The problem with guidelines

"The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond." -cdc.gov

And here we are, at 12 months.   Some people may be wondering when I'm going to quit exclusively pumping milk.  I think, first, that would be mixing up the maximum and minimum from the above statement.  Second, guidelines are based on the average baby.  (Mine is definitely not average, and neither is yours I am sure!)  Finally--it's gotten to be such a part of the routine that another few months won't hurt.

Like I did before starting solids, I am watching for signs that Sam is ready for something new.  When I see things like eating solid food as if he's actually hungry and not just playing, tasting, and practicing.  When he starts drinking out of a cup without choking.  When he says "no thanks" to the bottle a little more often. I'm not seeing any of this yet, so he'll keep getting breast milk for now.

"Power of normal"

Sitting in my son's pediatrician's office, I noticed a half dozen cans of sample baby formula on the counter.  I frowned, not because I think formula feeding is wrong, but because I think formula feeding being the norm is wrong.

Why is normal so important?   Seth Godin, a marketing blogger I follow, posted about the "power of normal" in a recent post.  (The other way I spend my time, after being a mommy, is head of marketing for a nonprofit.) He used the example of taxi cabs that now take credit cards and offer tip amounts of $2, $3, and $4.  "You can decide to be a cheapskate and hit the $2 button.... Except that if you had paid cash, you probably would have tipped 75 cents for that $4.25 ride."  The button cues us to what is normal and we fall in line.

So what do cans of formula in a pediatricians cue us to?  That formula feeding is normal, and we should fall in line.  How can we change this?

First, next to those cans of formula should be breastfeeding posters and literature, all with pictures of women breastfeeding.  The information should include helpful resources such as videos, books, and websites--and most important, access to one-on-one help by phone (a hotline that can give basic information and referrals to lactation consultants or other professionals, 24 hours a day, would be a great start).

Eventually, move those cans of formula into the medicine cabinet, leaving only the breastfeeding stuff.  If every pediatrician and hospital in America did this over the next five years, just through the cueing alone, we could make great strides toward our goal of getting 75% of new moms breastfeeding exclusively for the first six months of life.

One year of babyfood.

Then...










...and now.  Happy first birthday Samuel, my wonderful little boy, my inspiration.

Garden helper

Samuel enjoys digging potatoes from our garden, though he doesn't like to eat them.  He does enjoy sampling the dirt now and then, though!

And here are some purple beauties we grew.

Sadness

It seems like the longer I exclusively pump breast milk for Sam, the more I wish  I could nurse.  At first, when we couldn't nurse and I figured out pumping, I was so relieved to have a solution that I didn't mourn nursing too much, holding out hope Sam and I could eventually try again.  When he was three months old, I did try again, but had so much pain with nursing that I stopped.  When he was six months old, I tried a third time, but my breast was as foreign to him as if I'd just offered him milk in a shoe; that ship had sailed.

There are a lot of moments when I've felt sad about it.  For example, when Sam was just a few weeks old, I went to a breastfeeding support group, and felt like a complete outsider, sitting in that room with all those nursing moms, and me with my baby and his ridiculous bottle.  Other times, I feel sad when I am tied to the pump and someone else is feeding, caring for, playing with my baby.  I also worry about lost nutrients, bottle contamination, and other negative effects of putting a bunch of plastic between my son and his milk. 

But more broadly, I feel increasingly sad about the lost opportunity for bonding and connection as Sam grows more communicative.  While I am sure we made up for it in other ways, there is just no substitute for the nursing experience.  The good news is, I feel it is my loss and not so much my son's.  I know now that the failure to nurse resulted from a bad latch combined with a few other negative factors like edema, and if I had found the right help, it's possible it could have worked.  Maybe, next time?

Formula as an intervention

Lately I've been hearing the phrase "risks of not breastfeeding" a lot. This is different than talking about "pros and cons of breastfeeding," as it is often presented.  It was presented this way in the book I used during pregnancy, From the Hips by Rebecca Odes and Ceridwen Morris, which cited "more margaritas" as a "pro" to formula feeding; I think it was meant to be irreverent or humorous, but given what I know now  about the significant health differences between the average formula-fed baby and the average breastfed baby, I question its validity. (Though, this book did a good job overall on the whole in its breastfeeding section.)


What if infant formula were considered an intervention by the medical community? Then, the risks of using it could be listed, much like a medicine. The choice still belongs to the mother, but the argument is framed such that breastfeeding is the norm and formula is the intervention. For example, the natural way to keep our cholesterol low is eating a healthy diet high in fiber and low in saturated fat. But for some people, that isn't enough, and for others, sticking to a diet isn't feasible. In either case, there is medicine to help, for which the patient can understand the risks.

Of course, the "patient" in the case of breastfeeding is not one's self but one's infant. Does this change our responsibilities?  It it irresponsible not to attempt to breastfeed?  I'm not sure, but even if it is, it doesn't seem right to place this kind of accountability with individual moms when our society fails to support it.

Mommyfood

I just finished reading Eating Animals by Jonathan Safran Foer.  It's a report on meat production in the US and a philosophical and ethical viewpoint on eating meat.  The author turns to vegetarianism because it's the only way for him to avoid supporting factory farming, by which the vast majority of our meat is produced cheaply by externalizing huge ethical, humanitarian, and environmental costs.  While I have not created any new "rules" for myself, it has caused me to think more carefully about the food I eat.

We are extremely fortunate to be able to source and afford meats, dairy, and seasonal vegetables directly from local farms whose practices are acceptable--organic when possible and, with animal products, the animals are always pasture-raised, fed a natural diet, and cared for by actual human farmers and their families. Sweetwater Farm, Robinson Farm, Diemand Farm, Carter and Stevens Farm, and Adams Farm supply us with fantastic food here in central Massachusetts; Localharvest.org is also a great resource.)

On my food choices: where did it come from?  What did it cost the animal, the environment, the workers to make?  What will it cost my health (and thereby my child's health) to eat it?  Asking these questions could be a step in reducing my impact and being healthy, and also teaching my child about food.