Wednesday, June 3, 2009

...and, we're back and talking about Breastfeeding

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).


Heidi said...

OK, your post made me cry. I too am nursing my third baby and feel like I'm just not producing enough for him. We had to supplement briefly during a bout of flu and now haven't gotten out of the habit, mostly because the middle-of-the-night bottle means I get some sleep. Now I feel more guilty than ever (and the guilt factor was pretty high to start with.) I nursed each of my first two for a year and wasn't sure I could do it for this one. He's my third in four years and the biggest of them. The doctor thinks he's growing well but is fine with me supplementing. But I'm not.

You are right - it is about confidence. These 37 yr. old boobs just ain't what they once were. But that is no excuse. So I'm done with the formula (except for when the sitter is here.) Bring on the water... and the Guiness - after all, it's for the baby, right? ;) Thanks for reminding me why I started nursing in the first place.

Amy said...

Oh Heidi! I didn't mean to make you cry!!

Do not feel guilty! You made and continue to make the best decisions you can. Obviously you care very much about your babies - all three of them. Your situation sounds very similar to the friend I was talking about - she's on her 3rd kid and her oldest is only 3-1/2... And she's around 37, 38 years old.

I prefer my oatmeal in the form of cookies, personally. It really helps, on many levels! :)

You hang in there, Sweetie, and please comment again and let me know how it goes. Most of all, BELIEVE IN YOURSELF!

Much love,

Heidi said...

Took your advice and applied oatmeal cookies. Now feel much better! Thanks!

ML said...

Yipes! We're all so different. One Fenugreek capsule every other day made me gush (2nd kid at 36)!! Good reminder to have faith & confidence in yourself.

strwberrryjoy said...

I agree with everything you said. Very well written!

KaityK said...

I completely agree Amy, it IS hard to nurse at first, but I'm so glad that I stuck with it. Besides all of the health advantages, I LOVE the bonding time. The time that I HAVE to have with my daughter where we can sit and be quiet. I get to watch her nurse and rock her. I will remember those times for the rest of my life. They're so precious and if you don't stick with nursing, you would never get to do that. I think it's much more intimate than bottle feeding. Also, nursing is SO convienient. I mean, you don't need to heat it or fill it up, it's always right there, ready to go!
I know it's harder for some than it is for others, but the advantages of nursing are just totally worth it if you can make it work.

Erin said...

I'm just hanging in there until Abby starts sleeping through the night. Last night wasn't too bad. She nursed at 10pm before we went to bed and then she got up at 2am and 5am to nurse. It's the "up every 2 hours because of a growth spurt" thing that makes me want to chuck nursing, yet I perservere. I know from experience it's going to get better and it's the right thing to do for her.

Yes I do supplement when I need to. I always try to breastfeed first and if she's still fussing (and it's not her diaper, clothes, need to sleep, etc.) then I give her 1-2 more oz of formula and that usually does the trick of calming her down.

Wondering about nipple confusion? I admit it...I'm so lucky. Abby's good about taking a bottle and good about switching back to me. Katelynn hated the bottle until she was forced to get used to it at daycare which took awhile.

Please understand the supplementing is only less than a handful of times a week. Sometimes several days go by and I haven't even opened the can. But I've got it if I need it and I refuse to feel guilty for doing it. I'm not giving into that temptation. (And I did give into the temptation to feel guilty and that I was doing everything wrong with Katelynn. I still have to fight that with her.) Abby's growing. She's healthy. And she's sooo adorable!

I'm much more relaxed the second time around. :O) But I'm really looking forward to a good 8 hours of sleep!

Anonymous said...

Nursing is such a personal/individual experience.

I completely argee with you, Amy, half the battle is having confidence and the fortitude to do what you believe is right. I was convinced that breast-milk was better than formula for my tiny baby, but I had serious issues with OVER producing which led to nerve damage, a choking, under-nourished baby (b/c all he was getting was foremilk), and me crying for about 3 days straight. I fought to make it work because I believed in what I was doing...but I didn't love it. Ever. It got better after about 5 months, but mostly I felt ambivalent at best --completely frustrated nearing anger at worst. Little Marc and my breasts waged a daily war with each other.

I suppose I felt about breastfeeding what some women feel about being pregnant - some love it. Others? Not so much. Am I glad I did it? Yeah. Am I glad I'm not doing it anymore? Absolutely. Do I feel bad about the formula? Nope, because I did the best I could. Will I do it (BFing) again for the next child? In a heartbeat. Next time I'll just be prepared to not gush with love during feeding times. And I'll be confident that those feelings are normal and I'm still a good mom as long as I make sure he's full, dry, healthy and happy.

Anonymous said...

My compliments to the writer, Amy. You're very good at this kind of writing. Not everybody is. You can take a complex subject, make intelligent points and present the entire piece in everyday English so others can gain new understanding. Whether it's a discussion of breast or bottle, an explanation of what you do at the office, a showing of empathy for gays who are not allowed to marry, or a detailed accounting of some obscure point of science, you're able to articulate your thoughts logically and clearly. Figure out how to turn this uncommon talent of yours into money, and you have yourself a lifelong career.

Amy said...

Thanks for the comments, everyone!

I think it's important for us, as mothers, to talk to each other about our real nursing experiences. I think the LLL, for all the good it does, has kind of lost the plot over the years. As breastfeeding becomes more and more mainstream, they've had to become more and more dogmatic (nurse until your kid's in high school!). It's sad that few address the real difficulties and issues that come with nursing in our real lives - where work and stress and un-ideal circumstances - over and under supply, etc. - happen. I hope that everyone feels safe to discuss it here, whether nursing was a breeze or whether you've supplemented or even exclusively bottle fed.

We all have our reasons, and we all do the best we can for ourselves and our kids in our own specific circumstances. We should all support each other and our choices. No more mommy bashing! :)

Anon - you made my day. If you have suggestions for how I can turn my writing into money, I'm all ears!

Chrissy said...

I know that I shouldn't feel guilty for formula feeding (and believe me I have the best reasons for using formula), but posts like this one do make me feel guilty. Even more so now when I find out my son (2yrs 5mths) has a milk allergy that explains his reflux (from birth), his tummy cramps, his eczema, his runny nose & his lack of interest in food. Knowing that I gave him formula made from cows milk makes me want to cry. Also knowing that soy isn't that great for him doesn't help the guilt, but I haven't been able to find another adequate substitute. I think all good mum's feel guilty, it seems to come with having kids.

Amy said...

Chrissy - if you had "the best reasons" for using formula, and if you made the best decision that you could given the information and resources you had at the time, you should let the guilt go! It's not doing you any good. Please don't let anything I say ever shake your confidence as a parent. We should make each other think and reconsider, but not doubt ourselves. We're all growing in our journey as parents, right?

That is my one wish for all of us, that we could make our parenting decisions (particularly with regard to feeding) from a place of strength and information rather than self-doubt, no matter what those decisions are.

I do think you're right, though. Being a mom comes with lots of guilt. It's part of the job. I think half the reason is the way we are so hard on ourselves, and the other half is because we don't get results from this great science experiment that is raising children until 20 years or so from now!

If your kiddo has allergies, you simply must run out right now and pick up that book I mentioned - link in the post - The Unhealthy Truth. It will probably sting a little, but the mom who wrote it has kids with allergies, too, and made all the choices you did - until her kid was about the age yours is now, and then she started doing research and making different choices based on what she learned. She thinks (and I'm starting to agree) that you may be able to prevent further complications and immune system issues by altering your diet. It is certainly an idea worth considering, especially since the alternative is years and years of allergen avoidance and allergy medications.

Let's support each other!

strwberrryjoy said...

Hey...ideally the LLL leader's goal is to help the mother have the kind of breastfeeding relationship she wants to have...whatever that may be. I know you don't mean nursing until HS, but extended. I know a couple who are nursing 5 year olds and to me that seems old, but they are not my nursing 5 year old, so that makes them seem even older. I also think that one leader can taint your view on the whole organization and that sucks. I know from group-hopping around the Indy Circle, all the leaders are VERY different, which strongly influences the dynamics of the whole group. There are a few who are awesome and there are 2 that I think absolutely crappy at it. I think that many leaders get sick of giving the weaning advice because that is the number one thing they get questions about even more than newborn issues, so if they see a nursing relationship as going well at least from what the see, they don't want to "stop" it. But I don't know...just guessing.
Is there way to sign up to get comments via email? Or is that only if it's your own blog?

Anonymous said...

Aw, shucks. I'm glad I made your day. I suspect this particular niche of writing suffers from the proverbial liberal arts education conundrum -- it doesn't prepare you for anything in particular, but it can prove useful in myriad situations. You're far more entrepreneurial than I; I'm confident you'll figure out some means of spinning your writing pieces into gold.

You may wish to find an avenue for receiving feedback on a regular basis from an expert in the field. Since you have a penchant for reading, I suggest that you take an undergraduate-level literature course that includes multiple writing assignments every week that are graded by someone with a Ph.D. in English.

Keep up the good work, Amy.