Saturday, October 10, 2009

It's All About Choice

I am joining a discussion about breastfeeding. If you have a couple hours to spare reading links...continue on.

SuSu posed some questions to formula feeding mothers (there are numerous links through her site) I am not, nor have I ever been a formula feeding mother. The following is my opinion, and is strictly based on my experiences and observations.

No animals were harmed in the writing of this post.

Breastfeeding is a choice. Hopefully, while a women is pregnant she thinks about whether she will put her baby to the breast, or whether she will opt to formula feed her baby. I think much of her decision is based on what she has been exposed to. My mother breastfed all five of her children. My aunts all breastfed. Most of the women I knew breastfed their children. When I heard horror stories about breastfeeding I was able to easily blow them off. My mother nursed my little sister while I was in labor with my son. Obviously, my exposure to breastfeeding was ample. Not once did I consider doing otherwise.

However...

It's never that simple. It's not just a choice, or a desire to breastfeed that makes it so. Like many things you desire, once you walk into a hospital to deliver a baby, your desires often fall to the bottom of the list...and breastfeeding is easily at the bottom...right before "natural delivery". Your success in breastfeeding can easily be tossed aside due to interventions. It never happens that way of course, and I don't mean to imply that your medical staff is crossing it off while your laboring, but it happens...one supplemental bottle at a time.

I fought to nurse my son. Right after his birth, and for the entire next week. He lost over a pound in 5 days, not because my milk was inadequate, but simply because he wanted to sleep. I spent hours in the mother's lounge across the hall from his NICU room in order to assure that the milk they fed him in that bottle, was mine. I spent hours trying to get him to latch on and eat. I was told by several nurses to just "feed him formula", and had I not been so determined, I might have.

My sister struggled for a week to get my nephew nursing. She had a cesarean with him, and then he got an extended stay in the NICU. I watched my niece struggle with nursing her son, but the staff was stressing about him not gaining enough weight. In both cases I was able to see the frustration with mom, and the ease at which the staff was able to hand them a bottle. I could see how easy it was to throw up the white flag and surrender.

One of the original studies that started this debate (you'd have to follow several other links to get there) cites bottle feeding as a risk factor for PPD. I think it all depends on why the mother is bottle feeding in the first place.

Was it her choice?

Did she decide to feed her baby formula because she will be returning to work? Is her employer supportive of nursing mothers? Does she have access to a place to pump? Or time to do so? For the majority of women, the answers to these questions would be a deciding factor on whether or not they will be breastfeeding.

I think that a general lack of support is the biggest factor behind women ceasing to breastfeed. Support from hospital staff, support from family and friends, and support from the employer. I think poor birth outcomes is a contributing factor to formula feeding, and any resulting PPD. Lets not forget that a history of depression might be a huge factor as well.

What about women who just don't want to breastfeed? I would much rather see a woman happily formula feeding her baby, than grudgingly breastfeeding. For whatever reasons, I believe a woman has the right to choose how she feeds her child. A woman shouldn't feel obligated to breastfeed, anymore than she should be encouraged to formula feed. She should be given the support to do whatever it is that she desires. I only ask that they own up to it, whatever it is.

While there are genuine medical reasons to stop breastfeeding, I think that they are in the minority. There may be no studies to conclusively prove that medications in your milk don't harm your baby, just as there are no studies that prove immunizations do no harm...but folks keep shooting up their kids anyway. It's all in your perspective.

Were women given better care in the hospital, and more respect were shown for their choices, I think that there would be a smaller incidence of default formula feeding and PPD. I think that many women subconsciously come out of their deliveries feeling like they can't do anything right. Modern obstetrics care contributes to PPD. From the time you enter the hospital you are given doubt in your body to labor, push, and then breastfeed. No wonder women go home depressed!

How on earth are we supposed to feel confident in our ability to care for a child when we couldn't even get the delivery right?

12 comments:

  1. Exactly! If you start out a failure in this mothering thing just continue on the path....no, not really but it feels like that sometime.

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  2. I used to get sort of upset when mothers chose not to breastfeed. They would use excuses like they didnt produce enough milk, or the baby wasnt latching on correctly or it hurt too bad, or whatever. I was ranting about this to my midwife shortly after my baby was born and she just said simply, "Holly, they don't want to breastfeed." I stopped in my tracks and thought, huh- ok. I guess I can respect that. It is the mother's choice how she wants to feed her baby. And while I cant quite understand why a mama would NOT want to breastfeed, its ok that I don't understand, because frankly, its none of my business! A lot of my close friends formula feed their babies and there isn't a damn thing I can do about it!-Nor should I try to do something about it! I would hope that if a young mother did want to breastfeed and was having problems, then I could be a go to person.(Along with La Leche League or their own mother)

    That is an interesting point about Postpartum Depression. Makes sense.

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  3. I came from Rebirth. All the women around me have their babies at home, with a midwife, nurse, cloth diaper and carry babies in a sling. It was always strange to talk about this in my office - where formula, disposable diapers, bucket car seats and hospital births were the norm.

    Perhaps what bothers me most about the breast/formula debate is that it becomes another opportunity for mummy wars. Which just makes me sick.

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  4. "How on earth are we supposed to feel confident in our ability to care for a child when we couldn't even get the delivery right?"

    For real. I wish I had something more insightful or witty to say, but really it all just boils down to agreement and the crap-tastic reality most women exist in when it comes to being respected, fully informed, and treated with dignity surrounding their birthing time.

    For real.

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  5. lack of support from the hospital is often one of the first reasons why mothers either don't or quit breastfeeding after birth.

    my post about it at custom made milk
    http://custommademilk.wordpress.com/2009/03/21/guest-post-mrs-michael-on-hospitals-breastfeeding/

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  6. When I had both my children I had a c-section, they both had jaundice (b/c of different blood types) and ended up with 24 hour bili lights. EVERY single time I tried to feed my sleepy, weight losing infants, a nurse was trying to help me get them latch on. I went through all of the lactation consultants on staff, I tried and tried and insisted on only the tiny amount of milk I produced only be given to them. Even after the dr. went behind my back after I told her not to give my baby formua (still irritated after that one because she thought I was giving permission when I said I wanted what was best for my baby) anyway... I am still breastfeeding my almost 1 year old. It does work when you really want it too, but if I didn't try 100% then she would probably be formua fed right now. (I b/f my son until 10 months when I decided to stop to give my body a rest for baby #2!)

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  7. I came by via Rebirth. I love the blog from what I can see so far.

    I'm in month 3 of nursing my daughter after a cesarean. My second child, with 15 years in between her and the first. I nursed the first exclusively for her first year. Both girls did their part great right from the beginning and my milk supply has always been ample.

    That being said...

    When I did this before, none of my peers had even been pregnant. I was like the know-all mother. I felt no pressure to do anything any certain way based on what others had done. The generation ahead of me was old-fashioned and I was the pioneer for my generation. Now, as I'm going through this a second time, most, if not all, my friends and family now have children. I don't know anyone else who had a trouble-free breastfeeding experience. Some blame their body, some blame the baby, some blame the nursing staff for pushing supplemental feeding, some blame to lactation specialists for putting too much pressure.

    The point is, I feel terribly guilty talking about nursing now. I literally say nothing to anyone about how it's going for fear that I will offend. In this kind of an environment, I can imagine that healthy breastfeeding (both physically and emotionally) is very unlikely.

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  8. I do not agree at all the "breastfeeding is a choice." Nothing natural is a choice - doing the UNnatural thing is the "choice". We don't say that eating or urination or menstruation are "choices", do we? But you could use technology to circumvent these basic biological functions, so then why aren't they just "choices?" It is not a choice to be a human mammal. It IS a choice to fore-go our biology in favor of something man-made.

    This argument that breastfeeding is just a choice is the reason that we have hardly any breastfeeding support in the workplace (or anywhere else, for that matter.) Saying it's a "choice" makes it "elective" and therefore easy for insurance companies, employers, and legislators to ignore as a basic function of human biology.

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  9. I agree that it is a choice. What makes me sad is when moms want to nurse and they don't get the support they need to be successful.

    Also it isn't always easy. My first 2 boys nursed easily, even though my first was a preemie and in the NICU for 12 days.

    Then with my 3rd we really struggled. He had trouble latching, I had to supplement and pump. It was HARD. If I hadn't had the first 2 positive experiences I think I would have given up. But instead I kept on. I had good support and we succeeded at having a 15 month of great breastfeeding.

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  10. Feminist Breeder, excellent point. You hit the nail on the head. Bottle feeding is a choice. Breastfeeding is a natural function of all living mothers. I have nothing against the bottle feeding moms. But, wow, what a beautiful experience to nurse your own baby. And I did have plenty of family members try to sabbatoge my nursing because they wanted more to do with both of my babies.

    With my firstborn the hospital scared me and insisted that I let my son take formula to force the bilirubin out of his system. He had jaundice due to his blood type being different from mine. I was able to nurse him the following day. Because he had taken supplemental feedings the rest of the family wanted a chance to feed him. So every now and then I let them do a supplemental feeding. It did help in that I could take a nap while someone watched him. I weaned him too soon. About 5 months. I felt guilty and questioned if I did the right thing, but I was also dealing with postpartum depression.

    When I had my second child she went straight to the breast and refused an artificial nipple. I nursed her until she was 13 months old. The pediatrician asked if I really wanted to wean her when she was a year or if I had family members giving me grief. I told her at that time it was both. I continued nursing her for another month until I had to stay in the hospital with my spouse for an emergency surgery. I am grateful for those 13 months. :)

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  11. I had to fight tooth and nail to ensure that my baby was not supplemented in the hospital. There was no "real" reason to supplement. He did not lose too much weight and he was latching on fine, but he was sleepy. There was one nurse who decided that I let him sleep too long and that I didn't feed him for long enough. Anyone who knows anything about bfing knows that you cannot time feedings. She ended up ordering a blood sugar test for him. I think she thought that she could force me to supplement that way. His blood sugar was .1 below the hospital standard with the little porta tester so she ordered a "true" sugar which came back fine. He had to be poked every few hours for the next day and he cried evey time because of that .1. I still have trouble believing that the hospital was so unsupportive! If I were not so stubborn and if I had not taken a bfing class before having my baby I'm not sure how it all would have gone down. All I can say is I never let them supplement and he is perfectly fine.

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  12. Jocelyn--I think your situation is very common, and I believe that many women fall "prey" to medical staff bullying them into doing what goes against nature. It's just one more stituation that you are forced to fight for what you want. Good for you for doing what you felt was right...for yourself and your baby! It's just sad that you had to.

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