Breast vs Bottle

A mother’s group I am part of has had a few ‘debates’ recently about formula vs breastfeeding. I say ‘debate’ in inverted commas, because I really don’t think it is a debate. Ever.

I think that if you have ever had a hungry baby in front of you, at that point there is no ‘debate’ to be had. It is not a ‘choice’, because the alternative is a slow death from dehydration and starvation. How can we portray that as ‘choice’?

I breastfed both of my children, but not exclusively. Breastfeeding is hard. It takes work, and I’m not saying the solution to every problem is to just throw your hands in the air and say ‘oh well. Here’s a bottle.’ But see how thorny this issue is that I feel the need to clarify myself so much?

What I want to say is this: breastfeeding is like a ladder. It always takes work to climb it. But everyone’s ladder is different. Some are steeper. Some have rungs further apart. Some are slippery. Some have broken rungs. So we all need to think about how someone’s ladder differs from our own.

As part of that ‘debate’ I got a little piece of knowledge shared with me. That you never need to offer formula straight away, because you only know you aren’t producing enough milk once you’ve tried. Here is what my own personal experience tells me that is – it’s bullshit.

When my daughter was born I experienced a uterine inversion. That means my uterus came out with the placenta. It is a very serious medical emergency, for many reasons, one of which is that it is typically accompanied with severe haemorrhaging. I lost 3.7L of blood in a very short space of time. Post-partum haemorrhage is directly linked to delays in producing breastmilk. I faced a number of barriers to starting milk production. I was separated from my daughter immediately following birth, I was anaemic, and my body was so short of fluid following the haemorrhage that it didn’t have any to spare for her. Lastly hormone changes after birth that trigger milk production can’t occur because there literally was not blood flowing through my body.

My daughter was hungry and eager to attempt breastfeeding, in fact she latched perfectly. But when my body could not even produce colostrum until day three (really) it was no surprise. We began supplementing early on, and despite this at her first weigh-in at two days old she had already lost 9% of her bodyweight. We increased the amount of formula, as 10% loss is considered a danger zone. Tell me, what would have been gained by waiting and seeing? With me that sick in a hospital bed, listening to my daughter screaming with hunger, unable to produce milk to feed her, and starving her to the point we risked her health. Why should we have sat there thinking that milk would come eventually, when given the specifics of my case, things were going exactly as medical professionals expected. We can all speak in generalities, and discuss WHO guidelines, but guidelines cannot be written that cover every individual case. And, as Monty Python said, we are all individuals.

For me, there was no debate to be had. No choice. No regrets. I will never regret that my daughter was fed formula for her first meals. I am grateful to the nurses who bought it to her. I am grateful I gave birth in a hospital where formula could be supplied by hospital staff.

So that is why when people say ‘oh I’m sure you made an informed choice’ it comes across as patronising. It literally doesn’t matter whether you have read a million studies comparing benefits of formula vs breastfeeding (which frankly aren’t as one-sided as many people seem to think, because any study like that is inherently fraught with difficulties). And that is why people object when people say ‘it needs to be considered carefully, like any medicine’. Formula is not medicine. It is consumed like food, and metabolised like food – because it is food. Someone might have an allergic reaction or intolerance, but that can happen with breastmilk. It is regulated to make sure it meets nutritional standards, but it is not, and should not be, restricted like a medicine.

I am glad I was able to establish breastfeeding eventually. Not because I think my daughter will be healthier for it, but because bottle-feeding is a pain. Seriously: sterilising, getting the right temperature, and most importantly, you need one hand to hold the baby and one for the bottle, so unless you have three hands you can’t use the TV remote at the same time. Rubbish!

Even at the time ‘resorting’ to formula was the least of my concerns, so I’m pretty thick-skinned about my experiences and what someone else might think of them.  But I’m not writing this to defend or explain myself. I just want people to remember that nothing in life goes as planned. A lot of people are absolutely convinced they will breastfeed and then they can’t. And it is devastating for them. Careless words can really add to that pain. Especially when you are in those first weeks of newborn life and just trying to cope. There are some people who seem to think it is just a matter of trying harder (not just feeding – conception and birth seem to bring this out too), but it is much, much more complicated than that. There is a portion of all of this that is just luck.

So if you won in the biology lottery, remember the ladders. Remember that if the bottom rung is missing, like mine was, no amount of oatmeal or fenugreek or pumping or lactation cookies is going to be the answer. And remember some people can do everything right, and find they just can’t get to the top.

I write a lot about not judging others on their parenting journey. But, I’ll admit this – when I see someone standing on their non-slip safety step-ladder, giving themselves a clap and saying ‘it’s so easy. See how I did it!’ while the rest of us wobble around on rickety splintery wood that stretches into the clouds…

That is when I feel a bit judge-y.