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

Nurses Article   (19,286 Views 174 Comments 1,461 Words)
by cjcsoon2bnp cjcsoon2bnp (Member) Writer

cjcsoon2bnp works as a ED NP and Clinical Instructor.

8 Articles; 24,194 Visitors; 1,156 Posts

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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 4 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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Very good article, good article. Sorry to hear about the entire situation and how you and your wife were treated.

This breast is best movement has truly spun out of control. Not only from healthcare providers but other women and mothers. Have you ever frequented a mother-baby facebook group? Those ladies are vicious. Comments ranging from "if you had a c-section you didnt actually give birth, to it's abuse if you dont breast feed"

other mothers/ healthcare providers should be supportive of whatever choice they choose to make bottle or breast, and not shame them otherwise.

I have a co-worker who is one of these crazy type of people and every ailment i have I have a headache, i'm sick or my allergies are acting up she tells me that if i were breast fed this wouldnt happen :yawn:

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4 Followers; 17,676 Visitors; 2,726 Posts

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.

In a capitalistic society we cannot control what companies do for marketing but I certainly don't think the majority of health care providers agree with some of their tactics. As for the pediatrician well, he was being a "richard" as we know some of them can be. I really do think we are all on the same side here. As responsible health care providers, yes, we agree that breastfeeding is the healthiest option for every child...except when it isn't. The problem we see is it seems the pendulum has swung way over to the "breast-feeding or nothing" way of thinking and that has actually been harmful. Hopefully it will soon swing back to a more moderate position where the moms feel supported and the babies are fed!

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NurseAngie works as a RN.

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I told them I would do BOTH breast feeding and formula feeding during my admission to both L&D and the Postpartum units. I had a good experience doing this.

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1 Follower; 4,690 Visitors; 373 Posts

Very good article, good article. Sorry to hear about the entire situation and how you and your wife were treated.

This breast is best movement has truly spun out of control. Not only from healthcare providers but other women and mothers. Have you ever frequented a mother-baby facebook group? Those ladies are vicious. Comments ranging from "if you had a c-section you didnt actually give birth, to it's abuse if you dont breast feed"

other mothers/ healthcare providers should be supportive of whatever choice they choose to make bottle or breast, and not shame them otherwise.

I have a co-worker who is one of these crazy type of people and every ailment i have I have a headache, i'm sick or my allergies are acting up she tells me that if i were breast fed this wouldnt happen :yawn:

Using Facebook as a metric to determine the efficacy of healthcare messaging may be unwise. Facebook should be used for vacation photos and videos of your pets only.

I have found that Facebook groups are often viscous and misguided in whatever their orientation or messaging may be.

If you want to see viscious you should see my wife's knitting group. If you don't hand spin your yarn from organic, free range, hand raised angoran rabbits then you are a piece of expletive. I wish I was kidding.

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1 Follower; 4,690 Visitors; 373 Posts

In a capitalistic society we cannot control what companies do for marketing but I certainly don't think the majority of health care providers agree with some of their tactics. As for the pediatrician well, he was being a "richard" as we know some of them can be. I really do think we are all on the same side here. As responsible health care providers, yes, we agree that breastfeeding is the healthiest option for every child...except when it isn't. The problem we see is it seems the pendulum has swung way over to the "breast-feeding or nothing" way of thinking and that has actually been harmful. Hopefully it will soon swing back to a more moderate position where the moms feel supported and the babies are fed!

As someone who directly deals with marketing and is about to go to a marketing meeting in about 30 minutes I can tell you with confidence that the government has a great deal of control over what and how something can be marketed. The U.S. economy is more accurately described as a mixed market economy instead of a pure capitalistic economy.

What I am curious about in this breastfeeding debate is how many mothers are not breastfeeding due to a knowledge deficit still and how effective the campaign was against it?

No matter what educational campaign you launch there will always be a minority group that is either left out or disenfranchised by the campaign, there are always hurt feelings and inadvertent consequences. The important questions are how effective the campaign was, how important the objective is, and how bad the inadvertent consequences were?

If the campaign is limited to a few bad feelings but has had a substantial health benefit to the community then it is still on course, if it is of no benefit and it is causing extreme emotional distress then it needs to be readdressed.

Something tells me that there is still a large segment of the population that is still uneducated. Having to explain the benefits of car seats to my brother I would not be surprised at all.

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LibraSunCNM has 10 years experience and works as a CNM.

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Honest opinion? I think she, for what reason I cannot say, has a real beef against breastfeeding and is twisting some research to try to blame the BFHI for stuff it's not responsible for. She states that "lactivists" (really?? is she trying to be the next Rush Limbaugh?) claim that the BFHI is responsible for increasing breastfeeding rates, when in reality, that is due to other factors, yet I see no evidence for what those factors are. She states that "good quality" evidence shows that the BFHI is not generalizably beneficial for the U.S., yet I see no evidence to back that up either. Maybe if I had access to the full articles she's referencing I would see it, but the blog post as it stands, to me, is thinly veiled propaganda. And the BFHI is all about money??? Really? What does she think the formula industry exists for? Give me a break.

What was your take?

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LibraSunCNM has 10 years experience and works as a CNM.

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In a capitalistic society we cannot control what companies do for marketing but I certainly don't think the majority of health care providers agree with some of their tactics. As for the pediatrician well, he was being a "richard" as we know some of them can be. I really do think we are all on the same side here. As responsible health care providers, yes, we agree that breastfeeding is the healthiest option for every child...except when it isn't. The problem we see is it seems the pendulum has swung way over to the "breast-feeding or nothing" way of thinking and that has actually been harmful. Hopefully it will soon swing back to a more moderate position where the moms feel supported and the babies are fed!

I agree that, in general, a free market means that companies can market as they please. However, in the specific case of infant formula, the U.S. could choose to adopt the International Code of Marketing of Breastmilk Substitutes put forth by the World Health Organization, to try to ensure that moms and babies don't suffer at the hands of misleading info from formula companies. Since the formula lobby in the U.S. is as powerful as any drug company, however, we have never done so. To me, this is sad.

I absolutely agree we are on the same side. I just hear a lot, and this thread supports this, about the pendulum swinging "too far" in support of breastfeeding, to the detriment of moms and babies, and I just don't see it in my area/workplace/social circle; in fact, I've seen the opposite. Maybe I'm an anomaly. It's funny that someone mentioned "vicious" Facebook groups, because the two breastfeeding support groups I'm a part of have been such amazing resources for me as a new mom and have helped me troubleshoot through several tough times. Moms in both groups are a combination of exclusive breastfeeders and mixed feeders and there is no judgement from anyone.

Glad to keep this dialogue going.

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Elvish is a BSN, DNP, RN, NP and works as a OB, Nursery.

3 Followers; 17 Articles; 65,701 Visitors; 5,259 Posts

I'm doing my dissertation on breastfeeding - specifically, how to increase population breastfeeding rates via education of staff. It's hard. Women don't choose to breastfeed (or formula feed) in a vacuum. Staff education and assistance is one component, but you're also dealing with culture, religion, family systems, job requirements (it's often hard to take pump breaks even if they're legally mandated), and a dozen other things.

In doing chart reviews pre- and post-intervention I found that A LOT of women start out breastfeeding in the hospital and somewhere between days 4 and 30 postpartum, things often go sideways. I think we all kind of know that happens, but to see it in black and white that from the time women leave the hospital until about a month postpartum (in my case I am looking at WIC charts) the % of breastfeeding women dropped by half or more at the facility where I'm doing my project. They get home from the hospital and milk's not in, nipples are sore, the baby's screaming, and mom's exhausted, or pick your reason. It's easier to give a bottle. I really think we are failing new moms in a lot of areas, this being a primary one. We ask them to breastfeed but don't support them when they try, and when breastfeeding doesn't work we berate them. This is of course a generalization, but y'all get my point.

Formula companies advertise their products way too much, IMO. Formula's good when we need it but we don't need it to be advertised to consumers. Everyone knows it's out there. Like everyone else trying to sell a product, formula companies are not above sleight of hand. The International Code for the Marketing of Breastmilk Substitutes has been out since 1981. It's not new.

In the case of medical necessity, I absolutely agree - fed is best. That's what the leading reference texts say too. I'm glad to work in a place where the LCs are practical as much as they are passionate. OP, I'm glad you and your wife have found what works for you.

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LibraSunCNM has 10 years experience and works as a CNM.

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I'm doing my dissertation on breastfeeding - specifically, how to increase population breastfeeding rates via education of staff. It's hard. Women don't choose to breastfeed (or formula feed) in a vacuum. Staff education and assistance is one component, but you're also dealing with culture, religion, family systems, job requirements (it's often hard to take pump breaks even if they're legally mandated), and a dozen other things.

In doing chart reviews pre- and post-intervention I found that A LOT of women start out breastfeeding in the hospital and somewhere between days 4 and 30 postpartum, things often go sideways. I think we all kind of know that happens, but to see it in black and white that from the time women leave the hospital until about a month postpartum (in my case I am looking at WIC charts) the % of breastfeeding women dropped by half or more at the facility where I'm doing my project. They get home from the hospital and milk's not in, nipples are sore, the baby's screaming, and mom's exhausted, or pick your reason. It's easier to give a bottle. I really think we are failing new moms in a lot of areas, this being a primary one. We ask them to breastfeed but don't support them when they try, and when breastfeeding doesn't work we berate them. This is of course a generalization, but y'all get my point.

Formula companies advertise their products way too much, IMO. Formula's good when we need it but we don't need it to be advertised to consumers. Everyone knows it's out there. Like everyone else trying to sell a product, formula companies are not above sleight of hand. The International Code for the Marketing of Breastmilk Substitutes has been out since 1981. It's not new.

In the case of medical necessity, I absolutely agree - fed is best. That's what the leading reference texts say too. I'm glad to work in a place where the LCs are practical as much as they are passionate. OP, I'm glad you and your wife have found what works for you.

All of this, 100%.

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Thank you for writing this - MY son was born mildly premature and had seizures. He was whisked away from my arms to a NICU within hours of being born. During my pregnancy my breast never became engorged and I was never successful at breastfeeding or pumping. I had two different lactation consultants. the first was full of Rah Rah keep trying - the second thought I had something called aplastic breasts and would not be able to breastfeed. She helped me understand that the most important thing was that my son got enough to eat. He required a specific formula high in magnesium to prevent his seizures. As he matured his seizure disorder just simply went away. He is a healthy happy 15 year old today.

Thanks again

Hppy

I have IGT caused by hypoplastic breasts. I have 4 children, and saw approximately 20 lactation consultants between the 4 babies. I didn't figure out what my issue was until baby number 3 was almost 3 months old. Only ONE....ONE LC out of 20 knew what it meant for me to have hypoplastic breast. I do NOT have enough glandular tissue. My breasts are not shaped like normal breasts, they do not grow during pregnancy, they do not leak colostrum (ever), I cannot squeeze out a drop of milk if my life depended on it. I produce VERY VERY little (like MAYBE 1oz a day if I'm lucky).

I had a royal B*tich of a lactation consultant tell me that I was just "not trying" hard enough when I went to see her when I was desperate when baby #3 was 2 months old. I had been nursing every 2 hours, pumping in between each nursing session. Taking around 10 herbal supplements that were supposed to increase supply, and even taking a rx with a off label use of increased milk supply. I was eating any food I could that had even a rumor of having a positive impact on supply.

The babies were being fed formula, at the breast, using a small amount of tubing taped to my nipple. She told me that using formula was taking the easy way out (right, because what I was doing was EASY). When I was in her office, she weighed the baby, had me nurse (20 mins on each side) then weighed the baby again.... NO INCREASE in weight. Not even .1 oz. When I pumped, it would take me 15 - 18 pumping sessions to save up ONE OUNCE. That's less than 1oz a day!!! Yet...according to her, I wasn't "trying." I have never in my life wanted to punch someone so badly.

I would have loved to have breast fed my babies. I was breast fed, my sisters breast feed their kids (an average of 18 months per kid). My sisters all have MASSIVE over supplies (like able to nurse a baby, then immediately pump a full 10oz bottle after and do it again in 2 hours kid of supply). For example, my sister had a baby about 4 months before I did.... She had enough of an over supply to feed her child, feed my child....and still have a large freezer stash for "JIC".

The fact that I wasn't physically able to breast feed was a HUGE shock to me. It was crushing, emotionally. It still makes me cry when I think about it, honestly..and my youngest is 2.5.

I think that there are definitely people who take the "breast is best" WAY to far. Yes, everyone should be encouraged to try it. Everyone should be offered support and correct information that will hopefully help them to be successful. I don't believe that formula is "just as good" as breast milk. Is it a healthy alternative? Yes. But there is just so much more that breastmilk can give that science hasn't been able to duplicate yet. Mothers who cant BF, or choose not to, should NOT be told that they are not trying hard enough, or that formula is harming their child. FED is best.

Edited by Mkakids

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klone has 13 years experience as a MSN, RN and works as a Director of OB Services.

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All these stories make me so angry. I cannot even FATHOM a lactation consultant telling a mom "You're just not trying hard enough" (I'm not saying I don't believe you, just that it's so outside my own boundaries of appropriate behavior as a lactation consultant that it leaves me flabbergasted).

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1,535 Visitors; 88 Posts

All these stories make me so angry. I cannot even FATHOM a lactation consultant telling a mom "You're just not trying hard enough" (I'm not saying I don't believe you, just that it's so outside my own boundaries of appropriate behavior as a lactation consultant that it leaves me flabbergasted).

I should clarify... the VAST majority of the LC's I saw were genuinely nice and trying to help.... that that ONE nasty one.... ruined my desire to seek another LC out. Which is the entire point..... educate... teach... encourage and support. Don't belittle or demean or you will lose your audience and credibility.

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