When breastfeeding isn't enough...fed is best

[Birthdaypartyangstiness]

Anyone read this? (TRIGGER WARNING: link is about an infant death due to inadequate diet):

fedisbest.org/2017/02/given-just-one-bottle-still-alive/

It is a hard read but seems worth publicising.

I'm biased because I was in a very similar situation with my first child. Also have mild PCOS, poor fertility and produced copious watery milk with a baby who either screamed or "cluster fed" and suffered significant weight loss (dropped off the chart). And I just kept getting the breast is best message, feed him more etc and persuaded not to give him formula. I "gave in" at about 12 weeks and topped him up with formula and he suddenly thrived. I'm an educated health professional and yet the pressure to exclusively breast feed was enormous and I let go of my own common sense. Looking back now it's clear that there was objective evidence that my supply, though copious, was not nutritious. Milk I expressed sat in the fridge, and when separated due to cold had only the slightest "scum" of fat on top, the rest was just grey water. Showed the midwife and HV and just got the party line that all breast milk varies, you are making what your baby needs blah blah blah. Just ridiculous. We accept that there is variation in all other health matters, so why do we persist with the universal message that breast is best? Thank science for formula.

Birthdayparty, good to see the more nuanced update you have given.

Your situation was very individual - it can certainly happen in rare cases that massively over-productive breasts can lead to problems that need to be managed by a change in technique. But it really is not 'poor quality' milk - the milk is fine.

I understand. Thanks for clarifying.

I'm an educated health professional and yet the pressure to exclusively breast feed was enormous

I would guess the vast majority of that pressure came from yourself and your own expectations that you would breastfeed.

Tiktok it was an individual situation and that comes back to the point I made in my first point, that bfing advice is insufficiently individualised and this massive variation in this area of "health" is unappreciated and mothers to be and bfing mothers are generally underinformed. Incidentally, you gave me a lot of support at the time 5 years ago (thank you) under a previous username and as I recall you were extremely concerned about my DSes weight loss and the lack of any apparent action.

FATEDestiny
I would guess the vast majority of that pressure came from yourself and your own expectations that you would breastfeed.

Well yes, but I didn't internalise those expectations from thin air...and that was compounded by living in a rural community where I would say that bfing rates were extremely high, certainly in the overwhelming majority. There was very strong pressure from the MWs (who visited well beyond the usual 10 days) and HVs too.

It's quite clear that I am not unique in feeling this pressure -this board alone shows that.

So those risk factors are for having a very great oversupply and therefore lower calorie milk, if I've understood you correctly? Why is the oversupply milk lower calorie? And if there's copious amounts of it, wouldn't the baby still gain weight?

I thought the website was about lack of milk altogether, rather than poor quality milk?

Do you know what really pisses me off though?
By the time your child is at school no one asks how you fed them.
No one cares.
You don't 'win' at anything by breast feeding. But in the early days new mothers are under so much pressure to get it right, granted mostly from ourselves.
Any amount of breastfeeding is a good thing even if baby only gets the colostrum. We are so lucky to have access to formula and it was only a generation ago that FF was recommended as the way to feed your baby according to my mother and other family members.
There is absolutely no doubt that BF is the optimum food for your baby but BF is not easy for everyone and no one should be judged for not doing so particularly by hcps.

For fucks sake. That's the second time I have come across that link today. Obviously it is a very sad story but the title is just clickbait, which is horrible.

Of course "fed is best". No mother, ever, would put her baby at risk just because she was determined to breastfeed. I am absolutely sick and tired of shit like this floating around the internet, usually from women who have chosen to formula feed, or had trouble breastfeeding. That is your choice. Some women want to breastfeed, that is their choice. Stop fucking tearing each other apart over it and unite as mothers, as women.

As for terms like "breastapo" and breastfeeding propaganda, this is exactly the same thing just from the other side of the debate - shaming women who have made a different choice.

(Disclaimer I am having a strong personal reaction to this due to tensions in my family over this and probably shouldn't have posted.)

AssasinatedBeauty This particular case has oversupply as the issue, lots of wet nappies, lots of milk but weight loss and poor nutrition and there's discussion of this (and other issues) from various links. I'll have to go through my browsing history to find everywhere I ended up from this one story. But there are many other examples of why breast feeding fails on the site including delayed lactation and impaired lactation. I didn't read around them much as it was the particulary story I linked to that chimed with my experience.

Breast milk is on average 70 cals per oz, if I remember right. Fat is the most calorie dense constituent. So if it is very low in fat, it will be very low in calories, despite all the other good stuff that is in there. Feeding uses calories, especially cluster feeding, so an infant could use more calories than it gains if cluster feeding on this copious "foremilk" which some mothers over produce. Remember that babies have tiny stomachs and digestive systems in the first 4 months or so (hence frequent feeding and the necessity of night feeds) so what happens if they are full (volume) but depleted in calories? This is the issue as I understand it. My block feeding method, from LLL as I understand it (though Tiktok may know better) both slowed the oversupply and drained the breast right back to the fattier hindmilk.

So, more consistent and better quality breastfeeding support would help? Does that need to include HCPs offering formula much more readily and quickly if there's any doubt about the quality of milk or if there is a concern about low supply?

TheMasterNotMargarita I agree with everything you say.

AssasinatedBeauty Yes. And maybe more rational and scientific management of expectations pre-birth?

Personally I'd prefer a "Breast First" message - to give the message that breatfeeding should always be your first option, but is not the only option.

Beetlebum Sorry for your troubles, sorry that this has upset you. But this: No mother, ever, would put her baby at risk just because she was determined to breastfeed is evidently untrue, but gets to the crux of this discussion, that is, why this should happen...when no mother would want to put her baby at risk.

I think we as a society are suffering from the missing link of generational knowledge of breastfeeding. How many women of childbearing age grew up watching other women breastfeed? How many of us can turn to our mothers and grandmothers for breastfeeding advice and support? I'd wager the number is vanishingly small. Of course the NHS needs to buck up on the training and support, but I trusted my LLL lady because she has seen literally hundreds of women and advised them on a huge range of issues. Her knowledge base is enormous and her experience is worth so much to everyone she helps. She is a rarity, simply because we are only now making headway with the cultural expectations that bottle feeding is the norm. Granted, the pendulum has swung too far the other way for many people, and because there isn't that knowledge base in our families and friendship circles, the message of breast is best rings hollow and can cause strife.

I do hope that there will be a happy medium reached within the next 20 years - when we have a generation of women who can navigate feeding issues with the confidence that they will be given decent information. Maybe that's a pipe dream.

Hope so too. In the meantime, LLL are fabulous and formula is not poison.

Yes!

That movement suggests everyone should give a bottle after a breastfeed. I don't think that is right either. Yes, if it is going wrong definitely! But I don't agree with fear mongering that breastmilk isn't enough and everyone should supplement. It's a fine line in my opinion.

No one thinks formula is poison.

I don't know how the HCPs dealing with me could have suggested formula more quickly tbh. They didn't offer me any actual help with breastfeeding, I did my own research and solved my own problems, much to the surprise of my HV who I suspect thought that we would be stuck with mainly formula feeds as the breastfeeding would eventually peter out. They were quite happy with formula top ups turning into full formula feeds and the end of breastfeeding, as long as the baby was gaining weight.

Breastapo is a horrific term and whenever somebody uses it, I feel sad because I know I'm not going to respect their point or judge it to be at all balanced.
Fed is not best. It's illegal not to feed your child, so fed is the bare minimum.
Breast is not best either. It's the biological norm. Human milk for tiny humans. Cow milk for calves, goat milk etc etc.
Thankfully, theoretically at least, we live in a society where women can choose to ff if they want to. But how about not undermining those who want to BF by spouting damaging advice? Women are thwarted and let down far too often. For every woman who feels shamed for not breastfeeding (which is awful) I'd bet there's another woman who desperately wants to bf but is let down by any inadequate support system.
I completely sympathise with midwives and other HCPs who see our horrifyingly poor BF rates and yet have to, with v little resource, try to persuade women to try bfing, or to persevere, when they are up against a social rhetoric, propped up by the media, which has ff babies sleeping through the night, and then lures women into losing their supply by "just giving one top-up before bed" etc. It is incredibly demotivating to watch this unfold repeatedly.

Lots of good reading here but mostly this.

Stop fucking tearing each other apart over it and unite as mothers, as women.

Citymole I think most people on this thread agree that a lack of information and specialised support is the key issue. It's not a FF v BFing debate. I certainly agree with your comment re women being thwarted and let down in this whole area. Either by HCPs undermining Bfing by pushing top ups at the wrong time/wrong quantities, or just giving poor/conflicting advice, or by HCPs who press for BFing at all costs. Where is the easy to find, clear, balanced and informative literature?

Just as a reference point, I'm not going to apologise for breastapo no matter how many grown adults tell me it offends them. It fits my experience of a small group of HCPs harassing and pressurising me into persevering with something that was failing. An experience that was literally tortuous. If you have trouble coping with words you don't like in a discussion between adults on the internet that's up to you.

You don't need to apologise, but you'll have to accept that it undermines your credibility and puts women off from engaging with you.

puts some women off...just as I'm put of by people who insist on hearing only language that fits with their own sensibilities. It's a portmanteau, that befits a certain experience.

Yes, some. You can use it as you see fit, but as I said it undermines credibility and stops some women from engaging. I don't know why that's something you would want when you're looking to campaign on this topic.