Is Breast Best?

[ADaddy]

First of all I want to say that my heart goes out to all the women out there that are struggling trying to breastfeed their child and feeling the pressure to continue.

My wife gave birth nearly 3 weeks ago and since then has had a really rough time with breastfeeding. I just wanted to share some words with women in a similar situation. I'll put them in points to be more concise.

1. There is so much more to being a mother than just being a milk supply. Don't ever forget this!

1. This is about feeding your baby. It is too bad that they don't have "Feeding councillors" rather than just "Breastfeeding councillors".

1. Your baby's nutrition and hydration is vital. Don't feel guilty for making sure your baby has both of these.

1. The well-being of the mother is also vital. You need to be there for your baby, does your experience with breastfeeding enhance your well-being or make you feel like the contents of your babies nappies?

1. Unless there is imminent danger, Healthcare professionals will put breastfeeding above things such as sleep, washing, bonding, jaundice. It pains them to say the word "formula" so don't expect them too.

1. Healthcare professionals are mainly interested in the colour of poo, if wee is coming out and if the baby is at least gaining some weight. In that case all is well, forget the rest. This is NOT a holistic approach and one of my main bug-bears with breastfeeding promotion. There is a much bigger, far more complicated picture to consider to determine if breastfeeding really is working for you.

1. If you have a latch problem then they like that, they can help solve that. It's different when it is a supply problem, that is not always solvable and they tend to be in denial about it (mainly because it is far more difficult to solve).

1. Demand feeding:

a. Is lack or sleep good for mother or milk supply or to that end baby?
b. Is not being able to find time to eat good for anyone?
c. Is no time to wash good?
d. Does baby sleep a lot and forget to demand only to wake up ravenous and too fractious to feed?  Can't be possible, this does not fit in the ideal world of demand feeding :)
e. No routine, no structure, no way for an adult human to live?
f. Are you told, don't worry, keep going your milk supply will come through soon?
g. Feels like it is driving you insane?  Maybe it is!

1. Is the difficulty of breastfeeding affecting your bond with your baby? It is hard enough, healing, hormones, baby blues and worse, don't be pressurised into sacrificing this important step under some misguided notion that your baby will suffer by not being breastfed. He/She is likely to suffer more if you are not able to nuture this all important bond.

Of course, these questions and statements come from our personal experiences, although from what I have read on the internet, we are not alone.

If you read through my points and breastfeeding is still the right approach for you, great! If not, then do the best thing for you and the baby (yes, that is YOU too) and consider alternative approaches.

And before you ask, the only vested interest I have is in the health of my wife and baby and doing what is best for them.

Comments welcome.

ADaddy it is almost impossible to have a reasoned debate on this topic. Good luck with this thread, and FWIW I agree with the points made in your post.

ADaddy, your post made me cry :(. I wish my dh could see what you have written...

It sounds like you are having a rough time. Ime it is rough in the begining regardless of feeding method. You could help with alot of the points you make (esp on demand feeding)

Why do you think your wife has a supply problem?

Agree with MFM - life with a newborn is tough however you feed them.

If you feel like it OP, you could tell us a bit more about your wife's problems to give us an idea if the context?

My DH has always said that he found it difficult in the early days of BFing. it can be very hard watching the person that you love struggling and potentially going through pain. Breastfeeding is hard at the beginning, it is natural but it is something that has to be learned by both mother and baby. I say this as someone who had a lot of difficulty feeding DS1 and switched after just 4 weeks, I also have a very positive experience with DS2 and I am still BFing him after 7 months so I come at it from both sides. As Funnys has said it is almost impossible to give a reasoned and unbiased point of view when it comes to this issue, but I do try to.
1 - yes mothers are more than just milk supplies, but feeding is such a fundamental part of the early months of your baby's life and really they don't have that many other needs which is why HCP's place so much emphasis on it.
2 - HCP's should feel freer to give advice in a practical way about all methods of feeding, but formula does come with instructions and big budgeted marketing campaigns, breast milk does not.
3 - there is no getting around the fact that breast milk is the best way to provide your baby with hydration and nutrition, to the point where it will automatically change and adapt to your baby's changing needs however they improve formula, it will never be able to compare to just how good your breast milk is for your baby
4 - I agree with you on this, what made me stop BFing DS1 was the feeling of resentment I started to feel every time he wanted feeding, I needed to do something quickly before it developed further into depression, BFing IS important, but your ability to care and love for your baby is more important and if you are not well, you cannot do this effectively
5 - I think this depends on where you give birth i'm afraid. My experience was better than this but HCP's do need better training
6 - same as above
7 - I have not experienced a problem with supply, so difficult to comment, but I will say that one of the hardest things to do can be to let go of the control that FFing gives you. I have had conversations with people who are OBSESSED with how many ounces their baby is taking and will recite how much milk was made for them, and how much they drank for each feed that day. When you BF you have no clue how much milk your baby gets at each feed and it can be very difficult to trust that there is enough milk for them.
8 - surely lack of sleep is part and parcel of having a new baby, it doesn't last forever and although it does feel like it, there are breaks from feeds when the baby sleeps and you can do other things like sleep or wash or eat. If you accept that in the early weeks you wont have much of a routine, but that you will gradually get one again even if it is different to what you had before, that makes things easier. No one should ever expect that their lives will be in any way the same as pre-baby, they change everything, for the better of course. The early weeks that are the most disruptive are where the help and support of others is vital, personally, i'm not bothered about routine at all, but if there are things that have to be done, don't ever be afraid to ask for help.
and finally 9 - as I said I agree that caring and loving the baby is far and away the most important thing and if feeding, or anything else, is making you miserable then you should make a change. However there is so much help and support available and if breastfeeding is an important part of caring for your baby to you, then you should do everything you can to get that help because trust me, although the days do feel very long and painful at the moment it does get easier and you can come out the other side absolutely loving feeding your baby

Gosh you're brave OP!

Sounds like your wife is having a hard time. The first few weeks can be tough, though from your post I think I had an easier time than you two are. It does get much much easier as time goes on so for that reason I would say, without hesitation, that it is best for everyone. The bit where you feel close to insanity doesn't last long!

Wow, thanks for the speedy comments.

Hopefully I didn't upset you too much ebmummy.

In answer to your question MoonFaceMamaaaaargh, my wife has sat for hours and hours, if not days, at a time breastfeeding to try to increase her supply. The baby still screams inconsolably with hunger, his weight gain slows and he stops poohing. She also knows her body and feels that he is sucking on empty breasts.

There then begins a vicious circle of tiredness, screaming baby and consequently less milk. Things are eased when we take a step back and give mum a rest with a bottle. That works for us, unfortunately we had to work that out for ourselves which is not so obvious for first time parents.

It really is about what works for you and your baby but don't forget to consider the bigger picture.

"It really is about what works for you and your baby but don't forget to consider the bigger picture"

That sums it up nicely.

I wish there was a 'like' button as with Facebook Adaddy, as you have put it perfectly. The three of you should always do what is the right thing for you. Don't do anything in haste and don't do anything that you will regret in the future, but do what is right for you and your baby.

Hope it all gets easier for you soon

Adaddy if my DH could use the internet he might have written your post. We have a 3.5 week old DD, she was breast fed for 2 weeks but, then struggled to latch when tired and fractious.So i switched to expressing, manual pump first then quickly bought an electric, DD is happier on bottles, she gets food so much quicker, i think i had a supply problem. She is still fed on demand but with one formula feed in the evening to give us some down time, she will normally go 4 hrs after formula. DH hates the noise the pump makes and says i'm just like a cow, he'd love me to go completely onto formula, i'm resisting at present but for how long who knows, it would be great to go back to sleep at night after DD is fed and settled and not have to get up to pump. I'm writing this whilst pumping, i feel tied to pump, as i pump 8 times a day and it takes at least 30 mins a time.

Just like to add, if we could breast feed we would but when we were DD would feed for an hour a time but just fussed in the afternoon and evening ending up hungry, fustrated and upset.

Blimey justtrying that takes dedication - expressing to that extent. I never got on very well with expressing at all - you have my admiration for persevering with that.

1. Yes that' my I bf so I can offer comfort, pain relief, warmth, help with breathing (babies mimic mother's breathing pattern whilst skin to skin) and nutrition.

1. They do, they are called Infant Feeding Coordinators. Call your post-natal ward to speak to one.

1. First rule of bfing support is 'feed the baby' not 'bf the baby'. There is no point trying to resurrect a milk supply if the baby isn't there. In certain circumstances formula is needed and mothers will be supported in giving it.

1. Bfing does enhance my well being. Oxytocin is very good for a mother's well being. Bfing does have a protective effect on a mother's mental health BUT she needs to be supported by her family too.

1. Why can't you bf and sleep, bond, wash? Where does bfing preclude those things? If baby has a feed and then is cuddled by dad, mum can have a sleep (or can feed baby in bed if safely set up for bed-sharing and they both sleep) or can have a bath/shower. Dad can have some skin to skin time with baby and bond then. Jaundice doesn't preclude bfing either, it just might need extra assistance to get going well.

1. HCP aren't well known for their holistic attitude towards patients whatever their condition/problem. If you want to talk through whether bfing is working for your wife, call on of the BFing helplines and speak to a bfing counsellor.

1. If you are speaking to people who can solve a latching problem but aren't able to help with supply difficulties, you aren't speaking to the right people. You don't speak to a mechanic about points on your Driving License do you? If your wife suspects she has a supply problem she needs to speak to a bfing counsellor ASAP to see what can be done to help increase supply. What leads you to suspect your wife has low milk supply?

1. Demand feeding:

a. Is lack or sleep good for mother or milk supply or to that end baby? - Feed baby lying down in a safe sleeping position and sleep while baby sleeps. Lack of sleep doesn't really impact on supply but it can make mum feel rubbish if she is sleep deprived.

b. Is not being able to find time to eat good for anyone? Why can you not cook a dinner that you can eat with one hand for your wife and she eats and feeds at the same time? Pasta, pizza, sandwiches/rolls, sushi, fruit, cereal, cupasoup are all good and easy to prepare so your wife can eat.

c. Is no time to wash good? Hold the baby whilst your wife washes. It won't hurt the baby to be cuddled by daddy.

d. Does baby sleep a lot and forget to demand only to wake up ravenous and too fractious to feed? Can't be possible, this does not fit in the ideal world of demand feeding - Don't understand this? If a baby is sleeping too long and waking up ravenous, this suggests that the bbay isn't getting enough milk so latch/positioning/attachment needs to be checked by a qualified person to see if milk transfer is happening. This does not mean demand feeding isn't working but rather baby is sleeping to conserve energy and waking only when absolutely necessary.

e. No routine, no structure, no way for an adult human to live? So the baby gets short shrift so the adult gets a routine? Routine is an artificial construct - how long have private individuals had clocks, a century or two at best so not long enough for it to be an essential part of our life from a biological viewpoint.

f. Are you told, don't worry, keep going your milk supply will come through
soon? Not good practice if there are supply concerns BUT if the supply concerns are unfounded then it's correct. The vast majority of women get there milk 'in' between 3-5 days, some may get it at 2 days and some may take 7 days depending on circumstances (delays can occur if too much IV fluids are administered, c-section delivery, etc).

g. Feels like it is driving you insane? Maybe it is! Newborns drive you insane regardless of feeding method. They are unpredictable, fractious, needy and draining at the best of times, they are beautiful, calm, miraculous and amazing as well. Life with a baby is hard. Getting help and reassurance from family, friends and HCP will help you get through the early days.

It sounds like you are really worried about your wife, one of the key factors in a woman succeeding at bfing is having a supportive partner. Dads can literally make or break bfing for mums so have a read up here for ways you can support your wife.

Adaddy - I had a vile time after the birth of my DS trying to feed, 9 days in hospital, jaundice, sryinge feeding, trying to cup feed, having formula top ups etc... I don't blame breastfeeding I blame the hospital environment which didn't support breastfeeding, didn't allow ANY sleep and rest, didn't step in soon enough with electric pumps, denied formula when needed and had no continuity of care which meant that even the best professionals only saw me once and you can't give good advice in 10 minutes. I topped up for 6 six weeks and then breastfed on demand and co slept etc for over three years. Breastmilk is best for the baby, there are about 3000 research articles which have found formula to be not as healthy for the baby or or the mother in terms of preventing ovarian cancer etc... it is very hard work especially in the first weeks. After those dark weeks breastfeeding made my life a hundred times easier especially as my DS was fractious, it was always ready, it always provided him with the comfort he needed, he was rarely ill and even during the winter vomiting virus he kept feeding despite seriously vomiting and that probably stopped him being admitted to hospital. I have never taken a day off work because he's sick and he never makes a fuss having injections etc... which I feel supports the research that bf babies cope with pain better. I know it's difficult, I'm glad you are supportive of your wife but I hope you are supporting your wife to breastfeed. My husband never once said why don't you give him formula and I am very grateful that he was always 100% positive that breast was best which helped me through that time. XXXXX

Adaddy ime near constant feeding is the norm for a bf newborn. They need to continually top up their tiny tummy, want the comfort and are continually signalling to the breast to make milk to meet their ever increasing needs.

Infrequent poo is common in bf babies but i'm not sure from what age this would be considered normal...maybe someone else can tell us?

Screaming can be a sign of all sorts (reflux, colic, intolerance to something in the mothers diet).

Some babies gain slowly, sadly hv's don't seem to understand this and scare new mothers.

After the initial milk coming in engorgement, breasts can be much softer. Does your wife feel any engorgement when when she misses a feed, eg when you have given a bottle?

Babies often appear more "satisfied" after ff as it is harder to digest. And we now have several generations of ffers/ff babies who expect a baby to feed once every few hours, and be "saited" in between. But this is not how bf works (not at first though it soon gets like that for most).

Obviously i'm not trying to convince you that you shouldn't ff. You must do what is right for your family. But i would hate someone reading this to worry about their supply on the basis of what you have said, as i can't explictly see a supply issue there. Maybe i'm being daft. And i'm not an expert. I just spend too much time on here!

What does your wife think about how you should continue feeding?

Hi Gemjar

Thanks for your comments, however, I do take some issue with what you say.

"there is no getting around the fact that breast milk is the best way to provide your baby with hydration and nutrition"

only if you have enough, and even then, nutrition maybe, hydration almost definitely not. I would be surprised if a baby was admitted to hospital suffering dehydration and they were given breast milk, an IV drip maybe. I only say this to highlight the importance of stepping back from the breastfeeding mode and any associated problems and asking, what is really best for my baby?

On the issue of supply, a woman's ability to supply is not definite, it is a statistical distribution. Some women have more, some less. It is not helpful to only consider the average woman. This issue needs to be addressed on a case by case basis without any pre-judgement, otherwise the woman is left feeling "everyone else in the world can do it, what is wrong with me?"

Thanks again for your comments though

True supply problems are incredibly rare though. It is however, very common for people to think they do not have enough because they are not aware that newborns need to feed a lot in order to get the supply they need. The myth of the 3 or 4 hour feeding schedule does a massive amount of damage to bfing, it really does.

As for your other point, bm is both food and hydration, a baby will not suffer from dehydration if it is getting enough bm, there is no need for additional fluids. However, of course a baby admitted to hospital with dehydration will be given an IV because by that stage they will need a quick solution, the dehydration will have come about because they have not been getting enough bm over days/ weeks for whatever reason.

justtrying - it is very normal for a baby to fuss in the afternoon/evening.

I'm cross though that your DP is so unsupportive of your pumping. Doen't he know how hard it is to pump that many times a day with out him taking the piss out of you?

I pumped 12 times a day for 8 weeks until I got DD1 back to ebf and DH did all the sterilising, fed DD1 her bottle (he made/heated it too) when he was home from work and got way less sleep than me (I pumped and he fed baby, then I went to sleep and he went and sterilised pump stuff and brought up clean ones for next session).

He also helped me latch on DD2 when it all went horribly wrong on day 2 at 3am. Brought DD3 in for feeding when I was in hospital for a week twice over twice a day, checked which meds I could take, fought my corner when I was told to wean DD2 & DD3 so I could have meds (which were safe for bfing). I couldn't have gone on as long as I did without him and he is supportive of me bfing DD2 at 3.7y/o and DD3 at 20m and is grateful that I do bf them for as long as I do.

What is wrong with some men that they don't appreciate their partners?

Yes, but you build up the supply by feeding, and feeding and doing a bit more feeding, this is the thing that alot of people don't get as unless you have a mum etc... who has breastfed. Chilling, getting fed by others, having drinks handy and feeding! then the milk supply increases.

Hi MoonFaceMamaaaaargh

Unfortunately, in the last few weeks we have become aware of a lot of the points you raise. Our conclusion is that there is in-fact a supply problem and more importantly we are able to provide what is best for everyone's needs by supplementing feeds with formula.

Don't get me wrong, I am not promoting any particular type of feeding, only to do your best and consider the whole picture. Whereas there is a good case that breast milk is better than formula, in the grand scheme of things, breastfeeding may not be best for you and your baby.

ADaddy,
If your wife wants to continue breastfeeding please help her to stick with it.
I had all sorts of bf problems and topped up with formula for the first 5 weeks but my DD is now four months and ebf.
Topping up actually saved breastfeeding for us as feeds were taking an hour and a half and she would only go two hours between feeds so I know what its like to feed constantly. I would bf both sides first and then offer formula - that way helps maintain supply while you sort out the latch.
The secret to our success was my DH. He fed me, watered me, took DD whenever he could so all I had to do was feed and sleep.
Eating one handed was a god send and so was co-sleeping.
I had her in bed with me on the bad nights (be careful to do it safely) and Dh slept in the spare room.
The first few weeks are horrid but you will get through it and if you can get to six weeks breastfeeding then you are set and it all becomes so much easier.
Ask for help from as many people as possible, NCT, La Leche League, ect
Good luck and hang in there.

It sounds like you've had bad advice and support. Unfortunately, that is the norm in this country afaik, rather than the exception.

FWIW I was so grateful to my husband for supporting my efforts to breastfeed and for agreeing with me that breast is best for baby and that breastfeeding was really important to me, especially after ending up with a traumatic failed induction and EMCS rather than the natural home water birth I'd wanted.

In answer to your specific points:

1. True

1. There are infant feeding specialists within the NHS but thet can be hard to find or access. We did find that BFCs were sometimes at a loss for advice for what to do when formula was already part of the picture as it was for us after DD's SCBU start.

1. Agreed. Breastmilk is still the best food and drink for your baby. Formula is considered the 4th choice for infant feeding by the WHO after breastfeeding, expressed mothers milk and donated milk.

1. Breastfeeding shouldn't mean a mother cannot look after her own wellbeing.

1. actually, this is rarely the case IME.

1. They are the simple ways to see if baby is getting enough milk, that's all.

1. Yep, supply issues are trickier. And understanding the relationship between latch, positioning, mothers well being, baby's idiosyncrasies and supply takes an infant feeding specialist or lactation consultant IME. Supply issues can be addressed in almost all cases though.

1. You're really focusing on the negative extreme. Put the baby in a sling and take it for a walk to give your wife time to shower and nap. Help her to feed lying down safely. And make her food she can eat one-handed on the sofa. And get family/friend to help with this too. Saying "this is driving us crazy" isn't actually helpful!

1. Supporting breastfeeding can really help bonding.

Adaddy bm is eighty something percent water so i can't undertand why you feel it might provide nutrition but not hydration?

I Still fail to understand why you think your wife does not have enough milk. Other than you saying it is so?

Where do you get your info on the statistical distribution of womens supply? It's not something i've come across before (and as i say, i've spent a lot of time on here )

Finally, again, what does your wife think about the situation?

Should've said, we really struggled. DD lost loads of weight until 10 days old (inc 3 days in scbu) and needed top-ups for a month, first of formula plus ebm, then ebm only. I couldn't have done it without my DH's support for which I am so grateful. We're still breastfeeding at 6.5 months and its lovely.

sorry adaddy, didn't realise we had xposted last time. But i think my points still stand.