Tuesday, March 19, 2013

Breast is Best. But is it?

Breastfeeding is such a hot topic right now which has really impacting my feeling about feeding Dylan.

There are so many things I would have done if I had not had a preemie.  I would have taken a picture of my belly before giving birth.  I would have packed a hospital bag.  I would have saved cord blood. I would have requested to hold Dylan immediately after he was born. And I would have breast fed (ideally).

My pre-baby thoughts on breastfeeding were that I really wanted to do it for about 6 months.  At that point I had no idea when babies started solids, etc.  As soon as I had Dylan and heard more about it, I decided that I wanted to give Dylan breast milk for at least a year, maybe even longer since I feel like maybe I could protect him from getting sick since he is so vulnerable.

My hospital is extremely pro-breastfeeding.  There are signs everywhere.  At 32 weeks gestational age, I put Dylan to my "dry" breast after pumping.  He did great!  Then at 34 weeks, we started regular breast feeding.  I can't remember the specifics, but I'm pretty sure we mixed bottle and breast right from the start.

Things got frustrating after this point.

1) The nurses would ask me how much I thought he took.  I could never answer the question.  For all I know it could have been suckling only.  I did ask a few times about weighing him before and after, but I never got a good response.  I have no idea why and I did not take it up with the charge nurse.  This is the one thing I probably would have done differently.

2) At some point reflux became an issue.  Dylan was fighting the breast and the bottle.  We were also nearing 40 weeks GA and I really wanted to get him home and taking full feeds was the only way to do it.  Eventually I quit putting him to breast because it usually consisted of 10 or more minutes of fighting and crying, then I had to give him a bottle, then pump. It was extremely frustrating.  I knew that he wasn't going to take a good volume from the bottle if he was already tired from fighting the breast and I was getting emotionally drained from having our time spent in such a negative way, so I quit trying to breastfeed...always planning to go back when he got feeding down.

I wish that the nurses had given me a little bit more direction here, but everything is a judgment call and they did the best they could.

Then we switched to formula as a last ditch effort to get him to eat before getting the g-tube.  And it worked.  

After much speculation and observation, I think it's the thickness that is really the issue.  We did try adding rice cereal to breast milk a couple of months ago, but his volume went down quite a bit.  Adding rice cereal is also tricky because breast milk breaks down the rice, so you have to mix it within 5 minutes of eating.  The Enfamil AR is already thickened.  We could absolutely go back to thickened breast milk which I think I will ask about this week, but that will only solve half of my problems.

*     *     *     *     *
But I really want to breastfeed.  I have a new thing to be jealous about others moms for.  I know my "circle" for this issue is quite large - meaning I'm not nearly the only person in this boat, but still.  

This is really tough on me!  I agree that "breast is best."  But sometimes I actually feel like I'm being selfish trying to force it on Dylan.  Maybe it's not best for him.

Then I see posts online about defending breastfeeding.  I personally never thought it was under attack...it's really common in my area and my mom breastfed me for a year.  But the posts irk me.  They often say that the only reason someone doesn't breastfeed is because she didn't receive enough support in the hospital.  I don't want to feel like a mistake.  And I really don't think any were made.

I received lactation services the day of birth, had a pump in my post-partum room when I arrived that had a special "preemie" setting.  There was a pumping room before we switched to the new NICU.  I was able to get a great supply...something many preemie moms don't have.

I could have fought to EBF in the hospital, but what would that have looked like?  I wasn't going to live in that room for the 3 months he was old enough to BF.  So then I BF while I'm there, up to half of his feeds in a day.  We could have just gavaged all of the rest of his feedings.  

It could have worked.

But it could have taken a lot longer.  And because of the reflux, we probably would have had to introduce bottles anyway and it might have been much harder later in the game.  (He also needs to take his meds every day by bottle, so he would have always had to have at least one.)

I know this is rambly...I'm thinking through my thoughts as I go.

But the bottom line is that I feel like I have to defend not breastfeeding (or giving exclusive breast milk), even though I would prefer to be doing just those things.  And I feel like the people that do definitely feel like they are better than everyone else.  They do.  Even the nice ones.  And I probably would have felt the same way if I was them.

Don't you think I know how much easier it would be to just pull out my boob when Dylan was hungry?  Especially in the middle of the night.  

The bottom line is that I want what is best for Dylan.  And what is best for him, big picture, is calories.  I could probably teach him to breastfeed now.  But should I?  Struggle = calories spent.  (He's currently at 9lbs, 3oz which is about the 9th percentile.  Not bad, but he's gaining slowly and we don't have a ton of room left on the growth chart.

At the moment I'm adding 1/4 breastmilk to every bottle.  So out of the 26 or so ounces I'm producing at 3 pumps a day, he's eating about 6.  I can keep this up.  Even when I go back to work in May.  But it's very frustrating.  Especially because my husband doesn't get it.

So that's the story.  I hope it made a little sense while writing, because I don't have the energy to go back and revise!


  1. Whatever you are doing and continue to do for Dylan is what is best. Its is abundantly clear to me (and probably to everyone else who reads this blog) that you do ANYTHING for that little boy. Including continue to pump enviable ounces of BM for him to only take a small amount. THAT is dedication. You need to focus on his health. If he needs calories, get him calories. He is getting some BM daily, so he IS getting the benefits. Once he has feeding down and has gained more weight, introduce more and more.

    Your husband will never get it. Its not him, its biological. They might understand the importance, but not the bond or the emotions or the guilt that can come along with it. Try not to hold that against him, hes only looking at it as black and white.

    For now, continue to focus on keeping that beautiful little boy happy and healthy and growing. You have lots of milk to give him. You can get it into him eventually. For now, do what your heart and mind tell you is best.


  2. It was mandated by the pediatrician that we give my (full-term) wee babe formula from the git go. Like you, I've been trying to keep some BFing in the mix, though it's hard with pumping, etc. Actually in our house, it's my *husband* that is so pro-BFing. But I keep I wondering if it REALLY is that much better.


  3. I feel for you. I did not have a preemie...but was forced to go exclusivley to bottle fed (breast milk and rice cereal) because of my son's reflux. For 4 months he only got the bottle and I would give him a somewhat empty breast just to remind him what it was every couple days. But...he did show improvement in the reflux at about 5 months old (it started at 3 weeks)and we were then able to go back to the breast for about 50% of our feeds. Don't second guess yourself on what is best for Dylan. In your gut you know you are doing the right thing. but...I also understand that you have been robbed of the normal newborn/nursing/bonding time due to his prematurity and there is bound to be some mourning for the loss of that. don't let the boobie police intimidate you. they are doing what they think is best for their baby and it works for them....yay them. they don't need to be all judgy about the decisions of others...to advocate is okay...to bully is NOT!!!!
    Hang in there...you are doing great.

  4. ugh. I hated hated hated hated hated pumping, so the fact you do it SIX TIMES A DAY??? You are my HERO!

    I breastfed A until his 1st birthday. I, on the other hand, was formula fed and I turned out just fine. Whatever you feed your baby is best.

    Have you read this blog before? www.skepticalob.com

    Check her out. She has posts on this issue.

  5. You do what you've gotta do - sounds like little man is doing well, and that's all that matters! x

  6. doing what is right for Dylan is the most important thing. He is getting breast milk. He is growing. Yes, it's slow, but he's still growing. I was never able to get my daughter to latch properly and she had horrible reflux. I exclusively pumped for the first 6 months of her life and weaned during the 7th month (I'm old and we have frozen embryos we wanted to attempt to use before I'm really really old). I was able to feed her breast milk through 10 months with my freezer stash. I hated the looks I got from people when I gave her a bottle in public. People judging me for NOT breastfeeding even though she was getting breast milk. It was hard. I received wonderful support in the hospital and in an outpatient setting, but it just didn't work. I think you're doing an amazing job as a mom doing what is best for your son. Ramble away dear, this is one heck of a touchy subject.

  7. im so sorry you are feeling this way, what a heartbreaking post to read. my partner wasn't able to bf our twins and it was *extremely* emotional for her. even though she pumped for 12 months, she felt like a huge failure and felt judged by her family (who are very strong bf advocates). sadly, it's just the beginning of the "mommy wars" - constant competition and judgment, whether said or unsaid, between moms. we really need to do better _supporting_ one another...

    fwiw, it seems to me like you are doing an amazing job for your sweet boy - YOU are his momma and YOU know what he needs. keep doing exactly what you're doing. xo

  8. I'm going to say what all bottle feeders (is that a thing?) are thinking. Breast is NOT always best. I have come to loath the propaganda out there claiming that breast is best, and that your baby instinctively knows how to breastfeed upon being born, and that the real learning curve is for mom, and all the pats on the back that exclusively breastfeeding moms give themselves for making it to their breastfeeding milestones (6 months, 12 months, etc.). I understand that for some moms breastfeeding is difficult but they stuck with it when it got hard, found support, and were able to successfully breastfeed for their desired amount of time. For those moms I give kudos. For other moms breastfeeding just works, and aside from engorgement, leakage, and some minor blips on the path breastfeeding is fairly easy. And then there is a special group of moms (and it is bigger than anyone wants to think) that the roadblocks getting in the way of breastfeeding are too big to overcome. I don't know anyone these days who is pregnant and states that their goal is to feed a bottle of formula to their baby, or spend hours pumping with little return for the first year of their baby's life. Not breastfeeding is hard, time consuming, and emotionally difficult. And on top of that we have a lot of guilt associated with our 'failure' to breastfeed. You are not alone in this emotional journey. And you are not a failure if you choose to feed your son from a bottle. You are evaluating you baby's needs, and doing everything in your power to meet those needs. And isn't that more important that the vessel you serve his meals in? You are Dylan's mom. Only you know what is best for him. Go with your gut on this one.

  9. Breast is best... but it's a damn good thing formula is there for people who need it! And it sounds like Dylan is one of those people. It's so hard to advocate what's best without making people feel guilty when they can't do it, for whatever reason. Preemies are different; they have different medical needs. If he needs formula, well, that's what it's for. It is great that you're able to mix some BM into it. But it sounds like you're doing what's best for YOUR baby, and that's what counts. It just sucks that it's one more thing for you to feel left out about.

  10. i dont see anything wrong with trying to teach him BF now, as long as you don't stress him or yourself, as long as you think if he takes it, great, if he doesnt, great...

    1. I have tried recently, but it definitely expends energy and at our doc appt today, he's now in the 1st percentile, so better hold off a bit longer...

  11. Hi from ICLW. I really don't know what to say because I don't have kids yet. I know in theory I'd like to breast feed.

  12. Hi from ICLW...I wish I could add to the conversation

  13. I don't have any kids, and as you read on my blog if we ever have them they will probably be adopted so breastfeeding won't really be a choice. I do feel like breast is best and people should try to do it, but I don't think badly about people who did try and it just didn't work out for them. Really I don't think badly about people who didn't even try. It's more like when people tell me they've never read Harry Potter. "Really, you didn't even try?" but I say that in my head not out loud and after that brief moment I take a to each his own approach. Breast may be best when possible, but there are a heck of a lot of stuff I do that isn't best. Eating an ice cream float for breakfast isn't anywhere near the best choice so who am I to judge?

    1. And you probably had no idea that I'm and English teacher Harry potter lover...:).

  14. You keep doing what's best for you and Dylan. Mama knows best - and you're doing an amazing job!

  15. Hi there...I have lurked around your blog from time to time and stumbled upon this post from visiting another blog and am extremely thankful to have read it. I don't have a preemie but I totally agree and understand how you feel. It didn't work out for me either and like others have said, I have guilt also that I'm slowly working through. I just wanted to be one more person to say "you are not alone" and to let you know that, by reading this post, you have done the same for me. :) Thanks for sharing your story. We are certainly doing the best we can!!!