in your child's life. In the spheres of influence you're number one to the child. You're held to a higher standard precisely because you are the most important person, why would you compare yourself to a stranger in your child's life? Who better to have final say on your child's upbringing than you? Its definitely not myself, some random from the internet. You have a vested interest in the topic, strangers don't.
What I like about the shame cycle is that it encourages important conversations. Instead of seeing it as a negative how about we discuss the positive implications; like this thread that spread knowledge.
OR we could have the conversations in a nonjudgmental manner, as we seek to encourage and support mothers who are struggling to do what they believe is best for their baby, themselves, and their families.
I personally wonder if mothers didn't face so much judgment, whether that would reduce postpartum depression rates. Have you ever considered the negative effects of using shame as a behavioral tool, rather than a more positive focused method?
Why do strangers assume they know what is best and further, that they have a right to intrude into the personal life of others to interject their opinions, when they have no idea:
- if the mother can breastfeed (medications? illness? insufficient milk? etc.)
- if the mother has sufficient support (time off work? a pump that works, rather than a cheap one covered by ACA that breaks/works poorly?)
- if the mother is getting enough sleep/rest so she is not a danger to herself and others.
- if the mother is uncomfortable breastfeeding in public by others seeking to shame for that behavior (despite it's legality, it happens)
- if the mother is uncomfortable breastfeeding because of prior sexual assault, etc.
I'm now envisioning your world, where people go around shaming each other for anything they deem bad. A few thoughts:
1) That sounds perfectly horrid place to live where everyone is mean to everyone else rather than supportive. This trains up bullies of our children as well, who perpetuate this negative-focused cycle.
2) I expect the behavior to go underground rather than change. No reason to tell the lactation consultant you're still having issues - just tell her that you're all set, and buy formula online. Stop visiting and seeing the preachy friends. etc.
Obviously you're not saying I should support people who don't bring their critically ill kids to a doctor, some actions aren't acceptable by society. In the feeding discussion I disagree with anyone withholding food to babies, that's not cool. First and foremost a kid should be fed, I'm intolerant of militant viewpoints that cause children harm as I suspect most people are too.
I came from a non judgmental starting point; my first required formula that I administered (father), and was breast fed later on (mothers choice). I really didn't know what to do, I pretty much just listened to the doctors and trusted them. What I've seen is that people typically aren't malicious, they might come across that way but they're generally well intentioned. I encourage people to see the comments not as shaming; see them as concern gone into overdrive.
For example if your MIL says "you should breastfeed" what she's really saying is that she wants her grandchild to be healthy and she was taught (probably by a doctor when she had children) that breast was best. Essentially its a matter of perception, what some interpret as shame is often meant as constructive criticism (MIL meant well). I seriously doubt people are actively going out of their way to make mothers feel bad, I think their motivations are based more on trying to help. Perhaps I'm naďve but I think people are usually well intentioned, its a communication issue more than anything.
When you argue with her, you're essentially shaming her, I'll explain. She likely breastfed (based on her doctors advice) and now you're telling her she was wrong and should have done formula (or vice versa depending on your situation). The appropriate thing is to realize that she's being helpful, not trying to cause trouble. Extrapolate that to strangers, most of them were mothers and followed conflicting doctors advice based on their age and location, that's why they think they know best (a doctor told them when they had children).
Please note, I don't think you, CaptainFire, shamed anyone, its tough to get ideas across and I'm not the most eloquent. I'm curious about this topic, my wife and her mother butted heads and it was distressing (everything is with the first born in the first few days). I saw both their viewpoints and realized they were both correct; based on their personal timelines. Then I realized pretty much everybody was correct, its that the advice changed over the generations.
My world isn't full of shame, except a long time ago when I was a smoker, strangers regularly insulted me. I'm not defending smoking, it was an interesting lesson though on strangers will seek you out to call you disgusting. The way some people acted you would think I fed their kids formula or something (joking, sorry if its a bad one).
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This conversation on shame is fascinating, it would make a great topic of its own. Let's keep on-topic, eh?
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Another resource for readers interested in breastfeeding dogma, particularly how breastfeeding went from a benign recommendation based on some limited evidence to an all out moral warzone. The book explores how overzealousness in breastfeeding promotion has resulted in all sorts of bizarre and harmful side effects, like punishing disadvantaged mothers on WIC and the rise of completely unregulated human milk exchanges over the internet.
Lactivism by Dr. Courtney Jung
http://www.nytimes.com/2015/12/20/books/review/lactivism-by-courtney-jung.html?_r=0
I loved this book as the author did a great job incorporating the science and history of breastfeeding research and advocacy into a book that is both evidence based and also deeply personal. There's alot of science but also personal stories and tales that really put the human face on those mothers who desperately want, but can't achieve, the excessively high standards pushed by the Breast is Best culture. Be forewarned, many staunch breastfeeding advocates in the field HATE this book because they think it portrays the lactation field in a bad light, but in my professional opinion, Dr. Jung really does a nice job navigating the information to an absolutely reasonable, valid, and compassionate set of conclusions. Great for those parents who feel they need to recover from negative breastfeeding experiences or excessive pressure to conform to a limited and narrow view of infant feeding.
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I just read through this entire thread and have to commend the OP and many other posters for sharing their stories and providing everyone with such fantastic information. I 100% agree with the OP's main point.
My story: my sister had a horrible bfing experience and ended up exclusively pumping for 8+ months -- an insane routine that involved little sleep, tons of bottle/pump parts washing, and lots of effort to get her supply up (it was always on the low side). She got poor advice from lactation consultants in the immediate days following her daughter's birth that she feels set her on this course (long story). So when I got pregnant, bfing was the thing I was most anxious about. I read lots of books and attended a bfing class at the hospital I would be delivering at. I walked away from that class immensely relieved -- the instructor and materials made it sound like bfing works out for everyone and "if you're committed enough" you'll be able to successfully breastfeed. I talked to the instructor afterward about my sister's issues and she assured me that I wouldn't have those problems here because it was a "baby-friendly hospital." Phew! (I thought)
Fast forward a few weeks later when my son was born (thankfully healthy and full term). He struggled with latching and was a sleepy newborn. The nurses and doctors were concerned about his weight loss in the first 48 hours, so we ended up supplementing with formula starting on day 3. I remember being so worried and upset when they recommended supplementing -- afraid it would interfere with bfing (nipple confusion and all that) and that the doctors/nurses were being overly cautious/going for the "easy" out of formula feeding. But my husband and I wanted to follow their recommendations so agreed to do it. I also had serious nipple pain (like, tears at every nursing session) despite correct latching technique (and no thrush or other issue -- despite the conventional wisdom in the bfing community that "if you're in pain you're not doing it right"). We followed a crazy nurse, supplement, pump schedule for our first two days home (days 4-5 of our son's life). My milk didn't fully come in until day 4-5. Our pediatrician let us go off the supplementing/pumping routine when we went in for a checkup on day 5 and our son had started gaining weight back. Huge relief as we were getting no sleep and I had flashbacks of my sister's pumping hell running through my head -- but also was terrified that continued supplementing could possibly doom our ability to have bfing success. After that first week, I continued to have bad nipple pain for a couple more weeks before it subsided around week 4-5. Then it was smooth sailing from there on out -- nursing was comfortable, my supply was ample, and I had a long (by US standards - 6mos) maternity leave so didn't have to worry about going back to work for awhile. I pumped when I went back to work until 1 year (lucky enough to have my own office and a pretty ideal pumping setup at work, but still was ecstatic to stop when the time came), and then continued nursing in the morning and at night until about 19mos (basically because it was easier to keep going -- I could get a little more sleep in the morning while my son nursed, and had the magic bullet for bedtime/fussiness).
Side note: I NEVER thought I would nurse past 6-9 months (ad in my social circles nursing beyond a year is virtually unheard of), but it worked for us -- and part of me felt like those first few weeks were so difficult I wanted to get my full "money's worth" out of the ordeal (if that makes any sense). Point is how we decide to feed our babies is completely our own decision and what we end up doing doesn't always fit with what you thought you'd want to do, or what your friends/families expect.
General thoughts:
I think a major problem is the lack of consistent quality among LCs. Based on my and my friends/family members' experiences, it seems that for every great LC, there are about 4-5 bad or misinformed ones. So new moms end up getting conflicting or misguided advice at a time when they're extremely vulnerable -- like, "try a nipple shield!" (even though my understanding is that these are really only good to use in very limited circumstances), or "if you have pain your latch must be wrong," or "try this or that nipple cream/supplement/etc." Then you have some who are vehemently opposed to any formula (one friend's LC literally tells her clients "formula is the devil," I kid you not), and others who pull the formula trigger too quickly and suggest it upon encountering the slightest bfing challenge. I wish there were higher certification standards or some other quality control mechanism in place to weed out the bad ones and up the quality of lactation advice being given, especially in hospitals.
The other really tricky thing here is the fact that for many of us, bfing IS a challenge, and the beginning is the hardest part -- so it's easy to feel like it's too much work/not worth the effort in those critical first few weeks of life. I think this is why the LLL folks and other pro-bfing types go overboard with pushing bfing propaganda and touting the benefits -- because they want moms to realize that there is an incentive to getting through that initial hard period, and don't want them to refuse to even try it at first. Unfortunately the inaccurate/overly optimistic information being disseminated in these bfing courses, like the one I went to, only sets us up for shock when we encounter actual problems postpartum, and doesn't equip us for dealing with those problems. Thankfully I had a great network (sisters, mom, and one really good LC) that helped me get through our latching and pain issues, but a lot of people aren't so lucky.
Finally, even though I chose to bf for quite a long time, I think we cannot overstate how much of a burden exclusive bfing places on the mother, and how it really limits the role that can be played by the partner or father. This alone is a big enough reason to consider formula feeding, IMHO. The MOTHER is the one nursing the baby every few hours in those first weeks; often, by extension, soothing and comforting the baby when fussy (because baby comes to associate mom with comfort from nursing); pumping upon returning to work (3hrs a day at a minimum, even assuming her partner is doing all the pump parts prep/cleaning/etc.); and having her body essentially hijacked for milk production purposes. While there were many times when I loved the fact that our son wanted me to comfort him and felt at home in my arms, there were also many times when I wish I could have handed him to my husband with the same effect. And my husband, btw, is like the world's best super daddy, husband, and co-parent -- he did just about everything physically possible to support me and us (including waking up with the baby in the middle of the night and bringing him to me for nursing - I literally did not get out of bed). But he wasn't lactating so there was only so much he could do on the feeding front.
Long story short, advice for others: get informed, line up a knowledgeable LC if you decide to BF, and then roll with the punches if/when you encounter obstacles along the way. Do what's best for you and your situation and trust your own judgment. And then educate and support your friends when they go through the same process. It can be hard to tread the line between offering support and seeming like you're pushing a pro-bfing agenda, but I always try to ask pregnant friends if they're planning to bf, share my own experience/challenges/tips, and then make clear that I'm there for them regardless of what they decide to do (FF included).
Looking forward to learning more from this thread as I find these issues fascinating (and am taking everything under advisement for a future baby #2). Thanks all!
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P.s. Sorry, forgot to include my main point: I wish we hadn't spent so much time agonizing over the decision to supplement on day 3, and worrying about continued supplementing sabotaging bfing. Especially the more I read up and learn of the very real risks of dehydration and other complications like the OP experienced. So. Much. Useless. Worry!
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P.s. Sorry, forgot to include my main point: I wish we hadn't spent so much time agonizing over the decision to supplement on day 3, and worrying about continued supplementing sabotaging bfing. Especially the more I read up and learn of the very real risks of dehydration and other complications like the OP experienced. So. Much. Useless. Worry!
Thank you for sharing your story! I love that you spoke up and showed us all how supplementing can be successfully incorporated into a breastfeeding routine without jeopardizing your future ability to exclusively breastfeed. Parents need to hear these stories to counteract the misinformation out there. Even though we have data showing that supplementing is not harmful to breastfeeding as long as it is done appropriately, sometimes hearing a real story from someone makes more of an impact.
As a personal aside – Ironically, I suspect the fact that we didn’t supplement in a timely manner ultimately caused more nursing and lactation problems. This is the exact opposite of what so many people claim will happen if you supplement. How?
1. Well fed babies have the energy and organization to nurse at their next breastfeeding attempt. Nursing takes practice and is hard work for newborns, and weak/sick/fatigued newborns may not have the energy to latch and effectively nurse. This can create a vicious cycle where the baby’s feeding gets more and more ineffective, and in turn they get less and less nutrition. Supplementing a baby who is struggling (or at risk for struggling) can help keep them well and energized enough to continue nursing and get the hang of it.
2. By the time we were supplementing after readmission, my daughter was so sick and weak, we had to put nursing on hold at a critical point where babies are just starting to get the hang of it. Instead, we had to bottle feed her to give her nutrition in the fastest way possible, since she could only be out from her phototherapy lights for so long. Nursing would have been nice, but it would have taken too long when immediate treatment was necessary, worn her out and sapped her of what little precious energy she had left (it takes more effort for baby to nurse than bottle feed), and slowed down her overall recovery time. I am so happy we agreed to bottle feed her during her treatment as that was the safest, most effective, and most medically appropriate feeding method for her in her condition, but I suspect putting her nursing practice completely on hold for 24hrs probably negatively impacted our nursing ability.
3. My daughter’s deterioration in nursing ability during the first few days of life may have contributed to my milk being delayed, creating another vicious cycle where when she did nurse there was not much there for her. Ineffective nursing may not sufficiently stimulate mom to bring her milk in faster. By day 3 when we were rehospitalized, I had yet to experience my milk coming in (delayed lactation). I started pumping every 2 hours at the hospital that day to bottle feed the baby, and by the next evening my milk had arrived with engorgement. So, it took almost 5 days for my milk to arrive post birth, but less than 48hrs to arrive once I started pumping. This could be coincidence (after all, I had other risk factors for delayed lactation like being a first time mom), or it could be that my breasts were not being effectively stimulated by my deteriorating daughter in those first couple days.
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3. My daughter’s deterioration in nursing ability during the first few days of life may have contributed to my milk being delayed, creating another vicious cycle where when she did nurse there was not much there for her. Ineffective nursing may not sufficiently stimulate mom to bring her milk in faster. By day 3 when we were rehospitalized, I had yet to experience my milk coming in (delayed lactation). I started pumping every 2 hours at the hospital that day to bottle feed the baby, and by the next evening my milk had arrived with engorgement. So, it took almost 5 days for my milk to arrive post birth, but less than 48hrs to arrive once I started pumping. This could be coincidence (after all, I had other risk factors for delayed lactation like being a first time mom), or it could be that my breasts were not being effectively stimulated by my deteriorating daughter in those first couple days.
Yes, so true. I feel like education on pumping and how it can stimulate supply (and is essential to do if supplementing) is another area where we need so much more information out there. Pumping in the early days has been a game changer for my sister with baby #2 and several friends (not to mention me). My other key rec to friends is to RENT THE HOSPITAL PUMP if you can afford it. I found the Medela Symphony (hospital pump I rented) to be so much more effective and, importantly for me, so much more comfortable than both the Pump in Style and the Freestyle (I had both at different points in time). It was about $50/mo to rent it and 100% worth every penny, for me at least.
And I echo what others have said - take some time to learn how to use the pump, preferably before baby is born. On day 3 we were psyched to be discharged and had no idea we were going to be told to pump/supplement. A few minutes after we were told to do that by the medical staff, the pump lady from the hospital came into the room with the pump and all the supplies and was like, "So you know how to use this, right?" I was like, "Um, nooo, why would I?" and pretty much burst into tears. So many emotions in those first few days!
Btw, LBD, your experience sounds awful and I'm so sorry you had to go through this w/ your daughter! Thank you for sharing your story with everyone to help others avoid the same thing!
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Btw, LBD, your experience sounds awful and I'm so sorry you had to go through this w/ your daughter! Thank you for sharing your story with everyone to help others avoid the same thing!
Thank you for your support. It was pretty rough, but as crazy at is sounds, we lucked out. I have seen stories of mothers who didn’t get appropriate help until day 4 or 5 of life and their little ones ended up in the ICU with seizures and brain damage. The fact that my discharging clinicians recommended that we do our pediatrician follow up the morning after discharge (instead of the typical 48hr schedule) saved us. I find it even hard to think about what would have happened if they hadn’t made that life saving recommendation.
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More information on supplementing!
How can I tell if me/my baby will benefit from considering supplementation?
There are documented risk factors for certain moms and babies that are associated with increased risk of nursing problems and infant starvation. Please note, just because you have a risk factor (or two, or three!) does not mean you will definitely have problems, it just means you are probably at more risk of running into trouble than someone without those risk factors. Plenty of moms with a couple of risk factors go on to have smooth, healthy exclusive breastfeeding relationships. However, if you read this list and notice that your risk factors are piling up, you might want to be more proactive about educating yourself on effective supplementation while breastfeeding just in case, and be more willing to start it sooner rather than later if you are feeling unsure/worried.
Risk factors for insufficient milk supply/ineffective breastfeeding/complications in the first few days of life:
First time mothers*
*A study of mother/baby dyads found that 22% of first time moms had delayed milk, that’s 1 out of 5 first time moms
Mothers with a history of lactation insufficiency with previous babies
Mothers with history of breast surgery or suspected insufficient glandular tissue
Babies born preterm (<37 weeks) or early term (<38 weeks)
C-sections*
*A Kaiser study showed that a whopping 25% of exclusively breastfed c section babies had lost excessive weight, greater than 10%, by 72 hours of life – or 1 out of 4 c section babies.
Traumatic/difficult labor and deliveries (protracted labors, excessively long deliveries, physical trauma/blood loss to mom, emergency csections)
Risk factors for specific starvation related complications:
Hypoglycemia – gestational diabetes in mom
Hyperbilirubinemia – blood type incompatibility, moderate-severe bruising of infant from delivery
Preterm and early term babies – in general, the earlier a baby is born the more likely they are to have difficulty with their physiology and nursing ability. Preterm babies in the NICU are closely watched, but healthy late preterm (36+ weeks) or early term babies (37 weekers) are usually sent to the regular maternity ward and not followed as closely by medical staff. If your little one is born at 36-38 weeks, be extra vigilant even if they are otherwise healthy.
What does a high risk mother/baby pair look like?
This is what my risk profile looked like:
High risk - First time mother, difficult vaginal delivery with excessive 2nd stage duration, moderate cranial bruising on infant from difficult delivery, baby born early term, just after 37 week mark.
Other common higher risk scenarios might include first timers with csections (either planned or emergency), or mothers with c-sections prior to 38 weeks gestation.
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3. My daughter’s deterioration in nursing ability during the first few days of life may have contributed to my milk being delayed, creating another vicious cycle where when she did nurse there was not much there for her. Ineffective nursing may not sufficiently stimulate mom to bring her milk in faster. By day 3 when we were rehospitalized, I had yet to experience my milk coming in (delayed lactation). I started pumping every 2 hours at the hospital that day to bottle feed the baby, and by the next evening my milk had arrived with engorgement. So, it took almost 5 days for my milk to arrive post birth, but less than 48hrs to arrive once I started pumping. This could be coincidence (after all, I had other risk factors for delayed lactation like being a first time mom), or it could be that my breasts were not being effectively stimulated by my deteriorating daughter in those first couple days.
Yes, so true. I feel like education on pumping and how it can stimulate supply (and is essential to do if supplementing) is another area where we need so much more information out there. Pumping in the early days has been a game changer for my sister with baby #2 and several friends (not to mention me). My other key rec to friends is to RENT THE HOSPITAL PUMP if you can afford it. I found the Medela Symphony (hospital pump I rented) to be so much more effective and, importantly for me, so much more comfortable than both the Pump in Style and the Freestyle (I had both at different points in time). It was about $50/mo to rent it and 100% worth every penny, for me at least.
And I echo what others have said - take some time to learn how to use the pump, preferably before baby is born. On day 3 we were psyched to be discharged and had no idea we were going to be told to pump/supplement. A few minutes after we were told to do that by the medical staff, the pump lady from the hospital came into the room with the pump and all the supplies and was like, "So you know how to use this, right?" I was like, "Um, nooo, why would I?" and pretty much burst into tears. So many emotions in those first few days!
Btw, LBD, your experience sounds awful and I'm so sorry you had to go through this w/ your daughter! Thank you for sharing your story with everyone to help others avoid the same thing!
I had the same experience as above my first baby - inefficient nursing, delayed lactation, and engorgement, followed by low supply thereafter (actually started taking meds to increase my supply - crazy!). Even in the hospital with no experience, I felt that something was not quite right with how the baby was nursing - a few seconds of weak nursing and fell asleep ad nauseum. I asked several hopsital LCs about it, but no one mentioned pumping until two days after discharge, when we were probably on the verge of going back into the hospital. My husband frantically ran out to two different hospitals to track down a rental, and even then we could hardly figure out how to use it. The baby is now a healthy 6 year old, but I'm shuddering to think of what a disaster we made of it the first days of trying to feed her.
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Just wanted to say thank you for this thread, I wish it had been out there before I had my daughter! Although as many others have confessed, even with lots of education, the Breast is Best message has gotten sufficiently into our heads I still might have done things exactly the same. It would have been great to know how much company I had, at least! Thankfully my daughter did not lose enough weight to get into true danger, but took FOREVER to gain weight in her early months, and in hindsight I think her default setting of "often kind of cranky" was probably due to being hungry a lot. She did have quite a bit of reflux which may have been the primary reason for her slow gain, but we did also have some of the issues/symptoms I'm seeing others describe here which may have contributed. She is a really sweet, happy personality now, at just over a year old and up at the 50th percentile for weight. Does make me wonder if our first 4ish months could have been much smoother and happier if she were better fed!
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!
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Fantastic thread!
Since a couple people mentioned being mothers-to-be, if you facebook there's a great group that follows the same principles little brown dog was talking about. Great if you have nitty gritty questions along the way and want evidence-based answers that support exclusive breastfeeding, exclusive formula feeding, and combo feeding.
https://www.facebook.com/groups/evidencebasedfeeding/
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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!
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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.
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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.
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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!
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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.
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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/
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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 (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 (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/ (http://evolutionaryparenting.com/the-problem-with-breastfeeding-research/)
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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 (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 (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/ (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. :(
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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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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.
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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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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.
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My favorite breastfeeding resource is http://balancedbreastfeeding.com/blog/ (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.
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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.
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My favorite breastfeeding resource is http://balancedbreastfeeding.com/blog/ (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!!!
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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.
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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.
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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 :(
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**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..."
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**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.
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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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**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.
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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!
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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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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...
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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 (http://drghaheri.squarespace.com/blog/2016/9/26/further-evidence-to-support-the-benefit-of-tonguelip-tie-release)
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 (http://www.mouthmattersbook.com/2013/12/08/facial-meltdown-if-a-form-in-nature-isnt-beautiful-something-is-wrong/)
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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.
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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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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!
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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.
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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!
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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
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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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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.
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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.
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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 :
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:
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.
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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.
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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.
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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 :
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:
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
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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!
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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.
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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
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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.)
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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.
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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.
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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.
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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.
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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). 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.
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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."
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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.
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Want to talk today about an important issue – donor milk - because there is alot of misinformation swirling around out there regarding this subject.
Appreciated!!
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I was recently sent this link on comparing donor milk and formula feeding, and the risks thereof. It discusses both disease transmission, likihood, as well items such as holder pasteurisation. Comparative analysis of formula feeding and donor milk (http://Comparative analysis of formula feeding and donor milk)
A lot of parents never even attempt to donate to a milk bank, whether it be because there is not one near them, they don't know about them, or they want to make milk available to babies who do not meet the criteria for recieving milk from the milk banks.
Also, many do it for no recompense, which means many do not have the incentive to stretch the milk by adding to it. Also, in a lot of cases, the donor is willing to provide medical history.
This article discusses why why should look more to donor milk. (https://www.bellybelly.com.au/baby/human-milk-banking-sharing-first-alternative-babies/) It is incorrect to state that formula and breastmilk are equal and lead to equal outcomes. Formula is an AMAZING invention, and a literal lifesaver, but to imply there is no difference between the two is not true.
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I was recently sent this link on comparing donor milk and formula feeding, and the risks thereof. It discusses both disease transmission, likihood, as well items such as holder pasteurisation. Comparative analysis of formula feeding and donor milk (http://Comparative analysis of formula feeding and donor milk)
A lot of parents never even attempt to donate to a milk bank, whether it be because there is not one near them, they don't know about them, or they want to make milk available to babies who do not meet the criteria for recieving milk from the milk banks.
Also, many do it for no recompense, which means many do not have the incentive to stretch the milk by adding to it. Also, in a lot of cases, the donor is willing to provide medical history.
This article discusses why why should look more to donor milk. (https://www.bellybelly.com.au/baby/human-milk-banking-sharing-first-alternative-babies/) It is incorrect to state that formula and breastmilk are equal and lead to equal outcomes. Formula is an AMAZING invention, and a literal lifesaver, but to imply there is no difference between the two is not true.
I don't think the first link worked, can you check it?
The support for more milk banks would be great, but without that formula is the next best option. I'm hoping to donate some milk if I have the capacity and supply for it. The second article notes other forms of donation, and I think breastmilk probably lies on the harder end of the spectrum (not as hard as organ donation, though!) because you're probably really tired and trying to feed your own kid. Not that it couldn't be made a lot easier, but that it might take someone a bit of effort to set up a feasible collection and treatment option on a usefully large scale.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395287/ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395287/)
Hopefully that works.
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I was recently sent this link on comparing donor milk and formula feeding, and the risks thereof. It discusses both disease transmission, likihood, as well items such as holder pasteurisation. Comparative analysis of formula feeding and donor milk (http://Comparative analysis of formula feeding and donor milk)
A lot of parents never even attempt to donate to a milk bank, whether it be because there is not one near them, they don't know about them, or they want to make milk available to babies who do not meet the criteria for recieving milk from the milk banks.
Also, many do it for no recompense, which means many do not have the incentive to stretch the milk by adding to it. Also, in a lot of cases, the donor is willing to provide medical history.
This article discusses why why should look more to donor milk. (https://www.bellybelly.com.au/baby/human-milk-banking-sharing-first-alternative-babies/) It is incorrect to state that formula and breastmilk are equal and lead to equal outcomes. Formula is an AMAZING invention, and a literal lifesaver, but to imply there is no difference between the two is not true.
I want to address each of your items as you bring up some really good points.
1. Milk banks – absolutely we need more donors. Too many moms are not aware of milk banks and the need for donations, or they do not have access to a milk bank to donate to. We only have 24 milk banks total in North America…that leaves huge swaths of potential donors without a legitimate place to donate to. However, even if we addressed the access issue, we would still have large numbers who cannot donate due to failure to pass safety checks, and inability to produce sufficient amounts for donation. Most moms have “well regulated” supplies – enough to feed their baby and keep a modest/decent freezer stash on hand. I suspect those moms who make tons of milk…plenty for their child, and their own stock, and a bunch extra to donate are not typical. But still…if we increase access to the banks, we would definitely see a boost in supplies for preterm and ill infants in hospitals (the babies who actually need it most).
2. Regarding alterations of milk and lack of compensation – while the sellers are definitely the most unscrupulous lot in the informal sharing of milk, it is important not to mistake good intentions for safety. As the recent study out of Florida just showed, even very conscientious donors were routinely skipping out/missing major steps to ensure the safety of their donations. This can be remedied to some extent by education, but it shows that best intentions and being a “good person” don’t equate to safety or proper handling of milk. Donors aren’t typically preparing milk in sterile labs with a PhD in microbiology. They are regular people pumping, storing, and handling milk in regular living spaces. Contamination happens. Changes in health status, like STD infection, happen. We can’t make public health recommendations for parents based on overly optimistic hopes about the lay donors’ knowledge, medical status, and commitment to food safety.
3. As far as the comparative analysis goes, I found the concept of the paper extremely interesting although it is pretty clear to me from reading it that the authors are purposefully downplaying the risks of unscreened breastmilk while upselling the risks of formula. The authors seem to be writing specifically to convince people formula is just as bad as opposed to writing a truly objective cost analysis. This isn’t unusual when you see who the author is – Gribble is a known breastfeeding ideologue. This wasn’t done by some epidemiologist interested in objectively tracing risk through a population…it was done by someone who already believes breastmilk is best no matter what and from someone who supports peer to peer milk sharing. A few things tipped me off to the bias in this article…for every risk section associated with breastmilk there is a corresponding “but formula is bad too!” section. For the section on HIV, the risk of contracting such a devastating illness is dismissed as “rare” or unrealistic ways to “get around the risk” are given – intensive screening procedures like that imposed by milk banks, pasteurization - as if this is somehow a reasonable/totally manageable thing for the population at large to do and for a government to sanction. The author conveniently mentions absolutely nothing about the countless babies infected with HIV in developing nations, often through breastmilk, and why we are so strict about body fluids handling and donation today. The paper makes BIG CLAIMS about the harms of infant formula but then sparsely cites them (often only giving 1 or 2 outdated citations). A true cost analysis would use far more frequent research and would include more information on potential confounders, likelihood of being able to implement safety precautions in the population, etc. This just reads as a bizarre defense for encouraging the swapping unscreened body fluids instead of a real comprehensive risk assessment.
Regarding their “risks” of formula - A lot of their sources are really old and very cherry picked…like from the 90s, which is a bit odd because the paper was published in 2012 (it should also be noted that this was published 4 years ago and the AAP still came out against peer to peer milk sharing this year...so clearly the concerns still exist or have gotten worse). Research on long term health outcomes has come a long way since the 90s, with a lot more focus on socioeconomic status as a huge confounder for health. Most of the “risks” in the risks of formula section of this paper are controversial and highly impacted by socioeconomic status. The authors mention absolutely NOTHING about the confounding relationship between SES and formula use. That is crazy. Everyone in public health knows that SES is a huge predictor for all sorts of outcomes and yet the author says absolutely not one thing about the confounded relationship. The SIDS stuff is true…there is a protective effect of breastfeeding, but again it could be SES related, and it is MODEST. The author makes it seem like there is this big protective effect, but the truth is that breastfeeding is one of the least likely protective factors for SIDS. It is beat out by sleep position (back), sleep environment (own crib, no bedding), pacifier usage, etc. The allergy stuff has been called into question too – the author’ sources are from the late 90s but more recent research has revealed that introducing solid foods and formula before 6 months (between 4-6mo) might actually be protective against allergies, and there have been a number of studies showing no impact of breastfeeding on asthma and related illness. And as far as the intelligence/cognitive piece? Holy moly. Only two sources. Did you see the first reference? It was a study of PRETERM infants from 1992. Preterm infants are well known for struggling developmentally regardless of their food source…and it’s from 1992…well before a lot of the newest developments in infant formula. A lot of the infant formula back in the 70-80s was definitely not up to snuff…infant formula looks totally different today. You can't compare the two and yet the author kind of glosses over the fact that infant formula today is not the same stuff as it was decades ago. This whole infant feeding stuff is muddy and yet the author cites outdated and limited sources to make it seem like it is so obvious that formula is just as risky as feeding unscreened milk to your baby. This analysis would have been better if the author was up front and honest about all of the confounding factors, controversial evidence, difficulty implementing these protective procedures around screened milk, and used recent research using more rigorous methods.
4. You seem to think this thread is implying there is no difference between breastmilk and formula. Nothing in this thread says that. Breastmilk and formula are very different, and are not equal on all measures. Previously in the thread we discussed the known benefits of breastfeeding around infection risk, preterm infants and necrotizing enterocolitis, and benefits to mother. Breastmilk has unique bioactive properties and there is a reason it is recommended as the preferred nutrition source. No one here is saying there aren’t downsides to formula – there are. Formula prep has extra food safety concerns when compared to nursing, and formula lacks the cool bioactive properties found in breastmilk (which may or may not matter long term…research is still being done). It can be dangerous or deadly in developing nations where lack of access to clean water exists, or where mothers often do not have a steady supply of formula. It is also not recommended as the first choice for preterm infants due to increased risk of NEC. But the truth is that most of the benefits of breastmilk and the “harms” of formula have been grossly exaggerated to the public. Breastfeeding does not prevent your baby from experiencing SIDS, obesity, cancer, or ensure that you are better bonded to your baby. It probably has nothing to do with your IQ or future success. People like Gribble are using limited, muddy, mixed or sometimes flat out questionable evidence to portray formula as scary and bad and risky, while exonerating breastfeeding as this near perfect good - so good, it doesn't even need to be formally screened before being fed to an infant! They never tell women about all the studies that show no benefit to breastfeeding or exclusivity (and there are many). Women are being told that their babies will be sick, fat, and stupid if they drink any formula at all even though the research on long term outcomes is muddy and mixed at best. Women are being told that using unscreened breastmilk is SAFE simply because it is breastmilk. Babies are being underfed because of fears about formula. This is crazy town. The AAP also believes in the nutritional profile of breastmilk, and recommend exclusivity as best, but they still do not recommend peer to peer sharing and they still think formula is the better option over unscreened donor milk. That says something.
This thread is both breastmilk and formula positive because both are great ways to feed a baby – not equal on all measures, but both great options due to their unique strengths. Breastmilk has bioactive properties. Formula allows you to not starve your kid if you can’t breastfeed. Nursing is convenient if it works well. Formula allows a woman to have a baby that is just as healthy, smart, and happy as a breastfed baby without being strapped to an infant or pump 24/7. These complimentary choices are also not mutually exclusive and it is very possible to use both to get the benefits of both methods. The info in this thread supports using mother’s own milk, milk bank donated breastmilk, or infant formula as safe infant feeding options in developed nations, a position carried by the AAP and other major medical organizations. I support exclusive breastfeeding, majority breastfeeding with supplementation, combination feeding, comfort nursing, pumping, etc. I support breastfeeding for 1 day or 2 years or whatever duration mom wants. The things I do not support in relation to breastfeeding are 1) underfeeding a baby to preserve exclusivity, 2) peer to peer milk sharing due to its potential safety risks, and 3) overexaggerating the benefits of breastmilk with questionable evidence in order to support breastfeeding promotion or guilt/scare mothers into breastfeeding or breastfeeding exclusively. I cannot support these things because they cause measurable harm to infants and mothers (physically and psychologically) and/or create a situation where harm is likely to occur.
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On the belly belly article…there are numerous public health no nos in here. Really quickly…
1. They seem to conflate modern day milk sharing with old school wet nursing. Not even close. Globalization, modern medication usage, and pumping change the game and increase opportunities for disease transmission and contamination. We aren’t back in the day with our small village of 20 people we have known all our lives…things are different now. Parents need to know that.
2. They conflate the benefits of wet nursing in developing nations with that of developed nations. They cite pub health agencies like WHO and UNICEF that have to handle the serious issues of infant feeding in developing nations and flagrantly misapply their advice to developed nations (yay, wet nursing in Nigeria! Americans you need to do this too!). If you actually READ the cited WHO report, you will notice that they focus on undernutrition and things like diarrhea disease…major, major issues in much of the world. The “global report” is actually focused mainly on health issues in developing nations. OF COURSE breastfeeding and wet nursing are key components for those things. The report also specifically says this on page 10 of the english version: “For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances.” Ahhh the belly belly article conveniently left out that last piece about the breastmilk substitute and individual circumstances. Notice how they did that? They used an source primarily meant for developing nations/general guidelines, and then cut out a chunk of info to make it seem like UNICEF recommends wet nursing OVER infant formula even in developed nations. Not true, UNICEF recommends that we tailor our infant feeding choices to circumstance, you know...like being in rural Nigeria vs. New York City. Ridiculous. Let me repeat myself here for the last time: NO MAJOR MEDICAL ORGANIZATION RECOMMENDS UNSCREENED PEER TO PEER DONATED MILK OVER INFANT FORMULA IN COUNTRIES LIKE THE US. That includes the WHO.
3. Again with the confounded health benefits and absolutely no mention of SES or other critical factors in these outcomes…seriously…this is getting old.
4. The author of this belly belly article appears to have no actual pub health or medical cred whatsoever (at least based on her bio). She is a birth “educator” and a doula…neither of these things require any training or knowledge in public health or medicine, let alone epidemiology, disease prevention, etc. It is this type of information that scares me…a person with little training and knowledge cites an impressive sounding report from an actual authority figure/organization, misapplies the report’s information, and parents believe it is “evidence based” and therefore trust it.
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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.
Hi! I don't belong in this thread but had been wondering how you were and if you had had your baby and happened to see this post. Congratulations (on the baby - not the nipple shield thing)!!! I hope everything is going well for you and your new familial adjustment.
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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.
Hi! I don't belong in this thread but had been wondering how you were and if you had had your baby and happened to see this post. Congratulations (on the baby - not the nipple shield thing)!!! I hope everything is going well for you and your new familial adjustment.
Aw, thanks! Yup, had the baby the first week of January and am definitely still adjusting. Needy things, these babies!
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Commenting to follow
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Phew, just read the whole thread and am posting to follow. I'm glad to have the education as I'm due in September with my first baby and there is lots of good info here.
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My daughter is 3 weeks today and still not breastfeeding well (or really, taking a bottle well...). So I'm pumping what I can, letting her suckle when she wants and doing a few bottles of formula each day. It's been extremely stressful trying to determine if she is eating enough :( I'm so worried about her brain development...
I'm also furious to find out that while donor milk is $15 per bottle, that as an inpatient it should have been covered. I was only suppose to be given formula if I didn't consent to donor milk. And they never asked me :(
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My daughter is 3 weeks today and still not breastfeeding well (or really, taking a bottle well...). So I'm pumping what I can, letting her suckle when she wants and doing a few bottles of formula each day. It's been extremely stressful trying to determine if she is eating enough :( I'm so worried about her brain development...
I'm also furious to find out that while donor milk is $15 per bottle, that as an inpatient it should have been covered. I was only suppose to be given formula if I didn't consent to donor milk. And they never asked me :(
Ouch, I would be furious at being undermined like that too. Is there an IBCLC near you that can help? There can be all sorts of things that interfere with latching like tongue and lip ties, low muscle tone, and torticollis
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I've seen a number of lactation consultants, since day 2 of life...
She has an okay latch (though has been lazy about it today!), there is a minor tongue tie, but none of them are convinced revising it will definitely fix things. She has a weak, non nutritive suck. She also is extremely sleepy, even still, though has never been jaundiced.
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I've seen a number of lactation consultants, since day 2 of life...
She has an okay latch (though has been lazy about it today!), there is a minor tongue tie, but none of them are convinced revising it will definitely fix things. She has a weak, non nutritive suck. She also is extremely sleepy, even still, though has never been jaundiced.
Eeeshhh I have seen sooooooo many parents stating online that they were told a tongue tie didn't affect their kids breastfeeding (or bottle feeding) and that they just had a lazy latch. Get it revised, and they had a completely different child. As in, they had a failure to thrive child, were suddenly gaining half a kilo a week.
Often a provider will only know about them if they take a personal interest in them - usually someone they know had one.
But no, not definitive it will fix things, but in many cases it can certainly be cause for improvement. Not always instantly, it can take a few weeks
Dr Ghaheri is an ENT surgeon that will revise ties, and he has a blog about them - look up his name, he has many interesting posts about their diagnosis and effect.
If you want, I can post links to more information, such as this statement by the Royal Women's Hospital Tongue tie (https://www.thewomens.org.au/health-information/breastfeeding/breastfeeding-problems/tongue-tie/)
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She's always had a good latch when observed, but a crappy suck.
Today uts been a lazy latch as she mostly just wants to lick my nipple.
I worry it's from all the bottles, but the other options aren't great. The supplemental feeding system let her eat too fast, and I really hated syringe feeding her...it was like force feeding.
She's well latched now, and seems to be doing OK...but I know she doesnt transfer well.
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My daughter was like that - perfect latch, no suction. It happens.
With her, while I thought the problem was totally with me (I don't produce enough, even with pumping, and pumping hurts and is a pain), but it was shared, as it turns out. Still: she (partially) breastfed to 18 months, and we started using bottles instead of feeding systems within a few days. Oh, and the occasional licking-instead-of-latching is a thing too. Who knows why. It's like having a kitten or something.
Or, in other words: a) it happens, b) don't blame yourself, it happens, c) do what works, d) different kids respond and react to different things, and e) good luck!
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Being willing to use formula has been helpful for my wife and daughter, even though we've only actually used it 3 times so far, all in a 36 hour period of dealing with jaundice from age 3-5 days. Had we not been able to locate a biliblanket the pediatrician was going to admit her to the hospital, but after 36 hours of light therapy and giving formula via syringe when she wasn't feeding well or my wife needed more than 40 minutes to sleep, the jaundice was greatly improved, intake/output were great, and by 8 days of age she was back up to her birth weight. She's now 5 weeks old and is growing and eating well. We've made sure to give her a bottle of breast milk once a day since week 4 so that she will let me feed her when my wife is busy and this has also made car trips easier.
Our daughter never lost more than 6% of her birth weight, and that was mostly in the first 24 hours of life. My wife's milk came in quickly, but delayed cord clamping, breast feeding, and the trauma of vaginal birth can all lead to higher bilirubin levels. Combine that with delivering at a birth center that let us leave 8 hours after delivery and a pediatrician that insisted on taking over our daughter's care the next day rather than having daily home visits from nurse midwives from the birth center who would have checked for jaundice, so the levels were able to go unchecked for a couple days before being dealt with. Had we given a syringe of 10ml of formula after each feeding from the beginning we might have had less of a scare.
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My daughter is 3 weeks today and still not breastfeeding well (or really, taking a bottle well...). So I'm pumping what I can, letting her suckle when she wants and doing a few bottles of formula each day. It's been extremely stressful trying to determine if she is eating enough :( I'm so worried about her brain development...
I'm also furious to find out that while donor milk is $15 per bottle, that as an inpatient it should have been covered. I was only suppose to be given formula if I didn't consent to donor milk. And they never asked me :(
In fairness, pasteurized donor milk at the hospital is usually only offered to preterm infants or to full term infants if there is an excess supply and they can afford to give it away to the kiddos who don’t really need it. There is 0 evidence that full term babies who are supplemented with formula do any worse than those given donor milk. Chances are you were never offered because your child didn’t have a medical need for it and there wasn’t a large enough supply to be passing it out to the full termers. They don't offer the option if it isn't an option, and in the vast majority of hospitals it is never an option for anyone but the preemies.
It is important to realize that donor milk would not have made your child any healthier/happier, or better at nursing. Literally all you would have gained from it is the ability to say "my baby never had formula." Seriously…breastfeeding is hard enough (especially with challenges), don’t beat yourself up over not getting an extremely limited option rarely available to anyone with a full term infant (donor milk). Formula is NOT failure. <3
Edited to ask: how is her weight gain? If you are worried about her, then investing in an infant scale will do wonders for your comfort and help you feel more in control. I bought mine on amazon for about $35 bucks. Just weigh her every other day and you will quickly know if she is gaining. Good weight gain means she is receiving plenty of nutrition. Little or no gain warrants immediate evaluation by the pediatrician as well as increased amounts of supplemental formula (or pumped milk if you can produce it). Never withhold formula from the baby if you suspect she isn't gaining well...I've seen low supply moms purposefully only feed their babies as little formula as possible in the hopes that will make them produce more milk. All that happens is the baby gets underfed.
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According to the LC, donor milk is standard, formula is ONLY if the parent doesn't consent. Her first supplement was when I was under general anesthesia still, but they didn't ask DH either. The LC was furious and asked me to write up a report of the "incident". When donor milk came up, I assumed it was NICU only, since I had never been offered (and wouldn't have paid that out of pocket.). The hospital has a milk bank and if I was still in my last job milk would have been fully covered by insurance even as outpatient.
Her weight gain has been great. She lost 9%, but gained it back at 10 days. At 23 days she is still tracking nicely in the Hugh 40%. But that is gain with formula and pumped milk. She isn't breast feeding well, or really doing well sucking a bottle. I now have a referral to SLP for suck training and dentistry to see about the tongue tie.
Also, I'm not withholding formula. I just don't give it until I run out of pumped milk, so only about 4 oz a day.
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Ah that is too bad about the donor milk…it is really rare for full term infants to be offered it. That is fabulous about her weight gain! Sounds like she is doing beautifully on the combo feed plan. From what I understand, it is actually very common for first time breastfeeders to have slightly low supplies in the first 4-6 weeks before their milk supply regulates, especially if they are relying mostly on the pump because baby can’t nurse. If you are up for it, power pumping might help you boost your supply. But seriously at this point, her formula needs are so minimal that your child is literally losing absolutely nothing by not getting an extra 4oz of breastmilk a day (at least in terms of antibodies and health outcomes, although I know emotionally many moms just simply want to be 100% for psychological reasons not health ones). At this rate you are solidly “predominantly breastfeeding” so make sure you cut yourself some slack. Hopefully the suck training and referral will provide some improvement…it is a bit unusual for a baby to also struggle with bottles, so that’s good you are going to get her checked out to see if you can get some answers.
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I just thought I might throw in a bit of hippy advice to this thread. My resume: 2 babies had hyperbilirubinemia due to blood type incompatibility, one so severe he was in the NICU for over a week, other I had a C-section and had to go back into the hospital without baby for a week. So two very rough starts, we supplemented with formula for both. Middle child was perfect. All three nursed exclusively up to about 7 months and stopped around 12 months. So I have spent a lot of time breastfeeding! :)
If you stick with it, it can work out and be wonderful, breastfeeding my babies is my favorite thing from the baby phase. My first three months of breastfeeding were so bad! It was a good wake-up call for previously judgy me who was aghast when women said they were not planning on it.
A lot of my problems, in the beginning, looking back were anxiety based, between pain and just wondering were they getting enough, is the latch right. You just don't let down properly when that is going on, and I personally believe the baby can sense your moods. Get a relaxation routine down with nursing, music, comfortable spot, try to close your eyes, and breeeath.
Mentioned but want to reemphasize, nipple shields are amazing, give these a try for a while before quitting.
Remember to drink lots of water, mothers milk tea can be useful for some for increasing supply, I have heard oatmeal as well as a few other things.
Another controversial topic but I found co-sleeping and nursing went so well together and really enhanced the other. It made me sleep better and I think my babies ate better because of it.
Good luck ladies! :)
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Little one had her frenulum clipped on Friday. The speech-language pathologist really thought it should be done, the dentist was good with doing it but not too sure how much it will help, as it wasn't super severe. But he was happy to do it to see if it did anything- he only clipped 2-3mm. She also has a slight upper lip tie, but dentist said if she is latching there is no reason to revise that.
I'm not sure if I've noticed a difference. It does look like she is doing deeper sucks, but she still only eats for 5-10 (10 being really long) minutes at a time. I was under the impression that the sucking would be easier so she wouldn't give up as fast. Bah. So I'm still needing to pump after each feeding, as otherwise, the demand on my milk is way too low.
However, I've now seen her stick her tongue out 3-4 times, something she never did before. At the very least, it seems like she will be able to clear food from her teeth better (or at all) when she is older, which helps with preventing cavities.
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Little one had her frenulum clipped on Friday. The speech-language pathologist really thought it should be done, the dentist was good with doing it but not too sure how much it will help, as it wasn't super severe. But he was happy to do it to see if it did anything- he only clipped 2-3mm. She also has a slight upper lip tie, but dentist said if she is latching there is no reason to revise that.
I'm not sure if I've noticed a difference. It does look like she is doing deeper sucks, but she still only eats for 5-10 (10 being really long) minutes at a time. I was under the impression that the sucking would be easier so she wouldn't give up as fast. Bah. So I'm still needing to pump after each feeding, as otherwise, the demand on my milk is way too low.
However, I've now seen her stick her tongue out 3-4 times, something she never did before. At the very least, it seems like she will be able to clear food from her teeth better (or at all) when she is older, which helps with preventing cavities.
It does take time for the tongue to learn to use its new freedom properly - the mouth is formed at approx 6 weeks gestation, and they practice sucking and swallowing in the womb, so it takes time to unlearn old habits and build up the new muscle.
Some people recommend doing suck training to help with that, I think youtube might have videos on it?
Did the dentist clip the submucosal part of the tie?
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He didn't use the word submucosal, so I don't know...
He said it was a mild anterior tie. He also told me if it didn't work, we could come back for a deeper laser procedure, but that's usually for posterior or severe ties. Since she has to go to daycare and will need bottles there, I don't think I'll pursue it further. She can nurse well enough for comfort and she's gaining weight. So I think I did the right amount to pursue this.
The SLP gave me a few exercises, but I'll look at the suck training on YouTube.
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He didn't use the word submucosal, so I don't know...
He said it was a mild anterior tie. He also told me if it didn't work, we could come back for a deeper laser procedure, but that's usually for posterior or severe ties. Since she has to go to daycare and will need bottles there, I don't think I'll pursue it further. She can nurse well enough for comfort and she's gaining weight. So I think I did the right amount to pursue this.
The SLP gave me a few exercises, but I'll look at the suck training on YouTube.
One other suggestion that you may already be doing: have you tried hand expressing or pumping prior to nursing your little one to get your milk flowing so she doesn't need to work as hard to get your flow started, so she might nurse longer (and stronger)?
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He didn't use the word submucosal, so I don't know...
He said it was a mild anterior tie. He also told me if it didn't work, we could come back for a deeper laser procedure, but that's usually for posterior or severe ties. Since she has to go to daycare and will need bottles there, I don't think I'll pursue it further. She can nurse well enough for comfort and she's gaining weight. So I think I did the right amount to pursue this.
The SLP gave me a few exercises, but I'll look at the suck training on YouTube.
I agree…you have gone above and beyond with this. You have put in so much time, effort, and dedication. You have triple fed (the HARDEST version of breastfeeding, hands down), you have seen LCs, you have seen the structural specialists and paid for the revision, you have looked into suck training. All this while keeping it up around the clock for weeks on end. That is an insane amount of commitment. At this point, you absolutely 100% deserve to find a way of feeding you and baby ENJOY –pumping output, milk to formula ratio, or nursing effectiveness be damned. Go with what makes you feel good and accomplished, and just enjoy breastfeeding however it looks for you guys.
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Reviving an old thread because I could use some advice. My DD is almost 10 months old and she has just gotten her top four teeth in (bottom two came at six months). She is biting me, really hard, after just a few sucks, on every feed. I pretty much decided today that that's it, she's on full-time formula. But then I started Googling...I think to get validation for my decision? All I can find is articles telling me how to get through the biting, not any objective discussions/advice on how to figure out if I should be trying to get through the biting or if it's time for me (personally) to leave it and move to formula full-time. I had a look on fedisbest.org but I couldn't see much about the early-weaning/biting issue. Does anyone have any other good resources? I'm feeling conflicted because once we got over the very painful first 4 months of breastfeeding, I've really liked having that bonding time with DD at least in the mornings and evenings. But I think I'm also looking for someone to say "it's OK to stop now!", because all these how to stop biting articles are premised on the idea that I'm depriving her if I switch to formula (which I know intellectually isn't true, but emotionally the guilt is strong...)
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I have no resources and am just at the start of my own breastfeeding, Dreamer8887, but my mum weaned us as soon as we started biting to solid foods and (I'd have to check this) presumably formula as well. For her, the 2 middle children both thought it was a game and so she decided they'd had lots of months of feeding and were ready to interact with her in other ways. They really highly happy, healthy and intelligent individuals, so that's a little bit of anecdata for you :)
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Reviving an old thread because I could use some advice. My DD is almost 10 months old and she has just gotten her top four teeth in (bottom two came at six months). She is biting me, really hard, after just a few sucks, on every feed. I pretty much decided today that that's it, she's on full-time formula. But then I started Googling...I think to get validation for my decision? All I can find is articles telling me how to get through the biting, not any objective discussions/advice on how to figure out if I should be trying to get through the biting or if it's time for me (personally) to leave it and move to formula full-time. I had a look on fedisbest.org but I couldn't see much about the early-weaning/biting issue. Does anyone have any other good resources? I'm feeling conflicted because once we got over the very painful first 4 months of breastfeeding, I've really liked having that bonding time with DD at least in the mornings and evenings. But I think I'm also looking for someone to say "it's OK to stop now!", because all these how to stop biting articles are premised on the idea that I'm depriving her if I switch to formula (which I know intellectually isn't true, but emotionally the guilt is strong...)
It's OK to stop now! I was formula fed from birth (as far as I can tell purely of the convenience to my mom) and nevertheless was a precocious kid from the start, well liked, happy, and highly successful academically, also turning out into a pretty decent adult if I do say so :)
Despite that, DW and I originally wanted to BF exclusively but for various reasons have been exclusively formula feeding since our daughter was 5 weeks old. Today, she is growing like a weed, hitting/beating every milestone, and is very healthy and happy. It has been a true joy watching her blossom into an inquisitive and sweet 6 month old, who is now expanding into solid foods. I was nervous to make the switch initially for the same reasons as anyone (i.e. "breast is best in any/all circumstances" propaganda), but after exhaustively researching what I could find in the way of actual scientific publications, I have no doubts or regrets whatsoever.
10 months is a crazy long time to exclusively BF, as far as I'm concerned. You've done amazing keeping it up and should feel no guilt at all if you want to switch. Good luck!
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I stopped bfing my son when he was 9 months old because of biting. Everything online suggested that if I did various strategies he would stop, but he didn't stop and I hated it. It really hurt! Switched to formula for the last three months until he could drink cow's milk and it was fine. I had been combining formula and breastmilk for months while I was at work, so going exclusively to formula wasn't a big shock. He's 2.5 now and I don't see any problems in his health so far. :)
My four month old daughter is on combo formula and breastmilk while I work, and it's fine. Best of both worlds, if you ask me. I nurse her while I'm around her, pump for 1/2 hour every day at work, and make up the difference with formula.
I love this thread because it helps ease the emotional minefield of breastfeeding amid the various complications that life throws at you. Bottom line: just say no to the guilt. Do what works.
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He didn't use the word submucosal, so I don't know...
He said it was a mild anterior tie. He also told me if it didn't work, we could come back for a deeper laser procedure, but that's usually for posterior or severe ties. Since she has to go to daycare and will need bottles there, I don't think I'll pursue it further. She can nurse well enough for comfort and she's gaining weight. So I think I did the right amount to pursue this.
The SLP gave me a few exercises, but I'll look at the suck training on YouTube.
Anterior ties always have a posterior/submucosal component. And there's really no such thing as a "mild" tie. It's either there or not, and the SYMPTOMS are mild/moderate/severe. If you're having breastfeeding problems, it's not mild. I would not go back to that provider if you want to pursue getting the rest of the tongue revised. There is a Facebook group called "Tongue Tie Babies Support Group" with a ton of helpful information.
Our first son has a lip/posterior tongue tie (didn't know until recently), and our breastfeeding journey lasted 2 whole months due to our symptoms and my milk supply tanking due to poor feeding (he latched fine, just never a strong emptying suck). His symptoms were all-day-colic (this is not a real thing, colic should not be all day!), reflux, weak latch/suck, gasssss, etc. - it was all related to him eating inefficiently/poorly (both breast and bottle). Second son had the exact same issues starting around 3 weeks old, so I looked ALL over the place for answers. We have a very educated dentist in town, and he lasered the lip and tongue tie at 11 weeks, and now at 14 weeks we have a totally different baby and feeding relationship. Please please look into the possibility of your baby having a posterior/submucosal tongue tie that is affecting your breastfeeding. Once 3-4 months hits and your supply is more reliant on supply/demand vs hormone levels, if tongue tie is contributing to your problems, your supply may completely tank and you may have to prematurely end breastfeeding.
Not to sound preachy, I just want to scream it from the rooftops that we found a fix that may have made our entire first year with our first son a completely different experience. Pediatricians and even many lactation consultants, ENTs and dentists are NOT trained to recognize posterior ties. :(
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Reviving an old thread because I could use some advice. My DD is almost 10 months old and she has just gotten her top four teeth in (bottom two came at six months). She is biting me, really hard, after just a few sucks, on every feed. I pretty much decided today that that's it, she's on full-time formula. But then I started Googling...I think to get validation for my decision? All I can find is articles telling me how to get through the biting, not any objective discussions/advice on how to figure out if I should be trying to get through the biting or if it's time for me (personally) to leave it and move to formula full-time. I had a look on fedisbest.org but I couldn't see much about the early-weaning/biting issue. Does anyone have any other good resources? I'm feeling conflicted because once we got over the very painful first 4 months of breastfeeding, I've really liked having that bonding time with DD at least in the mornings and evenings. But I think I'm also looking for someone to say "it's OK to stop now!", because all these how to stop biting articles are premised on the idea that I'm depriving her if I switch to formula (which I know intellectually isn't true, but emotionally the guilt is strong...)
Its absolutely okay to stop and you shouldn't feel guilty about it. If you do want to continue breastfeeding, I can offer the article below on signs to look for so you can see why (is she done? Bored?) and try to stop before it happens. My experience was that both of my baby's did this around this age. It generally happened towards the end of nursing and I was able to proactively remove them from the breast before they bit (in part because I recognized a pre-bite pattern with each of them). It lasted maybe a week and then they were over it. Good luck, and whatever decision you make is the right one. Your happiness and comfort is important.
http://kellymom.com/ages/older-infant/biting/
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Dreamer8887 - All of the evidence based benefits of breastfeeding really occur before 6 months – namely the modest protection against lower level infections, and the reduced rate of NEC in premature hospitalized infants. Similarly, the benefits for mom tend to be concentrated in the first few months as well…as those tend to be the months that help delay the return to fertility. And even the highly questionable and super muddy evidence on long term health outcomes doesn't even explore or find differences between babies breastfeed at varying extended durations (most of the research focuses on 6 months as the cut off). As a result, there is no good evidence to date that suggests that babies who are breastfed for say 10 months rather than 12 months are any less healthy, less smart, less anything than their extended BF counterparts. If you are wondering why the recommendations go to 12-24 months, the issue is one of varying context. Most of the global health recommendations for extended breastfeeding to or past 12 months are predominantly due to concerns about infant formula/water quality in the developing world (better to breastfeed the baby than offer questionable water or animal milk mixtures which can be very dangerous) rather than a long term health benefit to baby in terms of receiving breastmilk over properly prepared, safe formula. In a developed nation, this threat is removed and so it really comes down to mom and baby's preference and whether or not the relationship is working well for them.
Biting is a serious concern, especially if your child is a legit threat to your nipple. My personal opinion is that an extra month or two of breastfeeding is absolutely not worth risking nerve damage or losing a nipple over. It also isn’t worth it if you begin to dread or fear feeding time due to the biting. Better to transition to the bottle and continue to enjoy feeding than continue with an unhealthy breastfeeding relationship. 10 months is a crazy fabulous achievement and you need to prioritize yourself now...even if that means ending nursing. You can also switch to pumping if you still want to provide breastmilk without threatening your nipples :)
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Thank you all very much for the replies. I did look at the Kellymom advice on biting, and I felt it was really useful. I gave it a few more goes but she doesn't even feed for awhile and then bite, it's pretty much one or two sucks then a giant bite. Little_brown_dog, thank you for starting this thread and for all of the evidence-based advice you and others are giving. It really is making a huge difference to my peace of mind. I don't feel 100% about weaning, because I will miss it. But I don't think it would be healthy for either my nipples or my PPA-riddled mind to try to persevere. I'm making sure DD gets lots of cuddles as I'm a bit worried it was an abrupt stop for her, but she seems OK!
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Happy to help! Weaning is a tough thing emotionally for many women regardless of the reason for it. I found it hard at just 3 months (and I wasn't even nursing!), and I know moms who still cried a ton and found it hard even at 2 years. It is 100% normal to feel a bit sad or even guilty when your breastfeeding chapter comes to a close with your baby, no matter when or why that chapter ends. And most of the time, it’s us moms who have a hard time with it – by and large the babies are just thrilled to keep eating and cuddling even if the food comes from a bottle instead! It sounds like with the consistent rough biting and your PPA, weaning is the best and healthiest path for you two right now. Great job!
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This thread was very reassuring as I started breastfeeding. I knew if I needed to, I had formula as a safe option. We had a rough start and settled down, with lots of wet nappies and OK feeding. After 2 weeks, I decided my little guy's tongue tie was affecting his feeding (not getting a good latch with proper seal, kept gulping air and dribbling). We got it cut today and he can get an impressive latch now, heaps of boob in his mouth and a much harder suck! He's 3.5 weeks old.
The doc who did it was great and said if I do notice my milk going down, any decrease in wet nappies or the baby still isn't settling, start supplementing with formula because a fed baby is the goal :)
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Thanks for starting the new thread which I want to follow. I have not read everything but breastfeeding, as I've read can be done by many, but exclusively bf is another story. My mom and women her age alike (my friend's mothers, etc.) exclusively bf. My mom even threatened that I must bf or she will refuse to babysit my daughter bc she will be fussy. Later on it was discovered that she only bf for 4 and 6 months. Not bad but you know the professionals recommend a year, so even she didn't do that yet she was putting SO much pressure on me. I also found out that her cousin never bf bc it just didn't happen. Culturally, she made it seem like YOU MUST bf bc everyone in ABC race bfs AND it's good for the baby. Yeah, well, we already know about the health benefits of bf.
I was not off to a great start but as many people will tell you (as they told me) it gets easier and it did, though to this day I still wonder 1) HOW MANY women TRULY exclusively bf (bc I still supplement, mainly out of convenience), and 2) at what point am I supposed to have SO MUCH milk that I can freeze [a winter's worth]? The 2nd question was discussed with a gf who is also bf, and I kept saying that it would be impossible for me to freeze milk unless I was supplementing. Is this freezing of the milk like some genius evil impossible ploy meant to make break milk freezer bag suppliers money and to add stress to a new mom's life? Is it only going to happen when my baby starts eating solids bc duh, now that would make sense! I just had some skewed image in my mind that like bf is easy, natural and like I was going to produce so much I could just easily freeze like how I saw in all the social media posts, campaigns, etc. No. no, no.
I friggin had mastitis three times. I didn't use an epidural but let me tell you mastitis felt like death to me. I didn't discover the nipple shield until way later. I was also so torn about bf vs formula bc my daughter had jaundice so severe that we went home with the Billy Rueban light, yet here I was thinking about what that nurse implied or said. I don't even remember. Oh, if you formula feed once you will counter your bf efforts. Like did some healthcare professional really tell me/imply this?! And I didn't know what I was doing so I believed her! Luckily my MIL and husband was like whatever formula feed her, or idk what could have happened with my daughter and this jaundice issue. Later on I even found out the pediatrician will likely recommend you supplement for the vitamins! WTF to bf exclusively. Oh, and I hated how the nurses kept on calling it the case of the bottles that my daughter wouldn't latch on. If you're such a professional why didn't you suggest a nipple shield instead of pushing me to use your $150 non covered hospital grade pump?! They eventually waived that. My nurse friend that worked at the hospital straight up told me that hospital gets funding for bf so don't be surprised if they push you to do it... pushing it is one thing but in hindsight I felt like I was downright bullied into bf or else you are a HORRIBLE HUMAN BEING! Whether it be verbally or not as they were probably passive aggressive about it, let's just say at a hospital over bf was the last place I'd expect to be god darned BULLIED!
Anyways, it got better, easier, more efficient and my supply is sufficient. I may just wean this bf at 6 months bc even when my daughter sleeps long I can't because my boobs wake me up. Ugh, no man will ever understand this, and in some ways it sucks esp mastitis, and vacations at this point are very complicated.
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...
I was not off to a great start but as many people will tell you (as they told me) it gets easier and it did, though to this day I still wonder 1) HOW MANY women TRULY exclusively bf (bc I still supplement, mainly out of convenience), and 2) at what point am I supposed to have SO MUCH milk that I can freeze [a winter's worth]? The 2nd question was discussed with a gf who is also bf, and I kept saying that it would be impossible for me to freeze milk unless I was supplementing. Is this freezing of the milk like some genius evil impossible ploy meant to make break milk freezer bag suppliers money and to add stress to a new mom's life? Is it only going to happen when my baby starts eating solids bc duh, now that would make sense! I just had some skewed image in my mind that like bf is easy, natural and like I was going to produce so much I could just easily freeze like how I saw in all the social media posts, campaigns, etc. No. no, no.
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Anyways, it got better, easier, more efficient and my supply is sufficient. I may just wean this bf at 6 months bc even when my daughter sleeps long I can't because my boobs wake me up. Ugh, no man will ever understand this, and in some ways it sucks esp mastitis, and vacations at this point are very complicated.
I think I only ended up with enough milk to freeze because I started pumping after one nursing session and again at night after he fell asleep. The night-time pumping session was recommended by a friend who works at WIC. She told me to pump for 5 minutes, then rest for 5 minutes, then repeat the cycle 3 or 4 times, in order to mimic cluster feeding. Theoretically this can trick your body into producing more, because it thinks your baby is having a growth spurt. I don't know if it REALLY worked, but my daytime pumping supply increased just enough to cover what he was eating at daycare, the 2 or 3 oz extra I was getting from pumping at night added up over time, and now I've got probably 2 or 3 weeks of frozen supply. Pumping at night when your baby is still waking up to eat 2-3 times at night is no fun, though. Blech.
Baby has just started almost sleeping through the night, and you're right about being woken up by your boobs :) I'm going to be really glad when he is more consistent and my milk supply equalizes a little. Avoiding mastitis is like a main life goal right now. I've had it twice, and it was so bad. Antibiotics and lecithin capsules are the best things I've ever purchased.
ETA: I have been exclusively breastfeeding for eleven months, but I've had a good supply, no tongue or lip ties, and a kid with a decent latch. It is a lot easier once there are solid foods involved, so I'm lucky I live close to a Wee Steps with a lactation consultant that is covered by my insurance, and that I have friends who had experience with lots of different kinds of breastfeeding issues who gave me good advice and help.
Edit 2: I guess I exclusively breastfed until he started eating solids and drinking a little bit of water out of a cup at ~ 6 months. What I meant is that I've never used formula, but he is definitely eating more than breast milk now, thankfully :)
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MrsCoolCat - I am so sorry you were bullied by medical staff, especially when your child clearly had a medical indication for supplementation. Those are the outdated, ridiculous beliefs that have caused many children to be underfed. Severe jaundice can be dangerous, and appropriate hydration is critical for protecting the children suffering from it. You did the completely correct thing by offering your child extra food.
To answer your 2 questions....
1. How many women actually EBF? The number is very low in the US. The 2016 CDC breastfeeding report card showed that only 22% of moms reported EBF at the 6mo mark. But, some of those moms also probably supplemented at least a little bit in the beginning before their supplies regulated, or due to medical issues like low blood sugar in their child (just because you are EBF at 6mo does not mean you were always EBF). So in reality, the number of true blue strict EBF moms who have never used even a drop of formula ever is probably even lower than 22% at 6mo. Combination feeding is actually the most common form of breastfeeding in the US, not exclusivity. At 12mo, only 31% of moms are still breastfeeding at all, combination or EBF. Given the dismal stats at 6mo, I would not be surprised if <10% of moms in the US actually make it to the 1 year mark EBF, even if we include those that supplemented at first and then transitioned to EBF later.
2. Milk supply - Some women naturally make a ton of milk and experience oversupply, but most are like you and have a "well regulated" supply unless they purposefully engage in additional pumping regimens ontop of nursing in an effort to build up more. It is not typical for moms to be able to nurse baby all day and still pump tons of milk for saving, as that means mom is making too much milk. If you have already had multiple bouts of mastitis, I caution against trying to force your body to produce more just for a freezer stash. Over supply moms often have to battle mastitis and plugged ducts and get caught in a vicious circle of needing to get all the milk out in a timely fashion (to prevent the plugs) which in turn stimulates them to keep producing so much milk. Oversupply can seem like one of those "love to have" problems but it can be really horrible too.
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Thanks Little Brown Dog! Very helpful & informative post!
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Chiming in about EBF and freezer stash. For my first kid, I EBF till 6 months and continued to breastfeed (with solids) till she was almost 2. However, since I was also working I fell into the trap of needing enough freezer stash and ended up doing a lot of pumping and filled up on freezer stash. But I found that my kiddo hated frozen and thawed milk, so much that she preferred to go hungry than drink it if it was the only option available. Thankfully my supply was on par with what she wanted so I didn't have to use the freezer stash. I ended up donating all the milk to a nearby hospital for their NICU use. If you are building a freezer stash, make sure you kiddo will actually use it before going through a lot of pain to build that freezer stash.
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2. Milk supply - Some women naturally make a ton of milk and experience oversupply, but most are like you and have a "well regulated" supply unless they purposefully engage in additional pumping regimens ontop of nursing in an effort to build up more. It is not typical for moms to be able to nurse baby all day and still pump tons of milk for saving, as that means mom is making too much milk. If you have already had multiple bouts of mastitis, I caution against trying to force your body to produce more just for a freezer stash. Over supply moms often have to battle mastitis and plugged ducts and get caught in a vicious circle of needing to get all the milk out in a timely fashion (to prevent the plugs) which in turn stimulates them to keep producing so much milk. Oversupply can seem like one of those "love to have" problems but it can be really horrible too.
This was me, especially with my second child, who was premature. The hospital LC's encouraged a very rigorous pumping schedule because he was nil by mouth for the first several days, and didn't breastfeed well for a few more weeks. Well...by a week in, I was pumping 40 oz/day. Some days closer to 50. It took months to wean down, and I did get mastitis. Even when my baby was sleeping 8 hours overnight, I had to wake up after 5 hours to pump. On the plus side, I was able to donate 2,000 oz of milk and still have enough of a freezer stash to stop pumping 6 weeks before he will turn one. But man, it is not all rosy on the oversupply side either.
More importantly - to a certain extent, your body will do what it's going to do. We can influence it, but only to an extent. My body, apparently, will make massive quantities of milk given half a chance. Other women's bodies won't produce enough milk no matter what steps they take. I wouldn't worry a lot about building up a freezer stash. However, if you think you might end up combo feeding in the future, maybe consider giving your baby a but of formula every few days, just to make sure they continue to be willing to take it. We found out the hard way that mine will not, after several months of not getting any (long story, but we had an interstate move and I donated all the milk I had frozen and then had to be away from the baby for a full day shortly afterwards - he was not a happy camper that day).
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2. Milk supply - Some women naturally make a ton of milk and experience oversupply, but most are like you and have a "well regulated" supply unless they purposefully engage in additional pumping regimens ontop of nursing in an effort to build up more. It is not typical for moms to be able to nurse baby all day and still pump tons of milk for saving, as that means mom is making too much milk. If you have already had multiple bouts of mastitis, I caution against trying to force your body to produce more just for a freezer stash. Over supply moms often have to battle mastitis and plugged ducts and get caught in a vicious circle of needing to get all the milk out in a timely fashion (to prevent the plugs) which in turn stimulates them to keep producing so much milk. Oversupply can seem like one of those "love to have" problems but it can be really horrible too.
This was me, especially with my second child, who was premature. The hospital LC's encouraged a very rigorous pumping schedule because he was nil by mouth for the first several days, and didn't breastfeed well for a few more weeks. Well...by a week in, I was pumping 40 oz/day. Some days closer to 50. It took months to wean down, and I did get mastitis. Even when my baby was sleeping 8 hours overnight, I had to wake up after 5 hours to pump. On the plus side, I was able to donate 2,000 oz of milk and still have enough of a freezer stash to stop pumping 6 weeks before he will turn one. But man, it is not all rosy on the oversupply side either.
More importantly - to a certain extent, your body will do what it's going to do. We can influence it, but only to an extent. My body, apparently, will make massive quantities of milk given half a chance. Other women's bodies won't produce enough milk no matter what steps they take. I wouldn't worry a lot about building up a freezer stash. However, if you think you might end up combo feeding in the future, maybe consider giving your baby a but of formula every few days, just to make sure they continue to be willing to take it. We found out the hard way that mine will not, after several months of not getting any (long story, but we had an interstate move and I donated all the milk I had frozen and then had to be away from the baby for a full day shortly afterwards - he was not a happy camper that day).
40 to 50 oz per day?!?!?!?!? Holy moley, that is an amazing volume of milk. When I pump at work I get 15 oz on a GOOD day. Granted, my kid is a snacker and also eats when I get home and before bed and once or twice at night still (/crying on the inside a little at the lack of sleep), but wow. Good job being able to make it work and then donate so much of it!
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I'm just posting because I'm planning to need this information in my future, thank you all so much for such a wonderful, informative thread.
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We BF 1st and 2nd; 2nd was much easier because DW was less stressed and wasn't trying to work PT. Stopped each at 1 year. Went well.
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I apparently have high lipase, because after a few hours in the fridge, my milk tastes horrible.
Little one seems willing to still take it, sometimes. Other times she'll reject it. I defrosted some milk and she took that, so hopefully we don't have issues when daycare comes. Otherwise I'm going to have to start scalding, and I just don't know how to find time at work for that...
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To revive this thread:
A new opinion piece published on CNN regarding rigid breastfeeding promotion in warzones. This is just another example of more people in the public health and medical communities questioning the safety of pushing rigid exclusivity in breastfeeding in varying contexts. This time it’s Doctors Without Borders and other aid workers expressing how a lack of willingness to provide infant formula due to rigid breastfeeding promotion policy is negatively impacting children in conflict areas/developing nations. The director for DWB in Iraq is on the record articulating that a baby's immediate safety is always the first priority - "if mothers need formula, we give it to them."
http://www.cnn.com/2017/08/12/opinions/global-breastfeeding-policies-opinion-lemmon/index.html
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Great thread. PTF.
I've been EBF for three weeks and it's getting easier but I wouldn't say I enjoy it. Keeping up hope!
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I weaned my second child a month ago. My boobs are tiny now. Way smaller than they ever were before. This did happen with my first as well, but when I got pregnant again my boob game got strong again. Sigh, now they're tiny, flabby, and listless.
I know there's nothing to be done about it, but why does this happen? Do things ever perk up again, or is this the "new normal"? I'll get over it but it's kind of sad.
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I weaned my second child a month ago. My boobs are tiny now. Way smaller than they ever were before. This did happen with my first as well, but when I got pregnant again my boob game got strong again. Sigh, now they're tiny, flabby, and listless.
I know there's nothing to be done about it, but why does this happen? Do things ever perk up again, or is this the "new normal"? I'll get over it but it's kind of sad.
How long was it between weaning your first and become pregnant with the second? It took a full year, maybe a little longer, for me to return to my normal, pre-pregnancy state (in that area) after weaning.
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It was about 9 months between weaning #1 and getting pregnant with #2.
It strikes me as such a small, petty thing to be concerned about. But I am, can't deny it.
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It was about 9 months between weaning #1 and getting pregnant with #2.
It strikes me as such a small, petty thing to be concerned about. But I am, can't deny it.
I was feeling the same but I bet you will be pleasantly surprised about a year or less after weaning your second.
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Unfortunately I think everyone is different on the post-baby boob changes. I know many women report a loss of “perk” or lift after experiencing pregnancy and breastfeeding. My understanding is that the increase in sagginess of the boobs post pregnancy and breastfeeding has to do with a loss of elasticity in the skin and tissue of the breast due to all that rapid growth and then subsequent deflation. Loss of skin elasticity is also exacerbated by the natural aging process. For the floppiness or the boob itself, at only a month out, your breasts are still in the process of switching over their tissue structure, which can take months. You might find that once they go back to more fatty tissue that they develop a fuller, less-deflated appearance, even if they do ride a bit lower than before. I wouldn't panic just yet at only 1 month out....6 months from now you will probably have a more accurate idea of what your future boobs are more likely to look like.
My boobs stayed larger than my pre-baby days after I weaned despite losing all the baby weight, and they definitely are a bit saggier than before baby (not particularly obvious, but noticeable to me). With this 2nd pregnancy, they got huge fast and are now really big – much bigger than they were first time around at this stage. I’m emotionally preparing myself for the fact that I’ll probably never get those perky little boobs back from my early 20s, especially after 2 kids. Ah well.
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With regards to the perkiness afterwards, the ABA counsellor that attended our meetings said that the sagginess was caused by pregnancy so there was nothing we could do to avoid it in the first place.
However, she did say that to help with reducing sagginess afterwards, to try to wean gradually if possible. I can't remember the full explanation why, but it was along the lines of allowing the skin time to adjust, and 'destretch' whereas if you wean quickly your body has a rapid change, which can lead to more stretch marks, + the skin hasn't shrunk as well.
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I love this thread. I'm trying to catch up - so much great info!
I've been EBF for three weeks and it's been tough at times, especially the beginning. I've seen multiple LCs and received a ton of excellent support.
I've been consuming delicious lactation cookies: http://www.organicmamacafe.com/2012/07/flourless-lactation-cookies-monster-cookie-style/
One thing that stands out to me is that my husband meant to be supportive but it really felt invalidating (as said on a previous page) when he repeatedly suggested pumping or formula. He just wanted me to stop being in pain and be able to sleep more, but I wanted him to say, "You got this. And I'll support you in any way you like."
In fact, there was a great Kelly Mom article that spoke to this but I can't find it again :/
Great thread, thanks for creating!
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Thank you, all, for creating and reviving this thread! I'm due in November with our third, and I was unable to nurse either of my first two past their first week of life.
Reading through all of the posts just made more and more things about my experience make sense, and it's given me hope that maybe with my third we will be able to have more success with breastfeeding.
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Unfortunately I think everyone is different on the post-baby boob changes. I know many women report a loss of “perk” or lift after experiencing pregnancy and breastfeeding. My understanding is that the increase in sagginess of the boobs post pregnancy and breastfeeding has to do with a loss of elasticity in the skin and tissue of the breast due to all that rapid growth and then subsequent deflation. Loss of skin elasticity is also exacerbated by the natural aging process. For the floppiness or the boob itself, at only a month out, your breasts are still in the process of switching over their tissue structure, which can take months. You might find that once they go back to more fatty tissue that they develop a fuller, less-deflated appearance, even if they do ride a bit lower than before. I wouldn't panic just yet at only 1 month out....6 months from now you will probably have a more accurate idea of what your future boobs are more likely to look like.
I am having to consider breast reduction surgery at this point after having 2 pregnancies. Losing weight has not helped, at all. They stay the same size. Doing chest presses at the gym doesn't help either. It's just given me really strong arms now.
The only thing that will help is surgery. Which insurance does not cover. I might consider getting surgery, though. And just paying for it. I can't deal with this!
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Can I ask a breastfeeding-related question here?
My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?
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Can I ask a breastfeeding-related question here?
My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?
I used to get that and it was so random. I don't think you have to worry about thrush, at least not yet. You can check your baby's gums and tongues for signs. If it's thrush, it'll be coated in white that doesn't come off when you lightly scrape. Your nipple and areola will also get red.
Keep an eye on it. Hang out with your flaps down when you can to make sure things air out. If you do suspect thrush, you can rub monistat directly on your nipples and it'll be fine for both you and baby.
I found that it was just one of those weird things that happened when I nursed. :/
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Can I ask a breastfeeding-related question here?
My right breast is having a sharp stabbing pain very infrequently. Since yesterday. Google makes me fear thrush or worse. The pain is very infrequent and not SO bad. If it got worse I'd go to the doctor. But maybe I should be doing something else?
I used to get that and it was so random. I don't think you have to worry about thrush, at least not yet. You can check your baby's gums and tongues for signs. If it's thrush, it'll be coated in white that doesn't come off when you lightly scrape. Your nipple and areola will also get red.
Keep an eye on it. Hang out with your flaps down when you can to make sure things air out. If you do suspect thrush, you can rub monistat directly on your nipples and it'll be fine for both you and baby.
I found that it was just one of those weird things that happened when I nursed. :/
The fact that that's an option is a total relief! Thanks :) I'll keep an eye on things.
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Odd sensations can be normal with breastfeeding – the key is to make sure it isn’t frequent/chronic or getting worse. If the sensation is in the breast itself and not the nipple area, it’s possible you might have a duct that is starting to clog up (one of the most common breastfeeding issues). If that’s the case make sure the boob is drained fully at every feeding (should go from swollen/firmer before feeding, to soft and floppy with practically nothing coming out if you hand express). You can also use some warm, wet heat (showers, bean bags or hot water bottles wrapped in damp facecloths, etc) and massage the area gently throughout the day to try to get ahead of the issue if you suspect it is a possible clog. Ducts clog when they don’t drain fully or sometimes when they get too compressed for too long (like if you sleep on your boob). A full blown clogged duct will often manifest as a really sore/tender area, often with flu-like symptoms such as low grade fever, chills, aches, fatigue. You’ll know it if it gets worse. I don't remember experiencing pain before my clogged ducts would appear, but I did have pain during them.
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Odd sensations can be normal with breastfeeding – the key is to make sure it isn’t frequent/chronic or getting worse. If the sensation is in the breast itself and not the nipple area, it’s possible you might have a duct that is starting to clog up (one of the most common breastfeeding issues). If that’s the case make sure the boob is drained fully at every feeding (should go from swollen/firmer before feeding, to soft and floppy with practically nothing coming out if you hand express). You can also use some warm, wet heat (showers, bean bags or hot water bottles wrapped in damp facecloths, etc) and massage the area gently throughout the day to try to get ahead of the issue if you suspect it is a possible clog. Ducts clog when they don’t drain fully or sometimes when they get too compressed for too long (like if you sleep on your boob). A full blown clogged duct will often manifest as a really sore/tender area, often with flu-like symptoms such as low grade fever, chills, aches, fatigue. You’ll know it if it gets worse. I don't remember experiencing pain before my clogged ducts would appear, but I did have pain during them.
Great tips, thank you!
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I occasionally got random "stabbing" sensations in my breasts during the time I was nursing (though not necessarily while my kid was actively feeding). Like you mention, LifeJoy, they happened infrequently and they weren't that bad, but kind of weird. Sometimes they seemed tied to thinking about my child or my child crying nearby, so I did wonder if it was some sort of production suddenly being stimulated.
I *did* get obviously clogged ducts a few times, just in one breast, and now that I think about it, that was the breast that got the stabby feeling more (it was also the breast that produced more milk when I pumped, and that my son generally seemed to prefer...). I was lucky that I was able to get it cleared up quickly each time and never progressed into mastitis or a chronic occurance. A hot washcloth and then lots of nursing did the trick the first two times, the last time the clog was actually right at the surface of the nipple and I wound up bursting it manually, which was crazy as I then had this out of control jet of milk going all over the place for a few minutes. It was not something I would want to have happen regularly, but as a one-time experience, it was kind of cool. Sort of like the satisfaction you get from popping a really big pimple, only moreso :)
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I occasionally got random "stabbing" sensations in my breasts during the time I was nursing (though not necessarily while my kid was actively feeding). Like you mention, LifeJoy, they happened infrequently and they weren't that bad, but kind of weird. Sometimes they seemed tied to thinking about my child or my child crying nearby, so I did wonder if it was some sort of production suddenly being stimulated.
I *did* get obviously clogged ducts a few times, just in one breast, and now that I think about it, that was the breast that got the stabby feeling more (it was also the breast that produced more milk when I pumped, and that my son generally seemed to prefer...). I was lucky that I was able to get it cleared up quickly each time and never progressed into mastitis or a chronic occurance. A hot washcloth and then lots of nursing did the trick the first two times, the last time the clog was actually right at the surface of the nipple and I wound up bursting it manually, which was crazy as I then had this out of control jet of milk going all over the place for a few minutes. It was not something I would want to have happen regularly, but as a one-time experience, it was kind of cool. Sort of like the satisfaction you get from popping a really big pimple, only moreso :)
Ha! Crazy story! And thanks for the tips :)
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Regarding latch:
If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?
I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.
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Regarding latch:
If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?
I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.
As far as I'm concerned: yes.
Daughter now transfers quite efficiently, is gaining great, is chunking up, I'm not in pain. But her latch is shallow and sometimes it looks like she only has nipple not aerola. Can't figure out what the point in trying to fix it is. She's happy, I'm happy. Who cares about textbook?
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Regarding latch:
If baby is getting fed enough milk (as evidenced by weeks of great weight gain), if feedings are efficient enough, if my nipples are not in pain, is that a good enough latch?
I ask because sometimes the latch is not as deep as I know it could be, but everything else seems fine... wondering if I should constantly attempt to perfect the latch or if good enough is good enough.
As far as I'm concerned: yes.
Daughter now transfers quite efficiently, is gaining great, is chunking up, I'm not in pain. But her latch is shallow and sometimes it looks like she only has nipple not aerola. Can't figure out what the point in trying to fix it is. She's happy, I'm happy. Who cares about textbook?
Sometimes my baby has just a little more than the nipple in his mouth, sometimes he has a giant chunk of boob. I'm with iowajes - as long as I'm not in pain, he's draining the boob and he gets happy and satisfied, I'm very happy and satisfied :)
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Yay! Good enough IS good enough!
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Yay! Good enough IS good enough!
Yup. The pragmatic definition of a good latch is one that: 1 – effectively transfers enough milk and keeps baby satisfied and gaining well, and 2 – one that is comfortable, not painful for mom and does not result in damage or harm to the nipple/surrounding tissue. If you meet both criteria, then you have a good latch even if it doesn’t seem to be exactly the same as some of the “perfect” latch demos you might see in breastfeeding resources. Every mom and baby are different in terms of baby’s mouth structure/size/ability to open, and mom’s nipple size and breast shape. As a result, a perfect latch varies widely because the exact “hardware” is different for every breastfeeding dyad.
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Yay! Good enough IS good enough!
Yup. The pragmatic definition of a good latch is one that: 1 – effectively transfers enough milk and keeps baby satisfied and gaining well, and 2 – one that is comfortable, not painful for mom and does not result in damage or harm to the nipple/surrounding tissue. If you meet both criteria, then you have a good latch even if it doesn’t seem to be exactly the same as some of the “perfect” latch demos you might see in breastfeeding resources. Every mom and baby are different in terms of baby’s mouth structure/size/ability to open, and mom’s nipple size and breast shape. As a result, a perfect latch varies widely because the exact “hardware” is different for every breastfeeding dyad.
The only reason I can think of to try to "perfect" your latch is plugged ducts/mastitis. My kid has one of these good enough latches, but all of the three plugged ducts I have had progressed to mastitis, and only one of them cleared up without antibiotics. I felt (perhaps wrongly) that if he had a deeper latch, he might have been more able to clear the plugged duct during nursing, and I might have been able to avoid the awful week of fever and pain each time.
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Sigh, I've ended up with a plugged duct. Best strategies for fixing it? I figured a hot shower & pumping while massaging, I've also been using different holds with my baby to hopefully get his suck to clear it out. Is there anything else helpful I can do?
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https://www.breastfeeding.asn.au/bf-info/common-concerns–mum/blocked-ducts
This is from the ABA.
I have also heard some mums get good results from massaging with electric toothbrushes, or vibrators. (Haven't tried it myself as I've never knowingly had one)
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https://www.breastfeeding.asn.au/bf-info/common-concerns–mum/blocked-ducts
This is from the ABA.
I have also heard some mums get good results from massaging with electric toothbrushes, or vibrators. (Haven't tried it myself as I've never knowingly had one)
Thanks for that, I forgot about checking there! I probably shouldn't have pumped, I hope it doesn't increase my supply, but it cleared the milk & then the lump shifted as soon as baby had a feed. Holding a heat pack on my boob was tricky but I'm pretty sure it helped, and I couldn't have held it while he was feeding, I suppose.
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My LC sent me this video:
https://m.youtube.com/watch?feature=youtu.be&v=GnBY3w9aVyo
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If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.
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If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.
A million times yes to soy lecithin if you can't get rid of the plug. I think I put this in upthread too, but I really truly believe it was the deciding factor the first time I got mastitis (after constant massage, two types of antibiotics, heat and cold packs, hot showers, immersing my breast in a bowl of hot salt water because I was willing to try ANYTHING, dangle feeding, feeding exclusively on that side, and vibration (I decided it was worth it to at least try, lol)).
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If you keep having trouble with plugged ducts, some moms have had success supplementing with soy lecithin. If you're able to dislodge it okay and don't develop mastitis, it probably wouldn't be worth the effort.
A million times yes to soy lecithin if you can't get rid of the plug. I think I put this in upthread too, but I really truly believe it was the deciding factor the first time I got mastitis (after constant massage, two types of antibiotics, heat and cold packs, hot showers, immersing my breast in a bowl of hot salt water because I was willing to try ANYTHING, dangle feeding, feeding exclusively on that side, and vibration (I decided it was worth it to at least try, lol)).
I'll keep this in mind, there is some in the Milo I have been drinking a lot of, but I suspect it's very low amounts.
My LC sent me this video:
https://m.youtube.com/watch?feature=youtu.be&v=GnBY3w9aVyo
Thanks for that, I will be watching it a few times!
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My son is 15 now and I still remember the pain of mastitis...happened at the end of weaning...thank goodness it didn't happen all year long! (first experience was hard, second easy) My daughter (12 now) didn't cause any problems.
I remember being told to point his chin toward the clog and to make sure to manually express it entirely...it was gross - he wasn't that interested and when I manually expressed it all out - it was clearly pus so no wonder he hesitated! Hot showers and definitely take care of it as soon as you notice!
Anyhow, some parts of motherhood will sear in your brain forever!
Good luck
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My baby girl was born on the 15th, we are breastfeeding but are off to a rough start. First we had latch issues, I have very soft short nipples and she had an uncoordinated suck (but strong!). I was given a nipple shield to use, she had bruised one of my nipples right off the bat. Additionally, within hours of birth her blood sugar plummeted. We had to supplement with formula to bring it back up. Fortunately we had a great lactation consultant that set us up with a supplemental nursing system (SNS) which worked decent with the nipple shield since you can just run the tube under the shield. She had me start pumping every 3 hours (hand expressing before and after too) and baby girl was given some supplemental formula at the same 3 hour interval. We followed a set of guidelines for how much to supplement for each feed daily which increased each day. We would give expressed breast milk as the first part of the necessary volume of supplement and then formula to reach the total. She also nursed anytime she asked (in addition to the 3 hour feedings.) Her blood sugar improved and we left the hospital on this regimen. She lost weight, started at 9lbs and was 8lbs 7oz at discharge. At her 72 hour appointment with her pediatrician she had lost even more weight and was 8lbs 4oz. The pediatrician wasn't concerned as it was still less than 10%. But he was concerned about how long she was nursing for (45ish minutes each? And I was pumping every 3 hours, super tired momma). He said she should only spend 10 minutes per breast and I should pump for 10 minutes after. He said we should stop supplementing too. I did tell him I was concerned with her latch but he felt there wasn't anything that bad. We met with the office's lactation consultant and she tweaked my nursing position a bit (both football hold and cross cradle) and said we could come back it 2 days to double check her weight.
I broke down and cried that afternoon because DH was frustrated and I was frustrated and she'd cry if she didn't eat for longer. The doctor specifically said he thought she was using me as a pacifier so I cried about that too. My husband suggested going to a bottle so I cried about that.
We had a home visit from another lactation consultant (3rd one involved if you're keeping track) the next day. My milk came in the day before (so much! I looked like I had a bad boob job) and I was told that I could stop the every 3 hour pump and just pump to comfort. This consultant gave me a and my husband a fabulous pep talk. We were officially off formula too! I continued to let her eat as she wished but she gets sleepy so we worked on that.
On Friday we took her in for another weight check and she'd lost another 2 oz. :( At this point she is right on the edge of a 10% drop. I had a bit of engorgement so I used cabbage to help (thanks for the pro top lifejoy! It only took 2 20 minute treatments). They basically told me to keep doing what I am doing and to come back in Monday for another weight check. We figured we'd have a nice weekend of baby wearing and nursing and cuddles and hope it helps.
Well I let DH take the first sleep shift last night, but she went down for a bit so I got in an hour and a half of sleep. I woke up to feed her again before he took over so I could get a decent stretch of sleep. I started feeling really cold but grabbed an extra blanket and tried to sleep. After an hour I was still completely freezing with chills. DH brought me a dose of 800mg Motrin an extra blanket and socks. Not much help. I asked him to check my temperature and it came back 101°F. We triple checked it but saw the same result every time. I called my OB and she said I needed to go to the ER. (details in the pregnancy thread) Bottom line baby got a bottle this morning because I didn't want her in the ER exposed to all the yuck. It wasn't as slow a flow bottle as I thought, DH said she took down 4oz of pumped breast milk in 10 minutes (two 5 minute sessions.) She went straight into a milk coma and slept for 4 hours straight, I had to wake her up to get her to eat again.
I'm on an antibiotic now (infection of some kind, not mastitis), but was told it was safe for breastfeeding and encouraged to continue breastfeeding.
Baby girl has been inconsolable unless she's on my breast the rest of this afternoon, I have had no sleep since midnight last night (it's nearly 4pm now). I just threw in the towel and am supplementing with her with pumped breast milk with the SNS at the nipple. She only ate a half oz and hit milk coma status.
At this point I'm still concerned we have a latch issue though the lactation consultants think it looks like I'm doing what I can. I need to sleep to recover, I'm reaching the point of going to bottle to recover but I don't want to lose the potential to breastfeed.
I guess let me know if you have any advice, sympathy is appreciated too.
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And she's awake and screaming... Forgot to mention while she's having enough wet diapers, she hasn't pooped since Wednesday...
Supplemented another half oz, but tried to make it flow faster. She's out again.
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I'm so happy your LC was/is a great support!! And I'm thrilled that the cabbage leaves helped - omg so soothing, amiright? But be conscious that it can reduce your supply maybe, so use only as needed.
I'm surprised your babe is only supposed to eat at the breast for ten minutes? I'm going to watch the clock but I'm pretty positive that sometimes my baby feeds for longer. However sometimes she has a very shallow latch. It has definitely been getting better over time.
In the early days I was so depressed and distraught and every time she would latch on I would yelp in pain because it HURT. It is now week 7 and has been getting better all the time! Like week four it was maybe markedly better? I can't remember. But we're at a pretty good place now.
Try not to lose hope. You will be amazed at how quickly things can get better, however you decide to proceed. It is really really hard to function and keep up hope when you're sleep deprived. If you aren't already, let everything else slide so that you can sleep. Make your partner be sleep deprived if possible, because he can down coffee like crazy! And he can nap whenever!
Ok thinking of you and hoping your infection goes away asap and that you get some sleep <3
Let me know if I can help in any way! It gets better, all of it, I promise.
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Breastfeeding is not easy, so while your struggles may be unique to you, struggling at first is normal.
A 10 minute limit surprises me. That seems very short. There might be some concern she is burning more calories than she is getting for food, and getting her supplemented is more important, but if she is just using you as a pacifier, so? What's the problem with that? Your nipple is as good as a dummy, as long as she isn't hurting you. Calming and cuddling is one of Mom's jobs.
Do you have any breastfeeding clinics near you? Our hospital has a free one once a week and I was a regular the first 3 months. It was good to have regular check-ins with the LC, and the opportunity to do a weighted feed. Before her tongue tie was clipped, she would often only transfer a half ounce in 30 minutes. After it, she can do 2-3 ounces in only 5 or 10. We never had weight gain issues because she was on so much formula at first, but the weighted feeds really helped e trust her to know when she had enough when supplementing stopped.
At 6 months she eats anywhere from 5 minutes to 45. I know sometimes I'm a pacifier, and I have no problem with that. (She does take an actual pacifier at daycare, but we don't use one at home.)
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EY so sorry you're having these issues. It sounds like we had very similar experiences (mine w DS when he was a newborn 3 yrs ago) -- latch issues, sleepy baby, nipple pain, and baby weight loss issues. Oddly enough, my pediatrician ALSO wanted me to do no more than 10-12 mins on each side and then cut him off (he was kind of old school, not sure if this kind of advice is consistent with modern best practices). When he told me that (at our 72hr appt I think?) I had already been nursing him for like 30-45 mins each side, so it seemed really odd to me that he wanted me to cut the sessions shorter. He also wanted us to nurse every 2-3 hours even if baby was sleeping, and supplement with formula (and do the insane pumping regime that goes with that) until he started gaining more weight (or losing less). The first 48 hours home were miserable - we were getting like no sleep, my milk hadn't come in yet, and to top it all off we had a major plumbing issue that resulted in basement flooding in the middle of our 2nd night home (not as bad as your ER visit but still we were like really??? this is happening NOW?).
Ultimately, a bunch of things happened that got us past the crisis mode. My milk came in abundantly, so we were able to stop pumping; the lanolin nipple cream I was using started to help the excruciating nipple pain I was experiencing; and we figured out our own way of doing things that kept us relatively sane and got baby what he needed. We rejected the 12 min limit but did generally try to keep it to 15 mins or so each side (this also helped my nipple pain). We got better at positioning with the help of an experienced LC who did a home visit. We tried to feed frequently but never got to the 10-12 sessions per 24 hrs that the pediatrician wanted us to do, and we also let DS sleep up to 4 or even 5 hours sometimes rather than wake him up. In the end we settled into a good rhythm, DS stopped losing and started gaining weight, and we were able to get more chunks of sleep to maintain our sanity. I still had nipple pain, especially right at the beginning of a feed, but that slowly and surely got better after 2-3 weeks postpartum (finally disappearing around 6-7 weeks I think? similar to what lifejoy was saying I think). And even though the first few weeks were so exhausting, painful and hard, I ended up bfing until DS was something like 20-21 months old, mostly just because it was easier to keep going than out of any particular goal to go that long.
So I guess I'd just say, so many of us go through these kinds of issues, and hang in there (but also allow yourself to cry about it...I did a lot of that for sure!!!). For most people it gets way better each day/week and you figure out a way forward that works for you (whether that involves supplementing or not). Am sure LBD will chime in with her usual expert advice, as will others! Just wanted to send you lots of sympathy and support - you're going through a lot and doing the best you can! Hugs.
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Have you tried giving her a pacifier while Dad holds her so you can get some sleep? The "mums mental health VS baby eating" was ROUGH for us for at least the first 2 weeks, and honestly still is at 5 months but, like Lifejoy, the actual breastfeeding was way easier around 4 weeks or so.
Maybe the ped wants you to keep switching sides of boob to help milk production? Other than that, I'm very sure we took 20 minutes per side to start with. I was also advised not to go longer than 4 hours, and to wake up baby if needed, because he had slight jaundice to start with. I can see why they want you to feed regularly, with the weight issue and initial blood sugar problem. Can you take 1 long break by giving a feed, you go straight to bed, then Dad does a feed, then you wake to feed or pump at her next feed time? Just today, to get some rest? Then see how you do tomorrow. I know skipping pumping/feeding isn't recommended way on for milk supply, but if you haven't had sleep you will start going actually crazy and won't be able to feed her anyway.
((((!HUGS))))))))
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We were waking the baby up every 2 hours during the day and every 3 (eventually switched to 4) overnight.
Never wake a sleeping baby would not have worked for us. She was such a sleepy baby she would have starved.
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Since my youngest is now nearly 9 years old, I'm going to skip reading 5 pages about breastfeeding -- it's no longer relevant to my life!
But as a mom of 3, I found that breastfeeding and supplementation worked very well for us. I also found that my three children nursed differently, one in particular was better at nursing than the other two. I decided early on that a happy medium between some breast milk and some formula would give us some benefits -- a lot less stress on me, the ability for my husband to help out, and no freaking out over production and latching and everything else.
I'm really glad that formula is available to help moms, and I'm really glad that many moms are also choosing to breastfeed. I enjoyed the combo approach, feel zero guilt about it, and would recommend it to anybody.
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And she's awake and screaming... Forgot to mention while she's having enough wet diapers, she hasn't pooped since Wednesday...
Supplemented another half oz, but tried to make it flow faster. She's out again.
Just empathy. Newborns are very hard to live with. But it gets better, you are in the hardest part right now and you can get through this. About 8 weeks is when the cloud lifts. Soon after you'll get the first smile and life will be a lot better.
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Hugs EngineerYogi, that sounds like a very rough start.
With regards to the latch, have any of the lactation consultants *actually* looked inside her mouth? Sometimes latches might look okay fom the outside, but they are hurting mum, are causing ineffective milk transfer etc. a common cause of this are ties, which are often overlooked.
This ENT has an excellent blog on ties http://www.drghaheri.com (http://www.drghaheri.com)
When you had her, did you recieve any IV fluids? Those can artifically inflate the birth weight, causing an apparent large drop on birth weight when baby then pees these excess fluids away. Some people are now advocating starting the measurements from 24hrs because of this.
Also, that 10 minutes per side sounds pretty crazy to me. A lot of very young babies take longer than this because they are still learning to breastfeed and develop a co-ordinated suck. I have heard of it with very poorly babies as they don't want them to expend all their energy eating.
And babies breastfeed for so many reasons - for comfort, for food, so they can be close to mum, because they are tired, because they are cold, because they are hot, because they want to etc.
I heard this quote just after I had Sir Ed :
You are not a pacifier; you are a Mom. You are the sun, the moon, the earth, you are liquid love, you are warmth, you are security, you are comfort in the very deepest aspect of the meaning of comfort.... but you are not a pacifier!" -- Paula Yount
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Thank you all so much for the support.
I definitely pushed aside the 10 minute rule, and agree she's still a tiny baby she needs me. Some days this works fine others she wants to eat every hour after mommy only got an hour of sleep. :/
I don't believe I got fluids, I gave birth in less than 30 minutes after arriving at the hospital. But I was retaining an incredible amount of water (I lost 26lbs in a week after birth!) the last two weeks of my pregnancy.
I'll be seeing the lactation consultant again in the morning and possibly try to get in with the pediatrician before her 2 week appointment this Friday.
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Oh EY I am sorry it is so rough.
First – re-read this thread if you need too. You are NOT abnormal in your experience. So many highly dedicated, highly resourced moms have been through similar things. Breastfeeding isn’t just challenging, sometimes it is really freaking hard for some dyads. This isn’t your fault in any way, shape, or form. First time moms are particularly prone to problems.
Second, the continued weight loss or weight plateauing is a key indicator that your child is not eating enough. The fact that it occurred after you stopped supplementing is highly indicative of a child not getting their needs fully met by nursing alone. The fact that your baby is screaming all the time unless nursing or eating is also another big clue. If she settles better after supplementing with pumped milk or formula, then you have your answer. She wants and needs more food and she simply isn't getting enough from nursing alone right now. If she has not gained enough by her next appointment, you know what to do.
As a general rule, newborns should be gaining weight DAILY and after the first couple of days should never lose weight. If baby isn't packing on a few ounces per day, that is a warning sign. If she isn't back up to her birth weight (or better yet, over her birth weight) by her 2 week check, that will be a big red flag. If you get to your check and the baby is not at birth weight without needing supplementation, and you are STILL told you shouldn't supplement with pumped milk or formula, I would personally find a different medical team as they are ignoring standard medical guidelines. As it is, a baby isn't supposed to lose >7% of their birth weight (10% is the older, outdated recommendation - the AAP updated it to be 7% in 2012 because 10% was too risky and too many babies were showing problems at that threshold, so they lowered it).
Please understand that many well meaning LCs and pediatricians are so brainwashed by outdated and misinformed ideas like “milk supply problems are rare” and “mom always makes what babies need” and "all babies can nurse well, just keep practicing!" they sometimes can’t see the writing on the wall when a child is floundering. A baby who is not gaining well, who is inconsolable except when attempting to feed, who isn't pooping regularly, etc is usually trying to show us they need more food. So many providers are convinced that supplementation is the devil, they will try to kick you off of it asap, even before baby and mom’s bodies are ready. Babies who are truly just pacifying at the breast don’t have weight gain problems – sure their nursing behavior may be annoying or atypical, but they grow well. Babies who nurse all the time and don’t gain well are quite simply, underfed babies. I am glad you listened to your instincts and went back to the SNS.
Fingers crossed her weight check goes well!
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I am so sorry you're having these issues. I didn't thoroughly read the prior responses so I apologize if these have been mentioned before.
1. Your LC should weigh your babe before and after a feeding. This is essential. That is the only way you will know how much milk your baby is transferring at your feed. If your baby is at your breast for 45 min and doesn't gain weight, you are dealing with a milk transferal problem.
2. Your breasts should feel floppy after a feeding and you shouldn't be able to pump much. If you can pump a lot, then the baby isn't getting your milk.
3. Ask around in local mom groups for an LC (and possibly pediatric ENT) who has good experience identifying posterior tongue ties.
4. A fed baby is best. I nursed all three of mine. I believe in it. But until you get this sorted out, make sure you're getting food to that baby. This is why formula was invented. Don't feel bad if you have to do it. It doesn't have to be permanent. It won't wreck your breastfeeding relationship. It won't mean you messed anything up.
I never fed mine for only 10 min per side. I have met some moms who could but that wasn't me.
For the possible latch issue, did the LC talk about a nipple sandwich? Basically, you grab your boob and squeeze it behind the areola so that it is flattened a bit and easier to get in baby's mouth. Here's a diagram - http://www.indianastands.org/positioning-latch-on-and-the-babys-suck-latch-on-part-3/ If you are too engorged to flatten it, start your milk flow (squirt it right into a bottle) until you've softened enough to compress it for baby.
The first 6 weeks of nursing are the hardest by far. If you can identify and get through the issues, I promise it will get better. Not just a little bit, but exponentially.
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We got DD in with the pediatrician yesterday and she'd lost even more weight. She was officially diagnosed as underweight. Way to break mommy's heart, my poor baby has lost a full pound since her birth. We are to supplement her now with as much milk as she needs/wants (my pumped breast milk first and formula if I'm out). Of course me being sick means my milk production plummeted and the small stock of milk I had was used up in just a few feedings. We're using a bottle for the supplementing too, she just isn't pulling milk from the breast efficiently enough, even with the SNS.
Very frustrating because the routine we were started on by the hospital LC was basically the right track, breastfeeding and pumping every 3 hours and supplementing her every 3 hours while allowing her to nurse on demand as well. The pediatrician told us to stop supplementing and only pump to comfort and his office's LC concurred.
So, I'm restarting the hospital LC's routine. Though I understand the 10 minute per breast recommendation now; DD gets frustrated quick because she isn't able to transfer efficiently and then she gets wore out and sleepy. Since we're giving her a bottle after being at the breast for 20 minutes total she's able to eat more and faster and I think she's getting more frustrated with the breast. I started using the SNS for each breastfeeding attempt and that seems to be enough to keep her on. In 20 minutes she's only able to eat a half oz via SNS on top of what she is able to pull.
I asked the pediatrician if he thought she'd get better at transferring milk and if this was temporary and he said yes. I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?
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When my daughter was having feeding issues we were referred to a speech language pathologist (part of a ENT clinic) for suck training. He was the one who finally told us her tongue tie was serious enough to get cut. Everyone else was "it's just not that bad".
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I'm sure you're heard this EY, but drink water and stay hydrated. Also, I"m wishing you and baby a nice nap soon! You deserve it! Hang in there.
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If her latch is that bad, I'd get a referral to a specialist now rather than waiting a couple of weeks.
I'm glad you went back to the hospital LC's routine, and she's eating more. It matches what I'm pretty sure 70% of the mums in my local mother's group did in the first couple of weeks, so it's been effective for others.
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I am so sorry her weight check did not go well. You are not alone in this experience, and you are certainly not the first mom to follow misguided breastfeeding advice that accidentally resulted in underfeeding the baby. I am happy that she is finally eating better and that she is now getting fed to avoid a more serious turn of events.
It sounds like you are on the triple feed regimen (nurse, pump, supplement) until further notice. Your ped is right in that most babies do go on to transfer better the older they get, so that is the good news. Many babies will show rapid improvement over the course of a week or two and can nurse decently well by 1 month old. I think you are right to look for a specialist’s opinion on her transfer issues, if for no other reason than to cover your bases and explore all possibilities.
The bad news is that triple feed regimens are extremely exhausting and are not usually feasible for long term usage >1-2 weeks because they are so time intensive and tend to cause moms to burn out. My recommendation is that as you look for a specialist to figure out her nursing issues, you also put a personal time limit on how long you are willing to do the triple feed schedule before switching to something more sustainable (be that just nursing and supplementing, or exclusive pumping for a bit and then trying nursing later, or whatever). Sustainability of breastfeeding and your enjoyment of it are just as important, if not more important, than breastfeeding a certain way. Now that baby is getting well fed, you need to focus on yourself too and make sure your breastfeeding regimen isn’t going to cause you to become so sleep deprived or depressed that you burn out and miss out on your new baby or enjoying breastfeeding.
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I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem). She was never "diagnosed" underweight - I think our doctor was unwilling to do that.
After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months. We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related).
Not gonna lie, this routine was a lot of work for about four weeks, but I got a break by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end. And I don't think we used the SNS for overnight feedings, just nursed.
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I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem). She was never "diagnosed" underweight - I think our doctor was unwilling to do that.
After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months. We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related).
Not gonna lie, this routine was a lot of work for about four weeks, but I got a break by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end. And I don't think we used the SNS for overnight feedings, just nursed.
Wow. I am blown away that you managed all of that AND went back to work at 6 weeks!!
How did you keep hope alive? I find that positive mindset is key for my BF journey. It can be hard when you're sleep-deprived, though.
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I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?
Yes. Do what you have to do to get your baby to a specialist. You need a pediatric ENT who has a reputation for being able to diagnose posterior tongue ties. Those are the hardest to dx so if s/he can find those, s/he should be able to find the rest. You may be able to get recommendations from a local breastfeeding group. Here is a link to one of the specialists in Atlanta so you can see what sort of background, certifications and interests you would hope to see - http://www.childrensent.com/providers/physicians/erik-bauer-m-d-f-a-a-p/.
One thing I've learned over 10 years with 3 kids is that your pediatrician is good only for general advice and first line assessment of issues. Once you have a problem, you really need to see a specialist to sort it out.
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I'm wondering if I need to advocate for a referral to a specialist so I can have her latch evaluated?
Yes. Do what you have to do to get your baby to a specialist. You need a pediatric ENT who has a reputation for being able to diagnose posterior tongue ties. Those are the hardest to dx so if s/he can find those, s/he should be able to find the rest. You may be able to get recommendations from a local breastfeeding group. Here is a link to one of the specialists in Atlanta so you can see what sort of background, certifications and interests you would hope to see - http://www.childrensent.com/providers/physicians/erik-bauer-m-d-f-a-a-p/.
Agreed. Now is the time to be seeking out a specialist, or specialists.
My son and I had similar and different issues- painful nursing, weight loss, slow weight gain which exacerbated newborn jaundice which resulted in a hospital stay. After two months of terrible pain, decreasing BMI, fussiness, 45-60 minute long nursing sessions, three lactation consultants, one pediatric ENT who said "it's not bad enough to fix; sometimes breastfeeding just hurts," we found an experienced pediatric dentist who diagnosed and fixed a lip tie. Immediately the pain went away and nursing sessions dropped to 20 minutes. We still had supply issues due to 2 months of baby not being able to suck out as much milk as he needed but breastfeeding went much much much better after that. I didn't do much with La Leche Legue for various reasons, but they are a good place to find referrals to lactation consultants, ENTs and dentists who are trained to rule out or diagnose lip and tongue ties.
I'm so sorry you are going through this! Hang in there. [I mean hang in there emotionally- as for feeding, do whatever you need to do for the physical and emotional health of your baby and yourself.]
Links:
Dr. Kotlow, a pediatric dentist who is a national leader in diagnosing and correcting tongue and tip ties. He trained the dentist we saw.
http://www.kiddsteeth.com/articles.php
http://www.kiddsteeth.com/breastfeeding.php
I wanted to add a link to Dr. Jack Newman's information about how to tell if baby is actually drinking on the breast, or just hanging out (which my boy did and which made time limits useless for us) but it looks like his site is down. I used his breast compression technique to increase the amount of milk my boy was getting until we got the lip tie fixed.
https://www.youtube.com/watch?v=56YzjsZr4hQ
http://www.breastfeedingmums.com/dr_jack_newman_breast_compression.htm
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I was in a similar spot with my first born - drop almost a pound from birth weight due to ineffective nursing and low supply (which are basically one in the same problem). She was never "diagnosed" underweight - I think our doctor was unwilling to do that.
After almost a month of SNS feeding (first) followed by pumping and bottle feeding (simultaneously) and using every supply-building suggestion and trick in the book, we were finally able to drop the SNS and continue a relatively normal BFing relationship until she called it off at 10.5 months. We also fortified her breast milk bottles with formula so that she would take in more calories, gain weight faster, and become a more effective nurser (as it's all related).
Not gonna lie, this routine was a lot of work for about four weeks, but I got a break by just pumping during the day when I was at work (went back at six weeks), so it was manageable and worth it to me in the end. And I don't think we used the SNS for overnight feedings, just nursed.
Wow. I am blown away that you managed all of that AND went back to work at 6 weeks!!
How did you keep hope alive? I find that positive mindset is key for my BF journey. It can be hard when you're sleep-deprived, though.
I'm not sure, really. It wasn't unusual for me to fall asleep on the couch right after work with the baby in my lap. I was very lucky in that she slept through the night for the most part (ironically my large, nursing-champ second child woke frequently at night) and my husband and I took shifts at night (he brought her to me to nurse during his shift and then put her back down or stayed up with her), so I wasn't as sleep deprived as I could have been. Plus my husband was very supportive.
But mindset was key. I took it one day at a time and tried to be very ok with it not working out. After a couple of weeks, getting to one month without weaning was a goal, then six weeks, etc. We were already supplementing and fortifying with formula as of a week from birth, so any desire/pressure to avoid it was gone and we could just focus on getting the baby to the point where it clicked.
On the top of tongue tie, we went to a pediatric ENT on the advice of our LC and he found nothing wrong. So some newborns just don't nurse well initially for whatever reason.
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EY, I just wanted to join the chorus sending you lots of virtual hugs and support. You are working your butt off to keep your baby healthy and fed, this mom thing is so hard, especially at the beginning! I'm no LC, but I have breastfed my three kids, using some formula supplementation here and there. A few thoughts in no particular order -
- Newborns are hard! I love my babies but the newborn stage is not my favorite for so many reasons! Hang in there, it gets better.
- I see you are in CA, this dr is in Portland and is supposed to be one of the best at treating tongue/ lip ties, http://www.drghaheri.com/, I *think* he does over the web consults as well. Definitely get checked out for a tie ASAP. My youngest had a tongue tie and it was clipped at our ped's office when he was just 2 or 3 weeks old. My ped is awesome and it was a minor tie so she didn't need to refer out. She highly recommended getting it done early because problems associated with a tie tend to get worse as the baby gets older. Plus bad nursing habits are hard to break.
- Get some rest! Pump or use formula, have your hubby give your LO a bottle and say "don't wake me up for at least 4hrs!" That amount of time won't wreck your milk supply, and you will feel so much better after some solid sleep.
- The 10min nursing thing sounds strange to me too. Newborns are terribly inefficient and have to practice a lot to get better at nursing. My first child in particular would nurse for WAAAAY longer, and that was fine. Which brings me to my next point...
- Don't feel guilty for offering a pacifier. Yes, it is mom's job to comfort and soothe the baby, but you CANNOT do it 24/7. My first child had a powerful suck reflex. At his 2wk appt, the ped took one look at me and said, "are you sleeping at all???" She said to give him a pacifier! I said, "but but but what about nipple confusion? And artificially satisfying him? And how will I know if he is really hungry?" She practically rolled her eyes (different ped than the one we have now, she was pretty old school) and said, "you'll know." And sure enough, gave him the pacifier and he was so happy and slept so much better and nursed until he was 15mo when he weaned on his own. My second child hated the pacifier and screamed at the sight of it, third was so-so. Each kid is different.
- Definitely try the soy lecithin for plugged ducts. I struggled with plugged ducts when I went back to work and had to pump 5 or so times a day (worked 12 hr days). Soaking the breast in a bowl of water also helped, but I obviously couldn't do that at work! When I started taking soy lecithin at the first sign of discomfort I found that pretty much eliminated the plugged ducts.
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Thanks again everyone for the support and suggestions.
DD gained 5 ounces in two days after starting the 10 minute nurse per side, plus bottle of as much milk (breast & formula) as she wants routine. My supply is still down though it seems to be increasing ever so slightly each day. She is also so much happier now that she's eating enough and she is sleeping wonderfully.
I got a referral to this place: http://milc.sacramentomnm.com/ they have Certified Nurse Midwives that can diagnose and treat ties as well as work with us to successfully exclusively breastfeed.
I have an appointment for next week!
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I experience nipple blanching after a feed. No extreme pain, so I'm guessing not Raynaud's Phenomenon. Should I be concerned? Baby seems to be eating enough. Latch might be shallow half the time though.
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EY... I am rooting for you. (pun intended?) Your description brings back so many memories. DD did get the tongue tie snipped and it helped enough that we continued breast feeding for 4 months, although bottle supplementation was always in the works after the first couple of weeks, and I did not have your strength to continue with all the different SNS systems and pumping cycles for long.
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I experience nipple blanching after a feed. No extreme pain, so I'm guessing not Raynaud's Phenomenon. Should I be concerned? Baby seems to be eating enough. Latch might be shallow half the time though.
I had that and my nipples haven't fallen off yet, so I guess it's okay! My babies also didn't have great latches until they grew a bit bigger.
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I experience nipple blanching after a feed. No extreme pain, so I'm guessing not Raynaud's Phenomenon. Should I be concerned? Baby seems to be eating enough. Latch might be shallow half the time though.
I had that and my nipples haven't fallen off yet, so I guess it's okay! My babies also didn't have great latches until they grew a bit bigger.
That is good :D
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Update: breastfeeding is going awesomely!! This is a far cry from the stress and pain I felt 7 weeks ago.
I want to thank whoever recommended the haakaa pump; best $30 I ever spent - that thing is AMAZING. Hands free, zero effort, easy to clean. Works like a charm.
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Can giving up dairy reduce my milk supply? Still got plenty of wet nappies from bub, but he's feeding for ages half asleep instead of taking naps during the daytime. He's got a suspected dairy allergy so I've given up dairy over the past week, which coincides with the sleep-suckling (for up to an hour, I get bored after that and move him and he wakes up).
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Update: breastfeeding is going awesomely!! This is a far cry from the stress and pain I felt 7 weeks ago.
I want to thank whoever recommended the haakaa pump; best $30 I ever spent - that thing is AMAZING. Hands free, zero effort, easy to clean. Works like a charm.
This is an awesome update! Really cool to hear that the haakaa is a good pump.
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Can giving up dairy reduce my milk supply? Still got plenty of wet nappies from bub, but he's feeding for ages half asleep instead of taking naps during the daytime. He's got a suspected dairy allergy so I've given up dairy over the past week, which coincides with the sleep-suckling (for up to an hour, I get bored after that and move him and he wakes up).
It shouldn't. But, if you're not getting enough calories or liquid, that may impact it.
If your babe is otherwise gaining weight, I would put an end to the sleep sucking. When he starts falling asleep, detach him. If he wakes up and wants to nurse more, fine but put an end to it when he falls asleep. If he is falling asleep before getting a good feed, do what you need to keep him awake (such as undressing, etc).
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What hold do people who use the haaka pump use? I can't figure out how there would be room to have a pump attached to my breast along with my daughter. (Not to mention now she is super kicking and wiggling while eating.)
I never figured out how to pump with a flange based pump while she ate. I sometimes use the freemie manual pump, but now she likes to pull the tubing.
I've upped her bottles to 4 ounces, which means I need to pump 16 ounces a day, and that is a lot. But I just can't figure out where the haaka would go...
Also- does it work at all if you don't leak when feeding?
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What hold do people who use the haaka pump use? I can't figure out how there would be room to have a pump attached to my breast along with my daughter. (Not to mention now she is super kicking and wiggling while eating.)
I never figured out how to pump with a flange based pump while she ate. I sometimes use the freemie manual pump, but now she likes to pull the tubing.
I've upped her bottles to 4 ounces, which means I need to pump 16 ounces a day, and that is a lot. But I just can't figure out where the haaka would go...
Also- does it work at all if you don't leak when feeding?
It would work with the football hold.
I haven't used one myself, but I understand it creates a vacuum around the breast, which is what draws the milk out,
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Haakaa pump - I use a modified cross cradle. I have baby on one side and a free boob in the other.
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I was able to pump in a cross-body hold. I just pumped over the baby while he nursed (carefully angled so it was over but not spilling). Not easy, but doable. Most difficult part is actually take the pump away from your body. I did use tubes rather than bottles, which may have helped.
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:/ I deleted my photo but it still shows up when I view this thread by title in my list of threads participated in... I hope adding a new photo will make that go away.(https://uploads.tapatalk-cdn.com/20171002/687ec8cbbbd355634de35f937c40146f.jpg)
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Ok let me know if anyone knows how I can remove my photo of my bust with baby haha.
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I only see a washing machine.
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Ok good :)
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The washing machine kinda looks like boobs, though.
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The washing machine kinda looks like boobs, though.
I thought so too. I figured it was intentional.
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The washing machine kinda looks like boobs, though.
I thought so too. I figured it was intentional.
Haha I wish I were that clever! Naw, I just grabbed a random photo off my phone :)
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Anyone have any experience with Bowen Therapy for a newborn and/or laser tongue tie revision? I'm still having breastfeeding struggles with Yogurt and had a couple of lactation consultants say I should have her evaluated for a tongue/lip tie. I found a highly recommended pediatric dentist that does the surgery with a laser. When I called about an appointment they said they also recommend Bowen Therapy before hand as a complement to the surgery.
Yogurt is a pretty happy baby, she definitely gets gassy but she soothes pretty easily. Bowen Therapy seems to be suggested more for colicky babies. I'm wondering if I should travel down this path or not?
I'm also trying to decide if I should keep putting in all this effort to make breastfeeding work? I'm not currently nursing at all because it was just too much when it wasn't actually doing anything. (Yogurt wasn't transferring at all, so her nursing was just incredibly frustrating for both of us. Based on some bad advice I stopped pumping after feeding her and that on top of my getting sick seemed to have tanked my supply. I'm pretty sure she's so inefficient that she isn't triggering milk production.) I am now pumping 8 times a day, I'm still under producing milk too. I also think I have a slow let down reflex. I pump for 30 minutes every pump session, I started out only getting around 8-9 oz per day (I was pumping more like 5-6 times a day). This week I worked on pumping at least 7 and then at least 8 times per day and my supply has steadily increased (Mon: 6 pumps 13.2 oz, Tues: 7 pumps, 13.6 oz, Wed: 7 pumps, 14.1 oz, Thurs: 7 pumps, 14.6 oz, Fri: 8 pumps, 15.1 oz, Sat: 8 pumps, 16.5 oz, Sun: 8 pumps 17.5 oz). But Yogurt eats an average of 30 oz per day so she is still getting supplemented with formula. All this to say that if she does indeed have a tongue tie and fixing it does make it so she will be able to latch and transfer milk efficiently I'll still have to supplement her until my supply reaches demand (which I hope it does, I'm encouraged since supply is going up). I expect this means I'll be back to the very exhausting nurse, pump, supplement routine for a while in order to get breastfeeding really established. I'm guessing this could take a full month? I go back to work in the middle of January and Yogurt will be off to daycare so she'll be bottle fed while there.
I feel like I have 3 options: continue to exclusively pump and bottle feed, go through the work for a tongue tie revision and "relactation" to get Yogurt to breast feed (possible this isn't successful), or switch to exclusively formula feeding.
Any tips, advice? What would you do? I'm just trying to really think this through. (cross posted in the Baby and Pregnancy thread)
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I'm not sure I'd get the Bowen therapy, but in your situation I'd probably get her assessed for a tongue tie, and cut if there is one. You can give yourself a "sanity timeframe" - if she's worked out breastfeeding within 2 weeks, awesome, if not, the tongue tie wasn't the issue and you can go back to formula/pumping or move to only formuka. If there isn't one, I'd probably move to formula only as my supply dropped from only pumping. *But* I'm not you :) Do you have the energy and support to try this? If you just don't want to do it, that's fine too :)
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EngineerYogi, sorry you're going through that, it sounds frustrating. My DD had a lip and tongue tie, and I had a pediatric dentist use a laser to get them both snipped. My thoughts:
- no guarantee the revision will improve breastfeeding - I had different issues to you, in that she was feeding and supply was fine, but it was a pain issue - incredibly painful and that continued for 4 months
- on the other hand, I've heard that lip ties can cause speech difficulties and tooth decay, and there were no downsides to having the revision done (other than the $600 I had to pay out of pocket) so I thought it was worth a shot
- I was often pumping instead of breastfeeding due to the pain being less on a pump, but I persevered for perhaps longer than I should have due to some internalized assumptions along the "breast is always best" lines that have been discussed really well in this thread. How do you feel about pumping? Is it interfering with your ability to rest, to spend time with baby? Are you placing undue pressure on yourself to get lactation to work out of misguided guilt/anxiety? Would it be a relief to just say "I tried, it didn't work for me, I'm going to switch to formula?" Others in this thread are far more eloquent and insightful about these issues, I guess I'm just trying to encourage you to look after yourself, not put pressure on yourself, and don't feel like you're "giving up" if it turns out that formula is the best option for your bub.
- on the other hand, if you're excited at the prospect of maybe being able to re-establish breastfeeding, then this thread is a great place for strategies on how to do that, and seeing a lactation consultant might be helpful.
Your baby sounds like she's doing wonderfully well, congratulations!
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Can giving up dairy reduce my milk supply? Still got plenty of wet nappies from bub, but he's feeding for ages half asleep instead of taking naps during the daytime. He's got a suspected dairy allergy so I've given up dairy over the past week, which coincides with the sleep-suckling (for up to an hour, I get bored after that and move him and he wakes up).
It shouldn't. But, if you're not getting enough calories or liquid, that may impact it.
If your babe is otherwise gaining weight, I would put an end to the sleep sucking. When he starts falling asleep, detach him. If he wakes up and wants to nurse more, fine but put an end to it when he falls asleep. If he is falling asleep before getting a good feed, do what you need to keep him awake (such as undressing, etc).
I forgot to thank you for the advice, it really helped. I wasn't getting enough calories and my supply has recently jumped! Baby is no longer sucking for ages either.
I'm into Week 4 of dairy free and some of his symptoms are back again. Trying not to worry and just hoping it goes away properly, we see the doc next week to check in :-/
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EY - my sons tie wasn't picked up until he was nearly a year old. We were able to breastfeed with it, but kept having issues cropping up (at the time I attributed them to other causes, such as teething). We actually left the hospital with him unable to latch without a nipple shield for the first 3-4 months
When he was diagnosed with it, the LC also pointed out the roof of his mouth was high and narrow, which was caused by his tongue being tethered, which can affect how airways develop - tongue tie can be a cause of snoring and sleep apnea.
We found that after Sir Ed has his ties cut he stopped snoring. At the time he also had 4 teeth, which he would grind. He stopped grinding completely after his ties were cut - if you know to look you can see the difference between them and the other ties. He didn't struggle with solids, but he definitely struggled with drinking - would cough and splutter and struggle everytime we gave him water.
I haven't heard of Bowen Therapy, but I know some places do recommend some sort of body work to help relax the muscles around the release - sadly there hasn't been much research conducted to determine how much/whether this helps with outcomes. (We never did any, so can't help there)
Edit: just wanted to add that in the tie support group I'm in, I have seen parents with tied babies also reporting difficulties with bottles too - struggle to get a good seal, so they end up taking in lots of air, and are quite windy/colic-y. No guarantees Yogurt would have difficulties with a bottle, or not, just something to keep in mind.
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Anyone have any experience with Bowen Therapy for a newborn and/or laser tongue tie revision? I'm still having breastfeeding struggles with Yogurt and had a couple of lactation consultants say I should have her evaluated for a tongue/lip tie. I found a highly recommended pediatric dentist that does the surgery with a laser. When I called about an appointment they said they also recommend Bowen Therapy before hand as a complement to the surgery.
Yogurt is a pretty happy baby, she definitely gets gassy but she soothes pretty easily. Bowen Therapy seems to be suggested more for colicky babies. I'm wondering if I should travel down this path or not?
I'm also trying to decide if I should keep putting in all this effort to make breastfeeding work? I'm not currently nursing at all because it was just too much when it wasn't actually doing anything. (Yogurt wasn't transferring at all, so her nursing was just incredibly frustrating for both of us. Based on some bad advice I stopped pumping after feeding her and that on top of my getting sick seemed to have tanked my supply. I'm pretty sure she's so inefficient that she isn't triggering milk production.) I am now pumping 8 times a day, I'm still under producing milk too. I also think I have a slow let down reflex. I pump for 30 minutes every pump session, I started out only getting around 8-9 oz per day (I was pumping more like 5-6 times a day). This week I worked on pumping at least 7 and then at least 8 times per day and my supply has steadily increased (Mon: 6 pumps 13.2 oz, Tues: 7 pumps, 13.6 oz, Wed: 7 pumps, 14.1 oz, Thurs: 7 pumps, 14.6 oz, Fri: 8 pumps, 15.1 oz, Sat: 8 pumps, 16.5 oz, Sun: 8 pumps 17.5 oz). But Yogurt eats an average of 30 oz per day so she is still getting supplemented with formula. All this to say that if she does indeed have a tongue tie and fixing it does make it so she will be able to latch and transfer milk efficiently I'll still have to supplement her until my supply reaches demand (which I hope it does, I'm encouraged since supply is going up). I expect this means I'll be back to the very exhausting nurse, pump, supplement routine for a while in order to get breastfeeding really established. I'm guessing this could take a full month? I go back to work in the middle of January and Yogurt will be off to daycare so she'll be bottle fed while there.
I feel like I have 3 options: continue to exclusively pump and bottle feed, go through the work for a tongue tie revision and "relactation" to get Yogurt to breast feed (possible this isn't successful), or switch to exclusively formula feeding.
Any tips, advice? What would you do? I'm just trying to really think this through. (cross posted in the Baby and Pregnancy thread)
We did not do Bowen Therapy so I can't comment on that. My baby had a very minor tongue tie and we were told by our lactation consultant that it would probably not solve our issues. We had it cut anyway, not just on the off chance that it might help with BF (spoiler alert: it did not) but because as others have said, tongue ties can have implications for speech, dental health etc.
I did triple torture (BF, bottle feeding and pumping) for almost two months, and then kept pumping without BF for weeks more before I just couldn't keep it up anymore. I'm really glad I kept trying for a while and saw my completely excellent lactation consultant, but I wish I had given up after the tongue tie revision didn't change anything. Everyone's experience is different, but for me pumping for hours every day got in the way of enjoying my relationship with my baby, and contributed massively to my sleep deprivation. Next time around, if I have issues again (which I most likely will) I will listen to the highly qualified and experienced LC if she says "you've done your best, this just isn't working".
TL;DR: in your shoes I would get the tongue tie cut, but then give up on BF a few weeks afterwards if it hasn't improved.
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I too dealt with a minor tongue tie. We got it clipped before he left the hospital (at about two weeks). I had hoping clipping would be the panacea, but although it helped some, it wasn't a one shot solution. I tried hard to get him to nurse, because he was accustomed to bottles at the NICU. At about 2 months, I finally had him predominately nursing. He had one day he nursed and didn't take a single bottle (except at night). And then, he got thrush around 2 months, and even though I wiped off the medication before nursing, I think he still could taste it some so I had to go back to using the nipple shield to get him to nurse. His weight dropped to 10% even though his height was 90% by his 4 month visit (it was 80% at birth and 50% at the time of leaving the hospital), so I stopped trying hard to limit the supplements and he popped back up to 17% by his 6 month visit. I triple fed until about 5/5.5 months when I gave up and just nursed first thing in the morning and otherwise I pumped. 6.5 months later I still haven't gotten him off the nipple shield.
At 6 mo I froze 3 mo worth of 4 oz portions, so he could get some benefit after I quit pumping. 7-7.5 months I started to slowly cut back my pump sessions (1 nurse, 6 pumps to 1 nurse, 4 pumps now at 8.5 mo). And now, my supply seems to have tanked upon getting my period. So I may be quitting soon. It'll be a relief in some ways, but I still feel guilty in others...
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I too dealt with a minor tongue tie. We got it clipped before he left the hospital (at about two weeks). I had hoping clipping would be the panacea, but although it helped some, it wasn't a one shot solution. I tried hard to get him to nurse, because he was accustomed to bottles at the NICU. At about 2 months, I finally had him predominately nursing. He had one day he nursed and didn't take a single bottle (except at night). And then, he got thrush around 2 months, and even though I wiped off the medication before nursing, I think he still could taste it some so I had to go back to using the nipple shield to get him to nurse. His weight dropped to 10% even though his height was 90% by his 4 month visit (it was 80% at birth and 50% at the time of leaving the hospital), so I stopped trying hard to limit the supplements and he popped back up to 17% by his 6 month visit. I triple fed until about 5/5.5 months when I gave up and just nursed first thing in the morning and otherwise I pumped. 6.5 months later I still haven't gotten him off the nipple shield.
At 6 mo I froze 3 mo worth of 4 oz portions, so he could get some benefit after I quit pumping. 7-7.5 months I started to slowly cut back my pump sessions (1 nurse, 6 pumps to 1 nurse, 4 pumps now at 8.5 mo). And now, my supply seems to have tanked upon getting my period. So I may be quitting soon. It'll be a relief in some ways, but I still feel guilty in others...
Hugs, it sounds like you have done your best.
And my hat certainly goes off to you - pumping is hard work!
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Wow Captain FIRE, you triple fed for months!? I am so impressed, that just completely crushed me. You have done amazing for your son.
I really think my daughter's initial weight loss was two fold, her poor latch and my low supply. At 6 weeks postpartum I am still seeing an increase in supply now that I am pumping 8 times a day for 30 minutes each session. She had only breast milk yesterday! 25.5 oz! So I'm confident I'm getting my supply issue corrected. Now to work on nursing/latch again.
Thank you for sharing your experience!
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In fairness, I should note that I was very lucky to have 6 months off from work. I felt guilty if I didn't try my best to breastfeed until I went back, given I had this incredibly rare (for the US) time off.
Good luck!
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I hope it's okay to post here even though it's been ages since anyone has posted...
I'm 31 weeks pregnant and just had the most upsetting breastfeeding class that had me searching for some more useful information. The class was just pushing breast is best and even though I really want to breastfeed, I felt like it didn't offer any useful strategies for making that happen and just made me feel like I'll feel like a failure if it doesn't work right away. Knowing so many people who have struggled, it felt really off. I'm so grateful that I vaguely remembered seeing this thread when I was first pregnant in October and went searching for it. After reading through it, I feel armed with much better information and I have some questions to talk about with the doctor we're meeting in a few weeks to "interview" to see if we like him for our baby's doctor. Thank you to everyone who has posted and contributed. I hope you're doing well!
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I think I posted about this in my journal and the baby and pregnancy chat thread but just for an update and closure on my story.
November 4th I produced more breastmilk than my daughter needed for the first time. I ended up having a surplus every day (producing an average of 45 oz) until mid January when she caught up and was eating 40 oz a day!
I never did get her to latch again consistently. She had a tongue and lip tie revision (via laser) done November 13th by a fabulous Pediatric Dentist who was recognized on Dr. Ghaheri's website (the leading expert in ties). The dentist said that my daughter had the highest palate she'd ever seen and it was likely that even with the revision we'd still have problems. The procedure was going to cost ~$750, but my husband came to the appointment in uniform and she comp'd it. I cried.
Even with the revision we only had a few successful feedings, mostly at night when she was still half asleep. During the day she wanted nothing to do with the breast and would just scream until I gave her a bottle. I was definitely pretty sad about it all. I definitely went through the stages of grief, bargaining is one I still come back to. I constantly wonder what if... But it's all too late now.
I continued to exclusively pump until the end of February (daughter was 5 months old) when I got diagnosed with postpartum depression. I was only pumping 4 times a day by then but it was still for about 3.5 hours a day plus setup and clean up. It was so incredibly draining (pun not intended, but so appropriate). I started to wean from pumping and worked my way slowly to reducing times of pumps and number of pumps in a day. It took some pharmaceutical assistance at the end to completely dry up by my last time expressing milk was over a week ago and my last time using my pump was March 23rd. It made such a difference getting the time back and allowed me to get more sleep.
I still have a few hundred ounces in the freezer so I'm giving my daughter a mix of thawed breastmilk and formula just to extend the amount of time she'll get breastmilk.
I still feel guilty I didn't breastfeed/exclusively pump for a full year, but I know I did what was right for us.
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Not sure if this has already been posted, but I'd recommend expectant parents spend some time on the website of the Fed Is Best Foundation: https://fedisbest.org/
I wish I had - maybe I wouldn't have accidentally starved my first (fortunately he turned out fine) or been so quick to buy into the ideas from lactivists that "everyone can breastfeed" and "low supply is really rare."
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I hope it's okay to post here even though it's been ages since anyone has posted...
I'm 31 weeks pregnant and just had the most upsetting breastfeeding class that had me searching for some more useful information. The class was just pushing breast is best and even though I really want to breastfeed, I felt like it didn't offer any useful strategies for making that happen and just made me feel like I'll feel like a failure if it doesn't work right away. Knowing so many people who have struggled, it felt really off. I'm so grateful that I vaguely remembered seeing this thread when I was first pregnant in October and went searching for it. After reading through it, I feel armed with much better information and I have some questions to talk about with the doctor we're meeting in a few weeks to "interview" to see if we like him for our baby's doctor. Thank you to everyone who has posted and contributed. I hope you're doing well!
I went to a class pre-pregnancy also and in retrospect, I'm not sure how much use advice and strategies are before you actually have the baby. I'm assuming they went over standard stuff like the baby will need to eat 8-12 times a day at first, and that a nursing session may well take an hour in the first few weeks? I recall also getting some pictures of what a "good latch" looks like but honestly, they were all at an angle that I was NEVER going to see the baby at, so...eh. And we got suggestions of different positions to try but again, not that helpful to "practice" with a doll.
I did find that once I was in the hospital, many of the nurses had good advice for trying different positions and showing me how to hand express colostrum (which I did quite a bit of the first couple of days as my son didn't seem to get all that interested in sucking until my actual milk came in, at which point he perked up and decided this nursing thing might be worth doing after all). Does your hospital/birthing center have lactation consultants on hand? We had one come by to visit twice during our hospital stay.
It seems that the struggles with BFing can be either that the mother just has a really hard time producing enough milk, or that the baby has trouble with extracting the milk. If it's the former, nursing or pumping more is usually advice #1, followed by making sure you are eating and drinking enough (remember, you're now supposed to be producing 24-36 oz of liquid every day, so you need to drink at least that much water on top of what you would normally drink), and including foods that may promote milk production in your diet (oatmeal, flaxseed, and nutritional yeast are the ones that get the most mention). If it's the latter, the challenge is to both keep up your supply while also working on getting the problem diagnosed, so you will probably need to pump quite a bit in addition to whatever your baby is nursing.
I would try not to worry about it TOO much before giving birth. Make sure your home is stocked with a few reusable water bottles that you can stash around to make staying hydrated easy, get some oatmeal along with the rest of your pre-baby stock up, and either order your pump or make sure you know the process for ordering once the baby arrives (my insurance wouldn't provide the pump until the baby was born). Find out what lactation support services are available at your hospital or pediatrician's office and keep any relevant phone numbers handy. And take the longest possible maternity leave you can possibly manage. I had zero problems with breastfeeding until I returned to work and had to start pumping, and in my personal circle of friends, returning to work has been the most prevalent cause of stopping breastfeeding.
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@EngineerYogi - thanks for the update...I think it sounds like you went to incredible measures for your daughter!
@atx - thanks for the link!
@cats - you're right, probably any breastfeeding class can only be so helpful in advance. I just wish it had been less shamey. We do have lacation consultants at the hospital, and a drop-in lactation clinic, and I just found out from a friend that they rent out scales so if we're concerned about whether the baby is getting enough food in during a feed, we could rent one to have at home.
I found your whole post much more useful than the entire class. :) So thanks for taking the time!
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Drink *all* the water. And don't be afraid to supplement. But really, drinking is so, so important. When my daughter was ten months old (she was a very early talker) she popped off and told me to drink water. I can't speak for anyone else, but my body acted like it had powdered milk stored up in there. It refused to let down any milk until I drank enough water. And then as soon as I drank, I would feel letdown and have this happy drinking baby.
I did have to pee all the time, but that's way better than a screaming kid and sore nipples. So my personal advice is to over-hydrate just in case, especially if you're having any suspicions about low milk supply.
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Just read through this whole thread. BabySLTD is 11 days old and a completely different baby from the 4-day-old who we took back to hospital because he was either screaming or comatose and going eight hours without trying/being awake enough to feed and had about one wet nappy in 24 hrs. I had read a bit of this thread while pregnant and am so glad that I decided my priorities were:
1. Inserting adequate nutrition into baby.
2. My long-term sanity.
3. Breastfeeding.
So when one of the nurses in hospital said that babies just cry sometimes after he'd been on and of both breasts crying for an hour and a half, I insisted he have a bottle and he chugged the lot down and fell asleep for three hours. Babies baby cry for complicated and unsolvable reasons sometimes, but this one was crying because he was HUNGRY.
We're home again and muddling through some combination of breastfeeding, pumping and formula and trying to find a routine that works for us (working out when and how to pump is hard). Much like my labour and delivery, it's not what I wanted in advance but it's what's right and good now.
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Congratulations on the new baby! Hope things continue to improve and you figure out a good routine soon.
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I have been enjoying this website: http://breastfeeding.support
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I keep hearing that you cannot over feed a breastfed baby. This smacks to me of propaganda. Can anyone shed any light on why they say this? My baby now wants to be on the breast 24/7 and frequently sucks a bit then coughs it up, which says to me that he's full but still sucking (for comfort, presumably) but I'm still not confident in distinguishing when he is hungry and when he is snuggly so I never want to refuse.
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I keep hearing that you cannot over feed a breastfed baby. This smacks to me of propaganda. Can anyone shed any light on why they say this? My baby now wants to be on the breast 24/7 and frequently sucks a bit then coughs it up, which says to me that he's full but still sucking (for comfort, presumably) but I'm still not confident in distinguishing when he is hungry and when he is snuggly so I never want to refuse.
Babies can regulate the flow by how they are sucking. So if he wasn't hungry, he could do non-nutritive sucking.
I think it is also because, unlike formula, breastmilk is not always the same- if it is really hot it becomes watery to help hydrate, at nighttime it becomes thicker to require more sucking to make baby sleeping, your body takes biofeedback from baby's saliva to provide them what they need.
BUT- if you have an aggressive let down, that can cause him to cough it up. Or if his stomach is sensitive to something you've eaten, he could cough it up. Or if he just isn't wired typically (not saying the baby is abnormal, but all advice is about averages) to switch to non-nutritive sucking, then I suppose he could over feed. But MOST breastfed babies will not over feed.
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I keep hearing that you cannot over feed a breastfed baby. This smacks to me of propaganda. Can anyone shed any light on why they say this? My baby now wants to be on the breast 24/7 and frequently sucks a bit then coughs it up, which says to me that he's full but still sucking (for comfort, presumably) but I'm still not confident in distinguishing when he is hungry and when he is snuggly so I never want to refuse.
He's around 3 weeks old, right? I would not worry that you are offering the breast too often yet. I am sure there is some potential for overfeeding a breastfed baby, but it is minute in comparison to the risk of underfeeding.
With regards to spitting/coughing up milk, it's pretty common with young babies. Our pediatrician advised more burping during and after feeding, and sleeping at an incline.
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Thank you for a supportive and evidence based thread on this subject. I'm currently pregnant with #2 and really trying to not fall prey to exclusive breastfeeding insanity the way I did with my first. We supplemented before she got to the starvation point but I berated myself for it to the point where it really exacerbated my PPD. I had lactation consultants to the house every freaking day for two weeks to try and figure out what was wrong. Just an all around horrible experience and it's really sad that my memories of her first weeks at home are so dark and sad. Reading all this is a good refresher on a more sanity based approach. I hope next time it goes better for us.
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I keep hearing that you cannot over feed a breastfed baby. This smacks to me of propaganda. Can anyone shed any light on why they say this? My baby now wants to be on the breast 24/7 and frequently sucks a bit then coughs it up, which says to me that he's full but still sucking (for comfort, presumably) but I'm still not confident in distinguishing when he is hungry and when he is snuggly so I never want to refuse.
He's around 3 weeks old, right? I would not worry that you are offering the breast too often yet. I am sure there is some potential for overfeeding a breastfed baby, but it is minute in comparison to the risk of underfeeding.
With regards to spitting/coughing up milk, it's pretty common with young babies. Our pediatrician advised more burping during and after feeding, and sleeping at an incline.
Oh believe me, I'm still convinced I'm underfeeding him! It just got me thinking. The main problem with the spitting up is that it's during a feed and therefore all over me because I haven't yet worked out how to arrange me, him and the muslin to catch it.
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SLTD – congrats on the new baby!
A few thoughts-
1) If baby is gaining well, urinating and pooping frequently (usually after most feeds at this age), and seems satisfied for at least an hour (ideally 2-ish) after nursing, then he is likely eating plenty.
2) Babies around 3 weeks can nurse frequently as they go through a growth spurt around the 1 month mark – this increase in nursing behavior will usually last a couple of days.
3) Reflux – some babies with serious reflux (GERD) begin to show early signs around a month old. Reflux babies will often cry a lot, and show hunger cues (rooting, desire to suck/nurse/feed constantly), because of their GI distress/discomfort. Reflux babies – even breastfed ones- may “overeat” because the action of eating and consuming soothes their stomach for a time. Remember, babies only have a very few limited ways of communicating uncomfortable tummy sensations like gas, hunger, or reflux pain – crying, scrunching/moving their body, and hunger cues (rooting, sucking, mouth movements). The difficulty is knowing whether the baby is acting hungry because they really need to eat, or if they are acting hungry because they are uncomfortable in some other way. Either way, it is always best to offer food just in case as underfeeding an infant is way more harmful than giving them a little too much.
More on reflux - Most babies have a little bit of reflux which is considered normal spitting after a meal (a little that comes up, after some feeds but not always). In typical babies, the spit up is often due to burps/wind and the natural "back up" of fluid that can come up from their stomachs as the valve isn't fully developed yet. But problematic reflux known as GERD is diagnosed in those babies who have persistent pain/discomfort, high volumes of spit up (soaking through rags, projectile spits), frequent spit up (multiple spits, usually after every feed), and substandard weight gain (because they lose so much nutrition while spitting up or because they get too fussy to actually consume sufficient quantities even though they might be on and off the breast or bottle a lot). They may frequently spit up during feeds, before they even finish the meal, or even choke and gag during meals because the food is coming back up as they are trying to drink. Both my girls had classic GERD. My second one began showing signs of it around 2-3 weeks, with frequent spitting, constant rooting/acting hungry, and starting to cry shortly after meals. By 5 weeks old, her weight gain was less than ideal and she was rapidly dropping percentiles as her volume of spit up dramatically increased. By 8 weeks she was screaming in pain for hours every evening and was unusually difficult to settle. It often gets progressively worse over the course of the first three or four months of life before it takes a turn for the better and starts to improve. If you notice the warning signs of GERD (pain, high volume spit up, very frequent spit up, difficulty feeding), be sure to mention them to the baby’s pediatrician. Most GERD is effectively treated with non-medical interventions like keeping the baby upright after feeds, taking the time to burp/wind the baby frequently during feeds, and thickening formula or breastmilk if spit up volume is a big issue. But if a baby is still in serious pain, and if that pain is affecting feeding and resulting in poor weight gain, sometimes medications are prescribed. The good news is, most babies with GERD do just fine and grow out of it by 6 months. With both of mine, it was like someone flipped a switch at the 6 month mark. They went from super soakers to completely normal baby spit up and no more discomfort.
PS: I AM SO, SO SO HAPPY YOU FED YOUR BABY! What you describe – the lethargy and the screaming – is a classic indicator of an underfed child. Great job identifying what your baby needed. You should be really proud of yourself for making the right call under such difficult circumstances (new parent, early postpartum, sleep deprived).
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Has anyone tried this pump?
https://shop.willowpump.com/products/the-willow-pump
Seems expensive but like it could be a good idea...
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Has anyone tried this pump?
https://shop.willowpump.com/products/the-willow-pump
Seems expensive but like it could be a good idea...
Wow that does look cool... Don't know about that one but a friend had the Freemie (similar idea but not with the all-in-one design) and raved about how great it was to pump on her commute so easily so she could reduce how often she had to make time for it in her workday.
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Has anyone tried this pump?
https://shop.willowpump.com/products/the-willow-pump
Seems expensive but like it could be a good idea...
Wow that does look cool... Don't know about that one but a friend had the Freemie (similar idea but not with the all-in-one design) and raved about how great it was to pump on her commute so easily so she could reduce how often she had to make time for it in her workday.
I was super intrigued by it, but gosh the cost of the bags!!! I was exclusively pumping though, so I'd need a lot more bags than someone who only pumps once or twice a day.
I tried the Freemies, it was awful for me. I got less than half my usual milk output. I pumped while driving using my usual setup and a big scarf/nursing cover with much better results.
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I found the freemies great for on the go pumping, but I only used the hand pump. I literally walked around the st. louis zoo while pumping, and they were much more discrete on the plane than when I had my spectra with me. Pumping next to strangers is great fun.
But I only used the freemies for relief pumping. Actually now that I am not pumping at all anymore, I still take them on business travel so I can pump an ounce or so daily. My daughter only nurses once a day or so, but it gets uncomfortable to go more than 2 days without her nursing.
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Love love love this thread, and everyone sharing information and stories.
My story: I have 2 kids, 3rd is literally due today. None of my first 2 got formula, as it didn't seem necessary although they both have always been on the slim side (as am I and much of my husband's family). Both lost 10% max body weight at the beginning, which was stressful but formula was never recommended (just supplemental pumping which worked, I guess). My colostrum came in right away and milk came in the normal time period. It took both of them 2 weeks to get back up to birth weight and gained weight normally after that. I say normally, but really their doctor was always badgering me about low BMI even as toddlers, but I tried to ignore it because the kids' genes are tall/slim and both developed normally. I literally have never taken either of them to the doctor because they were sick (just normal checkups and vaccinations). Some kids lay on the fringes of the bell curves, that's how the normal distribution works.
I nursed all through my second pregnancy at least 2x a day, and gave birth naturally 2 days after my due date. I haven't nursed as much through this pregnancy, as the kiddo isn't as interested. I consider myself a very experienced nurser (because I nursed continuously for 5 or so years) and I still anticipate the same with the 3rd coming any day: loss of birth weight, low weight gain.
I went back to work 3 months after each birth, but mostly worked from home for about 1 year and did take some time off while they were both toddlers. I hate pumping. Really dreading it.
Fed is best!
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Time to kiss this thread goodbye - it's been two years and we just stopped nursing last week! Bittersweet for me, but it only took a few days for her to stop asking for "beebees".
If I had to do it over again, I'd:
- check for tongue ties right away since apparently they're hereditary
- give my baby more formula in the beginning when she was struggling to gain weight and eat enough
- not even try with that bullshit supplementary nursing system because holy jesus that contraption was just impossible
- read up more on breastfeeding methods because I thought that shit was supposed to be easy, yo, and it was NOT
It took me until the 3 month mark until we were okay with breastfeeding. Milk not coming in, one of the most severe tongue ties the doctor had ever seen, and having to wake up every two hours to triple feed (nurse, pump, bottle feed) just about killed it for me. I was very lucky in that I had already FIREd with my husband and we made it through the tough parts and bleeding nipples. Kudos for those who decide formula is the way to go, modern medicine is great and sometimes breastfeeding is just not in the cards. No shame, feed your babies, mamas.
Last month we went on a cave tour for my birthday. We made it down 200 feet of stairs into the biggest cavern ever when baby starts to WAIL that she wants to go back up. It was seriously the loudest thing ever - the cavern made her cries echo and ECHO and ECHOOOOOOOOOO and you couldn't hear anything else. So I stuck a boob in her mouth and bam, tantrum over. Boobs are magic. Now I'll actually have to learn how to deal with a crying kid, ha!
Okay, good luck to you all!