To the mother struggling to breastfeed

Together

Dear New Mother,

It’s miracle isn’t it … the exquisite new human being that you and your partner created! You may be overwhelmed with love, overwhelmed with fear, and overwhelmed with the desire to do everything possible for your new baby. Perhaps breastfeeding has been the way you always imagined nourishing your newborn — you’ve heard that it provides a myriad of benefits — and now you are having difficulties. Maybe breastfeeding is painful; maybe your baby is not getting enough milk; maybe you’re struggling with mild or even severe postpartum mood changes.

A baby who is failing to thrive with exclusive breastfeeding is a tragedy of mothering, not a triumph of breastfeeding.

You didn’t expect this and now you’re not sure what to do. I want to offer some reassurance.

1. It’s not your fault!

In their zeal to promote breastfeeding, lactation consultants and lactivists have convinced themselves that the only limitation to successful breastfeeding is a mother’s will and the support that she receives. There’s absolutely no scientific evidence that these are the causes of breastfeeding difficulties. Indeed, to my knowledge, the breastfeeding industry has never asked women why they stopped breastfeeding or inquired about the real barriers and limitations. They don’t want to know. They’d prefer to pretend that any problems with breastfeeding can be traced back to the mother, not breastfeeding itself.

2. You’re not doing anything wrong!

The most damaging fiction of the many fictions that are promoted by lactation consultants and lactivists is that difficulty is always the fault of the mother. You’re not holding the baby properly; you aren’t ensuring that the baby’s latch is correct; you’re not breastfeeding often enough; you’re not pumping between feedings; you’re not taking the unproven supplements or off label medications that would increase your milk supply.

The truth about breastfeeding — the truth that the breastfeeding industry struggles mightily to deny — is that breastfeeding is OFTEN painful, especially in the early weeks; that milk can take days to come in while a newborn screams in hunger; that not every mother can make enough milk to fully nourish her baby; or, anathema to lactivists, some women have a greater need for medications incompatible with breastfeeding than the baby has for breastmilk.

3. From 5-15% of women (and maybe more) cannot make enough breastmilk to fully nourish a baby.

That’s a biological fact, just like it’s a fact that up to 20% of recognized pregnancies end in miscarriage. Just like there’s nothing you can do to prevent most miscarriages, there’s nothing you can do to prevent a mismatch between the amount of breastmilk that you can produce and the amount your baby needs. For women in that situation, the decision to continue breastfeeding exclusively is actually a decision to let a baby suffer and starve. It’s cruel, especially when safe formula supplementation is so easy to provide.

4. Supplementing with formula does NOT destroy the breastfeeding relationship and it causes no harm to the baby.

Without any scientific evidence, lactation consultants and lactivists have insisted that formula supplementation is an enemy of successful breastfeeding. In contrast, the scientific evidence shows that judicious use of formula in the early days, to assuage a baby’s hunger when breastmilk hasn’t come in, or to calm a baby who is so hungry that he or she cannot figure out how to latch properly, can actually AID the breastfeeding relationship by tiding babies and women over until breastfeeding is working well.

5. Hypernatremia dehydration and hyperbilirubinemia are serious complications of inadequate breastmilk.

Lactation consultants like to talk about the “risks” of not breastfeeding, but they are dwarfed by the risks of newborn dehydration and elevated bilirubin. Both excess sodium and excess bilirubin are brain toxins that can lead to permanent intellectual impairment, seizures and death. Don’t let any lactivist tell you that breastfeeding is more important than protecting your baby from these brain toxins.

6. There is no known benefit to feeding your baby another mother’s breastmilk and there may be actual harm to feeding your baby breastmilk purchased on the Internet.

To my knowledge, there has not been a single study on the impact of another woman’s breastmilk on a baby. I’m not talking about wet nursing where the composition of the breastmilk could theoretically change to match a baby’s needs over time. I’m talking about supplements of breastmilk taken at random from women whose babies might be older and might have different bacterial flora. If mothers make breastmilk to match the specific needs of their own infants (highly speculative but often asserted by lactivists) then their breastmilk isn’t matched to your baby’s needs.

Based on what we know, purchasing another woman’s breastmilk to feed a term baby is a monstrously expensive, totally unnecessary endeavor. Any woman who has extra breastmilk should donate for use in premature babies where it can be lifesaving.

7. The solution to most breastfeeding problems is NOT to breastfeed harder.

If there s a biological reason for low milk supply, no amount of breastfeeding or pumping is going to overcome that; it’s just going to exhaust you without any benefit to your baby.

8. Breastfeeding has nothing to do with mother-infant bonding.

That’s just another fiction fabricated by the breastfeeding industry to promote itself. There is NO scientific evidence of any kind that mother-infant bonding is contingent on any specific action. A baby will bond to anyone who meets its basic needs for nutrition, care and comfort; it doesn’t matter how those basic needs are met. Moreover, mother-infant bonding occurs spontaneously over time, and spontaneous bonding is incredibly strong. It’s not weak; it doesn’t need to be supported by any specific action, and it requires tremendous abuse or psycholopathology to interfere with it. Adoptive mothers bond just as strongly to their children as biological mothers; the same goes for fathers and for grandparents.

9. In industrialized countries with access to clean water, breastfeeding simply isn’t that important for term babies. The only proven benefits to breastfeeding industrialized countries is 8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infants in the first year. That’s it! Most of the other purported benefits of breastfeeding are based on scientific evidence that is weak, conflicting and riddled with confounders. Unfortunately, lactation consultants and lactivist organizations like The Baby Friendly Hospital Initiative are still promoting benefits that have been debunked long ago.

10. Outcome is more important than process.

A healthy, growing baby meeting its developmental milestones is infinitely more important than the process used to get there. Lactivism is an obsession with the process of breastfeeding at the expense of the physical and mental health of mothers and babies. That’s wrong. A baby who is failing to thrive with exclusive breastfeeding is a tragedy of mothering, not a triumph of breastfeeding. A mother who refuses to take medication for pre-existing conditions or postpartum depression because she’s been told that breastfeeding is more important than her physical and mental health is a tragedy of mothering, not a triumph of breastfeeding.

Do what YOU need to do meet your baby’s need for nutrition; that’s what a good mother does. Don’t let anyone tell you that breastfeeding is more important than your baby’s health, or your mental health.

  • ObiWan Kenobi

    Thank you for publishing this information, I find that so many new moms go searching for answers online only to get stuck in a web of lactivist lies. Physician says to supplement with formula because they’re not gaining weight? failing to thrive? Jaundice? Hyperglycemic? …”Well, are they bright eyed, having and having wet diapers and meeting milestones?” “It’s totally normal for newborns to lose 10% of their body weight” “Colustrum is enough, it’s thick and concentrated, your body knows what it’s doing” “If they’re not wetting diapers it’s because all of the Colustrum is being absorbed and used” “Pediatrians aren’t up do date on breastfeeding” “Hospitals are just pushing formula because they don’t know anything about breastfeeding” “Formula is harmful to your infant, it’s really messes up their stomach” “Hospitals just push formula for convenience” “Just take fenugreek, eat oatmeal, do “skin-to-skin” and nurse 24/7 and it will cure everything”…but “You REALLY need to see a IBCLC, Pediatricians aren’t really up to date on breastfeeding” always takes the cake. The priority problem is the infant’s pathophysiological condition, having a chat with a lactation consultant isn’t going to increase your baby’s output, eating fenugreek or a bowl of oatmeal isn’t going to nourish your baby, observing their appearance isn’t going to solve any of their problems…this is common sense stuff, so why are women suddenly dumbing down the solutions? It’s very concerning that there’s this whole generation of women who are educating themselves and each other on the Internet when they have direct access to professionals in the field.

    • demodocus

      Ironically, it was my son’s male GP who helped us figure it out, not the 2 lactation consultants.

  • Green Fish

    An Indonesian politician allegedly said that not breastfeeding turns baby gay:
    http://jakarta.coconuts.co/2016/02/25/tangerang-mayor-instant-noodles-can-make-your-baby-gay

  • Brooke

    Do you feel any guilt at all that you’re lying to new mothers and discouraging them from breastfeeding, even trying to scare them into stopping all so you can sell a few books? Or do you really believe you’re the only person who knows the “truth” about breastfeeding?

    • Monkey Professor for a Head

      If you would like to give specific examples of the lies that you feel Dr Tuteur has told in this article, alongside evidence to back up your opinions, then we could have a conversation. But perhaps first you might like to give us evidence for your previous claims that a 5% c section rate is optimal.

    • Who?

      Tell us about the evidence for 5% cs rate. As a sign of your good faith.

    • Inmara

      Rhetorical question: what will scare mothers away from breastfeeding more, honest information that they may need to supplement with formula (temporarily or continuously) to maintain breastfeeding relationship or realization that they have starved their baby in the name of exclusive breastfeeding?

    • Amazed

      Thingy, you’re progressing to a dangerous, disgusting beast. Do YOU feel any guilt at all when, after reading here about doctors other than the former successful breastfeeder Dr Amt who have had their children permanently harmed, almost dead due to failed attempts to breastfeed, you still come here to grace us with such nonsense that might actually kill a tiny innocent life? Tell me beasty.

      What are you, Brookie Beasty? A self-proclaimed “midwife” guarding her income? A LC with no basic knowledge about anatomy, as proven by your ridiculous 5% c-section rate, again guarding income? A dumbass who took a shot with her babies’ lives just in order to be able to push them out of her mojo-jojo while stuffing her face at home, starved them almost to death and dislikes this being pointed at her?

    • The Bofa on the Sofa

      As soon as Glinda had left the Emerald City, Tik-Tok and the Shaggy Man and Jack Pumpkinhead, who had been present at the conference, began their journey into the Gillikin Country, and an hour later Ojo and Unc Nunkie joined Dr. Pipt and together they traveled toward the Munchkin Country. When all these searchers were gone, Dorothy and the Wizard completed their own preparations.

    • Charybdis

      Please, please elaborate on how we are “lying to new mothers and discouraging them from breastfeeding, even trying to scare them into stopping”. Seriously, please elaborate.

      Or are you *SO* enamoured of the idea of breastfeeding and that everyone can do it, does it easily and well, and makes enough milk for their baby that you can’t even entertain the thought of a different scenario?

      Why are *YOU* lying to and trying to scare new mothers that things like nipple confusion and “one drop of formula will ruin you baby FOREVER are indisputable facts, hmmm??

      Oh, and about that 5% CS rate…we are still waiting on that.

    • The Computer Ate My Nym

      Which bit do you contend is untrue and what damage is it doing?

    • moto_librarian

      Do you feel any guilt that you and your lactivist buddies lie to new mothers about the benefits of breastfeeding? Do you care that the newborn period with my older son was a fog of depression, tears, and pain because my milk never came in? Do you ever feel shame for the guilt and anxiety that you cause to vulnerable new mothers who desperately want to do everything right and find themselves derailed by their own biology?

      You are an asshole, Brooke.

    • Monkey Professor for a Head

      Do you feel any guilt about spreading misinformation about vaccinations and c sections?

    • Nick Sanders

      Do you feel any guilt about not even reading these posts before you hurl accusations?

    • guest

      1+ 1 = 2

    • BonBon

      The author should have zero guilt, Brooke. You’re the one who should feel guilty about the BS you lactivists spread and your unkind (borderline cruel) treatment of new mothers. How about minding your own business unless you’re supporting the mother’s choice?
      And it shouldn’t be your concern if anyone is scaring anyone else away from breastfeeding. Not that this article is doing that at all, you obviously missed the point and didn’t read it, but let’s just say it was – again, mind your own business. What’s it to you if a woman reads an article and decides against breastfeeding? Why is it your concern how a mother decides to feed her child? Unless a woman is coming to you and asking you personally, it’s safe to say your advice is not wanted. People reading this article are reading it because they purposely came here and wanted to read it. If people want to hear what you have to say they can go to your lactivist websites. But that’s not where we are, so …

      Besides, ONE article is not going to solely convince a person one way or another anyways. Give women some credit and have a little faith that mothers are capable of seeking out a little more than one piece of writing off of a website, and they are also capable of using their brains and making their own choices.
      This article is not scaring anyone in to anything, it’s giving support, you should try it sometime.

    • Allie P

      I don’t feel discouraged from breastfeeding. I’m breastfeeding right now, as a matter of fact. Please point to the lies. Follow up with citations. Thanks!

  • Chi

    Only slightly OT:

    https://sleepsense.net/why-i-hated-breastfeeding/

    NOT plugging or anything, but I follow Dana because I actually used her sleep sense program when my daughter hit the dreaded 4 month sleep regression and it worked for us. So I’ve been keeping up with her blog and this was the latest article.

    As expected, the lactivist brigade are out in full force in the comments section. Get your lactivist bingo cards ready cos I’ve seen the full gamut from ‘you just needed to try more’ to ‘fenugreek’ to ‘you just need more support’. It’s horrible and this is why I come here to this blog.

    Thank you particularly for this entry Dr Amy.

    Cos it’s taken me a LONG time to take #1 to heart. It wasn’t my fault. The biology just wasn’t right. And that happens. My daughter is 2 now and I feel NO shame about how she was fed because now she’s bright and inquisitive and the absolute light of my life.

    • Gene

      Those comments were horrid.

      • Chi

        Yeah. I’ve gotten a bit snarky with a few of the more rabid lactivists because seriously who the hell do they think they are? What gives them the right to decide whether or not a mother truly ‘can’t’ breastfeed?

        There is a distinct air of ‘because *I* did it, everyone should’ and it makes me sick.

        • ObiWan Kenobi

          To be fair, they likely earned a degree in Pediatric Medicine by browsing the Internet. Clicking on the first three links in the Google search results is the equivalent to one year of medical school. Complete your residency in the comments section of a mommy blog and and you can apply to take your state boards and obtain a license -_-

  • AA

    I hope that Dr T is writing an article about Baroness Cumberlege’s proposed plan to
    https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf

    SkOb’s Facebook linked to a Daiyl Mail website

    “Those
    considered low risk will be offered £3,000 but there will be more for
    those with complications such as obesity, long-term illnesses or who are
    expecting twins.”

    Anyone able to find a source other than DM for this? It’s not in the PDF I linked above.

  • The Bofa on the Sofa

    Again Way OT: I posted this yesterday in the other thread and realized I didn’t do it well, so I’ll try it again. Yesterday, The Bofa got off the Sofa and donned a Hat and whiskers.

    http://www.chem.purdue.edu/wenthold/bge/DrSeuss.htm

    Please, it’s worth checking out. And not click bait, no ads, just a cool and fun project.

    • moto_librarian

      Nicely done, Bofa! Thanks for posting this!

      • The Bofa on the Sofa

        Thanks. The teachers have been great about it, and the principal has been supportive.

  • demodocus

    OT: this episode of Curious George has a real people short where the kids are visiting a naturopath. Um. No. Quick change to the morning news show for a minute and a half.

  • Allie P

    Dr T., do you have any links to the studies referenced in #4? I would love to have a place to direct people for that one. I absolutely believe that formula supplementation saved my ability to breastfeed, with both my babies, and I’m grateful that my unfortunate experience with my first made me smart enough to start the moment I got home from the hospital with my second. But the shrieks from the lactivists are loud, and I’d love a study or two to point to when I try to tell my struggling friends that a couple bottles of formula won’t hurt, and will probably help.

    Similarly, I want to know where this 5% failure rate comes from. They bandy this number about as if it’s vanishingly small, but one in twenty seems relatively common to me. Also, I don’t know if it’s true. It seems ridiculous that the combo of mothers’ production limits and babies’ appetites are always perfect matches. For instance, my mother had small babies, who were always called scrawny, etc. She exclusively breastfed, and I take after her in body type, small breast type, and most other fertility matters. My husband’s entire family has enormous babies who are always at the top of the percentage charts, teethe early, and shock pediatricians with how ready they take to solids. Well, guess who my babies take after? That’s right, my husband. So these poor kids have a mother whose breasts might be adequate to nurse a scrawny thing like herself, but can’t make enough for her giant shark children.

    • Inmara

      Check the comment threads of previous posts, there was a discussion about mythical 5% and data sources but I’m on phone and can’t look up myself.

  • yentavegan

    The pain associated with breastfeeding is the price the privileged class is required to pay . It’s like high property taxes. If you want to secure your rarefied status there must be a cost extracted to maintain universal balance.

    • AA

      I want to publish a book and see if it can get traction like Dr Sears’ book. I will promote the importance of walking widdershins around an orchid every 3 hours to promote your child’s longterm financial success.

      If walking during labor and taking red raspberry tea is so vital to the rest of your child’s life, who says that my plan is not required?

      • Azuran

        There is no proof out there that it isn’t. Which is all the proof woo people need to declare something true.

  • Inmara

    #3 Re: natural miscarriage rates. There are esoteric jerks who insist that women is to be blamed on THAT too (because “subconsciously she didn’t want to get pregnant”). If they are very esoteric jerks, then other family members (or some evil eye or curse) is to be blamed (which can be fixed for a hefty sum, of course). Seriously, when in my desperate attempts to find a cause for several health problems during adolescence I visited a “healer” she insisted that someone in the family had wanted me to be a boy so that’s the reason for my issues regarding reproductive health. Yeah, sure.

    • demodocus

      so who wanted my husband to be a girl?

  • #10. #10. We lose site of the outcomes far too often and at a tremendous expense. This applies to the same hyper-focus on un/under medicated birth – we need to define failure and success in ways that recognize that the process to get to the outcome might be different for different women.

  • Nick Sanders

    OT: The CDC has found rates of HPV infection have dropped 64% since the recommendation of the vaccine!

    http://www.cnn.com/2016/02/22/health/hpv-vaccine-teen-girls-effective/index.html?sr=fbCNN022216hpv-vaccine-teen-girls-effective1000PMVODtopLink&linkId=21491211

    Antivaxxers have predictably resorted to lying through their teeth.

    • Who?

      And is this despite all the extra sex these people are having in the wantonness (sp?) caused by the vaccine/knowledge they won’t get hpv?

      Amazing.

    • Roadstergal

      SBM posted that article on Facebook, and when I clicked open the comment, the first one I saw was: “Yeah. No thanks. I prefer to teach my daughter about the disease and prevention. Too many horror stories about this vaccine.” 67 Likes, from the SBM page. Ugh. A vaccine against CANCER, and it’s not good enough for the anti-vaxx brigade.

      • Who?

        You could do the teaching, and vax, of course. And I love the casual assumption that all sex is consensual, and planned, with someone you’ve discussed the ground rules and basic standards with.

        Sometimes I think these people have forgotten what it’s like to have hormones.

        • Mishimoo

          And have far too much faith in humanity, or are just so naive as to think that bad things will never happen to their kids “because I raised them right”

          • Who?

            Also true.

            Loving the cooler morning this morning!

          • Mishimoo

            Same here! There’s a lovely big storm cloud out the window, so I’m hoping that it rains on my garden.

          • Who?

            Lovely rain overnight here. My poor garden is looking terrible, just waiting for some cooler weather to get out and tlc it. There isn’t a lot of work to do, but more than I’m prepared to stand in the blazing sun for.

          • CSN0116

            Where the frig are you people from?! I sit here in NY freezing my ass off. Gardens? Wishing for cooler?! Pssshhhhh… 😉

          • Mishimoo

            Australia! This summer has been awful, thanks to El Nino, and down south is expecting a heatwave through the week. Hopefully it misses Who? and I.

          • Monkey Professor for a Head

            I’m up in North Queensland, it’s been bloody unbearable for the last week! I actually got driven out of my house a few times because our air con wasn’t powerful enough – I went and hung out in a shopping centre because it was cooler. But this week seems better, so hopefully Autumn is setting in.

          • Who?

            March will be better. Winter will be gorgeous.

            And there is nothing so good as industrial aircon.

          • Mishimoo

            My little sister is up that way too, but she moved up partially for the heat. I don’t know where she got that from! Industrial aircon is lovely, and getting out of the house is nice (even if it’s a necessity). How is your kiddo coping with it?

          • Monkey Professor for a Head

            He’s alright, I just keep him inside and keep him naked but for a nappy when we’re home. Winter is fantastic here, just have to suffer through a few more weeks first. We’re hoping to move down to Brisbane next year (depending on the whims of the surgical training scheme) so that’ll be an improvement.

          • Who?

            Sounds good. Brisbane is horrible in Feb also, though probably marginally less humid than FNQ.

            On the upside, there are many big aircon shopping centres to retreat to. When we lived in the UK I used to take my little ones to the shopping centre when it was freezing and raining for an outing. Love a pleasant artificial climate.

          • Megan

            Man , I loved Queensland when I visited (Port Douglas). Wish I could go back…

          • Who?

            I know, I’ve been watching the northern hemisphere on the news, feeling v envious of the cold. Which is nuts, because I really can’t bear it.

            Fingers crossed for the southern part of the continent this week, extreme heat and fires everywhere. And everything crossed we don’t get the tail end of it.

          • Megan

            Not only that but who’s to say that their kid won’t one day have a partner who doesn’t know or doesn’t disclose past exposure to an STD?

          • Mishimoo

            Or has the misfortune of a partner who cheats and brings something home. (As pointed out to me by my CNM when I said that I thought I was low risk for contracting HPV, because one can never truly know)

          • Who?

            I’ve had that happen to a couple of friends. A hell of a way to find out your husband is cheating, particularly when his response to the news of the diagnosis is ‘it’s probably something you’ve had for years, you were such a slut before we got together.’

            True story.

          • Mishimoo

            That is absolutely disgusting, what a complete tool!
            It’s sadly far too common, I’ve had friends affected in similar ways.

          • BeatriceC

            Yup. I’ve seen that story play out a couple times, including the slut accusation with one as well. It’s not just men. I’ve seen it play out in both directions. Disgusting no matter who the cheating party is.

          • demodocus

            nice. note the sarcasm

          • StephanieA

            I went to Planned Parenthood at age 17 for birth control. The nurse said she was going to test me for STIs and I told her I didn’t think it was necessary, my boyfriend and I were in a committed, monogamous relationship. She insisted because you just never know for sure. I was slightly upset by this, but a few months later I found out he was seeing another girl.

          • FEDUP MD

            Or won’t get raped by someone with it? Seen it twice.

          • Roadstergal

            It’s just like the comment at the bottom – they don’t want to think that such a thing can just _happen_ to their kid any more than it can just _happen_ to them. If they do X, Y, and Z ‘purity rituals’ (in this case, only doing the ‘right kind’ of sex – monogamous in a marriage), then they are magically immune.

          • Mishimoo

            Superstitious pigeons was one of my favourite stories when I was a kid.

          • Nick Sanders
          • Roadstergal

            The comments make me want to leave the planet.

          • kfunk937

            You are so right. One commenter says, “It has reduced HPV because most teenagers have been severely disabled or died”OMFG. I personally haven’t noted an entire cohort absent from the population, nor absent from my local uni. Maybe it’s just me.

          • JoeFarmer

            Ya, you’d think that if the entire high school girl’s basketball or volleyball team died, it would earn at least a brief mention on the sports page or something…

        • Roadstergal

          They’re consciously ignoring how the world works.

          “Seatbelts? No thanks. I just teach my daughter about defensive driving.”

        • toni

          Some say they don’t want their kid to get the impression they don’t have to practice safe sex if they get the shot or will feel that they can sleep around because they are protected. If that’s your concern just don’t tell them whats it’s for lol or spend 30 seconds reminding them that there are many other venereal diseases that the vaccine does not protect against. I got the oral cholera vaccine once and don’t remember thinking it would be okay to drink dirty water afterwards haha.

          • The Computer Ate My Nym

            I expect that should be an easy conversation, if done right.

            Parent: “You realize, I hope, that the HPV vaccine only protects you from HPV, not the many other STDs out there. Practice safe sex to reduce your risk of those. Here are some helpful pictures.”

            Kid looks at pictures. Kid: “Yuck! I am NEVER having sex.”

            STDs aren’t pretty.

            I got the hepatitis B vaccine when it first came out in the 1990s. It did not induce me to jab myself with every needle I saw.

          • Dr Kitty

            I don’t get that argument either.
            But then these are probably the same people who object to PDAs between same sex couples, on the grounds that they “don’t want to have to explain homosexuality to their young children”.

            Explaining homosexuality was one of the easier conversations I’ve had with kiddo #1, to be honest.

            I have a child who asks me questions like “I know we haven’t found water on any other planets, but how many planets do you think have water on them? And how long do you think before we find one?”
            Or
            “How long do lions live for?”
            Or
            “What is the most popular shoe size in the world?”

            It is like these people think kids have no curiosity and are immune to logic and reason.

            “I think cancer is an appropriate punishment for pre-marital sex” is the implicit message you send if you choose not to vaccinate your kids, especially if you choose not to discuss if further with them.
            Not a great message, parents.

          • Who?

            Well if the parents have no curiosity, and are immune to logic and reason, the kids’ geese may well be cooked, whether it’s nature or nurture that determines these things.

            And the kids who do stray, well they probably had the devil in them anyway, or whatever the secular equivalent is.

            With fear as their primary weapon of control, many of those parents are probably fine with that message, implicitly and explicitly.

          • The Computer Ate My Nym

            Well? What is the most popular shoe size in the world? Also, I think there is (liquid) water on a couple of the moons of Jupiter and/or Saturn and possibly on Mars so the answer to the second part of kiddo’s first question is “probably not long”. Mars has ice caps, at least.

          • Charybdis

            I have one of those kids. When he was 3-ish, he asked me what would happen if someone poured all the oceans on the sun. And how electricity runs through all the wires to get to people’s houses.

            I am a little embarrassed to admit to pulling his leg occasionally, when I am answering his questions. Like the time he asked me where wine comes from. I told him that there is a Great Grape Necromancer in California who sucks all the life force out of grapes. This life force is bottled and sold as wine and the dead, lifeless grapes become raisins. The sacramental wine is from particularly pious grapes and the grapes on skid row become things like Ripple and Night Train.

            I have also mentioned that from a lunar/space station perspective, planes in Australia and far South America are flying upside down and people are standing upside down, or nearly so. And that a triangle can have three 90 degree angles.

            I’m warping my child, aren’t I?

          • demodocus

            well, he’ll develop a strong skeptical streak. 😉

          • Azuran

            Ever since she was a baby, my boyfriend has been constantly inventing ridiculous stories whenever his niece asked him questions or asked him to read him a story.
            Now, whenever he tells her anything, she rolls her eyes at him and sighs just like her mom. She’s 4.

          • The Bofa on the Sofa

            My father would womanize, he would drink. He would make outrageous claims like he invented the question mark. Sometimes he would accuse chestnuts of being lazy. The sort of general malaise that only the genius possess and the insane lament.

            “Are you familiar with the term ‘delusions of grandeur?”
            “I believe I that term”

            https://www.youtube.com/watch?v=Jm41Mv-Vc7w

          • Nick Sanders

            Are you dating Calvin’s Dad?

          • Nick Sanders

            I am so stealing the Great Grape Necromancer.

          • swbarnes2

            Triangles CAN have three 90 degree angles on a globe. : )

          • Roadstergal

            “”I think cancer is an appropriate punishment for pre-marital sex” is the implicit message you send if you choose not to vaccinate your kids”

            I should have kept reading down before I posted – you said it perfectly.

          • Roadstergal

            Every time I get my TDaP booster, I dance around on rusty nails.

        • demodocus

          Thankfully, my husband’s assaulter didn’t give him/us any stds. Just some mental scarring and my poor guy’s surprise that proper sex doesn’t hurt a man.
          (I didn’t tell him until after we’d been together for 15 years that a woman’s first time hurts. He was so guilty even after that many years of happy marriage that I know i was wise to not tell him any sooner.)

      • I made the cancer argument with a coworker. She has a teenage son who has had all the usual childhood vaccines and she was debating whether or not to get him vaccinated for HPV. I told her in my opinion, it’s a no-brainer. It’s a vaccine for freaking cancer. How amazing is that?

        Sadly, I don’t think my enthusiasm persuaded. She was worried about the “unnecessary risks” of the vaccine. Ugh.

        • Who?

          We have v high rates of skin cancer here. If it was a skin cancer vax, people would queue for it. But because kids and sex intersect with this one, it is just a no go for some parents.

      • StephanieA

        My aunt didn’t get the vaccine for her two daughters, because for some reason she didn’t think they would become sexually active. Not long after that my uncle caught older daughter in the act. I hate when parents refuse to admit that their children are sexual beings, like most other people.

        • Roadstergal

          And this nasty idea that if the girls don’t live up to the parents’ sexual standards, they’re not worthy of protection.

    • Megan

      I saw this and all I could think was, “I guess that’s because of the huge strides we’ve made in sanitation in the past 6 years.” /snark

      • guest

        Damn straight! I wash my cervix with diluted Lysol every week! Oh, no, wait – that was a previous, un-vaccinated generation.

        • The Computer Ate My Nym

          Sorry, but ewwww!!!!!!!

          Also, if I were trying to find an excuse, I think I’d claim it was better sex ed. Because there’s definitely been great strides made in sex ed in the US in the past 6 years. The abstinence only stuff is totally working.

          Can’t buy it? Not even as a desperate attempt to deny the efficacy of the vaccine? Oh, well, there’s always the vast conspiracy that the entire medical community belongs to to fall back on.

          • guest

            Have you ever seen the old Lysol adds about douching with it? Horrifying. And I guess it may have been a secret code – it wasn’t really intended for hygiene, but as birth control.

            But when I hear people claiming HPV rates are down because of hygiene, that’s what I think of.

            https://thesocietypages.org/socimages/2013/09/27/the-secret-of-vintage-lysol-douche-ads/

          • The Computer Ate My Nym

            Thank you, guest. I think I’ll have nightmares about that one.

          • Roadstergal

            Douching overall was definitely sold as birth control. Some sort of flushing-the-sperm-out. Didn’t work, even with Cocoa-Cola…

          • guest

            No, definitely not effective, but I can see why people thought it might be. Wash that sperm right out, you know? And add bleach to kill them…*shudder*

          • Nick Sanders

            But when I hear people claiming HPV rates are down because of hygiene

            A good counter to that is that rates are only down in the strains included in the vaccine.

          • The Bofa on the Sofa

            Bah, you think facts actually matter?

  • ModernistMom

    My son was born at 32 weeks and was a nice chunky 4.5 lbs. Unfrotunately, he also would stop breathing on a regular basis, especially when being bottle fed. As I’m sure most know, the baby has to be nippling without apnea and bradycardia for a period of days before discharge. I had low milk supply as well but was still maniacally pumping because, well, they told me too. The docs took a break from nippling, meaning my son technically went without an A&B episode for a few days–and the insurance company thought he should be discharged with an apnea monitor. On a lark, I decided to try him at the breast. He latched great and had perfect O2 sats and respiration, but I didn’t have enough milk. I’ve never felt more helpless. I had food. I had a vessel. They just didn’t go together. Meanwhile, I was facing being forced by the insurance company to take a baby home I couldn’t feed without a ton of effort.

    In short, I am probably one of very few people who looked into a SNS to formula feed my kid. But I did, because babies need to eat and I needed options. Luckily, the neonatologist fought with the insurance company. My son needed a full two more weeks to take a bottle without episodes. Even then, he still failed his sleep study and was on an apnea monitor for months. I can’t imagine having been released early or using tube feeding for him or a SNS, but I would have done it. Because, once again, babies need to eat. Period. Outcome is more important than process.

    On another note, thank GOD for preemie, slow flow nipples.

    • StephanieA

      We use preemie nipples for both of our big, term boys! I always wonder what kind of babies can handle the regular size 1 nipples right away- my kids choke and formula runs out of their mouth with those (we use Dr Brown bottles, I don’t know if that makes a difference in nipple size).

      • demodocus

        my first could, but then my boobs are probably not for very young preemies, and he was a fairly big kid with a big head.* Probably found the bottle a relief, lol.
        *No one worried about his 75% head on a 50% body since they’d already met his father.

  • So, would it be best for everyone to supplement until the milk comes in? (Serious question, not being snarky.) I didn’t supplement when my second was a newborn. He latched on right away, didn’t seem hungry, and my milk came in on day 3. But he had jaundice and needed to spend a day under the blue light. I thought I was doing what was best by just nursing – but now I am wondering, did he get the jaundice because it took 3 days before he got anything but colostrum? He was born at 35 weeks, if that makes any difference.

    • Who?

      I’m wondering this too. When I think of the utter misery of messed up nipples with the latching etc, milk coming in (which needs to be actively stopped if you don’t breastfeed) perhaps everyone would be better off giving it a day or two…

    • AirPlant

      My logic brain goes to that conclusion. Supplementation is not known to cause major issues and babies are super delicate so it seems like better safe than sorry.
      My feelings brain though says that the majority of women will probably be ok, it is something like 5% of babies will be endangered and we can probably catch them before anything bad happens and so not defaulting to supplementation is probably just fine.
      In your particular situation I would say that you did everything right and you are a great mother and jaundice was for sure not your fault and never ever ever even think anything like that. 🙂

      • Haha, thank you for that. I have a ridiculous need for validation, I find. He really did amazingly well for a 35-weeker: no problems nursing or gaining weight, no NICU time, but that jaundice has been nagging at me lately. It didn’t occur to me at the time, but I have been wondering if I could have prevented it by supplementing.

        • AirPlant

          Oh goodness, babies get jaundice all the time! Formula from birth babies even get jaundice! My mother tells me she was a fountain of milk and I got jaundice! There is absolutely no need to be hard on yourself, it is a very minor complication in the grand scheme and not even a little bit your fault.
          I am just an internet stranger, but I am absolutely sure there is no need to be second guess your choices.

    • NoLongerCrunching

      I would say no. A good number of mothers have copious colostrum and their milk comes in early. So I would say mothers should pay close attention to their baby’s diapers, behavior, and amount of swallowing they do on the breast, and do what you think is best for your baby. If you do supplement, try to keep it to small amounts (see bfmed.org for guidelines) and do a little hand expression and/ or pumping throughout the day if you’re doing a lot of supplementing.

      • swbarnes2

        I believe there are some women posting here who have ported babies that were peeing fine AND had high bilirubin levels. And not peeing is a late sign of dehydration, not an early sign, right?

        • NoLongerCrunching

          Correct.

          • nomofear

            So these signs you say we should just look for aren’t reliable, and there doesn’t seem to be any harm from supplementing. As a recovering NCBer myself, I’m loath to rely on anything like bfmed.org. I’ll stick with my baby’s pediatrician, who was thrilled to see us initially combo-feeding, because, in her experience, those babies never lost too much birth weight, or dealt with jaundice. (Also, as soon as my milk came in, said baby refused all artificial nipples and formula, so there’s another case of one for nipple confusion being bs.)

          • Young CC Prof

            There are signs that seem to be reliable: Weight and behavior.

            The website newbornweight.org shows the normal weight loss of a baby within the first few days of life. Weighing every 24 hours and supplementing if baby falls below the curve is probably a reasonable plan.

            Behavior: Newborns cry, but they shouldn’t be persistently interrupting feedings to cry, or unhappy at the end of a feeding. It could mean they aren’t getting enough intake, could mean eating is somehow causing pain, but it’s not normal.

            These 2 signs measure insufficient intake. But parents can’t measure weight on their own, and they are told to ignore hungry crying while waiting for milk. The other warning signs we are given are signs of medical complications of insufficient intake, and we shouldn’t be waiting that long to supplement.

            WHY do we not have real protocols for this? Why are we making it up as we go along?

          • Brooke

            There are real protocols. At least at the hospital I went to both times I had to write down each feeding, how long it was, each diaper change, the baby was weighed etc. The nurses asked me both times if I thought my milk had come in before I left the hospital. Babies are not dying from being under breastfed. It’s a myth.

          • Young CC Prof

            Oh, do not go there.

            So, I imagined my son being readmitted to the hospital the day after he was sent home? His life-threatening hypernatremia was a myth? The photo I have of him under bili lights with wires everywhere is a fake?

            Actual death would be very unusual. Preventable emergencies due to breastfeeding failure, however, happen every single day, about 40,000 newborns every year in the USA alone. The protocols are either inadequate or not being properly applied.

          • NoLongerCrunching

            I definitely agree there’s no harm in supplementing. But if you want to exclusively breastfeed and you already have a good colostrum supply, supplementing could make the baby less hungry for breastfeeding. So that’s why I think a blanket recommendation to supplement before the milk comes in could create problems for some women.

            I also agree it can be hard to know what to do in those early days, which is why it’s so important for mothers to get unbiased advice and support from HCPs. Treating supplementation as anything other than a little extra food creates confusion and fear, and leads to outcomes like your pediatrician worries about.

    • swbarnes2

      There are subgroups it he US that do that, and seem to have good success going on to being full-time breast feeders (As some posters on this board have attested to). Also, this paper that shows that >2 oz of formula in the first few days drastically cut the # of babies who lost more than 7% of their weight in those first few days. (spoonfeeding dribbles didn’t really help that problem much)

      http://pediatrics.aappublications.org/content/127/1/e171.long

      See figure 1. This paper mentions something that was touched on here tangentially a little while ago, the idea that pushing fluids in the mother might result in baby having extra fluid, which would artificially make baby weigh more, and make the loss of that fluid look alarming. I couldn’t tell if the fluids pushed on the mothers to get that effect were substantial or not (women with epidurals are likely to get a push to keep bp up, but I have a hard time imagining how one push of fluid would add ounces and ounces to a fetus.)

      • Roadstergal

        I mean, aside from the imaginary ‘just one drop’ and ‘nipple confusion’ stuff the lactivists go on about, is there any danger to supplementing? It just seems like the outcomes would be on a spectrum ranging from ‘no harm’ to ‘saves baby from starvation’?

        I sometimes wonder if the ‘nipple confusion’ myth is a way of explaining a baby that’s getting the nutrition it needs from a bottle if the mom isn’t making enough?

        • Allie

          Yeah, anecdotally, no one I have ever talked to (and most of the women I know have combo-fed) has encountered this alleged nipple confusion. My experience was exactly in line with item 4, in that early supplementation (the first week) helped LO have the energy to keep trying to learn to latch until we both got the hang of things.

          • Allie P

            Ditto. Nipple confusion is a myth.

          • Monkey Professor for a Head

            Well my 8 month old did try and latch onto my face the other day, so maybe he’s confused!

          • StephanieA

            I have seen a total of ONE newborn with possible nipple confusion (I think baby wasn’t interested in breastfeeding because mom didn’t have milk yet). It’s irritating that this myth is so widespread, poor new parents are afraid to use a pacifier or bottle due to this.

        • Kelly

          Lactivists would claim that my first child had nipple confusion but really she just did not have the strength to get milk out by breastfeeding or with a slow nipple. She needed a medium nipple. When she was about a month old, I tried a very slow nipple because she spit up all the time and she did the exact same thing she had done at my breast which was to fall asleep and then wake up ten minutes later starving. I think this scenario is what happens to baby who have “nipple confusion.” If they like a bottle better, they may just be having a lot of trouble getting milk out.

        • Inmara

          Here is a review of available evidence about nipple confusion http://www.ncbi.nlm.nih.gov/pubmed/26181720

      • fiftyfifty1

        “the idea that pushing fluids in the mother might result in baby having extra fluid,”

        Yes, this is just a theory. Lactivists constantly cite this as if it were a proven truth, but in reality it is just an unproven idea. What little controlled experimental evidence there is, does NOT support the theory. Extra fluids given to the mother do NOT seem to increase the chance that a baby will have a greater than 10% weight drop.

        • swbarnes2

          Well, that article presents some data in favor of it so it’s not completely hypothetical. What wasn’t clear to me is the magnitudes of the fluid levels being discussed. If a woman is on an epidural for hours, and gets one push of fluid to correct for a bit of a drop in bp, how much fluid is that, and it that the amount that we might expect to make a difference? Or do a woman have to be pretty sick to require enough fluids to make a difference to the baby’s weight?

          “n logistic regression analyses with the theoretical model, only intrapartum fluid balance (<100 vs 100–200 mL/hour, P = .031; 200 mL/hour, P = .012) and delayed lactogenesis (after 72 hours; P < .001) predicted EWL."

          • fiftyfifty1

            Yes, this was a preliminary observational study that found an association. And of course this is the study that lactivists still cite. But it was plagued by confounding. Hard, long labors were already known to be a risk factor for excessive weight loss, the idea being that a long, exhausting labor can result in both poor/delayed milk production and tired infants that don’t feed as vigorously. The confounding is that hard, long labors have a much higher rate of IV fluid use (from epidurals, antibiotics, pit drips etc) than fast easy labors. A study that controlled for that, showed no evidence that IV fluids caused excessive weight loss. I can’t seem to find the citation right now, but I know we have discussed this paper on SOB before.

            To put this theory to rest, they need to stop measuring “excessive weight loss” as if it were some sort of evidence that infants can be made artificially edematous by maternal intrapartum fluids. If they want to see if such a thing is possible, they should measure Is and Os of the infants directly. This would be easiest to do on bottle fed infants, of course. Just carefully record how much formula they take in and weigh all diapers (and spit up rags). You don’t have to bother with weighing the baby at all. If infants born to mothers with high IV fluids are truly diuresing in the days after birth, this should be easily apparent. Their O/I ratio should be bigger than for infants born to mothers without IV fluids.

    • Amy M

      Not a doctor, but it is my understanding that pre-termers are more prone to jaundice anyway. My 36wk-ers were a somewhat yellow for a few days. They didn’t reach bili light levels but doctors were keeping a close eye on them, and then, by day 5 or 6, it pretty much worked itself out. We were feeding them formula that whole time though–my milk didn’t come in until Day 4.

    • guest

      It sounds like it wouldn’t be bad practice, but it isn’t strictly necessary in all cases. If someone wants to avoid it, regular weight checks (like, daily, or before and after feeds) can alert us to when a baby isn’t getting enough sooner.

    • StephanieA

      Not all babies need it, but it would be great if it was not so stigmatized and encouraged when needed. One of my sons definitely needed it, the other one I did give a little bit of supplement but didn’t need nearly as much as the first. Some moms are able to pump 20 cc of colostrum at a time, others have almost none.

    • Brooke

      No because its nipple stimulation that causes the milk to come in to begin with. Colostrum is all a baby needs for the first few days of life. Babies born before 38 weeks are at a higher risk of having jaundice.

  • Jules B

    I wish I had read this four years ago, when my daughter was born. It would have saved me so much heartache (and sleep!). The other things the lactavists never seem to consider is the baby’s desire to breastfeed. It is taken as an unquestioned given that all babies not only CAN nurse if Mom does her job well, but that they WANT to nurse. Many might scoff at the idea of newborns having preferences like that – lactavists like to portray breastfeeding as a deeply ingrained instinct that the infant has no say in, preference-wise. Yet they contradict themselves with their fear-mongering around “nipple confusion” (or nipple preference!). They come right out and say that babies often PREFER the easy/fast flow of the bottle. So clearly even newborns know what they like, right? And as they also like to say, breast-feeding is a “relationship” or they talk about the “dyad.” OK, so it takes two to tango, then right? Mom cannot lead the dance unless baby can/will co-operate. Yet somehow if that relationship fails to work due to infant preference, it is still Mom’s “fault” alone?

    My baby loved her bottle, with breastmilk in it. She was OK with formula mixed in, but her preference was VERY clearly my milk, in a medium or fast-flow bottle thank you very much. Trying to get her to do anything but that was just an exercise in frustration. And now she almost four years old, I see in hindsight that that stubbornness was right there from the get go! My kid knows her own mind, that is for sure.

    • fiftyfifty1

      Yep, babies do have preferences. I had a forceful letdown and a baby with a slow and discoordinated suck-swallow. The preference was very clearly a bottle…a super slow flow bottle. Never was able to graduate to a fast flow bottle, even as a toddler.

    • FEDUP MD

      I had oversupply and very fast letdown. Bottles didn’t have anything on me. Yet kept being told they might get a preference if we introduced one. Ridiculous.

    • Madtowngirl

      After a few days of me attempting to breastfeed my daughter, she definitely started showing a preference – it took her all of 2 seconds to realize she was on my nipple and start screaming.

    • Nick Sanders

      According to my mom, I saw my cousin drinking from a bottle when I was around 2 months old, and that was it, I refused to breastfeed from that point onward, instead demanding a bottle.

    • The Computer Ate My Nym

      My baby stubbornness and feeding problems story: When small one was born I didn’t make a lot of milk the first day. She got a bit dehydrated and spiked a small fever (something like 37.5). I got a bottle of formula and fed her. Her fever went away and she was happier. The pediatrician the next day suggested giving her some pedialyte to make sure she was well hydrated. We gave her two bottles, along with breast feeding, in the hospital.

      In the mean time, my milk came in with a vengence. I started to regret that “wet nurse” wasn’t a career option any more because clearly I could do it. But we were still supposed to give small one a couple more bottles of pedialyte to make sure she was hydrated. So when I was napping my partner took a bottle and tried to feed her. When I woke up, he looked rather rumpled. He said, “Two things. First, she’s not that thirsty. Second, she REALLY doesn’t like pedialyte.”

      Sniff. Baby’s first act of rebellion.

      BTW: After I went back to work she would deign to take expressed milk from a bottle, but really much preferred the breast. So much for nipple confusion.

  • Anne Catherine

    I have tears in my eyes… I wish that having all staff and new mothers read this was part of the Baby Friendly 10 steps

  • J.B.

    I wish someone had explained the pain that happens anyway for several weeks (it took a month with both kids) and vasoconstriction (ouch!) If I had another kid I would seriously contemplate bottle feeding or at least supplementing from the beginning.

    • Are you nuts

      The myth that it doesn’t hurt if you’re doing it right is one of the cruelest myths out there.

      • Commander30

        And on the other hand, there was me–breastfeeding was never painful for me in any way. So I must have been doing it right, huh? Tell that to the flat nipples, the nipple shields that my hungry baby kept knocking off, and the 30+ minute nursing sessions that still left my baby screaming in hunger. Similar length pumping sessions produced only a few drops. But hey! No pain, so all good, right? /snark

  • Gatita

    Another thing to mention: just not liking it is reason enough not to breastfeed. I’ve seen a lot of mothers who look sick to death of whipping out a boob every few hours but they keep at it anyway out of a sense of obligation. It’s okay to say “The way I’m feeding my baby is making me unhappy and I’m going to switch to the option that keeps baby fed and me happy.”

  • Charybdis

    There’s a typo in the first paragraph of #2 : “pumping between feelings” should be “pumping between feedings”, I think.

    • demodocus

      …both could work for me, considering my insane hormones…

      • guest

        Pumping between feelings would have been even more frequent for me. I don’t think I could have withstood it.

    • Amy Tuteur, MD

      Thanks! Fixed it.

  • Montserrat Blanco

    Thank you for this post.

  • demodocus

    As a small child my brother would as often as not come running and crying for me. (Mom worked 3rd shift, so my teenage self handled a lot of the minor stuff.) Bonding happens, even over PB&Js and walks to the store for an apple a piece. He also bonded with his father (my 1st stepfather), our mom, our sister, my best friend, Stepfather #2, the elderly couple who lived next door, our grandparents, and assorted other relatives.

    Breastfeed if that works for you, feed formula if that turns out to be your preference or need, or do a combination. In the long run, it won’t matter; only full tummies do. Look around at people in their 30s, and try to guess which half of us were fed which. Heck, some of us might not actually know, because by virtually no one cares by the time a kid is in school.

    signed, the formerly breastfed, obese asthmatic

    • BeatriceC

      On a related note Sibling number 4 is extremely close to sibling number 3 for a similar reason. My older siblings and I were 17, 13 and 12 when the youngest was born. I’m number 2. The following year, number 1 left for college and I left for a boarding school. Neither of us were home much. Number 3 spent a lot of time helping our mother care for number 4. To this day, 20-something years later, number 3 and number 4 are extremely close; much closer than any pairing of the rest of us (there are 6 total, with numbers 5 and 6 being adopted quite a few years after number 4).

  • NoLongerCrunching

    I think the 5% low breastmilk production rate comes from the same place as the 15% C-section rate the WHO recommended; as in out of someone’s ass.

    In any case, that statistic is about insufficient glandular tissue; it doesn’t take into account low supply caused by a lethargic baby not stimulating mom enough, or an ineffective suck that doesn’t allow the baby to get the milk that is available (later resulting in a poor supply). Then there’s low low supply caused by insulin resistance, postpartum hemorrhages, hormone deficiencies etc. Sometimes there is no known cause for low or delayed milk production.

    Some of these problems are solvable, and some are not. In the latter cases mothers should be told that they have the option to make peace with the milk supply they have, and be supported to make a plan to feed the baby in a way that works for them, rather than continuing to listen to people giving them false hope.

    • CSN0116

      5% is a joke. It may not be hard data, but go to any “birth board” on one of the main mother-baby sites, like “The Bump” or “Baby Center.” Out of 15,000+ mothers in a given month of birth, you will see hundreds upon hundreds of posts about no milk, too little milk, breastfeeding pain, troubles, “giving up” …you name it.

      In real life, the figure of those who will struggle immensely – to the point where their babies lose far too much weight and mom starts to emotionally/psychologically suffer greatly – is closer to 25%, in my experiences, which are rather vast at this point.

      I’d love to take any random pediatrician’s office and look at the charts of all their breast fed babies in the first four weeks of life. I’d love to see their weights and when “feed more frequently” and “supplement” was indicated due to weight loss. It is SOOOO much more than 5% of patients! I’d put my life on it.

      • Gatita

        Even if 5% were real, that’s one in 20 mothers. That’s not rare.

      • Valerie

        In the old-school psych paper I posted Friday about how a positive attitude towards breastfeeding affects milk production, they found that even among the most positive, enthusiastic breastfeeders, 25% still needed some supplementation with formula at the end of their hospital stay.

        • Who?

          This positive attitude nonsense is a subtle form of victim blaming.

          It makes me crazy when people with really serious illnesses are told to stay positive to improve their outcomes. I guess staying positive might make you take your medication properly, or work on your rehab, but at least some of that can also come from being well supported.

          And if a person can’t be grumpy and sad (if not in existential distress) over a serious illness, when is it okay to be?

          • Mishimoo

            Thank you for wording it so well, that’s exactly what frustrates me about it too.

          • Valerie

            That, and why would they think that people have such good control over their feelings? I guess positive attitude is the cure for all mood disorders too, right?

          • Who?

            The whole concept is idiotic. How can we appreciate happy if we don’t acknowledge sad? And sometimes a wallow can be therapeutic on its own.

            This idea that we have to run away from feelings that make us uncomfortable, rather than acknowledging them, makes me uncomfortable. Relentless positivity is also the opposite of empathy, and while I know empathy needs boundaries, none at all makes for a vicious world.

          • DelphiniumFalcon

            This. And I really hate how if you have depression or any other kind of mental illness the very second you’re angry, sad, or frustrated it feels like you’re not allowed to have those emotions. I mean I don’t take medication and do therapy be happy all the time without any down moments. I do it so I can actually have a range of emotions besides blah and hopeless.

          • BeatriceC

            There’s a little of both, I think, in a healthy person going through a serious illness. I think it’s okay to be angry or sad, but I think a long-term positive attitude is helpful. I see it in my boys. If they get into a funk for too long, then there’s a noticeable ability with their ability to deal with the ups and downs of their condition. I wonder if any research as been done on the topic.

            At any rate, in my house we have an organized pity party when we’re feeling down or upset about something. The way I see it, it’s normal to be angry, upset or sad when bad things happen. Those are normal emotions, but you can’t let them consume you long term. So we have a pity party to wallow in our emotions. Here’s the deal: a pity party, just like any party has a start and end time, entertainment and food. Depending on how bad the event is, we set a time anywhere from 15 minutes to 2-3 hours. During our pity party we eat what makes us feel good and do an activity that lets us wallow in our misery like a tear jerker movie or a first person shooter video game (you’d be surprised how therapeutic Grand Theft Auto can be), or reading or whatever. During that time we wallow in our misery. At the designated end time, the party’s over. We dust ourselves off and start trying to plan for getting through things.

            It’s really amazing how a short time acknowledging emotions can affect the way you handle the event. Obviously, this is not something that’s effective for a major event like a death, but for the normal ups and downs of life, it’s really a great coping tool.

          • Who?

            My daughter and I did just that before she left home. She didn’t want to spend her last two weeks here feeling sad, and so we agreed a time, and we wallowed. On the whole it was great, the couple of hours passed really quickly, and we both felt good after.

            Didn’t stop me howling when her best friend since grade 5 said goodbye on the way out the door (it’s melodramatic to suggest for the last time, but it was probably the big ‘end of an era’ moment for me, completely unexpected) and it was nice to acknowledge that sadness can be a part of even really great things.

          • FormerPhysicist

            I MUST copy your pity party idea. I MUST.

          • BeatriceC

            Have at it! I stole it from a fellow math teacher on a teacher discussion forum. It’s a great coping tool. It’s really made a huge difference in my ability to handle the ups and downs of life.

    • Mel

      I’d be amazed if the rate was only 5%. We breed dairy cows to produce copious supplies of milk and we still have a 10% primary lactation failure rate in first-calf heifers.

      • swbarnes2

        That would be a handy citation to have, but I’m not finding anything with google.

      • The Bofa on the Sofa

        So Mel, when that happens, do you cull? Or do you try again?

        • Who?

          Steak dinners all round!

        • Roadstergal

          Put them on a more frequent pumping schedule.

        • Megan

          Fenugreek.

          • Mel

            *giggles*

        • Mel

          Cull. Financially, we have already used 2 years of costs raising her. To try again, we’d have to wait 60-70 days, re-breed her and wait 40 weeks after for her to start milk production again.

          • Charybdis

            OT: Mel, is somatic cell count still a thing for dairies? When I was fresh out of college, I interviewed for a QC position in a dairy and was told that they did not use the somatic cell count metric.

          • Mel

            Oh, yes. It’s very, very important especially if you want to export milk to the EU.

          • AirPlant

            Is that emotionally difficult? I know that cows are not pets, but spending two years with an animal and then having to kill them over something they can’t control sounds kind of rough to a delicate city girl like me.

          • Mel

            It can be rough on my husband. He doesn’t mind culling older cows since he knows they’ve had a good life; he feel bad about the younger heifers since he feels like he’s missing out on getting to know the personality of the heifers.

          • canaduck

            Yeah, especially considering the fact that cows can live fifteen years.

    • Megan

      My educated guess from seeing moms and babies would be around 15-20%. I think 5% is way too low.

    • The Bofa on the Sofa

      Don’t forget the babies.

      Despite all the stuff about how breastfeeding is not supposed to hurt, it did hurt a lot for my wife with our second (it also did with our first until she changed the technique (she was doing everything according to the book, but it didn’t apply)). In the end, the LC’s response was, “Well, he’s just got a lazy bottom lip.” We tried to help him, but it wasn’t all that helpful.

      So she was fine, the baby just didn’t nurse well, and no amount of cheerleading was going to change that.

      My wife bore it out and put up with the pain until it eventually go better, but could anyone blame her if she chose not to?

      Yeah, don’t answer that…

    • Valerie

      I tried to track this down on Friday’s post. The only actual data (not just anecdotes) I could find was essentially that 15% of women make less milk than a baby requires at 3 weeks, even with all the best education, nutrition, and interventions. The author stated in another review that 2/3rds of those were secondary, not primary, lactation failures, but I didn’t see exactly how she was making that distinction or if it was just her best guess.

      Everything else was just pulling it out of thin air based on personal estimations (eg “In many rural districts in this country at least 95 per cent of women successfully establish their lactation.”) or a citation hole (citing a paper that cites a review that cites a clinical handbook that I don’t have access to) that never gets to the bottom of the clinical research.

  • Madtowngirl

    Awesome. I wish I had read this 8 months ago.

    • Tokyobelle

      I’m glad I saw this now. I’ve been lurking here for a week, having found it while researching causes and support for my failure at breastfeeding, which I was very upset about, but I’m coming to terms with now.

      I decided to throw in the towel because I wanted to bond with my baby, and constantly stressing out and being upset that I wasn’t producing was hindering my relationship with my son. That, and constantly having a pump strapped to my chest wasn’t helping either. It was also very dehumanizing, and I was miserable and very unhappy. I had ceased being a person, but rather a milkmaking machine.

      Formula feeding is making such bonding and closeness possible.

      I have a beautiful, healthy, thriving six week old who has only known formula, and if the exorbitant cost is the price I pay for it, then I do so gladly.

      • Who?

        Congratulations on the baby. Glad both of you are well and happy. Look after yourself.

      • Inmara

        Congratulations on the baby, and stay strong! For your reassurance – I was rationally prepared that I could have need to supplement, and I had read enough to know that formula is a great invention, yet I still felt like a failure when realized that baby indeed needs supplementing to gain enough weight. Since then, we’ve been through combo-feeding and EFF (now already introduced solids), and only thing that matters is healthy, happy baby (and family!)

      • SporkParade

        Yay, congrats on the baby and welcome!

      • J.B.

        I’m sorry it’s been a tough road. I’m glad you’re doing what is best for you and your baby!

      • demodocus

        congrats on your little boy and i’m glad you’re starting to feel better.

      • StephanieA

        Congratulations on your baby boy! I had a similar experience with my first. He was almost exclusively formula fed. He’s 2 now and is healthy, happy, and smart. He’s also insanely attached to me, despite the fact that I barely breastfed him. I felt like bottle feeding helped us bond much more quickly- feeding wasn’t associated with pain and frustration anymore.

      • Tokyobelle

        Thanks for the welcome! Coincidentally, I went to my six week checkup today and when the OB who performed my c-section asked how breastfeeding was going (who was not the CNM I had been seeing my entire pregnancy), I told him it wasn’t, and that I had given up on it (while preparing for a lecture). He then literally told me “breastfeeding is overrated”, and then went on to explain that while it was a wonderful thing, he did not believe in it at all costs like so many advocated.

  • The Bofa on the Sofa

    11. It doesn’t mean you are a failure.

    All of us have things that our body doesn’t do well. Normally, when that happens, we don’t put a value judgement on it (at least, as adults). I am not a failure because my eyes do not see well without glasses, and you are not a failure if you need to use formula to feed your child.

    • Roadstergal

      So much this.

      Unfortunately, there is a push to convince people that all of the random shite that happens to us is indeed due to some conscious action we did or didn’t take. You have T1D because of your eating habits (*headdesk*) and can recover by never eating white sugar. You have cancer because of EMF and if you just eschew EMF a la Chuck McGill, it will go away. Or you have cancer because of unresolved feelings…

      There is nothing new about this push – disease was often thought to be the result of some sort of impurity/sin in ages past. But I really wish we would move beyond it. (I think we never will, because acknowledgement that sometimes Things Just Happen mean they might happen to you, too, no matter how many Skinnerian routines around GMO/organic/etc you do.)

      • Amy M

        I agree with you, that the “blame the victim”mentality is ridiculous and harmful, and also that people have always done it. Something that can happen to anyone is too scary. Something that only happens to people who XYZ (and the victim blamer certainly doesn’t XYZ!!!) is more emotionally manageable.

      • Young CC Prof

        So much this. The idea that all disease is potentially preventable (with technology that exists today) does so much damage, emotionally, financially and sometimes physically.

      • Madtowngirl

        I’ve seen some horrible T2D victim blaming, too. Certainly there is evidence that lifestyle might be a contributing factor, but it’s clearly not in every case. There’s been some recent suggestions that one might be heavy BECAUSE they have T2D, which if that turns out to be true, makes it even more awful.

    • lilin

      Also, there’s a difference between being a failure and having failed.

      Maybe breastfeeding was important to you and you really feel bad about failing at it. The thing is, failing to achieve a goal doesn’t make you a failure. We all fail sometimes, and it hurts, but it doesn’t make you a bad person or bad mother.

      • Who?

        This is a very good point. Upvote.