A Canadian report was released looking at the impact of free formula on breastfeeding rates. At parentcentral.ca, Laurie Monsebraaten and Noor Javed wrote about the study in Free formula spoils breastfeeding:
Almost 40 per cent of new mothers leave the hospital with free infant formula, a recipe for spoiled breastfeeding according to a new Toronto Public Health report.
Women who didn’t receive the free samples were 3.5 times more likely to be breastfeeding exclusively after 2 weeks, said Breastfeeding in Toronto, Promoting Supportive Environments, released Tuesday.
The study, conducted in 2007 and 2008, found that of 1,500 first-time mothers surveyed, 39 per cent were given formula at hospital discharge. As a result, many of these women stopped breastfeeding sooner than those women who weren’t given formula.
These numbers are astounding, considering that 90% of Canadian women who give birth initiate breastfeeding. If we assume that the 10% that went straight to formula got a handout, then that means that almost 1/3 of women who do initiate breastfeeding are leaving the hospital with formula samples.
Overall, by 3 months:
- 32% are exclusively formula feeding
- 16% are combination feeding (some breast, some formula)
- 52% are exclusively breastfeeding
I am willing to concede that some of the mothers that leave the hospital with formula samples may not have overcome their breastfeeding difficulties even if no sample had been offered. That said, the combination of the high number of women receiving free formula when discharged and the likelihood that they will break into that sample by the two week mark is likely a strong contributor to the significant drop between breastfeeding initiation and continued exclusive breastfeeding.
According to the parentcentral.ca article:
“They give it to the women ‘just in case’,” she said. “But the real message is that you will probably fail… and one bottle leads to another.”
The Toronto East General Hospital is the only baby friendly hospital in Toronto, canceled its contract for free formula in 2005 to comply with the baby friendly requirements and the WHO International Code of Marketing of Breast-Milk Substitutes. Since they do not get the formula for free from formula companies, they need to actually assess whether a mom needs the formula, instead of handing it out 'just in case.'
Other countries with a larger percentage of baby friendly hospitals than we have in Canada and the United States also have higher breastfeeding rates. I think one of the many things that needs to be done to give moms the best chance possible of being successful at breastfeeding is to ensure that they aren't being sabotaged from Day 1. Don't you?
Note: source for all statistics on Canadian breastfeeding rates is the Maternity Experiences Survey from 2006/2007.
Image credit: D-Arb on flickr
{ 54 comments… read them below or add one }
We left with a ton of formula – but we needed it. My milk had not come in and my kid was starving. I still have a bunch of bottles upstairs. I wonder if the people who are leaving with the formula are the ones who’ve already had to use it with their baby for some reason – this would probably skew the numbers.
zchamu:
I think that is a good area for further study. The article did indicate that a lot of hospitals send moms home with it “just in case”. I also think that if 40% of moms needed formula before leaving the hospital, that is a indicator of more systemic problems that need to be addressed. Obviously some moms do have trouble breastfeeding, but with the right support they should not be giving formula to 40% of moms.
“I also think that if 40% of moms needed formula before leaving the hospital, that is a indicator of more systemic problems that need to be addressed.”
Word. The breastfeeding advice I got in the hospital was laughable. It was totally inconsistent from nurse to nurse and some of it was downright bad. In my experience, all nurses in the maternity ward I was in need to go for retraining on breastfeeding.
Absolutely. In the first hospital I gave birth in, I asked a nurse if there was an expert I could talk to — she said “the next nurse on shift knows a lot about bf”. Never mentioning that at that time *Dr. Newman had a clinic in the hospital!!!* Once at home, I had a visit from an LC that works with Dr. N — and learned so much from her. I asked “if you work in the same hospital, why don’t the nurses know what you know???” She did say they were hoping to do some training with the nursing staff. Considering the clinic has since been closed, I am going to guess that didn’t happen.
I agree. There is MAYBE one Lactation Consultant trained nurse in our entire Hospital here. I was luckier b/c I chose midwives for all three of my births and they are well trained! I think that it should be part of the curriculum for nurses, esp. if they are training for OB Nursing. I mean, what else are they supposed to be there for other than to support the new Mom, however she needs it!! Friends of mine who delivered in the hospital here (with OB/GYN’s) were ALL offered formula if the newborn didn’t immediately latch successfully! That’s terrible!! Besides the fact that most newborns will sleep for the first 24 hours after the birth if they have a drink upon arrival (a fact I learned from the midwives), probably 99% of new Moms are NOT going to have immediate BF success! It’s a learned ability and they aren’t going to learn if there is no one to teach them!
I also wonder, even in cases where formula is necessary, to what extent it is the hospital’s responsibility to send the mom/baby home with it? I needed pain meds and the hospital provided them while I was there, but did not send me home with more. I needed pads to deal with the blood. The hospital provided them while I was there, but I had to buy more to use at home.
I think there should be programs to help low income moms if they weren’t expecting to need formula and then did need it. But I think that most people who need it should buy it. The other alternative is for it to be provided via prescription, but there was tons of vocal objections to that on other posts too (for some good reasons).
I agree parents who use formula should not expect the hospital to supply it once their child is discharged. Of course parents are responsible for their children’s needs, making purchases when necessary. (I also think there should be programs for low-income families.) However, I believe formula sample bags are generally given to hospitals by formula companies to distribute to new parents. Formula companies foot the bill for those “goody bags” … not the hospital. I’m concerned about the attitude behind not distributing formula samples (–that ‘breast is best/ normal’ and formula is bad)– not the freebies themselves.
Suppose for a moment that pharmaceutical and feminine hygiene companies gave samples to hospitals to send home with new moms. Your reaction would probably something along the lines of, “Oh, that’s nice. Then new parents have a little less to buy.” It may occur to you those samples are a marketing tactic. But I doubt you’d object. If the products of which you have samples were not for you, you just wouldn’t use them. You could always switch to other pads and probably other drugs later if you wanted. (Note: Check with your doctor before changing your medication.) If you knew up front you were not interested in the pads or medication, perhaps you would decline the samples in the first place.
Thousands of products are marketed to people. But it is assumed adults are capable of recognizing an attempt to sell them something and making their own assessment of whether or not to purchase them. I don’t see why parents would not be capable of deciding what feeding products, (bottles, formula, breast pumps, nursing bras, nursing covers, etc.) if any, to use or buy.
True, distributing formula samples might look like an endorsement of formula feeding and/or a particular brand. However, I would blame that on poor/ lacking feeding advice, not the samples themselves… just as I would fault the hospital for not discussing different pain management options with new moms if they mistakenly thought only the pills the hospital sent home with them would do.
Personally, I would prefer that there be no marketing happening at the hospital. That said, I do think there is a difference between feminine hygiene products and infant formula. If I use feminine hygiene samples for a week and then decide they are not for me, it is not too late to change my mind. If I use formula for a week instead of breastfeeding, my milk will dry up. Sure, relactation is possible, but that isn’t a route many moms go down at that point.
Well, we may have to agree to disagree on some things. Here is my opinion:
True. However, I would hope a mom who wants to breastfeed would know that she needs to nurse and/ or express regularly (at least 8 times a day, according to most sources, and preferably by feeding directly from the breast… especially in the beginning) to establish and maintain her supply. If a new mom does not realize using formula for a week instead of breastfeeding would cause her milk to dry up, I think the hospital needs to improve their infant feeding education.
Perhaps I should be more specific about the advice I think hospitals should give. I think new parents should be informed about the pros and cons of each feeding method. This includes breastfeeding, formula feeding, combo feeding, pumping and donor milk. Good information and support should given regardless of the feeding method the parents choose. I realize many hospitals have a ways to go in this respect.
Hospitals would make it very clear that the “goody bags” are sponsored by formula companies; the hospital receives free or discounted formula in exchange for distributing the sample bags. The bags should not be interpreted as an endorsement of formula in general or any brand in particular. The hospital staff should explain that most babies will do fine on any commercial formula, including generics, (with the caveat that infants should not be given follow-up or toddler formulas until they are old enough) and can switch brands without problems.
When moms are breastfeeding, the hospital should let them know about the possibility of supply problems and nipple confusion if they introduce bottles, formula or pacifiers before breastfeeding is established. However, I would also say that relief bottles and supplementing can sometimes be helpful. Parents have to make a judgement call about whether or not to have bottles and formula in the house. Bottles and/ or formula can be removed from the bags if they prefer. If the parents are not interested in the “goody bags” at all, that’s fine too. Letting them know about alternatives to bottles, such as cups, spoons, syringes, droppers and SNSs would also be a good idea.
In short, I’m advocating making parents very savvy about formula marketing. That way, they can take advantage of the system instead of the other way around.
I also wonder if the moms leaving the hospital with formula had already given it to their babies — I know I was never offered samples as a parting gift (and both hospitals I gave birth at were uh, spotty, in their bf support and knowledge, to say the least!) But then, would that mean 40% of babies are given formula in hospital? Because, there is no way I can believe 40% of babies “need” formula in the first day or two of life, no matter how badly nursing is going. The whole “chick pea sized stomach” thing, and the fact that it is normal for milk to take a few days to come in and all that. So yes, this would be a case of bf being sabotaged from day one
Andrea:
My son hadn’t latched on before we left the hospital. They did give him formula, which in retrospect was completely unnecessary and a bad move (I didn’t know better at the time). I was pumping, was able to cup feed him colostrum, and my milk came in with a vengeance.
My milk did not come in for 3 full days and luckily my daughter was not given formula, but I think you hit the nail on the head with “(I didn’t know better at the time)”. If they had suggested that she needed formula because she was not getting anything, I most likely would have gone along with it. In those first few weeks after birth we are vulnerable. If there are problems with breastfeeding in the first weeks it is much easier to open that sample if it is right there. Of course there are babies that do need formula, but you can get formula pretty much everywhere and in many places that are open 24 hours. I can maybe understand hospitals in isolated communities giving out formula, but not in places where formula is readily available.
“They give it to the women ‘just in case’,” she said. “But the real message is that you will probably fail… and one bottle leads to another.”
My first son also had issues latching, and had I been offered formula at that time, I am certain I would have agreed as well, because I also didn’t know then what I know now. So I guess I have to hand it to the hospital that they didn’t offer, despite the poor advice I received otherwise — I pumped and tube-fed him with a finger and after home visits with a PHN and an LC, I finally managed to latch him.
“Because, there is no way I can believe 40% of babies “need” formula in the first day or two of life, no matter how badly nursing is going.”
What are you basing this belief on? Is it based on empirical evidence, or is it a theoretical argument?
I’m basing my belief on what I know about bf, that all baby needs in the first days of life is colostrum, that their tummies are tiny, and that only about 5% of women are physically unable to bf. It does not make logical sense that 40% (almost half!!!) of babies born in hospital would *need* to be supplemented with formula.
In addition to what Andrea said, the statistics from breastfeeding friendly hospitals also speak volumes.
Um, in Sweden, according to Dr. Jack Newman, 99% of mothers and babies leave the hospital exclusively breastfeeding, having not “needed” formula at all. Formula is only “needed” when hospitals engage in practices that sabotage breastfeeding–not latching the baby w/in the first half hour or hour, not practicing skin-to-skin which stimulates the feeding instinct in babies, separating mothers and babies so moms can’t see and respond to feeding cues; the list goes on (Ten Steps of Baby-Friendly Hospital USA); basically mangling something that works very well when not “booby-trapped”.
I am sort of disappointed that the authors of the study equate being given formula to take home with the perceived message “you are doomed to fail”. I like to think that women (new moms included) are smarter than that. In fact, that line sort of offends me (admittedly, I have a chip on my shoulder, even after 47 months of nursing my kids).
I don’t know that formula, free or otherwise, is really the problem (and hey, it’s expensive, so I can’t begrudge anyone giving their infants one of the two top foods a financial break). More education about what breastfeeding is really like might help to make mothers more dedicated to its success – such as, how sometimes a milk supply does not come in for a week, how just because a newborn wants to nurse all the time does not mean that one has a low supply, and also how supply regulation does not indicate inadequate supply either. I sort of wish that every new mom could be a patient of Dr. Jack Newman’s
I totally agree! I wish everyone could meet Dr. Newman and the lactation consultants who work with him! They’re fabulous! Luckily his book and website are full of great information too!
You make a good point here. First, the distribution of formula in the hospital is not becasue they think the mother is “doomed to fail”. Making that claim is just pure irresponsible and does more harm than good. Pharma companies provide the hospitals with samples to distribute to new mothers in hopes they will buy later. But, that being said, most hospitals do encourage mothers to breastfeed over bottle/formula fed. Sometimes however, it is not possible to provide the baby with the calories it needs.
of formula.
Some babies have difficulty attaching and maintaining a good seal at first. Some mothers arent producing enough colostrom to maintain a good calorie intake. Sometimes, with premies, additional calories are needed. There are a number of reasons to both bottlefeed or provide mothers with a formula sample. In addition, leaving with formula doesnt “result” in stopping breatfeeding earlier. That is an unscientific and unsubstantiated claim.
For the record, we breastfed through 9mo with both of our children and left the hospital with a motherload
I had one of those babies that needed formula in the first few days of life, but it was only given to DS as a last resort, with my permission and after an extended attempt to BF at each session had been made. I was also supported to pump as much as possible and offer that first (there wasn’t much, but we got there eventually). The lactation consultants and midwives were very supportive. We left hospital fully BFing. In Australia, they don’t give out free samples and (IME) if you choose to feed your child formula in the hospital (as opposed to having trouble with BFing) then you need to supply it.
My daughter received free formula in the hospital, and I have incredibly mixed feelings about it. I am mostly angry that she was given her first bottle before I had a chance to attempt breastfeeding, and without consulting me. However, between my pumping issues and the fact that she was premature and in the NICU, I don’t think it could have been avoided. Even baby-friendly makes a distinction between a healthy full-term infant and a preterm or ill infant, since their needs are different and the possible risks to their health by taking a wait and see approach are greater. We can all recognize, though, there is a big difference between a preemie in the NICU and a healthy full-term infant being given formula ‘just in case’.
We didn’t receive a ‘goody bag’ or anything along those lines with free formula. I think something like that is completely inappropriate. We can have flexibility to respond to an individual situation without passing out free samples. In the general case, hospitals have an obligation to promote breastfeeding as the healthiest option. Providing free formula undermines that message, and implies that someone WILL have problems. That is the difference for me – are you addressing an actual issue, or just trying to market a product?
We had a home birth with midwives, who were very supportive of breastfeeding (as you can imagine). However, my son and I had some difficulty with latching in the first week, and he lost enough weight that the pediatrician recommended giving him some formula while we figured it out. I was completely devastated about not being able to nurse BUT…our midwife helped us with a plan that included using a narrow tube taped to my nipple to deliver the formula and using a pump to stimulate milk production. So yes, he had some formula at the beginning, but we learned how to latch, and he is still breastfeeding at two years of age. What made the difference in our case was being given accurate information and support about how to use the formula in ways that supported breastfeeding.
I didn’t receive formula from the hospital where my son was born, but I did have a free sample of Nestle formula at home…I had a lot of problems latching during the first week when my son was home, and in a moment of exhaustion and despair I asked my husband to open the can and mix some formula which I gave to my son via finger feeding. The can was just sitting in our house, taunting me…providing me with an easy out during a difficult moment! My son is now over 2 and still breastfeeding, so it didn’t sabotage our long term breastfeeding relationship, but if I had to do it over I wouldn’t have given him any formula – he didn’t need it! I just doubted myself, and instead of turning to that free sample of formula I should have called a La Leche League leader or a breastfeeding friend for support.
Isn’t the marketing strategy just that… to sabotage and then have “their marvelous” product to help you along. Forgive me for this but it sounds like a chemical company giving a troubled teen a few addictive tablets to get them trough a rough patch… they will get through the rough time and they will indeed owe the hand that helped them for the rest of time. Opinionated I know, but seriously how many moms would have free food on hand for their babies if they weren’t helped by a formula company. Where I am in Cape Town there are so many poverty stricken moms with no access to clean water that are helped by formula companies and then dropped in a situation where they cannot afford to feed their baby – the unfairness of it makes me seethe. Just thought say!!!
I’m not really sure about making this statement, but is it possible that when you receive this formula, “just in case”, it may actually triger a subconcious stress that you won’t be able to breastfeed your baby? And because of this stress exactly, may lactation be impeded?
I’m not in Canada, so I don’t know how relevant my comments are, but both my OB and the hospital gave me a LOT of formula samples and coupons. The hospital even gave us a choice of Enfamil or Similac diaper bags to take home! I took one because I didn’t have the choice to opt out. The most ironic part is that it was labeled a “breastfeeding bag” and had pictures of a nursing baby and the word “breastfeeding” plastered all over it wherever they could find room for it, but it didn’t change the fact that it came with a formula sample, formula coupons, and some program where you could get formula checks mailed to you. When I go to the thrift store, I see these bags everywhere so I know this must be a widespread practice in my area. My baby was fed a bottle of formula when I couldn’t get her to latch on because, like others have said, I was vulnerable and didn’t know any better. The hospital staff made it sound as if I would be a bad mother if I didn’t feed my baby in one way or another. Also, I found out that even though I let them take her to the nursery for a few hours so I could finally sleep after being up for two days, and I had told them they needed to bring her back to me as soon as she wanted to be fed, she was given a bottle anyway. I was then mailed two full canisters of formulas as “just in case” samples within weeks of coming home from the hospital! (I donated all of it because it never got used.)
Seeing that this is common in Canada as well as America (and Americans have this image that everything is better in Canada) is absolutely outrageous. Something needs to be done, but it’s like no matter how loud we are, the people with the power don’t hear or don’t care.
I’m curious about cause and effect here. What determined which mothers took formula home and which did not – is it possible that mothers more committed to breastfeeding refused the formula samples, while mothers whose commitment to breastfeeding was more ambivalent accepted the samples?
My own experience was that we refused the samples due to strong commitment to breastfeeding. Then after the baby showed signs of dehydration when my milk took a bunch of days to come in, the IBCLC said we needed to supplement, which we did for a few days. I still think we did the right thing in refusing the samples, though, because I don’t like the idea of using formula without an IBCLC prescription. (Why did people object to formula being available only by prescription, btw? It seems like it would solve a lot of problems.)
Channa:
I’m sure that some mothers that were committed to and educated about formula refused the samples, so that is probably one factor. But with my first child, I considered myself educated about these things, having read all of the “expected” (read: mainstream) books. However, when a nurse (who also claimed to be a lactation consultant) said “why don’t we just give him a little bit of formula so that he’ll know what it feels like to have a full tummy and then may be more interested in the breast”, I figured she is the expert and I should listen to her.
But beyond that, I would assert that any mom who wishes to breastfeed, even if she isn’t committed to the point of having done iotas of research, still deserves a fighting chance and shouldn’t be subject to the potential sabotage of being sent home with samples of formula that she might reach to because she just wants a bit more sleep, because her nipples are a bit sore, because she wanted her husband to have a turn feeding the baby, etc.
I live in Israel and I think the hospitals here are definitely moving in the right direction.
First of all, normal deliveries are attended by midwives, who help you try to feed right away after delivery.
As soon as the baby goes for it’s exam they ask if you are exclusively breastfeeding and if so, a little sticker goes on the bassinet and no one even asks you about formula. There is a lactation consultant running around at almost all times and she does “rounds” to see how things are going – that was key… she got us off to a great start and checked on us periodically and gave me tips and feedback and was generally very encouraging.
What particularly impressed me though was the formula company – they came around WITHOUT SAMPLES. As soon as the rep saw our “Breastfeeding only” sticker – she informed me that they have a gift pack for us too and she came over and gave us a package of diapers, and book of coupons and a booklet of breastfeeding tips (some of which were actually very helpful – like a listing of Israeli products that are healthy for bf moms to eat, etc.) She didn’t even MENTION formula the whole time.
Well, my baby was BF-only until 13 months, but after that, I went for their formula. I really appreciated that they tailored their marketing activities around my needs – and at the end of the day it certainly wasn’t a waste for them.
It sounds like you had a good experience, Lauren, and it’s great to hear about other countries that seem to be doing things right when it comes to birth and breastfeeding.
I have to say I’m a little skeptical about getting breastfeeding tips from a formula company rep!! I’m glad they were helpful, but you have to wonder about motivation. Was she just doing it out of the goodness of her heart?
I think that they figure that even BF babies will get formula at some point – either in combination with BF, or the mom will give up on BF or (like me) the baby will continue to get a couple bottles a day once it is weaned from BF. For this rep it was a great bet – my baby’s 3 and won’t drink milk, so we’re still buying it even though she doesn’t really need it anymore!
Like Lindsay, I am skeptical of formula companies giving breastfeeding advice.
Helping Themselves: Breastfeeding Advice Nestle-Style
Nestle Answers: Can a formula company support breastfeeding?
I haven’t seen the materials that you were provided, but even the description makes me a bit skeptical. For example, telling breastfeeding moms that there are specific foods they should be eating may nudge them to choose formula instead of they feel like they cannot maintain that ideal diet, when in reality the mom’s breast milk is going to be better than formula no matter what she eats, unless she is severely malnourished.
I found it helpful (we bf-ed exclusively for 13 months). It was more along the lines of suggesting alternative sources of fiber if your baby is sensitive to the vegetables you would usually eat and also good non-fish sources of omega-3 and 6… stuff like that. I can understand the skepticism… but I honestly didn’t feel like I was being pressured to buy something.
You didn’t need to be pressured, Lauren. In fact, the more helpful formula reps are to breastfeeding mothers, the more they build brand loyalty, even if you never nuy formula. Chances are you will be more likely to buy the company’s other products, or spread the word on their behalf to a mother who is not sure about breastfeeding. The brand loyalty to formula given away in hospitals is so great that it’s written about in marketing textbooks.
I gave birth in Florida in the US. My daughter had no problem latching, but had no desire to eat. One nurse convinced me that since it had been over 8 hours since she’d eaten that she need to be supplemented. Again, “I didn’t know any better” and let her talk me into it. She was able to feed my daughter an ounce of formula. This led me to believe that there was something wrong with the way I was trying to breastfeed. I saw an LC the next day and we were able to get her to breastfeed twice that day and I was sent home. The nurse at discharge asked me outright if I was planning to breastfeed or formula feed. I replied, “breastfeed,” and she said, “that’s great,” and – no joke – handed me my free similac tote bag complete with bottles, a canister of formula, and coupons for more. I was also sent home with the remainder of the premixed bottles of formula that the nurse had opened when she fed my daughter.
After we got home, my daughter went several more days without wanting to eat much. Because I had seen the nurse have success with formula, I tried that. Luckily/unluckily she wouldn’t eat that either, and so I decided to keep trying with breastfeeding. After three days (during which time we paid a visit to the pediatrician and two visits to a LC) she finally realized she wasn’t still hooked up to the umbilical cord started eating. She’s 19 months now and we are still going strong with breastfeeding. I often think about how easily I was almost sabotaged in that effort, and how I would have missed out on the experience that we’ve had. I also think about the things that might have made it better, and top on that list is education – education for me as to what was normal and what not. But, the other factor is that they sent me home with the formula – like you said, implying that I would fail, and believing that I had failed, I gave it to her. If she had accepted it, I would never have continued breastfeeding. It’s knowing what I almost missed out on that makes me so upset about it.
I’m in the U.S. and was sent home with 1/2 dozen pre-mixed bottles of formula. I was in such a daze I didn’t even know what was in that little bag. It sat on the shelf for 4 months (supplemented at that time because I had trouble pumping enough at work) because my husband really thought we should keep it “just in case”.
The reason I was able to leave the formula on the shelf was because I had educated myself on breastfeeding and I had full support from my husband and family. If I had been uninformed and/or not had support, I might have opened one of those bottles in that first week when we were having trouble latching. Not every woman has that support, and that is why sending formula home with them “just in case” is paramount to sabotage.
And just FYI to anyone who worries about milk taking too long to come in, my milk came in at the end of day four. I gave birth at 6 pm Monday, and milk came it around 6 pm Friday. My baby was fine on colustrum until then, so don’t worry if mom’s milk doesn’t come in before leaving the hospital.
“But the real message is that you will probably fail…”
I think this statement is really important. No one told me how difficult breastfeeding could be. My friends didn’t know either. Somehow there is a culture that b/c it’s natural it must be easy and if it isn’t then you are a failure. Many many of my friends who have had children gave up b/c they didn’t know that it was ok if it was difficult.
The hospital that I gave birth at had no lactation consultants. If it wasn’t for the one nurse who took an interest in me, and then the breastfeeding clinic that I went to for weeks after, I would have failed. My hospital didn’t give any formula samples, but they did push bottle feeding. It was more convenient for them…no teaching, no waiting. On a side note, we were bombarded with formula at every turn. We still have about 12 cans in our cabinet “just in case.”
~Amber @ The Mom Road
I gave birth to my daughter at Toronto East General Hospital in 2008. I chose that hospital specifically because of their designation as baby-friendly and their promise of support of breastfeeding. Based on my experience, they really do live up to the designation. They offered a breastfeeding class as part of their prenatal education (which my husband and I both went to), and similar sessions were held in the L&D ward several times a week (we went to that one too – it was nice to get the information with an actual baby in my arms). Every nurse is trained to help, which we needed. We weren’t allowed to leave the hospital without having at least one successful latch (which we had, although it was a short one). There is also a breastfeeding clinic, which I believe is available to anyone (not just patients of the hospital). We went there when she was about ten days old just to be sure that she was getting food and that I was doing things right. (By that point, I think I was more paranoid than anything, but my milk did take about four days to come in.) I don’t remember any mention of formula at all, and I definitely did not get any samples. Here’s a picture of TEGH’s “Promise to Families” with regard to breastfeeding: http://www.flickr.com/photos/mpricemitchell/2835175993/in/set-72157607159140943/
One piece of advice I received pre-birth was to have a can of formula in the house “just in case”. I didn’t follow that advice because I was afraid that having that can would make it too easy to give up. I figured that if things truly got that bad, someone could go to the store and get it (the advantage of living in an urban area with several all-night stores). I realize that not everyone has that luxury.
I wish that all hospitals were this supportive of breastfeeding, or at least were able to point new mums in the right directions of resources who could provide breastfeeding support. I think having that support helped me breastfeed for longer than I thought I would pre-baby (we went till she was nearly 16 months, where pre-baby, I was hoping for anywhere between 6-12 based on my limited knowledge and when I would return to work).
The thought of “does giving a woman formula make her worry about not being able to breastfeed and therefore impedes her ability to lactate” is an interesting one.
Not to reply to myself, but I just wanted to clarify that don’t have any ties to Toronto East General Hospital outside of a good birthing experience and an OB who practices there. No disrespect was intended by naming names. I know other people’s experiences may not be as positive as mine, especially during such a tumultous, emotional time in a family’s life.
My hospital is very pro-BF, and since I had an emergency (no, it really) C-section, my milk didn’t come in for 3-4 days. So my son didn’t eat. I don’t regret that, though it killed me at the time. He also never learned to latch, so I pumped for 13 months, supplementing with formula for the last 4-5 mos as he didn’t care for baby food (purees, ew!).
The problem is that some moms will only be able to use formula, and they shouldn’t be slandered for that. The most important thing is having a healthy, well-fed baby – and how many people in the world would beg for that?
@Orodemniades:
Was someone here slandering moms who are only able to use formula?
Orodemniades, I don’t know what kind of latch problems you and your son had. However, I had a c-section too, and my milk took 4 days to come in (see my comment above). Milk taking an extra day or two to come in does not alone necessitate baby getting formula. Barring other complications like low birth weight, baby will be okay with colostrum.
Please understand I don’t say this to be judgemental of you. I just like to put it out there for future mothers so they don’t worry if their milk isn’t in by day two.
I’m intrigued that milk taking 3 to 4 days to come in is considered a problem. It’s my understanding milk can take 24 hours to 7 days to “come in” and there is sufficient colostrum for and baby being near the breast, even just nuzzling will speed things up.
Giving a bottle won’t speed things up.
The mothers’ wisdom I heard and found to be true with my three was your milk will come in when you get home from the hospital. The longer you stay out of your natural environment, the longer it takes. Maybe complete b/s but…
After a very long labour, my third baby nursed for a few moments then slept for most of the next two days, with only tiny sips of milk and nuzzling at the breast. We were concerned, but she remained hydrated and my milk came in just as quickly as with her more voracious and awake sister.
Radmama, you are right about milk taking 24 hrs to 7 days to come in being normal. That is why I find it surprising and sad when I hear women say things like “My milk never came in” (I want them to qualify what “never” means) or “My milk took 3 days to come in and my baby was starving by then so…” Really, I just wish LCs and nurses would tell mothers this information.
I probably don’t belong on this board, but there is a value in helping new mothers know what the options are. The LC at our hospital did not believe in nipple shields, pumping or formula. For us, this became a big problem. After a C-section because my daughter was breach, my milk didn’t come in for 5 days. Because my daughter was very small (5%ile), she was the size of the average 34 week old fetus. This size issue became a real problem in terms of achieving a successful latch. Because my milk didn’t come in promptly and the problems with the latch, her weight keep dropping. No one cared as her weight dropped to 4lbs 13oz because she had only lost 11-12% of her birth weight. At that point, I felt that it had gone too far, and I gave her formula. I think that this was a wonderful choice for us.
If the LC had a more moderate position, we might have started to pump earlier in the hospital. We could have tried the smaller nipple shields that I brought. Instead, I wound up with large 1/4 inch or bigger scabs on each breast and a child who was still loosing weight on day 5.
We ulitimately got it under control and my daughter has had pumped BM for the last 7 months. If the LC had been more flexible (pumping to stimulate milk, nipple shields), she might have been a more successful breast feeder.
Readers, please use my post as a brilliant example of How Not To Post When You Are Tired And Have Received Bad Bank News, Amongst Other Things.
And it’s so late in the day I can’t even remember what the heck was the bit I didn’t include in my statement. I think I forgot to add in something along the lines of an “I think so too!” and “It’s a shame that women aren’t told that sometimes there is no milk production at all, and that they shouldn’t be ashamed if they have to use formula”…?
I do know women who went through absolute hell with breastfeeding, finding out only later their breasts could never have produced milk in the first place. And that would be a good thing for the LLL and other pro-BF groups would be good to remember.
And, lastly, before I get back to work, that having a bad BF consultant is worse than not having a consultant at all. I personally did not have a fabulous experience, and felt really bad about myself for a long time. Heck, I still sorta do, but now with added resentment, which because I still get the ‘Oh, you bottle fed your baby’ thing, when, for the love of I pumped for 13 – thirteen, people! – months.
Ah, angst, the gift that never stops giving. In any case, my apologies for crappy writing.
I’m not sure if the free formula is what causes some women to give up on breastfeeding or if it is that there is limited knowledgeable support for many women who want to breastfeed. Even when baby latches on immediately with a good and pain-free latch, milk comes in right away, baby gains weight well, etc.; most women do not have someone telling them that cluster-feeding, fussy evenings, all night nurse-a-thons are absolutely normal.
Instead, doctors, nurses, grandparents all say that baby must be hungry, mom must not be producing enough milk, doesn’t mom just want a break to get some sleep?, baby should only need to nurse 20 mins max and is just using mom as a pacifier. Suddenly dad starts buying in to this as he sees his exhausted wife struggle. He should be offering to cook, bring her food and water, tell her to forget about cleaning, take over the other kids and support her choice to breastfeed with the outside influences. But often, the push to open that free can of formula or to buy a can and bring it home begins.
My husband thought he was being helpful suggesting formula with our first child but quickly realized that it wasn’t even an option. Now with our new child, he has never even mentioned it. In fact, he is now so educated that he knows about supply and demand, nipple confusion and all things breastfeeding. He is very proud that neither of our kids had a drop of formula. This wouldn’t have happened though if I had not been so stubborn and we were fortunate to have a breastfeeding supportive doctor who didn’t even stress out when our first wasn’t back to birthweight after 2 weeks.
I guess what I’m trying to say is that the free can may make it easier for some moms to give up or supplement but it’s really the support (or unsupport) team that makes the difference.
I really agree with you on this… I know that with my first, I owe a lot to the support I got from my LC, my mom, and most of all my husband – who all had 100% confidence that we’d get the hang of it – even when I didn’t feel that way. It makes a huge difference being surrounded by people who think that it really does matter and know how to provide the right support.
I dont necessarily think that any of this really has to do with free samples being given at the hospital. I am from Toronto and gave birth to all 3 of my kids in a VERY pro-bf hospital. No formula samples were given – formula was never given to the child w/o adult permission and if you had (before birth) intended to give your child formula it was on you to bring it. Only if the child was admitted to the NICU and had the parents permission were they given formula if needed.
I think most of the issue with breastfeeding for new mothers is really the lack of education on when your milk comes in, what engorged breasts looks like, how much the baby should be eating and where to find support when you need it. I think that if any parent thought their child was starving because their milk hasnt come in for 4-5 days (which is normal) they would run out to the store at 3am if they had to in order to purchase formula for their child. Whether a sample was given at the hospital or not it is still easy to find (and it should be).
Nurses are not always extensively trained in breastfeeding. At the hospital I delivered, although it was a very pro-bf place – they were so focused on how often the baby was eating and how long when i was in the hospital that it made it seem like something was wrong if they didnt eat like crazy that day.
People spend far too much time condemning formula usage and less time focusing on education on breastfeeding and i think that is where most of the issues come from.
But no one is condemning formula usage, only formula “over-usage”. If hospitals are indeed passing out formula samples to 40% of new moms, then it’s clear to me they are contributing to the misinformation out there by implying it will be needed, or that it’s the “same thing” and “one bottle won’t hurt”. I agree there is lack of education — but isn’t the hospital a good place for that? Part of that education must include the risks of formula usage and risks of supplementation when it’s not really necessary. And I agree with you, it’s pretty readily available in stores — so why the need for samples at all? Esp. at a rate of 40%? Perhaps because it’s a marketing ploy that works?
Interesting that a white woman living in Canada believes she knows what is best for the people of third world nations. As a person from a third world nation (UNLIKE YOU), leave us alone! You have nooo idea what we need. Not only is your voice and content ignorant and racist, it it is dangerous. Don’t be arrogant as to assume you know what is best for everyone else.
Concerned Citizen of the Third World:
Interesting comment.
(a) I wasn’t talking about the third world, I was talking about Toronto, Canada
(b) Your IP address tells me you are in Los Angeles, California, not the third world. Perhaps you are from the third world originally (or perhaps not).
(c) I’m not making anything up. Any information I do present on the third world (and again, this post is NOT about the third world), is based on information from the United Nations, World Health Organization, etc.
I left the OB’s office with an entire CASE of canned baby formula. I didn’t want to take it, but they insisted and said I could always use it to make pancake batter and use it like condensed milk in recipes. Nice alternative! I tried it and it tasted like crap though. I support more implementation of human milk banks. Come on, it makes damn sense. Women get paid for their milk by many human milk organizations. Insurance can (and does) pay for the milk. I for one was overproducing milk with AA cup sized breasts. That would have been great to pump and sell to a milk bank for side income. Some babies born cannot accept even human milk, but a severely small percentage. We can help all the rest of the parents with HUMAN milk, not formula. Of course proper breastfeeding education is KING. That prevent many from even not breastfeeding at all.
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