Friday, August 3, 2012

When a Mother Chooses NOT to Breastfeed...

There are so many choices that mothers make which will be debated over, questioned, and even attacked by strangers, coworkers, friends, and even family. How a woman chooses to give birth and feed her child is of particular interest and debate, especially in recent years.

Not only is it World Breastfeeding Week and I wanted to highlight a topic, but I just received the 'Birth Plan' for my next doula client and she explicitly states that she does NOT want to breastfeed and does not want any lactation counselors to come talk to her while in the hospital. I knew about this decision from our prenatal appointment, but as a passionate advocate for Breastfeeding, I was motivated to educate her and maybe change her mind with information and positive encouragement/support. I didn't fully accept her decision until I saw it in print... so I had to hang my doula hat for a moment and try to understand.  

We ALL know that 'Breast is Best', but do we know that formula IS NOT the second best alternative to mothers breast milk? When it comes to infant feeding, the hierarchy is as follows...

1. Feeding Baby at the Mother's Breast
2. Mother's own Expressed Milk (pump and bottle feed milk)
3. Another Mother's Expressed Milk (milk bank, donated milk)
4. Formula (not all formulas are equal, some are worse than others!)

Human milk can come from milk banks such as Human Milk Banking Association of North America where milk has a price and sometimes it is a little costly, but donors are screened and receive blood tests and the milk is pasteurized to kill bacteria (this does decrease some good properties of the milk, but only slightly). These banks need many more donations of human milk to meet growing need, but rigorous tests to be a donor, milk collection standards, and the cost deter many women. This milk is being used more and more for premature infants and the high standards/safety of the milk is an appropriate prevention strategy and is likely beneficial to these fragile babies.

Women have also shared milk and nursed other women's babies throughout human history. There are informal and formal networks for  milk sharing among women, one such example is Human Milk for Human Babies.There are some concerns about the spread of disease among informal breast milk sharing.

When marketed, formula appears to be 'almost' as good as mother's breast milk... but this isn't even remotely true! Formula can be contaminated with dangerous chemicals and powdered formula IS NOT sterile. Formula just isn't the 'almost' that so many parents are led to believe it is.

Some thoughts about the safety of formula-
  • Formula can be RECALLED due to contamination!! (In the photo to the left, the formula was recalled due to contamination from pieces of bugs and larvae)
  •  Formula can become contaminated during any step of the collection and manufacturing process as well as while being used in your home
  •  Contamination can occur from many sources and in severe cases can lead to death. Such examples include: Enterobacter sakazakii and other microorganisms in powdered formula, additives such as melamine and mercury, as well as from the water being used to mix the formula, improperly cleaned bottles and nipples, plastic can contain Bisphenol A, etc...
  • Most parents do not PREPARE powdered formula correctly to kill microorganisms such as E. sakazakii and many do not use formula as instructed (such as throwing unfinished formula away after feeding).
Powdered formula needs to be heated to at least 158 degrees F (to kill bacteria and microorganisms that can be IN the FORMULA) - then it can be cooled and fed to baby immediately, or refrigerated for no more than 24 hours, HOWEVER, this is rarely done by parents in the U.S. and even formula companies and WIC do not have updated recommendations for how to properly prepare formula.

Here is a link to the Health Department in the UK that describes how to properly prepare powdered formula.

Also, in comparison to feeding the baby at the breast, when bottles are used babies tend to be overfed and parents tend to hold the baby less during feedings (ie. prop up bottles). 
So back to mothers choosing not to breastfeed. As with many decisions made for a new baby, choosing not to breastfeed would be a very difficult decision to make; even though there is still a lack of respect and support for breastfeeding in the U.S., choosing NOT to breastfeed is fiercely protested by many, many others. I look forward to a day when Breastfeeding is the norm again and very, very few women feel uncomfortable or 'wrong' about breastfeeding and breastmilk. Until then, there needs to be more support for mothers who choose to breastfeed, access to donated and affordable human milk, accurate information about infant formula and proper preparation, and an environment supportive of women's rights to choose!

and remember...

Normal Feeding! 

~Wisdom and Birth

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