I’ve been thinking about something recently. When my daughter Hannah was born at 34 weeks, she was given a bottle of formula in the NICU before I had a chance to try breastfeeding her. When I did try to breastfeed her, she refused to latch. I started pumping, but I was never able to get as much as the doctors and nurses said she needed, so about half of her milk intake was formula. When she left the hospital at one week old she still hadn’t successfully latched, and the nurses tucked a few jars of pre-prepared formula into my diaper bag. That formula only lasted a day or so, so my husband had to go buy a can within 24 hours of Hannah’s arrival home.
Now, I should make something clear: I had really not planned to give my baby formula. I was intent on breastfeeding for at least 12-18 months before my first child was even born. But when you have a premature baby, and many people in white coats are saying that baby needs a certain amount of food, you give that amount. When that baby refuses to latch, and you’re having limited success with pumping, you supplement. Looking back I think that a whole lot of things could have been handled better in general – like, say, not separating me from my perfectly healthy baby within minutes of her birth – but this was one of those times in life when I found myself doing the best I could with the situation I found myself in.
The good news in this story is that the morning after my husband’s trip to buy that big can of formula, Hannah finally latched using a nipple shield. Within 48 hours I had stopped pumping and she wasn’t receiving any more formula supplements. I think we ended up mixing a total of two bottles out of the big can of formula. I kept it for a few weeks just to be sure that everything would go okay, and then I threw it out with glee.
In the years since my first baby was born, I’ve spoken with many other mothers who found themselves giving their babies formula when they hadn’t planned to. Many of these mothers do everything they can to limit the amount of formula their babies receive. I also know moms who go to great lengths to ensure their little ones never receive any formula at all, spending their lives attached to breast pumps and forgoing sleep and showers and regular meals in order to get breastfeeding going.
I think that every mother needs to make her own decisions about just how far she’s willing to go to avoid infant formula. Some moms may not even try to avoid it at all. That’s not really my point here. I’m not writing this to moralize on why breastfeeding is so important. I think we’ve all read the public health messages, and we all know the drill. What’s interesting to me, however, is how different parents will respond to having infant formula available. Will you still avoid it all costs – or will having it in your cupboard lead you to offer that first bottle just that much sooner?
The evidence suggests that mothers who receive formula samples from the hospital are less likely to breastfeed. This is true whether we’re talking about commercial sample packs from a formula company, or nurses tucking a few jars into a diaper bag, which is what I got. To a certain degree, this just makes sense. Regardless of where you stand on formula companies, I think we can all agree that they’re big businesses, and they’re unlikely to engage in a widespread marketing practice if it doesn’t work. Formula marketing – such as handing out samples – is meant to sell formula, and at least some of the time it does that at the expense of breastfeeding.
I understand the evidence, but it doesn’t answer my initial question. Why do some mothers view that formula can on their shelves with extreme suspicion, while others view it as a welcome back-up plan or occasional alternative?
There are a whole lot of factors that influence breastfeeding rates, as it turns out. Here are a few, based on the research:
- Social support
- Knowledgeable and supportive health care providers
- Maternal confidence and intention to breastfeed
- Mother’s age, education level and socieconomic status
- Previous breastfeeding experience
- Whether or not the mother was breastfed herself
- The breastfeeding issues a mother encounters
- Initiation of breastfeeding within 16 hours of birth
Looking at that list I see that there are a whole lot of factors that influence a mother’s breastfeeding experience. There’s no single thing that’s going to determine if a mother breastfeeds, how long she breastfeeds for, or whether she breastfeeds exclusively or supplements with formula. What’s more, any individual mother may have very different experiences from one baby to the next. It’s simply not true that any mom who has a can of formula in her cupboard is going to use it. However, that doesn’t mean we should all buy it, or that formula companies or hospitals should go ahead and hand out free samples “just in case”.
What I think it does mean is that, first and foremost, we need to make sure that mothers have good information and support. When you look at that list, most of the success factors centre around a mother who has access to the resources she needs, when she needs them. Whether it’s health care providers in the hospital, your mother helping you out at home, or a website you search out when you’re looking for information, if you can find the answers you’re looking for, you’re more likely to be successful.
Should we curtail formula marketing? I think we should. But I also think that we need to keep our focus where it belongs, and that’s on parents. The ideal outcome in my book is that parents are satisfied with their own experiences, whether we’re talking about breastfeeding or anything else associated with that transition to early parenthood. Because a can of formula in your pantry isn’t going to really be there for you, whether you ever give it to your baby or not.
What are your experiences with formula samples? Did you receive any? Did you use them? Where do you think we should focus our efforts at helping mothers succeed at breastfeeding? I’d love to hear your thoughts!
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Interesting experience with your daughter. I had similar problems with my baby, her latch was fine, but my milk came in late due to complications and I supplemented with bottle/formula until she was basically 11 weeks old. At the hospital (four very long night stay), I had to continually tell the nurses that I wanted to breastfeed her and to not give her a bottle. I ultimately had to give her a bottle at 6 days old, like at 1 am, because she simply wouldn’t sleep; she was so hungry. I always had a low supply of breast milk, but I did exclusively breastfed her while putting formula in her cereal. It seemed like an okay compromise for me. I thought that she wouldn’t get a drop of formula, but just like you said, you do the best in your situation. And yes we did use the samples that they sent home with us, and I do believe if I weren’t 100% committed to breastfeeding before she was born, I would have quit within a week.
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Interesting post. I had formula samples in my house when we brought home my son. They send you SO MANY if they get your address while you’re pregnant and I was saving them to donate. It never even occurred to me that the samples were there but looking at your list, I can see why. I would say that being breastfed myself made the biggest impact. I knew that I had my own mother backing me, and I have photos of myself being breastfed (all taken on my first day of life, but still) and can remember watching my mom pump for my brother before work. The online community (and millions of breastfeeding blog posts I read during my pregnancy) was also a big factor. Ultimately though, I had an easy baby who was a pro at the boob from birth and latched within an hour (He even did the breast crawl, just like the videos! I was so amazed by that). I also had great support, with a hospital-appointed lactation consultant who was pushy to the point of bossy but extremely helpful in the long run.
This post really made me think differently about why moms end up using formula. When I feel judgey, I (try to) make sure to remind myself that I had every single thing working in my favor for breastfeeding, a lot of which wasn’t even within my control.
I think if nurses will happily tuck in a formula sample, that is fine as long as a pamphlet to La Leche League is also included. It should be balanced. Breast is best, but it is hard. I worked three jobs, and went back to work after a few weeks. I was a single mom, but I stuck to exclusively breastfeeding with lots of challenges. I did the no warm food, no showers and missed sleep. I think it is up to people to do what is best for them, but the hospital should not be pushing one way and not the other.
Interesting post. You’ve touched on a complicated problem. I had really strong feelings about not giving my baby formula prior to his birth. I did a lot of reading on breastfeeding and talked to other mums. I felt prepared.
Of course, things never go as planned. My labour was ridiculously long (3 days!!) and ended in an emergency c-section. As a result my milk took a longer to come in than the nurses were happy with and my son lost more than 10% of his birth weight. We were told we had to supplement.
I think if I hadn’t been at such a progressive hospital or hadn’t had comprehensive aftercare from both nurses and midwives, I probably would have ended up bottle feeding formula to my son.
A few things made a big difference for me: I had access to the breast milk bank at women’s hospital, I was given tools and education to supplement my baby on the breast, I had incredible support – a nurse stayed with me all night until he latched on, and I immediately threw out every formula sample that made its way into my house.
I was very lucky that I always felt that choices about my son’s feeding were mine to make. Other than being hooked up to a huge hospital milking machine at 2 in the morning by an overly aggressive nurse, I felt in control, respected and supported in my decision. That gave me confidence to work through the inevitable difficulties that come with breastfeeding. If I hadn’t had that support, I’m certain I would have thrown in the towel. My boy is now one year old, is almost completely weaned and a healthy 28 pounds!
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I was in labour for 55 hours before an emergency c-section, and while I was in recovery, my daughter was fed a bottle of formula. What I wanted? No. Was it best, given the drugs I was on and the pain I was in? Most likely. We were in the hospital for 4 days and she lost 11% of her birth weight, in part due to a tongue tie and subsequent bad latch. (It was posterior, the staff in the hospital wasn’t able to deal with it and we had an appt to have a specialist fix it 2 days after we were out of the hospital.) After weighing her, the nurses freaked out, the LC was FINALLY brought in and we agreed that she needed to be supplemented until the tie was fixed and she regained her weight. The Calgary hospital does NOT send you home with formula, except in my case, were they sent us home with a several supply of the expensive ready-to-eat stuff. She weaned herself off the formula 5 days later – as soon as she could get enough breast milk. (By that, I mean formula was always the last option offered, and she simply wouldn’t drink it after breast milk from the bottle and boob.)
Then, in the mail, I got a formula and it’s still sitting there totally untouched, 6 weeks later.
So I guess I’m pretty mixed on it. It fed my baby when she was starving and that was great, and it didn’t interfere with breastfeeding. There was no nipple confusion or latch issue. (Er, related to the bottle. Obvs the tongue tie was it’s own issue.) I felt very supported about breastfeeding by the LC and the public health nurses and having formula around didn’t change that in any way.
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I had excellent support when I had my daughter. From the prenatal classes, to the nurses at the hospital to my doula, eveyone rallied for breastfeeding. I was lucky enough that my daughter latched on right away and the learning curve wasn’t too steep. Yes, I was given tons of samples and I did use them. As much as I’m for breaskfeeding and did as much of it as I can, formula gave me freedom. Freedom to have a night off and feel human again or freedom to get some much needed sleep. I did the pump for a few months in the begining and found it wasn’t working well for me….so I used the samples. My daugther was fed 98% breastmilk until she was 11 month, then she was on formula for a couple months, now cows milk. I think mothers need to do what is best for them and not worry about what other people think. You can never please everyone.
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I couldn’t breast feed due to surgery (NOT implants!) So was glad for the samples as it took a few different ones to find one that the twins liked/tolerated…two different kinds in the end!
I was ready to hire a wet nurse by that point ….oh if they only existed!
Formula was a godsend FOR US as hubby, gramma, gramps, etc could take the feedings for me.
Donate the sapmles to your food bank … They desperately need such items !!!!!!!!!!!!
(And diapers!)
Great post, and a new take on this topic!! Good point, to focus on women’s access to information rather than that free can of formula!! I’m going to link this for our upcoming Sunday Surf. =)
Weird thing happened to me recently: one year after the birth of my fourth child, a free sample of Similac arrived at my MOTHER’S house, addressed to ME, but using my MAIDEN NAME. Isn’t that weird? My mom wondered if they were just doing the mail equivalent of cold calling, assuming that I’m 34 and long ago I used to live at that address so I likely have children and voila, free formula?
I couldn’t figure that one out. =S
All my free samples get donated to the food bank. I figure someone can benefit, although I don’t believe in free samples the food bank is different. (*all=two cans total in 9 years of parenting; I suspect those ‘contest entry forms’ at the maternity clothing stores….)
Anyways, I think your focus on parent support is good because I can’t see the free cans stopping anytime soon, and we might be wasting energy yelling for companies to stop sending them. Ultimately it is best to focus on what works!!