How Formula and Fear Ended My First Breastfeeding Journey

The year was 1997, and I entered the hospital where I was planning to birth my first baby. I had read all the books, taken the classes and prepared to the best of my ability for my impending birth. My rolling luggage contained all the supplies recommended by the Lamaze teacher and close friends. I had a well-thought out Birth Plan. In all honesty, my entire plan consisted of avoiding medications and birthing a baby. I assumed that the hospital staff would fill in any blanks I had forgotten to complete. My "water broke" at home, so the hospital policy stressed the importance of remaining in bed to avoid "severe infection." Since we had not discussed this in prenatal classes, I deferred to the attending nurse.

The contractions were as regular as the hands on a clock, which caused the staff to predict a "fast labor." The nurse approached me and explained that the labor could and should be hastened, so I could deliver my baby before the day was out. I excitedly agreed--not comprehending that I was consenting to Pitocin administration. Almost immediately, I was consumed with incredible pain and fear. My body was reacting in a way that seemed uncontrolled or understood by my mind. I was still trying to focus, but was not as successful as I had been the previous hours.

Again, I was approached with an option of "lessening the pain" and "taking the edge off." The nurse offered a visit from the anesthesiologist who would happily provide the epidural--resulting in a "pain free birth." I declined, not because I did not want the relief, but because I had predetermined my pain management goals.

A few hours of intense labor and my son joined us earth-side. I was holding my perfect little baby and, for a time, everything was well in my world. I cuddled and stared in awe until we slept. I felt completely as ease while my baby and I synchronized our breaths and adjusted to our surroundings.

The shattering news was delivered only a few, short hours later. A new nurse (who replaced my kind, supportive day nurse) brought the discovery to my attention. She entered my room and abruptly stated that my son was jaundiced! I looked at her in confusion because we had not discussed this diagnosis in my prenatal classes. I asked if he would be all right. She said that his numbers were at eleven and he needed formula. She also stated that since my seven pound baby was very large, formula was a necessity. I reluctantly explained that I desired to breastfeed. Her quick, rehearsed response was, "Do you want this baby to live, or do you want to breastfeed?" What a terrifying question to be presented with just hours postpartum. What is jaundice? Why is my baby's weight an issue? There were no explanations, just fear and accusations. I immediately consented to formula--considering the alternative that was provided.   I was extremely vigilant in offering a bottle, along with breastmilk for every feed, until I left the hospital. The following day, I was applauded for my baby's progress, which the nurse attributed to the formula. She discharged me with several containers of formula and admonished me to continue feeding formula to safeguard against tragic results.

I took my bundle of joy and bundle of formula and left the hospital. I religiously offered a bottle of formula several times a day to prevent whatever condition would develop without it. I was too afraid of putting my baby at risk to exclusively breastfeed. I never spoke of my breastfeeding journey with friends. I was too embarrassed about them knowing I almost put my baby's life in danger by my "selfish" desire to breastfeed.

My six week check up resulted in more congratulatory remarks about my baby's development. When asked about feeding, I responded with a pro-formula remark since I understood there was a "danger" associated with exclusive breastfeeding. My schedule of formula feeding was positively reinforced and I conceded that my pediatrician was favorable of formula feeding.

At six weeks, when my baby experienced "frequency days," I was convinced that my milk was insufficient to satisfy my baby. I increased the amount of formula, not realizing that in doing so, I was signaling my body to actually slow milk production. By now the free samples had disappeared and I was investing hundreds of dollars into a breastmilk substitute. I read all the propaganda and purchased the most attractive cans that touted a closeness to breastmilk. Once again, my ignorance won out. I invested in a product that was trying its best to mimic the fluid I had in abundance.



My breastfeeding journey ended so much sooner than I desired. I had a personal goal of nourishing my outside of the womb just as I had for nine months. No one questioned how my body could grow a baby for forty weeks. No one questioned if I was providing adequate nutrition in utero. No one questioned how my body sustained life, but outside of the womb, apparently, my body failed miserably at the task. I questioned everything about my parenting choices. I felt like a failure because I was pronounced a failure. Perception is reality.

My second child made her debut twenty-two months later--at a Baby Friendly designated hospital. My labor plan was supported and within a few hours, I held my daughter skin-to-skin and was breastfeeding. I was prepared to defend my choice this time. I had researched the AAP jaundice guidelines and realized that jaundice was a common condition due to extra red blood cells and I understood what numbers would constitute a legitimate concern. I was ready to confront the fear--but the fear never came. I also anticipated being judged for "giving only breastmilk" to my large baby. After all, she was about the same size as her brother at birth. The judgement never came. My little girl was weighed, her diapers were counted and I was encouraged to "keep up the good work." The following day, an IBCLC visited me to ask how breastfeeding felt and if I was experiencing any pain. She requested that I allow her to observe a feeding session. My little girl latched, sucked and fed for several minutes. The session was used to educate me on signs of milk transfer and recognizing swallows.

The following day, I left the hospital with my bundle of joy and bundle of confidence. I was equipped with knowledge and confidence. I knew my body was capable of nourishing my baby. I knew I could provide milk for my offspring just as every mammal does. I was not going to be bullied or scared into making a choice that I did not agree with. I was older, bolder and more educated.

The combination of advocating for myself and a hospital that supported breastfeeding made my dreams a reality. Breastfeeding continued until her first birthday--and a breastfeeding advocate was born.

My third child presented some feeding challenges. We worked through issues with an IBCLC and each problem I encountered was resolved with a solution that allowed me to continue my breastfeeding relationship. When the issue of jaundice surfaced this time, I supplemented for twenty-four hours with my own expressed breastmilk. I was surprised that this little girl trumped her brother in size. Her birth weight prompted the nurse to advice breastfeeding "every chance I got." A quote that was not followed up with any severe warnings or fear mongering. My hospital stay consisted of small snacks, skin-to-skin holds and frequent feeding. My baby and I were only separated when I showered (at which time she transferred from my chest to her father's). I could not help but contrast this scenario with my first birth. I wondered what that event would have looked like had I been knowledgeable and supported.

Yes, hindsight it 50-50, but I hope foresight can be as well. We have come a long way in our birth and breastfeeding practices. The Baby Friendly Hospital Initiative has laid some great ground-work and provided a foundation for providing in-hospital breastfeeding support. The initiatives, protocols, policies--all aided by skilled and educated health professionals are helping to bring instinct and the biological norms back into the highly medicated and routinely intrusive process of hospital birth.

For those who find themselves where I was as a first-time mom, let me offer you the information and support I so desperately needed. First, you need to know you are amazing. You are, after all, capable of making a person! Your body is a super-factory that is able to create the most intricate life form known. Simultaneously, your body is preparing the perfect nourishment for its creation. What a spectacular system you are equipped with.

Secondly, know that you will face adversaries in your quest to breastfeed. There are people who have made a point to question your ability. I am both saddened and angered that instead of celebrating the power and strength of a woman, some choose to undermine and minimize the uniqueness of our gender. I suppose there are many reasons for the skepticism. Some sabotage breastfeeding for a profit, some out of ignorance and a few from habit. Old wives' tales are difficult to shake.

Here are a few reassuring points you need to commit to memory.

1. Your baby is not born "starving." Although food is often withheld from the laboring woman, the baby's access to nourishment is not interrupted in the womb.
2. Baby's are not born with an "empty" stomach. There is research on how much fluid a baby's empty stomach can hold and malicious people are using that information to question a woman's ability to satisfy her newborn. Remember, baby's gauge is not on "empty" at birth.
3. Mammals have milk for their offspring and instinctively nurse. Visit any zoo, wild animal park, pet store, etc. and ask to see the resident "lactation consultant." You will be met with blank stares and confusion. Mammals have been feeding their newborns for generations.
4. Babies have very tiny tummies. They are born with a desire to suck and suck they will. The more frequently the better. Because the suck reflex exists, if a baby is placed on the breast, he will often begin feeding spontaneously. The baby that is fed frequently, will be satisfied and signal (through hormones and biology) for the mother's breasts to make more milk. 
5. Moms have thick, rich milk the first few days that is full of protective factors and concentrated nutrients. This milk also has a mild laxative effect that encourages the expelling of meconium and reduces the risk of jaundice.
6. Since babies have tiny tummies and moms have small amounts of colostrum, the baby can eat constantly and not get overfed.  In fact, when the baby is satisfied, the suck will change from active eating to pacifying--another way a newborn instinctively stops himself from eating to the point of discomfort. 
7. The best way to make milk is by removing milk. Early, frequent feeds is the key. If a mom and baby are separated at birth, mom should remove milk manually or with a pump within six hours of delivery.
8. For full-term, healthy newborns, breastmilk intake is not measured. It is preferred to allow mom and baby and partner time to recover and bond. Measuring intake is not necessary since there are more favorable ways to ensure milk transfer.
9. Babies should have one wet diaper for every twenty-four hours of life until around day six, when they will begin having 8-10 wet diapers daily. 
10. Initial weight loss is common. Babies should return to birth weight by two weeks of age. It is important to get a good weight at discharge or the first week of life to make certain baby is gaining weight. 

Christy Jo Hendricks, IBCLC, invented the Lactation Lanyard to remind mothers that their milk supply is the standard for feeding, NOT the formula bottles.

The first few days after delivery is mostly about bonding, recovery and feeding. Most women who can birth can also breastfeed. It is the way a mammals body works. There are conditions (like the ones I had after delivering my third child) that require intervention and support.

Warning signs can include:

• No, or little diaper output
• Discontent, inconsolable infant
• Continued weight loss
• Signs of dehydration
• High billirubin
• Constant feeding without satisfaction

The breastfeeding mother may show warning signs:

• Little or no change in her breasts during pregnancy
• Breasts that do not feel softer after a feeding
• Pain while breastfeeding
• Diagnosis of retained placenta

The above is not an exhaustive list nor is it a list of reasons to abandon the breastfeeding path. These are, however, a few reasons to involve an IBCLC in your journey. Occasionally, temporary supplementation is necessary or even long-term supplementation, but a lactation professional can advise you on how much more milk is needed and what kind of supplementation is available.

Data shows that most moms want to breastfeed. Who are we to downplay their desires. We should do all we can to support the goals of women in our society, who, after all, are creating society. To effortlessly dismiss a woman's goal of providing human milk to her newborn or to sabotage her goals with fear and false information is disgraceful.

I have spoken with many women who feel robbed of the breastfeeding experience and others that are angry that they did not have the support or education that would have resolved their issues. The groups that are preying on these women to gain followers or instigate more anger and resentment are indeed deplorable. I hope we can see our government, communities, families, health agencies and medical professionals working to support breastfeeding and empower moms rather than stripping them of their goals and power.