…Contemplating the Core Elements of a Modern Breastfeeding Lifestyle
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Got Enough Milk? Part 1: Why Volume does not Correlate with Value

Breast milk is a bioactive fluid that contains so many amazing and dynamic constituents that it is impossible to memorize all of them; it packs food and fluids into small amounts and cannot be exactly duplicated in a lab or from one mother to the next. Formula, although the name sounds scientific, is just a processed food. It is always the same. Whether you give one ounce or 20, the only thing that changes is the calorie count.

Dr. Sears, a renowned Pediatrician and advocate of Breastfeeding, has a very helpful chart on his site comparing some of the key constituents of Breast milk and Formula.

Breastfeeding without any supplements is a very different experience for the baby and its parents than when formula supplements are added. Unfortunately, breastfeeding mothers are often encouraged to add supplements of formula by health care workers and family members. This suggestion is especially common during the early days of breastfeeding when the milk supply is being established.

Although no harm is intended, most parents do not realize that implementing this strategy, without any restrictions, can negatively impact the breastfeeding dynamic of supply and demand.  Supplementation changes the timing and frequency of feedings and can adversely affect the quality of direct breastfeedings.  To further complicate matters, giving different milks and using different delivery systems can skew the perception of what satiety looks like in a baby.

When assessing if a mother has enough breastmilk, these facts need to be considered.

  • Human milk is an energy-rich, bioavailable milk which nourishes and hydrates the baby in smaller volumes.
  • Attempts at pumping human milk, especially in the early days, will yield misleading results. What is pumped does not correlate directly with what the mother is making and what is available to the baby with direct breastfeeding.

Formula, on the other hand,  is a processed food. It is always the same except when the “additives” and “chemical formulations” are periodically changed to generate some kind of brand loyalty among members of the medical establishment and consumers.

  • Breast milk and Formula are very different foods; they each impact digestion, gas formation, appetite and linear growth and weight gain in differing ways.
  • When both milks are mixed together in the same stomach any negative reaction will generally be blamed on the mysterious Breast milk, rather than on the cow or soy based artificial baby milk.

Comparing the two milks is like trying to compare apples and oranges. They are both fruit, but the taste, texture and impact on digestion will vary. You could never tell if you were allergic to apples by eating oranges. However, an analysis of breastfeeding is often based upon how the baby takes formula when offered.

Formula is often added because it so readily available and convenient. Marketing 101.

  • If the baby needs to have its appetite stimulated by giving it supplements, the first milk of choice should always be human milk.
  • Even if only small amounts of extra breast milk are available at first, the biological impact is far more powerful than that of formula.

Technically, whenever formula is added to a breastfeeding relationship, it is the beginning of the weaning process. If more women were truly aware of this fact, I believe the use of formula by breastfeeding mothers would be far more judicious.

Mothers cannot help but question their own milk supply when the analysis is too often based upon adding in a different milk.

In Got Enough Milk? Part 2, we will examine how style of feeding and delivery method of the extra milk provided will further impact the mother’s confidence in her milk supply and breastfeeding success.

June 25, 2010   1 Comment

Breastfeeding Needs A New Marketing Mindset: Part 1

Breastfeeding has been, and remains, the biological norm for feeding human babies since the dawn of time. It is the completion of the pregnancy and birth cycle designed to nurture human beings in their accelerated growth and development after birth. The first 3 months are often called the 4th Trimester because it is during this period that the mother’s milk supply will be established based upon the feedback loop between the baby, breast and brain (pituitary glands).

Early in the 20′th century, drug companies started selling commercial artificial baby milks, aka formula. Gradually women were persuaded that breastfeeding was a choice, rather than the natural food needed to ensure the optimal growth and development of their infants during the first year of life and beyond. In the late 1960’s, formula began to be marketed directly to the medical community and a sharp decline in the initiation and duration of breastfeeding was noted throughout the world. In less than a century, it was no longer the birth right of human babies to be fed their mother’s milk.

What’s a breastfeeding advocate to do to combat the marketing prowess of Big Pharma? For the past 25 years legions of dedicated lactation professionals and breastfeeding women have pondered this question, myself included.

The basic approach has been to promote breastfeeding by proclaiming that it is natural and full of health benefits for both the mother and her nursling. Education and peer support have been the primary tactics to shift the global paradigm back to breastfeeding as the accepted norm.

Unfortunately, modern breastfeeding advocacy has been fashioned from a defensive mindset. Marketing efforts take on formula, tit for tat, pun intended. The activity of breastfeeding has been steadily taking a backseat to the commodity of expressed breast milk.

In their efforts to create an evidence-based model, many lactation consultants have moved their attention away from direct breastfeeding and are promoting pumping and breastmilk to go up against the competition, one-on-one, bottle by bottle.

The current breastfeeding marketing strategy is in desperate need of an overhaul. What do you think?

June 2, 2010   1 Comment

Dad Walking On Egg Shells

Had an interesting call this week from a dad.  He wondered what were the chances of relactating at 7 weeks? 

And no, before you go there, it wasn’t a crank trying to get a rise out of this passionate lactation advocate.  This call was legitimate.  He was a friend of a father in my practice who had encouraged him to reach out to me across state lines to sort out his dilemma.

He called me to suss out the situation and shared a very sad, but typical scenario.  His wife, had been buffeted on the seas of lactation support with inconsistent advice, emphasis on pumping and after two weeks was summarily dismissed and told to bottle-feed.  For approximately 6 weeks now his son has been bottle-fed formula.

In general, I always prefer to speak directly with the mother.  However, his voicemail touched a heart string as he confessed that he was calling without having yet broached this subject with his wife.  He was genuinely concerned and felt badly that they were missing out on breastfeeding because of the questionable support and consultation they had received in the early weeks.  

The reason for the abrupt weaning was the usual  ”Not Enough Milk”.  This was determined, of course, by his wife’s inability to pump enough to bottle-feed after the delivery.   More bottles and pumping led to formula and weaning.  The reason it was bothering him so much was that he noticed her leaking tons of milk a few days ago.  He didn’t understand why she didn’t just offer the breast to their son as clearly there was milk.

This dad was walking on egg shells. He was the support team during the initial battles and was now fearful of incurring her wrath by bringing up the notion of trying it again.   

I can empathize.  I’m often called in for these kind of situations and find the solution is not as simple as merely choosing between offering the breast or a bottle filled with human milk or formula.  The weeks of reinforcing a behavior other than breastfeeding and living a bottle-feeding lifestyle with their new baby could make the transition difficult on many levels.  

 I complimented this dad on his thoughtful and loving inquiry.  My suggestions were simple:

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1.  He could now share honestly some of his impressions about that stressful time with his wife.  Sharing empathy without the stress and pressure biting at their heels.

2.  He could share some of his conversation with his friend that led him to call me.  It would be helpful to emphasize that these situations are usually not truly black and white, but rather if she were empowered and given consistent support much would be possible.

3.  He could gently suggest that she offer their son the breast without worrying now if she had enough. Without pressuring her, he could point out it would be a shame if what she was still producing for their son would ultimately go to waste.

4.  He could share what he intuitively knew, and I corroborated, that milk supply is not increased by the pump, but rather by the baby breastfeeding.  Any amount of breastfeeding would greatly increase the odds of them being able to shift the balance of feeds away from the bottle and back to the breast.

5.  He could continue to offer his love and support reassuring her that it was ultimately her decision.  Sometimes knowing that it is a real team effort can make these transitions seem more possible.

Breastfeeding is a relationship and is relational.    It is the mother who ultimately breastfeeds and chooses whether or not she will continue or resume if there have been challenges.  However, her choices do indeed have an impact on everyone in her inner circle.  Breastfeeding does not exist in a vacuum and is very much a family affair.

How many of us sisters, moms, friends, partners, spouses, and  even lactation consultants, can identify with this dad? Have you ever been afraid to further encourage or advise a mom who had been beaten down and had weaned because of a negative experience with breastfeeding ?

Have you ever felt like you were walking on egg shells?  And what did you do?

July 16, 2009   1 Comment

Are You All Pumped Up?

Single-use, high quality electric pumps have been available for consumer purchase since the early 90’s.  During these intervening years, the amount of pumping has increased exponentially in the United States and across the industrialized world.  Pumping is very much part of the popular culture, often being featured in sitcoms and instructional media geared to expectant parents.  There is a not too subtle imperative to own a deluxe pump before the baby is even born.  Doctors, Nurses and Lactation Consultants encourage pumping as a way to both evaluate and to increase a mother’s milk supply. 

Pumping for some women is their idea of Breastfeeding.  Are you all Pumped Up?

Symptoms include, but are not limited to the following: 

  • You Breastfeed and pump after almost all feedings
  • You wake up in the middle of the night to pump
  • Your are pumping weeks worth of extra milk, just in case
  • You “power pump” if you get less milk out than usual in order to increase your supply
  • You pump whenever you feel something is wrong with your breasts
  • You pump to “empty” your breasts

I field inquiries in all my venues about pump management.  Mothers have been sold on the idea that the pump tells the whole story about their Breastfeeding.  They worry when they can’t extract the same amounts as their friends or in volumes that compete with ready-made formula bottles. 

Those women who do obtain copious amounts of milk when they pump will often have issues in their breasts while breastfeeding.  They tend to be out of sync with the baby and often contend with excessive leaking and engorgement.  Some will report having had Mastitis which was the result of inadequate drainage from only pumping or mixing pumping with direct, but inconsistent patterns of Breastfeeding.

Pumping can actually compound any problem brewing in the breasts.  Women who have sore nipples and engorgement are often advised to pump, rather than to correct the latch.  Congestion can build up and if not relieved the mother will spike a temperature leading to a course of antibiotic therapy.  Whenever, the health of the breast has been compromised it is essential to use the baby and not the pump to solve the problem.

Of course there is a time and place for Pumping…

  • Premature Delivery
  • Illness of mother or issues with the baby or babies that require a delay or interruption of direct breastfeeding
  • To obtain human milk if supplements are medically indicated
  • Returning to Work outside the home

Other reasons cited, may include:

  •  Mom needs a break from breastfeeding
  • Dad/partner wants to participate in feedings
  • To know how much the baby is getting at feedings

Since the mother is the only one pumping and Breastfeeding, it is not exactly a vacation.  Pumping will increase her workload and can create additional anxiety as her milk output can vary greatly depending upon when she pumps.  The mother who feels overwhelmed and worried about her milk supply may begin supplementing and make decisions that lead to early weaning. 

If you are pumping or have pumped what has been your experience?  Are you all pumped up?…or more aptly all pumped out?  I invite your comments and concerns related to pumping.

June 30, 2008   2 Comments