Feeling the Pressure to Breastfeed
“Formula isn’t poison.” That’s what an occupational therapist told me as we watched my preemie baby finally finish a bottle without choking. It was the first time in his whole life that he was able to complete a feed on his own without struggling or gasping for air.
Yet, instead of being thankful he was finally able to eat safely, I was devastated. With his early delivery, the doctors, nurses and consultants were all adamant about one thing – if I wanted my premature baby to survive, he needed my breast milk. I aligned myself to “Breast is Best” regime and followed a strict pumping schedule. I built up a strong milk supply and my freezer was jam-packed with frozen bottles of expressed breast milk. My son received breast milk through a feeding tube his first few weeks, but when he was older, all attempts to breastfeed and bottle-feed breast milk were painfully unsuccessful.
We’d later discovered he had a medical condition where he required thickened formula. I was deeply saddened because his only form of nutrition felt inadequate and almost toxic.
“Formula isn’t poison,” the occupational therapist repeated to me. “It’s specifically designed to provide your child with the nourishment he needs to grow and develop properly.” With every feed, I repeated her statement to convince myself. It became my mantra.
My son is now a happy and healthy four-year-old boy. As I watch him and his baby sister, who was exclusively breastfed, I see no huge or drastic differences between them. But then why did I feel so guilty my first child wasn’t breastfed?
Looking back, I wonder now that if formula isn’t poison, why do we treat it like it is? Why do we put so much pressure on new mothers to breastfeed, even when exclusive breastfeeding may not be an option?
No one can deny that breast milk is the optimal choice when deciding on how best to nourish your child. Toronto Public Health (TPH), the World Health Organization, Health Canada and the Ontario Ministry of Health and Long-Term Care all support exclusive breastfeeding to six months of age and continued breastfeeding with the appropriate introduction of solids for two years and beyond.
But the reality is that situations do arise when women and their babies are unable to continue breastfeeding.
Jaime Saltz, a Toronto mother to a five-month-old son named Nathan, endured over two agonizing months trying to breastfeed. She visited several lactation consultants, used nipple shields, pumped and supplemented feeds, worried over nipple confusion, tried lactation aids, and battled a diminishing milk supply by taking supplements, drinking special tinctures and consuming lactation cookies/teas. Nothing worked.
“[My son] became very frustrated at my breast,” remembers Jaime. “He’d either spend thirty minutes on each side, thrashing and fighting intermittently, or be totally unable to latch and cry…At 10 weeks, after experiencing tremendous anxiety before every feed, and coping with a screaming, crying baby, I decided to stop.”
Jaime felt extreme guilt with her decision, even though feeds were going more smoothly with formula and she knew with certainty that her son was being nourished. Unfortunately, women who choose to go the formula route often face public shaming and backlash.
This was the experience of Cassidy Bourassa, another mother in Toronto who gave up breastfeeding after nearly seven weeks of trying.
“Other people’s reactions were generally very negative,” admits Bourassa. “I heard the usual ‘well did you really try?’ or ‘Aren't you worried about the baby not getting any nutrients?’, ‘Formula is just sawdust and sugar,’ or even just disapproving tsks and downward glances when strangers asked about our feeding situation…I even had moms tell me that ‘formula babies develop slower physically and mentally.’”
Bourassa had a great deal of guilt with her decision to stop breastfeeding but that quickly faded once she realized that she and her child were much happier formula feeding.
“All families have the right to decide how to feed their children,” explains Olga Jovkovic, a manager of Child Health and Development, Reproductive and Infant Health at TPH. “As health care providers, TPH has the responsibility to provide families with accurate and unbiased information required to make an informed decision about infant feeding, and TPH staff will support all families regardless of their feeding choice.”
But for Bourassa, she felt most harassed by one public health nurse. “She called me every other day and as I struggled through the initial weeks of feeding, she insisted over the phone I ‘try harder’ and that ‘you don't want to let your baby down with formula’,” Bourassa recalls. “When I eventually did stop and I told her about it, she outright said I was making a poor choice.”
Cassidy’s baby girl, Zoé Nelia, is now eleven-months-old, in the 99th percentile for size and has achieved every developmental milestone early or right on time.
Prevailing beliefs that women who do not breastfeed their children are lazy or their bodies are inadequate are proving to be excruciatingly damaging to new mothers. Even more is the myth that formula-feeding hurts babies.
The recent and heartbreaking story of Florence Leung demonstrates the need for a larger conversation accepting that formula be an acceptable alternative. Leung was a new mother from British Columbia who took her own life after suffering from postpartum depression and difficulties breastfeeding. Her husband, Kim Chen, advocates for women like his wife on a Facebook page honouring Florence’s memory:
For all the new moms…Do not EVER feel bad or guilty about not being able to ‘exclusively breastfeed’, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes...While agreeing to the benefits of breast milk, there NEED[S] to be an understanding that it is OK to supplement with formula, and that formula is a completely viable option…”
A fed baby is a happy baby. The Fed is Best Foundation, a non-profit organization in the United States, has taken up the movement to end the stigma against women who choose formula. They believe that “babies should never go hungry and mothers should be supported in choosing clinically safe feeding options for their babies. Whether breast milk, formula, or a combination of both – #FedIsBest.”
Whenever a pregnant woman expresses apprehension or fear of how she will learn to care for her new baby, we’ll often tell her, “Don’t worry. You’ll figure it out. Trust your gut. It’s called mother’s intuition.” Let’s follow through with the advice we give. If a woman chooses to give her child formula, let’s trust she’s made an informed decision that is best for herself and her family. And let’s respect a woman’s right to choose.