The rhetoric about formula feeding - Page 5

[rmzbm]

I dislike "substitute" - makes it sound just as good. It cannot simply substitute BM, with all things remaining equal. It is substandard, it is inferior. No need to internalize those words.

[mrsdocmartin]

Originally Posted by rmzbm

I think those terms ("inferior" or "4th best") are neither negative nor derogatory. They are simply facts. One should not be offended by factual information. I am not one to "bash" FFing moms openly...but that doesn't change what IS. And formula IS those things.

:

[mrsdocmartin]

THIS is what I've been trying to say!

[songbh]

Originally Posted by milkeriffic mama

It's a public health rather than an individual health issue.

Bingo. Well said.

Also: I am always sorry to hear of browbeating strangers approaching mothers in grocery stores etc. I am sure that such behavior by whoever is rude or socially maladjusted enough to do that is counterproductive and harmful to the cause of lactivism.

However, I get really tired of these anecdotes being raised as evidence of how clear discussion of the risks of not breastfeeding is a bad idea. Busybody jerks in grocery stores (or on internet forums) are not lactivists -- they are busybody jerks with boundary issues.

It seems to me if a person is committed to the cause of increasing breastfeeding rates by removing societal obstacles and promoting the dissemination of accurate and reliable information and support for women who want to breastfeed ... that person, regardless of her own infant feeding history, will be able to look past her unfortunate encounters with busybody jerks and see the broader picture of the movement and the societies it is trying to change.

[Momily]

I have two entirely different thoughts about this, which I guess I'll put in two different posts:

I think there's a difference between guilt and grief. I don't have an iota of guilt about FFing my child. It was the right choice for us (and yes, although I'm definitely in the category that most people would call "not having a choice" I'm going to stick with saying that we made the right choice). I do however have grief -- grief that we weren't able to experience this beautiful thing, grief that he he experienced early health problems that might have been lessened if donor milk had been realistically available.

Similarly, I'm looking into special needs adoption for my second child. Let's say I adopt a child with Down Syndrome. I will probably not feel guilty that my child has DS (and neither should parents who give birth to a DS child by the way, I just mentioned adoption because that's the way I become a parent) but I am sure that there will be times when we encounter bumps in the road, whether it's prejudice, or worries about his future, or things he wants to do that he isn't able to do and I will feel grief -- grief that my child has a more difficult road to travel.

I think even in the most clearcut of cases (and our was pretty clearcut that FF was the right choice) whether it's galactosemia, or PKU, or a child whose lost his mother and is being raised by Dad, where the choice seems clear, a parent who strongly believes in BF is likely to feel grief.

[Momily]

And here's my second thought.

Imagine that I made a nice long list of choices for feeding and put them in order like this, including every combination of Mama's milk and Formula, donor, homemade, storebought, fed via the breast or in a bottle or a lactaid or a cup or feeding tube. It would be a pretty long list that might look something like this:

1) Exclusive Breast Feeding, straight from the child's biological mother
2) A combination of breast feeding, and expressed milk from the child's mother fed in a cup.
. . .
5) Breast feeding with a tiny amount of supplementation given in a lactaid
. . .
10) Organic milk based formula given in a cup (and I'm not sure that the WHO's argument that cup are safer than bottles applies in affluent Western countries)

15) Regular milk based formula fed via a glass bottle by the infant's mother wholding the baby in her arms.

. . .

25) Regular soy based based formula fed via a glass bottle by a combination of the infant's parents and substitute care givers who hold the child in their arms.

- - -


100) Some kind of substandard homemade formula (I'm not saying all homemade formulas are substandard vs. regular formula, just imagine that this one is), fed by an NG tube to a baby left lying awake by themselves.

Now imagine that I went about boasting that "I feed my child in a manner that's in the top 10th%ile!" Or "Ten out of 100 is pretty darn good". I'd be manipulating the statistics to make my point -- don't you agree? Well I feel the same way about the "4th best" rhetoric, even though I agree with the sentiment behind it (that in the vast majority of situations, breastmilk is the best choice, and that if getting it straight from Mom isn't an option, look for other ways to get it before you consider formula) -- Heck you could make it "5th best" by adding in Mama's who nurse AND pump between 1 and 2, or 6th best by adding Mama's who BF and supplement in there.

I guess that's why I think the 4th best rhetoric is unfair or misleading. In my mind there are two safe choices -- breastmilk and formula. One is definitely better than the other, and should be the first choice. Making artificial divisions between kinds of breastmilk or methods of delivery, but not making the same choices between kinds of formula or methods of delivery is just playing with the statistics.

[FREEmom1120]

Originally Posted by Momily

I think there's a difference between guilt and grief. I don't have an iota of guilt about FFing my child. It was the right choice for us (and yes, although I'm definitely in the category that most people would call "not having a choice" I'm going to stick with saying that we made the right choice). I do however have grief -- grief that we weren't able to experience this beautiful thing, grief that he he experienced early health problems that might have been lessened if donor milk had been realistically available.

I agree and can relate totally. I've often thought that people probably mistake my lack of guilt for lack of grief and that's just not true. Hell, I'm seeing a counselor for the grief I've experienced over our situation. But I don't feel guilty for the decision I made in light of our situation.

[PatioGardener]

Originally Posted by Momily

In my mind there are two safe choices -- breastmilk and formula. One is definitely better than the other, and should be the first choice. Making artificial divisions between kinds of breastmilk or methods of delivery, but not making the same choices between kinds of formula or methods of delivery is just playing with the statistics.

I understand what you are saying, but I would argue that there are 3 safe options: mother's own breastmilk, donor breastmilk, and formula. I think that by ignoring donor milk we minimize an option, that with governmental support for milk banks, would be a possibility for mothers who can't breastfeed, but babies who can have breastmilk.

[Momily]

Originally Posted by PatioGardener

I understand what you are saying, but I would argue that there are 3 safe options: mother's own breastmilk, donor breastmilk, and formula. I think that by ignoring donor milk we minimize an option, that with governmental support for milk banks, would be a possibility for mothers who can't breastfeed, but babies who can have breastmilk.

I guess I see breastmilk, and donor breastmilk as no more different than milk formula and soy formula, or formula via SNS vs formula via bottle. If you look at that way there are LOTS of ways to feed a baby.

I get the 4th best thing as a way of saying "consider donor milk before moving to formula", it just seems like a manipulative way to say it. If people want to say "Consider donor milk before moving to formula" why don't they just say it like that.

I think that the 4th best thing is one of those things that "demonizes" formula to the point where people post about wanting to put their 6 month old on goats milk, or make their own formula out of liver, or do other unsafe things because they believe that formula is bad. Formula's not bad, it's just not the norm, or the ideal. It's a second choice when the normal thing to feed your baby isn't an option.

[PatioGardener]

Originally Posted by Momily

I guess I see breastmilk, and donor breastmilk as no more different than milk formula and soy formula, or formula via SNS vs formula via bottle.

This is where we differ

I see donor milk ask vastly different from a mother breastfeeding her infant. I see it as something that would be used when a mother was not able to breastfeed her child, and ideally it wouldn't have to be used often because women would receive support to be able to breastfeed (on a societal, as well as personal level.)

Rather than "consider donor milk before moving to formula", I would like to see donor milk as the norm for mothers who are unable to breastfeed - that is, not a consideration, but the "go-to" option. Obviously this is not reality at the moment, which is why, if we as a society are going to move that way, I feel it needs to be a clearly defined option when when a mom doesn't have enough milk, or is unable to breastfeed. Which is why I don't see donor milk and mom's milk as the same thing.

[alegna]

Originally Posted by PatioGardener

Rather than "consider donor milk before moving to formula", I would like to see donor milk as the norm for mothers who are unable to breastfeed - that is, not a consideration, but the "go-to" option. Obviously this is not reality at the moment, which is why, if we as a society are going to move that way, I feel it needs to be a clearly defined option when when a mom doesn't have enough milk, or is unable to breastfeed. Which is why I don't see donor milk and mom's milk as the same thing.

This would be fabulous. I hope one day we will see this as the standard.

-Angela

[kimbersdawnly]

Examples of a gentle apporach?

So what language would any of you go to rather than "4th best" (which, inflammatory or not, I believe is just not an accurate representation of the ideas put forth in the WHO guidelines)? Last resort? Fail safe? Back-up plan? Plan D? I am having a genuinely difficult time trying to imagine something that doesn't sound derogatory, despite being what I feel would be an accurate description of the place formula should fill in our culture. Any thoughts on gentle but accurate approaches to the same issue? How do we express the reality that the difference between breast and formula is sufficiently large to warrant seeking other sources of breastmilk (currently a cultural taboo) before resorting to formula (a current cultural norm)? Is there really a way to communicate this without using language that would sound sensational or inflammatory to someone unacquainted with the truth and grounded in the current cultural norms????

(I am genuinely hoping for suggestions. This whole thread has been fascinating to me because I am trying to start the first BF support group in my area for more than a decade. I need to be able to communicate gently though my personal feelings are more than passionate. Unfortunately just stating facts can seem harsh in my opinion since the facts in this case really are decidedly set against formula. One cannot factually present a balanced argument when there is not a positive side to elective formula feeding. KWIM? I feel like I need to find a way into it that is positive, but I cannot do it at the expense of the very real truth that formula carries inherent risks and is not a decision to be taken lightly or without cause... Anyone out there with thoughts on this? Please just don't reiterate that we shouldn't apologize for the facts - I know that - I don't want to water down the truth, just get to it in a way where I don't lose my audience before the point is made.)

[Momily]

Originally Posted by PatioGardener

This is where we differ

I see donor milk ask vastly different from a mother breastfeeding her infant. I see it as something that would be used when a mother was not able to breastfeed her child, and ideally it wouldn't have to be used often because women would receive support to be able to breastfeed (on a societal, as well as personal level.)

Rather than "consider donor milk before moving to formula", I would like to see donor milk as the norm for mothers who are unable to breastfeed - that is, not a consideration, but the "go-to" option. Obviously this is not reality at the moment, which is why, if we as a society are going to move that way, I feel it needs to be a clearly defined option when when a mom doesn't have enough milk, or is unable to breastfeed. Which is why I don't see donor milk and mom's milk as the same thing.

PG as someone who fed her child prescription formula via feeding tube, I don't disagree with you that donor milk is vastly different from mom's milk, I just think that there are equally vast differences within formula feeding too. Certainly my experience was vastly different from mothers I know who bottle fed Enfamil milk based formula to their children from birth.

As far as seeing donor milk as the norm, I agree with you again, but that's something that has to happen on a systemic level, not on a mom level. For me, realistically donor milk wasn't an option -- the cost was prohibitive. For that to change, a better system for gathering donor milk would have to be available, combined with insurance coverage for any child with a documented reason why they couldn't have their mother's milk.

However, I don't see "fourth best" being used as a strategy for dealing with legislators and insurance companies -- honestly cute slogans aren't what works in those circumstances. We give legislators and insurance companies real arguments backed up with statistics. Where I see "fourth best" as being used is when it's targeted at FF moms, and in that case I think it's innappropriate. A better strategy, in my opinion, is to offer facts. "Donor milk is a better option than formula in situations when milk from the biological mother is not an option". Is it cutesy? No. Does it offer an accurate, unbiased assessmentof the facts? Yes.

[FREEmom1120]

I like last resort as a way of wording it. Although some moms who have a rough time can and will do more (for a whole host of reasons) than other mothers to get bm into their babies...so someone's "last resort" might come at a different point than another person's. Does that make sense?

[Momily]

Originally Posted by kimbersdawnly

So what language would any of you go to rather than "4th best" (which, inflammatory or not, I believe is just not an accurate representation of the ideas put forth in the WHO guidelines)? Last resort? Fail safe? Back-up plan? Plan D? I am having a genuinely difficult time trying to imagine something that doesn't sound derogatory.

I guess I think that whenever we resort to short hand to express important ideas we undermine them in one way or another. All the other suggestions you give above have the same problem.

I think what we need to do is to trust women's intelligence and instead of relying on slogans, give them sufficient information. So rather than reducing a complex issue to 2 words I'd say something

Breastmilk is the first choice for children, if breastmilk from a child's mother is unavailable milk from a milk donor should be used.

Artificial Baby Milk is for when human milk, from the child's mother or a donor, is either unavailable, or not an option for medical reasons.

[YummyYarnAddict]

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[annettemarie]

Originally Posted by YummyYarnAddict

One of my issues with "fourth best" has to do with cultural and class bias. I wasn't breastfed and I didn't get formula. Ditto for my brother and most other babies born in my family in the 40s, 50s, 60s, 70s, and 80s (and probably a handful in the 90s). I was giving carnation milk w/karo syrup as did most of my relatives and it was either that or goat's milk. Thousands, if not millions, of children have not only surivived, but thrived on these. Where does this fall in the WHO data? Not that I'm advocating for this, but it should be acknowledged and not completely ignored.

It's not included because it shouldn't even be an option. It's nutritionally inadequate.

ETA: I'm not talking about well thought out homemade formulas. I'm talking milk with karo. That's not good for babies. It doesn't have what babies need. The WHO isn't making a list of every possibility from best to worst.

[kimbersdawnly]

Originally Posted by Momily

I guess I think that whenever we resort to short hand to express important ideas we undermine them in one way or another. All the other suggestions you give above have the same problem.

I think what we need to do is to trust women's intelligence and instead of relying on slogans, give them sufficient information. So rather than reducing a complex issue to 2 words I'd say something

Breastmilk is the first choice for children, if breastmilk from a child's mother is unavailable milk from a milk donor should be used.

Artificial Baby Milk is for when human milk, from the child's mother or a donor, is either unavailable, or not an option for medical reasons.

I don't think I would have EVER considered the "shorthand" version instead of real information.

I'm only looking for a way to present the information in layman's terms, a lead in if you will (like "FF should be considered a last resort because of risks x, y & z. Source x suggests...) I get enough flak for sounding like an encyclopedia as it is, and I find people here seem to be put off by it. I need common language to accompany my facts and make them accessible, not replace them. I would never allow an argument to rest on some sort of slogan, but I need to accompany facts with something the woman I'm talking to is going to remember when she gets home/gets questioned by family/sees the evil pediatrician (I mean one in particular, it's a small town). I know very well that I rarely remember specific statistics thrown out at meetings and I tend to misplace pamphlets, but I remember the sentiment or general statements and whether or not I felt the argument was supported at the time. That's what I feel I need to supply. Like a thesis for a paper - I need something to sum up the argument, not to replace it.

[FREEmom1120]

Originally Posted by YummyYarnAddict

One of my issues with "fourth best" has to do with cultural and class bias. I wasn't breastfed and I didn't get formula. Ditto for my brother and most other babies born in my family in the 40s, 50s, 60s, 70s, and 80s (and probably a handful in the 90s). I was giving carnation milk w/karo syrup as did most of my relatives and it was either that or goat's milk. Thousands, if not millions, of children have not only surivived, but thrived on these. Where does this fall in the WHO data? Not that I'm advocating for this, but it should be acknowledged and not completely ignored.

I saw a lady with a baby in the grocery store the other day with a LOT of Carnation milk in her cart. I wonder if that is why? I've never heard of that.

I do have issues when people say that babies can "survive" on formula but thrive on breastmilk. I've seen babies NOT thrive on breastmilk because their moms let them cio and were otherwise dismissive of them. Thriving encompasses a lot more than what goes into the baby's tummy imo.

[YummyYarnAddict]

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