I'm curious

[torontomom]

deleted...

[alexsmommy]

Not offensive at all. It just makes me jealous. No, the US is definately not the most BF friendly country - and I too have wondered if our ridiculous maternity leave policies and failure to provide space/time/equipment at work to pump also hurts our BF rates. I have so many friends who BF up until they go back to work and then stop b/c they find it too hard to pump at work. I was fortunate and had a private office so I was able to do it for a year. Also, not all hospitals here have LC's on staff - or if they do, the may not have enough. Not all Dr.'s are BF friendly either. Some are very supportive and informed and understand weight gain, feeding schdules, dietary issues (allergies/sensitivities) etc while others say, "Oh, he/she's not gaining enough. You should switch to formula." Yep, that and even more asinine statements - I'm sure people will share their experiences. Again, I'm jealous you are in an environment that supports BF.
Alaina
Alex 2-4-03

[murpheyblue]

You can see some statistics on US breastfeeding here and compare them to rates in other coutries:

http://www.kellymom.com/writings/bf-numbers.html

I believe US maternity leave policies are a major factor in US moms not BFing beyond 3 months or so. As a society, we're not real friendly to BFing moms. I BFed my DD for over a year with most of those months pumping at work. It's hard and I can't fault moms who cannot make it work with their jobs.

As far as BFing doctors, some doctors will say their pro-BFing but encourage you to give it up if problems arise. Moms don't need a doctor who is blaming them for a baby's slow weight gain when that may be the baby's natural curve.

[californiagirl]

One of the women in my moms and babies yoga class was told that she ought to give her baby rice cereal at 4 months to help him sleep, because he was such a big baby and he didn't yet sleep through the night. When that just made it worse (who'd a thunk?) her Dr. told her to do CIO. Then her supply decreased (again, who'd a thunk dropping half your feeds, and those the nighttime ones that do most to increase supply, would affect your supply). But it came back, and kiddo, off the top of the weight charts and 50%ile for height was perfectly happy. Then he dropped to 90%ile for weight at 6 months (exactly as you'd expect for a breastfed baby) so the Dr told her obviously she didn't have enough milk and she should supplement with formula. He advised doing formula *first* at every feeding. Her supply dropped again, so she decided obviously she just didn't have enough milk. Said Dr , according to her, really encouraged her to breastfeed. With friends like these... (Yes, we did regularly point out that his advice was not current recommendations, etc, but she just loved him and didn't want to hear it.)

[babymama]

The hospital where I had DS had lactation consultants, in theory - but they were stretched very thin. Several shared part time shifts. So that there was only 1 on staff part time for the entire hospital - including the NICU - at any given time. So it's possible that unless you were very demanding about being seen by an LC, you may not have actually been visited by one. I was visited by 2 during my time in the hospital - neither spent that much time with me and both gave me conflicting advice.

My experience with our ped also was that when I was having a hard time getting DS to BF, she took a "no big deal" attitude with it. She told me not to worry about switching him to formula and that it was mostly just important that he get milk - didn;t need to be BM. SHe did give me a card to an LC that I could call, but never really showed a whole lot of support for helping me resolve my BF issues. I am one of those who feel guilty that I didn;t make it very far with BF (almost 6 months) the first time around. I've also read stories here about the US growth charts for infants being based on formula-fed babies, so that BF babies appear to be underweight - some peds will then pressure moms to supplement w/ formula to bring up the baby's weight.

So my impression is that there is a lot of lip service about breast being best, but when it comes down to it, moms must seek out a lot of support beyond their delivery hospital and their peds (like these boards or from private LCs) in order to help establish or continue breast feeding.

Lydia
Mama to Santiago, born 11/16/03 and
One on the way, due 01/03/06

[o_mom]

Our ped wasn't anti-BF, but wasn't the most supportive. DS1 had slow wt gain, which in hind sight was probably due to low production from a retained placenta fragment that was never caught (just my self-diagnosis after the fact). I showed up at the first appt (1 wk) saying "I have seen the LC every day since birth, here is the plan" and she just wanted to see him weekly for weight checks the first month. If I mentioned any problems, she would say "It's OK to switch to formula", but never said I had to. I don't know what would have happened if I didn't pursue other help on my own.

She was somewhat miffed with DS2 when I contacted early intervention for feeding issues (LC suggestion) since he was gaining weight just fine. I don't think she understood that bleeding raw hamburger nipples don't make for a good bonding experience. ;-)

[Melanie]

Sadly, no, it is definitely not like that in the US. The hospital where I delivered Ds had one LC on staff and she was on vacation when he was born.

We have a BF-friendly MD, but I hear so many stories of MD's suggesting someone stop BFing at the drop of a hat.

It's only offensive b/c you Canadians make it so darn hard for an American to emigrate there! ;-P

[wagner36]

Most of the peds at our practice are very pro breastfeeding. The ped that visited Charlie in the hospital gave us a schpeal about the importance of breastfeeding. When Charlie had a good weight gain, our ped would tell ME I was doing a great job for making such good milk. The head of the practice, an older man, gave me terrible advice once though, too. I told him that Charlie was dropping daytime feedings, so I thought we might start to wean and asked him how to do it. He said that no one had EVER asked him that before, and his advice was "just stop" - as if it was a ridiculous question. You've been a ped for 30 years and no one ever asked you this before? Totally unacceptable. I called the office manager about that one, and she sent me a bunch of materials, including links to Kellymom, which I thought was very cool. To be honest, it is the younger women and med in the practice that are so supportive - they're in the pro-breastfeeding generation. I really think there was a non-breastfeedig generation before ours, YKWIM?

The hospital has a breastfeeding hotline, but it is hard to get good advice over the phone. You can visit them, but it is hard to schedule appointments for when a newborn wants to eat, you know? They have LCs on staff, but it's hard to get them to come and see you in your room unless you have BIG issues, like cleft palate, etc. I was lucky that my nurse was incredible, and she told me right away that she is super pro-breastfeeding and would love to help anyway she could. She sent my husband home to get my boppy, and showed me everything. It was great.

So, basically, it is a hit or miss thing.

[cmdunn1972]

We are FFing our 6 month old since our adoption happened too fast to establish and induce lactation needed for adoptive BFing. However, I can speak to what other Moms in my Gymboree class have said regarding lactation consultants in our area hospitals.

Mostly, they (the lactation consultants) stink. Three out of four Moms are BFing, but only because they got strong support from the local La Leche League and/or midwife.

For one of the Moms, the LC gave virtually no instruction, then mentioned that she seemed "fine", asked the Mom if she was doing okay (as if she'd know), then said she had to leave to help a woman having trouble. As a first-time Mom she wanted more instruction, but felt guilty for asking since it would bring the LC away from her other "emergency".

One of our other Moms had a really hard time establishing BFing with her son, got even less instruction and support from her hospital's LC, and gave up as a direct result of the lack of help.

Frankly, these stories both bother and baffle me. Why would someone bother to get a job as a lactation consultant if they have no intention of supporting BFing Moms?

[MegND95]

Everthing seems very inconsistent to me. I had my older two kids in a large, military teaching facility, and the lactation care was terrible. I had a horrible time bf my first, and got mixed messages from the all the nurses. I can't even recall seeing a true LC. In fact, one ped encouraged me to "give-up" when all I really had were bleeding and cracked nipples. Not what I would consider worthy of abandoning bf all together. I just needed a little extra help, that by a fluke, I ultimately got from a nursing assistant at the ped's office about 2w after dd's birth. Incredibly frustrating.

My third child was born in a regional hospital that was staffed by two amazing LC's. I had some problems in the early weeks, and these women were amazing. Stayed after hours to meet with me. Patient. Kind. Knowledgeable. When ds #2 was 4m old, I had emergency surgery to remove a perforated appendix. The LC came to my room after surgery, gave me a hospital grade pump, and discussed how often I needed to pump etc. The dedication to bf was fabulous.

As I am one of the first of my friends to have kids, I advise all my gf's who get pg to look for the LC's at the hospital or in their community, and USE THEM.

[amp]

Without reading the replies yet, I'll respond. Although this hasn't personally happened to me, I have heard of docs who were VERY quick to recommend people supplement w/ formula, without having better knowledge of how to help a woman increase her supply or success w/ BF. Also, I gather, from other posts (etc) that there are docs who will say up front, "Of course I'm BF friendly" but act differently when they start pushing moms to start solids or formula for reasons that aren't sound.

It's unfortunate that one would have to *look* for a doc that really was truly BF friendly AND knowledgeable about how to support that!

[mamicka]

I haven't read all the responses, don't have time at the moment. But I have to say that I agree that the US isn't the most BF-friendly country, but I don't think that has anything to do with maternity leaves, peds not being supportive, etc. I think it has most everything to do with the attitudes our society has about breasts. On the one hand you have a lot of really conservative people who don't believe that mothers should BF in public because it's indecent & on the other hand you have people who think of breasts as purely sexual & thus are disgusted by seeing (or thinking of) babies at the breast. Most everyone I know who was not successful at BF or just decided not to try, was heavily influenced by one or both of these ideas.

Allison

[Katia]

I'm jealous of the way it is in Canada! :-)

In the U.S., I'd say there's a fair amount of pressure to breastfeed but not much support. My hospital had people who paraded around the maternity ward claiming to be LCs, but honestly, I think they used the title fairly loosely. The first one who arrived in my room, 12 hours after DS was born, tried to tell me I needed to give him formula. Most of the others weren't much better.

Our ped was supportive of breastfeeding, but was totally unhelpful when we developed thrush. So I saw a family practice doc who was not only unhelpful but incredibly rude. After she said, "Yeah, lots of women quit bfing because it's painful," she left the room while I was still in tears.

And then there are the TV talk shows where they criticize women for having the gall to nurse their babies in public.

On a positive note, however, I was lucky to have a boss (a male, BTW) who was really understanding about my pumping. AND despite my earlier difficulties and the fact that I never expected to nurse past a year, DS and I just passed the 2-year mark. Woohoo! :-)

[hez]

Not offended :)

All of my friends have at least made the attempt. Most who are WOHMs (other than those at my co. which has an amazing Mom's room now) stopped much sooner than I did because the set up they had (or did not have) at work to pump just didn't cut it in the long run. So, yup, the shorter maternity leaves here probably made an impact in those cases-- 6 weeks barely gets you through the 'break-in' period, let alone gets your supply established well!

Doctor-wise, well, speaking for myself I made them help me when I needed it, and otherwise educated myself. They weren't bad folks, but had no reason to step in 'cause Payton grew like a weed from Day 1. My LC in the hospital preferred to chit chat rather than help (and I was still self conscious at the time and not making it easy on her, either!). So in my case, I wouldn't give the doctors or the LC I saw in the hospital *any* credit for our success.

[nov04]

I delivered in a large Ontario city. I had no support for bf, there were LC's in the hospital, but they didn't perform that function (not all Cdn hospitals have LC's). Frankly, they spent more time looking for non-existent 'roids and pinching me than helping me in any productive way. Once they found out I was having problems, they asked me if I wanted a pump and stopped trying.

Our ped. didn't attempt to help at all when I was having problems, although I was past the point of wanting help, just wanted to enjoy dd.

I think Canada tries to look like a very pro-bf country on paper, but there are lots of instances where its just not suppported or encouraged. Have tons of friends all over who can attest to this.

[jerseygirl07067]

Interesting post...here's my cornucopia of thoughts on the issue...


I would say that overall, I have received more negative types of comments and advice from relatives/family/friends than positives about BFing. Many have been of the, "oooh, that's kind of weird, once the baby is over 3 mos/6 mos/1yr mark., yada yada..." nature. Or was told the rice cereal story, or to give formula at night, etc. etc.

Our American society is definitely hung up sexually, overall, which is why many people get wigged out seeing a woman BF in public, yet these same people are okay seeing Cosmo-like billboards all over town, or better yet, frequenting establishments such as Hooters.

My ped in the hospital was very pro-BFing, to the point where he told me to ignore the advice of a LC to give formula. The LC who I had was probably pushing formula way more than she needed to, since it was less than 48 hours, and my milk came in the next morning anyway. Um, colostrum anyone? Then, my last night in the hospital, I had Julia go to the nursery for 5-6 hours, so I could get some rest (after laboring for two days). My milk came in earlier that day, and I sent her down with 3 bottles of EBM. They wound up using 2 of them, and then gave her formula for the last feeding, because she was being "fussy". Whatever...Never bothered asking me either, despite me saying I'm exlusively nursing.

I do think that in our country, there is a lot of misinformation given out by peds, on lots of things, including BFing and I do believe that this has a great influence on moms. I do feel that the more educated and informed you are, the easier you can deal with the conflicting advice. Also, the better you are prepared for the reality of BFing and the challenges of those first few weeks, the more successful you will be.

Yes, our shorter maternity leave, and lack of employer support and benefits available for taking longer leaves makes it a lot harder for moms too, to BF longer. Motherhood in and of itself has its own challenges, then add in working outside the home and pumping to the normal work stress level.

Formula companies subliminally try to get you to wean to formula, as many hospitals give the, "breastfeeding success bag" that includes, what else, a sample or formula. That practice really bothers me.

And then there is the pervasiveness of books like Babywise and The Baby Whisperer (read both, each has its own pros and cons) that can be detrimental to some moms' BFing experience. Don't get me wrong, there are some good points to each, but as a whole, they both send a less than positive message, especially the longer the mom BFs.

This is no way a means to offend many people who couldn't get BF to work. The people I know who experienced problems were the ones who most tried to make it work, and were the most diligent. They deserve much credit (and hugs) for it. :)

So yes, I really do think American society makes it harder on moms to BF.

Marcy

[niccig]

I don't think it's just the US and finding good BF support. My friend in Australia had problems with chewed and bleeding nipples. Another friend gave her more support than the LC she saw. I sent her the Medela soothing gel pads my LC suggested for me (no longer available, but there were similar to soothies), and within a week she was healing and enjoying BF for the first time. When her sister experienced similar problems, they asked me to send more of the gel pads. I think your friends who have breastfed can sometimes be more valuable than a doctor. If you find a good LC, tell all your friends, which is how I found her.

Nicci

[TahliasMom]

I think it depends on where you give birth. I had a lousy HMO and since I gave birth on Sunday I had a over zealous nursery nurse trying to teach me how to BF. Lets just so by Monday my nipples were sore and bleeding and i cried everytime dd latched on. the LC was very helpful, got me some shields and soothies which helped a lot. my pedi was wonderful and very supportive. i'm just glad that i was albe to stay home with dd until she was almost 10 months. I couldn't have been able to pump at my old job.

[lisams]

I agree. As a matter of fact, my friend who was told she couldn't breastfeed at the city pool is now on a mission to get an ordinance that says a woman may breastfeed wherever she is allowed to be. She received a letter of support from Lawrence M. Gartner, M.D - the Chair of the Section on Breastfeeding of the American Academy of Pediatrics. Here is part of it:

"One of your constituents has told me that you are
considering an ordinance regarding breastfeeding in public places.
This is an issue of great importance for the health of children and
mothers. Restrictions on breastfeeding in public locations is one
of the most frequent reasons that mothers give as to why they choose
not to breastfeed their children. It is most unfortunate that this
is the case, since breastfeeding protects infants and children
against a large number of acute infectious diseases, chronic
disorders including cancer, and generally promotes optimal growth
and development...."

I could write 10 pages about what we've been through, but to sum it up, yes this is one of the biggest hurdles our nation is going to face as far as increasing the numbers of breastfeeding initiation and duration rates to meet the "Healthy People 2010" goals.

[Sarah1]

My personal feeling is that people tend to blow the whole BF issue out of proportion. I really don't pay attention to any of it. I have found everyone here (in Chicago) to be very pro-BFing. I've never heard a negative comment about BFing my kids, including on all the occasions that I've nursed in public...on planes, in stores, at restaurants, parks, you name it.

[lisams]

I'm guessing it really depends on where you live. Three moms in Arizona in the past few months have been told they would need to nurse in the restroom or leave while feeding their babies in public. I'm sure many more have had this happen to them too, these are just three that I personally have heard about. Arizona is a very conservative state, so that plays a part in it. I'm glad that where you live you haven't had any negative experiences!

[torontomom]

deleted...

[alexsmommy]

Mmm, I think you've been really fortunate. I had some not so great experiences outside of my traditional circle - and definately some in public both in Chicago and the 'burbs. Now I will say, I was thrilled to see someone NIP at the Aboretum last Friday and no one seemed phased. That made me smile.
Alaina
Alex 2-4-03

[caheinz]

Keep in mind that suburban Illinois is the birthplace of LLL.

There have probably been more BFing moms around here than most places -- and more doing so more visibly...

That said, we were in AZ for the first 4 months of DS's life, and I never had a problem there. Though, I'm not sure how much I NIP'd there... I wasn't avoiding it, we just weren't going out much with an impending cross-country move...

[ykc]

It seems to me a lot of breastfeeding success/failure really depends a lot on the woman's own assumptions and the support of her social circle, some on societal influences/expectations, and somewhat on the luck of the draw in terms of professional support. I agree with nearly everything everyone else has written, so I won't repeat, but I do have a couple extra comments.

First, I will say, for the record, that I am very pro-breastfeeding. On a personal level, I nursed my daughter for 9 months (had to pump 6 out of 7 days and every 4th night from the time she was 8 weeks old) until my supply dwindled to nearly nothing and she lost interest, and for 17 months with my son, when he self-weaned (I stopped pumping at 12 months though). On a professional level, I am always a bit sad when I have a new mom who doesn't even consider breastfeeding, and I do whatever I can to help a mom succeed at breastfeeding. I write scripts for pumps and for Reglan, I suggest fenugreek, I refer to LCs, if I have time, I watch a mom nurse (even though that's not what I'm trained in--at all!), and I try to help moms position and get the baby latched on. But I also nearly always tell moms that it's okay to give your baby formula if you need to (though I caution them about supply issues). It's not because I'm trying to undermine breastfeeding--it's because there are a lot of moms out there who feel terribly inadequate or incompetent or guilty or anxiety-ridden for having difficulty nursing, or not enjoying breastfeeding, or preferring to bottlefeed, or whatever. My SIL gave up breastfeeding in part because the nursing staff and LC at her delivery hospital were so militant about it. No formula, no bottle, I don't know what they said about a pacifier. She didn't feel like she could do it "right" so she quit altogether. Sadly, the day she decided to stop trying was the day her milk came in.

As far as breastfeeing-friendly peds are concerned, well, there are definitely a lot of pseudo-supportive docs and probably even more who just don't know a lot about it. Most of my knowledge comes from being a mom. But I feel compelled to say that the pediatrician's job is to make sure that the baby is healthy and gaining weight appopriately, however the baby gets nutrition in. Sometimes when a baby is gaining slowly, I'm sure the mom may feel like the doctor is not being sufficiently supportive of breastfeeding. I know it must be frustrating for some moms when they're just not connecting with their baby's doctor about feeding issues, but I don't think the doctor necessarily has a hidden agenda to push bottlefeeding. Ignorance can definitely be an issue (i.e. doctor doesn't know how to help breastfeeding), but for every mom who feels like too much formula is pushed on her, there is probably another mom who feels pressured into breastfeeding when she'd really rather not. It's hard for the doctor to always figure out which is which.

BTW, I'm not sure if the newest growth charts are based primarily on formula fed babies or not (they were revised in 2000), but breastfed babies are usually bigger than formula fed babies until about 9-12mos.

OK, hope I didn't rant too much, but I'm done now.

[sntm]

Lots of the points have been covered:
* the paradoxical love of breasts as sexual organs/revile of breasts as functional organs, exhibitionist/prudishness
* the pressure but lack of support to breastfeed
* the old guard medical professionals who give bad/outdated advice
* the tendency of Americans to push independence/detachment too early and/or substitute artificial soothers for breastfeeding
* 6 weeks (or shorter) maternity leaves
* reverse peer pressure (e.g., grandma woundedly protesting "I fed you formula and you are just fine!")

Regarding LCs, the title unfortunately is not yet regulated, so anyone can call themselves an LC. It's like calling yourself a psychic.

IBCLCs at least have to qualify based upon education, documented hours spent counseling breastfeeding dyads, and passing a test. But the system isn't perfect, and an RN in a hospital that wants to advetise that it has an IBCLC may be pushed into becoming one to keep her job, get a raise, etc. Plus, without an official apprenticeship/residency, who knows whether the counseling hours were done correctly or what the outcomes were. Which is why many IBCLCs want it to become codified, like nursing programs, dieticians, physical therapists, etc.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03
http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif[/img][/url]
Breastfeeding 2 years & counting

[erosenst]

My "worst example" is my OB's partner. I called him one night because Abby had shared her yeast infection with me - it was in my nipple. :(. As I was telling him my history (ie. I had BF'd for 17 months with almost no problem) he stopped to say in a shocked voice "You're STILL nursing????". I knew I didn't like him - that confirmed it :(. Unbelievable to me that an OB would have that attitude. Fortunately, my (female) OB was the complete opposite, and a big BF advocate.

[NZmom]

I just wanted to say that my BIL is a pediatrician and he told me that his cohort of residents were the first in 30 years at that teaching hospitial to have any training at all in breastfeeding! My BIL is 36 years old and finished his residency about 5 years ago, so the "old guard" who know nothing about BFing aren't necessarily that old!

Robin

[kijip]

It varies regionally IMO. Here in Seattle, I have found pressure to BF and a wide spread acceptance of public breast feeding. The LCs were helpful and my docs supported bf-ing. However, I can think of some ignorant, bf un-friendly advice given, mostly by the older nurses at the first pediatrician's office we used.

It also occurs to me that to some extent people find/emphasize what they are looking for. For all the support that is readily availablehere, I am sure a Seattle mom with a differnet perspective would have a different answer. Not to say that feelings of pressure to bf or ff don't exist, just that they both exist and we tend to take offense at what is not in alignment with our own beliefs- maybe not hearing or noticing the pressure that we agree with. It seems to me that FF moms, especially those who were unable to nurse and had to stop sooner than they wanted to (myself included), tend to see all of the pressure to BF and BF moms tend to see all of the anti-bf things more clearly. But when I hear reassuring things about FF I might take them as supportive while a BF mom would take that as pressure. I know that the pressure I felt to BF was perpetuated by folks with nothing but good intentions who thought it was helpful support to keep me BF. Just my 2 cents.