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Breastfeeding Benefits or Formula Risks – Does it make a difference?

I’m writing this post during world breastfeeding week, spurred on by the usual promotion of breastfeeding – romanticised photographs of smiling mothers and breastfeeding babies and the standard ‘breast is best’ taglines, usually followed by a list of breastfeeding benefits and once again I’m wondering if this is the right approach.

Breastfeeding rates are still very low, in the UK 83% of mothers breastfeed their newborns but by 6 weeks only 24% are still exclusively breastfeeding (stats from HERE), what is happening in those intervening 6 weeks to spur such a huge abandonment of breastfeeding?

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The answer is surely a lack of support. I have supported many mothers in the early weeks struggling with the establishment of breastfeeding and often getting appropriate support is like looking for a needle in a haystack. I’m sure breastfeeding supporters will shout me down here, but I write this as somebody fully aware of all of the different organisations and individuals providing breastfeeding support. The problem is that there are just not enough of them and oftentimes the quality of support varies greatly. It is hard enough establishing breastfeeding without doing so on the receiving end of conflicting advice from people you are supposed to trust. Then there is the dreadful provision of tongue tie diagnosis, but – more importantly division services. A friend’s baby was recently diagnosed with an upper lip tie which made breastfeeding very difficult, despite this being spotted in the first few weeks it took until the baby was 16 weeks old for her to receive a referral appointment (not everybody lives near, or can afford to use a lactation consultant), that’s just not good enough.

Not only is professional support too patchy, we are growing up in a society where formula feeding is the norm, our friends and family bottle feed and our mothers see us struggling and suggest “why don’t you just give him a bottle?” adding “it was good enough for you”, this leads me to the point of my post, formula feeding has somehow become the mainstream norm in our society, so much so that breastfeeding is now considered a ‘beneficial extra’. If breastfeeding is beneficial, then that surely means that formula feeding is the norm and the norms are considered healthy and well ‘normal‘…For many women, for whatever reason, breastfeeding is too difficult and they have a perfectly acceptable alternative in formula milk (or so they think). Occassionally formula is not only seen as normal, it is seen as superior to breastmilk – here I am talking about the ‘hungry baby’ milks (implying that breastmilk is not enough to satiate a baby’s appetite), ‘follow on milk’ (implying that breastmilk is not adequate past 6 months) and the ‘lactose free’ formulas (implying that breastmilk is not suitable for babies with lactose intolerance).

I fell for the last two myths. I breastfed my firstborn for 16 weeks until I began to wean him (as was the advice then, I cannot tell you how much I wish I hadn’t and how I had watched for the real signs of weaning readiness, not myths such as waking more at night, dribbling, putting everything into his mouth and looking at food, perhaps he would not now have coeliac disease if we had waited), we then moved onto follow on milk as I truly believed my breastmilk was no longer enough for him. My second born had typical signs of lactose intolerance so, on the advice of my health visitor I switched to a special formula when he was 8 weeks old, again certain that it was better for him than my breastmilk (nobody told me about avoiding lactose in my diet). My sons now are happy and healthy (aside from the coeliac disease) and I don’t seem to have done them any lasting harm (or so I hope), but being duped into giving them formula and ceasing breastfeeding prematurely is right ‘up there’ in my parenting regrets list.

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What if we changed our vocabulary to “The risks of formula milk” instead of “The benefits of breastfeeding”? – Would that then imply the truth that breastfeeding is the norm for our species and as the norm has no benefits, as the norm anything else must surely carry risks? Would this change of vocabulary make a difference in the informed choice parents make in terms of feeding choices? What about those mothers who do not have enough support to breastfeed – would it make society lobby harder to get the support we need? What about those who truly cannot breastfeed for medical reasons – would it make us lobby harder for the availability of donor breastmilk?

I’m not writing this to be sensationalist, I’m writing this as a mother who has both breastfed and formula fed and a mother who has looked past her own guilt at not doing the best for her babies because I didn’t know better, to now one who is angry at the powers that be rather than her breastfeeding contemporaries.

The risks of formula feeding are many, they include:

For the baby:

  • An increased risk of otitis media
  • An increased risk of gastroenteritis
  • An increased risk of pneumonia
  • An increased risk of type 1 and 2 diabetes
  • An increased risk of leukaemia
  • An increased risk of obesity
  • An increased risk of SIDS
  • An increased risk of necrotizing enterocolitis

For mothers who do not breastfeed:

  • An increased risk of breast cancer
  • An increased risk of ovarian cancer
  • An increased risk of type 2 diabetes

See THIS article for more.

Now, perhaps it’s just me, but if I had seen this list of risks (and by no means is my list complete!) whilst I was pregnant with my firstborn, or somebody had talked them through with me when I was holding my newborn I’m pretty sure my choices would have been different.  Am I angry? You betcha! Why wasn’t I given this information? At the time I made the best choice I could have done with the information I had, I have forgiven myself – but I can’t forgive those people who knew this information yet didn’t share it with me.

So often breastfeeding mothers – or ‘the breastapo’ as they are so charmingly called (really – these are fellow mothers, who just passionately care about getting this information out there – do they really deserve to be compared to murderers?) are attacked for being insensitive when they talk about this information and I’m pretty sure my inbox is going to be flooded with similar emails when I hit the ‘publish’ button on this post, but it isn’t fellow mothers we should be angry with – we need to get angry at those in power – the governments and policy makers – for keeping this information from us and angry at those who, in a quest to spare our feelings, opt for the lame “breast is best” tagline and tell us of the “benefits of breastfeeding” rather than tell us the truth. It makes me laugh that very often those who try to share this information are called “anti women” or “anti feminist”, because really this could not be further from the truth, those who suppress the information about the risks of formula feeding are the REAL anti feminists, suppressing this information and keeping women in the dark so they cannot make choices with all of the information, if we really want to support women then this information needs to be out there!

When we know the truth only then can we make an informed choice and only then can we see how important it is to campaign for better support for breastfeeding mothers. Only then do we have any chance of increasing breastfeeding rates. Happy World Breastfeeding week.

Sarah

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Posted on August 2, 2013, in Babies, Mothering and tagged , , , , , , , , . Bookmark the permalink. 17 Comments.

  1. I absolutely agree with you Sarah. I live in the UK and I didn’t feel I got the right support with breastfeeding when my son was born last year. It took me rigorous research in multiple languages to overcome the difficulties – not everybody has the patience/time for that. Luckily one year on I’m still breastfeeding alongside solids.

  2. Brilliant post !!! Support is appalling in some areas of the UK (I’ve seen this first hand) but for me the culture of ‘all or nothing’ with breastfeeding as well as the lack of support puts enormous pressure on new mums.

  3. Oh wow wonderful article, as a mum of 8 I breasted all of my babies, first one only for 4 months when I was pressured to feed her food to make her sleep better, second one for 6 months for same reason..you don’t have enough milk you can’t feed him you need to give him real food third one I fed exclusively for 8 months then introduced solids he was bf til is baby sister was born when he was 20 mths, fourth was bf for 9 mths then solids and she had colic so screamed non stop for hours and I was told to stop, she was bf til her sister was born at 22 mths, baby 5 was 2 weeks early and couldn’t latch on so I expressed and bottle fed her then at 8 weeks she started to feed properly and I fed her til the day hi went into labour with her sister 18 mths later, baby 6 was bf fully til 11 mths no interest in food then she took to food and was bf til 2 yrs when her baby sister was born and she is gifted very intelligent, baby 7 was born he fed duly for 9 mths and she was a 10 lb baby she was fed til her baby brother was born 2 yrs later and the last baby was bf exclusively for 10 mths then solids but he continued to feed til he was 4 then weaned himself, so I fully recommend it if possible and I try to give helpful a advice and support to bf mums

  4. Manuela Marçal

    Dear Sarah,
    I’ve read your article and I believe there are some imprecisions as far as the increased risks caused by formula are concerned, namely the increased risk of breast cancer. This last fact is true for mothers until 25 years old. For instance, I became a mother at the age of 34, so I couldn’t have that plus on my side and that wasn’t a fact that led me to bottle feeding. I have a skin problem which did not allow me to breastfeed. I also have a friend who breastfed and still got breast cancer, due to genetic problems, increased by hormonal changes caused by pregnancy. I believe it’s very important to raise awareness and more support for breastfeeding, but bottle feeding shouldn’t be “demonized”. There are always two sides for everything, and for every choice.

  5. Thanks for this Sarah, I certainly concur with the lack of support issue. A big issue for me is being kicked out of hospital within 24hrs and having to deal with other children at home, rather than being able to rest and establish some form of connection in peace. I had no grandparents around me to help and although I went to a BF support group, it took three counsellors three hours to get my son to latch on. He lost 16% of his birth weight in the first week.That was the nail in the coffin, he hadn’t fed properly for 4 days by this point, I was exhausted and he was hysterical as soon as I turned him to me. I turned to formula that day when I got home. With my second son he fed well, although lots, but I just couldn’t hack the sleepless nights and having to get up at 6am and care for my then 2 yr old all day as well. I was offered no support from the health visitors, in fact they discharged me the second day after Thomas was born.

    I tried to keep BF Thomas but just became too exhausted and put him to formula just to establish a routine quicker and enable me to function. Sounds terrible as I type this, that I put myself first, but if I became a dithering wreck, who would have looked after my children?

    I not sure where I stand on the “risks of bottle feeding” I think there are “risks” in all sorts of things we do in life, there are “risks” just to be born. Risks don’t always manifest themselves and often are triggered by a number of factors. I do feel the media sensationalise the views of the “pro breast feeders” to provoke heated debate, however I also think some pro breast feeders make it sound all so easy and chastise those that for whatever reason choose not to.

    I’m not sure whether revealing the “risks of bottle feeding” would really make that much difference, offering women to stay in hospital longer, alongside dedicated breast feeding support staff would really of helped me.

    Thanks for such a balanced article.
    Xxxxx

  6. Great post. I totally agree about lack of support out there. So many of my friends didn’t continue breastfeeding due to what must have been bad latches and of course they assumed the HVs knew what they were talking about and so trusted their advice but it just wasn’t enough. So much more needs to be done to support new mothers. I appreciate now how lucky I was that my babies latched easily because I was clueless when I started.

  7. Antonia Kinlan

    A wonderful article. I breastfed my daughter to 12 months (despite tongue tie, so much negativity, being shamed into feeding in bathrooms, and even breaking my back) and it never occurred to me to stop because I knew the “benefits” but mostly what had entered my brain was the things that were NOT good for baby if I didn’t (asthma, eczema, poor dental development, increased risk of illness, lack of natural immunity etc.)

  8. Sarah,

    What a good article you wrote! It is really sad to know that so many people give formula, because they do not know how important it is to breastfeed our babies. It is unbelievable how often mothers still think that it is better for the health of their baby to give formula.

    I also believe that it would be better to inform mothers more about breastfeeding and its advantages. We, young mothers, need to be supported by our environment, the doctors and the hospitals en we need to be advised to breastfeed our babies.

    Thank you very much for your article! I hope it will inspire a lot of moms to breastfeed their babies!

  9. Fantastic article Sarah, I wholeheartedly agree. As a breastfeeding supporter myself I hear a barrage of misinformation & myths (& undiagnosed tongue ties!) on a weekly basis, often from health professionals, surrounding breastfeeding and the introduction of formula milk. Not to mention the well meaning comments from the obligatory friends & family of the breastfeeding mother. On the positive, I do feel that attitudes and training are slowly changing in maternity services in my area, especially with the introduction of UNICEF BFI training & assessment as standard for midwives, MCAs, peads & NICU staff. I was lucky enough to attend this two day training with a group of forward thinking newly qualified midwives and the training certainly focused on the risks of formula milk and the necessity of breastfeeding, especially for premature and sick infants. I fully agree this information needs to be relayed to mothers, it certainly feels like ‘informed choice’ isn’t a term that can be used in this instance as most new mum’s are far from informed, the issue of course, lies with HOW. The breast v formula debate is an unfathomably sensitive & emotive one, regardless of stance, so providing true and accurate information is likely to provoke feelings of guilt, failure and anger from a large proportion of society! How do you provide that information without the backlash?

  10. we’ll have to agree to disagree about that change in vocabulary. for me risks of formula vs benefits of bf means the same and when I was preggers I heard both versions. I moved my DD to formula not because I thought it was about equal to bf. in fact I was dead scared of her becoming asthmatic, allergic to everything, constantly ill aso, which luckily she is not. I moved to ff ONLY (and I mean ONLY) because she was not latching on, lost too much weight and I received NO support (despite asking). To say that I and most others mums are probably ill informed about the risks of ff feels quite insulting seeing the docs that we are all given by NHS during pregnancy, which are scaremongering as you like.

    The fact that 83 % of mothers bf their newborns and only 24% exclusively bf after 6 weeks only means one thing: there is not enough support out there, and of course, the undertrained HVs and relatives who just say “give her a bottle” don’t help.

    We know that roughly 2% of mothers unfortunately cannot bf because they have no milk, and there is no cure for it. A bit like some women cannot conceive naturally or carry a baby full term. However, most women just like you Sarah, and myself, move to formula unnecessarily. I suggest that they change the message to “You don’t need formula”, which would apply to over 90% of women who are producing milk, maybe just need help with latching issues or a change in their diets, aso.

    NB: When it comes to the term “breastapo” which I don’t use, it does not refer to bf mothers. It refers to anybody, men or women, parents or childless, doctors or not, who demonise formula and insult ff mothers. If I used that word, I would not label BabyCalm as a member of it.

  11. Not sure how I feel about what you wrote. This may be true in the UK, but in the United States, where I live, it’s not for lack of education that most women turn to formula.

    I knew all of those risks. And I knew all the benefits of bresstfeeding. Times have changed. That information is everywhere. You can’t escape it. That’s great, and I’m glad for this kind of societal change. For a long time that wasn’t the case.

    But breast feeding failed miserably anyway in my case, despite my education, money spent on lactation consultants, and all my breastfeeding gear. My baby was born healthy, full term.

    Let me name a few things that went wrong within the first four weeks, all things that my LC’s neatly devised plans and advice couldn’t fix:

    –Tongue tie. Frenulum cut way too late. Despite a decent latch, she couldn’t suck and would give up and sleep two minutes in, little/no swallowing. In later weeks, due to her bad sucking habits and subsequent reliance on bottles, she would fight me at the breast.

    –A sleepier-than-average newborn who refused to wake every two hours for feeding. Yes, the nurses and LCs tried all the tricks in the book. They wouldn’t let me leave the hospital for three days on account of how bad her feeding was. She didnt.want.to.suck. The nipple shield didn’t help.

    –for whatever reason, she still had the correct amount of wet and soiled diapers, so that was not a good indication of intake.

    –my milk didnt come in until day 5

    –pumped round the clock after her supposed feedings from Day 1 at the hospital. It did little to increase my supply. By week three, I averaged 1.5 oz every few hours. About half the supply I needed. (No, baby wasn’t taking the other half of my milk in! By that time she refused breasts altogether)

    –baby lost more than 10% of her body weight that first week and was not making gains despite LC support and pumping. My pediatrician was freaked and pressured me to give her bottled formula on the spot, threatening me that my baby was close to being sent back to the hospital for testing and failure to thrive

    –the SNS system failed. She wasn’t taking in enough milk with it, and baby’s poor suck still wasn’t stimulating my breasts to make enough milk. She fell asleep a few minutes into it just like with my bare breast.

    –I got sick with a medical facility-spread bacteria spore infection called C-Diff when starting antibiotics for a UTI two weeks postpartum. Raging diarreah and severe abdominal pain made pumping and feeding nearly impossible. I couldn’t sit and pump for ten minutes straight, let alone stay hydrated, eat, or sleep properly.

    –I couldn’t relactate once I got well. Once the milk was gone, it was gone for good.

    These are all things no one tells you. Everyone paints a very rosy picture of breastfeeding and assumes the LC will cure all ills, that if you just hang in long enough, you’ll succeed. I don’t give up easily, and it failed. Miserably. I still shed tears of guilt daily because if it were the olden days, my baby would’ve likely died without the aid of a wet nurse (good luck, lady–baby refuses to suck or swallow!) or goat’s milk.

    I suspect other women put there run into similar problems, stuff other than just sore nipples or bad latch.

    I think the real problem is that LCs can’t be at your bedside 24 hours a day, nor are they free. Books didn’t address my set of BFing problems, and nothing prepared me for how ridiculously horrible, alienating, and emotionally painful this experience would be.

  12. This article has been on my mind since you posted it.

    I wanted to breastfeed, I was aiming for a year. We got to ten weeks, including a hospital stay for mastitis in week two, and by week four as many pain killers as I was allowed in 24 hours to get through the pain. Despite a tongue tie snip in week two, and going to as much breastfeeding support as I could manage – NHS, La Leche, reaching out to friends, watching you tube videos of latching ‘right’, my son’s weight gain was relatively poor and I was in agony.

    I knew the benefits of breast feeding and (most) of the risks of formula.

    If I had read this in January, I would have sobbed more, but I don’t think it would have changed the decision to move on to formula. I am glad you didn’t write this then.

    All I would say, is that when you write about co-sleeping (of which I am a big fan) and you present the scientific evidence, you highlight any flaws with the research. I note there is none of that with the breastfeeding research, and you cite only one study, its very rare that a scientific study is perfect, perhaps you could apply the same rigorousness to the opinions that you agree with to those that you disagree with?

  13. My son is now 13months I still breastfeed him but he also has a couple of bottles of formula. He still wants to breastfeed. I’m up and down like a yoyo about stopping him feeding. But recently, what I am finding really sad is the way as mothers we don’t support eachother instead we seem work against eachother.

  14. I really don’t think that diet causes coeliac disease – my mother had this [though undiagnosed until she was 40] and two other relatives have it too. Though not automatically hereditary, everything I’ve read points to some families having a higher risk of developing it than others. Please don’t blame yourself at all. It is unfortunate but can’t be helped. Luckily it’s much more readily diagnosed now and the choice of foods and places to eat is amazing compared to the 1960s… I remember my mothe making all her bread, scones, buns and ckes as well as teaching full time and running Guides.
    I have an excellent recipe for a rich Christmas cake that works very well with gliten-free flour if anyone wants it.

    Jo Hanson

  15. My goodness another daming article on mothers that don’t breastfeed. For goodness sake please stop. Anyone who feigns ignorance of the merits of breastfeeding these days (certainly in the UK) are in my opinion doing just that feigning ignorance. Breastfeeding is best is on all formula, on posters at the doctors, discussed by midwives, in every baby book, app, blog and website you can think of. Everyone knows breastfeeding is best. Certainly, I agree more support in the practicalities of breastfeeding is of course a good thing and would help many mothers. But debating if we should be saying the risks of formula/not breastfeeding!? Let’s just a bit metaphorical stick and beat new mums up. For goodness sake after struggling with breastfeeding (c section / 10lb+ baby / high initial weight loss at 15.5%) right from the start I carried on for over 3 months. I tortured myself by breastfeeding feeding, then bottle feeding to ensure baby got enough finally sitting attached to pumps for hours a day. Attached to these machines I couldn’t lift or carry my daughter, in fact I couldn’t do much. I’d then get up through the night as baby slept to pump and try to boost supply. I was spending hours which was time taken from my daughter. Quite simply it wasn’t best for my family but whilst I dealt and cried that I was unable to feed my baby I also had to deal with ‘what will people think ofme’. No one should feel like that and I know a number of others who also felt the same. Yes breast is best but if it wasn’t for formula many children simply wouldn’t be here under the blanket of failure to thrive. Please continue to push breastfeeding is best but let’s give formula it’s place as a fantastic and wonderful tool for those that are unable to breastfeed.

  16. You write about letting go of guilt but pile it on a bit here. I did my best to exclusively breastfeed but despite my best efforts & several visits with lactation consultants,my son refused to latch on, every feed was a struggle and frankly traumatic for both of us. I stuck with it for 3 months, a large portion of which was spent attatched to a breast pump, but had nowhere near enough milk for him. As he got bigger and hungrier he was mostly on formula anyway so I weaned him (actually he kind of weaned himself,I offered boob but didn’t push it if he wasn’t interested and he didn’t seem to miss it at all). I got sick & tired of smug mothers asking me if I was still breastfeeding and then exclaiming in suprise ‘oh well he looks really healthy anyway’ when I said no, as though I was feeding him poison. Now apparently I’m giving him cancer & making him obese as well! I’ve looked into the research on these theories and its pretty sketchy, whilst breastmilk is undoubtedly the best milk for bub, there are so many carcinogens that we’re all exposed to on a daily basis, I think formula is the least of our worries. All this kind of article serves to do is make mums who struggle with breastfeeding feel inadequate.

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