Why do lactivists think it is okay for hungry breastfed babies to cry it out?

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Most attachment parenting advocates are strongly opposed to the sleep training method known as “cry it out,” abbreviated CIO.

According to Darcia Narvaez, PhD:

With neuroscience, we can confirm what our ancestors took for granted—that letting babies get distressed is a practice that can damage children and their relational capacities in many ways for the long term. We know now that leaving babies to cry is a good way to make a less intelligent, less healthy but more anxious, uncooperative and alienated person who can pass the same or worse traits on to the next generation.

That’s nothing but nonsense, of course, on a variety of levels. It’s nonsense because crying it out does not cause brain damage and it’s nonsense because it is based on the myth of our “noble savage” ancestors who had nothing better to do with their time than endlessly soothe their multiple babies.

But let’s take CIO opponents at their word for the moment. If they honestly believe that CIO harms babies, why do they think it is okay for hungry breastfed babies to cry it out?

Hunger is probably the most elemental of infant drives and, as anyone who has seen an infant scream from hunger would probably agree, is experienced by the baby as suffering. For most mothers, myself included, the sound of their own infant crying is piercing in its intensity and distress. I remember being surprised by this when my first child was born. I had spent my entire professional life surrounded by crying babies and it had never bothered me, yet I found my son’s crying unbearable and always rushed to determine what was wrong and fix it in any way possible. I cannot imagine letting any of my infants cry in out in hunger for any length of time without feeding them.

So why do lactivists think it okay to let babies cry it out for hours at a time because of desperate, all consuming hunger?

Why do they advise women whose babies aren’t getting enough milk in the first few days CIO arguing that assuaging an infant’s hunger now, when he is suffering, will undermine breastfeeding? Why do they view supplementation in the first view days as an evil so great that it is preferable to force babies to CIO and thereby destroy their brain cells?

Why do lactivists think it is okay to ignore an infant who is not gaining weight because of a maternal milk supply that does not match that infants needs? Why do they denigrate women who find their baby soothed and content after a bottle of formula, and chastise them that they should have let the baby CIO?

Why do lactivists who have children who try to wean before their mothers have planned to stop breastfeeding counsel each other to starve the baby into submission? Why do they tell each other to offer no other source of nourishment and let the baby cry it out until forced to give up his or her drive for independence and bow to the mother’s will to continue breastfeeding in order to survive?

Why do lactivists consider maternal mental health/postpartum depression to be a trivial reason for letting babies CIO, but consider that establishing or preserving a breastfeeding relationship is a perfectly acceptable reason for CIO?

Feel free to correct me, but I’m not aware of a single lactivist or attachment parenting blogger who sees anything wrong with letting a hungry breastfed baby cry it out.

Why the hypocrisy?

Because lactivism and attachment parenting have little if anything to do with babies and their wellbeing and everything to do with parents and their self-image. A “good mother” supposedly sacrifices her sleep and mental health and is willing to spend every minute of every day soothing an infant in order to avoid crying it out. But a “good mother” also breastfeeds and therefore, any amount of CIO is acceptable to preserve bragging rights to exclusive breastfeeding.

  • Lanie

    yikes.. that is not at all what lactivists stand for.. you are very wrong.

  • Alicia

    I fell into the trap when my son was a few days old. My milk had come in and engorged me so much I ended up with flat nipples. So my son couldn’t get a latch and couldn’t feed. Well, instead of having just giving him some formula from the samples we had in the house, I drove from store to store trying to find nipple shields after telling my husband just to soothe our baby. By the time I got home, our husband had ignored me and given our son formula. At the time I was really upset because I thought that it would ruin any chance I had of breastfeeding, then I fell into the trap of pumping on top of trying to breastfeed until I couldn’t handle it anymore. I was tired, my son was tired, and we both just wanted him to be fed, so I switched to formula. Now that I look back I recognize that it was so much more important to simply feed my son, and so I try to help other moms who are having issues to not feel guilty about using formula so their babies can eat. I hate that there are those that continue to pressure moms into starving their babies.

    • Samantha Anderson

      If you had read perhaps even one paragraph of a book or article about breastfeeding, or asked a friend who had breastfed, or called a lactation consultant, or hell, GOOGLED, you would have known that by expressing a bit of milk to soften your breast, your son could have latched. You don’t need a nipple shield for engorgement. You SHOULD feel bad about switching to formula over an engorged breast. It was a stupid, hasty, ignorant, easily-resolved situation.
      And your son wouldn’t have “starved” in the time it took you to express.

      • Poogles

        “You SHOULD feel bad about switching to formula”
        NOOOOOOPE! No mother should ever feel bad about switching to formula, no matter the reason. Get a grip.

        • Samantha Anderson

          For making a decision to feed your baby man-made sub-optimal processed milk instead of your own milk because you’re too dumb to hit “Search”? Yep, that’s a good reason.

          • Bombshellrisa

            If it’s so important, why trust an answer from Google?

          • Samantha Anderson

            Because it’s such a simple concept that any idiot posting in Yahoo! Answers could inform you.

          • Bombshellrisa

            Well, that explains it then.

          • Stacy21629

            No kidding. “Any idiot posting in Yahoo! Answers”. Couldn’t have said it better…

          • Samantha Anderson

            If you google a topic, many pages will result, including many results from people asking the same questions over and over and over on Yahoo! Answers.
            Idiot.

          • Stacy21629

            Whoosh! Right over her head!

          • Samantha Anderson

            Oh shucks! You really got me! *slapping knee*

          • Amazed

            I wonder whether your arrogance will go into your calves through your magical milk.

            I can see why your children never needed formula. They got cow milk straight from the breast.

          • PJ

            Samantha, you look silly and you really appear to have no clue why. Which kind of makes you look even sillier.

          • Bombshellrisa

            At least suggest asking Siri!!

          • Siri Dennis

            Oi Bombshell, I know I’m an oracle, but how do YOU know?!

          • Teleute

            Whoa… wait, slow down… I thought we were talking about Google here.

          • PJ

            I love it when people are too ignorant to detect the irony in their own nasty posts.

        • Teleute

          Indeed. Formula kept my kid ALIVE for the first few days (okay, perhaps from days 2-5) of his life, and I think it was quite liberating for both of us when I switched him over to formula at nine months. (No regrets about BFing though.)

      • Stacy21629

        Seriously? Are you a Poe? Or just completely and utterly cold-hearted?

        This mother completely bought into the rubbish she was fed – that if she so much as let her child look at an artificial nipple he’d never take the breast. It’s 100% entirely possible that she never heard to just express some milk, or that she did and in the sleepy hormonal stressful stupor that is the first week of caring for a new baby she didn’t remember.
        Go away unless you have something kind or constructive to add. “If you can’t say something nice”…keep your freaking mouth shut. 🙂

        • Samantha Anderson

          “If you can’t say something nice”…keep your freaking mouth shut. 🙂

          Hmm, that’s funny, because this whole blog and forum seems to be about being a raging bitch. When in Rome…

          • Stacy21629

            No one made you come here. If you don’t like what was said, then go away. Don’t read it. This is Dr. Amy’s personal blog.
            What you wrote was a personal attack on a mother. Dr. Amy wrote an insightful post that obviously hits a little too close to home.

          • Samantha Anderson

            It scares me that you think that this drivel is “insightful”.

      • Box of Salt

        Samantha Anderson “It was a stupid, hasty, ignorant, easily-resolved situation.”

        All hail Samantha Anderson, the wise and knowing one can Google, and knows exactly how to solve a breastfeeding problem over the internet and in retrospect.

        • Samantha Anderson

          Amazing how one can be mocked for saying something completely logical in response to an idiotic statement. Dr. Amy’s blog is like an alternate universe.

          • Box of Salt

            Yes, Samantha, I mocked you. You might think you are posting logical responses, but to me they read as arrogant and rude, and suggest that you are too narrow minded to imagine that other women have lives that are different from yours.

          • Samantha Anderson

            If by arrogant you mean something like, “can find the answer to a problem when she encounters one” then yes, I am totally arrogant.

          • Stacy21629

            Do you believe that addressing Alicia in the way that you did will encourage her (or any other mother) to breastfeed again should she have another child? In what way does calling her “stupid” support breastfeeding?

          • Samantha Anderson

            If she is so ignorant that she cannot figure out the answer to a very simple problem in her body, then it is my hope that she doesn’t reproduce any more, so the problem won’t come up.

            She has found a nice little niche here on this blog where she can tell her “story” and others will coddle and “respect” her for her ignorance, so it probably doesn’t matter much to her what I think. And it shouldn’t.

          • Stacy21629

            As opposed to MDC?

          • Samantha Anderson

            I am unfamiliar with the acronym.

          • Stacy21629

            Mothering.com You should check it out. No dissent there. They delete the comments and block the poster.

          • Teleute

            Wow, and I thought babbiecenter was bad.

          • rh1985

            I can’t stand Babycenter. On my due date club there is a mom who needs a c-section at 39 weeks at the latest due to risk of rupture. She asked whether she should deliver at 38 or 39 weeks because at 38 weeks her doctor would not be available who did her previous surgery that caused the risk. Instead of answering the question almost everyone tried to talk her into waiting until 40 weeks or until she goes into labor. /facepalm

          • Amazed

            Everyone can Google it and see that it is the place for you.

            Idiot.

          • Marna McAlexander

            Oh my word. What is the hell is wrong with you?

          • Dr Kitty

            So…armchair eugenicist then.
            Super, just what the world needs.

          • pygmymouse

            Samantha, I just started reading here and I note that you never use evidence. Do you in fact have any evidence to refute the stats posted here, or is it all just what you believe?

          • Something From Nothing

            Holy shit. Im guessing there isnt much anyone here can say to help you see how nasty your approach is. You have no way of knowing from what she wrote that she had a “simple problem in her body”. Breastfeeding is very challenging for a lot of women, for many many reasons. It is her right to make the decision to switch to formula for whatever damn reason she likes. It doesnt make her stupid or wrong. Engorgement obviously wasnt her only breastfeeding issue and I have seen lots of women stop nursing after engorgement issues / cracked nipples / whatever because for them it simply wasnt worth the stress, So what????? Does that give you the right to be abusive?

          • Sarah

            I think people are mocking you because you’re a cunt, Samantha love.

      • Karen in SC

        I breastfeed two children before there was google and the internet, and I didn’t know that about engorged nipples.

        • Samantha Anderson

          Then obviously I’m not speaking to you, right?

          • Marna McAlexander

            No, you’re just snarking because, well, because you can. The deal here is whatever some other woman chooses to do to feed her baby–it is not YOUR business. You are not a saint for breastfeeding; she is not a sinner for formula feeding. As long as the baby is fed, what’s the beef?

      • Vyx

        Do you think she switched over to formula because of the engorged breast? Perhaps we are reading different things into her comment, but it seems like she attempted breastfeeding for some time before she switched to formula.

        “I fell into the trap of pumping on top of trying to breastfeed until I couldn’t handle it anymore.”

        I don’t know her personal situation, but it seems like she truly wanted to breastfeed and tried before giving it up.

      • Trixie

        Please tell me someone is screenshotting this and submitting it to Sanctimommy.

      • Marna McAlexander

        Oh brother Samantha. Give it a rest!

      • Something From Nothing

        You seem to be a very judgemental woman. You call her stupid? Yes, the cure for all problems related to engorgement is to simply express a little milk. How stupid could she be? Too bad you weren’t there to tell her how easy it all is. You could have saved her baby from the evil formula… Why don’t sanctimonious, judgemental women never know that they are sanctimonious and judgemental?

      • Katarina

        Pull that bus over to the other side of the pretentiousness turnpike!

  • Teleute

    My son did not eat until 23 hours after he was born.

    He was my first child, and my mother (who’d adopted me at five weeks) didn’t have any more experience with newborns than I did, so we initially listened to the recovery ward nurses who said it wasn’t necessary for babies to eat within the first twenty-four hours of birth.

    My son had some of the classic latching problems (which we would later overcome), but more importantly, I WAS NOT PRODUCING ANY BREASTMILK. I never produced any colostrum, and the milk did not start coming in normally until several days after the birth.

    But the nurses assured me I would produce milk if I kept trying to latch him on. And so I did, even though it felt as if I was banging both our freaking heads again the wall.

    When he was ten hours old, I asked for formula. The nurses convinced me it was unnecessary, and to keep on trying to latch and/or pump. At twelve hours old, I asked again. A nurse instead came in to “coach” me. At this point, I was torn between “doing the right thing” (holding out to EBF) and doing what was “convenient for me” (feeding a starving baby).

    Please keep in mind that I was new to all this, utterly-sleep deprived (I’d been averaging two hours a night for the past five days), on oxycodone, yet still in a terrible amount of pain. I figured these nurses were the “experts,” and when they offered me a newborn pacifier to “soothe” (i.e. shut up) my hungry baby, I gladly accepted.

    A few hours later (and after few more timid requests for formula), they sent in a lactation consultant who simply reiterated everything I’d already read in books. We agreed that I’d wait until he was 18 hours old before resorting to formula, which somehow turned into 20.

    At 20 hours, I insisted upon feeding my baby formula. The nurses offered some excuse or another as to why the “breastfeeding-friendly formula” (Similac) wasn’t available at that particular moment in time. At 21 hours, I finally called my father in another state (my mom did not have her car) to go to the store and bring me some damned formula. He arrived with Similac about an hour later, but the nurse told me it wasn’t the *correct* Similac; unless I used the RTD version (which was supposedly the same consistency as breastmilk), I’d have no hope of ever breastfeeding my baby. (Keep in mind these people gave my kid a freakin’ pacifier!)

    I’d finally had enough, and at 22 hours I told them to find me whatever the hell I was supposed to feed my baby or I was going to give him powdered Similac. It took my mother following up half an hour later, but at 23 hours old my baby was finally permitted to eat… a single ounce of formula. Any more, I was told, and my baby would get sick. :-

    Thankfully, my milk came in a few days later, and I was able to EBF my son for the next 8.5 months. But because of my experience, I never lost sight of the fact that while breast may be best, it isn’t everything. And there is seriously something wrong with anyone who would readily sacrifice their baby’s health (or overall well-being) for the sake of an ideology.

    • Alicia

      I can’t believe that they lied to you and said that babies didn’t need to eat! Where did they get such a stupid idea?! Babies are constantly fed while in utero, so of course they need to be fed after the placenta is no longer feeding them. Ugh! Those idiot nurses need to be smacked with a frying pan.

      • Teleute

        They claimed he had sufficient fluids from being in the womb, that most newborns aren’t even hungry for the first 24 hours after birth, and the ones who are barely have the stomach capacity to hold anything down anyway. Also, introducing a bottle would inevitably lead to nipple confusion — but apparently only if they’re being fed formula, and pacifiers are perfectly acceptable for shutting up those hunger cries.

        • Samantha Anderson

          “They claimed he had sufficient fluids from being in the womb, that most newborns aren’t even hungry for the first 24 hours after birth, and the ones who are barely have the stomach capacity to hold anything down anyway.”
          Yes, those are all true.

          • Sister

            I agree with all your posts here Samantha but these are some of the nastiest commenters I’ve ever encountered so trying to teach them anything is a losing battle.

      • Teleute

        Hey, I think Samantha Anderson likes me better than you. She validated my decision to starve my son (THX, GURL!) while calling you stupid for feeding yours.

      • Bombshellrisa

        I just had a visual of someone wielding a cast iron skillet at one of the lacto-nazis in the mother baby unit-thank you!!! Hehehe

  • Rachel Mills

    *Like* that is all.

  • The Computer Ate My Nym

    Dehydrated babies are at increased risk of stroke. How much brain tissue is that bragging right worth?

  • yentavegan

    Here is another “truism” touted as breastfeeding support.. Your baby wouldn’t be able to cry that strong and loud if he wasn’t getting adequate calories from your breastmilk. A cry that strong is a sign of health.

    • Young CC Prof

      That might be true up to a point. Personally, I’d rather not have a baby who’s too weak to cry properly. At any point. The idea of good infant care is to PREVENT that sort of situation!

    • MichelleJo

      Amazing how they come up with their twisted logic to try and show that they are right. The fact that they are playing with babies’ lives seems to be lost on them.

  • yentavegan

    Everyday I do damage control, uncertain if my post on breastfeeding websites goes unnoticed. I get frustrated by the copious amount of ill informed breastfeeding mammas and the drivel they pass off as advice. I have seen mammas advise each other to cut back on the bottles so that baby will nurse more and I want to scream. Babies who have not regained their birthweight by day 10 are suffering from starvation. Quacko lactavist try to blame this on mammas getting iv fluids during labor claiming the baby’s birth weight was inflated do to extra fluid. “Keep at it Mamma” they cluck to one another. Un accountable for the damage they inflict.

    • Wren

      Is there actually any truth to the idea that IV fluids for mom in labour will increase baby’s birth weight?

      • yentavegan

        I have never seen a documented study verifying the claim that IV fluids artificially inflate a baby’s birthweight.

        • yentavegan

          and why would it be preferable to forgo iv fluids? Ought a mother suffer from dehydration while in labour? Where is the logic in that?

          • LynnetteHafkenIBCLC

            If it is true, the baby would pee it out in the first 24 hours, and still have normal stools and weight gain by Day 4. Less than 3 stools a day and < 20 g daily weight gain after that is a clear sign the baby is not getting enough.

        • Trixie

          http://www.internationalbreastfeedingjournal.com/content/6/1/9

          This shouldn’t be used as an argument against IV fluids (although crazy people do use it as that), but rather as a consideration if the newborn loses an unexpected amount of weight in the first 24 hours. Anecdotally, my baby who was born via c section after 24 hours of labor with an IV the whole time lost a lot more weight than my baby who was born vaginally with only a very small amount of IV fluids (antibiotics for group b strep). Actually, the c-section baby was born peeing and peed all over a nurse on the way out! 🙂 My milk came in quickly and copiously both times, and both were good nursers immediately. My c-section baby lost 13 oz in the first two days, and my VBAC baby lost 4 or 5.

      • Dr Kitty

        Maternal and foetal renal function ensure homeostasis.
        The foetus will just urinate any unneeded fluid out (so will mama)

        These people seem to think that IV fluids are just like being hooked up to a hosepipe, with all the water flowing straight into the baby. Doesn’t work like that.

        If it did we’d solve every case of IUGR and oligohydramnios with a few bags of IV normal saline.

      • Becky05

        There’s evidence of a correlation between amount of intrapartum IV fluids and weight loss after birth. Just a couple examples:
        http://www.biomedcentral.com/content/pdf/1746-4358-6-9.pdf
        http://pediatrics.aappublications.org/content/127/1/e171.full

        One reason for this could be artificially inflated birth weights. Another reason could be that IV fluids, particularly with pitocin which increases fluid retention, can lead to swelling including in the breasts which can make latch on difficult.

        The way around this is to use the 24 hour weight as the baseline weight rather than the birth weight itself.

        • Box of Salt

          I will point out this important line from the first paper’s (Noel-Weiss 2011) conclusion: “The effect seems time limited, and further weight loss after the first 72 hours is not likely connected to maternal fluids and should not be dismissed as a fluid correction.”

  • MichelleJo

    Whenever I hear something like – I used to let my babies scream, but it doesn’t seem to have done them any harm, they’re fine now – it gets my gut. They are suffering while they are screaming! They are suffering right now! What’s the difference if they will remember it or not when they grow up?

    • fiftyfifty1

      Meh. I’m all for feeding hungry babies because that’s what they need biologically. But I don’t get too upset about crying in general. I was in charge of my younger brother who had colic. Trying to get a colicky baby to stop crying is an exercise in futility. They may be suffering, but there’s nothing anybody can do about it, so what’s the point of getting all upset yourself. And sometimes the crying is for a good cause-vaccinations, pokes for blood tests and sleep training are all good examples. In these cases and many others, a parent can take some consolation in the fact that they don’t remember.

      • MichelleJo

        I’m talking about leaving hungry babies to cry it out. Although personally, I can’t take a baby crying about anything; it eats me up. And I’m a cruel epidural taking bottle feeding mom.

        • fiftyfifty1

          Total agreement! Babies have enough reasons to cry that we can’t help fix, why add on hunger. It’s cruel.

  • Bystander

    Perhaps there shouldn’t be lactation consultants, but feeding consultants instead. Their remit would be helping you get your baby food, however that looks like: lactation, supplementation, exclusive formula, whatever makes sense for mother, baby and family.

    Just a modest suggestion.

    • Jocelyn

      I LOVE this idea.

      • MichelleJo

        We already have them. Obstetricians, pediatricians. But the lactivation propaganda has made sure that every word they say is seen as poison. I have benefited a lot over their common sense advice over the years.

        • Antigonos CNM

          I have done, in my capacity as a midwife, lots and lots of breastfeeding coaching in my career, both in hospital and at home. Home visits in particular give me a chance to sort out numerous problems which impact on nursing while not seeming to be directly connected with it, since I also check the mother’s and baby’s physical condition as well as see what the home situation is like.

    • Jenelle

      I appreciate what is at the root of your thought, but I respectfully disagree.

      Despite all of our varying opinions and biases, the fact is American culture and business supports formula and bottles first and foremost. So as to not be hypocritical, check out these studies:

      Prevalence of formula advertisements
      http://www.ncbi.nlm.nih.gov/pubmed/23906772

      Lack of BF imagery on baby products:
      http://www.ncbi.nlm.nih.gov/pubmed/22335774

      We need IBCLCs because of their special interest in lactation, just as we need OB/GYN (or midwives) in place of GPs. And while it’s only anecdotal evidence, I needed a LC. My mom, grandma, and great grandma used formula. My culture, large and familiar, couldn’t inform or support me the way I needed.

      • fiftyfifty1

        I don’t get it. Are you saying that lactation consultants aren’t very smart? Because an OB not only delivers babies but is also capable of doing pap smears, tubal ligations, hysterectomies, colpos and lots lots more. But you seem afraid that if a lactation consultants generalized even a little bit and went from being lactation specialists to being infant feeding specialists they would fall to pieces?

        • Jenelle

          I think you know that is not what I was saying. If you disagree, feel free to just say so.

          • fiftyfifty1

            But that’s the implication of what you are saying isn’t it? That if lactation consultants take their eyes off “The Goal” for an instant, they might be influenced by the evil marketers of formula or the (culturally constructed dammit!) concerns of mothers and then they wouldn’t promote breastfeeding with the single-minded vigor you believe it needs. Your argument reminds me of the argument that ProLife used awhile back. They argued that if OB/Gyns performed abortions somehow a mentality of not caring about infant outcomes would creep into their psyches and they wouldn’t be able to provide safe OB care. It was an argument driven by ideology, and so is yours.

      • Amy Tuteur, MD

        The reason the breastfeeding rate is low is NOT because of culture, but because for many women breastfeeding is difficult, painful and inconvenient. If lactivists really wanted to increase breastfeeding, they’d address these issues honestly. Instead, they jerk everyone around with inane arguments that formula companies are sabotaging breastfeeding or that women don’t understand the benefits.

        • Jenelle

          I agree BF is so hard sometimes, and it was really painful (for much longer than I anticipated), but I actually find it to be incredibly convenient (instant, no dishes, free).

          Maybe these are the reasons less people choose to BF, but doesn’t that suggest women need more support and advocacy? Supporting one choice does not mean shaming the other, both can coexist.

          I’m not sure what inane arguments you’ve heard about formula companies, but it is a business that profits from selling food for babies. Nursing moms don’t stand to gain much from self-advocating beyond preserving their own rights (bragging included, if you wish). Who wins in this scenario: bragging rights vs. billions of dollars?

          To be clear, formula has its place. To save lives, and sanity alike.

          • Young CC Prof

            If support and advocacy means campaigning for more paid maternity leave, and researching the medical causes and treatments of nursing problems, I’m all for it. (Those are the two most common reasons women who want to breastfeed don’t, the need to return to work in just a month or two and physical difficulties.)

            But as far as just telling women breastfeeding is important, I think that’s been done enough already.

            Now, don’t get me wrong. Back in the 1970’s, LLL did an amazing thing. Formula companies HAD been allowed to advertise their products so aggressively that lots of mothers believed formula was the best, safest, most modern way to feed. And a group of mothers got together, built a support network, and changed the status quo. In less than a generation, they changed the conventional wisdom on breastfeeding. Still, it sometimes seems like LLL leadership is still back in the 70’s, still thinking that breastfeeding is radical and counterculture.

          • Jenelle

            Wow, yeah. Nicely said. I completely agree, and I appreciate your perspective.

          • Trixie

            I agree with this. I would add that formula companies are still aggressively marketing in this way in third world countries, where safe water is often not available to mix powdered formula, and breastfeeding is still necessary to prevent things like dying from diarrhea. Of course, the long term solution involves not just regulating formula companies, but more importantly, providing proper infrastructure for sanitation and safe water.

          • AllieFoyle

            Yes, it’s a complicated issue that deserves a more nuanced approach.

          • araikwao

            Kind of like home birth fanatics, too. All those awful things that will happen to you in hospital that, in reality, don’t happen routinely at all?

          • Esther

            “Nursing moms don’t stand to gain much from self-advocating beyond
            preserving their own rights (bragging included, if you wish). Who wins
            in this scenario: bragging rights vs. billions of dollars?”

            Especially if you’re not in the position to make billions of dollars, “bragging rights”, as you put it, can be a very strong motivator indeed. There are many motivators beyond the monetary, and in any case lactivism isn’t about self-advocacy, but validation (in persuading as many other women as you can to make the same choice you did).

          • Jenelle

            How are you defining lactivism? Before today, I had never heard the term, so I looked it up. “Lactivism is the advocacy of breastfeeding.” That would mean advocacy for self and others.

            I’m sad for women who feel shamed about their choices. A person who shames another into breastfeeding, or is persuasive to feel validated, isn’t a lactivist, s/he is a bully.

          • Esther

            I’m defining it in the same way Dr. Amy is. And sadly, I think much of breastfeeding advocacy as is practiced today – first and foremost by the large lactivist associations – is full of bullying and deceit.

          • Jenelle

            Which is…? neither of you have defined it yet.

          • Esther

            I prefer to call it ‘lactofanaticism’, but in my book it means the type of breastfeeding advocacy that pushes breastfeeding at all costs – even and including the cost of Mom’s physical and mental health, inflates the benefits of breastfeeding beyond what the research actually suggests and demonizes formula and the formula industry. The kind of activism that suggests that women need a ‘good enough excuse’ to stop breastfeeding (or not initiate it), and they, the lactivists, are entitled to judge what excuse is or isn’t good enough. The kind that denies any risks to breastfeeding (e.g., the risk of contracting HIV via breastmilk – has the LLL changed its ‘uh, dunno’ stance on that?).

            (If I sound a little pissed, it’s because just last week, for the second time in the past 5 years, I encountered a young woman who put off checking out a lump in her breast which arose during breastfeeding because ‘women who bf are protected from breast cancer’.)

          • Jenelle

            yeah, I hear where you’re coming from and I get it. I see how it can be a polarizing issue. I’m just a mom and I only truly know my own experience. I appreciate our differing views.

          • Kumquatwriter

            Jenelle, I have to say that it is awesome to see you taking in opposing views and learning from them. That isn’t meant to be patronizing – its a very real compliment because it isn’t as common as it should be. 🙂

          • DiomedesV

            I think the tipping point was when breastfeeding advocacy went from touting the benefits of breastfeeding (which exist) to demonizing formula and the mothers who use it. This is 2013, the developed world. That is simply unnecessary.

          • DiomedesV

            Unless you’re going to advocate that all women stay home for 1-2 years after each baby, no amount of advocacy is going to make working and pumping breastmilk for as long as the AAP recommends easy and dishes-free. It’s only convenient if you’ve rearranged your life so that it will be by staying at home. Which is fine. But for the majority of women in the US, it will never be hassle free.

            Maternity leave might give many babies a few more months (but I don’t see that materializing right now, do you?), but it will never get them 1-2 years in the US.

            So the question is, how much more can advocacy achieve?

          • Anka

            Exactly! Particularly since they’re touting harmful untruths in an effort to be supportive: “everyone’s body was made to do this! There’s no way you can be in that 1%/5%!” “That’s not insufficient supply–it’s NORMAL for a baby to be exhausted, crying, and feeding for twelve hours at a time, seven days in a row. It’s cluster feeding, and it’s only a problem if that’s your attitude!” “Not co-sleeping is making him hungry!” “Inductions and pain relief during labor ruins your milk supply. I’m not SAYING you’re GUILTY of ruining your milk supply–I’m just LETTING YOU KNOW.” “Nobody needs the big pump flanges!” etc. If anything, they’re hurting their cause with this “advocacy,” and causing PPD and PPA in many cases.

            Or at least they’re demanding that everyone conform to an upper-middle-class ideal that is quite difficult to achieve, logistically, unless a) you happen to be in the optimal physical condition with no underlying issues, b) you have the financial privilege of staying at home, c) you can handle extreme sleep deprivation–not everyone can–, and d) you have backup/support in the form of a partner AND someone else to help out in terms of mother/other relatives/social network/nanny to look after your baby sometimes so you can rest, or look after your other kids if you have them /etc. I don’t have any of these things except the ability to stay at home at the moment, and exclusive breastfeeding hasn’t been possible for me.

          • palmafm

            Yes! Unless you can stay at home with your baby for as long as you want to breastfeed its not the most convenient option.
            My boy is now 5 months and I’m in the process of switching over to formula whilst I’m at work. Expressing is not convenient and definitely not hassle free. And makes more dishes than a bottle of formula.

          • Jenelle

            You are arguing for all or nothing and of course that won’t work.

          • DiomedesV

            Combo feeding makes this easier for working women, but the AAP recommends exclusive breastfeeding before 6 months. The demonizing of formula has led many women to avoid that all costs. I maintain that the current goals of breastfeeding are not convenient for most women.

          • moto_librarian

            You would have to live in a cave in the United States to NOT know that “breast is best.” Even the formula manufacturers are required to put that statement on every can of formula that they produce, and it is standard boilerplate in every advertisement that I have ever seen about formula.

            Would you like to know what isn’t convenient? Trying to recover from a pph as a first-time mother while trying to breastfeed an infant when your milk has failed to come in adequately. Pumping, feeding bottles of expressed milk, and putting baby to breast meant that I wasn’t resting at all, to say nothing of getting any sleep. I sobbed for two days out of fear that my inability to nurse was going to leave my child vulnerable to H1N1. Finally, two weeks into parenthood with still no supply to speak of (if I was lucky, I could pump half an ounce in 20 minutes on a hospital grade pump, no engorgement, no feeling of “let-down”) my mother sat me down and gave me the best advice ever. “It doesn’t matter how your baby is fed, as long as he is eating.” I was finally able to give it up and get over the guilt. When I encountered the same exact problems with nursing my second son (I have yet to experience what “let-down” feels like), it was easy to transition him over to formula. From where I’m sitting, it’s time to give EVERYONE support, no matter how they choose to feed their child. This obsession with breastfeeding in the developed world is insanity.

          • Jenelle

            That sounds impossibly difficult and not convenient for you at all.

          • Guesteleh

            What is the cost-benefit ratio of breastfeeding advocacy? As a public health intervention, wouldn’t it be better if we sank more money into ensuring all mothers have prenatal care, all children have access to healthcare, promoting exercise and good nutrition in schools, creating safe routes to schools so kids can walk and get more exercise, etc. That would give you more payback for your investment. Why should we sink more money into advocacy for breastfeeding when the health benefits are modest at best?

          • Something From Nothing

            Breastfeeding wasn’t “free” for me. I’m self employed, no benefits, returned to work at 12 weeks postpartum, booked time off to pump, during which I lost substantial income over the 5 months that I did this. Saying breast feeding is free is misleading. It’s only free if my time is worthless.

          • Jenelle

            WHAT?! Are you serious? That is a RIDICULOUS argument. You won’t consider it free because now your time needs to be compensated for? What about the time it takes to feed your baby, breast or bottle? Do you need compensation for that too? Or the time it takes to go buy formula, make it, and clean up? You sound ridiculous. You obviously just want to complain about something.

          • Something From Nothing

            No, I don’t just want to complain about something. I think the argument that breastfeeding is free is ridiculous. It wasn’t free for me, and isn’t for many many women. How is that ridiculous to you? Open your thinking a little, janelle. I was the only one who could breast feed my baby. Someone else could have given a bottle, while I worked. It’s insulting to women who work to call it free. It isn’t free. My argument is far from ridiculous.

          • Something From Nothing

            I sacrificed a lot of time and money to breastfeed both of my children. Please explain how it was free. My pump cost enough to have supplied me with formula for four months. People who say breastfeeding is free are the ones who sound ridiculous.

          • Jenelle

            insurance covered my pump. actually everyone I know recently has had insurance cover their pumps

          • Something From Nothing

            That’s good for you. I don’t have insurance, or maternity benefits, or sick time. Still exclusively breastfed both of my children for eight months. I’m glad I did it. But it wasn’t free. Not by a long shot.

          • Jenelle

            wow, must have been expensive for you then. it seems weird as a doctor you wouldn’t have insurance

          • Box of Salt

            “it seems weird as a doctor you wouldn’t have insurance”
            Why? Anyone who is self-employed in US has to buy their own individual policies.

          • Certified Hamster Midwife

            I’ve had lots of regular full-time jobs that didn’t provide insurance: they were temp, internships, assistantships, or part-time. Many people work multiple part-time jobs now.

          • Guesteleh

            But for a doctor, it’s weird. Jenelle is right. Unless she had a preexisting condition that made her uninsurable or made insurance so expensive she couldn’t afford it. Doctors for the most part do have insurance coverage.

          • fiftyfifty1

            I myself was 6 months pregnant when I graduated from residency. I Cobra’ed at a very high cost to myself until the baby was born. After that bought a catastrophe-only policy that was affordable but paid for nothing. Had no paid maternity leave etc. It’s a fairly common position actually for female physicians. We delay pregnancy until our last year of residency because of the grueling schedule and then get by on urgent care moonlighting for a few months after the baby is born before taking a full time job.

          • An Actual Attorney

            Insurance covering pumps is a very new — only within the last two years thanks to the Affordable Care Act. And some insurance companies don’t cover hospital grade, which is the only thing that worked for me.

          • Certified Hamster Midwife

            Insurance covering something doesn’t mean that it’s free.

          • Jenelle

            I think for as much as I have disagreed with people on this post I have kept a very open mind, but the same has not been reciprocated. Instead people seem to enjoy tearing apart the smallest bits of what I’ve had to say. You did literally only complain about what I had to say and nothing else.

          • Something From Nothing

            No, I didn’t. I simply pointed out that it is misleading to say that breastfeeding is free… I am an ob/gyn and I always encourage women to breastfeed, but I would never tell them that it is free and tout it as a benefit. Don’t be so bleeding sensitive. It isn’t free. It simply isn’t. Now, if that is me complaining about you, then you are too sensitive to be here.

          • Kumquatwriter

            I don’t think it was meant personally. This issue has come up before on this site. She didn’t mean she needs to be compensated for time feeding the baby. The issue is that by being the only person able to feed the baby, she was financially impacted – so to say breastfeeding is free is incorrect. Further, this issue impacts a lot of families, and comes down to the fact that women *could* spend hours working but spend that time doing the unpaid work of parenting. I’m a SAHM btw, and beginning to bristle at the idea that I’m “unemployed”

          • The Bofa on the Sofa

            I think for as much as I have disagreed with people on this post I have kept a very open mind, but the same has not been reciprocated

            Open mind to what? The claim that breastfeeding is free? Um, ok, I’ve considered it. Nope, still not true, for all the reasons that have been provided. It absolutely comes with a cost.

            Now, here’s the deal. The reason no one is bouncing up and down on this is because we have heard it all before. You aren’t the first person to come around telling us how breastfeeding is free. We’ve heard it, we’ve considered it, and we have explained, many times over, how it’s not true.

            OTOH, your response, one of complete surprise, makes me wonder whether you’ve actually considered the counter position before. Have you actually ever encountered someone who questioned the assumption that breastfeeding is free? If so, what was their objection, and how did you counter it?

          • Jenelle

            This whole blog isn’t about right or wrong, or open-mindedness.

            Some people can only see the negative side of things, some even seek it out.

            Perspective is a choice. If you only look for bad things, that’s all you’ll ever find.

            Gratitude. It’s not only a happier way of living, it produces returns.

            I’m pissed I let myself get sucked into this disgusting place, but I’m glad I found my way out.

            Good luck to all of you who seem so miserable. It’s a sad way to live.

          • KarenJJ

            “I’m pissed I let myself get sucked into this disgusting place, but I’m glad I found my way out”

            Seems to me like you’re viewing it in an overly negative light.

            How is it ridiculous that for some people they are unable to breastfeed and work? Not all jobs have time and space for pumping. It costs money to not work. Breastfeeding is free if you’re not earning money to start with. Formula feeding allows someone else to care for the baby while you’re out earning money.

            I don’t understand your negativity to this idea?

          • Samantha Anderson

            Breastfeeding costs food – food you’re already putting into your body. The female body was elaborately designed to breastfeed. Our modern schedules and problems, our insecurities and sometimes shortcomings do not change the fact that we are at best animals and breastfeeding is what our bodies do.

          • Bombshellrisa

            Food costs money. If I am stuck at home, endlessly pumping or nursing or both in an attempt to feed my child, I have little to no chance to be able to work to earn that money.
            I am not interested in the “elaborate” design involved in breast feeding. I wish I was elaborately designed enough to NOT feel pain in childbirth

          • Samantha Anderson

            Who is “endlessly nursing”?
            Shouldn’t you have planned to be able to physically care for your child before you became pregnant? This sounds like a personal problem – all too common in our culture – I need to work, having these damn babies is such an inconvenience.
            Why have children if you’re going to shove a bottle in their mouths and shuttle them off to childcare?

          • Eddie Sparks

            Its a fairly dichotomous view of the world to suggest that women have to choose between working and having children. It is viewpoints like this that cause me to reject much of NCB/lactivist opinion as anti-feminist/woman/mother. It is also fundamentally anti-father/grandparent/carer to suggest that mothers have to shoulder sole responsibility for physically caring for their children. I do not believe that either approach is helpful for many parents living out here in the real world.

          • Samantha Anderson

            That’s all fine and good, I guess the childcare biz in the US is booming, but I repeat my question – why bother having children if you want to work? What is the REASON to have children? No one can answer that, they just say it’s “anti-woman”. Well that’s fine but who’s suffering here? The children who spend 1 hour a day with mom and dad?

          • Bombshellrisa

            It’s hard to find a partner who is able to do all the support financially while being a partner emotionally to you, who is also able to be a parent. I also worked damn hard to get where I am, I happen to enjoy working. I don’t think it’s the worst message in the world to show my child/children that an educated woman can enjoying being a parent AND work outside the home. I promise you she doesn’t ask why I didn’t formula feed and my next kid won’t ask why they weren’t breastfed. They are usually too busy asking when we are going to do something fun like bake cookies.

          • Samantha Anderson

            “It’s hard to find a partner who is able to do all the support financially while being a partner emotionally to you.”
            Sounds like you should raise your standards.

          • Bombshellrisa

            Nothing is a sure thing. I am fortunate that me not working is possible, and if we do end up having to go that route that we will be able to sustain it. But it’s not realistic to expect that someone can shoulder all the financial responsibility working full time, while still having time to spend with you alone and also spending lots of time parenting. There simply isn’t enough time in a week.

          • Eddie Sparks

            Are you seriously asking “what is the REASON to have children”? Seriously? You can’t think of any?

            Once you have thought of some reasons to have children, the next step in your argument is to deny those reasons to women to want to/have to stay employed in the workplace. Which I still maintain is anti-woman.

            Next, to hyperbolically suggest that there is no middle ground between women staying home full time to physically provide all of the care to their children, and both parents entering the workforce to such an extent that they are away from their children 23 hours per day, is a ridiculous exaggeration. There is clearly a huge amount of middle ground. I suspect that your comment is designed to make working mothers and fathers feel bad about their choices. You would be better off explicitly saying that working mothers “SHOULD feel bad”. At least that would be a clear statement of what you believe.

            Finally, all of this argument originated with the suggestion that breastfeeding wasn’t free, but there was a cost associated with it, largely linked to the value of a woman’s time. No one was asserting that parents are not prepared to accept some level cost in order to care for their children. Just acknowledging that the cost exists.

          • Samantha Anderson

            Ridiculous exaggeration? I didn’t say that they worked 24 hours a day. But pray tell, when do these hard-working parents sleep?

          • Eddie Sparks

            Quote from your post:
            “Well that’s fine but who’s suffering here? The children who spend 1 hour a day with mom and dad?”

            There are 24 hours in a day. You suggest that children are suffering if they are only spending 1 hour per day with either of their parents. That implies there are 23 hours in the day when the parents are away from the child. I have no idea where you were including sleep in your original statement.

            I agree with you that children are may be suffering in these circumstances (as long as we broaden the definition of “parent” to include “adoptive parents/close family members/primary carers/etc”). I maintain that it is a ridiculous exaggeration to suggestion that most/many/any working mothers structure their schedules in this fashion.

          • Samantha Anderson

            There are 24 hours in a day. Surely working parents are not coming home from work and spending every waking moment with their children? You get home at 6, let’s say, and bathtime and bedtime routines start at 7, 730, whatever. So how much quality time did you get with your child?

            Does that help you understand?

          • Eddie Sparks

            I’m pretty sure that *I* understand the concept. I am also pretty sure that *you* understand the concept.

            I was objecting to your exaggeration and use of provocative language. In my opinion, that language was used deliberately to make working mothers feel bad.

            The words that you use to express your opinion matter. I was responding to the words that you used. If you want me to respond to something different (eg. the question of quality time spent between the hours of 6pm and bedtime) then use different words.

            By the way, you have changed the language of your posts from third person (“these parents”) to second person “how much quality time did you get with your child”). Are you now personally questioning *my* parenting choices? Or, are we still discussing an amorphous group of hypothetical working mothers?

            Emotionally, the use of the second person pronouns is much more provocative. Are you suggestion that *I* should feel bad for my parenting choices? You don’t even know what they are.

          • Stacy21629

            Why have children? Biology. And they smell nice.
            Should we start denying girls an education now because they might just waste it by wanting to have babies and staying home?
            I work 40+ hours a week, nights. I have a 3 month old and started back when she was 6 weeks. DH has a flip schedule and one of us is with our 2 children 100% of the time, have been since birth. I work because I LOVE it and I’m good at what I do.

          • Bombshellrisa

            I work nights too-one of us is always home. It helps that my husband is able to help out around the house and that we can use a day during the week to spend together to grocery shop and have a lunch date (right now we use it as the day we attend my OB appointments too). Being able to have our own jobs but still be able to connect and then go home and be parents works for us.

          • S

            Because they want children, obviously. Why does anyone have children?

            This post actually made me grin. Where i grew up, no one had a mom that stayed at home; i literally cannot think of a single person except two whose moms worked night shift. Please, continue to amuse me by enumerating exactly how we “suffered.”

          • Samantha Anderson

            Oh good, you telling me your own personal story just completely changed my attitude.

          • Box of Salt

            Samantha Anderson “you telling me your own personal story just completely changed my attitude”

            I’m curious: what would make your change your attitude?

            Please think about it. I’d really like to hear what that might be.

          • Bombshellrisa

            Probably nothing short of having a baby who can’t nurse and having formula be the only option, while people speak to her in the same tone she has spoken to others.

          • Samantha Anderson

            Nothing, because individuals’ sob stories about why they can’t breastfeed, why they don’t care about their children enough to sacrifice for them, why they’re so fragile that they need a pat on the back for every parenting decision they make, these things disgust me.

          • Box of Salt

            Samantha “Nothing”

            That’s what I thought. You’re so self righteous, assuming your way of doing things is best and ideal for everyone.

            I really hope you are a Poe. If you are not, and your posts here are serious, you are one incredibly unsympathetic human being.

          • Samantha Anderson

            It is probably the dumbest comment in history to say “YOU JUST THINK YOU’RE SO RIGHT!!” Wouldn’t we change our attitudes if we thought what we were doing was wrong? My life is fucking amazing, so yes, I do believe that what I’m doing and have done is right.

            As for sympathy, sometimes it just doesn’t have a place. Human beings are resilient and strong; there are few occasions when coddling and moaning together is productive in ANY way. G’day.

          • Stacy21629

            “Wouldn’t we change our attitudes if we thought what we were doing was wrong?”
            You’re right. I used to think just like you. But I managed not to be a complete closed-minded intolerant bigot and changed by attitude.

            “As for sympathy, sometimes it just doesn’t have a place.”
            Good grief, we’re talking formula and breastmilk not the freaking holocaust.

          • Samantha Anderson

            So if you believe your opinion is correct, you’re a “closed-minded, intolerant bigot”? My dear, if I’m right, there’s nothing to be “tolerant” about.
            If you’re too “open-minded”, your brain may fall out. Might help to have a backbone about some things.

          • Box of Salt

            Samantha “dumbest comment in histroy,” less than an hour ago you complained of someone else’s misreading of your comment, likening this conversation to a game of telephone. Now here you are deliberately misquoting me.

            Did you do that because I hit a nerve?

            Did I make you think? I hope so, because I think you need to take a little more time looking around outside of yourself and your own situation.

            Describing humans as “resilient and strong” does not justify the rude and heartless treatment of others.

          • Samantha Anderson

            Saying “human milk is best for human babies” is not rude and heartless. One real problem is how offended and butthurt people get over a statement.

          • Box of Salt

            No, Samantha, rude and heartless is when you respond to someone’s story posted on the internet by calling her stupid and telling her she SHOULD feel bad because she sholved a problem a different way than you think she should have – and that’s only the beginning of why I see you that way.

          • Teleute

            No one is disputing that human milk is NUTRITIONALLY best for babies. But as many people have already pointed out, there are other factors to take into account in determining what is best overall for the baby and its family.

          • I’m sorry, it sounds like you think the role of a mother is to sacrifice everything she is or could be for the sake of being a Mother.

            That’s … incredibly patriarchal of you. Really. I can’t believe you believe something so terribly against your own interests.

          • Samantha Anderson

            Nope, I merely believe that if you’re going to bring a human into the world then you should be prepared to physically care for it if you’re able.

            And it’s not “against my own interests”. My life is great because I’ve engineered it to be that way. There’s nothing more powerful than physically nourishing another human. It’s not a sad, depressing sacrifice.

          • “It’s not a sad, depressing sacrifice” … for you. You are not all women. You are only you.

            And why is bringing a baby into the world that you can feed and love and care for and then go out and work to earn the money necessary for feeding and caring for this new person not counting? Children do fine with stay-at-home dads. They do fine with paid caregivers. So long as they’re loved and cared for by someone, babies will be fine, and when the mother comes home she can care for the baby during that time.

            What evidence would convince you that being a SAHM is not necessary for healthy child development?

          • Amy Tuteur, MD

            It’s so awesome that you showed up, Samantha. Here I am, satirizing the ignorant, self-absorbed lactivists clowns, and people might think I am exaggerating. But then you show up and prove that those people really do exist. Thanks!!

          • Young CC Prof

            The patriarchy cannot hold up without the eager enforcement of women. Every society of oppression is dependent on a substantial portion of the population supporting it against their own interests. It’s just human nature, unfortunately.

          • S

            So your argument is, “Working parents harm children because fuck youuuuuuuuuu!” Okay.

          • Samantha Anderson

            See, like the game of telephone, my original statements have gotten convoluted. Maybe you should go back and read.
            If you’re planning on sticking formula in your kid’s face, you don’t want to breastfeed, you want to work, your career is important, you don’t have the money to stay home with your child, why bother having a child? That’s not exactly the same as “working parents harm children”.

          • S

            You are right, i must have misunderstood your question (“Well that’s fine but who’s suffering here? The children who spend 1 hour a day with mom and dad?”). Maybe you can help me out. Who _is_ suffering here?

          • Samantha Anderson

            Babies with mothers who choose formula because they can’t bear the thought of being so “attached” to their baby. Children who spend 50 hours a week with someone making $8 an hour. Families that miss out on quality time because they need to have that 25-foot SUV and 4-bedroom house, so everyone of working age must be employed.

          • S

            So, how are they harmed?

          • Samantha Anderson

            The way I stated those situations should imply that they are negative situations. Or at the least, not optimal. Or are you like Dr. Amy – make broad opinionated statements and then require seven statistics for every statement that your opponent makes?

          • S

            Yes, it’s pretty obvious that you think they are negative situations. I don’t agree with you. I think that for the most part, you’ve presented perfectly neutral situations. I don’t see anything inherently harmful in feeding a baby formula, and research backs me up. If a child spends a lot of time with a caring caregiver that is not a parent, i don’t see the harm there, though obviously, a neglectful or abusive caregiver is a different story. Your third situation is debatable. For my family, the extra bedroom was important because we are solely responsible for three aging parents and expect that one or more will eventually stay with us, short-term (e.g after surgery) or long-term. I’m not a fan of SUVs personally, but they are probably appropriate for some families.

            It’s up to you to prove that formula, or working, or prioritizing a higher standard of living, are negative things. So again, please tell me how your scenarios actually harm children? What are examples of the actual negative consequences to the children?

            For what it’s worth, i don’t work, and i enjoyed breastfeeding my baby (He’s now 2, and the delay in response was me nursing him before bed). I have no personal stake in this argument. I just like knowing where people are coming from. Though at this point, i’m not sure you’ve really thought your opinions through, so don’t worry, i’ll quit asking now.

          • Bombshellrisa

            For survivors of sexual abuse, having a baby at your breast is it’s own kind of trauma. Being triggered multiple times a day is hell. It doesn’t mean these women don’t deserve to have children. I won’t be less attached to my son because I choose to formula feed him (as opposed to being in absolute hell like I was with trying to do the “right” thing for my daughter).

          • Trixie

            I have read stories of survivors of sexual abuse whose experience of breastfeeding was one of healing and/or empowerment, however. So maybe not all survivors feel the same way as you about it? I am in no way minimizing your experience or decision. Good for you for feeding your baby in the way that works best for you.

          • Bombshellrisa

            I know it can be. I just hate that there are people who judge and feel the need to be vocal about someone not breast feeding, without even taking into account that for some women it’s not about working, co parenting or any kind of convenience. It’s about being able to not have to worry about what the next feed will leave you feeling like.

          • Trixie

            Oh, definitely. Makes perfect sense.

          • Vyx

            Whoa. What about the families that have to have everyone of working age employed so they can have food and heat and clothing?

            You seem to be coming at this topic from a very middle to upper class viewpoint.

          • Bombshellrisa

            Thank you for saying that!

          • Teleute

            I’ll tell you who is likely suffering: THE WORKING MOTHER. I was lucky if I had even that much time with my son when he was an infant; I would sometimes go a good two or three days without seeing him awake. But by no means did HE ever suffer; he had his Grandma to take care of him, and his grandfather as well in the evenings. To this very day he has maintained a strong bond with both his grandparents — a lot stronger bond than I’ve ever had with them.

          • S

            Oh, i believe it. It’s why i got a work-at-home job, then quit that. People have told me how lucky i am to have that choice, and i smile and agree with them, because i am!

            I assumed Samantha wasn’t going in that direction, especially since she seems to place so much value in mommy-martyrdom. =)

          • Bombshellrisa

            Someone can choose to formula feed with no intention of working. Maybe a woman would like the option of splitting up those night feedings with a partner. Maybe the baby is adopted. Maybe a sibling wants to feed the baby (and there can be quite a gap between kids. Dd is going to be able to handle feeding her baby brother when he is born, once in a while). Maybe grandma wants to babysit so mom can go to a doctors appointment and she gives a bottle. Who said its about “why bother to have a child”?

          • S

            You do have a point. It is rude to shove things in people’s faces.

          • Samantha Anderson

            Unless it’s a sandwich.

          • Bombshellrisa

            Of course, being able to understand that people have all kinds of situations and those can add up to “breast feeding doesn’t work” wouldn’t hurt you either.

          • Samantha Anderson

            Different situations do not change the fact that human milk is what’s best for human babies, and quite frankly I’m embarrassed that so many people want to coddle anyone who tells their sob story about why it “didn’t work” for them.

          • Really? All other things being equal, breastmilk is a tiny bit better than formula, but things never are equal. A baby whose mother has PPD and severe sleep deprivation from pumping all the time to try to deal with low supply is going to be better off with formula and a rested mother than breastmilk and a frazzled, sleep-deprived one.

            A baby whose mother works is going to be better off with a roof and clothes and formula than breastmilk out on the street.

            People share their stories to show that breastfeeding isn’t always easy, and it isn’t always possible, and that’s okay. Some people have also shared their stories of EBF, which is also fine. As long as the baby gets fed, it doesn’t really matter how.

          • Trixie

            You really have had an easy time with pregnancy and childbirth and breastfeeding, haven’t you? And you’re white and upper middle class and don’t have to earn an income to support your family, do you? That’s really exciting for you! Congratulations!

          • Vyx

            What was your REASON to have children?

          • Teleute

            She was ready to commit to a serious “nursing relationship” and required an infant. Duh.

          • Box of Salt

            Samantha Anderson “why bother having children if you want to work?”

            Because I, acting as one of their role models, want to raise children who develop into independent adults, self-supporting with a line of paying work they chose for themselves – regardless of gender.

            I am not raising children who expect that females should plan on becoming financially dependent on others.

          • Siri Dennis

            For me personally, having children WITHOUT intending to return to paid work would feel much more selfish than formula feeding from birth. I want my children to grow up expecting to be financially independent; I don’t care how they decide to feed their babies.

          • rh1985

            Apparently women who cannot afford to stay at home should all practice abstinence or have abortions? Since it sure doesn’t sound like Samantha would want to pay for public assistance for them to stay home.

          • Samantha Anderson

            That’s not what I said at all. In fact, I’m not sure how, if you have a grasp of the English language, you could glean that from what I’ve stated.

          • rh1985

            You say why have children if you aren’t staying home? Well, first off, 50% of pregnancies are unplanned. What do you suggest they do? (not that I think there’s anything wrong with a working mother choosing to have kids)

          • Bombshellrisa

            Well, apparently she was able to find a young man who was totally on board with her staying with their children and him working to support them, all while they have both magically paid off their student loans and bought a home and have their pregnancies perfectly planned. We should all do that. Cause, you know, we are just supposed to breast feed and never have a thought to what might be fulfilling for us. ((And I know that while Dr Amy enjoyed breast feeding and was an awesome mom who could sew her kids matching pjs, she also had her own thoughts and would never club anyone over the head with the fact that her situation worked out well for HER))

          • Teleute

            My kid was on breast milk for nine months, and his GRANDMOTHER fed him the majority of it out of a BOTTLE while I was at WORK. So yeah, you make a pretty good point. 🙂

          • Bombshellrisa

            Who said anything about bottles or daycare? A feed can take an hour, and at first between healing from birth and being tired anyway and feeling like your nipples have been put in a Cuisanart and reattached and simply trying to get a moment to escape to the bathroom, the Idea that you have to breast feed and it’s the only choice you have for feeding is overwhelming. Knowing that your partner, sister, parent or best friend can grab a bottle and help out is probably a tremendous relief.

          • Samantha Anderson

            If you can’t handle feeding your child after you’ve given birth, maybe you shouldn’t have any more.
            I repeat my original question, why are we so fragile that we can’t feed our young and need help from others to assist?

          • Bombshellrisa

            Maybe because we are already helping others as part of our family dynamic? I had my daughter two weeks after my mother had a CVA. I was the only one who could assist in caring for her, my brother was living across the country and my dad had to work so he could have the health insurance that made her recovery with doctors and therapists possible. While I know that most women with newborns aren’t caring for a parent or grandparent as well, it shouldn’t be considered a unique situation. My mother exclusively breastfed us kids and didn’t have problems because her situation lent itself to being able to do that. I felt like she supported what I was doing completely. But physically, I was in a lot of pain. It hurts to breast feed (something I couldn’t appreciate until I actually had a baby attached to me), and while I had cheered many clients whose births I had attended and patients I helped in the hospital, if anyone had just told me “feed your baby, do what works best for you” it would have been so much easier for me.

          • Stacy21629

            Seems to me she handles feeding her child just fine. The baby isn’t DEAD after all.

          • Bombshellrisa

            Kind of wondering if the newest commenter has done a lot of breast feeding. I can’t be the only one whose nipples bled and who cried from pain. Although I thought it was normal because the baby was getting fed and seemed ok. I am not making that mistake this time.

          • Vyx

            So many babies used to die (and still do in developing countries) during their first year due to insufficient nutrition. And babies have always had a statistically higher chance of surviving if there are alternate caretakers available (grandmothers are an evolutionary advantage). We’re not all too fragile to feed our young without assistance, but in the past if you were then your baby died. Isn’t it great that we have formula now, so death or a wetnurse aren’t the only options?

          • Stacy21629

            How does one physically plan for losing all 25# of baby weight the first 10 days postpartum and then keeping up while nursing?

          • Vyx

            Providing a competent caretaker and an adequate source of nutrition is not a good plan to take care of your child?

            Not all women are lucky enough to be able to plan all of their pregnancies. Even when parents do plan, they can only do what works best for them as a family.

            Do you believe that parents who work love their children less than parents who give up careers to become attachment parents? How are you quantifying love? Are poor women who have to work, less deserving of children?

          • Young CC Prof

            You know, I did everything I could to secure my family situation prior to becoming pregnant, but now it seems I might have to have surgery shortly after birth. It won’t be a big deal, but if it happens, I will be unable to eat solid food for a couple weeks and will therefore lose my milk supply due to hunger. I will also require help to physically care for the baby for at least a week or so.

            Wow, what an unsolvable dilemma! Oh, wait, formula, grandparents, daddies and friends exist. The child and I will both survive.

          • Vyx

            I certainly wished I lived in a world where nothing unexpected ever happened, all partners were perfectly able to do everything needed of him or her, childbirth was relatively painless, milk supplies were never insufficient, poverty was unimaginable, and all women were perfectly content and satisfied either not having children or doing nothing more than caring for a child.

            Well…at least some of those things sound nice.

          • Trixie

            Wow. Another screenshot for sanctimommy, I hope?

          • KarenJJ

            This is my favourite sort of Skeptical ob troll. Right on the money for the sanctimony, callousness, black and white thinking and completely oblivious to their own sense of privilege in the options and choices available to them.

            Thanks Samantha for dropping in and showing everyone the worst of the excesses of NCB. Wishing you all the unicorn sparkles in the world. I’m glad to hear that your children are growing up to be so shiny.

          • Stacy21629

            Actually for me, breastfeeding costs MORE food. I am underweight at 3 months postpartum and struggle daily to consume enough calories because my baby is sucking the life out of me. Breastfeeding is not “free”.

          • Samantha Anderson

            *world’s tiniest violin*

          • Stacy21629

            I feel so encouraged to continue my nursing relationship. You would make a great lactation consultant.

          • Teleute

            I had to consume ~3500 calories a day just to maintain my weight and milk supply. I was on my feet 12 hours a day at work, and the only time I had to sit and “relax” was while I was pumping. Do you like juices? V8 makes some amazingly delicious (and convenient) fruit and vegetable blends. I also ate a lot of nuts, although it retrospect that might not have been such a good move because my kid ended up with a nut allergy. (Congratulations, BTW!)

          • Vyx

            Food is not free, it is the basis of all wealth in every economy in the world. Breastfeeding requires an extra 500 calories a day for the nursing mother, which is certainly not an insignificant cost to some families.

            And while someone has to feed the baby, the mother does not have to be the one feeding the baby if expressed breast milk or formula are available. But expressing takes time in addition to the time required to feed the baby. If the mother has to work to support her family, this time is a finite resource, and that spent time is a loss for the family.

          • Box of Salt

            Janelle, let me try to give you a different perspective on this:

            breastfeeding is free only if a woman’s time is worth nothing.

            This isn’t about being compensated or paid.

            Do you value your time?

            If you do, then value it – and breastfeeding is *not* free.

          • Samantha Anderson

            So is bottle-feeding expensive as a resource of time?

          • Teleute

            My personal expenses:

            Cost of breast pump: $450.
            Cost of spare pump: $50
            Cost of extra tubing: $30
            Cost of Nursing Bras: $150
            Weekly cost of bra inserts: $7 (x 40 weeks) = $280
            Bottles, Nipples & Other Accessories: >$50
            Lactation consultant: $240

            It certainly WASN’T free, and the up-front costs were staggering.

          • fiftyfifty1

            It’s not ridiculous and it’s not a form of complaining, it’s called Opportunity Cost and it’s a well-established economic principle that is so important that it is taught in every introductory college Economics class.

          • Samantha Anderson

            Well, you have to feed your baby whether you’re breastfeeding, pumping, or not, so if this is a rational way of thought then every bottle-feeding mum should also be compensated for her time to hold a bottle.

          • rh1985

            Formula for a working mother’s child can be prepared by the caregiver while the mother is at work.

          • Something From Nothing

            No, Samantha. None of us are claiming that bottle feeding is free. You see, if I claimed that bottle feeding was free, you would think me ridiculous. Im simply saying that breastfeeding is not free either.

          • Teleute

            Breastfeeding is FREE?

        • Samantha Anderson

          Why do we find breastfeeding so “difficult, painful, and inconvenient”, Dr. Amy? Millions upon millions of women have been breastfeeding for thousands of years, and many while doing a myriad of other duties for their communities, not huddling in a corner crying and pouting about how “inconvenient” it is to feed their children. Why are we suddenly so incapable of caring for our young?

          • rh1985

            Considering the infant mortality rate in the past, I’d hardly consider it an ideal era.

          • Vyx

            Just because women did it doesn’t mean it wasn’t difficult, painful, and inconvenient. In the past there were no good alternatives to breastfeeding if you couldn’t hire or convince another woman to be a wetnurse. Now we’ve used our big brains to come up with an alternative that provides good nutrition, is more convenient for some women, is not painful, and allows women more freedom to do other duties for their communities.

            I would argue that this makes us, as a species, more capable of caring for our young, as babies are surviving now that would have died without formula.

          • Amazed

            LOL.

            I’ve got news for you, Sammy Dumb: because there was no other way to feed their children. Those who could afford a wetnurse jumped at the chance. Ladies and queens nursing their own children was such a rarity that it caused wonder and was mentioned in archives.

            Those who could afford a wetnurse did so because for women who had choice, nursing was considered undignified, let alone painful and time-consuming.

      • Antigonos CNM

        When I was a baby, and Dr. Spock was king, there weren’t any powdered formulas available. Making bottles was a fairly complicated and lengthy business, involving measuring ingredients and sterilizing a day’s supply of bottles, every day. Yet it was regarded as the peak of modern, scientific infant care, and definitely superior to breastfeeding. I grant you that today’s advertising is slanted toward formula — the companies making Similac, et al, are not producing artificial breasts, after all, but it is wrong to assume that the amount of bottle feeding today is entirely due to their nefarious propaganda. Women began choosing bottle over breast from early in the 20th century.

        There isn’t going to be any real increase in breastfeeding numbers until there is a “Mother-friendly initiative” that gives mothers adequate technical, emotional, and financial support to make it worth their while. Sent home before the milk supply is established, and without anyone who can coach her, without a means to get the housework and care of other children done while she gives substantial amounts of time to her baby, and takes a large, and probably critical, financial loss by remaining out of work –who can blame a woman for throwing in the towel and heading for a bottle?

        • Jenelle

          I never said we should try to make/help every woman breastfeed. I have only ever supported there be help for those who need it. You’re trying to throw the baby out with the bath water.

      • Dr Kitty

        As a GP who provides antenatal and postnatal care, and will give infant feeding advice if required, would you care to clarify your statement at all?

        • Jenelle

          Well, Dr., It was an analogy to simply say precedent exists for supporting clinicians who choose a focus. If someone specializes in an area, they have potential to know more than someone who doesn’t. I’m not sure why that’s the piece some of you have decided to attack.
          I notice you and many others don’t offer novel information or ideas when you disagree, so, I guess you’re just here to argue. In which case I’m done.

          • Dr Kitty

            You characterised the care I provide as substandard, because women “need” midwives and OBs instead of GPs.

            I (understandably, I felt) took issue.

            I don’t attend births.

            It doesn’t mean the antenatal care, post-natal care, well woman care or early infant care I provide is lacking, just because I can also diagnose and treat urological, respiratory, psychiatric, cardiological problems (sometimes, in fact that comes in very handy).

            I’m a Generalist, sure, but that doesn’t mean that you’re not very good a lots of things, it means you’re GOOD at lots of things, and I resented the implication.

          • Jenelle

            Great! But does that mean you would get rid of OBs? No.

          • Dr Kitty

            No, of course not, although both your comments strongly implied that GPs are unable to provide the same quality of care as Midwives and OBs. Which is unhelpful.

          • PJ

            I loved having a family doctor for my second child, and she was capable of handling more complicated pregnancies on her own than the midwife I used for my first child–one of the things I actually liked about using a family doctor/GP.

      • LynnetteHafkenIBCLC

        IBCLCs should have a basic understanding of formula feeding, for those cases when supplementation is needed or you’re inducing lactation for a fully formula fed baby.

      • AllieFoyle

        I don’t think anyone isn’t pleased that you got the support you required; it’s more that not just a few of us have encountered situations in which LCs are breastfeeding enforcers instead of facilitators. LIke all professions, I’m sure there is variation among individuals, but a substantial portion of them seem to be coming from an ideological place that values breastfeeding above all other factors, including at times the health of both baby and mother, and fails to acknowledge and address the real physical difficulties that many women experience with anything more than a rigid insistence that they persevere, no matter how futile or counterproductive it is.

        LCs can provide a useful service, but when a woman consults one, she should be confident that the person advising her is knowledgable about all facets of infant feeding (including formula feeding when appropriate) and is not just parroting the same, unhelpful “breast is best” message that few women in 2013 haven’t already heard ad nauseum.

    • Alicia

      I completely agree. I would love to be a feeding specialist who can help both formula feeding and breastfeeding moms.

  • Jenelle

    Dr. Tuteur, your posts are so infuriating, it’s almost comical. You have not included a definition of what you consider a “lactivist” to be, leading your readers to assume all BF advocates are zealots and uneducated. Also, there are no citations of the misguided practices and philosophies you mention. Are your posts intended to be educational or cathartic? It’s no wonder your readers are butting heads so violently.

    • Kumquatwriter

      Actually, the majority of anti-Dr Amy people DON’T read her blog.

      • Jenelle

        You are probably right about that. It’s painful to witness a person with power and a platform abuse their position.

        • yentavegan

          Jenelle, I am a La Leche League Leader and this blogsite has helped me identify when and where my folksy good-hearted breastfeeding support is inadequate and potentially harmfull/useless.

  • Dr Kitty

    I will repeat this story.
    Shortly after I returned to work after I had my daughter, when I was working in a Childen’s hospital we had a six week old who weighed less than his birthweight.
    His mother was taking Domperidone and fenugreek and pumping and nursing around the clock. She hadn’t had more than 90 minutes continuous sleep since the birth. She was lucky if she pumped an ounce.

    That baby was STARVING, and she was going to LLL meetings and being told that some babies are just slow growers and Drs always overreact and push formula.

    After several (male) doctors failed to get her permission to give formula or breast milk with a fortifier, they decided to send in the big guns.

    The big guns were me (a breast feeding mum) and a female paediatrician who had fed all 4 of her children. 45 minutes of tears and hugs later we were finally able to persuade her that we didn’t want to sabotage breast feeding for her, but her baby wasn’t thriving and needed fed.

    5oz of donor EBM and fortifier disappeared into that baby in about 5 minutes and he slept for four hours…as did his mum.

    THAT is what bad lactivism does; it makes mothers doubt their basic instinct to feed their children. It drives people crazy with sleep deprivation and it doesn’t help babies.

    There was no reason why they couldn’t have combo fed, but that child’s first six nightmarish weeks can’t be regained.

    • Gene

      We had something similar happen recently in my ED: screaming, hungry baby. Mom’s milk not in and latch difficulties. Baby was so pissed off he couldn’t/wouldn’t latch. And his caregivers were two docs, a nurse, and a tech that had all breastfed their own children within the past 5 years. Baby sucked down 4oz of formula and slept for the first time in two days. It was 11pm and I sent mom out with enough pre-mixed formula samples to hold her for about 24 hours (she had a Ped appt the next afternoon). Mom and Dad hugged us when they left.

      • MichelleJo

        And these are the lucky babies that make it to the hospital. I wouldn’t like to know how many starving babies there are due to the actions of the lactivists.

        • Young CC Prof

          There was one case about 15 years ago of a baby who apparently starved to death due to insufficient breast milk. Supposedly it was because the mother had had breast reduction surgery.

          Still, going THAT far is extremely rare. The mother was young and very poor, red tape prevented her from getting to a doctor, other things went wrong, etc.

          • AmyP

            And that’s why it’s not a bad thing for people to go to ER for “routine” issues.

          • araikwao

            I remember a case presented some years back where lactation failure led to a neonate’s severe dehydration, peripheral shutdown and amputation of at least one limb (below knee, I think). Missed by the home visiting midwife.

        • DiomedesV

          They don’t have to starve to death to experience permanent impairment. How long can a baby go without sufficient food to thrive before they suffer cognitively?

        • MichelleJo

          I would like to add that in the fifteen years since I innocently starved my infant, I have not gotten over the guilt. I still cannot talk about it; even thinking about it brings tears to my eyes. (And he’s now a healthy, bright, strapping 80 KG Iad who certainly doesn’t remember it.) I was lucky enough to get sensible intervention at the three week mark, and we never (that I knew of) got to the dehydration stage, but what he must have suffered during those three weeks… I can still hear his pitiful cries. I had an HG pregnancy, and know what it feel likes to starve. Hell. Call me what you like, but I think that by and large, because I know that there are exceptions, breastfeeding counselors should be arrested for child abuse.Their job should be to facilitate breastfeeding where there are ‘teething problems’ in cases where the mother has, or potentially has, enough milk, and she wants to nurse. And throughout that period, the baby should not be starved of a gram of milk. Instead.. well we all know what they do instead.

  • Anna C

    I think you may have misinterpreted Darcia Narvaez. The quote comes from a fully referenced piece about ‘cry it out’ (http://www.psychologytoday.com/blog/moral-landscapes/201112/dangers-crying-it-out). The article that you quote does not argue against formula feeding (although Narvaez is a strong advocate of demand breastfeeding) so there is no reason to believe that Narvaez believes that it is better for a baby to cry from hunger than to be fed with formula. Narvaez argues that when babies are allowed to become extremely distressed then their cortisol levels rise and that this may lead to adverse consquences such as irritable bowel syndrome. It is quite legitimate for you to argue with that view but your argument
    should also be supported by properly-cited peer-reviewed scientific
    papers.

    • fiftyfifty1

      CIO causes irritable bowel syndrome? Where’s the peer-reviewed scientific paper on that one!

      • Anna C

        I didn’t say that it does. I said that, according to Darcia Narvaez, stress in infancy may lead to IBS “Disordered stress reactivity can be established as a pattern for life
        not only in the brain with the stress response system (Bremmer et al,
        1998), but also in the body through the vagus nerve, a nerve that
        affects functioning in multiple systems (e.g., digestion). For example,
        prolonged distress in early life, resulting in a poorly functioning
        vagus nerve, is related to disorders such as irritable bowel syndrome (Stam et
        al, 1997). See more about how early stress is toxic for lifelong health
        from the recent Harvard report, The Foundations of Lifelong Health are Built in Early Childhood).” This is not my research and it is not my argument.

        • Box of Salt

          Anna, proper citations include more than an author and year.

          “it is not my argument.”
          Then why did you post it?

          • Anna C

            There is a full list of references at the end of the article and I have provided a link to the article (which Tuteur did not). In case you missed the link, here it is again: http://www.psychologytoday.com/blog/moral-landscapes/201112/dangers-crying-it-out. The argument about CIO is Narvaez’s, not mine; that’s why I used quotation marks. I posted my original comment because I believe that Tuteur is quoting Narvaez out of context. Narvaez may be right or wrong about CIO but the piece from which Tuteur quoted is NOT about breastfeeding. However, Tuteur is using the quotation to support her argument that lactivists believe that it is acceptable to allow a baby to cry from hunger. There is nothing in Narvaez’s article that indicates that Narvaez holds that belief.

          • Anna C

            I should have added that I support Amy Tuteur’s work; she doesn’t need to cheapen it with unsupported side-swipes at other academics.

          • Wishful

            The way she used the quote wasn’t about breastfeeding, she used it as an example of the AP position on CIO. So it doesn’t need to be about breastfeeding, it just needs to be about CIO. Are you saying the paper doesn’t suggest she is against CIO?

          • AllieFoyle

            Narvaez’s Psychology Today articles are very poor quality, in my opinion — more ideologically driven opinion pieces than scholarship, and all endorsing biological essentialism but with an academic veneer.

            In this case, she took the results of legitimate studies and overextended their conclusions to support her probably predetermined personal convictions. It’s the same old drab anti-intellectual strain that wants to maintain womanhood as it existed in some imaginary, idealized past era.

        • Guesteleh

          http://developingchild.harvard.edu/resources/reports_and_working_papers/foundations-of-lifelong-health/

          The report addresses the effects of severe abuse and neglect as well as poverty on development and well-being. There are no references to CIO. The kind of stress they’re talking about is being raised in a household impacted by drug abuse or alcoholism, mentally ill caregivers, food instability, lead exposure, financial instability, etc. This is taking a well-established phenomenon–severe stress in early childhood leads to lifelong problems–and extrapolating it to a ridiculous. degree. There is no evidence that CIO will harm a child who is otherwise being raised in a stable, nurturing, financially secure environment.

        • fiftyfifty1

          So what’s your opinion based on what she has written and the links she has provided? Do *you* think CIO is a cause of Irritable Bowel Syndrome?

      • Dr Kitty

        IBS is a functional disorder with multifactorial causes which, as yet, have not been fully elucidated.

        • The Bofa on the Sofa

          Therefore, CIO causes it!

    • Esther

      Narvaez’ arguments are not well-referenced, despite the bibliography salad at the end of the article. She’s been justifiably savaged for it in the comment section as being full of sh*t. As are the overwhelming majority of her blogposts.

  • Lis

    I visited this blog from a link on twitter by someone I follow. I reserved opinion until I read a couple of this Doctor’s other pieces. It’s disappointing how argumentative and condescending she is regarding so many of these empowering women’s topics. In trying to justify her point that women have choices, she is so often berating and judging large groups of women for theirs. I would strongly advise any woman to get her butt to a local library and research birth, breastfeeding, and women’s health and form her own opinions before siding with a divisive and caustic blog author. This is obviously not the place for me, and I’m sorry I followed the link.

    • The Bofa on the Sofa

      Yeah, because it’s easier to run away than to actually address the comments.

      • Lis

        I’ve been “addressing comments” for about an hour now and it’s obvious that it’s more fun to argue over semantics than communicate, so yes, it’s easier to stop commenting. I have these crazy people in my home who expect me to be a wife and mother rather than argue on the internet.

        • KarenJJ

          We have been communicating with you. If it helps to understand my position I spent my life with an undiagnosed rare condition that is one in a million and caused all sorts of issues before it was finally diagnosed.

          So 1 in 20 is common and I am suspicious of its repeated use by people when they are describing breastfeeding issues. If 1 in 20 people have issues with breathing or drinking or eating it would be seen as being very common. I personally find it as dismissive as when I went to my doctor and she said ‘it is incredibly unlikely to have xxx syndrome because it is so rare’ (luckily she is a very nice doctor who then went through the symptoms with me, said “I suppose someone has got to have it” and wrote me a referral to get it all checked out).

          Also Lis, it is possible to learn new things, change your mind and support people even if something isn’t “perfect” or isn’t “rare”.

          • Lis

            What I find dismissive was the comment stating that breastfeeding works out “occasionally”. That was my only real contention with anything anyone has said. I have a problem with anything that discourages women from breastfeeding. That’s why I said that physical problems are rare. Issues with latch, supply, confidence? Damn, yes those are very, very common. And I make it my business to answer those with endless encouragement and advice to a mom who wants to make it work.

          • An Actual Attorney

            But, I don’t understand, how is it your business? What do you do that people ask you advice?

          • Lis

            That’s an odd question. Isn’t it my business if someone asks me for advice? I’m a wife, mother, friend, sister, and I’m almost – alllllmost – studied enough to be a post-partum doula and I’d love to be a LC one day when I don’t have little ones like I do now. I’m also a bookworm about everything related to childbirth and the like because I find it so awesome.
            (And no, I do not think formula is poison nor do I advocate breastfeeding at all costs to a woman and her family!)

          • KarenJJ

            Considering you are a doula, can I suggest a blog that you might enjoy by Dani who is also a doula?

            http://whatifsandfears.blogspot.com.au/

          • KarenJJ

            We’re not taking issue with the correction of occasionally but that you added an entire level or argument about it being rare and the argument about propagation of humans. They have had some discussion on here before and ping a few alarm bells. Humans have also propagated because they use technology to solve biological problems.

          • Young CC Prof

            OK, clearly I need to apologize for that, it was snarky. What I said was, it works perfectly occasionally. In fact, breastfeeding works well enough most of the time.

          • Lis

            No apology needed at all (I’m fluent in snark). Obviously others here knew what you meant and I, as a visitor, did not.

          • fiftyfifty1

            ” I have a problem with anything that discourages women from breastfeeding. ”
            Even if that something is true?

        • The Bofa on the Sofa

          I thought this blog was “not the place for you”? Why are you still here?

          • Lis

            I’m finding common ground being communicative and speaking clearly with people who are reading what I say and responding in kind rather than just being an asshole.

    • KarenJJ

      Or speak to a trusted doctor or two for second opinions.

      • Lis

        That is good advice, if the doctor is supportive and knowledgeable about your goals, whatever they may be.

        • The Bofa on the Sofa

          What if your goals are not consistent with good medical care?

          Why should a doctor be supportive of that?

          • Lis

            Um, I’m assuming there that a person consulting a doctor has good health goal in mind for which to ask help.

          • The Bofa on the Sofa

            But what if their goal is not about outcomes, but about methods?

            If a woman insists on breastfeeding at all costs, and they are not medically able to do that, why should the doctor support their goal to the detriment of the baby’s health?

    • KarenJJ

      “What is wrong with admitting that issues with breastfeeding are quite common, can sometimes be fixed and if they can’t then formula is a good substitute?”

      This was my question below and about the only one I really want answered by anyone that considers themselves a lactivist. Because I don’t see what is wrong with that.

      How is it not empowering to provide women with accurate information and the ability to choose what works best for them and their babies?

      • Lis

        There is not anything wrong with that. I never typed differently. I totally agree with that statement. There was some internet explosion that happened when I used the word “rare”.

        • KarenJJ

          Because it’s use was wrong and it appears to me that you don’t like learning something new. Like I said, it’s not personal, but many of us here don’t like seeing poor information stand. More people then us read this blog and the comments and we (in general) prefer the information to be correct. Anyway, now you may have learnt something today so it’s been worthwhile. It might seem pedantic to you, but I do think it’s better to be correct in such important things.

          • Lis

            So I had 3 people trying to teach me new vocabulary when I referred to 3-5% as rare, but no one batted an eye when Young CC Prof stated that breastfeeding works perfectly “occasionally”? I’m sorry, arguing over one word when the general sentiment is the same is stupid and a colossal waste of time.

          • Guesteleh

            It shouldn’t have to be said, but Young CC Prof was clearly being sarcastic. Which is an entirely different thing than you putting out a specific percentage in a medical context and then declaring it rare, when it objectively doesn’t meet the definition of rare.

          • An Actual Attorney

            Even when it works well, it rarely works perfectly. Few things in life do.

          • Lis

            Almost nothing, I’d say.

          • Antigonos CNM

            In my experience, true, there have been few women who literally do not produce colostrum or milk at all. There have been quite a few who produce only a little, or so little that the baby is not satisfied. But I don’t think that is really the issue. So a statement of “3 to 5%” means little to me.

            There are anatomical issues, such as inverted nipples. Women who have undergone cosmetic surgery on their breasts often [not always] have problems with nursing. Some women find the phenomenon of leaking breasts, their changed size, etc. to be distasteful. Babies often take quite a while to become efficient at nursing; some never do.

            There are emotional issues. These are harder to classify, but they can range from feelings of actual disgust to more amorphous feelings that they will be less attractive to their partners, or that their breasts will be permanently changed in ways they don’t want, through breastfeeding. I’ve had women who told me, so far from feeling positive about nourishing their infants, that they felt drained of their very essence, as if the baby was some kind of vampire. Also, if a woman is bullied into breastfeeding by her partner or relative [especially a mother!] with whom she has a problematic relationship, a lot of resentment builds up over time, and it’s often directed at the baby [the woman herself can be completely unaware of this] There are men who don’t want their wives to breastfeed. They feel left out, and a surprising number worry that their wives will not be as attractive to them as before.

            Breastfeeding has been endowed with all sorts of subliminal messages due to various ideologies, most of which imply “failure” or guilt if it doesn’t come easily and well. This in itself sets a woman up to perceive herself as inadequate if she and the baby don’t get on like a house afire from the very first experience. The typical hospital stay of 48 hours means that the mother most often has very little to offer a baby who may be quite uninterested in eating until his system gets rid of all the meconium, and she goes home without any support system. If she is at all ambivalent about nursing, for whatever reason, the incentive to go to bottle feeding is huge.

            The whole business of breastfeeding is not just about the mechanics of it; in fact, I think that is really just the tip of the iceberg.

          • Lis

            Sorry. I’m generally pretty good at the sarcasm font but I missed that one completely.
            Your argument over semantics remains stupid and a colossal waste of time.

          • Guesteleh

            Semantics… You keep using that word. I do not think it means what you think it means.

          • Lis

            Study of words and what they mean? Yes, that’s what I mean. You’re not actually communicating, you’re just being an asshole.

          • Guesteleh

            I’m communicating fine. I’m communicating that 3-5% is not rare and you declare it to be semantics because you can’t admit that you were wrong. And now you’re resorting to swearing at me because you have nothing else to say.

          • Lis

            You’re right. You’re an asshole, you’re argumentative over the choice of a word, so no, I had nothing left to say. It’s ok, you can be an asshole. I’m one too, I just make sure I’m not being an asshole over something ridiculous and trivial when there’s a really big topic at hand.

          • Box of Salt

            Here’s some more sarcasm for you, Lis: I really respect people who argue via insults.

            Please read some of my replies to you to understand why the word choice “rare” was inappropriate, and please think about it.

          • Guesteleh

            This reply isn’t really for you but for anyone else who may be reading: the reason the argument over word choice isn’t ridiculous and trivial is because saying “physical inability to breastfeed is rare,” it serves to marginalize and dismiss women who do have these problems. Women get shamed and blamed for not wanting it enough and not working hard enough, with no acknowledgement that for a significant number of women (as many as 1 in 20), it doesn’t matter how committed and hardworking they are, breastfeeding won’t work. And that is a big problem.

          • The Bofa on the Sofa

            But even if we DO consider 1 in 20 to be “rare”, so what? That means little to the 1 who is having problems. It means nothing to them that 19 others can do it just fine.

          • thepragmatist

            Amen! I was in that “rare” category, meaning I did it ALL and still couldn’t EBF. I did breastfeed until my son was 18 months old, but I could not produce enough milk for him with supplementing.

            I’m interested in comments up thread about insulin resistance because my son was born was very low blood sugar and my family has a history of GD. I was on a highly restrictive diet for all of my pregnancy called “throwing up after even water” until my ebil big pharma pushing OB/GYN identified the problem correctly (after my MW just let me suffer) and gave me a proton pump inhibitor. Only then did I gain weight. My MW also only did one insulin test, the 1 hour screen, early in pregnancy, and treated it rather flippantly.

            Now I sincerely wonder if I had GD and didn’t know it, because of my tiny size (not having the physiological markers). Because my son sure came out crashing and I’ve read that this is usually due to GD. And then I could not produce milk to keep up with him.

            NEVER using a MW again. I liked mine, but she probably permanently damaged multiple parts of my body unknowingly, by doing things like recommending chiro for hyperlaxity of my pelvis and letting me have untreated heart burn for months on end. And later, not advocating for me when I had severe pain from a post-op hematoma that led to sensitization of the region due to lack of pain management, and ditto that in the hospital. And not informing me in hospital that I had severe anemia, severe enough for a blood transfusion (I was never asked if I wanted a blood transfusion vs. being terribly sick for weeks and weeks from anemia)

            As time passes I find her care more and more suspect even though I really liked her.

          • Young CC Prof

            Glucose screen early in pregnancy is useless, since most of the time GD hasn’t shown up yet. It has to be done around the beginning of the third trimester. (Sometimes high-risk women or those with symptoms are screened earlier, but, if negative, it should be repeated around 26 weeks.)

            Sounds like you probably did have GD.

          • thepragmatist

            I think I was screened earlier than later BECAUSE I did have a high risk and notified by MW– ALL of my aunts developed GD in pregnancy and my dad is a diabetic. But I do remember that she told me not to worry too much when I was super anxious about fasting, due to vomiting. Told me to eat anyway. And I know the one hour one is not very specific. I am kicking myself now, because there is really no other reason he would’ve had crashing blood sugar, and I feel lucky he didn’t have IUGR. She did have me eating a steak every day, which was the most f-ing disgusting thing ever. I had to cut it into pill size pieces because I was so sick and swallow them whole, and I still cannot eat steak. You know what really pisses me off, since I am ranting about the idiocy of midwifery care? ALL SHE HAD TO DO WAS TELL ME THAT THERE WAS A MEDICATION TO FIX MY HEART BURN? When my care was transferred to an OB, and the OB took one look at me and said, YOU LOOK LIKE SHIT. How can I help you? LOL. Then she prescribed a tiny little pill that gave me back the capacity to eat and I was able to actually eat for the last month of pregnancy and put on a lot of weight. Thank goodness. (I love my OB, and yes, she posts here, so I shall just say THANK YOU, LADY!)

            Since then, I haven’t had any investigation into it, but I sure act like I may be en route to Type 2 diabetes if I am not careful. I have to eat heavy protein breakfasts or I get sick in the morning. Eggs and more eggs. In pregnancy I was dizzy and puking the entire time. In real life, I carry around nuts and other snacks because I have to eat all the time, which is hard for me, because I already feel sick. I drink coffee in the morning with about a tablespoon of sugar to get me going because I wake up feeling sick. Every day. And have to eat right before bed. But I am, at times, medically anorexic (not on purpose) I am so tiny, so it’s kind of a conundrum. I’ve taken to drinking Ensure to try and fight off the low weight. I think it is coming from a med but I am at a loss which one. The fear that I will develop my dad’s diabetes is HUGE as I’ve watched him suffer terribly from it. Obesity runs in my family. It’s nothing to laugh at. I have no idea why I am so skinny, though. I eat. And it’s also the reason why I won’t touch certain psych meds and I don’t really care whether the information is still “inconclusive” or not, it’s my body. Had a lot of arguments over the years about atypical antipsychotics because of this. I really don’t want to be diabetic, thanks. My dad’s kidneys are failing AND his legs and feet are covered in constant sores that bleed and fester. I feel terribly for him.

            As for my son’s crashing blood sugars resulting in his initial supplementation in hospital, it all makes more sense though. I wish I knew now what I knew then. I wish, also, I had known that I was so horrifyingly anemic after losing a lot of blood during my c-section/post-op hematoma so at least I couldv’e had a say in whether I wanted to be crashing into walls for weeks after I got home. I looked like a ghost. Nobody told me!

          • LynnetteHafkenIBCLC

            It’s probably over 3-5% in the US at this point. Insulin resistance and overweight/obesity may be causing issues with milk production:

            http://www.cincinnatichildrens.org/news/release/2013/breastfeeding-insulin-07-05-2013/

            http://www.ncbi.nlm.nih.gov/m/pubmed/20457594/

          • Box of Salt

            Lis, I’m sorry: apparently you missed the point. Your definition of “rare” was off by two orders of magnitude. You can’t write off an error of that size (yes, that’s wordplay) by trying to dismiss it as a vocabulary error.

            I’ve noticed you’ve characterized two different posters as “asshole” in the last five (or so) minutes. Is that really the direction you want to go?

          • Lisa the Raptor

            It’s not even the correct statistic.

          • KarenJJ

            You are new, you added a few other things that pinged our ‘woo’ radar and CC Prof has been here a while has been sarcastic in the past.

            And if you feel that this is an argument over one word, then I’m sorry that is all you are getting out of this discussion.

        • DiomedesV

          Here is why you are having a “semantic” problem:

          “And it really doesn’t matter what you “feel”, statistically
          breastfeeding generally WORKS. The physical inability to breastfeed IS rare. (I think it’s like 3-5%) If you think that’s wrong you’re welcome to check out some books on the topic.”

          You used the words “statistically” and “rare” in two sentences back to back. In statistics, the term “rare” has a specific meaning, usually specific to the empirical context in which it is being used (in my field, we might define “rare” as two orders of magnitude lower, for example). So, you misused the word “rare” in the context in which you introduced it. That is not a semantics issue. That is a simple informational issue.

          The word doesn’t mean what you think it means. This might be an early sign to you that you should be careful in the language you use on this site. There will nearly always be someone who is very well trained in any given field in the sciences and statistics.

          It’s not surprising that you (or anyone) would find 3-5% rare in an English-language sense, because it doesn’t sound like that much to most people. But when you’re talking about a medical phenomenon that has major implications for lives of women and babies, 200,000 mother-baby dyads a year is nothing to dismiss. Think about any major medical decision or event in your life and ask yourself: if someone told you a major complication only happened 1/20 times, how comfortable would you feel?

          • fiftyfifty1

            Yep, on an L&D ward that delivers 20 babies per day, that’s one mom each day who for physiologic reasons alone will never be able to make enough milk for her baby. This baby *will* run into medical problems, either sooner (dehydration) or a bit later (failure to grow and develop) if not recognized and given formula.
            And this number does not include the women who are not able to produce enough milk due to other, potentially modifiable reasons such as a temporary problem with latch, a sleepy baby, a borderline preemie, not putting the baby to the breast often enough, breast infections, etc.
            Rare my ass.

          • The Bofa on the Sofa

            Yep, on an L&D ward that delivers 20 babies per day, that’s one mom
            each day who for physiologic reasons alone will never be able to make
            enough milk for her baby.

            🙂

            That’s what I said.

            And I go back to the rest of my comment: so what that it’s only 1 in 20? That 19/20 can do it means NOTHING to the 1 that can’t. Besides, that 1 in 20 is a descriptive stat, not PROSCRIPTIVE. Each person needs to be assessed on their own, not in relation to anyone else.

          • fiftyfifty1

            Also, lactivists misuse the 5% stat. Probably because they don’t understand even basic stats. I have heard comments that go something like this: “I talked to a mom yesterday who told me she planned to breastfeed but had to stop because of low supply. But only 5% of women have a medical reason they don’t produce enough milk, so really she almost certainly (95% certainly!) could made enough milk and was just making an excuse.”
            Think of what happens when lactation consultants use this same faulty logic. Let’s say 20% of women see a lactation consultant at some point for concerns of low supply. And 5% of women are physically incapable of making enough milk. This means that one out of every four women presenting with this concern is never going to be able to produce enough milk no matter what the lactation consultant recommends or how carefully the woman follows her suggestions. We can argue whether 5% is “rare” or not, but I don’t think anybody can argue that 25% is rare.

    • An Actual Attorney

      Lis, I do suggest you take a look at some of what is said on line about BFing. I, like you, had a wonderful LC who helped me establish a BFing relationship with early supplementation. But, woo boy, there’s a lot of crap out there. Much of it from main stream sources.

      • Young CC Prof

        Oh yeah! LLL International website! Some of it is true, but a lot of it is not just wrong but absolutely absurd to anyone who’s ever taken a single biology class. Like mothers being able to pass on antibodies to diseases they’ve never had.

      • Lis

        I’ve been online, I’ve read dozens of books, I’ve attended classes and seminars. The internet is crap. You can google anything and receive hellacious amounts of faulty information. You have to be able to pick and choose the things that make sense and trust the right sources. The blogger saying “WHY DO LACTIVISTS LET BABIES STARVE HMMM? HMMMM??” is stupid and childish. Anyone who lets a baby starve is a moron. And I don’t think that’s common advice. I hope that if someone hears that opinion, they quickly get a second opinion!

        • Guesteleh

          I received terrible advice In Real Life. From an IBCLC. Someone who is regularly interviewed in the media. Someone who speaks at national conferences. The problem isn’t just some random crazies on the internet. The profession has a serious problem with ideologically driven advice that has no basis in reality.

          • Lis

            So now you get to declare that lactation consultants are mostly crazy and a tainted profession? Your standards for blanket statements are a bit hypocritical.

          • KarenJJ

            We have a few LLL leaders and lactation consultants that post on here. They might have more to add later. Lactation consultants are a mixed bag, I think most people can agree there. It would be great if the standards increased such that lactation consultants become more professional and weeded out the more unprofessional and more ‘woo’ elements.

          • Lis

            I’m either in a really awesome, well-informed region or I just have been lucky to be referred to great people. I’ve always been the kind of person who totally ignored someone if I believe they’re giving out faulty info, so maybe I just haven’t seen all these nationally-known crazy “lactivists” y’all are talking about.

          • LynnetteHafkenIBCLC

            I hope that will happen. It is a young profession, after all.

          • Young CC Prof

            I don’t know many lactation consultants. I have no idea how many of them are crazy, the only one I know personally is pretty normal. However, La Leche League’s own website has some alarmingly inaccurate information. Prominent members of the organization say really nutty things in public. I agree with Karen, they have a lot to offer, but they need to get together and NOT support their nuttier members.

          • Lis

            I’ve never used LLL, or even looked at their website, and now I’m glad I didn’t. I was referred to one LC, who was awesome, and I’ve met a dozen or so since then who are totally rational, logical people. Is this something in a certain part of the country??! Because I really was not aware there were so many “crazy lactivists”! (I’ve always considered the word lactivist a good thing! I will think twice before I use that to describe myself and am looked at as crazy!)

          • Young CC Prof

            I THINK that the epicenter of this particular crazy is the Pacific Northwest, as it is for most left-wing antiscience. (The right-wing antiscience, different verse same song, is emanating from places like Texas and Kansas.) It has tendrils all over the country, however, and representatives in many other countries.

            But yeah, the people who upset us are ones who say things like, “All women can give birth naturally,” “Birth interventions usually do more harm than good,” “Formula is poison,” “Vaccines cause horrible death,” etc.

          • Lis

            Oh nah, I would never say any of those things. I do believe that there are IDEALS (wouldn’t it be awesome if birth was a spiritual and wonderful as some women say they experience??), but we all do things the best way we can. I’m a total advocate for education, so that “the best we can” really IS the best we can. I had a successful vbac 2 months ago – tried natural but ended up using an epidural and pitocin. Do I feel like a failure? Hell no! I still think that natural would be “best” but it just ain’t always possible.
            I’m right smack in the Bible Belt so I hear lots and lots of slightly different yet similarly insane opinions.

          • DiomedesV

            This stuff is highly regional. Perhaps ironically, the Bible Belt is more mainstream and downright sane with respect to childrbirth and breastfeeding, at least in my experience.

          • Awesomemom

            I would have to agree with this. I got a great LC and wonderful support when I gave birth to my third kid in Kansas. The rest of my kids were born in California where I got crap support and crazy advice.

          • fiftyfifty1

            ” I do believe that there are IDEALS (wouldn’t it be awesome if birth was a spiritual and wonderful as some women say they experience??), ”
            Nah, that’s not the ideal any more. The new ideal is orgasmic birth.

          • Dr Kitty

            My daughter’s birth WAS magical and spiritual and wonderful. I felt profound joy like I have never known when she was put in my arms.

            But apparently I’m deluding myself, because an elective pre labour CS can never be as good a natural experience. There was nothing “less good” or “not as ideal” about my experience.

            I exclusively breastfed until kiddo was over a year old. The first six weeks were hellish, but then I enjoyed it. Would I put myself through all the hoops I did (pumping at work etc) again though? Probably not.

            Only stories that fit the accepted narrative are accepted by NCB. Anyone who has an experience or opinion that doesn’t fit into that is discounted immediately.

          • thepragmatist

            I felt the same way. My son’s birth was the best day of my life. I will forever remember every single moment of it. It was triumphant, beautiful, and perfect. He was the best thing ever. I could’ve eaten him up, I loved him so in that moment. And I delivered by elective maternal-request c-section.

          • Anka

            Incidentally, Toronto is full of lactation consultants who say things like that! I assumed that Canada, especially Canada’s largest city, would be more progressive and less woo-filled, but I saw twelve lactation consultants overall (one LLL–the worst–and the rest public health), and all but two of them were like that. The other two asked me in a kind way how I would like to feed the baby–whether I’d like to include formula or not, and one of them showed me better ways to formula feed. But both of them pooh-poohed the idea that my baby would need more milk than I could ultimately produce due to physiological issues on my part, and evidence is actually pointing in that direction. Like someone said elsewhere on this thread, it didn’t matter to me that the other 19/20 of mothers could do this. I was in the supposed 1 out of 20, and being told that that is just about impossible was demoralizing. (Also, I know that the supposedly awesome Jack Newman’s clinic is here, but I didn’t have the money for it.)

          • Anka

            At the hospital where I gave birth, famous for being epidural-friendly and doing all the c-sections, the first lactation consultant I talked to informed me that my combination of induction + epidural + pitocin + believing the pediatrician at his 48-hour checkup when she told me my baby was starving and supplementing with formula as a result could have “ruined” my supply “forever.” Just as an example. And this is a government employee.

          • fiftyfifty1

            I live in the Midwest. I have seen 4 IBCLCs:
            #1 totally crazy and driven by ideology. Told me my son’s abnormal suck was due to brain damage he had sustained due to the epidural. Recommended cranio-sacral therapy from her friend to try to fix him.
            #2 Totally crazy. Told me I had a full-body systemic candida infection causing my nipple pain/bleeding. Recommended I go on a 1 month treatment of fluconazole pills for myself, gentian violet for my baby and an elimination diet.
            #3 Very sensible. Correctly diagnosed me with crush-injury reynauds.
            #4 (consulted over the phone when baby #2 was crying constantly at 4 weeks with what I knew to be her hungry cry, nursed constantly and desperately and displayed all the signs that they tell you to watch for as hunger cues to let you know to feed you baby on demand)- “You must be reading her wrong. She’s probably not hungry. This is just a normal developmental stage I’m sure. A lot of babies go through a fussy stage. Let her cry.”

          • The Bofa on the Sofa

            So are you saying that not all LCs are crazy?

          • Lis

            I know one who definitely is not nuts. So yes, I can declare that not ALL of them are craycray.

          • The Bofa on the Sofa

            If that is the best you can say, then that profession has got a SERIOUS problem.

          • Young CC Prof

            Well, I’m not sure that’s fair. For example, I can name one gastroenterologist who’s very good. That’s all. Does that mean the others all suck? Nope, just that I don’t know most of them.

            It would be an interesting study, what percent of LCs are nuts. Of course, you’d have to define “nuts,” and it might vary depending on the client’s perspective. Your LC might be a total nut job, but her advice just happened to work for you. Conversely, an LC might be smart, well-informed, practical and compassionate, but the client was in a bad place at the time, or had issues that simply couldn’t be resolved by any means.

          • The Bofa on the Sofa

            But if you say, “I’ve encountered a bad gastroetc” no one ever says, “Not all gastros are bad.” They say, yeah, there are some bad ones, but they are rare and no one likes them.

            That is completely opposite of what you hear about folks like LCs, midwives, and chiropractors. “Not all X are whacko” is the worst criticism of a profession you can hear. It means that there are too many loons.

          • AmyP

            My oldest had feeding problems. The pediatrician had an in-house LC that was very helpful. There was weirdness, though. She told me to tell the baby that it was OK to hurt me, because she obviously had some sort of New-Agey belief that my fear of being hurt by the baby was preventing us from feeding. She also asked a somewhat relevant question about our sex life (purportedly certain sexual practices make breastfeeding more problematic?????). But aside from that, she set me up with the pump that I used for the next year and encouraged us to give the baby formula. So it was about 50/50 weird vs. helpful, but the proportion of weird is high enough that you have to wonder about the profession.

          • fiftyfifty1

            Icky weird!
            I sometimes think we would be better off without lactation consultants at all. Instead we could hire a few nice high school students, the sort who might normally work as a lifeguard or mini-golf attendant. They could hand out the pumps and encourage women to use formula if needed. No more cray cray “it’s ok to hurt me” affirmations or weird-o sex questions (or referrals to cranio-sacral therapy, or paranoid theories about formula makers intentionally leaving out the vitamins in order to brain-damage babies, or instructions about how to buy black market milk-increasing meds from shady internet sources). Finally some sanity could prevail.

          • An Actual Attorney

            My LC was helpful, but also had the weirdness. I made a pre-birth appointment because I was really worried about BFing and had some specific questions about meds and some anatomical oddities. My wife came with me. As we walked in, the LC said, “are you her village?” My dear wife said, “Village?? What?? No, I’m her (damn) wife.” Later, my wife said that even she never got that exited about my breasts.

            The LC did suggest combo feeding and was very helpful. But looking back, she also suggested that I wake up every three hours to nurse instead of having wife use pumped milk. I had to tell her in no uncertain terms that I was at high risk for PPD and I was getting what sleep I could. Period.

            She also suggested CST, which I sort of considered. Until wife said no one was pushing on our baby’s head and if it wasn’t hard enough to hurt him then it wasn’t hard enough to do anything.

            It just doesn’t seem like, in retrospect, it was worth it to dig through the crazy for the useful bits, but I really didn’t know anything about BFing so I went to the place I thought was the professionals.

          • Young CC Prof

            “Her village”? Really? I recognize the reference, but to just say it like that, with a straight face, that’s classic.

            And yes, no one should allow chiropractic, CST or anything like it on babies!

            Now I want to found a school of science-based infant feeding consultants, because at this point, lactation consultants are kind of like yoga teachers. They have a lot to offer, but sometimes you have to dig through loads of woo to get to the actual knowledge. And unlike your typical yoga student, a newborn’s parent is generally not it good shape to go knowledge-mining.

          • An Actual Attorney

            We still laugh about the village comment, years later. This city is generally more gay friendly than the Castro in June, so it was a strange moment.

          • LynnetteHafkenIBCLC

            I beg to differ :). The majority of my clients have pain during breastfeeding, and almost always that can be fixed in one session. If a mom wants to breastfeed, it’s worth it to make it enjoyable for her. I also teach clients to breastfeed lying down, deal with oversupply and low supply, and recognize when medical help is needed (thrush, mastitis etc). Sure it’s not brain surgery, but I think women who want to breast-feed deserve a skilled helper (not a high school student!) to help them have a good experience.

            I do agree with you on taking the crazy out of the profession though.

          • fiftyfifty1

            ” and almost always that can be fixed in one session.”
            I keep hearing lactation consultants say that pain can “almost always” be fixed by some quick suggestions about technique. And then I know story after story of women (including many of my personal friends and myself) who say that they suffered weeks of pain despite consulting LCs and doing everything they were told to do…..hmmm the math doesn’t add up.

          • LynnetteHafkenIBCLC

            Let me clarify. If the mom is experiencing pain level of 8+ on a scale of 1 to 10, I can usually help bring that down to a 3, with positioning changes etc. 200 mmHg of suction on your nipples is usually not going to feel any more comfortable than that, until the nipples get used to it, which just takes time. If the mother is still experiencing pain greater than a 3, or she just does not like the sensation, then we discuss options. No one should (a) be in pain 8 times a day or (b) feel like it’s her fault for doing it wrong.

          • Teleute

            Eh, all I needed was one session. Granted, it was kind of a long one.

          • Kumquatwriter

            Ick, I have to ask, what “sexual practices” supposedly interfere with bf?

          • Trixie

            Um, yeah. What?

          • Esther

            There are wonderful LC’s (who aren’t necessarily IBCLC’s) and bad ones. But when the official journal of the USLCA comes out with a whole issue about the dangers of CIO (as they did last June, written by some of the Web’s worst sanctimommies – http://www.clinicallactation.org/Volume/4/Issue/2), I think it’s reasonable to think the profession is tainted by an agenda other than helping women who want to, breastfeed. (The same goes manyfold for the LLL, incidentally).

          • fiftyfifty1

            I think it’s fair to say that the profession is tainted by ideology. And she never said they were crazy, just that the profession has a problem with following ideology rather than evidence.

        • KarenJJ

          Yes, my awful experience was in a hospital and my baby didn’t get back to her birth weight for six weeks. Do I feel like a moron? Yes, I think I do. I was a mess at the time.

          Lis, you sound like you are taking this very personally and getting a bit heated about the topic. Maybe it is best to take a breather for a bit and read it later.

        • Kara

          My experience with a LC was that she preferred my baby starve and be hungry and cry non-stop for months while I BF than to actually NURISH her with formula. So yes, in my experience, DR Amy is asking a valid question. Why was that ok, but then when I sleep trained my daughter, and she cried for a few days that is not ok? I just think you don’t understand what she’s asking.

        • thepragmatist

          Well, ACTUALLY, my visiting home worker AND my GP let my baby starve. My GP said (which in hindsight is complete LUNACY) that my baby only needed 50% of his daily caloric intake to survive. It was only when I took my son into me weighed after noticing his fontanelles looked sunken and he had lost 8 ounces in a week (at 4 months old) that I realized he was F-ING STARVING TO DEATH. And everyone around me was too busy pushing “breast is best” to notice. I got the formula out, and we combo-fed from then on and I pray I didn’t kill too many brain cells during that time. And as time passes, I actually feel more and more angry at my the people involved. They should’ve known better. My visiting home worker told me babies who are hungry don’t sleep. Yes, they do, they become LETHARGIC from STARVING. Sorry, to shout, but the hubris… oh the hubris of some of our trolls…

    • SuperGDZ

      You read the piece and didn’t form a conclusion until you’d read enough unrelated material to decide that you didn’t like Dr Amy and ergo everything she says must be wrong? That tells us more about your capacity for rational decision making than it does about Dr Amy.

  • amazonmom

    People might see what I comment and think I’m not supportive of breastfeeding. Not true at all! I just think lactivism is ridiculous and sometimes dangerous. We don’t need to LIE to promote breastfeeding, nor do we have to force it upon women who don’t want to (or can’t) do it. After my own experiences with the lactivists as a patient I just refuse to let them anywhere near me. I am very disappointed that women in the community consider where I work to be the “boob police”, and a lot of them actively avoid the hospital for that reason. If we were as mom friendly as we are “baby friendly” I wonder how many more women would choose us over competitors that are very long drives away.

  • Lisa the Raptor

    A friend and I were told once that ur babies didn’t wean themselves at 14 months. That the reason they weaned was because we were offering them table food and cups. Well, duh I guess. My pediatricians recommend feeding a baby table foods and cows milk after a year. I didn’t realize, that I should have just been offering my son breast milk. I guess I should have swatted his hand away from my plate. So what if babies want to be big people and are so proud of themselves for eating the same meal as the rest of the family (Sometimes with a big boy fork!). So what if these people are denying their kids that pride.

    When I was in college I recall a favorite professor talking about the current “child worship” culture and how it was the first time in history that parents really spent a lot of effort on their babies and children. We talked about “Mother’s Little Helper”, an 18th century opiate that was sold to knock the baby out all day so it could be left at home for the day while Ma and Pa worked at the factory. I don’t think the “Child Worship” culture is a bad thing at all. If anything it’s a product of having pretty close to perfect odds of our babies surviving, but one should never assume that the people in the past thought like we do now.

  • Lis

    Who are these women who let hungry babies cry to have breastfeeding “bragging rights”?? Who are these people who think that BREAST IS BEST in 100% of cases and would see a starving baby with a mom with IGT or very low supply and not supplement?? These women must exist in the same universe with the women who are walking aroud topless to breastfeed and offending everyone’s sensibilities, because I’ve never seen any of these women.
    I kindof wonder why the hostility toward women who are supportive of breastfeeding. I think it’s one of those things where there are some very extreme people out there who believe something wacky, and people get all defensive and fairly offensive too. Why are you wasting your breath talking about anyone who would let a hungry baby cry? That’s not attachment parenting. That’s not lactivism. That’s silliness.
    I’ve seen a handful of LCs in my day, and befriended and spoken with many more, and many doulas and midwives too. Step 1 is always FEED THE BABY. If you still want to breastfeed, then you look for the problem, but no LC or AP advocate in her right mind would tell you to let the baby cry. If one has said that, she is wrong and I can absolutely guarantee you that she is on the fringe, not the norm in her profession.

    Oh, and to the commenter who said that breastfeeding works “occasionally”, my dear, it’s a lot more than occasionally. We are mere mammals, and human female bodies work to produce food for their young MOST of the time. Complications may arise for individual cases like working or stress, but that is our schedules’ fault, not our bodies’.

    • Kumquatwriter

      Um, I’ve seen lots of both kinds here in Eugene. LOTS of women have bf issues and complications, and NOBODY here does NOT support moms breastfeeding – if they WANT to.

    • KarenJJ

      See below. I was refused formula in hospital for an unsettled baby and exhausted mum. This was a private hospital in a big metro city. This was almost 5 years ago, so I hope they are kinder to their mums and bubs now.

      “We are mere mammals, and human female bodies work to produce food for their young MOST of the time” We are also humans and have been using technology to get around our biology now for a very very long time.

      • Lis

        Part of having our wonderfully developed brains and logic is knowing when we need to “get around” something and when biology is working exactly right.

        Why do people act like breastfeeding is so radical? Like it’s some miracle if a woman’s body works in this way? Like it rarely “works out”?

        Anyhow, we’re all probably arguing the same point – that babies need to be fed, period. My only beef with this blog (which I saw linked to on twitter) is the generalization of lactivists as baby-starving baby-haters. Being an advocate for and proponent of breastfeeding does not a baby-starver make. Using generalizations like that comes acros as hostile, and it’s bizarre, ignorant, irresponsible, and honestly kindof embarrassing for the author.

        • Young CC Prof

          “Lactivist,” as used here, is actually a pejorative term. It doesn’t mean a mother who breastfeeds, or someone who is in favor of breastfeeding and helps other mothers do so. It’s someone who promotes breastfeeding at all costs or almost all costs, or claims truly outlandish health benefits to breastfeeding, like that breastfed babies never get sick at all.

          Most people who are pro-breastfeeding are not lactivists.

          • KarenJJ

            “Most people who are pro-breastfeeding are not lactivists.”

            Absolutely. I’ve advocated for better workplace accomodation of breastfeeding at my office and I’ll stand up for the right to breastfeed in public.

            But I’ll also stand up against shaming new mums for not breastfeeding or someone providing misinformation such as “the inability to exclusively breastfeed is rare”.

          • Lis

            The physical inability to breastfeed IS RARE. Medical, physical inability. I’m sorry but you’re wrapping up personal feelings (“shame”) with facts (breastfeeding is normal and natural and generally works). That’s not misinformation, it’s based on statistics and, hell, the propagation of our species as humans. You’re mixing science with people’s feelings, opinions or experiences.
            Breastfeeding is normal, natural, and generally works. If and when it doesn’t, it’s generally something that can be fixed (latch issue, tongue tie, etc.). If it’s truly a physical issue (breast reduction, IGT, low supply etc) then maybe there’s nothing you can do, and donor milk or formula is the way to go.

            I just really get aggravated when people act like breastfeeding is some miracle that never works. This stupid attitude only leads to discourage women who do WANT to do it, because they feel like, “Well, it doesn’t work for anyone else, so I probably can’t either.” It “works” for MILLIONS of women and babies, and women need to see that and not distrust their bodies immediately because “a lot” of women have problems.

          • KarenJJ

            You’ve contradicted yourself. 1 in 20 is not rare, but you keep saying that it is. I don’t know what to say now. A lot of women can’t breastfeed and telling us that it’s really rare is not actually helping. Especially when we discuss it with others and find all these other women that have had problems.

            Are you prepared to hear the other side? What is wrong with admitting that issues with breastfeeding are quite common, can sometimes be fixed and if they can’t then formula is a good substitute?

          • DiomedesV

            “That’s not misinformation, it’s based on statistics and, hell, the propagation of our species as humans.”

            I’m not aware of any statistician that considers 1/20 “rare.”

            Not much success at anything is necessary for the “propagation of our species as humans”. Have you ever read anything about population growth and selection? I’m guessing not.

          • Lis

            Oh.
            Well then my beef is with using the term in a pejorative manner. Maybe I’m naive but I’ve never heard the term used to imply that they’re mostly psychos.

        • KarenJJ

          “Why do people act like breastfeeding is so radical? Like it’s some miracle if a woman’s body works in this way? Like it rarely “works out”?”

          Maybe, just maybe, because so many of us have had a difficult time of it.

          • Lis

            Ok, but this is where I’m so often frustrated online – your personal experience is not indicative of everyone. Statistically, breastfeeding works. Anecdotal stories of what you experienced is not an accurate representation of something that generally biologically works.

          • KarenJJ

            I think it’s fair enough to dismiss my experience as an individual case, but when there are a few of us saying the same thing when do lactivists start listening? And when you keep repeating that it generally biologically works I feel that you actually have no idea whether it works or not but you just want it to. You don’t dismiss diabetes because the pancreas generally biologically works.

          • Lis

            I never dismissed anyone’s personal experiences or disappointment, or mistreatment, or misinformation. Some of the stories in these comments are just horrible regarding misinformation.
            And it really doesn’t matter what you “feel”, statistically breastfeeding generally WORKS. The physical inability to breastfeed IS rare. (I think it’s like 3-5%) If you think that’s wrong you’re welcome to check out some books on the topic.

          • KarenJJ

            1 in 20 is not rare. That is incredibly common. Rare diseases have varying definitions of anywhere from around 1 in 10,000 to 1 in 100,000.

            And considering the following people often have issues with breastfeeding:
            Women with PCOS
            Women with anemia
            Women with mental illness
            Women with drug dependencies
            Women with little support
            Parents who have adopted or are single parents
            Women who have had breast surgery
            Women who have underlying breast/nipple issues
            Women who will be returning to work
            Women who have sexual abuse history.
            Women with underlying conditions
            Women with illness that can be passed on to the baby via breastmilk

            I don’t know if the 3-5% includes all of these women or not, but I’d be surprised if it did. Would be interested in where this 3-5% comes from. I was able to breastfeed with a lot of support as well as supplementation from formula, so am I a part of the 3-5% statistic or not?

          • Young CC Prof

            3-5% of the population really isn’t all that rare, it’s a large enough group to be worth worrying about. In the USA, that’s 200,000 mothers a year. Also, up to a third of mothers have some issues with breastfeeding, although most of them can be solved.

            Yes, most women can breastfeed, but breastfeeding problems are not rare and exotic.

          • An Actual Attorney

            I just quickly googled and that’s a little bit less than the incidence of red hair in the US population. So if you aren’t prepared to deal with BFing problems, that’s basically like a makeup counter not selling makeup that goes well with redheads because it’s so rare: it doesn’t make any sense. Like red hair, BFing issues are common enough that it shouldn’t even be remarked about.

          • Guesteleh

            A 3-5% failure rate isn’t rare. There are 4 million babies born in the U.S. annually. The medical definition of a rare disease is a 1 in 2000 rate, i.e. .05%. Assuming all of those mothers attempted breastfeeding, a 3-5% failure rate translates into 200,000 babies unable to be breastfed each year. So can we please stop saying the physical inability to breastfeed is rare? It’s not.

          • KarenJJ

            Is there a medical definition of a rare disease? I keep coming across different numbers.

          • Guesteleh

            Definitions of rare diseases, according to Wiki: http://en.wikipedia.org/wiki/Rare_disease#Definition

          • Lis

            The first statement I made was that breastfeeding works “most” of the time. (I don’t know when I brought in “rare” but jesus, I wish I hadn’t). Would you like to point me to a Wikipedia about what “most” means? You’re good at google.

          • Lis

            So now we’re going to play semantics games over the choice of a word? How about uncommon? Infrequent? It’s so obnoxious that I’m actually AGREEING with what the blogger said (that babies need to be fed first and foremost and anyone who advises ignoring a hunger cry is nutso), but several women are arguing with me because I said “rare” before googling the medical definition of “rare”. THIS has got to be the definition of “mommy wars”: women arguing amongst each other, most of them kindof agreeing, but getting so hung up on 1 or 2 words that they end up cursing each other out and yelling.

          • Young CC Prof

            I’m not trying to argue with you, or attack you. I’m trying to explain a position. The fact is, there are folks out there telling dangerous lies about breastfeeding, obstetrics and infant care, and some of those lies have been told so many times that most people believe them!

            THAT is what this site is designed to fight.

          • KarenJJ

            I’m correcting misinformation in case you go around telling other women that they can’t be having breastfeeding issues because breastfeeding issues are rare.

            If it helps, it is not personal and I can only go on the words you are using in this forum.

          • Lis

            I never said I “go around telling women they can’t have issues”. I don’t think I even alluded to that.
            As a point of interest, I had “breastfeeding issues” with my first, and with the help of a great LC I first supplemented with formula and then developed an awesome breastfeeding relationship for eight great months with no further supplementation. Would I have gotten the same support and info from a doctor? I don’t believe so.

            There is a tenuous line we walk between supporting mothers in their breastfeeding goals and encouraging them to just stop. We don’t want to hurt anyone’s feelings by implying that she’s a bad mom, which she may already feel! But I always lean toward the side of encouraging breastfeeding – not at ALL costs, but to reasonable costs. Medical professionals should be skilled in the biological processes of breastfeeding enough that they can give accurate and encouraging advice to nursing mothers. And if a mom doesn’t want to nurse or cannot? That’s ok too. But when something can be corrected with some educated help or encouragement, I believe that it should. That’s why I want to become an LC one day – to help moms the same way I was helped. I think and hope that that’s the goal of most LCs. Are there some crazies? Sure. They’re everywhere in every profession. I hope that women are smart enough to see an extremist in ANY camp and run. Hi, I’m Lis, I strongly advocate breastfeeding, but I’m not a psycho. Nice to meet you.

          • Box of Salt

            Lis “Would I have gotten the same support and info from a doctor? I don’t believe so.”
            You making assumptions and overgeneralizing.

            You would have gotten that kind of support from my pediatrician – I did.

          • LynnetteHafkenIBCLC

            “Would I have gotten the same support and info from a doctor? I don’t believe so.”

            I don’t see why not. Most pediatricians in my area either have LCs on staff, or refer moms to them. I have had many moms tell me specific things their peds have done to support their breastfeeding success.

          • Guesteleh

            This isn’t semantics. If you think breastfeeding problems are rare, then you’re going to be a lot more dismissive of women who say they’re having a problem. no matter what you think or feel, words have precise meanings and they should be used correctly, especially in a medical context.

          • KarenJJ

            I don’t know what you do for a living or how you provide breastfeeding support but you seem to be happy giving us this type of info so assumed you are potentially also doing so in a professional or an activist or support role.

          • The Bofa on the Sofa

            Rare? Uncommon? Infrequent?

            Really?

            At that incidence, a LC in a medium sized hospital would be encountering that problem DAILY. That’s not infrequent nor uncommon. What should she say to those moms? I’ve got 19 other moms on this ward who aren’t having a problem, so therefore, yours isn’t real?

          • thepragmatist

            Well, they DO say that. LOL. Does that count?

          • Box of Salt

            Lis, do you know what percent means?

            3% is 1 in 30.
            5% is 1 in 20.
            Does that help put this in perspective? 1 in 20 should not be called “rare.”

          • Lisa the Raptor

            So that is women who can’t make milk from day one. You are leaving out women who lose milk much later in the baby’s life, women who have physical nipple issues, women who have extreme depression while nursing, women who suddenly come down with an autoimmune or other chronic condition that impedes feeding or causes the mother to lose supply, babies who have issues nursing and basically everything other that improper glandular tissue to produce milk. Do you see how much higher that percentage is now?

        • S

          I think we all understand that breastfeeding works most of the time, but the subject of the conversation is what happens when breastfeeding does not work. So arguing over whether it’s “most of the time” or “usually” or “almost all of the time” (made up quotes) is completely beside the point (especially if you are not enjoying the argument!).

          The important thing here is that when breastfeeding doesn’t work, lactivists have been known to give unhelpful and even dangerous advice.

    • Lisa the Raptor

      Guggie Daly

      • Lisa the Raptor

        I personally have been told several times that there was no way that my 9 month old daughter (who still weighed the same she had at four moths) was not getting enough milk. It clearly had to be that she had some horrible disorder that caused her to not metabolize what must have been gallons of breast milk. It was a huge FB thread that resulted in my sister finally shutting everyone down with a big old STFU. There was also some doctor slamming, as in, of course breastfeeding is the first thing they go after. Never mind that my ped had noticed the lack of weight gain at six months and said it was most likely nothing. Never mind that they did a blood sugar test after a nursing that came back fasting (we should have weighed her after to see if she got any milk.), never mind that my daughter reached for that formula so fast and frantic that it made me cry and never mind that she gained a pound after one week on formula. Women never have production issues after having an established supply.

      • Box of Salt

        I want to agree with your answer, but I can’t bring myself to “like” anything associated with particular menace with a blog.

    • Hi Lis – I appreciate your comments. Here’s the problem I have: the attitudes are so prevalent that it goes beyond “supporting breastfeeding” and “breast is best, when it works” – into making moms who don’t breastfeed for whatever reason feel like shit for that choice. As an example, look at this page from Ottawa public health (Ottawa is the capital of Canada and a major Canadian city) http://ottawa.ca/en/residents/public-health/pregnancy-and-babies/make-informed-decision-about-feeding-your-baby It’s entitled make an “informed choice” it then goes on to list all of the benefits of breastfeeding and all of the risks of formula feeding. I can only imagine how such a page might be received by a new mom, for whom breastfeeding isn’t working. The idea that BF is all unicorns, rainbows and good health and formula feeding is all death, disability, rotten teeth and disability IS dysfunctional. It’s not even evidence based – the evidence on the relative benefits of breastfeeding in developed countries is pretty marginal and largely swamped by other factors like socio-economic status.

      I wholeheartedly support breastfeeding – and think that it should be an option. But I also support formula feeding. Because at the end of the day I support babies who are having their nutritional needs met safely and mothers who have made a choice for themselves in their particular circumstance and can feel good about whatever that choice is – be it formula feeding OR breastfeeding.

      • thepragmatist

        I can tell you how… I cried for about an hour. I didn’t WANT to feed my newborn formula. My MIDWIFE strong-armed me into it, because the baby had crashing blood sugar. About a year later, I realized he had such low blood sugar that he was very very close to needing an IV and that is why she was insistent. I had spent the entire time hooked up to a pump trying to get what little colustrum I could out of me, something that was horrific, as I was a sexual abuse/rape survivor, but I SO wanted to breastfeed. As I left the hospital, they gave me some formula, and a sheet like that. I wept. Not only was I failing my baby then, but apparently, I was going to fail him for his WHOLE LIFE. As most know, that first week being a new mom is a pretty hectic time emotionally. That was the last thing I needed to read. It was a big part of what provoked me to continue to try to EBF even when my baby was clearly not thriving at 3-4 months, right up until he started to exhibit clear signs of FTT. Nobody helped me then. I had to figure it out myself and luckily, had one not nutty LC who said, “Just FEED your BABY!” Still, I cried and cried, thinking if I fed him formula, even supplemented, I would hurt him. And right now, he is sick all the time– new daycare, and first flu season off the boob completely– and I still feel horrible twinges of guilt. So there’s the answer. What damage do these “public health” campaigns do? LOTS.

    • fiftyfifty1

      “Complications may arise for individual cases like working or stress, but that is our schedules’ fault, not our bodies’.”
      Complications absolutely can arise due to working or stress. But the 3-5% inability to produce enough milk statistic refers to women who have a purely physiological (“body’s fault” to use your own language) reason. That’s 1 out of 20 women who will never be able to supply their baby’s milk needs even if they do everything perfectly. On an average L&D ward of 20 births per day, that’s one baby per day who will starve unless the problem is recognized and the baby is given formula.
      Wow! That’s a significant issue.

  • Young CC Prof

    Reading through the comments, I’ve gotten the impression that the main problem is that so many people believe ANY supplementation either:

    a) Will ruin your chances breastfeeding, or
    b) Will harm the baby in some way.

    I think the key issue is to get the message across that supplementing is OK, one bottle will NOT interfere with breastfeeding. Women with low supply can breastfeed and supplement for months. If a newborn is hungry and there’s no milk yet, it’s OK to give an ounce or two of formula to keep him happy. If a mother is exhausted, another caregiver can use a bottle of formula to let her get a solid block of sleep.

    Supplementing as soon as needed and without guilt or drama might actually INcrease the number of women who breastfeed successfully.

    • Rochester mama

      I think their fear is women will get a taste of the convience of formula and not think breastfeeding is worth the hassle.

      • Wren

        But isn’t breastfeeding supposed to be easier and cheaper?

        • Young CC Prof

          Sure it is! When it works perfectly, which it does… occasionally.

        • Rochester mama

          Cheaper than what? A tub of Similac is cheaper than what I feed a year old in a week.

        • Lisa the Raptor

          I think it depends on your life at the time. Easier if you are a stay at home mom without other kids who need to be tended to? Yes. Easier if you work or school full time and have a toddler on your heels? Prolly not.

          • me

            I found it easier the second time around (with a three year old on my heels) and easiest the third time around (with a 6 year old and a 2.5 year old on my heels). The first time was definitely the hardest. But *everything* about the first baby was hardest for me, lol. Learning curves being what they are. By baby #3 I could pour a drink for offspring the eldest and help offspring the middlest wipe her nose without ever breaking latch 😉

    • Guesteleh

      Totally agree. I was likely never going to be able to EBF my kid, but had I been told it was okay to combo feed, I probably wouldn’t have developed that nasty case of PPD after feeling like I’d failed the first test of motherhood.

    • Antigonos CNM

      I think the message needs to be that there is no reason a baby should be hungry, period. By all means, breastfeed! but should there be, for any reason [low supply, not in a place conducive to nursing, taking care of multiples, whatever], it is a greater fault to let a baby be hungry than to give a bottle, of either formula, or expressed breast milk.

    • Trixie

      It is true, though, that below a certain threshold, which is different for everyone, if you’re not nursing and removing milk frequently, especially in the early weeks, you’re less likely to establish a full supply. Combination feeding is certainly possible, of course, and is a fine thing to do if you so choose.

      • Young CC Prof

        Oh, yes, during the early weeks it is important to try to nurse or pump frequently, to build supply. The pro-breastfeeding movement got THAT idea across. The one they missed is that if supply is building too slowly for the baby’s appetite, there’s nothing wrong with finishing off that frustrating nursing session with a little formula so the baby stops screaming.

        • Trixie

          True, but if you keep doing that every single time, then your supply may not increase at all.
          I found that at the end of that type of session, where the baby is still hungry, that by burping, and taking a few minutes’ break for myself to use the bathroom or have a snack, I’d get a second letdown a few minutes later when we tried again. That’s me though.

          • KarenJJ

            But wasn’t your baby crying for those few minutes you took a break? My baby screamed if I stepped away to use the bathroom and she was still hungry. Or even if I pulled her off and tried to burp her.

          • Trixie

            Sure, sometimes. But that’s not “crying it out” and that’s not what Dr. Amy is talking about in this post. I wasn’t withholding nutrition from my children or causing them to starve or suffer for days. I don’t think she’s talking about making your baby momentarily unhappy because you as a mother also have basic functions to attend to now and then.

          • KarenJJ

            No I don’t think she’s talking about that either. I think part of what breastfeeding advice is missing is advice from people that didn’t successfully breastfeed. Can a mum who suffered supply issues and/or hated breastfeeding become a Lactation Consultant?

            I also got advice like to pump for the first few minutes before feeding my baby or to switch sides repeatedly. My baby was unsettled (mostly) because she was hungry so all this was doing was increasing the hunger and the crying and was distressing for both of us.

            Advice like ‘take a break for a few minutes and come back and try again’ meant that I pulled off an unwilling baby and let her scream while I cried and tried to attend to my needs. I’m sure it could help someone and that is why you would give this advice, but for a hungry baby and increasingly tired and distressed mother, this type of advice doesn’t work. A lot of lactation advice I encountered seemed to come from the assumption of a settled, well fed baby.

          • Trixie

            There’s no requirement that a lactation consultant be a mother at all. In fact one of the best ones I’ve met, wasn’t. For that matter, they don’t even have to be a woman, although in actuality they almost all are.

          • Young CC Prof

            I think the real issue is training. Real medical professionals don’t have to have personally experienced the problems they’re treating, but they do have to train long enough to see the full spectrum of problems, and how they can be solved, or not. Someone who has no experience with tougher lactation problems (or denied them when she saw them) cannot possibly make a good LC.

    • R T

      Especially if you do it like I did! I put a feeding tube against my nipple in the hospital and used a syringe to slowly push out formula while my son nursed at my breast. He never realized it wasn’t coming from my nipple and my milk came in later and he was none the wiser, lol! It was a win, win! He got enough to eat and stimulated my breasts to produce more milk! The Peditrician was really happy! I had such bad GD when pregnant my son got really big. After his birth he wasn’t getting near as much to eat and dropped weight shockingly fast! He stopped once I started supplementing with the feeding tube and we got to go home on time!

    • S

      It amazes me that women’s bodies are expected to endure labor, an enormous physical change usually undergone with minimal food and rest (and often ending in surgery!), and then, with minimal recuperation, somehow suddenly make food for another human being. After all that, no wonder it can take awhile for the milk to come in!

      I don’t know and i had no trouble with supply, but i suspect that in those first few hours, a solid block of rest and a big meal would do more for a woman’s supply than constant nursing, nursing, nursing. It’s not like those hormones just suddenly disappear.

  • Felicitasz

    I like the questions of recent posts very much. Just sayin’. 🙂

  • Allie P

    The head of the breastfeeding center of Washington DC told me that if I supplemented, I might as well give up on breastfeeding. She has me on an insane nurse, pump, then feed the baby the pumped milk through some bizarre straw-taped-to-my-breast system where we ended up losing half of it. This system, by the way, literally allowed for no sleep because of hte time commitment involved (the whole system ran every two hours). But I could not stand my baby crying of hunger. I supplemented, and ended up breastfeeding for 10 months.

    This head of the breastfeeding center of DC also happily sold me supplements and pumps, told me I was to blame for the problems because I was on advil for my episiotomy, and told me all my efforts (my baby was 7 days old) were “too little too late.”

    • Felicitasz

      OMG. It would be polite and appropriate to say “I am sorry” but that is not what I am reading this, I am _outraged_ about your experience.
      Good for you having decided to supp and do as you saw best.

    • Young CC Prof

      Wow, that is completely insane. Why do hospitals allow this kind of thing?

      • The Bofa on the Sofa

        Huh. Amazingly, when I read her comments, my response was, “Wow, that is insane.” Thank you for typing it for me.

    • Guesteleh

      This is what I mean when I say that the profession has a problem.

    • KarenJJ

      I sent my husband to the nurses at my hospital to ask for formula for my baby, as I was done and she was so unsettled. They refused him. It was a low point in my hospital stay with a baby that constantly fed and then catnapped for half an hour before waking up and starting again. She lost 9.9% of her body weight in our 5 day stay after she was born and didn’t get back to her birth weight for 6 weeks (we started supplementing with formula at 3 weeks).

      My supply was also increased using the breastpump, despite the almost constant nursing of my newborn, and yet for the last 12 hours of my stay I didn’t use the pump and was deemed “exclusively breastfeeding” upon discharge. This meant that when I asked for information on pumping the nurse refused to give it to me as it was for those who would be pumping at home…

      There was a lot wrong with breastfeeding advice and “support” I was getting in the hospital and it was NOT because someone was “undermining” my breastfeeding relationship…

    • DiomedesV

      I have yet to see any reason to take any one in the lactation profession seriously. They seem to have no standards of education, training, or background in statistics.

      • Elaine

        I went to a breastfeeding support group at the hospital I delivered at, and continued to attend off and on for over a year. The IBCLC who led that group was great. She tried to help women meet their breastfeeding goals and was always so sympathetic when someone was having difficulties. She wasn’t anti-formula either; I distinctly remember her telling the group that she wouldn’t tolerate anyone being judgey about formula towards moms who showed up with bottles.

        By contrast, even though I was EBFing, I found LLL to be so judgmental towards moms who used formula that I only went to one meeting.

    • amazonmom

      I was told to “suck it up” and that “your baby will love you more” if I just kept up the every 90 minutes cycle of nursing, pumping, and feeding EBM. It didn’t matter that I hadn’t slept at all for 7 days, that I was a begging, sobbing mess, or that my child was obviously sick. When a reasonable person told me they were worried about her and I obviously wasn’t following instructions I told them the nightmare their LC staff put me through and that I was going to feed formula to satiation. I also threatened to have the NICU medical director come down and hear my story. All of a sudden my plans were just fine…. They are so lucky I wasn’t pushed into postpartum psychosis by their crappy advice ( I was later diagnosed with bipolar 2)

  • Zornorph

    When I had the photographer come in to my hospital room the day after my son was born, she remarked at how easy he was to shoot. She said she got a lot of breastfeeding moms whose babies were hungry and the mothers also wouldn’t allow them pacifiers to soothe. My son had a tummy full of formula and I had no problem letting him get his oral fixation on with a paci, so he was a dream to shoot.

  • fearlessformulafeeder

    Like so much of the breast/bottle debate, this is hypocrisy in it’s finest and clearest form. I love what you said about your own crying infant, Dr. A. To this day, other people’s crying infants don’t bother me one bit. But my own? Jesus, I could not handle it. I would sit there and shake, and feel totally queasy. (My husband on the other hand had no problem sleeping through their cries, but that’s another issue altogether…) I would do ANYTHING to make the little monsters stop crying – and in the throes of PPD, this feeling was exacerbated. I’ve never thought about it in this way – the irony of being so adamantly against CIO but dismissing a baby’s cries as a reason for “succumbing” to the bottle – but now that I do, it’s rather infuriating.

    • Kumquatwriter

      Word.. In fact, there’s s fellow Mom right here who used to swap kids with me regularly because its so much easier to deal with someone else kid crying!

    • Lisa the Raptor

      This is universal. My kids cries are like nail files on my spine, but the hubs had to do the CIO while I left the house. And yes we ferbered. After 3 days of 15 minute crying spells it was a miracle. None of my three are damaged or feel unloved or lack the ability to love. They are fantastically loving and tender, all.

  • Guestll

    I don’t do CIO. With that said, I *wish* my daughter had cried more when she was so desperately hungry.
    My supply began to tank at 10 weeks with the return of my period (despite EBF on demand, despite bedsharing, despite having her in a sling during many of her waking hours) and although my daughter cried at first, as the days passed, she stopped.
    Before you judge…I received terrible advice from our then-GP and his NP. We were told to keep it up, that breast was best, don’t supplement. The NP was particularly dogmatic in this regard. I tried a variety of methods to boost my supply, but nothing helped. Eventually went on Domperidone, which helped a great deal.
    I made milk. We had no mechanical issues. Breastfeeding came rather easily for both of us. I just didn’t make enough milk due to very low prolactin levels.
    But my daughter didn’t cry that much, despite not gaining/growing appropriately. I wish she had. And I wish I’d had the fortitude to change GPs earlier in the game.

  • LynnetteHafkenIBCLC

    It’s heartbreaking to see a baby not getting enough calories and their distraught mothers who are avoiding formula because of fear that it will hurt breastfeeding, and by extent hurt their babies (because of formula being less than ideal gold-standard nutrition).

    I am grateful to have been taught that judicious use of formula can save breastfeeding by giving babies enough energy to cope with a low supply (along with stimulating the supply with a pump, which never gets too tired or sleepy to do its job, unlike an underfed newborn).

    Demonizing formula to me is equivalent of a “destroying the village to save it” mentality. We can’t withhold necessary nutrition in service to giving the baby optimal nutrition. Even if the plan had been to exclusively breastfeed, when there is a supply issue, making the baby wait indefinitely should never be on the table. It’s easy not to overfeed formula if you give colostrum-sized amounts on Days 1-3 postpartum if needed. And after that, it is still outright harmful to underfeed a baby.

    People truly educated in breastfeeding support understand the appropriate use of formula for a breastfed baby. Random internet zealots should not be giving medical advice.

    • amazonmom

      I wish you or someone like you had been my LC in the hospital the first time around! Maybe I wouldn’t be so scared of the lactation team if I had good help the first time.

  • Trixie

    Again, though, a lot of this goes back to giving bad information to women who genuinely want to breastfeed. Like, is the baby not gaining because of mom’s supply, or because of, say, an undiagnosed tongue tie that’s impacting mill transfer? Of course the first rule is always to feed the baby. Then you work on figuring out what is going on.

    I’ve been hanging around on BF message boards for many years and I’ve rarely ever seen the advice to let the baby scream in hunger. Or, if it pops up, it gets shot down pretty quickly, even by some otherwise crazily crunchy mothers. So I’m not sure that this is really a thing.

    • LynnetteHafkenIBCLC

      Trixie I understand where you’re coming from; you are right that almost no one would outright say to avoid formula at all costs. However there is an often unspoken message that mothers are getting that formula is to be avoided unless there is an urgent medical need like imminent dehydration. Mothers are getting this impression, whether lactivists mean to give it or not. It’s a side effect of treating formula as harmful, rather than what it is: appropriate food for a newborn who needs more than what he is currently getting from Mom’s breast.

      • Trixie

        I understand what you’re saying. And you are absolutely right that there is a lot of “formula is evil and full of GMOs and chemtrail” on the Internet.

        • SkepticalGuest

          There are also a lot of CRAZY people on the internet. And without meeting them in person, their craziness is not always obvious. When you meet the crazies in person, it’s really painfully clear that they are mentally ill.

          • Kumquatwriter

            AMEN and WORD.

          • KarenJJ

            I agree. I’ve been reading a blog that is outing a serial internet liar and it’s amazing to me to see the sort of stuff someone will make up. Amongst my friends, even the hippy leaning ones, are pretty reasonable and ‘do what works’ in real life.

            After reading that blog I can easily imagine a mum with a baby getting a bottle of formula encouraging others online to do daft things, like use raw goats milk or not feed their baby during a nursing strike in order to get them hungry enough to go back to breastfeeding…

          • Kumquatwriter

            Which blog? I am an avid reader of them.

          • KarenJJ

            Truth about Ruth.

          • Kumquatwriter

            Good one! Have you ever read A Piece of Fakey?

          • KarenJJ

            No, I’ll take a look. I’ve been on the internet for a while and seen a few liars outed but never thought much about what would drive the people behind it all to create such personas or to lie about it all so much. It’s interesting and makes me so much more suspicious about stuff I read on the net.

      • stacey

        I have heard moms told to use RAW goat milk if necessary, but never formula.

        • Mishimoo

          I’ve also heard that it’s better to give breastmilk containing small amounts of alcohol than formula.

          • Trixie

            Occasional moderate drinking is not generally considered a reason to interrupt breastfeeding.

          • Mishimoo

            Which seems somewhat contradictory to me considering all of the public awareness ads we have here about not allowing under-18’s to drink any alcohol due to developing brains.

          • Young CC Prof

            I’m not aware of any evidence that light drinking damages teen brains. (The problem is so many teens don’t stop at one.) And they actually did some tests on drinking and breast milk, and, if I remember correctly, the amount of alcohol in breast milk after one drink is negligible and after about half a day, drops to undetectable. (Of course, if you got dead drunk, you should probably throw away your milk for at least 24 hours.)

          • Mishimoo

            It’s Australia – We do everything bigger here 😉
            But seriously, I’d rather not have our government-released health pamphlets demonise formula. I’d prefer a more balanced approach and awareness about standard drink sizes, and for new mothers to not feel guilty about giving formula if they decide to have a big night.

            (I should probably point out that this is more about some of my friends than myself, as I don’t drink often and prefer a good book to a night out.)

          • Trixie

            It leaves your milk at the basically the same rate it leaves your bloodstream. So unless you’re still drunk 24 hours later, you wouldn’t need to avoid nursing.

            As a milk donor for preemies, I could donate milk pumped 12 hours after my last drink. But my own healthy, full term baby, although I usually had a drink after she went to bed, I didn’t hesitate to nurse during the night if she happened to wake up.

          • Trixie

            The difference is the dose. The % of alcohol that’s in a mother’s milk after 1-2 drinks is less than what’s in a loaf of homemade bread or an overripe banana. The % of alcohol in milk is roughly equal to the morher’s BAC. So with a BAC of 0.05%, the amount of alcohol making it to the baby in 3-4 oz of milk is tiny. Alcohol also temporarily reduces the milk letdown reflex, contrary to the conventional wisdom that beer is good for milk supply. Of course, you shouldn’t be drunk and breastfeeding, but then, you shouldn’t be drunk and caring for an infant regardless of how you’re feeding it.

            Now, of course, out of an abundance of caution, it’s better to usually time drinking so that you won’t have to nurse again for a couple of hours. But it’s nothing to freak out about.

    • antigone23

      I see all the time on various message boards women telling other women to ignore their doctor’s advice to supplement because of excessive weight loss/low blood sugar/jaundice, with the claim that all doctors are just formula pushers and don’t know anything about breastfeeding. They don’t explicitly say to let the baby cry (and many hungry babies just get sleepy after awhile), but it seems to me that the notion that exclusive breastfeeding MUST be maintained is often promoted over the baby’s immediate need for more fluids/nutrition in lactivist circles.

      • Trixie

        This is true. There are also times when women have been given genuinely bad breastfeeding advice. Hopefully, this is slowly improving. I think some of the problem is standard Internet craziness, and some of it is pushback from several generations’ worth of crazy and harmful breastfeeding advice from doctors and nurses. My sister’s mother-in-law was told years ago by her son’s pediatrician that she shouldn’t BF because “her breasts were too large and they would frighten him.”

        I was told only 5 years ago to break my baby’s latch after 5 minutes and switch sides.

        Even more recently, we’ve gone from the older CDC growth charts to the WHO charts — moms of older BF babies who were “falling off the charts” were told to supplement when according to the WHO charts, they weren’t falling off at all.

        Hopefully we can arrive at some evidence-based middle ground.

        • Guesteleh

          I hope that the lactation consultants get better training in general. My personal experience with one was very negative and downright harmful. She was an IBCLC and told me formula was poison, I needed to cosleep to nurse, that my bleeding scabbing nipples were far from the worst she’d seen and that my baby’s latch was fine–which was completely wrong, as I learned a year later when he was diagnosed with a feeding disorder. And I’ve heard similar stories from other women, including one who went to the same LC practice and was berated for “letting them do that to you,” i.e. have a CS. These aren’t crazy LLL moms, these are paid professionals working with hospitals. If they are giving out shitty, ideologically driven advice, then where are women supposed to go for help?

          • Trixie

            Like anything, some are better than others. You got an awful one and I hope you reported her. But I’ve had several encounters with very good ones. Also, not every LLL leader is crazy. And at one time, LLL was really the only place you COULD turn to if you had a BF question or problem. It’s a very recent development to even have IBCLCs in hospitals and attempting to help solve BF problems at all.

          • Guesteleh

            Except that this is THE business everyone in my very large city gets referred to when they are looking for a private LC. She and her partner are nationally famous, speak at conferences, are interviewed for major magazines and newspapers. They are considered the gold standard for lactation consultants. So what does that say about the profession in general?

            As for LLL, I don’t know what it’s like in other places but in my relatively crunchy city it’s crazycakes. Promoting no vaxxing, homebirth, cranial-sacral therapy for infants, etc.

            Your comment reminds me of people who say there are good, responsible lay midwives out there. It’s true, there are. However, when the leading lights of the profession are Ina Mae Gaskin and Henci Goer and the rest of the extremist brigade, the profession has a problem.

          • Trixie

            Yeah, I hope my comment didn’t come across as minimizing your experience. I completely believe you. I’m just saying that I’ve had several experiences with a couple different very reasonable and non-judgy LCs. I’m in the suburban Northeast corridor, if that matters.

            It may be that most of the people who are not crazy who, 2-3 decades ago, would’ve become LLL leaders, are now seeking actual training and certification and employment as LCs. I’m just trying to point out the dearth of information that existed just a generation ago, if you were trying to breastfeed your baby and ran into a simple problem. LLL was really the only place to turn. My mom was an LLL leader when I was young, and she’s not crazy. She vaccinated us and believes in science! Mostly she just tried to help people with things like inverted nipples or babies who refused to nurse on one side, or just reassure them that cluster feeding was normal.

            Much like, when I was born, your hospital birth was all but certainly going to involve being separated from your husband, mandatory shaving and enemas, paternalistic doctors, and being separated from your newborn much of the time. Although crazy, the homebirth movement — at that time — had some valid points about how women should be treated in labor and delivery. Now, women have spoken, and that’s no longer the case. But the homebirth movement has to keep making crazier demands to keep themselves relevant. Perhaps that is what has happened to LLL as well.

          • LynnetteHafkenIBCLC

            Also, LLL literature is very clear on the dangers of underfeeding a baby. Leaders are trained never to give advice, but to share accurate information from the book that has been vetted by experts and to encourage mothers to dialog with their pediatricians. Individuals who attend meetings but are not Leaders are not constrained by rules against giving potentially dangerous advice.

          • Trixie

            Great points. I grew up being dragged along to LLL meetings and I don’t remember the type of craziness people are describing here. This was before the internet, though.

          • Lis

            The internet can be a blessing and a curse when it comes to information.

        • slandy09

          A pediatrician told me to only nurse my daughter 15 minutes per side every 2 hours because “longer than that and she’s just using you as a pacifier”. My daughter ended up losing weight and my milk supply in jeopardy because of this advice. We only found out because my lactation consultants offered free weight checks, and my mom was curious to see how much my baby weighed. When we saw that she had lost weight, I was brought in right away for an appointment. The IBCLC was no-nonsense–she told me to feed the baby every chance I got, even if I just fed her. I also rented a pump and was told to bring DD back in a few days for a weight check. I was also told to prepare for the possibility of supplementing with formula if she didn’t gain enough in the next few days.

          Once my daughter realized that she didn’t have a deadline for nursing, she nursed like a champ and gained like crazy. I hardly had to use the pump. You see, DD was born at 37 weeks and was a sleepy eater, so feeding sessions took forever. Thankfully, things got easier as time went on.

          I never ever went back to that pediatrician. I still feel bad that I took his advice, but my daughter is thriving and happy.

          • SkepticalGuest

            That’s just ridiculous. Babies continue to need more milk as they grow, and the way they tell mom’s body to make more is by clusterfeeding and nursing for really long times.

            You’re lucky you were able to switch peds!

          • AL

            I had a pediatrician like that here in Los Angeles who said the same thing. I took my son in for another issue, and he gave me the 15 minute rule thing because “any longer than that would damage breast tissue.” Huh? Fortunately I had read other articles, and my sons other pediatrician made no such suggestion and was a mom of two herself. He also told a coworker of mine that you shouldn’t give solids until the baby is a year because it will cause obesity. He is still at the same practice where my boys pediatrician is, but I can guarantee if my kids need to see a doctor last minute due to an illness and he’s the only one available, I pass and go to urgent care instead.

          • Trixie

            Yeah, my kids were both frequent nursers, too. And what people don’t realize when they give this “15 minute per side” advice is that a mother might have gotten a second letdown of even fattier at, say, 16 minutes.

    • SkepticalGuest

      Trixie, I have to say I agree with you. Because my son at a lot of feeding issues, I networked extensively with other breastfeeding moms in the early months. I’ve probably met no less than 100 different moms from support groups, breastfeeding classes, generic playgroups, local listservs.

      And you know what…I have only known TWO moms who really were starving their kids. Both moms were CRAZY. One was actually at risk of having her child taken away. Last time I saw her, CPS was investigating. The other was a stark raving lunatic but off the CPS radar.

      Yes, both moms were super-woo lactivists. But even that is not enough to drive most moms to starve their babies. You need the philosophical underpinning of natural parenting AND you need to be truly coming mentally unhinged. But really, I think the philosophical stuff is just a cover for the CRAZY.

      • Pillabi

        Here (in Italy) women are sometimes told by nurses or midwives IN HOSPITAL that “if you supplement ONCE your baby will NEVER latch anymore because bottle is much easier than nipple”. And I’ve actually met a woman who was very proud of not having supplemented her baby for 18 DAYS until she eventually got breastmilk. And she was so thankful to her husband for supporting her in this choice, even against the advice of the rest of the family. The problem is, she was not a lunatic posting on some internet board, but a mom speaking at the public launch of a breastfeeding support group. Great, uh?

        • araikwao

          18 days???! How was that baby still alive on a few ml of colostrum at a time?

          • amazonmom

            I have no idea. My kid looked horrible after 7 days with only a few mL of food at a time, and had lost 16 percent of body weight! I’m guessing that mom had more in her breasts than I did!

      • thepragmatist

        No, you don’t have to be crazy. You just have to be surrounded by people insisting that to be a good mom you need to breast feed, and have to really, really want to be a good mom, and be a first-time mom. That’s how my son starved. I know other mom’s who went through similar. Of course, none of us would EVER miss FTT again, but we were first time moms, and we were JUST FOLLOWING INSTRUCTIONS! Here it is a high pressure environment. Breast is best. It’s everywhere.

    • Wren

      In my case it wasn’t a newborn, but a 9 1/2 month old who adamantly refused the breast after illness (hand, foot and mouth, with very painful mouth blisters). I had a number of members of a certain forum suggest I refuse him all other food and drink until he gave in. I couldn’t starve my child though. I tried pumping and contacted both LLL and lactation consultants. I couldn’t pump enough, even with a hospital grade pump, when I was looking after a very busy toddler full time. When I gave in and bought formula,me backlash from these same people was horrible. Yes. It certainly does happen.

      • Trixie

        Well, that’s horrible and crazy advice. Clearly you made the right choice.

      • me

        God that’s ridiculous. Who could think of starving a sick baby? My oldest had a nursing strike at about the same age as yours. I just continued to give her her regular meals of solids, and pumped milk (just pumping what I needed to in order to not get engorged). In a little over a day she was happily nursing again (she had a head cold, the stuffy nose made nursing difficult for her, once the nose cleared enough, she was a boob-aholic again).

        Same thing happened recently with baby #3. Head cold, didn’t nurse for three days. Now, she is over a year old, so I didn’t bother pumping, just gave her cow’s milk along with her regular solids and water. Once the cold was gone, she wanted to nurse again.

        Oh, and my failure to pump (pure laziness on my part) didn’t result in my milk drying up. Supply did diminish somewhat, but it’s back up to where it was before.

        And if either of them had never gone back to nursing? Oh well. I had gone about 9 mos with my first and about 15 mos with my third before these strikes happened. Yes, I’m glad they went back to nursing, but jeez, the way I saw it I had already ‘done my duty’ so to speak wtr bfing. Why would anyone feel bad about that?

        • thepragmatist

          My son weaned himself around 18mos, but prior to that we took hiatus from breastfeeding so I could trial a med for bipolar. I didn’t want him exposed. It failed. My supply went back up as soon as I put him back on the boob. Later, way later, my ex and I separated amidst a ton of terrible drama, and you know what, my son wanted the boob again. And viola, it made milk. I am duly impressed.

          Still couldn’t EBF though. Ever. Weird. But I bet I could relactate in a natural disaster enough to share my breastmilk with a newborn, so I should please the LLL.

    • Becky05

      Actually, I think this advice is *very* common. For instance, mothers are regularly told “Your baby doesn’t need anything more than your colostrum” even when baby is obviously unhappy and hungry. Books and websites may say, “There’ll be some hungry days, but they build up your supply,” without the consideration that a “hungry day” is likely damn miserable for the baby. I could list many more very common examples.

      • Trixie

        I think there needs to be a distinction between a normal growth spurt/cluster feeding day and a baby who actually isn’t transferring enough milk. Which again, goes back to poop and weight gain. A baby who is acting hungry and wants to nurse frequently isn’t a problem if the baby is growing and pooping enough.

        • Becky05

          “A baby who is acting hungry and wants to nurse frequently isn’t a problem if the baby is growing and pooping enough.”

          Even if baby is miserable and unhappy?

          • Trixie

            Formula fed babies get unhappy during growth spurts, too. Sometimes babies get unhappy. If the baby is still miserable despite getting enough to eat, then maybe there’s another problem going on that needs to be addressed. I’m not talking about a mother with low supply withholding nutrition from her baby.

            My last baby was gaining about 10 oz/week for the first couple months. She was clearly not underfed. She was still unhappy and wanting to nurse frequently during her 3 week growth spurt. Every time she nursed, she got plenty of milk, and was gulping loudly. Are you saying I should have given her formula?

          • LynnetteHafkenIBCLC

            Trixie, do you think you might have had oversupply? That can make a baby almost as miserable as a low supply.

          • Trixie

            Oh, most certainly! Which is why I became a donor to an HMBANA milk bank. At my peak I was pumping 12 oz at a sitting, first thing in the morning anyway.

            Looking back, I’m sure I had it with my older child, too. He was fussy and gassy, and would nurse to soothe himself, then get gassier, etc. But he was never a fast gainer (although his diaper output was upwards of 100/week), so I dismissed the idea that it could have been oversupply. Now that he is 5, and still very slim, and still consuming huge amounts of food, I realize that’s just how he’s built.

  • Mel

    So my twin sis and I were 28.5 week premature. After my lungs started working, I had a pretty uneventful journey to healthy baby land.

    My mom said the hardest part was keeping to the feeding schedule while we were in the hospital. I wanted to feed about every 2 hours but was only allowed to be feed every 3-5 hours so my digestive system energy needs wouldn’t overwhelm the rest of me. Mom got the rationale behind it, but she said it nearly drove her crazy to try and comfort me while I screamed my guts out for 0.5-2.5 hours until the next allowed feeding. Mom mentioned in the journal she kept that she kept wondering if a) the amount of crying was using more calories than the digestive process could and b) if my slow weight gain was affected by the crying jags.

    Once I was home – at about 6 weeks after birth, the neonatologist said to continue the 3-5 hour feeding schedule while the pediatrician said feed on demand. Mom went to feeding on demand. I went from very slow weight gain to growth spurt within a week and caught up with my size for gestational age within two months.

    • amazonmom

      In that situation I would inform the physician that the baby is inconsolable and ask what we could do.

      • Mel

        She did. Repeatedly. It was viewed as an unfortunate side-effect of not dying from too much energy being re-directed from the digestive process. (It was also 32 years ago – some premature cousins of mine had a less scheduled feeding schedule)

        • amazonmom

          I should have been more clear. I meant in my role as the NICU nurse. When I hear from older colleagues what used to be done to babies I cringe! It’s never a parents job to notice problems in the NICU and I’m sorry my message read that way.

          • Mel

            The nurses were on Mom’s side :-). It was the neonatologist who was afraid of feeding leading to death…. which made some level of sense, especially when we were more fragile.

            In my baby book, Mom has pictures of all the NICU nurses who had us as patients. Mom and Dad have always been so grateful for all of the hard work the nurses put in keeping us alive. Plus, the nurses had a polaroid camera so they could catch “cute” moments that happened when Mom and Dad were gone. One of the nurses caught me sucking my thumb for the first time!

    • BeatlesFan

      My husband was born premature- not as early as you and your twin, but at 32 weeks, near 35 years ago. My MIL has mentioned (numerous times) that his stomach was so tiny, he had to eat every 45 minutes. I can’t imagine how hard it must have been for your mother to try to space your feedings out so much!

  • S

    “I’m not aware of a single lactivist or attachment parenting blogger who
    sees anything wrong with letting a hungry breastfed baby cry it out.”

    Do they explicitly say that it’s normal for a hungry breastfed baby to cry?

    I think a bigger problem is the idea that if a breastfed baby ISN’T crying, then mom’s breasts must be making enough milk, which isn’t necessarily true. Or if he does cry, the solution is to nurse him more (which is fine if your milk is about to come in, but otherwise the baby’s expending energy and getting no calories in return).

  • MelodyCason

    Though I planned to breastfeed, both of my children got bottles while I was in the hospital. The first got one because I was in a lot of pain and needed a break. The second got one because he was very hungry, and would latch on and pop off and scream, when he had previously been eating like a champ and appearing satisfied. After a few minutes of struggling to get him to latch, I paged the nurse for a bottle. He drank it down and slept peacefully for the next 6 hours. I tried to wake him to feed him, and when I was unsuccessful, the nurse told me with a *tone*, “It’s probably the formula.” With my first child, the nurse told me that letting my daughter drink the whole 2 oz bottle would hurt her belly. It didn’t. It’s amazing to me the grief I got from those in the medical profession for making sure my babies were fed. With my first, I wasn’t going to sit there in pain to feed or let her go hungry because I didn’t want to feed, and with my second I wasn’t going to let him scream himself to sleep just because there was nothing in my breasts for him to eat at that feeding. BTW, with my son, I resumed breastfeeding the next feeding and kept breastfeeding successfully for the next 6-8 weeks. So there. And also BTW, we do CIO for sleep training in our family. I do not do CIO if they are hungry, poopy, or sick.

  • amazonmom

    The only thing that still makes me upset about my daughter’s birth is the lactivist that lied about my screaming, suffering daughter’s weight loss so ” you wouldn’t stuff formula down the baby like all the NICU nurses do”. It still brings tears to my eyes when I think about it. My clinical skills helped me see through the lies, another parent might not have been able to see what was happening.

    For my son’s birth next month there will be no lactation staff welcome in my room unless I ask for them. I will not be taking him to the “postpartum care center ” that is staffed by lactivists. I will pay cash for a real provider to follow up with me and my baby if my insurance won’t pay. That’s a real possibility because I work for the hospital where I am delivering and they want to spend as little as possible. This will be a big battle because after all I work for the first Baby Friendly hospital in the United States….

    • Bombshellrisa

      So how do you let the lactation staff know you don’t need them? I am giving birth in February at a hospital which sounds like it has “baby friendly” aspirations (which is incredibly disappointing to me. What kind of practice puts the book “The Womanly Art of Breastfeeding” as part of a “required reading list” for patients?)

      • LynnetteHafkenIBCLC

        “Thanks for the offer to help, but we’re doing fine with feeding.”

      • Josephine

        I would sincerely like to know as well. I was actually going to ask people for suggestions on how to “arm” myself against LCs/breastfeeding pressure at my otherwise great “baby friendly” hospital. I really just want to make a sign saying “No LCs please”, but I don’t want to come off as hostile/difficult.

        • rh1985

          I would like suggestions as well. I’m planning to ask my doctors for it to be put in my chart in huge letters and also to try and have someone there in the room with me to chase unwanted people away but if anyone has any more suggestions please post!

      • amazonmom

        I’m going to a pre op visit where you go over your birth plan with an RN. Hopefully they will not harass me over the feeding plan I have worked out with my psych provider. I’m planning on using the fact that I’m already trained in infant feeding to help my cause. I also have a hubby that will help me toss out people!

  • Young CC Prof

    Good point! Yes, all babies lose weight the first week, and a one-day-old might not need terribly much to eat yet. Yes, some women who have a low supply at first will produce more milk if they keep trying, and it’s good to know that. However, the first priority is NOT making breastfeeding work, but making sure the baby is properly fed.

    All mothers of newborns, especially those relying exclusively on direct breastfeeding, should be aware of the signs of an underfed baby and watch out for them. If the baby needs less than a dozen diaper changes a day, if he continues losing weight past the first week and doesn’t return to birth weight within 2-3 weeks, your baby might not be eating enough. (Or might be sick, totally separate problem.)

    • Jessica

      Brick dust, too. My son lost 11 ounces in his first three days of life. We were supplementing with donor milk through the SNS (horrible and annoying), then supplemented with the bottle after each (failed) nursing session. He would suck on the nipple and didn’t appear to be drinking much, so we weren’t quite sure what was going on, as he still had wet and dirty diapers. The red discoloration in his diaper confirmed that he was actually dehydrated and not transferring milk at the breast or from the bottle. That was when my husband poked a hole in the nipple of the ONLY bottle we had on hand (b/c you don’t need bottles on hand if you’re going to nurse, right?) and suddenly baby could EAT. He wolfed down 2oz and had the most blissed out milk drunk look on his face when he was done.

    • Pillabi

      a dozen diaper changes?

      • Burgundy

        Yap. That sounds right.

        • Pillabi

          I’d rather say half a dozen…

          • Trixie

            Yeah. A dozen? Maybe, maybe with cloth. But disposables hold a lot.

          • araikwao

            We’re advised 8-10 cloth or 5-6 disposables 🙂

          • Dr Kitty

            But not poop. My EBF daughter had about 6 bowel movements a day, every day until we started to introduce solids. Nothing wrong with her, just the way she was. Even now, aged 4 she’s a twice a day pooper.
            We were on 10 pampers a day for the first six months.

            My own bugbear is explaining to new parents that their infant doesn’t have “diarrhoea”. It’s supposed to be loose, and yes, sometimes it will go up their back and out the leg holes. Sorry, no, the kid doesn’t need something to “bung it up a bit”.

          • Burgundy

            My young one finished a box of 72 diapers in a week when she was 1 month old. She hated dirty diapers and would scream as soon as the diaper was a little wet. Now she is 17 months old and already attempt to change the diaper herself. I am going to try potty train her this long weekend and see what happened. Now she uses about 7-10 diapers a day.

          • SkepticalGuest

            Good for you! My son was the same way. Starting easing him onto the potty by 19 months. Other moms used to try to offer me tips to get him used to a dirty diaper, but I went the other way–use it to your advantage to potty train early.

            It’s slower going when you start younger, but it’s SO exciting for you and for your child. And totally worth it to be Done With Diapers!

          • stacey

            I was told I should wait, until he was “ready” (even after he trained himself, then reverter upon babes arrival). No thanks. The extra month or so it took was well worth it.

            I will say training early has one big downside- they have itty bitty bladders so when you go out, you have to be ready to stop on the side of the road, and hit every bathroom in the city. I carried a little potty with me, it was just easier. Still, better than diapers.

          • Pillabi

            Both my kids were ok with about 5-6 changes a day from the beginning on. That’s why I thought “a dozen changes a day” could be a typo, but perhaps it wasn’t.

            Anyway, good luck with your WWE = wet weekend! 🙂

          • Mel

            My husband was potty-trained at 18 months. He hated being dirty and seemed “to be relieved when I taught him to use the potty” according to my MIL.

          • stacey

            Good luck! My DS trained himself at 18 mo, so you could have lots of success. He did revert back when we had DD a few months later, but was re-trained in short time with bribes (candy or treats for pottying). A little effort, but way better than all that time changing diapers.
            Just wish DD would be so interested.

          • Anka

            I’m glad to hear this! My 4.5-month-old hates dirty diapers too and screams as soon as he urinates and feels it, and we’ve been going through 30 diapers per day for the past couple of days. I’m so glad we decided on disposable, even though the cost is worryingly high for us, because I can’t imagine trying to keep up with him with cloth ones, especially since one of their “advantages” is feeling the wetness faster. I hope he’ll be like your daughter and be very interested in potty training too!

        • LynnetteHafkenIBCLC

          In the newborn period, weight loss/gain and amount/color of stool are much more reliable indicators of baby getting enough milk than wet diapers. The body will continue to produce urine even if milk intake is inadequate.

  • Amy M

    Serious question: How long will a hungry newborn cry before it is too exhausted/weak/hungry to cry anymore? My children were very sleepy newborns, and we actually had to wake them to eat for the first 2 wks, else they would have lost too much weight. They didn’t cry for food. They were also born at 36wk gestation, which is why (I assumed) this was the case, but I have heard of it happening with some full term babies as well. It seems that a newborn could quietly starve, because it could become too weak to cry, so the mother wouldn’t be getting the age-old signal that it was hungry. If she was breastfeeding, and the baby appeared to be latching sometimes, she might not realize it wasn’t actually getting anything until it gets weighed. Would/Could this be a reason that some avid breastfeeding activists would say that hungry newborns aren’t crying it out? Because they aren’t actually crying?

    As for the older babies, I think that nursing strike thing is ridiculous. If the baby is old enough to be eating solids, is not refusing food due to being sick and has decided it is time to wean, then wean. Forcing it to continue nursing is unnecessary and taking away the agency of the child.

    • amazonmom

      My daughter screamed her head off until the jaundice started. She was lethargic and a poor feeder, and her cries became feeble. That’s when my nurse self decided I was going to supplement as I wanted and to hell with the lactivists.

    • Trixie

      You mean, if a 6 month old stops nursing for a couple days because of teething, just wean it and feed it solids instead?

      You can’t force a child to nurse who doesn’t want to nurse. But generally the thing that’s bothering them (cold that makes it difficult to nurse and breathe, teething pain) resolves within a few days.

      • Amy M

        No, I was thinking more of a 12 month old and up. I should have clarified, sorry.

        • Trixie

          Ah, okay, makes sense.

          “In nature,” a 12 month old who weaned suddenly might not have had a great outlook, especially if other food sources were scarce or unreliable, and no animal milk was available. But somehow that has translated into Internet wisdom of “babies can’t self-wean before age 2.”Which is silly.

          • Young CC Prof

            My mother liked nursing, one of us was mostly breastfed and one was exclusively breastfed, and she says we both gradually lost interest around 12 months, once we started to really explore the wonderful world of finger food. (After all, not only can you eat it, you can fling it around the room, which is like toddler nirvana.)

          • Trixie

            Yeah, it also depends on whether you continue to offer at certain times of the day or not. I self-weaned around 18 months. My sister not until 3. My son self-weaned around 20 months, although I had limited to just nap and bedtime for several months beforehand. He climbed out of the crib, weaned, and stopped napping, all in the same week! Fun times!

          • thepragmatist

            Yes, my son ABSOLUTELY self-weaned. He became very interested in solid food and had a complete diet. He did go back to the breast for comfort for a few months, later (about 2.5) but he was steering that ship, not me.

    • m

      But crying isn’t the “age old signal” anyway. IIRC the advice is that crying is a LATE hunger sign. You should be looking for a baby rooting, sucking her fist, licking her lips, etc. If the baby is crying, now you have two problems – you’ve got to calm the kid down enough to get her able to latch on, then you have to feed her. Also, IIRC, the advice is to go no more than 3 hours between feeding (with one 4 hour stretch at night), especially in the first week.

      And this is the issue I have with the post in general. I’ve never seen a lactavist suggest a baby should CIO. Quite the contrary – they make it out that if your baby cries at all you’ve done something terribly wrong. Don’t get me wrong, that’s certainly not a better viewpoint (especially for a PPD mom with a colicky baby), but, yeah, most lactavists get the message out that crying is a late hunger signal, if you wait til they cry, you waited too long.

      Oh, and since weaning is gradual and would barely be noticed by the mother until close to completion, I can only assume Dr Amy means nursing strikes when she writes of babies attempting to “wean”. While I don’t advocate starvation in either case (!), nursing strikes are definitely different than weaning and it is not unreasonable to handle them differently.

      • Wren

        My son outright stopped at 9 months. It started when we both got hand, foot, and mouth but he was absolutely unwilling to go back. I tried everything short of starvation to get him back on to the breast but he was done.

        My daughter was weaned by me at 35 months when I told her she drank all the mummy milk, offered her the slow side while very deliberately thinking about anything but my (very big) baby nursing. She tried for about 10 seconds, got nothing and that was it. She’s 6 now and still talks about it from time to time, but never asked again.

        My daughter weaning was certainly easier than my son, but both were equally effective in ending the breastfeeding relationship.

      • S

        I have a similar issue with the post. Yes, the end effect of starving babies is that some of them end up crying. (Not all of them do. I think it is important for new parents to understand this, not to panic them but just as a reminder to monitor the diapers and keep those well check appointments.) But from what i’ve seen, lactivists either (1) won’t admit that this can happen, or (2) insist that mom just needs to nurse more, or give homeopathic colic tablets, etc. They’re not arguing that crying is okay in this instance. There’s no hypocrisy. There’s blindness, dishonesty, and nonsense, but no overt hypocrisy.

      • Amy M

        Ok, that’s fine, I was never told that, and my babies didn’t do much in the way of signaling, at least at first. As newborns, they slept until they woke up and started to whimper at which point, I fed them, which was about every 3hr anyway. When they were older and spent more time awake, we (all the caregivers who fed them) were aware of their cues and routines and by then, they rarely got to crying to eat, except maybe in the night when everyone was asleep first and the crying cued us that they had woken up. But they’d calm down when they saw us, so it wasn’t a problem. I’m not really seeing the issue here…its not like they were crying for an hour before they got fed, maybe as much as 3 or 4 minutes, if that. So what? Is that only relevant to breastfed babies? Like if they are crying they won’t latch or something?

  • I have a problem with the “Good Mother” narrative – and find myself rather annoyed with the propaganda around birth and mothering. By promoting breastfeeding and normal birth – what are we telling those who need or choose the alternatives? We’re telling them that they are “Bad Mothers” – we are buying into the idea that their autonomy and their decisions do not matter. That what is best for an individual mother and baby does not matter if it does not help to meet the broader goal of increasing breastfeeding rates and lowering cesarean rates. We are also – by extension – saying we do not care about undernourished babies, we do not care about severely disabled babies, we do not care about traumatized mothers, we do not care about informed conset…we care that people do everything they can to avoid a cesarean or the use of formula. Seems silly to me. Too bad it is as harmful as it is.