Wednesday, August 05, 2015

Is Breast Always Best?

I am republishing this post below to include a link to a new article: Not celebrating world breastfeeding week. I continue to be a huge proponent of breast feeding. But continue to want women who can't do it or have trouble continuing, to not feel like they are not a good mother. I want to keep it real!

One of my MD friends sent me a link to the following article: Is Breast Always Best?

In a previous post, I admitted that after two babies who suffered from "failure to thrive" with breastfeeding, my husband and I decided, months before Hannah was born, that we would not allow the same thing to happen again. So when it quickly became evident that the same thing was happening with Hannah that happened with Elijah and Abigail, we decided to supplement with formula.

What has resulted has been an entirely different motherhood experience this time around. We believe that my milk expels very slowly. With Elijah and Abigail, I would feed for one hour on and one hour off all day long. They were not gaining any weight. (In fact, Elijah dropped to the 8th percentile. When we switched to formula, he went up to the 87th percentile within 10 days!)

I definitely believe that breast milk is best for babies. So does my husband who is a family medicine physician.

However, what I do not believe is that women need to feel shame when they cannot (or even if they choose to not) breastfeed. I had a friend admit to me recently that she found herself lying when asked whether she was breastfeeding or bottle-feeding due to shame and embarrassment. This is ridiculous!

Not that I blame her. When I bring out a bottle, I immediately feel judged. With Elijah and Abigail, I felt the need to explain. "I tried to breastfeed! But they weren't gaining weight, and we had to go to the bottle."

I loathe hearing women say to me, "You need to keep trying until it gets easier." That is just ... not ... true! For some women it is. But in my case, I tried everything. I also think that your experience is effected by the chemistry of your family at the time. If it is your first child, you might have the luxury or extra time or ability to pump and feed or sit on the couch all day and breastfeed.

But what if you, like me, have a 9 month old (Isaac) when you are dealing with breastfeeding concerns with your newborn (Elijah.) Or in the case of Abigail, I had two two-year-olds to watch while trying to breastfeed her. My family was better off with me bottle-feeding.

Written by an MD this article really, truly, honestly, said everything I have felt about breast feeding recently. I was especially "moved" by the following quotes:

"Let me be very clear: breastfeeding is an excellent choice for most mothers, and I applaud the many nurses, obstetricians, lactation consultants, pediatricians, and administrators who have worked to make it an integral part of prenatal, neonatal, and infant care. I am equally grateful for the policy-makers who advocate for breastfeeding support for mothers who return to the workforce. Despite my appreciation for the movement’s intention, I find myself appalled by some of its associated rhetoric. To quote Tina Fey, “Invented in the mid-1800s as a last-ditch option for orphans and underweight babies, packaged infant formula has since been perfected to be a complete and reliable source of stress and shame for mothers.”

"In a striking departure from the decades when formula was handed out routinely on labor and delivery wards, Michael Bloomberg’s Latch On NYC initiative now instructs staff to restrict access and track the distribution of formula, as well as to have any mother who uses it listen to a mandatory speech about why 'breast is best.' Every time I open a can of formula, I am faced with a warning label akin to that on a pack of cigarettes that states 'Breastfeeding is recommended. If you must use formula, we have one that is right for you.' The AAP handbook on newborn care states “breast milk is impossible to duplicate and the health benefits it offers invaluable.” The language is nuanced but damning, with the implication that a woman is elevating her own needs over those of her infant by deliberately choosing an inferior product. As with most issues, the online community is far less subtle; the blogosphere is full of web sites branding women who are unable or unwilling to breastfeed as unfit for motherhood."

The quote that stood out to me THE MOST in this article, had to do with post-partum depression and breastfeeding concerns:

A 2011 study of 2,586 breastfeeding women identified negative early breastfeeding experiences as key predictors of postpartum depression among new mothers and recommended screening women with breastfeeding difficulty for depressive symptoms.

After facing post-partum depression with both Sidge and Abigail, we decided that this time, we would be proactive in the depression battle. We made sure that I was not alone with the baby (or with all the kids) if at all possible. This way I would always feel like I had a teammate to tag out to. We would also make sure that I got more rest and that I did not feel that intense need  to breastfeed that left me on the couch for hours and hours every day with a baby who still screamed when I took him/her off the breast and was not gaining weight on top of that.

The author continues:

"In our efforts to promote a medical culture that encourages the majority of women to breastfeed, obstetrician–gynecologists unfortunately may be isolating a silent minority who are unable to do so. In the months since my daughter’s birth, I have sought out literature on the topic of breastfeeding and have listened to the experiences of friends, family, and colleagues."

"There are doubtless individuals who feel that I just didn’t try hard enough, didn’t get enough support, or had to return to work too soon. Although it is difficult for me to evaluate these critiques objectively, I do observe that they all place the burden of guilt on the mother. After failing the depression screen at my 6-week postpartum visit, I was grateful for a sympathetic obstetrician who spent 45 minutes during a 10-minute appointment slot gently but firmly telling me to let it go. I was lucky to have a pragmatic pediatrician who reassured me that I was endangering neither my baby’s health nor her IQ and, perhaps most importantly, a compassionate partner who asked that I trust him to make the decision that I, through my guilt and self-blame, could not—that it was time to move on and that our baby was going to be fine."

Other blog articles on this topic that I have enjoyed:


Anonymous said...

I guess I look at this "debate" in a different way. Perhaps a mom suffers with PPD, has many children, doesn't feel comfortable, has a baby with a bad latch, etc., BUT that doesn't change the fact that breast IS best. Statistics show that the percentages of moms PHYSICALLY unable to breastfeed is actually tiny. A slow let down, for instance would not be put in that category. Technically, with a slow let down you could switch to exclusive pumping.

That said, it does take a LOT of time and a LOT of hard work. Perhaps it's a season in life where pumping 8 out of every 24 hours just isn't going to work for a family. Perhaps a mom needs to be on meds that are incompatible with breastfeeding. I get it, and in fact, I'm nervous about the time aspect as D nursed for 1.5 hrs, 8 times a day. Doing that with a toddler- ahhh! But again, none of that changes the fact that breastmilk is God's perfectly created nutrition for a baby.

It's one thing to say I can't and another to say I choose not to. I wish moms who choose not to, for whatever reason, would just say that, it's not for me. I think saying "I can't" further promotes the belief that there is a significant amount of the population that is unable to breastfeed. No guilt needed, it's just a decision that moms need to be okay with owning, reducing the stigma on both sides.

(And let me take a moment to say that I disagree with outright shaming/criticism from either "camp" in regards to either decision.)

And the warning labels and printed information? They don't say anything about the quality of mother in regards to her decision, they simply say that medically, breastmilk is the best option. I think we owe it to children to pass that knowledge to their mothers. Formula is not banned, and is still heavily promoted (I received a month's supply at my 12 week appointment!). Formula is available to anyone who chooses it. Do we stop distributing scientific information because it might make someone feel bad? Should we remove the warning labels on cigarettes? Or bumbo seats? Should we end the anti-childhood obesity campaign?

There is a big difference from presenting straight forward information (breast is best), vs. making a statement of judgement (breastfeeding is gross). There is a big difference between how I feel when I assume someone is judging me (pulling out a bottle or nursing in public) vs. someone actually making a comment (why are you doing that?).

I think the issue is with us as mothers, and being able to own our decisions, much more so than with the current trend of breastfeeding promotion.


Wendi Kitsteiner said...


Knowing that you and I are completely different people and yet knowing we will always be friends and I that I like you a lot despite the whole tiaras vs. non-tiaras debate, I must get into a slight debate with you here.

I totally respect what you have said and agree with nearly everything you write. I actually I agree with everything you write.

I agree that the warning labels are okay.

I agree that God designed us to breast feed and therefore it is obviously best for our babies.

However, your blog post on breastfeeding on your blog listed a few things that I think are exactly the "issue" for moms like me. Specifically you write that:

2. It's true, it WILL get better

And that's the "issue" that I disagree with. While that is often true and usually true, for some moms it is NOT true.

And that reason may be that they have a physical reason (which we believe is the case for me) or that they simply can't keep up lifestyle-wise. But no matter what the reason, their reason is, in my opinion, valid.

Before I struggled with bf'ing, I agreed with you. I thought it was ridiculous that women got WIC money for formula when they didn't even try. (I still think that actually.) But I really judged women who didn't breastfeed. I labeled them as lazy and not as good of a mother.

I really did!

But when it happened to me, I realized that I cannot say whose reason is good enough ...

When we finally gave up bf'ing with Elijah at the 4 month mark, I was trying to pump. I was waking up an hour early, staying up an hour later, and having to basically shove Isaac off into a corner to pump while he was crawling around. It was terrible.

John walked in and saw me and was like THAT IS ENOUGH. And the thing was, I was doing it and trying it and wanting to because of the pressure that I felt society had put on me.

While I do believe the breast is best is a good thing, why don't people tell us that it is okay if we can't? I just feel that no one talks about this. That's the dialogue I believe we need to have. That's the dialogue I wanted to start.

And the fact is, that in my case, I don't believe, like your #2 states, that it would ever get better for me. It didn't. It wasn't about pain or even time. It was about the fact that my 100th percentile son was now in the 8th percentile and crying non-stop day and night because he was starving.

I believe that much of my PPD issues were because of the fact that I felt that I had to do this to be a mom. I believe the 5 years of infertility and then the bf'ing issues just broke me.

I met with 3 lactation consultants. They told me that my only option was to use those supplementation cords that you tape to your nipples and give formula while breastfeeding. They gave me some tips, all of which involved more time and more stress.

I believe that if, back with Elijah, someone would have explained to me that it was okay to stop or to supplement and really made me feel like I hadn't failed, I wouldn't have tail-spinned into the PPD issues that I did. But instead, I felt like a failure.

The truth is, mothers judge each other NON STOP and I am TIRED OF IT. We judge for how we discipline, how we feed our kids, if we work outside the home, etc. etc. etc. Facebook is the worst. Post all the great things you do and it makes other moms feel bad.

I am sure you get what I am saying.

(All research shows that it is better that kids don't go to daycare and are home with parents. But this is not written on the outside of daycares.)

Anyways, I don't disagree with anything you are saying but I do think that not enough grace is shown to mothers ... I didn't feel enough. I felt judge and shamed and ... maybe I did put it on myself ... but it was still very real.

My point in writing this is to say the truth ... breastfeeding IS BEST. I wrote that in the post. But women need to know that they are still good mothers if they don't.

So we agree ... mostly!

Wendi Kitsteiner said...

I love that you promote moms to quit putting so much pressure on themselves. I had enough milk to feed a football team, but I hated breastfeeding. I did it with both kids, but only because we were broke and it was free. They were completely weened by 5 or 6 months old because they wouldn't sit still and I didn't care to fight them, or have my boob exposed to whomever I was talking to. I refused to sit in a room alone because I spent most of my days alone already, I was not about to give up the 1-2 hours I actually had with another grownup just because I had to feed again. And my kids have turned out just fine. I think it's wrong to even have this debate. It only makes those out there who have complications with breastfeeding or those who don't have the option feel awful and we should never do that to new moms! I think moms are harder on themselves than anyone else. Every family works their own way and we need to encourage each other instead of pointing out all the things they are doing wrong. There. Off my soapbox. Miss you and hope you are rocking it out!!!


Wendi Kitsteiner said...

English Brownderson -- I don't even have kids and find myself stressing about how I would handle the whole thing. Great job, Wendi, love

Wendi Kitsteiner said...

Heather Thomas Savio -- I yelled at a male doctor and a male nurse when they tried to shame me for not breast feeding. For me I wanted to enjoy me kids and love them without resentment. With twins I literally wouldn't have time to eat or pee.

Anonymous said...

I feel like breastfeeding is right up there with politics and religion. There are very strong opinions.

Wendi, I say any breastfeeding is a job well done. I say feeding your babies formula is a job well done. You are loving, caring for and bonding with your babies no matter how you feed them. It's special, quiet time together that will be yours forever.

Best wishes,

Anonymous said...

Is it possible that maybe the timing on things getting better for a situation like yours would have been 6 months when he could start solid food? It could be. But, if you didn't feel like you could make it until then, that's fine too.

(As a side note, my post was written for moms looking for BFing encouragement.)

My main point is that it's okay to make the decision to stop because it doesn't work for you, but that moms should say just that, "it's my decision." Simple as that. It's the right of every mom to make that decision, no explanation needed. I think the explanation (or accompanying reasons) comes from a personal sense of loss/guilt/fear/shame/etc. and is not usually the result of someone else's outright comments or statements. Also, giving all those accompanying reasons cause stress for people like English, who have yet to come to the issue.

I can't find it at the moment, but I read an interesting article that gave statistics regarding perceived mommy wars and actual events. While most of us agreed that mommy wars existed and were a problem, few of us had ever been treated rudely by another mom in regards to the debated decisions.

To say that moms "judge" other moms...while I am sure there are moms out there who do say rude things, I think a lot of the issues come from our personal sensitivities. For instance, it is important for you (and I) to stay home, we have decided (or judged) that that is the best way to raise our children. So yes, we have assigned a value to something, home is best. However, that doesn't mean that we are rude to moms that work, even if we feel like that's not the best decision. Does that make sense? "Judging" is simply valuing one thing over the other, but rude behavior is something different.


Wendi Kitsteiner said...

My main point is that it's okay to make the decision to stop because it doesn't work for you, but that moms should say just that, "it's my decision." Simple as that. It's the right of every mom to make that decision, no explanation needed. I think the explanation (or accompanying reasons) comes from a personal sense of loss/guilt/fear/shame/etc. and is not usually the result of someone else's outright comments or statements. Also, giving all those accompanying reasons cause stress for people like English, who have yet to come to the issue.

Casey ... Agree ... Totally!

Anonymous said...

Thanks for this post. Both my children were adopted and so were formula fed. I am quite sure formula was better than the alternative for their little lives. They are healthy and thriving and for that I am thankful.
As to the judging I agree with you, Wendi. It does happen and all the responsibility does not need to be put on the person feeling judged. To the example of a mom working vs being at home I think there are gracious ways you can support that mom without simply saying "hey being at home is best, working is second best, if you feel bad about me feeling that way it is your fault for being to sensitive" That is exactly the attitude that is the "mommy wars" And that may not be said to that person directly but it was said in this blog in a comment that other moms will read. And I am a stay at home mom.

Anonymous said...

I am confused by this comment: "I thought it was ridiculous that women got WIC money for formula when they didn't even try. (I still think that actually.)" Much of what underlies the discussion in these comments is not judging other mothers. This sounds pretty judgmental. Who is to decide whether they have "tried" sufficiently? Are they supposed to sit and explain to someone how they feel that they sufficiently tried and then that person makes some sort of external assessment ("yes, you've tried hard enough in our option that you may now have public assistance for formula")? The most zealous breastfeeding advocates might say that you didn't try hard enough (I don't agree with this, but I'm sure some people might), particularly since at least some of the reasons you give for ceasing breast feeding were personal (i.e. other kids) rather than actual physical barriers.

While I think any woman (including one receiving WIC) should be given information and resources to help her pursue breastfeeding if that is her choice, I don't think it is reasonable to refuse to pay for the cost of formula if she feels that she cannot breastfeed (for physical reasons, personal reasons, etc.) until we feel she has tried hard enough. What is supposed to happen in the interim before she meets the standard of having tried hard enough? Either she resentfully breastfeeds her child or she does not, and her child receives inadequate nutrition.

Wendi Kitsteiner said...

Anonymous I see your point .... But that comment is more geared at the fact that I think our government gives a lot of free mo ey to everyone. I still feel that just getting money for formula isn't necesaarily fair. But I agree, I'm not sure how you would judge what trying is. So you may be right, I might have to change my thinking on that. But I do think generally speaking, there are fewer people breastfeeding in the lower income category and maybe you are right. Maybe that is due to a lack of education.

Anonymous said...

Just to be clear, I don't think it is entirely due to a lack of education, although I did mention that I think education is important (for all women, not just those who receive WIC). I'm sure there are a variety of reasons that people in lower income categories don't breast feed as often. They likely have less ability to stay home with their babies (i.e can take little or no maternity leave from work). Some of the lowest income mothers are young mothers who are still in school and perhaps are trying to continue school. Lower income women likely more frequently do shift work and/or have long shifts and/or long commutes to and from work on public transit, which may make it difficult to breast feed. I am just speculating. There are probably a whole ton of factors that play into lower income women breast feeding less frequently. I just don't think it is possible (and even if it were, I would certainly not support it) to evaluate whether they have "tried hard enough", particularly in light of the sometimes difficult and complex circumstances in which some of these lower income mothers may live. There is likely a great deal about the lives of many women who qualify for WIC that is not fair, and so I am not at all bothered by the fact that they get money for formula and I don't. I fully support the small amount of my taxes being used to provide formula so that we know their children will be adequately fed. That leads to my next point...

We will have to disagree on the government giving away a lot of free money point. I'm not going to open that can of worms.

Wendi Kitsteiner said...

I totally agree that there are a variety of reasons. And after the terrible time I had, I support those reasons.

I think my bigger "complaint" was that, if I make the decision not to breastfeed, I have to factor in what that will cost us as a family. I don't find it entirely fair that other people can make that decision without having to factor in that it might cost them something. I agree that helping pay for hungry children is important. I just think that it should be a factor in decision making.

However, I recognize that society has different opinions on how much the government should help.

My bigger point though in writing this piece (and linking to others) is sharing the fact that I think breast feeding is not cut and dry and you have enlightened me to that even further.