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…?

Yes, this!

I had a bingo card of things that made breastfeeding tricky (tongue tie, c-section), but it felt like the advice from all involved health professionals was different; top up, snip the tie/ it might be ok, pump and feed expressed milk, formula top ups, don’t use formula. I was told so many different things so as a new mother naturally just blamed myself when the baby didn’t put on weight quickly enough.

The infant feeding support in my borough is great, but so overstretched. The process to get a referral for the tongue tie snip was also too long - when you’re feeding your baby for 7-8 hours a day even a week feels a long time.

I use to be a breastfeeding support worker. Most breastfeeding fails due to poor attachment rather than poor supply. This is also further complicated by mums wanting to create a feeding routine and supplementing feeds.

Breastfeeding tends to be successful when the new mum is well supported by family, professionals , society and work. When there are no impacting health issues with baby or mother and when baby is fed on demand.

From my experiences I did have 'enough' milk but it was just enough- when I've been exclusively breastfeeding I've had clingy, restless and discontented babies. Once I've supplemented with formula they always seem much more content. They seemed to get enough to grow from me but never enough to have that lovely full feeling. Mine have always slept better after a bottle of formula too.

Breastfeeding fails because new mothers aren’t told that you should expect to feed on demand all day and night for weeks in order to establish supply. The biological feedback loop won’t kick in if the baby is put down. Obviously, this is impossible for lots of new mums, so they just assume they weren’t producing enough milk when they inevitably have to switch to formula.

No judgement, it’s bloody hard and exhausting!

I also believe we should have a ‘fourth trimester’ information campaign. Human babies are born early and extremely helpless, and it’s up to us as parents to meet their needs by anticipating feeds, keeping them extremely close and not trying to impose our ideas of order, routine and independence on them.

Agree that the secrecy about cluster feeding and how clingy breastfed newborns can be doesn't help. It would make anyone think they don't have enough milk.

@nutbrownhare15 please can you send the source for breastfeeding stats? Also whether that’s uptake or at 8 weeks / 6 months / 2 years.

I know some mums that tell me their countries don’t encourage breastfeeding at all and in one instance it’s considered almost shameful to breastfeed so I find it difficult to believe it’s the absolute lowest in the UK.

I think it’s less about supply and about milk transfer. But as PP mentioned, spending hours pumping only to top up anyway isn’t good for mental health. Feeding doesn’t need to be all consuming.

@sunlover1123 , you’ve reminded me of a friend, who was a midwife or HV for 10 years before having her first baby. During that first month with her baby son, she told me that she’d done every single thing she’d been telling new mothers not to do for ten years!

You supplemented early on against medical advice and as a result had low milk supply. Neither of your babies sound like they were actually in need of supplementation, you were just (understandably) worried. This is a cultural problem in the UK where everyone expects a full and settled baby from the start as formula feeding is so common it has become the benchmark against which we compare newborn behaviour.

Glad it's not just me then. Went in for a check up recently as baby is at weaning age, mentioned baby isn't weaning yet and HV said 'you must be feeding him too much' I pointed out it's on demand with BF which she agreed with but then continued to say feed less. I smiled and left, re-checked the NHS guidance and of course she was wrong. How can HV's not follow nhs guidance? Give me facts and not opinions.

The safety net is they weigh the baby frequently and certainly will advise to top up with formula. A common complaint I hear is that midwives and GP s are too quick to advise formula when the mother just wants more support with latch, tongue tie etc.

I was advised to give formula in hospital with my first baby. After a slow start for 3 days (probably caused by traumatic birth) I breastfed with no formula for 6 months. I felt the advice to give formula was more to make life easier than for any real need (for me recovering but also for the midwife, who just wanted baby fed and ticked off the list). It also depends on social class.. middle class HCPs are far more keen on BF.

I know lots of people who topped up with formula at the start based on medical advice and went on either to ebf or to bf with occasional formula top ups.

Personally I think there's too much emphasis on breastfeeding and the marginal benefits of BF are far outweighed by the benefits to maternal mental health of FF. There are lots of other things that are far worse for babies and children than FF but these are rarely mentioned. Thinking of screen time, sugar, inadequate exercise, nursery before the age of 2 etc. (I did all those myself so no judgement just an observation).

@Pacificisolated I don’t know if this post was for me or someone else who posted here.

I still don’t know if I actually have real supply issue or not and don’t think will ever find out. It does feel as a likely possibility given all that happened so far but again don’t know for sure.

With the second in the A&E they were concerned about the amount of weight loss so early and so wanted to admit to the maternity ward but then things took different turn and all that was forgotten.

I did a lot of pumping with first and one breast never produced more than some 25ml, to start with literally nothing. The other was better but not great, 40ml was the max. I can see now that breast still has less milk. My pump was double pump. We breastfed successfully but never exclusive.

I had issues conceiving first time round and when they did some checks they questioned if I had PCOS because of my hormones but never actually properly tested for it. My mum also has thyroid issues but I was never tested.

I think with me we will just never know, but I’m glad the formula is there, we are still breastfeeding (better supply this time round admittedly), but as the posts are confirming listening to the advise given can actually confuse things more rather than anything else, and sometimes perhaps end in tragedy.

To the poster(s) who ended up in A&E with dehydration glad your babies are ok.

I was in hospital with both of mine for a week as they were both on IV antibiotics ,attempting BF both times ,but both times the midwives said they needed to be supplemented with FF as both lost too much weight. I probably wouldn't have known what was happening if I'd gone straight home as my first was a really sleepy baby who didn't really cry much . Historically babies would have died or been fed on cows/goat milk ( my mum was fed on milk straight from cow from day 1!!!!) or been wet nursed so we are fortunate to have FF as an option in my view.

Lack of training for health care professionals is a huge problem. The average midwife gets between 2 and 4 hours of breastfeeding training (health care assistants, GPs and Paeds get less). As a breastfeeding counsellor my training was about 90 hours and I trained as a peer supporter before that which is about 20 hours. Above this are the International Board Certified Lactation Consultants (IBCLC). This is a very specific term, anyone can say they are a lactation consultant but IBCLC is very specific and a much higher level than breastfeeding counsellor. Our NHS is so screwed up it doesn't regard giving new families access to trained support important.

Heya, oh certainly yes, I have no doubt there are some women whose bodies just don’t produce enough milk, and certainly it makes sense this could be linked to hormonal differences - eg PCOS. Sorry I should have acknowledged this in my post.
But as a pp said in the UK we have one of the lowest breastfeeding rates in the world. Of course this is no issue if this is due to women’s choices, but research seems to suggest that most women would like to breastfeed. In my view low rates are due to over intervention where women are constantly given unrealistic expectations and targets around feeding and then told they need to do things like pump and combi feed which only further reduces supply. (Baby’s sucking is much more efficient than a pump). In countries where there is very little intervention breastfeeding rates are much much higher (eg senegal).

I agree with @WillowCraft there is too much emphasis on breastfeeeding. When I stopped at 12 weeks my mental health was in the gutter. I feel like I was failing my baby because all lactation consultants could tell me was that I was "not trying hard enough" and to power pump (or whatever it was called) for 12 times a day rather that 10. Bearing in mind I couldn't hold my baby while pumping because I had to hold a pump (the bra for it didn't help much) and it was taking 40 mins each time, and when I was feeding her she was getting upset because the tiny 5ml I could produce in 1 hour had already gone in the pump.

The day I decided to give up was actually one of the best days I'd had in motherhood. The sun was shining, we went for lovely walk, I didn't have to worry about finding somewhere to pump, she was smiling at me from her pram, we found a lovely shaded spot by the river and had a lovely cuddle...I also had a call from a lactation consultant who asked me how my pumping 12 times a day was going. I told her that I'm done with it, it's simply not feasible - her answer was "but how will you bond with your baby?". To which I said "I've haven't been able to bond with her so far, because of the pressure of breastfeeding.

I really wish that these "experts" got better clued up on real causes of low supply. The narrative of "99.5% of mother have adequate supply" is quite shit to be honest.
My own health was at risk with retained placenta and not one lactation consultant - I saw 4-5 in total - said that the fact I was still bleeding up to 11 w pp was related to my lack of supply. I was just told to relax, do skin to skin and keep pumping.

Bf both DD and now DS.
As a first time mum it was a struggle to get latch right with DD but I wanted to bf so persevered. She would never take a bottle and I didn't want the faff of sterilising bottles and having a baby screaming in the night and not being able to sort it quickly. It was tough going through cluster feeding, constant wakes, teething but we got to 12 months and she self weaned.
I didn't get much support with bf her apart from an amazing maternity support worker who came to see me daily for a week. I was so determined though that I tried everything.
I did try pumping but I couldn't pump much and it's never a true indication of how much milk you have.
DS was born 5 weeks early and in NICU tube fed for 2 weeks. I pumped constantly (had a much better pump borrowed from hospital) and took it in for him and he eventually took a bottle. We learnt to tube feed but he took a turn overnight and bottle fed. We got to take him home and I expected to have to FF him but I tried latching him and that was it. He's been EBF ever since. He's almost 12 months now and I'm hoping to start weaning him off as I'm a bit fed up of it.

If I hadn't had the experience of bf DD then I definitely would have just FF him but I'm glad I tried to bf him.

There definitely needs to be more support for mothers who want to breastfeed. A lot of HV have outdated advice and and I do believe a lot of women are told their supply is low when it isn't but they just need some help to get a better latch

Urates are normal at the start for many babies if that's what you mean by crystals? And the weight loss you had sounded normal. So you probably could have EBF. The formula would have made baby more content, but baby would have been fine most likely without it. My baby had both those issues but I EBF and while she needed to feed constantly the first two weeks or so to increase my milk supply, it then settled down and her weight gain was excellent after the first few weeks.

There is a lot of misinformation out there to though about supply. e.g. a PP says lack of let down and leakage is a sign of low supply. That's not the case at all, some women just don't have a strong let down sensation and don't leak. I never leak and don't feel the let down and also can barely pump anything but my 5 month old high centile EBF baby is thriving. So I think there's misinformation both ways- sometimes low supply is not acknowledged but I think people being misinformed they have low supply is even more of an issue. The best indicator is your baby's weight gain beyond the first couple of weeks and that they're doing wet and dirty nappies and not dehydrated.

BF isn't the panacea it's made out to be. Lots of women and babies struggle. The same way not everyone is able to be a fast runner or weight lifter. My first DC struggled, my second never even lost weight while bf and ony had short feeds.

Years ago they'd have wet nurses or supplement with cows milk just to keep most of them alive.

I EBF my DC for 9 months when they both decided nope, not doing this anymore. 18 months between them and they both chose the same age to refuse.

They also refused bottles of expressed milk every single time but would sip from a cup around 3 months.

I think just do what suits you best. EBF means you are solely responsible 24/7 and it's exhausting. Plus side is no sterilising, bottle washing, formula to make up. Oh - and an excuse to hide from PIL because FIL hated me feeding my DC in front of him!

Oh god this thread reminds me of my horrific experience 17 years ago going into the hospital with no formula as I just assumed I’d breast feed. Absolutely nothing came out, no colostrum, no milk, no full feeling in my boobs, nothing. But it was at the height of ‘breast is best’ militancy and as a first time mum I believed the experts who told me the baby would ‘definitely’ be getting something if he was latched on and got cross with me when I expressed concern that I didn’t think it was happening.

I was told that babies are born with full tummies and could last ‘days’ without much. They shouted at me when I asked for formula and made my baby wait hours and hours when I asked them on day 4 to give him something because he looked half dead. They poured a tiny egg cup of milk out of carton and poured it down his throat.

I was young and trusting so it took me a few days to believe they were wrong and my babies life was on the line. I discharged myself and my baby on day 5 when his eyes had sunk and was too weak to cry and got formula at 2am.

My colostrum came in on day 8 and milk day 11. They would have let him die. I will always be bitter about those vile midwives at Chase Farm hospital in 2006 which has now closed and I hope Karma has come to them. They were so nasty to me.

I believe the statistics about who ‘can’ breastfeed are wrong. The research to make those claims with any accuracy just isn’t there. It’s an educated guess at best. Because it’s much more than milk supply and the entire environment including the community in which the mother and baby live is (I believe) the key to success.

Is that the Chase Farm hospital in Enfield @OlympicProcrastinator ? If so I was born there in the late 60s and my mum still talks about how awfully the midwives treated her. Said they destroyed every shred of confidence she had. 😔

I exclusively breast fed all my babies but I had the most problems with my fourth who initially wasn't latching quite right and made me very sore. As an experienced mum I knew it shouldn't be like that so persevered with it and her latch and eventually things settled but if that had been my first experience of bf I might have given up. I always had plenty of milk.

I'm EBF my 2nd son. I had a supply issue (came as a surprise as I didn't with first at all) and son dropped over 7% and was told by a community rapid response team to start combi feeding because he "hadn't put enough weight on"

Breast feeding support was not as it should have been. I didn't start combi feeding against medical advice.

My son put the weight on he required.

I pumped until I adequately increased my supply. (4 times a day once in the middle of the night)

A lot of people will resort to combi or be advised to. Your body can produce enough milk for your baby - it just sometimes needs a (at times a very significant) push to do so which for some is too much effort.

If people want to combi so be it. But I should've had far better advice and support around actually EBF.

EBF babies always take longer to gain and HV get their knickers in a twist all the time.