Infant Feeding - Massive Straw Men with Ambivalence & Gaslights

[Ineedacupofteadesperately]

I've felt for a long time that something is 'off' about the discussion in the media around infant feeding. Apart from anything else the fact that the alternative to a mother breastfeeding is automatically accepted to be formula rather than donor milk, and no-one seems to ever question this. Why? Throughout history the alternative was wet nursing, not feeding cows milk. We have successful blood donation - why have all the milk banks been destroyed, we used to have more? Why is no money put into this in a supposedly rich country?

Anyway, someone sent me this link and I found it thought provoking. I think the comparison of adult feeding habits very pertinent at the end, but I do think part of the problem is that there are vested interests very focused on this remaining seen as individual choice rather than individual decisions in a very stacked environment without proper investment to support women, which often means there is no real choice at all.

www.analyticalarmadillo.co.uk/2019/02/infant-feeding-massive-straw-men-with.html

Or 70 actually, my maths went a bit funny.

I donated with my second child. It was purely altruistic - dd1 was seriously ill as a newborn and although in the end we didn't need a donor for her it was touch and go and I hated the though of babies even sicker than she was not having access to milk. I found the screening and collection process easy enough, and the milk bank were lovely, but the actual pumping was hideous. I was terrible at it; never collected much more than 30ml at a time. It pisses me off to high heaven that pumping is billed as the easy option so you can go back to work or let your partner feed the baby. It bloody isn't for everybody. I found it tiresome and degrading and lonely, and it's only through sheer stubbornness that I managed to donate a litre in all.

I agree with you, OP, about women's feelings not being taken into account. It's not unusual for mothers to feel grief over the end of a breastfeeding relationship, and it's not helpful to have those feelings dismissed. And it's terrible to see women suffering guilt through a feeling of failure when they haven't failed at all, they have actually been failed by an inadequate system and subject to commercial interests to undermine breastfeeding. I second the recommendation of The Politics of Breastfeeding. It's excellently written and a real eye-opener.

I too have been a milk donor. I would want donor milk available if my baby was poorly, so it seemed only fair that I should donate if possible. Donors are thoroughly screened, and because your baby has to be under 6 months when you start donating there is up-to-date health information about you.

As it happened, my baby was very poorly at 10 months. She didn't need donor milk, but the fact I was donating meant that everything I expressed while she was unconscious in PICU could go to the milk bank and wasn't wasted. It also meant every time a doctor expressed (no pun intended!) doubts about her breastfeeding once she woke up they were swiftly rebutted by a nurse saying 'she's a milk donor' (Every single doctor did this - more undermining!)
Absolutely agree that women shouldn't be paid or expected to donate. It is a lot of extra work.

Oooh I didn't know she was still writing.

Agree Politics of Breastfeeding is a fantastic read.

I have to admit I don't feel quite right about the alternative to breastfeeding being donor milk. It is quite right that there are milk banks around for premature or otherwise vulnerable babies and mothers who want to donate. But I'm not sure I like the idea of milk banks being the main source/demand for non-breastfed babies. It just feels like there would be exploitation going on. I definitely see the problem with profit being such a huge part of the formula industry but I don't see donor milk as being the solution, probably more restriction on formula companies - and I very much dislike the way this is often framed as criticism of formula feeding mothers, I feel there ought to be scope to discuss how formula companies manipulate the market and the narrative around breastfeeding without it being taken as a personal insult.

What I did find interesting in The Politics of Breastfeeding was the description of societies where breastfeeding is still so normal that wet nursing is done almost casually and considered such a normal part of life that it doesn't even really have a name - if a baby needs to feed and its mother is not present then another woman will breastfeed it, including post-menopausal women! I think I would actually feel much more comfortable with this. Though my DS2 had quite a lot of formula, in the end.

yes, do read the Politics of Breastfeeding
I think the issue with donor milk replacing formula is one of scale
It would be feasible to set up systems to allow altruistic donating of bm for babies in special care etc or with mothers temporarily unable to feed (eg I worried loads before DS1 that I'd have an EMCS and be unable to feed him)
but to replace formula would require an industry scale operation with all the possibility for exploitation PPs have mentioned, and while it might benefit the babies, it wouldn't benefit the mothers
the casual wet nursing will only work in small scale societies where bf is the norm, so an unfed infant will never be far from a lactating woman who feels some kinship/duty to the baby or it's mother
I think the simplest solution is to properly value and support breastfeeding (which means valuing women and babies more than profit)- so far we have failed dismally at this

Formula is a perfectly good alternative to breast milk.

The issue is the way women are being pushed 'breast is best' and made to feel second best if they struggle to properly get going.

Mums are asked 'is he a good baby?' What's meant by a 'good baby'? One who sleeps during the night, sleeps between feeds, goes 3 hours between feeds, takes a feed very quickly and give mum lots of rest.

Well unfortunately breastfed babies, like to cluster-feed, start feeding 10mins after they finish the last feed, they like to feed at 3am when mums milk making hormones are highest, will go a max of two hours between feeds, feeds can take 30mins or longer, so actual time between feeds is 90mins therefore they don't fall into the category of 'good babies'.

Expectations of babies (and new mums) needs to change. Donor milk is not the answer as expressing is hard work esp on top of a breastfeeding baby. The milk banks will only take milk if the mum gave birth less than 6mths ago because milk changes to suit a 6mth old and isn't suitable for a tiny prem.
Some donors would be put off if they thought their milk was going to healthy full term babies who could happily use formula rather than poorly babies born too soon and before their mum can make milk.

Breast milk is a living liquid which contains lots of things not in formula, the two can't really be compared. Breastfeeding is also protective against a number of illnesses in the mother including significantly reducing the risk of a number of different types of cancer (womb, ovarian, breast) as well as other diseases (e.g. endometriosis, multiple sclerosis).

I find it interesting that people are always so keen to worry about the age of the nurslings for donated milk. Do we only use milk from cows who gave birth 6 months ago to produce formula? I doubt it.

I do agree that at the moment it seems the NHS tends to just promote the idea that 'breast is best' without providing any real world support at all (most of the council funded breastfeeding clinics were shut near me after I had DD2) - so it's almost a campaign designed to make mothers who are unsupported and hence fail to breastfeed to feel bad. I don't see the point of saying breastmilk is better, even if the science backs that up, if you're not going to put the resources in place to enable women to breastfeed. It seems quite cruel and anti-woman to do so.

I think the simplest solution is to properly value and support breastfeeding (which means valuing women and babies more than profit)- so far we have failed dismally at this Completely agree with this.

I found it astonishing that throughout pregnancy and antenatal (NHS & NCT) and then in immediate aftermath of a pretty grim labour and birth, still nobody had wanted to really discuss alternatives to breastfeeding. Even the paraphernalia on the walls in the hospital were all about breastfeeding. As it was, I couldn't do it because baby had a rough time and so did I. I felt disappointed like I'd failed or something. Awful.

There's plenty more interesting historical and academic discussion for this topic but on a really basic level I just wish women weren't treated like idiots, were given full information on all forms of feeding (donated b milk included) and not made to feel like awful mothers if breast just doesn't work or isn't their thing. I'd quite like it if women were just left to make their own damn informed decisions actually. (In consultation with partner as appropriate yaddayadda)

I find it interesting that people are always so keen to worry about the age of the nurslings for donated milk. Do we only use milk from cows who gave birth 6 months ago to produce formula? I doubt it.

Cows only lactate for 9mths before being rested for their next calf.
Cows milk is altered during the process of turning it into formula for babies.
The nutrient balance of older babies milk is different to younger babies milk. Hence it can't be donated for prem and ill babies.
The nutrient balance of cows milk may change, I don't know however the milk that is formula is made so its the same.

Ed that's interesting, and yes, ingredients are added to cows milk to make formula and it's pasteurised so any live cells will be killed anyway.

Of course, formula companies are constantly trying to make formula more like human breastmilk and add in ingredients which mimic those in breastmilk. The degree of their success is debatable, and sometimes of course adding a single component does not have the desired effect due to interactions among the compounds in breastmilk.

there ought to be scope to discuss how formula companies manipulate the market and the narrative around breastfeeding without it being taken as a personal insult

For sure; I also don’t think donor milk is going to ever be large-scale enough for most babies. We should be able to discuss the politics of BF without people taking it as a personal attack against mothers who choose to FF. Many more, IME, wanted to BF but were let down by the system. We should be able to talk about that

Breast milk donated to milk banks is pasteurised too (part of the reason you need to give a litre to make it worthwhile).

I had to exclusively pump for dd1 as she was very sick and donated most of it to a milk bank as she didn't take much when she was alive and meant my stash went to a good cause when she died. I had to have additional blood tests to check I was healthy (they wouldn't take the results from my pregnancy ones).

Pumping was hard work, 30-40min sessions 5 times a day and I was a fairly good producer compared to some of the other mums I met in intensive care. Some folks would struggle to get an ounce out in a session (although suspect the stress everyone was under didn't help). I'm currently feeding dd2 and not sure I would find the time to pump enough to donate the required 1litre (although I might like too but my nearest milk bank is too far away)

Although human milk banks for all babies might seem like a nice idea, I'm not sure it works in real life. The blood tests and day to day grind of pumping would put a lot of women off. I also suspect some mothers would not been keen on their babies having another mum's milk. I think we should be greatly that a viable, good alternative to breastmilk exists for those who don't want to or can't breastfed and try to promote breastfeeding more (whilst still recognising that it's not for everyone and no one should feel guilty about not doing it whatever the reason)

Donor milk is not an option beyond the current milk banks for sick babies. It's effectively asking mums to produce milk for two or more babies, theirs and a random baby. Even cows don't try and feed their baby and give milk away. Current farming techniques the calfs are removed at 2 days old, males are shot, females raised on a formula before switching to a feed mix.

The UK lost breastfeeding experience
and knowledge in WW2 & post war generations. The government pushed formula to get mum's back to work. They even produced National Dried Milk. Being able to buy formula was a seen as a status symbol, why go to the effort of BFing if you can affort to buy milk. All of that damage needs to be undone.

New mums are told breast is best, without real information on what breastfeeding is like. Struggling with a cluster feeding infant and you keep hearing 'I tried and couldn't', 'My GP told me I wasn't making enough milk to just switch to formula', 'I could help if you gave a bottle' etc.

It takes encouragement to keep going and not cave into the pressure. Much of my support came from a lady on another forum.

In some cultures around the world new mums only care for their newborn for first 40 days. The grans and aunties look after older children and run the house.

In the UK partly because of lack of BFing experience and knowledge new mums are expected to get on with running the house, shopping, caring for older children, doing school / nursery runs. But remember the newborn wants to feed during the night to build mum's supply. So poor mum's been awake half the night and still expected to function normally during the day. Then mum feel like failures and cave into formula.

So instead of thinking donor milk is the answer we need to be looking at getting proper support for BFing mum's to get themselves to the 6week mark.

Great post Edthebear.

Breastfeeding is fucking hard work and yet it’s sold to new mums as the perfect ideal, with very little real advice and help. So when new mothers inevitably fail they feel doubly shit because it’s the gold standard.

We need to repackage the whole thing. Breast isn’t best, it’s NORMAL. And like childbirth and child raising it is hard and often painful. Babies don’t sleep through the night and they will want to feed constantly in the early days. Mothers should have the opportunity to just hunker down and feed for the first few weeks at least. They should know to expect pain and soreness and be helped through this. Taught properly about latch and position and tongue tie and mastitis and supply and all of the things that are likely to crop up.

We’re all sold this idea that Bf is natural and calm and if you don’t take to it immediately then there’s something wrong. And formula had had billions invested in making it the obvious choice.

Littlebelina sorry to hear about your DD.

Pumping really is hard work. I don't think I ever managed to get more than a few ounces at a time.

Anybody who says "no point crying over split milk" has never spilt a bottle of hard worked for expressed milk.

Thank you ed

I managed to leave a bottle of milk that I expressed this time round in the cupboard not the fridge. It was pretty gutting (although dd2 is stubborn and won't take a bottle anyway so didn't really lose anything!)

"Inthe UK, milk banks used to exist in every hospital that delivered babies"

Can that be evidenced? Because it really dienMt ring true for a number of reasons, and o does not match my (albeit limited) direct experience.

I'm just not convinced given the relatively low number of women who breastfeed in the UK that they could realistically be expected to provide enough milk to feed all the babies currently formula fed. Maybe it would be different in a country where most mums breastfeed.

It seems to be fashionable to demonise formula milk.
My generation were majority bottle fed, and are the longest lived and healthiest generation in history. This is an inconvenient truth to the breast feeding zealots!
By all means breast feed if you want to and are able to. But it is not the end of the world if you don’t. Your child will still grow up hale and hearty. I feel so sad, seeing demoralised women who feel failures for simply not managing to breast feed. All the pressure is likely to cause or worsen post natal depression.

I should also point out that breast milk is deficient in vitamin D and iron. Breast fed babies need vitamin D supplements from the start, and iron supplements from 4 months (when their own stores run out) if they haven’t been weaned onto solids by then.
Formula milk contains the correct amount of both, and no supplements are required. It’s designed to provide full infant nutrition.

Not deficient in iron; the iron is more bioavailable.

Only 'deficient' in vitamin d if mother isn't getting enough, highly likely in the uk if not adequately supplemented.

Haven't read it in great detail but I read a WHO report on vitamin A supplementation for lactating mothers around the world and it said the fat soluble vitamins do change a lot according to maternal diet / intake.

“I should also point out that breast milk is deficient in vitamin D and iron. Breast fed babies need vitamin D supplements from the start, and iron supplements from 4 months (when their own stores run out) if they haven’t been weaned onto solids by then”
Hmm- well at least this is easy to spot propaganda on behalf of the formula industry. Usually it’s much more subtle.

I completely agree that donor milk is not the complete answer - formula is a necessary thing and it's good that formula companies are trying to make it closer to breastmilk all the time.

My point really was about the narrative around milk - we never hear that the milk banks that we used to have have been closed / defunded (why?) and donor milk is not used to support mums who want to breastfeed to help them establish their supply (why?). This charity is trying to change things

humanmilkfoundation.org

They say

The HMF was conceived in 2017 by a group of parents, scientists, milk bank experts and doctors. The initial drivers came out of frustration at a lack of support for donor milk provision and countless stories of parents who wanted to access donor milk for their babies, who did not meet the criteria for donor milk use.

and also

The vicious circle of disinvestment and consequent lack of research had to be broken.

My point about donor milk is that it's NEVER part of the discussion despite there being a thriving online community of mums who give away their milk stashes to other mums (yes, it's mostly mums who expressed for their own babies who then have a frozen supply, sometimes absolutely masses of milk). This is done via facebook groups and other means and I applaud the mums that do it - and they'll often drive miles and miles to bring milk to another struggling mum, but WHY do they get no support? Here we have a Mum who wants to give away their milk and a Mum who wants to feed it to their baby, and there is no NHS help for them. To be fair they just do it themselves as Mums always have I guess, but why no help? And I know some women find it really hard to express, but other mums are really keen to donate given their seemingly superhuman ability to lactate and express easily. And often these women are told they can't donate. Doors are shut in womens' faces all over the place. Who does this benefit? Not women and babies.

The point of the article I originally posted is I think is how heavily loaded the discussion is towards the scenario which benefits the profit making formula industry.

The lack of discussion of the benefits of breastfeeding in physical terms to the mother is another notable lack. Any other lifestyle intervention which reduced risk of cancer so much would have massive public health programs dedicated to it, but even mums who are breastfeeding happily and easily aren't encouraged to continue beyond a year (even though WHO recommend a minimum of 2 years) and I can say from experience that the level of disapproval from random strangers when feeding an over 1 year old is quite upsetting.

What are the criteria for donor milk. When DD went to NICU she was just put straight onto formula, I remember being asked what type we wanted but no discussion of donor milk. I wasn't well myself so didn't challenge it.