Breast is best – or is it?

Madonna and child enthroned (cut-out) – Jan van Eyck

I firmly believe that breast milk is nutritionally better than formula. It contains natural antibodies from the mother that help the baby to fight infection – something not contained in even the best bottle milk on the market.  I am more doubtful about the studies showing links with everything from increased intelligence to being a better lover, as it is so hard to separate the effect of breast milk from other factors such as parents and environment. I also think the nutritional difference is fairly modest. But, to keep it simple – nutritionally, breast milk is best.

Breastfeeding, however, is another matter entirely. To illustrate this, I want to briefly relate my own experiences.

I was committed to breastfeeding from the start. When my first daughter was born, she was put straight to the breast, and I had support from the midwives who helped me to try out various positions and get a good latch. After an initial bit of fumbling, we got into a routine for the feeds. I found it hard, however, to work out when my daughter had had enough – or even to check if she was really drinking at all, or just sucking. But, as her weight climbed in the first few days, all seemed to be going well, and my confidence grew.

Then, all of a sudden, her weight dropped. We started giving her extra breast milk via ‘fingerfeeding’- putting a finger and a syringe of milk into her mouth, and letting her suck on it. Her weight remained too low, so we were advised to give her some milk in a bottle. And that was when it all fell apart. Once on the bottle, which was far easier to drink from, our daughter was far too canny to go back. She stopped latching on to the breast. Every few hours, I had to first attempt to breastfeed her, then go downstairs to warm up some stored breastmilk, feed it to her in the bottle, then go and express more milk. A lactation consultant came to see us, and suggested all sorts of things, from a cooler room, to different positions, to nipple shields. Each feed I would start full of hope, each feed ended in going down to the kitchen to get the bottle, sobbing, while my child howled in hunger. After I broke down in tears, the consultant decreed a rest. For a week, I would express milk and feed my baby from the bottle, but not attempt to breastfeed. During that week, she drank well, and gained weight. At the end of the week, we tried the breast again – and, like magic, she latched on without any problems.

That was the start of happy months of breastfeeding. There were occasional mishaps, uncomfortable lumps in my breasts, growth spurts when my daughter needed more feeds, and a spate of diarrhea for her because I had eaten too many raisins. But these could all be sorted out. Each feed was an intimate moment between me and my baby, a time of peace, pleasure, and closeness. When we were delayed on a plane journey, she got hungry on the train home. No problem, I just opened up my shirt, and she happily drank her fill. After I started work again, I cut back first to the morning and late night feeds, then just the morning, as she grew bigger and her late night feed fell away. When a bout of flu ended my production, it felt like a natural end. I was proud I had persevered, and had very happy memories of my time breastfeeding.

For my second daughter, I was confident all would go well. After all, I knew what I was doing this time. When she was born, she latched on and started suckling much more vigorously than my first daughter. Just as the first time, however, I had my doubts as to whether she was drinking properly. But the midwife pooh-poohed these, as she was gaining weight fine. In vain did I explain how the same thing had happened the first time – I was told not to worry.

After a few days – déjà vu. My daughter’s weight was dropping. Just as before, she was given supplements, just as before, she stopped latching on. There was, however, one big difference. While my first daughter had always slept for a few hours between feeds, my second daughter woke up and demanded another feed not long after the previous one, or even started crying again as soon as the feed was completed. The lack of sleep, the constant demands and the gnawing uncertainty quickly wore me down. I was again referred to a lactation consultant. She suggested clusterfeeding in the evenings, so, while my partner was eating dinner with our older daughter and putting her to bed, I was giving the baby feed after feed, each time patiently trying to get her to latch on, sometimes succeeding, more often having to resort to a bottle and then express milk. It was the same hell I had gone through with my first daughter, but now not every 2-3 hours, but constantly. I was exhausted, and so was my partner, and that took its toll. Late one night, after crawling back into bed after a feed, the baby started crying again. My partner said, ‘Darling, I think the baby’s hungry’. I screamed at him, ‘I’ve just fed her!’. After another nighttime shouting match, my two-year-old daughter called me into her bedroom. She took my hand, and said solemnly, ‘Mummy, you need to stay calm’. My eyes filled with tears.

After doing a wonderful job of supporting me and taking care of our older daughter through all of this, my partner now felt that enough was enough, and wanted us to stop trying. But I desperately wanted to continue. The lactation consultant talked about the long-term, about various options we could try out over the next few weeks to see how they worked. The Christmas holiday started, twinkling lights and joyous carols that couldn’t penetrate my misery. A few days later, I cracked. I couldn’t take another day of this, let alone weeks. Sobbing, I called up the consultant and told her I was stopping.

Once we had made our decision, the situation rapidly improved. Our daughter was finally well fed, and started to gain weight, and sleep properly. My partner could take a turn in feeding, and it was a pleasure to see him nestle up in a comfy chair with our tiny little daughter and a bottle, watching raptly as she drank it down, talking softly and cuddling her. Life wasn’t instantly simple. It was a tough schedule during the transition, having to express milk and bottlefeed at the same time. Bottlefeeding brings its own challenges, and we had to experiment with various bottles and types of formula before our daughter stopped regularly regurgitating milk all over her bed. Bottles also require extra work – measuring out formula and water, warming the bottle, sterilizing it afterwards. But the major difference was that the pressure was off. l no longer approached my daughter’s bedroom door with the sickening anticipation of trying – in vain – to get her latched on, knowing I would hear her howls ringing in my ears between each attempt. A feed ceased to be yet another struggle ending in yet another defeat, and became a peaceful part of the routine of caring for my child.

Rationally speaking, I should have had no problem with our decision. I knew that breast milk was best, but I had never believed the gap with formula to be significant, not in a country with access to clean water, trustworthy formula and reliable sterilization. My own partner had been exclusively bottle-fed, and was perfectly healthy and intelligent. But I was not capable of rational thought. I could not see the situation in any light other than that of my total failure to care for my child. The loss of those precious intimate moments with my child that breastfeeding had provided grew in my head to a bereavement.

Why was this?  I think it is because breastfeeding is so heavily promoted – and also because of the way in which it is promoted. In the Netherlands, the slogan is ‘Borstvoeding is best, flesvoeding is prima’ – ‘Breastfeeding is best, bottlefeeding is fine’. What parent wants ‘fine’ for their child? We all want ‘best’. The information evening about breastfeeding that we attended showed dreamy pictures of animals feeding their young, with in the middle, a photo of a contented mother sitting with her beautiful baby at the breast. The message was clear – this is the natural, loving way. While my rational mind saw little difference between breastfeeding and bottlefeeding, these appeals clearly went straight to my heart, where I couldn’t argue them away. Somewhere along the line, scientific comparisons were lost and I came to equate a mother’s milk with a mother’s love. And feeling that you are not giving your child enough love is a fatal blow to any parent.

Breastfeeding to me became a sort of gold fever. With my first child, I struggled valiantly and hit the mother lode. With my second, I started out full of hope, and as time wore on, I ignored the mounting costs, sure that just one more day would bring success. At least a gold digger can count their shrinking financial reserves. As a parent, it is much harder to recognize how close you are coming to emotionally bankrupting yourself – and your family – in your search for that elusive gold strike.

After it was all over, my partner often bitterly referred to the ‘breastfeeding mafia’. I don’t share his anger. I fully understand the passion of the pro-breastfeeding campaigners. While breastfeeding mothers are still being asked to leave public areas, working mothers are having to express milk on the toilet, and unscrupulous formula companies are pushing their products in third world countries, it is vital to support mothers so that they can breastfeed if they want to. I do, however, believe that in their dedication to their cause, many campaigners are doing exactly what they accuse the formula manufacturers of – pushing their ‘product’ with no regard to the cost for the parents and child. The benefits of breastfeeding are exaggerated, the parents’ emotions are played on, the costs are trivialized. That’s a great way to entice parents to start breastfeeding. It’s also a quick way to lose them again, when they run into problems and don’t realise that it’s perfectly normal, and that with some help they still stand a good chance of success. And it’s a terrible betrayal of those parents who wear themselves out pursuing the holy grail of breastfeeding. Not to mention their babies. A child needs good nutrition, but they also need their parents, and an exhausted parent on the edge of a breakdown is not in any child’s best interests.  

I am complicit in this, however. Until I wrote this post, I had never told anyone – anyone, including my partner – just how bad things got for me. I will describe this more in my next blog, but for now it is enough to say that my perception of my breastfeeding ‘failure’ blighted those first precious months with my daughter, and left me with psychological trauma that led to serious problems later. My main reason for talking about it now is to make sure that others out there realise that they are not alone, and can regard feeding their baby not as the ultimate test of their fitness as a parent, but rather as just one in the long line of choices they will make bringing up their child, and as a challenge that has many different, perfectly good solutions. It is, thankfully, becoming more acceptable to talk about the challenges of breastfeeding. What concerns me, however, is that there is a temptation to take sides in the battle between breast and bottle. As far as I am concerned, parents – and children – are better served if the weapons are lowered, and both breastfeeding and bottlefeeding experts work together to support parents in finding what works best for their family.

Breastmilk is better than formula milk. Whether breastfeeding or bottlefeeding is better, depends entirely on the child, their parents, and the situation they are in. For my first daughter, the balance was in favour of breastfeeding, and I am happy it worked out that way. For my second daughter, things were different. Looking back, I no longer feel guilt that the breastfeeding didn’t work out. Instead, I feel guilt that I pushed myself and my family so far in pursuit of it.  Given I couldn’t give her both a happy, contented mother and breastmilk, I would rather have chosen for a happy, contented mother and formula, than breastmilk and a mother crying at every feed. I think that all parents are entitled to honest, objective information about their options, and support to help them find what is truly the best for them and their child, whether that turns out to be breastmilk, formula, or a mix of both. Honestly evaluating the situation and changing your choice to one that better suits your family should not be regarded as failure, but as success.

I have two daughters. One breastfed for four months, one for ‘only’ two weeks. Both are happy and healthy. Over the years since, my partner and I have cooked them nutritious meals, brought them up to enjoy nature and the outdoors, taught them a love of books and cycling, comforted them when they cried, and shared in their laughter and games.

Parenthood is so much more than milk.

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