The Twists and Turns of Infant Feeding: Continuing the Journey
Earlier this month we highlighted the exclusive pumping experiences of 3 mothers, 2 sets of twins, and a total of 180 ounces of breast milk produced daily. The experiences of these moms demonstrated how infant feeding isn’t one-size-fits-all.
To celebrate the end of National Breastfeeding Month, we’re introducing 3 new mothers: one who’s tried everything under the sun to feed her child, one whose choice to formula feed improved her mental health and relationship with her child, and one who’s been exclusively breastfeeding for almost a decade in total. While each of these moms experienced a wide variety of unseen challenges, they ultimately all chose what was best for them and their families.
Maddie: Everything Under the Sun
Meet Maddie, 35, a mother to her 4-year-old son and most recently, her 10-month-old son. She’s somewhat of a ‘renaissance woman’ in the infant feeding world, having tried almost everything you can imagine to optimize her children's feeding journeys.
When we asked Maddie to think back 4 years to her infant feeding goals for her first child, her answer was straightforward: she always assumed she would be able to exclusively breastfeed. Her postpartum reality, however, started off with a lip and tongue tie that went undiagnosed until her son was 6 weeks old. “I wish there was more education around the importance of the first few weeks…from everything I’ve learned, that’s the most important period for getting your [milk] supply set up”, she explained.
“I never made more than half of what he needed for the entirety of his breastfeeding experience”
Maddie went to a lactation consultant in Charlotte, NC when her son was 6 weeks old - which is when the lip and tongue tie was diagnosed. Maddie described her consultant as a savior. Her son was underweight and the consultant was direct with Maddie: “‘I'm gonna do the best I can with you. I'm gonna put you on a crazy regimen, but you're not ever going to make enough milk.” Maddie shared with us, “that’s kind of what I loved about her, she was very real, very honest.” The lactation consultant ultimately helped her increase her milk supply from milliliters to 5-6 ounces a day, a process that required Maddie to put in work 24/7.
“I was nursing six times a day, and then pumping 12 times a day, including like 4 pumps in the middle of the night. So I was barely sleeping. I was just pumping all day.”
Though Maddie was able to increase her milk supply, she had to supplement with infant formula as well. Maddie’s family is dairy free; she couldn’t find any plant-based formulas that she felt were healthy enough for her child on the first pass. After an exhaustive search, she ended up using a soy formula that she was unsatisfied with, sharing, “I had to do what I had to do”. She gave donor milk a try as well, an incredible help to many mothers, but a process that requires constant scheduling and became logistically challenging for Maddie. Informal milk sharing has historically been relevant to infant feeding but modernly comes with risks from its lack of regulation, high expense or reliance on prescription requirements, and barriers to access for mothers who live rurally .
The experimental effort to best feed her baby didn’t stop there though, “I tried everything you could possibly imagine. I took supplements, I ate as much oatmeal as possible, and the last thing I tried was domperidone, a drug not allowed in the US, for good reason.” Domperidone is sometimes used to increase maternal milk production in other countries, and the side effects for mothers vary in severity (it’s worth mentioning that there are many studies showing no side effects from domperidone on infant health). The FDA has warned against the use of domperidone because they cannot guarantee the quality of the product . “[Domperidone] made me very ill, to the point that I ended up having to have surgery after my second was born because of some repercussions that the prescription drug caused four years later. So that was a mistake, but, you know, there wasn't anything I wasn't gonna try.”
Maddie maintained her 5-6 ounce-a-day milk supply for a year while supplementing with soy formula. In preparation for her second born, she started going to a lactation consultant before giving birth. She planned to start milk production before her son entered the world - and it paid off. She now pumps upwards of 9 ounces in her morning pump alone, has been exclusively feeding him breast milk, and has even had the opportunity to donate milk. “I thought it wasn’t possible”, she explained.
Maddie multitasking while breastfeeding.
Maddie’s biggest takeaway? “Get a lactation consultant even if you don’t think you need one. Focus on your self-care and the baby; focus on really building that bond; if you want to succeed at breastfeeding, [the first 6-12 weeks] is the most important time.”
Alejandra: Formula, For Mom and Baby’s Well Being
Alejandra (some may know her by her Instagram handle, @mamaconformula), is an activist for guilt-free motherhood, a mom to a 2-year-old girl, and recently added a 6-month-old son to her world. Her formative infant feeding experience with her first born has helped to shape an educational career for her: one where she shares scientific information on a platform with over 24,000 followers on infant formula, breastfeeding, and mixed supplemental feeding. She’s spent years teaching herself about infant formula, the science behind breastfeeding, and has completed lactation consultant courses.
When Alejandra gave birth to her daughter, it took about 2 weeks for her milk to come in. She tried everything she could, had multiple appointments with lactation consultants, many clinical consultations, and the consensus always seemed to be the same: everyone told her she was fine, even as her daughter lost over 20% of her body weight in her first week of life. She started supplementing with formula to keep her daughter’s caloric intake up, but was frustrated with the cards she was dealt; the health benefits of breast milk were important to her, and the cultural norms in Chile (her home) strongly promote exclusive breastfeeding. “It’s hard for a new mom to make the decision in the clinic if you want to use formula here… you can ask for it but if they don’t want to give it to you, they don’t have to give it to you. You are at the mercy of the nurses and doctors.”
After consistently pumping for 2 weeks, her milk supply finally came in. However, the mental toll of pumping for 2 weeks with no milk output never faded: “The sole noise of the pump gave me chills. If it had been only my decision with no one around, I would have stopped [pumping] at 1 month.” When her daughter was 5 months old, Alejandra decided to exclusively formula feed.
“We [Alejandra and her daughter] were in a fight. Every time she had to eat, it was like a fight with her. I didn’t want to do it anymore.”
Though her husband and family were supportive of her decision, the societal guilt began to build up. She described her ‘breaking point’ to us, which resulted in the creation of her current Instagram page, @mamaconformula. She was at a party and a woman approached her asking why she hadn’t seen Alejandra feeding her daughter breast milk. Even after she explained how formula feeding was better for her mental health and that she and her daughter were both happier that way, the woman responded by condemning her decision, quipping, “why would she do that to her daughter”.
Alejandra recognized that she was not the only one experiencing the pressure from society to exclusively breastfeed. Her Instagram account resulted from a combination of universal mom-guilt in the infant feeding space and lack of pediatric advice on infant formulas in Latin America. Within one week she had over 2,000 followers, a majority from women in Latin American countries as — “there’s no one here talking about it”.
An example post from Alejandra's Instagram.
She now spreads scientific knowledge on choosing infant formulas, how to mix-feed with breast milk and formula, and shares mother’s stories on their feeding experience to prove that no one is alone.
“Formula and breast milk are like enemies for some people, but they can live together. That’s my goal, to show people that they can live together.”
Alejandra receives an influx of inquiries from moms seeking advice and information on infant feeding, so she is constantly studying to make sure she is sharing scientifically correct information. She has even created her own reference database of pediatricians in Latin America that support supplemental formula feeding.
Her biggest piece of advice for new parents? “Trust your instincts. It's amazing how we as a mother or father know exactly what our kids need.”
Jessica: 101 Months and Counting
Meet Jessica, 44, mother to 4 children (ages: 15, 9, 7, and 3), and has lactated for a total of 101 months and counting throughout her life. 15 years ago, when she gave birth to her first daughter, she didn’t have any explicit infant feeding goals. She intended to breastfeed but was working full-time so she assumed she would have to pump as well. Her postpartum reality included an emergency delivery at 34 weeks due to severe preeclampsia. Jessica and her daughter’s discharge from the hospital didn’t last long, they were readmitted shortly after because of feeding issues. “I felt like my body had failed her in that I hadn’t carried her to term”. Jessica’s daughter was tiny weighing 3 pounds and 12 ounces, wasn't able to take in enough milk via bottle, and was not able to breastfeed at all due to latching issues.
Jessica’s first-born receiving breast milk via a nasogastric tube
This resulted in a resilient determination to provide breast milk for her daughter. However, Jessica still felt very ill due to her preeclampsia, so she was “prompted to pump” by the hospital’s lactation consultant.
“[I] was kind of given permission to exclusively pump. That really hadn’t been in the paradigm or what I thought, that you could feed breast milk without breastfeeding. Going back 15 years, the tone of not shaming mothers who choose not to or cannot breastfeed has changed a fair amount in that time.”
For the next 4 months, she exclusively pumped every 3-4 hours around the clock to keep her milk supply up. Her daughter eventually learned how to latch at 4 months old and was officially weaned off of breast milk at 18 months with no supplementation needed, a milestone worth celebrating especially given the circumstances of her early postpartum experience. Her following breastfeeding journeys only increased in duration: her second weaned at 20 months, and her third at 25 months.
Fast forward to Jessica’s fourth child, currently 3 years old, and still nursing from the breast. “Pumping was a huge part of my first baby’s experience. It’s been almost no part of my fourth baby’s experience”. Her experience with her fourth child brings an interesting perspective to the infant feeding conversation: how do you balance comfort nursing from the breast with a child who can now verbally communicate?
“She’s a ‘three-nager’ and a strong-willed kid. If it were up to her, mom’s diner would be open 24/7”
Jessica explained that she plans to wean her daughter soon for many reasons, one of which revolves around the conversation of bodily autonomy. Jessica talked about how she is now trying to show her daughter that she doesn’t have to hug or physically interact with someone if she doesn’t want to and she has the right to say no if she is uncomfortable. However, this can be difficult to teach when the same daughter is reaching for her mother’s breasts, “I really feel like I’m dancing the line of enabling a demanding behavior at this point. Which I would never say about any other woman, I’m not judging someone who feeds their kid till however old… I just know my kid. I know this is part of her nourishment to some degree, but this is my body and I’m not comfortable, and we get into an argument about that. It’s so bizarre. I get ‘no means no’ too.” Her second reason for weaning:
“I have been breastfeeding for 101 months and counting over the course of my life. It's been almost eight and a half years, I’m 44, and I’m just kind of tired.”
From experiencing the trauma of her first birth’s complications, to pumping on bathroom floors in her workplace, Jessica is a seasoned veteran in infant feeding. She closes this series with her biggest advice for new parents: “Give yourself grace, but also think outside your box. There’s so many perspectives on nourishing both with nutrition and love for your babies. There’s so many ways to meet their needs, and that makes all the difference because every child and feeding parent is different. Knowledge is what empowers you to make that choice.”
Cohen, M. (n.d.). Should human milk be regulated? UCI Law Scholarly Commons. Retrieved August 30, 2022, from https://scholarship.law.uci.edu/ucilr/vol9/iss3/4/
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