How Breastfeeding Coercion Stripped this Psychiatrist of Her Confidence and Mental Health

 

By Michelle M., Psychiatrist, MD, and First-Time Mother

It’s taken me a long time to really have the strength to talk about this, but I think it’s time.

I’m a 40-year-old, first time mom to an amazing 9-month-old son. Throughout my pregnancy I was repeatedly asked if I would breastfeed and received endless lectures on the benefits.  I was honestly skeptical about the claimed breastfeeding benefits… (liquid gold? seriously?), but continued to answer “yes”, as it felt like saying “no” would be the wrong answer.

I figured I would try, and if it worked, great!  If it didn’t, then formula was “Plan B”.  I really didn’t think much of it, and figured the baby would get fed one way or another.

Fast forward to my 37th week of pregnancy.  My water broke with no warning, and I had an awful labor due to a failed epidural and uterine tachysystole.  Then to top it all off, I had an emergency c-section when my baby’s heart rate disappeared from the monitors. Labor and delivery didn’t go exactly as planned, but I was elated when it was over, and I had my beautiful baby. 

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The Ten Steps to Ethical, Successful, And Inclusive Infant Feeding

In most hospitals and prenatal educational materials, exclusive breastfeeding (EBF) is the recommendation for infant feeding. EBF is promoted as the only healthy way to feed a baby, with partial breastfeeding, temporary supplementation, and formula feeding falsely characterized as “suboptimal.” Other infant feeding options, such as exclusive pumping or formula supplementation, are discouraged, even when requested by parents. But does this narrow definition of healthy infant feeding support patient rights and ethical infant feeding principles? No, it does not

 Infant feeding support in postpartum units should consider ethical principles of autonomy, beneficence, justice, and non-maleficence when considering the extent to which lactation should be promoted. 

What Are The Principles of Ethical Infant Feeding?

Autonomy: The parents choose how they intend to feed their baby at each feeding, and maternal bodily autonomy is affirmed and respected.

Beneficence: The benefits of infant feeding types are provided to the parent to help them make an informed decision. Healthcare providers must not decide what is best for the parent.

Justice: Do not assume a feeding method. Ask the parent how they want to feed their baby. Affirmative consent must be obtained before touching a patient’s body. 

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Is Formula More Dangerous than Irreversible Brain Damage?

Is that some kind of sick joke? Infant formula is safe nutrition—scientifically created to replace human milk and thus consists of fluids and nutrients necessary to nourish a baby. Brain damage is irreversible.  That should be glaringly obvious, but it looks like the AAP Breastfeeding Section responsible for the recently released “Breastfeeding and the Use of Human Milk” (June 2022) has lost sight of this critical fact.

Let’s focus on this appalling statement:

“The need for phototherapy in an otherwise healthy infant without signs of dehydration and/or insufficient intake is not an indication for supplementation with formula unless the levels are approaching exchange transfusion levels.”

Hyperbilirubinemia (excessive jaundice) and Phototherapy

To explain why we are horrified, let’s look carefully at what the statement means. Jaundice is a common and usually benign condition experienced by about 60% of healthy newborns. It is caused by a substance called bilirubin, a breakdown product of fetal red blood cells after birth to transition to mature red blood cells. However, if a baby’s bilirubin levels are greater than a certain level and continue to climb, the risk for brain damage increases.

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Is Breastfeeding Twelve or More Times a Day Normal? Not Always

A meme posted by an IBCLC states that breastfeeding 12 or MORE times a day is “normal” with no further education on when it can be a sign of newborn hunger, poor feeding, inadequate milk transfer, or failure to thrive. 

Overly simplistic memes like this are irresponsible and confusing and, in some cases, are why parents miss red flags that require medical attention and lactation assessment to be sure the baby is receiving adequate nutrition and fluids when nursing. (Source of meme to the left, Facebook, Lucy Ruddle, IBCLC)

Here at the Fed Is Best Foundation, we receive messages frequently from families who tell us they were repeatedly assured by trusted health professionals that nursing 12 or more times a day is completely normal. 

But is it always normal?

No, it’s not.  Continue reading

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. 

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