Awful birth ‘options’ meeting

[Padronpeppersplease]

I’ve just had my 28 week birth options meeting with a midwife and wondering if anyone else has had a similarly pushy experience. She asked me about whether I intended to breast or bottle feed and also what I’m planning for the birth. I said I was 99% sure I wanted to exclusively bottle feed and then also that I was considering an elective c section. I’d heard previously that the NHS try and push both breastfeeding & natural births but I was not prepared for how pushy this midwife was! She said to me that bottle feeding was ‘way worse for baby’ and that ‘a c section was a million times harder on my body’ than a natural birth would be. According to her as my body is built for birth I don’t need to worry about the pain of natural labour and tears during labour aren’t anywhere near as bad as the potential complications of a c section, she also said that opting for a c section would limit the number of children I could have. Despite all this I’m still leaning towards a c section, I’m under no impression that it’s easy recovery & without risks but I honestly feel now like I’m doing something totally outlandish by opting for it.

👏🏼👏🏼👏🏼

What a lovely balanced response to read when so many posters on this thread have done exactly what @Padronpeppersplease was talking about in her OP, and just railroaded over her about vaginal births and breastfeeding.

Also, I don’t know about birth because I was never interested in other options than straightforward vaginal birth, but there’s a lot of misinformation around breastfeeding, often coming from health professionals, It takes being proactive and advocating for yourself to succeed.

There’s a gap of a few generations who were aggressively promoted to FF so the skill that was once passed from older women to new mothers is lost. How the newborn latches in reality is far removed from how breastfeeding is depicted in films and tv. Or how much a newborn baby eats - it’s very little at the beginning, a table spoon or so, while new mothers are being told that they don’t have enough milk - which is another bullshit, milk is being made while the baby eats. It’s also quite normal not to be able to pump a lot. I was never able to pump more than 10 ml, while my children were growing and gaining weight without any issues. I also couldn’t understand why I should top up with formula once I got back to work when my kids were 8 months old. They ate small quantities of normal food by then and they would get my milk when I was back home. Kids adapted quickly to this and the was just no place for formula in their diets.

The hospital I had DC1 in had some BF certification badges on display and the midwives who delivered my baby were knowledgeable about breastfeeding and ready to help. Many things were completely new to me and I didn’t have anyone in the close family to show me the practicalities.

https://fivethirtyeight.com/features/everybody-calm-down-about-breastfeeding/

I'm begging you to read this

The OP wants to formula feeding not breast feed

OP says "I don’t even know if I can breastfeed due to breast reduction surgery and although I’m open to trying at least for first few days..."

I think a good MW would help OP find out whether her breast reduction will impact her ability to BF. w/o knowing if she can BF she cannot make a fully informed decision.

OP’s decision is none of my business. But it’s an open forum read by millions of people, including unregistered users. Many times I found invaluable information on various threads, seemingly OT.

No I don’t need to thank you. I’m perfectly calm and the title sounds like it was written by someone a bit patronising.

Also it was written by an economics associate professor so I’ll leave the science to the professionals.

How disappointing. I looked at the articles you shared.

The article I linked to is an explanation of why the articles you've shared do not constitute good evidence. This is because they are based on associational data rather than RCTs and sibling studies. The latter methods are the gold standard in research, and these find little to no evidence of a casual effect of breastfeeding on obesity, suggesting that the association was due to confounds.

I lecture on research methods and the impression I get is that most people who insist upon the large effects of breastfeeding on a range of outcomes are not familiar with best research practices, and not particularly interested in learning about them. I would write this off as just a bit annoying, if it wasn't for the potential to harm a lot of women and babies.

I've skimmed it and followed through to a couple of the studies. You have to be really careful when you post such articles.
e.g. one of the studies it cites states "we find relatively little empirical evidence to support the notion that breastfeeding results in improved health and wellbeing for children between 4 and 14 years of age."
Very interesting, but you'd need to extend that study to beyond age 14 if you then want to use it to tell people to 'calm down'.

nb anyone starting off an argument, debate or discussion with 'calm down' has already lost my interest and respect.

This is very true re breastfeeding and the breaking of knowledge passing through generations. To me it's one of the saddest things I've experienced and witnessed.

That particular Economics professor has probably done more than anyone to publicise the need for evidence backed maternity services/advice.

Are there rcts or sibling studies that extend beyond this age, that you're aware of?

The Probit research it links to isn't, however, and that hasn't found that bf reduces the likelihood of obesity. It's better quality evidence than the observational stuff claiming it does.

I've always been a bit surprised people are so willing to believe the obesity stuff, just because of it actually being a beneficial trait for humans until about 5 minutes ago. You'd expect bf to eg reduce gastro issues on a population level, that makes sense. But not obesity.

People get really het up over all this.

In an ideal world a straightforward vaginal birth is obviously better than a caesarean, because there are benefits to baby and mother: baby is squeezed through birth canal which helps their lungs, and there is evidence that the bacteria they pick up along the way helps their microbiome develop, the mother obviously doesn’t endure major surgery, which carries risks including to future pregnancies and a scar.

BUT it’s not an ideal world and no one can ever guarantee a straightforward vaginal birth. (Fwiw I had 2. My first birth was quick, easy and lovely in a birthing pool, so it can happen.)

Similarly, everyone knows that - in an ideal world - breastfeeding is better for both baby and mother. Not just because breastmilk is different from formula (it adapts instantly to the baby’s needs, including by passing on antibodies when the baby is ill, its taste changes depending on what the mother eats, which prepares the baby for weaning, it is more or less dilute depending on how hydrated the baby needs to be), but also because the act of breastfeeding helps a baby’s physical development (of the mouth, jaw and teeth), and because - which is so often ignored - there are significant health benefits to the mother, including reduced risk of developing a number of cancers and diabetes.

BUT again, it’s not an ideal world. Bf is very hard work for the mother and doesn’t always work out, for lots of reasons, even when people really do want to do it.

A lot of these “choices” aren’t really choices at all, which is the problem.

Where you are making a choice though, it should be informed. It’s the midwife’s duty to give you all the information so that you can choose whether to take it into account, or not. That’s not to say that she didn’t behave unprofessionally in the way she delivered the info - we really don’t know - but giving you the facts isn’t objectively wrong.

OP, if it helps, I felt quite similarly to you about breastfeeding. The very rigid nature of the birth centre midwives and some of the OTT (in my view) materials were really off putting to me. Reading about how some babies might need to feed for hours at a time, and I was just expected to be a milk machine at the cost of my own health and sanity didn’t appeal. I went into it with the view that I would give it a go. If it worked without too great a toll on me, great. If my baby did in fact need to spend upward of 12 hours a day on the breast (like one pamphlet suggested), I was happy to give it a hard pass.

I’m happy to report that my experience was nothing like I’d read about. After the initial few weeks of just general nipple soreness with DD1, I fed her for 18-months. I fed my other 3 for a similar length of time. It was nothing like the all consuming and draining experience I had read about. I probably could have produced enough milk to keep the whole neighbourhood going, and my babies all fed quickly and efficiently. It was far easier than formula would have been.

If the idea of giving it a go doesn’t cause anxiety, give it a shot. You could find it very easy. If not, there is nothing really lost.

Oh dear, here they come...

She shouldn't have lectured you or been pushy. But she is probably right on both points, yes vag. birth can have issues too, but she is right your body is designed to give birth that way. --

As for the breast feeding, I did it, managed 18 days, nipples looked as if they'd been set about with a grater, baby spitting out due to taste of blood so latching on was a trauma. Packed it in, felt immediately more relaxed but had been howling as I felt like a failure because of some of the shit midwifery team. Took a very pragmatic older midwife to tell me I had tried, baby had received the all-important colostrum and this boosted immunity and not to worry.

It was also great to see how much she'd drank and to hand off feed to DP.

However, what I did notice is, my child (now 17) has never been prone to any form of infection or virus - even chicken pox was 10 spots and done. My sister's two raised the exact same but bottle fed from the start caught every bloody thing going. I know the BF is not a silver bullet but I do believe even a short time can make a difference. It's definitely more convenient, would have kept it up if possible rather than all the sterilising faff. No-one should be pushing you though it's what's best for you and your family circumstances. Good luck with the baby xx

Huh, interesting. I have a background in evo science and never really thought about it like that.

This is probs not the best place to have asked about this😂😂 however I chose to bottle feed my baby knowing that breast is best. I did have a natural birth but that was also my choice and what I wanted!! The birth was fine, no intervention and no pain when recovering even though I had a second degree tear. You make the best decision for yourself OP, then there’s no one to blame after..that was my thinking😂

I read the linked blog post, out of curiosity. I agree that it’s very difficult to prove a causal relationship between obesity and breastfeeding with some many confounding factors, even the siblings study sounds challenging unless they were identical twins?

The link between bottle/breast and obesity never bothered me but I am buying two explanations, which were not studied/published at the time my children were born and breastfed.
First is the hunger/fullness cues - especially at the beginning of life babies don’t eat a lot and it’s quite easy to overfed them with formula. It’s also very normal for babies not to sleep through the night or for long periods, all those babies sleeping like angels after a bottle are most likely stuffed full. It’s very common for overweight and obese people to miss satiety signals (90% of weight loss threads on MN mention that as a problem) so it makes sense to me that if these signals are repeatedly overridden already early in life it would be harder to relearn them later on.
The other one is the link between microbiome and obesity, and the fact that some of the microbiome is unique to breastfeeding babies and passed on from mother to baby.

I am also a bit sceptical about obesity being determined and passed on as a genetic trait for the majority of the population. If this was the case many more people would be able to survive famines, concentration camps and so on. I think it’s mainly due to lifestyle factors otherwise there would not be so many socioeconomic factors affecting body weight.

@Eltrut

There are no RCT's comparing outcomes for bf vs formula fed babies because it wouldn't be possible or ethical to do them.

The best we have are sibling studies, which point to the benefits of breastfeeding for children over the age of 4 having probably been overstated in relation to IQ, obesity, asthma.

I think the most important benefits of breastfeeding are seen in the early months of life - helping keep babies out of A&E and away from the GP's. And in reducing the likelihood of SIDS, which is the most common cause of death in babies under 1, so deserves some attention.

Did you read the article I linked to? PROBIT was a randomized trial.