Monday, February 17, 2014

I Why not just switch to formula?

2 day old Sullivan nursing with the help of a nipple shield
I have to admit that I don't really want to write this post. Well. That's not true. There is a lot I want to say but I'm never sure who it is I need to say it too. Parents? Healthcare providers? Other support people? Or really what exactly I'm trying to do by saying it. Encourage other parents? Call out bad healthcare providers? Challenge those who support pregnant and breastfeeding women to think about things in a different way? Demand better support and care for women and children in general? 

What I can be sure of is that by writing this and publishing it online I will no doubt be spending the next few hours/days/weeks moderating comments and emails from people who think I am being hard on or unfairly 'judging' parents who formula feed their babies even though I'm writing this entire paragraph to say that I AM NOT. 

What I am doing is addressing some of the suggestions and questions I have been getting since my second son was born 6 months ago. All of which boil down to the same thing. 'Why don't you just switch to formula?'. 

A little history: after having breast reduction surgery in my late teens breastfeeding my first son, Oliver, in my early twenties went relatively smoothly, a few bumps in the hospital that resulted in unwanted, coerced and non-evidence-based formula supplementation and latch issues that left us reliant on a nipple shield for over 5 months but over all he gained weight (slowly), blebs & plugged ducts happened here and there but were never serious, and we "successfully" breastfed for over 4 years. 

I use the quotations around "successfully" because when I became a doula and learned more about breastfeeding through other birth and lactation professionals I found that many if not all of the trouble my oldest son and I did have could be traced back to a tongue and lip tie. And as it turned out many things I was told were 'normal' or dismissed as 'not a big deal' were actually huge red flags that we had some serious problems. Everyone survived so I'm not going to think on it more than lessons learned, we struggled but we managed and I don't regret it for a moment. 

Pregnant with my second son, Sullivan, I did a lot of research, identified the red flags I had missed the first time around and was very glad when a dentist in my area started offering laser frenectomies in his practice. 

I cannot begin to say how thankful I am that Sullivan was my second. While Oliver and I had struggled a little and he was, in hind sight, a slower gainer than he should have been, he never lost any weight, he always filled diapers regularly, he was alert and met milestones early or on time. 

Sullivan, on the other hand, struggles with the scale constantly, when my supply drops in the slightest he immediately stops dirtying diapers, and he regularly goes through phases of being sleepy at the breast eating just enough to take the edge off his hunger but no more. Had he been my first, had I not known that I was capable of nursing a baby well into childhood, had I been less aware of not only the risks of formula use but the absolute joy that the breastfeeding relationship brings, I would have folded at my ten week midwife appointment when my midwife looked me in the eye and told me no one would blame me for giving up if all the work I was doing to breastfeed became too much for me. 

(Note: while that statement may be technically true, that no one would have blamed me and it would be 'ok' to switch, suggesting that, as a professional, to a tired new mom when that's not what she's asked you is about as helpful and supportive as telling a labouring woman it's 'ok' to have an epidural when she has expressed that she wants a natural birth. And if you don't know why THATS not helpful or supportive I suppose I'll have to write a whole other post about it.) 

Nursing with a homemade at-the-breast supplementation system
Instead, under the close supervision of an IBCLC,  I max out doses of herbs like fenugreek, blessed thistle, alfalfa, fennel, and lemon balm. We limped along with a nipple shield (properly this time) to get him feeding without swallowing too much air and transferring milk effectively, I pumped regularly every day to supplement his intake with an at-the-breast-supplementer off and on for months. I feed him almost hourly at the slightest cue of hunger doing breast compressions to make sure he gets enough without tiring too quickly. I have not used any artificial nipples what so ever, no soothers, no bottles, not even my fingers, if he wants to suck he does it at the breast. I weigh him every day to make sure he's on track. Sullivan has now been to the dentist for frenectomy not once but twice and we have been seeing an osteopath regularly to improve the mobility he needs to feed effectively. He is growing, he is happy and fed, but it doesn't come 'easy' like it did the first time around. 

So why do I do it? Why not 'just switch to formula'? 

  • Because to me making the switch to artificial milk should not ever be the first suggestion or made out to be the easiest or best alternative when breastfeeding hits a bump. There are literally dozens of other ways to manage supply issues and other common problems.
  • Because using artificial milk, even prepared properly (which most people don't), has very real and sometimes serious health risks for both mothers and babies. 
  • Because breast feeding isn't just about health and nutrition. It is an integral part of the way I parent my children. It provides biological protection for my babies in our family bed, it soothes them when they are hurting or teething, it settles them when they're overstimulated, it provides security and builds trust, it forces me to slow down and engage my children even when life gets hectic. 
  • Because becoming reliant on artificial milk would be a huge financial burden on my family, thereby negatively impacting my older child and my family's food security in general. 
  • And mostly because the way we start our life is important. Everyone needs to stop discounting that. 

Do I expect that every mother should work as hard as I did to breast feed exclusively no matter her situation or support network? NO, absolutely not, I get that it is my privilege and my connection to a network of well trained birth and lactation professionals that allows me to do so. 

But I do expect that every single person who works with, provides any type of care to, or even comes in the slightest contact with mothers and babies understand that when we do things to interfere with or damage the breastfeeding relationship between mother and child we are interrupting vital biological systems that can drastically effect not just the health and development of that baby, but also entire communities. So maybe there is a small part of my brain that just wanted to prove even with multiple factors that can negatively impact breast feeding, bottles and formula don't have to be a part of the management plan. 

We need to stop treating breastfeeding like it's a great thing to do 'if it works out', and start treating it like a vital biological system that must be protected and maintained. It isn't binary, and bottles of formula aren't the inevitable conclusion when things don't start off or continue to go well. 

In short; If you are a mother who's baby isn't doing well and the only advice you are hearing is EITHER "just keep feeding, just keep feeding, you can do it, he's just small" OR "you're starving/harming your baby, you need to give him formula right now" know that there are amazing care providers out there who can give you real answers and help you find a management plan that will help you achieve YOUR goals. If you are one of the people handing out the above advice on either side, please search out the amazing professionals who have real answers and let them educate you. 

"Why not just switch to formula?" Because you don't really have to. Not if that's not what you want, and you can find the right support. 

To find a qualified IBCLC you may search for your area at: 


Shawna said... [Reply to comment]

Your story is so important. You are proof that breastfeeding is important and is made to work even when it is not convenient or easy. My heart bursts for your struggle and your strength. I hope other people will read this and be inspired by you, your journey, your success, and will start demanding and becoming the support new, vulnerable mothers need to make this work for infants. The health of our entire species depends on it.

Victoria Wilson said... [Reply to comment]

I'm a first time mom and grateful that Breastfeeding has been going well for my 6 week old and I. We are well supported but, even then, I have been SHOCKED at how disparaging people can be when Breastfeeding goes WELL. Comments like how I need a break, I can't be a human pacifier, wouldn't it be nice to just give her a bottle and so on. You are an amazing woman for fighting so well to nurse your kiddos. Keep inspiring others and working for change!

amanda @ twoninenine&ever after said... [Reply to comment]

This. Yes. Thank you.

My baby girl is 5 months old. She's my first and formula was never an option for me. We have limped our way through a posterior tongue tie we had to fight for anyone to recognize, reflux, suspected infections, suspected mastitis, which actually turned out to be vasospasms, ongoing blocked ducts and pain and one very violent and frustrated baby while feeding. Consequently I was told I must have slow let down (despite spraying when trying to manually express a little) and that she had learnt "bad habits"...

Recently *I*, not a health professional, discovered her upper lip tie. She had it corrected on Thursday and we are trying to relearn everything from the last 5 months in an attempt to have the breastfeeding relationship we should have had from the beginning.

It frustrates me to no end that formula is offered (or threatened!) as the "easy fix", instead of proper support and advice for breast feeding families. It's what nature intended, therefore shouldn't we try everything in our power to help it along, before resorting to artifical milk? There is not enough support for parents who want to explore every possible avenue to make their breastfeeding relationship amazing. We shouldn't have to "limp along" working things out for ourselves to avoid the pressure of formula.

Natalie Ballew said... [Reply to comment]

This post couldn't come at a better time for me. My daughter was born at a healthy 9lbs and we didn't have any latching or nursing issues. But, a little back story, I have a son who I only got to breastfeed till about 5 months. This is when I went back to work and my son no longer wanted to breastfeed but only would take the bottle. I tried to pump and keep up but this became to much and I folded into just giving him formula. Which we then had major issues with him spitting up and having gas issues that we never had with breast milk. So with this little bit of history.

In december I got sick and was unable to nurse my daughter for 2 days. When I did resume my supply had taken a drastic hit. And, she was losing weight she ultimately lost 1lb before I had to start supplementing. I was determined to get her back to breast milk only but struggled. I was nursing every hour and taking all sorts of natural supplements and lactation cookies to help. Nothing was working so I ordered a SNS system. This helped a lot she started to regain much more interest in breastfeeding. And, today was the first time in over a month that I didn't use the SNS system. I feel empowered and accomplished because it took determination and patience to get to this point.

Thank goodness my husband was amazing and so supportive as he understands the bond a child has with a mother. But, some of my family and friends as hard as they tried couldn't understood why I was putting my self through so much lengths. And, I have heard "Formula isn't the worst thing. She did get a few months. Maybe she will do better with formula" All these things were so horrible to hear because it made me feel alone in my quest to give my daughter the best I had to offer.

So thank you from one struggling mother to another for writing this. And, yes formula is a option just not one I'm willing to give if I don't have to. And, reading this post has given me a sigh of relief that "I'm not alone." SO THANK YOU

Erika said... [Reply to comment]

Very well written! You've successfully delivered a very important message that I hope many get the opportunity to read.

Erika said... [Reply to comment]

Very well written! You've successfully delivered a very important message that I hope many get the opportunity to read.

Julian@connectedmom said... [Reply to comment]

@amanda @ twoninenine

go mama! those lip ones are sneaky and so much trouble. i highly recomend finding an osteopath or chiropractor who works on babies to help in the relearning process! that kind of 'physio' was what ended up *clicking* for us to get on track.

thanks for sharing!

Leslie said... [Reply to comment]

Well written. Thank you for being brave enough to share an important message even though you know there will be backlash. Thanks for encouraging new moms. (From a mom of twins and a singleton that were all exclusively breastfed to 14 months despite lots of initial struggle and pain.)

Julian@connectedmom said... [Reply to comment]

@Natalie Ballew

PARTY! good work mama! The SNS was so helpful and
I was so grateful to have it but damn it feels good to get rid of it!

Jennifer Andres said... [Reply to comment]

Thank you for writing this! I have breastfed all three of my girls until they weaned naturally and am doing the same with my son who is currently almost 16 months. Not saying it was easy, my twins were born over two months early and came home at under four pounds each and gained weight very slowly. I pumped to make them high calorie supplements and used an SNS so they could nurse and receive the supplementation. They continued to gain weight slowly and when I refused to stop nursing and solely pump and bottle feed (and add formula) at the pediatricians orders, she called child services claiming medical neglect and we were forced to stay at the Children's Hospital for a week so we could be monitored. The girls were discharged doing exactly what I was doing when we were admitted (nursing and supplementing with additional breastmilk with an SNS) and were just monitored by their NEW pediatrician as 'slow weight gainers'. They nursed until naturally weaning at 3 1/2 years old and are still a little small at five, but they have met every milestone early and are excelling in school. It can be done! I am hoping to become a lactation consultant as my little ones all start school so that I can give the encouragement to other young women, that I wish I had had while going through all of this.

Natalie Ballew said... [Reply to comment]

Amen..i'm so happy and was kinda shock when I nursed her and she didn't cry to have more.

I def needed this post today

Jae said... [Reply to comment]

I love your honesty! I am a Nanny of 11 years. I have seen many different combinations of breast/formula. I am an advocate of people breast feeding. It is the best thing in the world for that baby. I hope to someday have a baby of my own and will too fight to nurse exclusively. Blessings brave and courageous one!

Lauren said... [Reply to comment]

As someone who suffers from mammary hypoplasia/IGT, I must interject that sometimes it isn't about what the mother wants. Babies must be fed, and there are a small percentage of women out there who cannot produce enough milk no matter how many galactogogues we take or how many times a day we nurse or how much skin-to-skin contact we have with our babies. We try hard and do all we can, but we have to put our pride aside and feed our babies in order for them to survive. Some use donor milk and some use formula. Most of us often hear the title question ad nauseum, too. We do what we can to ensure our babies are healthy and happy, and anyone who hasn't walked a mile in those shoes should hold off on providing opinions.

Erin Shetler said... [Reply to comment]

I think however people feed their kids is fine. The health benefits of breastfeeding are collective. If it's better for your baby but he is not getting enough to grow and thrive, formula is FINE. If you are able and want to breastfeed, that is WONDERFUL. The reason people say "if it works out" is that sometimes it doesn't, and it's unreasonable to make people feel bad when that happens. My baby didn't get enough to grow properly from my breasts. Instead of going insane (which would be unhealthy for her) or letting her not get enough (same), I supplemented as a first resort. It was the best thing for our family. People understand breast it best. There's no reason to beat the drum with most of us. We all make decisions for our families and try to make the best ones. I'm confident I did that, and that you are doing so as well.

Aleri Monroe said... [Reply to comment]

I really enjoyed your post and kudos to you for being successful but not everyone is as lucky. I was able to feed my son for about 4 weeks until my supply completely diminished over night. I tried every supplement and medication and natural remedy you could possibly think of yet j still didn't produce enough for my son. Formula was out of the question for me although everyone including drs told me to use it. My son is 9 weeks old and he has a permanent milk donor so although he does not get my milk he does get human milk. Another reason was that bc my milk supply dropped so much i had to supplement and this being my first baby and being hundreds of miles from home no one told me that i could do this without using a bottle and he then became nipple confused. Even using a breast shield he would just scream bloody murder. Again kudos to you but o do feel bad for not being able to feed My son but i will forever be grateful for his donor.

LKB said... [Reply to comment]

Lauren, I think you're taking this post way out of context in its intent. The author makes it clear that she by no means thinks that everyone has to or should do things they way that she did. She does not for one second criticize any mother who has had to use formula for any issue. From the article, it's pretty clear that she new from previous experience that the type of things you mention were not struggles that she had, so finding a way to make it work was a viable option for her. I wasn't able to breastfeed at all, and I found this in no way judgmental toward those of us who haven't been able to provide breast milk. And her opinion should be shared. There are going to be women out there with similar situations to her looking for experiences and answers to how to help continue breastfeeding. Just because some of us could not, doesn't mean we need to read more into an article like this than is being said and assume that the opinion being provided is directed toward our particular situations. Like I said, I couldn't breastfeed. Really couldn't. And I know that this article isn't judging me.

Krystal said... [Reply to comment]

Good for you, that you were able to figure out what the issues were and continue breastfeeding! Like Lauren, I also have IGT, and it is impossible to produce enough milk for my baby. Sometimes no matter how badly you want it, you CANT meet your goals. Sometimes breastfeeding isn't possible even if you meet with every doctor, specialist or consultant in the world. Some bodies don't make breast milk, and so some women need to feed their babies donor human milk or formula. I dont think you are judgmental, I just wanted to clarify that last bit in your post.

Tammy said... [Reply to comment]

I couldn't be happier you shared your journey. I was so blessed to have nursed all three of my babies until they were 13 months (all self weaned). The one comment I hear to often is "it just isn't for me"...make me so upset. Thank you for sharing!

Tammy said... [Reply to comment]

I couldn't be happier you shared your journey. I was so blessed to have nursed all three of my babies until they were 13 months (all self weaned). The one comment I hear to often is "it just isn't for me"...make me so upset. Thank you for sharing!

Anya said... [Reply to comment]

Thank you for this post! I enjoyed how well written it was and I soooo agree with the message. I can't produce enough milk for my little one, but even though I have to supplement (mostly with donor milk from a family member, sometimes organic formula), I will continue to give my baby what little I can give him! I've learned to not get shocked when I'm being asked why I even bother - "why not switch to formula?" I just reply that formula does not have immune cells, nucleotides, hormones, etc and if my body can make half of what my baby eats, why not at least give him that?? :)

Heather Evans-Dorn said... [Reply to comment]

I'm very grateful I stumbled upon your page. Long story short: I am a mother of two going through a divorce. My youngest just turned 2. She still nurses on demand...which is still very frequently :) But the courts have temporarily given dad visits (that are sometimes as long as 4 days in a row) with our 2 year old daughter despite my efforts to convince the courts that this is not healthy for her. I feel so helpless. I've been refused the request of nursing her while he has her. It just seems the court and legal system do NOT or are not motivated to get into the "taboo" topic of a CHILD's RIGHT to choose to breastfeed. The courts have continuously failed our breastfeeding children and it enrages beyond explanation...I am sad that laws haven't been made to protect our babies and children in re: this matter. There is a total lack of advocacy for these most important phases of our childrens' lives....especially when the court is SUP'D to rule in FAVOR and in the BEST INTEREST of the CHILD.

Kate Cotton said... [Reply to comment]

I love that you advocate for BF so strongly; I wish the tone of your post were a little less harsh because in spite of your trials, even bigger trials do exist and people who go through them do not need to feel even worse than they do. And they can be sensitive about it. My grandmother almost died giving birth to my uncle in 1937 and was brought home in an ambulance in a coma that she was in until he was three months old. My grandfather gave the baby milk and my uncle has been as healthy as anyone else for his 77 years. Back then, the culture was as you wish for, breastfeeding being the majorly main thing- formula didn't exist. I agree that we need the culture to shift so that breastfeeding is the norm without question. But you need to know that even when that was true, sometimes people gave their babies milk to keep them alive. Oh, and more babies died back then for various reasons. We have historical accounts of BF as you wish it to be, so let's discuss how it went and how we want it to be. And BF can and should be done by more than it is done today. All my support people (2011 and 2013) worked with me to BF more than anyone supported my sisters in the 90's and 00's. The trend is in the right direction, we just have to keep it going!

Jennifer Loher said... [Reply to comment]

Thank you for sharing this. We persevered through and are still nursing after a rough 5 months. I am curious how you knew your son we could just take the edge off? I look back with guilt and doubt of my son getting enough ( sometimes to this day I do despite ample wet diapers and him having solids at 9 months). I know this mentality started early and is hard to shake. My son was never diagnosed with anything but slow weight gain at the beginning and now today since he is older has measnt he is small but I wonder if he was destined to be small regardless if we stopped breastfeeding. It is certainly not all or nothing and that us what got me through the days of pumping and supplementing.

Jennifer said... [Reply to comment]

@Lauren I second what Lauren said. I maxed out on herbs and medication. Spent almost all day with my baby on my chest for constant skin to skin contact. Pumped to "boost" supply and never got better than 5% of my kids needs.

The attitude I should have done more or tried harder or stuck with it despite being an utter failure created severe postpartum depression for me. So women like me and others should feel supported but how do that and create a culture where breastfeeding is normal? Education for one. Once it was clear my issues were not normal every LC bailed on me. Same with LLL even when I said I know what to do I just need moral support. I couldn't get that because I was told to help me denormalized breastfeeding by a few.

So the question is how do we embrace and support the 1-4% of women that honestly can't nurse without creating an atmosphere that others expect failure?

Natalie Ballew said... [Reply to comment]

I don't think she was trying to be judgmental in anyway with this post she was just voicing her struggle and what she was able to get through. We as moms do need to support one another. Because in the end whether you formula feed or breast feed, have challenges or don't. We as moms are ONLY TRYING TO DO THE BEST WE CAN FOR OUR KIDS!!!!

Jessica said... [Reply to comment]

Sorry but it's women like you that make other mothers feel inferior. Breastfeeding is best but not all can do it or want to do it. Formula is not poison and sorry but good luck picking out a breastfed and formula fed child. When it comes down to it a good parent is not deemed by the breast.

Unknown said... [Reply to comment]

Please forgive me, as I know I will probably take quite a lot of flack for this comment, but I respectfully disagree with the entire premise of your sentiment. First, let me come right out and say that I am a stay at home dad for our beautiful seven month old baby boy and that he is currently formula fed. This has not always been the case however, as he was exclusively breast-fed for the first four months of his life. Unfortunately my wife struggled badly with post-partem depression in those early months and the routine of breastfeeding/pumping only made the situation worse. After finally seeking treatment for her depression, the decision was made to switch to formula. To be honest, the switch was always going to happen when she went back to work, it just happened two months ahead of schedule. I cannot even begin to tell you how much guilt she put upon herself for not being to continue providing what was "best" for him, ie -breastmilk. The reality of our situation couldn't be any farther from that "truth." While I will gladly concede that breastmilk is certainly the better alternative, it is only better when it works for everyone involved. My wife was not herself in those early months and our son was subsequently deprived of the mother he deserved - the mother I always knew she would be. So truthfully... What is better - a loving, fully involved mother that provides her child formula, or an empty, despondent shell of a woman who acts more as a "milk-machine" than a mother? Contrary to the sentiment of this article, I will openly argue that we need to do a better job educating new parents that they need to do what works best for their family and that it's perfectly okay if formula is the answer... Yes, breastfeeding is best - but only when it works. It's very much akin to your epidural reference... My wife was dead-set on having a natural childbirth during her entire pregnancy... Right up until she started going into active delivery when she summarily changed her tune. Despite all of the stories revolving around how epidurals slow delivery, etc, etc; our son was born 3 hours after we reached the hospital with a whole six minutes of active pushing. It just goes to further show how everyone is different. I also take issue with the "biological" defense to breastfeeding as far babies health is concerned. Our formula-fed, home-cared son has been sick all of once this winter with what basically amounted to a mild cold; yet several of my wife's friends who exclusively breast-feed, but use day-care have been repeatedly sick this winter... The one has already had three colds and it now fighting an ear infection. Obviously it is common sense that many breast-fed babies are taken care of by a stay at home parent, as such, I would really like someone to do a study on which contributes more to a baby's health - breastfeeding or home care? Either way, especially in this internet age with such a loud and vocal breastfeeding community, we need to do a better job with helping all mothers (and fathers) cope with dealing with newborns - regardless of what they're being fed. Because in the end it really only matters how you parent, not what you feed them - as the two are not inextricably linked.

Leah said... [Reply to comment]

Thank you for this post! I very much respect and admire you for all the work you put into providing what was best for you, your baby, and your family.

emma @ said... [Reply to comment]

Thank you for this! I remember not knowing if we would make it to 6 months breastfeeding, now almost 17 months and nursing still. Becoming a mom was overwhelming and I didn't realize the commitment breastfeeding was, I asked for help so much and I am happy I did. I am privileged to be able to feed my child so I do. Some of my best times with her are breastfeeding, I want other moms to know those times too. It is a struggle, even when it's "easy" but worth it. Thank you for this, I agree with you.

Sarah La Rosa said... [Reply to comment]

Thank you for sharing so vulnerably and honestly from your experiences, Julian! As a soon-to-be mama myself (9 weeks to go!), I value the information as well as the perspective you offer here. I know that not everyone will receive it in the same way (as evidenced by the diverse comments I've come across), but as a fellow online blogger/writer, I hope you are able to take away the many more overwhelmingly grateful responses to your personal insight. Count me as one of those. I found nothing you wrote to be judgmental or harsh in any way. Thank you for encouraging us to use all available resources for as long as our conscience dictates, for the good of our children and our own bodies & minds.
I look forward to reading more from you, and am glad to have found you here (thanks to on Facebook)
Many blessings!

Amber Lee said... [Reply to comment]

THANK YOU!! I wish I would have read something like this 4 years ago or even 2 months ago. I am struggling with bf my 3rd child. He has been the most successful latch but does not gain weight and all I am told is to supplement with formula. That my milk is not nutrient rich. I also have supply issues. I have shed many tears over this and your words were greatly appreciated. Thank you!

Gavin's Mom said... [Reply to comment]

Absolutely beautiful! These are the stories that make me WANT to go to work (WIC). Thank you for your courage and devotion. Nicole CLC

MamaHuss said... [Reply to comment]

I absolutely love this. I particularly appreciate your acknowledgement that it is often from a position of privilege (either through access to information or resources) that many breastfeeding moms find their success, however they define it. I so wish our society had the mentality you have here. So many moms would find breastfeeding easier (relative to past experiences) and more widely excepted. Thank you for writing this.

Kristen Calderon said... [Reply to comment]

Thank you SO much for this article! I have been in a battle to breast feed my son since he was born. He was born on Dec. 20 and I had to have a c section so by time we left the hospital it was the day before Christmas eve. The hospital wouldn't let me leave unless I had an appointment with a pediatrician the next day because they were concerned over his weight loss. Which I didn't get because I thought all babies lost weight after birth. Based on what I told her about how often he was eating, etc. she told me there was no way my son was getting enough to eat and that I needed to supplement with formula. I told her I would not and she basically made me feel like I was starving my son. She kept pushing forumla and I kept refusing. All the research I had done before hand and the breast feeding people I had spoken to told me not to supplement. She begrudgingly let me leave the office with a follow up appointment the day after Christmas. I went back and was validated in the fact that my son had gained back all the way up to his birth weight. I was proud of myself for standing my ground. At his month check again she tried to get me to give him formula because he hadn't gained as much weight as she wanted him to. Again I refused. He is now 2 months old and thanks to a visit to the er this week we found out his has an allergy to milk protein and soy which may explain his slow weight gain and a host of other issues. Again the simple solution to to give him prescription formula. Cutting soy and dairy out fo your diet is hard enough, but I am a vegetarian which makes it even a little more diffcult. Overwhelmingly people wonder why I put myself through this why not just give him formula. Well the answer is because I love my son and in loving him I want what is best for him and that is to be breast fed. It's hard to find people who sympathize with my struggle vs wondering why I put myself through all this when there is such an easy alternative. I needed your article today, thank you.

Julian@connectedmom said... [Reply to comment]

@Jennifer Andres Oh my goodness I couldn't Imagine. We live in a very backward world. Good for you for staying tru to what you knew to be right for your babies and not allowing them to bully you.

Julian@connectedmom said... [Reply to comment]

@Jae Thank you! I hope you find all the love and support you need when the time comes!

Julian@connectedmom said... [Reply to comment]

@Lauren I am certainly not trying to take away from your experience at all. I know many amazing women who have continued to feed their babies at the breast despite being unable to provide all of their nutrition due to IGT or BFAR, I also know many who chose to supplement away from the breast or take feeding away from the breast all together. I would never judge any of those choices. My only wish is that they all had the support and information needed from their care providers to keep feeding at the breast if that is what they wished to do and unfortunately that is almost never the case.

Julian@connectedmom said... [Reply to comment]

@Erin Shetler My biggest concern with this type of thinking towards 'if it works out' is that *From a healthcare point of view* jumping directly to formula supplementation does not address the root cause of WHY the baby is not getting enough from the breast. women are led to believe that when their babies don't gain weight it is because their bodies just couldn't produce, but what if it is because of a structural abnormality (like my son's LT/TT) or injury from a difficult birth? formula does not solve those issues and they dont just go away.

for a *Healthcare provider* to dismiss these difficulties and not follow up with treatment or management is irresponsible.

For parents, you do what you gotta do with the information you have at the time. I will not question anyone's personal decisions. only the Care and advice they received in the process.

Julian@connectedmom said... [Reply to comment]

@Aleri Monroe I was incredibly lucky to have the amazing support that I did. My IBLC deserves a medal. or a hundred medals. I am so glad that you have found a permanent milk donor though! I cannot say enough good things about the women out there who give such a precious gift.

Julian@connectedmom said... [Reply to comment]

@LKB Thank you for getting it! peace!

Sarah Calfee said... [Reply to comment]

Thank you for sharing this. I agree with you wholeheartedly.

Julian@connectedmom said... [Reply to comment]

@KrystalI agree that there are special circumstances. In my own case having had previous surgery and two TT/LT babies set us up for trouble. Knowing both times that there could be supply issues I had already decided to put feeding at the breast at the very top of my priority list, whether it was my own milk on demand, or supplementation with donor milk or formula. I still consider these arrangements breast feeding as that is where the feeding is happening. I guess I just wish that feeding at the breast with supplements was more of a norm because I got some pretty crazy looks from professionals who should know better when we were doing so,

Julian@connectedmom said... [Reply to comment]

@Tammy Thank you!

Julian@connectedmom said... [Reply to comment]

@Anya Thanks for your comment! Good job on continuing to provide what you can and I think its so wonderful that a family member is able to provide you with such a wonderful gift of donated milk!

Julian@connectedmom said... [Reply to comment]

@Heather Evans-Dorn I am so sorry you have to go through us. You're right. While my post is mainly directed at healthcare professionals it is important that EVERY system in our culture be breastfeeding friendly, from courts, to workplaces, to businesses. Thanks so much for your comment.

Julian@connectedmom said... [Reply to comment]

@Kate Cotton I am not sure you fully understood the meaning of my post. at no point did I suggest that formula should not exist. That would be like saying I was against pace makers keeping people alive because most people have healthy hearts or can manage heart conditions without surgery.

I merely wish for a culture in which formula supplementation and feeding are treated like life saving medical intervention it is, but not recommended by medical professionals for mass mainstream use without trying other treatment or management plans.

Julian@connectedmom said... [Reply to comment]

@Jennifer Loher Thats a very good question. His habit of just taking the edge off was identified by my IBCLC and is common for babies like mine who seem outwardly calm and content but show other signs of not getting enough milk. (sometimes termed 'content to starve). basically he would nurse just long enough to get a letdown, take a few gulps, then fall asleep, waking again in 20 minutes or so to do that again.

There is a lot of differing opinions about growth patterns and the idea that some babies 'are just small'. In my case, I dont believe I would birth 9 pound newborns if they were meant to be small babies and toddlers.

But what matters most is that your little one is healthy and strong now. You did a great job getting him to this point and you can only look back to reflect before moving forward.

amanda @ twoninenine&ever after said... [Reply to comment]

Thanks Julian! We have read that eill help so we are trying at the moment to find someone in our area who is experienced with babies... it's proving hard but hopefully we'll get there.

Good article. Well done. Someone commented on Facebook (yes, there were some gems amongst that rubble) something along the lines that "formula should be treated as the medical intervention it is - something that is wonderful to have when really necessary but treated as a last resort" I thought this was a good summary of thinking! Xx

amanda @ twoninenine&ever after said... [Reply to comment]

Well done. What a (excuse the language) shitty pediatrician! Slow weight gain can be an *indicator* of concern but if they were healthy in appearance and meeting milestones there's no reason to claim neglect!

Julian@connectedmom said... [Reply to comment]

@Jennifer I am in no way suggesting that you should do anything but what is best for you. My comments were mostly aimed at those who support moms and babies. I think if we lived in a world where breastfeeding was truly supported and held as the norm and formula and bottles only used in those cases where there were truly a medical need there wouldn't be so much tension. We would see a woman bottle feeding and think how great it is we have the technology to help her and her baby instead of wondering why she felt she couldn't or didn't want to breastfeed.

Julian@connectedmom said... [Reply to comment]

@Natalie BallewThank you. you are right. that is what we are all trying to do and it would be so nice if we had the supports needed within our systems,.

Julian@connectedmom said... [Reply to comment]

@Jessica I am not responsible for other people's feelings about what I do. I do feel that as a professional who supports moms and babies who is also a mom withj this experience it is important for me to demand better support for breastfeeding as a healthcare issue.

it is a fact that breastfeeding is the biological norm for our species. you may not be able to tell one from the other on an individual level but it is an absolute fact that communities with low breastfeeding rates have poorer health outcomes in general.

that is not a comment on any individual mother. it is a comment on medical professionals and our healthcare systems.

Stacey Lawlis said... [Reply to comment]
This comment has been removed by the author.
Julian@connectedmom said... [Reply to comment]

@Unknown Let me just say that I think your voice as a father is very important so thank you for taking the time.

I just want to respond by saying that it is not you or your wife or your individual decisions that I am judgemental of. I was very clear to state that in the article.

I only want better care for all families to make breastfeeding goals attainable without all the stress and guilt. To use your example of the epidural:

I do not judge your wife for choosing one, as a doula I work with families from all walks of life all with different plans for their birth. HOWEVER. I would ask about the care your wife received when she was preparing for the natural birth she wanted. Was she given a non-medical support person? was she given any reassurance that what she was feeling was normal? Was she provided with any non-medical tools or suggestions to cope with the intensity she was feeling? more importantly: was she informed at the time of epidural placement that the drugs used could negatively effect breastfeeding and told about how to manage those possible concerns? If not then I would reiterate my point that it is not mothers who are failing here, it is*healthcare providers*

our current healthcare system sets women up to fail. you absolutely should be angry about this.

Stacey Lawlis said... [Reply to comment]
This comment has been removed by the author.
Anonymous said... [Reply to comment]
This comment has been removed by a blog administrator.
Anonymous said... [Reply to comment]

Oh wait... i worry that my opinion will be deleted? i hope that the previous deletions that show up as being removed by the auther were abusive in some way, I'd hate to see moderation of comments that differ in opion from that of the OP

Baby&me said... [Reply to comment]

Thank you thank you thank you
Because as you say a mothers choice to breastfeed should be supported and not simply stop being the expert advice when hurdles are met, because whichever your choice everyone should respect encourage and support that choice (which I see some haven't got from your blog based on their comments which are completely unnecessary) my son has issues with allergies and many a dr has told me I should move to special formula for me, but we move dr we don't give up because for me as my choice and for my son breast feeding is the only way forward it brings him so much comfort post operative, when his teeth or anything hurts because it is special for us
Thank you for your blog x

Julian@connectedmom said... [Reply to comment]


Your first comment has been deleted because it is both abusive and ignorant. It tells be that you have huge deficits in your education on the subjects of breasts, breastfeeding, child development, and the socio economic realities facing many families around the world, were it not for your tone I would attempt to educate you but considering the nature of your comment I do not believe you would be receptive.

The previous deleted comments were deleted by the person who wrote them, I am not sure why as I did not get a chance to read them before they were deleted.

Another Jen said... [Reply to comment]

BeeBea, I had the chance to read your comment in it's entirety before it was removed. I would think that it was removed not simply because you disagreed with the author, but because it brought nothing to the conversation. No where within this piece does the author accuse bottle feeding mothers of anything. At all. It's an article asking health care providers in particular to support mothers who want to breastfeed despite difficulties.

I agree completely. There are far more options than breastfeed or don't. There is more than you are not trying hard enough or just give a bottle. That's the issue. When I was nursing my now almost 6 year old, no one I spoke with (pediatrician, family doc, L&D nurses, the list goes on) ever mentioned or looked for a lip tie in my son. He was gaining fine but nursing was sooooo painful. Every latch on cracked and bleeding nipples made me wince and sometimes cry for 2.5 years. The only thing I heard from everyone was that the latch looked good but if I didn't like it I could give him a bottle instead.

The thing is, is that we have a myriad of care providers who claim that they support women in breastfeeding, but when it comes down to it they either do not posses the knowledge to assist in identifying and assisting in issues or they do not take the time to diagnose any such issues. That is the problem. Women go to care providers for answers, they are the "experts". Why is it that when problems actually arise women are left with so little support or told to research it on their own? If a woman wants to feed her child at her breast, she can, almost no matter what. It's not black and white. There are so many reasons that could be "fixed" AND there are other options besides just give a bottle of formula (SNS of donated milk OR EVEN formula being an example). It's the women caught in the unknowing that later have guilt. They didn't know and did the best they could with all the knowledge that was given to them, only to later find out there were other choices. Other choices they could have made but had no idea of their existence. It's not fair to those women or any other woman who has suffered in their breastfeeding experience because of an "experts" inadequacies.

Julian@connectedmom said... [Reply to comment]

@Another Jen I keep looking for the *like* comment on your comment. I couldn't have said it better.

Kate Darwin Oz said... [Reply to comment]

What a fantastic post. I totally hear you and completely agree that without a 'fairly' positive first experience it's far easier to give into those saying it's ok to formula feed even if that's really not what your wishes are. It seems it's so much easier to say it's ok you gave it your best shot than to actually help a woman find the right support to turn the experience around.

With my first son we breastfed exclusively for 6 months. It was wonderful, nurturing and mostly without any hiccups. I have since realized I probably didn't dry up like I thought and could have breastfed longer.

This time around armed with my first wonderful breastfeeding experience and slightly more knowledge I intended to breastfed again. We had terrible latch issues. I got mastitis several times and if it weren't for the wonderful support and assistance of a lactation consultant and more so a doula (who I only met thru a friend coincidentally) I know I would have unwilling and upsettingly switched over to formula. I'm happy to say with the right support (which involved pumping and a nipple shield for a short period as well as a baby chiropractor and some latch advice) we are still happily breastfeeding 9 months on. And now everything is positive with our experience it is easy to ignore the comments about how now she had teeth it surely won't be long until she's on the bottle. I will be returning to work @ the 12 month mark but intend on breastfeeding as long as possible after that. So glad for my support. So sorry for those who wanted it and missed out on it.

Anonymous said... [Reply to comment]

I had to pretty much re-lactate with my first, I had been sabotaged and did not know what I did not know, and I will just say AMEN.. Why not "just" switch to formula?? Because it is not a "just" thing and because I do not want to switch! I WANTED TO BREASTFEED. I did, eventually, but it was a rough experience and a lesson for me about how I was and continue to be ignorant about many things and need to go into situations better prepared. I am trying not to let life catch me with my "pants down" so to speak in the future.

I nursed him until he was over 4, and his sister was a much easier nursling and is 13 months old happily nursing..

I don't think you deserve any flack at all for this article. You aren't saying "if you cannot breastfeed but wanted to it is because you did not try hard enough", not even a little is that what you are saying. You are saying "women who really want to breastfeed and TOTALLY COULD are not doing so because they aren't being supported enough to do so or are being sabotaged outright (by things like misinformation about medications and misinformation about weight gain and tongue ties and how to increase supply etc".. How unfortunate that is.


Elizabeth Schier said... [Reply to comment]

Thanks for sharing. My son had a tongue tie too and if I had been even a little boy less determined I would have given in to formula. And that is despite being in a wonderful hospital with very supportive staff and regular access to a lactation specialist

Jot said... [Reply to comment]

I'm a third time mum with a very similar story with my third child. I want to thank you from the bottom of my heart for this article. My baby is 9 months old and I'm still pumping and topping up with EBM, it's been the hardest slog I've ever experienced. But I don't regret it for a second. Thank god for the constant support of my husband and the best lactation consultant in Australia!

I had a counsellor ask me why I put myself through it all, pumping, domperidone, tube feeding, etc and before I had a chance to answer she said, "It's because you hold yourself to a higher standard than others. You wouldn't expect others to do the same would you?" I was dumbfounded.

I'm going to print out this article and send it to her. It says everything I was unable to. Thank you so so much.

Anonymous said... [Reply to comment]

Yeah thanks for the freaking guilt trip. Btfw, my kid is happy and healthy. My god I can't stand pretentious people.

Christine Calhoun said... [Reply to comment]

I would like to start off by saying I did not find this article offensive as a non-breast feeding mom, I understand why you made the choice you did and I understand why I made the choice that I did. With that being said, you brought up a very interesting point but think you missed the mark a little. It's not about a mother child breast feeding relationship, but a mother child relationship that providers and all people need to support. I say this because I had the exact opposite experience of you with a lactation consoltent. Shortly (2days) after I had my first daughter I got a sever infection that lead to me almost dying, I stopped breast feeding because no one knew what I had or if I could pass it to the baby. I can still hear the consultant yelling at me and telling me "you are going to a horrible mother, you already are for not breast feeding!" As the infection got worse I could no longer hold my daughter all I could hear was that lady in my head. My daughter is 10, happy, healthy, and amazing....but, thinking about that day still makes me cry and feel like I failed her on some level. After I was better and released (a month) my milk was dry and I couldn't breast feed. I still had to deal with people's obnoxious comments about bottle feeding and how I wasn't giving my baby the best. It's not just breast feeding mothers who have to deal with comments, pain and's mothers, and until we stop pitting ourselves against one another we will never be able to unite the rest of the population to mind their own business about how or where we feed our children. I can not tell you how many times I checked out of a store crying and humiliated because of people's ignorant and mean spirited comments.....we should build each other up and support each others choices so we can reach our full potential!

Leslie said... [Reply to comment]

I had quite a bit of trouble (that I won't get into on here) breast feeding my daughter. I was determined to give her breast milk, so I have been exclusively pumping since she was 3 weeks old. She is now 7 months old. It has been a huge commitment, but I am glad I've been doing it. She has not tasted an ounce of formula and I hope that she will never have to.

That being said, I don't look down on people who give their children formula. My sister and I were both given formula as infants and we have both always been very healthy. While I do think mothers should give breast feeding a chance, I think society needs to stop judging mothers who aren't successful. A friend of mine breast fed her first child, but her milk never came in for her second child. Is that her fault? No. She shouldn't feel shamed that she had to feed her second child formula.

Jenny Theuerkauf said... [Reply to comment]

Thank you for this. This is important to put out there.

When nursing my first, she had slower than the doctors wanted weight gain (although never lost weight except the initial weight loss right after birth) and met or exceeded all of her milestones. Still, my relatively pro-breastfeeding family practitioner pushed formula supplementing.

It wasn't needed. I stood my ground, we did nurse-ins (a weekend of nothing but nursing) and she nursed every 15-30 minutes while awake and every 90 minutes to 2 hours during sleep time. If the LC hadn't been so supportive and if I hadn't done enough research to have confidence, I would have stopped.

I would have given in to the misinformed nurse who pushed formula because "it's not that bad, lots of mothers use it" and the MIL who repeatedly pushed "What's wrong with formula? All my babies were formula fed?"

My daughter is very healthy, very happy, very well nourished and I don't regret the time put in, I only regret that for a moment, I almost gave in, I almost went against every evidence-based source of information I had found, I almost went against my maternal instincts to listen to one misinformed medical professional.

After I stood my ground and my baby jumped right back on her growth line, the doctor thanked me for standing my ground and teaching her something new about breastfeeding and just how different it can be for everyone (she breastfeed her own son and was doing so at the time).

As for the secondary debate going on here: The defensiveness and judgement just needs to stop period. My choice to breastfeed my daughter and/or to cite the evidence to support that choice are in no way demeaning or deterring anyone else. Facts are not judgments.

Olivia Jane said... [Reply to comment]

Well said mamma. This is a beautifully written piece that has a very important message at its heart.

Can I please point out the difference in a breastfed babies physical relationship to its mother as opposed to a bottle fed babies relationship. The significance of the two options for feeding our children is huge, a breastfed baby is held almost continually, they enjoy the comfort of their mothers arms, her smell, her warmth, her breath, her voice, this relationship is extremely special and is unlike any other relationship we experience in our lives.
This for me is one of the greatest dangers of bottle feeding being the 'easy' option. Babies under two shouldn't really be put down and left alone at all in my opinion and bottle feeding allows that and sometimes well meaning supporters voice that as one of the god send to bottle feeding, that a mamma gets to have time to herself while her baby feeds itself. That is the safest part about the choice to bottle feed in my eyes.
I know some mothers cannot breastfeed and while that can be and is sad and frustrating, when bottle feeding is the option taken, the relationship shouldn't change, just the method of delivery.
I believe if mammas who bottle fed held their babies the same way as if they were breastfeeding there wouldn't be nearly as many issues or judgments surrounding that choice.

Olivia Jane said... [Reply to comment]

That is one of the saddest parts not the safest.

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