When breastfeeding isn't enough...fed is best

[Birthdaypartyangstiness]

Anyone read this? (TRIGGER WARNING: link is about an infant death due to inadequate diet):

fedisbest.org/2017/02/given-just-one-bottle-still-alive/

It is a hard read but seems worth publicising.

I'm biased because I was in a very similar situation with my first child. Also have mild PCOS, poor fertility and produced copious watery milk with a baby who either screamed or "cluster fed" and suffered significant weight loss (dropped off the chart). And I just kept getting the breast is best message, feed him more etc and persuaded not to give him formula. I "gave in" at about 12 weeks and topped him up with formula and he suddenly thrived. I'm an educated health professional and yet the pressure to exclusively breast feed was enormous and I let go of my own common sense. Looking back now it's clear that there was objective evidence that my supply, though copious, was not nutritious. Milk I expressed sat in the fridge, and when separated due to cold had only the slightest "scum" of fat on top, the rest was just grey water. Showed the midwife and HV and just got the party line that all breast milk varies, you are making what your baby needs blah blah blah. Just ridiculous. We accept that there is variation in all other health matters, so why do we persist with the universal message that breast is best? Thank science for formula.

[AssassinatedBeauty]

Your link doesn't work.

I find the website it comes from to be fairly scaremongering in tone, and nothing in it relates to my experiences of feeding my baby after births in a large UK hospital. This is a US site talking about US data I think?

[littledinaco]

What a sad story

Unfortunately, some babies also die from contaminated formula and the mum's could be saying 'if only I had breastfed, my baby wouldn't have died'.

Formula is used my many parents for many reasons but breastmilk (in the majority of cases) is the best thing to give babies. Fed is better than the baby starving but formula is not comparable to breastmilk.

I'm sorry you had such a tough time.

I think more training on breastfeeding is needed for HCPs as so much poor advice is given.

[littledinaco]

*by many parents

[Birthdaypartyangstiness]

AssasinatedBeauty not sure why you are having problems with the link. Yes it is a US site, but I don't see it having much bearing on the topic really.

My impression is that breast is usually best, but we are all different and there is a problem with pressing this message without taking into account individual differences. Formula has saved lives. And is not as inferior to breast milk as the brestapo would have you believe. You can read this site any day of the week and see the guilt and stress caused by that message.

My experience is far from unique in the UK.

Fortunately things went better second time around (as often happens, the most significant problems in mothers with the problems described in the article are experienced first time round) and DS2 was exclusively breastfed, with good support from LLL. I still had copious watery milk but block feeding and avoiding expressing made a big difference.

[AssassinatedBeauty]

I find use of words like "breastapo" to be really offputting, I wish that this topic could be discussed without these sorts of terms being used.

The issue I have with a US site is that all their data is US based, which has a totally different breastfeeding culture, totally different healthcare system and a totally different maternity leave system. I don't see how what they say is necessarily relevant to the UK. Is this a common issue here? I wonder what the uk stats are regarding newborns dying or being hospitalised with dehydration.

[Whatsername17]

I'm lucky because my expressed milk looks like double cream. With dd1 I had primary lactation failure. Thank science gorgeous formula indeed. It wasn't an 'easy' option for us though - dd1 was lactose sensitive so she didn't do well on formula. She would have died without it though when I didn't lactate. I wish there was more support and proper advice. I wish there wasn't such a divide - people choose a side and get so defensive of it. I've done both now so I'm going to sit firmly in the middle and say just love your babies and feed them however works best.

[HeyRoly]

I hope the tide starts to turn towards a more common sense approach. Sadly, I think we're a long way away from women NOT being told that formula is substandard/potentially dangerous and one should breastfeed at all costs.

This image popped up on my FB news feed a few weeks ago. I was so shocked by the sight of this poor starving baby (contrasting with the Instagram worthy posed shot you see everywhere now) because it was apparent that nobody seemed to realise how ill he looked.

Also note the irony of "he likes eating a lot". Nope. Starving.

Unfortunately, some babies also die from contaminated formula and the mum's could be saying 'if only I had breastfed, my baby wouldn't have died'

I think they'd be more likely to say, "if only the formula wasn't contaminated, my baby wouldn't have died", don't you? Otherwise that sounds a lot like victim blaming to me.

Am also dubious at any recent documented cases of infant death from contaminated formula that wasn't due to incorrect preparation or storage, but that's another thread...

[HeyRoly]

Forgot the image.

[littledinaco]

Brestapo is really offensive.

The US is relevant, they have a completely different breastfeeding culture (a lot more expressing for example) which can cause supply problems for instance.

I'm pleased that breastfeeding worked out for you the second time as it sounds like that's what you wanted. It does go to show though that support and the correct advice is more beneficial than 'formula will fix everything' advice that is often used and can lead to mum who don't want to stopping breastfeeding.

Without knowing the stats for babies dying from dehydration due to insufficient breastmilk it's difficult to discuss. It would be interesting to compare it to the figures of babies dying from problems related to formula.

You are correct, formula saves lives. So does breastmilk.

[AssassinatedBeauty]

This is becoming "don't exclusively breastfeed or your baby will starve" scaremongering with pictures like that though. Are you r

[AssassinatedBeauty]

...sorry, posted too soon.. Are you really saying that in the UK it's likely that babies would be that underweight and not treated appropriately by HCP?

[CaravanOnCraggyIsland]

The US doesn't have the same sort of health surveillance system that we do as well. They don't get postnatel care and health visitors coming into the home and weighing baby.

Plus that website is hardly reliable, this is one woman whose grief has fueled this foundation. We don't know the full story, only what they choose to present. Personally I think it's very damaging to be spreading this website. It's very scaremongering.

[Rocket1982]

Escobar et al. 2002 estimated rehospitalization from dehydration due to breastfeeding problems was just over 1/200. Not that uncommon! More infants will experience moderate dehydration but avoid rehospitalization because of early supplementation with formula. I do agree that the scientific evidence for the benefits of breastfeeding over formula feeding is quite marginal, and the marginal benefit needs to be weighed against the reality of supply problems in the message given to women who struggle with breastfeeding (I was one of them initially both DC lost >10% birth weight and social pressure to EBF from the start caused me much stress!).

[Screamer1]

The problem is that the debate is so divided. My first was readmitted for dehydration and lost 15% of his birthweight. My milk hadn't come in and it was day 3. He was starving.

The pediatricians gave him a bottle of formula and he downed it. I was then put in a regime of expressing, breastfeeding and topping up. I eventually managed to get back to almost completely breastfeeding and continued to do so for 13 months.

This is not a unique story and I have many friends who've gone through similar. If I'd been educated to know that you could top up if your baby was starving in the early days, and how to wean off that too, he would never have ended up in hospital.

I too was told he was cluster feeding, the cluster part was true but the feeding part wasn't.

[Rocket1982]

I have had one baby in the US and one in the UK. Breastfeeding rates are higher in the US than in the UK, and my experience in the US was that there was much more breastfeeding support available (e.g. More lactation consultants available at hospitals and clinics) thank in the UK. They also weigh sooner (from day 1 or 2 and then every 2 days in clinics until birth weight is regained) than in the uk where the first weigh isn't for a week! That would have been too late for my DD who lost 12% birth weight by day 3. So from my admittedly limited experience I don't think that the breastfeeding culture in the US would make supply issues more likely, or that initial weight gain problems would be slower to be picked up- if anything I think it would be faster.

[welshgirlwannabe]

Fed is better than starved, yes. I guess if there was no other option, cow's milk and baby rice at 3 months is better than no food at all. As is sweetened condensed milk. Better than the alternative of starvation, definitely. But in terms of ideal nutrition for babies, mothers own breastmilk is "most ideal", followed by donor milk, followed by formula.

Fed is always better than hungry but not all food choices are nutritionally equivalent. Breastmilk is the best source of food for babies. I know that saying that can upset people and I'm sorry for that but it is true

[AssassinatedBeauty]

What is the website suggesting as a change that they think needs to happen in the UK? That weighing should be done sooner and more frequently? That women should be told to use formula in the first few days as a general rule? What is the focus of this campaign?

[littledinaco]

I think they'd be more likely to say, "if only the formula wasn't contaminated, my baby wouldn't have died", don't you? Otherwise that sounds a lot like victim blaming to me.

I was basing it on the article 'if only I'd given him one bottle he wouldn't have died'. That could be seen as victim blaming too as I think it should be 'if only I had been given proper advice he wouldn't have died'.

It was more to highlight that very sadly and very rarely babies die due to dehydration when breastfeeding. Some babies also die due to problems with formula (whether that be incorrect preparation or another related reason).

It would be better if the article could help to highlight that many (not all) HCPs are lacking in breastfeeding training rather than breastfeeding is 'dangerous' and formula is 'safe'.

[Screamer1]

But the problem is that woman who have issues feeding their babies are being made to feel even more terrible by the suggestion they're giving their child a nutritionally inadequate food source.

I don't think anyone is denying that breast milk is the first choice. IF you are able. That's an important qualifying comment.

[Screamer1]

I also don't think that the suggestion is that breastfeeding is dangerous.

[CaravanOnCraggyIsland]

That study was done in Canadian hospitals and the stats were 2.1 in every thousand. So over the year of the study, 110 babies were readmitted out of over 50000 babies. Plus the study is well over a decade old, so newer studies would have been done in the time since.

It's the same with water birth, there are studies which show its good with preventing infections in mothers. At the same time there will be studies showing that its a risk in infection control. I suppose what I'm saying is if people are quoting studies etc to prove a point, what's their bias, what's the counter evidence, is the evidence actually any good.

[AssassinatedBeauty]

Who is making them feel terrible? Healthcare professionals? Or other parents? Or the media? All of these?

[AssassinatedBeauty]

Screamer1 that website is definitely giving the impression that breastfeeding is taking a massive risk with your baby's health and you'd be better off giving them formula, either supplementing or entirely.

[Screamer1]

Just the constant blind repetition that breastfeeding is best. The influence these messages have can be incredibly powerful, especially for first time mothers who have little experience.

Look clearly breastfeeding is optimal, I just wish the message was "breastfeeding is optimal but you may have to rely on formula for a bit in the early days (or longer if you want, it is your choice after all) if things don't go to plan"

Although I realise that's not very catchy.

[AssassinatedBeauty]

Is there even a problem with increasing numbers of babies in the UK being hospitalised for dehydration due to issues with breastfeeding?