I wish people wouldn't be so quick to advise others to mix feed

[NineUnlovelyTinselDecorations]

I know I am going to get jumped on for this but I am going to say it anyway.

I have noticed a few threads of late where a BF mum is struggling and asking for advice or support to carry on. Some posters have said something along the lines of "I know it's not advised, but I introduced a FF at bedtime/mixed fed and it was fine." It's not that people aren't entitled to share their own opinion and experiences, but it worries me sometimes that new mums/people struggling with BF will not read the It's Not Advised part but only the It Worked For Us part.

There's a reason that it's not advised, which is that it very often inteferes with the supply/demand of BF and one FF often turns into more and the end of BF. I know that it works for some people, but my own experience of exclusively expressing EBM for my son was that I was able to build up and maintain a plentiful supply by expressing 4 times a day. But for the vast majority of women that would not be the case (I would have followed advice and done it 8 times etc if I hadn't been very ill). Therefore I don't tell women who are struggling to express for their babies "It's okay, it's not recommended but I only expressed 4 times and we were fine". Because I think that would be doing other women a disservice.

What do you think? Shall I get me coat?

Sabire, the word precious may seem a little OTT but my post was a response to how I felt about the veggie analogy -

which NBD has just explained and perhaps I read it as a bit loaded initially - I see what you mean now.

And yes, having formula pushed on you is horrible. I've posted about it lots on MN, DP doesn't like it (BF), MIL told me when I was six months pg 'don't bother with that nonsense' - I am very pleased that DS is not getting any more formula and would love to be able to say he hadn't had any at all - but at what cost - I honestly believe those few small feeds broke the ice with DS and DP and had they not happened when they did - had I forced DP to wait until I could express enough - not sure where we'd all be now, and it's not exactly bliss as it is.

Does this mean I sacrificed my DSs wellbeing in favour of my DP? Obviously wellbeing is about more than just how he is fed, so the gains that were made in his father's relationship with him are worth it. I don't feel bad about it because I haven't the time and energy but as I posted before, very weird to give a baby formula when you are engorged.

Sorry if I was unclear or came across as thinking exclusive breastfeeders are fetish-ish (?! ) as I don't think that - but do think vegetarians have a point when criticising tuna-loving 'vegetarians'. Does that make sense?!

But as an aside I feel sad that in my case the beauty of the mother and baby bond is the very thing that threatened any father and baby bond - that's obviously not what nature intended.

And I don't 'thank' formula for my DP being able to enjoy his son, I thank my DP for wanting to be involved - just in case I've made a mess of explaining, in this post, and previous, I am extremely tired.

"The more feeds the higher the health benefits. So although exclusive breastfeeding gives the optimal health benefits, one feed a day is great for the baby" - yes, this is how breastfeeding is 'sold' to women in our formula dependent society. Any breastfeeding is good - any.

The problem is that when it comes to the HEALTH benefits of breastfeeding (which admittedly aren't the be all and end of of it), the research seems to show that they're seriously compromised by the introduction of formula. For instance, with gastro-enteritis - partially breastfeeding only seems to result in a very small reduction in the rate of gastroenteritis, whereas fully breastfeeding offers a five fold reduction in the rates of gastric illness for babies under six months. Ditto respitory illness.

It worries me that the desperate efforts of MW's and HV's to up breastfeeding rates by telling women that 'any' breastfeeding is good, they've somehow managed to mislead them over this issue, hence the reason why so many women think that supplementing is no big deal - it's part of 'normal' breastfeeding to give a bottle of formula now and again.

The other side of this is that we've arrived at a place where the majority of women can't conceive of living a bearable life as a new mum without having access to formula - including for the mums who're breastfeeding. For me that's the real problem. It's that casual acceptance that exclusive breastfeeding just isn't possible or feasible for the vast majority of normal mums. I don't know - maybe it isn't. Maybe the way we live our lives now and our expectations of motherhood make it too difficult for us.

Exclusive breastfeeding was impossible for me. Impossible. I do think the focus on exclusive breastfeeding is unhelpful tbh. I would have done it in a trice if I could have but I couldn't.

I do quite a lot of gentle promoting of bfing to women who are in two minds about it - telling them to exclusively bf for six months would be the best way to put them off altogether. I tend to emphasise that it can be hard work at the beginning but that it's worth persevering and once you've cracked it you might carry on for months because it's so easy and nice but only once you've cracked it. Setting people up with an almost unattainable target (numbers of women managing to exclusively bf for six months are tiny for a reason) really doesn't help imho.

I'm sure there are many benefits to exclusive bf just as I'm sure there are many benefits to doing an hour's exercise a day, eating no processed food and eating 10 f&v a day. But life is more complicated than that.

I completely understand the use of the word "precious". And I say that as someone who wants to see more bfing and who thinks of herself as a promoter of it. As I've said before, I think bf campaigners should do some research on the impact of the current bf messages on hesitant new mothers. I think they do a great job of supporting those who are wholly committed to bfing and need help through the tricky times. I'm less sure about the impact on women who are thinking of going for formula and frankly aren't that committed to bf in the first place.

I am completely bored of this aversion to mixed feeding and the militant demands that mothers should do whatever they can to exclusively breastfeed.

I mixed fed all of my babies as and when I felt the need to give them something other than my breast (ie when I was exhausted or when I felt I had given all I had or when they were screamingly hungry 10 minutes after a feed). All of them were breastfed for the minimum of 6 months and 2 of them for over a year.

There is no harm in mixed feeding. I enjoyed breastfeeding and I felt good that I was giving my children the best start in life, but I did not feel in any way that I was letting them down when I got out the formula. In fact, I was rather stupidly proud of the fact that they could feed from both nipple and teat!

There is such a strong message out there right now that mothers should exclusively breastfeed all they can, that I am happy to redress the balance a bit if occasionally I see a mother struggling and I tell her my positive experience.

M&J, you raise a good point about the messages being given to mothers. Quote: "Setting people up with an almost unattainable target (numbers of women managing to exclusively bf for six months are tiny for a reason) really doesn't help imho."

Yes, the numbers are tiny, but the reason is not because the target is almost unattainable. With consistent support, appropriate and informed intervention if there are problems, removal of these and other barriers to breastfeeding, it is not at all difficult to bf excl for this time....but those barriers are of course real, and alongside any breastfeeding promotion and education we have to work out ways of tackling these barriers.

I think the 'Excl bf to 6 mths' is best seen as an exhortation to HCPs, employers, people in general, government to enable this to happen, rather than an instruction to individual mothers.

We know that partial bf, while worthwhile and rewarding as an experience, has a negative health impact, and that should be every mother's right to know - just as it is everybody's right to know the research on exercise levels and healthy eating and the health impact of obesity and so on. We don't worry too much about telling people to ensure they exerise regularly in case the ones who don't (for whatever reason) decide not to exercise at all, or feel 'guilty'. But we do recognise that enabling people to exercise, eat healthily and maintain a healthy weight is as least as important as telling them they 'should' do so.

Dumbledore, you say "there is no harm in mixed feeding".

This is just not true.

Of course people may find it a positive experience for other reasons, and a solution to individual difficulties...but it's a myth it has no health impact.

I just think people should know that!

And Dumbledore, WTF is 'militant' about saying that mothers should be enabled to bf excl for 6 mths, if they choose to opt for this?

one person sees "Exclusively bf until 6mths "it as a militant command

I saw it and thought
D'oh of course I will what else would I do

I'm sure it works for some mothers, which in those circs is really good news

However if a mum really plans to keep breastfeeding in the long term, then she should be made aware of the impact of early mixed feeding on her supply and also that babies quite often having had the weight of a FF in their tummies and equating that with fullness, suddenly fail to seem satisfied with a breastfeed and there you have it, mother suddenly sees her milk as inadequate and that's the bf gone.

I used to volunteer as bf peer when ds1 was a bairn (over a decade ago)

Harm is a strong word but when you see a mum who was wholly committed and desp to bf for a good length of time, who was just not told of the impact of offering a ff here and there and had her bf relationship destroyed by lack of advice and support... well also given that the advice she rec'd was from a post natal midwife as well... to top up as mum was not told that 5 wks is a growth spurt and to ride it through
She thought she was not good enough, HP concurred and that was that.
Had she been told a few simple facts...
Well

Mixed feeding has enabled me to carry on b/fing until 8 months, infact longer than this as I have no plans to stop in the immediate future. Had a not introduced a bottle of formula as the night-time feed at 6 weeks I would have, without adoubt given up b/fing as I was utterly and totoally exhausted and could not seem to satisfy ds.

"Setting people up with an almost unattainable target (numbers of women managing to exclusively bf for six months are tiny for a reason) really doesn't help imho."

Two things: nobody ought to tell ANYONE what they SHOULD or SHOULDN'T do re: feeding. I don't think for one minute that mums should be told that they SHOULD exclusively bf for 6 months, only that they should have a clear understanding of the benefits of exclusive breastfeeding, which most IMO DON'T at the moment.

As for exclusive bf being 'unattainable' for most women - yes, it is unattainable for most women now - not because it's intrinisically physically impossible, but because of cultural issues - namely a deeply entrenched formula reliant society and a medical profession who doesn't understand or know how to support breastfeeding.

"I'm sure there are many benefits to exclusive bf just as I'm sure there are many benefits to doing an hour's exercise a day, eating no processed food and eating 10 f&v a day. But life is more complicated than that."

This sort of comment worries me. NHS recommendations on infant feeding as they are draw quite heavily on a particular study, called the Dundee Infant Feeding study - a very large and good quality study that was published a few years ago. This study found that only 2% of exclusively bf babies had a bout of diarrheoa in the first six months, as opposed to 15% of mixed fed and 17% of fully formula fed children. There's also a mass of evidence showing that fully breastfeeding would prevent a large proportion of hospital admissions for respitory illness for babies under six months. In other words - this is a serious health issue for babies and for the NHS and not really comparable to the examples you give which are far more about lifestyle and long term prevention and reduction of a range of illnesses.

"I think bf campaigners should do some research on the impact of the current bf messages on hesitant new mothers." - what, and water them down? No - we need to tackle the poor support women get with breastfeeding, and the dodgy marketing tactics of the formula companies - not soften the message on breastfeeding. That would be a disaster!

"I think they do a great job of supporting those who are wholly committed to bfing and need help through the tricky times. I'm less sure about the impact on women who are thinking of going for formula and frankly aren't that committed to bf in the first place." - In my view the appropriate response to this isn't to downplay the benefits of breastfeeding or the risks of formula feeding in order to encourage reluctant bf to keep going. Women need the most accurate and most accurate information about both options and then they need practical help to keep going. If a woman doesn't want to breastfeed she won't, and it's easy for her not to breastfeed in a society where formula feeding is seen as the acceptable and healthy 'norm' - which is the where we are now in relation to this subject.

As some of you might have noticed, one of my hobbies is to read the medical literature about infant feeding and then bore MN rigid with it.

(I don't do this in real life, I promise! )

Sabire is right, mix feeding has definite risks compared to exclusive breastfeeding. They seem to be related to gut immunity, affecting the baby's resistance to infection.

Then there are a host of other factors which are dose dependent, ie the more breastmilk the baby gets, the better.

What the studies suggest, also, is that 6 months exclusive bf isn't an all-or-nothing thing. The big recent UK study on hospitalisation risk showed that for each month of exclusive bf, babies had a lower risk of being hospitalised with infections. So 6 months was better than 5 months was better than 4 months etc. (You can't tell what happens to the risk after 6 months as virtually no-one was exclusively bf past that point).

For bf women, a better approach than setting artificial targets might be to work on the assumption that the longer they can bf exclusively the better, however long or short that time is.

And if at any point they decide it would be better to mix feed, the baby will still be benefiting from bf in a dose-dependent way.

It's all about being able to make informed decisions. So I get agitated when I see posters advising people to mix feed as if it made no difference. It does make a difference, and only the individual concerned can make the call as to whether the difference is important. I'd be livid if someone told me it was fine to introduce a bottle and I later discovered there were potential risks, so I think we owe it to people asking about mix-feeding to make that clear.

great post, welliemum. Said all I wanted to say, but could not muster the energy or brain cells for.

WRT the OP. I totally agree.

If when DS had his growth spurt at 5 weeks and I spent all night up with him wondering why on earth he wouldn't quiet I had been told to mixfeed because it 'did me no harm' then I probably would've done it.

Instead I read my little leaflet I had from the hospital that told me all babies have growth spurts and feed lots at certain times. This was ds's.

Mixfeeding as the last possible resort is great, it sometimes stops mothers from giving up completely.

When the only option to someone in their mind is either mixfeed or stop breastfeeding then of course mixfeeding is a great thing.

But when a mother just needs some support, a thread full of 'It's horrid isnt it, happened to me, but it settled, I know how you're feeling' is much better for them than 'Mix feed, a bottle at night helped me loads'. They are asking for support, not advice on how to stop!!

If however someone posts a thread saying 'I'm giving up breastfeeding today and I feel terrible, but I really can't do this anymore, today is the day dc goes on formula' then by all means post saying 'Hey, you know what, if you're planning on giving dc formula did you know that you might not have to stop completely???' and giving them the best advice on mixed feeding. Which btw, is not just add a bottle here and there, to mixfeed successfully, expressing is very important, as is letting baby feed as often as possible when you are feeding from breast.

I know I would be pretty pissed off if someone told me that to savemy sanity and still be able to breastfeed I should add abottle and it fucked up my milk supply so I had no choice but to stop feeding.

Mots

Have skimmed this thread and haven't posted much in this section....

Personally speaking, when someone suggested offering a ff in the early weeks after ds was born by emCS I felt like I was kicked in the guts, again! Feeding my child myself was all that was left that I could get right, imho. So I perservered and eventually I could rise from seat whilst still attached to ds to open the front door, he never had a bottle and we mutually weaned, albeit a little too early for my preference.

DD came along some years later and again she was bf, and we stopped by mutual agreement at 15 months by which time she was eating solid foods well, has no allergies, rarely is ill and is a happy, secure and content child, even though dp and I are severely stressed.

The health benefits of bf have been discussed so I won't go there, but I just think that bf is so easy on the mum once she's established it seems so silly not to. There's no cleaning, sterilising and preparing, there's no packing all that you need to go out... You just pick up baby and go. It really is the Lazy Woman's dream! Ok, so no-one else can feed your baby but I didn't want anyone else to. This was MY job and my pleasure! I failed to express well and now I'm glad I didn't!

This was something I could do for my child, and, selfishly, do not want to share this responsibility! Getting up during the night only lasts for a short while and the whole period of feeding your baby only lasts a short time in your life. What's so hard about that?

What is so terrible is the lack of support for women who want, and in cases like mine need to feed their babies themselves.

There are support organisations out there like NCT and ABM etc but I don't think new mums think much about them when struggling to get established. They call their HV, they call their mum or their best mate... Then they get this 'advice' that is very often not well informed, although with best intentions.

I don't know how well HV are trained in Lactation Support, and I know that a lot of hospitals are not Baby Friendly yet. My local hospital is just working towards it now, with their Certificate of Commitment. Which seems odd to me, considering they are the ones who did the research paper mentioned earlier!! You'd have thought they'd have followed it through and been the first to get Baby Friendly!

So to that end, I'm going to start the training to become a BF Peer Supporter at the hospital in the new year. Once going in regular as a volunteer to support women to get started I hope that more women can go home encouraged and strengthened to learn to bf with their babies, and to know where to get the correct support to continue for as long as they want to.

I watched a mum feed her 4 month old recently and I realised that I missed it a lot as I watched her looking down at her baby, absent mindedly stroking her, with love in her eyes and totally not listening to the meeting that was going on around her. I just melted!

So some women may be happy to mix feed, and some to bottle feed and that's fine but for the women who need to feed their own children it is important that they are supported during the early weeks when it can be draining. The way I saw it was that I was guaranteed a sit down to rest every time baby needed a feed.

All that is my personal opinion but I'm sure there are many out there who feel similar and so being told to 'offer just one ff' can be very damaging to self esteem. It would be far better that the family is offered cooked meals, the housework is gently and quietly taken care of, older children taken care of and the mum hugged and told that she is doing a great job & that she will be looked after until bf is established. We need to mother the mother so that she can grow into her role with her new baby, we don't need to take her baby off her and feed him/her. That HURTS

Sorry, I've gone off on one, haven't I?

santaklaws - the things you say in your post are SO important. I feel very sad when I see mums switching (or choosing) to ff because they and their family think it'll help them rest and make life easier for them than continuing or opting to breastfeed. I'd challenge you to find many women who've bf to six months who'd say that ff gives you an easier life or makes you happier than bf - and that includes all the mums who've really struggled at the beginning. IMO bf gives you time to rest and relax with your baby, and it gives your self-esteem a powerful boost at a time when your ocnfidence is often being tested. Breastfeeding can be hugely empowering - something you really don't have any awareness of until you're doing it.

I'm tired of hearing that 'the most important thing is that you're happy with your choice' in relation to women choosing not to bf or to stop bf. Personally I think that most women who choose not to breastfeed simply don't understand the reality of the breastfeeding relationship - why would they if they've not been there? I certainly didn't have a clue until I'd done it myself. How can you make a rational, informed choice as to what's best for you and your baby if you simply don't understand what breastfeeding IS? And what it's NOT?

From the loooooong hours I've spent reading posts on parenting boards the main impression I've come away with is that women who breastfeed for as long as they want feel incredibly proud of their ability to nurture their babies in this way - and it makes me so sad that the majority of women in this country are missing out on that, and that their babies miss out on the pleasures of breastfeeding too.

Fio, no one as far as I can see is 'frowning' on people who use bottles.

Use of formula does not wipe out the effects of breastfeeding, but it does have an impact - and women need to know that, in order to decide on what is best for them. The convenience of breastfeeding is, I agree, something that they need to know about as well, but this is personal - some people don't think it is convenient at all!

I get twitchy when I read about things that should 'never' be done - in saying that top ups should never be advised, you're being dogmatic, and you imply you don't like people being dogmatic! There are situations where top ups may be needed (yes, far more rarely than they are advised, I agree).

You're minimising the risk of one or two bottles - the impact on breastfeeding is very variable and unpredictable, and while it may be something some women can get away with, they don't know in advance whether that's the case or not.

I've a copy of the latest NCT magazine, NewGen, open in front of me at an article called, "Mixed feeding - making it work!".

I think, often, women post "oh, those effing bf nazis" or similar without knowing what "those breastapo bullies" actually do and say, you know...

Sabire, I appreciate your comments about the reality of the breastfeeding relationship. As an "extended" breastfeeder myself I know how wonderful this is.

But the reality for some women (including myself) is that the problems with breastfeeding can be so severe that mixed feeding becomes a necessity. You can say that this shouldn't be so with the proper support etc (and I would agree in theory), but in reality when things get really bad you have to muddle through in whatever way you can, and mixed feeding can end up playing a part.

Of course we should know about health risks associated with formula. But we should also know what magnitude of risk we are talking about compared to the overall wellbeing of mother and child. And yes I do think that 'the most important thing is that you're happy with your choice'.

I was really distressed at having to give my dd formula in the first week of her life and convinced I was setting her up for a lifetime of asthma/allergies/god knows what. But I had to do it. We muddled through with mixed feeding, and we're still breastfeeding two and a bit years later.

The worst possible outcome for a woman in this kind of difficulty is that she believes mixed feeding takes away all the benefits of breastfeeding, ends up ditching breastfeeding altogether and feels incredibly guilty about doing so. And that seems to happen all too often.

See I do feel as though people who are bf campaigners often had a really good experience with bfing and didn't mix feed and didn't have to.

I'm sure that doesn't apply to all but it does mean that I think what those of us who really struggled with it and who mix fed as a way to get any bfing done at all are not really listened to or maybe not even really believed.

It's as if, if I had tried harder or wanted it more or been more committed or lived in a more bf-friendly society, I could have exclusively bf. This is just not right. I was 100% committed to it, never thought I would do anything else and was absolutely floored when it was really bloody hard and at times impossible. My supply was bursting out all over iykwim and still we struggled and struggled. It was horrific.

In those circs, what "harm" does formula feeding alongside bf do? It's not as harmful as letting your baby get severely dehydrated which is what happened to mine.

I feel a lot of this argument makes the great the enemy of the good. We're all committed bfers on here and want to promote it but I'm telling you from my experience, promoting exclusive bfing as the zenith of anyone's experience isn't helping. You can tell me it's the ideal all you like but if I have to introduce formula on day 10 because my daughter has just been readmitted to hospital (which happened to a friend) then that is entirely irrelevant to my life and experience.

As I keep saying, I think it's much more about promoting bf as a choice and a positive choice and as great in so many ways. And then offering the relevant support. Not telling people that if you can't run a marathon there's no point going for a walk because you'll never be fit.