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"Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms

Nurses Article   (19,304 Views 174 Comments 1,461 Words)
by cjcsoon2bnp cjcsoon2bnp (Member) Writer

cjcsoon2bnp works as a ED NP and Clinical Instructor.

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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. You are reading page 3 of "Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms. If you want to start from the beginning Go to First Page.

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Just as it is not OK to stigmatize moms for giving formula, it is also not OK to undermine breastfeeding when it is a mom's goal to breastfeed exclusively.

I honestly don't recall anybody here saying anything that remotely undermines breastfeeding nor have I read it anywhere. Really, I think we all advocate for it as much as reasonable because we know the benefits. The issue is that the consequences of rigidly insisting "breast only" as many here have experienced or witnessed are much more dire than those of using formula. No infant, ever, has died as a consequence of not being exclusively breast fed. Many children have suffered unnecessarily and some have died as a result of the "breast is best" campaign militantly adhered to and pushed by SOME LCs. I watched one of them make my best friend at the time cry because she all but accused her of being a bad mother for even considering supplementing regardless of the fact that her baby was clearly failing to thrive and my friend knew she was starving her. The best thing I ever did was immediately went to the store, bought some formula and fed that poor child. It's unfortunate when something so well-intended spins out of control in the hands of zealots and the misinformed. While I have no doubt that you do NOT fall into this category, sadly, some do and it's the infants and the mothers who suffer the consequences. NO baby should die of starvation when an acceptable (note I did not say perfect)substitute for breast milk is readily available. Thank you for being mom and baby focused. I truly hope you are in the majority of all the LC's out there.

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Cococure has 7 years experience and works as a RN on a mother/baby unit.

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Amen and hallelujah for this article!!! I am a post partum nurse and 100% support breastfeeding BUT I think it has gone a bit too far! I have see so many more babies with weight loss and jaundice issues than I have ever seen in the past. I can only say that I have heard the comments from other nurses, lactation consultants and friends of the patients. At one point I was questioning are we doing best for the patient or promoting the hospital agenda of "Breastfeeding friendly hospital". I have sat with many moms that are not producing enough for their 9lb baby and watch them cry because they are exhausted, frustrated and baby screaming with no end in sight. And you know what I offer different options ...continue to breastfeed, donor milk or bottle? And the look of relief in the parents eyes is like "yes there is hope" whatever their choice I support it. I have seen the trend of what some of us nurses refer to as "mom shaming" you didn't give birth naturally...shame on you. Or ...you have a C-section oh no ...shame on you! And the best one ...of course the Breastfeeding...oh no you want to give a bottle oh no baby will not be an Einstein. It's time we stop being doing damn judgemental or stop promoting the hospital agendas and go back to supporting the patients and help her adjust to being a new mom. And don't get me started on the looks some nurses or lactation nurses give the mom that decides to only bottle feed her baby....they make those moms feel terrible and it angers me so! Well I gave more than my 2 cents ...

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Irish_Mist has 100 years experience as a BSN, RN and works as a Registered Nurse- cardiac neuro telemetry.

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I am not an L&D, PP, or Lactation Consultant but rather, a cardiac telemetry nurse. I can't tell you my perspective as a nurse but more as a patient.

I never felt pressured to breastfeed. The lactation consultants I saw provided me with education about proper latch, positions, etc. They were very helpful. Having said all of that, I believe this is very shaky territory and that nurses in this specialty should be very cautious in how they present information. I too found out my son's billi levels were high and was given the recommendation to breastfeed on both breasts and then give formula afterward. I happily obliged. I also began to pump using a hospital grade Medela Symphony model I rented. I know the general recommendation is to wait 6 weeks to pump, but I also believe pumping helped me establish what turned out to be a great supply. My son ended up weaning shortly after his second birthday. Unfortunately, my experience isn't universal. I had a lot of support and teaching from professionals as well as my own mother who breastfed me.

Here's my stance: Breast is best but formula is a life saver when it is needed. Formula is a perfectly fine substitute or supplementation. Your wife is not a failure. If her breastfeeding journey does not work out, that's okay. If she wants to pump, I don't see any harm in doing so. I think that the push for breastfeeding as the norm is great, but it needs to be carefully executed so as not to break the confidence of mothers.

I wish you and your wife nothing but the best. Congratulations on your sweet baby! Continue to feed him in whatever way makes him thrive, breast or formula.

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LibraSunCNM has 10 years experience and works as a CNM.

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I honestly don't recall anybody here saying anything that remotely undermines breastfeeding nor have I read it anywhere. Really, I think we all advocate for it as much as reasonable because we know the benefits. The issue is that the consequences of rigidly insisting "breast only" as many here have experienced or witnessed are much more dire than those of using formula. No infant, ever, has died as a consequence of not being exclusively breast fed. Many children have suffered unnecessarily and some have died as a result of the "breast is best" campaign militantly adhered to and pushed by SOME LCs. I watched one of them make my best friend at the time cry because she all but accused her of being a bad mother for even considering supplementing regardless of the fact that her baby was clearly failing to thrive and my friend knew she was starving her. The best thing I ever did was immediately went to the store, bought some formula and fed that poor child. It's unfortunate when something so well-intended spins out of control in the hands of zealots and the misinformed. While I have no doubt that you do NOT fall into this category, sadly, some do and it's the infants and the mothers who suffer the consequences. NO baby should die of starvation when an acceptable (note I did not say perfect)substitute for breast milk is readily available. Thank you for being mom and baby focused. I truly hope you are in the majority of all the LC's out there.

Just to clarify, I'm not a lactation consultant, but a former Mother/Baby nurse and now a CNM, and a new mom who is breastfeeding. I wasn't saying that anyone posting here was undermining breastfeeding, but rather that, in my opinion, we hear a lot about how breastfeeding can and will go wrong, and formula is medically necessary, but not as much about how breastfeeding can go right, if moms have proper education and support. That's so terrible that your best friend was made to cry by an LC, I can't imagine what that person was thinking, bullying a new mom that way.

I am a bit puzzled by your statement that "No infant, ever, has died of not being exclusively breastfed." What about infants who have died from infections caused by contaminated formula? What about formula companies like Nestle pushing their products on poor, uneducated women in third world countries who mixed the formula with dirty water and their babies died from diarrhea? Formula does have risks, it is not the same as breastmilk, it just isn't. Being militant about exclusive breastfeeding is impractical and unhelpful, but implying that breastmilk is the same as formula is not good either (not saying that you or any other posters believe this, I'm just trying to give food for thought and offer another perspective).

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4 Followers; 17,741 Visitors; 2,727 Posts

I am a bit puzzled by your statement that "No infant, ever, has died of not being exclusively breastfed." What about infants who have died from infections caused by contaminated formula? What about formula companies like Nestle pushing their products on poor, uneducated women in third world countries who mixed the formula with dirty water and their babies died from diarrhea? Formula does have risks, it is not the same as breastmilk, it just isn't.

Give me an example of one infant in the US who has starved to death while being properly bottle-fed/supplemented with untainted, properly mixed formula in the absence of a metabolic disorder or allergy.

I already gave you an example of an exclusively breast fed baby who has.

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LibraSunCNM has 10 years experience and works as a CNM.

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Give me an example of one infant in the US who has starved to death while being properly bottle-fed/supplemented with untainted, properly mixed formula in the absence of a metabolic disorder or allergy.

I already gave you an example of an exclusively breast fed baby who has.

Starving to death, OK, I get your point and thank you for clarifying. I don't think that infants are starving to death as a result of exclusive breastfeeding at quite the rate that this thread would have one believe, but I can tell that my attempts to make this a balanced discussion about the many difficulties faced by moms who breastfeed are possibly falling on deaf ears. So be it.

OP, once again, I'm glad that your wife and baby are doing well and that you've found a feeding plan that works best for your family.

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Daisy4RN has 20 years experience.

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So sorry for what you had to go through! I believe that we, as professional nurses, are obligated to assess the patients needs/situations, provide accurate information/training as needed, and let patients/families decide what is best for them. It is not our job to inforce breastfeeding, and as noted by OP it can be very detrimental to the situation. Our job is to assist in the healing process, this goes for any situation but is especially important when it turns/has the potential to turn what should be a very happy time into a stressful guilt inducing situation. I don't know when exactly this push for breastfeeding started but it has gone too far.

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4 Followers; 17,741 Visitors; 2,727 Posts

Starving to death, OK, I get your point and thank you for clarifying. I don't think that infants are starving to death as a result of exclusive breastfeeding at quite the rate that this thread would have one believe, but I can tell that my attempts to make this a balanced discussion about the many difficulties faced by moms who breastfeed are possibly falling on deaf ears. So be it.

Just because I/we may not agree with you does not at all mean we are not listening. Having different opinions does not invalidate the value of the discussion or your point of view. My experience has apparently been much different than yours. I can honestly say I have never heard anybody extol the virtues of formula over breast milk or seen anyone shamed for choosing breast over bottle. Nor have I ever heard of formula pushed as "medically necessary" unless it actually was for some of those weird metabolic things that can happen. On the contrary I have seen the opposite many, many times. Perhaps the demographics of your patient population are different. I also don't see evidence of anybody here over-stating the death rate from starvation (one example is certainly not proof of exaggeration) but there has been an observed increase in re-admissions for things like dehydration. Purely anecdotal so take it with a grain of salt if you must. I also think that the difficulties of breast feeding and the need for more support has been very clearly discussed in multiple posts and championed by all of us here. Regardless, I'm sorry you only feel the discussion is balanced if we agree with you. That takes all of the fun out of, you know, discussing.

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LibraSunCNM has 10 years experience and works as a CNM.

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Just because I/we may not agree with you does not at all mean we are not listening. Having different opinions does not invalidate the value of the discussion or your point of view. My experience has apparently been much different than yours. I can honestly say I have never heard anybody extol the virtues of formula over breast milk or seen anyone shamed for choosing breast over bottle. Nor have I ever heard of formula pushed as "medically necessary" unless it actually was for some of those weird metabolic things that can happen. On the contrary I have seen the opposite many, many times. Perhaps the demographics of your patient population are different. I also don't see evidence of anybody here over-stating the death rate from starvation (one example is certainly not proof of exaggeration) but there has been an observed increase in re-admissions for things like dehydration. Purely anecdotal so take it with a grain of salt if you must. I also think that the difficulties of breast feeding and the need for more support has been very clearly discussed in multiple posts and championed by all of us here. Regardless, I'm sorry you only feel the discussion is balanced if we agree with you. That takes all of the fun out of, you know, discussing.

I certainly don't feel like everyone has to agree with me! I would love to keep this discussion going (I admit I have a hard time deciphering tone on the internet sometimes). I just felt like I was only seeing thoughts along the lines of: breast is best is wrong, lactation consultants are bullies, babies can and do die from moms exclusively breastfeeding, breastfeeding doesn't always work, etc., and I wanted to offer my own thoughts. Just as some moms are frustrated by or feel shamed by others about their difficulties with breastfeeding and/or their use of formula, I get frustrated at the idea that exclusive breastfeeding is something that only a few lucky women are capable of doing. And it is very hard, for many women, because of various shortcomings in our healthcare system and in women's workplaces, and that frustrates me too.

When I talked about formula being pushed by health professionals, I'm talking about it NOT being medically necessary, as in my examples of formula samples given out to moms who want to breastfeed, or sent to them in the mail. I saw a pediatrician once insist to a mom that a 9 lb baby couldn't possibly thrive being exclusively breastfed and, though he was nursing well with no issues at that time, pushed formula on the mother. I guess 9 lb babies never survived before formula was invented, and my own 9.5 lb baby is a miracle! Inaccurate information and marketing like this does have repercussions on the success of breastfeeding, and it's that kind of undermining that makes me really sad, because we have stacks of literature that show the kinds of health benefits we could see if more moms breastfed (not even just exclusively).

We know from the literature that in the U.S., about 80% of pregnant women state their intention to breastfeed their infants, and that at 6 months of life, only about 27% are doing so. This says to me that we need a better way to help breastfeeding moms meet their goals, and that's where I'm coming from with my comments. But I also completely agree with everyone that moms need help and support no matter what their feeding choice is to ensure the healthiest start for their babies, because a supported, happy, sane mom is the best way to do that.

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LibraSunCNM has 10 years experience and works as a CNM.

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I forgot to add to my previous post that my point in bringing up babies harmed by contaminated formula, which I probably didn't make clear, is that starvation isn't the only way a baby can be harmed by a feeding choice, and babies can and have died in the U.S. from formula-related infections, not just in third world countries. But I understand that this thread has focused on the starvation aspect.

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NurseBeans has 15 years experience and works as a school nurse.

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I'm so happy to see this is coming out into the open as an issue faced by many.

A bit of background on me: I am a mom of four beautiful children, all healthy, none exclusively breastfed. I tried with each of them and never was able to get it to work. I had lactation consultants out the wazoo attempting to help me, including the nurse at the pediatrician's office who simply said "sometimes it doesn't work". Ok.

At a young age I was molested by a neighbor/friend of the family, and without going in to too much detail, my breasts were touched in ways no 11 year olds' breasts should ever be touched. So when my first child and the lactation consultants were vigorously manipulating my nipples, it was all I could do to not to throw my baby and throat-kick the LC. I do not tolerate manipulation of my nipples. Period. I did not choose this for myself. I would not choose those childhood events for anyone. One friend (who is no longer a friend) actually suggested that maybe if I couldn't breastfeed I should not have chosen to have children. So by the logic of an exclusively breastfeeding lactivist, anyone who has been traumatized by childhood events and cannot see their way to breastfeeding because IT MAKES THEM VIOLENT should just forgo the whole having-children thing.

I call BS. Women have choices these days, from how to get pregnant, to when, to how to deliver and where, to be unmedicated for the birth, how many children to have, to have a husband/partner or not...so they are trying to tell us we can have all these choices, but not have a choice how to feed our babies?

Breast is best, unless you can't or simply don't want to.

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