After a lot of research, and decision making, my husband and I had decided that for us and our lifestyle, it would be best to formula feed. We researched all the different kinds of formula, and talked about it with our doctor. We were all prepared, but lately I've been thinking about breastfeeding, not because I want to, but because everytime I tell someone I'm formula feeding, they find a way to make me feel guilty, and bad about not breastfeeding. One person even questioned me by asking "Do you love your child"... I am well aware that breast is better, but I was prepared to do formula, and now I do not know what to do? Should I be feeling this way? How can I formula feed my child without anyone judging me?

Health care professionals who encourage mothers to breastfeed are providing evidence based information so that parents can make informed choices about infant feeding. Giving parents this information is not intended to promote guilt among those who decide to formula feed. Unfortunately, especially in the USA, much information on infant feeding is provided by the drug companies who make formula, and they are protecting a multi-billion dollar industry. The truth is that formulas have improved in the past generation, but they can never replace human milk in its ability to protect babies from a multitude of illnesses; therefore, formula feeding is risky to the the baby's health when compared to breastfeeding, the biological norm.  I know that in our society, many women who truly want to breastfeed, and start out doing so, have their breastfeeding derailed by incorrect information and lack of effective support from the health professionals caring for them and thier babies.

People who see a mother bottle feeding and make negative comments should keep their opinions to themselves. They do not know why that mother is bottle feeding.

If a health care professional asks you about breastfeeding, or even suggests you start breastfeeding after you have decided not to do so, they are often trying to protect your baby's health or suggest a remedy for a problem that has developed (such as formula intolerance).

The best reply I can make here is the following article (used with permission) from Dr. Jack Newman, a Cadadian pediatrician with extensive knowledge about infant feeding. I include the information here not to make anyone feel guilty if they make a choice not to breastfeed, but to present facts about infant feedings so that feeding choices can be based on fact and not on the advertising of the formula companies. (By the way, there is no formula that is "better" or "more like breastmilk" than another. All of that is just advertising. For moms who cannot breastfeed, the ideal choice would be banked human milk. We need more milk banks so that this option would be a possiblilty for babies who need it.

Breastfeeding and Guilt

Written by Jack Newman, MD, FRCPC
(revised January 2000)

One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should "not make the mother feel guilty for not breastfeeding". Even some strong breastfeeding advocates are disarmed by this "not making mothers feel guilty" ploy.

It is, in fact, nothing more than a ploy. It is an argument that deflects attention from the lack of knowledge and understanding of too many health professionals about breastfeeding. This allows them not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding, which could have been overcome and usually could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed. This argument also seems to allow formula companies and health professionals to pass out formula company literature and free samples of formula to pregnant women and new mothers without pangs of guilt, despite the fact that it has been well demonstrated that this literature and the free samples decrease the rate and duration of breastfeeding.

Let's look at real life. If a pregnant woman went to her physician and admitted she smoked a pack of cigarettes, is there not a strong chance that she would leave the office feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty? If a mother admitted to sleeping in the same bed with her baby, would most physicians not make her feel guilty for this even though it is, in fact, the best thing for her and the baby? If she went to the office with her one week old baby and told the physician that she was feeding her baby homogenized milk, what would be the reaction of her physician? Most would practically collapse and have a fit. And they would have no problem at all making that mother feel guilty for feeding her baby cow's milk, and then pressuring her to feed the baby formula. (Not pressuring her to breastfeed, it should be noted, because "you wouldn't want to make a woman feel guilty for not breastfeeding".)

Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their advertising to convince most of the world that formula feeding is just about as good as breastfeeding, and therefore there is no need to make such a big deal about women not breastfeeding. As a vice-president of Nestle here in Toronto was quoted as saying "Obviously, advertising works". It is also a balm for the consciences of many health professionals who, themselves, did not breastfeed, or their wives did not breastfeed. "I will not make women feel guilty for not breastfeeding, because I don't want to feel guilty for my child not being breastfed".

Let's look at this a little more closely. Formula is certainly theoretically more appropriate for babies than cow's milk. But, in fact, there are no clinical studies that show that there is any difference between babies fed cow's milk and those fed formula. Not one. Breastmilk, and breastfeeding, which is not the same as breastmilk feeding, has many many more theoretical advantages over formula than formula has over cow's milk (or other animal milk). And we are just learning about many of these advantages. Almost every day there are more studies telling us about these theoretical advantages. But there is also a wealth of clinical data showing that, even in affluent societies, breastfed babies, and their mothers, incidentally, are much better off than formula fed babies. They have fewer ear infections, fewer gut infections, a lesser chance of developing juvenile diabetes and many other illnesses. The mother has a lesser chance of developing breast and ovarian cancer, and is probably protected against osteoporosis. And these are just a few examples.

So how should we approach support for breastfeeding? All pregnant women and their families need to know the risks of artificial feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once the baby is born. Because all the good intentions in the world will not help a mother who has developed terribly sore nipples because of the baby's poor latch at the breast. Or a mother who has been told, almost always inappropriately, that she must stop breastfeeding because of some medication or illness in her or her baby. Or a mother whose supply has not built up properly because she was given wrong information. Make no mistake about it: health professionals' advice is often the single most significant reason for mothers' failing at breastfeeding! Not the only one, and other factors are important, but health professionals often have influence and authority far beyond their knowledge and experience.

If mothers get the information about the risks of formula feeding and decide to formula feed, they will have made an informed decision. This information must not come from the formula companies themselves, as it often does. Their pamphlets give some advantages of breastfeeding and then go on to imply that their formula is almost, well, between us, actually, just as good. If mothers get the best help possible with breastfeeding, and find breastfeeding is not for them, they will get no grief from me. It is important to know that a woman can easily switch from breastfeeding to bottle feeding. In the first days or weeks, no big problem. But the same is not true for switching from bottle feeding to breastfeeding. It is often very difficult or impossible, though not always.

Finally, who does feel guilty about breastfeeding? Not the women who make an informed choice to bottle feed. It is the woman who wanted to breastfeed, who tried, but was unable to breastfeed who feels guilty.

In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support. This is not happening in most North American or European societies.

and an article about guilt by Dr. Nancy Wright:

^{1 2 3} Despite the proven health benefits of breastfeeding for both mother and infant, physicians have traditionally been reluctant to take a stand for fear of making parents who choose to bottle feed feel guilty. This is a dissimulation for two reasons. ⁴ to the contrary, research studies of breastfeeding promotion programs note that women generally do not feel guilty for choosing to bottle feed. The only individuals who ever mention guilt are the older generation whose daughters are now choosing to breastfeed. "If only she had known .... if only her doctor had told her ...." ³. ⁵ As pediatricians we do not hesitate to make our patient’s parents feel guilty about having their children wear bicycle helmets, using infant car seats and seat belts, obtaining immunizations and fencing in pools. We use guilt to help adult patients lose weight, exercise more, stop smoking, drinking alcohol, and taking drugs.

The artificial milk companies are experts at the subtle undermining of a woman’s confidence in her own body’s ability to provide what is needed to nourish her infant. They also seek to increase market share by reinforcing US cultural prejudices that breastfeeding is only for young infants, breasts are sexual objects not feeding vessels, and that breastfeeding, like sex, should only be done in private.

The literature contains many studies of infant feeding choices. Many women who choose bottle feeding admit they could have been persuaded to choose breastfeeding if only someone had cared enough to tell them how important breastfeeding is.

Peggy Robin’s book

Second, is guilt bad?

Breastfeeding is a health issue, not just a lifestyle choice. Why is this health issue so different from the rest? As ethical, caring professionals we owe our patients accurate information, appropriate guidance and long-term support. Let us continue to promote what is best for infants and let the guilt fall where it may!

References:

1. Baumslag N & Michels DL, Milk, Money and Madness (1995), Bergin and Garvey, Westport, CN.

    

2. Stuart-MacAdam P & Dettwyler KA, Eds, Breastfeeding: Biocultural Perspectives, 1995, Walter DeGruyter, Inc, Y, NY.
3. Lawrence, RA, Breastfeeding: A Guide for the Medical Profession, 4th ed, 1994, Mosby Yearbook, Inc, St Louis, MO.
4. Robin P, Bottlefeeding without Guilt, 1996, Prima Publishing, Rocklin, CA.
5. Oski, F, In Defense of Guilt, Editorial, Contemporary Pediatrics 1995, December, p 9.

if there is no formula that is even close to breast milk, and its all advertising why does my ob/gyn say that similac is the closest formula supplement to breast milk?.. and what about infections, they are not rare or uncommon, my mother had a breastinfection while breast feedin my sister, and when she breastfed me she had lumps caused from clogging in her milk duct?.. I also read that breastfeeding has a quicker postpartum recovery rate, but in my opinion that fact doesnt seem to make sense to me. Though I am a young mom, I wouldnt say I'm stressed but I definetly have my work cut out for me. My husband is a full time university student, as well as works for a renovation company at night, so I manage our household all day, and soon will have a baby. Breastfeeding defiently ties a mother down to her child more so than bottle feeding, which in some people could result in them becoming more stressed, feeling like they have no time for themselves, or that they do everything with no help of them husband. I'm not saying that happens to everyone, but I don't want it to happen to me, and I have done much studying and my health care advisors have informed me that postpartum in young mothers is higher as well, and I can admit that though I am married, and have a school education, I am still young, and my reactions to different situations may be different that a mother who has had more than 1 child, or has been married for a long time, or is just older and wiser than myself. I want to do everything that is right, not just for my child, but for myself as well. I think its important to keep myself happy and not stressed in order to be a good mother for my child. That is not wrong ..is it?

Also, looking at the marriage aspect of it, we are young, and my husband works very very hard for his family, and I would like to go back to school, and finish my major, and I want him to have just as much bonding time as I would get. I want everything to be 50/50 in our relationship.

About the question regarding one formula being better than another; From Dr. Jack Newman again:

How to Know a Health Professional not Supportive of Breastfeeding

is

"All health professionals say they are supportive of breastfeeding. But many are supportive only when breastfeeding is going well, and some, not even then. As soon as breastfeeding, or anything in the life of the new mother is not perfect, too many advise weaning or supplementation. The following is a partial list of clues that help you judge whether the health professional is supportive of breastfeeding, at least supportive enough so that if there is trouble, s/he will make efforts to help you continue breastfeeding. not supportive:

S/he tells you that formula x is best. This usually means that s/he is listening too much to a particular formula representative. It may mean that her/his children tolerated this particular formula better than other formulas. It means that s/he has unsubstantiated prejudices. "

 For some reason, the article is not copying well here. You can read the entire article by Dr. Jack Newman at  http://www.breastfeedingonline.com/18pdf.pdf