Through ignorance and ideology lactivists hurt women and babies

Adrienne 1

The stories about your experiences with natural parenting and guilt have started arriving in my inbox and they are by turns amazing and distressing and often both. One story struck me so profoundly that I asked permission of the author, Adrienne, to share it with you. It is an object less in how lactivists in their ignorance and commitment to the ideology that “every woman can breastfeed” cause harm to both mothers and babies. Thank you, Adrienne, for your submitting your eloquent and powerful story. I’ve excerpted your story below, but posted it in its entirety here. I hope that by reading it lactivists, lactation consultants, obstetricians and nurses can learn to be more knowledgeable and compassionate.

I found out I was pregnant with my first child in January of 2008. Despite being only 19 years old at the time I knew from the start that I wanted to breastfeed her. I asked my doctor about my breasts, they aren’t like other women’s breasts. One is long and tube shaped (kind of like a golf ball in the end of a tube sock); the other is prepubescent flat; my areolas are huge in proportion to the rest of my breasts. I was told that all breasts make enough milk, no matter what the size or shape.

My labor with her wasn’t how I had imagined. Never in my wildest dreams did I think it would be so hard. At the 21 hour mark I got my epidural; I had been begging for the epidural since hour 8 or 9 but was told I couldn’t have it because they didn’t want to “stall” my labo. She was born “sunny side up” and I tore badly and hemorrhaged. I barely remember seeing her for the first time, let alone holding her or breastfeeding her. She was supplemented with formula from the start and after a few weeks I gave up, thinking that I wasn’t successful at breastfeeding because I just didn’t try hard enough (I really didn’t try that hard at all).

The hospital staff and my OB were extremely supportive of me. My daughter’s doctor was a different story. During her 8 week appointment he asked me if I was still breastfeeding. I told him I had stopped breastfeeding two weeks prior when I had a second hemorrhage. He was aghast. He told me “you should go back to breastfeeding, it’s not too late, just cut out the bottles! You’ll love it, she’ll love it, and putting her needs over your feeling tired is what being a mom is all about”. I was crushed.

My daughter grew normally and rarely got sick until just after her first birthday. She started getting recurrent infections and would frequently lose weight (10-15% of her body weight at times). She was tested for every condition under the sun. Every test came back normal. During this time I received a few comments along the lines of “if you had breastfed her, her immune system wouldn’t be so weak”. These comments NEVER came from her care team, the staff at the children’s hospital .

In December 2012 I found out that I was expecting my second child. This time I was 100% committed to breastfeeding, I convinced myself that my son wouldn’t go through what his older sister went through, that if I breastfed him he wouldn’t get sick the way she did. My pregnancy with my son was complicated. I went into preterm labor at 29 weeks. Thankfully, the doctors and nurses were able to stop my contractions. I went into preterm labor several more times, but my son stayed put until 39+4.

Labor with my son, Harrison, was the complete opposite of labor with my daughter. My labor was 4 hours, start to finish. I didn’t hemorrhage this time and I immediately had skin-to-skin time, he latched like a champ and breastfed for the first time about 20 minutes after he was born. I just knew that this time things would be different, and I would be able to give him the strong immune system that I didn’t give my daughter.

Before we were discharged the pediatrician told us that had lost just under 10% of his weight and was mildly jaundiced. He assured me that he probably lost the weight because he was jaundiced and to wake him up to feed every 2 hours, round the clock.

We went home on a Saturday and the public health nurse came for a weight check the following Monday. He had lost another two ounces. She assured me that it can be normal for jaundiced babies to take a while to gain back to their birth weight and that my milk was just late coming in. He was having enough wet and dirty diapers (barely) so she said to just stay the course.

A few days later I was concerned because he looked more jaundiced to me so I took him to his doctor. They tested him and his bilirubin levels were in the 280s (μmol/L). His doctor gently suggested that I think about supplementing Harrison’s feeds with formula. I pleaded with his doctor to let us try a little longer and his doctor reluctantly agreed, but I had to bring Harrison back to retest his bilirubin levels every second day.

During this time I was completely convinced that I was doing something wrong. I saw the lactation consultant almost every second day trying to perfect his latch, I pumped after every feed, I chugged water like it was going out of style, I took supplements, I tried everything and nothing worked. Still, I plowed forward, blind to the fact that my son was suffering because of my desire to exclusively breastfeed him.

At his three week appointment he was still 4oz below his birth weight, he was dehydrated and his fontanel was sunken, he never cried (he didn’t have the energy), and his bilirubin levels were still in the 280s. He was starving. His doctor sat me down and said that I had to either start supplementing immediately or we needed to admit Harrison for IV hydration. I cried harder than I ever had before as I gave him that first bottle.

I started looking online for a reason why and I stumbled across the blog “Diary of a Lactation Failure”. Suddenly it all made sense. I had every marker for IGT [Insufficient glandular tissue, explanation and pictures here]. Every single one. I went back to the lactation consultant and asked if I had IGT; yes, she had thought that for quite some time. To her credit she was amazingly supportive. She told me that supplementing didn’t mean that I couldn’t have a breastfeeding relationship with my son. She gave me the tools to make a homemade SNS [supplementary nursing system], and recommended domperidone. I was on the maximum dose, but it didn’t do much to increase my supply. I also found the IGT and Chronic Low Milk Supply support group on Facebook, that resource has been the most helpful of all!

During those three weeks I was told by everyone (except for the hospital lactation consultants) that I should be pumping more, that I just needed to put him to the breast more often, that it was because I gave him a paci, that it was because I had an epidural, that whatever I do, I should NOT supplement. Everywhere I turned the message was the same: I just wasn’t trying hard enough. I felt guilty for starving my son while trying to exclusively breastfeed him and I felt guilty for supplementing with formula.

I had joined a few mainstream breastfeeding support groups on Facebook; the “support” I received was downright abusive at best and dangerous at worst. If I asked a question about how to maximize supply with IGT, they’d tell me to go somewhere else, that I was “fear mongering”, and that I didn’t belong in their group if I supplemented with formula. Their scary advice was suggesting that I take donor milk from strangers on the internet, because surely that was better than the “poison” I was feeding him. Several women suggested that I make my own formula using goat’s milk, chicken broth, raw egg, and some other ingredients, because apparently a recipe given to me by an untrained stranger on the internet containing raw egg was better than formula.

Now I realize that the people propagating the idea that if you have been unsuccessful at breastfeeding then you’re simply not trying hard enough are dead wrong. If only those women could have spent 24 hours on my schedule. My son had to be fed every two hours. After breastfeeding without, and with, the SNS I would pump for 20 minutes. Then I would clean my pump parts and prepare the SNS for the next feed. Each feeding session took about 1.5 hours; I only had thirty minutes between each session to sleep

I kept up that rigorous schedule for months. I felt like it would have been selfish for me to back off, that it didn’t matter how tired I was (emotionally, mentally, and physically). One day when my son was six or seven months old, my daughter broke down crying. She asked why I never spent any time with her anymore and why I didn’t love her anymore. My desperation to exclusively breastfeed had not only hurt my son, but it had hurt my daughter; not only had I been blind to my son’s suffering, I had also been blind to my daughter’s.

The message from lactivists is that breastfeeding makes you a good mom and not breastfeeding makes you an inferior mom; this message that made it difficult for me to see the damage I was causing to my children in my quest to exclusively breastfeed my youngest. If breast really is best, then it shouldn’t hurt the baby you are trying to feed or your older children. So, if it was hurting my children, maybe breast isn’t always best after all. Maybe what is best is dependent on the situation.

This realization was incredibly liberating for me. I stopped pumping the day my daughter broke down, and everyone was a lot happier for it. I still breastfed and I still used the SNS, but I also began bottle feeding my son so that I could share feeding responsibilities with other family members. I was able to give my daughter the time she deserved and I was able to give myself the time I deserved. The realization that exclusively breastfeeding (or relentlessly striving for exclusive breastfeeding when circumstances beyond your control make it impossible) wasn’t what was best for my family opened me up to the idea that maybe it isn’t always what is best for other families either.

I have learned so much from trying to breastfeed and the struggle to come to terms with the fact that my body just can’t make enough milk. I have learned that I am irreplaceable as my children’s mother because no one can love them like I do, no matter how much milk I do or don’t make. I learned that a mother’s reasons for choosing formula or breastfeeding are absolutely none of my business, and I don’t get to judge whether or not their decision is “valid”.

I have also learned that, while breastfeeding is natural and wonderful, it is not perfect. Breastfeeding doesn’t always work perfectly and that’s ok too. My breastfeeding relationship with my son may not be “perfect”, but it is perfect for us.

Adrienne 6

  • Stephanie

    I remember being lectured by a pediatrician rounding in the hospital on my son two days after his birth. Breastfeeding was going horrendously (my milk didn’t come in for 4 days after his birth), and he was HUNGRY, obviouslyl and cried nonstop. I told the pediatrician that I had broke down and given him formula in the middle of the night (there was no way I was going to let my newborn be hungry), and he gave me the whole ‘breast is best’ lecture. As a new mom I was exhausted, terrified, and vulnerable. I didn’t respond, but looking back it pisses me off. I had PPD that went undiagnosed for months, and I had signs in the hospital- absolutely no appetite after giving birth, tearful, etc. The PPD was worsened by sleep deprivation and a baby that needed to feed every 45 minutes. That pediatrician did not take the time to consider that I had no clue what I was doing, that my fiance and I had spent the 48 hours since our son’s birth walking him around the room trying to console him, that I was falling asleep with my newborn in bed with me on accident because I was so exhausted I didn’t realize he was there (I cringe at what could’ve happened), that not one staff member had asked if I was eating, if I needed maybe two hours of unbroken sleep? But not to worry, they asked me nonstop about breastfeeding. My fiance ended up begging the nurses to let him take our son in his bassinet to an empty room so I could sleep for an hour.

    I didn’t mean to rant, but damn this pisses me off. How is it safe in any way to send new parents home on literally a couple hours of sleep? Shouldn’t the baby’s safety take precedence over breastfeeding? I combo fed my son for three weeks, then let my milk dry up. I did not enjoy breastfeeding, we never got a latch that wasn’t painful, and because of the undiagnosed PPD I wasn’t eating enough, so I don’t think I was producing enough. Our son was a terrible sleeper (at 13 months he still doesn’t sleep through the night) and it was so great that my fiance could bottle feed him at night so I could sleep. I definitely could’ve tried harder, and at times I have a lot of guilt for not doing whatever I could to breastfeed.

  • dixiegirl3179

    After reading this, I feel incredibly blessed that virtually nobody I knew in real life had any sort of opinion on the way I chose to feed my son. I can only recall one person having anything to say about it, but she also tried to tell me that if I had given birth naturally at a birthing center, I wouldn’t have had a c-section, so I didn’t give her opinion any weight. I didn’t even try to breast feed. I just didn’t want to. My best friend exclusively breast fed both of her kids and even she didn’t say anything negative to me about it. I’m sorry that the author of the story had to go through that.

  • Sue

    Thanks for sharing so frankly! From insight comes wisdom.

  • Marf

    Wow, powerful story. Thank you for sharing. Your children are lucky to have a parent who obviously loves them so much.

    The answer I always gave whenever people would ask me if I planned to breastfeed was: “If I can.” I had known women who could, and women who tried and it didn’t work out for an array of reasons. If I ended up in the latter group, I wasn’t going to feel like I had personally failed. A typical lactivist would interpret my answer as me setting myself up for failure. But it wasn’t. It was setting myself up for accepting whatever reality was about to unfold.

  • Shelly

    This is tragic. It is particularly tragic when women are given inaccurate and unsupported lactation advice. And even more unfortunate if it is an actual lactation consultant(?) giving non-evidence based support.
    But it is also tragic when negative terms like lactivist are used to refer to ? A lactation counselor? Counsultant (IBCLC) or any person who is working to help women reach their feeding goals for their infants. Ineptitude or malpractice would be better terms regarding inappropriate and effectively damaging advise.
    As an IBCLC I strive to support mothers within the parameters in which they live within the support systems which the live. Please do not group all lactation supporters into this category.
    P.s. As I read many of the comments I realize how uninformed most people are about breastfeeding, infant feeding behaviors and the first feral lack of postpartum support for women in American culture. A lack of maternity leave pay for women in the U.S. Is just the tip of the iceberg.

  • Lynn

    Hi there, I’m sorry that you went through this. I went through something similar, I have IGT (which I did not know until my second child was born), I tried so hard to breastfed my first, but between the jaundice from abo hemolytic anemia, and my low supply, he just did not gain weight, and the jaundice just got worst. He ended up with bilirubin induced neurological dysfunction, also called subtle kernicterus. It makes me so angry sometimes, I wish the nicu would have just given him formula! He may not have the problems he has now if he was given it 🙁

  • Adrienne

    Hello everyone! Thank-you for all of your support, I really appreciate it! Also, to answer a few questions:

    @disqus_CxcvKoW3m5:disqus, it is my understanding that the increased risk of heart complications as a result of taking domperidone is not applicable to otherwise healthy breastfeeding mothers. The heart complications were not seen in individuals younger than 60 years of age and one study showed no increased risk for women of any age. Furthermore, the individuals who suffered sudden cardiac death had several comorbid conditions (diabetes, high blood pressure, altered blood lipid profiles, etc) that would increase their risk of sudden cardiac death. The recommendation in Canada is that these studies should not alter the management of otherwise healthy women of childbearing age who are taking domperidone to increase milk supply. http://www.motherisk.org/prof/updatesDetail.jsp?content_id=981

    @DiomedesV:disqus, IGT is a congenital deformity of the breasts. It is just starting to get researched now, the OBGYN who looked after me during my pregnancy, labor, and delivery with my oldest was an older lady, she retired a few months after Tova was born, I doubt very much she had ever heard of IGT and how it can impact breast milk production.

    @SuperMouse2:disqus, I never reported the lactation consultant. Maybe I’m being naive here, but I like to give her the benefit of the doubt. I was pushing to keep trying and I think she did her best to support my desire to keep trying. Also, I think the education a lot of LCs and IBCLCs get in regards to breastfeeding management is based in the “everyone can breastfeed” school of thought where the incidence of mothers experiencing true chronic low supply is greatly downplayed. I’m not sure the issue was a result of poor practice on her part or poor information/teaching on the part of the individual or organization who certified her as an IBCLC.

    @disqus_gF8cOMlvRL:disqus, she was an IBCLC (newly certified) and a labor & delivery RN. Again, I think the issue comes down to lack of information regarding true chronic low supply (and the red flags to indicate that a mother might experience primary lactation failure). I think she did her best in the circumstances, as I did, and I have a hard time faulting somebody for that.

    Overall, I’m not sure that it was any one individual (or a group of a few individuals) who “failed” me during this whole ordeal, I think it was the whole system of “breast is best” and “baby friendly” hospital initiatives that set the stage for all of this. Ultimately, nobody forced me to do anything. I chose to try to exclusively breastfeed and my son suffered as a result, I own the responsibility for that.

    And thank-you to everyone for saying how adorable my kids are! I agree, they are fairly adorable, but I might be a little biased.

  • Trixie

    Thanks for sharing your story!

  • GuessT

    This is so sad and frustrating. I am glad everyone made it through healthy.

    Just recently, a new mother in the UK (Charlotte Bevan) with mental health issues left the maternity ward and killed herself & her newborn. She had stopped taking her medication so she could breastfeed. Would she have done that regardless? I don’t know- but stopping her medication surely didn’t help.

    http://www.dailymail.co.uk/news/article-2863261/Did-tragic-mother-fear-baby-going-taken-Charity-worker-dead-daughter-referred-social-workers-three-times-weeks-leading-birth.html

    • Mishimoo

      That is heartbreaking.

    • MS

      So needlessly tragic.

      Contrary to what some may think (I’m talking about people who claim that mental illness and medication is not an excuse for not breastfeeding), the issue of mental health and breastfeeding goes far beyond the issue of medication passing into breast milk. The physical, mental, and emotional requirements to nurture an infant can be formidable, which can easily aggravate a mental illness–even if the mother is properly medicated. Psychiatric medications are not magic, and even if they are not contraindicated for breastfeeding they do NOT guarantee a stable mother. The added pressure of breastfeeding–making enough milk, being the only one to feed the baby, establishing a nursing relationship–can be unhealthy even if a mother is under a doctor’s care and medicated. (note: this rant is more about BFing and mental illness in general, and is not a specific response to the article linked above)

      This “breastfeeding at all costs” garbage needs to go. Now.

      • sdsures

        “I’m talking about people who claim that mental illness and medication is not an excuse for not breastfeeding”

        !!!!!!! Oh geez. Don’t they know that some medications that can be VERY harmful to a baby can pass through breastmilk?

      • sdsures

        “The added pressure of breastfeeding–making enough milk, being the only one to feed the baby…”

        Can you (everyone here) imagine how horrible that exclusion must make a spouse feel? Yikes.

        • Elaine

          My husband doesn’t seem to mind. He says he has plenty of other ways to care for & bond with the baby. I think on balance breastfeeding makes his life easier because he does not have to do any feedings at all when I am home and the only bottle-washing is of bottles from when I am at work. This more than compensates for the slightly increased nuisance of transporting pumped milk when caring for baby vs. transporting formula (he is a stay-at-home dad).

          • sdsures

            Glad you guys have a good system worked out.

          • sdsures

            I’ve heard of families who have the dad be the last one to give baby a feeding at night before bed. Sounds lovely.

          • Bombshellrisa

            We are doing that with my son. It works well for us.

          • sdsures

            Grab the camera! 😀

      • Elaine

        I think it has gotten really twisted from “Just because you take psychiatric meds doesn’t necessarily mean that you can’t breastfeed *if you want to*”, which I feel was the original thrust of a lot of stuff that has come out recently about meds in breastfeeding, to “You should definitely breastfeed even if you take psychiatric meds”. I’m all for a mom with a psychiatric illness who wants to try breastfeeding doing so with the support of her medical team, but it’s an equally valid choice to decide she’d rather not rock the boat any more than she has to and giving formula seems like a better option.

    • Who?

      Similar one in Sydney a couple of weeks ago. I understand baby spent a week in hospital and has now been released; Mum presented at the police station and has been remanded in custody on a charge of attempted murder.

      http://www.abc.net.au/news/2014-11-23/newborn-baby-boy-found-in-drain-near-sydneys-m7/5911804

      So much sadness and loneliness in our big cities.

    • Sarah

      The deaths of Charlotte and her baby were a great tragedy. I mourn for my fellow mother, and take small comfort from the fact that she seemed, from the footage, to already be somewhere else mentally when she left the hospital. She didn’t look to be suffering then and I hope she didn’t at the end, either. May we never fail any more as we did her and Zaani.

    • toni

      The sleep deprivation on top of it all, ugh. How can any new mother be expected to be sufficiently rested (and therefore rational) when they are put on post natal wards with six other women and their babies with nothing but a curtain to separate them as seems to be the norm in nhs maternity units? My mum didn’t get a wink of sleep at the hospital after having me because of the other babies crying all night. When she finally dozed off during a brief period of relative quiet in the afternoon a nurse woke her up to tell her I was fussing.. “excuse me your baby is crying, you need to pick her up.” She demanded to be discharged that day. They told her whilst doing the paperwork that it was only going to get worse so the lack of sleep at hospital helped mothers get used to what was to come. My mother is extremely fortunate though, she had staff at home to take care of me while she caught up and never had to do any housework. A lot of women (probably most? Myself included when I had my son) don’t get much rest at home, can’t rely on family or hired help and need all the sleep they can get at the hospital.

  • Isramommy

    Thank you for this article, and thank you to Adrienne for sharing this story.

  • Anna T

    “I have learned that I am irreplaceable as my children’s mother because no one can love them like I do, no matter how much milk I do or don’t make.”

    This, a thousand times over!!! Your story is so touching and it’s obvious you’re a wonderful, committed mother. I find it absolutely infuriating that you had to go through this, when you could have just enjoyed those precious first months with your son by breastfeeding as much as you wish/reasonably can, and supplementing for the rest of his needs.

    This is as heartbreaking as the story recently mentioned here, about a breast cancer survivor who had gone through complete mastectomy but was ignorantly told by nurses in the hospital to “try anyway”. Or that her milk could “come in through her armpits” (I don’t want to imagine this).

    I’d say, if breastfeeding involves long-term use of SNS, pumping around the clock or medications, then something about the plan of action is *probably* wrong. Domperidone? Really?! In its list of warnings it actually states it should NOT be used during breastfeeding!!!

    I love breastfeeding. I’ve breastfed 2 children, so far, into toddlerhood and never used formula or bottles. In a month I’m looking forward to starting all over again. My breasts are already producing colostrum. It’s all so wonderful and exciting, BUT it’s not all, or most, or the most important part, of my identity as a mother. Otherwise what is my place once my children are weaned? And what is my husband’s place? He is just as irreplaceable as I am, even if he never feeds them until they start solids. There is nothing like sitting back after an exhausting day with a newborn, and smiling as you see them snuggling on their Daddy’s chest, utterly content.

    I wish you much joy in your parenting journey and don’t let anyone bring you down.

  • DiomedesV

    At one of my OB appointments, an NP performed a breast exam. Is this not standard? Wouldn’t this have revealed IGT? Women who have this condition should be alerted before they have a baby so that they know that they are likely to struggle with producing enough milk. Then they can decide whether it’s worth it.

    For me, knowing that I wouldn’t be able to breastfeed before I had a child was a bit disappointing at first but ultimately, tremendously liberating.

    • DiomedesV

      Rereading, it sounds like at the very least, her first OB was either incompetent or was unethically withholding information from her, like the LC did later. This is completely unacceptable.

    • Sullivan ThePoop

      I had breast exams with every pregnancy. With my last pregnancy I had no breast changes and my OB never said anything until after when I couldn’t breast feed. Then he said he was worried that would happen. Why didn’t he say something before?

    • Joy

      Not in the UK, no one ever looked at my breasts or asked about any changes. (There weren’t any really, which should have been a sign.)

  • CanDoc

    1) Thank you for sharing. This story is exactly what everybody needs to hear.
    2) I’m an obstetrician, and I’ve never heard IGT to mean anything besides impaired glucose tolerance. Dr. A, it might be helpful if you including the term in parentheses as used in this setting (“insufficient glandular tissue”, thank you google) to provide context.

    • Adrienne

      It is also called “glandular hypoplasia” or “tuberous breast deformity”

  • Smoochagator

    This story is both heartbreaking and inspiring. I am so sorry that Adrienne went through this terrible ordeal but so glad that she chose to share her experience and what she learned from it. Hopefully many women will read this and give themselves and other moms a break.

  • It all comes down, in the end, as with so much else in life, to flexibility and common sense.

    I’m sorry that any woman has to go through the entire learning curve, one would think that succeeding generations would get some benefit from the preceding ones, but during my career I’ve noticed that it doesn’t seem to happen. I was giving the same guidance in 2012 to new moms that I had given in 1967. If anything, there is greater rigidity now. At the start of my career, while breastfeeding was encouraged, bottles were not Instruments of The Devil.

    Glad you managed to work everything out, Adrienne.

  • Guest

    “I learned that a mother’s reasons for choosing formula or breastfeeding
    are absolutely none of my business, and I don’t get to judge whether or
    not their decision is “valid”.”
    THIS. A million times this.

  • Renee

    You are an AWESOME mom, I am glad you are no longer letting others that have ugly hearts make you feel inferior.
    Thank you for sharing your story.

  • MLE

    Super cute kids!

  • Bugsy

    Adrienne, I’m sorry for what you’ve gone through and also admire the strength and empathy you’ve gained from it. Your children are absolutely beautiful; enjoy every moment with them!

  • Dr Kitty

    Adrienne, you, and your children, deserved better.
    I’m sorry you went through all of that.

  • Young CC Prof

    Stories like this strike me particularly hard. My son had to be readmitted to the hospital for dehydration/jaundice at 4 days old. If his first checkup had been scheduled for afternoon instead of morning that day….I knew that low supply happened, but I had no idea it could turn so dangerous so quickly.

    And I managed to put my finger on something that was bothering me, the idea of breastfeeding safe spaces. Do women need space (mental and physical) and support to breastfeed? Absolutely. But somehow those safe spaces have turned into spaces that exclude women who couldn’t, which is problematic for a number of reasons.

    1) It’s bad for the mothers who are excluded, because, hello, you just cut the mother of a newborn right out of her support network for a reason that was beyond her control. Nope, you’re not welcome in the club any more! No one to talk to about cleaning up puke at 3 am, or how lonely it is being home with a newborn.

    2) It’s bad for the pregnant women learning from these groups, because they get the idea that nursing problems can pretty much always be overcome. I just poked around on LLLI for a while, and I couldn’t find one breastfeeding story with an “unhappy” ending. It’s not realistic, and women seriously struggling with nursing need to know that failure is an option, that it’s not the worst thing that can happen, and that in the long run it doesn’t matter. Even if you choose to keep trying, it’s important to realize that you have the option to quit if things get more difficult.

    3) It’s bad for skill of the supposed experts and peer counselors. Quite a lot of these folks have never seen a newborn suffering from dangerous lactation failure, or a child struggling with a brain injury from kernicterus. Some say that doctors are too inclined to fear the worst, because they constantly see the worst. It’s a problem, but it’s better than assuming everything’s fine because you have no idea what disaster really looks like.

    4) I’m not entirely sure it’s good for the mothers who succeed, either, since it’s a pretty distorted worldview.

    • MLE

      That’s a fabulous point because it makes “failing” seem like some horrible terrifying unknown that cannot be spoken of.

    • Babies, especially newborns, have small reserves. It is amazing how rapidly they can become really ill from dehydration, whether because they aren’t getting enough to eat, or from diarrhea. Too many times I’ve seen LCs simply ignore this fact — until the baby winds up in the ER.

      • L&DLaura

        Had a patient a few years ago whose baby was quite definitely dehydrated; hypernatremia, jaundice, lethargy. The mom was relieved that he needed IV fluids so she didn’t have to use formula.

        • Yes, I’ve had patients like that, and also mothers who were trying to hydrate their newborns by SPOONING either D5W or breast milk into their mouths — to avoid [gasp! horror!] “nipple confusion”.

          • demodocus’ spouse

            The nurse practitioner squashed my half-fear of nipple confusion on LO’s 4 day check by saying she’d never yet met a baby who was confused about nipples. (She wanted us to supplement for a couple days since LO was a bit jaundiced and had lost more than 10%)
            I wonder how common it really is, if it does exist.

          • Cobalt

            Nipple preference in an older baby is common enough to think about getting them used to everything.

            Newborns will latch onto just about anything they physically can. Milk coming out clears up any confusion.

          • I don’t think “nipple confusion” really exists, although many women seem to feel it ought to, and therefore claim it does. [1] Babies will literally suck anything that reaches their mouths — it’s a reflex. They don’t ask whether what they are sucking provides milk. [2] Hungry babies just want to be fed — the need overrides the method. [3] It is quite true that, especially if the mother has less than optimally sized and shaped nipples, babies find bottle teats easier to get milk from, which is rather like the difference between driving a stick shift or an automatic gear car. Both work, and while [men, particularly] there are those who like to claim that the stick gives more control, etc., the bottom line is that with an automatic, you just concentrate on the road and forget all that fiddling with gears. Sometimes I think that women who won’t give bottles because they fear “nipple confusion” are really afraid of discovering how easy bottle feeding can be.

          • Box of Salt

            ” Both work, and while [men, particularly] there are those who like to claim that the stick gives more control, etc., the bottom line is that with an automatic, you just concentrate on the road and forget all that fiddling with gears.”

            I don’t like your analogy. I am woman who drives stick. Guess what? It does allow more control. And I can drive an automatic transmission vehicle without any additional training. The reverse is just not true.

            “Concentrate on the road”? As a So Cal resident as far as I’m concerned, all driving automatic does is allow folks to chat illegally on their hand held cell phones while driving.

            Breast vs bottle? There are pros and cons to both, and some aspects of either will seem easy to some, but difficult to others. There are trade-offs.

            Once I got it figured out (which took time), breastfeeding was easy for me, and did not require extra dishwashing.

            No matter how you look at it, driving an automatic car is always easier. The analogy fails.

          • Who?

            Yay I too am a woman who drives a manual and I totally agree, it does give more control.

            We made our kids both learn to drive a manual car, none of their friends had to. Which is just another line on my tough love t-shirt. It’s great discipline and a good reminder of the power of the vehicle.

          • KarenJJ

            Same. I love my manual car. Much more fun to drive.

          • Siri

            Babies learn to express preferences quite early on – if you’ve ever seen a small, hungry human delay feeding until its lactating mum returns rather than take milk – ANY milk, including EBM – from a bottle, you know there’s no confusion involved, just sheer determination. Likewise if you’ve seen a tiny baby given one bottle a day ‘because everyone says you should introduce one before they get old enough to refuse’, and then seen that same baby force its crying mother to change to bottle feeding one feed at a time, you know the word ‘confusion’ doesn’t apply. Babies are not suckling/feeding automata; they are people. We forget that at our peril.

          • Nicole

            If you look closely, a baby using a bottle/pacifier will make a motion more like chewing… When you are breastfeeding, you should see a rocking, almost circular motion in the jaw… the chewing can cause nipple pain… just to explain nipple confusion for you……

          • Mishimoo

            ‘should’ but didn’t – all of mine suckled the same way and had no nipple confusion despite being offered pacifiers and bottles. They were VERY adamant that the nipple was superior until they decided to wean.

          • SporkParade

            When my son was born, the LC suggested spoon-feeding since he had gone so long without eating (thanks, nursery, for letting me naively assume you would feed my baby until I could get out of bed) and couldn’t latch. Was that bad advice? Should I have pumped instead?

          • The problem with spooning liquids [more than a couple of drops] into a newborn’s mouth is that he can aspirate. Swallowing is a different technique from sucking, as mothers learn when they begin feeding solids and see the baby at first doesn’t know which “way is down” [it’s not just the texture]. It would have been preferable to give either EBM or formula supplement via bottle, IMO.

      • Jessica

        Which is why I will be forever grateful to my LC, who, after a weighed feeding when my son was five days old said, “You need to keep supplementing. I love breastfeeding, but I love smart babies even more. Babies this age NEED food for brain growth. First rule is always FEED THE BABY.”

    • Smoochagator

      Very good points, especially for expectant mothers coming to believe that breastfeeding is ALWAYS possible, and successful breastfeeders who believe that their experience can always be replicated.

    • D/

      So right on the mark!!

      My oldest daughter’s close circle of friends/acquaintances has a significant membership of home birthing, placenta eating, breastfeeding, (anti-vaccine or) vaccine questioning, homeschooling, homeopathy/ essential oil promoting, internet-information-overloaded type of women.

      The “fact” that ‘only 1% of mothers can’t actually produce breastmilk’ is reflected as something more like 20+% among their ranks (and all are aware that even when your mother is an LC you can’t fix it). It has been interesting watching the dynamic of how my daughter reconciles the differences of what she believes/knows and still remains friends with the collective group and how they have all remained supportive to each other. She recently shared, however, that there is currently some ‘you should just home birth’ encouragement being recklessly offered to one. She’s trying to decide the best approach in responding, and I know she expects that it may test their bonds.

      For myself, I can’t imagine how handicapped my practice as an LC would be without having been a NICU nurse first. It’s one thing to be “aware” of the dire consequences for unfed or severely underfed infants, but quite another thing to have actually seen and been responsible for them. Lactation failure cannot be wished away, and LCs who can’t recognize, *intervene* and prevent babies from getting into dangerous situations are worse than having no help at all!

  • ChrisKid

    For a while I could have been on my way to becoming one of ‘those’ lactivists. But then I started seeing the very extremes of that attitude and the harm it can do, along with the total lack of both logic and compassion. I know better now. The claim, or worse, just the implication, that mothers who use formula don’t love their babies as they should just hacks me off. Seeing a mom link her toddler’s cancer to the single bottle he got in the hospital, and then blame herself for ‘allowing’ that feeding still breaks my heart when I think of it.

  • Karen in SC

    OT: anyone else having Facebook problems?

  • anh

    Your children are gorgeous.
    I’m truly horrified by how much ill treatment you received. I want to hug you and make you some hot chocolate

  • Amy M

    Adrienne–did you ever report that lactation consultant, for her negligence? She neglected to tell you important medical information, and even if she wasn’t qualified to diagnose, she could have suggested you see a doctor and mentioned her suspicions. And from this negligence your son could have been harmed—that’s not ok. I am assuming, of course, that there is someone you could report this person TO…..

    • Renee

      Had she seen an IBCLC I think it would have gone better. LCs are not all trained in the same way, even if the work with the hospital. There just aren’t many standards.

      I also wonder if theLC didn’t want to say anything “negative” because she was hell bent on supporting a mom that was also hell bent on trying. With the focus on BF until you drop, I can see this happening. I bet she thought it would turn around eventually, and didn’t want to be guilty “of sabotaging” if she told her to supplest sooner.

      This doesn’t excuse for not letting her know, but I think is likely explanation. The ideological creep and bad information that makes BF out to be the ultimo in mothering and nutrition is exceedingly harmful.

  • D/

    Oh, Adrienne! ((Hugs)) Your story strikes such a chord with me.

    My own daughter’s breastfeeding journey with IGT was one I dreaded from the moment I accidentally came into the bathroom on her undressed as a middle-schooler. Seeing her manage her breastfeeding experience long-term taught me so much though and is something that made me a better LC.

    I *cannot* imagine keeping an obvious lactation assessment of IGT and its implications from a patient. Nor can I imagine working with a mother every other day who I have “thought for quite some time” has IGT … and yet leave her baby with inadequate weight gain, dehydrated and jaundiced! I am so sorry you had that added burden placed on you.

    That. Should. Not. Have. Happened!

    Oh, and btw “perfect for you” breastfeeding experiences are the only perfection there actually is!

  • fiftyfifty1

    ” I went back to the lactation consultant and asked if I had IGT; yes, she had thought that for quite some time. To her credit she was amazingly supportive.”

    It is so incredibly unethical for her to have withheld what she thought was going on. You were suffering and your baby was in danger, and she suspected the problem all along. It sounds like her bedside manner was emotionally supportive, and I’m glad that is the case, but from a professional standpoint that does not get her off the hook! Serious violation of patient trust.

  • fiftyfifty1

    cutest kids ever!

  • Cobalt

    And people wonder why Dr. Amy is so angry.

    Well, Dr. Amy, you should be angry. We all, as mothers, parents, former infants, care providers, and decent human beings, should be angry. I know I am. There is no reason for women and children to suffer on an altar for breastfeeding or primitive birth practices when such excellent and safe alternatives exist as we have available today. For these “professionals” to demand that good parenting include such senseless suffering is evil.

    Adrienne, I am sorry that you were put through such pain.

    • Bugsy

      Absolutely correct. “Good parenting” does not equate to letting mommy and kids suffer as mommy tries to live up to stereotypes of the “perfect mother.” These stereotypes make me so mad.

    • Smoochagator

      Agreed. The more stories I hear of moms and babies hurt by NCB ideology, the angrier I get.

  • Are you nuts

    My goodness. I’m so sorry this happened to you. I have found that lactivists use this 1984-esque doublespeak that drives me insane. “Breastfeeding should never hurt…. everyone can breastfeed.” THAT’S NOT TRUE!!! As if it’s not frustrating enough for nursing not to turn out how you had hoped, you have people making you feel crazy because, according to them, your “problem” can’t actually exist. I’m so glad you made it out ok on the other side. Isn’t it a relief to know that your children will never know or care that all of this happened?

  • I can see this being even more damaging to mothers who are older or younger than they and the medical professionals around them perceive to be the “norm.” In trying to do what the people around them say is what’s right for their babies and seeking to be considered a “good mom” to make up for the perception that they [got knocked up too young]/[waited around too long to have kids] they do harm without even realizing it.

    I’m sorry to hear that you and your kids went through this, Adrienne, and glad that you’ve come out the other side with a more balanced perspective.

    Also, Dr. T, could you explain or at least spell out what IGT stands for? There are plenty of non-parents/pregnant women here who don’t know what that means. I don’t.

    • fiftyfifty1

      insufficient glandular tissue.

  • Katie Chapman

    This made me teary–out of both sadness and anger. Hugs, Adrienne!