Tag Archives: breastfeeding

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.

Only the best is good enough

Before my son was born I went to the free breastfeeding class at the hospital. It was terrible. They didn’t spend time discussing common problems women have. No mention of tongue tie, delays, or even mastitis. It was a typical ‘agenda’ class. Breastfeeding is natural. Baby will latch on, your supply will magically match itself to baby’s needs. They did have a mother come in to discuss feeding her infant. She hadn’t had any problems feeding, her baby slept through from six weeks (wtf?), and when she fed her baby in a class full of women there to learn about breastfeeding, she used a cover. I’m not sure what we were meant to learn from this experience.

Feeding a newborn is hard. It is work. It is work when it works out, and work when it doesn’t. New mothers are often so badly supported by the networks who are meant to help them. You can go to a class, and not learn anything, other than they thought they should teach a group of heavily pregnant women who had voluntarily turned up that they should at least try to breastfeed. As though that wasn’t exactly why we were there. And then things go wrong, and people say ‘I didn’t know’.

So in the hope that these words will be read by someone who needs them, I offer up to you my story. My stories that should be. Two very different experiences of feeding newborns.

My first. I was lucky. Oh so lucky. How I hate that word. Not only did my milk come in, I had an abundance of it. A massive oversupply that meant I was so engorged my son couldn’t latch on without me expressing first. That sent huge gushes down his throat that promptly came back up again. And that I was in so much pain I wouldn’t sleep, waiting to get him feeding again to ease the pressure. He vomited and vomited and vomited. But he gained weight. ‘He’s just a happy chucker’ they said, though my son was anything but happy. We were drowning in a sea of milk-covered-washing but he was gaining weight. So we had nothing to worry about. He went from the 10th percentile at birth to just over the 50th. ‘He was born hungry’ they told me, ‘babies don’t overeat’ I was assured again and again and again. So I kept feeding. And he kept screaming.

Our doctor eventually referred us to paediatrician, but we had a long wait; ‘baby screams a lot’ doesn’t exactly get you on the priority list. I spoke to multiple midwifes and health nurses. I gave up dairy. I wept. He wept. Then came the night he refused to try feeding after he got upset. The next morning I managed an appointment with a different doctor. ‘Have you tried medication for reflux?’ No. We were told multiple times a baby gaining weight could not have reflux.

It was silent reflux.

Even though we had to pin him down to syringe the medication down his throat, his mood and then mine improved dramatically. Not quickly enough to keep him growing. He developed a phobia of us putting anything in his mouth. He was well into seven months before he would try solid food. My milk supply finally let me down, I couldn’t keep up. He woke hungry multiple times a night. His weight plummeted down to just below the 5th percentile. But once he started eating, he didn’t look back, and was fully self-weaned at ten months.

My second. A difficult birth, with a severe haemorrhage. Blood loss of that magnitude typically causes delays in milk production. My body barely had enough fluid to keep itself going, of course it couldn’t manage colostrum as well. My daughter was a healthy, hungry baby. She latched on straight away and just kept trying. I’ll say this for my babies, they are suckers. But as we got into the second day, she got angrier. Quite frankly we were relieved when a nurse walked in carrying formula. She fed and fell into a happy sleep. She had a few more top-ups that night, as well as sucking away at me. The next morning she was weighed, she’d already lost nine percent of birth weight. We kept going with breast first, formula for afters. Eventually she began to regain weight. And by a month old we were exclusively breastfeeding.

This is where I know I was lucky. We had a cast iron reason for why my body was not producing what she needed. Did I feel like my body had failed? Yeah. I felt like it failed when my uterus went walkabout and tried to kill me. But I survived, so after that we just had to deal with where it left us. But lying in the hospital bed, watching my husband feed the baby I wasn’t strong enough to actually hold yet, I cried. Of course I cried. I cried many times. I cried once we were home and I couldn’t tell if she was hungry crying, and needed more formula, or crying because she just wanted something to suck to help her sleep. The two of us were a big crying mess a lot. And while she was louder, she was also cuter.

Sometimes I wondered why I was so persistent, considering how much I hated breastfeeding the first time round. Once it was working, mostly it was ok. Sometimes it was frustrating to be stuck when my boy wanted me to play. Sometimes boring. Sometimes, in the middle of the night, when it’s just me and her it can be nice; I’m not pushing her to quit. Sometimes after four years of pregnancies and feeding I really look forward to putting this work behind me and my body being my own again.

When you have a new baby, and you go out and see other women with theirs, it’s easy to feel that they’ve got it all worked out. That you are the only one struggling. But everyone has a story, or will get one eventually. Those Mums might have had a start as difficult as yours, and with just a couple of months under their belt are able to get out and look ok, because things do, and will get better.

We tell each other this, we tell all new Mums this ‘It gets better’. But that doesn’t always help someone now. There are too many judgey people, and too many people unable to look beyond their own problems. I was told so many times to stop complaining about oversupply because it was not a real problem. And that hurt. When I sat in bed crying, trying to convince my son to stop crying, those words hurt. We have to remember it is not a competition and there is no one legitimate problem.

So here is my most important point: how you feel matters.

‘Fed is best’ might be true. But it is also reductive.

It implies that as long as your baby is fed, it doesn’t matter how you feel about it.

There is no job where you are expected to love every aspect of it. People have a moan about loving the work but hating that their colleague is always yelling. The retail worker complaining about not being free to take toilet breaks when they need them. Or, a waiter, who always gets food spilled on them staining clothes and making large quantities of washing. Or the plumber on call 24/7 receiving midnight call outs when they want to sleep. See if it is an actual job, a real job you get to complain.

Newborn babies can spend eight hours in a day feeding. That is a full-time job. A full-time job where at best they fall asleep, or at worst they crap on you.

So, go ahead complain that it hurts and doesn’t work. Complain that you are sore. Complain about being tired. Complain about the mess. Complain that you are heartbroken that it didn’t work out. Complain that people judge you for choosing not to try breastfeeding, because you are still feeding your baby aren’t you? Reach out in the middle of the night when you feel alone and as though you are doing it all wrong. And the rest of you reach back to lift others up when they need.

Feel how you feel. Own it.

But also know this. Eventually you have to let it go.

…a little child, born yesterday, A thing on mother’s milk and kisses fed…

It finally happened. I always knew it would, it was only a matter of time before I got my first breastfeeding-in-public disapproving look.

I was thinking my morning was going well. I’d already achieved a) a shower b) getting dressed c) leaving the house and d) finishing my shopping. Which is, by the way, four more things than I’ve achieved so far today. So when my daughter began to stir I decided not to tempt fate and sit down and feed her before my bus ride home. So I went into a cafe.

First mistake. You don’t really need a coffee. Are you kidding – I have two children, of course I need coffee!

If you do you should drink in solitude at home. <sobs> But I only have instant.

So I ordered my coffee and sat down and began to do the worst thing some people can ever imagine anyone doing ever. I began to unbutton my shirt. And then I saw it. That middle aged man at the table next to mine. The wide-eyed stare as he realises what I’m about to do. I’m going to sit in proximity to him while I feed my baby. And while he’s thinking something like I need to stop staring, at least that’s what I’m thinking he should be thinking. I’m thinking, that’s right, that’s exactly what we’re doing.

And I’m doing it here, because this is the only damn place nearby that isn’t full of bar stools. And have you ever seen anyone feed on a bar stool? No. Because no women has ever been fool enough to try. Unless she’s really desperate, in which case you gotta do what you gotta do. But we all know sitting on the floor is a better option.

I’m all nonchalant now, but at the time I was a little worried he’d say something. And then I’d have the whole awkward can-you-repeat-that-in-english conversation. But then I realised, while I might not be able to get myself understood, I can understand what other people are saying. Because he turned away from me, and instead starts to complain to his wife (?) about how old and uncomfortable the chairs are. And then their morning tea arrives, and she starts complaining about the lack of butter with her roll. And if you have ever eaten a roll in Denmark you will know that’s not true. Because they always give you like, three of those little packets, and then say ‘let me know if that’s not enough butter’. And really, that should be enough butter for one roll.

So while I prefer not to be evil-eyed while I feed my baby, it was a reminder that the kind of people who have a problem just aren’t worth worrying about. They’re the kind of people that would disapprove if I ended up with a screaming baby for the whole bus ride. And they’d disapprove if I whipped out a bottle. Or a dummy. Because they know I just procreated to inconvenience them. Sorry. (Not sorry).

But that doesn’t mean it doesn’t matter, what they do. Being a parent is hard. Feeding your child is hard. Which ever way you end up doing it. It was hard when M had silent reflux and screamed his way through every feed. And it has been hard to get back up on my feet after surviving a seriously life-threatening hemorrhage. And after that, it took hard work (and some luck) that I was even able to build up a supply so I could be sitting here, feeding my baby. Hell, I’m glad I’m sitting here.

So when my daughter is quietly, contentedly feeding, and looks up at me, with her happy little eyes, and I just want to enjoy that quiet moment, don’t put your disapproval on me. I’m not interested. Life’s too short.