Why I “shouldn’t” have been able to successfully breastfeed

I knew I wanted to breastfeed my children even before I was sure I wanted children.  My mother breastfed me and still talks about how much she enjoyed it.  She was a bit of an aberration amongst her friends and neighbours though.  She was breastfeeding at the height of formula marketing.  She was probably seen as a quaint, harmless dippy-hippy…afterall, she did try to get married in a fetching crop top and bell bottom ensemble she crocheted herself (Grandma put a stop to that).  My husband and all of his siblings were formula fed.  Most of my friends were formula fed.  If that had gone on for another generation or so, we would probably have lost a lot of the art and knowledge of breastfeeding.

So thank gawd that breastfeeding is making a resurgence.  Its promoted by Health Canada, the Public Health Agency of Canada, the Canadian Pediatric Society, hospitals, physicians, nurses, obstetricians, midwives, doulas…oh, and of course lactation consultants.

I firmly, 100%, believe that breast is best.  But I also firmly believe that formula comes a close second.  Babies need to be fed.  I fail to see why feeding babies should become so complicated and fraught with controversy.

Ah controversy and accusations and finger pointing, fear-mongering and just plain badgering abound.  Sometimes it gets beyond ridiculous (check out this WTF post).  Here are some less than helpful statements about breastfeeding that could have caused me anxiety had I been a more suggestible individual:

Babies born to mothers who have an epidural during labour have a difficult time/ can’t breastfeed.

Really?  The epidural rates in Canadian provinces varied between 30 and 70% in 2008-09 (this document is fascinating reading btw).  If having an epidural decreased your ability to breastfeed, I would expect breastfeeding rates to be pretty low since so many women are opting to have an epidural.  According to Statistics Canada:

Women aged 15 to 55 who had given birth from 2005 to 2009 were asked, in 2009, about breastfeeding experiences related to the birth of their most recent child.

Of those women, 87.5%, or 1.3 million, breastfed their most recent baby, if only for a short time. The percentage of women who initiated breastfeeding rose from 81.5% in 2001 to 87.0% in 2005, and has held steady since then.

We’re doing pretty good up here in the great white north.  Yay Canada!

Where did this idea come from anyway?  Well, breastfeeding is under hormonal control and supposedly taking away the pain of childbirth will monkey with hormone release and your milk supply.  It might be biologically plausible, but there is no evidence that this is the case.  Secondly, there is the suggestion that a drugged fetus won’t be awake enough to latch/ suck.  The amount of fentanyl in the stock epidural solution of every hospital I’ve worked at is 1-2 micrograms per mililiter.  We run that at 5-10 ml/hr into the epidural space…if I gave that dose all at once into a vein, most people wouldn’t really feel it.  Since it doesn’t accumulate or get trapped in the fetus, its not hard to see why women who have labour epidurals should expect to be greated by an alert newborn.  Heck, I’ve seen babies go under general anesthesia for surgery who successfully nurse in the recovery room!  Those babies are given more narcotic than what they would be exposed to from a labour epidural.

I had an epidural.  My son had apgars of 9 and 9.  This idea that epidurals “drug” babies and make them dopey is ridiculous and false.  Babies may be sleepy for other reasons on delivery but you cannot blame the epidural.  Even babies born by C-section where the epidural has just been topped up with stronger medication, or with mums under general anesthetic tend to come out alert.

Of course, I’m planning an entire post reviewing the evidence on this topic so I’m trying not to get ahead of myself.

If you don’t get the baby on the breast right away, you’ll have a hard time and might not be able to breastfeed.

Newborns tend to have a window of alertness during their first hour of life.  Its an ideal time to get them on the breast and a great way to start the bonding process with the new arrival.  Unfortunately, I had an expedited vacuum assisted delivery for some late decels during the second stage and got a second degree tear…the repair of which occupied my physicians and nurses for long enough that we didn’t get to attempt breastfeeding during the “golden” hour.  But here we are two months later, exclusively breastfeeding.

Now, don’t try to blame my decels on my epidural – it was a cord issue.  And don’t blame the epidural for the vacuum either.  I had full motor control of my legs, could feel pelvic pressure and was pushing very effectively.  We just ran out of time…FHR in the 60s = pull that sucker out already. 

I don’t think women who want to breastfeed should be unneccesarily worried if they have a c-section or other complication that keeps them from breastfeeding their infant in the first hour.  Just start as soon as you can, and everything will be alright.  Unlike the milk and yogurt in your fridge, breastfeeding doesn’t expire.

Supplementing with formula will cause your milk to dry up/ supply to diminish and you’ll have to wean.

My child was jaundiced and hadn’t peed or pooed all day when we saw our family doctor on day three of life.  He also smelled like ketones.  Ketones are made during starvation – they’re a product of your body eating itself.  My little guy was eating himself up and his jaundice was making him sleepy so that he wasn’t nursing effectively.  If things continued like this, he was headed for the bili lights.  My family doctor convinced me to supplement with formula.  My response – I cried and felt like a failure.  I thought for sure this was it for me and breastfeeding…but it was the best thing we could have done.

For the next 18 hours, as soon as I was done nursing, I passed our baby to my husband who tanked him up with a few ounces of formula while I pumped.  We added my pumped milk to the next bottle of formula.  This was exhausting.  Nursing took 30-40 minutes and then pumping took an additional 30 minutes.  We were waking our baby up every 3 hours for forced feedings so no one got any sleep.  I don`t think I would have been able to sleep anyway, I was feeling so guilty about not being able to feed my son.

But by the morning R was peeing and pooping again and his jaundice hadn’t gotten worse.  And my milk had come in.  I think all told we fed him 8 ounces of formula.

If you give your baby a bottle or pacifier before breastfeeding is firmly established they will get nipple confusion/ prefer the bottle or pacifier to the boob and you’ll have to wean.

I don’t think this is true for most babies.  Really young ones don’t seem to have much memory.  One night of bottle feeding didn’t make any difference for us.  Later on, at 4 weeks, we reintroduced one bottle feed a day (of expressed breast milk).  Again, no problems.  Baby R is really smart.  If its vaguely nipple shaped and milk comes out of it, he’ll suck.  Otherwise he doesn’t care.

Breastfeeding shouldn’t hurt.  If it hurts, you’re doing it wrong.

I call BS.  Breastfeeding hurt for the first 4-6 weeks.  When R would latch, I would hold my breath or grit my teeth for the first few sucks – after that BF’ing started to feel good.  Now my nipples are used to the feeling or they’ve toughened up.  BF’ing hurt even though our latch was perfect.  But for the first 2 weeks, until I was reassured by the lactation consultant, I thought I was doing it wrong and had all this worry that I didn’t need to have.

Get out of the hospital as quickly as possible…hospitals don’t support breastfeeding.  They’ll take your infant away, feed him formula or sugar water and totally undermine your mommy-baby relationship. 

Again, I call BS.  Hosptial standard of care in Canada is rooming in with your infant after birth, no supplemental feedings and support from knowledgable RNs and lactation consultants.  The charge nurse wanted to keep us another day because that morning I had expressed some insecurity about my latch.  Once we figured it out, she was happy for us to go…but she made it very clear that if I was still feeling a bit iffy, she’d rather I stayed longer.  At one week postpartum, I had a bad infection and was readmitted to the hospital for IV antibiotics.  When the doctors and nurses found out that I was breastfeeding they made sure that the antibiotics and other medications they offerred me were compatible with it.  Even though the maternity ward was full, they opened up an extra room (and created extra work for already busy staff) so that my baby could stay with me.  Had I been sent to a regular ward, the baby would have had to go home after visiting hours were over.

If you are anxious, you won’t have enough milk or you won’t be able to let-down.

Hmmm….I’m so type A I’m a caricature.  But I have lots of milk, and enough let down to put out a fire across the room.

I’m an earth mother, mystical birthing goddess.  My baby climbed up on her own out of my vajajay during my unassisted homebirth and latched perfectly onto my nipple without any help and then cut her own cord once it stopped pulsing.  What?  You needed help or asked for an intervention?  You’re doomed to be a bad mother.  …(kidding…sort of.  You read this kind of thing a lot on birth forums.)

I needed help.  I needed help during labour and delivery and I needed help while learning to breastfeed.  And I am an earth mother mystical birthing goddess thank you very much.  And I am an adequate mother.  And I am just as amazing as you.  

I took advantage of the last 100 years of science and progress.  I had a beautiful, amazing, birthing experience during which I felt 100% supported and respected by everyone involved.  I have a beautiful son and lots of special memories.  I have no memories of fear or pain or uncertainty.  I have no birth trauma.

Women are notorious for taking on too much and not asking for help.  If breastfeeding is important to you….ASK FOR HELP.  You don’t have to go it alone, and most women can’t.  Needing some extra help, whether its attending breastfeeding meetings or going to a lactation clinic doesn’t make you a failure.  It doesn’t mean that breastfeeding isn’t going to go well or that you’ll have to wean before you are ready.

The reality is that the majority of women start breastfeeding and continue to breastfeed for 6 months.  This idea that its really difficult and any little event is going to heavily interfere with breastfeeding is more harmful than helpful. 

Instead of inspiring all this fear, we should tackle the three biggest reasons for not starting breastfeeding (at least in Canada):

1) health problems in mom or infant.  This would include babies that are really premature, babies that have congenital problems or other reasons to need surgery or hospital care immediately after birth, health problems in the mother such as the need for medicationss that are incompatible with breastfeeding.

So, we need to focus on better prenatal care, healthier moms, decreasing the potential for multiples (single IVF transfers), better nutrition, exercise, folate supplementation…

2) breastfeeding is perceived as “disgusting” or “unappealing.”

I’m not making this up. – its really one of the top reasons women cite for choosing formula over breastmilk.  Breastfeeding should be seen as beautiful and normal.  We need to take it out of the shadows.  Children need to see it…adults need to see it.  We need to see it in the media.

3) breastfeeding is perceived as “difficult” and/or “inconvenient.

Yeah…maybe because women are being told that it is and that any little hiccuph will mean breastfeeding failure.  We need to change our tune and stop with statements like the ones in bold above.  We need emphasize that breastfeeding is easy, convenient and beautiful.

You will be able to breastfeed if you want to.  So relax, put your feet up, put that little sucker on the boob and enjoy a good book. 

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2 comments

  1. Great post! And I also call BS on the whole “if it’s hurting, you’re doing it wrong” thing. Both my kids breastfed beyond two, and breastfeeding both was painful for the first four weeks. This was in spite of multiple visits to the IBCLC for latch checks. I think so-called lactivists are doing women a disservice by yelling them this in an attempt to get women to try it. If you’re honest about it up front, women who try it are more likely to continue if they realize it’s eventually going to stop being painful.

    1. That’s “telling” not “yelling” but it almost makes sense either way…

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