Breastfeeding - do the ‘experts’ really know?

[BreastIsBestBut]

Posting in AIBU for traffic and title might be a bit misleading.

There is a strong push for exclusive breastfeeding, or so I found during my two pregnancies. I did actually want to exclusively breastfeed anyway.

All the advice says avoid bottle / formula as it affects milk supply and once you start especially in the early days it’s much harder to go exclusive (to get the milk supply). It feels to me like the thinking is pretty much everyone can produce enough milk for their baby and it is normal for the baby to have lost some weight in the first week.

However, then we also hear that not everyone can breastfeed. But it never seems to be acknowledged by the people you speak to immediately post birth (the breastfeeding support etc).

What are people’s experiences and is there anyone who was actually told they have milk supply issue and therefore will need supplementation (whether in form of formula or donor milk)?

I ended up mix feeding both of mine and am now convinced I’m not able to produce enough milk. With first it was bad start but with the second I did everything ‘right’ and he lost in the first 36 hours app. 8% of his weight, had crystals in his urine which is supposed to be sign of possible dehydration but all that seemed to have been brushed to the side. I ended up giving some formula against the advice and had immediately much happier baby. Still kept and keep going with the breastfeeding but ending up having to do formula (after baby spends so much time on the breast and still crying).

Are there many people who were actually advised by the ‘experts’ they need to supplement. Or do people largely end up doing it themselves against advice?

Kind of makes me feel if you follow what they tell you and trust what you are told you could do more harm to the baby than good…?

I suppose its down to the mother.
I breastfed all 4 of my children.
1st daughter till she was 6 months
2nd daughter till she was 3 years old
3rd son till he was 1 year
4th daughter currently still breastfeeding as she is 3 weeks old.

I wanted to bottle feed my 3 week old but she didn't take to it so I'm breastfeeding. To be honest I find breastfeeding the best especially the first 6 weeks anyways as it gives them a boost.

But for some women like mn's have stated some babies lose weight and don't bottle feeding better.

I struggled with breast feeding from the get go. Although I did have a midwife say not to attempt to feed my baby after she was born and refuse to help with breast feeding for her whole first day so that probably didn’t help. I then had support from the infant feeding team and midwives, all of which pushed breast feeding. I even paid for a private breast feeding consultant but still couldn’t get it right. It soon became apparent though that my little one was literally starving so we supplemented with formula. Thankfully I then discovered exclusive pumping and while I didn’t make enough initially I was able to increase my supply to meet her needs and have a modest oversupply and I’m now 10 months in to feeding my girl that way. I also discovered (due to my own observations and pushing for assessment) that my little one had a tongue tie no one picked up on, and this was snipped around week 7.

Most people can successfully breastfeed if they want to. The biggest barrier is often getting the right support and information.

So often the answer to any form of query is to top up with formula, fine for those who want to and those babies who genuinely need it. Not so helpful for those who are looking for ways to keep breastfeeding.

We don't invest in skilled infant feeding support in this country. Which leads to women feeling pressured to breastfeed, alone when they hit (often common and really normal bumps in the road), and like they did something wrong when they introduce formula.

It's normal for some babies to lose weight. My son did. He went from 8lb 9oz to 7lb 15oz but quickly put it back on.

I mix fed both my children, both times that was against the advice I received. I had always planned to mix feed them both and that's what I did. DC1 was exclusively formula fed by 12 weeks. She eventually got a bottle preference when she was having 60 per cent bottles which hastened the weaning process, but I couldn't cope with more breastfeeding than that by then as it was still agony and I'd seen every specialist under the sun and nobody had any solution for me. DC2 was much easier to breastfeed and so had about 3 bottles a week until I decided to wean him fully onto formula at about 10 months. He was drinking very little milk then and suffering from constipation and we had a period of heat waves, he drank larger volume from bottles so I decided to switch then. Also knowing he was going to soon be starting nursery so it made that easier too.

My experience was a mix. My son spent a day or so in high dependency, we were 5 days in hospital. Feeding still wasn’t quite right when we went home - turned out his latch wasn’t good. I only found that out after going to an outpatient breastfeeding clinic, which helped a lot - DS was about 10 days old then. In the meantime, I had reached breaking point with constant waking and feeding in the night, and bleeding painful nipples. We decided to formula feed one night - DH gave DS the bottle and he got a good feed. However I didn’t give up, went to the clinic, kept going, and within a few weeks feeding went really well and I BF up to 7 months. I enjoyed BF and found it easy after the first couple of horrible weeks, and much easier than formula, especially when out (no need to carry anything etc). However we continued to give DS just one bottle a day for various reasons - we knew he would be going to nursery when I returned to work and he would need to take a bottle there; it gave me a rest now & again; and allowed DH some close time with DS as well. But I never had supply problems - in fact I remember when DS went through growth spurts and was hungry, sure enough within a day or so I would have more milk.
Boobs are amazing but it doesn’t hurt to mix with a bit of common sense. I was also lucky I had access to support early on. (The cottage hospital where I got that clinic support is now converted into flats 🙄)

My experience was that actual breastfeeding experts do know what they are talking about - that is infant feeding specialist midwives, or lactation consultants with appropriate qualifications. (In my area they are accessible through a local charity.) However, most midwives, health visitors and assistants in maternity wards are not experts, and they can and do give bad advice and miss things.

My latch and breastfeeding was great. However I had a sleepy 37 week baby who would not wake to feed. I was sent home from hospital without ever seeing a full qualified midwife (a trainee did my discharge). I saw a midwife for feeding advice every single day til Day 5 - by which time my baby was 20pc down on weight, dehydrated and in the hour it took to drive to our hospital after our Day 5 check, became completely non-responsive. She ended up in intensive care, nearly died, and they never even tried to give her the milk I pumped - just tubed formula straight into her tummy, as soon as she was well enough to take it. After she recovered, it took a while before she gained weight, and midwives kept telling me to give more and more formula as top ups (wrongly, the poor thing kept throwing it up she was so overfilled - not to mention that they were danaging my supply further!)

A lactation consultant I saw through a charity picked up the pieces after this, helping with the guilt and trauma, as well as managing combination feeding. I am still breastfeeding my 1 year old, now, but I never developed a full milk supply or pumped more than 30ml at a time! When I looked into it, though, I have most of the risk factors for low supply.

I now advise new mums to do as much research of their own on feeding before their babies are born, and to know how to access expert support locally (ie not from your standard midwife or HV).

I mix fed all three of my children. Not because I had a low supply but so my husband could give them a bottle while I slept and so that I was able to leave them for more than a couple of hours.

Both mine haven’t been very good at latching. I express for DD (5 months) - it isn’t much fun. Hoping to get to 6 months then we’ll see.

Losing 8% bodyweight and having a small amount of urates in their nappy in the first couple of days (until the colostrum turns to milk) is normal and fine.

When my first wasn't gaining weight on his curve at 6 weeks, my GP told me either to start supplementing or to bring him in to be weighed by the HV every week and we could monitor it for a bit longer. I saw a lactation consultant privately at that point who taught me some tricks for maximising my supply (switch feeding and breast compressions, also looked at tongue tie) and that did the trick.

With my second in the early days I just fed LOADS, round the clock, any time he so much as squeaked I put him to the breast. He went shooting up the centiles, and I was regularly leaking milk and could get loads if I used a hakka on the other breast while I was feeding.

In my experience it really is about supply and demand and you might need to feed a young baby much more often than every 3 hours or whatever they tell you in hospital (which is often based on how often a formula fed baby might feed). I know that's not true for everyone but it was/is for me.

I had a tremendous amount of support from lactation consultants, and a tremendous amount of support from all staff as some interesting moments made it semi-impossible for me in those first few days. I had nothing but support with both children, including when traditional EBF was no longer an option.

It was presented to me both times as something to give the very best effort possible - and adjust as needed depending on my needs and our babies’ needs. And they were definitely watchful and aware of our child’s needs.

I breastfed all of mine. Still breastfeeding 13 month old DD. Not one of them lost weight after birth they all gained straight away. They’ve never had formula.

Some countries have breastfeeding rates above 90% so it is just about possible for everyone https://worldpopulationreview.com/country-rankings/breastfeeding-rates-by-country

It helps a lot if breastfeeding is commonplace, seen as normal, you've seen others do it and they can help and advise etc.

But it's not an area pharmaceutical companies are particularly interested in so funding for research is lower than other areas. No company is going to get rich from helping you latch your baby. And research around maternity is very very hard.

I was hell bent on EBF and can honestly say I gave it my all. Was told on day 7 by a midwife to immediately and urgently give formula (and she wouldn't leave until I did) because baby was desperate for milk. Cried my eyes out and felt like the biggest failure ever. Successfully mix fed for the next 7 months but at a cost to my wellbeing. Did not put myself through it with baby 2. Mix fed for a short time and she fairly quickly rejected the breast and it was formula thereafter. Didn't sweat it second time around and enjoyed my newborn waaaaay more.

I had no issues with supply with DD, my milk came in straight away and I was able to express very easily. At one point I was feeding not only DD but also donating breast milk to a set of preemie twins because I had such an oversupply. She never lost weight, maintained first week and then gained from then on.

The problem I did have was that DD had an undiagnosed tongue tie, no one believed me that there was an issue, I was fobbed off and ignored, then I was blamed and told that I'd 'made her lazy' because I had bottle fed her expressed milk from the beginning. I wasn't given any other option, I couldn't just let her starve, and she physically wouldn't latch on, ever. We didn't have a single successful latch, she would just come straight off.

By the time they did eventually listen to me, she was 12 weeks old, and they refused to then snip it because it was 'no longer an issue', and we couldn't afford private.

Now expecting DD2 and worrying we'll have all the same problems again. NHS breastfeeding support is just laughable and it makes me really angry and upset.

Breastfeeding is bloody hard work and can sometimes feel absolutely relentless, especially when building up the milk supply in the beginning and helping the baby to latch on correctly.
It requires total self dedication, and I feel like people aren't fully briefed whilst pregnant about how much they will need to perservere.
I breastfed all of mine from 1.5-2.5 years, which I am proud of.
Truthfully though, as enjoyable as it was, it was a total sacrifice of freedom to do it, and took its toll mentally on me.
I quite often envied the ones who formula fed, who in my eyes, had a much easier life and a more content baby (formula takes longer to digest).
As long as the baby is thriving and the mother is well supported, that's all that matters at the end of the day.

In my view the horrors of UK maternity services and birth culture are responsible for a lot - poor treatment in hospital, terrible postnatal wards, being isolated alone with new baby etc.

I would put good money on more women being able to bf if they had better care and support. Stress plays an important role in lactation.

I just don't think you can make such a blanket assertion unless you've done a lot of research and spent time with lots of mothers and babies. Every mother/baby combo is different. Most, though, will go off how their baby is actually doing. If the baby is screaming and clearly starving, never settling, losing weight, not doing lots of wet nappies, mother never feels much of a let down or leakage, then of COURSE you need to consider the fact that something has gone wrong with the physiological process somewhere, even if no formula has yet been given.

With my own first child, I managed to give him one or two intial colostrum feeds, which felt like they went well (uterine contractions etc), baby settled afterwards, dirty nappies etc. Then I waited for my milk proper to come in. And waited. And waited. And waited. 5 days and still nothing. By day 6 baby was literally starving, so unsettled, bringing up bile. No sign of any milk. Clearly there was a problem with my supply. I wil be forever grateful to the very kind midwife who gently suggested giving DS a little cup feed to see how he went. He was much more settled after that. I continued to latch him on but nothing much HAPPENED with the supply.

I've since found out that my grandma in the 1930s had similar issues. And I have PCOS, a hormonal imbalance (which often runs in families). There's been studies done since my experience which shows that PCOS can have a detrimental effect on a woman's ability to breastfeed successfully. As can breast hypoplasia. For some mother/baby pairings, alternatives to breastfeeding absolutely SHOULD be considered, and it should be discussed openly and gently rather than make a mother feel like she has failed her child.

Love the post and good question. I would have loved to have combi fed however would you believe there is not a lot of research out there! I believe a colleague of Professor Amy Brown recently asked for volunteers to fill out questionnaires to get a better understanding of this to help mothers in future (sorry can’t remember who is doing the research). I was told not to as my baby would be ‘confused’ by the bottle…. What a load of bullshit given to me by a midwife. I’d like scientific research to back up such bold statements next time!
I was told I couldn’t go to their NHS breastfeeding clinic because I hadn’t had a baby yet. I had major complications and so didn’t get to go when I had my baby. I was told my baby had a tongue tie but it didn’t matter for feeding. All of it makes my blood boil as it’s all wrong information just with no scientific basis - just someone’s opinion. Imagine if we treated all health queries that way?

Sadly the training given to so called feeding specialists and HV in the UK doesn’t seem to be robust and training never seems to happen as they tend to give old outdated and not scientifically based guidance. IBCLC’s are completely different and should be employed by all hospitals and run breastfeeding clinics in my opinion. They keep up to date with research and guidance.

in other countries other than the UK breastfeeding rates are much higher which can be put down to so many different factors such as support, education and understanding of breastfeeding mechanics, birth itself and delivery the list is endless. My mum breastfed two babies and actually a lot of her experience helped my positive experience, after all it helps to learn from someone else :)

I have recently met an infant feeding specialist who works in the NHS and has only recently had a baby. She’s never breastfed before and yet was somehow giving women advice…? She then said that after breastfeeding a baby herself that a lot of the information she’d given felt a bit daft in hindsight. Mind officially blown!

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Absolutely zero judgement regarding how anyone chooses to feed their baby but: the “top up trap” is often not explained properly (by midwives etc).

worry over milk supply > supplement with formula > supply does not increase to meet baby’s needs > formula is required

of course for whatever reason top ups are sometimes needed and as I said no judgement - but I’ve heard of so many stories where because baby was perhaps slow to regain weight, or was cluster feeding, or was unsettled, mother freaks out that she might have low milk supply so is terrified of starving her baby (understandably), gives formula, baby guzzles formula (because they have a sucking reflex so will down the bottle), mother is confirmed in her fear she has low supply, formula top ups continue, milk supply tanks.

It’s so hard, I’ve been there - but with advice from a good midwife on day 5, pumped and fed round the clock (literally) to get the milk in and it worked, weight gain took off. A different midwife might have advised formula top up which I of course would have done.

This!

i seethe when I think of my first week with my newborn.

I asked the midwives over and over again to give my baby formula. They wouldn’t let me. “She was getting enough” before my milk came in…. While she got yellower and yellower. They watched her getting yellower. Called over each day to measure how much yellower she got. “3 below the box”, “2 below the box”…. Until we were admitted to AE.

The doctor PRESCRIBED formula and reassured me that midwives don’t know everything. The only way to clear jaundice is with fluids. Impossible when one’s milk hasn’t come in.

i’m still traumatised and the pushy, ill informed boob brigade and can go and get fucked. FED IS BEST.

What I learnt from EBF two children to 2years is that the rhetoric around breastfeeding in this country is ALL wrong!!

The line women are fed here in general is that it’s natural and simple and that, if their experience is difficult, they are somehow doing it wrong. Coupled with a complete lack of informed professional help in the weeks after birth this means that many, many people think it isn’t working and stop before they need or want to.

The truth is that breast feeding, in the early weeks and months especially, is difficult (sometimes physically sometimes mentally/emotionally). It takes up all your time and energy. It is often boring, sometimes painful, can be isolating. Essentially it is HARD WORK.

I felt as though the NHS had decided not to share this women in case for some reason it put them off. Rather than thinking it might help them feel reassured that their experience isn’t abnormal, that their struggles are almost universal and that it is worth persevering with.

Why that should be the party line in this country, I have no idea. Is it because women refuse to undertake activities that are hard work but ultimately worthwhile…?! I still find it mystifying many years on.

Ten years after I had my first, I was back in NCT and it transpired more than one women had been told in hospital that BF babies don’t need to be winded after feeds - the poor things couldn’t understand why their children were in distress. What kind of crazy nonsense is this?!

It’s almost as though policy is set by people who have never breastfed an infant… men perhaps?!?! 😡🤣

1000% this.

I had an awful time in hospital, and I was there less than 48h. I actually took to breastfeeding very well - great latch, lots of colostrum harvested, baby regained weight steadily.

I was still bossed around and made to feel like shit by midwives, and the health visitor was been and gone in 5m. The hospital environment was bloody awful, everything they advise against in encouraging positive births.