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Tuesday, September 25, 2007

The Breastfeeding Conference Part II: Supplementing

If anyone had told me that when my older son (OS) was just a few days old my husband would be using a syringe to push formula into a catheter taped to my nipple one mL at a time, I would have thought that they were nuts. In fact, I probably would have laughed at the images that this would have conjured up in my mind. When I think about it today, I once again see the humor. When it was happening, it left me in tears.

I had many frustrations about breastfeeding. One of them was the teeny tiny fact that I proved medically and physically unable to breastfeed for longer than five weeks.

A second frustration was that while the hospital dished out diapers, Tylenol, and Motrin as freely as tap water, they hoarded nipple shields because apparently nipple shields alone were responsible for rising health care costs. All I know is that we had to have nurses sneak them into my room, and I have a bizarre memory of a nurse telling me they lose an insane amount of money per week on nipple shields. I have a further memory (no less bizarre) of acting like a lunatic after my younger son's (YS) birth when a nurse discarded my bloody nipple shield out and I felt like I had just witnessed an object with the same value as the Hope Diamond being thrown in the trash. Luckily he got me a new nipple shield, and he did not get me a psych evaluation.

A third frustration was that I had a hard time finding information about supplementing. This frustration grew with the birth of YS since I was aware that I would need to supplement, and I was on the lookout for the information. I was looking forward to seeing how supplementing would be addressed at the conference. Based on my own personal experiences, it seemed like there is quite a difference of opinion out there.

Supplementing was first brought up in a presentation about obesity and breastfeeding. According to the speaker, research shows a woman's milk comes in a half hour later for every 1-unit (1 kg/m2) that she is measured above a normal BMI pre-pregnancy. So a woman whose BMI is 4 units above normal is not likely to be able to breastfeed until 2 hours after a woman with a normal BMI. What should a new mom do in the meantime to feed her baby? The speaker focused on hand expressing colostrum into a teaspoon and feeding that to the baby. My friend Linda, who accompanied me to the conference, was actually the person who added supplementing with formula to the conversation. She raised her hand to discuss her experience using a supplemental nursing system (SNS).

SNS is the official designation for a catheter taped to a nipple. The basic idea behind an SNS device is that it allows the baby to suck at the mom's nipple to stimulate breastfeeding or to supplement the breastmilk while at the same time providing the baby with formula. Using an SNS provided Linda with the comfort of knowing that her baby was being nourished while she was waiting for her milk came in. Once her milk came in, she was able to exclusively breastfeed her son and then, a year later, her daughter. While the speaker acknowledged that an SNS is a legitimate way to handle a delayed milk supply, she was somewhat dismissive of it. She also continuously referred to formula as an "alternate feeding method."

That same speaker also later delivered a presentation answering the question of whether insufficient milk supply is real or myth. Apparently she considered formula to be a mainstream solution when a mom does not have enough milk, because she abandoned the "alternate feeding method" euphemism and called formula..."formula." She also presented SNS as one of the first solutions that a mom could use to handle a low or delayed milk supply. I'm not really sure what made formula and SNS more acceptable in one presentation than another. I suspect it had something to do with the different focus of each session.

There are other ways to supplement. A lactation consultant at the conference said she sometimes advises women who cannot pump in their workplace to nurse in the mornings and the evenings and to have the daycare provider feed the baby formula during the day. Some moms breastfeed first and then provide a baby with a bottle of formula. This way the baby gets the mother's milk, but is able to finish with formula if he's still hungry. Although not mentioned at the conference, I've also heard of women who breastfeed in the morning when their milk production is higher and then formula feed in the evening.

As I wrote yesterday, there is a fine line between having a lot of supportive information and having information that makes breastfeeding overwhelming. When I think back to the images that I conjured in my head when the nurse first described an SNS to me, I wish that I had learned about it ahead of time. I also wish I had known about the hole in our health care system caused by nipple shields being stolen from the hospital and possibly sold on the black market how difficult it would be to obtain nipple shields, so that I could have saved up during my entire pregnancy to purchase my own nipple shields ahead of time; although while I'm not positive, I'm pretty sure I was billed for the ones I got in the hospital and they cost more than they do on-line.

Dr. Stuebe and I had a great conversation about the problem with the all or nothing attitude in the breastfeeding vs. formula debate. Many times a middle ground works best.

A. Elliot's Lesson Learned: Some women can and want to exclusively breastfeed. Some women are unwilling or unable to breastfeed and thus exclusively formula feed. For everyone else, there are a variety of ways to combine both.

Labels: , ,

posted by Alex Elliot @ 9:21 PM   7 comments
7 Comments:

  • At 9/26/2007 12:01 PM, Anonymous Pinks & Blues said…

    AMEN!!!!! Great post Alex!!!!!

    I would still love to do the Zoo with you at some point with my boys. Would you still be up for it??

    - Audrey
    Pinks & BLues

     

  • At 9/26/2007 1:15 PM, Blogger BOSSY said…

    Super Informative. But is it wrong to say that Bossy is relieved she's facing Menopause?

     

  • At 9/26/2007 5:39 PM, Blogger soccer mom in denial said…

    I'm overwhelmed reading this. You are just amazing. I wish pre-kid moms were reading this....

     

  • At 9/27/2007 12:12 AM, Blogger VDog said…

    Right on, girlfriend! We need to support each other, booby juice or formula don't matter, during the RRRRROUGH post-partum time period.

    Where you needed to be was the NICU, where they handed those nipple shields out like candy. :) LOL

     

  • At 9/27/2007 1:31 AM, Blogger Chantelle said…

    Hear! Hear!

     

  • At 9/27/2007 10:00 AM, Blogger CableGirl said…

    I actually found the SNS made BFing worse for me. When DD discovered that the boob with the SNS gave off milk more easily she stopped sucking as vigorously and made BFing even harder, leading to a further decline in my milk production.

     

  • At 10/05/2007 3:24 PM, Blogger Suzanne said…

    As a person raised on the "alternate feeding method" who is married to someone also alternatively fed, I can see why we are so maladjusted in life. Or something. I know this has nothing to do with SNS, but I wanted to use the phrase "alternate feeding method" because it cracks me up, as though my mom came from Uranus and couldn't figure out how normal earthlings feed their kids.

     
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Name:Alex Elliot
Home:MA, United States
About Me:Professional Mom of two cats, a dog, an ant farm, and oh yeah...two boys: a 6 year old and a 3 year old. Also found in my house is my husband who is known on this blog as The Big Giraffe.
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For those of us who didn't get an instruction manual with our babies and for whom parenting hasn't always gone as planned. On a more serious note this blog is about supporting a woman's ability to make her own choices about parenting including the choice, for whatever reason, to bottle feed her babies formula.

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