Author: B. Jody Segrave-Daly, RN, IBCLC

I Am Celebrating 20 Months Of Combo-Feeding- Despite All Of The Lies Taught By My Hospital LC

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Today, after 20 months of combination feeding, I gave my son his last bottle of milkies. I wasn’t able to keep my supply up after I stopped pumping at work. But I feel so proud of myself. 20 months of combo feeding. I made it 20 months!

When my son was born, I expressed concern about possible nursing problems because of my history of hormonal issues—but I was repeatedly dismissed. He lost 10% of his weight in the hospital. I was told that supplementing would basically end my breastfeeding relationship. That it would hurt my supply. I was instructed not to pump. I was told about tiny infant stomach sizes and that the constant crying and nursing was normal. I was told not to worry about insufficient feeding until day five. Well, by day five my son had lost 13% of his weight. That’s when we brought him back to the hospital.

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After a weighted feed, we found that my milk hadn’t come in and that I was barely producing any colostrum. My son’s gums and tongue were dry. The nurse admitted he was a day away from hospitalization. She was one of the nurses I called in a panic after we got home. She taught the breastfeeding class and parenting class I attended before my son was born. She visited our room at the hospital several times after the birth. And she simply believed the lie that under supply is rare and that tummy size are tiny. I found out recently that the hospital is still teaching this. That same nurse who, after finally acknowledging my son’s drastic weight loss and recognizing that I actually did have supply issues, developed a triple feeding plan for us. It wasn’t until ten days after my son was born that my milk finally came in.

I was devastated to find out that I couldn’t exclusively breastfeed my son. And I was angry that my risk factors for low supply were ignored. Angry that despite my son’s obvious distress and significant weight loss, my concerns were dismissed. Angry that I was instructed that just one bottle would ruin any chance I had at breastfeeding.

I am now proud that I made it 20 months. 20 long months of combo feeding a child with dairy and soy allergies—despite being told my odds of doing so were pretty much impossible. I shouldn’t be the exception. Women are often told that long-term combination feeding just isn’t possible. It is possible for many of us, but not all of us. I know too many women who—like the Academy of Breastfeeding Medicine is finally acknowledging—believe that one bottle means “the horse is out of the barn” and that they might as well stop breastfeeding. It doesn’t need to be this way.

Sometimes I am asked, “If you truly believe formula is equal to breast milk, then why did you keep nursing despite your struggles?” To that I say, it’s what I wanted to do; it’s something I love doing. And that is good enough. I don’t need everyone to be exactly like me and to find meaning in what I love. I don’t need to feel superior. I don’t need to justify why I continued to nurse by denigrating someone else’s decision or inability to not do the same. One does not cheapen the other. Fed is best!

 

To learn how to prevent newborn feeding complications, please go to the following:

  • Resources for Parents – information on how to supplement while maintaining the breastfeeding relationship and how to closely monitor infants for underfeeding
  • Feeding Plan – a way to communicate your feeding preferences to your health providers
  • Weighing Protocol – a way to monitor your baby’s growth and prevent dehydration

HOW YOU CAN SUPPORT FED IS BEST

There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Join the Fed is Best Volunteer group to help us reach Obstetric Health Providers to advocate for counseling of new mothers on the importance of safe infant feeding.
  2. Make a donation to the Fed is Best Foundation. We are using funds from donations to cover the cost of our website, our social media ads, our printing and mailing costs to reach health providers and hospitals. We do not accept donations from breast- or formula-feeding companies and 100% of your donations go toward these operational costs. All the work of the Foundation is achieved via the pro bono and volunteer work of its supporters.
  3. Share the stories and the message of the Fed is Best Foundation through word-of-mouth, by posting on your social media page and by sending our resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. Write your local elected officials about what is happening to newborn babies in hospitals and ask for legal protection of newborn babies from underfeeding and of mother’s rights to honest informed consent on the risks of insufficient feeding of breastfed babies.
  7. Send us your stories. Share with us your successes, your struggles and every thing in between. Every story saves another child from experiencing the same and teaches another mom how to safely feed her baby. Every voice contributes to change.
  8. Send us messages of support. We work every single day to make infant feeding safe and supportive of every mother and child.  Your messages of support keep us all going.
  9. Shop and Fed is Best Foundation will earn cash back! We hope to develop our online safe infant feeding classes with these funds.
  10. If you need support, we have a private support group– Join

Thank you so much from the Founders of the Fed is Best Foundation!

 

The Medical Professionals At The University Of North Carolina Allowed My Baby To Starve

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I wish I had done more research about hospital exclusive breastfeeding policies before my son was born. I’m a registered nurse with a Bachelor of Science in Nursing, but my maternity and pediatric experience was limited to nursing school. I was always on the fence about breastfeeding—I said that it was my goal but that we would see, so I hadn’t bought in to the narrative of “Breast is Best”. Still, I expected the medical professionals at the hospital where my son was born to tell me if they thought my baby was starving while attempting to exclusively breastfeed.

I delivered at the University of North Carolina Hospital, a top medical center. I felt reassured that I was in great hands. They were called “baby friendly” after all. I didn’t look into what that meant, and I thought I was well prepared. I was induced after being diagnosed with preeclampsia, but, thankfully, it was caught very early. I was two days shy of forty weeks. I had a long labor, followed by a C-section due to my son’s position. I’m also thirty-five years old, so by all accounts, I was high risk. It also meant I was at risk for late or low breast milk supply.

First, my husband and I were laughed at when we said we planned to use the nursery. Thank God for my husband—he did the baby care and brought our son to me while I was bedridden so that I could breastfeed. I was told the latch was great. I felt confident things were going well. But my son was inconsolable by the time he was forty-eight hours old.

My baby nursed a lot. I was told everything was normal and he was “cluster feeding”. Later, as my training came back to me, I never remembered cluster feeding being a thing. During my training, babies were supplemented when mothers didn’t have enough colostrum babies were supplemented and were taken to the nursery if a parent requested. I went to Duke University, and I rotated through WakeMed. These are excellent hospital systems.ClusterFeeding (1)

I was concerned about my baby’s very dry lips, and I was told not to worry. I asked about the few wet diapers that my son produced. Dismissed. I trusted that the medical professionals had my and my baby’s best interests at heart. I asked if maybe my milk hadn’t come in, and I was told all is well. We went home on the evening of the third day after birth, and my baby was looking jaundiced. He cried a lot, but nursing helped soothe him from crying–sometimes.

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We saw the pediatrician the next day, and I found out my son had lost twelve percent of his weight since birth. We did a weighted feed in the doctor’s office, and his weight before and after nursing were exactly the same. My pediatrician, my husband, and I had a conversation about giving the baby formula. My husband and I had already decided we were going to supplement with formula before we saw the pediatrician, and our son’s weight loss confirmed that we were right to do so. We did not hesitate, and he had his first bottle minutes after we got home. He sucked it down, and he was finally calm and content for the first time in days. I tried to pump and barely got anything. My milk eventually came in, but we continue to supplement. His weight rebounded, and he gained well, but I was beside myself knowing that my baby had starved. It shouldn’t have come to that.

I am upset that the nurses (most of whom were fairly new) don’t know the difference between true cluster feeding and starvation. I am livid that no one even suggested formula.

 

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Can Redefining Infant Feeding Goals Enable Families to Feel Confident About How They Nourish Their Babies?

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Written by Dr. Ruth Ann Harpur, Clinical Psychologist

Current guidelines from the World Health Organization (WHO) encourage women to exclusively breastfeed their babies for six months and to continue to breastfeed, alongside introducing solid foods, throughout the first year and beyond. These guidelines are adopted by major health authorities throughout the world, and millions of pregnant women are unilaterally encouraged to follow them.

However, the WHO standard is clearly not attainable for all women, as is borne out by the data. Despite the fact that most women initiate breastfeeding, only a minority will attain the six-month standard. For example, in the UK, only seventeen percent of women are exclusively breastfeeding at three months, and by six months, only thirty-four percent of babies are receiving any breast milk at all (Infant Feeding Survey 2010). In the US, 44 percent of babies are exclusively breastfed at 3 months, and at 6 months, 22 percent of babies are exclusively breastfed.

Current research shows that women who intend to breastfeed but subsequently turn to formula, are at particularly high risk for postnatal depression (Borra et al., 2015). Interestingly, the paper also indicates that women who don’t intend to breastfeed, but who breastfeed anyway, are also at increased risk for postnatal depression.

Whatever the reasons women turn to formula, studies examining the experiences of these women consistently report feelings of guilt, anger, worry, uncertainty, and a sense of failure. At the same time, these mothers also reported a sense of relief when formula was introduced  (Lakshman, Ogilvie, & Ong, 2009).

We do not yet have a solid evidence-based understanding of why this link exists, as the relationship between feeding experiences and postnatal mental health issues is likely to be complex and different for different women. However, one thing is for sure, there is a huge human and emotional cost for many women and their families when breastfeeding doesn’t work out. Stories such as this one, Postpartum & Motherhood: Battle Wounds & Badge of Honour which Masumé has generously shared, speak to these costs, show that these women are not alone, and, thankfully, give hope that recovery is possible and motherhood can be fully enjoyed and embraced with or without breast milk.

However, I think we need to ask ourselves, as a society, and especially for those of us who work in healthcare, if there is a different way. My experience as a mother and as a clinical psychologist has led me to believe that our current definition of “success” and “failure” is a large contributor to the psychological distress many mothers experience when they are unable to realize their hopes for how they feed their babies.

First, I think we need to recognize that the WHO standards are clearly not attainable or safe for all women and babies. Some newborn babies experience serious feeding-related complications in an attempt to reach this exclusive breastfeeding standard. Evidence shows up to one in five new mothers will experience delayed onset of mature milk, while an unknown amount mothers never establish lactation. Pushing exclusive breastfeeding in the face of these realities puts newborns at risk for feeding-related complications ranging from hyperbilirubinemia, hypoglycemia to acute dehydration, and even death.  For some babies, supplementation is literally life-saving, and yet their mothers still feel a sense of failure for not achieving the prescribed breastfeeding standard.

I propose we collectively redefine successful feeding to take into account the unique needs of each mother, baby, and family. Rather than focusing on the feeding process, we should set goals that prioritize healthy outcomes for families and which are attainable through all available safe feeding methods.

I was particularly inspired to write this article because of the many mothers within The Fed is Best Foundation’s private support community who have experienced difficulties while breastfeeding their first baby, and are confused and torn as to whether or not to try again with a second child. As an expert in mental health, I feel we must help parents set realistic goals that allow them to feel positive, confident, and supported in the process of nourishing their baby.

1) The first and foremost healthy and attainable feeding goal is a fully nourished, thriving, and satisfied baby.

If your feeding method of choice isn’t keeping the baby fully nourished, then it’s time to do something about it. Maybe you started out breastfeeding, but the baby is showing signs of hunger. This can be assessed using The Fed Is Best Foundation’s HUNGRY guidelines. If we revise the unrealistic goal of exclusive breastfeeding for every woman to the goal of a nutritionally satisfied baby, then making the informed choice to supplement with expressed breast milk or formula becomes a positive solution to a problem instead of a negative indication of failure.

That said, the act of feeding a baby provides more than physical nourishment. It also brings comfort, family, community, sharing, and bonding, and perhaps never more so than when nourishing a newborn eight to twelve times per day.

2) This brings us to the second healthy and attainable feeding goal: for mother and baby to feed in comfort.

There’s no getting around it. Some babies take to breastfeeding like a duck to water. Others need a little help in learning to suck effectively. Mothers need time and support to learn breastfeeding positions that work both for themselves and their baby. Some babies experience gas and reflux, and those babies may need some help to feed comfortably. Sometimes, no matter how much support is given, a mother will experience breastfeeding as painful, or a baby will be unable to attain a good enough latch to suckle effectively.

If breastfeeding is not comfortable for you, as a mother, then take action. Get help with latch and positioning, and seek medical advice for possible conditions that may interfere with comfort while breastfeeding.

Sadly, some women find breastfeeding so uncomfortable that they begin to dread feeding sessions. Preserving through constant pain and discomfort helps absolutely nobody and may threaten the bond between mother and baby. This is an urgent reason to re-evaluate feeding methods. A baby needs to be fed with love and comfort, not through a mother’s tears or gritted teeth.

For instance, if a mother finds direct breastfeeding too mentally or physically painful to continue, but still wants to provide some breast milk, then expressing milk may be an option. Pumping can work for some women, or it can become too emotionally and physically demanding for others. Time spent with a mechanical pump is time in which a mother is unable to rest and possibly unable to spend time with her baby or other children. If pumping doesn’t work for a particular woman or family, then, sometimes, the best thing is to let go of that goal without guilt.

3) The third healthy and attainable feeding goal is for the mother to be fully present and emotionally available to the baby, older children, and/or partners.

This really does come down to individual families and what they need, given their particular circumstances. However, being emotionally available to the family unit requires at least a reasonable amount of sleep, management of physical pain, and treatment of any physical or mental health conditions.

For some women, breastfeeding is a very positive and fulfilling experience that enhances family life. For others, it has a negative and draining effect on the family dynamic for a variety of reasons. More individualized approaches are beneficial, as any number of issues may arise for which a re-evaluation of the goals is required in order to maintain everyone’s emotional and physical wellness.

For example, if a mother feels her mental health is impacted by sleep deprivation, a partner can give a night time bottle feed to allow mum to get some much-needed rest. I have worked with women for whom a full night’s sleep is essential for that mother’s mental health. Under such circumstances, a partner helping with night feeds becomes vitally important. Breastfeeding may still be possible with expressed milk or supplementary formula given at night, however, we should keep in mind that the goal is not exclusive breastfeeding, but rather, a happy and functional family.

Other mothers wish to breastfeed, but then find that their mental or physical health must take priority. Sometimes the best thing is for a mother to fully formula feed in order to take medication that is incompatible with breastfeeding. This is an entirely reasonable thing to do. A mothers’ physical and mental health matters to them, to their partners, and to their children. Nobody benefits from a mother who is suffering, least of all a baby who needs, above all else, to feel loved and enjoyed by their family.

Each mother and each family needs to consider their own circumstances and determine what is a priority for them.

I encourage parents to set aside the WHO recommendations, and instead take up these three feeding goals of a fully physically nourished baby, a comfortable feeding relationship, and a mother that feels emotionally available for her family. These goals are attainable regardless of which (clinically safe) method you use to get there.

By changing how we define successful infant feeding, we can empower families to feel positive and confident about how they nourish their babies, and we may prevent the psychological stress which results when things don’t go according to plan.

We must recognize that a feeding method is successful when a mother is comfortable and relaxed, and she is confident her baby is nourished. Successful feeding is a fully fed baby who knows he or she is loved and nourished, physically and emotionally, in a calm, healthy, and happy family.

RuthAnn

Ruth Ann holds a Ph.D. in developmental psychology from the University of Southampton and a Doctorate in Clinical Psychology from the University of East Anglia. After unexpectedly turning to formula to feed her daughter, she came across The Fed is Best Foundation and was moved and disturbed by the level of psychological distress, depression, anxiety, and trauma which many women reaching out to The Foundation are experiencing. An expert in mental health, she is passionate about empowering women to confidently nourish themselves and their baby, whatever their feeding method.

HOW YOU CAN SUPPORT FED IS BEST

There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Fundraising Group.    Please send an email to [email protected]  if you are interested in joining any of our volunteer groups. 
  2. If you need infant feeding support, we have a private support group– Join us here.
  3. If you or your baby were harmed from complications of insufficient breastfeeding please send a message to [email protected] 
  4. Make a donation to the Fed is Best Foundation. We are using funds from donations to cover the cost of our website, our social media ads, our printing, and mailing costs to reach health providers and hospitals. We do not accept donations from breast- or formula-feeding companies and 100% of your donations go toward these operational costs. All the work of the Foundation is achieved via the pro bono and volunteer work of its supporters.
  5. Sign our petition!  Help us reach our policymakers, and drive change at a global level. Help us stand up for the lives of millions of infants who deserve a fighting chance.   Sign the Fed is Best Petition at Change.org  today, and share it with others.
  6. Share the stories and the message of the Fed is Best Foundation through word-of-mouth, by posting on your social media page, and by sending our FREE infant feeding educational resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  7. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write to them about feeding complications your child may have experienced.
  8. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  9. Write to your local elected officials about what is happening to newborn babies in hospitals and ask for the legal protection of newborn babies from underfeeding and of mother’s rights to honest informed consent on the risks of insufficient feeding of breastfed babies.
  10. Send us your stories. Share with us your successes, your struggles and everything in between. Every story saves another child from experiencing the same and teaches another mom how to safely feed her baby. Every voice contributes to change.
  11. Send us messages of support. We work every single day to make infant feeding safe and supportive of every mother and child.  Your messages of support keep us all going.
  12.  Shop at Amazon Smile and Amazon donates to Fed Is Best Foundation.

Or simply send us a message to find out how you can help make a difference with new ideas!

For any urgent messages or questions about infant feeding, please do not leave a message on this page as it will not get to us immediately. Instead, please email [email protected].

 Thank you and we look forward to hearing from you!

Click here to join us!

 

 

 

I Was Producing Drops Of Breastmilk And My IBCLC Denied My Request To Supplement My Baby With Formula.

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My son, Harrison, was born 8 weeks ago at a Hospital in Fredericksburg, Va. He decided it was time to meet mom and dad two weeks before his due date and was born via C-section after 22 hours of labor. At birth he was 8 pounds 2 ounces and 21 1/2 inches long.

Before giving birth, my husband and I took every class the hospital offered. We took the two hour infant CPR class, nine hour childbirth class, three hour bringing home baby class, and three hour breastfeeding class. As first-time parents, we were filled with nervous excitement. Harrison is our miracle baby. I went through fertility treatments because PCOS and hyperthyroidism made it impossible for me to get pregnant without medical intervention.

After the unplanned C-section I was in no shape to help with Harrison’s care. The sweet nurses spent time with my husband and showed him how to diaper and swaddle. When it came time to breastfeed, Harrison latched right away and fell asleep soon after.

This continued for 12 hours and I started to become concerned. A lactation consultant was making the rounds and stopped in to check on us. I told her I didn’t think Harrison was actually eating or that I was producing anything. She specifically asked if I had PCOS and said that having that condition could affect my milk production. A few minutes later, she sent in another consultant to hook me up to a pump.

I pumped for 20 minutes and got droplets. The other consultant assured me this was enough to feed my eight pound baby. This was Thursday.

On Friday afternoon my husband left the hospital to install the car seat, set up the bassinet, and buy a few things at Target. I was left alone for the first time since Harrison’s birth. Harrison was born at 10:35 a.m. on Wednesday, so by midday on Friday he was really starting to get hungry. Knowing I wasn’t producing milk and that my baby hadn’t eaten, I started to cry—a lot. A nurse came in and asked what was going on. I explained that I didn’t think Harrison was getting any milk. She sent in a lactation consultant.

I asked the lactation consultant for formula to supplement, but she didn’t give me any. She said to keep trying to breastfeed because I was able to produce droplets the day before and she put me on a pumping regimen.

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We left the hospital Saturday afternoon. Harrison was jaundiced and had lost 10% of his birth weight.  He hadn’t eaten yet in his life and I still had no milk. We got home and I continued to breastfeed him every two hours. He’d latch, then fall asleep. My husband would try to wake him up and then hand him back to me to feed. The cycle would continue for an hour. Then we took an hour off and tried it again. At this point Harrison didn’t want to latch any more.

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My Inability to Exclusively Breastfeed Was a Constant Destructive Force in My Life After My Son’s Birth – I Had a Suicide Plan

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Written by: Allison Stillwell Young, RN, BSN, Graduate Student and Team leader of the fed is best foundation mental health advocacy team

is an oncology nurse at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. A graduate of Belmont University, she has spent her entire nursing career between research oncology and behavioral health. After the birth of her older son, she developed anxiety and depression directly related to difficulties she experienced with breastfeeding including low supply and feeding judgment. She discovered Fed Is Best during her recovery from PPD/A and found the Foundation to be indispensable when feeding her younger son. As a researcher and mother living with chronic mental illness, she believes that the treatment for perinatal mood disorders should have evidence basis, and she therefore co founded a large, online pro-science peer support group for those experiencing PMADs in 2016. She sits on the board for the Tennessee chapter of Postpartum Support International and functions as one of their state support coordinators for the Midstate.

I had our second child last Monday. Since that evening, we’ve been supplementing with formula due to the fact that I have insufficient glandular tissue (IGT) and I am not physically able to exclusively breastfeed. Yesterday, our older son wanted to help feed his baby brother a bottle and, while he was helping, my husband took this picture of them that I loved. I made it my profile picture, and the fact that I felt comfortable posting a picture of my sons with a bottle really shows a sea change in my feelings about infant feeding. Because of that picture, I wanted to post my story about lactivism, which is extremist exclusive breastfeeding advocacy, and how it affected my postpartum mental health after my older son’s birth. It’s pretty long, but I hope my story illuminates how The Fed is Best Foundations provides important support for new mothers. Continue reading →