Lack of Support & Info for Bottle Feeders (not bottom feeders!)

[Davros]

I breastfed my son (nearly 8 yrs now) for 6 months, no problem and enjoyed it. My 3.5 month old baby girl has been bottle fed from day one and I am shocked at how little info and support there is for parents (not just mothers) who bottle feed. There is nothing that I can find. It seemed that many of my early observations were met with "oh, its because she's bottle fed", e.g. she didn't lose much from birth weight, she got hiccups a lot at first, was she constipated etc. If that is so, why isn't there more info and support available? We also had a BIG debate about what forumula to use (inc soya), what bottles, how to sterilise, what positions, how to prevent wetting her clothes etc etc but NO info or suport and only any help if we specifically asked for it.......... I'd love to know about others' experiences and what they think.

[aloha]

Brilliant and kind article, Mears, even if he isn't a statistician

[wobblymum]

Thanks mears. Apart from a couple of very minor points, I agree with him totally. Mums who bottle feed shouldn't need to feel guilty because they should have made the decision after receiving the best possible help from healthcare professionals. Unfortunately that isn't happening, at least in the UK. So mums who've done the best they can under the circumstances shouldn't be made to feel guilty as they've "made the best of a bad job".

Centuries ago mums coped with breastfeeding on their own perfectly well but times have changed. Mums have more to deal with, which means they need more help, and more babies needing special care survive, which means more babies needing help to start feeding.

Over the last few weeks I've realised that with the start my dd got, I'd have had to know all the info myself and be feeling 100% and totally 'on the ball' to get breastfeeding started. As a new (exhausted) mum I wasn't. It was 4 hours after birth that dd was put on the breast, about 16 hours after that I actually got any help or advice about breastfeeding and a few days after that I found a concerned midwife who would listen to me and give me the help I needed instead of spewing out standard advice which didn't apply. After that dd never picked up much with breastfeeding, which is why I changed to bottles. However, had those first few days been different, I'd probably be breastfeeding and loving it now. AND I should have had more access to help than most because I had 2 weeks in hospital. The midwives were much more concerned with showing people how to bath their baby etc than how to feed them!!!!! Um, WHICH is more important???? So as I couldn't get the help I asked for, I dread to think what it's like for mums who go home after the first day and only have a couple of visits to get help.

Yes formula companies will try and spin the truth their way whenever possible but if the support for breastfeeding, especially in the crucial early days, was better, it wouldn't matter because mums who wanted to breastfeed would have no reason to look to formula. Who'd want to pay for something that they can make free?

But as the NHS isn't going to change overnight, in the mean time all we can do is be a bit sensitive to people who feel they've got no choice but to switch and not make them feel so guilty when it's not totally their responsibility anyway.

[mears]

Here is an interesting article on guilt

guilt

[mears]

Now if only I could write like that for my assignment. I am away again to try and get it finished.

[mears]

You have hit the nail on the head Wobblymum - breastfeeding is best for babies but unless the support is there, women with problems will not be able to overcome them and will need to use formula milk. The emphasis on the benefits of breastfeeding is not there to ram down people's throats but because many women did not know that there was much of a difference between formula milk and breastmilk. The assumption was that formula milk was just artificial breastmilk therefore it didn't matter which you used to feed your baby. A friend of mine who is a teacher did not realised that formula milk was made from cow's milk. Therefore the assumption cannot be made that the benefits of breastmilk speak for themselves.
Unfortunately there is still a lack of decent support from professionals. The skill of breastfeeding has been lost over the years. Many women have never seen a baby being breastfed. They may not have had any friends who did it. Our mothers lived in an era where hospitals had regimented approaches to breastfeeding and it was a nightmare feeding your baby. Restricted feeding, timing of feeds, weighing babies before and after made women lose confidence in their own ablilities. Poorly attached babies caused pain. The thinking behind the timing of feeds was to sort the pain. Little attention was paid to how babies fixed. Even when I started training as a midwife, babies were not allowed to be fed until they had taken a water feed from a bottle at 4 hours lod. They were also only allowed on the breast initially for 3 minutes each side, building up daily to no more than 15mins each side. Babies cried with hunger and mothers resorted to bottles. All these practices made breastfeeding almost impossible. If you were fortunate to have loads of milk you managed despite the professionals. Those women have had daughters and are unable to support them in their choice to breastfeed. There are still a number of professionals who have not updated themselves on evidence based practice. There are midwives who hate breastfeeding. It is so much easire to put a bottle in a babies mouth than support breastfeeding women.
The promotion of breastfeeding is to counterbalance the entrenched formula feeding culture that is prevalent in the UK. Until women are supported by professionals who have the knowledge, many will not succeed and will feel failures. Breastfeeding supporters do fabulous work but women do not contact them early enough thinking that the midwife or health visitor knows best. As has been demonstrated numerous times on mumsnet, women are given all sorts if inappropriate advice. It is little wonder that breastfeeding does not get established for many women. Hopefully in this evidence based age, professionals will have to get their act together. There is so much more known about the benefits of breastfeeding that it won't be long before a mother sues for being depirived of the ability to feed her baby due to professionals incompetence.

[wobblymum]

I wasn't trying to argue about what should be the baseline. If you want to use breastfeeding as a baseline, that's fine, as I said halfway through my post. But if you're using it as a baseline, then you can't talk about the positive effects of breastfeeding because that is your baseline. However, many people, including some posting on here use the baseline of an 'unfed' baby, ie not considering the effects of breastfeeding or formula. That is why you have people saying "breastfeeding gives EXTRA immunity" etc etc, because it's not being used as a baseline.

What you use as a baseline is irrelevant, you just have to bear in mind that your baseline changes the statements you can make. That probably wasn't very clear because I didn't use the word baseline (good word, thanks). But what I said was that if you use breastfeeding as your baseline you CAN say formula has a negative effect, but if you using an (and this is the only term I can think of) 'unfed' baby as your baseline, then you can say that breastfeeding has a positive effect. My main point was just that you can't say both at once, because then you're using two baselines together. They haven't proved in any way yet that formula feeding has a negative effect (from the 'unfed' baseline).

There are always extensive studies going on about the effect of formula on the immune system, to allow the manufacturers to improve their formula. Ok, they might care more about profits, but who's going to buy the formula if it's shown to be harmful?? I haven't got too much time on the PC right now so I can't look up the studies now but I will try to in the next couple of days.

Tissy - I don't want to convince myself that formula is better, I know for a fact that breastfeeding is better generally for babies. Or to use breastfeeding as the baseline, yes formula is worse for babies. However, that's still only generally. I didn't start formula feeding because I looked at the general stats and decided formula was healthier. I went onto formula because for my individual baby, formula was overall a better choice, for many reasons which I will list if anyone wants but this post will be long enough already. I'm not trying to use the wrong baseline to make a point, I'm just saying that the baseline you use affects the statements you can make.

tamum - the thing about the wet nappies is true and for a very healthy baby it works fine. But when I was breastfeeding, my baby didn't wet her nappies much. First of all the midwife treated me like I was stupid and said that I wouldn't be able to feel if they were wet because the Pampers I was using were super absorbent and would lock it all away. Then when I pointed out that I was judging by weight and they weren't much heavier than a fresh nappy, she told me it was because dd was drinking just what she needed and holding on to it all!!! Which was utter s**t. So nappies aren't all that helpful if there is a problem, however small. Whereas seeing milk go from a bottle does always let you see exactly what goes in. But that's not a reason to switch to formula, it's just an extra reassurance.

I'm NOT trying to argue in favour of formula, I just think that breastfeeding has so many benefits anyway that they speak for themselves without having to be rammed down people's throats. My point all along has just been that I don't agree with the facts being "rammed down people's throats" like that and I don't see how it will help the breastfeeding cause much. What would really help is better human support, such as better midwife support in hospital etc. I know some people have brilliant midwives who make it easy to breastfeed but that's not a standard across the country. I think that's why the bf'ing rate is so low here compared to other countries.

Formula is just a welcome alternative for a lot of people but why should they be made to feel bad just because the support wasn't there, or there were too many problems, for them to continue breastfeeding. Years ago, if a mother couldn't breastfeed, midwife support would have been a lot more intense, which must have helped, and there were even wet nurses in case you really couldn't feed your baby. Formula is the modern day replacement for this and while it's sad that there needs to be a replacement for human support, it's what we're stuck with.

I have got to stop doing such long posts!! I should stop having so much to say!

[tamum]

I was about to say the same as Tissy. Your logic is at fault here, wobblymum, not tiktok's. It is the baseline that measurements are made from. The basline HAS to be breastfeeding, logically, because that is the default, historically. It makes no sense at all to have an artifical feeding method introduced in the last century as a baseline.
Another minor point- if you breastfeed your baby and the baby is having wet nappies on a regular basis, then they are taking in fluid. You don't need to see milk vanish from a bottle to know that they are drinking.

[Tissy]

...and how do you know that formula doesn't depress the immune system? Has it been studied?(apologies if it has). Formula is made by cows for cows and then adapted to make it more suitable for humans. There are plenty of children around whose asthma and eczema, autism and other conditions are exacerbated by dairy products. (yes I know plenty of breastfed infants have eczema too, my dd did, but there are fewer of them).If dairy products can have an effect on theimmune system of an older child, why not on that of an infant?

[Tissy]

In medicine, if you are trying to decide on the effectiveness or otherwise of an intervention or treatment,one way to do it is to compare the new treatment or intervention to the "gold standard". In this situation, the gold standard has to be breastfeeding. It is the way that we were meant to feed our babies, it is the "default" position. Comparing formula to breastmilk, there is a clear detrimental effect. You are convincing yourself that formula is neutral, and breastmilk is better, because that is what you want to believe; you have chosen the wrong default.

[wobblymum]

tiktok - the point is that just because breastfeeding can have a positive impact on a baby's health does NOT automatically mean formula feeding has a negative effect. Taking vitamins and other supplements can have a positive effect on health but not taking them doesn't have a negative effect, it just has no effect. This is the same as feeding formula. Breastfeeding does give a baby many advantages such as extra immunity, which is the positive effect. But formula feeding does not take anything away from the baby, it just has no extra benefits. A baby is statistically more likely to be ill from formula feeding because it does not have the extra protection NOT because the formula itself is reducing it's immune system.

One good example of this is what you said about breast cancer. Having a baby doesn't put your risk of breast cancer up so when breastfeeding reduces the risk, that's a positive effect. But formula feeding doesn't do anything to the risk, so you have the same risk as most other people. So not breastfeeding hasn't had a negative effect on the mum's health, it's just had no effect. The main thing is that not getting the positive effects of breastfeeding doesn't result in a negative effect, it's just no effect.

The only way you can say formula feeding has a negative effect is if you are comparing it to the health of a baby who is already breastfed. Then you can say formula feeding might have a negative effect, as it's removing the availability of bf'ing benefits. But then you can't say bf'ing has a positive effect because you're already basing it on a breastfed baby.

So you either say bf'ing has a positive effect OR you say formula has a negative effect, NOT both. Hope I managed to explain that ok, I'm not that good at explanations.

I take your point that knowing how much a baby is taking doesn't mean it's taking the right amount but it's still very helpful and very reassuring. For a start you can see that the baby is taking at least a very small amount. When I was bf'ing I never knew if my baby was even taking 1 oz, whereas that's not a problem with bottlefeeding. If you're worried, you can then keep a record of what they take and if they lose weight or don't seem to be doing well, you have an accurate picture of what they take to discuss with a midwife or HV. Unfortunately you don't get that with bf'ing, you just have to check positions, techniques etc and wait another week to see if it's worked.

Formula is netural to health, it's still food and it doesn't harm a baby. Just because it doesn't come with the benefits of breastmilk is not the same as saying it actively harms a baby, which it doesn't. IMHO, saying formula has a negative effect on health is the result of so much emphasis on the benefits of breastmilk. This just results in making mums who decide to bottle feed or need to because of problems they have with breastfeeding feel unnecessarily worried and guilty when this is the last thing they need. However you feed your baby, you're still trying to do the best for them and no-one should be made to feel bad about that, especially for no good reason.

[tiktok]

I've heard lots of women say the same as you, Jenie, that expressing (or giving formula) means 'you know what they're getting'.

But knowing what a baby is getting is not a guarentee they're getting the right amount - lets say you see 3 oz in the bottle and the baby drinks it. You still don't know in advance that it's enough for that baby on that day at that time....maybe he's gonna need 6 oz! You only know if it's enough by the baby's behaviour after drinking it, and his overall growth and development over time. And that is just the same as breastfeeding. Mothers guage from their baby's behaviour if the baby has had enough.

In fact, babies who glug down a bottle of formula or EBM after a breastfeed may be responding to the super-stimulus of the bottle teat, which makes them suck and swallow as a reflex action...once sucking they have to swallow what comes out, and you get a chug-a-lug of a feed which sometimes makes the mum feel 'oh my God he was starving'. Not necessarily.

(there may be times when bf is going badly and babies need a supplement though)

If there's any response to this, and I am silent, BTW, it's because I am on holiday

[Jenie]

I don't think that it would matter how often I'd been told "you have enough milk" without seeing it measured in a bottle I was never entirely happy about it.

Even then it didn't look as white or feel as heavy as formula so it does knock your confidence just having the option there.

I always thought about how bad I'd feel if my ds or dd were starving and I didn't realise until I next took them to the gp or hv! I shouldn't think that that scenario happens very often or even atall but given my sickly ds (floppy larinx) from birth I wasn't going to take too many chances.

I did breast feed for 3 - 4 months though, even if I expressed sometimes (just to make sure).

[aloha]

Actually, it was day 4 when I really lost it. I think baby blues and fear that I couldn't breastfeed really kicked in at once. I cried so hard I think I even shocked the midwife! I had done so much research beforehand (you know me!) but wasn't at all prepared for 'not having milk' as it seemed to me. The BFC showed me how to express and let me see that I was producing colostrum and that it was great for a newborn etc etc. I even thought that giving any formula would mean the baby wouldn't breastfeed, which wasn't true at all and was reassured on that too. As I say, from then I felt much more confident, which I really think is half the battle with breastfeeding. I recently read some research that says the obsession with 'not having enough milk' is a worldwide phenomenon - even in countries where 99% of the population breastfeed women feel like this! I think they expectation that our breasts will feel 'full' hugely contributes to it. It's normal for breasts never to feel full, but I remember pinching them anxiously to check if I had 'enough' to feed my baby. I think it's so wrong to say we have more than enough info on breastfeeding, as we clearly don't.

[tiktok]

Wobblymum, I am going to take issue with you disputing that formula has a negative impact on health - you concede that breastfeeding has a positive impact, but not the logical corrolary that formula has a negative one!

Formula is 'not breastfeeding'....so if a child's health actively benefits from breastfeeding (as it does, and no one argues against this), then 'not breastfeeding' removes those benefits.

Women who breastfeed are less likely than women who don't breastfeed to get breast cancer....so formula feeding has a negative effect on their health.

Formula milk allows the baby to be more at risk of a range of infections...so it has a negative effect on health.

In fact, as breastfeeding is the normal, physiological way to feed a human baby, it only offers 'benefits' in comparison to formula.

Now, this is not to say that these measurable health effects are the only criteria in deciding on feeding method. There are other issues, such as mother's and baby's happiness and comfort. These are lot less easy to measure, and of course the only person who can assess their impact on them personally is the mother.

Stress, by the way, doesn't get 'transmitted' to the baby in breastfeeding (it does in pregnancy) or at least we have no evidence it does. A depressed mother - and she may be depressed because bf is going really badly - does not interact with her baby in optimal ways, and this has a sometimes lasting impact on learning and emotional development. So I think it is perfectly in order to be concerned about a mother's happiness and comfort with regard to breastfeeding, for her sake and her baby's. And it is up to the mother to work out what is right for her as an individual, as everyone here agrees.

But she has to have the facts and the whole truth - and then support for her right to make her own choice.

Pretending that formula is neutral with regard to health is not part of this.

[suedonim]

You know, Aloha, I didn't even consult a BFC as I thought they were for people with 'real' problems. I didn't realise soreness etc is a 'real' problem, I just thought it was supposed to be like that. And that was with Baby no4!! I also assumed a bfc would expect me to know everything as it wasn't my first baby.

I, too, found enough info on artificial feeding on the cans of formula and there always seems to be a section in childcare books, too. Apart from the longchain fatty acids aspect, I was under the impression that the common brands of formula are much of a muchness anyway? The brand I fed ds1 in the 70's, Ostermilk, isn't available any more - I wonder what was in it!!

[aloha]

Suedonim, what you say is so right. I wish I'd seen a breastfeeding counsellor at once, not three days later when I was very very upset because milk wasn't in and baby seemed distressed - however I was producing colostrum and the counsellor was so reassuring that this would be fine for ds and not to worry about the weight loss which the dr was stressing about. If that hadn't happened it would have been very, very easy and tempting for me to give up breastfeeding there and then. I am not arguing that people like Wobblymum have made a bad choice for their personal circumstances, just that I am glad that formula companies aren't allowed to advertise. Personaly, I can honestly say that I had all the information I needed about formula feeding in the tin of formula.

[Jenie]

sil is a mid-wife her baby is over 1yr and she's decide that she's not going to say that breast is best anymore because she simply doesn't belive it any more.

Me well I've done a bit of both, breast just after the birth and until I could be bothered to make up the bottles and steralise them and clean them. But I found that both worked for me.

I think that each and every parent has to choose the one that's best for them. Regardless of what that option is every one copes with different things in different ways and if you have the energy to sit up with a bottle to make sure you baby doesn't drown in the white stuff then good on you. If you like to stay in bed and just pop them in next to you and catch another 40 winks then that's great too. But not one way is right and another wrong.

[GHet]

Wobblymum - thanks for such a measured and well argued set of contributions, you put it much better than I did.

[Tissy]

I am really sorry that people feel "pressurised" into breastfeeding. It is what our bodies were designed for, and should be the first choice for feeding a baby, not an alternative. I think there should be a huge amount of information available to all those people who have been brought up thinking that formula feeding is the natural thing to do, but this must be backed up by excellent practical support. Before formula was available, all mothers would have the support of their own mother/ MIL who of course had breastfed. If a mother couldn't breastfeed, then a wet-nurse would do it.

Unfortunately, since the advent of formula milk, these skills have disappeared, and people who can't breastfeed thus feel as if they've failed. It's not surprising that this is such an emotive subject. Breast feeding counsellors, are available, but on the end of a telephone, not generally at the mother's side when she's starting to breastfeed. Most midwives have scant experience of the practicalities of breastfeeding, and are not confident enough to help a mother through a bad patch. If I had my way, each mother would have the personal support of a bfc until feeding was established, and be available on the telephone thereafter. I'm sure there would be plenty of people out there willing to train, if it resulted in a paid full-time job.

[Demented]

GHet, I just wanted to say that I was bottlefed as a child and I have had and do have health problems which may have been prevented if my Mum had breastfed me (she tried but was having problems and the Midwives told her to stop). I am with aloha here too, I didn't do the best for my DS1 either, he had his first bottle of formula in Hospital and was mixed fed from five weeks to 16 weeks. I know in the grand scheme of things it won't make much difference but it matters to me. I think it is great when Mums give breastfeeding a try but I feel sad when they are let down by poor support, whether that be Midwives, HVs or even husbands/families and I think that b/feeding should be promoted above formula as this would be in no way denying anyone who wants to buy formula the chance as we all know where it is on the supermarket shelves. When I was having problems feeding DS1 I would look longingly at the tins of formula in ASDA, I didn't need additional advertising but I could have done with the help of a good BFC.

[wobblymum]

Aloha - I certainly don't want formula companies to be allowed unregulated advertising. I don't think they should ever be allowed TV commercials and I'm not very happy that they're allowed to advertise follow on milk so much - I don't see the point at all. I just think the information should be more easily accessible if you want it, but still able to be ignored if you don't. That's why I suggested leaflets in supermarkets by the formula milks themselves. Then any breastfeeders won't naturally go looking there but if you want to you can, and get all the info you want easily.

Even though I now feel I was totally right to switch to formula, I don't think it should be allowed to be advertised in the way everything else is. I also do agree that breastmilk is better. I just don't think the benefits should be stated so much and so strongly that mums might feel pressurised out of having a fair choice. After all, that's what the formula companies are rightly stopped from doing.

All I think should change is that mums should have more space to make the choice freely by themselves, and they should have easy access to any information they want, when they want it. No info should be rammed down anyone's throats, whether it's about breastfeeding or bottlefeeding. I think it's terrible that bf'ing rates here are so low but I don't think going on and on and on about the benefits of bf'ing is going to help that much. It's just adding more pressure at a time when less stress is needed, not more.

The facts should be available, and it should be left at that. With everything else to do with babies (eg immunisations etc), the facts are easily available but no-one goes on about either side and I think that's how it should be with feeding.

Don't think that just because I formula feed, I'm suddenly on the multinationals side (if I could buy homemade formula from a farm down the road I would!!!). I just want people to have more choice.

[suedonim]

I'm with you on this, Aloha. I only bf my first baby for three weeks, whilst I fed my other three babies for more than a year each. Inside, I know ds1 was shortchanged in the feeding stakes, I would find it patronising if it was suggested otherwise. But at the same time I tell myself that I did the best I could with the knowledge I had at the time - a comment that finally helped me come to terms with the situation more than 20 years after the event.

[Davros]

Wobblymum, great post IMHO. I completely relate to GHet's comments too.

[aloha]

I didn't do the best for my son. I didn't. It's hard and I do try to make up for it in other ways. It's not the single most important thing, granted, and it doesn't haunt me, but it is important to me. I don't believe in soft-soaping the truth, even if it hurts.

[aloha]

Wobblymum, I've followed your dilemma and I do understand, but there is no doubt. Breast milk is better. Of course it is! How could it not be? Do you really think that multinationals should have the opportunity to turn women against breastfeeding, because that is what unregulated advertising would be? I say this again, I USED FORMULA! I didn't need advertising. I think advertising of formula is unreservedly bad. It is not and never will be as good as breastmilk. When something is a baby's entire diet it is different from being part of that diet. Thank god we have regulation, I say.