Posted by: Hannah | 01/11/2012

long rant about breastfeeding

To answer a question from yesterday, yes, I’ll be giving the new baby a blog name soon – dear Hubs announced the real names of all three boys on Twitter, so I didn’t see the point dissembling on the blog. But I won’t use it again. I’m thinking that to fit the theme, “Neville” would be a good choice. Besides, Neville is the hero who steps out of the shadow of the two main characters to save the day. Pretty good omen, right?

***

I’ve had a post brewing for a few days now; pretty much since Saturday evening, after a long boring day in the hospital staring at the walls around me and being checked every hour on the hour (I didn’t hemorrhage, exactly, but it took a long long time for the bleeding to stop. TMI, I know. But it’s why I pretty much spent the first day of Baby’s life curled up in bed, not walking or even standing much.)

All three of my babies were born here, at the IWK Health Centre. It’s a huge hospital, and if you or your child has an acute or chronic illness they certainly provide, from all I’ve heard, excellent care. It’s a teaching facility with lots of dedicated staff and I know I’m lucky to have them practically on my doorstep.

BUT.

They are fiercely pro-breastfeeding. On their website, they state that “The IWK Health Centre seeks to protect, promote and support breastfeeding and encourages a breastfeeding friendly environment”. They say that all of the nurses and staff in the birth unit are able to help new moms with breastfeeding. There isn’t a room I saw on this last visit – including the early-labour assessment room, the delivery room, and the bathroom in my room on the recovery ward – without posters offering tips for starting breastfeeding off right.

I BFd my two older boys. I had what I would consider a successful outcome in both cases, although it was not easy. With Harry, I had a five-minute meeting with a ‘lactation consultant’ (I put it in quotes because I have no idea what her actual qualifications were) 30 hours after he was born. She grabbed my boob like it was a tomato at the supermarket, rammed it into his mouth, and said “put him on there every two to three hours. If it hurts, pop him off and re-latch him. A proper latch will not hurt.” Then she left.

Well, for the first week every. single. time. that child nursed it felt like someone was sticking a hot nail through my nipple. They cracked, bled a little, then scabbed. I cried when he nursed. And he ALWAYS wanted to nurse, much more frequently than every two to three hours, so I spent a great deal of time trying to distract him from the boobs with pacifiers, a fingertip, heavens knows what, while he cried and fussed and rooted. When he was about a week old my mom came to stay for a few days. She nursed all four of her children for at least a year (and well beyond) and reassured me that even the best latch will make for chapped nipples eventually… that letting him eat when he was hungry was really the best thing, schedules be damned… and that I needed to trust his instincts, and mine. We did eventually get sorted out, but our nursing relationship was never great, and my supply could never meet his demand. I supplemented with formula, started him on solid foods the minute the doctor gave me the go-ahead, and didn’t fight it when he weaned himself at around nine months.

With Ron, there was no LC available at the hospital at all – they don’t work weekends. The public health nurse didn’t do a home visit because it was my second child. I was prepared for the first two weeks to suck – and they did – but I thought we were doing OK. In retrospect we weren’t – he was jaundiced and probably discharged too early, and the follow-up care wasn’t what it should have been because my family doctor didn’t deliver him and no one person was really responsible for his immediate care in that first week. He slept a lot and was a disinterested nurser… result, my supply again didn’t match demand and he weaned himself quite abruptly at seven months once he had tried a bunch of solid foods and decided they were better.

(This is going to be a long post. Sorry about that.)

Enter Baby # 3. While reviewing the ‘what to bring’ list from the IWK last week, I saw something that surprised me a little. If you will not be breastfeeding, it said, bring your own formula, bottles, and all necessary equipment. The IWK protects breastfeeding and as such will not provide these items for parents who bottle feed.

Huh. That’s… not cool.

There are a million reasons why women breastfeed. It’s cheaper, more nutritionally complete, more convenient (eventually), promotes bonding and raises IQ and makes rainbows unicorns poop that doesn’t smell like formula shoot out of your baby’s bottom.

There are also a million reasons why women DON’T breastfeed. Some will be going back to work right away and don’t work in an environment where pumping will be possible. Some have medical conditions or circumstances that make BFing difficult, or not safe. Some just don’t want to. Or won’t have the support at home needed to establish the relationship in those first two or three really tough weeks.

All mothers want the same thing – or they should – happy parents and healthy babies.

Health care providers should want the same.

But right now – they don’t. Or it doesn’t look like they do.

Imagine you’re a first-time mom. You give birth. Your first experience with BFing is being handed your baby shortly after its born, and told “here, put him to your breast. Look, there he goes!” (This is exactly what happened for me all three times, so I know this is the ‘method’ at the IWK, anyway). You feel good, because in most cases it probably works just fine that first time.

Then comes the first 24 – 36 hours. That baby is a cluster-feeding rapacious monster that mouths at you whenever you pick him up. He chomps his way onto your increasingly sore nipples. He gulps. He’s hungry. You’re tired. And an LC tells you that if it hurts, you’re doing it wrong.

OR, your baby is a sleepy puddle of indifferent nursing who needs to be prodded awake every two hours to feed. Strip the baby. Strip yourself. Lay tummy-to-tummy. Tickle his lips until his mouth opens. Keep him awake and sucking even if you are beginning to suspect he has narcolepsy. Your nipples *still* hurt. And an LC once again tells you that you’re not doing it right.

At some point during this first few days, you will cry. Because you have been told that BFing is natural, and wonderful, and the very best thing you can do for your baby, and you hate it a little bit (or a lot) and it feels like you’re failing. You’d rather stick your tits in a rat trap than feed the baby again. And you feel terrible because of it.

***

Yesterday the public health nurse called for the new baby checkup. Here’s the thing – I always try to sound perky! and well-adjusted! and JUST FINE THNX BYE when I get this call, because I hermit until my milk comes in, and if I want any health advice I’ll call my doctor. She started off with “so, how’s the breastfeeding going?” Not “how are you feeding your baby?” or something else non-judgmental. It really rubbed me the wrong way. So did all the other obnoxious, high-pressure lactivist bullshit she spouted during the rest of the call, including:

“Oh, you didn’t nurse your other children for the minimum one year? You should have, you know.”

“Supply problems are always fixable. ALWAYS.”

“If your nipples are sore, you are not getting a good latch. I can come and look at your nipples, if you like.”

“If you weren’t breastfeeding, what were you doing? Supplementing with formula?” (in tones of disgust)

“We are encouraging everyone to nurse for two years. It really is not that difficult! I have many clients who have done so and they are very happy!”

And so on and so on, with me biting my tongue nearly in half because I didn’t want to get tagged as a possible PPD case in the system.

A call like that if this were my first rodeo would have sent me over a cliff of guilt, shame, anger, and inadequacy. As it was, it just really pissed me off on behalf of every other first-time mother that idiot called this week.

My baby is not even a week old. I have been bombarded with pro-BR propaganda… but more alarming to me is the anti-formula rhetoric that’s going with it. The whole ‘promote & protect’ mandate has completely run away with common sense, and now anyone who doesn’t breastfeed is being told by the health care system that they are not doing right by their babies.

It was bad enough when moms would compete and snipe and put each down for their feeding choices / decisions. Now we’ve got the goddamn doctors and nurses doing it, too. With the obvious clear conviction that they are doing the right thing. It’s scary. And sad.

***
One final thought – I was born in 1978. My 19 year old mother was determined to breastfeed. She was the only mom on the ward at the time who was doing so. The nurses thought she was crazy and had to be continually stopped from sneaking me bottles of formula or sugar water. Any time she nursed, she was told to close the curtain around her bed lest the sight ‘upset’ or ‘disgust’ the other mothers. She was judged, maligned, and made to feel small because she was going against the grain, making the choice that best suited her and her baby.

I wonder, if I’d been on a ward and decided to bottle-feed Baby, if I’d have been screened away from the other mothers in case the sight of a bottle disgusted them too much?

 

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Responses

  1. I breastfed all four of my babies, and I had supply issues with every one. And the first two weeks of breastfeeding hurt every time too, even when the latch was perfect.

  2. They really seem to have gone from one extreme to another. If the problem is big enough to leave moms feeling hurt/guilty/whatever, then it needs to stop, but if it’s big enough that someone who doesn’t have or want kids (like me) gets increasingly pissed off as she reads her friend’s predominantly diplomatic and polite rant, then it’s gone way to far. This all sounds very in line with the idea that baby always comes first and that means that society doesn’t care how much the mother suffers (which reminds me of what I consider to be the extreme idea that a mother’s health is always secondary to a childs “right” to be born, even if it means there’s a risk that it’s siblings will lose their mother … what?!). But, how the hell does it help the baby if the mother is stressed out, frustrated, guilt ridden, and in pain? Shouldn’t the focus be on making sure that all things (not just feeding) are good for the baby? That would mean helping moms who have to go back to work find a reasonable (!!) means of feeding their child that won’t get them fired or autracized at work or forcing them to use their much needed breaks trying to find somewhere private where they can pump. That would mean being encouraging to moms and looking for real solutions as opposed to making stupid comments about how other moms can do it better. That would mean accepting the fact that everything isn’t black and white and some moms need to find compromises in the grey zone.

    But, obviously, you know that. So, I’m just preaching to the choir.

  3. I don’t believe any of the it-can-always-work stuff. I had a very rough go. The Bug never latched successfully in the hospital despite the nurses (who were very kind) helping me and some visits with lactation consultants. We kept going to see the LC’s for weeks afterwards. We tried pumping and nipple shields and all kinds of things. In the end, they told me he’d have to get OT/PT to breastfeed. A baby just a few weeks old. We went once… and then I couldn’t do it anymore. (Add mastitis and a supply that never got a chance to come in all the way and it was too much.)

    Now I look back on those first 7 weeks when I was trying to breastfeed and I was miserable. I don’t think I got a chance to bond with my baby the way I would’ve liked because there was always so much stress.

    This time i’m determined to try and hope it goes better. It’s possible this baby won’t have the same problems with lips, palate, tongue, jaw that my last one did. But if we can’t make it work I refuse to make myself miserable. And I refuse to be bullied.

  4. Oooohhh. This opens lots of bad feelings for me. I…can’t even articulate how angry this makes me. Like you say, at least you’re a seasoned mom, but for all those first timers, that kind of judgment can really push a mother into a post-partum funk, if not a depression. Hey, I believe breast is best, but I also believe a healthy baby and a happy mother is the ultimate goal. A FED baby, by whatever means. Promoting and protecting is one thing, kicking a woman in the face is another.

  5. If I had received that phone call, I would have been so upset. My skin feels thick with baby number three. I don’t care if someone doesn’t like my choices – they are mine to make; I have the luxury of choice. But if I had the same phone call from a nurse, I probably would have gone down in a flood of tears. Awful. This stuff is hard & they aren’t making it any easier.

  6. Ugh. I am sorry you experienced that judgement. It is not right. We have gone round the bend on this issue. While I do understand why hospitals are not generally providing formula – their are ethical problems that arise when they receive it for free from companies – I do wish they would purchase some fair and square at market rate for families that need or choose it. I think some of our hospitals locally are moving that was a less extreme position (on either side!).

    We have such a hard time achieving balance as a culture when it comes to mothering and babies. I wish I had something more hopeful to say but it does seem like a hamster wheel we cannot get off.

    I say this is a birth doula and childbirth educator who is pro-breastfeeding, we all need to be more compassionate, more aware of our own bias and less in a hurry to label, dictate and advice mothers. We need to listen more and to ask more open ended questions. I promise some of us are trying.

    Thanks for helping to take off the cultural binders more and more of us have in this area.

  7. I think this whole issue is fraught with guilt because of the “best” part. For instance, it is BEST for my kids not to watch as much tv as they do, and eat better nutritionally, but hey….

    I wonder if a better approach is the “breastfeeding is normal”. And the assumption that one is breastfeeding falls in line with it. There is nothing “second best” about formula or other supplementation, it just isn’t normal. What we can’t do is get back to the years before WWII where there weren’t any other options, so all babies were successfully breastfed or they died. KWIM? On the other hand, at that time, all women had experience with it, or had a hundred relatives that did, and problems were more familially taken care of.

    So, if we treat breastfeeding as normal, but provide support, emotional and educational, for the mothers, and encourage them to ask for help if it isn’t going well, I think that is a good thing, and not guilt inducing. The problem, as I see it, with formula, is that it is often provided, in large quantities, just “in case breastfeeding isn’t ‘working'”. And what happens is that that first week, which is very intense even at the best of times, and really painful and heartbreaking often, is the most vulnerable for a new mother. And in the middle of the night when she is four days post-partum and her milk hasn’t come in, and she has what appears to be a STARVING baby, she breaks down and gives him a bottle and he appears satisfied and then she does it more and b/c he is no longer nursing as much, her supply never really sorts itself out, etc. etc. etc. And then it is just easier to feed more, or all formula, and so she “quits.” And if she has another baby, depending on how horrid the first experience was, maybe she doesn’t even try. No one has told her that she will probably make more milk the second time around b/c she made more breast tissue.

    There are a BUNCH of issues here, all fraught with emotion because we WANT to be good moms.

    I say all this )disjointedly) as one with low supply. I have hypoplasia and just don’t have enough breast tissue to do it. I had to supplement both my boys, the first much more than the second. I do wonder what would have happened if I lived 100 years ago. I probably would have had to milk share, or farm out my kids, or something.

    Gah.

  8. One of the best things the nurses at my hospital did to support my breastfeeding was hooking me up with a little vial of formula that I could stick between my boobs with a little tube attached that I could stick on my nipple. Pie had a tendency to just scream when she was hungry – she wouldn’t latch on – but if we dribbled a little bit of formula into her mouth she’d start sucking and the rest of the feeding would go fine. Both my babies were ravenously hungry for several days before my milk came in, and with Bub, I felt as if every drop of formula were poisoning him – at least the second time around I understood that my milk would come in eventually, and that a few ounces of formula in the meantime would only make both of us happier. In both cases, I then went on to breastfeed exclusively from the day the milk came in until they were ready to take solids – I’m just GLAD my babies were born before formula became totally contraband in the hospital.

  9. UGH. Why don’ they understand?! Fighting social stigma of nursing mothers and making sure people aren’t all “Ew! Boobs are for SEX, not for babies” is one thing. But being pro-breastfeeding isn’t the same thing as being anti-formula. And stigmatizing non-nursers is just as unhelpful as stigmatizing nursers. And just as distressing for the mom in question. As if moms didn’t get bombarded with enough judgement and shame from their peers, for frack’s sake.

    Shouldn’t moms who have chosen not to nurse be able to get a nurse’s advice on choosing the best formula and on making sure the bottles are clean and whatever else formula feeding entails? At the very (and I do mean VERY) least they have the right to not be written off as a “bad parent” because of their decision.

    My friend struggled with thrush so bad that she got eczema on both nipples. It was absolute agony to nurse her daughter. She tried everything, including a full 3-week elimination diet (while nursing through the pain), but it was too late for her poor boobs, and she ended up weaning her daughter at 9 months. And it pisses me off that we’re dealing with a system where that struggle would be written off by someone as “not doing right by her kid” or “not trying hard enough” or whatever. RAAAR.

    I’m seeing this a LOT all over the place—organizations seeming to think that in order to be pro-something you have to be anti-the-opposite. And it’s hurting so many people. It makes me crazy.

  10. […] a blog and the woman who writes it has just had her third baby. Today she posted this entry: http://hodgepodgeandstrawberries.wor…breastfeeding/ I like the idea of a pro-breastfeeding centre but I was shocked by the judgmental attitudes she […]

  11. I think a big part of the problem is western medicine’s tendency to break things down into its constituent parts and divorce them from their original context (e.g., vitamin c from fruit, breastmilk from the breastfeeding relationship, etc. etc.). So it’s not a mutually beneficial mother-baby dyad but a mother and a baby whose interests are or may be in competition. I will say that when I was in hospital for 3 days with my first’s birth, I didn’t find the lactation consultant helpful – I felt more confused. But my experiences after that with public health nurses and a lactation consultant the community health centre were much better. And I noticed that with two separate public health nurses nearly six years apart, and with the community LC, they all made an explicit effort, before offering any advice, to praise my intuition, my obvious love and care for the child, my determination, or something else that reinforced my confidence and the mama-baby relationship. In fact, it was the community LC from whom I first heard, “Never should on yourself.”

    Breast is best when it’s best for both mother and baby. Breast is not best if, for whatever reason (sexual or other abuse, poor supply, difficulty with mechanics, whatever), it makes the mother miserable. That said, clearly, health professionals can do a lot to alleviate or prevent some of that potential misery.

  12. I just participated in a study on baby feeding in mothers with histories of depression and anxiety, so I got to have a 60 minute long dialogue with the research person about attitudes towards breastfeeding.

    Here’s the thing – I think that our health care needs to be firm on the “breast is best” stance because they are trying to counteract so much other thinking from the surrounding culture. I can’t think when I last saw a woman breastfeed on TV. I have spoken to a lot of mothers who have said things like “well, it’s the baby’s choice, right?” or “well, he was crying and nursing all the time, so I knew he wasn’t getting enough milk” which shows that a lot of people still operate under misconceptions about breastfeeding.

    BUT.

    The health system is pushing the wrong message. Most people know that “Breast is best”. They have been told and told and told that they SHOULD nurse.

    What they aren’t getting is the actual information about HOW to nurse, or WHAT to expect, or WHY giving a single bottle can derail the whole thing.

    So they try, and they fail, and they feel guilty.

    And that’s not what we want.

    The health system is trying to force women to breastfeed, when they should be concentrating on HELPING women breastfeed. MOST women TRY. It’s the success that is the problem, not the initial attitude.

  13. I didn’t get a chance to read what all of the other commenters have said yet- so this may be a repeat of what they’ve said.

    I nursed both kids every HOUR for the first 5 months. I was nursing on demand, and apparently my giant children have my giant husbands appetite. I had SUCH a hard time with Claire (especially). I tried substituting formula (much to the chagrin of the public health nurse) but after a while Claire just rejected the bottle. WOULD NOT USE IT. After much research and pleas for help, someone finally reccommended Newman’s Nipple cream. I swear, I couldn’t have nursed her without using it. It saved me.

    You’d think after nursing Claire for so long (I nursed her for a year, exactly), that it would have been easy when Simon came along but it took over a month for us to get in the swing of things. In the end, I chose to bf because well, it’s free, and it was so much easier. The only reason I wrote all of this was to let you know- if your nipples still hurt, ask for this prescription- it was a lifesaver for me.

  14. […] Some women I know even feel that the hospitals are getting too pushy about it. It’s one thing to educate parents about the benefits of breastfeeding, it’s another thing to harass them about it, or to refuse to help mothers who cannot breastfeed for legitimate medical reasons (mastectomy, incompatible medications, etc). […]

  15. […] they need to start seriously educating people in more than just “breast is best”. We don’t need guilt. We need realistic expectations. We need education. We need practical […]

  16. […] they need to start seriously educating people in more than just “breast is best”. We don’t need guilt. We need realistic expectations. We need education. We need practical […]

  17. Any chance that nurses name was Carmel?

    • I honestly don’t remember. That was almost exactly five years ago now! Did you have a bad experience too?


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