Wow, sorry about the blog break, folks. I was in a particularly hellish bad mood. I couldn't write (I actually wrote two posts and deleted them because they were so snarky). I couldn't speak without yelling. I couldn't think. I think I'm better, though. Hormones suck. A lot.
Anyway, that's not what I'm here to talk about. I was talking to a really good friend yesterday whose 3rd child is about 7 weeks old. She is concerned about her milk supply. It got me to thinking about how much of successful breastfeeding is about confidence.
Think about it. Your baby hits a growth spurt (generally around 6 weeks old, 3 months, 6 months, 9 months...) and he's nursing constantly. If you're confident in your supply, you think, "Awww... cute! A growth spurt!!" but if you're not confident you think, "OMG, he's not getting enough milk! I'd better supplement!" Then you give him a bottle of formula and he sleeps for 8 hours, and you think, "Oh God, I've been starving him! I'd better give him another bottle!" Meanwhile, your supply is diminishing (because he's getting those ounces of food from Nestle, not from you) and he's actually sleeping 8 hours because he's in a food coma (not unlike a grown person getting tired after a huge meal, say Thanksgiving). But your observation (he's sleeping! He must be full!) leads you to continue to supplement, which drives down your supply, which means he's going to need more formula... You see how it goes.
Of course, of course, the parent's instincts are natural and healthy. You want to give your child the best. You want him to be satisfied and full. You really want him to sleep. I am not suggesting that my friend, or any other mother in her situation, has done anything wrong - far from it!
I'm suggesting that the entire formula industry, and its advertising, is geared toward instilling in mothers a lack of confidence.
It's hard to be confident when you can't see how much the baby is getting. It's hard to trust your body (especially if, like me, you've had an adversarial relationship with your body on other levels for your entire life!!). It's hard to look at that pumped ounce of milk, and think, "If I can only pump an ounce, how can I be sure that he's getting enough??"
Babies are more efficient than pumps.
I breastfed my kids for 28 months and 22 months, respectively, and was NEVER able to pump more than a few drops. I would've been thrilled with an ounce. But my kids didn't starve. Far from it! Once things got going, we were fine, and now MG is the height of your average 5 year old, at 3. Claire's tiny, but I'm only 5'4". She's a healthy tiny. (Think about it - we give most kids in this country formula as infants, but when they're 8 or 10, how many of them have obesity problems? Maybe it's time to stop listening to the medical establishment and stop following the charts when it comes to our babies' weight gain!)
Pumps don't stimulate your breasts to produce more milk the way that babies do.
And the formula companies know all this. It's no coincidence that you get a "free" sample of formula when your baby is about 6 weeks old - that's a known time of major growth for infants, and the breastfed kid will ramp up the amount of nursing at that time, naturally. Naturally you'll think he's not getting enough, and you'll give him a bottle. He'll sleep for hours because he's over-full. It's very reinforcing. And that's how formula companies sabotage breastfeeding. Oh yes, I believe they do it completely on purpose. Think about how much money a single bottle-feeding family spends on formula in a year - thousands!! Think about how many babies are born in a year - thousands!! Think of the profits! If you believe that companies like Nestle aren't in business for the money, your faith is much stronger than mine.
I honestly believe that formula should only be available by prescription (and then maybe it would be covered by insurance!) for those who are truly having problems nursing (and they are out there - I had major supply problems with MG, and I had to take Reglan, which causes depression, and which I think caused my post-partum depression, to fix it). Perhaps if the insurance companies were looking at paying for a year of formula versus funding a course of medication, like Reglan or Domperidone (see below) they'd be more willing to help those of us who have trouble.
Domperidone is not FDA approved, although it's used widely in Canada and safer than Reglan. In order to get it here, you have to have a very cooperative doctor and a compounding pharmacy. It has fewer side-effects than Reglan, and is reported to work better.
But instead, my OB (who had never heard of Domperidone) said, "Just give her a bottle." I refused to give up, and sought help elsewhere (Jeni, the local LLL leader, is a goddess. If you're local and having trouble, go to her first. E-mail me if you need contact info).
Anyway, I think if the financials of the decision were reversed - if the burden of "just" giving a bottle would fall on the insurance companies instead of on families - the insurance companies might pressure doctors to change the advice that they give, and encourage women and their doctors to try every possible course of action (medication, oatmeal, dark beer, fenugreek, etc.) before resorting to formula - and I think that would be good for babies and for mothers (and for wallets!).
Please understand that I am not blaming mothers. I know that there are lots of healthy ways to feed babies, and I do understand that formula has its place. Many, many women are unable to stay home for a year and nurse their babies - they have to work. Many of those same women are unable to let down for a pump, like me. In those cases, of course, formula becomes necessary. And I do not believe for one minute that I'm a better mother than any formula feeding mother simply because I was fortunate enough to make it work. Far from it. The measure of a mother requires a lot more factors than simply what she chooses to feed, or not feed, her kids. There are breastfeeders who beat their kids, and there are formula feeders who could be Mother of the Year candidates. Breastfeeding is just one small aspect of who I am as a mother, and if you choose to feed your kid formula, I trust that you have made the best decision possible for your child and your family that you could, given the individual circumstances you found yourself in at the time. No one sets out to hurt her child or to give him sub-standard care. I know this. I am not a sanctimommy when it comes to breastfeeding (anymore!).
I simply want to encourage any mom who might find this post (via searches for "problems breastfeeding" or "low supply" or "not enough breastmilk" or anything else) to TRUST HERSELF. Have confindence! Count wet and dirty diapers - if you're getting at least 6 wets and at least 1 dirty a day, you're ok. Keep an eye on the baby's weight - if it drops, obviously, you have a problem, but if it slows (per the chart) or even stalls for a couple of weeks, chances are that you're ok.
To build your breastmilk supply - take fenugreek (capsules, liquid, or tea). You have to take enough to make your BO smell like pancake syrup - about 3 capsules 3 times a day, for me. I found both the liquid and the tea nauseating, so I took capsules. The liquid is more effective. Try dark beer, like Guinness, because the brewer's yeast helps milk supply (or buy capsules at the health food store to avoid the alcohol). Eat lots of oatmeal. Drink plenty of water and get lots of rest - the milk-making hormones are more active when you sleep. Talk to your doctor about Reglan and Domperidone (and be SO careful with Reglan). Nurse your baby in a variety of positions so that all of your milk making glands are being stimulated (try to get as much of the dark part of your breast in his mouth as you can. If, like me, it's impossible for you to get all of it in that tiny mouth, make sure that you're getting all of it in there at different times over the course of the day - nurse lying down, in the cradle position, in the football position, etc. so that those glands all get stimulated. They're all around the outside of the areola. The motion of the baby's chin stimulates them. If you can't get your baby's chin to a certain spot, massage it with your hand while you nurse).
And remember that formula, while it has its place, also comes with risks. There have been plenty of recalls of formula since my kids were born (when I started paying attention). I remember one, in particular, where there was ground glass in formula powder. YIKES! The book I'm currently reading, The Unhealthy Truth, which I'll talk about in more detail once I've finished it, suggests that soy formula can wreak havoc on your kids' hormones. It also suggests that the proteins in non-organic cow's milk formula could be the cause of the rise in allergies that any parent who isn't in a coma has noticed over the last 20 years.
(By the way, if your kid has allergies, asthma, ADD, or autism, don't wait for me to finish that book - go get it right now, because it has important stuff in it that you really need to know, and God knows when I'll actually finish it and sit down to write about it. No one's paying me to review it by the way, I just happened to pick it up, and I think it's important... See previous blogs about organic milk and beef, etc.)
Most of all, though, please don't allow anyone - whether it's another mother, or a blog post, or a doctor, or a formula company, or a combination of all those - to take away your confidence. Make your feeding decisions from a place of strength, confidence, and information - not from a position of fear and self-doubt.
As always, if I can be of any help with this (or any other parenting) issue, please e-mail me. Finally, KellyMom has a ton of breastfeeding resources. Every mother who intends to breastfeed should read it, preferably before the baby is born (because afterwards? You totally won't have time).