"Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms
In my last article “Becoming Dad: A Humbling Birth Experience of a New Father and Nurse,” I discussed my journey to becoming a first-time parent and included some of the challenges that being a nurse and a parent present when it comes to the health of your children. This article continues on my journey with the battle we fought against the “breast is best” movement, which advocates that mothers exclusive breastfeeding babies for the first six months of life.
Before I go too far into this article, and risk being stoned to death by the maternal-child nurses, lactation consultants, and midwives out there, I would like to make a few critical points.
I'm not against breastfeeding.
I absolutely believe that breastmilk is the best food and source of nourishment for babies.
I think that mothers should be encouraged to breastfeed their babies and supported throughout the process.
I make no claim to be an expert in neonatal, obstetric, or pediatric fields. However, I'm a husband and a father and I will fight for what is best for my wife and child; even if that means it doesn't fit with the strict guidelines of the "baby friendly hospital" or "exclusively breastfed movement."
As I mentioned in my last article, my wife and I are both nurses. Throughout this pregnancy, we have read every article about raising healthy babies/children and have committed to improving the health of our family. We live in a smoke-free home, try to cook healthy meals, engage in primary care regularly, and believe in the benefits of immunization/vaccination. So before our son arrived, it seemed like a no-brainer that he would be exclusively breastfed as recommended by the American Academy of Pediatrics (AAP) and World Health Organization (WHO), among many others. Fast-forward to after bundle of joy arrived as I helplessly watched my wife and son struggle with the complicated process of learning to breastfeed.
One-by-one each nurse caring for my wife and son would help with positioning and latching, but it never seemed to work correctly. After each nurse had left the room, I saw the look of exhaustion and disappointment in my wife's eyes because it was becoming harder with each feeding and not easier. We inquired about using one of the hospital's breast pumps to help stimulate milk flow but this was met with a great deal of hesitation and remarks of "It's really best to just keep trying naturally, he will catch on soon." Next came the lactation consultant, a nice enough woman who is clearly passionate about her job but made it clear that there is only one way to feed a baby "breast is best". To her credit, she spent an extensive period of time coaching my wife and helping my son. She strongly discouraged the use of a breast pump by suggesting that this be reserved until closer to when my wife would return to work. Whenever my wife voiced anxiety, concern, or disappointment she was told that this was "a part of the process", "completely normal" and "just because it's natural doesn't make it easy." We were discharged from the hospital with packets of paperwork, breast shields, and other tools that reminded us to keep up with the exclusively breastfeeding.
Over the next 24 hours at home my wife, put our son to breast at least every two hours (usually every hour), and he would latch for 15 - 20 minutes on each breast but continued to appear fussy after feedings. We were told that this was common with "cluster feeding" and not to worry or allow this to derail the breastfeeding efforts. He remained alert, active and had plenty of wet diapers, so we continued to watch him closely. At the next day appointment with the pediatrician we were told that our son had severely elevated bilirubin, lost 12% of his birth weight, and had to be readmitted to the hospital. As parents, we felt that we had failed our child. We followed the treatment team's discharge instructions implicitly, and still he decompensated so quickly. We are nurses, and yet we have missed such significant weight loss. How could we have let this happen? If I had only gone to the store and bought some formula, I might have avoided this.
He was readmitted to the hospital and placed in phototherapy, we sat by him and watched helplessly hoping that it would help his little body to remove the excessive bilirubin quickly. My wife remained quiet, but I saw the look on her face knowing that she felt like she was a failure as a mother. I requested that the nurses provide us with formula and a breast pump while we resumed a two-hour breastfeeding schedule with formula supplementation to ensure he received at least 1 oz. per feeding. Breastfeeding continued to be a struggle, but after each attempt, he was offered pumped breast milk and formula (if needed) to ensure he had enough to eat. In the morning the same lactation consultant came to our room to visit us with a commitment to help "fix the problem." She "permitted" my wife's use of the breast pump after each feeding to obtain additional breast milk but wanted to work on getting the baby "back to the breast where he belongs." She made no qualms about "strongly discouraging" any use of the formula because it "can't match the nutrition that your breast milk provides" and "we only want the baby eating the best and most nutritious food". Each time that my wife expressed concern with the idea of stopping the formula supplementation I saw the lactation consultant shut down her protests. As a psychiatric/mental health nurse, I knew that this form of coaching transitioned from inspiring and supportive to instilling guilt and dismissive of my wife's needs, a method that was sure to fail in the long-term.
Eventually, I decided that this dad had enough and I had a "come to Jesus" moment with the well-intentioned lactation consultant and spoke to her "nurse-to-nurse". I told her that my wife would continue to try to breastfeed, but I would not allow her to be bullied into doing things only one way and that my son will be fed in whatever way he needed to grow. I refuse to sacrifice her mental health and ability to bond with him just to say that he was "exclusively breastfed the natural way". While the consultant's intentions were good and she was clearly an expert in this area, I told her that this form of coaching does not best ensure a patient's long-term compliance with any health promotion intervention (e.g. weight loss, smoking cessation, breastfeeding). If a patient's needs are so easily ignored then it creates a divide between patients and providers that is unhealthy to the working relationship. As you might expect, this was not met with tears of joy or heartfelt thanks but we came to an understanding that we would do what needed to be done for our child.
We are now at home, my son primarily consumes breastmilk out of a bottle with some formula supplementation, and he is doing very well. This may not be what works for everyone and does not follow the strict recommendations of exclusive breastfeeding for the first six months of life but it works for us. I haven't told this story to discourage people from breastfeeding their babies or to imply that we ungrateful for all of the help and support we received in the hospital. I shared our story to help educate parents and healthcare providers.
Parents, you need to listen to their instincts and if you feel something is jeopardizing the safety of your child(ren) then you need to speak up. You need to work with your healthcare providers to achieve the best possible health your child(ren) because you are on ultimately the same team. Healthcare providers, we have a great deal of knowledge and access to resources that the public doesn't have but if we don't listen to parents/families then we won't be able to foster therapeutic relationships or achieve the best possible health outcomes for our patients.
I would like to begin a discussion with the allnurses.com readers include the perspective of parents/grandparents/family members and healthcare providers. Here are some questions to consider...
Do you think that we have gone too far in advancing the "breast is best" movement
Should we be advocating for "fed is best" instead?
Have you personally felt pressured that breastfeeding is the only correct way to feed a baby?
Do you see patients being pressured to feel this way in your workplace? If so, who are the groups/individuals who are responsible for this?
How do you feel about some baby-friendly hospitals refusing to provide parents with formula unless there is a physician's order (as a method of enforcing exclusive breastfeeding)?
What are your tips for encouraging breastfeeding in a way that is supportive of parents without being dismissive of their concerns and beliefs?
omg somebody shoot me....i cant believe this topic is even necessary. nurses please get out of the judging business...no matter what your good intentions.......can we please remember the golden rule and treat others as we would like to be treated??!!!
this is when you know you have been a nurse too long and have seen way too much crap to put up with this kind of BS anymore...
Families please follow this dad's lead and advocate rather than humiliate your wife who just bore your offspring. What a wonderful gesture he showed his wife by putting her and the baby before the ego of a lac consultant....which i am judging now as i type, to be not a real nurse but a lackey or a failed out/burned out nurse who really has no control and weilds her power only in the area she can....so moms please put a breast or a bottle in that baby's mouth and feed it for crying out loud!!! and don't let other people TELL you what you will and wont do with your body and your kid!!
Just my opinion after 20 something years of critical care nursing of big people, little people and people who chose not to breast feed....
From a post partum nurse mgmt has A LOT to down the this ....they check charting to see who is giving bottles to moms, the watch and question the patients about what we tell them about breastfeeding. So many of us want moms to feel safe happy and enjoy baby. But the hospitals agenda is shoved down our throats on a daily basis. Again I am for Breastfeeding until it's not the best choice for mom or the family. Don't get me started on the LCs that criticize us for giving the mom a bottle to help her over that hump at 3am ...when she is about to breakdown ...I would love to know the stats newborn readmisions for weight loss and jaundice
First of all bullying is not helpful and not using common sense when caring for individuals is just ridiculous.
As a youngster I knew I wanted to breastfeed my kids after hearing my mom's stories who was quite a rebel in her day for insisting on nursing when she was at first advised it wasn't as good or enough.
I was not a nurse then, but read everything and also was advised it wouldn't hurt if you did it right. They lie. It is a big mistake for educators or writers to use their limited experience to pronounce such ridiculous statements. I nursed both of my kids for one year and both times there was a period of just pure torture until the nipples toughened up. I had a cheapo evenflo pump that was better than the painful grip of my newborns' mouths and would occasionally use it for a break.
I understand there are rules to keep baby friendly status, but if that is what drives someone to stop nursing, there is a problem. Why not use a good pump? Getting those antibodies into the baby should be of primary importance.
A few people posted here about formula becoming better and closer to breast milk. I doubt this. As time goes on, the value of breast milk is becoming more apparent. We are talking about life saving immunity! The newborn only has a passive immunity from mom and then the antibodies through breast milk so that whatever mom gets exposed to and develops immunity to, she passes on to baby. This became very real to me with my second child who was perfectly healthy at birth, then in serious danger a few weeks later. At week two the Dr told me she would not have made the recovery she did if I had not been nursing. These statements are not about shaming someone who doesn't or can't nurse; these are just facts that should be known.
If you have a bad experience with one MD, would you not ever go to another physician again? It seems unreasonable, particularly for someone in healthcare, to paint the entire profession based on your interactions with one, especially if your interactions with all the others have been great.
I did not say that I never went to see another LC...just that it made me not want to go back to another one. I didnt want to hear another rude and biased opinion regarding my ability to feed my child. I did seek out another LC after that one though, because I wanted to make sure that I covered all the "bases" so to speak, and made sure that I tried EVERYTHING in my power to be successful....just as I would get a second opinion from another Dr if needed.
I just had my baby last night & it was such a great experience. Even when asked if I was gonna bottle or breast feed I never felt pressured or guilty for not breast feeding. All of the nurses have been amazing. From the triage nurse to post partum, it has been an amazing experience. But maybe I'm still on the post baby high.
I absolutely love the way OP advocated for his wife but I also can't believe this is a topic, or rather sad that it is. I had some guilt for my breast feeding decisions (all 3 of my kids and their pregnancies were different) but mostly I was of the get the **** out response to anyone who tried to proselytize.
I wonder how many people who have raised kids through their teen years have as strong of an opinion? In hindsight we know that there are so many fish to fry and if you get your kids to a safe and happy adulthood, whatever means used should be lauded.
I only read the article (not the thread), but OP, I agree with you. Fed is best. I know so many people that have been made to feel like a failure because they couldn't breast feed for whatever reason. It's ridiculous.
When I was in nursing school we had to teach a class to teen moms and one of the students in my cohort had been assigned the topic of nutrition for teen moms during breast feeding. One of the teens got genuinely upset at the idea that she may have done something wrong by not breastfeeding. I stopped the other student's lesson and told her it was no big deal. I asked her how old her son was (over a year), and then said she must have been doing something right because he was still alive, and then told her not to worry about it. I was not about to sit there and let it slide.
I've seen sickly children that were exclusively breast fed and healthy children that never were. I've even seen a doctor feel like a failure as a woman and a mother because she wasn't able to breast feed. It needs to stop. It's great if you can- but if you can't- don't torture yourself and tell the nosey moralizers to mind their own. If it were me, I'd have tons of parenting advice to give that sort in return (because they usually need it).
I just had my baby last night & it was such a great experience. Even when asked if I was gonna bottle or breast feed I never felt pressured or guilty for not breast feeding. All of the nurses have been amazing. From the triage nurse to post partum, it has been an amazing experience. But maybe I'm still on the post baby high.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Haha. That's how we get SO many nurses! They have a baby and realize what an awesome area of nursing OB is. :)
Lol! The post partum nurse was running around like a chicken with her head cut off & talking about how desperate they were for more staff. I felt so bad. She also mentioned that the amount of births has been increasing year after year.
Cococure
373 Posts
From a post partum nurse mgmt has A LOT to down the this ....they check charting to see who is giving bottles to moms, the watch and question the patients about what we tell them about breastfeeding. So many of us want moms to feel safe happy and enjoy baby. But the hospitals agenda is shoved down our throats on a daily basis. Again I am for Breastfeeding until it's not the best choice for mom or the family. Don't get me started on the LCs that criticize us for giving the mom a bottle to help her over that hump at 3am ...when she is about to breakdown ...I would love to know the stats newborn readmisions for weight loss and jaundice