Thursday, September 23, 2010

Prescription Formula and Bugs in the Bottle

So, two big news stories have shaken the mothering communities across the world in the last week.  In Australia, a midwife by the name of Dr. Jennifer James has created waves of anger, shock, and vitriol when she told an Australian newspaper that formula should be given by prescription only, and all formula advertising should be banned in the country. (Story here: Women everywhere have been shouting their opinions about the matter on blogs, message boards, and news comment sections across the intrawebs worldwide.  "You don't know me and you don't know my situation!" one formula-feeding mother rages.  Another comment on is from a breastfeeding mom.  "I really feel that we shouldn't be demonizing formula, or making moms who feed formula made to feel more alienated or guilty than they already do.  Some moms just can't breastfeed."

While I understand the outcries of anger over James' statement, I can't help but feel it has some merit, particularly in the wake of this week's recall by Similac.  (Story here: Recall information here:  The fact of the matter is, the prescriptive drug industry is far more regulated than the food industry.  In the States, the FDA has thorough processes in place to test the safety and value of a drug before allowing it into the market.  Similar processes are in place in Canada.  While the formula industry has already recalled several of their products in various countries around the world this year, there has only been one recall of Children's Motrin and like products.  The drug recall was dealt with quickly and efficiently, and stores and pharmacies were stripped of the offending product as quickly as possible.  Within two days of the recall, there was not a single recalled product to be found in any of the stores here in my city.  The news reports included the recall numbers in the report, and parents were able to check quickly to ensure that they did not have any recalled product in their medicine cabinet.  This Similac recall, however, surely as important as the great Motrin Mishap of 2010, has been handled poorly and without the urgency.  The news reports did not include recalled batch numbers, causing Similac's recall website to crash, their phone lines to be permanently busy, and leaving many parents poring over their cans of formula, wondering if they possibly contained beetle body parts, and if they would make their children sick.  What to do?  Many moms I've talked to have simply pitched $40-$100 worth of formula.  Imagine all that money going down the drain with the beetle larvae.  Many parents can't afford to throw that much away, and many parents are left wondering if that illness their baby experienced in the last month was related to undigestible bug parts in the baby's intestinal tract.  What kind of regulation is that?  If formula were indeed a prescription drug, the formula companies might even have to step up and start regulating what is IN the cans, making the recipe consistent, rather than just using whatever ingredients are at hand and cheap at the time (Newman and Pittman, 2009, p. 34)(1).  A warning in Canada last week was issued when a baby became ill after consuming formula that had been tampered with, a man had replaced the formula powder with flour.  If formula was behind the counter and safely in the hands of pharmacists, parents would not have to worry about contamination or tampering.  Mothers would feel less guilty, as their decision to formula feed, or need to formula feed, would have been vindicated by a medical professional, and they would know that they had taken every possible step to try and breastfeed.  There would be less doubts about the mother's decision to bottlefeed.  In addition to this, with a ban on formula advertising, as purported by the WHO's International Code of Marketing Breastmilk Substitutes (, the millions of dollars that formula companies pour into advertising each year could be put to better use improving and regulating the actual formula.  Rather than targeting expectant, new, and already breastfeeding moms to use their product, formula companies could ensure the product is safe and consistent in content, creating a better alternative in cases where breastfeeding is not possible.  Pamphlets could be created to teach formula-feeding parents how to safely formula-feed, and the proper procedures for sterilizing bottles, water, and equipment.  More money could be put into ensuring that the formula itself is more sterile, and not as susceptible to outside contamination.  Formula-feeding pairs could only benefit from this kind of monetarial input, and industry regulation.

Finally, we all know that breastfeeding is the normal biological way for a baby to eat, and as such, more emphasis should be placed by the health systems on assisting mothers in breastfeeding when they encounter difficulty. As a mom who hit walls with breastfeeding every step of the way, I know what it is like to go and see a doctor for breastfeeding assistance, only to find out I know more about the issue than they do.  Dr. James' intentions are not to humiliate mothers, or to make formula-feeding parents feel guilty, but rather to push the healthcare systems in Australia (and worldwide) to develop more breastfeeding resources, and to look at formula as a medical solution, rather than an equal alternative to breastmilk.  If formula is made into a prescriptive medication, babies can only stand to benefit from better regulation on the industry, better help from the medical community in achieving breastfeeding goals, and a safer option for those mothers who legitimately cannot breastfeed.

(1) Jack Newman and Teresa Pittman, 2009 - Dr. Jack Newman's Guide to Breastfeeding - Toronto, Canada - HarperCollins Publishing Ltd.

Wednesday, July 7, 2010

My Birth and Breast Story

It's been a long time getting this together.  My birth experience was not necessarily tramatic, but it was not at all what I had dreamed and hoped for.  At the time of my birth, I knew little of birth, or the choices we have in it, but as I learned in the months following the birth of Babe, I began to mourn the loss of the birth I could have, and should have had.  Sometimes there are extenuating circumstances that lead to induction, but I know, given the chance to go back, that I would have fought to go full-term, and that I would have fought for more time to labour and prepare my body.  I may not have fought for my birth, but I have fought for the last 7 months for the right of myself and my child to breastfeed.  Here is my birth and breast story:

I was 23 when I got pregnant with my daughter. I was still a newlywed, my husband and I had been married all of 8 months, and we had blissfully been enjoying our married life. We lived in Fort McMurray, Alberta, a northern mining town in Canada, and all around us women were getting pregnant, or had new babies. I was envious, and my husband was starting to notice babies whever we went out, wanting to play with them, commenting on their looks, their size, their cuteness. We decided maybe we wanted to start having children. We had decided to take the "Hey Sarra, sarra" approach to having children. We tossed away all contraception and decided whatever would be, would be. Within two weeks of our toss-away decision, we were pregnant. Until that point, I had never given any thought as to how I would feed my baby. I had always seen bottles and formula as the norm, so I assumed we would formula feed. When I called my parents to tell them I was pregnant, they were very excited, and my mom gave me the recipe for her homemade formula.

At 4 months pregnant, we decided to start attending birth preparation classes. I've always been the girl scout type, so I wanted to ensure we were prepared in every possible way. A local doula group, called Birth Choices, offered free prenatal classes to expecting parents the second tuesday of every month. They advocated for natural birth, but explored every avenue with expectant moms, including epidurals and medical pain relief. The main teacher, Lisa, had a 7 month old son that spent the classes happily crawling all over the room, playing with parents, and generally getting into whatever he could get into. Halfway through the second class, Connor crawled up to Lisa, who was sitting at the front of the class, and started tugging on her shirt and rooting. We all chuckled, and Lisa calmly pulled up her sweater, unhooked her bra, and latched Connor on, then continued to talk. There was a shocked silence, and from the corner of my eye I could see my husband, Lyle, desperately trying to catch my eye. His cheeks were flaming red, and I could tell he was embarrassed, but I refused to meet his eye. It was the first time either of us had witnessed a woman breastfeeding, and we discussed it a lot on the way home that night. We laughed a little over our embarrassment, and decided that if he needed to be fed, well, I guess he needed to be fed. I had been breastfed myself for six months (my husband was formula fed from day 3), but I didn't know it until I discussed the 'incident' with my mom on the phone. "Some women are comfortable like that." was my mom's airy reply.

At 8 months we decided to attend a more formal prenatal class. Our local gym held a prenatal class over a weekend twice a month, and so we signed up to attend. Our instructor was a South African midwife named Vilia, and it was because of Vilia that I became determined to breastfeed. Vilia was a breastfeeding advocate and lactivist. We spent nearly the whole weekend watching kangaroo videos, charting the benefits of breastfeeding over formula, discussing the health risks of formula feeding, and reading Jack Newman's handouts. My husband is a severe asmthatic, and had expressed worries every night that our child would be asthmatic as well. That weekend, he became gung-ho about breastfeeding as well, as soon as he discovered that if I breastfed, our child was much less likely to develop asthma or diabetes, conditions that plague his side of the family.
So we awaited our due date, December 8, 2009, eagerly and with much anticipation. Unfortunately, the pregnancy took a turn for the worst, and I developed high blood pressure, and then pre-eclampsia. At 38 weeks the the obstetrician told me that I needed to be induced, for my own safety, and the safety of my baby. On Tuesday November 24, I went in at 7 pm for the first application of cervical gel to soften and dilate my cervix, and hopefully bring on labour. The OB wasn't hopeful though. My body showed no signs of being labour-ready. I went home and rode out the contractions, breathing and counting with my husband. We were due back at the hospital the next morning for a second application. After a night of small, uneven contractions, we arrived at the hospital at 7 AM, where I received a second application around 8:30 AM. At 9:30 AM, the OB on call decided to start pitocin. The contractions were now excruciating, my body wasn't ready, the baby was sitting high, tucked against my ribs. All day I tried to breathe with the contractions, and keep my labour natural. I ended up with one shot of morphine, and decided against having any more drugs. The morphine nearly stopped the contractions, so they cranked up the pitocin again, and I rode the crimson waves of my contractions. At around 8 PM the contractions all but stopped, coming infrequently and without the same intense feeling they had contained all day. At 11:00 PM my daughter kicked me in the ribs, and my heart sank as I realized she had not dropped even an inch. At 11:30 PM the OB arrived and checked me, then announced I was only about 3 cm dilated. He was worried about the baby's heartrate, and the pounding she was taking from the false contractions. I was in for a C-Section. I was disappointed and upset, but too tired to argue. I was prepped and taken down, and the whole procedure went down without a hitch. From behind the curtain I heard my daughter's first scream, and I caught my breath. The delivering doctor swooped by, flashed my baby at me, and then took her out of sight, to a table behind me. I strained my neck to try and see her, and Lyle patted my hand reassuringly and went to be with our daughter. I felt dizzy, and the doctors shouted that my blood pressure had dropped to an extreme.

My baby and husband were rushed out of the room, and after I was bandaged up, I was sent to recovery for an agonizing two hours without my child. I felt disoriented and confused. After my two hours were up I was wheeled upstairs and sponged off, then lifted into my hospital bed. My daughter was placed on my chest, and I put her to my breast, while my husband and I agreed on her name. I honestly can't remember if she fed or not. I'm assuming she did, but I was so drugged and so tired that I can't remember those precious few moments, and the first few hours of her life have been narrated to me by my husband. She was bundled up and placed in a bassinet next to me, and we slept. Whenever she cried that night, my husband brought her to me, and I put her to my breast again. The next day the pediatrician came to see our baby. The doctor was concerned because Babe was covered head to toe with bruises (probably from the pitocin-induced contractions) and she had a high white blood cell count. They put a tiny IV into Babe's wrist, and we were ordered to stay in the hospital for 3 days, so that antibiotics could be run through the IV every four hours, with sugar water running through the rest of the time. My daughter became lethargic. Fed by sugar-water, she didn't want the breast. Hurt and confused, she cried constantly. I was frantic with worry, and so was my husband. We waited with bated breath to be told everything was going to be alright.  On the 4th day we had all our bags packed, beyond excited to get home, where my parents were waiting to help us, with a clean house and tons of groceries.

It was not to be. Babe's bloodwork came back with high bilirubin. The sugar water prevented her from breastfeeding, the lack of breastmilk allowed her bilirubin levels to climb higher and higher. She needed 48 hours in a bili-tank. I cried for almost two hours. The nurses brought the huge fishtank looking thing into our room, and ordered me that I was only to take her out every three hours. The more I took her out, I was warned, the longer we would have to stay in the hospital, and the longer Babe would need to be in the tank. I was a new mom, I had no breastfeeding experience, no access to a lactation consultant, and no breastfeeding resources. I didn't know that putting the baby on a schedule would ultimately affect my milk supply. After two days of bilitank, we were finally allowed home. Each night I sat in front of the Christmas tree and nursed Babe. We coslept, I nursed her on demand, I was blissful.

Two weeks after our arrival home, I developed mastitis. I spent two days in bed, feeling absolutely wretched. My mother-in-law, who had come to help, was sure that Babe was starving. She cried constantly. My MIL begged to feed her a bottle of formula. I don't know why, but I refused. My MIL was helpful everywhere else, but breastfeeding frustrated her. She couldn't see how much the baby was getting, she wasn't able to offer advice. After 5 days, my MIL left. Lyle and I settled down into a routine. Babe was difficult to feed. She was constantly sleepy. I'd no sooner put her to the breast than she'd fall asleep. We stroked her with a wet cloth, tickled her feet, undressed her and nursed skin-to-skin, but to no end. At 3 weeks old, Babe was again hospitalized with severe jaundice. This time her bilirubin count was higher than it had been at 4 days old. Again she went to the bili-tank, this time in the pedes ward. Again she was put on a schedule. The pedes nurse told me she was a breastfeeding advocate, but she didn't believe in starving the babies. They told me I had no milk. This was determined by my pumping output after a feed, which was less than an ounce. Again, I had no idea that this was a normal output for a nursing mother, well within the normal range.

 Babe was ordered to be supplemented with formula after each nursing session. I felt horrible every time I gave her a bottle of formula. She writhed and cried and screamed, waving her little arms around. I stood next to the bili-tank with my hands on her almost all the time she was in. I stroked her head and assured her she would be okay. I sang to her, and every three hours on the nose, I pulled her out and breastfed her, clutching her to me as long as I could. The nurses got annoyed with me. I was scolded twice for taking her out to feed her before the three hour mark, and given heck for taking longer than a half hour to nurse her. After two days, we were allowed to take her home again. They sent us home with a huge box of premixed Enfamil, and orders to supplement her after every feeding. The on-call pediatrician told me I should skip two nursing sessions a day and replace them with formula, to allow my breasts time to fill up. I remember having the insane urge to giggle, picturing  my breasts as milk jugs slowly refilling themselves.  I was near hysterical.  If I started laughing, I don't know if I would have been able to stop. 

When we got home I immediately started breastfeeding Babe, and with a heavy heart I sterilized, mixed, and then fed her formula at the very end of the feeding.  I had to stop and analyze my feelings.  Why was I feeling guilty?  So many moms formula feed, why did I feel so awful for doing it myself?  I have long understood that we cannot ignore our feelings and instincts.  Mine were telling me that this was wrong, wrong for me, wrong for Babe, and despite its commonality, just wrong for us.  (I later was vindicated in this feeling, as it turned out Babe has bad dairy and soy allergies, which would have been difficult, if not impossible to avoid when trying to find a dairy and soy free formula.  I have to keep my diet dairy and soy free to avoid projectile vomiting and other complications on Babe's part).

I told my husband I would need uninterrupted hours with her. He agreed. We stocked my nursing area with DVDs, water, snacks, books, and blankets. I was frustrated by the nurses and doctors, and felt like a failure for being told my breastmilk wasn't enough. My instincts said something was wrong, and I have long trusted my instincts above medical advice. As I spent the next few days nursing Babe around the clock, I began to search YouTube for videos of breastfeeding. I googled supplementing, and its necessity. Everything inevitably brought me back to Jack Newman. I ordered his books and began to read them in earnest. I learned that breastmilk was a natural laxative, and expelled bilirubin from the baby's body faster and more efficiently than formula. I learned that pumping output was a poor indicator of milk supply. I learned that the more I supplemented, the less milk I would produce. The second night home from the hospital, I took all the formula samples that came in the mail, and all the formula the hospital sent home with us, and chucked it out. Maybe that was extreme, I should have probably donated it, but I felt both a need to express my frustration (the clang of the formula cans hitting the bottom of the garbage can was sooo satisfying) and I had a fear the hospital would find out what I had done and come yell at me some more. 

As I studied the latching videos on Jack Newman's website and taught myself to breastfeed, I also taught my daughter. I took fenugreek and drank olympic-size swimming pools of water (maybe too much water, I learned later on). Two days later, I defiantly told my pediatrician that I would not supplement my daughter. To my surprise, the pediatrician (not the one from the hospital) chuckled and said she agreed with me, and that I should not supplement my daughter. Two months later, when we discovered Babe was allergic to both soy and cow's milk (through allergic reaction to the proteins in my milk), we again felt proud and relieved that we had had the strength and determination to make breastfeeding work for us. Babe is now a happy, bright-eyed 7 month old, curious about the world and everything around her. She loves to give her dad, me, her grandparents, and my boobs affectionate kisses accompanied by a loud "Mah!" noise. She's our joy, and every time I watch her nurse to sleep, or feel her warm body cuddle against me at night, I feel a surge of love inside, and a telltale dripping feeling at my breasts. I am sure the two feelings are linked. ;)

Author's note:  After learning about oxytocin, I know for sure that they are!

Saturday, June 26, 2010

New Blog Woohoo/The Amazing Levitating Boobs!

Hey world! (crickets)

So I've been meaning to start a blog for a long time now. When I was a child, and then an overdramatic teenager, writing was my ultimate release. The steady flow of ink on ruled paper was a purging, a cleansing, a wonderful burgeoning expulsion of all my emotions and thoughts. I've always wanted to be a writer, but the world and life caught me in its throes, and so I've decided to blog instead.

I want this blog to be about many things. My experiences as a new mother, how my view of the world has changed as I've immersed myself deeper in parenthood, and all the incredible changes it brings. I want this blog to be a wealth of information and interest for other new moms. I want to advocate those parenting practices I believe in, and to explore some of those that I might otherwise disdain.

Maybe an introduction. You can call me Breast. My 7 month old daughter is Babe. Some days, I feel as though I am only a personality attached to breasts. That's weird, you might think. Maybe, but as a full-time breastfeeding mom, the sentiment of being a floating pair of boobies is not so odd as one might believe. My whole life has become about Babe, and as for Babe, well for the first few months of life, her whole life revolved around momma's breasts. Now, at 7 months, Babe still has most of her life revolve around her momma's boobies. She's become somewhat of a conoisseur, though. She stops halfway through eating to hold a boob in both hands, admire it from every angle, pinch it, talk to it, and then return to taste-testing. She's realized that they still exist when out of sight, and is bound and determined to see them under the cloth when they are hiding. Every food she tastes is compared to them, every person who holds her gets the privilege of a visual breast exam from her, and sometimes a pinch as well. It's the most important part of mommy, and sometimes I have to practically wave my hands and dance a jig to get her attention away from them. Is it so strange then, that I sometimes feel like a set of levitating boobs? As any breastfeeding mom can attest, nah, not really.

How did I decide to breastfeed? How were our major parenting decisions made? Next time. It's a long story.