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Thursday, 23 September 2010

Bridging the Gap

I'm into breastfeeding. Nothing comes close. No-one will ever convince me that it's not the optimal way to nourish and nurture your child. What's more, I think everyone should do it, and I think the benefits for everyone in society would be huge if breastfeeding was 'normal'. As regular readers of this blog will know, I am aware that it's not always easy and sometimes it's very difficult to breastfeed. I am also a huge believer that mothers need guidance and support to be able to do it. In something like 98% of cases, a mother has the potential to entirely sustain, protect, and comfort her baby for the first 6 months of its life and she can continue to do this for years on end. Formula companies can never even hope to compete with something so special. To pretend that formula milk comes even close to the complete, living food that is breastmilk is to live in ignorance.
But.

What about the mothers who don't breastfeed - whether through choice or circumstance? What if they don't provide this 'liquid gold' to their babies? Does it make them bad mothers? Some 'breastfeeding advocates' seem to think that it does.
I'm not one of those people.

I was born and raised in Northern Ireland - I grew up with the Troubles. My father was active in the peace process. He used to say 'you've got to take people with you'.

Now, I'm not for one moment comparing the divide between formula feeding mothers and breastfeeding mothers to the problems in the North of Ireland (although I can think of a few internet posters I wouldn't want to have in the same room!). However, I do think as breastfeeding advocates we need to start 'taking people with us'.....

Many mothers who stop breastfeeding - and even some who never start - experience terrible guilt. They might not admit it publicly, but privately they will tell you that they do. Many others who formula feed feel judged and patronised. They feel that no-one cares about the background to their situation, about why they come to be formula feeding. How can we ever hope to improve breastfeeding rates if this 'them and us' situation continues to prevail? Women who have chosen not to, or who have been unable to breastfeed at one point in time will simply shut their ears. They won't listen and they won't know how to support their friends and daughters if they choose to breastfeed.
Apart from the myriad health benefits of breastmilk itself and the potential risks involved in formula feeding, breastfeeding is more than just breast milk.
It's not just WHAT we feed our babies, it's also HOW we feed them.
Whilst I am aware that many formula-feeding mums take time to cuddle and hold their babies when feeding them, there are others who don't.

I'll be completely honest - I really struggle when I see this:


Cute baby - but although many of you might see nothing wrong with this picture, I feel something is missing - loving arms!
One of my pet-hates is when I'm out and about and I see a baby in a car seat with a bottle propped up in it's mouth.
'But when I'm doing the shopping I'm busy and I haven't got time to hold the bottle' one mother told me during an online discussion.
I guess the products below are ideal if you're too busy to spend time holding your baby.


I doubt very much that I'm the only mother to be bothered by these images. Partly because obviously leaving a baby to 'feed' itself in this manner is dangerous, but also because children fed this way are completely separated from their main care-giver. With breastfeeding the care-giver and the nourishment go hand-in-hand. It's unavoidable and it's not just because the baby is in your arms - it's chemical too.

When a breastfeeding mother gives her baby a feed a hormone called oxytocin is released into her bloodstream. It triggers the 'milk ejection reflex' which allows her milk to flow. This hormone gets into her milk and the baby receives it in the feed.
Oxytocin is very interesting. Recent scientific research has led to a greater understanding of how it works and it's effect on us. Some people have called it 'social glue'.

Oxytocin is also released during labour and birth - the high levels of oxytocin present after birth help mothers to bond with their babies, and cause the uterus to contract helping it to return to it's normal size.
'Oxytocin has been described as the ‘love hormone’ and it is secreted when falling in love with another adult, or a baby, and it makes mothers feel relaxed, contented and less anxious.' ~ New Zealand Ministry of Health
Oxytocin levels are also raised by skin to skin contact, by hugging, kissing, caressing, touching, and by sustained eye contact.  This is my point. Despite not breastfeeding, a mother can encourage increased levels of this hormone in herself and her baby just by keeping the baby close! This is why when I see a baby with a bottle propped up in it's mouth I feel sad. The very thing which would help reduce the loss of the breastfeeding relationship (to both mother and baby!) is not being done.

Now, obviously there are very many mums who formula feed and make a point of keeping their baby close. However, I do see many in real life who do not, and the devices shown above would indicate that there's even a market for products which allow the baby to feed without being held.  I wonder if this difference in HOW we feed is a significant factor in creating the 'lazy mother' myth which quite rightly upsets so many formula feeding mums? 
Ok - so if breastfeeding didn't go well for you, what can you do to minimise the impact of this loss to yourself and your child? Do you really have to 'throw the baby out with the bath-water?'

How many bottle-feeding mothers are aware that by mimicking practices more usually associated with breast-feeding they can increase and enhance their baby's exposure to oxytocin?  Studies into the effects of oxytocin in the body reveal that increasing levels of the hormone in men caused them to be more 'empathetic'.  Some research has been done into the effects of the hormone on high-functioning autism and it concluded:
'we found that after oxytocin inhalation, patients exhibited stronger interactions with the most socially cooperative partner and reported enhanced feelings of trust and preference'.
A study focusing on new parents showed that both genders experience a rise in oxytocin levels during the first six months of their baby's life, and commentators have suggested that this increase may be nature's way of helping the new parents to 'bond' with their offspring.
So how can a formula-feeding mother close the gap between giving her baby a bottle and breastfeeding?  
How can formula feeding mums increase their baby's exposure to this 'social glue'?
  • Feed your baby yourself. Formula feeding frequently means that a very young baby can be passed around from person to person for feeds. Each time this happens an opportunity to foster oxytocin development for both mother and baby is lost. Speaking about recent findings which suggested breastfeeding mums were less likely to abuse their babies, the report's author said:
    "
    Breastfeeding may simply promote that interpersonal bond between a mother and her baby - the physical touch, the holding, the eye-to-eye contact. It ensures that physical touch occurs in an attuned way, but I would imagine a similar result for any mother who has that same one-on-one contact while they're feeding on a regular basis." - Lane Strathearn
  • Have lots of skin to skin contact. Breastfeeding necessitates skin to skin contact with the mother, but just because you bottle-feed doesn't mean you can't enjoy the benefits of skin to skin. 'When mothers hold their nude infants against their chests in direct skin-to-skin contact, increases in maternal responsivity and bonding are observed ... skin-to-skin contact might elicit such effects via elevated oxytocin levels in the caregiver's plasma and cerebrospinal fluid.'
  • Practise 'Attachment Parenting'. Wikipedia lists the following as key to this theory of developmental psychology.
    1. Preparation for Pregnancy, Birth and Parenting 2. Feed with Love and Respect 3. Respond with Sensitivity 4. Use Nurturing Touch5. Ensure Safe Sleep, Physically and Emotionally 6. Provide Consistent Loving Care 7. Practise Positive Discipline 8. Strive for Balance in Personal and Family Life.You can see from the list above that if you bottle-feed it does not mean you cannot  be an 'attachment parent'. For more information about attachment parenting have a look at this website.


  • Baby-wear. This is really an extension of skin-to-skin. Rather than pushing your child around in a buggy, consider using a sling. There are lovely ones out there, and for a fussy or refluxy baby they can be an absolute god-send!
    Recent research has shown that 'Our distant ancestors spent much of their time being held and caressed by their mother, forming a close bond.' ~ Professor Darcia Narvaez, from the University of Notre Dame in Indiana, US  Keeping your child close by baby-wearing helps to reduce anxiety and has myriad other benefits, many of which are listed here. The slings are pretty darn nice too ;)
  • Consider Co-sleeping. There are many benefits to co-sleeping, physical and emotional.  Remember that the term 'co-sleeping' actually covers room-sharing too. Many couples like to remove the side of the cot and push it up to the side of the bed, for example.  Experts strongly advise against bed-sharing if families are formula feeding their babies, as this can have a fundamental affect on their awareness of their babies, the way their baby sleeps, and their natural immunity to certain pathogens in the environment.  More on this is here.*
  • Feed on Demand.  Stop clock-watching!  A historic culture of 'scheduled feeding' has ensured that many bottle-feeding mums still think they should only feed their baby at certain intervals.  The latest advice differs though, the Baby Friendly Initiative recommends demand-feeding whether you breast-feed or bottle feed'You should feed your baby as much as he wants, as often as he asks, provided he is not regurgitating significant amounts.'  They also caution against over-feeding.  I have frequently heard bottle-feeding mothers say 'it's not time for his feed yet'.  My husband likens this to telling your baby 'it's not time for your nappy to be changed'....  Feeding on demand also helps to mimic the 'little and often' feeding pattern that breast fed babies naturally adopt and lessens the likelihood of them bringing up excess milk.  A great article on 'baby-led bottle-feeding' is here.
I am absolutely sure that a lot of formula-feeding mothers who read this blog will already incorporate many of these suggestions into their parenting. I am equally sure that our predominantly formula-feeding culture means that many others do not.
As we strive to promote breastfeeding in our communities, perhaps the best way to do it is to promote a change of parenting culture.

*This section has been edited (10:05:11 & 21:05:12)  and my thanks go to Charlotte for an extremely thought-provoking discussion about co-sleeping!

Links:

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(07)00617-8/abstract

13 comments:

  1. i've found that when i breast feed in public or at baby groups non-breast feeding mothers always give me a reason why they haven't or had to stop breast feeding. i never ask why they don't as it's none of my business but being the only bf'er in my baby social group does single me out. it's even got to the point that i've been asked why i still bf (my baby is 15 weeks) so often that rather than come across as a self righteous breast feeder i just say it's free instead of explaining any of the real reasons such as the health benefits and closeness i feel to my baby while doing it.

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    1. I experienced this as well. Half the time I breastfed while chatting with another mother who didn't breastfeed, they tell me their sob story. I'm not an asshole so I would just nod, sympathetically. I got annoyed with having to be so understanding about it "not working out" for them, especially when I knew many many women who struggled more than they did but got *help* and went on to reach their breastfeeding goals. I hate being the poster child for doing what is biologically normal for human beings. I'd rather you ask me about my babycarrier or my baby's leggings or how cloth diapering was going.

      Now that I'm a lactation counselor training to be an IBCLC, I will offer suggestions if they talk about having more kids - about how to overcome those hurdles they faced the first time and the key success factors to consider the first 48 hours following birth such as having the baby room in, holding the baby when you're awake during the first few weeks, skin-to-skin contact, etc.

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    2. Sad that you just dismissingly call them "sob stories". I am a total breastfeeding advocate and breastfed my daughter until she was ready to stop, it was a wonderful experience for both of us and I can'T wait to do it again when my new baby comes, along with cosleeping and babywearing. BUT I also have a "sob story", as you put it - a placental abruption at week 36 in my first pregnancy, baby was taken to the intensive care unit and they IMMEDIATELY gave him a bottle without even ever asking me. I had no choice, I couldn'T have my baby with me in the first hours, and this hurt very much. As soon as I could, I rushed to my baby and tried to breastfeed him again and again, but unfortunately, the horrible nurses on the NICU just kept secretly giving him bottles even though I begged them not to. The result was an unresolvable nipple confusion, I ended up pumping for 6 months after having trief EVERYTHING to get him back to my breast. And yes, it hurt me a lot that breastfeeding mothers would give me dirty looks when I gave my baby bottles of pumped milk in public - they just assumed I was one of the moms who "didn't try hard enough or just didn't want to bf. All I ask is for a little more tolerance and compassion, maybe a lot of the "sob stories" are very painfu personal experiences for a lot of women!

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  2. I thought cosleeping wasn't recommended if you were bottle feeding as when you stop breastfeeding your sleep behaviour changes and you can turn back on baby, basically you stop protecting them during sleep?I've always found even pro cosleeping information says they should go in a cot if you switch to bottle?

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  3. Hi. Thanks for your comment! The term co-sleeping doesn't just mean bed-sharing, as stated in the article. It seems that keeping the baby within 'sensory range' is the most desirable thing. Some experts argue that bottle-feeding parents should not bed-share for the reasons you've stated but other types of co-sleeping arrangements are still desirable. Baby Friendly advice suggests that bottle-fed babies should sleep in a cot by the bed, and this is suggested above.

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  4. Thank you for such a non-judgmental post, and as a formula feeding mom to an 11-month old very smart and healthy baby, I too am appalled by the products shown. I have never propped a bottle for my baby, we to this day cuddle when she takes a bottle. I have worn her in a sling/wrap for much of the time and am very involved in her life. I appreciate the stance you take, as I have to admit it's rare to find among most pro-breastfeeding places online. I have even read formula equated with rat poison by a self-proclaimed "lactivist." I have nothing against breastfeeding, and am very happy for those who wish to do so. The bottom line when it comes to feeding our babies is that we are loving them and meeting their needs in whatever way works best for our unique families.

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  5. It makes me sad that there is a mutual feeling of being persecuted on both sides of the fence - bottle feeding moms from breastfeeding, but also vice versa! Like Anonymous, when I am asked why I still breastfeed, usually the asker doesn't really care the great benefits of why I am still nursing, and that's even assuming I could figure out how to share them in a way that would not make them feel like a bad parent. So I too have pretty much just given up and say something like it's free.

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  6. I agree, I just say 'Oh I'm far too lazy to bottle feed'. I'm being told that there is no difference bewteen formula and breastmilk and that I'm denying others the bonding experiance offeeding my child and that I need to make my child wait longer between feeds. I'm sick of all the defensive negativity that I get from parents in general that have ff. I never judge them for formula/bottle feeding so why should I be judged for my decision to breastfeed, which is what we are biologically made to do!

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  7. I don't mean to be rude and I appreciate what you're trying to do here, but the entire first two paragraphs are EXACTLY why formula feeding mothers feel guilty.

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  8. I'm really sorry that the opening paragraphs illicit that feeling - I'll have a read back and see if there are changes which could be made. BUT - I still believe that to deny the real differences between formula milk and breast milk is crazy. I don't want to give the impression that they're not important differences... No-one should be under the impression that they are similar substances. However, if someone finds that they cannot breastfeed, or makes an informed choice not to, then OF COURSE formula milk is a viable alternative. The point of the blog wasn't to say 'it doesn't matter what you feed your baby' - it was to say that there is MORE TO FEEDING than food. The way we parent and interact is so hugely important, and I don't believe that THESE things should be determined by what you feed your child. It seems 'attachment parenting' is thought of as a 'hippy' & breastfeeding only thing to do - when there are good reasons to think it shouldn't be. xo a

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    1. A lot of the reasons breastfeeding "doesn't work out" for so many is because they don't know anything about doing it nor do they understand that there are some very important yet simple things they can do within the first 48 hours after birth to get breastfeeding off to the right start.

      If mothers spent as much time learning about breastfeeding as they do in picking out the color scheme for their baby's nursery or which stroller to get, we might see a higher rate of continuation of breastfeeding.

      In the US, about 77% of women initiate breastfeeding after birth but fewer than half of them are doing it AT ALL by 6 months postpartum. I'm very curious about the 33% of women who have no interest whatsoever but that's a topic for another day.

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  9. A note on breastfeeding "not working out"

    I feel that stress has a HUGE part to play in it 'working out' or not. Both my best friend and I had problems breastfeeding, and we were both completely pumped (ha! accidental pun) to breastfeed our babies as long as we could. We had problems.

    My boyfriend at the time (father) left about 6 weeks after my son was born. Breastfeeding was going great. Then a giant ball of drama and stress hit and BAM, everything stopped working, I would be getting 4 ounces from each breast at a feeding, now I was struggling to get 3 oz total. And that stressed me out even more. And the more I tried, the worse it got. I tried everything: consulting, supplements etc. etc. I just couldn't get it back. Baby was a fantastic breastfeeder, the only thing stopping the milk from flowing was me. The stress just got so bad that everything completely shriveled.

    Our emotions and stress take a much higher toll on us physically than maybe we give credit for. Once you're going downhill with it, it's extremely hard to go back up. I couldn't do it.

    Just because it was so easy for you, or your group of friends or whatever, doesn't mean that it will be easy for everyone else (even though yes 98% of us are fully capable)

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    1. BTW my comment isn't meant to be a criticism on you or you post, I really enjoyed reading your article (so many people just spout random facts without citing anything!) I just wanted to offer a viewpoint from someone who unwillingly ended up on 'the other side'

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