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Challenge: Bringing Home Baby: What Do You Wish You’d Known?

I wish we'd known how hard breastfeeding can be!

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We wanted to breast feed our baby for six months. We were committed to it. In fact, I was worried that as the dad, I wouldn't have enough to do in the first months to care for our baby. But it just didn’t work out that way.

We – but of course mostly my wife – struggled constantly for two months to breastfeed our daughter while I looked on, feeling helpless. We had a normal, uneventful delivery, and she’s otherwise healthy, and a perfect angel really! But she just wouldn’t latch. Let me tell you - we tried. For hours, doggedly and desperately. Nipple shields, syringes and tubes, pillows, massage, hand expression, "lactation cookies", lecithin, goat’s rue, countless cups of tea, rain dances and magic invocations... The few times she did latch, she did not get enough milk to satisfy her. So we started pumping and feeding from a bottle, and then after weight loss, dry diapers, and a lethargic baby, we started supplementing with formula. Our stress level went down, and our baby sprang to life!

We saw four lactation consultants (two in the hospital, and two since we got home). They gave us terrific support - hours of individual attention and lots of moral support. They are wonderful, encouraging, and compassionate people – and I would not say we’ve felt bullied into breastfeeding. I’m very thankful to our insurance (Kaiser Permanente) for providing the support, because we didn’t want to give up. O ur pediatrician and an ENT specialist checked for tongue-tie, and found nothing amiss. They also worked with us on the pump, so we really gave this an honest effort. We just don’t know where the issue was.

Both baby and mom were in tears after attempt after attempt - robbing them of pleasurable bonding time. I watched my wife in tears over the pain of engorgement and plugged ducts, a bout of mastitis, and the frustration and embarrassment of being hooked up to a pump while I get the pleasure of holding and feeding our baby. We didn’t have to supplement with formula much after the first week, but it’s come at a huge personal cost.

So, my wife became an exclusive pumper. Maybe our experience is atypical, but pumping takes forever. She spent close to an hour per session, many hours a day, just to keep abreast (pun intended) of the demand. It took at least half an hour before she gets any flow. There simply were not enough hours in the day for her to pump, sleep, and hold the baby. So in the name of "breast is best", our baby was being deprived of the comfort of her mother's arms.

We blindly subscribed to the “breast is best” philosophy. Since these problems stated, however, I went back and read the primary literature on breast milk versus formula (I have a PhD in immunology, and my wife has a MPH and worked for the World Bank in the nutrition hub). I was surprised at how weak the evidence for breast milk over formula was! The most convincing evidence I can find is that breast milk protects babies from GI infections, which makes sense if you don’t have a clean water supply as a basis for your formula. That’s not a significant concern in the developed world, however. For nearly every study I read, the differences in IQ and every other measure are less than the test-to-test variation seen in individual children. (i.e., the difference seen between a breast fed and a formula fed baby is less than the difference seen if you tested the same baby twice.) Even if you believe those differences, the link between intelligence and breastfeeding is confounded by the many other variables that cluster with extended breast feeding, especially socioeconomic factors.

I reached the conclusion that this is not serving my wife or our baby’s best interests. After a final bout of mastitis and a visit to urgent care on Thanksgiving, we decided that "extraction" of breast milk was dominating their relationship to the detriment of both of their health. I would rather see my daughter held in the arms of her happy mother drinking formula than look across the room at my wife's teary eyes while I feed the baby breast milk sucked from her body.

I still support efforts to encourage breast feeding, but we have to be wise enough to recognize when it isn't serving the best interests of the mother or baby. Public health recommendations are based on large groups of people – they cannot (nor do they try) to predict the best action for all people in all situations. If breastfeeding works for your family, that is wonderful and I'm genuinely happy for you. Please respect that it does not always work, despite desperate desires to the contrary. We didn’t want or choose this outcome, but I don’t feel bad for making a decision that protects my family’s physical and emotional health.

We’ve been feeding exclusively formula for the last three months and the improvement in my wife’s emotional and physical health is immense, and our daughter is thriving.

Being a parent sometimes making hard decisions, and recognizing when what you planned to do just isn’t going to work. We need to be wise enough to do what is best for our families, and recognize that what’s best can vary from family to family.

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