The guilt started on day four. Weeping, a heart that literally hurt with pain. As I put the bottle of formula to my beautiful new baby's lips I felt overcome with regret. But not for the reason you think.
I am perfectly happy to feed my new baby formula.
The aching guilt I feel is for not feeding my first baby formula sooner.
Five years after she was born, I still ache for starving my first daughter for her first six days of life, letting her lose 13% of her birth weight because I was trying to exclusively breastfeed her.
Seeing my second baby well-fed and content thanks to formula, my heart breaks anew at the memory of my first daughter's hoarse little cry as she wailed every night, all night, from hunger.
I had been brainwashed by the all or nothing ideology of 'breast is best', and health professionals who told me to 'just keep going' when I should have been listening to my instinct, which told me she needed more food than I could give her.
Thank goodness that nurse that told me I should top up with formula on day six. Thank goodness my baby had suffered no permanent damage, or even more tragically died, like little Landon Johnson, from dehydration. Thank goodness for that tin which means both my babies can receive all the calories, vitamins and minerals they need to grow healthy and strong. Thank goodness for formula.
This past few weeks there has been much coverage of Landon Johnson's tragic case, as profiled on Fed Is Best. He died before he was a month old. His mother, guided by health professionals, had tried to exclusively breastfeed him. She didn't know that she had no milk. When he was feeding for hour after hour, like so many mothers, like me, she was told to keep breastfeeding and that her milk would eventually come in. Even though, like me, she had risk factors for inadequate or delayed breastmilk production, these were overridden by the advice of health professionals.
Landon eventually died of complications from insufficient feeding. It is just too tragic to even contemplate.
Thankfully, cases like Landon are extremely rare, but in the US 1 to 2% of all newborns are readmitted to hospital in their first week because of complications arising from insufficient nutrition. Doctors have also questioned whether they are missing cases. (1)
Breastfeeding advocates argue that very few women have such a serious shortage of milk that supplementation is necessary, but evidence suggests otherwise.
A well-conducted study of 431 Californian first-time mothers showed that 44% of them did not have their milk come in by day three.(2) For those women and their babies, that is a serious problem.
Being told to 'just keep going' is not a solution, not when you have a baby losing more than 10% of its birthweight. Not when it is screaming all night from hunger and sleeping all day. Not when the risks are so serious.
Because I supplemented with formula from the start of my new daughter's life we avoided these problems, and I have been able to continue breastfeeding longer than I did with my first baby. Eleven weeks in, I'm still going, supplemented by formula.
A relatively recent study also concluded that supplementing with small amounts of formula in the first few days until a mum's supply actually prolonged breastfeeding, when compared with a group who didn't supplement at all. This flies in the face of what breastfeeding advocates say is needed to establish breastfeeding, but it makes sense. A mother who is not overly stressed because of a screaming, hungry baby, if guided in appropriate supplementation (in the case of the study, via syringe not a bottle) can feel more confident in her body's ability to eventually nourish her child.
The blanket, one-size-fits all mentality that mothers must suffer through these first few days and just hope that eventually the milk starts flowing doesn't work. For many of those women, yes, the milk will come. But for many others, it won't be enough, and for some it will never come at all.
When I gave birth this time I went in with a feeding plan, knowing I would be supplementing with formula from the very beginning. I communicated this to the nurses, who respected my decision.
This plan meant this time round I have not been desperate, listening to a little baby cry all night, sleep all day and feed for hours at a time, trying to get breastmilk that is never coming. Supplementing with formula means I have enjoyed my baby from the beginning, rather than stressing over feeding. This has helped me bond so tightly to her.
As the weeks have progressed (and the hormones have subsided) my crushing guilt over not supplementing my first daughter with formula earlier has gone from raging pain to dull and occasional ache. I still feel guilty even though I know it wasn't my fault I didn't listen to my instinct, but rather the fault of the institutionalised, rigid promotion of breastfeeding that doesn't sufficiently allow for mothers and babies to be individuals, with individual feeding needs and capabilities.
I'm just so grateful I didn't end up like Landon's mum, even though his tragic death was not her fault.
I'm so grateful I have my two perfect, formula-fed babies.
(1)Moritz, ML, Manole, MD, Bogen, DL & Ayus, JC 2005, 'Breastfeeding-Associated Hypernatremia:Are We Missing the Diagnosis?' Pediatrics, vol. 116, no.3, pp. e343-347
(2)Nommsen-Rivers, LA, Chantry, CJ, Peerson, JM, Cohen, RJ, Dewey, KG 2010, 'Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding', American Journal of Clinical Nutrition, vol 92, no.3, pp. 574-584