Guest post: A Canadian perspective on breastfeeding support

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Shared anonymously by a reader.

Before my son was born, I decided it would be unwise to be narrow-minded in my parenting choices. This decision was based on anecdotes I heard from friends and family who cautioned that each infant is unique and that the ways in which we meet each child’s needs are situationally-dependent. While I had every intention of exclusively breastfeeding in the first six months of my baby’s life, I was also open to the possibility of having to supplement with formula or to exclusively formula feed in the event there were variables outside my control such as low milk production or the inability of my baby to latch.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”I am asking the Ottawa health community to practice sensitivity in dealing with postpartum mothers when it comes to infant feeding.”[/pullquote]

My husband and I were at peace with that decision, thinking that nourishing our child was paramount to any marginal benefits associated with exclusive breastfeeding.

While still pregnant, I had attended a public health information session on breastfeeding. I left the session disappointed. The speaker clearly demonstrated a bias in favour of epidural-free births conducted in homes or birthing centres rather than in hospitals, and she barely entertained the notion that some women might not be able to breastfeed. When I asked about the possibility of combining formula feeding with nursing, I was told that “we’re unsure what happens to the gut when formula is introduced” and that if we have issues with nursing, we “can’t say there isn’t any support out there” given the innumerable clinics and individuals that offer lactation assistance in the Ottawa area.

I discovered that this was at least partially true: there is a lot of support out there for women experiencing difficulty with nursing, but the quality of that support varies wildly.

My son was born a healthy weight at 8 lbs 7 ounces. He latched immediately, and nurses declared that it was perfect. I was also producing colostrum, the first type of milk a mother produces in the early days of their child’s life. While he lost almost 10 percent of his weight in the first few days, he quickly regained a substantial portion of that weight once my milk fully came in. At his five-day check-up, I asked a nurse about potentially needing to supplement with formula, and she responded that there would be absolutely no need given his great gains over the past couple days.

However, days passed, and my anxiety began to creep as he cluster fed regularly. I soon discovered, after weighing him on a kitchen scale and then promptly bringing him to my doctor’s office, that he was failing to gain grams on a day-to-day basis. By two weeks of age, he was not yet at his original birth weight.

Distraught, I visited my doctor’s office numerous times, only to be told that given my baby was not losing weight and did not appear languid, that it was not a cause for concern. My doctor did suggest that if I was still worried, to mix some powdered formula in with pumped breast milk, although the goal would be to stop any type of formula supplementation once we were satisfied with his weight gain.

I also received advice from three different lactation consultants, all of whom gave me differing opinions:

One stated that there was no need to worry given he otherwise appeared healthy and cautioned against feeding him “garbage formula.”

Another told me that he needed to gain weight but vehemently opposed giving him formula, stating my only viable options were pumped breast milk or donor milk.

Another was far less judgmental, suggesting I bottle feed him pumped milk four times a day in addition to nursing, but that formula was an option if I was struggling. She also suggested that my son’s tongue-tie be released, as it was likely impeding his ability to nurse effectively.

Others, including my doctor, opposed the procedure, unconvinced that it was the culprit. In the end, my husband and I opted for it as we thought it was for the best. We’re still unsure if it was the right decision given the discomfort our son endured. We’re also unclear as to whether it truly had a positive impact on his ability to nurse effectively.

Despite having originally been open to formula feeding, I suddenly found myself confused by the varying opinions, and began to feel guilty that I was letting my son down by not giving him “the best start in life.” The rational side of me was overtaken by anxious thoughts, fueled by the fear-mongering on the internet that suggested formula was anathema and would render my child deficient. These feelings were compounded by both the subtle and overt comments made by healthcare professionals whose advice I sought.

It was only after a particularly distressing visit to the doctor’s office where my son lay screaming in hunger as we tried to weigh him that I broke down. After discussing it with my husband, who saw me struggle with pumping multiple times a day and witnessed a particularly nasty spell of engorgement, we decided that supplementing with formula was completely reasonable and that, as supported by scientifically-based studies, our son would be fine. More importantly, it relieved an enormous pressure I had felt since the feeding issues began.

I came full circle to my original intention; however what I had truly been ill prepared for was the emotional strain of external factors, namely the judgment of healthcare workers who professed to support, but in fact undermined my confidence as a parent.

I have heard countless stories from women in the Ottawa area about their struggles with the lactation support community. One woman had virtually no milk and despite “trying her hardest,” couldn’t produce enough for her child to thrive. Another friend felt shamed and patronized by a lactation consultant after a very traumatic birth experience in which her child was placed in the neonatal intensive care unit and she was expected to pump despite her terrible ordeal. Another spoke about her prenatal class in which the instructor informed them that she would not be covering formula feeding in the course and passed out “statistics” regarding the cost savings associated with breastfeeding versus formula. This instructor clearly never took into account the possibility of having to rent a breast pump for 6 months, hire in-home sessions with lactation consultants, not to mention the various costs associated with maternal mental health deterioration.

After reading the scientific literature and consulting the data, I am certain there are benefits to breastfeeding, but that those benefits are marginal and should not trump a woman’s reasons for wanting to use formula whether it’s because she must or because she wants to. What is most important for a healthy, thriving baby is a healthy, thriving mother who feels empowered to make choices and be supported in those choices.

I am still nursing my son who is now a happy eight month old. I also still supplement with formula when I sense he needs it. We still don’t know why he wasn’t able to nurse effectively in those first few weeks, but at the end of the day, it doesn’t really matter why. What matters is that he’s properly fed and cared for by his loving parents.

There was a time I was so discouraged with breastfeeding that I contemplated switching exclusively to formula. I’m glad I was able to continue to breastfeed, but it’s not because I think my son is better off than his formula fed peers; it’s because I was able to make a conscious choice to continue to breastfeed based on my son’s needs and mine.

In writing this piece, I am asking the Ottawa health community to practice sensitivity in dealing with postpartum mothers when it comes to infant feeding. While breastfeeding should absolutely be encouraged and supported, this should not come at the expense of shaming women who are struggling or who elect to use formula either as supplementation or exclusively. There are many paths to being a good parent. What matters most is the outcome.

In the end, I can say that my son is happy, thriving, and well-nourished and that I am enjoying motherhood. Before doling out advice on feeding methods to vulnerable new mothers, it might be worth asking oneself whether that advice will lead to the outcome I am now grateful to experience.