Pressure to exclusively breastfeed is causing neonatal starvation; what will be the long term effects?

Newborn

Everyone knows that breastfeeding provides benefits to babies. That’s true even in first world countries where the threat of pathogen contamination of the water used to prepare formula is nearly nonexistent.

Those benefits are so small, however, that they are measured in individual IQ points, and fewer episodes of mild neonatal illness like colds and diarrhea.

Nonetheless,among ambitious privilege parents in first world societies, incredible social pressure is brought to bear to force exclusive breastfeeding in the first six months. This pressure has been stimulated in large part by the efforts of lactivists (breastfeeding activists) and the breastfeeding industry, comprised of lactation consultants, and hospital credentialing agencies like the oxymoronically named Baby-Friendly Hospital initiative.

As a result, many infants are starving. Stories of breastfeeding failure abound and countless women are tormenting themselves and their babies, taking herbs, supplements, pumping around the clock, and refusing to supplement with formula in an effort achieve and maintain exclusive breastfeeding.

Which raises the question:

What are the long term consequences in brain function and other areas for babies whose mothers do not produce adequate milk and who, therefore, starve for weeks at a time?

The answer to that question, to my knowledge, is unknown.

We know that dehydration as a result of inadequate breastmilk can cause serious health problems in neonates.

Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey:

Hypernatremic dehydration in neonates is a potentially devastating condition. Recent reports have identified breast-feeding malnutrition as a key factor in its pathophysiology.

Breastfeeding-Associated Hypernatremia: Are We Missing the Diagnosis?:

The incidence of breastfeeding-associated hypernatremic dehydration among 3718 consecutive term and near-term hospitalized neonates was 1.9%, occurring for 70 infants…

Conclusion. Hypernatremic dehydration requiring hospitalization is common among breastfed neonates…

Fatal Hypernatremic Dehydration in Exclusively Breast-Fed Newborn Infants Due To Maternal Lactation Failure

In this case report, we describe unrecognized fatal hypernatremic dehydration in two exclusively breast-fed neonates due solely to failure of maternal lactation. We further describe epidemiologic and etiologic features of such deaths …

Fortunately, severe complications like death, seizures and permanent disability are relatively uncommon in first world countries, because most mothers will ultimately offer formula supplementation or will seek medical care and a pediatrician will strongly recommend formula supplementation.

The overwhelming number of babies who are getting inadequate breast milk will ultimately survive to get formula supplementation, but they (and their mothers) suffer greatly in the meantime.

I wrote last week about the mother who ultimately resorted to using her friend as a wet nurse after her baby languished for nearly a month without adequate food.

She wrote:

… I tried to be cheerful, but when we were alone, I wept, lashed out at my husband, and spiralled into exhausted, muddy irrationality, panicked about failing the precious boy we had only just met. There was very little distinction between day and night. Time took on a strange new cast. I nursed and pumped and nursed and pumped and nursed some more. I remember my husband singing to our crying son while I soaked my breasts in bowls of warm, salty water. I remember cooling my breasts with cabbage leaves, drinking herbal tinctures, pumping and pumping and pumping. I remember hoping each new lactation consultant was going to be The One. I remember hoping the midwife would drop by, or at least return a call. The baby was wetting nappies, but he needed to nurse constantly, and never got a full belly on which he (and I) could rest for a few hours.

Today on Gawker, another mother writes:

… I’d existed practically shirtless from the moment the baby was born, nursing her every time she whimpered or stirred. I gave her the smallest amount of formula I could soothe her with at a given time, having read that every ounce of formula I gave would be an ounce my body wouldn’t make. I was taking all the herbs all of the other lactation consultants had prescribed, pumping every time I had a spare moment. I was doing everything anyone had ever suggested might help. I was desperate to feed her. I was more determined to figure this out than I had ever been about anything in my life…

But my baby was hungry all the time. And very thin.

What happens to infant brains as a result of short term starvation?

It’s shocking that, as far as I know, there is no research on this question. We devote reams of scientific journals and endless pages of parenting websites to debating the subtle value of the additional antibodies in breastmilk, or the possible existence of unknown long chain fatty acids that may promote brain development in the critical early weeks of the neonatal period, but we devote no effort to determining the effect of the tremendous metabolic insult of starvation — lack of calories, lack of fluid, increased serum sodium, etc. — that occurs in those same critical early weeks of the neonatal period in a significant portion of infants whose mothers are attempting to breastfeed them exclusively.

We know that a significant proportion of women (5% or more) cannot produce enough breastmilk to fully nourish an infant. We know that, as a result, a significant proportion of babies spend days, or even weeks, starving, losing weight, hungry (and screaming) for hours at time, unable to settle or sleep.

That cannot be good for the developing neonatal brain.

Does it impede neonatal brain development? Do these infants lose IQ points?

We have no idea.

So why are we pressuring women into exclusive breastfeeding when have no clue whether we are consigning a significant proportion of infants not merely to weeks of misery but possibly a lifetime of subtle (or not so subtle) cognitive effects?

  • Crystal

    I”m surprised that, as a doctor, you don’t know why there are no studies on short term infant starvation. It’s because you couldn’t possibly ethically conduct a randomized controlled trial. Who would sign their baby up for such a test? There are no studies because no one will knowingly starve their baby.

  • Sylvia

    LISTEN TO MY STORY AND BE CAREFUL!!! On December 6, 2015 I gave a birth to my first child, a beautiful daughter Lili. She was almost 8 lb. I didn’t know much about newborns but I had a feeling that something wasn’t OK. I was advised to breastfeed as much as possible but I was worried if I had enough milk. I even asked the nurses to check if the amount of milk that was coming out of my breast was enough and they assured me that I was doing great. I delivered my baby on Sunday morning and the next day I noticed that she had extremely dry lips ( nurses said that was normal!) I told the nurses that I don’t see that my daughter was having wet diapers, I just didn’t see the urine. They said that the diapers are really absorbent and probably that was the reason. On Tuesday my baby was really sleepy- I asked why- they said it is normal. In addition, she lost 9.5% of her weigh which I wasn’t aware of. They discharged me at noon and I was back with my baby 7 hours later because she was unresponsive!!!!!!!!!I It turned out that she was highly dehydrated and they had to hook her up to IV!!! Her heart beat was extremely low because she lost a lot of electrolytes. I thought I was going to get a heart attack. I was sitting near my baby and constantly crying. I was soooo angry that they didn’t connect the facts- dry lips, no wet diapers, sleepiness, and the weigh loss. I was angry because as I first time mother I thought I was in good hands but I realized that I can only trust myself. I just can’t comprehend how the medical professionals didn’t see that my baby was so dehydrated. If we waited longer my baby would not be with us right now. In addition, I had a feeling that they wanted to shift the blame to me because they said that I was probably not producing enough milk. Imagine how I felt at this moment- I was so depressed thinking that it was my fault. But then I realized that they should had noticed and give my baby the formula. I would not care at all!!!

    Thanks God we reacted quickly and my baby was doing better after 2 days being hooked up to IV. Now she is 2 months and 12 lb already. I breastfeed her and also supplement with a little formula.

    My advise- if you want to breastfeed that is really amazing but please insist on giving your baby some formula at the very beginning. I learned my lesson that I can only trust myself!

    • Daleth

      I’m so sorry that happened and so glad you were watching her like a hawk so she got what she needed pretty quickly!

  • MHAM

    I had no trouble nursing my two babies and I honest to God had no idea how bad things could get until this year, when my friend and I had healthy babies born one week apart. I had a boy, she had a girl and they were within 1 or 2 oz of each other at birth. My friend has half killed herself trying to nurse this baby and this poor baby is rail thin. She feeds, pumps, gives the pumped milk in a bottle, feeds again. It is absolute madness. She pumps in the car any time she drives anywhere, even short trips to the store. The baby is ALWAYS hungry and she is a tiny, tiny thing now. I know that boys and girls are on different growth curves and it’s normal for my boy to be bigger. But the difference between them now, when they were so similar at birth, is heartbreaking.

    My friend is miserable. She feels like a complete failure. She feels ashamed when she does give formula – she prefers to give donated breastmilk when she can, but she has to source it herself as there is no donor bank here. She is outraged when other people suggest that she give formula. She is constantly at odds with her husband and her family now. She has gone through a string of pediatricians. My friend has struggled with anorexia in the past and while she handled the pregnancy very well and remained very healthy, she is exhibiting very concerning controlling behaviors again, like she did when she was very sick.

    Nothing I say seems to help or matter. I honestly don’t know where the pressure to nurse is coming from. I’ve done everything I can think of to communicate to her that whatever works for her and her baby is the BEST choice – that I myself would never view her or her baby as somehow “inferior” or “disadvantaged.” I don’t know of anyone in our community of mothers who would treat her that way either – many of our mom-friends either supplement or give formula exclusively.

    She has started solids and the baby has taken to it with gusto (of course!). I hope that this will turn things around for good and take the pressure off the situation.

    If I had read something like this article a year ago, I would have scoffed, blown it off. No mother would let her baby be hungry. But now…unfortunately, I have seen it go down.

  • Megan

    I just wish more research would be devoted to the true incidence of insufficient lactation and lactation failure and on treating it rather than study after confounded study about 4 extra IQ points from breastfeeding. I imagine that incidence of insufficient lactation and lactation failure is much higher than the often quoted numbers, especially with older women and more women with comorbid conditions having babies. If we only researched this maybe we could get away from telling moms to “just try harder.” Thrn again, it’s so much easier to just blame moms than to actually help them…

  • Daleth

    Thank god my hospital wasn’t “baby friendly.” They gave the babies formula from the start because one was in the NICU, one had a glucose issue and I was out for the count due to severe pre-e and a hemorrhage that led to hypovolemic shock. Even so, the NICU doctors kept pushing me to pump and give the babies breast milk despite the fact that I told them I was on opiates and lasix (a diuretic)! I gave them colostrum but just could not bring myself to give opiate and diuretic-laced breastmilk to preemies.

  • Charlotte

    This happened to me at my “baby friendly” hospital. My daughter was so dehydrated she was peeing crystals, and the doctor said she needed immediate formula supplementation. However, the nurses refused to give me formula because it was wrong to feed anything other than breast milk and suggested I send her to the NICU for IV rehydration instead. Unbelievable! My husband and I ultimately decided to sneak formula and bottles from home and fed her behind the nurses’ backs. When we got caught the next day, we got chewed out by multiple nurses for not doing what’s right for the baby and also for messing up the hospital’s breastfeeding numbers (every baby given formula counts against them and too many means a loss of millions of dollars in funding from pro-breastfeeding organizations).

    • The Bofa on the Sofa

      I hope you told your pediatrician. Those nurses need to be fired.

      • toni

        if you’re so lacking in ethics and common decency that you will ignore doctors’ orders to feed a starving baby with formula for money .. why not just lie to to whoever’s asking about breastfeeding rates? seems like less hassle and a lot less danger. who’s gonna know what the real rate is? ideally they would just tell them to stick their money but if you insist on being a douchebag it’s better to be a lying one than a baby-harming one

        • a small person

          I’m calling BS on this. There is no hospital in the US where nurses can disobey written orders in the medical chart. I’m guessing there were no orders.

      • Charlotte

        The head nurse backed them up, though she did say she felt it was unfortunate that the Baby Friendly rules force them to do this to moms. Ironically, refusing to allow supplementation caused their breastfeeding rates to drop dramatically because many moms would just switch over to all formula if they weren’t allowed to give a bottle while they waited for their milk to come in. She wishes it didn’t have to be this way, but they would lose millions in funding from the Baby Friendly organization if too many moms fed formula to their babies. Hence the need to coerce them to breastfeed through any means necessary. I’m expecting again and I plan to list myself as a formula feeding mom (they make you state it at registration) and make a HUGE fuss if any breastfeeding bullies try to stop me. I’ll breastfeed when I get home, but while I’m there I’m going to mess their system up as much as possible. I am so done with this crap.

        • toni

          i don’t buy that the baby friendly rules ‘force’ them to do what they did. it’s a voluntary accreditation and the suggestions to increase breastfeeding numbers don’t supersede good medical practice.. surely? They can’t just ignore a paediatrician’s orders for Christ’s sake.. how long ago was this and have you complained? I’d go to the papers if that happened to my sprog… ‘starving kids for bribes’..not great publicity. And that head nurse omg. The hospital’s financial affairs should not have been made your (or your child’s) concern as a patient. why should you care? The hospital I delivered my son at have become ‘baby friendly’ since he was born so i’ll be interested to see what changes have been made. they were already doing the harmless things like initiating bf within an hour and encouraging 24hr rooming in (not forcing it) but I got two free jugs of ready made similac to take home just in case.

          • Charlotte

            This was in 2012, and when I complained the excuse was that they had been recently certified and the nurses had been told terrible things would happen to them and the hospital if too many moms failed to breastfeed, so they were overzealous. I gave birth there again in 2014 and there was slight improvement. Nurses gave me bottles when asked, but they said each time I asked the guidelines required them to tell me why formula feeding is wrong and to try and convince me not to do it. The hospital said all the other hospitals in the region are becoming baby friendly so they felt they had no choice but to go along with it.

          • KarenJJ

            It seriously doesn’t make sense that they’d go against a doctor’s order for supplementation.

            Plus the crazy idea that it would be more “baby-friendly” to try and stick an IV into a dehydrated newborn rather than feed them appropriate food. I have actually heard of parents that would prefer an IV (rather than ruin the “virgin gut”) on internet forums but I would never have seriously considered nurses would prefer that too?

        • D/

          Just to reiterate, what was explained to you is not the “way it is”. BFHI does NOT provide hospital funding … In fact, hospitals fund the BFHI through the application process (> $11,000) and yearly maintenance fees (> $1,200) required to obtain and keep Baby Friendly designation.

          You *will* be asked your feeding intentions on admission. JCAHO now requires that it be documented. As far as blaming the BFHI bogeyman for requiring coercion by any means to exclusively breastfeed, just call them out on it. Their requirement is to document the informed maternal choice of intended feeding plans and support you in however you choose to feed your baby … whether it is breastfeeding, combo feeding, or formula feeding.

          FYI, if you need to get a “head nurse’s” attention this time just ask what is more likely to affect the hospital’s funding … You supporting my stated feeding plan of choice and doing whatever you need to do meet BFHI documentation requirements or you “coercing” me right into giving you a negative HCAHPS rating?

          http://www.hcahpsonline.org/files/August_2013_HCAHPS_Fact_Sheet3.pdf

        • Daleth

          The head nurse can “back them up” all she wants–they still went against a doctor’s express orders, which they are not allowed to do, BFHI or not.

    • araikwao

      That’s ridiculous – they would suggest IV over oral???! The world has *actually* gone mad..

      • Evelyn

        For a family with history of dairy and/or soy intolerances, it would be appropriate.

        • araikwao

          I understand the appropriate management in that situation would be for mum to be on a dairy&soy free diet, with the understanding that it is not a guaranteed cure, or to use an amino acid formula. IV would still not be preferred over that.

          • Evelyn

            Speaking from personal experience, I would absolutely elect to use IV hydration rather than insult the gut of an allergic baby. Of course, breastfeeding management first, but I am in an area where the first push is formula, and when I said elemental-only, they opted for an IV instead.

    • Roadstergal

      “every baby given formula counts against them”

      What kind of crazy-ass Gilliam-nightmare world are we living in?

      • Ash

        They are actually correct. In terms of their BFHI goals AND The Joint Commission, hospitals are seeking to increase the number of infants that are exclusively breastfed in order to meet targets.

        • Ash

          If it wasn’t so expensive to get copies of your own medical records, it’d be very interesting to read all the nurses notes and the physician orders. Do most hospitals have formula as an order now? So there was a documented order in the chart for formula that was never completed? hmm

      • Alannah

        The magic number is 75%.

        That percentage of mothers need to be breastfeeding exclusively at discharge for the hospital to keep its BFHI certification. BFHI in and of itself may not have any funding attached to it but the current climate surrounding breastfeeding makes it a high profile, high stakes issue for a hospital so there certainly is a lot pressure on staff to reach the target.

        Hospitals use all kinds of techniques to prop up the number, ranging from ridiculous pressure on pregnant women (`infant feeding contract` anyone?) over witholding formula down to simply lying about the feeding method on a sufficient number of discharge summaries (wich is probably the kindest way to do it).

        • D/

          “The magic number is 75%.”

          Depends are where you are. Specifically required percentages of exclusive breastmilk feeding is not a universal criteria for BabyFriendly designation. In the US, for example, the requirement is implementation of the Ten Steps … which is expected to result in an “increase in breastfeeding rates” but a specific target is not defined by BF-USA. Even without BabyFriendly designation, JCAHO imposes the same expectation of “increased rates” for hospitals with >1,100 deliveries, but the specific breastfeeding targets are set by the individual hospital.

          You’re absolutely right about the high profile, high stakes, high pressure aspect surrounding breastfeeding in general … My primary employer is not pursuing BabyFriendly and has an exclusive breastfeeding rate in line with our region (~65%). The organizational-defined targets include a required 10% yearly increase in exclusive breastfeeding rates as part of the annual performance evaluation to determine salary increases for all Maternal-Child staff AND (an unreasonable and dangerous) documented target of ultimately reaching 100% exclusive breastfeeding.

    • D/

      This is crazy on so many levels I can’t wrap my head around it. An RN (even a “head nurse”) can’t independently just “send a baby to the NICU for IV rehydration” nor can a parent on a nurse’s suggestion … Babies are *transferred* to the NICU and are given IV rehydration on a physician’s order (written/ verbal/ standing order protocol/ etc).

      If an RN (or LC) questions or disagrees with a physician’s order or if an intended plan of care was discussed by the physician with a parent but an order was not received, the conversation to be had is between the physician and nurse. If *after* discussing those concerns it still felt that an order was inappropriate, there is a specific chain of command to address those concerns. Ignoring an order or just making up a contradicting plan of care is *never* appropriate!

      If I did what you’re describing I’d expect to have myself a new professional orifice ripped by the physician in question and to be placed on probation with a corrective action plan or more likely immediately terminated.

      As for “required breastfeeding numbers” and breastfeeding funding, I’m speaking only for the US. (It may be completely different elsewhere.) There are no outside regulatory expectations placed on a hospital from JCAHO or BFHI to meet any specific target of exclusive breastmilk feedings (although individual hospitals can choose potentially unreasonable targets). To my knowledge there are no pro-breastfeeding organizations anywhere providing any funding (much less “millions”) to hospitals based on their breastfeeding rates.

      Specifically,

      National benchmarks guidelines (such as Healthy People 2020) are typically the discussed breastfeeding rate recommendations to “work toward” and call for an initiation rate of 81.9% and among breastfeeding babies for 14.2% (or less) to receive formula supplementation in the first 2 days.

      JCAHO does not require any specific % of babies to be exclusively breastmilk fed. Data must be collected on exclusive breastmilk feeding rates and the expected improvement is “an increase in rate”.

      BFHI does not require any specific % of exclusive breastmilk feedings. The requirement regarding supplementation in the well-baby population is at least 80% of the breastfed babies are being fed only breastmilk, OR documentation indicates that there are acceptable medical reasons OR fully informed parental choices for formula-feeding.

    • Alannah

      Wait… you were faced with severl nurses knowingly refusing to carry out a doctors explicitly stated orders for a sick baby? For all they knew the severely dehydrated baby still hadn`t had the prescribed formula 24 hours after the pediatrician ordered it?! And of course they didn`t have the guts to tell the doc they weren`t going to do it and they left it to the parents to deal with the situation. The lack of professionalism is just unbelievable.

      Have you contacted the hospitals legal and risk management service and the director of the pediatric department? Tell them you are considering a lawsuit. I`d love to hear what they have to say about this doozy. Seriously, not carrying out a medical order on purpose without informing the doc is a career-ending offence.

      • Charlotte

        I complained to multiple people multiple times, and the answer was always that the nurses were right to try and convince me not to bottle feed because the BFHI requires the hospital to get as many women to breastfeed as possible, but that they went too far by outright refusing to give me formula. When I had another baby two years later the nurses did not refuse to give me formula, but each time they brought me some they gave me very harsh lectures on why I should not give my son bottles.

        • Roadstergal

          Harpies.

  • Guest

    I am so angry at breastfeeding and the constant pressure to continue it and the way it adversely affected the first year of my first sons life. It took 5 days for my BM to come in, and the midwives would not give him formula, apart from one lovely young mid who gave him a bottle, resulting in the only sleep he had the whole stay. I was so exhausted from pumping and feeding post c section that I almost fell asleep holding him and he nearly dropped to the floor. But they didn’t care about his safety or my wellbeing only BREASTFEEDING. I eventually established breastfeeding and he initially gained extremely well. He gained almost two kilos in five weeks on just breastmilk. But at three months my supply dropped and by six months it was getting so low that I needed to take galactagogues. He was a big boy and I couldn’t produce enough for him. Because I hadn’t introduced a bottle and formula before six weeks, he refused both, and it got to the point where they said the only way to get him to take formula would be to forcefully starve him of BM until he ‘ cracked’ this would have to have been done in hospital and the GP warned me that he had seen babies go for up to 36 hours before they accepted a bottle of formula. So I had to soldier on endlessly breastfeeding and taking galactagogues which were passed on to him in my milk until he could take enough solids and cows milk from a cup, which was 13 months. He hardly slept. It was hell on wheels and I developed PND which took several years to fully recover from. I am pregnant again and will not be making the same mistake! A bottle of formula at night introduced as soon as the baby comes home.

    • Montserrat Blanco

      I am sorry you had to endure that. I find it appalling when lactivists affirm milk supply is perfectly matched to the baby’s needs. My supply lowered after three months when I was breastfeeding my son for every feeding except one daily for more than one month. I do not know what happened and I am not worried since he is thriving on formula, but I think it is absurd the way they minimize the number of women with supply issues.

  • Anne Catherine

    A 22 day old baby in Florida died last December. The mother said that she was exclusively breastfeeding and her parents were are in custody for murder.

    They were negligent because they had not had the baby in for regular care, they may have been negligent in other ways, ….and there may have been other forces in play that helped cause this terrible tragedy

    But….I suspect that the idea that breastfeeding always works, low supply is perceived, and giving the baby formula would result in a lifetime of chronic disease and low IQ may have played a role in this baby’s untimely death

    http://www.theledger.com/article/20150327/NEWS/150329361/0/news300

    • toni

      Oh no that’s too horrible. maybe they did deliberately neglect/starve her but it would not surprise me if the mother was just not producing enough milk and didn’t know. this could easily be one of the many mdc mums who start threads about their babies losing weight and are advised told ‘keep at it’, ‘it’s normal to lose at first’, ‘don’t supplement’ etc. although it is odd that they hadn’t taken her to a doctor at all

  • a_m_o

    I experienced this pressure from the hospital lactation consultants while my son was in NICU recovering from surgery to repair esophageal atresia/tracheoesophageal fistula (a rare defect we didn’t know he had prior to birth). Our transfer to the NICU in another hospital and the shock of his defect was incredibly traumatizing and exhausting, I was barely functional and separated from him for the first week of his life while he was on a feeding tube. All the IBCLCS had to say to me was PUMP PUMP PUMP. Round the clock. I physically and emotionally couldn’t keep up. My state of mind was never a concern to them. Once we got home, I decided to prioritize bonding with my baby rather than torture both him and me in trying to establish BFing (neither of us took to it very easily) after the hospitalization delay. While it was hard to finally let go of pumping and trying to nurse him, to the extent that I did, much of that difficulty was directly related to the external pressure to BF him rather than my own feelings about the subject. He is now exclusively formula fed at 6 weeks and absolutely thriving after his very rough start at life.

    • KeeperOfTheBooks

      I’m so glad you’re both doing better, and that you’ve figured out what works for you! Get those newborn snuggles in while you can, and enjoy them! πŸ™‚

    • Montserrat Blanco

      I am sorry you went through that whole experience of NICU and early surgery for your baby. I am also sorry you had such a bad experience with hospital staff. It must have been hell. I am really glad you both are doing fine now.

    • a small person

      Believe it or not, the staff was trying to do what was medically best for your infant. There are oxytocin receptors in the gut, which have a huge effect on autonomic nervous system function when they are met with breast milk. For an infant who has suffered so much, that boost of oxytocin (also the hormone of love) can have a huge impact on his autoregulation through the trauma of recovery from those surgeries. It also causes less reflux than formula, which would be gift after TE fistula repair. Not only does breast milk meet the needs of your infant in a way that formula cannot, babies acutally die in the NICU all the time from gut death, in much larger numbers if they are formula fed.

      No, they did not offer you the support you needed. The patient is the infant in a NICU, not the mother. But mothers should get more support. But they did want what was best for your baby. The heath effects are massive, and if you see babies suffering in the myriad of ways they suffer in a NICU, and what the effects of breast milk are, you become an advocate for those infants by unapologeticly encouraging pumping.

      You can’t fault the staff for asking you to give your infant a miracle medicine that hospitals have no access to.

      • Nick Sanders

        You dug up a two year old comment to spew a bunch of buzzwords and bullshit, then say that a woman who had just given birth wasn’t a patient? Get lost, creep.

        • momofone

          But what a fitting pseudonym, don’t you think?

        • Roadstergal

          Oh, Nick, you’re so mean. You need more love hormone.

          • Michael McCarthy

            Maybe ‘a small person’ would be willing to let him breast feed so that he will get the oxytocin to the appropriate gut receptors?

      • demodocus

        I wasn’t a patient when my daughter was in the NICU? Then why was I wearing a johnny and an IV?

        • Maud Pie

          You weren’t a patient, you were just a machine producing hormone of love and magic medicine. The medical apparatus was just equipment for operating the machine. Don’t get any ideas into your head about your well-being, lest small person think you’re a bad mother.

          • a small person

            Nope, Maud, I don’t think she’s a bad mother at all. Not one bit. I think that it is extremely difficult to be a NICU mother. And I couldn’t have pumped, either, like that. I’m only explaining the perspective of the NICU monsters who tried to to the best for their patient. But that makes me a creep, right?

            I wish we could offer greater support. I wish we had beds by the incubators where moms could sleep, and pumps in the room so moms could hold their infants or at least lay hands on them and smell them while they pumped. I’m doing everything I can to make that happen. I wish lactation consultants would talk to moms and support them in the difficulty and trauma that is the NICU, but hospitals are not staffed for human interaction.

            Demonize me all you want. I keep those babies alive, day after day, and I love the families and the babies through the horror of the NICU experience. I was just trying to present another perspective so you don’t think we’re just trying to hurt you. We’re not. We’re trying our best to keep babies alive. It’s not a situation I would wish on any family.

            It is not uncommon for milk to take 5 days, and the stress of that is painful. It is not uncommon for the stress to make milk extremely difficult to make adequate- especially if it is a first baby and delivered very early, before all the breast tissue is able to develop. That just doesn’t change the fact that the milk you make, in whatever quantity, gives your baby the best chance for survival. Should we stop encouraging that?

            I’m glad you and your baby are well.

          • Roadstergal

            If nurses pressed vaccination and Vitamin K a fraction as hard as they pressed breastfeeding, I’d take this ‘for the benefit of the baby’ business a lot more seriously.

            The other thing I don’t understand is – it’s generally accepted that sleep deprivation makes the body work less well. If the goal is to get lactation going as quickly as possible, why is the woman not allowed to get adequate sleep? I’ve heard lots of nurses spout off on how you need to pump 24/7 to get milk going, but haven’t seen any evidence that this regimen actually does any good. Where’s your evidence that pumping is more effective than resting at getting milk supply started?

          • Sonja Henie-Spinning Jenny!

            What is your evidence that nurses don’t “(press) vaccination and Vitamin K”? Vaccination, except for the birth dose of Hep B, doesn’t usually happen in the hospital, except sometimes in the NICU. Vitamin K is given at delivery. No one is saying it is necessary to pump 24/7, either.

          • a small person

            Yes, sleep is important. Nature did not design newborns to be fed after 8 hours of sleep. In order to keep milk supply up or encourage production, pumping every 3 hours (that’s 8/7, not 24/7) is what is recommended. A newborn at home, healthy and term, would not allow you to sleep for 8 hours. Protein must be constantly circulating in the body in order to build new cell structures. It cannot be stored for use later like energy, so infants must be fed often. That is why we encourage pumping every 3 hours, 4 at night, so you only really have to pump once in an 8 hr night time period.

          • corblimeybot

            It’s this kind of attitude that was so, so dangerous to me while I was recovering from HELLP syndrome and massive PPH, and LCs pushed me onto this idiotic pumping schedule. Thank god my father stayed with me for a few days and fed my baby formula supplements while I slept. But after that, it was this exact schedule that contributed to my health being a huge fucking wreck postpartum.

            Everything got a lot better when I dropped the pumping and just fully accepted combo feeding.

          • a small person

            It’s not an attitude, corblimeybot, it’s information. You don’t have to get angry at me for information. I’m not telling you what to do, I’m telling you the reason it is done. You do what is right for you. It would be reprehensible for the NICU staff to NOT tell you what is best for your baby. In the end, you decide what is best for the both of you.

          • Erin

            Speaking as another NICU mother, I agree with regards to the information but tone and what happens once that information has been imparted matters too. I have a very good reason (in my opinion) why hand expressing and pumping are not options for me. I was fine with the NICU nurses presenting facts to support their desire for me to hand express/pump. What I really struggled with and to be honest, still do was their determination to make light of my reasons, to tell me I was wrong in my thinking and to belittle the mental health crisis I was going through. Repeatedly telling a woman who already believes she’s failed her baby that she’s hurting them because she can’t hand express does one thing and one thing only, it pushes her further over the edge.

          • Bombshellrisa

            Pumping every 3 (or 4 hours) leaves very little time between cycles to get any kind of rest. For me, somewhere between 38 and 42 minutes with cleaning pump parts, caring for baby and getting to use the bathroom or getting a snack.

          • corblimeybot

            That’s exactly what happened to me, and in fact I wasn’t able to eat at all during most of the day when I was doing the “every 3 or 4 hours” pumping schedule. I was totally alone during the day from week 2, because my husband had to go back to work. I only had time to pump, attend to the baby’s needs, and drink fluids.

            I’m sure someone will come along to explain to me why I really DID have the time, but I was so stupid I didn’t realize it. In advance, I request they bite me.

          • Bombshellrisa

            Yeah, waiting for the dumb comments. Maybe Brooke can chime in and tell you that drinking only fluids is fine, as long as it’s a Starbucks frappacino.

        • a small person

          Not in the NICU. I don’t know if you were a patient in the adult ICU (unlikely) or post-partum. But I was talking about the pressure to pump for a NICU baby. Look, it is traumatic and awful. I am not diminishing that. Pumping adds a ton of stress and lack of sleep. I’m not diminishing that, either. I’m just saying they were trying to do the right thing for your baby, medically speaking. If the hospital could provide anything close to your milk, they would. They can’t. So they encourage you to. Even when it is hard. You make the choice about what is right for you, but it is the job of everyone in the NICU to do what is right for your baby. One thing I learned as a mother is that it is not just my baby, it’s both of us. I make choices for us both. The NICU staff’s job is only to do right by your baby. They weren’t trying to hurt you or even being insensitive. We know how hard it is. We do. We still advocate for the baby because we see babies die from gut death all the time. And no one wanted that for you. No one knows which babies will get it and which will not, but the odds of it, or reflux, which would have been painful with his condition, are much higher than with formula.

          • demodocus

            It would have done squat anyway. My milk didn’t come in for 5 days the first time and 4 the second.

      • Roadstergal

        Oxytocin receptors in the gut? What are the gene names? How has the pattern of expression been determined? Where has the downstream signaling pathway been published?

        Love hormone, my posterior. It’s a parturition and lactation hormone. I admit, it’d be fun to go around injecting people with Pitocin to make them fall in love with me, but reality gets in the way.

        If by ‘gut death’ you mean NEC, I didn’t see where in her narrative she said the baby was premature. Preemies are the population where it has been shown that breastmilk – only some women’s breastmilk, it’s a bit of a roll of the dice – can reduce their elevated risk of NEC.

        And it’s small, but pet peeve. Myriad is an adjective, plethora is a noun. So ‘myriad ways’ or ‘plethora of ways,’ not ‘myriad of ways.’

        • a small person

          Um, yes. Oxytocin in the gut. Here’s an article about it from the Journal of Comparitive Neurology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097117/

          If you have questions about that, maybe you should do some research of your own and disprove it?

          Oxytocin as the love hormone- yes. Oxytocin is what is responsible for our feelings of “love” and bonding.

          And here’s some information about NEC in full term infants. BTW, one thing we know about NEC is that if there is one case, there tend to be more in the same unit. Indeed, we treat it with antibiotics, in part. And the compounds in breast milk are thought to seal the cilial gaps which might contribute to NEC.

          https://www.ncbi.nlm.nih.gov/pubmed/12861534

          Why are you so angry with me? For providing information and perspective that isn’t angry at anyone?

          • Heidi

            So, a small person, what does that first study say? I ask because I (kind of) read it and it meant diddly squat to me so I’m asking for your interpretation of it.

  • sdsures

    Just the other day I saw yet ANOTHER article from the Guardian on breastfeeding and pushing EBF on new moms. They should call pieces like this “guilt articles” – what do you think? http://www.theguardian.com/lifeandstyle/2015/mar/29/pains-and-gains-of-breastfeeding-new-mothers?CMP=fb_gu Not because the writer, a mom who went through the agony of difficult breastfeeding, is saying that all moms should feel bad for using formula, but because she felt guilty and was judged harshly (silently harshly sometimes, those sad smiles) when she pulled out the formula at work.

  • Guest
    • Samantha06

      Too funny!

  • Mariana

    My daughter starved for the first month of her life. I was too stupid to give her formula sooner. I tried and tried, until the paediatrician saw her and told me in no uncertain terms she was starving, and waaaay too thin. She is 4 now, and as bright as they come. For so long I worried I had cost her IQ points for not breastfeeding… I may have cost her even more by starving her. I was so determined to do the best for her, it pains me to realise I only managed to do harm.

    She is smart, she has a vast vocabulary (for a 4 yo), and she learned how to read and write on her own (she would ask us how to write the sounds and about letters and we indulged her… Pretty soon she was writing on her own!). So maybe she is blessed enough to have been spared too much damage… Maybe she would have been a genius and will now will only be “smart”.

  • GiddyUpGo123

    Is it really as high as 5 percent? When I was (failing to) breastfeed, I was repeatedly told the number was less than 1 percent, if it was a number at all (many people claimed that there wasn’t any such thing as a woman who can’t produce enough milk). Five percent is huge. That’s like one in twenty. That’s not a remote number at all–if you know 20 moms, at least one if them couldn’t produce enough milk to feed her baby.

    • anh

      I read a study that said when you combined both primary and secondary failure the number was up to 15%

    • justme

      The people who said there was no such thing are idiots. If they had said everyone’s kidneys work perfect or there’s no such thing as congenital heart defects it would be immediately obvious that they’re wrong. How are breasts the one part of the body that always functions perfectly?

    • Cobalt

      Based on my experiences working with animals, talking to other moms, and whatever historical information has seeped into my brain, I would guess that around 25% risk starvation or malnutrition without supplementation.

      An honest study would be nice.

  • sleuther

    I sometimes share this story in the comments in the hopes that it will be of help to someone…

    My grandmother had two kids. The older one, my aunt, she successfully breastfed. The younger, my dad (born six years later, in 1935) breastfed but he wasn’t gaining ANY weight. He had plenty of wet diapers. She knew what she was doing BF-wise as she’d done it previously. But she visited the doctor with my dad who was not gaining weight.

    The doctor asked her a lot of questions and it became clear that my grandmother’s beloved father had recently died. That affected her breastmilk somehow – it was copious in volume but it had no nutrition. It was “like water.” The doctor recommended switching my dad to formula (the 1935 version thereof, which had to be mixed from several ingredients and was a whole production.) She took the doctor’s advice and my dad started gaining weight. He went on to have successful life, earned his Ph.D., had a family, earned tenure at a top university, and retired. He turned 80 a couple of weeks ago.

  • NewMom

    I am glad you addressed this topic. After my son was born nursing wasn’t going well. He would nurse for hours and never be satisfied. Several LCs told me not to worry and just to keep trying despite the fact that during weighed feeds he would only get like half an ounce in half an hour . He gained some weight initially and then had a steep drop. Thankfully our no-nonsense pediatrician insisted on supplementing. He started gaining steadily and ,what is more striking in my eyes , went from 15th percentile in head circumference to the 60th percentile within a month.

  • MichelleJo

    This is something that desperately needs addressing. There is one consequence, for the mother, which absolutely comes from this, and that is terrible, never ending guilt. It’s been almost seventeen years since I starved my first born to the chorus of “there is no such thing as not enough milk”, “it works by supply and demand”, “not being able to produce anything by pumping doesn’t mean you don’t have milk. The baby’s sucking action is way more effective than a pump”, “babies are supposed to cry for three hours a day”, “if you don’t nurse, your baby will be ill, daft, fat”. I thought they were right, and the fact that he hadn’t slept for longer than an hour at a time since he was born (as neither had I), was for some other reason. But subconsciously, I knew. The night before he was due to be circumcised, I said that this child is starving and is going nowhere without being fed first. He gulped down a bottle of formula, and slept for ten hours! Then another bottle and eight hours. This went on for a few days, until he settled into a normal routine. He hardly cried for more than three minutes a day. I still cannot talk about it without tearing up, and it doesn’t help to tell me that he’s non the worse for it and he doesn’t remember it. At the time, he was suffering terribly, he was starving! And I did it to him, fell in for all the woo.

    • Sue

      What a distressing situation. Hopefully you will come to understand that it was you who took matters into your own hands, despite the pressure, and made the change that has helped him thrive.

      • MichelleJo

        Thank you both of you. The knowledge that it took myself to save the situation is calming. When I was due with my daughter, I was deliberating on whether I should start off combo, or maybe EBF as supposedly lack of milk is more common after a first birth. But once she was born, and I held her in my arms, all deliberations went out of the window. What had I been thinking?! She was fully formula-fed from birth. She was my daughter, a helpless, precious human being, not an experiment.

    • NoLongerCrunching

      I’m so sorry for what you both went through. I know nothing helps, but you are an amazing mom for listening to your own instincts and doing the right thing.

  • FortyMegabytes

    CSB: When my daughter was born, we tried breastfeeding. My daughter lost weight to begin with, enough so that at less than two weeks old we brought her in to the emergency room because she was practically skin and bones. They diagnosed her with “Failure to Thrive” and gave her formula. That staunched the weight loss, but she didn’t gain weight until we switch to high-calorie formula. Then she started putting on weight.

    The hospital told us that if we weren’t so obviously concerned about her weight loss, they might have call CPS on us for starving our daughter. Thank goodness we weren’t hard-core lactivists. While my wife wasn’t happy she couldn’t exclusively breastfeed our daughter, at no point did she let those feelings get in the way of getting our daughter what she needed to thrive.

    • RMY

      I read a bunch of ttc/birth/baby blogs (by lesbians, since we have a harder time getting knocked up), because I was ttc (we ran out of funds to try), and there was one blog I couldn’t follow. While I think being a SMBC is a respectable choice, she didn’t seem to think financial security before parenthood should be a priority, and got pregnant, thankfully she gave birth in a hospital, but after that she got it in her head (based off of a .pdf she found online) that her son would get celiac disease(which she has) if she fed him any formula and her milk took a while to get it. When the child was becoming lethargic from hunger and dropped from the 50th to 5th percentile, the doctor told her to give the child formula, and she refused and was super pissed off when CPS showed up citing the obvious medical neglect.

      She never did give her poor kid formula, and he’s a tiny, tiny toddler who has challenges. πŸ™ And she still pats herself on the back about what an awesome mom she has been. It just makes me sick.

  • The Bofa on the Sofa

    I think it’s interesting that you didn’t mention anything about potential epigenetic effects.

    When I think of the potential problems of starving the baby, I think of how NCBers jump on everything they can, especially related to c-sections, as causing epigenetic problems, but hey, starving a baby? Nah….they’ll get over it.

    And what effect does it have on the microbiome? Doesn’t the lack of food cause microbiome changes? Hmmm?

    • lawyer jane

      There actually is research showing that growth restriction can result in obesity, because when kids start getting enough food they go through a “catch up” growth spurt that can trigger bad metabolic processes. http://onlinelibrary.wiley.com/doi/10.1111/j..2002.00005.x/full

      This is what happened to my own kid – he was falling off the charts until we supplemented & started adding in a lot of solids at 6 months. Then he skyrocketed towards the 90% percentile by a year, to the extent that we’re now worried about overweight!

    • Daleth

      The gut flora!!!! The gut flora!!!!! Oh, the humanity!
      πŸ™‚

      • yentavegan

        or the virgin gut..wtf is up with that! Must we expand the parts of the human body that can/should have virgin status?

        • KarenJJ

          The virgin bowel.. The virgin nose (soon to be defiled by various toddler controlled substances and digits). The virgin feet…

          • Sue

            The virgin brain…

          • KeeperOfTheBooks

            *chuckles* Indeed! DD, age 12 months, has just learned how to stick her finger up there. Pardon me while I cringe, twitch, and redirect. A lot.

      • KarenJJ

        Stupid question, but why is it “gut flora” if it’s bacteria. Wouldn’t it be gut “fauna”? My 20yo high school biology is failing me… Or are bacteria actually plants? (off to google…).

        • Sue

          Good question! Maybe gut “biota” – since bacteria are neither animal nor plant.

        • Roadstergal

          Separate kingdoms. We say ‘microbiome,’ but occasionally say ‘gut flora’ when we’re feeling poetic – I’d guess it’s historical…

          Also
          http://xkcd.com/1471/

    • Cartman36

      I hate when lactivists say use epigenetics as proof that “breast is best”. It reminds me of this meme.

      • The Bofa on the Sofa

        I hate when lactivists say use epigenetics as proof that “breast is best”.

        But it is conveniently forgotten at other times…

        • Medwife

          I’m starting to hate when anyone aside from biologists say the word “epigenetics”. 99% of the time it is followed by a stream of bullshit.

          • The Bofa on the Sofa

            It’s the bio equivalent of “quantum”

  • anh

    I cringe painfully when I see pictures of my daughter at 5 weeks. She wasn’t back to birth weight until 6 weeks AND she grew an inch in that time period. You can imagine how awful she looked. My dear friend from colllege who is a pediatrician now wrote me an email after seeing pictures of her on facebook, very gently telling me I needed to fix this situation now. I cried forever.
    What kills me the most? I was following medical advice. Her PNP was also an IBCLC. We had a big weight gain (9 ounces in 4 days) around 3.5 weeks, and I was told to stop supplementing, that if she was hungry she’d eat. She also said her tongue tie wasn’t an issue and didn’t even notice her lip tie. Over the next ten days I struggled to EBF, truly honestly following medical advice, and starved my daughter. starved her. My husband tried to convince me to supplement, but I knew better! KellyMom warned me about unsupportive people like him. Over those 10 days she grew weaker, her latch got shittier, her suck got worse, and the supply I’d built up dropped and dropped. She lost 6 ounces over those ten days. I still feel so shitty about this.

    • Maya Markova

      I was the same with my first child, and I feel the same way.

    • lawyer jane

      Wow, I’m shocked that your own pediatrician encouraged this. Scary. Did they at least do the post-feeding weigh ins to see if the baby was getting anything? That borders on malpractice.

      • NoLongerCrunching

        That seems like the very definition of malpractice to me.

    • yentavegan

      Please don’t beat your self up over the learning curve every mother has to endure.

    • SporkParade

      I’m still kicking myself for believing the hospital nurses when they said that the glaringly obvious signs of neonatal dehydration were nothing to be concerned about. I should have trusted my instincts but I made the mistake of assuming that they were medical professionals and bound to some sort of code of ethics.

      • Joy

        Same here. No wet nappies for over 8 hours (I just didn’t notice) no dirty nappies at all (maybe CF!), feeding for less than five minutes a side before falling asleep (they don’t need much food). Thank God for my husband bringing in the RTF bottles so I could prove how little she was eating and thank god for the trainee consultant (? or whatever she was) who listened before everything went to total shit.

  • SuperGDZ

    There is also the issue of insisting on exclusive breastfeeding between 4 and 6 months – there is reason to believe that some infants may suffer from iron and zinc deficiency if complementary foods are introduced only at 6 months.

    • Cobalt

      I now hear a lot about how complementary foods, especially those that are iron fortified, actually contribute to anemia because they interfere with the gut’s ability to absorb the (far superior) iron in breastmilk.

      I am very skeptical of this idea, and I’ve not seen a pediatrician promote it, so I’m giving my (mildly anemic) baby all the supplemental iron he’ll take.

      • Amy M

        I thought there wasn’t much iron in breastmilk? And even if there was, how would it be different from the iron supplements?

        • Cobalt

          According to the proponents, the iron in breastmilk is formulated in such a way that it is used completely by the virgin gut, so a little goes a long way. Giving ANY supplemental iron (formula or cereal or vitamin drops) ruins the guts ability to absorb the breastmilk’s iron properly.

          This is sometimes extended to claim that the supplements will actually create anemia by ruining the virgin ability to process the iron in breastmilk, creating a need for hyper-supplementation and various other ill effects.

          The addition of actual red meat (and never the jarred stuff!) can be ok or not ok, depending on the source of the information. A site whose scope pushes “natural parenting” beyond infancy is more likely to say meat is fine, a site limited to just infant feeding tends to lean heavier on the breastmilk’s special iron.

          The solution is, as always, to just use more breastmilk and for longer.

          • Amy M

            That sounds like a bunch of hooey to me.

          • Cobalt

            Well it starts with something that is reasonable and probably true (the iron in breastmilk is easily absorbed) and then uses that to justify ignoring all other facts (you can’t absorb what isn’t there, babies need iron), ending with nonsensical conclusions that reinforce ideology (anything other than breastmilk is BAD, giving your baby iron in anything other than breastmilk will make them anemic).

            Hence, I agree with your conclusion. And my kid is getting formula in cereal after I talked WIC into testing him for anemia because I was worried about his mostly breastmilk diet being insufficient. She was SHOCKED that our “breastfeeding success story” included anything less than perfect anything. What shocks me is that he eats formula in cereal. He won’t take either separately.

          • Amy M

            Where do they even get this from? I mean, I wonder who the original bull-sh***er was, and if he or she is congratulating him/herself on fooling a whole lot of gullible people? On fb the other day, a friend of mine saw something that was completely ridiculous on a page called “I f**king hate science” and didn’t recognize the meme OR the page as satire. She would probably believe the above clap-trap about the iron in breastmilk. πŸ™

          • toni

            my son was found to have low iron levels I think around 1 year old, maybe earlier. I don’t know if he was actually anaemic they just said it was on the low side. He didn’t take to solids, wouldn’t take a bottle so he was still getting 95% breastmilk. I gave him those horrible iron drops (in the bath usually- messy stuff) that he hated but what he swallowed of it must have been enough because his levels were normal at the next appt so as far as i’m concerned it is absorbed just fine! i still worry that i deprived him of adequate iron for so long

          • toni

            i mean he’s two now and barely says five words though he does recognise a lot more. could be that i confuse him by speaking too many different languages (?) but I can’t help worry that it reduced his brain function somehow

          • Cobalt

            My older son didn’t really talk until he was two and a half. He’s now grade levels ahead in language arts. Some kids just talk late, especially if they don’t NEED to (like if they’re using sign language or otherwise getting their point across without words) or if there are multiple languages being absorbed at once. You can have an evaluation done if you’re worried (see if Birth to Three is available where you are- they specialize in identifying and treating developmental concerns, regardless of financial status), but there’s a really good chance it’s just his curve.

          • Courtney84

            Our son is only 15 months, and pretty much doesn’t speak. He says mama and dada, but doesn’t always use them correctly or with intention. He makes a vacuum cleaner sound and woofs like a dog. But he’s always been pretty early with the gross and fine motor skills. We also have a pretty relaxed parenting style of mostly letting him do things/figure things out on his own when it comes to things like toys or daily activities. Our ped chalks up his not talking to: it’s easier/faster just to do it himself so he’s not highly motivated to figure out speech.

          • An Actual Attorney

            N=1 here, but Actual Kid didn’t really speak at 2. Took him to be evaluated for various issues, including autism. Pediatrician was nice about it, but clearly saw us as two over-hyper first time moms.

            He was right. Actual Kid is 4 now and WILL NOT SHUT UP!!!!

          • Amazed

            My dad went through the periods as follows: 1) When is she going to start talking? 2) Doc, why all those questions about whether she truly uses full sentences? Is something wrong with her? *old fear catching up. At my birth, poor man was convinced that a head this strange (vacuum) could not have NOT sustained brain damage; 3) Is she going to shut up, ever? 4) She takes our conversations hostages! She always tells my MIL exactly what she shouldn’t. HELP!

          • Medwife

            I have read that children being raised in a multilingual household are sometimes slower to get started but in the long term benefit hugely. I’m not saying don’t get him evaluated for language delays anyway, but it’s a possibility.

          • SporkParade

            It’s a debate whether multilingual children are actually slower to learn because they are busy sorting the languages out, or they just appear slower because what they are learning is distributed among the languages. In any event, they need to hear a language about 1/3 of the time to learn it, and the maximum number of 1st languages appears to be 4. Not that I overplanned what to do with my kid or anything. πŸ™‚

        • Sarah

          There isn’t much, certainly not enough. That’s why we’re born with several months worth and by the time it’s used up, we’re on solids. Because we’re not meant to get much of our iron from milk. But what iron there is in breastmilk is quite easily absorbed. Lactivists mix the two facts up all the time.

          • Daleth

            I love how “nature’s perfect food” (according to lactivists) actually doesn’t have enough vitamin K or iron for babies. And, of course, it only has enough of anything else if MOM has enough of everything else. I once read about a woman whose baby was diagnosed with rickets because she had low blood levels of vitamin D and was EBF.

          • SporkParade

            It doesn’t have enough Vitamin D, but my understanding was that babies just aren’t very good at metabolizing Vitamin K plus placentas aren’t very good at transfering it while they’re still in utero.

          • Bugsy

            This is really good to know. My toddler wanted boobie over foods any chance he could get until I weaned him at 2. His weight gain was also in the tank, but I naively believed that my milk was the most perfect food for him.

            Anyway, come to find out a few months ago (2 years, 3 mo) that he’s severely anemic. It’s so frustrating to know I bought into the hype without actually knowing the facts.

  • KarenJJ

    I have to say that this “What will be the long term effects?” does haunt me at times and I very much regret my initial commitment to exclusively breastfeed (which was also reinforced by nursing staff who refused my request for a bottle of formula in hospital for my hungry and unsettled infant).

    My mother and grandmother worked in baby nurseries in hospitals during their nursing training. In their words it was heartbreaking work with crying infants being taken at scheduled times for feeds/changes/naps etc. Something needed to change and it did.

    But instead of listening to women and instead of providing MORE information and options to women, instead we are still treated to “this is the best way for mothers to behave and you must follow it” mentality. So breastfeeding and rooming in are the only possible options “supported” in a hospital and other options are unavailable or need constant “re-education”. Instead of helping mothers to find their feet, they are still subjected to “we know what’s best for your baby and we will enforce it for your own good”.

    I’m more than happy for hospitals to give evidence based information on good feeding practices and good sleeping practices etc, but not enforcing it through denial of options, information and manipulation of circumstances such that there really is NO choice. We should be demanding more for women and babies overall, not just demanding choices that only reflect our own preferences.

  • Sue

    Perhaps we need to share and publicise the research on the potential IQ deficit occurring as a result of neonatal starvation – I expect the evidence is much stronger than any cognitive advantage that might be associated with exclusive BF.

  • SporkParade

    What I don’t get is how we’ve gone from encouraging women to breastfeed to pressuring them to breastfeed exclusively. I can’t think of any other area of health where, not only are people providing medical information NOT trained medical professionals, but they are also encouraged to lie to, hide information from, and flat out gaslight their patients. Guess what, breast Nazis? If I see my baby isn’t doing well on exclusive breastfeeding, and you are telling me is that combo-feeding is a slippery slope to drying up, I’m not going to “try harder.” I’m going to just go straight to formula.

    • KarenJJ

      “they are also encouraged to lie to, hide information from, and flat out gaslight their patients.”

      This happens is so much in maternity and infant health care. I wish nursing and midwifery organisations would look much closer at how they are delivering patient care to mothers and infants. Some seem to be in it for the control and manipulation over women’s behaviour that such a role can give them and it seems to be difficult to get the complaints heard.

      • Sue

        Extraordinary, isn’t it? Imagine if people were encouraged not to report their chest pain lest they be diagnosed and treated for a heart attack!

        • Bugsy

          Next up in the all-natural world…

      • SporkParade

        Fair enough. I’m in a system where the power of midwives is very limited, and the qualifications to be come one are very high, so I think I was spared.

  • WordSpinner

    This reminds me of c-sections–for a low-risk woman, not having a planned C-section has some benefits, but natural birth enthusiasts interpret that as C-sections are bad and shouldn’t be done… and therefore cause complications that would have been prevented by a c-section.

    Similarly, for women in developed countries who can breastfeed, breast milk may provide small health benefits over formula, but lactivists interpret that as formula is all bad all the time, and babies starve as a result.

  • I have not read through all the comments yet – but as a hospital LC, I am not hesitant to suggest supplementation when needed, nor are my fellow LCs. We do not pressure. (We are not “baby friendly” – but are friendly to all babies.). But one thing that is beginning to impact us is this: https://www2.aap.org/breastfeeding/files/pdf/NewJointCommissionPerinatalCareCoreMeasure.pdf
    There is beginning to be more pressure to increase “exclusivity” and ultimately this will likely be tied to reimbursement. All hospitals with over 1000 deliveries per year are required to report these rates (starting in 2014) and demonstrate an increase in exclusive breastfeeding rates each year.

    • Young CC Prof

      Definitely, it’s the whole culture that’s the problem. And there are several issues with the Joint Commission’s plan. The first is that pushing absolutely exclusive breastfeeding in the hospital is not necessarily a good way to promote long-term breastfeeding success.

      The second and much bigger problem is the very idea of rating hospitals on breastfeeding rates. Breastfeeding, or not, is a choice that families make based on their own circumstances, and it’s not at all appropriate to ask medical professionals to push it the way they’d push smoking cessation or medication adherence.

      And finally, increased rates every year? Do they expect to reach 100%?

      Here’s a much better measure for the JC, something which is actually within the hospital’s control: Feeding support.

      Women should be asked about their feeding plans, and women who plan on breastfeeding should have the chance to initiate immediately after birth unless medically unfeasible. They should be provided with LC services on the day of birth and as needed thereafter, with easy access to additional help post-discharge. And all first-time parents should be trained in safe bottle feeding, even those planning exclusive breastfeeding. It’s not rocket science, but the training takes like three minutes and could save a baby from serious harm.

    • SporkParade

      I am glad your hospital has normal LCs. That was not the case at all at the hospital where I gave birth and was denied information on supplementing over multiple shifts.

      • Roadstergal

        “There’s an e-mail address at the end of the slides. I’m gonna give them a piece of my mind.”

        That’s a great idea. Things will only change if those with the purse-strings hear the mothers who aren’t in line with these measures.

        • rh1985

          The only perinatal core quality measures on the list that make sense to me are the steroids for babies who are at high risk to be born very premature and the newborn infection one. The breastfeeding one is ridiculous (especially since the hospital still loses points in one of the two breastfeeding categories if the mother chooses to exclusively formula feed from the start, seriously, I chose to formula feed long before I ever got pregnant for health reasons, the hospital should not be punished for that and nor should they feel they have to pressure moms to change their decisions), I dislike the early elective delivery one for the same reason I hate the 39 week rule, and I reallllly hate the c-section one as a mom who chose a MRCS (even though it turned out to actually be medically necessary, but I did not know that would end up happening at the time I made the choice and scheduled it)

          3/5 are nonsense and the hospitals aren’t even required to report things like birth injuries that actually MATTER

      • I’m sorry you had a lot of pressure and no information. It is true that SOME babies may stop breastfeeding as effectively or often with frequent supplements of large volume – based on what I see – but if a mom wants to do “both” – I explain a plan that may help a baby still be willing to latch (if that’s mom’s desire) – (i.e. small infrequent supplements works better to keep baby at breast).
        Curious – was the hospital a “baby friendly” hospital?

        • SporkParade

          The hospital wasn’t “baby friendly” since I’m not in a country where that’s a thing, but they do promote themselves as supportive of breastfeeding. Our situation was that we were basically in a downward spiral of dehydration, but the nurses minimized the seriousness of the situation and refused to let me ask questions about supplementing in order to railroad me into accepting more risk than I was willing to for the sake of increasing their breastfeeding rate.

    • rh1985

      It is bizarre to me that exclusive breastfeeding (something that is, and should be, ultimately out of the hospital’s control and not their decision) is something a hospital is rated on, as are c-sections and elective deliveries, but they aren’t rated on preventable infants deaths or brain damage.

    • Sue

      So glad to hear from a rational LC working within a community of rational LC’s – thank you!

      Valerie, what forces do you think are driving the zealotry, and what advice would you have about overcoming it? (Other than early discharge, which just releases families from the clutches of the zealotry earlier).

      • I am aware of the zealotry, and the Joint Commission’s goals – but mostly I just want to help a mom reach her own personal breastfeeding goal – or help her through the grief of things not working as planned. “Define her own success” is a good plan. Our department provides individualized care – based on mom/baby – not stats and numbers. I stay out of the zealotry mostly (too mentally exhausting) – and focus on one mom at a time in my real world. The hospital setting is interesting – a lot of “I have no milk” and moms learning about babies and parents scared and exhausted. Plenty of opportunity for education and tons of emotional support to be given. πŸ™‚

    • J.B.

      I do think it’s a problem for parents of newborns to be discharged so quickly from the hospital. If you’re trying to breastfeed has the milk even come in yet? With your first kid how would you know everything is even ok?

      • How to know everything is ok: adequate output based on which day of life, not continuing to lose weight after day 3, f/u with pediatrician within 1-2 days post hospital discharge to monitor weight and for hyperbilirubinemia, mom experiencing engorgement by day 3-5, hearing more swallows as baby is feeding, having a frequently feeding baby (8-12 times a day), being aware of risk factors for supply issues and informing moms of this, understanding how to assess whether a baby is contentedly nursing often vs. protesting and not latching anymore due to low supply, monitoring type of stool and color of urine – all of which we teach at discharge. So although the full supply is not likely in at discharge day – especially for vaginal deliveries – most moms are beginning to feel heavier and hear more swallows. If not, we teach about when / if baby might need a supplement and how to pump (short term) to sustain incoming supply. We have a warm line and we see outpatients (pre/post weight done) at the request of the mom or pediatrician. We have 3-7 outpatients each week for f/u. (latch pain, low supply, oversupply, etc… are typical problems) Pretending some moms do not make enough milk is very risky to babies. Our department was organized over a decade ago by an LC (nurse) who experienced low supply and she became an LC due to the poor advice and guidance she received over 30 years ago. πŸ™‚

  • Anne Catherine

    Thank you for bringing some much needed attention to this common, dangerous, preventable problem.

  • Froggggggg

    I just wondered about this on another post a few days ago, so I’m glad to see a whole post on the subject. As I said in my comment there, I wish LCs encouraging new parents to starve their babies would try it on themselves to see how it feels. And really, their tactics only work because they’re paired with the blur of new motherhood, taking advantage of the vulnerable state many women are in – a perfect time to brainwash someone and lay on the guilt.

    I hated being pressured to let my little (now almost as tall as me) boy go hungry and I still remember the cries. πŸ™ I feel far more guilty about him having to go through that than I do about not breastfeeding him for long.

    • theadequatemother

      It’s not just new babies…when mine went on boob strikes around 8-10 months I was told to withhold bottles to force continued nursing. No thanks.

  • Young CC Prof

    My son was readmitted for hypernatremic dehydration and jaundice. What haunts me to this day is that I didn’t see it coming, I had no idea how badly off he was. I am so grateful that I had the ability to take him to where he could get the IV fluids and light treatment he needed to save his life and brain function, and even more grateful that afterward, I could go out and buy the specialized formula he needed to realize his full potential.

    It really is incredible how demonized supplemental feeding is. Instead of a reasonable stopgap or a tool, it’s painted as a perilous choice.

    Just like unassisted childbirth is a choice that can only be made by someone who’s never seen a woman die in childbirth, “Wait for milk indefinitely” is a choice that could only be advocated by someone who’s never seen anyone starve.

  • Minnie

    It amazes me that women value breastfeeding over feeding their child. I just had a baby in December and I wanted to try exclusively breastfeeding, but I had a big baby (9 lb, 13 oz) via C-section (contractions for a week, but my cervix wasn’t softening or dilating at all) and the milk didn’t come in right away and he was a poor latch, even on a bottle. When his blood sugar was dropping the nurses asked me if they could feed him with a nipple, but had to get my permission first. Of course I said okay, but it amazed me that there are women who will say no to that and have to be reasoned with! Your baby is starving!

    When my milk came in, I had plenty, in stupid amounts (probably for the big baby–even 6 weeks after I stopped breastfeeding I still produced milk). Still, he was a poor latch the first couple weeks (even on the bottle), and took two weeks to learn how to breastfeed. Eventually, no matter how much milk I had, it didn’t come fast enough and he really didn’t want to breastfeed. He stopped latching and preferred his slow flow bottles. Most people I know, even the more NCB types understood, but the really extreme side with saying take away anything that will interfere with him wanting to breastfeed. No thanks. He needs to eat. And before he latched I vaguely considered a lactation coach, but if he is refusing to breastfeed I couldn’t really see the point in dropping more money that might end up with just more stress. I get that women want to breastfeed, but it really baffled me to see that women were doing it to the point where it is actually harmful.

  • Cartman36

    This drives me nuts. We won’t let our kids share a comb for fear of lice but apparently breast milk is so magically important it is totally cool to have your friend nurse your baby despite the risk of communicable disease when we have formula at every corner store. WTF?

  • alannah

    There IS a lot of info about malnutrition impacting brain developtement. Lots of studies from developing countries.

    Bottom line: not feeding infants makes them less smart.

    Starving the baby as you wait for the liquid gold to magically spring from your breasts is not the right strategy to optimize IQ.

    http://www.orphannutrition.org/understanding-malnutrition/impact-of-malnutrition-on-health-and-development/

  • Guesteleh

    I can’t get over the people in that Gawker article encouraging the mother to feed her baby raw milk formula. Horrifying.

    • Bugsy

      The whole thing was alarming…especially the knowing nods of approval from everyone when she said that her hypoplasia was probably caused by pesticide exposure.

      I’m admittedly not a scientist, but a mom who read (and was appalled by) The Womanly Art of Breastfeeding. Of course its author would try to blame failure to breastfeed on something that isn’t all-natural! Because naturally, women can and should breastfeed, right?

      • Young CC Prof

        All women can breastfeed easily and naturally, just like all women can get pregnant easily and naturally, right?

        • momofone

          And don’t forget how easily we can all give birth easily and naturally! (unless we’re not Real Parents, or not intended to be)

          • Cobalt

            Real ParentsΒ©

        • Bugsy

          Heh, as someone who only gets pregnant through IVF…yep! But then again, that probably disqualifies me from being a Real Parent…

      • KeeperOfTheBooks

        I believe I’ve mentioned this here before, but when DD was about 3 months old I got rid of my copy of The Womanly Art of Breastfeeding, all of Ina May’s stuff, and a stack of other NCB/all-breastfeeding type books at one fell swoop. It was extremely therapeutic. πŸ˜€

    • Nick Sanders

      Nothing like a little TB to toughen up your baby’s immune system while getting them used to the idea that life is shit.

      • Guesteleh

        Ha!

      • theadequatemother

        My dads brother died at age 18 from drinking stream water downriver of a cow field. Intestinal bovine tb. That was almost 50 years ago but my dad describes his brother sobbing and pleading with his parents that he didn’t want to die. I’m all for pasteurization and antibiotics.

        • FormerPhysicist

          I’m so sorry.

        • KeeperOfTheBooks

          Ugh, mistakenly hit the “vote down” button rather than the reply…I think I fixed it by upvoting, but if not, my apologies.
          I am so sorry. That is truly awful.

    • SporkParade

      I can’t get over people who think raw milk is safe. Have they never spoken to anyone from a country without pasteurization? Even the dairy farmers knew not to drink the milk without boiling it first, no matter how fresh from the cow it was.

      • Cobalt

        They should also eat their meat and eggs raw, for the same reasons and with the same justifications.

        • KeeperOfTheBooks

          Yum, chicken tartar!

      • Bugsy

        Completely agree.

  • TsuDhoNimh

    From one of the medical articles:

    “Conclusion. Hypernatremic dehydration requiring hospitalization is common among breastfed neonates. Increased efforts are required to
    establish successful breastfeeding.”

    NO!!!!! When it’s not working, redoubling your efforts isn’t the solution.

    Educate women that feeding formula along with or instead of breastfeeding is not a sin … starving your baby so you can brag they are exclusively breastfed is one.

    • NoLongerCrunching

      As I have said many times on this blog, sometimes establishing successful breastfeeding involves temporary or ongoing formula supplementation. A baby who is lethargic from inadequate calories is not going to be breastfeeding well, leading to poor stimulation of mom’s milk supply, leading to even less milk going into that baby. It not only doesn’t work to continue to avoid formula, but it causes unacceptable suffering for the baby and its parents.

      • Tsu Dho Nimh

        With orphan lambs, calves or kittens … they usually adopt better to a foster mom if you feed them enough by bottle that they aren’t frantic with hunger.

        Seems logical that humans would work the same.

      • Aliciaspinnet

        It also seems to make sense to me that a woman who is well fed, hydrated and rested is more likely to produce a higher volume of breastmilk. Yet it seems the standard advice to increase supply is to nurse then pump every few hours, leaving the woman exhausted. Subbing in the occasional formula feed so that a mother can sleep/eat seems like it might help to me.

        I wonder if anyone has ever done any studies comparing the above with the nurse/pump/no formula regime.

        • NoLongerCrunching

          God, I wish. Mothers are not only exhausted but they are usually panicking over their babies’ hunger, which can’t be good for the hormones that cause milk production. When you’re pumping, you tend to get less milk if you are hunched over, staring at how much is coming out and stressing over it.

        • Young CC Prof

          I looked into it, and none that I could find. I suspect it’s because anyone who would ask the research question already knows it’s a bad idea, and the people doing it would never think to test.

  • PrimaryCareDoc

    That Gawker article was so sad. I can’t imagine being so completely obsessed with breastfeeding that you have it take over your life like that.

    And I can’t find any scholarly research regarding pesticide exposure and insufficient glandular development. This seems to be a canard invented by lactivists.

    • Amy M

      Yeah, I don’t think anyone believes that ingesting pesticides is a good thing, but until there’s actual evidence of a direct link between pesticides and lactation failure (and pesticides and all the other things people try to link it to–autism! adhd! migraines! ms!), I’m going to withhold my accusations against Monsanto.

      • PrimaryCareDoc

        I’m actually finding articles about pesticide exposure causing early breast development, but nothing about lactation failure

        • Amy M

          Oh, I’m not arguing that pesticides aren’t linked to some serious health issues, and I believe they could be linked to others that we don’t know about yet. I’m just saying I don’t like to decide that X causes Y without evidence. πŸ™‚ You know, when there’s a disorder that doesn’t have a concrete cause and people who can’t handle uncertainly decide what that cause must be (like vaccines and autism.) I think that’s dangerous. Avoiding pesticides is probably a good thing, but avoiding vaccines is not, so I guess its good the LC didn’t tell that lady it was the vaccines that caused her IGT.

    • PrimaryCareDoc

      Ok, I found one article from 30 years ago: http://www.ncbi.nlm.nih.gov/pubmed/3928347 It was a cohort study and showed that women with higher concentrations of DDE breastfeed for a shorter duration than women with a lower concentration. Nothing about why it was shorter. And even the women with the highest concentrations of DDE breastfed for a mean of 9 weeks, so it is not an issue of insufficient glandular development.

  • Sarah1035

    I’ll spare you the breasting story, beyond it simply didn’t work and is filled with the same BS pressure many other women go through. But the interesting thing is after investigating some odd development quirks my 2.5 yr old son has, we received a 16p11.2 microdeletion diagnosis. One of the common symptoms is early feeding issues. Even after switching to a bottle he would take 60 minutes to eat 3oz. I kept him gaining weight and off a feeding tube but it took some effort. He also couldn’t drink out of a straw till he was two and when switching off the bottle we went through 7 brands of sippy cups to find one he could get fluid out of.

  • Isilzha

    From the gawker article:
    “If it meant starving my baby while I taught my body what it surely
    knew, I would do it. There was ancient knowledge locked away within me
    and I was determined to find the key. I was raising a girl. For her sake
    and mine, I would take this as far as I could.”

    At least she did finally start using formula, but how can someone knowingly starve their baby?

    • Amy M

      Yeah, that line stood out at me too…”for her sake?” How can you starve someone for their own sake?

      • The Computer Ate My Nym

        If you believe that formula is poison and the baby is better off starving then, yeah, it’s for her sake. And people who believe that will never stop trying to breast feed in the face of a starving infant. Because they want to do what’s right for their child.

        • Amy M

          I have a hard time believing that even people who are reluctant to use formula think that starvation is better. They can’t possibly be that blind—they KNOW how many formula fed people there are walking around, perfectly healthy–or obese I guess, if you listen to the propaganda. Wouldn’t something poisonous cause wasting away? If formula was really worse than starvation, our population would be significantly reduced.

          • Bugsy

            They really, really think that formula is poison. It’s that rigid of a doctrine. I don’t think that the majority of the population is like this, but I’ve witness firsthand extremely rigid doctrinaires of lactivism refer to formula – as well as to any food that isn’t the purest of pure – as POISON. Their caps, not mine.

          • Amy M

            Sure, I’ve heard that, but they don’t even take that to its logical conclusion. I mean, they recognize that the majority of American mothers do not exclusively breastfeed for 6mos or more, so they must be using formula. That’s a lot of poison, yet Americans are a pretty well-fed bunch, and very few look pale, bony, haggard and dead like we’d expect someone who has been poisoned to look. Shouldn’t we be able to recognize the formula fed babies on sight, since the poison should be negatively affecting them?

            I’ve definitely seen/heard references to formula=poison, I’ve just never really thought about it until now, about how it truly makes no sense and clearly the people who say it aren’t thinking it through. I would love someone who believes that Similac is poison, to answer my questions above. Also, how the formula manufacturers, which are subject to various regulatory bodies, are getting away with poisoning large swathes of the population. If someone can really think about that and still believe that formula is poison, that is a serious tin foil hat she’s got on.

          • Bugsy

            Lol, I’d offer to have Crazy Lactivist come on and answer your questions…but that would involve re-friending her on Facebook. Not gonna happen!

            I completely agree with everything you’re saying, by the way. The lactivists we knew had literally come to the conclusion that everything other than the home-grown, non-GMO produce they painstakingly grew in their garden was poison produced by big corporations affiliated with Monsanto. Sadly, they boasted how they’d taught their preschooler things like “Candy is POISON,” and that they’d found a diet that got rid of all of the evil toxins of modern society, thus allowing their child to live to be 100.

            Now that I’m completely removed from their lives, I have to say that it just seems incredibly sad and ridiculously. Crazy Lactivist, before becoming a parent, was a bright & educated young woman. What happened?

          • Bugsy

            To add: I wouldn’t be surprised if the true die-hards think they can recognize a formula-fed baby on appearance alone. CL was adamant that she could always recognize attachment parent kids by their sensitive souls. (I personally wonder if she meant by their inability to handle life without mommy’s consoling or boobie, but there you have it.)

          • demodocus’ spouse

            That’s really silly. I don’t want to know how she tries to explain siblings of whom one is quite sensitive and the other is manifestly not.

          • Bugsy

            My guess: the parent obviously didn’t do a good enough job at attachment parenting for the child who isn’t as sensitive. It seems like in the NCB world, doesn’t it always come down to the parent’s ability (or inability) to parent according to “proper” guidelines?

          • Melissa

            I also have a friend who fell into this lifestyle. It was just impossible to deal with since so much of her derision was at people like me and herself. After all, she’d had years of ingesting toxins in regular food and so by talking about how brain dead, ugly, unhealthy, and terrible people were who had ever ingested that stuff she was talking about herself.

            Her husband around the same time of the birth went from a guy who didn’t care about politics to a survivalist type. He started collecting guns and joined a group of sovereign citizens. He began claiming that he (and his family) could opt out of citizenship and start their own society. Just very strange things, yet they melded well with her view of needing to separate from society to protect their child from toxins.

            The fact they both seemed to have this apparent sudden urge to separate from society when they had their child was strange to me but it seemed to happen overnight. Maybe these had been interests they had both had prior but having a baby motivated them to put them into practice.

          • Bugsy

            I completely understand, Melissa. It sounds very similar to CL. If I may ask, what happened with your friendship with her? It’s really hard to watch friends go down such a cultish & self-righteous path, isn’t it?

          • Busbus

            I think all these fears about the supposed insidious effects of all kinds of aspects of modern life (pesticides, vaccines, interventions, formula) are really a fear of modernity (or maybe of life itself) in disguise. I think a lot of these people believe – truly believe – that all of us are damaged, and this becomes the explanation for everything, first and foremost their own unhappiness or inability to live a more satisfying life. Happy people do not become obsessed with toxins or breastfeeding or anything else to the point of fanaticism.

          • Busbus

            Actually, thinking about this some more (and also in light of today’s post, http://www.skepticalob.com/2015/04/nature-thinks-babies-are-expendable.html ), maybe the point is that in some ways, we *are* all damaged, because no life is perfect, everyone goes through some amount of heartbreak, even the most loving parents make mistakes, and even if they didn’t, everyone will still encounter difficulties of varying degrees as they grow up, and later as adults. Maybe that’s why this idea that we are all “damaged” is so easy to sell – because, in some way, it’s kind of true. Maybe part of the problem is this belief that there actually could be a “perfect” life, if it wasn’t for “toxins” or whatever else is fashionable at the time.

            I don’t mean this to be dark. In fact, to me it is kind of comforting to think that there is no “perfect,” as much as we want there to be, and that ultimately, we all muddle along and have to contend with imperfect circumstances.

            I think, chasing “perfect” is very exhausting, both to yourself and to everyone around you, and most of all, it is futile. Better to aim for a life lived, warts and all, in this big mysterious universe out there. Then, instead of expending our energy in a futile attempt to erect a bubble or cage that shall protect us and our loved ones from the vagaries of life, we might actually go out and live it. I don’t want my kids to learn that living means being ruled by fear, I want them – and myself – to be bold and courageous. And not to sweat the small stuff, but to rise above it.

        • T.

          She is not doing it for her child. She is doing it for herself, to get HER ancient knowledge which is her WOMANLY PREROGATIVE DAMMIT.
          The child is a prop for that.

    • Sue

      “ancient knowledge locked away”? Pity her body forgot the ancient knowledge that starvation leads to death.

      • KarenJJ

        Yes, the ancient knowledge was to give the baby whatever food you could in the hope it would survive… Which over the years, collaboratively and with ongoing refinement, we now have formula…

  • NewMom

    At the end of week one, my baby was still losing weight and my milk had not really come in. Our pediatrician recommended supplementing and a trip to the lactation consultants, both of which I did. The lactation consultants insisted that I must not be trying hard enough, and that if I would just work harder, it would happen. They also questioned our pediatrician’s recommendation to supplement and suggested that I just let my son go hungry so he’d “be more motivated to nurse.” I didn’t do it, because I couldn’t bear the thought of letting him go hungry when I had the ability to feed him easily (with formula). I kept trying till week 8 but never managed to produce more than a couple ounces a day, and by then he ate a lot more than that! Now, a few months down the road I cannot believe the callous cruelty of letting a brand new baby go hungry, especially when you don’t know what’s wrong or whether it’s fixable. What an upside down world! It is too bad that breastfeeding didn’t work out for me this time – I enjoyed what little I did of it. But the pressure makes people lose sight of common sense. Babies need to eat, first and foremost.

    • moto_librarian

      Our older son had to have a brief stint in the NICU for TTN. One of the requirements for getting discharged from the hospital was a demonstrated ability to feed. My milk never did come in, but at least we were supplementing him from the start because of the NICU. I still spend three weeks postpartum in the living hell of pumping, putting baby to breast, and then supplementing. I felt like all that I did was pump, feed the baby, and then wash bottles and pump parts. Our son started passing blood in his stool, and was diagnosed with dairy and soy allergies, so we wound up putting him on Nutramigen anyway. I got awful advice from the hospital LC, and I still regret that I didn’t advocate for myself better. With our second child, I tried nursing again, but when it was clear that I was experiencing primary lactation failure for the second time, I gave it up without the guilt and went to formula.

      • NewMom

        Yes, now I mainly feel grateful that my son and I live in a time and place where all of these problems can be solved with a trip to the grocery store. And yes, I too feel like i should have better advocated for myself (and him) with the LCs. Good for you for trying again and then bagging it when it didn’t work.

    • Allie P

      I was told the same thing. I regret listening to them. Won’t happen again. I will absolutely try to nurse again, and I will absolutely not let my baby go hungry in order to do so.

    • Alexicographer

      Amen. I was lucky (as was my son), the LCs at the hospital where I gave birth worked with us about 5 days in and said, “He’s hungry and he’s not getting enough BM. Here are some bottles of formula.” They worked with me on using an SNS and on pumping either or both which in retrospect may or may not have been worth the effort, but they also prioritized *getting the baby fed*. Thank goodness. I’m sorry this wasn’t your experience.

  • A couple of links:
    http://www.theguardian.com/commentisfree/2015/mar/23/for-profit-breast-milk-her-body-her-choice

    hthttp://www.salon.com/2015/03/20/the_rise_of_big_breast_milk_a_boon_for_healthy_babies_or_exploitative_of_low_income_mothers

    Food for thought?

    • Amy M

      I read the one by Jessica Valenti yesterday, and I thought she had a great point, when she said that bit about “stopping commercialization of breast milk would be saying that the benefits of breast milk are murky.” Of course a bunch of commenters swooped in to tell her she’s wrong and that breast milk is a magical panacea that prevents every disease under the sun and makes people smarter, but they didn’t really comment on the actual point of the article.

    • Ash

      Looks like Medolac found out their ” Co-op Campaign to Increase Breastfeeding in Urban Areas” was a dud and discontinued it. I didn’t get to read the original press release/letter but if it was seeking specifically low-income black women, I don’t think the campaign was a good one. I’m not surprised at the commercialization of breastmilk given the demand, and this is an appropriately screened product for safety. If women want to sell their milk, that’s their choice.

    • Cartman36

      I started reading the comments but I to stop after “no one is judging formula feeders…..but if you don’t breastfeed you are lazy and selfish.” ***Sigh****

  • Driving

    I have copious breast milk (if I forget a pad it will squirt out of the other breast and get everything wet while the baby is feeding) but it usually comes in late, around day 5 or 6. After dealing with a 9 lb baby who cried for three days straight and developed jaundice, I gave him formula and he so happily sucked it down. With the next one I supplemented immediately and had a great time until my milk came in.

    • FEDUP MD

      Me too. Still nursed my now 12 month old exclusively thereafter to her 1 year birthdate and am still nursing her a few times a day. But supposedly this can’t happen according to lactivists……

  • Ash

    Think of all the anguish that could have been spared if in both articles, there was a consistent message from LCs “supplement with formula or exclusively formula feed, your baby needs to eat”

    Argh.

    In the first article, I wonder how days/weeks/months the friend BF’d the author’s child. I can’t imagine knocking on my friend’s door several times a day “hi, can you breastfeed my baby right now, he’s looking peckish”

    Also, when I think about it I’m confused by the Guardian article. Author mentions a friend named Miranda, then Heather comes over, breastfeeds the baby, then another friend, Miranda, BFs the baby on a regular basis. So did Miranda not even get any advanced warning–“Hey, I’m inviting you over for tea, would you like to breastfeed my child as well?” Another woman, Maddy, gives the author frozen breastmilk.

    Keep in mind that the author said she wasn’t able to BF “on track” until the child was 3 months old. I don’t know what kind of cobbled together regimen the author was on until then. The author has very generous friends.

    • “Sure, untested donors, let my newborn – who, by the by, has such a weak immune system that it’s not a great idea to take him out in public – suck up your secretions!”

      • Cobalt

        Don’t bring the newborn into the public, but go ahead with putting the public into the newborn?

        That CANNOT be right.

    • Bugsy

      “‘…your baby needs to eat.'”

      Wouldn’t it be amazing if this were the sole message given to all new parents, to heck with the details?