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

Nurses Article   (19,314 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 5 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.

quazar has 20 years experience.

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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.
Just to clarify before I say anything else, I agree that there needs to be moderation in formula promotion, yes, and the marketing they do (especially pushing it in 3rd world countries with no reliable source of clean water. omg....). I think experiences and attitudes with breastfeeding vary by geographic location. Where I live, it's a very liberal/earthy/hippie/crunchy/granola-friendly type area. Freestanding birth centers, able to go shopping in actual stores (as in more than just one) for infant slings and cloth diapers, an active midwifery and doula population, lots of unschooling and homeschooling families, etc.. In my area, for example, on a playdate one time, one of my mom friends just sat down in the grass in the middle of the (very heavily occupied) city park and breastfed her 3 year old child. No one blinked. Bottle feeding mothers, however, get snide comments and the stink eye out in public often. I hear the comments made and see the nasty looks. I struggled to nurse my babies, and although I nursed both of them successfully into toddlerhood, I absolutely 100% HAD TO supplement the first one. I remember how guilty and embarrassed I felt giving him a bottle in public, like I had to hide. I was so relieved when he was able to suck effectively and my supply was adequate enough so that I didn't have to give a bottle any more. It took me over a month to get there, though, and it was a mighty struggle.

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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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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.

Oh. See, that's unfair.

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.

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NurseCard has 13 years experience as a ADN and works as a RN.

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I too felt "breast is best", and struggled to breastfeed both of my

children. My daughter would not latch on, lost a lot of weight, and

ended up having to stay an extra day in the hospital, during which the

peds doctors ordered me to give her formula. She eventually did

learn how to latch on and I breastfed and gave her formula both,

for two months. I would have breastfed her longer, but I pretty

much dried up it seemed, plus I had to go back to work.

My son did latch on and was quite the successful feeder. The

problems? HORRIBLY painful, scabby nipples. Plus, the child

would stay latched on for, no kidding, six or seven hours at a

time and cry soon after I took him off! Then, when I tried to

pump, I would never get any milk out. So, when I went back

to work, so went the breastfeeding.

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NurseLife88 is a ADN, RN and works as a Peds Nurse.

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I am just going to share my personal experience with the subject. I have three children all breastfed but all differently. My first was what most would consider textbook easy. He latched on well, he got plenty to eat, and both of us were happy and healthy. During this first experience I had only one interaction with a lactation consultant whom spoke with me about 5 minutes offered up some reading material and never returned. Thank my lucky stars it came easily. My second child initially latched on well but due to complications after birth he was placed on NG tube feedings. Therefore I had to pump. Pumping for me was uncomfortable and always had been but I still did it because the breast is best was always in my mind, even more so with the complications. The hospital offered the use of pump, freezer, and fridge. They were helpful and provided me with a lot of independence in my feeding choices. After the NG was discontinued it was not easy to get back into the routine. There were many tears and difficult times. I was still breastfeeding when I became pregnant again, not solely but approximately 2/3 of the diet. I ended up stopping as advised by my OB due to problems not gaining weight amongst issues with low milk production. My littlest was also breastfed. But never really seemed to be full and fussed often so I chose to supplement with formula and it made a big difference in size as well as fussiness. All babies are different and some do better with different methods. All mom's are different and the choice they make in how to feed their children is really theirs alone. Yes unless we live under a rock we all know the benefits of breast milk. But we also live in a time where there are so many healthy substitutes that may work better for some moms and babies. Breastfeeding may be great for some women and not for others. And there is absolutely nothing wrong with that at all.

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4 Followers; 17,781 Visitors; 2,731 Posts

Oh. See, that's unfair.

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.

You make a good point Klone but perhaps the difference is the emotional mess many women are in as they adjust to being moms, especially first timers, leaves them a little more sensitive and so the impact, positive or negative, leaves a more permanent mark. I'm not sure calling those feelings "un-fair" isn't a little heavy-handed. It's true we shouldn't paint an entire profession based off one encounter but the feelings are understandable.

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I think

More teaching and follow up needs to be done after discharge on the fact that when moms go home some never produce enough milk for their baby. My son was the perfect baby in the hospital. Our first night home out of nowhere he became very fussy and cried nonstop for a few hours. Nothing we did helped. I tried breastfeeding but at that point my milk hadnt come in. Finally at 4 in the morning contemplating taking him to the ER I noticed his mouth and tongue were like sandpaper and his lips were dry and cracked. I had a sample of formula that was sent to me in the mail and nervously decided to try. I fed him 2 oz and he stopped crying and went right to sleep!!!! I was so upset. They make it as if you give them formula then they will never want the breast. Not true!!!! Im glad I did this bc now Ive heard horror stories about babies not being fed sufficienty and ended up with complications. Also i think its not one size fits all. The nurses assure you that your baby can go a few days without feeding after birth but how can you compare a baby born at 7lbs versus say 9 or 10 lbs. My son was 9lbs 4 oz. So logically I would this his need is more than a smaller baby. They should account for this!!

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AtHomeNurse has 16 years experience and works as a Home care RN.

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Okay, I have just read the OP, not any of the responses. And I will preface this with full disclosure: I am an OB nurse and an IBCLC.

I am also a mom of three children, all of whom were breastfed, but all of them with their own sets of challenges, including primary lactation failure with my last child, which resulted in my son being diagnosed with failure to thrive at a month old, and necessitated supplementation for half of his nutritional needs until he was well into solids.

My philosophy as a lactation consultant is that I need to meet the mom where she's at. I cannot and will not be MORE invested in making breastfeeding work than she is. I never spend more than about 10-15 minutes at a time trying to get baby latched. More than that means an exhausted baby and a frustrated mom, and those are not conducive to learning a new skill.

The first rule that any good lactation consultant knows is: FEED THE BABY. If breastmilk isn't available, formula is the next best thing. If baby is not eating well at the breast, we know that pumping is important both to stimulate milk production and to extract milk that we can give to the baby.

Formula is something that we are glad we have when needed, but it is not the best for baby, and does carry risks. Ideally, if mom does not have milk to give baby, every nursery should have pasteurized donor breastmilk available with which to supplement.

The Baby-Friendly Hospital Initiative, when implemented as it was designed, is a beautiful thing. If a woman doesn't want to breastfeed, or cannot breastfed, she does not need a physician's order to give her baby formula. For women who are trying to make breastfeeding work, it makes sense to have a physician's order to provide parameters for which nurses are to give formula. But at any time, if the parent wants to give formula, they can. They don't need an order. It's YOUR child. Not your pediatrician's.

I'm sorry you were failed by the providers at your hospital. I could tell you stories, because in many ways, I too was failed with my last child.

But in the grand scheme, breastmilk or formula, it's such a tiny blip in your child's life. If your child is fed and loved, that's all I, as a nurse and a lactation consultant and a mom, ultimately care about.

To the part I bolded, can you back this up with anything? What risk does formula carry? Do you also realize that you have gone ahead and continued to guilt trip moms who can't, or choose not to breastfed? You are perpetuating the guilt heaped on woman who don't breastfeed, and for what?

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LibraSunCNM has 10 years experience and works as a CNM.

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Perhaps the difference is the emotional mess many women are in as they adjust to being moms, especially first timers, leaves them a little more sensitive and so the impact, positive or negative, leaves a more permanent mark.

I think this is a very important point. I can see how the most innocently intended comment could be construed as judgment when something you really wanted to do for your baby isn't working and you're devastated about it. And then there seem to be more than a few women who received not just innocent, but extremely unprofessional and hurtful comments as well, which would obviously make things inordinately worse.

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LibraSunCNM has 10 years experience and works as a CNM.

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To the part I bolded, can you back this up with anything? What risk does formula carry? Do you also realize that you have gone ahead and continued to guilt trip moms who can't, or choose not to breastfed? You are perpetuating the guilt heaped on woman who don't breastfeed, and for what?

Really? You don't believe that formula carries risks? In addition to the risks I already listed that can occur with contamination, which, as I stated, has happened here in the U.S., not just third world countries with no access to clean water, there are stacks of research showing that formula feeding increases a baby's risk of developing obesity, asthma, Type I and Type II diabetes, SIDS, and even some childhood cancers. Additionally, literature show that moms are missing out on the decreased risk of breast and ovarian cancer, diabetes and metabolic disease that breastfeeding affords. Stating these risks is not guilt-tripping anyone. These are supported by research. Your argument is like saying promoting vaccinations for kids is automatically guilt-tripping anti-vaxxers, when in fact, it's just stating the science.

And before anyone jumps in with their anecdotes, yes I know plenty of formula fed babies that are healthy as horses, and plenty of breastfed babies who get sick all of the time, and I do know women who have breastfed who have had breast cancer, but that doesn't negate the fact that the large bodies of research we have support the risks to formula that I've listed, and that in no way equates to guilt-tripping anyone.

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I think this is a very important point. I can see how the most innocently intended comment could be construed as judgment when something you really wanted to do for your baby isn't working and you're devastated about it. And then there seem to be more than a few women who received not just innocent, but extremely unprofessional and hurtful comments as well, which would obviously make things inordinately worse.

This a million times over. Beautifully stated!

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AtHomeNurse has 16 years experience and works as a Home care RN.

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Nearly 12 years ago I had my healthy, full term son with every intention to breastfeed exclusively. I was ready. When he was just a few hours old he had a low blood sugar, over the next 12 hours I would nurse, then the wonderful on nurses would cup feed, and on and on. No matter what we did he couldn't keep his blood sugar or temperature up and off to the nice he went. He spent 5 days, in that time I never had any engorgement etc. I kept nursing on demand, and topping off with a bottle. For the next 2 months at home I was a wreck. We made several visits to an LC. I took reglan, I would nurse for 15-20 minutes each side, top him off with formula in an SMS system then pump for 20 minutes each side. By the time I was done the process it would be time to start again. I was a mess, and finally decided in hysterical tears that I couldn't do it anymore and switched to bottles exclusively.

8 years ago baby number 2 was coming. I convinced myself that my problems with baby number one were due to the stress of his nicu stay, this time I was going to exclusively breastfeed. I spent hours researching breastfeeding, bought herbs, supplements and teas, I was ready. She came along, healthy, latched beautifully, we were home 24 hours after she was born. All seemed ok, except she nursed constantly, and fussed whenever she wasn't. I reached out to LC''s and support groups they all strongly encouraged breastfeeding, formula is evil, don't cave just persist! Finally my husband gave her some formula one night since she just never seemed ok, she sucked it down and I was worried. I made an appointment with an LC the next day, she wanted to do weighted feeding. At nearly 2 weeks old my girl was still under her birth weight. Weighted feeds showed she was getting about an ounce total from me. The LC was so concerned she handed me a bottle and didn't let us leave until my girl had eaten, and strongly suggested supplementing. Her evaluation of all factors was no matter what I did my breasts were not going to produce enough milk to feed a baby, ever. I cried, a lot. I had been starving my baby, and for what? Because I had let other people convince me that to be a good mom I must never give my child formula?

So with my second child I continued to breastfeed and formula feed until she was 7 months (I had some medical issues and the medication I was taking wasn't compatable). She nursed for comfort a lot, she was a clingy needy baby and what she needed was me. I stopped feeing guilty that she always needed a bottle to top off. She was healthy, happy, and growing.

So, I almost starved my baby. I spent months with my first baby stressed and crying. I was the recipient of dirty looks and snide comments when I gave my babies a bottle out in public. I was a failure to many. And for what? Having a body that didn't do what it was supposed to? I think breastfeeding is great, but the aggressive push at all costs has got to stop. Formula is a safe and healthy alternative for parents who can't or don't want to breastfeed. I am an intelligent woman, a nurse for goodness sake and the preassure to breastfeed led me to starve my second child and miss out on so much with my first. It's out of control!

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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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To the part I bolded, can you back this up with anything? What risk does formula carry? Do you also realize that you have gone ahead and continued to guilt trip moms who can't, or choose not to breastfed? You are perpetuating the guilt heaped on woman who don't breastfeed, and for what?

Libra covered it succinctly, but I will expound if you wish.

And I will repeat what she said above, and yeah, Imma shout here: ACKNOWLEDGING IN A PROFESSIONAL HEALTHCARE FORUM THAT FORMULA USE CARRIES HEALTH RISKS IS NOT PERPETUATING MOMMY GUILT.

Do you REALLY think I go around saying that to moms in the hospital who need to use formula, or even WANT to use formula?

The World Health Organization lists formula as the THIRD best option for women who need to provide supplementation to their newborns.

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