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: 

http://www.ilca.org/i4a/pages/index.cfm?pageid=3432

Three Things Women Should Stop Saying To Other Women

A little reminder of how we don't really know anyone's story except our own. I personally have heard each of these. Have you?

You're so lucky that you get to stay home with your kids. Maybe she is thrilled to be a stay-at-home mom. Maybe she wishes like anything she could have kept her career. Maybe it was a no-brainer decision for her family. Maybe it was a difficult, perhaps agonizing decision for both partners to make. Maybe finances are ridiculously tight and the family is struggling. Maybe she does consider herself lucky. Or maybe she feels trapped. You have no idea, so don't assume. On a related note, please no I don't know how you leave your children every day to go to work comments either, okay?

I support breastfeeding, but [cover up, don't do it in public, you should wean by this arbitrary date, etc.]. You either support breastfeeding mothers or you don't. Once you start putting qualifiers on it, you're being wishy-washy, and wishy-washy is not support. And it probably goes without saying, but for the love of squirrels no negative comments to a mom who formula feeds, either. You have no idea why another mother has chosen to feed her baby the way she has, and frankly, it's none of your business.

I don't understand why people say they need a break from their kids. I will speculate that mothers who say this have a supportive partner, probably one who works a job with regular hours and is home in time for dinner most nights and every weekend. Maybe they have parents or in-laws or close friends nearby. They are likely not in a situation where they are going it alone, either permanently (single parent, divorced, widowed) or temporarily (spouse is military or in a career with significant travel). Their "breaks" may just not be as obvious as a night out or a regular babysitter, but having someone around to share the daily mental energy matters.

What would you add here?

Thanks for reading and have a blessed day.

What a Busy Mom Needs

My youngest child is a little over two months old now. I found the postpartum period incredibly easy this time around--perhaps too easy. Physically, I bounced back almost instantly. I was up and around, preparing the house for guests the morning after. I may have given the

impression that things are completely back to normal, but they are not. Despite my quick recovery, I am still balancing the needs of a newborn and three older children, household duties, and paid freelance work. It can quickly become overwhelming. I have been thinking about what I need, and I decided to share it here. I do not claim to speak for every busy mom, but hopefully some of you can find commiseration here. Maybe friends, family, and partners could also learn a thing or two about the kind of support a mom needs.

I need a friend who will listen and allow me to vent without judgment. When I talk about struggles I am facing with my child, I do not want to hear about how lucky you are that you have a "good" baby. I do not want you to informally diagnose my child with some mental

disorder or suggest I abandon my parenting style. I just want someone to listen. I would be happy to do the same for you. And when I don't have time to hang out, please don't take it personally. Weekends are often the only time my whole family can be together, and we really need that.

I need family members who love and accept me, imperfect as I am. Your opinion means so much to me, so try not to be too disappointed if I fall behind in my day-to-day tasks. I am doing the best I can. There will be time enough for chores when my babies are older. When you plan a get-together, please consider my children. Everything goes so much more smoothly when their needs are met. I might be intensely emotional around you, and I apologize, but know that this

is because you are one of the few people I trust enough to open up to. If I parent differently from you, I do not mean it as an insult. I am just doing what I feel works best for my kids. I know it sounds silly, but I really just want you to be proud of me.

Most of all, I need a partner who will support me, not just in word but in deed. I appreciate that you value my thoughts and opinions, but what I really need is for you to act on it. If you want me to be an attentive mother to our children it will require a lot of my time and energy--especially when they are little. Please support me in this effort by picking up some of my slack around the house. Keep up with the messes you make. Do a load of laundry or pick up a broom now and then. Sometimes, I feel emotionally depleted at the end of the day. Please know that I love you and that I am not intentionally ignoring you. Even when I am not up to being intimate, I still very much need
your affection. The rest will come in time.

To all of my loved ones, thank you for listening and for always being there. To my fellow moms, you are not alone. I hope you find everything you need.

5 Ways Partners Can Support Breastfeeding Moms

1) Help her prepare:

Chances are, if your partner wants to breastfeed she’s going to mention it at some point before the baby is born. There is actually a great deal of preparation, both mental and physical that goes into a successful breastfeeding relationship. You can help your partner, and show your support for her decision to breastfeed by educating yourself about it, listening to and helping her set goals and letting her know that you understand how important it is to her to breastfeed.

Another Take on Breastfeeding

There I was, holding my first baby after an unnecessary c-section. Disappointed with the delivery, I couldn't wait to nurse my son for the first time. First try, he latched! That was about the easiest nursing experience we had. From day one, I struggled with breastfeeding my son. Nurses encouraged me to pump, pump, pump! I did. I pumped until I thought my nipples would bleed away, or worse, fall completely off. Cracked, bleeding and sore, I was lost. What do I do? Why you supplement! You give your baby a bottle or two of formula, and you let your nipples heal. Really? I did just that. I "supplemented" and I offered my son bottle(s) I quickly realized this was NOT helping my latch issues. In a moment of frustration and a feeling of failure, I asked for help. Not the "give your baby a bottle" kind of help, but real help. A lactation consultant came to my room and helped me. Really, truly helped me. My son was latched, and I was feeding him from my sore, cracked, painful breasts.YES! I was told and led to believe that a bottle here and there was just fine. For me, this is what led me to troubles. While I nursed for about 90% of his feedings, I did turn to a bottle here and there. That worked out ok for a while. But eventually Tolliver realized that feeding from a bottle was faster and easier. He started to refuse the breast at about 5.5 months. He would scream and cry and have nothing to do with the breast when offered. What did I do? I offered him a bottle. Why? Because clearly he was starving and I wasn't producing enough. Ugh. So with this belief, I nursed when I could, and gave bottles when he wanted them. Eventually, he was on formula more often than the breast. I wasn't ready to stop nursing, but I also couldn't handle watching my son scream. It wasn't until much later that I realized that I set up my own failure by offering bottles. I promised myself I would do things much differently with baby #2, and I did. Holliday arrives after a legitimate emergency c-section. I offer the breast, he latches! I offer again, he latches! This boy loved the boob! The copious amounts of IV fluids swelled every inch of my body, and eventually the easy latch became difficult. This time, instead of fussing around, I called in the help of Daleen Bybee. At the time, Daleen was a local Le Leche League leader. I knew her as I would attend her meetings, but I had also began to know her on a slightly more personal level. I felt comfort in calling her in for encouragement and knowledge. She came in, helped me, and there we were, cruising along. I won't say it was easy from that moment on, but I will say that the outside advice and encouragement is what I needed. With work and commitment, we got it. When Holliday was about 5 months old I ran into health issues that required 2 unexpected surgeries. I was in the hospital for a week, and could only pump so much. My husband was forced to do some formula feedings. Argh. I was so scared things would end badly. After hitting the road to recovery I faced some serious supply issues. I pumped, and pumped and pumped. I ate ungodly amounts of Fenugreek, dug out my Domperidone prescription, and drank water until I thought I would drown. Frustration, failure, fear and anger are all emotions that engulfed me. What was I doing wrong? What am I to do? I am NOT giving up! Daleen picked up the phone and called to check in on us at the EXACT moment when we needed it. Once again, her encouraging words and advice saved me. She talked me through it, made me realize I was putting more stress than necessary on myself and that I could overcome this, if I wanted to. Dump the pump, enjoy the feedings and try not to stress. I did just that. I dumped the pump, put him on my breast every chance I had, and within a week, all was good! We were almost back to where we were, and I was SO grateful.

I can truly say that I LOVE breastfeeding. I love the closeness that it brings to me and my son. I love that I am the only one that can offer him that comfort. I love that it forces me to sit down and relax. I love that I am offering my child the absolute best that I can.... but it's not easy. It is a huge struggle. It's not something that with one attempt, you're a pro. We face our obstacles, but I wouldn't trade it for anything.

Not everyone takes advantage of the resources out there, but they should. I had a chance to pick Daleen's brain. I asked her some questions that I feel could help others along their journey.

What are 3 common misconceptions about breastfeeding?

-- It's easy!

-- There are no advantages after 6 months, or 6 days or 6 weeks....

-- What if I "can't" breastfeed? (less than 1%)

What are 3 common struggles mothers run into with breastfeeding?

-- pain

-- supply issues

-- infection or yeast (mastitis, plugged ducts, thrush, nipple trauma etc.)

What is the most common reason people turn to breastfeeding support coach?

-- Pain or supply issues "My baby isn't getting enough" or "I'm not making enough milk!"

The World Health Organization is recommending (and has for some time now) that women breastfeed for 2 years and beyond! Approx. 14% of women are breastfeeding at 6 months. Initiation rates are hight, but women quit without support and ACCURATE information!

LEARN about breastfeeding as a pregnant Mama, it's part of the "job" when the baby arrives, you'll be happy that you took the time to find out about it, so there arent so many surprises. Hang out with a breastfeeding friend. Go to a peer support group. Read a good book. "The Womanly Art of Breastfeeding" or "Dr. Jack Newman's Guide to Breastfeeding" or "The Breastfeeding Book" by Dr. Sears are good books to start with!

If you are an online kinda gal, http://www.LLLI.org/ has a great search engine with AWESOME FAQ pages on all the topics mentioned here... and more!

Daleen Bybee

Co-Founder FootprintsFamilyHaven.com

Breastfeeding Peer Counsellor

Birth Doula

I strongly encourage all women to turn for help when it's needed. There are so many available resources. I can truly say that the help and knowledge I received, is the exact reason I am still successfully breastfeeding Holliday today. I owe many thanks to Daleen for all of her support, and her true passion for breastfeeding.

Tammy, Connected Mom