Planning to breastfeed? Bring formula and pacifiers to the hospital!

Milk bottle for baby feeding and dummy

I’ve been writing for years about how the Baby Friendly Hospital Initiative (BFHI) is harming babies. The incidence of severe dehydration, sometimes accompanied by permanent brain damage, is rising. Also rising is the incidence of skull fractures of babies who fall from their mothers’ hospital beds and smothering deaths when mothers fall asleep while feeding or cuddling their babies. In a truly appalling development, exclusive breastfeeding has become the leading risk factor for newborn hospital readmission.

I’ve advocated for ending the BFHI on the twin grounds that it is not friendly to babies and it doesn’t work to promote breastfeeding. It’s going to be around for the near future, though. How can mothers learn to successfully breastfeed AND protect their babies and themselves from the harmful, unscientific Ten Steps of the Baby Friendly Hospital Initiative? Bring formula and pacifiers to the hospital!

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It’s YOUR body and YOUR baby. Take back control![/pullquote]

I recommend bringing formula and pacifiers for both practical reasons and philosophical reasons.

The practical reasons include:

  • We KNOW that many women won’t have their milk come in for more than two days after birth, but babies may get hungry before then.
  • We KNOW that up to 15% of first time mothers don’t make enough breastmilk to fully nourish and infant, especially in the days following birth.
  • We KNOW, as even Dr. Alison Stuebe of the Academy of Breastfeeding Medicine acknowledges, that as many as 44% of babies will need formula supplementation in the early days.
  • We KNOW that judicious formula supplmentation INCREASES rates of successful breastfeeding.

In other words, women who have easy access to formula supplementation in the first few days are MORE likely to breastfeed successfully, not less. The BFHI explicitly ignores this.

Sadly, breastfeeding promotion has become both humiliating and punitive.

  • The BFHI mandates refusing to offer supplementation to hungry babies.
  • It forces mothers to beg for formula and subject themselves to lectures on the benefits of breastfeeding (as if they aren’t already aware).
  • It muzzles postpartum nurses from appropriately counseling women about the risks of dehydration and the benefits of supplementation.
  • It mandates counseling mother about purported risks of pacifiers even though there is no evidence that pacifiers interfere with breastfeeding and a growing body of evidence that they reduce the risks of SIDS (sudden infant death syndrome).

These practices aren’t merely humiliating and punitive. They are fundamental violations of medical ethics and they rest on a deeply misogynistic view of women.

Lactation professionals cling to their beloved fiction that women don’t breastfeed or stop breastfeeding because they are too stupid and gullible to resist the marketing of formula manufacturers. The truth is quite different. The truth is that women don’t breastfeed because initiating breastfeeding can be frustrating for both mother and baby, and painful. They stop breastfeeding because continuing may be frustrating, painful,  inconvenient and may fail to provide the baby with enough nutrition.

Lactation professionals are afraid. They fear that if mothers see how easy, convenient and satisfying formula is, women will be seduced into using it instead of breastfeeding. So they prattle on about how easy and convenient breastfeeding is when it’s neither. They babble that breastmilk is the perfect food when it isn’t perfect if there is not enough of it. And, of course, they grossly exaggerate the benefits of breastfeeding when the truth is that in countries with clean water the benefits are limited to a few less ear infections and episodes of diarrheal illness across the entire population of babies in the first year.

Women are not selfish fools who must be forced into breastfeeding. Most women want to breastfeed and will make strenuous efforts to do so.

If you are one of those women I recommend that you take both formula and pacifiers to the hospital. Your baby will probably never need the formula, but knowing you have it will be reassuring. If your baby screams incessantly from hunger, you can offer a little formula to settle her and allow her (and you) to get some sleep. Pacifiers can also help in bridging the gap between your baby feeling distressed and your milk coming in.

The practical reason for bringing formula and pacifiers is that they can promote successful breastfeeding, but there’s a philosophical reason, too:

Having easy access to formula and pacifiers puts mothers, not lactation professionals, in charge of both babies and their own bodies. It eliminates the ability of hospital personnel to pressure and humiliate women into fulfilling the lactivist agenda and leaves personal decisions to the person actually affected by them, the mother.

HER baby, HER body, HER breasts, HER choice!

If you want to control your own body, protect your baby from the excesses of aggressive breastfeeding promotion AND ensure a successful breastfeeding relationship, take formula and pacifiers to the hospital. You may not need either, but if you do, you’ll be very glad you brought them.

  • Blake Lee

    I was shamed by nurses for giving my newborn formula in the hospital. They did make me beg for it. I didn’t care! My baby was hungry and I was going to feed him. I simply asked for the on call pediatrician to prescribe it to my baby so I could keep a 6 pack in the room. My baby got full and I got rest. Two days later my milk came in and I breastfed him until he self weaned at 2 years and 10 months. Breaking him from his pacifier was harder. He loved those things.

    I’m pregnant again and plan on doing the exact same with this baby boy. Two days of formula didn’t stop nearly three years of successful breastfeeding so I’ll be doing it all exactly the same. However, this time I will ask the doctor to prescribe the formula before the nurses have a chance to try to make me feel like a bad mom and withhold the formula.

  • Shawna Mathieu

    I remember all the BFing books I read constantly saying that you should throw away any formula samples you got in the hospital or you’d be “tempted”. How damn condescending. Women were supposed to be empowered to make their own decisions – but are, simultaneously, too weak to even be trusted with a single can of formula for fear they’d cave.

    They gave me a small can of formula at the hospital with my son. I was going to do what all the books said, and throw it out. I didn’t. A day after I came home, late at night we ran out of pumped milk, He cried and cried and I couldn’t stand it. I cried while making that bottle, I felt I was a failure as a mom for doing so. I hated myself for deciding to feed my baby when he was hungry!

  • Gremlin

    Thanks for drawing attention to the hideous Full Cream blog. You’ll notice the same names commenting there as on BAA, anything to do with Midwife Cath, AMA posts on breastfeeding etc. Its frightening to think she has a qualification in public health and is a breastfeeding counsellor. I really hope shes not with the ABA – I’m guessing not because they aren’t hatey enough for that type. She could seriously harm women and babies with her vomitous rhetoric. One J Fraser is a huge fan and reposts all her shit on the Joyous Birth FB page.

  • mabelcruet

    The argument that mothers/fathers are unduly influenced by the marketing of formula is totally bogus. In the UK, formula companies are banned from advertising newborn formula, all they can advertise is follow-on toddler milk. There are really strict regulations governing formula companies-the formula tin has to carry a declaration emphasising the superiority of breast milk (even though that’s completely false) and that parents should only use formula on medical advice. The only way formula is marketed is when the mother is looking for it in the supermarket. It might be different in other countries, but in the UK there is no public marketing of science milk, so how can they say that mothers are being brainwashed into using the stuff?

    • Casual Verbosity

      Australia has similar restrictions on advertising. As far as I’m aware, the only other product that has more advertising restrictions than infant formula is tobacco… Tobacco. There are fewer restrictions on alcohol and gambling than infant formula. And there are some lactivists who have suggested plain packaging for formula, which would put a product that is perfectly safe and beneficial for many families on the same level of risk as one of the most accepted carcinogens in the world.

      • mabelcruet

        I was in the pharmacy today collecting my prescription. They had the formula tins behind the counter-behind!! Completely out of reach to anyone-I asked the assistant why they were there, and she said that the company (a national chain of chemists) had a policy, and anyone asking for formula had to speak to the pharmacist before they could buy any. I’m seriously thinking about making a complaint-in the UK, certain pharmacists take on extended roles and can deal with minor issues and do basic prescribing (like medication for thrush), so obviously they are treating formula like a dangerous medication that you have to get pharmacy advice on before using-its absolutely ridiculous.

        • rational thinker

          You should absolutely make the complaint.

          I have posted this before but there is one store by me that keeps the formula locked up next to the cigarettes. Every other store in the area has the formula in the isles where you can grab it yourself.

          I think this sends a subliminal message that says what you are giving your child is very bad for their health.

          I cant imagine how a new mom who needs formula feels when she has to ask for a can of formula and say “the one next to the cigarettes”.

        • Lurker

          I’ve seen formula in a locked case a whole bunch of times, and it never occurred to me that it was because they were treating it like a controlled substance. I always thought it was because formulas is a high-value item that people really need, so they were worried about theft.

          • mabelcruet

            Possibly, but the cans of formula are really big though-I don’t it would be that easy to shoplift them

        • Mel

          In the US in the late 1990 and early 2000’s, some stores kept formula locked up or under heavy surveillance. My mom was a member of loss prevention for a regional mass grocery store and realized that there were some really strange patterns of shrink (e.g., theft) around formula.

          When people are stealing due to poverty, they steal a small number of basic items – like a loaf of bread and bologna or a can of formula or a small pack of diapers. It’s both to reduce the risk to the person shoplifting – but it’s also human nature. No one wants to be a thief, so they steal the least they can get away with. (These people broke my mom’s heart- and she worked hard to connect them to social services so they could get food stamps or TANF or VA services….)

          Instead of that, massive amounts of formula would go missing at a time – like 30 to 100 cans – which could wipe the entire stock of a store out. Then a different store would be hit.

          Long story short: Organized crime was stealing formula at suburb locations that had high volumes available, making a huge amount by selling the stolen formula to small stores in urban or rural areas at face value, and victimizing high poverty areas by only selling formula at above face value – because these were women and men who didn’t have transportation to purchase formula elsewhere.

          Pretty quickly, the FBI got involved and formula got locked down until there were enough criminal convictions to drive organized crime and shady grocers out of the game.

          • mabelcruet

            That’s awful. I volunteer at our local food bank and we had a bit of a to-do here because there was a lot of criticism that the Trussell Trust (which runs most of the food banks in the UK) refused to accept baby formula on the advice of UNICEF. It’s appalling-its discriminating against low income families. It’s difficult enough for families to accept help from the food bank, most people feel stigmatised for it already, and imagine being officially told that your choice to formula feed is poisoning your baby so much so that the food bank won’t accept it. The bank I work in can’t accept fresh food as we don’t have appropriate facilities or refrigeration. I think tinned hot dog sausages, salted and preserved tins of fatty ham and spam are far less healthy than formula, but we hand those out to anyone. Our bank ignored official guidance, and we did have some formula donated-a limited range, obviously, but mums were allowed to choose which one their baby preferred. But we had to keep it really quiet as the main charity totally disapproved. They allowed baby food though, just not formula.

        • Ozlsn

          There is an issue here with formula being bought and sent to China for resale. The main issue is that as soon as the supermarket shelves are stocked it sells out, and there have been local shortages. So they put in a can per customer limit, which slowed it slightly and have been talking about making it prescription only, which hell no (supermarkets agree on that one!)

        • Casual Verbosity

          If that really is the motivation behind the move, then that’s truly awful. I don’t know whether this could be the case in the UK, but in Australia we have problems with individuals buying formula in bulk to send to relatives in China. To combat this, most retailers have limits of 1-3 tins per customer, however the formula aisles are often empty, which means families have to visit multiple retailers to be able to feed their children. If the UK has a similar situation, then maybe the chemist chain wanted to put them behind the counter to make it easier to control how many tins people can buy in a single transaction. Regardless of the motivation, it contributes to the image of formula as a controlled substance, which is detrimental for families.

  • Ozlsn

    My friend did that with her second baby after her milk cane in late with her first. Had powdered formula and bottles ready to go and asked for some water. They wouldn’t bring it until she signed the consent form, and then didn’t bring her the form to sign. By the time I came in to visit her baby (about 24 hours after birth) was wanting to feed every 40 minutes, would sleep briefly and then want to feed again and my friend was exhausted. I asked if she wanted me to get some water, she said yes, so I got two bottles from the cafe and we made up formula and fed him. Baby finally slept properly – I left so my friend could get some sleep too. Apparently the nurses got stroppy with her because she hadn’t signed the consent form that no one had given her. I can’t understand the point of letting babies be hungry or of exhausting mothers who need to recover. Her milk came in late, same as the first time, and she combo fed after that. You should not need to sign a consent form for them to bring you water ffs. It still amazes me that that happened.

    • Mel

      You shouldn’t need a consent form to feed your kid unless your kid has a medical condition that makes feeding them AMA. Since the average newborn needs to be fed something…a consent form is pointless.

      That reminded me of one of the goofier interactions with the crazy LC I had in the NICU. My son was doing great and I had made friends with a mom whose son was a month or so behind Spawn in the small baby unit. We were chit-chatting about DIYing sports bras into pumping bras in the lobby when crazy LC entered from elevator.

      I startled a bit when I saw her and blushed a bit; she’d not been happy to find out that I’d been telling the front desk and my son’s bedside nurse that I “was not up for a LC visit” every day – but hey – I know my rights as a parent about limiting visits by a random professional who was not on my son’s care team.

      She asked what we were talking about.

      I said “The various annoyances of pumping.” (I was REALLY over this lady at this point.)

      She reminded us that there were HIPPA limitations around medical information being shared.

      I blinked like 30 times and said, “Yeah, HIPPA limits the amount of information you can share about either of us – but HIPPA lets me share any amount of my medical information or my son’s with whomever I want. Ditto for her.”

      She flounced off which was fine with me.

      • mabelcruet

        Seriously, they have absolutely no understanding about consent or confidentiality. I’ve no doubt she was grumbling with the other LCs about the stroppy client she had to deal with. We had an issue with a dozy manager once-patients being admitted to in-patient wards in my last hospital got a ‘named nurse’ who was specifically there as their lead person for coordinating care. In each bay (which were generally 4 bedded bays), there was a notice above the beds stating who the named nurse was, so that families could know who to talk to. This manager claimed that having that information contravened patient confidentiality-the only thing on the notice was the nurses name-no patient name, no clinical details. But he argued that the fact there was a named nurse gave information about the patient had been admitted to hospital. No, the fact that the patient was lying in bed in their pyjamas was evidence of the patient being admitted to hospital.

        • Mel

          I don’t think the crazy LC knew what to do with me, honestly.

          I was always well within the bounds of politeness – but I shut down any conversations about the milking status of my breasts while insisting on getting the equipment I needed for said milking.

          They had the option of ignoring me – which I would have liked – but I was also the only long-term NICU mom who was still pumping. They needed me – if only to justify their efforts to themselves.

          But I didn’t need or want them – and that drove one lady nuts.

    • rational thinker

      It sounds like the only thing those nurses were worried about feeding was their own ego’s.

  • StephanieJR

    It’s like taking an umbrella with you when it’s forecast to rain and you’re out; it might just drizzle, it might just rain a little, it might not rain at all, but if a downpour happens, you’ll be grateful you thought ahead.

  • Christine O’Hare

    Yes, yes, yes! Fortunately with my first the hospital wasn’t BFHI and I had been reading this blog long enough to know better. After my C-section I was extremely groggy from medication and while both me and baby were doing good with our first try at nursing, I hit the point where I didn’t think I could keep my eyes open and requested someone take her. She still clearly wanted more to eat, so the nurse helped my husband give her a bottle and then took her to the nursery so we could get some much needed sleep.
    Our routine through my hospital stay was to nurse during the day and send to the nursery at night (with pacifier). And when she was too hungry to properly latch and nurse in the middle of the night, a bottle was given and everyone got another great chunk of sleep. Once we went home and my milk came in full force, we didn’t need to supplement again until she was 5 months old and her appetite out paced my milk production.
    As Dr. Amy so often mentions, that early formula supplementation was in everyone’s best interest and did not interfere with our long-term breastfeeding. Same with early pacifier use, helpful in the hospital and did not interfere with breastfeeding or anything else – she never was much of a pacifier baby (i think my cats used them more than the baby).
    Now that I’m pregnant with my 2nd and I’m not even batting an eye about feeding this baby. The only thing i need to check is that things haven’t changed at the hospital since they’ve come under new ownership since last time. But regardless, I know our plan regardless of how helpful the hospital is.

  • Loved it when my hospital left off trying for BFHI certification (too many complaints). Not only did they not shame me when I asked for formula for Kid 3, they gave me extra RTF bottles when I left–such a contrast with Kid 2. Kid 3, by the way, breastfed very well despite tongue and lip ties, and was at his birth weight 1 week postpartum.

  • fiftyfifty1

    Yes! You can bring any type of formula, but the kind I recommend to my friends, family and patients are the little “ready to feed” bottles. They are convenient because they come sterile, premixed, with a nipple, and they don’t need to be refrigerated before use. You can keep them in your bedside table, which is nice in case you have limited mobility due to either CS or vaginal tears etc. You don’t need to heat them up. Room temp is warm enough (you do need to either refrigerate them or throw them out after use though.) Now they are more expensive than formula powder, so they would be cost prohibitive for long term use, but you can buy just a tiny pack to bring to the hospital. Enjoy your baby!

    • KeeperOfTheBooks

      Awesome ideas; might I suggest a slight modifier?
      If you fill out the appropriate online forms for both Enfamil and Similac, they will send you all sorts of free samples and coupons, including, woohoo, a box of the RTF bottles! My standard suggestion even to those moms who plan on breastfeeding is to get the free samples and bring them. Whether you use them or not, you have them available, and if you don’t use them, hey–donate them to a local food or formula bank! No downside!
      (Two of my three kids did well on Similac, and the other did much better on Enfamil. Since Baby Books 1, I get samples from both companies, and see which works best for that particular baby, then donate the samples I can’t use and post the coupons for both–generic versions being *much* cheaper locally, and my kids do just as well on them–on the library’s bulletin board for anyone who can use them to take. They’ll send you $5-off coupons for first formula, then toddler formula for two years after baby’s due date.)

      • Kelly

        I didn’t get anything from Similac this last time except coupons but Enfamil hooked me up with samples. We ended up switching from Alimentum to Nutramigen when my daughter had a milk protein allergy because I could get more samples from Enfamil than Similac as well.