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Breastfeeding, Bottle Feeding and…. Somewhere In-between…. Why the Guilt?

There has been so much discussion circulating in the blogosphere right now about breastfeeding.  I thought I’d add my 2 cents because….I have an opinion and….. I have just a little experience in this field both in study (2 year Lactation course, IBCLC for 10 years, current CLC) and in practice (35 years).

I thought I knew so much in 1988 after nursing 3 babies and assisting others for nearly 15 years. I actually thought I could just take the IBLCE exam based on my experience!

I was so ignorant and naïve!

I started to talk to some IBCLC’s and my eyes were opened wide to the real world. Up to that point, at that time, (I sadly and guiltily admit) I had no idea about the volume of study and research in the field of lactation. I had NO idea just how wrong we were doing things at my hospital.

I launched into a lactation course, soaking up all I could, 3 years of study preparing for certification. I set out to change the world… at least my world. I wrote big proposals for the hospital. I applied for grants to fund a lactation program. I developed education competencies for the staff. I started breastfeeding classes. I thought everybody shared my passion, that they too would want to learn …. because I was right!!

Instead I was the target of all the boob jokes you could think of and I had almost no support. My ideas were rejected left and right.

Long story short…it took me a long time to come to terms with accepting small changes, taking baby steps…..continuing to do the best job I could with each mother-baby couple and to keep a positive outlook. I needed to remain realistic about how much I could actually accomplish one step at a time. Slowly I began to have people under my wing trying to learn. Yeah!

I learned a lot about how to approach physicians, co-workers, managers and most of all …. mothers.

I am not an expert in journalism or critical analysis so this is my opinion of what is going on right now. 

There have been some irresponsible journalists, those who have a bigger platform than most of us, writing negatively about something they have not studied or truly researched. They are expressing their opinion and including an emotional component which has, in my opinion, gotten the reaction they hoped for from breastfeeding advocates as well as those who concur with the authors. More hits, more readers. I feel they have twisted the facts to benefit or support a point they want to make. I read some of them.. other’s I really just scanned then brushed off so I don’t know everything that’s been said. On the positive side, these articles possibly give us a larger platform to provide correct information to a larger public in reply.

I read a lot of blogs and I really respect and admire all the research that many breastfeeding advocates put into their fabulous posts. These are educated women who are trying to provide current accurate information! (@phdinparenting, @bfmom, @MommyNews , @JakeAryehMarcus, @blacktating ,@AmberStrocel,  and so many more). I applaud their passion and breastfeeding advocacy. They are doing a very important job. Breastfeeding IS very important and deserves advocacy, protection and support! There are still large scores of women out there making choices with only tiny bits of information, who really do not know the important benefits of breastfeeding. It is because of this, and because we still haven’t met the US Dept HHS Healthy People Goals for 2010, that breastfeeding advocacy needs to continue. I have been there, advocating in a time where I faced great adversity and a lot of negativity. I am bothered that it still exists…and exists now in so many new ways.

I am more disturbed that some mother’s out there are upset. I always try to understand just WHY a mom feels guilty if she chooses to formula feed or do some combination of formula and breastfeeding. I always hope she’s made her choice with good information and that it is her own true choice. Then good for her! I am not to judge. She needs to be comfortable and confident with her decision. Perhaps her guilt comes from how one single little word or sentence was said, even if what was said is accurate and true. Perhaps her guilt is coming from her own internal struggles. I don’t know.  She needs to come to terms with that herself,  and not punish herself and or publicly criticize the advocates saying they are causing the guilt.  Although there are some very zealous advocates out there, I feel in my heart they are not trying to make any individual mother feel guilty. I read a comment from a mom somewhere that said something like… “perhaps if moms knew it wasn’t all or nothing, maybe more would try breastfeeding.”  My first thought was..why do they even think that..are there really mom’s who feel it has to be all or nothing? Is this causing the guilt because they don’t think they can breastfeed exclusively for the first 6 months as the experts recommend?? 


Over the years, I have learned this:

  • It is inappropriate for a health care professional to indicate to a mother directly or indirectly that formula feeding and breastfeeding are equal. Human breast milk is the superior food for human infants. Properly prepared infant formula is an acceptable substitute for those who cannot or choose not to breastfeed.
  • The first approach is probably the number one factor in gaining a mother’s interest in what you have to say.
  • The education process to a mother needs to be in small doses, sensitive to her unique learning abilities, her cultural beliefs and practices and most importantly, her choices and individual breastfeeding goals.
  • With that in mind, try to provide her with the information she needs to make her decision.
  • Never overestimate a mother’s desire to breastfeed her infant.
  • Never underestimate a mother’s desire to breastfeed her infant.
  • Listen to the mother; help her define her true desires and goals.
  • Many times, the first question she asks may not be what she really wants to ask.
  • The mother’s individual breastfeeding goals, how she defines them, how important they are to her and how she relates them to her actual breastfeeding experience all help define how she measures success.
  • Support the mother, support the mother, and support the mother.


Here are the top 3 responses to the feeding choice question pertaining to breastfeeding at my facility on admission:

  • “Breast and Bottle”
  • “I’m going to do both”
  • “I’m going to ‘try’ to breastfeed”

To each of these I respond very positively with something like… “Great! Tell me what you’ve learned about breastfeeding.”     I will then ask the mom a few questions to somehow find out her true wishes.  

Then I say  “We will support and honor however you wish to feed your baby.  I’d like to give you some information so you can really understand and then tell us what you’d like to do.”  

 I explain some things,  i.e.: how the milk production works, the importance of early feeds etc.. and how formula introduced at that time could  interfere with the process of production, the baby’s ability to latch properly and so on… I usually end with..”We usually recommend to  focus on breastfeeding for now and then offer bottles later after milk supply is established if that is how you’d still like to manage feeding”. ETC…ETC….  Here’s what I then see:

  • There have been so many mom’s who — after a little  bit of information decide they would like to focus on breastfeeding. There have been many who totally fell in love with it.
  • There have also been many who really didn’t want to breastfeed after one single feeding.
  • There are many many still that like to breastfeed and bottle feed in combination right from the start. If they have the right info and understand how things may progress… I still say “Good for you!”
  • I have seen many continue that way for months and they are very happy with that.
  • I’ve seen many mom’s “partially” ( I don’t like to say it that way) breastfeed and feel very proud. I say “good for you!”  They don’t think of it in terms of “exclusive” or “partial”… It’s more like any breast at all…. is breastfeeding vs. no breastfeeding at all.
  • There have been many who also never wanted to try until all of a sudden they see milk leaking!
  • I’ve worked with mom’s where I can see tremendous improvement in her situation, I think she’s going to keep going…but she decides to totally quit. I simply praise her for all her efforts and help her feel proud of herself.
  • I’ve worked with mom’s who have hardly put forth any effort to overcome small obstacles, I think they will probably quit outright… Then..I find out they are the ones exclusively breastfeeding down the road.

I got a comment from a breastfeeding mom @TheFeministBreeder that I absolutely have to share. She describes her own experience in the full comment and on her new blog post.  She comments:

 “Yes, I think that’s the most important part – informing a mother of any and ALL benefits/risks to supplementing, and helping them work through the option they choose.  But to tell a mother to supplement without explaining that it could undermine her efforts is just plain mean.  And too many medpros are doing it.  I’m glad there are more nurses like you who will give out the real information to empower a woman to make her own choice.  My smart friend always says ‘It’s not really a choice if you don’t have all the information.’ “

For those mom’s really trying to breastfeed and struggling, there’s more than I can say right here to cover that. I’m sorry for your struggles and hope it gets easier for you. It is important to have a skilled competent support person assisting you who listens thoughtfully and helps you get to the root of your problem… and helps you define and realize your goals. If you are experiencing guilt from your struggles or from not being able to fulfill your goals, desires to breastfeed….I think that kind of guilt is different from what I’m trying to discuss here. I am not a an expert on that. It is valuable to get the best help out there that you can as soon as possible.

I’m adding this after reading some comments on other blogs.. When approaching a mom to observe or assist with the latch process…. Permission is a must! I ALWAYS ask the mother if she would like any assistance with the latch or if  I may observe how well her baby is latching….. If that answer is yes… The next question is ALWAYS.. May I touch your breast? (if that needs to part of the process). I prefer to help moms by having the mom and BABY do the latch. I try to keep my hands out of it.  All nurses and LC’s should practice this. I am sorry for the mom’s who aren’t asked permission to be helped or touched.  😦


One of my favorite things I like to say to any breastfeeding mom is:

“Try not to make any final decision when it’s dark outside”.


On another note, regarding some reader comments on various blogs about public breastfeeding, a skimpy bikini or the bathing-suit issue of a favorite sports magazine show more skin in a provocative, sexy way than any mom breastfeeding. Even the movie stars in their gowns with plunging necklines are showing almost the entire breast! Somehow, that is OK. There are volumes of video footage and photos all over the place… even on billboards. It is sad that the public opinion of a baby breastfeeding (the most natural way for him to eat) is something that should be done in private … yet young girls are encouraged by media to bare more and more skin. Of course being discreet while feeding is important, but I can assure you, most girls in a tiny bikini are thinking more about “tacky exhibitionist behavior” than a mother breastfeeding her baby. Why aren’t law-makers focusing on any of that?

64 Comments Post a comment
  1. Your approach seems to be very warm and encouraging and I am sure the moms you work with really appreciate all that you do (as do I!)

    May 8, 2009
    • Birth_Lactation #

      Thanks so much Elita! I loved your spot on BlogHer Backtalk! Great to put a face to a name! I appreciate all that you do also. I love your blog and I’m happy for the recognition you are getting. Melissa

      May 8, 2009
  2. What a great post! I have often had the conversation with a mom about “all or none” and I think that is the biggest thing – most moms DON’T realize that it doesn’t have to be all or none – you can do what works for you and your schedule. I think this is so important. Thanks for reminding me…hmmmm – it seems I may have fodder for my next blog post now…..thanks again!

    May 8, 2009
    • Birth_Lactation #

      Thanks Judy! I agree, it is very important. I am happy that those of us who can be in a position to help a mother with education, decisions, or choices keep that in mind. You provide a ton of excellent info for mothers and I have really enjoyed reading your posts and tips. I look forward to your next one now! Thanks again, Melissa

      May 8, 2009
  3. I think the moral of the story for everyone is AVOID OBNOXIOUS, SANCTIMONIOUS PEOPLE. I do. I have a special stink eye just for them. Anyone who unrelentingly tells you what “women should do” with no concern for the individual situations and souls affected has problems.

    What I find interesting about this internet breastfeeding conversation is that the picture of sanctimonious zealot is painted of anyone advocating for supporting women in breastfeeding (or unmedicated birth for that matter). The big picture is totally lost on some people. Open your mouth about planning an out of hospital birth and prepare to unleash the fury in any passerby, acquaintance and their mother (literally). Open your shirt to nurse a child that can walk or talk and prepare for the “Oh my God, are you sill nursing that child? Isn’t she like 13 months? Gross!” There is NO shortage of strangers willing to jump in and tell you that you should just do what your doctor says or do what everyone else does.

    Of the women I know personally who breastfeed, give birth “naturally” or eat organic foods, I can think of only two that are judgmental enough to roll their eyes when talking about a mom who chose to formula feed without ever trying to breastfeed. HOWEVER, my status quo friends and acquaintances are very eager to talk about how weird the more “natural” set is. So, who are the sanctimonious zealots?

    You started work as a nurse when people culturally held doctors up as gods. If a doctor in a white coat says formula is cleaner than breast milk, you listen. If a doctor says birth is a medical procedure to be performed on you while you are anesthetized, you listen, little lady. Today, of course, most people know docs are human and subject to the same fears, bias and greed that any professional is. However, I think that Americans still cling to a powerful cultural belief that medicine, technology and science are what will save us from the horrible, painful, disgusting, unhealthy innate state of our own bodies.

    And challenging cultural beliefs invariably causes discomfort.

    I’m glad you’re doing what you’re doing.

    May 8, 2009
    • Birth_Lactation #

      Jill- OMG you are FUNNY and so right! Touché! And yes…those white coats were gods and the little white angels such as myself had to stand at attention when they arrived on the unit! I agree with everything you have said. Thanks so much, Melissa

      May 8, 2009
  4. I think too few women realize that it is more “all or nothing” than not. The introduction of a bottle almost always undermines the process. Supplementing with formula is what ruined my breastfeeding relationship the first time. Why? When baby was fed a bottle, my body wasn’t being told to produce milk. Supply and demand. No demand, no supply. I quit breastfeeding after 4 weeks, and after countless hours of crying in pain because I never produced enough milk. I only realized years later exactly *why* my body wasn’t producing that milk.

    The second time around, I told myself formula supplementation was absolutely not an option no matter what the misinformed medpros told me – and here I am a year later (while working and going to school) still breastfeeding and never having had to use a drop of formula. Same breasts, same body, but they worked entirely different when I treated breastfeeding differently. I committed 100% to the job. My baby demanded, and my body supplied. It worked just like “they” said it would – I just had to believe in myself.

    Are there really, truly situations where a mother doesn’t produce milk? I suppose – but more often than not it’s a really ill-informed medpro telling the mother she’s not producing when really she would be producing if the breastfeeding relationship was being handled properly.

    However, if a mother is well informed and completely okay with what supplementation may do to the relationship, then that is totally her choice. I just hate to see a woman supplement, lose her supply, and then believe it’s because she is defective in some way. Women are made to feel defective far too often in every aspect of childbearing/rearing these days. It’s how The Man keeps us down.

    We are not defective; we’re just drawn that way.

    May 8, 2009
    • Birth_Lactation #

      TFB– Love that nickname “misinformed medpro”. I admit I was also ignorant and I used to be one of them. Sad but true. I think when I realized how much misinformation and bad advice I had once given to so many moms, I was horrified! I believe that was a catalyst to push me forward and try to make so many changes. I think an important thing to understand here is that for some healthy breastfeeding mother/baby couples, some formula doesn’t do much at all to their overall production, their overall experience. I believe that my colleagues and co-workers only look at that…… and don’t feel anything is wrong with it. What they DON’T see is how for some other mother/baby couples, a single bottle can cause a whole gamut of problems and a negative spiral situation. They still don’t all realize that before they use the formula, They need to educate and council options for the mother. We do need to use formula for medical reasons sometimes, but the mother STILL needs to understand and consent. Your first breastfeeding experience sounds as though you had zero support and misguided help…if any. I’m sad it made you so sad and sorry you had to go through that. I am happy you have realized your goals for this baby! Congratulations! Melissa

      May 8, 2009
      • Yes, I think that’s the most important part – informing a mother of any and ALL benefits/risks to supplementing, and helping them work through the option they choose. But to tell a mother to supplement without explaning that it could undermine her efforts is just plain mean. And too many medpros are doing it. I’m glad there are more nurses like you who will give out the real information to empower a woman to make her own choice. My smart friend always says “It’s not really a choice if you don’t have all the information.”

        May 8, 2009
      • Birth_Lactation #

        @TheFeministBreeder–That is the best quote I’ve heard all week !! … I’d like to post it at
        work and use it in my next inservice about educating mom’s and obtaining
        consent. I’m going to infuse parts of this comment into the body of the text
        and give you all the credit! Thank you!

        May 8, 2009
  5. I like Elita want to comment on your warm, encouraging and respectful approach. I like you feel that it is important to meet moms where they are and go from there in a gentle but educating fashion. I really appreciated reading the way you talk with new moms. Thanks for writing this. I also appreciate the blog mention. You are very kind. 🙂

    May 8, 2009
    • Birth_Lactation #

      Thanks Melodie, That’s so very nice of you to say. I do start where they
      are, on their level and go from there. I have found it builds respect. I
      hope I can always do that. It is really hard when I may have < 5 min for
      what should be a 30 min conversation. I want to get to a point where I don’t
      feel I have to “save” them from my co-workers. (wait– did I say that out
      loud?) I do believe my mom has influenced me in my way of speaking to mom’s.
      Thanks for your fabulous posts! Melissa

      May 8, 2009
  6. “Try not to make any final decision when it’s dark outside”.

    I love that! I think I just might steal it. 🙂

    It can be a tough balance to support breastfeeding without becoming critical of moms who don’t. It sounds like you’re striking a good balance. I’m still working on it, and I appreciate reading the lessons you’ve learned, there’s a lot of good info there.

    May 8, 2009
    • Birth_Lactation #

      Thanks Amber… go right ahead. I think I heard it at a conference millions
      of years ago!
      I probably have the ability to view things from a different perspective
      because of the changes in the breastfeeding climate over the years and my
      experiences both as a mother and a nurse/lactation consultant.

      May 8, 2009
  7. What a fantastic post. In anticipation of my second baby, I have been re-reading “The Womanly Art of Breastfeeding” to remind myself of the finer points. Naturally, this has had me thinking back to how things were with Baby #1. I remember I hadn’t really made up my mind about anything or really knew anything before someone gave me the book. All I knew was the commercials I had seen on tv since I was a kid about which formulas had brain-building proteins.

    To make a long story short, I read the book and made up my mind to breastfeed. There were some initial difficulties, but being equipped with knowledge and resources, we did okay and went on to nurse for 21 months. When I look back on that, I can see how easy it is for a woman to just not understand breastfeeding, how to do it and why to do it.

    It is hard to know how to approach people and teach them, though, especially with some of the attitudes out there. That is why I like your post so much.

    May 8, 2009
    • Birth_Lactation #

      Thank you so very much! Such kind words and praise. It is a continual
      challenge to try to come up with the “best” approach for the moms. nurses
      and doctors I encounter. I am excited for you about your new baby! Hope
      everything goes well for you. Thanks again, Melissa

      May 8, 2009
  8. Joy #

    I just wrote a post about breastfeeding. When I wasn’t able to breastfeed my daughters for as long as I wanted, the guilt did not come from the recommendation that babies should be breastfed for at least 6 months.

    It came from grieving over the loss of my expectations. I expected to be good at nursing. I expected it to be easy and that my babies would love it. When it didn’t happen I felt guilty because my gals are flat so it takes a little more effort in the beginning than I realized.

    Without any help or support in the hospital, too. I’m very proud that you’re trying to help one momma/couple at a time! Sometimes it is all we can do.

    May 8, 2009
    • Birth_Lactation #

      Hi Joy, I am so happy to hear from you again! Thanks for your kind comments! I just read your breastfeeding post..I think the one you are talking about.. end of week 16? I have to say that wherever you delivered…the staff on shift should all have been able to support you better, provide assistance and evaluate the latch if there is no LC available. I hope you wrote some comment about that to the hospital when they send you the little survey… They should be educating the rest of the staff. I am just a staff nurse who chose to further my education. We don’t even have a position for an LC… despite how many times I’ve suggested it. All that aside— Thank you for sharing your story and providing insight to me about another one individual’s experience with guilt. I always try to learn from mom’s and I think your story is another example of how we should “never underestimate a mom’s desire to breastfeed”. It is obviously very important to you. I am now going to say that I hope you have a really good assessment of the latch with your next baby by a competent skilled person. It’s not enough for an LC to say that a Caucasian woman of Irish descent would have “very very sore breasts” as was told to you. It is a common complaint for some early mild discomfort for some women when everything still seems to be going well, that still needs to be properly evaluated …. but “pain” usually means something isn’t right. I don’t know your whole story, but I truly hope you receive prompt skilled evaluation and proper advice this time around. Congratulations on your pregnancy!! Happy Mother’s Day— Melissa

      May 8, 2009
      • Joy #

        I can’t remember if I had written on the survey about the lack of BFing support but I most likely did because I can’t imagine why I wouldn’t have.

        Thank you- I hope I receive better care this time as well!

        May 9, 2009
  9. “Try not to make any final decision when it’s dark outside.”

    Amen! My first child is just two weeks old — this is such good advice! Somehow, things always seem more desperate and stressful at night, don’t they?

    May 9, 2009
    • Birth_Lactation #

      Thank you Jessie. Congratulations on the birth of your baby! Things do usually look brighter in the morning!

      May 9, 2009
  10. hey

    What a lovely article. Im training to be a bf supporter and its really heartwarming to see such encouraging words for moms. We really hope that all new moms get to have the joy that comes from feeding your baby and its so true that often moms struggle and quit due to lack of help, information and much needed support at what is a very emotional time. We often hear that best is best and this can add much pressure to moms however breast is not best just whats natural and normal, and often due to media and miss information moms truly believe that formula is equal or jus as good. Moms want the best the tiny little life they are caring for and so much pressure is put on them to do everything perfect. Instead moms need the right information to help them make the right choice for them and no one else not partner, health professional or social network. I fed my two daughters for 15 months my first was born 6 weeks early and i was seriously ill after i fought everyone to feed her and at times cried with despair often feeling that my choice to do so was viewed as the worst thing for her and that i was being a bad mother for not giving her formula. Im happy to say that with in 3 weeks of leaving hospital she had doubled her weight and everyone was then praising me and i remember looking down at her feeding looking so content, happy and healthy and crying tears of joy that i had on my own succeeded. This is why im moved to try help other moms.
    Thank you

    May 9, 2009
    • Birth_Lactation #

      Thanks Madabutterfly– It’s wonderful to hear that you’ll be turning your positive experience of breastfeeding despite the negativity and lack of support into helping other mom’s! I love it! You should be extremely proud of yourself! Thanks for sharing and for yur kind words about this post. Melissa

      May 9, 2009
  11. Yvonne #

    Thank you for such an inspirational post! I really needed it today. Yvonne (Student Midwife)

    May 11, 2009
  12. I posted a link to this blog on my community site I think what you have learned is similar to what most breastfeeding advocates go through during the process. You write about it so well here. It is a wonderful learning experience and a bit disheartening to see so many women misled. We all need to do what we are doing with the compassion and warmth you showed here. Thanks!!!

    May 13, 2009
    • Birth_Lactation #

      Thanks Crystal! I agree that many of us go through a range in this lraerning process of helping mothers and babies. I am grateful for the link!

      May 13, 2009
  13. This is an incredibly important post. I am linking to it from our site . . . we are a non-profit that is aiming to market and brand breastfeeding as mainstream as motherhood itself, and reveal and remove the “the booby traps” to breastfeeding successfully. One of the biggest barriers to breastfeeding is that all too many professionals and well-meaning friends and families do not know how to support a woman to make a decision that is best for her and her family and her baby, whatever that decision is. Too often women are being badgered and not coached and cheered on, hence some of the unfortunate backlash. Thank you, thank you, for setting the record straight! Your summary should be required reading for every medical professional dealing with expecting or new mothers.

    May 18, 2009
    • Birth_Lactation #

      Bettina, Thank YOU for reading and understanding the importance of what I have said here. I feel strongly that that listening to the mother is most important and then how you chose your words as you gently support, encourage and educate a mom can have a far greater impact than the words themselves as she makes the decision which is best for her. Thank you for the link, please encourage your readers to comment and let me know they’ve been here!

      May 18, 2009
  14. You have me in tears, absolute tears. You are the first person to really “get” this whole guilt thing that I have ever read online without going through it yourself or pushing the “guilt tag” back onto the other person. Your compassion and passion are extremely evident through this whole entry and those that you help are so lucky to have you. I wish there were more people in the world like you.

    May 25, 2009
    • Birth_Lactation #

      Thank you Gayle! I am glad you “get” what I am trying to say here… There were many transitions in my Lactation career as well as my whole OB career. I learned many of my approaches. I hope I can spread some of that around my self! I “cringe” at times in report when I hear what was said and especially how things were said to moms by people who mean well but really don’t know how to talk to people… but most importantly LISTEN. I’ve learned more by really actively listening and supporting what the mother tells me. I checked your blog, it is really interesting. I’m really sorry for all your troubles and I admire you for all you have done. You certainly showed remarkable restraint when visiting with those relatives. Your MIL esp was insensitive. I have a new grandson, 10 months old now, and he was maybe breastfeed once at the breast and was fed some pumped milk. I think she would have never fed him any breastmilk at all if she didn’t know what I did for a living. My son encouraged her — but was also very supportive of whatever SHE wanted to do. She didn’t feel comfortable talking to me about what her decisions were with feeding so I never asked. I never said a word. Of course I was happy he got some breastmilk… but when it was clear she was formula feeding, I got her all the free formula I could get from the reps at work. Thank you, you have made my day! Melissa

      May 25, 2009
      • Communication is a tricky thing, especially communication on the Internet. It’s hard to read w/out seeing the speaker. Also, this is obviously a topic about which many tend to be passionate and perhaps that further entrenches us in our positions instead of letting us reach out to each other.

        Thank you for your kind words and for taking the time to check my blog. I rarely share it, but felt comfortable enough to do so with you. It is so nice to have a dialogue about this with someone as knowledgeable as yourself without feeling pressure or boxed in.

        Hope you have a wonderful evening. 🙂

        May 25, 2009
  15. Guilt ridden #

    I am one of the guilt ridden. I exclusively breast feed and have since birth. Now, at ten weeks, I have my period and no milk. My doctor has given me reglin to bring milk back. This the third child I have had this problem with. I am faced with try to transfer my child to formula over the next week. I just don’t feel like I am completely giving my child the benefits of breast feeding, or myself. I have pumped, tried fenugreek, you name it what am I doing wrong?

    May 25, 2009
    • Birth_Lactation #

      You must feel so very upset. I am really sorry this is happening to you…for a third time? I hope there is something I can say to make you feel so VERY PROUD of all you have accomplished so far… and less guilty…. I could bet that doesn’t help you at the moment or to feel less frustrated. I certainly wish I had an easy answer. I’m sorry this isn’t really a quick answer for you….
      I would suggest a consult with a competent lactation professional, an IBCLC or Lactation Consultant is the preferred choice. The first questions I would want to ask is how the baby is doing with weight gain, what are you experiencing to tell you that you have no milk, try to recount a typical day of feedings, baby behaviors etc. This is all part of a complete history. A Lactation Consultant would need to gather all the information, including some medical history and explore possible reasons including underlying hormonal issues for your problem then develop a feeding plan you’d like to try.
      Again I’m sorry it isn’t a simple answer but the point you say– that this is the third time– makes it even more difficult to simply suggest more ways to increase milk production. This is a “see you in person issue“.
      You have breastfed exclusively for 10 weeks! You have tried some of the most common tricks! You are exploring other ways to try hard to turn your problem around! I am proud of you…. I hope you can get the right kind of “hands on” help ASAP!
      If you have time, I’d love to hear how things progress for you and your precious baby..
      Thanks for reading….

      May 25, 2009
    • dreamom #

      I am going to add my two cents and say that you need to kick that guilt out of the door. You know what you want, you have been trying to achieve it, and you are looking for information in every nook and cranny of the vast internet (or so it appears to me). That is really good stuff. That is more time and energy than a lot of mom’s do for whatever reason. Being stressed and having negative energy won’t help. You are making educated choices with the information and situation that you are in. That is a GREAT thing. You are seeking out more information… Excellent job!!!

      September 2, 2009
  16. Erin #

    Thanks so much for this post. I’m still nursing my 7 month old, but do supplement with some formula which has at times been a huge source of guilt for me. Recently we’ve been having trouble with our nursing relationship because she’s become more distractible and I think also therefore more eager to take a bottle than the breast. I realized a couple weeks ago that her formula intake had crept up from 0-4 oz a day to 12-14 oz and I freaked! Now I’ve been spending the last two weeks doing everything I can to wean her off the bottle some – pumping constantly, feeding her as often as possible, etc. This post has really given me renewed encouragement to keep working on this (I am back down to only about 4-6 oz of formula a day again – yay!) and keep nursing for as long as possible without totally stressing myself out with an all or nothing mentality. Thank you so much!

    May 27, 2009
    • Birth_Lactation #

      Hi Erin, Thanks for stopping to leave me a note with that feedback. You made my day today! I am so happy you are feeling better about your nursing relationship! You have already done so much for your beautiful baby! I’m glad that anything at all I said — helped in any way to help you feel proud and not guilty. You have turned things around beautifully! This post by Breastfeeding Moms Unite! is a good source of information about night time feedings and supply… Some of these recommendations are what I give to moms returning to work who wish to increase supply if they notice a decrease. Even if bedsharing is not for you–maybe there is something here you haven’t tried that can help you maintain supply… I know how difficult it is at that age, It was the same for me. Such busy little babies so pleased with themselves and their new skills! Anyway~ I am so happy you stopped in and I hope to hear back from you again. Thanks 😉

      May 29, 2009
      • Thanks for the reply and the link to the article – I do sleep with my daughter and breastfeed throughout the night and have since birth. I recently went to a LLL meeting to talk to them about my breastfeeding troubles and they commented that at least when you’re bedsharing you do have somewhat of a guarantee of maintaining a supply, and I guess it’s true based on the article! I’m happy to report that things are getting better and better and I haven’t had to supplement with any formula at all for the past few days. I’ll definitely keep reading your blog – thanks again for the encouragement!

        May 29, 2009
  17. wow! thank you for summarizing your more than 15 years experience with breastfeeding moms into those 10 insightful points. how can i contact you? was hoping to ask permission to use those points. thank you. jenny

    June 8, 2009
    • Birth_Lactation #

      Thanks Jenny! You can post these in your blog, just link back to me for the credit.. Thanks so much!

      June 8, 2009
  18. Emily #

    Thanks for this – I was determined to BF from the outset, but didn’t fall in love with it until I faced struggles with baby’s low weight gain and had to confront my own selfish and bitter attitudes about all the feedings. It was the hardest thing in the world to accept that for whatever reason, my body wasn’t adequately nourishing my child. Every ounce of formula felt like a reminder that I wasn’t enough. We exclusively pumped for awhile (only about 14 oz a day max) and made up the difference with formula, and then started mixing and matching bottles and breast. She’s now 10 months old and gets almost all of her nutritional needs met from formula and solids, but you have never seen a baby that loves to nurse more. I consider our nursing relationship to be a successful one because the trials taught me to truly treasure that precious gift in a way that an trouble-free breastfeeding would not have. And for that, I am truly thankful.

    September 9, 2009
    • StorkStories #

      I am so very happy you have shared your story with me and with the readers. You have so very much to be proud of and so many reasons to be proud of yourself!! You worked very hard and your baby has a wonderful wonderful mommie. I am glad you are enjoying this relationship! Congratulations on your success and thanks again for sharing!

      September 9, 2009
  19. Meei #

    You are so right! I’ve always tried to veer away from the all-or-nothing route because it puts a tremendous amount of pressure onto mom. Most friends I know give up because of this. If they “partailly” breastfeed, I congratulate them. If they don’t, but express that they will try again with next baby, I tell them: good for you, if you need help, call me. I may not know alot but I’ll tell you my experiences. (Am breastfeeding 2 now)

    January 4, 2010
  20. Karen #

    This is a huge issue. As a new mom (my daughter is 9 weeks), I’ve been trying to breast feed since day one. I pumped and tried without success for almost the first two weeks before she would latch on – and then with only a breast shield. Finally got rid of the breast shield at 8 weeks. In the meantime I had a large infected galactocele that had to be drained by a breast surgeon twice – and seemed to decrease production in that breast. So it has been a long struggle. For about three weeks now she has only gotten one bottle a day – at night she gets expressed breast milk and some formula after a full feeding off me – seems to be the only way to get her to go to bed at night. But because of the 1-4 ounces of formula (and expressed breast milk) she gets each night I wonder if I can honestly just answer “yes” when someone asks if I am breastfeeding …

    May 24, 2010
    • StorkStories #

      I am so sorry I didn’t respond to this before now. Of course you say YES you are breastfeeding! You have gone through more and past many more obstacles than an average mother would to preserve your breastfeeding relationship! Emphatically YES! I am so sorry for your long struggle and congratulations to have come this far! i hope it continues to improve for you!!!!

      June 11, 2010
  21. Nicole #

    I stumbled onto this post when a girlfriend of mine recommended I Google “breastfeeding guilt.” She recommended it because I’m struggling with the decision to wean right now. I don’t want to, but I fear that the combination of my baby’s difficulty nursing for so long and my lifestyle (working full time, not being able to co-sleep) will force my hand. I successfully nursed my daughter for a year, and my intention has always been to do the same for my son. But he’s never really nursed efficiently (he breaks latch several times during a feeding) and therefore never really totally emptied my breasts. I’ve tried nursing only on one side per feeding and both sides. I’ve gotten up at 230am to pump when he sleeps until 6 or 7 to make sure I still have a nighttime “feeding.” I pump as often as my schedule will allow at work (usually 2-3 times) and nurse as often as he wants in the evening. All of these things and I still notice my supply slowly dwindling. Last night I had to give him a bottle of expressed milk after he nursed because I couldn’t fill him up. I’ve spoken with an LLL leader and incorporated what advice from her I can. As a last ditch effore, I’ve reached out to the lactation consultants at one of our hospitals and started a fenugreek supplement. I’m hopeful that these last two efforts will push me through, but I’ve had to slowly bring myself to realize that it might not be enough, that in order for my baby to be full and to get the minimum nutrients and hydration he needs, I might have to let go. The idea makes me so unbearably sad. But unless the LCs have a trick I’ve not found or the fenugreek works, I can’t punish my family with my own stress for 7 more months. They need a mommy and wife who can expend the bulk of her energy loving them rather than worrying about her breasts. This post has definitely helped. I think that if armageddon happens, I’ll at least feel less guilt than before and I’ll concentrate on mourning and moving on than on my inability to nourish my baby. And for me it will be mourning. I’ll take any amount of good vibes anyone can send me if it helps. 🙂 Thanks for the ear.

    September 10, 2010
    • StorkStories #

      Nicole, you are a strong and wonderful mother! You have done so much for your baby, your daughter, and your family. I can only comment on what you have shared here. I am gathering that your son is about 3 months old? It sounds like he’s possibly been having ineffective nursing tendencies from the start and you have been doing everything possible to improve your situation. Good for you! I am happy to hear that you have reached out to a lactation professional. Perhaps she will have suggested power pumping, super switching and others if you haven’t tried them already to maximize the stimulation and effective drainage at each feed session. I hope his weight is on target- don’t think you mentioned how thats been. Fenugreek may be very helpful for you. Sending positive thoughts!! You have a lot on your plate (huge) and you have worked extremely hard to keep your breastfeeding relationship on track. You are a true example of a wonderful wife/mother because now you are starting to think that you are stressing the rest of your family out by working on something you know is best for your baby. I know we do this to ourselves all the time. Please take some comfort in knowing you have done a great job so far. Seriously. I applaud you! It is a grieving/mourning process to end any breastfeeding relationship. You are not alone at all! Many mothers have struggled with this decision. Once you have come as far as you have, I wonder, are you feeling you need to stop all together?? I am not sure what you are saying really..ending breastfeeding or ending exclusive breastfeeding. What I have written about in this post was actually initially targeted at those moms who practiced some form of mixed feedings and then were feeling guilty that they weren’t exclusively bfing. At least that’s what I started out writing about. Some have even asked me “Can I say I am breastfeeding if my baby gets some formula every day?” I say.. “Does your baby still breastfeed?” Mom says .. Yes…then I say “well ~then you ARE a breastfeeding mother!” I don’t know if I helped you. I hope so. Keep loving your baby and your family. If you are able to exclusively breastfeed then that is fabulous! If you aren’t, perhaps you can consider continuing what you can and then those feedings, those moments when you are able to keep breastfeeding can be enjoyed for a long long time without guilt.

      September 12, 2010
      • Nicole #

        Just wanted to send an update and answer some questions. My son is 4.5 months old, and my thinking was that once I had to stop bfing during the day, it was only a matter of time before I would have to give up bfing altogether. So I was emotionally steeling myself for a very painful process. You did help veery much by letting me know that limited bfing can be sustained for as long as we want.

        We saw the lactation consultant last week, and the wonderful news is that she thought my supply issues were more perceived than real. She observed us and we weighed my son before and after, and the little booger had eaten 140 mls in about 6 minutes. It wasn’t that he wasn’t nursing effectively and I’d stopped producing. It was that he was a Hoover and I was probably over producing for a long time, so the reduction was alarming. She thought we could continue as we’d been for as long as we wanted. I was so relieved. Of course, I’m sure we’ll have other challenges along the way (not the least of which is a business trip I have to take to Europe for a week in Oct.), but I’m just so happy that I can provide what my munchkin needs.

        Your good thoughts must have helped :). I think the hardest part of all this is the feeling that today is permanent and irreversible. In my calmer moments I can remind myself that as long as I have milk, nothing is irreversible, and as any weaning mom can attest to, it’s a lot harder to get rid of milk than we are often worried it is. It took two very painful weeks when my daughter weaned. I like the advice not to make decisions when it’s dark outside . . . I think I would use that metaphorically as well. It was very dark for me a week ago; I should have known better than to try and be decisive.

        Thanks so much for your kind words. I know I’ll be turning to them often when obstacles crop up as they always do. I hope you won’t mind if I check in sometimes.

        All my best,

        September 18, 2010
  22. Karen #

    So … same Karen back again. The good news is that she eventually started going to be ok without that bottle – so she’s had no formula in a few weeks, and probably less than 20oz total July – August. (just for convenience if we were out somewhere and needed to give her a few ounces until we got to a better place for me to bfeed … she’s distracted easily now, which has made feeding in public more difficult) Of course she isn’t just on my milk either – she’s on peas and carrots and sweet potatoes and squash and applesauce and …..

    My daughter is about to be 6 months. She’s just started daycare and I am fortunante enough to be able to spend my lunch hour to go feed her (in person at the daycare). She gets a jar of solid food and a 3oz bottle of my milk in the morning “brunch” and the same in the afternoon “tea time”. So she eats directly from me at 7am, 1pm, 5:15, 7:30 and 9:00ish, plus overnight some nights. (some nights she sleeps through)

    I’m pumping one sided in the morning when I feed her at 7am and at 5:30, if I bring her home from daycare before feeding her.

    My question – once we pass 6 months, would it be a problem to give her juice or formula for those two bottles, but continue to feed her myself 5+ times a day? The pumping is really getting old, and is a lot to drag with us if we travel for just that little bit of milk.

    September 12, 2010
  23. StorkStories #

    HI Karen!
    You have come a long way! Congratulations! What an awesome success story you have!
    Deciding when to use formula now instead of your own pumped milk is a choice only you can make. I hear what you are saying. It can feel like a lot.
    Formula is a nutritionally appropriate substitute and as much as she is breastfeeding at her age, you should still be very proud of your accomplishments and perseverance past all your previous obstacles.
    Follow your heart and do what you feel is best for you and your baby without added guilt.
    As far as using juice in place of your milk, I’d recommend you discuss with her doctor whether that is acceptable given her whole diet/growth etc. Many Peds don’t prefer juice used at all. I couldn’t really comment on that.
    You are so wonderful to have done so much for your baby! I think it is especially cool that you can be there at your lunch to keep nursing! Great supportive environment for you both!

    September 12, 2010
  24. StorkStories #

    aren’t you helpful!

    October 22, 2010
  25. Hi! This is an incredible post 🙂 May I repost it in my blog? 🙂

    June 6, 2011
    • StorkStories #

      Thank You! Honored but please don’t post in entirety~ I’d prefer a link 🙂

      June 7, 2011
  26. C Bazzel #

    Hi, if there is a way to email you, I’d love to know. Thanks.

    December 31, 2011
    • StorkStories #

      meliyet (at) ptd (dot) net

      December 31, 2011
  27. ConfusedMama #

    Hi! I’m a mom of 2 (ages 4 and 6) and I came across your blog while searching for info on bottle feeding and breastfeeding. I mainly breastfed both of my daughters. However, when they were a few days old we did try to bottle feed (with expressed breast milk and some formula) so my husband could also have a chance to feed them and because I wasn’t sure if I was making enough milk. They never really liked to eat from the bottle and fought it, so we eventually gave up and turned completely to breastfeeding. Now, I am pregnant with our third child and my husband brought up the topic of trying to feed the baby with expressed milk in a bottle so that he can help out with some of the feedings. I guess I feel guilty because my first reaction was “not again.” I had pretty much figured that I would be only breastfeeding since bottle feeding hadn’t worked for us the past 2 times. However, after some thought, I would like to try it again so that he can have a chance at bonding with the baby the way I do through feeding. However, I am scared that if the baby does like to take the bottle this time, he might not want to breastfeed as much and then my supply would go down. Is there a risk of my supply going down if I pump instead of the baby being the one sucking the milk? What’s your opinion on bottle feeding expressed milk and breastfeeding? Thanks for your insight and for such a wonderful article.

    January 4, 2012
    • StorkStories #

      Hi Thanks for stopping by! Your concerns are very valid and quite common. Everyone figures out what works best for them. The best advice to someone who wishes to combine some bottles with breastfeeding is to get all the information so your decisions are truly informed. It is always best for your supply to start immediately from birth-Skin to Skin and breast feed with in the first minutes to an hour and as often as possible after that. The baby, if nursing effectively, is far better than any pump at stimulating the hormonal response, and fully draining the breast. For mothers who are unable to experience the above for any reason, regular pumping in combination with hand massage, or hand expression can generate a full supply and maintain it if they keep up the consistent draining of the breast. If you wish to express occasionally while actively breastfeeding your baby and then periodically offer your milk in a bottle or some other device, you’ll have a better chance of meeting your goals. Most moms have found that focusing on breastfeeding, building a good supply for the first 3 weeks is the best approach and practice pumping or expressing about an hour or more after a feed- usually in morning hours- after that 3 weeks. Offering a bottle to baby after that is sometimes easiest if done by a person other than you- with the baby in a position not like a nursing position …. (like having dad and baby both facing forward with baby’s back against dad’s chest….. and offer the breastmilk when baby is NOT hungry yet… A hungry baby expects what they are used to and this is the most common issue for young babies who won’t take a bottle or bottle fed babies who won’t latch on to the breast! It is managed so many ways really. Your concerns or fears about the baby NOT wanting to breastfeed after having bottles is a valid concern shared by so many mothers. Many have found that if approached like I described above and waiting until at least that age group to start… Not at newborn and not a lot later…… that they can do it how they want. You can run the risk of your supply dropping anytime the baby doesn’t nurse when they should be draining the breast. There is a good book out there called “Balancing breast and Bottle- Reaching your bfing goals” by Peterson. Think you can get it on Amazon. I hope this helps. Also remember every baby is different even though you had a similar experience with 2 babies.

      January 4, 2012
      • ConfusedMama #

        Thank you so much for your prompt reply and for the information you have shared. It’s so nice to know that there are nice, knowledgeable people (like yourself) out there willing to help others.

        January 4, 2012

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