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It's the breast for us.
February 21, 2010 3:49 PM   Subscribe

Breastfeeding has a variety of health benefits for both the mother and the infant. The World Heath Organization has a global strategy to encourage it, and Salma Hayek famously breastfed a baby in Africa. When mothers New York City have trouble with this sometimes difficult task, they bring in Frenda Rosenfeld, a certified lactation consultant.
posted by elder18 (84 comments total) 3 users marked this as a favorite

 
Enter the lactation consultant. Ms. Rosenfeld was certified in 1990; there are now some 20,000 worldwide, including 582 in New York State.

It's news to me that this is news or unusual. The hospital we had our kids at (two different ones ranging from 1999 to 2007) all had lactation consultants on staff. They typically visit the maternity ward for first-time mothers but also for other circumstances (twins, etc). And you can call them for advice.
posted by DU at 4:01 PM on February 21, 2010 [2 favorites]


Yes, lactation consultants are pretty standard here in Canada. Last April the lactation consultant was the first person we met when we checked into the maternity ward. We had them in England too, in 1999. And they are worth their weight in gold.
posted by unSane at 4:03 PM on February 21, 2010


Can I ask what the point of this post is? What value this adds to the front page, what enetertainment or discussion value will be generated, what information shared? Seems pretty odd, pretty weak to me.
posted by wilful at 4:05 PM on February 21, 2010 [3 favorites]


Can I ask what the point of this post is?

It's an article from today's New York Times and some padding. So that people wouldn't complain about a single link to an article in today's New York Times, presumably.
posted by mr_roboto at 4:08 PM on February 21, 2010 [2 favorites]


I'm continually amazed at how many young parents just assume that they're going to bottle-feed their baby from day one, as if there's no other way to do it.
posted by dunkadunc at 4:08 PM on February 21, 2010 [2 favorites]


Um, yeah, not new. La Leche League International has been certifying lactation consultants since 1956 and has a presence in 68 countries, many of which are not Brooklyn.
posted by AlsoMike at 4:10 PM on February 21, 2010 [7 favorites]


Yeah, I'm curious as to what she would have done differently from the three IBCLCs I saw after leaving the hospital with my son that would have saved my milk supply.

And two of those three came to my house. I didn't go anywhere.

And nursing for a year is hardly "trouble nursing."
posted by zizzle at 4:11 PM on February 21, 2010


Post seems fine to me. And there are more constructive ways to note otherwise if you disagree.

This said, I found this sentence a bit odd, "The clip of Hayek nursing a very hungry baby boy (ironically born on the same day as her own daughter) has surfaced on YouTube as well as on dozens of other web sites, drawing thousands of comments."

I'm missing the irony. Not all coincidence is irony. This is like Alanis Morissette style irony.
posted by cjorgensen at 4:12 PM on February 21, 2010


La Leche League International has been certifying lactation consultants since 1956 and has a presence in 68 countries, many of which are not Brooklyn.

I found out about Le Leche by reading an article in today's New York Times! It's the same article that elder18 linked to in his post, here, believe it or not!

There, I also read about the International Board of International Lactation Consultant Examiners, which certifies consultants in 87 countries.

Reading is amazing!
posted by mr_roboto at 4:14 PM on February 21, 2010


My mom spent the last 10 years of a 30 year career as an OB nurse (and a 40 year nursing career) as a part-time Lactation Consultant, which her hospital offered as a free service to their patients. She set up the program, and worked with the various organizations to set in place good practices that are now mandatory though the larger network her hospital was a part of. She's proud of it - it's her life's work, she believes in it passionately - and when problems arose, and my wife just couldn't continue, my mom was supportive and enthusiastic and helpful in transitioning us to formula, as a happy, healthy baby is her goal.

Yeah, she's my Mom, but she did this sort of thing for everyone who came to her for help. Our baby is happy and healthy and growing like a weed.

What these people do is very important - every time you see a three-month-old with a bottle full of apple juice or fruit punch, given to them by desperate or ignorant parents, or you notice that formula is kept under lock and key as it's =the= single most shoplifted item, you see a reason for Lactation Consultants.
posted by Slap*Happy at 4:14 PM on February 21, 2010 [3 favorites]


Lactation consultants are a godsend. New baby, new mom, neither of which have any experience breastfeeding? Bring in the lactation consultant.

Ours was a tremendous help. Aside from pointing out some things that made the process go a lot smoother, they helped my wife understand that it's normal to experience the problems she was having, and that there was light at the end of the tunnel.

Things got a lot better immediately after the LC arrived at our house.
posted by spikeleemajortomdickandharryconnickjrmints at 4:16 PM on February 21, 2010


or you notice that formula is kept under lock and key as it's =the= single most shoplifted item,

Really? It's not locked up around here.

What an odd thing to shoplift, but then, people seem so very confused about breastfeeding.
posted by madajb at 4:17 PM on February 21, 2010


Were the article on a topic that's been commonplace for 50+ years and it was also factually groundless and focused mostly on the author's friends, well, it would be in the Style section. Just dated and factually iffy? That can go anywhere in the Times.
posted by allen.spaulding at 4:18 PM on February 21, 2010


Can I ask what the point of this post is?

My name is jimmythefish, and I approve of this post and, indeed, any post which reaches out and holds boobs in a good light. They are far too often ignored on the internet.
posted by jimmythefish at 4:19 PM on February 21, 2010


Madajib, when you're spending over $100/month on formula and you're making minimum wage, you'd be tempted to shoplift, too.

Many women who don't breastfeed are low income and they formula feed because they have to go back to work before breastfeeding can be successfully established because they don't have maternity benefits, or if they do, it's all unpaid, and they just can't afford not to work at all for any length of time. Some may qualify for WIC, which would assist both with the breastfeeding and cost of formula, but some won't because they make just a bit too much. Those ones are left on their own --- so they don't qualify for assistance, but they can't afford formula, either.

I've said it before and I'll say it again, if people want to increase the number of women of breastfeeding, then maternity benefits need to be improved first. When woman have the time and the means to learn how, then breastfeeding rates will rise as will duration of breastfeeding. Organizations like LLL that do nothing to improve maternity benefits but decry women who formula feed are putting the cart before the horse.
posted by zizzle at 4:22 PM on February 21, 2010 [32 favorites]


1 Breastfeeding is great. People who object to breastfeeding on aesthetic or "moral" grounds are wrong.

2 Breastfeeding is of enormous benefit where clean tapwater and sterilising systems are unavailable - that is, most of the developing world, which has an appalling rate of infant mortality and morbidity.

3 I can't find any good scientific evidence showing that breastfeeding is better than bottle feeding for careful, smart Westerners. It's all people asserting this and linking to each other. Has anyone got any?
posted by alasdair at 4:23 PM on February 21, 2010


What an odd thing to shoplift

It's expensive and essential to taking care of your baby if you can't/don't breastfeed.

That or it's used to produce meth, I guess.
posted by sallybrown at 4:25 PM on February 21, 2010 [1 favorite]


3 I can't find any good scientific evidence showing that breastfeeding is better than bottle feeding for careful, smart Westerners. It's all people asserting this and linking to each other. Has anyone got any?

The section title "The Need" in this policy paper from the American Academy of Pediatrics reviews the literature related to health benefits of breast feeding specifically in developed countries. (They even bold the word "developed").
posted by mr_roboto at 4:33 PM on February 21, 2010 [1 favorite]


Do the Hasid breastfeed? Just trying to tie these two FPPs together.
posted by fixedgear at 4:33 PM on February 21, 2010


Anyway, the literature is extensive. I'm surprised you had a hard time finding it.
posted by mr_roboto at 4:34 PM on February 21, 2010


What an odd thing to shoplift, but then, people seem so very confused about breastfeeding.

Five years ago, powdered formula ran about 25.00/can. A can lasts maybe 4 days for a baby who eats a lot (ours did). I'm sure it's more expensive now. You can get help through WIC and formula coupons, but you have to know how. Not always easy for a working newborn's mom.

Low income moms are those least likely to have the education/help/or support from employers to breastfeed (support meaning time to pump, a refrigerator for storing milk, time to go change your shirt when your milk lets down unexpectedly etc). Also, infants tend to glom on to a particular brand, and so you can't buy whatever's on sale if you want your baby to eat. Thus: shoplifted formula.

Or worse, cow's milk too soon, overdiluted formula, or apple juice. My MIL is a lactation consultant and once had to tell a woman that no, V-8 juice was not good for 2 week old babies.

Or even worse, stolen and sometimes doctored formula off the back of a truck from some dude. Black-market formula is apparently a big business. Not all of it is actually safe.

Breastfeeding, as this article indirectly illustrates (180.00 a consult=not happening for lots of moms) is a class issue.

alasdair, really? Is it so hard to believe that milk that is human is better for humans? Cow's milk contains more sugar and the makeup of it is significantly different from human milk. Formula is basically powdered cow's milk (or soy-based) with many compounds added/subtracted to make it palatable for humans. It works, for most kids. But it is not as close a match to their nutritional needs as their own mother's milk. Or even another woman's milk. Some babies cannot accept any formula, no matter how well-done, and so have to have very expensive milk-bank milk from women.

My son was formula-fed out of medical necessity, and thankfully he did not have any allergies that made it impossible. He'll probably be fine, but I would have been able to give him more of my own immunities with my breastmilk (a fact easily Google-verifiable I would think, not going to do such basic research for you).
posted by emjaybee at 4:41 PM on February 21, 2010 [5 favorites]


Alasdair -

There was an article in the Atlantic Monthly last year looking for the same evidence. The author couldn't find any medical studies that conclusively proved there are any lasting benefits of breast over the bottle.
posted by bgroff at 4:43 PM on February 21, 2010 [3 favorites]


I breastfed until I was 3.5 years old. :)
posted by kalessin at 4:44 PM on February 21, 2010


Breast milk contains phenylalanine, which is the SAME poisonous neurotoxin found in aspartame. Why are we teaching mothers to poison their children hamburger?
posted by shii at 4:44 PM on February 21, 2010


I can't find any good scientific evidence showing that breastfeeding is better than bottle feeding for careful, smart Westerners. It's all people asserting this and linking to each other. Has anyone got any?

There are certainly benefits to breastfeeding, but they have been pretty exaggerated. The biggest benefit is that the mother passes certain immunoglobulins to the baby through her breast milk. These help prevent digestive issues, especially diarrhea, which can be pretty severe for babies.

There are other claims linking breastfeeding to higher IQs, and claims that the mother passes along antibodies that help prevent things like ear infections. Really, though, the mother passes most of her antibodies to the baby through the placenta during pregnancy. The fact is that breastfeeding does have advantages, but those advantages have been exaggerated in the interest of encouraging more women to breastfeed (and sometimes demonizing women who don't breastfeed, which is wrong).
posted by lexicakes at 4:45 PM on February 21, 2010 [5 favorites]


Breastfeeding is of enormous benefit where clean tapwater and sterilising systems are unavailable - that is, most of the developing world, which has an appalling rate of infant mortality and morbidity.

One of the allegations I keep seeing hurled at Nestle is that they run ads in developing nations which assert that their formula is better for babies than breastmilk- leading not only to people spending tons of money on overpriced baby formula but also to dead babies thanks to the formula being mixed with dirty water.
posted by Pope Guilty at 4:53 PM on February 21, 2010 [1 favorite]


FYI, I know someone who feeds her baby bottles of Karo syrup dissolved in water and decided before her child was born not to breastfeed because "it's gross." It's her choice, but Karo syrup?
posted by spikeleemajortomdickandharryconnickjrmints at 4:54 PM on February 21, 2010


zizzle and emjaybee bring up great points. Breastfeeding needs time to be properly established, and once it is, it takes time (shirt changing, pumping and fridges) to be able to do when not around the baby. Women need better maternity benefits. Basta.

Lactation consultants? Here's my free advice: drink lots of water, if you feel blocks take hot showers where you massage your breasts (or rather milk them) until you lactate a steady stream, it'll get the block out, and that painful time before the milk really kicks in will pass, so hang in there.
posted by dabitch at 5:00 PM on February 21, 2010


I know someone who feeds her baby bottles of Karo syrup dissolved in water

Call CPS. Seriously, for the love of god, CALL CPS.
posted by Pope Guilty at 5:00 PM on February 21, 2010 [6 favorites]


I know someone who feeds her baby bottles of Karo syrup dissolved in water

Why Karo syrup? Has she explained why she goes for that rather than formula (or even juice)?
posted by lexicakes at 5:03 PM on February 21, 2010


when i gave birth to Thing1 i knew i was going to breastfeed. i had to pay extra for the lactation consultant because the insurance company wouldnt cover any of it and the hospital only offered a one-time, 20 moms at the same time "this is how you feed your baby" talk RIGHT AFTER WE GAVE BIRTH!

but what really infuriated me was that not only the hospital kept stocking my room with infant formula that my mom and the father of my children would have to return. the hospital had not trained many of the nurses and NA's in breastfeeding and they kept pushing for feeding my son with formula whenever he cried while i was asleep --i was in the hospital for a while due to c-section.

and to add insult to injury, the hospital gave a manufacturer of baby formula our address so they could, surprise surprise, deliver a while box of it to our door.

ask me if i consider the infant formula industry as EVIL
posted by liza at 5:04 PM on February 21, 2010 [6 favorites]


Lactation consultants can be a godsend or a miserable curse. There is such a thing as taking a good idea and turning it into a dogmatic cudgel against parents already nearing the break of sanity.
posted by docpops at 5:07 PM on February 21, 2010 [6 favorites]


breastfeeding is great for women who can do it - i don't think anyone is arguing against that.

however - in my 10 years working at a mall portrait studio i had a lot of those lower middle class to near poverty moms who had been given such a huge guilt trip over breast feeding that they felt like terrible mothers because they couldn't afford lactation specialists, couldn't take the time off work after the birth to really get it right, and were given no access to break time/space to pump (much less had the spare money to buy a good pump).

i think it's important in the developed nations to separate fact from fiction with regards to benefits/harm on breastfeeding/formula. first time parents are given so much crappy information that doesn't help their already elevated stress levels.
posted by nadawi at 5:11 PM on February 21, 2010 [2 favorites]


The Facebook breastfeeding picture war continues.

Then there's the Nestle boycott, which has been going on since 1977. I posted the Wikepedia link, as it's hard to find a neutral link on the subject.

I breastfed both my kids, switching to the bottle w/my first due to low weight gain. Back then, lactation consultants were not common in small New England towns. My mom and sister both bottle fed, so didn't have any tips for me. They fed their babies on a 4 hour schedule & breastfed babies need more feedings at first. Nobody around me knew. The doc recommended formula so I did and she grew up fine.

I don't think it's fair to decry either breastfeeding moms or bottle feeding moms, and everyone should do their research while expecting and decide what's best for them and their situation. The only thing I really hate about formula feeding is the tendency to prop the bottle up and walk away from the baby instead of holding them.

Also, the breastfeeding is gross thing is only in the U.S. as far as I know. So many generations have bottle fed that it's considered out of fashion still in some circles. Karo syrup is not just gross, it's grossly negligent to feed a baby something w/so little nutrional value. Especially when they have WIC programs to get free formula.
posted by Marie Mon Dieu at 5:14 PM on February 21, 2010


I'm sure there are lactation consultants who do amazing work and provide a fantastic service to their communities.

However, my experience with the ones we interacted with in the hospital after my kids were born in an emergency c-section, and with La Leche League several months later were profoundly negative and disturbing. I would never, ever recommend that any new mother consult La Leche League in any way.

First, the lactation nurses at the hospital tried to make my wife feel like an unfit mother when our preemie twins didn't latch on. My kids were fed pumped breast milk out of bottles for *three months* before demand began to outpace production. When my wife called La Leche League to ask for help and advice, they told her that pumped breast milk wasn't good enough. In fact, one lactation consultant at LLL had the balls to tell her she was being "selfish"(!) when she was physically unable to produce enough milk to keep up with our kids' needs, and then again because she wasn't feeding them from the breast. They said she was denying them the important tactile experience of breastfeeding.

As for the shoplifting issue, I can only add that my kids' formula cost about $200 per month when we initially put them on it. At the end of their first year, it was costing us about $250 per month. (They were drinking more.) Diapers and wipes were also a major expense. We made the kids' food ourselves instead of buying jarred stuff, but I can imagine that would have been a big expense as well. It doesn't surprise me that some parents find it difficult to make ends meet.
posted by zarq at 5:18 PM on February 21, 2010 [5 favorites]


shirt changing

What? I breastfed my daughter for almost 2 years. I went back to work full time in a professional environment 7 weeks after her birth. I never had to change my shirt.

I was successful because I had strong breastfeeding role models (my mother home birthed and breastfed 3 siblings), I was REALLY determined, I could afford a good pump, my boss allowed and my coworkers supported 2 breaks a day for pumping, and my workplace had a (couple of) dedicated spaces for pumping. Even with all of those supports, the first couple of weeks was tough. I never considered formula an option for us, but I can completely understand how mothers without my history and support could opt for what seems easier.

That said, I think when healthy moms and healthy babies in middle class homes with good support and resources opt for formula-feeding - that is sad. The biggest benefit I saw from breastfeeding was the hormone dump. All that oxytocin makes you feel calm, loving, patient, and peaceful - exactly what you need to parent an infant. It is a wonderful synergy of good health for the baby and good health for you. I don't understand why moms dismiss that for the expense and inconvenience of formula feeding.
posted by jeoc at 5:29 PM on February 21, 2010 [2 favorites]


FYI: The Case Against Breastfeeding.
posted by Jacqueline at 5:30 PM on February 21, 2010


zarq & liza- stories like that piss me off so much. like new moms need any more grief, especially the mom of twins or after a c-section! that's why this whole "breast feeding is best"/"formula is best" BS needs to end and be replaced with "if you can breastfeed without adding stress to an already stressful situation, that's great. if you can't - there are worse things than formula to feed your child (like karo syrup!)"


the guilt trips don't stop with how to feed the kid, either - i had moms tell me horror stories about doctors that would freak out because the kid didn't sit up on their own until late 6, early 7 months - or was a little late cutting the first teeth - or did words before walking. just like everything with humans, babies aren't one size fits all. development and nutrition are individual things and should be treated as such. but that doesn't sell books and it's hard to advertise that with multi million dollar budgets.
posted by nadawi at 5:31 PM on February 21, 2010 [4 favorites]


nadawi, I was completely infuriated. My wife was already feeling insecure and overwhelmed in the hospital. The last thing she needed was to be guilt-tripped for any reason, especially considering that she believed the problem was her fault.

Liza, we had the opposite experience. I'm sorry you went through that. :(

The hospital did give us a can of formula. We signed ourselves up on Enfamil's website ourselves, so that if and when we needed coupons, we'd have them. (I was very thankful for that when we did switch.) But my wife had one-on-one appointments with lactation consultants two times a day in her room until she was released. (She went home on the fifth day after her c-section.)
posted by zarq at 5:48 PM on February 21, 2010 [1 favorite]


My cousin just gave birth about six months ago - a terribly traumatic event that required three surgeries. In preparation for the surgeries she was dealing with the stress of having an infant and trying to nurse him. She found nursing almost impossible, and when she was finally told that she COULDN'T nurse because of the antibiotics/surgeries/whatever, it was like the clouds parted and she realized that this whole awful experience didn't have to be quite so awful.

Like nadawi, I feel so sorry for women who are made to feel bad because they aren't doing things the "right" way. Whatever you happen to think that "right" way is - bottle or boob.
posted by greekphilosophy at 5:52 PM on February 21, 2010


Just looked up Karo syrup , that baby is going to die. CALL HELP!
posted by dabitch at 6:00 PM on February 21, 2010 [1 favorite]


jeoc , you never had to change because you had time to pump.
posted by dabitch at 6:04 PM on February 21, 2010 [1 favorite]


just like everything with humans, babies aren't one size fits all. development and nutrition are individual things and should be treated as such. but that doesn't sell books and it's hard to advertise that with multi million dollar budgets.

Truer words were never spoken.
posted by zarq at 6:06 PM on February 21, 2010


A (not distant enough) relation put her newborn on a diet.

We probably should have called CPS.

The Karo syrup thing is just hard to grok though. Does Mom herself like a good stiff Karo at the end of the day, and figure if it's good enough for her, then it's good enough for the critter? I mean... what? Is there some unraw-food movement of which I'm blissfully ignorant? I'd have expected Metafilter would have ridiculed it by now.
posted by Rat Spatula at 6:13 PM on February 21, 2010


Zarq, I had a woman come up to me on the subway in Boston when I was taking my son home from a sick visit to the doctor. She saw me mixing a bottle on the train, and she told me directly that I was poisoning him and I should be breastfeeding.

I was dumbfounded. She said this to a woman who spent the first three months of her son's life nursing on demand for however long it took but definitely no less than every two hours, pumping after every single feeding, giving back what was pumped to the baby instead of saving it (what was pumped in those ten minutes was maybe a .25/oz), supplementing with a .25 - 1 oz of formula if needed, rinse, lather, repeat. I took fenugreek, blessed thistle, drank dark beers, ate oatmeal, made lactation smoothies and cookies full of proteins and healthy stuff (recipes found in books), went to breastfeeding support meetings, and eventually went on Reglan for close to a month.

And you know what? I still didn't produce enough milk! Yet this woman had the nerve to tell me I was poisoning my son three weeks after I gave up nursing because all my time was spent feeding the baby and doing absolutely nothing else for essentially nothing as he stopped gaining weight. We made great progress around 4-6 weeks, but around weeks 9-10, he stopped gaining weight again. I was done with the pumping. I was done with the herbs. I was done with holding my baby for ten minutes/day for non-feeding reasons. I was done with trying to breastfeed. I worked my butt off trying, and it still didn't work, so we went to formula so I could be a better mother overall. And then this woman comes along and tells me I was poisoning him. What the hell, people? That didn't exactly engender me to the breastfeeding cause, and I'm kinda pissed that I couldn't receive formula coupons and samples in the mail because Massachusetts banned the practice. They sure could have helped us out.

(Yes, his latch was perfect. No, he didn't have problems.)
posted by zizzle at 6:19 PM on February 21, 2010 [4 favorites]


The Karo Thing:

My wife said that it's not straight Karo. It's 2-3 tablespoons of Karo dissolved in water. We saw this being done during Christmas and we were both kinda stunned by it. We asked if the doctor prescribed this or something (does the kid have a problem gaining weight? Is there a medical necessity for corn syrup at 5 weeks?), and were told that all the babies on the mother's side of the family "just loved Karo", and that it helped them to "not be colic-y."
posted by spikeleemajortomdickandharryconnickjrmints at 6:22 PM on February 21, 2010


Of course they love Karo. It's corn syrup. That babies love it doesn't mean that they should have it.
posted by Pope Guilty at 6:24 PM on February 21, 2010


Unless we plan to directly take up the care of such babies I think it is rarely if ever okay for us to moralize about how folks feed or care for their babies.

Also, maybe take the Karo syrup convo to metatalk?
posted by kalessin at 6:30 PM on February 21, 2010


Dude I'm not defending it. Apparently it's a rural Texas old wives' tale.
posted by spikeleemajortomdickandharryconnickjrmints at 6:31 PM on February 21, 2010


All other things being equal, breastmilk is obviously best for babies and for mothers. It's cheap, it's convenient, it's easier on wee tummies.

all other things, though, are almost never equal. Women have to go back to work when their babies are days old, or people have had breast reduction surgery, or babies have a tongue tie, or production just isn't there for a zillion reasons. Formula has its place, and I say this as a woman who weaned my daughter a week before her third birthday. Women inevitably make the best decisions they can with the information and resources they have available, and it angers me beyond anything when the judgment and condemnation that SHOULD be pointed at the culture that separates women from very young babies and refuses to make room for parenthood instead comes down on new parents like a ton of furious bricks.

Breastfeeding was easy for me. My mother is a La Leche League leader, and I grew up surrounded by nursing mothers. I had seen hundreds of babies nursed and dozens of nursing troubles fixed. I gave birth in a hospital with strong nursing support, including 24x7 access to a lactation consultant for a year after birth. I didn't have to go back to work, my husband took six weeks off, and my mother stayed with us for the first ten days. But for the woman who's never seen a newborn baby latch on in her life, who has no partner at home for the first weeks of her baby's life, or who goes back to work at a job that may not have any more support for a nursing mother than "if you can find a place to pump, we won't fire you as long as you don't take more than 15 minutes twice a day," it can be an insurmountable issue even without an underlying medical reason.
posted by KathrynT at 6:52 PM on February 21, 2010


feed babies karo syrup

hot damn. apparently a lot of pages out there for that. seems to be suggested for constipation, not colic though. still, seems like not the best and brightest of all ideas.
posted by nadawi at 6:53 PM on February 21, 2010


Oh, and my two uncles were fed exclusively on evaporated cow's milk diluted with tap water and sweetened up with Karo. For reals. They both survived to adulthood.
posted by KathrynT at 6:53 PM on February 21, 2010


My first three babies were born in a fantastic private hospital which had lactation consultants on staff who were not only available if needed, but insisted on checking on every breastfeeding mom. My first grabbed on and started sucking hard right after birth and I thought we were golden. The lactation consultant wouldn't take my word for it that everything was fine and kept coming back until it was a good time to watch me nurse. Turns out it was painful because my daughter wasn't doing it right, not because I just wasn't used to it. They worked with her for a while, it stopped hurting, and I was able to nurse for fifteen months. They were even available for free consultations for several months after birth if problems came up.

My youngest was born in a pretty crappy hospital that serves a lot of poorer women. They offered an optional class, but no individual consulting. If there had been a problem, I would have been on my own. Up to that point I assumed that the support I got at the first hospital was maybe above average, but not atypical. Evidently I was wrong.

For the record - I've heard of the Karo syrup thing too. It's not for nutrition - it's something extra to soothe a fussy baby. Bad idea in my opinion, but not likely to be fatal.
posted by Dojie at 6:55 PM on February 21, 2010


My Mom had us mix a half-tablespoon of Karo into 4 oz. of formula once a day - this was to relieve constipation. It didn't work all that well, so she had us switch to a half teaspoon of prune juice, and had us stop when baby was dropping diaper-bombs on a daily basis.

It is emphatically not a part of a daily diet, and will likely make the kid seriously sick, or worse, if he doesn't get enough formula because Mommy thinks Karo is a good substitute.

And Lactation Consultants are only a class thing in ass-backward hellholes that don't have socialized medicine... like Brooklyn. (My Mom's hospital in urban New England offered free consulting to their current and former OB patients, as well as grief counseling if needed. This is not usual practice in the US, alack.)
posted by Slap*Happy at 7:04 PM on February 21, 2010


lower middle class to near poverty moms who had been given such a huge guilt trip over breast feeding that they felt like terrible mothers because they couldn't afford lactation specialists

or who, perhaps, were prosecuted for manslaughter after they totally failed to get it right? in the prosecuting of Tabitha Waldron, they totally used the cudgel.
posted by toodleydoodley at 7:06 PM on February 21, 2010 [1 favorite]


Five years ago, powdered formula ran about 25.00/can. A can lasts maybe 4 days for a baby who eats a lot (ours did). I'm sure it's more expensive now.

Oh sure, it's crazy expensive, no doubt.

But if you've got an essentially free supply of food for your kid right there attached to you, than it seems like that'd be a better choice than risking jail.

But, I suppose if you can't breastfeed for whatever reason, and can't get WIC, then you have to do what you have to do.
Gotta say, it seems like a screwed-up system when someone has to steal food for a baby, though.
posted by madajb at 7:08 PM on February 21, 2010


But if you've got an essentially free supply of food for your kid right there attached to you, than it seems like that'd be a better choice than risking jail.

Maybe when you're reaching the conclusion that a lot of poor people are doing an absolutely senseless thing, you should check your premise.
posted by moxiedoll at 7:41 PM on February 21, 2010 [7 favorites]


From Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries (2007), a 415-page analysis by the Tufts-New England Medical Center Evidence-Based Practice Center, for the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services.

[Summary, if you don't want to read it: Evidence for the superiority of breastfeeding is overwhelming. Claims otherwise are horseshit, and the people making them should be doing some self-evaluation about their motives.

Sure, there are areas of greater and lesser certainty (e.g. "The relationship between breastfeeding and cardiovascular diseases was unclear."), and even myths here and there (e.g. "There was no relationship between breastfeeding in term infants and cognitive performance.") And there's lots more research to be done.

But just like, for example, global warming, the overall scientific picture isn't in any doubt.]

-----

"Results: We screened over 9,000 abstracts. Forty-three primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or metaanalyses that covered approximately 400 individual studies were included in this review. We found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. [...]

For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression. There was no relationship between a history of lactation and the risk of osteoporosis. The effect of breastfeeding in mothers on return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on postpartum weight loss was unclear. [...]

Conclusions: A history of breastfeeding is associated with a reduced risk of many diseases in infants and mothers from developed countries."
posted by namasaya at 7:53 PM on February 21, 2010 [4 favorites]


Maybe when you're reaching the conclusion that a lot of poor people are doing an absolutely senseless thing, you should check your premise.

THANK you.
posted by zarq at 8:19 PM on February 21, 2010


Lactation consultants can be a godsend or a miserable curse. There is such a thing as taking a good idea and turning it into a dogmatic cudgel against parents already nearing the break of sanity.

Lactation consultants can be aggressive to the point that we were instructed in my nursing program that we might need to "intervene" between LCs and patients if it starts to get too rough. I was surprised to hear that as I assumed that LCs were always a net benefit for new mothers, but I think some of them stop seeing the mother as a person and more as a breast with an infant attached.
posted by supercrayon at 11:16 PM on February 21, 2010 [1 favorite]


"Evidence for the superiority of breastfeeding is overwhelming."

if the baby latches, if the mom produces enough milk, if her nipples will stand up to daily feedings (sometimes even the nipple shield isn't enough to fix this problem) if there's time to do it correctly. all things being perfect, the breast is best. as all things are rarely perfect (especially with kids) - it's harder to come to that conclusion 100% of the time. it's not like it's a fountain you can just turn on, pour out the correct amount, and then turn off.
posted by nadawi at 11:30 PM on February 21, 2010 [1 favorite]


Thank-you all for the scientific references. I genuinely looked a while ago and the best I could find was a UN report that didn't make any claims for developed countries.

I haven't eaten Nestle deliberately for fifteen years now. Gosh, I miss Aeros and Rolos (chocolate bars).
posted by alasdair at 11:50 PM on February 21, 2010


Right, okay, now it's the next morning and I'm a bit smarter, I've found the "UN report" that I found before - it's the "Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries", 2007, cited above. Here are the conclusions from the executive summary in full:
A history of breastfeeding is associated with a reduced risk of many diseases in infants and mothers from developed countries. Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings. Also, there is a wide range of quality of the body of evidence across different health outcomes. For future studies, clear subject selection criteria and definition of “exclusive breastfeeding”, reliable collection of feeding data, controlling for important confounders including child-specific factors, and blinded assessment of the outcome measures will help. Sibling analysis provides a method to control for hereditary and household factors that are important in certain outcomes. In addition, cluster randomized controlled studies on the effectiveness of various breastfeeding promotion interventions will provide further opportunity to investigate any disparity in health outcomes as a result of the intervention.
May I point out: "Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings."

Essentially, for smart, middle-class Westerners, this does not provide evidence that breast feeding is better. We don't have evidence that breastfeeding and better outcomes are linked causally: they may both be dependent on another third factor (i.e. social class). That is, mothers who have the financial and social resources to breastfeed and the class and cultural background to do it have better outcomes, but not because of the breastfeeding itself.

Now, the "Breastfeeding and the Use of Human Milk" 1997 document from the American Academy of Pediatrics is more positive, and is directly contradicted by the U.S. Department of Health and Human Services report above. The AAP document is ten years older. Anyone help me out in comparing the validity of each?
posted by alasdair at 12:26 AM on February 22, 2010 [1 favorite]


We had trouble breastfeeding our first (inverted nipples -- yay nipple shields!), and Kaiser San Francisco sent a lactation consultant to our apartment. It was a GUY, which was confusing. He presented as gay, which was sort of better and sort of more confusing. But he was a big help.
posted by msalt at 12:39 AM on February 22, 2010


"But if you've got an essentially free supply of food for your kid right there attached to you"

It's only "free" if you consider the mother's time to be worth nothing.
posted by Jacqueline at 2:45 AM on February 22, 2010 [8 favorites]


Yeah, the amount of judgment out there is really staggering sometimes, especially if you're a sleep-deprived, hormonally ravaged new mom who's having a tough enough time figuring out what's what.

I never could get my kid to latch; at first it was because she was so small when she was born, and even when she got bigger, she was having none of it, in spite of my trying a million times during the day with her at various stages of hunger and using all the techniques and tricks that are out there. So I pumped as much as I could (which wasn't much) throughout my maternity leave and supplemented with formula. The LCs I talked to sternly warned me that, since I couldn't get her to latch it was a moral imperative that I pump every single time I fed her. Every time. It was essential that I "fool" my body into thinking I was breast feeding her so that I could keep up my supply. This meant that I was hooked up to the fancy expensive pump we bought for a minimum of eight hours cumulatively throughout the day, every day. Have you ever tried to pump that much while caring for a brand-new baby? It's not easy or fun. Pumping is messy, it's time consuming, it's a little humiliating because it's hard not to feel like Bessie the Guernsey Cow when you're doing it, and, if you're having issues keeping up your supply (as I was), it's a vivid reminder that your body is not doing what it's supposed to, so there's an extra layer of guilt there.

For a while I was on a Yahoo group for moms who pumped, and at one point someone linked to that terrific Case Against Breastfeeding mentioned in Jacquiline's link above. Can I tell you that even there, on a list specifically designed to support moms who are pumping, many of whom are pumping because their supply isn't great or their kids can't latch on and who therefore have no choice but to supplement with formula? The amount of judgment leveled against women who supplemented was really awful. There were women on there who absolutely believed that if you're giving your infant formula you might as well drop in some strychnine in there as well, because you are POISONING YOUR BABBY, OMG. And even when more reasoned women tried to calmly point out that, yes, we all agree breast is best but there are myriad reasons why some of us might have to use formula, the squawking that we were putting our children at risk for obesity, diabetes, heart disease, stupidity, and DEATH didn't cease.

At three months, right as I was going back to work, I made the difficult decision to give up pumping entirely and hope for the best. Rationally, I know I made the right choice; my kid is happy and thriving, I'm much better off for it, which in turn makes me a better mom, and it delights me to no end that she's being raised in an environment that is far more loving and peaceful than the lives her dad and I knew when we were kids. But damn, that sub-intellectual, primal feeling that I failed my daughter in some fundamental way is really, really hard to kill.
posted by shiu mai baby at 5:18 AM on February 22, 2010 [2 favorites]


May I point out: "Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings."

Only if you don't believe in relativity, which was confirmed by purely observational studies.

Causality can easily be inferred from observational studies by the simple mechanism of deriving several apparently unrelated observable implications of the causal theory (which had not yet been tested) and finding that they are empirically confirmed.

That's unlikely to be the case here because the theory on offer -- "breast milk is better" -- is so weak and vague that it doesn't really count as a theory; there's no actual causal mechanism being described that can be broken down into parts so that the implications of these parts can be tested. I expect this is just because it's a meta-analysis.

But in general, while "correlation != causation" is still true, a bunch of apparently unrelated correlations is nonetheless a convincing case for a causal story.
posted by ROU_Xenophobe at 5:24 AM on February 22, 2010


It's only "free" if you consider the mother's time to be worth nothing.

And if the mother wanders out at night to eat garbage instead of paying for food. The milk isn't conjured from nothing by beneficent magic or transported through mammary wormholes from a mystic zone of goodness. It's built out of food. Or out of Mom, I suppose.
posted by ROU_Xenophobe at 5:30 AM on February 22, 2010 [2 favorites]


alasdair -- The sibling studies did find a cognitive benefit from breastfeeding. I know Rosen, the author of the Case Against Breastfeeding piece, dismissed those findings because (1) she didn't consider the benefit that big (though, across a population, as opposed to any one individual child, it would be pretty great), and (2) you couldn't separate the benefit of cradling the baby against the breast from the actual breast milk, but I'm not sure I see why that objection matters: if breastfeeding is mechanically beneficial, it's still beneficial.

I know that a reduction in future development of auto-immune diseases, particularly Type 1 Diabetes (juvenile diabetes), is associated with breast-feeding, and those are not diseases associated with low income or low education, so you wouldn't expect to find the causation-correlation problem you note above.

Anyway, I personally breastfed my two children and plan to do the same for my third, mostly because after a very rocky start, I love it, but I also strongly believe that the prime directive is Feed The Baby, and I've seen the enthusiasm for breastfeeding get in the way of that prime directive.
posted by palliser at 6:05 AM on February 22, 2010


The milk isn't conjured from nothing by beneficent magic or transported through mammary wormholes from a mystic zone of goodness. It's built out of food. Or out of Mom, I suppose.

We-ell, some of us may have a little extra, you know, energy stored hereabouts after giving birth.
posted by palliser at 6:07 AM on February 22, 2010 [1 favorite]


Breastfeeding/lactation consultants go out the door when your child has a severe milk protein allergy. Then you catch all the guff from the pro-breastfeeding Nazis I've encountered that make you feel less of a mother and that your child is less of a human because--gasp--he drinks Allimentum!!

But hey, at least he's not pooping blood anymore and in pain from severe gas.
posted by stormpooper at 6:48 AM on February 22, 2010


Karo syrup = rotting of gums/teeth. My husband was fed the same thing back in the day and by the time he was 3 he had metal mouth.
posted by stormpooper at 6:50 AM on February 22, 2010


jeoc, you are unusual in not experiencing the "oh no, I'm having a letdown right now and the bra shields, they do nothing!" experience.

But believe me...it happens. Seeing or hearing another baby can sometimes trigger it, I'm told.
posted by emjaybee at 7:32 AM on February 22, 2010


For women who are unable to breastfeed but reluctant to give their baby formula, there's a fantastic organization called MilkShare, which can put them in touch with local mothers who have excess breastmilk to donate.
posted by Dragonness at 8:18 AM on February 22, 2010


Right, Dragonness, because added to the guilt of not being able to breastfeed ourselves is the fact that some women are able to produce enough for not only their babies, but someone else's baby, too.

And MilkShare doesn't guarantee the safety of the milk from the donors. I'm all for immunities and antibodies, but the point is, the antibodies going into the baby would have been mine related to what I have been exposed to, not what somebody else had been exposed to --- and I don't know what someone else may have been exposed to in the course of her day, week, or for that matter, life. I consider milk share to be dangerous because there is no regulation.
posted by zizzle at 8:55 AM on February 22, 2010 [1 favorite]


It's a personal decision, of course. I, for one, was very grateful to have discovered MilkShare when my second baby was born.
posted by Dragonness at 9:29 AM on February 22, 2010


Maybe when you're reaching the conclusion that a lot of poor people are doing an absolutely senseless thing, you should check your premise.

I can't tell if you are attempting to be profound or snarky.

It's only "free" if you consider the mother's time to be worth nothing.

What?
posted by madajb at 9:51 AM on February 22, 2010


I wasn't trying to be profound or snarky - I was just suggesting that it seems like you don't know very much about breastfeeding or you wouldn't be so baffled by the idea that someone might be desperate enough for formula to steal it. For one thing, breastmilk is a use it or lose it commodity, so if someone's been formula feeding from the get go for whatever reason - and then they run out of formula and they're broke and have a hungry six month old - they can't just default to the attached supply of free food, because it's not there anymore, even assuming it ever was. Also, even if you don't know anything about lactation, there's really no excuse for saying "jeez why don't they just use the free attached food?" because the very FPP we're chatting underneath is about women who very much want to breastfeed and who have every advantage in terms of education and medical care and yet have to pay a lady $200 a visit to try to get things working. And sometimes they can't. Summary: Sometimes babies need formula, and it's not because their stupid mothers forgot that they have breasts.
posted by moxiedoll at 10:17 AM on February 22, 2010 [7 favorites]


For anyone still boycotting Nestle, you might want to check out whether they are still doing that thing that you were boycotting about -- as far as I know, they stopped a couple of decades ago.

But on a sad, and possibly ironic note, in some places some mothers are being encouraged not to breastfeed -- the water may not be great, but at least it's not got HIV. But, depending on the local water, it can be like choosing between Scylla and Charybdis.
posted by jb at 10:24 AM on February 22, 2010


Okay -- read the wikipedia link -- Nestle is being accussed of still promoting formula by giving it away free. (As they do in the developed world).
posted by jb at 10:28 AM on February 22, 2010


Ugh, I'm so tired of the endless litany of hatred towards women for not breastfeeding. Can you tell a breastfed adult from a formula-fed adult? No? Then shut up.
posted by agregoli at 7:17 PM on February 22, 2010


Has hatred been on display here? I guess I'm asking whether you want someone here to "shut up," or if you're talking to some other folks.
posted by palliser at 7:53 PM on February 22, 2010


I was just suggesting that it seems like you don't know very much about breastfeeding

That'd be a shock to my child. heh.

Regardless, I see what you are saying, and it isn't at all what I intended to convey. I apologize for the confusion.
posted by madajb at 8:28 PM on February 22, 2010


Nope, not at anyone here. Referencing what plenty of other people have referenced in the thread.
posted by agregoli at 3:24 PM on February 23, 2010


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