Monday, June 06, 2011

Breastfeeding Advocacy and Formula Feeding Guilt

By Jack Newman, MD, FRCPC
Author of Dr. Jack Newman's Guide to Breastfeeding, The Ultimate Breastfeeding Book of Answers, and The Latch and other Keys to Breastfeeding Success, among others. Learn more from Dr. Newman and subscribe to his newsletter on his homepage, DrJackNewman.com

Mali of Belly and Bunting Birth Services & Beyond helps a mother perfect her newborn's latch.

One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should "not make the mother feel guilty for not breastfeeding." Even some strong breastfeeding advocates are disarmed by this "not making mothers feel guilty" ploy.

It is, in fact, nothing more than a ploy. It is an argument that deflects attention from the lack of knowledge and understanding of too many health professionals about breastfeeding. This allows them not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding, which could have been overcome, and usually could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed. This argument also seems to allow formula companies and health professionals to pass out formula company literature and free samples of formula to pregnant women and new mothers without pangs of guilt, despite the fact that it has been well demonstrated that this literature and the free samples decrease the rate and duration of breastfeeding.

Let's look at real life. If a pregnant woman went to her physician and admitted she smoked a pack of cigarettes a day, is there not a strong chance that she would leave the office feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty? If a mother admitted to sleeping in the same bed with her baby, would most physicians not make her feel guilty for this even though it is, in fact, the very best thing for her and her baby? If she went to the office with her one week old baby and told the physician that she was feeding her baby homogenized cow's milk, what would be the reaction of her physician? Most would practically collapse and have a fit. And they would have no problem at all making that mother feel guilty for feeding her baby cow's milk, and then pressuring her to feed the baby formula. (Not pressuring her to breastfeed, it should be noted, because "you wouldn't want to make a woman feel guilty for not breastfeeding.")

Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their advertising to convince most of the world that formula feeding is just about as good as breastfeeding, and therefore there is no need to make such a big deal about women not breastfeeding. As a vice-president of Nestle here in Toronto was quoted as saying: "Obviously, advertising works." It is also a balm for the consciences of many health professionals who, themselves, did not breastfeed, or their wives who did not breastfeed. "I will not make women feel guilty for not breastfeeding, because I don't want to feel guilty for my child not being breastfed."

Let's look at this a little more closely. Formula is certainly theoretically more appropriate for babies than cow's milk. But, in fact, there are no clinical studies that show that there is any difference between babies fed cow's milk and those fed formula. Not one. Breastmilk, and breastfeeding, which is not the same as breastmilk feeding, has many, many more theoretical advantages over formula than formula has over cow's milk (or other animal's milk). And we are just learning about many of these advantages. Almost every day there are more studies telling us about these theoretical advantages. But there is also a wealth of clinical data showing that, even in affluent societies, breastfed babies, and their mothers, incidentally, are much better off than formula fed babies. They have fewer ear infections, fewer gut infections, a lesser chance of developing juvenile diabetes, cancers and many other illnesses. The mother has a lesser chance of developing breast and ovarian cancer, and is better protected against osteoporosis. And these are just a few examples.

So how should we approach support for breastfeeding? All pregnant women and their families need to know the risks of artificial feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once baby is born. All the good intentions in the world will not help a mother who has developed terribly sore nipples due to her baby's poor latch at the breast. Or a mother who has been told, almost always inappropriately, that she must stop breastfeeding because of some medication or illness in her or her baby. Or a mother whose supply has not built up properly because she was given wrong information. Make no mistake about it - health professionals' advice is often the single most significant reason for mothers failing at breastfeeding! Not the only one, and other factors are important, but health professionals often have influence and authority far beyond their knowledge and experience.

If mothers get the information about the risks of formula feeding and decide to formula feed, they will have made an informed decision. This information must not come from the formula companies themselves, as it often does. Their pamphlets give some advantages of breastfeeding and then go on to imply that their formula is almost...well - between us - actually, just as good. If mothers get the best help possible with breastfeeding, and find breastfeeding is not for them, they will get no grief from me. It is important to know that a woman can easily switch from breastfeeding to formula feeding. In the first days or weeks it is no big problem. But the same is not true for switching from formula feeding to breastfeeding. It is often very difficult or impossible, though not always.

Finally, who does feel guilty about breastfeeding? Not the woman who makes a deliberate choice to formula feed. It is the woman who wanted to breastfeed, who really tried, but was unable to breastfeed, who feels guilty. In order to prevent women from feeling guilty about not breastfeeding what is required is not avoiding the promotion of breastfeeding, but the promotion of breastfeeding coupled with good, knowledgeable information and skillful support at every step of the way. This is not happening in most North American or European societies today.



Helpful articles, books and sites linked on the Breastfeeding Resources Page.
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24 comments:

  1. That's me in the picture! With Mali's help we've made it to almost 14 months nursing with no end in sight! She really is an amazing doula and was (and still is!) such an asset to me!

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  2. What an absolutely fabulous article. I hope to disseminate this widely.

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  3. It annoys me when you hear "breastfeeding reduces the risk for..." when really, formula-feeding is increasing those risks. I know they are only stating it that way so the formula-feeding mother's don't feel guilty, but by choosing to not even try breastfeeding, they are personally choosing to negatively affect baby's health and they need to know that! Then you hear people say, "Well, at least they are not starving their baby." Well, yeah, the baby will survive on formula, but they won't thrive like they would have they been breastfed! (That was kind of a rant!)

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  4. I think the parties that should feel guilty are the doctors and nurses and hospitals who refuse to learn about breastfeeding. There is a hospital in my town where I do not know a single woman who has given birth there and has breastfed successfully. (I'm sure some have, but out of the multiple people I know who have given birth there, none of them have been successful.)

    I do not think the mothers should be made to feel guilt given the amount of PROFESSIONAL misinformation, the societal "booby-traps" and quite frankly people who try to do good without the knowledge and information or only some knowledge and some information, but in the end do much more harm not only to the breastfeeding experience but to the mother's psyche.

    Unless you are the woman or her LC or her doctor or have specifically asked, you don't know the reason a woman is not breastfeeding. Maybe she was entirely undermined by her family, her medical staff, her job...maybe she ACTUALLY physically can't, maybe she adopted the child. Maybe she can't because of medication she needs to be on. And maybe she just didn't want to, for any number of reasons. The point is, by attempting to shame women who use formula (by necessity or by some level of choice) you're NOT furthering the breastfeeding cause. You're making it so women who are on the fence of success back away from seeking help. Women who are nervous don't even want to try. They don't want to encounter the boob-police and they don't want to be made to feel worse than they are already making themselves feel (which increases stress, decreases supply...vicious circle).

    We must absolutely, without delay, educate pediatricians, lactation consultants (who you would THINK would know what is going on, but many don't, many are just as clueless as the random woman down the street), OBs, midwives and other professionals about breastfeeding. Including how does supply work? If supplementation is needed, what is the best way to do that under what situations to help increase supply or at least prevent a decrease. What medications ARE safe? What medications are absolutely not safe? What medications have some risk but it's a calculated risk (I breastfed three kids and was on the same medicine the whole time, and the recommendation regarding that med and breastfeeding changed each time...). What do you do about nipple pain when the latch is fine? Teach them about the differences in weight gain, many doctors are still using the old WHO charts, and have no idea how breastfed babies grow, eliminate waste, gain weight or develop. Stop undermining women's own experiences...

    Educate employers, especially in lower wage industries, on WHY it is best for their company to support their employees in breastfeeding. And FFS educate the family. So many women are undermined by well meaning, concerned husbands who don't have any idea about breastfeeding.

    I've heard "why do you need a class if breastfeeding is so natural..." well because we've lost the intrafamily education from grandmother to mother to child that existed previously. Our generation is in a weird place in that many of us were not breastfed and our mothers aren't able to give actual advice. So get the class in place where it is accessible and affordable. (10 am on a Friday isn't suitable for people who have M - F jobs). Everyone needs to be able to have access to an educated and informed LC if they're having trouble.

    But if the trend of shaming and guilting the mother continues...we aren't going to be successful in promoting breastfeeding as the normal and natural way to feed a baby. Ever. (The same way that SHAMING someone for overeating, or smoking doesn't work...although I really don't find these to be comparable, the article and others have made the comparison. Providing them with the facts AND the tools necessary to succeed works...shaming, especially disguised as facts, doesn't.)

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  5. Defiantly a good blog. I will say i did NOT nurse my oldest at ALL. I was very niave and thought i couldn't cuz of some meds. I feel absolutely horrible. But promoting breastfeeding and even saying things like you increase the babies chances of a, b, or c does NOT upset me AT ALL. IT is, infact the truth. However, i have heard these comments. No exaggerating. "YOu might as well have had an abortion if you didn't plan on nursing". "I'm sure once he was a year you fed him McDonalds everyday since you've been feeding him junk food since birth". "Formula is almost as bad as slowly poisioning your child". "Guess i just love my child more than you love yours". "The reason your child has speech problems is because you didn't nurse him." These are comments i've heard addressed to myself or friends. So be truthful, don't worry about the guilt others may feel. But please remember some tact can go a long way. I will say most lactivist are NOT like this, but there are some mean people out there.

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  6. There were certain people who tried to undermine my efforts to breastfeed my daughter, who is now 10 months old. Probably part of that reason is that I have cerebral palsy. But breastfeeding my baby is actually easier than bottle feeding my older daughter was. I wish I'd listened to myself then, but glad I listened to myself for this time. Many women can overcome challenges. I have, and I don't have the full use of my body! :)

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  7. I am one of those mothers feeling guilty! I did extended breastfeeding with both of my daughters. I am a doula and a certified lactation consultant too. Then my son was born. We had 5 weeks of breastfeeding and him being healthy...and then he dropped 3 pounds and was in the hospital failing to thrive. In the hospital he caught RSV and developed complications with that...right down to his kidneys starting to fail. All along I pumped and nursed and pumped and nursed and used the Supplemental Nursing System, etc. We did tests and had therapists and doctor after doctor trying to determine the cause for his sudden failure to thrive. My supply seemed adequate, but I took all the herbs and even domperidone, at the urging of my midwife. In the hospital my insurance covered the cost of donor milk. No satisfactory answer ever came, but I was determined to continue to give my son breastmilk, to use the SNS forever if I had to. I found a pediatrician who is a breastfeeding medicine specialist. I had loads of support and encouragement outside my home...and inside to a degree.

    For 8 months I pumped 8 hours a day to give my baby about 60-70% breastmilk and added formula to make up the difference because my insurance would not cover the cost of donor milk outside of the hospital. I used the SNS at every feeding. I was trapped in my house because my son was left with an immune disorder following the fight with RSV, et all. Taking him outside the home wasn't an option. Pumping and then feeding took up my entire day. My home was in complete disarray, nearly unsanitary. My family was eating meals made entirely of processed trash because I didn't have time to cook. And I wasn't getting THAT kind of support.

    The stress, I imagine, is what caused my supply to diminish little by little, though I continued to take blessed thistle, fenugreek, probiotics, domperidone, etc. Eventually my supply was only making up beteween 20 and 30% of my son's diet, and I was on the same pumping and feeding schedule and I made the decision to give it up when he was just 1 year old. He will be 3 this autumn. That decision has haunted me every single day. My breasts still ache when he cries. Some days I am distressed enough to cry with him, feeling so much loss for both of us. I literally grieve. I KNOW I did all I could. I KNOW I tried absolutely everything. I KNOW I had no choice but to at least supplement with formula all those months because it meant his very survival. I KNOW it, and still...I feel guilty. I don't know how that could be changed.

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  8. I wholeheartedly agree with Elly. I tried to breastfeed. I really did. Several nurses and two lactation consultants spent lots of time with my baby and I, trying to get him to latch for more than a few seconds. He just wouldn't latch. He screamed and cried and pushed away from the nipple. You can't imagine how this made me feel. And hearing him cry out of hunger... I just couldn't take it any longer. I tried to pump milk and feed it to him in a bottle, which I considered the next best thing to breastfeeding. Nothing came out. I kept trying, and eventually I was able to pump about an ounce of milk total after almost an hour of pumping (from both breasts combined). So my son was able to get a tiny bit of breastmilk for a little while. After about three weeks of this, my milk suddenly just dried up on its own, no matter how often I tried pumping. I took fenugreek too, and this didn't work.

    When I read blogs or whatever by breastfeeding moms that are very judgmental about formula feeding moms, this doesn't exactly make breastfeeding seem more appealing. It pushes us away and makes it more likely that we won't even TRY to breastfeed subsequent children. Moms who have been successful at breastfeeding should offer encouragement, advice and support, NOT judgement.

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  9. Burrowing, you should absolutely not feel guilty. You went above and beyond what most women would even consider doing. I think you are a wonderful mother and did a wonderful thing for your son...and the fact that you had to stop in the end, had to, is obvious. I don't think anyone could take that amount of pressure/stress/time commitment/physical commitment. You should NOT feel guilty! You did WONDERFUL.

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  10. I am still breastfeeding at 8.5 months. I am not a zealot. I understand that it doesn't work for everyone. It works well for us though. My baby enjoys it and I enjoy the closeness it provides us since I work outside of the home. I am blessed to work for an employer that accomodates my choice. Even with President Obama's initiative breastfeeding once you return to work remains a challenge. We shouldn't make anyone feel guilty, but we should support them and educate them. A percentage of women are unable to breastfeed, but some just give up out of frustration. That is incredibly unfortunate.

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  11. I had my daughter at 29 weeks. She had eatting issues. I pumped for as long as I could which was horrible and painful. Here I am trying to balance home and going to the NICU for three months and pumping. I was so stressed out I dried up before she came home. Honestly I hate the fact that I was made to feel guilty for not being able to breast feed. I would have continued to pump as I was actually getting anything. I had to thicken my daughter forumla or breast milk so she could keep it down. So I do believe in breast feeding if you can do it but I do not believe in guilt if you can not. There are times where you just can't. It would be nice to get support from other mother's and I felt alone a lot as my baby was different. I can say now that she is a very healthy 4 year old who is smart way behind her years and I have come to terms with it and I know that I did and still am doing the best I can for my daughter.

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  12. I definitly agree that shaming moms who formula feed is not going to fix the problem, bu the time they have something to feel guilty about, it's usually too late to go back to BFing. All shaming does is gives BFing moms a bad name. I tottky agree that the energy needs to go toward education before birth, support immediately after birth and an overall sense of normalcy. I think many women think that it's pretty common to have no milk come in, or difficulty latching. So they think since it's so common that must be the answer, even before the milk comes in, moms make the conclusion that they can't BF. Making women feel ashamed for smoking during pregnancy rarely prompts them to quit, I assume they figure by the time they have something to be ashamed of, the damage is done, or it's too hard to quit. So again the energy and focus shouldn't be on belittling moms who smoke, but provide more education and help to quit before conception and early on.
    The point I'm making is that shame or guilt is an afterthought. The best medicine is prevention.

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  13. Now, I'm a doula and very pro breast feeding, BUT, I also have tubular breast tissue and no amount of work can make me produce enough to feed a child-which is a HUGE sorrow in my life!

    Now, when I had my first son I worked and worked for that supply-- medications, herbs, water, pumping, SNS, Lact-Aid, co sleeping....everything....and one day I was at church after I finally had to stop and give my oldest the bottle, and this woman ( who Im sure is a breastfeeding advocate ;-) ) said,

    "you are killing your child, you should have worked harder!",

    So.....she had no idea that I would give my husbands left nut to have been able to produce, and instead made me feel awful.

    Since then, I've had 2 other kids, I KNOW I will never make enough-so instead I used a lact-aid filled with formula and I nurse and give my babies as much as I possible can!

    I think often as advocates for BF we forget how we can come off! I really don't think it's quite the same as smoking, or drinking, I think the lady honestly wants to "educate" me and "help" me....

    I find with being a doula Im open with my clients about my struggles and how even though I have to use formula I love every moment of BF my child-even if it can't be my own milk!

    I hope in my story they can see how important it is, and how much I would have loved to...but at the same time that I wont hate them if they can't, or think that they are undeducated if they don't succeed---because I have been there, and I have had those looks, and I know the silent sorrow.

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  14. The percentage of women who are actually unable to breastfeed is very low, that is women who are physically UNABLE to produce milk, less than 5% of women. Everything else can be corrected. Usually breastfeeding relationships are ended because of incorrect milk management.

    Elective breast surgeries should not be performed until after a woman has had children. I can say that this is certainly one of the reasons why some women have a low milk supply or CANNOT produce enough (some of those 5%) It is unethical, in my opinion, to perform a surgery that could prevent breastfeeding on an 18 year old without children. Just as it would be unethical to perform a vasectomy on an 18 year old without any children.

    Physicians, oh my, they are seemingly the MOST detrimental to breastfeeding relationships. I recently had a patient who's physician told her to introduce a pacifier at 2 weeks because her son suckling for comfort was actually counterproductive for her milk supply! Who TOLD HIM THAT?!?! He made it through medical school, doesn't he understand the elementary concept of supply and demand?

    Anyway, I try to normalize breastfeeding as much as I can to whomever I am around. I nurse discreetly but without a cover, anywhere that my 10 month old wants to eat. I talk about it, I bring it up. I make the women around comfortable with me nursing, and comfortable with talking about their experiences. And when people ask the question, "how long are you going to breastfeed for?" I smile and say "Oh he normally only eats about 4-5 minutes." And when Mom's say, I understand breastfeeding but when a kid is able to choose which breast they want or unbutton your blouse, that's when it's time to stop. And to that I smile and reply, "Well, I hope you child doesn't figure out how to open the refrigerator or cabinets, he/she'll certainly go hungry!"

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  15. When I had my first daughter, I was surprised at how hard it was to breastfeed her. I had watched my ewe give birth many times, and effortlessly feed her lambs (she just stood there while they nursed) and I rather expected it to be that easy for me. It wasn't. It took me an hour - a long, frustrating hour - to get my daughter latched for the first time. And for most of that hour, my midwife was standing right beside me, encouraging me, helping me, suggesting new positions for me or my daughter. During that first night, it was still very hard to breastfeed, but I was determined to breastfeed. At one point, I was so tired and frustrated that I was crying, and my husband woke up and began encouraging me as he had seen my midwife encourage me. It made a huge difference. I've now nursed both of our daughters with no problems after the first couple of days, and I LOVE breastfeeding. I'm grateful to my midwife and my husband for their support.

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  16. Thank you for this wonderful article. I struggled with my (tongue tied) son for 6 weeks until he finally learned to breast feed; we had his tongue clipped because he couldn't even suck at the beginning. No meds involved, since we had a homebirth. But I have a dear friend who nursed for 4 weeks, fine latch, but her son was failing to thrive because she literally had only about 1/2 ounce (pumping) per feeding. It is a miracle her son is okay. She tried everything. But I told her, her son just needs to eat and she is at peace with having to give formula (I gave her about 30 bags of my bm, but that only lasted about 2 weeks). Anyways. It's important to advocate, but some (most) situations are not simple. It hurts. My son (now 10 mths) bites me. There are complications. We should all be understanding, but also advocate during pregnancy, not during the struggle. http://amyelizabethsmith.wordpress.com/2010/10/10/my-breastfeeding-journey/

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  17. Miscommunication and misinformation are among the most frustrating breastfeeding issues. I read things like, "All this crap from breastfeeding nazis makes me wanna formula feed just to spite them." Do we see the occasional zealot who beats people over the head with it? Sure. But that isn't anything like the majority of us who just want mamas to give it a try with the best support she can find.

    I completely understand the feelings of insecurity and guilt over giving up breastfeeding, or not trying it at all. But maybe new mamas don't know that there is ALWAYS gonna be something that makes you feel guilty or question your choices in those early months.

    And women could do a lot better with being supportive of each other, no matter what. We're never going to get people to change their minds and see our side if we shame them and judge them for their choices. Although, admittedly, the gentle approach hasn't been all that successful for me.

    When my brother's wife was pregnant, I guess I just assumed that she would at least try breastfeeding and give it a chance before making a final decision. She had been around our mom, who breastfed three kids and was a leader of La Leche League. I figured my brother told her she could ask mom anything and get help with it if she wanted to try. After all, it can't hurt to see what it's like, right? Well, I wasn't surprised that she didn't end up breastfeeding, but I was very disappointed that she couldn't even give it a TRY. And this is a mama who says her babies are the center of her universe.

    By the time their second one came along, I again thought she'd try it. After all, a lot of us make "mistakes" with our first that we attempt to rectify with the new baby. Not only did she not try, she wouldn't even discuss it. And that seemed a real contradiction to her parenting style and love of her kids.

    So I don't know what the right way is. I think it's very subjective and depends on the mama and the people who educate and help her learn how to make it work. It also depends on social status, race, cultural traditions, religious beliefs, and a billion other factors. Whatever it takes, as long as we have women who are passionate about breastfeeding, we will have teachers and good information to share.

    In this internet age, the options and answers and support are at our fingertips. And that gives me endless optimism for the newest generations of breastfeeding moms. It's not perfect, but it's the best it's ever been!

    AHodges

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  18. The amount of milk a woman can pump is in now way indicative of her milk supply. I have a huge oversupply. At work I will pump 8-12oz in 10 min and can't get any more from the pump. At home I can pump that much and then nurse my baby to her satisfaction. According to the pump I am empty. But according to the baby and manual expression there is still milk. Many women can not pump,they simply produce no milk or very tiny amounts, so they need to be taught to manually express....again the responsibility of the healthcare provider to completely and accurately inform has not been met and yet another woman thinks she can not feed her baby.

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  19. As a mother who breastfed each of my two children for over 12 months and a grandmother who's daughter fed each of her three for well over 12 months this article is amazing and so accurate. I do not blame or believe in blame though a neighbour, who received the incorrect advice 30 years ago from her GP (a very caring but ill informed man) was brave enough with support from me, to give it one more shot regardless of that advice. She successfully and with much joy breastfeed the third of her three children, she had no success with the first two due primarily to poor advice. I wasn't anyone special, I just provided support and care which was all that was required. Breast feeding is absolutely the best, support is absolutely required but blame and guilt have no place in this mother-child relationship and it saddens me to hear it happening. It is often not because anyone blames but because those who are hearing seem to feel guilt or that they are being blamed. I so love to hear the success stories and I long to hear the support stories as that is what it is all about.

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  20. I completely agree with this. I do not have kids, but I am passionate that when I do, they will be provided with breastmilk, either mine or donor should something go wrong with my ability to produce, and that their health and happiness will be my main concern. My older sister is pregnant with her first, and she cannot get past the "sexual aspect" of breastfeeding, and she cannot breastfeed and continue to take her anti-depressants. So she has decided to do soy formula. Every argument I make falls on deaf ears because I do not have kids, therefore apparently my opinion is invalid. My mother, who feels guilty for being unable to breastfeed either of us (I was 8 weeks preemie and was fed through a tube; my sister wanted more than Mom was producing and Mom didn't have the support to stick it out so she switched to formula), is on my sister's side and falls back on the argument that "You girls had formula and you turned out fine." Which I hate. My sister is one of the least healthy people I know and always has been, and I have extremely fragile bones that are prone to stress fractures. I can't help but think that breastfeeding might have helped that a little. I know that when I do have kids, my decisions to keep boys intact, to breastfeed for a minimum of 2 years, and to not use chemical disposable diapers on my kids will be met with sarcasm and little support from my family. I love that I find groups like this all over the internet to supplement the lack of familial support. I am in school to be a social worker, and I plan to pass on my passion to women that I work with in the future. :)

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  21. I made every effort to breastfeed, I met with lactation consultants, talked to my OBGYN, the pediatrician, and got almost no help. My so called International board certified consultant was pretty much useless, handing me a nipple shield and saying this would solve my problems, even when I still struggled she just told me to keep using the shield but not to long, because it wasn't good for the baby. I did end up pumping exclusively and provided my child with that for the first five months until we went to half and half with formula, and finally full formula. I still feel guilty that I was unable to breastfeed. The lack of help I received was incredible.

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  22. The thing that makes me the most angry about feeding my second born is that I COULD have gotten help from so-called Attachment Parenting friends, but didn't. My son was a few weeks premature (not too big a deal) but then went into shock and crashed and had to spend a few days in the NICU. Still not as bad as many other stories I am hearing, but bad enough for us. I pumped, I tried to get him to latch, I must have wonky breasts because it was EXCRUCIATING. Just excruciating. (I had to stop nursing my first born at 7 months because he was getting more blood than milk-but that's another story) Then I started to have health troubles of my own...several surgeries...I couldn't even hold my 5 week old baby at one point without a lot of help. It was scary, to say the least. At that point, pumping was yielding next to nothing, and I was on big time meds so it was pump and dump anyway, but I tried to keep up a supply for when I COULD give him breast milk again. Complete failure. I felt like crap with every bottle of formula I fed him. And the thing that is the real kicker, the thing that makes me so angry that now, 2 years later, I am still fuming over it, is that I was "friends" with people who not only did extended nursing for their children, but DONATED MILK TO STRANGERS!!! That's great, I'm so glad you were willing to help out those other people, but I was your FRIEND and you never even offered to help the baby you knew. The baby you saw at play dates at the park, the baby I grieved over with ever artificial bottle of crap. If I had any inkling that people did things like milk sharing, I would have asked, (and did make jokes about needing a wet nurse) but the fact that they DID it, and didn't offer was just the most heinous crime to me. So I try not to feel guilty about making sure my child got nourishment (even a McDonald's hamburger is better than letting a kid go hungry), and when I hear of a friend having trouble nursing, I let her know that there IS such a thing as milk sharing. Maybe it will help her and her little one.

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  23. I am a mom who experienced great amounts of guilt. I struggled and struggled and struggled to nurse my son. I had good information and many people around me who were supportive. My hospital had an amazing LC who helped me out so much. My husband was an amazing help to me, cheering me on and creating an environment at home that allowed me to relax and spend all the time needed to nurse our son.

    We had almost every nursing issue there is, and after 9 months we ended up switching to formula, then at age 1 to milk. This still haunts me. I went to great lengths to hide the formula feeding from people in my life, and I experienced post-partum depression when I stopped nursing. If I could go back and do it all over again, i would do things differently. But I can't and I have to be proud of the choices I made, knowing I was doing what I felt was best at the time.

    I recently wrote about our struggles here: http://thismummaslife.wordpress.com/2012/04/25/my-breastfeeding-and-formula-story/ in the hopes that my story might help other moms who had similar struggles.

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  24. My first daughter was 8 weeks prem and has severe lip and tongue tie. She also has severe cerebral palsy. I wanted so badly to feed her myself. I tried everything going. Whilst she was in hospital I pumped, I had little to pump. Once she could suck a little I tried feeding her as often as I could. It was so stressful, so heartbreaking. When she was discharged I was feeding her but due to her mouth issues just wasn't getting the milk she needed and being so tiny on discharge (4lb) got too tired to suck. We had to top her up with formula to keep her alive. As time went on she got more and more frustrated about not getting enough milk and finally at 5 1/2 months refused to even try and feed from me so was then formula fed. I feel so guilty about not giving her the best and not being able to pump enough ongoing. To top it off I had severe post natal depression. We had second daughter who was term, she has bf exclusively and is still feeding now at 2.5. I wish there had been clearer advice from the hospital and staff. I found a local breastfeeding support team after we came home and they were excellent but it's too little too late. The hospital staff need educating and to all be singing off the same hymn sheet!

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