How does treating new mothers as breastmilk dispensers impact women?

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One of the most pernicious results of our unthinking embrace of lactivism is the impact on women’s mental health.

My email inbox is filled with messages from women who hate themselves, blame themselves and are nearly incapacitated by guilt at being unable to breastfeed exclusively. Why? It’s certainly not because breastfeeding in industrialized countries is so beneficial for babies that it has any measurable impact on mortality rates, life expectancy or IQ. Walk into any kindergarten classroom and it is impossible to tell which children were breastfed and which were not.

It’s because in the past 30 years we have seen the rise and professionalization of a movement, lactivism, thats benefit from viewing new mothers in one dimension: as breastmilk dispensers.

Regardless of the difficulty, the lactivist prescription is always the same: “Breastfeed harder.”

Consider:

The concept of choice simply doesn’t exist among lactivists. There is only one acceptable choice and that is the choice to breastfeed. They will go to great lengths to help women who make that choice, but they will do nothing for women who bottlefeed.

A mother’s pain is irrelevant. For lactivists, just because a mother has cracked and bleeding nipples is no excuse for her to avoid being a breastmilk dispenser.

A baby’s hunger is irrelevant. For lactivists, just because a baby is screaming in hunger is no excuse for his mother to provide milk from any other source than herself or another mother breastmilk dispenser.

Breastfeeding difficulties are irrelevant. Regardless of the difficulty (poor latch, flat nipples, poor suck, insufficient breastmilk) and regardless of the severity of the difficulty the lactivist prescription is always the same: “Breastfeed harder.”

A mother’s need for sleep is irrelevant. She is supposed to dispense breastmilk 24/7/365. What else could be more important than being a breastmilk dispenser?

A mother’s need to control her own body is irrelevant. If breastfeeding makes her psychologically uncomfortable, she’s supposed to get over it.

A mother’s mental health is irrelevant. Lactivists are much more concerned with whether treatments for postpartum depression are compatible with breastfeeding than with whether they are the best possible treatment for the mother’s psychological condition. The mother must continue dispensing breastmilk even if she is inexorably approaching psychological collapse.

The connection between breastfeeding and postpartum depression has been noted, but lactivists have chosen to spin it as evidence that successful breastfeeding prevents postpartum depression when the reality is more likely to be that pressuring women to breastfeed when they can’t or don’t want to do so is a contributing factor to postpartum depression.

Treating women as breastmilk dispensers has a corollary in pregnancy and childbirth and that corollary has been emphatically rejected by most women. The corollary is treating pregnant women as walking wombs, evaluating every decision they make by asking whether it is good for the baby. Ironically, many of the same people who would be horrified by reducing pregnant women to baby incubators, have no problem reducing new mothers to breastmilk dispensers.

Why?

It is because we have moralized breastfeeding far, far beyond any actual benefits. And it hasn’t merely become a signifier of social status and an emblem of maternal superiority, it has become a requirement for being a “good” mother.

As a result we treat new mothers as if they were cows and there only reason for being is to dispense breastmilk. Even if breastmilk were “the elixir of life” as some lactivists pretend, that would not justify this cavalier treatment of women. Since the benefits of breastmilk are in reality trivial, treating women as breastmilk dispensers isn’t merely unjustified, it’s gratuitously cruel.

Every women is capable of looking at the scientific evidence about breastfeeding in industrialized countries (the real evidence, not the wildly exaggerated benefits) and making her own considered decision of how she wants to feed her infant. Insisting that it is anyone else’s business but hers deprives a woman of autonomy and renders her nothing more than a breastmilk dispenser.

  • Mimc

    I suspect the causation goes the other way. Depressed mothers are less likely to breastfeed. I know that I didn’t really have the energy to work through even minor breastfeeding problems when depressed so I chose to focus on the important things.

  • Howlandyouth1722

    This blog in a nut shell:
    “I don’t like people judging me and writing mean blog posts about how I choose to feed my child, so I’m going to judge and write mean blog posts about how other people choose to feed their child”…. makes sense..

    • Julanar

      “I’ve learned over the years that claims like mine require a presentation of my bona fides. No, not my college and medical school training, nor my years of internship, residency and private practice. I’m talking about my bona fides as a mother, since opponents try to dismiss my presentation of the scientific evidence as sour grapes from someone who couldn’t muster the requisite “achievements.” It is assumed that where you stand on an issue depends on where you sit, but that doesn’t apply in this case. I have four children (adults and college age now). All were born vaginally after easy labors, two with epidurals and two without. I breastfed all four children until they weaned themselves. I carried them around all the time and my husband and I had an “open bed” policy that resulted in many nights of a small child splayed in the middle of our bed and the two of us trying to sleep while clinging to the edge and hoping to avoid falling out.

      But if I’ve learned anything from practicing medicine and from more
      than 25 years as a mother, it is this: what works for me and my family is not necessarily what is best for anyone else. The experience of practicing medicine allowed me to meet people from every walk of life, every ethnic group, and every culture. I learned that there are a lot of ways to successfully raise children. That conviction has only been strengthened by watching the children of my friends, and the friends of my children grow up. Many were raised very differently, and they turned out to be happy, confident, accomplished young adults.

      My observations led to me to a fundamental conclusion: the most
      important thing for children is the sense that their parents love them. The specific method of birth, infant nourishment, and how many hours they were held each day is irrelevant.”

      – Dr. Amy Tuteur, directly contradicting you

  • Froggggggg

    This completely mirrors my experience when I had my first child – nothing mattered more than breastfeeding, every other factor was irrelevant, and the way it was all wrapped up and presented, I didn’t even realise there was a choice (and I’m by no means a silly person)… I’m sure a lot of new mothers are too dazed, sleep-deprived, hormonal and sore to question things. It’s a perfect time for brainwashing.

  • Elaine

    Dairy cattle are routinely separated from their calves and calves are fed a mill replacement formula in order to maximize profits. so it is not mothers who nurse their own babies who are being treated like dairy cows, but rather those who are forced to leave them to be fed with artificial formula. As for electric pumps–yuck–poor mothers–at least they’re trying, but it seldom works long tern–and electric pumps DO remind me of dairy farms.

    • Dr Kitty

      Tell me Elaine, what about those of us who work outside the home?
      Because pumping is necessary if you are apart from your infant for 8hrs and intend to breastfeed.

      Should we just FF from day one, given we’re going to be damaging our babies by working and pumping and all?

      Should all women give up their jobs as soon as they have children, so they can stay home to nurse and never need to pump?

      Or, here’s a revolutionary thought, should each woman make her own choice about feeding her infant based on her own unique circumstances, and should everyone else realise that it is none of their damn business?

      • Elaine

        If you must work full time then pumping will be necessary. Also for some mothers of sick babies. I applaud their efforts. Still, I say “poor mothers”. We are the only industrialized country in the world that does not mandate extended paid maternity leave, and I am very sorry. We all do what’s necessary.

        That said, if there is even a short maternity leave, mothers may find it easier to establish their milk supply by nursing their babies rather than using a machine until milk supply is well established. Also, for many women, hand expressing works better than a machine–just something else to try if the machine is not working. Finally, some women just cannot produce for a machine. If the baby is gaining weight at a healthy pace, and not dehydrated, their milk supply is OK, even if they can only produce a few ounces for the machine. When these moms have to go back to work, because of our inhumane leave policies, they may have to use formula, but they may be able to continue to nurse their babies at night.

        • PrimaryCareDoc

          If you must work, huh? What about if you WANT to work?

          And hand expressing working better than a machine? I’m sorry, I have never, ever heard of a woman being able to hand express more than with a good double electric pump.

          As for long-term pumping seldom working? Where do you get that from? Many, many mothers pump at work and nurse at home without problems. I’m one of them.

          • Charybdis

            I’m the odd duck there. I always could hand express more than I could pump. But I hated doing both, as it took so damn long. I never produced enough either way to make it worth my while and nursing? Yeah, I absolutely HATED it. Hated being tied to DS 24/7, hated the fact that I was the ONLY one who could feed him and hated the fact that I was expected to “just do it” and have a boob ornament on constantly.

            Switched to formula after a month and everything, and I do mean EVERYTHING, got better in a hurry.

          • Roadstergal

            “What about if you WANT to work?”

            That’s something that often gets lost, IMO. A lot of women really love and enjoy their careers and their work. Their lives shouldn’t be sacrificed on the altar of the boob.

        • Nick Sanders

          I notice there isn’t any room for free will or deciding what best fits one’s own unique situation in your description.

          • Who?

            I couldn’t jump on yesterday to see what Lawrie was up to-Disqus had a buffering issue, whatever that means-but got tantalising glimpses from the sidebar.

          • Nick Sanders

            The only way I can get to it now is to view the conversation itself through Disqus.

          • Bombshellrisa

            I can’t get to it at all. I haven’t participated but have read a lot of his comments. I wanted to tell him that eunuchs in China did useful things like be explorers, invent classical music and invent paper. Maybe he could stop focusing on his genitals and do something useful with his life.

          • Nick Sanders

            But you don’t understand! They only lost their testicles! At least they still had their foreskins!

          • Bombshellrisa

            I think we need to just do what someone suggested and talk about breastfeeding when he tries to pipe up. He goes way beyond anything else we have ever had here(that includes idiots, CPMs with chips on their shoulder who dox posters and NCB propaganda junkies)

          • Roadstergal

            I read a story, thanks to some friends of mine, about a fellow who had surgery to remove his penis and testicles entirely, as he didn’t really like them. And he still has an active sex life.

        • Bombshellrisa

          Sometimes it isn’t about the short maternity leave but about the fact that we don’t have universal healthcare. Someone has to carry the health insurance and for many families, it’s also the person who gave birth. This is especially true for families where one parent is a small business owner, often the other parent has to work so the family can have health insurance through their work. It’s not just about working outside the home, having a hectic schedule within the home can be a reason why formula feeding is better. If you have parents or grandparents or parents in law (or grandparents in law) who live with you and/or require care, it is often too much to also have to nurse a baby.

    • Who?

      What dairy calltle and women in thall to lactivists have in common is that their value is determined by their capacity to lactate.

    • Charybdis

      Exactly when did the feeding of expressed breastmilk become denigrated? Now it has to be straight from the boob to be considered *really* breastfeeding? Jeebus, the competition and sanctimony never end, do they?

      • Exactly. It seems the only “right” answer is to quit my job. Which is not really an option for me or millions of others who are supporting our families with our paychecks.

        Sanctimony, meet privilege.

      • Roadstergal

        I have a hunch it has something to do with breastmilk in a bottle being very similar in appearance to formula in a bottle. The lines need to be very clear so these women know who to shame and who to praise. It’s not about the baby.

  • Elaine

    For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, myocardial infarction, and the metabolic syndrome. […]The American College of Obstetricians and Gynecologists (ACOG) therefore recommends 6 months of exclusive breastfeeding for all infants.2 The American Academy of Pediatrics (AAP)3 and the American Academy of Family Physicians (AAFP)4 similarly recommend exclusive breastfeeding for the first 6 months of life, continuing at least through the infant’s first birthday, and as long thereafter as is mutually desired. The World Health Organization (WHO) recommends at least 2 years of breastfeeding for all infants. [Reviews in Obstetrics and Gynecology http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

    • demodocus

      None of these are huge advantages. My sister formula fed her boy and the only things on your list happened before she could nurse him. But then when you get breast cancer at 24 and find out you have ovarian cancer because it was splattered all over your son’s umbilical cord.
      I don’t have the details, but I’m fairly sure socioeconomic status has something to do with it. If Mom has to work 50 hours a week at Walmart to make ends meet, breast-feeding is going to be damn near impossible. Minimum wage jobs don’t have good insurance that pays for a pump, nor do they offer much in the way of breaks or rooms in which you could pump. Its fairly common knowledge that diabetes, heart disease, and obesity are also diseases that disproportionally affect the poor in the U.S. You can’t afford to go to the docs much, you can’t afford to take time off, and you put off having that thing checked out. You can’t afford whole grains or much in the way of fresh vegetables. I’ve lived this. Pantries for the poor do not often stock perishables, and if the box they send you has spam and over salted canned creamed corn, then guess what you’re eating. Box mac & cheese with a few hot dogs cut into it will fill your kids’ bellies for under $4. You might even get to eat too.
      And then there’s when PPD gets exasperated by bf’ing, especially if sanctimommies are telling you that you must bf, implying that you are a bad mother if you don’t. Seriously, a mother who is off her head can be way more immediately dangerous than a future chance of leukemia and diabetes.

    • Monkey Professor for a Head

      I don’t think anyone here is saying that breastfeeding is not a great choice when it works for both mother and child. But it is not the best in 100% of situations, and women should not be shamed for formula feeding in those situations.

      Also bear in mind that studies on the outcomes of breastfeeding versus formula feeding are difficult to conduct as it’s generally not considered ethical to force women to breastfeed or not to breastfeed against their wishes. This is why the majority of studies on the outcomes of breastfeeding are observational, and thus suffer from the possibility of multiple confounding factors – for example socioeconomic status (see the post below by demodocus), and pre existing maternal and child health issues. So the evidence behind breastfeeding benefits is not as strong as presented by many. I don’t think that anyone here thinks that women should not breastfeed, but they should be given accurate information about it and allowed to make their own decisions.

      • Elaine

        Totally agree. What I object to is the comparison of nursing mothers to cows –see photo in OP.
        Confounding factors in BF studies certainly exist. The other factor you do not mention however is that most studies do not compare no breastfeeding to exclusive breastfeeding for 6 months and then continued breastfeeding for a year or more. Instead they compare “some breastfeeding” to “a bit more breastfeeding”. These factors would tend to understate the benefits. But hey, perhaps the American College of Gynecologists, American Academy of Pediatrics, and American College of Family Physicians are just making up stuff to shame women and don’t base their recommendations on evidence.

        • Sarah

          You can’t honestly think healthcare policies are always purely based on evidence with no politics in there, surely?

    • Azuran

      And what do you think are the effects of not gaining any weight or even losing weight during the first few weeks of life because the baby cannot get enough breastmilk?
      What could be the long term effect for a baby who is in constant distress because of hunger?
      Or the effect on development of having a depressed/exhausted mother who spends her whole time pumping instead of giving the baby attention and love?

      Here’s a new’s flash: Everything makes you fat, everything makes you stupid, everything gives you cancer.
      The world is full of nuances and what is ‘theoretically’ the best is not always going to work in real life. Everyone has different circumstances and different value. Both breastfeeding and formula are two totally acceptable option with both positives and negatives consequences. Breastfeeding or not is going to have a ridiculously little effect when you consider the millions of decisions you will make in raising your child for 18 years so you should totally do what feels best for you.

    • Megan

      And why, pray tell, do you care so much about how other women feed their babies? Are you insinuating that you care more about their children than they do? Also, I’m curious to know what you think of the discordant sibling study? (http://www.sciencedirect.com/science/article/pii/S0277953614000549)

    • AllieFoyle

      key word there: “associated”

    • Sarah

      Actually, whether breastfeeding is associated with weight loss or not depends entirely on the country being surveyed. One often finds that breastfeeding is associated with retained gestational weight gain. And not breastfeeding allows a woman to go on the combined oral contraceptive pill, which is similarly associated with a reduction in ovarian cancer.

      As for the rest, let’s see you control for social class. For example, I’m sure we all know which ethnic and social groups are more likely to suffer from Type 2 diabetes, right? And guess which groups are least likely to breastfeed? Ooh, it’s almost as if there’s a correlation between poverty, certain behaviours and certain diseases isn’t it!

      • Roadstergal

        “I’m sure we all know which ethnic and social groups are more likely to suffer from Type 2 diabetes, right?”

        And which are more likely to have to take the kids to daycare = infections, which live in food deserts and have little money to buy good food and time to cook, and neighborhoods not conducive to play outside = obesity, and which are less informed about safe sleep practices = SIDS. (Although the message that pacifiers – cheap and easy to provide – help prevent SIDS is seldom put out there. Why not a program to provide pacifiers to low-income mothers?)

        I have a hunch that owning a high-end German or Italian car is also negatively associated with these outcomes. It doesn’t mean running yourself ragged and sacrificing to buy one is going to change anything. But bullying women is way easier than addressing the real social, economic, and healthcare inequalities in our nation. Way, way easier than getting access to clean water to women in the developing world.

      • KeeperOfTheBooks

        My OB, who a) has been practicing for 40 years or thereabouts and b) is quite supportive of breastfeeding, albeit without being pushy about it, says that in his experience, breastfeeding moms here in the U.S. generally hang on to an extra 10-15 pounds until they wean, when it comes off fairly quickly unless they’re eating pretty unhealthily.

  • Anna

    I have flat nipples and had little milk. My daughter never latched properly. Once she started loosing weight I insisted on her being formula-fed (in a baby-friendly hospital, huh). I wouldn’t have her starve for the sake of some dogma. At the same time I understand that breastfeeding may work very well for women with normal nipples and good supply. We are all different aren’t we? Lactvists have precisely this “one fits all” approach that they accuse OBs of having.

  • Josie

    I have printed this in the latest comments section but here is it below

    http://www.thejournal.ie/hse-report-baby-mark-molloy-death-2403796-Oct2015/

    “After the baby’s death, Roisin Molloy said a midwife gave them a document which had a memory booklet with a lock of hair and hand and foot prints, but also information on breastfeeding.”

  • Allie P

    I found this blog via my own struggles with nursing #1. Somehow, I bypassed all the pregnancy and delivery woo, only to fall face first into the lactivist nonsense. I know better now. I combo fed #1 for 10 months, and I’ve been almost exclusively feeding #2 (was planning on combo feeding, but my breasts keep coming through for me) for four months and counting now. Getting the pressure off and combo feeding from the start made a huge difference to me. Also, pumping is for the birds. FORGET IT. (For me.)

  • Madtowngirl

    And once again, I so wish I had found this blog during the early days of my daughter’s life. I fought so hard to breastfeed, because it would make me a “good mother.” I never produced enough for her. I think the most I ever pumped was 1 oz in one session (I no longer believe that the amount you pump has no correlation with what baby gets out). The guilt of using formula was immense. It got me a fantastic case of PPD that I’m still fighting, I missed out on spending time with her, I felt like a cow, and now, I don’t want anyone or anything touching my nipples. If my shirt rubs the wrong way, I get horrible flashbacks of my daughter screaming in hunger as I curled my toes to try and work through the pain.

    • Elizabeth A

      Oh no! That’s awful. I am so sorry, that’s D-MER on some major league steroids. I truly hope things get better soon.

      In the meantime, I hope you’re loading up on rest and baby snuggles. I truly did not realize how charming my daughter is until I stopped pumping and got a few nights of solid sleep, but those two things made a huge difference for us and I hope that the second one of those is soon in coming and makes that difference for you too.

      (This may be the point where you get to tell me that your daughter is fifteen. If so, please accept my sympathies and assume that I’m blushing.)

      • Madtowngirl

        She’s actually 5 months old. 🙂 You’re totally right, though. Once I gave up the pumping, we were all so much better off. She’s not sleeping through the night yet, but we’re all getting much more sleep, which helps so much.

      • KeeperOfTheBooks

        I really didn’t bond much with my daughter until I stopped nursing. Until then, I saw her as a source of constant pain and stress. Once I could just sit down and feed her, and not fight over latching, or panic over how much it was hurting or would hurt, I finally “felt” love rather than just acted on it.
        Never again. (The nursing, not the kiddo!)

    • mythsayer

      I had the same problem. I was lucky if I ever got an ounce out of one side. I usually could barely get that from both sides. I just couldn’t believe that she was getting 4 times the amount of milk I could pump. That didn’t make sense. And sure enough, I never made enough milk no matter what I did.

      We even went through a bout of chicken pox (zone first, then her). When she had it, she was 10 to 12 weeks old and covered…including her mouth. It hurt so bad she wouldn’t take a bottle and she was so distraught she basically stayed attached to me for the entire 2 weeks. If I was EVER going to make enough milk, it would’ve been after that, right? Nope. Still not enough. We combo fed until she was 8 months and then I got sick of taking fenugreek a million times a day, sick of drinking beer (which I hate), and taking brewer’s yeast and eating oatmeal…so I just stopped. If only been doing it for comfort for a long time anyway (for her…it was her favorite thing to do at night).

      • CharlotteB

        4x as much? I find that very hard to believe.

        Not that it matters, but when we did before and after feeding weights, my son got between 1-1.5 oz per side, and guess what I pumped? Just about the same. In about the same amount by of time. Obviously that means nothing, but where do people come up with this stuff?

        • Dr Kitty

          I can get 8oz in 10 minutes with my double pump.
          If my baby was actually getting four times that amount he’d be a medical miracle,given that he feeds every 3hours during the day.

        • demodocus

          I always got at least 5 oz on one side. 4 times that seems improbable.

        • Amy M

          Though I tried nursing in the hospital, I didn’t have any milk until I got home and had already decided to combo-feed, with pumping (so no more direct nursing). I never got more than an oz or two/side during a (45min) pump session, with a hospital grade pump, but I STILL got constant plugged ducts. I don’t know if I was doing something wrong (wrong size horn things? wrong pump setting?), if pumping simply wasn’t efficient enough, and if I’d been able to either nurse or pump efficiently, would there have been more milk? No idea, will never have the answers to these questions. What I do believe though, is that the idea that a baby could/would extract 3 or 4x/amount pumped, is BS.

        • Inmara

          From my experience, properly nursing baby indeed empties breasts better that I can do it (no hospital grade pump, though, I like to express milk by hand) but I’m talking about 10% better not several times better.

      • Bugsy

        What is realistic for a baby to be getting at each feed, and how often? I realize I have no idea. The last time around, I was able to pump around 6-8 oz w my double pump in ten minutes, but this time around, my left side has been producing about half the volume it used to. Little one did surpass his birth weight by two weeks (and I’m enjoying not having the crazy oversupply issues I had last time), but I wonder if he is getting enough.

        • Inmara

          From what I’ve read full production of milk should be between 750 and 1000 ml a day. Divide by number of feedings and you’ll get approximation of amount per feeding.

          • Bugsy

            Awesome, thanks. Now to figure out the number of feedings for a little guy who likes to sit and drink throughout the day at his leisure. 🙂

          • swbarnes2

            A wine bottle full of milk every day. : )

        • Kelly

          I had that happen to me. My right one ended up taking over and I was able to pump the same amount. I am not sure if that is the same for other people though.

          • Bugsy

            Yeah, my right one is starting to take over, but kiddo’s latch is getting better and I’m optimistic I may be able to get more of a balance. He gained 13+ oz in the past week, so my overall milk production isn’t an issue.

          • Kelly

            My left one had issues because I had gotten two breast infection in it with my first baby. I think that is why it started getting wonky with the second kid and it would only produce an ounce every other time I pumped and it took a long time to let down. Before the infections it was producing half of what my right was producing. The funny thing is that my left was larger than my right.

    • KarenJJ

      Same. One of my biggest regrets was getting caught up in the breastfeeding treadmill of those early weeks. It was awful and my eldest didn’t get back to birth weight for 6 weeks. Horrible times. I now know that all the “breastfeeding support” in the world was not going to work for us. It just made me fail after fail after fail with no end in sight. Formula was not to be discussed and no information to be given because knowing how to fix a bottle would “sabotage my breastfeeding relationship”… Crock of shit. Makes me so angry.

      • yentavegan

        Oh Karen JJ! I am truly sorry that my tribe of lactation consultants/volunteers lied and misled you and made you and your infant suffer. I hope my fellow breastfeeding educators take responsibility for the harm they have done. Hey LLL/ IBCL’S ARE YOU PAYING ATTENTION!!!

      • demodocus

        as far as milk goes, I had the opposite problem, but my consultants didn’t listen too well either. One kept insisting 10 minutes on one side then 10 on the other. My kid couldn’t empty *one* side in 20 minutes.

        • Chant de la Mer

          Hey me too, excessive milk production and a baby that wasn’t big enough to consume all of it. Luckily my consultant was good and explained block nursing to me and it worked perfectly.

          • Dr Kitty

            All the health visitors and midwives were “have you offered the second breast?” And I’m like… No this one isn’t empty.

            My BF resource was my mum. She’s the one who said “just give one side per feed and only offer the other one once it empties or the other side feels too full”. Yes you are a little lop-sided, but it works.

            She’s the one who told me not to bother with breast pads. I have good supply and a painful let down but I don’t leak, ever, just like her.

    • Dr Kitty

      Kellymom is out there telling women that pumping 1/2-4oz total per pumping session is perfectly normal. I mean, it might be common but it isn’t adequate in terms of volume or calories if that is how you plan to exclusively feed your child.

      You obviously love your baby, and made the best choices you could with the information available to you at the time. Don’t second guess yourself, the important thing is that your baby is fed and happy and loved.

      Breast feeding doesn’t always work out and it never has, and we’re lucky to live in a time with excellent alternative options.

      • KeeperOfTheBooks

        LLL leaders and IBCLCs say this all the time, too. I was told the same thing by all of them–that it was “normal” to only be pumping 1/4 ounce *combined* at each session. When I’d point out that the kid needed rather more than 1/4 of an ounce per feed and that I was pumping 5+ times a day in addition to nursing on demand but that she was still losing weight, the answer was “pump more.”

        • Megan

          Yes, same for me too. Even when I pumped 10-12 times a day (yes, you read that right), I onyl got 8 ounces. I highly doubt that I would’ve gotten 3-4 times as much nursing, even with a good latch. The advice was always, “how about power pumping?” or “have you tried this supplement?” None of it is evidence based and no one would come out and say that perhaps I just didn’t make enough and should consider formula. It angers me that despite all of this I still can’t get anyone to say that I probably have IGT despite that experience and the fact that I have many of the physical characteristics of IGT. Heaven forbid I have good information to make a choice becuase then my choice might now be to breastfeed!

          • Megan

            might *not be to breastfeed (not now)

          • Madtowngirl

            The more I think about my experience, the more angry I get, as well. One of the nurses that cared for us after my baby was born even pointed out that I had one inverted nipple, and that could cause problems. The LC insisted I could solve that problem by pumping before each feeding. But I was also supposed to pump after every feeding. And power pump. And put the baby to breast every 2 hours. Sleep? Pish, that was unimportant, who cares that you’re also recovering from a c-section?

          • Megan

            It is all very unrealistic. It’s like these people have never had a newborn or recovered from a CS. They are so afraid mothers might not make the choice they want them to that they will not even entertain the idea that breastfeeding may not be working and suggest combo feeding or EFF. It is maddening!

  • Dr Kitty

    OT, week three of Nexplanon.
    So far, loving it.
    5minute painless insertion, very minor bruising and absolutely no side effects I have noticed yet (EBF, so no bleeding issues).
    Hopefully things will remain like this, and if they do, Mirena may have been supplanted as my most favourite birth control option.

    • Roadstergal

      Ha, I went the other way (well, with Skyla, not Mirena). The implant (two rounds) prevented any pregnancy, but I only had brief amenorrhea and my period came back strong, which annoyed me, and my husband never got used to the feel of a stick in my arm, so I’m giving the IUD a try. The insertion was horrid, the recovery was quick. No period so far. I’m just so happy to have options!

      I do have some pretty noticeable scars from the two implant removals (the second implant had gathered a webbing of scar tissue and took some work and extra cutting to get out). I’m cool with scars, but it’s a note.

      • Dr Kitty

        Yeah, scars don’t bother me, and I like feeling the implant and knowing it is there.
        Options are good.
        Hope your IUS works out, I loved mine, while it was in place and behaving itself!

        • Roadstergal

          I couldn’t stop playing with it, not after 5 years. That probably didn’t help with either the scarring or with my husband being squicked!

      • StephanieA

        I LOVED my Mirena. The insertion was easy for me (probably because I had it done 6 weeks postpartum), so I’m sorry yours sucked- I’ve heard they can be awful. The only negative was that my husband could feel the strings at certain points during my cycle, but it didn’t happen enough for it to be a huge problem. Hope it works well for you.

        • Kelly

          I had mine in three weeks now and I am still spotting. The insertion was easy because I have had three kids but the spotting is super annoying. I hope it goes away soon.

          • Blue Chocobo

            My spotting lasted 10 weeks post insertion (inserted 9 weeks postpartum) and I had odd heavy periods for 3 “cycles” after. Now I have very regular light periods, when before I had fairly regular “how can I bleed this much for this long and not die” periods.

            It is likely to get way better.

          • Kelly

            Thanks! This is the first time I have gotten an IUD and I was not expecting the spotting but I would take that over being pregnant again. I can’t wait for the super light or no periods. It was the main reason besides birth control that I went for it.

        • Dr Kitty

          I had my first Mirena put in under GA while I was having some endometriosis surgery, and it worked like a charm for the two years I had it, with an easy removal (I took misoprostol, which helped).

          The second one, not so great. My cervix wouldn’t co-operate, even with a cervical block, so I had it put in under a GA, then I got periods after 3 years, and an ovarian cyst, so I was clearly ovulating. Then it got stuck behind some endometriosis and scar tissue on my cervix and I had to have it removed under anaesthetic.

          Hence the switch to the implant. Honestly, I’d probably have tried another Mirena, because it was great while it worked,, but my Dr and DH vetoed it.

        • Charybdis

          I love mine too! I’m on my second one. I had the first one installed at my 6 week postnatal checkup. No period, no spotting, no cramping after the first couple of days. I had been on the pill for 17+ years when DH and I decided it was time to try for kids. I quit taking the pill in early January and had DS in December of the same year. I wanted something I didn’t have to remember to take and was not doing Depo. So a Mirena for me. BEST thing EVER!

          • araikwao

            I love mine too. Amenorrhoea = freedom, to me at least. From annoyingly heavy, and peculiarly frequent periods once they came back after kidlet #2, and from the inappropriate teariness that accompanied them. I think I’ve had an ovarian cyst in the year and a bit since having it in, but the pain spontaneously resolved, and I didn’t want to be told I had to have the Mirena out.

          • Roadstergal

            I’m watching an ovarian cyst slowly yet steadily grow on ultrasound (it’s funny to be going in regularly to see something growing on U/S next to all of the women watching more conventional things grow on U/S). Bleah, I wish they’d just have it out already, it doesn’t seem like it’s going away any time soon…

            But yeah, I had some dark mucus discharge for about a week post-insertion, and bad cramps day-of, and that was it.

    • demodocus

      There are one or two distinct advantages to having a sterile spouse. On the other hand, having to repeat “he’s sterile” to a zillion different people in a row when they were talking about birth control was a wee bit irritating.

      • demodocus

        (and a fairly normal cycle, unlike a friend of mine who has birth control to temper her insane period)

        • Dr Kitty

          I have endometriosis with terrible, horrible, no good, very bad periods and a history of ovarian cysts, and yet despite that, I get pregnant very easily.

          Something that will reliably shut down my ovaries is a necessity!

      • RMY

        As a lesbian, I find it weird that anyone asks me about birth control. I mean, I put my wife’s name on all the forms, you’d think the nurses would at last glance at my chart before asking questions. When I was getting IUIs, it was even stupider, every time I’d call about a positive OPK they’d tell me my husband needed to arrive at 6 am to provide the sample.

        • demodocus

          lol. ‘Least when my best friend, who’s gay too, was at the doc’s, her doctor said something to the effect that “here’s were I’m supposed to talk to you about birth control, but we don’t need to worry about that, do we.” This was the same doctor she first came out to the year before, crying so hard the doc stayed with her for an hour. (She was embarrassed to have taken so long to realize her preferences and to have told herself and all her friends she was straight for 20 years. Not that *we* cared. I’ve mostly stopped teasing her about not telling me for nearly 2 years.)

    • Amy M

      Is the Nexplanon equivalent to the mini-pill, in terms of hormones that are involved? are there any estrogens in it?

      • fiftyfifty1

        Yes, it’s progestin only. Not the exact same progestin as the minipill, but same idea. Since it releases the progestin slowly but surely without user error, it is both lower dose and much more effective than the mini-pill.

    • Melissaxxxx

      Is contraception very controversial in Ireland? Thinking of the case where lady died without a D&C. Or more easy to obtain?

      • Dr Kitty

        Contraception is free and very easy to obtain in Northern Ireland.
        GPs will do pills and depo and refer for sterilisation, implants and coils.
        Family planning clinics are open access without appointments to all comers and will hand out condoms and some brands of pills and do implants.
        You can buy Plan B OTC or get it free on prescription from your GP or family planning clinic.

        In the Republic of Ireland you may have to pay for your contraception prescriptions, but basically a similar situation, although some of the Catholic hospitals have issues with sterilisation (although medical reasons are usually found).

        There are always a few doctors who won’t prescribe for religious reasons but they are very much in the minority and easily bypassed. I worked with one, his beliefs were widely known by his patients and they just asked for appointments with other Drs in the practice, no big deal.

        It is probably easier for low income women to obtain contraception in Ireland than in some parts of the USA.

        It is thanks to this system that I’ve tried progesterone only pills, various brands of combined pill, had two Mirenas and now an implant, with no other consideration than what method suited me best at the time. No issues with cost or coverage.

        • AA

          Dr. K, I have an unrelated question for you. I think you mentioned once that in the UK, all medications essentially go through you, even medications prescribed by consultants. Is this true? ALso, you mentioned that a midwife would have to ask you to prescribe a medication for BV or YI (can’t remember which). If MWs can’t prescribe this, what can they prescribe? In the US, a certified nurse midwife has prescriptive privileges, they could certainly prescribe this.

    • Inmara

      Thanks for sharing, I’m considering this option too. Though I’d like to try something similar in pill before to make sure I don’t have any side effects (I have fairly low libido and to pay big bucks for BC which could make it even lower would be, erm, ironic).

      • Dr Kitty

        Just FYI, I did not enjoy the Desogestrel progesterone only contraceptive which I used after my daughter was born, while nursing and waiting for the Mirena. No libido and a bit emotionally labile.

        However, nothing like that with either Mirena or Nexplanon (so far).

        All of the progesterone only methods use different doses and drugs, and aren’t equivalent, so side elects with one method aren’t necessarily indicative of another.

        Personally, I had a massive spike in libido at the start of every new packet with Qlaira, but that was probably just me. It is definitely my husband’s favourite contraceptive, but not compatible with nursing and I’ all about fit and forget methods…

    • Mel

      I liked the insertion of the Nexplanon and had no problems with the removal. The insertion and removal took a 45 minute appointment, but my body doesn’t respond to local anesthetics very well.

      I had three normal periods. Then the spotting started. I didn’t mind the spotting until it turned into light menstrual bleeding plus normal periods. My OB/GYN put me on Monessa to control the bleeding. That worked for a few weeks, then the bleeding started again. After a few months of non-stop bleeding, I called my OB/GYN and asked if I could get it removed ASAP. They got me in within the week which prevented me from needing to start “Backup B” which involved a quart of vodka for me, some rubbing alcohol to clean my arm and a scalpel from the farm for my husband to cut the damn thing out.

      I wish it had worked out. I liked the idea behind it.

    • ladyloki

      Love my Nexplanon. Though when I have to go to the doctor and they ask me when my last period was, I can’t answer and have to explain. I had about a 6 week period when I first got it, but very light, then the rare one day with a little bit of spotting once every couple of months. The best part is not having to think about it.

      Except when my husband accidentally touches it and freaks out. He is so grossed out by things inserted under the skin or needles. I call it my alien implant 😉

  • Inmara

    Semi-OT to show how lactivist agenda can reach somewhere deep into reasonably rational women.
    During last few weeks I have had two psychological meltdowns (like, screaming-hysterically-in-pillow-and-hitting-inanimate-objects type of meltdowns). They were result of several stressful factors crammed together but both were triggered by inability to express milk. Baby doesn’t want to nurse during the day so I was pumping milk and feeding him from bottle but somehow my letdown reflex got derailed and I just could. not. get. the. milk. out. And I felt so betrayed by my body, similar to realization that I can’t produce enough milk to EBF (because of medical problems in the past which brought some serious psychological issues – but I considered them to be sorted long ago, ha!). It’s just that ability to pop out healthy children and feed them has been a measure of woman’s worth for thousands of years and it’s hard to let go feeling of inadequacy when you can’t do it. And lactivist message “Every healthy/normal woman can breastfeed her baby!” is adding to that feeling even if rationally you know that it’s not true.

    • moto_librarian

      This isn’t off-topic at all. In fact, I think it illustrates the fact that women are suffering from this ludicrous message.

    • yentavegan

      Formula feeding does not revoke your fabulous, devoted edgy cool hip mother card. You can be the mother you always imagined you could be irrespective of whether your baby is fed via the breast, the bottle or whether the baby drinks formula or breastmilk.

      • Inmara

        Actually, I haven’t imagined what kind of mother I would like to be, I’m just trying to not screw up something serious (like all first time mothers, no?)

    • Blue Chocobo

      Milk doesn’t make a mother. Infant feeding should work for you and your baby, not you and your baby working for it.

      If you want to stop, if breastfeeding is costing more than is fair to you, if you have access to formula, it is safe to stop. Your baby will love you just the same either way.

      I wish you the best in getting what works best for your family.

      • Inmara

        I don’t doubt that baby loves me no matter what I feed him; actually he clearly prefers bottle and doesn’t give a damn what’s inside (I have tried breastmilk, formula and combination of both and it all goes down quickly). At the moment, I’m keeping supply only to have easier night feeds and occasional nursing to soothe, whereas main source of baby’s nutrition is formula. It’s expensive as hell, though, so to have a cost reduction in that area is nice bonus.
        Thank you for support!

    • demodocus

      *hugs* You’re sensible enough to make sure kiddo is fed, and that’s what matters. Boobs are overrated.

      • Nick Sanders

        Breastfeeding is overrated. Boobs are glorious.

        Although I admit that I may be a bit biased…

        • Bugsy

          My husband fully agrees with you. Truthfully I think he looks forward to when I’m done breastfeeding…hehehe.

        • demodocus

          I hate mine.

          • Nick Sanders

            I’m sorry. It always sucks having your own body give you stress.

          • Charybdis

            Me too, Mine, I mean. I have no opinion on yours. ;P

    • Chi

      The thing is, a LOT of postpartum mothers AREN’T rational. Their hormones are still cycling up and down like a freaking ferris wheel AND they’re chronically sleep deprived.

      They are in SUCH a vulnerable state that things they would be able to think critically about and shrug off as crap pierce right to their core. So now they’re all of the above AND worrying about their ‘mummy cred’.

      And it’s BULLSHIT (pardon the expletive). I don’t know why there are mothers who feel the need to brag and flaunt their ‘success’, not caring that to do so, they need to tear down other mothers who don’t follow their example. I do know that they probably have WAY bigger issues than hormones and sleep deprivation and I personally took solace in the fact that both of those things would eventually pass for me – they on the other hand were likely to be bitches the rest of their lives.

      Mothers need to support each other. Because at the end of the day we all want the same thing – for our kids to grow up happy and healthy.

      At the end of the day, it makes NO difference how they are fed, diapered, weaned, worn, etc. As long as they are loved.

      So, may I just say – I support you.

      Do what’s best for you. Because believe me, your child will benefit more from a mother who is ALSO happy and healthy, than they will from one who is struggling mentally. Take care of yourself. Give yourself permission to be happy, to look after your mental health and do things for YOU. You’ll both be better off for it.

      I support you (however little much that helps 🙂 )

      • Bugsy

        Bingo. As a hormonal and sleep deprived mom to a newborn, all I have to say is that you hit the nail on the head.

        OP, I support you too. Do what is best for you. If mama isn’t happy, no one is happy.

        • Inmara

          Thanks! I’m doing my best and usually breastfeeding and pumping is not a big deal but it tends to become the straw that breaks camel’s neck sometimes.

    • Megan

      I felt the exact same way when I was struggling. And I needed someone to give me permission to stop (at least that’s how it felt then). So in addition to all of the other supportive messages below, let me add, “You have permission to stop. (And I don’t mean to intend you need anyone’s permission but in case it helps…). For me, once I started to draw down on pumping and my milk started to decrease, a fog lifted for me and I suddenly realized that I didn’t need permission to stop from anyone but me and that we would all be fine if my daughter was fed formula. I really think breastfeeding and postpartum hormones make you vulnerable and lactivists know it, and take advantage of it. I hope that you can come to a decision about what to do that makes sense for you and your family. Take care of yourself!

      • Inmara

        Thank you for kind words and support! I have considered decreasing pumps during the day because my main concern is to keep supply for night feedings. I’ll give it a try gradually and see how it goes.

    • KarenJJ

      ” It’s just that ability to pop out healthy children and feed them has been a measure of woman’s worth for thousands of years and it’s hard to let go feeling of inadequacy when you can’t do it. ”

      It’s not just you having trouble letting go of that. Society has a huge problem with letting go of this.

  • LizzieSt

    It breaks my heart to see women feeling shame, guilt, and even self-loathing because their babies don’t drink milk from their breasts. And that other people are making them feel this way for it. This may be because I was a medical social worker, and my definition of “good parent” has been defined down over the years. Have you ever broken your six-week-old baby’s arm? Did you smoke crack three days before giving birth? Did you never feed your two-year-old anything (even though you had enough money to keep yourself fed), so he became malnourished, started having seizures, and had to be placed in a foster home for medically-fragile children? Did you feed your infant watered-down Carnation condensed milk instead of baby formula?

    Is your answer to all of these questions “no”? Then Congratulations! I hereby bestow upon you the title of Good Mother! And now you know why I’m not a medical social worker anymore.

    • Chi

      Oh yeah, that would be totally devastating. I have such great admiration for social workers. I know I couldn’t do the work they do.

    • Roadstergal

      Oh man. 🙁 🙁

      The lactivists are very clever, though. They don’t say you’re a _bad_ mom if you don’t BF. Oh, of course you can be a perfectly adequate mom if you FF! It’s not the _worst_ thing for a kid, they’ll still probably be okay… I mean, I loved my baby enough to make it work, but it’s all about priorities, isn’t it?

      Ugh. Been spending too much time listening to this shite.

      • LizzieSt

        I like to think of myself as a reasonable person who abhors violence. That said, those lactivists can go sit on a tack.

      • AirPlant

        Just go on any lactivist facebook page. Its not that they hate formula, they just think it is a substandard, unethical, unhealthy manmade chemical that should be used only in very rare and extreme cases where death is the only other option and you for sure were not one of those cases because they are rare.
        What do you mean that is an offensive statement? I am just telling the scientific truth! You only feel bad because you know I am right and you didn’t love your baby enough to try.

        • Amy M

          Don’t forget..”And IF you feel bad, well it’s because you know deep down you are wrong. After all, no one can make anyone else feel bad without their permission.” (I would love to meet Eleanor Roosevelt today, and get her to clarify her statement, so it stops getting twisted towards these ends.)

          • demodocus

            She was a woman who needed a lot of therapy herself.

          • AirPlant

            You took me out of context! When I said that formula makes babies fat, stupid, and that feeding that poison to your child is gross neglect that wasn’t meant to insult mothers who feed their child formula! God it is awful when people project their insecurities onto me.

      • D/

        Hmm, this recent group discussion on framing breastfeeding benefits might change your mind on giving cleverness credit though.

        “I like to present this as the mother’s body thinks the baby died … if there is no breastfeeding. That’s a physiological and emotional difficulty for the mother which would increase her risks of breast and ovarian cancer, depression, heart disease in later life, all sorts of things.

        One of the things we become afraid to mention, in the guilt-trip thing is that it doesn’t benefit mothers to have sick, stupid or dead children (risk factors if they are not breastfed). … this is not the kind of thing you can say to individual mothers, but to groups – I think yes, you can.”
        ~~~~~

        Later in the same conversation it was pointed out that research shows many people will shut down and stop listening in response to negative framing and scare tactics. The above LC responds, so “… we _shouldn’t_ frame things in ‘the risks of formula-feeding’ way rather than ‘the benefits of breastfeeding’?? I would actually be so glad to hear that that’s true because sometimes it just doesn’t feel “right” to me to do it that way, so I don’t! … and then I worry about being jumped on by my colleagues (you can’t win!)”
        ~~~~~

        The day I am expected to encourage breastfeeding by telling any mother, in a group or otherwise, that it does not benefit her “to have sick, stupid, or dead children” will be the last day I worry about doing this for a living!

        • CharlotteB

          Uh, what about women whose babies have died?? I’m sure grief isn’t particularly good for you, but the insinuation there is that the psychological effects of not breastfeeding or weaning early have a physical result? I know that’s not being said directly but wow.

          I wonder if anybody has studied failure to thrive/jaundice babies to see how many are Breast fed vs. Formula. I’d bet, if you controlled for socio-economic status (meaning, nobody’s watering down bottles) EBF babies make up a larger portion of those infants, since so many mothers are scared to supplement.

        • Sarah

          Having stupid children would definitely benefit me. They’d be much easier to control that way.

          • ana

            Agree 100%. I tried so hard by having an epidural, C-Section(by CHOICE!), formula feeding, Ferberizing, vaccinating. Nope, the little creatures are freaking geniuses.

    • AirPlant

      My friend’s mother is an emotionally unstable, abusive woman who subjected her children to an appalling amount of bullshit and continues to be a grade A bitch to this day.
      She also breastfed exclusively and will tell anyone who will listed about how she was made to be a mother due to the bounteous oversupply that she exhibited.

      • LizzieSt

        Yikes. Milk does not a good mother make. You would think that Harlow’s Cloth Mother and Wire Mother experiments would have settled this once and for all. But apparently not!

        • AirPlant

          Sometimes in your life you meet a very special kind of narcissist unable to believe that their contribution to the world is anything but golden sunshine.

        • fiftyfifty1

          “You would think that Harlow’s Cloth Mother and Wire Mother experiments would have settled this once and for all.”

          Yes, isn’t it strange? The attachment parents have got Harlow’s conclusions exactly backwards. They believe that nothing short of breastmilk straight from the tap will do, and that a mother who is not *immediately* actively comforting her baby if it so much as lets out a whimper will cause any bonding to be destroyed.

          • Nick Sanders

            The cloth mother was neglectful by letting the baby explore the cage, instead of keeping it strapped to her at all times.

      • Bugsy

        Wow – how many years later is she still harping on the prowess of her boobs? Makes me think she doesn’t have enough going on in her life.

        • AirPlant

          Well my friend just turned 40, so I am going to say long enough to have the subject worn out. Honestly she is such a hateful woman, her boob milk is almost a conversational relief.

          • Bugsy

            Lol – that paints quite the picture!

          • AirPlant

            Just imagine: after a half hour of Obama conspiracy theories, Fox News talking points and untempered racism you are just like FINE we can talk about your tits some more.

          • demodocus

            oh good heavens. *eye roll*

    • demodocus

      I broke my kid’s leg. Accidently, because I’m f’ing clumsy. He’s okay now, but I don’t even want to go near the playground I tripped at. my husband is wondering whether I should see someone…

      • LizzieSt

        Awww, accidents happen. 🙂 The mother I’m talking about claimed that her six-week-old infant mysteriously broke his own arm while lying in his crib (and he did not have an underlying bone weakness disorder).

      • Nick Sanders

        I broke my own leg when I was 2. I fell off the toilet…

      • namaste863

        Accidents happen. This is coming from someone who well and truly has earned the name Kim the Klutz.

      • Who?

        Sorry about that. It happens. I tripped and dropped my daughter when she was a couple of months old, she was fine but I still go cold thinking about it 20 years later.

        Hopefully he was too young to remember much about it and will have no lasting issues.

        • Amy M

          I did that too…boys were 18mos old, I was carrying one, tripped, dropped him right on his head. He was fine. I was a mess, of course.

          • AirPlant

            I was playing bounce the baby with a friends baby. Cracked her head on the low ceiling. In front of her mother. I am not sure who cried harder, me or the baby. That little giggling face turning into horrified betrayal killed me.

      • Dr Kitty

        Accidents happen.
        Trips and slips while carrying or wearing a baby, babies suddenly learning to roll and heading off the bed or sofa onto the floor, hot tea being pulled off a table, fingers getting trapped in doors… Stuff happens and paediatric ER staff have seen it all.
        Doesn’t make you a bad parent.

        Although there is a reason we don’t have a trampoline in our garden. Summer working in a paediatric ER is an endless stream of supra condylar fractures, head injuries, buckle fractures, sprains, dislocations and lacerations, most of which seemed to involve trampolines. Put me right off them.

        • Megan

          Ah yes, trampolines. A year of urgent care work was enough to make me vow never to have one for DD either.

        • Tigger_the_Wing

          Did you ever see a teen boy with a trampoline spring stuck on his finger? That happened to one of my boys.

          He was at a friend’s house. The trampoline was old and literally falling to bits. He picked up a spring, and was absent-mindedly poking his fingers in and out of it whilst watching TV. Until he couldn’t pull one out.

          His friend’s mother tried oil, butter, ice water; nothing doing. Eventually she called me and I took him to A&E.

          They tried creams and ice water. After four hours, they decided to call the fire brigade; who declined to come out on the grounds that their machinery, although perfectly capable of slicing through hardened steel, was not delicate enough to cut off the spring without cutting off his finger.

          So they injected his hand with a local anæsthetic (which, unluckily for son numbed the two fingers either side, but not the trapped ones) and the biggest, strongest security guard in the building twisted the spring open enough to pull it off.

          Everyone has a role to play in Accident and Emergency!

          • Dr Kitty

            The ERs I worked in kept tool kits with weird things in them, just in case they were needed.
            Bolt cutters, pliers, screw drivers, hair removing cream, WD40, a monkey wrench, various clamps, super glue etc..

            What usually happens is that there is some bizarre accident, which could be easily fixed with a piece of equipment that doesn’t happen to be in the hospital, and so it gets added to the kit for next time.

            Every hospital also has a big guy (maybe security,or a porter or a nurse, maybe, as in one hospital I worked in, the cardio thoracic surgeon who was 6’7″ and a martial arts fanatic) that you call upon when brute strength is required.

            Tweenage boys and super glue are as much a recipe for disaster as trampolines.

            Pranks and dares accounted for the vast majority of ER visits for boys aged 9-16.

          • Monkey Professor for a Head

            You reminded me of an incident a few months back, where my husband (as the surgical reg on call) had a stand up fight with an ED consultant over a patient with a stainless steel ring stuck on his penis. The consultant wanted to bring in his home power tools to remove it in ED! Thankfully my husband talked him out of it and it was safely removed in the OT.

          • Dr Kitty

            You know those ER docs, gung ho adrenalin junkies to a man!

    • Gatita

      I’ve had this conversation with folks. I’m like, are your kids growing up in a household with no domestic violence, no substance abuse, and enough money to cover the necessities? You’re way ahead of the game. But they always look at me like I’m crazy because they take it all for granted. They have no idea how privileged they and their families are.

    • StephanieA

      Thank you for this perspective. I’ve been feeling like an awful mom lately (third trimester of pregnancy, working night shift, tired), and am stressing myself out about my toddler’s screen time and the fact that I do not have the energy to think of fun things for him to do. I need reminders like this so I can chill out a little bit. On a side note, were the mothers feeding their babies condensed milk because they couldn’t afford formula? I live in a conservative town and the nurses I work with constantly complain about the mothers that formula feed because they get formula from WIC. Its so irritating, I want to tell them to STFU because they are feeding their babies in the way that works best for them.

      • LizzieSt

        It’s certainly possible, but I suspect money was not the only issue with this particular family. We did set them up with a WIC appointment, though.

      • fiftyfifty1

        “and am stressing myself out about my toddler’s screen time ”

        I know I can’t make your stress go away by just saying so, but my kids have had unlimited screen time since babyhood (and have gone through stretches where they have really put a lot of hours in) and they are bright, loving, creative, playful happy kids.

        • mythsayer

          Mine spends the majority of her hours on her iPad (yes…my 5 year old stole my $1,000 iPad and it literally now belongs to her) and she has the vocabulary of a 10 year old. At least. She knows words like emulate. So I have nothing bad to say about screen time, other than I think it has turned her a little too independent (born stubborn to the point of refusing to keep her head on my shoulder at only a week old…but she now thinks she should be given adult status lol). I know it’s the iPad that has given her her giant vocabulary and an insane understanding of things she shouldn’t know (not age inappropriate things…just things she wouldn’t learn for years and years in school normally).

      • Blue Chocobo

        How much TV did you watch as a toddler? What about your coworkers? Can you tell who got the “right” amount of screen time?

        • StephanieA

          Sorry, I didn’t mean to derail the thread with this since I asked about TV time on another post. I know logically that he will be just fine, you just hear so much negative about screen time, and I’m the worrying type.

          • Elizabeth A

            I abandoned a lot of ideals about screen time when my kids were 5 and 2.5. End result, 3.5 years later? Kids who groan “Moooom, we are NOT watching Ocean’s Eleven *again*!”

          • The Computer Ate My Nym

            Nice job. Now they’ll think of TV as that boring thing that mom does.

          • demodocus

            Hey, the peds nurses put on PBS Kids for my 20 month old when he was in for the broken leg. The ER nurse played Thomas for him on her phone

          • Blue Chocobo

            It’s not terribly different than the formula shaming.

            TV, like bottles, is a tool. As long as you’re using it appropriately (formula, not soda, kid’s shows, not porn) it’s fine.

        • LizzieSt

          I was a Sesame Street and Wheel of Fortune addict, starting at age 1. Now I have far too many books and a master’s degree. I think my brain turned out okay.

      • Allie

        I sometimes feel guilty for not thinking of fun things for my LO to do, but then she my LO thinks of plenty of fun things on her own, like chewing on her shoes and drinking water from the toilet brush holder. Her immune system must be awesome! Great mom, right here : )

    • namaste863

      Fabulous. I’m working toward my MSW to become a medical social worker. Should I run away screaming?

      • Mishimoo

        No, it’s a field that needs as many compassionate people as possible. You might want to organise a therapist that you like and trust before beginning employment though, just so you can check-in when needed. You can’t help people unless you look after yourself.

        • LizzieSt

          Yes, do get a therapist please! I wish I had done that from the very beginning.

      • LizzieSt

        The field needs good people. And I have to say that I am grateful for the experience because it made me tougher, gave me some backbone because you need that to survive in a hierarchical environment like a hospital. Also have to say that I vastly prefer inpatient psychiatry to the medical units. You get more respect as a professional.

      • demodocus

        Please remember that being disabled doesn’t automatically make one an incompetent parent. Still grumpy about the social worker I saw when I was doing IVF. She was so very certain that I would effectively be a single parent just because my husband’s blind.

        • LizzieSt

          Damn. Makes me so angry to hear stories like that! There are plenty of judgy social workers out there. I mean, I can be judgy too but I saved the judging for after 5pm.

          • demodocus

            We do get it a lot. There’s always someone who seems to think I have to wipe my husband’s bum for him. They just cannot imagine how someone can do stuff without looking. Fools. Someone after a concert once congratulated him on being able to read his music while he was singing!
            Maybe she’s only seen the elderly who are recently blind and feel they can’t do anything anymore or people who were trained to helplessness (we know a couple of those). The SW was very young. Still, most people who went blind in childhood and are young enough to be parents are as competent or not as any other group of people.

      • The Computer Ate My Nym

        Depends…How do you feel about hitting your head against the wall repeatedly?

        The field needs good people. A good social worker is a critical team member and I know several people who would be dead without one. But it’s not an easy field.

  • Bugsy

    This post makes me love my GP all the more. At #2’s 2-week appointment with her, she asked how feedings were going. I mentioned that after suffering from exhaustion trying to wake up for each of his nighttime feedings, we had adopted the same system we had later on for #1 – DH handles the earliest feeding w a bottle of milk I’d pumped earlier that day so that I can get some continuous rest.

    Her reply: “it sounds like it’s working well for you guys, so I encourage you to continue it. Just do me a favor. Don’t go online and read other people’s thoughts on it (ie: Nipple confusion).”

    I love her.

  • Mel

    If we treated our cows the way lactivists treated women, we’d be in trouble.

    It is never acceptable for a cow’s teats to be cracked and bleeding. EVER. My husband and his dairy colleagues can talk for hours about the benefits and drawbacks of each type of teat dip and the suction attachments for the vacuum milkers. If cows “yelp” when the milking system turns on, there is a massive review of what’s wrong.

    We have lots of tricks to feed calves with sucking difficulties. I’ve developed a fine tactile based understanding of what a calf’s mouth is supposed to feel like when sucking on one of my fingers and some tricks to help them bottle-feed if they can’t. If they really suck at it, we tube feed them for a few days until they get the hang of bottle feeding. A starving calf won’t learn how to feed more efficiently; the calf will be frantic with hunger or too weak to feed.

    “Cow comfort” reaches a level of obsession. We make sure their food is appealing, that they have access to fresh, clean water, that their free-stalls are roomy and soft. We keep cows in groups so that they can do normal herd things like grooming each other, fighting each other, and hanging out with their cow buddies. (Think junior high girl cliques with the mental levels of a toddler.)

    Lactivists should take some tips from farmers.

    • AirPlant

      That actually makes me feel so much better about my low level milk addiction. My vegan aunt tells all kinds of stories about cow mistreatment and I hate the idea of giving up cows milk. My birth control gives me mild morning sickness as a super fun side effect, so I have to stay away from strong smells and flavors and without a glass of milk first thing I will throw up. I had tried switching to water or juice, but milk is the only thing that helps and it is nice to thing that the cows are happy…

      • StephanieA

        I adore milk. I grew up in a family that had milk with every meal, not water. Its a good thing my husband doesn’t like it, because my son and I go through quite a bit every week.

        • AirPlant

          Every time someone says that humans are not designed to drink cows milk I want to laugh in their face. We are also probably not designed to drink vodka but I am not giving that one up either.

          • demodocus

            Not designed to drink vodka?!? The devil you say!

          • AirPlant

            The headache is medicinal?

      • Mel

        We try to keep them as happy as possible. We like to see them doing normal cow things like grooming each other, having some random dominance fights ( since we make sure cows don’t have to compete with each other for food, water, or space, the cows fight over other things like who is closest to the dog or who gets the “best” feeding space or who gets to stand by the corner…it’s a herd animal thing), rubbing against things, and messing with humans. If they don’t have the energy or the curiosity to try to outmaneuver a human during group movements, we’ve got a problem.

        OFC, people swear that livestock take after their owners, so that’s why our cows are known for being smart and stubborn…..

        • AirPlant

          I love the idea of happy competitive cows fighting over puppy time. That you for giving me that mental picture.

    • demodocus

      Nothing but mother’s milk and blood before 6 months!

      • Suzi Screendoor

        Don’t forget puss!

        • Azuran

          It’s what makes the breastmilk alive.

        • demodocus

          I didn’t but my morning sickness hasn’t quite faded all the way yet. blech

    • Kelly

      I thought of your many posts as I watched a documentary on elephants. It was commented that the baby elephant had to learn how to nurse as it showed a baby elephant sucking on the wrong end of the mother. The narrator also commented on the fact that the baby had to learn a lot of things and that it was not innate. All these facts about animals and what goes wrong has helped me fight back the “natural” arguments that people like to talk about.

      • Mel

        Calves do that about 25% of the time since 3 out of 4 sides of the mom lead to the udder. If a calf is too rough on the mom’s teats, she’ll shove the calf away with her head or leg. They learn pretty quick to be gentle.

        My favorite was a calf who decided a still-pregnant cow whose milk hadn’t come in was her mom. The cow kept trying to push the calf away, but the calf stayed so close to her flank she couldn’t move the calf. At first, I was freaked out that the cow would hurt the calf. My husband pointed out the cow was being quite gentle. Five minutes later, when the calf found the cow’s udder, latched on, then started trying to help milk letdown by pulling on the teat -hard- I made my husband take the calf out of the pen because that looked horribly painful to the cow. By that point, the cow had pretty much given up trying to get rid of the calf and had a look of depressed resignation. Which also shows that babies are active players in bonding as well – this one was well on her was to getting an unrelated female to care for her…

        • AirPlant

          That might be the cutest story I have every heard, and I have kittens in my life right now.

          • namaste863

            Squeeeeeeee!

          • AirPlant

            two words: Clumbsy. Pouncing.

          • Chi

            I miss kittens. I have a grumpy middle-aged cat who likes to sleep a whole lot. When hubby and I finally get around to buying our own place, I am totally going to sign up to be a foster mummy to kittens. And my cat can just suck it up.

          • AirPlant

            We are just cat-sitting over the holiday so it is not forever. Just so freaking adorable. Just always.

          • Tigger_the_Wing

            I have kittens too. Previously feral, one was orphaned and the other is disabled. I got them ten days ago from a TNR charity (Trap, Neuter, Release).

            They are utterly adorable, and very, very affectionate.

            I’m not getting much sleep, though. =^_^=

    • Dr Kitty

      My SIL and BIL have a cow that went through the robotic milking parlour something like 50 times in one day in order to get more food. Thankfully the computer senses things like that, and while it allows the cow inside and gives it acces to food, doesn’t actually milk them if they go in too much.

      Their vet bills have gone down since they got the robot, the cows now decide when and how often they want to be milked. It seems that even cows have very different preferences, with some seeming to prefer to be milked little and often and others like long, infrequent sessions.

      The one who went in 50 times in a day was just greedy and smart enough to have worked out how to game the system in her favour.

      • Mel

        Yeah, we’ve heard of that happening since the cows often get corn or some other kind of “cow candy” during robotic milkings. We don’t have robots yet, so ours just steal donuts from my MIL…..

    • Mel

      My husband pointed out that stress is horrible for milk letdown. We try to keep the cows very calm before milking because adrenaline can screw up the whole process. Acute stress -like having a baby clamp down on a cracked, bleeding nipple- is worse than the normal day-to-day stresses.

      • Tigger_the_Wing

        Having gone through that with my third, I heartily agree. I really wished I hadn’t bought into the ‘breast is best’ to the point that I thought that bottles were the worst. Fortunately, my husband was being rational, and talked me into bottle-feeding her.

  • demodocus

    Sure, because it’s so freaking easy to get over psychological distress. I bf’d kiddo until I literally couldn’t take one more moment. I was shaking and praying neither husband nor infant would ever touch me again. It’s been more than a year and I still shudder at the thought of breastfeeding.

  • Amy M

    Even that crazy lactivist with the cartoon portrays herself as a cow. Cows are the top of the pyramid in the lactivist world, I guess. They can feed their own calves, plus lots of people.

    I worked on a dairy farm for a bit in college….and since then, have sometimes referred to people who are being bitchy as cows. Maybe not fair to the cows, because mostly they were very sweet. But sometimes, they’d be in heat, or it was too hot, or they’d just had their first calf, or whatever else can put a cow in a bad mood, and they would kick off the milking machine, kick us, refuse to go where they were wanted and in one memorable instance, stage a breakout complete with charging. So that’s where I get my use of “cow” as a derogatory term.

    I’ve definitely heard lactivists (as well as most breastfeeders) say they don’t like being likened to cows. And then you get “Hathor” over there who glorifies the milk-dispenser thing. Does anyone take her seriously, or is she too out there even for most lactivists?

  • Blue Chocobo

    “Even if breastmilk were “the elixir of life” as some lactivists pretend, that would not this cavalier treatment of women.”

    There’s a word missing, probably “justify” or “excuse” or “create some semblance of ethical acceptance of” or some such.

    • Amy Tuteur, MD

      Sorry about that. Fixed it.