UPDATED: Hospital's Breastfeeding Contract Sparks Shame, Annoyance For B.C. Moms
Bonnie Munroe* planned on exclusively breastfeeding her baby. A diligent mom-to-be, she prepared by reading breastfeeding literature, purchasing high-end gear (including four nursing bras) and participating in an educational lecture. She even hired a doula specializing in breastfeeding. Following the arrival of her baby boy -- born at a Fraser Health hospital in B.C. -- breastfeeding initially went well. Munroe left the hospital feeling confident and didn’t flinch when a nurse whispered in her ear, “Stay away from formula.”
“I will,” Munroe replied.
Today, the nurse’s words stay with her.
Back at home, Munroe experienced sleepless nights with an unsettled baby. Her son was unsatisfied and wasn’t gaining weight. The new mom immediately sought help from her maternity clinic, followed up with her family doctor and was referred to a pediatrician. She also received phone support from her local public health unit and attended a breastfeeding support session with a lactation expert.
“I found it difficult to implement the myriad of recommendations I received because I desperately wanted to produce an abundance of milk without intervention,” she says. “I received great care from all of the professionals I visited, however, I ultimately felt alone. As I began supplementing with formula, I remember being in tears numerous times feeling inadequate as a woman and mother.”
“Stay away from formula.” The nurse was not simply extolling her personal option. Rather, Fraser Health and many other health authorities are dedicated to promoting breastfeeding. It would seem, however, that they could use a little sensitivity training.
The New Moms Contract
New moms who deliver in Fraser Health hospitals are given an infant feeding declaration to complete and return to a nurse. The form listed the pros of breastfeeding and the cons of formula and asks women to sign next to their feeding plan of choice. Some highlights from the form include:
- “Although most babies grow on formula, studies show the routine use of formula comes with some risks to both mothers and babies.”
- “Even one feed of formula can damage (baby’s gut) coating and make illness more likely.”
- “Babies who do not receive breast milk are more likely to get significant illness and disease.”
- “And…mothers can take longer to lose their pregnancy weight.”
So, your baby may not grow on formula, even one bottle can make him sick and the little guy is 38.5 per cent more likely suffer from SIDS. Oh, and you’ll be wearing those maternity jeans for a while longer.
Insulting And Upsetting
Megan McMillan* received the “contract” on the ward after her baby was born. She too had been planning to exclusively breastfeed, but her baby was one month premature and her pediatrician recommended formula as he was losing weight. The nurses pressured McMillan to sign the declaration, but she refused.
“I found the form to be insulting and upsetting,” she says. “It gave the impression I was putting my son at risk if I followed the doctor’s direction. It implied he would have a higher risk of getting cancer even. Thankfully, my critical thinking skills came into play and I brushed it off but it still crosses my mind at some points. I refused to sign something saying I may not give my son a good start in life.”
Victoria mom Jessica Smith* says it wasn’t formula that put her daughter’s life in danger; it was lack thereof. When her baby’s weight was dropping, her doctor urged her to supplement with formula, but she ignored his advice. “Using formula represented the ultimate failure to me,” she says. “Everything you hear is about how supplementing interferes with breastfeeding and that almost all women are able to exclusively breastfeed. I thought my doctor was just a formula pusher.” But the baby’s weight got dangerously low and her doctor said she was dehydrated and starving. It was the word “starving” that finally convinced Smith to break out the Similac. As she feared, when she started supplementing her milk supply evaporated. “I still don’t know what the right answer was. But I do know my daughter is healthy.”
For Smith, it got worse before it got better. After a few insensitive comments and more than a few judgmental looks when she bottle-fed her daughter at her local baby groups, she stopped going. She started to plan her outings around her baby’s feeding schedule, so she wouldn’t have to break out the bottle in public. “I think bottle-feeding moms face more harassment than breastfeeding moms in public. I was feeding my daughter on public transit and a woman called me lazy and selfish.” The lack of social interaction with other moms and babes, and the formula-induced guilt gave her the baby blues.
Munroe experienced similar shame: “I remember trying to cover the bottle in the diaper bag so that nobody would see it or hoping that others would think that it was full of pumped breast milk instead of formula. It seems absurd now that I look back.”
Nurses have been mandated to push breastfeeding. Celebrities are sharing gorgeous photos of themselves nursing their babes. La Leche League leaders are lingering in the formula aisle, asking women if they need breastfeeding support (true story -- it happened to my friend). Mothers are judging. Babies are starving.
Has The Breastfeeding Campaign Gone Too Far?
Yes and no.
The strength of the campaign gave me and countless other mothers the resources, support and confidence to exclusively breastfeed. I nursed my eldest until she was 26 months, well aware of the World Health Organization’s recommendation to continue breastfeeding until the age of two or beyond. Awareness breeds acceptance and I’m grateful I can feed my baby where I want, when she wants.
Sometimes you have to push hard in one direction to get any movement. Breastfeeding advocates are up against formula companies, which have big advertising budgets and strong influence. Breastfeeding rates in Canada are going up, and that is a good thing. According to Statistics Canada, 26 per cent of mothers are breastfeeding exclusively (2011-2012 numbers) compared to 17 per cent in 2003. The most common reasons cited for stopping breastfeeding before six months were “not enough breast milk” and “difficulty with breastfeeding technique.”
How We Can Support, Not Judge
So how do we help women who have difficulty breastfeeding overcome their feelings of shame, inadequacy and guilt?
We can start by showing support, not scorn, when a woman is bottle-feeding. We can ask our childbirth educators to discuss the medical reasons why some women may have low milk supply (i.e. polycystic ovary syndrome, diabetes, insufficient glandular tissue) and the reasons some babies may have trouble feeding (i.e. jaundice, cleft lip or palate, tongue-tie). We can demand more balanced information from our health authorities.
Instead of telling moms their babies are up to 42 per cent more likely to have diabetes if they’re bottle-fed (according to Fraser Health’s form), we can share with them balanced research, including a recent study from Ohio State University entitled Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons. The study, which received widespread attention, looked at siblings who had been fed differently and found no statistically significant differences in health or academic outcomes (at least those that the study investigated) for breastfed and bottle-fed children. The study suggests that the risks associated with a failure to breastfeed are drastically overstated and mothers who are unable to breastfeed for a range of reasons should not be stigmatized.
“I would like to hear more conversation around breastfeeding troubleshooting opposed to in-your-face breast-is-best campaigns, which marginalize women who are facing challenges,” Munroe suggests. “I would encourage other moms going through this to share their stories to release some of the weight off themselves. I think they’ll find that there are other mothers who share their experience. It breaks the shame barrier when you don’t feel like the only one and a failure. You don’t have to hide behind the nursing cover.”
*Last names have been changed.
*UPDATE: The Fraser Valley Health Authority has since pulled the pamphlet after receiving many complaints from the public. Read their statement here
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