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…?

@Tacotortoise yes! That’s the one. The maternity unit is now closed thank goodness. I’m so sorry to hear about your mums experience. Unfortunately her experience or mine wasn’t unusual. I have had friends who had what can only be described as sadistic experiences and a lot more happened to me regarding my ‘care’ during labour that I haven’t posted here. It was full of absolute witches.

If it had happened to me when I was older and wiser I’d have raised merry hell. So glad that place has closed.

I think if the NHS wants women to breastfeed they need to offer an awful lot more support and education around it and bottle feeding both before the baby is born and after, this was sorely lacking in my experience. I had inverted nipples, a premature baby with, to quote one midwife “the worst tongue tie”
she’d ever seen and I was still pushed to breastfeed. It really affected my first 6 weeks with the baby and caused a huge amount of unnecessary stress. The only support the NHS offered was a daily phone call, and that support soon felt like pressure. Her tongue tie wasn’t sorted until 6 weeks and so by that time the damage was done both to my mental health and milk supply so then she was exclusively bottle fed.

Both mine were supplemented with formula from day 5 on midwife advice based on weight loss and mild dehydration. We carried on mixed feeding past 1 year. I was told by an infant feeding specialist midwife that I had a medical low supply issue and would never exclusively bf.

In my area, I (and friends) have found that generally midwives and doctors are very quick to suggest formula top ups for any feeding issue. It's is the health visitors, NCT and breastfeeding peer support groups that push the "everyone can exclusively bf if they want to badly enough" message.

I just wonder where does that antenatal push-breastfeeding-at-all-costs-and-don't-even-mention-formula leave the mothers who then have to supplement with it.

Even if it's only a small minority that have supply issues it's really shitty on them to have formula made into this taboo and then have to use it anyway. I don't agree with letting a baby fail to thrive because you don't want to use formula but it's easy to see why these cases sometimes happen.

I wonder how many have failed ultimately because of the BF or nothing push. It’s clear mixed feeding can have its benefits and can be temporary.

Is fenugreek and domperidone ever mentioned these days? They weren't when DS was born 20 years ago. I had no idea they existed. I first heard of them on these boards a few years after the info would have been helpful for me! Maybe for me they would have helped. But the ONLY thing I had rammed down my throat was "Breast is best. Little and often. Be patient and your supply will come in - there are very few mothers who won't produce enough milk." Literally no other information about how to help yourself if it DIDN'T go as smoothly as all the literature led you to believe it would. Just "if they're doing plenty of wet nappies then they won't be dehyrated". But if you're a first time mum who hasn't ever changed a nappy how are you supposed to know what a full one feels like? How are you supposed to know how much "plenty of nappies" is?

I think the way Western society is set up doesn't help breastfeeding. There is limited opportunity for women to see others breastfeeding and learn from them. There is certainly limited opportunity for most to be surrounded by and nurtured by other experienced women straight after birth who will take over the household chores and cooking and caring for younger kids and let a new mother recover physically from the birth for 2 or 3 days so that the milk production can be most efficient.

Unless someone is on medication that is unsuitable for babies and that enters the milk supply or the mother is very unwell it is very unusual to not be able to make enough milk. You need to feed almost continuously for the first few days/weeks to get the supply going. People who don't have enough milk generally just haven't fed their baby enough.

I had a very poor supply. I’m the oldest of 18 grandchildren - I saw breastfeeding all my life and knew what it looked like when it worked.

I nearly went insane trying to bf my first and just accepted the lack of supply much sooner with my second.

It was utterly ridiculous how little milk I made.

I am a bf expert - I am very able to recognise when feeding is going wrong because of supply or feeding issues. Ultimately feeding issues can also become supply issues. I think your chance of meeting a bf expert is low and when you do they should be evidence based and person centred, supportive of what you want to do but realistic about the terms on which it can be achieved. The amount of poor experiences is testament to the lack of expertise amount hcps and those who work with postpartum mothers and their babies.

I couldn't agree more. The period in which I tried (and failed - baby never once latched) to breastfeed was the darkest of my life and I'm genuinely not sure I can even bear to consider attempting to breastfeed my next despite it being something that was initially so important to me. Looking back, the advice we got from professionals was contradictory, confusing and often just wrong. The priority was clearly to get us out of hospital and then off their books, but I didn't realise that and felt it was all my fault and that they'd tried their best for me. I didn't want to approach breastfeeding organisations as I felt so guilty and was sure they'd judge me for having used formula. I was pathetically grateful when the midwife told me it was fine if I wanted to fully formula feed, even though it wasn't what I actually wanted at all, I just needed someone to help me. Moving to formula has always been framed as my own choice and I guess it was in a way but how long could I have gone on pumping around the clock (and producing a pittance), not sleeping and repeatedly trying to latch a confused and angry baby whilst also trying to recover from a c-section and never seeing an iota of progress indicating that we might be able to breastfeed?

It is so unfair to take sleep deprived new mothers, give then minimal information on breastfeeding, keep them in noisy chaotic hospitals, feed them low-calorie hospital meals and then send them off home to work it out themselves before then blaming them when it inevitably fails. If the NHS genuinely believes in the benefits of breastfeeding, why is all the onus on new mothers to make it work when clearly so many do struggle. Even without complication, breastfeeding can be exhaustive and restrictive. Women need to be properly supported. Trying to save money by telling women it's simple and natural and easy rather than providing decent breastfeeding support (and whilst restricting sales of formula and being instructed not to give new mothers in hospital information on formula(!)) seems like a recipe for creating stressed new mothers rather than one for encouraging successful breastfeeding.

My son (who was only 2.7kg at birth) lost 9% of his birth weight in the first 3 days and I was strongly advised to supplement. I ignored the advice because I really wanted breastfeeding to work out and I'm glad I didn't give in so easily.

This isn't intended to be a judgement of mothers who formula feed or supplement. Just that it was the other way round for me. I am in France though so the culture is not the same.

Expressing saved my sanity.

DS was checked for tongue tie, and they said their wasn't a problem. But he wouldn't latch properly. I was in bits on day 3 and was about to give in when a neighbour caught DH and she said to express as sometimes you breasts are too full. That did help but he still wasn't patching properly. But he would take a bottle. So I did that for four months.

I had loads of issues with the HV and midwives who knew nothing about expressing and just wanted me go to formula. I gave up on them. The internet was more useful.

Then he decided he wanted to breast feed and would go near a bottle! So much for confusion between the two!

I then went for a doctor visit who promptly said 'oh yeah there's a touch of tongue tie in there'. FFS. But we'd managed to cope.

When I went to the 1 year check the doctor was like 'still breastfeeding? You really should give up'. I didn't. I knew it was against advice. (I got norovirus from that visit to the doctor - it was the only place I'd been out that week, DS didnt get It cos I was breastfeeding, which was a massive blessing. It knocked me out for four days and I lost half a stone)

Honestly every HCP we came up against was utterly useless for breastfeeding.

I wanted to breastfeed exclusively but baby kept falling asleep at my breast and a really prominent tongue tie was picked up on post natal ward. I wasn't allowed to go home from hospital until I gave me baby some formula. Ended up combo feeding, had tongue tie snipped and I did exclusively breastfeed for a while but weight started dropping, went back to combo feeding. It was a frustrating emotional journey and managed to breastfeed alongside some formulae for 18 months. It would have been helpful to get some combo feeding advice prior to baby arriving but I did NCT who strongly advocated exclusively breastfeeding and made it sound easy.

And this is part of the problem. Because there are so few people who have a supply issue what about them?

Given the people advising are more often than not NOT true experts on breastfeeding (as this thread also seem to suggest) it is never considered as an option there is an issue and the advice given (just keep going with the breast) is not always the correct advice.

What about those people and those babies?

My second wasn’t really producing any wet nappies for example but did have about 5 poos in the first day. How normal that is I don’t know but I was told given he is pooing he is getting milk.

Midwives and health visitors are not experts in infants feeding, I can assure you, and I say that as a midwife. It’s really a very small part of the job albeit a big part. Properly trained lactation consultants are the actual experts but unfortunately are mainly only around if you can afford them. In an ideal world all women would have access to them from day dot until feeding is fully established.

as others have said, it’s really not all about basic milk supply, there are so many variables. I genuinely don’t think I had enough milk for my DS1 and after 3/4wks went to formula, my DS2 I had more than enough milk and ebf stopping when he was 2.5yr… Totally different births, different postnatal experiences, different babies.

I am not really sure whether I had a milk supply issue but my baby definitely had latching problems. She lost 13% of birth weight and took 2 weeks to get back to it. I was really keen to breastfeed and told by professionals to keep doing this. This meant my baby was constantly starving, unsettled and upset. She also struggled with weight gain. Eventually I moved her to formula and she’s now a really happy and healthy baby. I really think someone should have discussed formula with me earlier as it’s clear to me now I was damaging her health by breastfeeding. But they were so fixated on EBF they just told me to keep going with it. It breaks my heart to remember my tiny baby so hungry now.

Milk supply is linked to hormones ... which are variable and ubpredictable - I don't fall for the BF bollocks about supply demand etc - yes if you FF supply will decrease, BUT if you're not making sufficient on the first place then ff is fine

See, I DON'T especially have a supply issue, but I still make light use of supply stimulants, because I feel that he's satisfied more quickly and happier as a result. Instead of a boob that feels depleted by the end of an evening and spending hours feeding, he can take a feed from one that feels promisingly full at any time of the day, and the feed is much quicker. This is especially important now that he's getting more interested in the world. And I can express enough to have a stash when needed.

It just FEELS different to not using the supplements.

(For the record - oats, fine, plenty of protein, fine, fennel good, brewer's yeast gives the baby terrible wind and an aggressive letdown.)

I was repeatedly told by midwives that it was almost impossibly unlikely for me to not be producing enough milk, and that it was very rare to not produce enough and to ignore scaremongering about low supply

Some time later, I mentioned my poor experience with breastfeeding to my rheumatologist who I see every couple of years for an autoimmune condition (that my midwives were well aware of) and she was immediately just like "yep, low supply often happens to patients with your condition" with a shrug that basically said "duh"! I was gobsmacked and so angry that I'd essentially been gaslighted into thinking I was imagining my very real supply issues.

That's because MW aren't qualified or equipped to deal with medical issues- they should never have been giving any advice if you have underlying conditions

Not one I spoke to when I was having issues asked if I had any underlying issues, if I’d had a traumatic birth etc.
It’s one of the fundamental issues of BF advice.

Midwives and health visitors literally do not care how you feed your baby. The evidence shows that breast feeding is beneficial to you and your baby, they provide you with this information.

It's easier for them if you formula feed because you need less support.

Of course people are advised to supplement if it's indicated.