Breastfeeding Survival Strategies: Beware of Wolves in Sheeps Clothing

I have been noticing an alarming trend among the mothers calling me for lactation support. Almost all of them are actively supplementing their breastfeeding. Of great concern to me is that they are using more and more formula and reporting they feel pressured into doing so by their pediatricians.  Driven by concerns over weights and measures, these mothers have no confidence in their own milk and are finding little support for exclusive breastfeeding from the medical establishment.

I caution you to remember the old adage…actions speak louder than words.  I have yet to meet or hear of a pediatrician in my tri-state area who blatantly discourages breastfeeding to consumers who are planning on breastfeeding their babies.  But they are wolves in sheeps clothing.  While paying lip service to breastfeeding, they manage formula feeding. 

This problem often starts in the hospital.  One of the loop holes of the 10 Steps for Baby Friendly Hospitals is that formula can be offered when medically indicated.  Tired after labor and left largely on their own with a new baby, the parents are often scared into supplementing for “health reasons”.  Under the guise of a medical need for formula : ”your milk is not in yet” “your baby seems very hungry” “you need your rest” “your baby is dehydrated” “your baby has lost too much weight”…The dye is cast.

Once parents succumb to the pressure, their baby’s patterns of digestion and state will have changed.  They quickly notice that after supplements, especially of formula, that their baby sleeps much of the time between feedings.  Their expectation of what a successful breastfeeding session looks like has thus been altered.

When they resume exclusive breastfeeding, after days of supplementation, they may find their baby is fretful or awake after a feeding.  This may prompt them to pump to check if they have enough milk; they often get negligible results since they have just breastfed.  If a breastfeeding session has been skipped, they may pump a larger amount the first time, but the amounts will drop and/or plateau if pumping is done in lieu of breastfeeding during the early days of developing a milk supply.

I was thrilled a while back to see a thread on this topic going back and forth among my friends on Twitter.  Sadly, it does seem that you may have to defend your decision to breastfeed every step of the way.  Tara, on Growing Up Green outlines 5 strategies that can help counteract medical misinformation and questionable support.

Doctors express, no pun intended, their shock and awe when exclusively breastfed babies grow as well or better than their formula-fed peers.  If the growth patterns are different, they assume it is a problem with the mother’s milk or her baby’s digestion of her milk and immediately suggest formula.  

It is disappointing to me that fewer pediatricians these days even suggest pumping and giving extra human milk when the only issue is weight gain.  When they do include adding extra EBM after breastfeeding as part of their care plan, they often recommend amounts that ensure the need to make up the difference with formula. 

 A local doctor used her trump card, or so she thought, on one of my moms by telling her it would damage her baby’s brain because her daughter had gained only 4 oz in about 5 days. She tried to instill guilt and scare her into using formula when her baby was gaining too slowly for her taste.  Brain cells by the ounce?

It appears that this reliance on weights alone for assessing the health of newborns has gone global. Danielle from Born.In.Japan.net wrote of a similar experience in recent months. She did not mention supplementation in her post, but shared feeling that the doctor wanted her baby to “fit in a box”.

So many babies are now being double-fed that no one really knows what is a normal growth pattern.  We are mixing gene pools and methods of feeding and are expecting standardized outcomes.

An important breastfeeding survival strategy must be for us all to question this one-size-fits-all model of management.  The emphasis should always be on achieving a conscious breastfeeding connection that is optimized to be pain-free. 

As long as there is evidence of steady growth, even if it is slow, there should be no reason to be concerned if your baby isn’t the “fattest baby on the block”.