All of these things are like the others

What do milk expression, donated milk and formula have in common? They are some of the most commonly misused tools for feeding babies.

A mother should never be set to pumping to fix a problem. Sadly it’s something I see all the time. Women who have problems start pumping and can’t break the habit. Pumping as a longer term solution should be reserved for mothers separated from babies, ill infants or babies otherwise unable to nurse. Pumping is an amazing tool for premature infants, working mothers and as a temporary measure for other issues. Pumping can even work for some women who do not want to breastfeed, but still want to be the sole provider food for their child. It is rarely emphasized, however, that this is an unrealistic ideal for many women. Pumping shouldn’t be seen as an alternative to breastfeeding for mothers experiencing pain or a non-latching baby. Those are real problems that can be addressed through actual support, but too often women are fobbed off, either by their care team, or as a misguided self preservation method, to using a pump.

Donated milk is an amazing tool for ill mothers, orphaned or adopted babies, those required to take medications unsuitable for breastfeeding, those with chronic lactation issues and as a temporary measure for those with potentially solvable lactation issues. I’ve talked to a few women who had breastfeeding difficulties and instead of getting (and sometimes even seeking) professional support turned to donated milk and eventually formula.

Similarly with formula- an amazing tool for those who do not wish to breastfeed for whatever reason, a shelf stable resource for feeding babies, or for those not wishing or able to use donor milk.

Formula, by far, seems to carry the most emotional baggage. Far too often women are urged to use formula by a health care team to smooth over something anomalous and end up in a downward spiral ending in lactation failure. In these circumstances the infant formula is demonized, ignoring the reality that it is just a tool. A tool that is being misused the same way as milk expression or donor milk can be. When I was supplementing (with a tube taped to my breast) someone had the temerity to ask me why I wasn’t using donated milk. Because, what I was doing (through luck I may add, no credit for any equivocal mothering skill here) wasn’t apparently good enough. So much pressure for those that have problems.

In the absence of any real help all these tools achieve the same result-women unhappy with their experiences, potentially prematurely ending a much desired breastfeeding experience. I can say that had I had a good supply of diet controlled donor milk, or expressed milk of my own, I would have still felt bad. Other people may have looked more kindly on me, but I would still have been unhappy. Justified sadness, in my view. I was not doing something the way I had envisioned it. And I was getting no help. Don’t forget that. Too often our health care teams have fallen prey to wanting to meet goals, check boxes and move on in the name of efficiency and overwork. I’m trying to be generous to the health care teams, but the failure to treat every mother-baby pair as an individual case potentially needing individual solutions and support has a huge fallout. Emotional trauma appearing as regret, fear, anger and grief is unfortunate and common.

I’m not saying that breast feeding is complex, but the practices surrounding labour and childbirth may be, and  can and do complicate matters. And without knowledge even simple problems are very problematic. Breastfeeding shouldn’t be this complicated.  And I don’t think it really is, but for the fact that we’re re-learning how to do it.

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