Who benefits from shaming formula feeders? Hint: it’s not those mothers or their babies.

Lactivists shaming you

Shame is integral to the contemporary lactivism movement.

Indeed, it is so integral that there’s actual a blueprint on how lactivists can shame other mothers. Entitled Watch your language it was written by lactation consultant Diane Wiessinger and published in the Journal of Human Lactation in 1996. It is a primer on how to mobilize language to shame women who bottle feed.

Wiessinger identifies the problem for those wishing to shame mothers. Merely telling them that “breast is best” leaves open the possibility that you can still be a good mother if you formula feed (also known in Wiessinger’s parlance as artificial feeding):

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding…

So what if that’s the truth and women deserve accurate information in order to make informed decisions? We shouldn’t allow the truth to get in the way of manipulation:

Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

Actually, they are ugly, shaming words and Wiessinger is just getting started:

Because breastfeeding is the biological norm, breastfed babies are not “healthier” artificially-fed babies are ill more often and more seriously. Breastfed babies do not “smell better”; artificial feeding results in an abnormal and unpleasant odor that reflects problems in the infant’s gut.

The shaming of mothers for the ostensible benefit of babies benefits only those who profit from the shame.

Wiessinger has the temerity to insist:

When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.

Since when is deliberately inducing shame a form of decision making information? It has never been before, and it isn’t now.

Why would anyone undertake shame as a deliberate effort to promote breastfeeding. For Weissinger, it isn’t about babies or mothers it’s about promoting a “breastfeeding culture.”

We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.

And:

All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances. A vital first step toward achieving those goals is within immediate reach of every one of us. All we have to do is…watch our language.

Maybe that’s what those who profit from lactivism want, but it’s not what those in the health professions want. We want babies to be healthy, fed to satiety and not left to cry in hunger. We want mothers to be healthy and not in pain or struggling to manage a fraught breastfeeding relationship while dealing with new motherhood.

Over the past 20 years Wiessinger’s dream of using shaming language to browbeat women into breastfeeding has succeeded. The breastfeeding initiation rate has reached a 100 year high. And the impact on infant health has been … negligible to non-existent.

breastfeeding and infant mortality

In contrast, the impact on maternal mental health has been profound. Simply put, there is an epidemic of guilty mothers who are ashamed that they cannot breastfeed exclusively.

The authors of a recent paper, Shame if you do – shame if you don’t, explain:

The message frequently summarised as ‘breast is best’ reflects scientific knowledge on the nutritional and immunological benefits of breast milk for infants as well as carrying moralistic dimensions. In many cultures, breastfeeding is synonymous with ‘good mothering’. When mothers make a decision not to breastfeed, they may experience guilt, blame and feelings of failure. Taylor and Wallace, in their theoretical framework aimed at understanding maternal responses to infant feeding, argue how formula feeding mothers may experience shame (as opposed to guilt) through ‘failure’ to live up to ideals of womanhood and motherhood…

Shame is considered to incorporate affect (e.g. fear, anger, humiliation, self-disgust, anxiety, low self-esteem, depression), cognitions (e.g. feelings of rejection, inferiority and inadequacy) and actions (e.g. withdrawal and isolation or retaliation). Although shame is often used interchangeably with guilt, these are considered to be two distinct emotions. Shame is believed to occur when there is a breach between the cognitive evaluation of the ideal self and that of the actual self. The self-evaluation giving rise to shame emerges through an awareness of a deficiency or feelings of not being good or good enough: a global negative feeling about the self in response to a goal not reached, or some shortcoming…

Just what Wiessinger was hoping for!

Interestingly, the sense of shame was precipitated or intensified by exposure to those who were supposed to provide breastfeeding support:

The quote[s] below suggests that what professionals may view as a positive approach may in fact augment the experience of shame due to the inherently judgemental nature of language used:

I got fed up of people telling me I was doing a good job. […] I wanted somebody to help me and actually find a solution to the problem I was facing. I think it is underestimated how vulnerable you feel and how much of a failure you feel and that is not really the right thing to say to people.

Some of the women who formula fed from the early post-natal period or after a period of breastfeeding also reported marginalisation through a lack of support:

When you bottle-feed you don’t get as much help. I did try so hard [to breastfeed] I kept blaming myself that I couldn’t do it. […] it was too painful and however much I tried I couldn’t get him on, and wasn’t feeding properly. […] But when you decide ‘I don’t want to do it anymore’, it seems the support goes out the window. […] It did get me very very down, it felt like they turned against me because I was bottle-feeding.

Restrictions or inhibitions on discussing substitute feeding methods (both on the post-natal ward and in the community) left women feeling dejected and isolated:

Bring the choice back for god’s sake, when breastfeeding doesn’t work, bottle feeding is a good alternative. I didn’t have a clue what I should be using.

The enforced dependency of mothers on the medical model was also in evidence when women experienced incapacity to breastfeed, perceived or otherwise:

They wouldn’t allow me to cup feed her, so I had to wait for a midwife to be free […]. I did ask as it was distressing that I couldn’t feed my child.

In The concept of shame and how understanding this might enhance support for breastfeeding mothers, Leeming and Marshall note:

Previous discussions of the potential for breastfeeding promotion to cause distress for women who do not breastfeed or who struggle to do so have tended to assume that the problem is guilt. In response to this a frequently made point has been the importance of recognising that apparent ‘failures’ to breastfeed are not best understood as the mother’s omission or ‘choice’ but instead as a consequence of the many barriers to breastfeeding in Western societies… However, as Taylor and Wallace point out, women’s emotional responses may be more complex than has sometimes been assumed and for many mothers who struggle with breastfeeding or turn to formula milk, shame may be as much if not more of an issue than guilt.

… When we are ashamed we experience ourselves as inferior or flawed before a more powerful critical ‘other’, whether this is an actual person we perceive as devaluing us or a sense of a generalised ‘other’ in front of whom we are inadequate and lesser. With shame the focus is on a sense of a damaged and unable self, rather than on specific actions. Therefore an example of shame would be a mother whose distress about feeding difficulties arises from the possibility to her that these difficulties mean she is fundamentally flawed or inadequate as a mother, and possibly exposed as such before critical others…

So if babies don’t benefit in any measurable way from breastfeeding promotion through shaming and mothers are actually harmed by it, who does benefit?

Lactivists benefit and they benefit in a variety of ways.

First, lactation consultants benefits by increased employment and income. If every women is shame into attempting breastfeeding, and shamed if she attempts to stop, and shamed if she combo-feeds with formula, and shamed when she is seen bottle feeding, there will be greater need for lactation consultants.

Second, lactivists benefit in the same way that those inflicting shame on others always benefit, by enhanced self-esteem through feeling superior to the shamed.

Finally, lactivists benefit by enjoying ugly behavior that is usually forbidden but is actually encouraged in the case of formula feeding. There is simply no limit to the cruelty of lactivists toward women who don’t or don’t want to breastfeed, and no limit to the delight that lactivists experience in sanctioned cruelty to other mothers.

Wiessinger’s blueprint for lactivists, promoting careful choice of shaming language in order to browbeat women who choose formula is an ugly document, and the result, inevitably, has been a rise in ugly feelings of shame among those mothers.

So now the rest of us need to ask ourselves if we have been duped into harming women for the benefit of a lactation consultants and lactivists who have been preying on them. Wiessinger was on the mark when she pointed out that “breast is best” leaves open the possibility that you can still be a good mother if you formula feed and that our personal experiences tell us that optimal is not necessary. We need to make it clear, in the strongest possible terms, that formula is an excellent substitute for breastmilk, that you can definitely be an excellent mothers if you formula feed, and that the shaming of mothers for the ostensible benefit of babies benefits only those who profit from the shame.

  • Allie P

    I’m in the thick of this now with my week old child. After the feeding dificulties and jaundice and pressure from LCs with my last child (actually how i discovered this blog in the first place), I decided that I was going to supplement as needed with this one. As far as I can tell, it’s going swimmingly — the baby is putting on weight, we’re nursing well, I am not stressed about being the sole food source for my child, and that creates a positive feedback loop. She gets about 2-4 oz of formula a day, and the rest breastmilk.

    The only problem has been the fact that “non-exclusive breastfeeding” is not seen as a viable goal to anyone and no one — not the pediatrician, not the hospital LCs, the pediatrician’s LC, or anyone else, can seem to give me advice on how to go about this. The pediatrician is supportive, and, to their credit, all the LCs have been too, but mostly because I come in to conversations about it going, This is what I am doing and this has been my experience that informs my choice. But there doesn’t seem to be a script for it.

    • Young CC Prof

      Sounds like feeding is working for both of you! Awesome!

      There is a serious lack of guidance and guidelines for combination feeding. It’s a problem, and I think that if combination feeding were presented as a viable option, along with information about how to do it successfully, the end result would actually be more breast milk inside of babies.

  • Amy

    So, as a pure mathematician and a total non-business-oriented hippie, I confess I wasn’t that into the one econ class I took as an undergrad. But the one big thing I took from the course was that every decision we make is a complicated tradeoff involving myriad factors. It’s not like a woman sits down while she’s pregnant and goes, “Breast is better, so I’ll breastfeed because I want to be a good mom” or “Breast is better but I don’t care about being a bad mom so I’ll use formula.” That’s what the lactivists want people to think, but put in such stark terms, it’s obvious just how wrong they are.

    Breast is better when it’s JUST AS EASY AND CONVENIENT as formula. AND when there’s adequate supply. AND when it suits the entire family’s lifestyle. If the mom isn’t making enough milk, formula isn’t just better, it’s a lifesaver. If the mom’s work schedule is incompatible with breastfeeding and/or pumping, formula is what allows the family to make ends meet. If the mom just plain doesn’t WANT to breastfeed, formula allows her to ENJOY being a mother and not resent the act of feeding her child.

  • bbb0420

    I’m sorry to say I have felt lots of shame over my recent breastfeeding difficulties thanks to some asshole attitudes I’ve encountered. I had a baby about a month ago, and thanks to this blog, I felt validated in my personal choice to give breastfeeding a whirl without feeling like I’d be a failure if I decided it wasn’t for me, and the idea of combination feeding was really intriguing to me. (I also happily agreed to my OB’s offer to induce and had an awesome birth at 40 weeks and 3 days and I would do it again tomorrow if I could thanks to reading Dr. Amy’s recent article about how elective induction improves outcomes between 39-41 weeks. I loved knowing when I was going in, loved having an epidural and getting to sleep before pushing and feeling rested for that, and bringing my kid into the world calmly without screaming my head off in pain. The only glitch was my husband passing out in the delivery room and hitting his head on the windowsill and having to go to the ER and almost missing the birth, but it makes for a good story now. Anyway…) Turns out my son had a pretty tight tongue-tie that the pediatrician recommended we have clipped. The lactation consultant who first visited me in my postpartum recovery room noticed it right away after she tried to latch my son on me and I just about jumped through the roof it hurt so bad. Because of the tie, he can’t extend his little tongue far enough to get around the nipple so he just chomps on it with his gums. The lactation consultant kept trying to latch him on me even after she noticed the tongue-tie and I kept crying from the pain and my nipples got raw and sore right away. The second lactation consultant that came to see me suggested we get a hospital-grade breast pump and take the pediatrician’s suggestion to get my son’s frenulum clipped. I was distraught because I’d never heard of such a thing as a tongue-tie and why did I have to alter my newborn baby’s anatomy just so I could breastfeed? I asked the on-call pediatrician at the hospital about just formula feeding and he said “well, it’s not as good as formula and we want you to breastfeed for a year…it’s also easier for you, you don’t have to wash bottles and prepare formula all the time.” Really? How do you know what’s easy for me or not? So anyway, after we left the hospital we went right over to the pediatrician’s office to get the tongue-tie clipped because my husband was insistent on it and I wish I could have been stronger and said no to the doctor, the lactation consultant, and my husband, but I wasn’t. I was exhausted, sore, and hormonal so I cried all the way there and through the procedure…and supposedly that was going to fix our latching problems, but it still really freaking hurt. I had three separate appointments with a third lactation consultant at the hospital, and she could latch my kid onto me without it hurting as much, but I just could not do it on my own at home…and I was pumping at the same time to get my supply up, which also hurts. I felt like a damn Jersey cow hooked up to that thing 8-10 times a day. The lactation consultant gave me a bunch of free Similac samples at my first visit and said “I love costing the formula companies money” or something and then something else disparaging about formula. So I kind of avoided breastfeeding my baby and pumped and supplemented with the evil Similac samples…Luckily, at my son’s first weight check with the pediatrician we’re going to see regularly, she asked how the feeding was going and I burst into tears and told her how hard it’s been and how much pressure I feel to do it, and she said “It’s about what works for you and the baby, no matter what anyone else tells you…formula-feeding moms are still great moms.” That was what I needed to hear and I felt a little better about quitting…and my kid is thriving and a good eater but I still felt sad for awhile that I couldn’t “do it right”…I hate breastfeeding and it never stopped hurting but I feel like no one around me understands that. My own father, who is a family physician, said “I don’t understand why you’re not breastfeeding,” and when I told him it’s really really painful he said “well it’s supposed to hurt for awhile.” Really, Dad? You’re welcome to try my son’s little tongue-tie latch out on your own nipples and see how you like it. I feel like I would exclusively breastfeed if it didn’t HURT so badly, but because that’s my reason for not wanting to do it, I feel like no one considers that a legitimate excuse to stop. My husband, my father, my mother, my NICU nurse sister-in-law and lactivist all expect me to…so yeah, I feel ashamed, even though I KNOW in two years no one is going to know or care how much breastmilk my son was fed as a baby, the attitudes and language of people around me and “authorities” like old-school doctors and lactation consultants get under my skin.

    • Kelly

      That is so sad that your own family does not support you. I count the pain in my nipples as one of the worst pains after labor. They are so sensitive to begin with and the constant brushing against clothing was awful. I even got the prescription cream and it did not clear anything up. I feel for you and one of the main reasons for me to quit was the awful pain. I support you and I know how it feels. You are a good Mom and you made a good decision. You know yourself well and how you can handle things and you made the best decision for yourself and your baby.

    • Mac Sherbert

      First, let me say you sound like a loving caring mom who needed support and didn’t get it. Thank goodness for your pediatrician. I BF my 1st baby for about six weeks and for six weeks I was in pain. I took the meds from my C-section not for the C-section pain, but for the BF pain! I was so relieved when I went to FF fulltime because I could finally hold my baby close to my chest without being in pain. I could wear a bra and not be in pain. Oh, and my baby was finally happy and not crying to eat every 30 minutes. My baby was just a barracuda so I couldn’t even say it was a tongue tie issue.

      People who have never experienced that kind of pain BF simply cannot relate. It wasn’t until I BF my 2nd baby that I understood just how bad it was with the first. My 2nd baby had the greatest most gentle latch and I’m sure she was able to get more milk at any one feeding than my 1st baby ever could. I BF her for 18 months and combo feed at the end.

      And FF 1st baby is happy, healthy and 3 grade levels above his peers in reading. 😉

      • bbb0420

        Thank you for the support, and I hear you–I almost stayed on my Percocet to deal with the BF pain too! Kudos to you for persevering for 6 weeks!

    • Megan

      I can’t believe that pediatrician told you it would be easier for you!! (Actually yes, I can believe it but I’m disappointed to hear it.) I hate the “you won’t have to wash bottles argument because if you do any pumping at all or are ever away from your baby you do have to wash bottles! And formula is just not that hard to prepare! Besides, how would he know what it’s like to be you or what your circumstances are? Anyway, I am also very sorry to hear that your father has not been supportive. Maybe your should latch your kid on to his nipple and see how he feels!! I too have a child with a tongue tie and I had low supply myself. We had many challenges and after a lot of pain, incessant pumping around the clock and feeling like I was a failure, I finally said enough is enough and combo fed, eventually switching to all formula. I truly wish I had done it sooner because I could finally enjoy my baby when I did. I was no longer attached to a pump all the time (which gets much harder to do if you’re home with them alone and they start to get mobile) and my husband can help me so nights are easier. My advice to you as a fellow mom and as a family doc is to do what is right for you and your family. Formula feeding is a totally legitimate feeding option and you can feel confident you are not harming your baby! You ARE a great mom!!

      • bbb0420

        Yes, you are right–who really can get away without SOME bottle washing, even if you exclusively breastfeed? The first pediatrician I mentioned is also the one who performed my son’s circumcision–I asked him about it helping to prevent the transmission of STDs and he said “well, not if he’s promiscuous and doing things he shouldn’t be doing…” What?? Why are you making value judgments about my son’s future sexual encounters, sir?? Ugh…I actually did offer my father the opportunity to experience my son’s tongue-tie latch but he declined 😉 Thank you so much for the support!

        • Amy

          Two words: disposable bags. One more word: dishwasher.

    • Sue

      Amidst all that…it’s great to see Amy’s blog helping another person.

      Congrats on the new little one!

      And you are right – in a few years, all that will pale into insignificance amidst all the other pleasures and challenges of parenthood.

    • indigosky

      I am sorry your family is incredibly unsupportive. It’s easy to judge when they are not the ones having to do it, isn’t it?

    • Inmara

      So sorry that people around you have been such jerks! But I really wonder why pediatricians didn’t explain you that tongue tie is an issue not only with BF but also negatively impacts speaking abilities, it has always been primary reason to check it and solve as soon as possible after birth because later it’s much more complicated.

    • Daleth

      Have you checked out the Fearless Formula Feeder site? It really helped me when I was dealing with guilt over not BF’ing.

    • EmbraceYourInnerCrone

      I’m really sorry your family has not been supportive. Even though my daughter was born in the 90’s the Breast is best , You Have to try it attitude was already creeping in. I did not want to breastfeed, for a lot of reasons, so I took the path of least resistance, nodded my head, tried to get her to latch and then got formula and bottles and fed her that way anyway. She loved it and found it much less frustrating than breastfeeding. Feeding her was one of my happiest times, I miss baby snuggles…She’s healthy , smart and successful. I mostly put that down to lots of trips to the library, the zoo and museums on discount days, readin to her every night from the time she could sit up and making sure she had lots of stuff to engage her mind(ok the chemistry set might have been a mistake…or not. no permanent damage to my kitchen). The healthy part was partially due to the fact that as a member of the military she and I had good, free medical care. And luck. You are a great mom and it seems like you are doing whats best for your kid, yourself and your relationship with your kid.

      I was also the lazy Mom who got the Playtex disposable nursers and the cans of ready to feed formula…yup I’m going to hell

  • Esther

    Sort of like the NHS/Lamaze term “normal birth”…same idea, same results.

  • Dr Kitty

    I’m personally intending to BF the current uterine tenant (I EBF #1 without any issues) but I have written “Do Not Wish To Discuss” across all the Infant feeding checklists in my maternity notes.

    It is a basic list of all the “benefits of breastfeeding/risks of formula” the midwives are supposed to discuss with you before you leave the hospital.

    1) I know the information, I don’t need it repeated to me, and I think it is disrespectful to insist upon doing so.

    2) In every other area of medicine it is a patient’s right to only receive the information that they wish to. I personally think that this universal checklist is shaming and intrusive and I don’t want to encourage its use.

    I’m expecting raised eyebrows, but I don’t care.

    I see a lot of women for their 6 week post natal checks. The combo feeders and women who had wanted to BF but have switched to formula because of supply issues or pain or whatever are often in pretty bad emotional shape.
    The ones who planned to FF from the start, or after a set time and the ones who find BF easy aren’t.

    The message I try to give is that parenting is often about making compromises, that all families are different, and that as long as you and your children are happy and healthy and thriving, how you feed them is irrelevant. You made the best choice for your family, good for you!

    It gives me no joy to have to deliver that message to someone openly weeping because she feels guilty and ashamed that she didn’t meet some idealised standard, which happens very frequently.

    I’m more than happy to explain that to anyone who decides to question me about it.

    Judging by the responses I got to “I have no desire to VBAC because I have seen a uterine rupture and too assorted many obstetric disasters firsthand to be comfortable with the risks involved” it may not go over well.

    • fiftyfifty1

      “In every other area of medicine it is a patient’s right to only receive the information that they wish to.”

      Wow, it’s different here in the US. When we do informed consent, for instance with a surgery, they have to listen to the risks, they are not allowed to say “Oh, I don’t want to hear that”. Well, I suppose they don’t HAVE to listen to the risks. They can space out. But we have to say them.

      • Dr Kitty

        You have to document (carefully) their refusal, but if a patient says “actually, I don’t want to hear about all of this” that is their right. You have to be sure that they know enough to give consent, but if they say “I don’t want to hear about this in detail, I trust you to do the right thing doc” that’s where it ends unless you think there is something so vital that not to tell them, or to proceed without telling them would be negligent.

        Usually, the best solution in those cases is to give them written information in an envelope with advice that you recommend they read it and call you with any questions, but that it is ultimately their decision whether or not to read the information.

        I’ve had several patients who just do NOT want to discuss possible medication side effects, or to have conversations about which of two or three treatments to try. I don’t actually enjoy practising that way, but if someone does a “you decide doc” I don’t have a lot of choice.

        • Megan

          It always makes me uncomfortable as a doc (in the US) when a patient says to me, “I trust you to decide for me” because if something goes wrong, even if that patient really did trust me and the negative consequences were unavoidable I would most definitely lose a lawsuit in that situation. I usually tell them that it is their body and that while I can give hem plenty of info to help them decide, it is ultimately they who will have to live with the choice.

          • Azuran

            Yea, I don’t do the ‘I trust you to decide’ either. Luckily, as a vet I don’t have a high risk of lawsuits,
            However, those ‘I trust you/you decide’ people are usually the one who then refuse to pay the bill at the end. So, I don’t care that they don’t want to talk about it, they shall listen to me list all the options, all the prices, make the decision themselves and sign a treatment authorization form with an estimate of the cost.

          • FormerPhysicist

            I hear you, but I hate the way the consent forms are structured. I really think there needs to be a checkbox for discussing expected outcomes and risks of no treatment as well as checkboxes for risks of treatment and procedures.

          • Megan

            Agreed. Leaving off risks/benefits of no treatment always bugged me too. I’ve only worked at one practice where that was on the informe consent (and one of the docs there was a former lawyer).

          • Mel

            My husband underwent gastric sleeve surgery recently. We went through the whole list of potential side-effects of the surgery while smiling and nodding the whole time.

            The surgeon was confused as all get out and asked us if we understood what he was saying.

            I looked at him and asked “So what do you think is worse – a less than 0.3% chance of early leakage needing a repair and a very, very low chance of death OR my husband’s chances of surviving to 40 at his current weight without morbidity and to 50 without mortality? Because I have no interest in being a widow at 40 – but think I have a decent chance of being one if my husband doesn’t lose a lot of weight soon.”

            Point made.

          • Michele

            Best of luck to him! My husband had gastric sleeve surgery earlier this year.

          • Dr Kitty

            I document carefully.
            As an NHS GP I can’t fire patients just because they don’t want to get involved in an in depth discussion of risks vs benefits.

            If not treating is likely to cause more harm than treating, and I can’t get the patient to enter into any kind of discussion with me I don’t have any other option but to act in their best interest and be willing to defend my actions on those grounds.

            Those patients are few and far between, thankfully, and tend to be elderly and non litigious anyway. They’re just more comfortable with a paternalistic care model.

            Our accountant wonders why our practice is spending more money on paper every year, given almost all our patient referrals are now electronic, we mostly contact our patients by phone and our hospital colleagues by email.

            We reckon it is because every year we print out more and more advice leaflets- diet, exercise, alcohol, stress reduction, smoking, medications, contraception, mindfulness, CBT workbooks, self care leaflets for common minor ailments, explanatory pamphlets about screening tests, fitness to fly regulations, local support group contact information, how to access benefits: you name, it we’ll hand it out.

    • phoenixfire

      I was forced to listen to the “risks.” I told them that they could prattle on and I was going to ignore them and think them to be uneducated while they read them off. I proceeded to play Sudoku on my iPhone in the meantime and didn’t hear a word they said. They tried to make me sign something about what they read and I told them when hell froze over, and if they made me sign I was going to put naughty words. They wrote “patient declined to sign” in the signature area 😉

  • Nyx

    My daughter was born with severe hypotonia, which made it impossible for her to latch on and suck correctly from the breast. It was also extremely difficult to get her to drink from a bottle. Instead of trying to figure out why she had these problems, the lactation consultants and maternity ward nurses were incredibly rude and cruel to me. I tried so hard, but they would say things like, “you’re just not trying hard enough”, “she already tasted breastmilk, so she’ll never drink anything else”, “you have to force her to latch on”, “if you don’t get her to eat, she’s going to get low blood sugar and have to be put on a feeding tube or she could die”, “you don’t really want to bottle-feed her.” Ugh.

    • demodocus

      Horrible.

    • anotheramy

      I am so sorry you had that experience! And to scare you by saying she could need a *feeding tube* before they even tried or recommended a bottle is absolutely insane.

    • somethingobscure

      Wow. What the fuck is wrong with these supposed healthcare providers? There is no way the marginal benefits of breastfeeding could possibly be worth such tremendous risks of your baby had such issues with breastfeeding. This type of advising is not only unfair to mothers, it’s dangerous for babies.

    • SporkParade

      I wish I could say I was surprised.

    • phoenixfire

      Wow, I hope you reported them. That is completely insane. They could have killed your daughter because of their stupidity.

  • Who?

    And just because this is the bandwagon I’m on this morning, why is it always about what the mother decides? Unless dad is absent for some reason, there are two adults responsible for caring for the baby and making decisions about its welfare. Why are dads’ opinions not of interest to lactivists?

    • MegaMechaMeg

      I don’t know, that feels kind of dangerous? I personally would rather not breastfeed but my husband would prefer that I did. It is my body so I win. There are plenty of parenting decisions that can be split down the middle between the parents but things get messy when a human’s body is intimately enmeshed in the choice.

      • Who?

        But surely dad is entitled to an opinion, whether or not you and he agree. Both have an opinion, discuss it, and come to a decision, as you have.

        My husband was probably keener on breastfeeding than me. I did it because it was really important to me to be at home with the kids, so breastfeeding seemed like a reasonable part of that. Also I like to tick boxes. He brought them to me at night and whenever he was home and did a lot of the family/house admin that babies bring, when he was around. Had he been less keen, and encouraging, and (practically) supportive, would I have persisted? Maybe not. Had I felt I didn’t want to do it, and made that clear, would he have insisted I continue? No, of course not. Marriage, family life is compromise.

        • MegaMechaMeg

          Not all relationships are good though. In a previous relationship of mine we discussed kids and I said that I didn’t want to breastfeed and he told me that breast was best and any child of his would get the best and he would sabotage any attempts I made to purchase formula. He was obviously an emotionally abusive asshole, and that experience could be coloring my opinion but I barring supply issues where the child is not thriving I can’t think of a situation where the non lactating parent gets to make demands like that ethically. Once feeding is divorced from another human body negotiate away, and certainly discuss with your partner, but if breastfeeding (healthily and successfully) is on the table the mom at the very least gets the final say.

          • Who?

            Glad you let him go!

            I’m not talking about demands, I’m talking about cooperative, caring people in a mature relationships. It’s perfectly possible for two thoughtful people who care about each other to disagree, and parenting is a breeding ground for just that.

            Bad relationships like the one you describe are bad in a million ways, and of course mum should have the final say-doesn’t mean dad gets no say at all, or that his thoughtful but differing view shouldn’t be respectfully considered, even if rejecting it was always going to be the outcome.

          • MegaMechaMeg

            Well he also thought I should be back in pre pregnancy shape in six weeks because “I would have nothing else to do” and “he chose a woman who looked a certain way”. Oh, and also “his friend’s wife lost the weight right away without all this whining”. I am gonna go on record saying that it was no real loss.

            I think we are arguing the same thing but calling it different. I assume negotiation is going to happ n in any healthy relationship so when I say that the lactating parent gets the final say I assume a discussion happened first and the non lactating parents needs and wants were considered.

          • Who?

            He sounds delightful. Lucky girl who got him in the end-though probably there will be more than one…

            And yes I think we do agree.

          • anotheramy

            Lol to the “friend’s wife lost a lot of weight right away”… thanks to a PP hemorrhage and just not having much appetite or time to eat after my third was born, I lost a lot of weight quickly. I found it amusing when people complimented/ congratulated me on it… um, thanks? I followed an awesome diet plan: just lose copious amounts of blood and the pounds just melt away. 🙂 I think biology (or maybe luck) is the biggest factor in PP weight loss.

          • Who?

            It’s true. I was back in my jeans a week or so after number one was born, didn’t put on a lot of weight with number 2 but the structural rearrangements caused by two pregnancies with two big babies led to a need for new jeans-half a size bigger but totally different shape. My mum was much the same.

            I’ve never lost that half size but I’m pretty small and a healthy weight so I’m not bothered.

            Biology is huge, as is how the birth went, how big the baby is, all sorts of things.

          • Amy M

            ha! I had a similar situation–a significant portion of the weight for me, was the babies, so when they exited, that made a difference right there. But yeah, the blood loss and lack of time to cook/eat after the babies were born definitely helped.

          • demodocus

            me three, ‘though I think I only lost the usual amount of blood. I gained a net of 10 or 15 pounds and had an 8.5 pounder. Nothing special, just a random quirk that gave me anti-cravings rather than cravings.

          • MegaMechaMeg

            My mother was 105 pounds before babies and has been over 150 at her skinniest after. I am significantly more than 105 pounds and I do not lose weight easily. I am just going to go ahead and assume that weight gain is in my future and there is only so much that I will be able to do about it. I am trying to set a base of physical fitness before I start trying for babies in the hope that I will be able to keep it up after but I am tempering my expectations.

          • Amazed

            That would be my mom, without the PP hemorrage even. I’ve seen the picture of her leaving the hospital with brand new yours truly. Sundress and all, sticking to her concave belly. Of course, she couldn’t hold me because she was too weak after a glorious vaginal birth. But her body did look like she was headed from the hospital straight to the beach. If skeletons went there – and she fit the skeleton image, face concerned.

            Have a big baby who prefers pushing your organs in all directions to make herself a comfy house, instead of bulging out, a terrible labour and no appetite, and you’ll have your immediate weight loss. Alas, that doesn’t push the organs back in their place.

            In the aftermath of not gaining weight and everything she gained the privilege of having her babies cared exclusively by Dad because she wasn’t up to the task. For months.

            Not worth the trade.

          • Daleth

            Yep. I was back to my pre-preg weight in six weeks with no effort at all… in fact, I was almost making an anti-effort, in that I was eating 3+ ounces of dark chocolate almost every single day. Pure genes and luck.

          • Megan

            I still have a huge diastasis recti so even once I get back to prepregnancy weight I’ll never be my prepregnancy shape! I still look pregnant 9 months postpartum!

          • Sarah

            Horrifying.

        • Allie

          A husband forcing his wife to let him fondle her breasts against her will is committing a crime called marital rape. Why is a husband who makes his wife breastfeed when she doesn’t want to any different?
          Breastfeeding is not a small thing. It takes up most of the day and night, is physically and mentally draining and can be excruciatingly painful. There is a healthy alternative available. No-one but a woman herself can decide whether she wants to do that or not.
          Can you imagine giving abusive partners the power to force their wife/girlfriend into breastfeeding? Perhaps to save money on formula? Lactivists would certainly want this but we can thank our lucky stars it hasn’t become acceptable (yet).

          • Who?

            Completely agree. And I wasn’t suggesting any such thing, just noting, with some surprise, that those who push breastfeeding at all costs aren’t co-opting the dads into their cause, given that the dad has at least a passing interest in the baby.

            Saying one parent isn’t entitled to an opinion about the care of that child is a slippery slope; suggesting that all relationships are frankly abusive is incorrect and unhelpful to thoughtful discussion.

            A prominent local paediatrician, practising from the 70s through to the late 90s, was a nut for breastfeeding, and told all his patients that he insisted his wife exclusively breastfed their five children. She, as it turned out, and unbeknownst to him, had exclusively bottlefed all of them. Which of them was the more disrespectful of their partner? For my money you can’t get a struck match between them: him for being so high-handed and demanding, and her for being so devious. They remain married, presumably at some level happily, though the whole thing sounds like a nightmare to me.

          • Daleth

            The person resisting an irrational demand made by someone who has no right to make it always wins over the irrational demander, in my book. If deviousness is their only way to resist, or if they’ve examined the alternatives and determined that it’s the best way for them, then so be it.

          • The Bofa on the Sofa

            While this discussion has focused on the dad wanting the mom to breastfeed, what about the other direction? Mom insists on breastfeeding, but Dad wants to use formula. Could be for lots of reasons, including the possibility that her attempts to breastfeeding are not going well but she is determined to make it work. In that case, by the “irrational demander” standard, Dad’s right to introduce formula to help the baby.

            But let’s go to the other extreme. Maybe Dad wants to introduce formula because there is an upcoming custody battle, and he is going to have a harder time if the baby is EBF. Can she prevent him from giving the baby formula? We can agree that he can’t force her to breastfeed, but can she “force” him to not formula feed, if he wants to do it? This is more difficult. I agree it’s slimey, but from a legal rights standpoint? If we concede that there are circumstances in which it is perfectly justifiable to give formula against mother’s wishes (as in the example above), then the question is when is it justifiable?

            The latter case here is extreme, but I think it is debatable (not so much ethically, but legally). If we agree that the baby does not require breastfeeding (not a premie and no health issues) then does the mother have the right to insist that she breastfeed as the only feeding method?

            And even if the conclusion is that the latter case is too slimey, the line is somewhere between here and there.

          • FormerPhysicist

            Or if Dad just wants feeding cuddles. Though I suppose then there’s breast milk in a bottle. If the mother can and will pump.

          • The Bofa on the Sofa

            But he can’t force her to pump, so if she refuses?

            This is a good challenge to the “irrational demander” criterion that Daleth mentions above. In your situation, who is being the irrational demander? Dad, who wants to share in the enjoyment of feeding, or mom, who insists that the baby can only be breastfed? Or even only have breastmilk? There is an argument that supplementing can diminish the ability to breastfeed, so it’s not completely baseless. So where’s the answer?

          • Daleth

            Maybe this is pedantic, but um, forced or coerced breast-fondling is not rape. Not even when it’s done by a complete stranger.

        • Sarah

          What exactly do you mean by ‘dad is entitled to an opinion’? If you literally just mean he has the right to take a view on it, yes of course. Everyone has the right to an opinion. You seem to be suggesting more than that, though- you mention the word compromise. That worries me, because it makes me wonder whether you think that if the mother doesn’t want to breastfeed, and the father wants her to, you might think the appropriate solution was something other than the mother not breastfeeding? My apologies if this is not in fact the case.

          • Young CC Prof

            Two separate thoughts: I think that a supportive father (or other coparent) is a key to successful breastfeeding, but, the mother has veto power. It’s her body, if she says no, it doesn’t matter what the father thinks.

          • KeeperOfTheBooks

            Well, it may depend on mom’s reasons not to breastfeed.
            Assuming my body produces milk better next time than it did last time, I still am not terribly keen on the idea of breastfeeding. DH doesn’t give a crap either way as long as the kid’s fed appropriate food and doing well on it. However, if it was important to him, and if my reasons were negotiable, then we *might* come to an agreement wherein I’d at least give it a whirl.
            For example, if my primary reason was that I didn’t want to be the only person getting up at night, he might say that he’d bring the baby to me, have me nurse, and then put the baby back to sleep after doing a diaper change so that all I’d have to do is sit up, latch the kid on, take the kid off, and hand him back before falling asleep. That might be enough for me to say, “Fair enough, then I’ll give it a go.” Or if my objection was that I didn’t know how I could handle postpartum recovery, breastfeeding, AND dealing with the house and toddler, he might say, “I have a big block of saved vacation days, and I’ll take ten days off when the baby’s born and will do all the housework, cooking, and toddler-chasing while you lie there and rest.”
            In the end, of course, mom has the final say, but it’s certainly something that can be discussed and then a subject of a compromise.

          • Sarah

            I’m not sure that’s a compromise, so much as the father making some changes that lead the mother to make a different decision. Removing some of the barriers, if you like. My question was more what the pp was advocating if the parents were in disagreement.

          • Who?

            Mum has the veto, if Dad wants to do things to make it easier/more bearable and she is happy with that, great. Ultimately it’s Mum’s decision because it is her body on the line.

          • KeeperOfTheBooks

            At this point, it might be a question of semantics: to me, “compromise” means that each party gives in somewhat in order to reach a solution that’s acceptable to both, as in the above example wherein dad gives up sleep and vacation time while mom agrees to take on the work involved with breastfeeding. I’d quite agree with you, though, that in the end mom makes the decision.

    • RMY

      I think it’s because they may fear father’s may be more interested in, you know, boobs being available for fun times than anything else. A lot of the natural parenting movement is very gestational parent-centric (as a lesbian I’m more aware of how it plays out in same-sex couples). The dad or non-gestational mom seems to exist only to support the gestational parent, rarely encouraged to take an active role as a primary parent.

      • Who?

        That makes sense, actually. I guess in a world where attachment parenting is all about mum and the baby sling, feeding is a no-brainer.

        The husband of one of the women in the first mothers group I joined refused flatly to allow his wife to breastfeed for just that reason (‘those breasts are MINE’, seriously, was his position) which for my money is just as demeaning and controlling as insisting that they do.

        For my money having a husband/partner who issues edicts in either direction is Bad News.

        • Roadstergal

          “I guess in a world where attachment parenting is all about mum and the baby sling”

          Surprisingly for me, given where I live, I actually do see dads carrying babies in carriers on hikes as often as moms. Technology, IMO, should allow for both parents to share child-raising. Carriers, bottles, formula…

          • demodocus

            The carrier was a lifesaver for us. It was uncomfortable for me with my oversized chest, but worked well for my husband, since he could carry Short-stuff and cane at the same time without his arm getting tired. (Using your navigation cane is like using a pencil, most people have a decided preference and really suck at using the other hand)

          • Megan

            My hubby and I both wear DD though he gets overheated with the carrier and I carry her more often. DD loves it and they look so cute together. I even taught hubby how to use a woven wrap though he never really took to it. I have even seen grandparents wear babies (though mine weren’t interested). I think it’s a nice way to involve all who care for a baby to feel close to them (and it’s nice to be hands free).

          • Young CC Prof

            My husband made his own baby carriers, because he didn’t like the commercial ones. They were pretty adorable.

            And on a long hike, especially with an older baby, the carrying is serious work and taking turns is just basic common sense.

      • Cobalt

        I actually read something recently about the non-gestational mother inducing lactation so both parents could breastfeed, and how it was just the bestest thing ever. I don’t think that’s necessarily a bad thing if it works out without straining everyone, but it sure sounds like an awful lot of pressure to put on someone. I’ve heard about this with adoptive mothers, but now at least some lesbian mothers are feeling the pressure, too.

        • RMY

          Inducing lactation seems to work out, almost never, but it did for a couple people, so now it’s a thing people try and fail at.

          • GuestWho

            The first time I read about inducing lactation I thought that they were kidding.

            I stand by my opinion that the entire concept is a glorious piece of trolling that got incredibly out of hand.

          • Who?

            I am going to ask, as a matter of kindness, that anyone who wants to describe how this might be achieved puts a big note warning everyone at the top because my squick-o-meter may explode.

          • GuestWho

            If anyone starts telling you about dry nursing? Run. Don’t even be polite, just peace out of there, the conversation is going nowhere good.

          • Who?

            Thanks I’ll bear that in mind!

          • Busbus

            Oh God, dry nursing (which happened when I was still breastfeeding my older child while pregnant with no. 2) is about the most horrible, aweful feeling in the world. I quit breastfeeding a couple months into my pregnancy, and I sometimes wonder if these horrible feelings contributed to the nursing aversion I had almost immediately with my second child.

          • Azuran

            BIG NOTE WARNING

            Possible to do. But you shouldn’t get your hopes up that much. Lactation is directed by hormones. If you give the right hormones to a woman the right way, you could induce lactation. (but that is as unnatural as it get, so of course, the super ‘natural’ people will probably totally love it)
            Studies have been done for a long time in cows to make them lactate without needing to birth a calf every year. So far, it is super expensive, hard to do, and produces very low amounts of milk.

            Spontaneous lactation does happen to some people who are in contact with babies. IF they start to breastfeed a baby, maybe they could eventually make enough to feed it…I dunno. But trying to make this happen on purpose is probably as effective as trying to force yourself to have identical twin babies.

            Really, it’s setting yourself up for failure.

          • Who?

            My squick-o-meter thanks you 😉

          • Daleth

            It apparently does work if you use Domperidone, but that drug has been banned in the US because it can cause sudden death by cardiac arrythmia. That, however, doesn’t stop lactivist types trading info online about how to get it illegally.

            It’s just insane. They are literally reasoning that breastfeeding is SO IMPORTANT that it’s worth risking the mother’s life. Um… do we really need to do a study comparing formula fed babies with living moms vs. babies who breastfed for a while until their mothers suddenly died, to see which babies do better?

          • Young CC Prof

            Domperidone is a drug that can and probably should be used to treat certain severe digestive disorders, especially in people who are suffering dangerous weight loss and don’t have cardiac risk factors. I really suspect that the reason it’s never been FDA approved is because they don’t want nursing mothers to get their hands on it and use it for low supply.

          • Megan

            My view was that Domperidone has never (and probably never will be) FDA approved because the manufacturer has never paid for or gone through the clinical trials and current FDA approval process and can’t be grandfathered in because it wasn’t previously FDA approved. Now, the manufacturer will probably never do it because it will be too expensive for a generic manufacturer to afford. In the recent past it was only available from compounding pharmacies. Now it is only available through those pharmacies for the diagnosis of delayed gastric emptying (eg in the case of diabetes) and the patient and pharmacy have to fill out a bunch of paperwork in order to do it legally. As far as I could ever tell, the cardiac issue with it is QT prolongation and in its oral form it’s not any worse than a tricyclic antidepressant, for instance (it is a bigger issue in IV form at higher doses). That’s why I think it’s more of a regulatory issue despite the FDA saying it’s just about safety. I will say though, that I do not think that risk is worth it for improving milk supply (especially given lackluster research on its efficacy) and that it is only worth it if you have gastroparesis and have failed other treatments, in which case you can still get it through the special exemption at a compounding pharmacy.

          • Joy

            Well, I live in the UK. It was pulled as an OTC drug last year and my GP refused to prescribe it for me off label for bfing use last year when I asked for it in my moment of weakness. So, I guess the FDA isn’t the only one.

          • GuestWho

            That sounds like an excellent cost/benefit ratio. Right up there with the lady who used donor milk exclusively delivered from a tube taped to her nipple.

          • demodocus

            “better than” that evil formula, according to this book a friend lent me.

          • Joy

            I am on a tongue tie board where someone regularly says that she took it and has a heart condition and didn’t die, so that means anyone with a heart problem can do it. The FDA is in the pocket of Big Formula you know.

          • Young CC Prof

            Because all heart conditions are the same. Heart is a very simple organ, you know, it only breaks in one way.

          • Daleth

            Again the pointless question: how can people be so STUPID?!

          • Trixie

            I’m pretty sure it’s more possible if you’ve lactated previously. I bet I could induce lactation if I tried really hard.

    • Kerlyssa

      Because it is her breasts, not theirs. The other parent does not get control over the mother’s body just because they are caring for the baby as well.

      • Poogles

        Yes, the woman’s body is her own and whether her breasts are used for infant feeding is entirely her decision; but Who? didn’t say “control” she said “opinions” and I agree that the father’s opinions about feeding should at least be considered by both the mother and LCs.

      • EmbraceYourInnerCrone

        NO but that should not stop a worried other parent from going out buying, some formula and feeding the baby if they are starving. At a certain point the baby’s need to eat SOMETHING is more important than the mother’s feelings about “failing” at breastfeeding. And yes I understand how hard it can be to do what’s safest for the baby over the other parents wishes but, in the end the needs of the helpless , hungry infant have to be the priority. Just because the mother carried the baby for nine months doesn’t mean she gets to starve it to death over the other parents objections. My husband is just as much a parent to our daughter as I am and while he got no say in whether I breastfed, he got a lot of say in decisions about her health and wellbeing.

    • Azuran

      I get what you mean. Sure, the father cannot force a woman to breastfed or not breastfed, the same way he can’t decide if she should have an abortion or whatever.
      However, where are the father in all those stories of EBF babies losing weight and failing to thrive? All those mothers spending the entire night up breastfeeding/pumping? When the baby is crying 24/7 because he is starving? When women are pushing themselves into PPD and bleeding nipples?
      Surely, as a partner, the father should be able to see this is not right and do something. But you never hear about them in any breastfeeding story. Makes me wonder, are they pushed out of any say by the mother? Or do they really don’t have a clue?

      • demodocus

        well, he could force an abortion, if he could find someone as unethical as he is, knock the mother out, and get the procedure done.

      • KeeperOfTheBooks

        In my case, I never had much of a supply, but was desperate to BF. I pumped incessantly, supplemented only with a tube taped to my breast, and so on.
        I cried all. the. time. to DH, who didn’t say very much until I decided to try Reglan to increase my supply–a drug which, when taken, can occasionally cause permanent Parkinson-like side effects. At that point, he (being an accountant) walked me through a risk/benefits analysis of taking it. I didn’t realize how insane I was on the subject until I rated “DD not breastfeeding” at the same level of risk/problem as my having to potentially deal with facial drooping/shaking/walking with a cane for the rest of my life. When those words came out of my mouth, I still felt like I was doing the “wrong” thing by not taking Reglan, but I was able to realize that wasn’t quite (no freaking kidding!) a balanced perspective.
        Later on, when I asked DH about it, he said he thought the whole business was totally insane, but thought if he said so that I’d blow him off and get more angry and more stubborn, and that what I needed at that point was him to be supportive, not, however justifiably, critical. I’d spent my entire pregnancy insisting I Was Going To Breastfeed Because Everyone Can. He would NOT have stood back and let me, say, refuse to give DD formula, but he wasn’t going to have a full-blown argument with a sick, exhausted, two-weeks-postpartum woman about most of the associated stuff.

      • Mac Sherbert

        I’m going with clueless. My DH wanted to me to BF, so I did. Not being one to fail I wouldn’t stop even though I hated it and was in constant pain. DH being DH did not understand what I meant by pain until he woke up one night and found me crying “I’m so sorry, I’m so sorry.” and the baby laying beside me on the couch crying frantically. At that point he went and made a bottle, picked up the baby and told me to go to bed.

    • phoenixfire

      My husband told me that while it was half his child, it was all my breasts, not to mention having to carry and nourish for nine months then give birth so I had the final say. He had no idea there was some big debate, he thought it was just two different choices (bless him!) He did admit that he liked that I went with formula so we could more equally split care sessions.

  • NoLongerCrunching

    Her name is spelled “Wiessinger.” Not trying to be pedantic (this time lol), just making sure Google is aware of your post about her.

    • Amy Tuteur, MD

      Thanks!!

    • D/

      Ha, you beat me!

      So I’m curious … in my experience I’ve never found the “risks of formula” approach to be palatable for myself or in any way helpful in my interactions with the families I work with. Do you find it to be commonly used among your hospital-based IBCLC partners?

      Also I’ve also been reading **a lot** the last couple days on the hierarchy of infant feeding (typically quoted in the majority of recent lactation literature as the World Health Organization’s specific “recommendation” for 1) breastfeeding, 2) mother’s own expressed milk, 3) expressed milk from a healthy wet-nurse or human milk bank or 4) formula, as a cup feeding because of safety concerns … in that order). The WHO documents that I’m finding substituted the blanket best choice is “in this order” verbiage for the best choice “depends on individual circumstances” somewhere between their 2003 and 2010 editions, depending on the document. Do you (or your partners) independently recommend milk sharing between mothers?

      • Daleth

        Do you recommend giving human bodily fluids from a non-relative to an infant? Knowing that those fluids could contain any number of diseases (such as herpes, HIV…), as well as whatever drugs the milk donor has been taking?

        Didn’t think so.

        It is INSANE to recommend donor milk over formula.

        • Sarah

          It’s not so much the drugs the donor has been taking that bother me: I reckon most (not all) women wouldn’t breastfeed if they knew they were partaking. It’s the drugs whoever the donor has been sleeping with has taken, and potentially whoever they’ve been sleeping with or sharing needles too. It’s one thing to trust that a woman who’s giving her milk to her own baby will not be doing anything to endanger them, quite another to extend that to her partner/s.

        • SporkParade

          Why would you assume that bodily fluids from a relative are safe?

          • Daleth

            Mom knows her own health history and medication, and thus at least has a basis for knowing whether her own milk is safe. She may also be very familiar with other relatives’ health histories and medications–some families are open like that. But there is no way she could know either of those things about a stranger’s milk.

          • EmbraceYourInnerCrone

            You can’t really know that about family members either, also people including family members may not know their own status when it comes to their exposure to HIV , HEP C etc. Assuming ones family members could not possibly have any illnesses is a mistake. Also, people take all kinds of over the counter supplements , vitamins and “herbal” medicines which they don’t consider drugs and don’t realise could adversely affect an infant.

          • D/

            Haha. I’d be more comfortable taking your milk (if you were sharing), than taking anything from *ANY* relative of mine! I come from a tribe of secret keepers that would straight up lie about any disease if they thought you’d think less of them by knowing the truth.

            I had exactly one friend when my kids were babies that I had the kind of relationship with that at the time I wouldn’t have thought twice about sharing milk with … Turned out she had a cheating-ass (now ex-) husband that shared several diseases with her. So yeah, sharing is a much too multifaceted arrangement for me.

        • Anne

          There was a woman with an 8-month-old baby in my local mom’s group who was begging other women for breast milk because her supply was dropping. She ended with “she has never had any formula, and I would like to keep it that way.” Because breast milk from strangers with unknown health/medication/drug histories is way safer than formula.

          • Roadstergal

            That’s what all of those “Benefits of breastmilk/risks of formula” handouts mentioned above do to someone. : Seriously, your HCP gives you information on the ‘risks of formula’ – what effect do they expect it to have? The more I hear, the angrier it makes me.

          • Daleth

            I’m old enough to know that this is a pointless question, but HOW can people be so STUPID?

        • D/

          Nope, I “missed” that practice question posed by my re-certifying partner from her exam preparations course. (In fact all of my IBCLC partners at my primary workplace missed it too.) I do end up having regular conversations about milk sharing for term babies though. Not initiated on my end, but usually “what can you tell me about …” questions from mothers after someone offers them milk or suggests milk sharing to them.

          I was really oblivious to the amount of active on-line promotion of milk sharing by nationally recognized IBCLCs … and validating it with quoted documents that don’t even say what they are suggesting … at all!

          If I’m going to take these WHO documents (and unselectively) use them, I’d actually need to tell a mother whose using a pump with a 1 month old to switch to hand expression instead and exclusively cup feed due to sanitation concerns related to cleaning bottles and nipples. Since, you know, available and safe options for mothers in sub-Saharan Africa should directly shape my practice recommendations for middle-class families smack in the middle of the good old USA.

      • Megan

        There’s a big didferce between using milk from a milk bank (tested, pasteurized, etc.) and informal milk sharing.

  • Back in the 70s, when I was in the UK, each new mother, when she arrived at the postpartum ward, would be interviewed by the Ward Sister, a dignified personage with an accent which shouted “I am a superior person” [Brits are acutely tuned to accent]. Since most of the patients in the Cambridge area were essentially rural “peasants”, this was highly intimidating.

    And the first question the Ward Sister asked was, “Are you feeding the baby YOURSELF, or are you [slight pause here for emphasis] ARTIFICIALLY feeding it?”

    Not many new mothers had the courage to ask for a bottle after that.*

    *District midwives discovered that most switched to formula as soon as they got home.

    • indigosky

      This reminds me of a story a friend in the UK told me. She was asked the same question about feeding in the same way. She cheerfully replied she was artificially feeding in her artificially made bed wearing artificially made clothes, enjoying artificial air conditioning. The nurse got her a bottle and didn’t say another word about her feeding methods, nor did any other nurse. I think they were warned.

  • yentavegan

    Here is what drives me bonkers in my own breastfeeding support face to face meetings…lactavists believe they are educated enough to answer questions regarding a whether a medication a mother takes is safe for her breastfed infant. THe lactavists rely on a number of different websites to look up the info and then pass on the “green light” to the mother. I am constantly reminding the women to have the mother check with the baby’s doctor. We have no idea of the baby’s underlying health issues and therefore are NOT qualified to answer the question.

    • Mattie

      I mean, you could look stuff up in the BNF but isn’t it the case that most things are just not ‘known’ as studies often aren’t done on pregnant/breastfeeding mothers? In which case the only person/people who would be able to make a judgement call are doctors/pharmacists

      • yentavegan

        Unless the babies medical/health status is taken into consideration all information about the safety of a drug taken by a breastfeeding mother is suspect.

    • Cobalt

      LactMed is an EXCELLENT resource for medication interactions while breastfeeding, and its available as a smartphone app. The information is split into effects on mom, effects on baby, effects on supply, alternatives if available, and information on the studies done on each drug so you know how much testing has actually been done.

      • An Actual Attorney

        I think that Yentavegan’s point stands. Regardless of the source, lay ppl are not qualified to answer the medical question. Advising on medication is practicing medicine. It should be left to those who are trained and licensed to do so.

        • Cobalt

          I’m not disagreeing with her, just wanting to share a good, unbiased, science based resource. Asking your own doctor is not always imminently available, and its much more reliable than the edited-by-anyone internet. I wish more doctors knew about LactMed, they could use it as a shortcut to the most recent studies.

        • Mattie

          I don’t think there’s anything wrong with providing information that women could find themselves, especially if it’s good information. As long as you encourage them to also check with their doctor or HCP at the earliest opportunity. For example most websites for OTC medicine will have information for pregnant/nursing people, or things like LactMed or the BNF are widely available, reputable sources that women can access. What’s the difference between a mother accessing those sources, or someone else who then relays the information?

      • D/

        If I only had a finder’s fee for every doctor I’ve hooked up with LactMed, I could take a little vacation! I went so far as to personally put the website shortcut on every computer in Maternal-Child and then requested that it be added to the MDs IT resource list as well. Really a great resource.

    • Megan

      I also like Thomas Hale’s book ‘Medications and Mother’s Milk.”

    • Tiffany Aching

      Very true. I see it all the time online : women are told to ignore their doctors’ advice because “they don’t know anything about breastfeeding” and advised to go on breastfeeding while on possibly dangerous medication, because obviously breastmilk laced with diazepam is MUCH better than formula.

  • phoenixfire

    It is because of crusaders like Dr. Amy and the FFF that the shaming did not work on me. When I got pregnant I knew I wasn’t going to want to breastfeed but the guilt tripping made me realize that I was goig to be forced to or be labeled a bad mother. I cried, miserable until my 4th month of pregnancy, wishing that I wasn’t pregnant anymore. A kind friend directed me to REAL information regarding formula feeding and breastfeeding. A few months of reading this wonderful and accurate information made me more and more confident that formula was a great way to feed a baby and that I didn’t have to breastfeed.

    I enjoyed the last few months of my pregnancy and practiced in front of a mirror my responses to people’s jerky comments and inquiries. Now my daughter is six months and while I have encountered many using this language to me, I have been confident enough to realize how they are trying to brainwash me and can fire back. And I am not a very confident person, I have little to no self-esteem.

    • shygirl

      Did you have any difficulty with doctors? Some obgyns seem to have drunk the koolaid 🙁

      • Gatita

        In my experience, OBs and pediatricians are the least judgy and most supportive. My pediatrician basically said, eh, you tried and he did get some BM so don’t worry about it. I wish I could’ve taken his words to heart but the lactivists deliberately undermine confidence in doctors (see Modern Alternative Mama).

        • An Actual Attorney

          So grateful our ped is a married gay man with a daughter a few months older than Actual Kid. Other than telling a story about his daughter trying to nurse from his hairy husband, he didn’t seem to have much to add other than that bf was nice, but obviously not necessary.

          • Kerlyssa

            Now I am thinking of that one scene from family guy.

        • phoenixfire

          Our first pediatrician was judgy, so my husband told her off and we found a new one.

      • phoenixfire

        No, luckily the OB I had picked was a great guy. He had been giving me breastfeeding literature because that is what is done around here – everyone breastfeeds. I finally confessed that I didn’t want to breastfeed and he felt guilty, because he felt like he had pushed it on me. We were both at fault, I should have communicated sooner. Now he asks his patients what their feeding plans are and makes sure they know that any way is great.

        The first pediatrician my husband fired because she was judgmental. He took our daughter to her first appointment so I could get some rest and glad he did or I probably would have cried. The second one rolled her eyes when I told him about the first one and said she could never pick out a breastfed baby from a formula fed baby after the age of one.

        • toni

          how can they tell before one? other than there being a breast or bottle in their mouth lol

          • phoenixfire

            Different growth charts for formula and breastfed babies apparently. But by one we were told they are eating food and most likely off the breast/bottle and that balances it out.

          • fiftyfifty1

            “Different growth charts for formula and breastfed babies apparently.”

            Actually, the only time there is a significant difference in growth is in the first few days before milk comes in. Breastfed babies reliably lose more weight than bottle fed ones. After that there is no reliable difference. Some studies find formula fed babies growing slightly faster and fatter, others (like the PROBIT study) have breastfed babies being fatter. Of course the exception to this is if a mother is not making sufficient milk, or if a child is allergic to a certain formula etc. Both of these situations can cause failure to thrive.

          • SporkParade

            Wait, then why are there separate growth charts? I’m legitimately curious. And desperately hoping that my pet theory (an ideological preference for inadequate nutrition over formula supplementation) is wrong.

          • anh

            there aren’t separate growth charts. At least in the US all babies are measured on the WHO chart until they are 2, per the CDC’s guidance.

          • fiftyfifty1

            “Wait, then why are there separate growth charts? ”

            There aren’t.

          • Detail-Oriented

            Because formula-fed babies are initially shorter for their weight, but then catch up in height and maintain the initial very fast growth rate of babies under 3 mo longer.

            The EBF charts were very carefully constructed to exclude children who might have infectious diseases, be affected by malnutrition, etc, and the researchers tested whether they might have missed any such factors by playing around with the data before proceeding. (You can find the whole methodology at http://www.who.int/childgrowth/standards/en/, but it’s a technical discussion so unless you work with statistical modeling it’s not going to be very understandable to you.)

          • Detail-Oriented

            “Breastfed babies reliably lose more weight than bottle fed ones. After that there is no reliable difference. ”

            All you need to do to notice that the above statement isn’t true is to compare the shapes of the curves of the EBF growth charts and the older mostly formula-fed charts. Since both are showing you time trends of roughly Gaussian data distributions of the two groups, comparing the curves is a quick and handy way of comparing the statistics of the two groups. Formula babies grow slower initially (on a week or month scale after birth), but maintain that relatively high (compared to later times) initial growth rate longer. Of course, I see from your comment below that you aren’t really aware of the existence of the two charts, so perhaps finding the two is a first step. Very googlable from official websites so that shouldn’t be a problem, right?

            Breastfed babies do not reliably lose more weight in the first few days after birth than bottle-fed babies when breastfeeding-friendly circumstances around the birth and postpartum practices help establish breastfeeding right from the start. Avoiding that dip that is the reason lactivists are trying to create beastfeeding-conducive situations in hospitals, so that moms who want to breastfeed are given the best opportunity to make that choice for themselves and their families.

            I had an unmedicated birth with no separation afterwards, my LO latched in 28 minutes. She had “regained” her birth weight in 24 hours (did she ever even drop, one wonders, with that short of a time interval?) and it’s only been up from there. My milk came in in two days and LO sucks like a champ. At 5 mo she can drain a full breast in 5 minutes. But I had the benefit of everything stacked to help me execute my decision to breastfeed. Not everyone gets that support for their decision to breastfeed.

          • Lesley P

            That is great for you that everything went so well. Just as another data point, I had an unmedicated birth and all the support you describe, and my baby still lost more than ten percent of his body weight. We eventually worked it out and he is still nursing at 13 months. Support does not guarentee a perfect breastfeeding relationship.

          • Detail-Oriented

            Of course there are no guarantees of success with support. But I note that you also succeeded. Absence of guarantee doesn’t mean that support is a waste of time. Support is the difference between success and failure for at least some moms.

          • Megan

            Well, la-dee-freaking-da, breastfeeding was so wonderful and easy for you! I also had everything “stacked” to helped breastfeeding work and I really wanted to do it too. But my daughter lost 18% of her birthweight and had to be hospitalized for jaundice. A fair amount of moms truly are not able to adequately breastfeed their babies and it has nothing to do with support. My hospital is part of the BFHI and In total I met with four different LC’s and had access to their help basically whenever I wanted. My DD also had a tongue tie that was repaired and we STILL couldn’t make EBF work. Sometimes it just. doesn’t. work. I get so tired of hearing that we’d all be fine if we just “had more support.” It’s so trite. And it’s not true a fair amount of the time. And some women don’t WANT to breastfeed and that “support” is only perceived as shaming. Why is it such a big deal if not all women breastfeed??

            And by the way, considering fiftyfifty1 is a physican, I’m quite sure they are aware that there are two different growth charts…

          • fiftyfifty1

            “considering fiftyfifty1 is a physican, I’m quite sure they are aware that there are two different growth charts…”
            Except that their aren’t 2 different growth charts. There was an UPDATE to the growth chart a few years ago, and the new growth chart replaced the old. It’s true that the old growth chart was made based on a population with a higher percentage of white formula feeders, the new chart with more different ethnic groups and more breastfeeders. But only lactivists are spreading the lie that “there are 2 growth charts one for formula, one for breast”. The CDC and WHO recommend the new chart for ALL babies, no matter the form of feeing, because it doesn’t matter.

          • Megan

            Hrm. I wonder why our Health system has and uses two different charts then? I had not heard about a new single chart. Maybe I missed it on maternity leave. Do you have a link?

          • Megan

            I guess it’s just the WHO chart?

          • Detail-Oriented

            Saying that support can help more women breastfeed successfully is not the same as saying that support can help all women breastfeed successfully. That there are women who can’t breastfeed is not a counterexample to that breastfeeding support increases breastfeeding success.

            The key point is that there exist women for whom the support is/was the difference between getting to breastfeed like they wanted to and not being able to breastfeed like they wanted to, and that we know a laundry list of things that consistently can be that difference, and so we should do all of those things for everyone who wants to breastfeed to try to make sure we do the things that needed to be done to help each such mom even when we can’t know ahead of time which of the laundry list items it might be for each individual.

            “A fair amount of moms truly are not able to adequately breastfeed their babies and it has nothing to do with support.”

            Can you quantify “fair”?

            “And some women don’t WANT to breastfeed and that “support” is only perceived as shaming. Why is it such a big deal if not all women breastfeed??”

            Am I to infer that you think that in order to not inadvertently hurt the feelings of people who decided to formula feed, in case they might interpret staff trying to help other patients as personal criticism, we should leave people who decide to breastfeed to their own devices and hope they figure it out even though we know what could be done to help people who chose breastfeeding execute the decision? How would you have felt if you had been told no one was going to help *you* because it might hurt someone else’s feelings if you got help? That’s just horrible.

            The big deal is that women who want to breastfeed don’t get to, unnecessarily. You should be able to choose the feeding method that’s best for your family freely, as much as theoretically possible. That means that we need to work really hard to try to make sure that everyone who wants to breastfeed gets to for as long as they like. The formula cans open for everyone who choose them. Breastfeeding isn’t like that, so to ensure real choice (as far as theoretically possible) breastfeeding support is a must, even if not everyone can or wants to breastfeed.

          • Young CC Prof

            Helping women who want to breastfeed doesn’t “inadvertently hurt the feelings of people who decided to formula feed”. What deliberately hurts the feelings of people who decided to formula feed (or wound up formula feeding because it was formula or death for the baby) is when breastfeeding is pushed as the only reasonable option, by the careful use of loaded language, emphasizing the “dangers” of formula feeding. Over and over “You really should breastfeed, why aren’t you?” There’s nothing inadvertent about those insults.

            The Baby-Friendly thing works for some people. Absolutely, I think that mother and baby should be able to stay together and there should be lots of professional support for breastfeeding, from the day of birth through after discharge.

            But what about the mother who had a hard birth and is nearly fainting from exhaustion? There has to be a nursery to send the baby to, because falling asleep while holding a baby on a hospital bed is really dangerous. Many Baby-Friendly hospitals are now unable to care for the newborn, even if the mother has no overnight support person.

            What about the baby who becomes dangerously ill from insufficient intake because hospital policies put exclusive breastfeeding above heading off a medical emergency? This isn’t a crazy hypothetical, it happened to my own child, and it happens to babies in every hospital every day. I would have been happy to supplement, but I had no idea what was happening, and the medical professionals told me everything was fine.

          • Detail-Oriented

            “Over and over “You really should breastfeed, why aren’t you?” There’s nothing inadvertent about those insults.”

            An insult is something like “You’re a poopyhead for not breastfeeding!”. Repeatedly pointing out the fact that there are risks to using formula (even modern, even in developed countries) is not an insult. You need to add more, such as “…and you’re a bad mother for feeding formula”, or at least an expression on a face, to get shaming or an insult.

            Now, I can totally get why that question would break your heart when you wanted to breastfeed but it didn’t come together for you and you are grieving the loss. But that doesn’t make it intentional (e g an insult). Sure, ideally staff should communicate such that they would already know that someone wanted to breastfeed but is feeding formula because of whatever it is, but that again isn’t some conspiracy. It’s just life being shitty in everyday life ways. Staff not communicating perfectly causes all kinds of other problems too, such as medication mistakes for example. It is possible to _be_ insulted without _being_ insulted.

            That said, I’m sure there are people who do actually insult people who formula feed. But you can’t just jump from that fact to the conclusion that all negative statements of any kind at any time about formula are insults intended to shame formula feeders. There’s so much missing in the middle.

            “But what about the mother who had a hard birth and is nearly fainting from exhaustion? There has to be a nursery to send the baby to, because falling asleep while holding a baby on a hospital bed is really dangerous.”

            Rooming in doesn’t necessarily mean co-sleeping in the same bed. Co-sleeping includes just sleeping in the same room, such as in one of those plastic warmer thingies. I thought that’s what they were for, for putting the baby in when the mom has to sleep. Even non-Baby Friendly hospitals that have nurseries have those, at least in my area.

            “What about the baby who becomes dangerously ill from insufficient intake because hospital policies put exclusive breastfeeding above heading off a medical emergency? This isn’t a crazy hypothetical, it happened to my own child, and it happens to babies in every hospital every day.”

            Sorry to hear you had an emergency with your child so early! What was the medical emergency? What happened?

            However, like in the case above, you can’t jump from one or a small number of cases to a general conclusion without filling in all the steps in between. Do you have any documentation of that hospital policies put exclusive breastfeeding above heading off a medical emergency such that babies in every hospital [in what geographic area?] every day experience unnecessary medical emergencies? If that statement is true, then it’s true of non-Baby Friendly hospitals as well. Why would that be the case? Shouldn’t that sort of obsession be more likely in a Baby Friendly hospital than in a non-BF hospital? In fact, couldn’t you test that hypothesis by comparing rates of medical emergencies related to feeding or lack thereof in BF and non-BF hospitals? Has someone done that? Has anyone done any work to show that policies put babies at risk? It would seem to me that hospital lawyers would have a big stake in making sure that is never the case with respect to any policy about anything. What about the research that shows overall better outcomes for mothers and babies in BF hospitals? How do you account for that?

            Without support, the statement just doesn’t seem likely to be true to me. Nothing I’ve seen or read makes it ring true. If I’m just not aware of a slice of reality, you’re going to need to show me the slice, not just say that it’s there. Now, if it’s there, we’d need to take a closer look at how you can both eliminate pressure to formula feed _and_ rapidly spot budding medical problems. The sort of default response to a lot of pressure in one direction is to push across the board in the opposite direction. If that is also causing problems then more nuance is needed. But – to get the right nuance you need to have a specific problem statement backed by documentation.

          • Daleth

            What risks are there to using formula in a developed country? Please be specific.

            And is there any particular reason you think it’s reasonable for people to go around telling formula-feeding parents about the supposed “risks” without also mentioning the risks of breastfeeding, which include Vitamin D-deficiency induced rickets. You want bow-legged babies with weak bones? Go ahead and exclusively breastfeed!

            “Physicians have known for more than a century that exclusive breast-feeding may be associated with vitamin D deficiency and rickets, and that the condition is easily prevented and treated with inexpensive vitamin drops or cod liver oil. But doctors are reluctant to say anything that might discourage breast-feeding.”
            http://www.nytimes.com/2008/08/26/health/research/26rick.html

          • Roadstergal

            Along with the informed consent forms for vaginal vs C-section birth instead of just the latter, there should be proper informed consent forms for breast vs bottle feeding, for both baby and mother. They probably wouldn’t help the BFHI ‘goals,’ though.

          • Cobalt

            It is an insult. It assumes there is something about the mother is deficient, emotionally or intellectually, that prevents her from making reasoned choices for herself and her baby. Now, IF the “risks” of formula were real AND breastfeeding information/education not pervasive AND there is an appropriate relationship (health care provider, for example) between the mother and the questioner, then maybe it’s a valid question.

            All other questioners are nosy gawkers, and likely sanctimonious ones at that.

          • Young CC Prof

            My son was readmitted for hyponatremic dehydration and jaundice. It happens to something like 3% of breastfed newborns, which isn’t at all rare. Our current protocols do not emphasize prevention.

          • fiftyfifty1

            Growth curves have been updated over the years, and the populations used to create these curves have varied over the years, but the fact remains that medical professionals do NOT use different growth curves for breast vs formula fed babies because their growth is not reliably different. Thus neither the CDC nor the WHO recommends using different growth charts either.
            As for whether babies who are breastfed lose more weight in the first few days, the data from multiple studies clearly show that they do. Your anecdote about your own milk coming in on day 2 is nothing more than an anecdote. Milk coming in on day 2 is unusual and especially so for a nullip. Setting up women to believe that an outlier outcome is to be expected “if they do everything right” is deceptive and cruel.
            When breastfed newborns struggle with the medical consequences of weightloss, it helps nobody (not mothers, not babies, not anybody) to deny their situations with your No True Scotsman arguments.

          • Detail-Oriented

            Two sets of data (or more) means that there are two (or more) sets of distributions to plot and compare. You said “Breastfed babies reliably lose more weight than bottle fed ones. After that there is no reliable difference.” I said that you can see that that’s not true from comparing the two growth curves. They do not overlay; ergo, there are continued differences between EBF and formula-fed babies after the initial weight loss. That’s all on that point. Whether you should use one or two charts in clinical practice is a related, but different, topic. Whether it’s problematic or not that formula fed babies grow differently is also a related but different issue that needs more information to assess (as others have done in the literature, of course). But you shouldn’t say there is no difference when there is one so that people know that they need to decide whether they think it’s a difference that matters or not.

            Of course my anecdote is an anecdote. I told it because it happens to contain several key features that the literature says are important. (This is only kind of a coincidence, since I selected a birth setting in large part based on whether it had the breastfeeding support shown to be effective in the literature.) The set of actions identified as baby-friendly does work but you need most or all of them to really see good results:

            Pediatrics. 2005 Nov;116(5):e702-8. Merten S1, Dratva J, Ackermann-Liebrich U. Do baby-friendly hospitals influence breastfeeding duration on a national level?

            From the results in the abstract: “Known factors involved in the evaluation of baby-friendly hospitals showed the expected influence, on the individual level, on duration of exclusive, full, and any breastfeeding. If a child had been exclusively breastfed in the hospital, the median duration of exclusive, full, and any breastfeeding was considerably longer than the mean for the entire population or for those who had received water-based liquids or supplements in the hospital. A positive effect on breastfeeding duration could be shown for full rooming in, first suckling within 1 hour, breastfeeding on demand, and also the much-debated practice of pacifier use. After controlling for medical problems before, during, and after delivery, type of delivery, well-being of the mother, maternal smoking, maternal BMI, nationality, education, work, and income, all of the factors were still significantly associated with the duration of full, exclusive, or any breastfeeding.”

            The birth center had no formula to push and certainly wasn’t interested in doing so either. I got breastfeeding support from the midwives. I “roomed in” to the extreme (no separation at all and two-week babymoon). First suckling was within an hour, made more likely by the unmedicated baby. I breastfeed on demand. I don’t use a pacifier though.

            My less key contention that the size of the weight loss after birth in EBF infants is highly linked to the efficacy of the breastfeeding support moms get is substantially also supported by the literature:

            J Acad Nutr Diet. 2012 Mar;112(3):410-3. doi: 10.1016/j.jada.2011.10.024. Epub 2012 Mar 1. Grossman X1, Chaudhuri JH, Feldman-Winter L, Merewood A. Neonatal weight loss at a US Baby-Friendly Hospital.

            From the abstract: “Complete data were collected on 121 infants. Mean weight loss was 4.9% (range=0.0% to 9.9%); 19.8% (24 of 121) of infants lost >7% of their birth weight; no infant lost >10%.(…) Clinical practices at a Baby-Friendly hospital, which support and optimize breastfeeding, appear to be associated with only moderate weight loss in exclusively and mainly breastfed infants.”

            I will correct my statement to be that the size of the weight loss in EBF infants does not have to be semi-commonly medically problematic when proper breastfeeding support is offered. That’s what I really meant but that’s not what I wrote. I assumed that what you were getting at was the additional finding that EBF infants have medically concerning weight loss more often than formula-fed infants, but that’s not what you actually said.

            It’s just common sense. More early suckling – more stimulation – better odds of milk coming in sooner – better odds of smaller weight loss. It’s an extension of the same general mechanism that accounts for why formula-fed babies consistently lose very little weight after birth – the sooner you start eating, the less weight you lose, and the smaller the odds that problems due to excessive weight loss crop up. So, that naturally leads into my third point – basically, that the reason that lactivists are trying to implement WHO/UNICEF Baby Friendly practices in hospitals is because they are effective, including on the point of protecting babies from medically problematic weight loss after birth.

          • N

            I like what you write and agree.
            Also I would like to ad, that even if birth conditions went not as planned, like ending in en emergency c-section, if the hospital is baby friendly, and mother is well informed, breastfeeding can work out great. With the right help, even if baby does not latch on within the first hour, it may work. As we have to learn to breastfeed, it is not instinctive, and we don’t have that much role models anymore in society, we need help. All the help a baby-friendly hospital may provide.

          • Detail-Oriented

            Yes. Everything certainly doesn’t have to be optimal for it to work, and those who want to breastfeed should be given the help. I am grateful that I did not have to find out what circumstance not being conducive could have derailed my breastfeeding. It just worked and it’s been one of the most enjoyable things I’ve ever experienced. I might feel differently later but right now I’m a little sad that one day she’ll want to wean. I love coming home from work and getting to snuggle in with my LO for some snuggly, loving R&R with my feet up first thing. I wish it could be like that for everyone who wants it since it obviously isn’t.

          • Tiffany Aching

            “including on the point of protecting babies from medically problematic weight loss after birth.”

            Well, I don’t know about that. A nurse from a baby friendly (yes, we have that in France too) hospital told me that she was sick of seing babies crying and starving because the personnel believed that supplementing would interfere with breastfeeding. She thought that waiting for the baby to lose too much weight, while he had obviously communicated his hunger by crying for several days was downright cruel and a very strange way to welcome a fellow human being into this world. I couldn’t agree more.

          • Monkey Professor for a Head

            I had an (awesome) epidural and whilst I didn’t get separated from my son I slept through his first breastfeeding session (23 hour labour and big PPH – my husband didn’t have the heart to wake me so he put the baby on my chest and let him do his thing). Despite that I produced loads of milk from the start and my son never lost any weight. He’s 5 weeks old now and has been exclusively breastfed since birth. It’s not because of anything I did, it’s just the way my body is built.

            Your last paragraph basically boils down to “I did everything right and that’s why I was so successful at breastfeeding. Why can’t all other mums just do the same thing”. The spin off of that way of thinking is that if someone has difficulty breast feeding then they must be doing something wrong. But I have news for you – while I’m sure that the support helped, a good part of both of our success was luck, nothing more.

          • Detail-Oriented

            My last paragraph ended with “But I had the benefit of everything stacked to help me execute my decision to breastfeed. Not everyone gets that support for their decision to breastfeed.”

            The spin-off for that way of thinking is that all hospitals should implement and adhere 100% to the WHO/UNICEF Baby Friendly guidelines so that we are systematically providing breastfeeding support to all moms who choose breastfeeding for their family and maximize the chances for each individual woman to receive the specific support that she happened to need at that time. The primary responsibility for creating a the conditions to make breastfeeding as easy as possible should not lie with the patients. While some will make it work anyway, it’s still a systems issue.

            “(…) while I’m sure that the support helped, a good part of both of our success was luck, nothing more.”

            If it’s mostly luck, then some groups of people are luckier than others, and the level of luck can go up and down over time. That’s an interesting quality for luck to have, don’t you think?

          • Tiffany Aching

            Wow. Here is you golden star. You’re the best breastbragging mama of this thread.

          • Cobalt

            The poop! At least in the beginning.

  • Roadstergal

    That Breastfeeding Initiation graph can be overlaid on so many things. Chronic diseases, autoimmune diseases, IQ, lifespan, any of a number of Important Things That Breastmilk Is So Important For, and show no effect of that dip-and-rise.

  • MegaMechaMeg

    When my godson was a baby I went on a daytrip with his mom. He needed to eat at about the same time that she needed to pee so she made up a bottle, settled us on a bench and walked away. In the two minutes it took her to come back some random mall lady showed up with a prepackaged lecture about how I didn’t love my baby and he was going to be stupid and fat because of my choices. I am a shy and conflict adverse kind of person so I didn’t even manage to squeek out that it wasn’t my baby and the bottle had his mother’s milk in it. Definately one of my more bizarre life experiences.

    • Kelly

      I just don’t get how people will randomly come up to you and say that you are doing something wrong and give you a lecture. I would not go up to someone smoking and say good luck later in life with your stroke and lung cancer if you don’t quit now. I am not saying that I don’t judge but I do keep it to myself and plus it is so much work to judge everyone. I am too busy keeping my life together to care what everyone around me is doing.

      • Mattie

        I say it to my dad, and I glare at people smoking in places they shouldn’t be lol smoking IMO is totally different because if you’re close enough then they’re forcing you to passive smoke which is gross.

        • Roadstergal

          Yes, there’s secondhand smoke and secondhand vape. There’s no secondhand formula. If there were vodka in that bottle, it wouldn’t matter to me.

        • Kelly

          The point is that we all know that smoking is bad for you but I don’t feel like I need to go give everyone I see smoking a lecture.

          • Monkey Professor for a Head

            I agree – my sister used to smoke, and as much as I hated to see her do it I never said anything to her about it. She’s an intelligent woman and she already knew the risks – it would have been patronising and unhelpful to lecture her.

      • Gatita

        There’s a strong correlation between depression and bipolar disease and cigarette smoking, not to mention smoking and low SES (i.e. people with the least access to mental health care) so I despise how people feel free to hate on smokers and say that lung cancer victims deserve their illnesses.

        • Kelly

          That is terrible. I would never say that anyone deserved any kind of cancer. I have had two grandparents die of cancer and it was awful to watch them suffer. I also do not judge smokers because I feel it is their choice and I know how hard any addiction is to overcome. I just used it as an example where people have a strong opinion on it and there is scientific evidence to back up that opinion but you still don’t see people who have any sense of decency going up and lecturing them.

        • FormerPhysicist

          Hunh, I thought I heard about a correlation with schizophrenia. I’ll have to do some digging.

          • Gatita

            I think you’re right.

          • FormerPhysicist

            Not in the mood to dig deep, but this site claims both schizophrenics and those with bipolar.

            http://www.schizophrenia.com/smoke.htm

            Another article similarly quotes that 88% of schizophrenics smoke.
            http://apt.rcpsych.org/content/6/5/327

          • An Actual Attorney

            Anecdatum, my friend’s sister is institutionalized from schizophrenia. My friend buys her sis cigarettes just because it’s one of the very few true pleasures she can give to her sister. And sis has no real rational reason to quit. So, correlation may not be causation.

            OTOH, I struggled with smoking for decades, and as soon as I got on the right anti depressantdepressant to treat my depression (not one that is used for quitting) the urge to smoke totally disappeared. So, maybe correlation is causation.

          • fanonj

            I spent some time in an locked inpatient psych facility (depression) and cigarette breaks were the only outdoors time, so I would go along and not smoke. I was only there a week, but I can see how people join in. Similarly, it’s a way of dealing with less healthy addictions (cousin picked it up when dealing with drug problems — it was certainly the lesser evil).

          • KeeperOfTheBooks

            In a rather lighter scenario, back when I worked at the bookstore, a lot of us non-smokers got a bit fed to the teeth with the fact that store management, smokers all, always and promptly ensured that the smokers got their cigarette breaks, but those of us who didn’t rarely, if ever, got our legally-mandated 15-minute breaks.
            A number of us decided en masse to take up “smoking” one week, “smoking” meaning “smoking hot cup of coffee/tea/bevvie of choice.” It got the point across effectively. 😉

          • Tiffany Aching

            Same experience here – smoking was the only occasion to go out and feel a little bit normal. I think that I smoke at most one pack a month normally but I reached one pack a week when I was in a psych ward for depression.

        • Megan

          There is also a correlation between smoking and untreated ADHD (e.g. in teens or adults). I think there is a correlation between smoking and a lot of mental illness. It’s self-medicating.

      • Young CC Prof

        Yes, unlike formula feeding, smoking has clear and serious adverse health consequences. However, going up to a stranger on the street to tell them to stop smoking is weird, inappropriate, and really unlikely to produce changes in behavior.

        • Kelly

          Yeah, if I don’t do it to someone who is actually harming themselves why would I do it to someone who is not. Of course they think my child will be obese, behind, etc. but they don’t have enough science to back up any of those.

      • Tiffany Aching

        Oh but people do that with smokers too. I’ve been lectured more than once by complete strangers on my filthy habit. And I live in France where smoking still isn’t as rare and condemned as in the US.

    • Who?

      Yep, people are strange. I am neither shy nor conflict averse and have no idea what I’d say in that scenario.

      • MegaMechaMeg

        What is there to say? It isn’t my baby? This isn’t formula, but it would be fine if it was? He was born with a double ear infection and bottles hurt less and still screams murder when he sees a nipple so his mom pumps and that is none of your business anyway? I’m sorry I didn’t hear you because I am kind of silently freaking out that this white liquid is a biological excrement and I can’t stop thinking about nipples?

        I don’t know how people can be so brave when they are being so rude and why I am so timid when I try and be polite.

        • Who?

          Very true.

          I don’t think they are trying to be rude, perhaps just lacking some self awareness. And for all you know they are shaking in their shoes as they speak, but believe so passionately that they have no choice but to speak out. All of which the baby and baby feeder don’t need to know and care about, of course.

          A few times when my kids were small I had some fairly robust unsolicited (and unhelpful) advice, and on those occasions I looked the speaker straight in the eye and asked if they were offering to actually help, or just butting in with impertinent suggestions. They usually scuttled off immediately. They had shared their pearls of wisdom and were probably going to head off anyway, so who knows if that question made any difference? Made me feel better though.

        • Sarah

          What is there to say? I’d have started with ‘fuck off’ and taken it from there, really.

    • Sue

      Perahps the best response might have been to briefly withdraw the teat from the baby’s mouth, reverse the bottle and squirt the offender, then calmly continue feeding. With a smirk.

      • Mattie

        I like this because it works for any feeding method, anyone gets antsy at you for anything…milk in face.

    • Mel

      OT – but similar: When I was 16, my aunt and uncle had a surprise, late-in-life set of twins. I was walking through a store with one of the girls on my hip on a shopping trip. Several people came up to me and asked how old the baby was. I said “Um. Got me. Fourteen months?”. I got a major stink-eye. It took me awhile to figure out that people thought I was a teenage mom who didn’t know how old they were.

  • Smoochagator

    One of my friends tried to breastfeed for about 2.5 seconds with her first child, said it was kind of awkward and difficult, and switched to formula. So far as I can tell, she felt absolutely ZERO shame or guilt about the decision… probably because she spent absolutely ZERO time in internet chatrooms discussing natural childbirth or attachment parenting. If only I had been so smart! I wish that every woman could feel that way when she becomes a mother – wholly unconcerned that someone, somewhere might think she’s doing a poor job of it.

    • MegaMechaMeg

      I am pretty supportive of cry-it-out as a parenting technique, but when I was babysitting and the baby wouldn’t stop crying after being put down and the parents instructions were to let her go all I could think was that her brain was getting changed from the stress hormones and I was causing emotional scars by not going to her. I can’t even imagine how I would feel if she were mine. The internet is just horrible that way.

      • SporkParade

        Ugh, and of course these parents make everyone else who uses mainstream sleep training methods, like the Ferber method, look evil. It’s kind of amazing to me how women who know absolutely nothing about sleep training feel free to tell me to my face that I’m a horrible mother because my baby spent maybe two hours crying in total over the course of three nights.

        • demodocus

          I have to laugh, because my persistent child spent 2 hours and more the night we tried it. Should have known he’d be mule-headed. Glad it worked for you guys, sad it didn’t work here!

        • MegaMechaMeg

          God, when they narrate what the baby is thinking? like “Mommy, I am all alone, where are you? Don’t you love me mommy?”. I want to be emotionally resilliant and know that I am being manipulated but it just breaks my heart. My mother sleep trained both me and my brother and we are both fine! There is absolutely no reason for me to feel guilty that a baby cries! Children cry! If it were that freaking harmful then the human race would be in pretty terrible shape! But no. I put a baby to bed and all I hear is a tiny querellous voice asking why I am abandoning her is this giant cold room all alone where she is scared and mommy is gone and nothing feels right. That shit is seriously insideous.

          • SporkParade

            Oh, I was openly mocked yesterday for suggesting that babies sometimes cry at night because they can’t fall back asleep and they’re exhausted and that’s really frustrating.

          • KeeperOfTheBooks

            DD, age 16 months, will still sometimes do this. I’ve learned to wait. If I hear a despondent, miserable wail or three followed by silence, it’s an “I’m awake and don’t wanna be and why am I wake I’m sleepy” wail that trails off into sleep. If it’s long-term and persistent with more anger in it, it usually means either teeth or “I’ve slept in a weird way and my diaper got twisted and I’m lying in a puddle, Mom, help!”

          • Kelly

            Or that persistent wail might mean, “I have tried to climb the crib, got my foot stuck between the wall and crib, and am now upside down with the blanket over my face,” like mine did the other day. If her ankle wasn’t so twisted and hurting, I would have taken a picture.

          • KeeperOfTheBooks

            Toddlers: cute, yes. Geniuses, not so much. 😀

          • Tiffany Aching

            People doing this kind of narrative are only really talking about themselves and what they project on their babies. As SporkParade said, crying can be the baby’s way to expression exhaustion and frustration. It is not necessarily about his/her mother.

    • Gatita

      Part of the problem is a lot of first-time mothers don’t have close family members who can help them through the first difficult months so they turn to online “support” that turns out to be a vicious snake pit. I had that problem and avoided online and real life groups (I live in a crunchy area) and it was horribly isolating. I so badly needed help but the only “help” available to me were groups of mean girls itching to beat up women who didn’t conform. I ended up with a nasty case of PND as a result.

      • RMY

        The internet is always available, and it’s not hard to find someone who’ll call themselves an expert on anything.

      • SporkParade

        That’s the issue I’m having now as an expat. It’s like, I need the resources from the other English-speaking mothers, but they are insanely crunchy. The local mothers are much more practical, but they have less information for me.

      • KeeperOfTheBooks

        I could have written that myself. I hope you found help and support eventually!

        • Gatita

          I did, thanks for asking!

      • superhappycamper

        Same here – it happened when I looked for support online about anything relating to childbirth and infant feeding. That was a while ago. it looks as if the number of people with an axe to grind on these issues has only gone up.

  • Amy M

    And of course, this is where my dreaded pet peeve fits in: the lactivists, who are basically given permission to do their best to shame other women and MAKE them feel inferior, often come back with that Eleanor Roosevelt quote (“..no one can MAKE you feel inferior without your consent.”) when called on their behavior. I’m pretty sure E.R. didn’t mean that its ok to be a giant a*hole to anyone, anytime, because you can just blame your victim for “choosing” to feel offended/guilty/ashamed.

    These same lactivists also say that “formula feeders should own their decisions and actions and not make excuses.” Well, maybe lactivists should own their decisions (to be a*holes) and actions (deliberately harrassing and bullying other women) and not make excuses. As a (former) formula feeder, I didn’t feel shame or guilt about it, and I do own it: after an attempt to combo-feed, a number of reasons led me to use 100% formula. No excuses. I simply decided that the breastmilk part of the combo wasn’t worth it. I did NOT try my hardest to make it work, and I’m fine with that.

    Wouldn’t it be refreshing to see lactivists say: “Well, I chose to shame and harrass other women about breastfeeeding because I’m really a small-minded, petty and insecure person, and this is one of the few things that its socially acceptable to be a big jerk about. I know it makes me a terrible human being, but I’m ok with that.”

    • GuestWho

      Oddly enough, of the three personal aquaintances that I have had fall down the lactivist rabbit hole, only one managed to exclusively breastfeed for any length of time. Of the other two one supplimented until her supply went out at about six months and the other never really made enough and then dried up completely two months post partum. I feel like any rational person would classify them as combination or formula feeding, but you would have no idea just by looking at their online presence or listening to them talk. When I am feeling kind I tell myself that their continued participation in extreme lactivism is an expression of their guilt and embarassment for not being sucessful at EBF after being so vocal during the pregnancy, or maybe some kind of crazy cognitive dissonance. When I am feeling bitchy I imagine going to their facebook comments claiming to have EBF two children to whatever age and replying with a photo of their kitchen counter and/or diaper bag
      It is a good idea to remember that internet claims and stranger testimonials are not necessarily a reflection of reality and shouldn’t be used as the measuring stick of your sucess as a parent.

      • LibrarianSarah

        So Facebook EBFer is the grown woman equivalent of the “secret Canadian girlfriend that I totally scored with at summer camp.” God it’s even more pathetic too.

        • GuestWho

          Oddly enough the friend who was successful completely back pedaled and seems completely over breastfeeding as a conversational topic. Her baby is over a year now and she is actively trying to trick the kid into weaning.

      • KarenJJ

        Like yesterday with Katie Tjetje and her tearing after childbirth – what she is saying publicly is very different to what she is saying when she thinks it is more private. Similarly I once found Janet Fraser’s original birth story on the internet (haven’t found it since – I think she’s cleaned up her internet presence – I really wish I’d created a screenshot at the time) – it bears very little resemblance to the “birth rape” story that she now tells.

        • GuestWho

          I am kind of a self deprecating mess in my real life, but I do notice that there are a lot of people who get really committed to narratives about their lives and they get really weird when their paradigm is disrupted. If how you give birth or how you feed your baby is your personal measuring stick for a successful life then the temptation to fabricate and omit has to be huge.

          • Sue

            Yep. Because, for some people, that embellished story becomes an important part of their identity.

          • Megan

            And changing their views is akin, to them, like admitting your wrong. So to save face and avoid cognitive dissonance, it’s easier to cling to something that isn’t true or right and justify it by any means necessary.

      • phoenixfire

        I had a “friend” who tried to guilt me about formula. Found out the backstabbing snake had only BF for 2 weeks and then turned to formula because it was “too hard” to breastfeed. She knew I knew this, as I had taken her 3 AM calls when I was 6 months pregnant! You can bet I let her have it, and told her she was a flat out liar and hypocrite and to never talk to me again. And she’s probably out there spreading lies to other women.

        • GuestWho

          Well she sounds great! I should invite her to my book club…

    • Sue

      The great irony of this “no-one can MAKE you feel inferior…” is that infant feeding is the one area where many smart, capable women can be reduced to a quivering mess of guilt, regardless of background and previous accomplishments.

    • SporkParade

      I actually had this problem with a different parenting issue yesterday. “You’re acting defensive because you are feeling guilty.” “No, I’m defensive because you are accusing me of child abuse.”