insert witty bo.ob pun here

Over the past few years, basically the time during which I started seriously thinking about babies, I’d planned to exclusively breast feed. While I was pregnant I asked my doctors over and over again about whether or not I could breast feed while on my medication and secretly fantasized about how if at the end of my pregnancy I hadn’t developed any complications I would wean myself off my meds mainly so I could breast feed without any guilt (and because I have no intention of being on medication for the rest of my life).

Obviously that’s not how things went. Starting at about 32 weeks my blood pressure crept up, the protein in my urine increased and while it was pretty clear (at least to me) that this was pre-e and not lupus, part of me was too scared to quit my meds as it became clear my health was heading south.

So I was a good little patient and I remained on my medication, though unbeknownst to my doctors I had actually reduced my dosage to 2/3 of what they wanted me on somewhere around the fourth month of pregnancy.

After T was born, one of the very first things I asked the neonatologist in the NICU was, “Can I give him my milk if I stay on this medication?” He looked into it and came back the next day and said that his recommendation would be to give T my milk. I was SO relieved.

I pumped day and night. Even though my baby was in the NICU this did not mean I got any extra sleep. I was still up every three hours with my pump. My mom wanted me to stop, she felt like there was a risk to me (since lack of sleep often triggers my flares) and a risk to the baby (since I was still on my meds) but I was determined to keep on with it. I can’t tell you how it compounded my heartbreak after T took his turn for the worse and his doctor decided that, at least for the time being, they would not give him my milk in case it was in fact my medication that had caused the downturn in his health.

Based on my own research I really did not feel like it was my milk causing the problem but there was still a part of me that felt so bad and so guilty that in trying to give him something good, I had actually hurt him.

Eventually when his diagnosis turned into MAS (macrophage activation syndrome brought on by maternal antibodies) I was terrified that it was not the meds but rather my horrible, evil antibodies that had been in my colostrum that had pushed his health over the edge. I held in the question for a couple days but eventually did bring this up to the neos who assured me that the antibodies had been transferred in utero and that this was not a reason not to breast feed. They did not think my meds had caused the problems but they said they were still more concerned about the risk of my meds than the risk of the antibodies going through my milk. Eventually during one of our “care conferences” they told me that they thought the risk of my meds in the breast milk was extremely minimal and that they thought partial BF-ing would reduce any risk further and therefore make the risk-reward analysis of BF-ing vs formula feeding come out in favor of BF-ing. This is how we ended up with the current modus operandi whereby I take my medication all at once instead of splitting it into two doses and I dump for the six hours after I take it. The rest of the day I nurse or pump.

Why am I telling you all this? I was reading a blog today that I have been following for a pretty long time, this woman has struggled through many years of infertility and miscarriages and finally had her miracle baby three months ago. She is needing to wean the baby off one bre.ast due to major health issues arising over BF-ing from that bre.ast, and even though for months she has upheld BF-ing over her own health issues she still is suffering from major guilt over potentially supplementing her baby with formula.

To me this is emblematic of how the pendulum has swung too far towards BF-ing nowadays. Obviously I must buy into the whole “bre.ast is best” thing too on many levels since I’ve suffered (although not nearly the way she has) and even weighed risks and benefits in order to keep giving T my milk. I think this has a lot to do with hormones, what I wrote about being a NICU mom, and also, let’s face it, a lot of brainwashing.

A generation ago women were told that formula was just WONDERFUL and probably better than their breast milk and women like my mother were encouraged not to breastfeed for various reasons. And then at some point there was a complete 180 degree turn and women who feed their babies formula nowadays are made to feel, however subtly, that they must not love their children as much as women who EBF.

I completely agree that women in third world countries really should NOT be giving their babies formula. I think there is extensive literature that documents how damaging the myth of formula superiority has been in places where women cannot a) afford the proper amount of formula and thus dilute it beyond what is healthy for the baby and b) mix formula with water that is diseased. In places like that there is no question at all that breast is a zillion times better than formula and I think formula companies that push their product in those countries are completely evil.

However, in the US and other developed nations where those considerations are not really in play, I have serious questions about how much better bre.ast really is vs formula. My questions are more on a logical level than an emotional one, because obviously on an emotional level I really, really want to BF my baby. But, especially after my conversations with the neonatologists in the NICU (who were VERY pro-BF, so it wasn’t about them not being supportive of BF-ing, just the facts they were giving me about what the benefits really are of BF-ing according to current research) I don’t really think there is a huge difference between BF-ing and formula feeding.

For example, why weren’t they concerned about my antibodies getting to him through my milk? I was really worried about this as a barrier to BF-ing because I had always been under the impression that the antibodies in milk were a huge reason to BF. It stood to reason that if good antibodies could get through that bad ones could too right? Well, what the neos told me was that actually the antibodies that are so good for the baby are the ones that line the gut, they don’t pass through the gut. They help with digestion and things along those lines but live antibodies don’t actually really make it into the baby’s system as a whole because they are (duh!) going to be digested.

As I mentioned before, our parents generation was steered away from BF-ing and heck all of us turned out just fine right? I know I have lupus now, but as a child I was always extremely healthy and rarely got sick. My sister wasn’t BF-ed at all (I actually got a few days) and she didn’t get sick for the first time until she was nine months old. Both of us were healthy children (I can count on one hand the number of times I got a fever over 100 degrees as a kid) despite the fact that my mom doesn’t even believe in using soap or dishwashing detergent! I have plenty of other examples of babies that weren’t BF-ed, or weren’t BF-ed for very long who are now healthy, intelligent children and adults.

And from what I’ve read, the research regarding the benefits of BF-ing over formula is shaky at best.

So I don’t know. I wish that there was more of a grey area in all of this. Breastfeeding is awesome. But women who formula feed or supplement with formula should not be made to feel like they are in any way doing something that is denying their baby an advantage. At least not until there is some definitive evidence of how much better BF-ing really is. And yet this belief completely permeates our society nowadays. Again, going back to that NICU lactation room, there were so many moms in there who weren’t making enough milk for their babies but trying their damndest and I don’t see how making them feel like they’re depriving their children of something (that we’re not even really sure makes any difference) is doing anyone any favors. Whenever the conversation in there would turn towards having to supplement with formula I would always do my best to try and make them feel better about it and applaud them for trying so hard to pump whatever they could.

Personally for me, I don’t feel guilt over the fact that I fortify my expressed milk with formula. I guess it’s easier for me to feel that way than for women who have had to stop BF-ing altogether or supplement with formula, since at the end of the day he is still getting all the benefits of my milk, just the added bonus of the calories from the powdered formula in it. But I think even so I would not really feel THAT bad about not giving him my milk. I enjoy breastfeeding more so for the bonding aspect of it. It makes me feel like his mommy, and it makes me feel like he knows I’m his mommy. If we couldn’t BF this is what I would mourn the loss of more than anything else.

I’ll quit my sleep-deprived rambling now and just say this to all my fellow mom’s out there who are needing to exclusively formula feed or supplement/fortify with formula, please don’t buy the hype! You are doing the very best for your baby and yourself and don’t ever let anyone make you feel bad about that.


  1. EndoJourney says:

    Thank you for this. Really needed to hear this tonight. 🙂

  2. Lian says:

    Under typical circumstances, “Breast is best” and any amount, whether a few days of colostrum, a few months, or a few years should be regarded as an achievement (cuz it takes lots of effort!). With that said, formula is a great tailor made source of nutrition that many babies have thrived upon, not poison. No mom should be made to feel guilty about formula feeding. All families have their own circumstances. I only have a problem with myths, maternity wards, and advertising companies misleading moms who want to try breastfeeding and then get undermined. Moms need support for their parenting decisions, not judgement. Titus is lucky to you as a mom.