Thursday, June 15, 2006

Return of the La Leche Legion

I know Father's Day is coming up but I'm writing on the travails of motherhood today, specifically, the trials and tribulations known as breast-feeding. I wrote about this way back when, over the difficulties Sam and I had with the guilt-ridden, anxiety-inducing act of giving baby L some formula right after she came home because Sam's milk production hadn't kicked in yet. I think many women can relate - it f*cking sucks when you feel as if your choices are either 1) starvation or 2) feeding formula as if you were serving up rat poison in a bottle.

Thanks to the NY Times, here we go again. The latest medical wisdom is that breast-feeing is so important that one legislator wanted it printed on formula bottles that not breast-feeding represented a medical and developmental risk for your baby. Aiya!

What I find really astounding in much of the literature on the issue - including in this article itself - is that no one mentions something pretty simple...that being: of course breast-feeding is ideal. Very ideal. You should, if you can at all do it, breast-feed. Ok, we can agree on that principle. But if you have to resort to formula, especially in those early days where breast milk production is potentially low (not all women lactate like Holsteins, particularly in the first few days following giving birth), it's perfectly ok to supplement with formula. The pediatric practice our daughter goes to pretty much says the same thing.

Yet this debate always seems to take on an all-or-nothing quality and I find that rather odd. Is it that people are so afraid that formula use is a slippery slope that they won't even acknowledge times where formula use would be acceptable (such as, y'know, when the baby is starving?) I really don't get it.

Like I said, I'm a big advocate of breast-feeding - and it should be noted, so is my wife since she's actually the one who's done it. L was exclusively raised on breast milk for her first six months and continued to nurse through her first year and I think this was good for her health and development. But I'd seriously want to spare any parent the nightmare of avoiding formula 100% simply out of fear or guilt.

The other issue too - and this is something that the NYT piece acknowledges is that most American businesses are limited in the kind of support they lend to breast-feeding women:
    "urging women to breast-feed exclusively is a tall order in a country where more than 60 percent of mothers of very young children work, federal law requires large companies to provide only 12 weeks' unpaid maternity leave and lactation leave is unheard of. Only a third of large companies provide a private, secure area where women can express breast milk during the workday, and only 7 percent offer on-site or near-site child care, according to a 2005 national study of employers by the nonprofit Families and Work Institute.
As usual, public and business policy lags far, far behind medical wisdom (not the least of which is because it's probably a lot harder to squeeze money out of a mom breast-feeding than it is to pay for formula).

--Poppa Large


la dra said...

I work at a health clinic that serves mostly working poor populations (monthly household income $1000). If big companies lag behind, imagine the total lack of support for moms who work sorting carrots, picking grapes, etc. I can guarantee that no one is going to pump in the middle of the grapevines! I had a hard enough time pumping during my busy clinic schedule! (Is the doctor going to be much longer?)

Formula still plays an important part in our babies' health. Obviously, breastmilk has unique benefits, but let's not go to the extreme and label formula as hazardous.

Motherhood Uncensored said...

You put it perfectly. Apparently the medical field (which I sort of knew) is not in tune with the rest of country i.e. our shitty mat leaves, the unsupportive breastfeeding work environment, and all this hulabaloo about NIP (nursing in public).

Labeling it will just make folks who can't bf (for whatever reason) feel a whole hell of a lot worse. We have way more things to beat ourselves up about than that.

Ka_Jun said...

We're at month six with the little man and our pediatrician wants us to start introducing the solids. We're a bit hesistant, honestly. He's in the 75th percentile for weight and seems healthy by all measures.

Didi said...

"especially in those early days where breast milk production is potentially low... it's perfectly ok to supplement with formula."

I really disagree with this. In the first few days, it's vital that the baby not be given supplemental formula when you're trying to establish your milk supply, not to mention how important getting colostrum is. Breastfeeding is a supply-and-demand relationship. If the baby doesn't nurse and stimulate the breasts often enough you risk not making enough milk.

I've known so many women who supplemented before their milk came in and then they ended up having to permanently switch to forumla because they couldn't produce enough milk. Then they think that they "couldn't" make enough milk, when in reality they sabotaged their milk supply by not nursing enough.

Didi said...

I wanted to add that when Noodle was born, we were pressured into giving her a little formula because she had a little jaundice. At the time I didn't know that
a)colostrum or breastmilk is much better for clearing up jaundice because it clears out the meconium from the baby's intestines much more quickly, which helps lower bilirubinlevels faster
b)asian/hapa babies are much more likely to have jaundice and that it's perfectly normal

When I found those things out I was extremely pissed off that my doctors were so clueless.

I ended up going back to work when Noodle was 10 weeks old, and I pumped for her until she was a year old and started to refuse bottles. We continued to nurse at night and on the weekends until she turned 2.

Poppa Large said...


My wife's milk supply took about 72 days, post-partum, to really kick in. In the first 48 hours after birth however, our daughter had already sucked the colostrum out and after that point, she was nursing to establish the physical connection but wasn't actually getting any actual nourishment.

Now, it's not like if she had to wait another day she would have died from malnutrition but of course, we had no idea when the milk production would kick in and the baby was very clearly upset FROM BEING HUNGRY. Constantly crying, not sleeping and you can imagine how badly we felt as well.

I can't understand the logic in not providing some kind of basic nutrional comfort by simply saying, "hey, if the baby is hungry, and you're not producing enough milk yet, let her have some formula." This basic, common sense was repeated back to us by not just our pediatrician but also the lactation consultant that we went to see.

We never stopped trying to breastfeed and my wife was already pumping what felt like every two hours (even when nothing was coming out) as a way to stimulate production. Once the milk was a'flowing, we put away the formula and very rarely went back to it again. Bottomline, not all women produce the same amount of milk - we had friends who were putting away what seemed like a pint of extra milk a day. Sam was lucky to get a few ounces per pumping and always felt inferior as a woman and mother. That kind of psychological stress isn't healthy for either mom or baby and I think breast-feeding advocates tend to use a lot of fear tactics to induce compliance. Better to use a carrot than a stick.

Didi said...

"We never stopped trying to breastfeed and my wife was already pumping what felt like every two hours (even when nothing was coming out) as a way to stimulate production."

That's the difference. Most women, ime, who supplement until their milk comes in *don't* pump in the meantime. The extra stimulation can be crucial to whether or not you establish a sufficient supply.

eliaday said...

tae just weaned! (she is 20 months old.) i went back to work when she was 4 months old, and since then have had a steady relationship with my breast pump.

i have to say, not very many people understood the whole pumping thing. what all those parts were, why i needed to do it so regularly, what i did with all that milk. i'm glad that i was around students throughout my pumping days. they were always curious about the contraption, and i hope i made them a little more aware about the choices that mothers make.

i wish more employers could be as understanding as mine have been about giving me the time and space to pump. spending $300 on a nice pump so i could breastfeed as long as i wanted sure beats spending ooooooodles of cash on formula. i guess i was lucky.

Nina said...

Amen Poppa Large!

I breastfed (or haha, still am breastfeeding) our son and I exclusively breastfed him until maybe 5 months when I had to give him a few bottles a week because I couldn't pump enough at school. Luckily my milk came in really quickly and if anything I had an oversupply for the first few months (hence, plugged ducts almost every other day, ugh!).

Caius also had jaundice during his first week and, and we were told by the doctor that if we wanted, we could give him formula and that this would temporarily lower his bilirubin levels. He had first recommended breastfeeding in indirect sunlight, but since we were spending 6 hours in the hospital everyday taking and waiting for tests, there was hardly any sunlight to be had. As far as I know, the formula would have (at least temporarily) brought down the bilirubin levels (temporarily is sometimes all it needs because if the bilirubin reaches to high a point, there's a danger of brain damage), but we chose not to because I felt this pressure to exclusively breastfeed. Everything turned out fine, but I'm still not sure if I had to do it again, which decision I would make. I was very scared and tired after giving birth and having to go out everyday for several hours when I could barely sit or walk. But in my head I kept hearing "formula is bad!!!!"

I disagree with Dana...I think that you two made the decision you felt was best, based on the information and advice you were given. It makes sense to me that if your baby was showing signs of hunger and you couldn't satisfy her with breastmilk, it makes perfect sense to give her formula. I think it just goes with the idea of responding to the needs of your newborn.

I also agree that if we're going to promote breastfeeding so much that we make women who feed their kids formula feel like crap, then we should foster a society that actually supports breastfeeding.

Anonymous said...

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