The New Seven Letter “F” Word

As soon as the word “formula” rolls off your tongue and leaves your mouth for everyone to hear, uncomfortable silence occurs. Parents are reluctant to talk about or admit freely they feed their babies infant formula. Most are suffering from the deeply entrenched shame and judgment that is associated with formula feeding; they have experienced it first hand in countless social media parenting groups, from friends, their health care professionals, WIC offices, and even in their hospitals.

How did we get to the place where talking about infant formula is profoundly divisive, shameful, and anxiety provoking for parents? 

 Let’s face it, infant FORMULA is the new seven letter F word. The scarlet letter F.  FAILURE. 

I frequently receive questions from anxious parents who want to know if everything they have been told about formula feeding is true. They often convey feelings of failing their baby and question their worth as a parent who could not provide exclusive human milk. The emotional suffering they carry is the foremost reason why I wanted to write about the topic of infant formula shaming.

Is the current breastfeeding advocacy responsible?

One of the problems of our current breastfeeding promotion is it has characterized infant formula as a substandard or dangerous form of nutrition, by providing false and misleading claims. The Just One Bottle campaign was intended to persuade parents to avoid formula citing risks of formula that are mostly speculative. But the message of this campaign continues to be taught to parents daily. Promoting false and confusing medical information is grossly unprofessional, unethical, and reckless, as this false information has put infants’ and mothers’ lives at risk.

Avery’s life was one of them. She writes: I had more than enough support for breastfeeding, but very little support for switching to formula when I knew it was best for my own mental health, and for my son. I can’t fathom telling a mom she’d better breastfeed or might as well be dead. But I was told this—and I believed them. I remember being in the basement bathroom and looking up at the tiny window and thinking that would be the last thing I saw before I died. I was ready to go. 

Let’s take a look at an example of exaggerated and false formula feeding information:

After reading this pamphlet from WIC, I can understand why parents are panicking. The formula risk brochure is grossly inaccurate and false and specifically says:

40–50% will develop asthma 

Greater chance of dying from SIDS

40% are likely to be obese

More likely to get leukemia and other cancers

Higher risk of dying from diarrhea and lung infections

This educational pamphlet is one example of what parents receive about formula feeding risks from WIC, in California. Up to 50 percent of US families receive nutritional benefits for their babies from WIC and will receive similar education.

This is an example of how formula is described as junk food by a lactation consultant  

 

 

Sara writes : The main reason I used formula was that I didn’t make enough breast milk, and my daughter was starving. They always leave that one off when they lie to women about how “everyone can breastfeed.” When people say fed is minimum or formula is junk food, they make me feel ashamed that I have a medical condition, which is so messed up. If I had continued to exclusively breastfeed, my daughter would be dead. Formula saved her life. But any time I bring this up, I get told I didn’t try hard enough, or I didn’t actually have a low supply. It’s ableist and abusive.

Human milk is depicted as magical

Social media has elevated the status of human milk from desirable nutrition for babies into pure magic! Human milk can cure everything they say. A Google search yields countless treatments using human milk to cure eye infections, stretch marks, ear infections, diaper rash, cancer, and even COVID. But it can’t and doesn’t. 

Human milk doesn’t have to be a magical elixir to be valuable. Do you know what is magical? Inclusive infant feeding support free of shame and judgment. And oh, a 6 month paid maternity leave.

However, shaming infant formula is oh so easy. Shaming infant formula is the easy way out.  It’s cruel to shame infant formula when parents are unable to push through the barriers that exist. The decision between breastfeeding and formula feeding is increasingly complicated by the barriers that exist in the United States. In fact, many times a mother doesn’t have a choice whether she can exclusively breastfeed for 6 months. We need to remove the many barriers FIRST before breastfeeding promotion saddles parents with the burden of exclusive breastfeeding, while receiving abysmal support. But formula shaming is so much easier.

 

 

This is an example of what formula shaming does.

Laura writes:  At first, I felt like a total failure and could not understand why my breasts would not do what they were supposed to. I would sob as I fed her formula. But over time I saw how much she was thriving and I started to forgive myself. I truly believe supplementing and then exclusively formula feeding saved me from hurting myself and allowed me finally to love my baby.

In the US alone, 75% of babies will receive infant formula before the first 6 months of life.  Parents who are formula feeding require education about how to safely prepare and feed their babies formula, during a period of time when their brain and body are rapidly growing, when formula is their sole source of nutrition. Formula feeding parents deserve to be treated with respect and without any kind of shame or judgment.

Did you know there are no unbiased educational resources for formula feeding parents readily available like there are for breast/chestfeeding parents? Not. one. Parents are forced to figure out how to formula feed their babies all on their own, searching the web for self-proclaimed formula experts, or using formula industry–created resources. 

The demonizing of the F word has now driven formula feeding parents who are seeking support and education straight into the arms of Big Formula!

Just this week, a study tells us that “It is important to understand the messages caregivers are receiving directly from formula companies, whose websites are targeting pregnant women and new parents with marketing claims disguised as feeding advice and support.”

The study, led by researchers at the NYU School of Global Public Health and published in the journal Public Health Nutrition, is the first to compare information and portrayals of breastfeeding with infant formula feeding on manufacturer websites directed at U.S. consumers.

This leaves a significant number of parents who are being supported only by formula companies. This is a problem, not only for exclusively formula feeding families, but also for those who want to keep breastfeeding while also adding some formula into their routine. While parents have access to the experience and insight of their pediatricians, well-baby check ups are relatively brief and infrequent. Facing a whole grocery store aisle filled with different brands and types of formula, and unstandardized prices per ounce, parents often feel paralyzed and helpless. Formula companies thrive on this confusion, because it enables them to sway parents towards their brand and charge more money for attributes that have not been proven to be necessary for infant health. This is especially problematic for WIC recipients. Since WIC typically provides only one brand of formula in quantities that are not enough to fully meet infants’ needs, parents are often under the impression that they must buy more of the same brand, instead of the equally nutritious generic equivalent.

Parents often ask me why infant formula is despised by breastfeeding zealots and I wish I had an answer for them. Is it because they hate Nestlé and formula company marketing tactics? I get it. I do. I have no love for Big Formula and their ruthless tactics to sell their product. The difference between me and them is that I don’t hate their product and would never, ever call it substandard nutrition—because it isn’t. 

We can easily support breastfeeding while supporting formula feeding parents. I have done this every day of my professional life for the past 30 years. 

Silence and shame have no place in health care, and I encourage all health care professionals to talk about infant formula, so that parents can trust you with their questions to keep their babies safe. Otherwise, they will resort to finding answers to their questions by unqualified people or those with a profit motive. I encourage parents to talk about formula too, because there is nothing shameful about feeding your babies with a safe, healthy, scientifically formulated milk. 

Stay tuned as I begin my blogging series about safe infant formula feeding in an unbiased manner. I will be interviewing pediatricians, neonatologists, and food scientists to talk about infant formula, and giving you accurate information straight from the experts.

Jody Segrave-Daly, MS, RN, IBCLC

If you need infant feeding support, please join us here.


An Evaluation Of The Real Benefits And Risks Of Exclusive Breastfeeding.

Breastfeeding Benefits: The Real, the Imagined, and the Exaggerated

The Shaming Began In My Hospital Breastfeeding Course And Never Stopped

Is Breast Milk Stealing The Spotlight Of A Novel Anti-Tumor Compound?

The Process of Healing from Infant Feeding Trauma, Guilt, and Shame: When You Wanted to Breastfeed, but Couldn’t

I Attempted Suicide From The Pressure Of Breast Is Best

I Was Having Suicidal Thoughts Because I Was Shamed For Not Making Enough Breast Milk For My Baby

Dear Chrissy Teigen, You Are Right; We Need To Destigmatize Formula Feeding Our Babies

What Happens When Mothers Are Told Being Fed Is The Bare Minimum?

I No Longer Judge Other Mothers; My Breastfeeding Challenges Have Absolutely Changed Me As a Mom, a Woman, And a Friend

 

 

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My Breastfed Baby Starved While Under The Care Of Health Professionals For 5 Weeks

My beautiful baby girl Mary-Kate was delivered by emergency c-section, and although there were complications during labor, she was healthy on arrival. Having done a bit of research and listened to the advice of professionals, as well as the threat of the global pandemic posing a risk, I decided I would breastfeed my daughter, to provide her with passive antibodies for COVID-19 from my milk.

I began exclusively breastfeeding in the hospital and the midwife said Mary-Kate had the perfect latch. I loved being a mummy, I could not stop looking at this beautiful little human me and my partner had created, but Mary-Kate was becoming increasingly unsettled. She was almost always attached to my breast and would fall asleep soon after latching on. I spoke to the health visitors, and we were told her crying was colic.  We began giving Mary-Kate lots of colic-type remedies. 

Each time somebody came to weigh her whether it be the GP, HV, or Midwife, Mary-Kate was not gaining and was in fact losing weight. I could not understand, because she was ALWAYS feeding. Nobody seemed alarmed by this. I was told to just keep trying, she might be a ‘slow starter’. Never once did they check to see what my milk supply was or how much she was getting. The professionals would leave, and I would carry on as normal. Baby attached to the breast, me trying to maintain some sort of order in the home, taking care of my personal needs and sleep. Mary-Kate would just cry and cry and cry unless asleep at my breast.  I was exhausted, I was falling asleep whilst holding my baby and I knew this presented its own risks.  Continue reading

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Why Fed Is Best: From One Therapist’s Point Of View

Written by Sarah Edge

I am a Counsellor Psychotherapist, specialising in postnatal mental health in the United Kingdom. I am also a Mum of two small children. I recently wrote a guest blog on “The Process of Healing From Infant Feeding Trauma, Guilt, and Shame: When You Wanted To Breastfeed and Couldn’t” for the Fed is Best Foundation, and when I was asked to write again, I jumped at the chance. In this piece, I aim to examine the Fed is Best message through my therapist lens and discuss why the Fed is Best message is an essential part of healing and recovery. 

It is well known amongst those in the psychology field, whether it be researchers, psychologists, or therapists, that people are often drawn to study and work in a field where they have personal experience. The well-regarded and highly accomplished trauma academic Bessel Van Der Kolk has described his own research as “self-search.” And most have heard of the phrase “the wounded healer.” I am no different. I became interested in working therapeutically with postnatal mental health and infant feeding guilt due to my own experience of breastfeeding difficulties.

I personally have a complicated and emotional relationship with infant feeding. I experienced formula feeding my firstborn and breastfeeding with my second child. I have personally undergone my own therapy and recovery, meaning I am now able to work safely and supportively with other women experiencing psychological distress compounded by, or sometimes caused by, their infant feeding experiences. But that’s not to say my heart doesn’t ache when I hear a mother shares her raw and moving story of when breastfeeding didn’t work out. Continue reading

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The Process of Healing from Infant Feeding Trauma, Guilt, and Shame: When You Wanted to Breastfeed, but Couldn’t

My name is Sarah Edge, and I am a counsellor psychotherapist and mum of two. After my experience with breastfeeding trauma, guilt, and shame, and the associated decline in my mental health after the birth of my son, I was motivated to start my own practice specialising in postnatal mental health. 

I suspect that most of you reading this are doing so because you have your own experience of infant feeding guilt or trauma, where breastfeeding didn’t work out how you had planned. My personal story is a tale as old as time. My son was born late preterm, healthy but sleepy and unable to latch. He developed significant jaundice and low blood sugars, resulting in us returning to the hospital, and him being admitted onto the children’s ward at five days old.

I tried everything to breastfeed: nipple shields, continuous pumping, cup feeding expressed breast milk, triple feeding, lactation consultants, and infant feeding professionals. I had alarms set every 90 minutes to feed my son, and I kept this up for almost two weeks without any results. His feeding consultant then prescribed him formula milk, and he began to thrive. He was happy and healthy, and we returned home to start our lives as a family of three, this time formula feeding him. 

My baby was finally thriving but I was not. I was left with so much sadness, jealousy, disappointment, and animosity towards breastfeeding. World Breastfeeding Week was unbearable, as the social media pages were flooded with beautiful photos of babies at breast, and seeing other women breastfeeding sparked this intense and animalistic jealousy I had never felt before. 

So why was I left with all this sadness?

 

Sadness is an emotional pain that is associated with feelings of loss, sorrow, depression, grief, guilt, disappointment, shame, despair, helplessness, fear, and disadvantage.  It can be difficult to shake and needs to be processed.

 

I was personally experiencing grief. I had suffered a loss. Breastfeeding was important to me, and my feelings were—and are—absolutely valid. 

No matter the reasons you could not breastfeed—and there are countless—you are allowed to mourn the loss of breastfeeding. Just because your baby is thriving without breastmilk doesn’t mean you don’t deserve to grieve or ask for support or comfort, especially if healing has been difficult. 

Continue reading

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Dear Chrissy Teigen, You Are Right; We Need To Destigmatize Formula Feeding Our Babies

Dear Chrissy Teigen,

Thank you for your Twitter post raising the very important topic of stress, guilt, and sadness when a breastfeeding mother experiences low milk production.  

I could feel the deep despair you expressed through your words because I have supported thousands of mothers, just like you, who felt tremendous guilt and stress when they tried their best to make enough milk.

Can I emphatically tell you something? You and your body did not “fail” with making enough milk. You were failed by the current breastfeeding education and guidelines, which don’t fully inform mothers about their biological and psychosocial risk factors for low milk supply. Instead, parents are taught that every mother can make enough breast milk if she has the right support; but the research tells us that low milk supply is far more common than people realize.   All of the support in the world cannot increase breastmilk supply if your body cannot biologically produce it!       

Continue reading

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Is My Baby’s Weight Loss Normal Or Excessive?

The Newborn Weight Loss Tool can provide an answer.

Parents are taught that it’s normal for babies to lose 7–10% of their body weight in the first few days after birth, but is this true? Well, that depends. According to the AAP, a baby who loses more than 7% of his body weight may be losing excessive weight and requires a comprehensive lactation evaluation to rule out delayed onset of copious milk production, primary lactation failure, and/or infant oral anomalies that prevent adequate colostrum/milk transfer.

From the American Academy of Pediatrics HealthyChildren.org website. Breastfed newborns should lose no more than 7 percent of birth weight in the first few days after birth before starting to gain weight again. (Accessed July 16, 2020)

Weight loss has typically been assessed using simple percentages, but now there is a much more precise and accurate way to track excessive weight loss in newborns and many hospitals, pediatricians, and lactation consultants are adopting this method for greater accuracy in making clinical recommendations. The Newborn Weight Tool, or NEWT, is an online tool, the first of its kind, to help pediatricians determine whether exclusively breastfed newborns have lost too much weight in the first days of life. The tool was developed at Penn State College of Medicine through research conducted jointly with University of California, San Francisco. It was developed using a research sample of hourly birth weights from more than 100,000 breastfed newborns. For a quick synopsis of this tool from the lead investigator and one of developers of the tool, Dr. Ian Paul, watch the video below.

Source: Penn State Health News

In this video, Dr. Ian Paul, professor of pediatrics and public health sciences at Penn State College of Medicine and pediatrician at Penn State Hershey Children’s Hospital, talks about how NEWT fills an important void.  Determining whether an exclusively breastfed newborn is losing excessive weight is important because higher weight loss almost always reflects suboptimal milk intake. It is also associated with increased risk of medical complications such as low blood sugar, jaundice, and dehydration, which can result in the need for medical interventions and future health and developmental problems. This weight-loss tool shows that how quickly babies lose weight is just as important as how much they lose.

Continue reading

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The Loss Of Our Son Has Devastated Our Family – This Time I Will Be Supplementing With Formula After Every Nursing session

I had a beautiful, healthy pregnancy with Bryson, with the help of Clomid (a fertility drug), like my first pregnancy with my daughter. After about 31 hours of induced labor, Bryson was here. Seven pounds, twelve ounces, and seemingly healthy! He latched like a champ immediately, and we had zero complications of any sort while in the hospital. He had wet and dirty diapers and was breastfeeding well, every 2–3 hours. His discharge weight was 7 lbs, and I had a follow-up appointment scheduled for two days later.

NEWT is the first tool that allows pediatric healthcare providers and parents to see how a newborn’s weight during the first days and weeks following childbirth compares with a large sample of newborns, which can help with early identification of weight loss and weight gain issues. Bryson was discharged with a weight loss of 9.7 percent at 36 hours of age. The NEWT graph indicates his weight loss was excessive.

Continue reading

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Liquid Courage Sometimes Comes In The Form Of Baby Formula

Written by: Sarah L. R.

“I think it would be very courageous for you to do this.” 

My psychiatrist leaned forward in his chair, clasped his hands together, and smiled at me. 

Grabbing a tissue from the box on the table, I sniffed, “Then why do I feel like the biggest coward for making this decision?!” 

“Sarah, what’s braver than making sure you’re the best mother you can be?”

It took several more conversations and even more tissues, but eventually, I made the decision to forgo breastfeeding entirely, and feed my daughter formula milk from birth. In doing so, I hoped to avoid postpartum depression and anxiety that haunted my earlier experiences as a new mother. 

Continue reading

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Why I support #FedIsBest And Safe Sleep Practices As A Breastfeeding Mother Of Twins

 

In October of 2017, I was skimming Facebook and came across a question in one of my favorite Infant Safe Sleep support groups.  A new mother was having a hard time with breastfeeding and was looking for an evidence-based breastfeeding group that supported safe sleep for infants. When she got very little feedback, I began to think about creating a Facebook support group for safe sleep practices and breastfeeding because I knew there were plenty of mothers who wanted to exclusively breastfeed while practicing safe sleep.

As a mother of exclusively breastfed twin girls, I practiced the ABCs of safe sleep according to the American Academy of Pediatrics, and I felt confident that I could provide current evidence-based resources while providing practical tips and support, but the only real experience I had with breastfeeding was with my twins. I began to search for like-minded group moderators who wanted to help compile up-to-date scientific resources for which we called Breastfeeding Without Bedsharing & Evidence-Based Feeding.

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Nurses Talk About Delivering, Feeding, And Caring For Babies Following The AAP Guidelines When A Mother Is infected With The COVID-19 Virus

 

We know everyone’s anxiety level is very high right now because of the uncertainly of delivering your baby during the COVID-19 pandemic. Our goal is to provide real-life experiences of nurses who are taking care of people in labor and postpartum so that parents can have an idea of what to expect when delivering their babies.

The most recent guidelines released by the AAP, CDC, and ACOG apply to babies in the U.S.A.

Since these guidelines are different from the WHO guidelines and parents have been receiving mixed messages and are asking for clarification. We want to clarify the recommendations for parents so they can be fully informed of their choices. Generally speaking, parents who live in developed countries such as the USA have access to breast pumps, clean water, masks, cleaning supplies, and formula. The science-based recommendations are based on these choices.

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