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Infant feeding

Get advice and support with infant feeding from other users here.

What to use instead of best or normal?

80 replies

hazchem · 12/12/2013 08:39

I had a meeting today and a midwife said "breast is best" and I said well no "breastfeeding is normal". One of the other attendees said that she was uncomfortable with the use of "normal" as it can make people feel abnormal if they can't breastfeed and would make them feel bad.

I've tended towards breast is normal because it think it takes some pressure off and suggest that it just something that humans do. I hadn't thought about it making women feel worse.

Has any else come across this? Is there a move towards another term. Natural?

OP posts:
SootikinAndSweep · 12/12/2013 10:44

I like 'Every Breastfeed Counts'. Agree that it has positive messages for people who do any amount of BFing. Although of course it does exclude those who decide prebirth not to BF at all.

The point I made about the marketing thing was because I perceive the people needing protection from unethical marketing practices to be the 'undecideds', who may be swayed by the formula companies.

tiktok · 12/12/2013 10:45

BTW hot dishwasher should be fine.

BitScary · 12/12/2013 10:48

I just don't think that 'Breast is Best' works at all from a marketing perspective. (And it is really a PR issue, actually -- I think tiktok's post alludes to this.) It sounds chiding. It's unspecific (best what? in which way?). There is no positive association to give people the warm and fuzzies. It rolls off the tongue too easily, in fact: you have people saying 'oh yeah I know breast is best blah blah BUT'.

'Every breastfeed counts' does have a warm, positive ring to it IMO. It would give pause to a mother or MIL who never breastfed herself to be more supportive to a daughter or DIL who was trying to get established with it. I think.

BitScary · 12/12/2013 10:50

By the way I'm not suggesting that breastfeeding itself is all warm and fuzzy when you're dealing with a newborn for the first time! It certainly wasn't for me!

Again it's just how marketing works Wink

SootikinAndSweep · 12/12/2013 10:51

Regarding support, BF needs to up its game. I had a 3rd degree tear and internal injuries resulting in PTSD and PND. DD had undiagnosed tongue tie (actually I did ask them to check, to be told that there was nothing wrong with her). My physical and mental problems meant that BF had to be easy, I simply couldn't cope with anything else. Of course, it was agony due to the TT.

The BF consultant at the hospital was on holiday, as was the only lactation consultant for miles around. Midwives and HVs kept telling me the latch was fine. The helplines were lovely, but obviously weren't able to physically be with me.

A good slogan would help, of course, but until the support for those finding BF hard can really compete with the readily available instructions on the back of a tin, FF will continue to be the norm.

Badmumof3 · 12/12/2013 11:23

Toktok: A dishwasher doesn't get hot enough to sterilise bottles! It's not a risk I would advocate taking!

tiktok · 12/12/2013 11:43

Badmum, a hot dishwasher is fine, as long as the bottles and teats and tops and so on are throughly cleaned of milk traces beforehand....honestly.

But whatever.

I was more interested in your assertion that there is insufficient information out there to prevent people mixing up powder and water incorrectly. The info is there - sometimes people don't bother to read it of course.

tiktok · 12/12/2013 11:46

Badmum:

www.babycentre.co.uk/a554982/sterilising-bottle-feeding-equipment

www.tommeetippee.co.uk/support/sterilising/methods-of-sterilisation/

Key is to use a hot wash programme, and as I said, the equipment has to be cleaned of all milk traces beforehand.

hazchem · 13/12/2013 03:51

So I up and left but had some tech issues.

Every time I think I have a handle on handling breastfeeding discussion I get tripped up.

I like the "every breastfeed counts" I think because it is both individual, so the one breastfeed of colostrum after birth, but is also a bit of a call to arms at system/society level too, so support really proper support for women but also for staff so there should be proper holiday cover, good training opportunities ect.

I feel like I'll keep coming back to this debate, even just in my head, for quite a while.

OP posts:
Mutley77 · 13/12/2013 05:13

Totally agree with the "every breastfeed counts". I think that is really supportive and inclusive.

I couldn't breastfeed despite every single hcp in the world trying to support me with all 3 of my kids (well that's what it seemed like at the time!) I truly believe that it wasn't physically possible for me which made me feel extremely guilty - I think any discussion of bf needs to bear in mind that there are people who can't do it. It is a tough one as if you "allow" people to believe that there are some that can't bf it can make it easier to give up but you do have to make sure that people aren't tied in knots through guilt which will affect their relationship with their baby. The normal sort of makes that worse as I felt abnormal enough having to get out a f**ing bottle instead of my boobs esp when my babies were tiny - I felt really judged.

"Every breastfeed counts" would have really helped me as I did manage to express and feed my children breast milk for varying lengths of time before moving to mixed feeding then ff - I know they benefited from what little breastmilk they did have but weren't harmed by the formula and all 3 are currently extremely healthy although I know we were lucky.

tiktok · 13/12/2013 13:42

I like 'every breastfeed counts' as well - as a slogan it's quite empowering.

It doesn't do exactly the same job as 'breast is best' or 'breast is normal' try to do...which is to sort of encompass what breastfeeding 'is'.

I am still waiting for Badmum to explain why she feels there is insufficient information about how to make up formula, when the instructions are widely available. I do think there is a question about why people don't read them, and I think this is probably to do with the cultural preference to do what your own mother/MIL did or what you see others do, over and above new information which might be different.

But the info is definitely out there :)

CalamitouslyWrong · 13/12/2013 14:22

See, every breastfeed counts just makes me think of tesco.

tiktok · 13/12/2013 14:25

:) :) Grin

hazchem · 14/12/2013 05:49

If only breastfeeding support had tesco's marketing budget and reach :)

OP posts:
MigGril · 14/12/2013 06:36

badmum have you never opened a dishwasher during a dry cycle? The ones we have had would always release loads of steam if you did that. I'm sure that is just the same as stream sterilizing. Some countries recommended this as a way of sterilizing baby bottles so it can't be that bad.

There is lots of info out there about formula feeding and most formula companies have helpline phone numbers to. it's harder to get good breastfeeding support which is ridiculous considering thegovernment wants more people to breastfeed.

I don't like 'breast is best' it makes it sound as if it's the gold standard but most people don't gain the highest stranded in anything. 'every bestfeed counts' sounds good, but actually dispite how it mite make people feel 'beat is normal' is really the correct term. We can't control how people react to that but it is technically the right term. should we really sugar coat it to make people feel better about there choice (I do appreciate its not a choice for everyone, many are let down by our current system, or can't feed due to medical issues) Buttalking about breast is best isn't helpful either. So it's a hard one to call.

DeckTheHallsWithBoughsOfHorry · 14/12/2013 08:46

I disagree. We should sugar coat. Women are very irrational sensitive and vulnerable in late pregnancy and especially when newly delivered. Anything remotely critical can be catastrophic.

Aggressive pushing of bf as the only acceptable option (eg "breast is normal") puts people off because they know damn well that formula is a remarkable complete food for infants. Pushing ebf at all costs, particularly with the "just one bottle" and "virgin gut" theories, means people believe if they give one formula feed on day nine in sleep-deprived desperation they might as well give up bf altogether.

On the other hand, promoting mixed feeding as a good alternative, which it really is, gives babies all the immune (etc) benefits. And "every breastfeed counts" supports that, just as it supports natural term feeding.

SliceOfLime · 14/12/2013 08:56

DeckTheHalls what are the 'just one bottle' and 'Virgin gut' theories please?

tiktok · 14/12/2013 09:49

Deck, why would you 'promote' mixed feeding? Why not just share information about it?

The virgin gut theory (google it, SliceofLime) is as I have said before an over-dramatic way of describing the fact that a baby's gut environment is changed if you give a bottle of formula - it goes on to explain that this is not a permanent change and it is easily restored, so anyone worrying that they might as well not breastfeed is not reading the info properly.

In any case, other effects of breastfeeding are not cancelled by even regular amounts of formula - that would be part of any information about mixed feeding.

But why 'promote' it?

tiktok · 14/12/2013 09:50

And no....mixed feeding does not give 'all the immune benefits' of excl bf.

DeckTheHallsWithBoughsOfHorry · 14/12/2013 11:18

When DS1 was born we had terrible trouble getting started bfing (tiny mouth, borderline tt, inverted nipples). The mws could only help me to continue trying to bf - the flip side of baby friendly status. It wasn't until I asked about expressing or mixed feeding that they could offer advice on those topics. Madness.

As for immune benefits, I realise there's a theoretical immune risk of ff, but the immunity agents in bm concentrate into however many feeds baby takes - so in that way the immune benefit is the same.

tiktok · 14/12/2013 12:01

"the immunity agents in bm concentrate into however many feeds baby takes " - no, they don't. I can point you to research that shows this does not happen.

Seems to me you had appropriate help from the midwives. They helped and supported you with bf, and then when you made it clear you wanted other options discussed as well, they gave you advice.

DeckTheHallsWithBoughsOfHorry · 14/12/2013 12:29

We've been reading different papers, evidently.

I don't think I was adequately supported. I only had a clue that expressing was plausible (see also mixed feeding and use of nipple shields) because a friend who had gone through similar suggested it. Without her I'd have been ff from about day five and none of my three DC would have had any bm at all.

Ask someone pg with DC1 what options there are for infant feeding and she will say bf or ff. She won't know that there's a spectrum in between.

tiktok · 14/12/2013 14:49

Deck, you have been reading some strange papers if you have understood them to say that the quantity and range of antibodies in breastmilk remains consistent, no matter how little breastmilk the baby gets.

It is certainly true that antibodies remain active in partial breastfeeding, so it is worthwhile to continue bf alongside ff. But the more breastfeeding the baby gets, the greater his protection.

A good paper that shows the 'dose response' of the immune-supporting factors in breastfeeding is this one pediatrics.aappublications.org/content/119/4/e837. Exclusive breastfeeding = lowest incidence of rep. and gastro infections in the population studied; no breastfeeding = highest incidence; partial bf = somewhere in the middle.

Still waiting for you to explain to me why you think mixed feeding should be 'promoted' .

DeckTheHallsWithBoughsOfHorry · 14/12/2013 16:43

My reading and discussions led me to believe that when a baby/child reduces feeds, the active immune agents (brain... antibodies?) don't reduce in quantity per 24h but tend to concentrate into the fewer feeds. Also the dynamic infection exchange from baby's mouth to mother's areola continues, to stimulate mother to make the right antibodies in the first place.

Now, I think mixed feeding should be promoted because I think it would raise bf rates:

At present the message is that everybody should breastfeed exclusively for six months. This is an aim I fully support (DS1 had about half a dozen ff in what was otherwise six months ebf; DS2 was ebf for six months, 5wo DS3 is ebf). But it isn't necessarily attainable by everyone, whether for physiological, psychological or social reasons.

So what do we want for the babies who aren't ebf? We obviously want them to have any breastmilk (medical exceptions excepted, obvs).

If the available support is or appears to be aimed at exclusive breastfeeding, women will perceive that the options are ebf or ff. Promoting mixed feeding could keep those women giving some breastfeeds. Maybe not for long (supply issues) but that's still feeds baby wouldn't have had if the mother switched straight to ff.

We hear so often that a woman isn't going to bf because she's going back to work after a short ML, or because she doesn't want to BFIP, or because she wants to share night feeds. These women haven't heard of mixed feeding. A little promotion would go a long way.

You can get back to full-time breastfeeding from mixed feeding. Relactation from dry is far far harder.

tiktok · 14/12/2013 18:17

Deck, I'm going to C&P to answer your points.

"My reading and discussions led me to believe that when a baby/child reduces feeds, the active immune agents (brain... antibodies?) don't reduce in quantity per 24h but tend to concentrate into the fewer feeds."

I think you have misunderstood. There is some concentration of antibodies when there is less breastfeeding, but this happens with very well-established breastfeeding, and nature assumes the less breastfeeding is happening with an older baby/toddler/child whose immune system is more developed/robust than a small baby's. It's absolutely not the case that switching to (say) half-breast, half-formula, allows the baby to have the same quality and quantity and range of immunity as he would if he were fully breastfed. Like I say, what have you been reading to indicate anything else?

"Also the dynamic infection exchange from baby's mouth to mother's areola continues, to stimulate mother to make the right antibodies in the first place."

Indeed - but this does not work as extensively as it might, if the baby is not fully bf. But the 'exchange' does continue, you are right.

"Now, I think mixed feeding should be promoted because I think it would raise bf rates:"

That is highly speculative. The evidence we do have - a lot of surveys, including our own internationally-respected UK Infant Feeding survey - indicates the absolute opposite. The sooner infant formula is introduced into a breastfeeding relationship, the less likely there is to be any breastfeeding within a short time (the UK Infant Feeding survey consistently shows this - a bf baby who has any formula introduced in the first week is much less likely to be bf at all a few weeks later. It's not pure cause and effect, of course, but it is not encouraging.)

Now, there has been one study which gave small amounts of infant formula to 'problem feeders' among bf babies very early on (at 2-3 days, I think), deliberately to see if this increased the length of time the mothers bf for. The methodology was truly awful, the sample tiny, and the results inconclusive.

It may be the case that in individual cases, judicious use of infant formula where there are bf problems may be helpful and enable the mother to continue bf - as you rightly say, going back to full bf remains possible anyway. But as a basis for promoting mixed feeding, we have no evidence at all that it would do anything at all except reduce bf.

"At present the message is that everybody should breastfeed exclusively for six months. "

No - this is not the message. The message is that the best health outcomes are seen in babies who are excl bf for six months. There is no instruction to individual mothers that 'everybody' should do this....though of course people take it as such. The 'instruction' should be seen as a call to agencies, HCPs, employers, matenity services, to enable women to do this.

" But it isn't necessarily attainable by everyone, whether for physiological, psychological or social reasons"

Quite true.

So we want individualised support and enabling for everyone, full and frank info for everyone, and HCPs responding to what women say they want to do.

I do not believe that many women are unaware that some bf babies have formula as well. They may not know the term 'mixed feeding' but as 99 per cent of all UK babies have formula milk at some point, I am confident the majority of them know this form of feeding exists.