formula in the hospital promotes breastfeeding?

alli2672 · August 2013

It looks like babies supplemented with formula in the first few days are less likely to be recieving formula at 1 week and 3 months. I will say that this goes along with my own experience. With DS1 and DS2, my milk didn't come in for about 4 days. With DS1, they would not give me any formula. I had to beg and plead, then there was no guidance on using it. It was excruciating, I didn't know what I was doing, I felt incredibly guilty about using the formula, and I just wanted to quit BFing all together. With DS2, I had a different LC in the hospital, and she had me nurse for 20 minutes on both sides, then give formula or BM from a bottle until he was full, then pump for 20 minutes. I did it every two-three hours. By the time I left the hospital, I wasn't using formula, and I was confident about the whole thing. (I had sections, so I was in the hospital for 4 days).

Anyway,
Here is the abstract:
https://www.ncbi.nlm.nih.gov/pubmed/23669513

Here is the article I got it from, which is really inflammatory, but an interesting read:
https://ideas.time.com/2013/05/13/viewpoint-the-breastfeeding-police-are-wrong-about-formula/

Stefibeth · August 2013

Eesh. I don't know. Haven't read the links yet, but I would think that the formula thing would have to be really case-by-case basis. I think it could go either way - being helpful or detrimental depending on the situation.

Some hospitals want to push it when it's unneeded and way too early to need to supplement. Obviously introducing a bottle or formula can be extremely unhelpful to breastfeeding. I also think jumping to supplementing can really undermine a woman's confidence in the process. At the same time, a lot of women don't have easy deliveries, which can delay milk production. Might be helpful to get everyone off to a good start because lord knows if your baby drops an ounce more than they're comfortable with things start getting crazy. Basically, yeah, I think it has to be a case-by-case sort of thing like all maternity and baby care really should be anyway.

MomIn2013 · August 2013

I can say it's been true in my case. We supplemented with formula in the hospital and for the first week after getting home, gradually increasing to only BM by the end of the week. I know it's not what is recommended by all the pro-BFing sources, but I think it worked for us because I wasn't so stressed out about my milk coming in quickly enough. I now EBF, going strong at over six months.

penguingrrl · August 2013

Eh, everyone has their own experiences. With DD1 the nurses gave her formula without my knowledge or permission, pressured me to supplement in the hospital and no matter how hard I tried nursing never worked. It nearly killed me.

With DD2 and DS they never had formula in the hospital and nursing went beautifully. DD2 never had any formula (she couldn't because she was intolerant to dairy and soy and we couldn't afford neocate and our insurance wouldn't cover it). At this point it's likely that DS will never have formula either, although if a supply issue develops later and my freezer stash runs out it wouldn't bother me in the slightest.

Socialworkgirl · August 2013

We supplemented with formula in the hospital and then I ended up pumping exclusively because we could never get her to latch on despite some visits with the LC. By about 3 weeks old, I was pumping enough to meet her needs. Having formula available and some guidance on using it really took some major stress off of us because I was so worried about the whole thing. I resisted going to formula at first but after about 24 hours, she wasn't getting anything from me and was getting really fussy.

pitterpatter129 · August 2013

I read this awhile ago. The study is eh to me. They only used 40 infants. They had all already lost some weight, but only 5%, which isn't a reason to supplement. They didn't use bottles at all to supplement, which is what most people would think to use if not given the facts. It was only 10 mL of formula and only during the period of moms producing colostrum, which has been shown to be the most important breastmilk for baby to get! All the parents supplementing were given instruction and support, where the parents who didn't supplement were on their own. Therefore I call bogus on the whole thing. More information and post partum breastfeeding support minus the formula would probably have the same results.

WinsyWade · August 2013

In my experience...
DS1, they gave formula without my permission (before I even saw him, yes, I'm bitter). BF was really hard. I gave up. He was FF until 1.

DD, I BF (after 4 hours without her) and supplemented (spoon or syringe) formula in hospital. She BF until 14mo

DS2, I BF after about 20 min. He was awesome at it. He went to NICU for blood sugar after about an hour in the room. Neonat doc wanted formula, against my opinion (nasal cannula). I had to sneak BFing with nurses. He BF until 14mo.

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Stefibeth · August 2013

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

Dochas · August 2013

nowababy said:

Maybe this makes me a bad mother, but I never noticed or knew when or if my milk came in.... I mean, I know it did eventually, but I have no idea when. I just assumed everything was doing what it was supposed to. Maybe I was just lucky and things happened as they were supposed to. But I don't totally get the whole "my milk isn't coming in" thing. Not trying to be mean about it, but it didn't occur to me to be concerned about that. Not to say BFing was easy. It was painful as hell for weeks. So my point is, if things are going as they should, milk still might not come in for days and baby will be fine without formula. But I could see how it could be helpful in certain cases. Like as PPs said, when the delivery was rough for some reason.

I don't get it either.

Stefibeth · August 2013

Dochas said:

nowababy said:

Maybe this makes me a bad mother, but I never noticed or knew when or if my milk came in.... I mean, I know it did eventually, but I have no idea when. I just assumed everything was doing what it was supposed to. Maybe I was just lucky and things happened as they were supposed to. But I don't totally get the whole "my milk isn't coming in" thing. Not trying to be mean about it, but it didn't occur to me to be concerned about that. Not to say BFing was easy. It was painful as hell for weeks. So my point is, if things are going as they should, milk still might not come in for days and baby will be fine without formula. But I could see how it could be helpful in certain cases. Like as PPs said, when the delivery was rough for some reason.

I don't get it either.

Well, IMO the whole "my milk isn't coming in" is facilitated by a whole societal/cultural issue. Basically we don't trust our bodies, especially when it comes to maternity care and by extension our bodies abilities to care for a baby. Care providers facilitate these negative perceptions.

Plenty of women don't understand the process of their milk "coming in" and that it can take a while, but that they need to trust that their baby is getting what they need and it's normal. You're in the hospital and a nurse is coming in every few hours wanting to know exactly how long baby ate for how many wet/dirty diapers they are having, it can be stressful and if baby starts dropping weight (which is totally normal) it's like you have to hold your breath lest it seem like they're starving. Also, baby's birth weights are typically inflated due to IV fluids, which doesn't help anything.

With DS he was supplemented WAY early and it wasn't indicated. I did end up having legit issues so it ended up being the right course of action, but it could have waited for sure. I'm surprised by how quickly they jumped to formula.

With DD (same hospital) we didn't supplement in the hospital, which is extremely surprising to me still given my history with breastfeeding and the fact that we were going down the same road. I'm surprised how long they waited to advise us to supplement, but she was totally fine. Probably just a little hungry.

Anyway, I think this topic brings it right back around to not trusting our bodies. We need proof that things are working rather than waiting until something tells us otherwise.

kcisthebombdotcom · August 2013

nowababy said:

Maybe this makes me a bad mother, but I never noticed or knew when or if my milk came in.... I mean, I know it did eventually, but I have no idea when. I just assumed everything was doing what it was supposed to. Maybe I was just lucky and things happened as they were supposed to. But I don't totally get the whole "my milk isn't coming in" thing. Not trying to be mean about it, but it didn't occur to me to be concerned about that. Not to say BFing was easy. It was painful as hell for weeks. So my point is, if things are going as they should, milk still might not come in for days and baby will be fine without formula. But I could see how it could be helpful in certain cases. Like as PPs said, when the delivery was rough for some reason.

I always knew when you milk came in your breasts would be large and engorged. I didn't think too much if it though. When the pedi came in and said baby doesn't have enough wet diapers and appears dehydrated, lets get some fluid in him before we discharge him I knew there was a problem.

KaylaL08 · August 2013

Stefibeth said:

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

Yea...not every baby is given formula in the hospital. I was in the hospital for 27 hours and my baby never had any formula.

Honestly, I think the best thing that can be done to improve successful breastfeeding rates is more education. I know so many women who try to breastfeed and either aren't successful or are only successful for a short time simply because they aren't educated enough about it.

My sister and I had babies a week apart. She was actually due a week after me, but went 2 weeks early so she had her baby first. She is only 18 and was living with my mom and my mom's boyfriend at the time. Her son started freaking out fussing, crying and wanting to nurse constantly (like babies often do on their second night of life). My mom and her boyfriend along with the baby's dad (all of whom had NEVER breastfed) told her he was hungry and to give him formula. After that she yo-yo'd between BFing and FFIng for a week until she finally gave up.

My son was born and he did the exact same thing the night we were in the hospital. Thankfully the hospital where I delivered was very baby/mommy friendly. My son never went to the nursery and the nurses never encourage me to FF. When the baby was fussing my husband kept pushing me to give him a formula sample because that's what he had done with DSS. I stood my ground because I was educated and knew it was normal. He never got the formula, and even though he had a tough time latching the first 6 days, we ended up BFIng.

Fast forward to today, both of our babies are 5 months old. I am BFing full-time and my sister is struggling to afford formula even though her son's formula needs are supplemented with WIC.

I really think it is a case by case basis.

WinsyWade · August 2013

Stefibeth said:

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

It sure seems like it from what I've heard IRL, talking with friends and multiple moms in my group. Obviously, here, no. There were some moms that stated their child never had formula.

WinsyWade · August 2013

KaylaL08 said:

Stefibeth said:

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

Yea...not every baby is given formula in the hospital. I was in the hospital for 27 hours and my baby never had any formula.

I was in the hospital for 4 days each time (c-sections) maybe that's where the higher rate of formula given can come in? Just a thought.

Honestly, I think the best thing that can be done to improve successful breastfeeding rates is more education. I know so many women who try to breastfeed and either aren't successful or are only successful for a short time simply because they aren't educated enough about it.

I absolutely agree. This is where my downfall with DS1 came in. I wasn't given/didn't look into myself of getting more help.

(sorry about the formatting)

Stefibeth · August 2013

Agreed with education being important as well as baby-friendly hospital practices. It's amazing the poor advice you can get about breastfeeding from medical professionals. They steer so many women wrong, it's just sad and shouldn't happen.

pitterpatter129 · August 2013

Neither of mine were given formula in the hospital. Two different hospitals. DS1 had a little at home because my milk took 10 days after a csection and he was losing weight. If I hadn't received terrible advice from doctors/nurses at the beginning, we probably wouldn't have had issues. I breastfed him with no formula after my milk sorted itself out until he was 19 mo old. DS2 had exactly 2 oz over a period of one week to help move the jaundice out of his system quicker when he was still yellow at 2 weeks old. He's been EBF ever since.

sschwege · August 2013

Stefibeth said:

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

This

I know DD never received formula because other than the hearing test she never left my side. With DS he was in the Special Care Nursery for both nights (breathing issues) and even still before they would allow me to hold/feed him they gave him fluids through his IV, he never had a drop of formula. We made it known we didn't want him to have formula, a paci or first bath and they were respectful. They called me every time he was hungry, if I wasn't in the room already.

notreallyirish · August 2013

I agree it is very much a case by case situation and the most important factors are education and support. I supplemented with both of mine. I didn't want to with DS1, but he got formula in the nursery then in the NICU. The LC agreed he needed it.
It worked out fine. We supplemented for a week or so then he pretty much never accepted a bottle again and nursed until 2.5.

With DS2 I decided to supplement because he was big and fussy and I thought my boobs could use a break. It actually made my boobs more sore because it made his latch a little lazy. We rectified that and now at almost 3 weeks he has a bottle of pumped milk or formula every other day or so because we don't want him to refuse the bottle like DS1. If we were having any nursing troubles I wouldn't be doing the bottles yet, but the slight latch issue is gone and I'm not concerned about my supply.

lightgetsin · August 2013

I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies.
What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

notreallyirish · August 2013

tmsgrl said:
I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies.
What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

Yeah, I'm not sure why exactly medical professionals push formula unless there is a demonstrated need. I think it is primarily the fussiness they are going off of.

With DS1 everyone agreed he "needed" supplementation because he was large even though his blood sugar, weight gain and output were fine. Like I said it worked out fine, but it wasn't medically necessary.

With DS2 I was well aware the main reason I was supplementing was for comfort--his and mine. He was hungry, I was tired and sore. No shame in that, but it was not necessary for either of us.

ETA: I imagine they mostly push it for convenience and the ability to quantify. The nurses especially with DS1 seemed constantly annoyed that he was STILL nursing when they wanted to do something.

Stefibeth · August 2013

tmsgrl said:

I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies. What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

I don't really know. Care providers do a lot of things that go against evidence based practices. I think it's probably a complicated answer.

WinsyWade · August 2013

w

sschwege said:

Stefibeth said:

WinsyWade said:

I think at some point in the hospital every baby is given formula, whether it is to start a latch or because mom is worried baby isn't getting enough. So I think the logic that formula at hospital = successful BF is moot.

Not every baby is given formula in the hospital.

This

I know DD never received formula because other than the hearing test she never left my side. With DS he was in the Special Care Nursery for both nights (breathing issues) and even still before they would allow me to hold/feed him they gave him fluids through his IV, he never had a drop of formula. We made it known we didn't want him to have formula, a paci or first bath and they were respectful. They called me every time he was hungry, if I wasn't in the room already.

I replied to that above. I would say you are lucky that they respected your wishes. That was not my experience with any of my babies.

Eta, at two different hospitals. First two were born at the same hospital. The hospital changed its outlook on mother/baby care from separate to joined care between baby #1 and 2. They still pushed formula, and basically fear mongered me.

Allycat11 · August 2013

I am still fairly against formula in the beginning. Without writing a novel, they forced formula on us in the hospital because my idiot day nurse was not educated on BFing and there is no LC on weekends (I delivered at 1:41 Sat morning). My milk came in on day 6 or 7 and BFing ended up being a huge struggle. Thankfully we stuck with it, spent a lot of time with a LC and OT and made it work.

alli2672 · August 2013

I was surprised to see everyone's experiences. I am so sorry for people who had their babies essentially stolen from them for a few hours. That would be so distressing.

FWIW, in the study, they made formula available to new moms at the end of a breastfeeding session. It doesn't sound like it was forced on anyone, and only 2 of the 20 moms were still using any formula at 7 days.

alli2672 · August 2013

LalaMama81 said:

Well a csection can delay milk coming in, so I guess that why you were told to use formula?

Besides the mother needing more education, information and support - nurses need it, too. In my hospital experiences I found them rather useless.

No one had to tell me to use formula when I could see that my baby was hungry. I asked for it. The first time it was denied for several hours, multiple times. The second time, I was given formula with some instruction.
FWIW, I did not have any issues or need to supplement with my third baby.

I don't think this is entirely an issue of "more education." It looks more like the research just isn't really done on this.

I agree with pp that this should be done on a case by case basis, rather than dictating one way or another 100% of the time.

alli2672 · August 2013

pitterpatter129 said:

I read this awhile ago. The study is eh to me. They only used 40 infants. They had all already lost some weight, but only 5%, which isn't a reason to supplement. They didn't use bottles at all to supplement, which is what most people would think to use if not given the facts. It was only 10 mL of formula and only during the period of moms producing colostrum, which has been shown to be the most important breastmilk for baby to get! All the parents supplementing were given instruction and support, where the parents who didn't supplement were on their own. Therefore I call bogus on the whole thing. More information and post partum breastfeeding support minus the formula would probably have the same results.

Maybe.
Honestly, what was most shocking to me about all of this is that even with stuff like the baby friendly hospital intiative there actually isn't evidence that baby should never have food or drink other than breastmilk without impeding breastfeeding. It looks like with this one tiny study, that the opposite is actually true. It seems possible that is why these pediatricians who have seen hundreds and thousands of children are giving advice to supplement if baby seems to need it.

Also, not all of the babies in the formula group had formula. They were just allowed to have formula if they wanted it.

I agree with you: give by syringe, no more than 10cc, etc. would be good things to tell new moms who are planning to breastfeed, but choose to supplement in the beginning.

lightgetsin · August 2013

alli2672 said:

Stefibeth said:

tmsgrl said:

I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies. What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

I don't really know. Care providers do a lot of things that go against evidence based practices. I think it's probably a complicated answer.

They do know better. It is you who does not know better. How on earth is not giving formula an "evidence based practice?"

I think you need to calm down a bit and really think about your statement. Do you really believe that your body is not equipped to feed your baby? Babies cry in the days before milk comes in. They cry because they are hungry. They cry and their mom's put them to their breasts to nurse. This is what makes your milk come in. This is how nature planned it. If you feed your baby formula when he cries, he will not stimulate your milk production. Your milk will not come in. I get it. Billions of other women get it.

penguingrrl · August 2013

alli2672 said:

I was surprised to see everyone's experiences. I am so sorry for people who had their babies essentially stolen from them for a few hours. That would be so distressing.

FWIW, in the study, they made formula available to new moms at the end of a breastfeeding session. It doesn't sound like it was forced on anyone, and only 2 of the 20 moms were still using any formula at 7 days.

My baby wasn't stolen from me. I had a serious reaction to the meds they gave me after my (unnecessary) c-section and spent 12 hours vomiting then dry heaving and it wasn't safe for them to give me the baby.

ariel06 · August 2013

With DS1, my milk didn't come in until day 7. He screamed constantly starting day two. LC had me supplement with a small tube taped to my nipple and also started pumping every 2 hours. I lasted about 6 weeks.

With DS2, the pedi recommended giving a little bit of formula to help with jaundice.

My hospital had crib cards stated whether babies were breast fed or not. Breast fed babies could not be given formula or pacifers.

KaylaL08 · August 2013

Also, what about the virgin gut theory?

https://www.thealphaparent.com/2011/07/virgin-gut-note-for-parents.html

Yes, I know this is a blog but I'm too lazy to look up real evidence

lyingliarlies · August 2013

tmsgrl said:

alli2672 said:

Stefibeth said:

tmsgrl said:

I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies. What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

I don't really know. Care providers do a lot of things that go against evidence based practices. I think it's probably a complicated answer.

They do know better. It is you who does not know better. How on earth is not giving formula an "evidence based practice?"

I think you need to calm down a bit and really think about your statement. Do you really believe that your body is not equipped to feed your baby? Babies cry in the days before milk comes in. They cry because they are hungry. They cry and their mom's put them to their breasts to nurse. This is what makes your milk come in. This is how nature planned it. If you feed your baby formula when he cries, he will not stimulate your milk production. Your milk will not come in. I get it. Billions of other women get it.

WTF is this alli and why did you delete?

seems to me that maybe you're exactly the type of physician that we're talking about. and with the god complex too, yikes.

Stefibeth · August 2013

lyingliarlies said:

tmsgrl said:

alli2672 said:

Stefibeth said:

tmsgrl said:

I think women expect to have milk as soon as they deliver. In reality it takes 3-5 days. It took me 5 days each of my 4 pregnancies. What I don't get is why so many pedis push formula in that first week. Don't they know better?? I had one pedi threaten that I would need to supplement but my milk came in before he put the hammer down. For my next baby I found a new pedi.

I don't really know. Care providers do a lot of things that go against evidence based practices. I think it's probably a complicated answer.

They do know better. It is you who does not know better. How on earth is not giving formula an "evidence based practice?"

WTF is this alli and why did you delete?

seems to me that maybe you're exactly the type of physician that we're talking about. and with the god complex too, yikes.

Well, evidence based practice would be allowing a mother who intends to breastfeed to feed her baby from the breast. That's kind of how breastfeeding works. Everything I've ever read (other than this small study) says that interfering with the natural process has a big risk of screwing things up. Makes sense considering it's a natural process for a reason. Women's boobs are designed to feed their babies and they don't need a care provider undermining their bodies' abilities unless there's an indication that things are going wrong. Not that they "might" go wrong.

lollitots · August 2013

Add me to the case by case basis. My first two didn't get any formula at the hospital. Not even my 32 weeker that went to the NICU after birth (I pumped for her). My third did because I sent her to the nursery on the last night in the hospital so I could get 6 straight hours of sleep before going home and not sleeping that long for another few months. That was her only time.

I am surprised some didn't know when their milk came in. I had two huge rocks attached to my chest when it came in. There was no question there!

I had a very pro bfing hospital. They discouraged formula.

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