“It’s okay to try formula, you know.”
Those are the words our family doctor uttered when I burst into tears in her office when my first born child was four weeks old and still hadn’t latched on once. I’d been pumping every two to three hours around the clock with a manual Avent Isis pump ever since he was born, feeding him the pumped milk, and trying over and over again to get him to latch on; to no avail.
“Yes, I know,” I said, blowing my nose between sobs, “but I don’t want to.”
I was at my doctor’s office that day on the advice of my International Board Certified Lactation Consultant (IBCLC). She had been working with me for weeks and was running out of ideas. She suggested that I ask our family doctor for a referral to an Ear, Nose and Throat (ENT) Doctor to see if she could figure out why he wasn’t latching on. She gave me the referral and three long weeks later (after all, my child wasn’t starving and there were other children with more serious problems), I finally got to see the ENT. Her diagnosis: tongue tie. It wasn’t the first time I’d heard those words. The night nurse, the paediatrician and the lactation consultant had all diagnosed it within 24 hours of his birth and we had the tongue tie clipped in the hospital when he was two days old. Evidently, they didn’t clip enough. The ENT clipped his tongue tie again and that afternoon, at seven and a half weeks old, he latched on for the first time, marking the beginning of a wonderful two and half years of breastfeeding.
“It’s okay to try formula, you know.”
Those are the words my doctor spoke to me and those are the worlds that Dr. Brian Goldman, host of White Coat, Black Art on CBC Radio 1, thinks that health professionals should say more often. On May 6, the topic of Dr. Goldman’s show was Mother’s Milk (click the link to read a summary or listen to the podcast) and focused on the question: “What happens if you are a mother bombarded with “breast is best” messages, but you can’t?”
In the show, Dr. Goldman speaks with two mothers who wanted to breastfeed but had low milk supply issues and eventually took the “culturally unpopular” (Dr. Goldman’s words) decision to formula feed when it became apparent that their babies were starving. He also spoke with a lactation professional at Toronto Public Health and with a manager from the human milk bank in Vancouver.
At the end of his show, Dr. Goldman concludes:
But, when it’s not working, don’t throw mum and baby out with the breast milk. When I hear that a newborn is starving because mum isn’t being given the message to try formula – as happened to both the mothers I spoke with on our show – that’s carrying a passion for breastfeeding to irrational extremes.
I understand Dr. Goldman’s concerns with the moralization of infant feeding, but I don’t share his opinion on the root of or solution to the problem.
In my experience, there is a big gaping hole between “Thou Shalt Breastfeed” and “Try Formula”. The gaping hole needs to be filled with affordable, accessible, quality breastfeeding support. Instead, that hole is too frequently filled with pressure and guilt, from society and from within.
Moms who have trouble breastfeeding are often bombarded with Booby Traps: bad advice from friends, family or health professionals who have inadequate training in lactation. Bad breastfeeding advice often leads to low milk supply and eventually starving babies if the mom doesn’t do something about the problem or supplement with formula or donor milk. Since most (but not all) low supply problems can be fixed with appropriate breastfeeding protocols, moms are often blamed and made to feel guilty when things don’t work out. After all, breastfeeding is supposed to be “natural” and if it isn’t working, people will send the mother the message that she just isn’t trying hard enough or just doesn’t care enough. When the void is filled with guilt instead of help, we have a problem.
I read a great post once called Breastfeeding, Bottle Feeding and…. Somewhere In-between…. Why the Guilt? In this post, the author, who has been providing lactation services for more than 35 years, pointed out that you should:
- Never overestimate a mother’s desire to breastfeed her infant.
- Never underestimate a mother’s desire to breastfeed her infant.
Among other important points, she came to the conclusion that we need to “support the mother, support the mother, and support the mother.” Telling a mother who wants desperately to breastfeed her baby that she needs to try formula isn’t any more useful than telling a mom who wants to formula feed that she has to breastfeed.
When I walked into my doctor’s office that day, I had a game plan. I wanted a referral to an ENT, as suggested by the IBCLC. In the absence of that game plan, the words “It’s okay to try formula, you know”, may have marked the end of my attempt to breastfeed my baby and the beginning of a guilt-ridden downward spiral. Instead of going on to nurse him for two and half years, I may have simply switched to formula, a move that would have come with financial and health consequences for both of us. I don’t think that mothers need to be told that they must breastfeed and I also don’t think that mothers need to be told that they must try formula. What would happen if, instead of feeling the need to TELL mothers what to, health professionals simply asked: “How can I support you in your feeding decision?” From there, the conversation needs to combine compassion and knowledge, supporting the mother while also answering her questions and educating her without judgement or pressure.
Yes, health professionals have an obligation to watch out for the health of the baby. But perhaps if they approached that obligation from the perspective of a partnership with the mother, there would be less guilt, more healthy babies, and fewer unhappy moms.
Annie has been blogging about the art and science of parenting on the PhD in Parenting Blog since May 2008. She is a social, political and consumer advocate on issues of importance to parents, women and children. She uses her blog as a platform to create awareness and to advocate for change, calling out the government, corporations, media and sometimes other bloggers for positions, policies and actions that threaten the rights and well-being of parents and their children.