As is the case with most parenting-related decisions, breastfeeding, and the right not to, are the subject of a polarized debate with potential feelings of shame, guilt, and resentment experienced by those mothers who feel that they “don’t measure up”.
When, in the realm of birth and childcare, we depart from what we have been evolutionarily designed to accomplish, we often learn that our assumptions about what we thought we knew, turn out to be embarrassingly reductionist.
Formula and breast milk are not alternatives to one another. Formula’s early incarnation in the 1800s as a concoction of wheat flour, cow’s milk, and malt has progressed into more sinister territory in the modern day.
Cornucopia institute reviews the concerning ingredients in organic baby formula (they don’t even deign to comment on the GMO and pesticide-laden poisons in non-organic brands) with a focus on refined sugars including corn syrup and brown rice syrup (laced with arsenic), palm oil and hexane extracted fatty acids, carrageenan, synthetic preservatives and nutrients.
Sadly, the report ends with a sort of hands-in-the-air shrug, seemly to say, “sorry, there’s just nothing out there that will do.”
One of the primary and fundamental problems with the concept of replacing mother’s milk with a processed food is that we can only account for what we know at the time. We are barely beginning to appreciate the complexity of this living liquid including vertical transmission of bacteria through breastmilk as discussed in a previous post.
Between the lack of proper fatty acids, probiotics, oligosaccharides, and vitamin dosages based on incomplete assessment of nutrient-deficient volunteers, formula is a sorry offering for your baby’s developmental needs.
The reality is that, statistically, a full 50% of women are not able to meet their breastfeeding goals. There are many reasons for this, some of which include:
- Aggressive promotion of formula-feeding in hospitals including supplementation in NICUs.
- Limited lactation support and resources including insufficient family encouragement and shared community wisdom.
- Workplace impediments to pumping, and unfinanced maternity leaves.
- Pediatricians who overvalue growth charts and encourage supplementation.
- Alcohol, nicotine.
- Infrequent feeding.
- Use of pacifiers.
- Depression and anxiety.
- Medications.
I discuss environmental barriers to adequate supply including high sugar diets and environmental pollutants here.
But what about breastfeeding for those who are depressed? How are these entities related?
Many of my patients struggle to establish breastfeeding in the early months. For some, this effort can become a source of obsessive rumination and hypervigilence. A recent paper in the Archives of Women’s Mental Health asks the question: Does breastfeeding offer protection against maternal depressive symptomatology? This two year study looked at 205 women, and followed them prospectively, beginning in pregnancy and through 2 years postpartum, to assess depressive symptoms and breastfeeding patterns.
Their results support previous data suggesting that women with antenatal (before birth, in pregnancy) depressive symptoms are less likely to initiate breastfeeding within the first 3 months and tend to wean sooner (average 2.3 months) than those without mood symptoms.
They also found that women who breastfed more frequently at 3 months postpartum (pumping or nursing) were less depressed at the 2 year mark suggesting that there is a “bidirectional” relationship between depression and breastfeeding — i.e., that one can limit the other.
Of note, exclusive breastfeeding dropped off from 43% at 3 months to 5% at 6 months with no woman exclusively breastfeeding at 12 months. Proposed protective mechanisms of breastfeeding on maternal mood include anti-inflammatory effects of breastfeeding, hormonal release of oxytocin in the mother (with a cumulative rather than acute protective effect), the “reset hypothesis” which states that metabolic changes related to breastfeeding help to restore health postpartum, maternal infant bonding, and healthier children that put less stress on parents.
This seems to suggest that intensive lactation support in the first three months postpartum may help women to establish breastfeeding, and that once it is established, we may expect their risk of depression onset to decrease. I would also advocate for ruling out any complicating factors to successful nursing including undiagnosed thyroid imbalance, environmental toxins that can interfere with production and pass to the baby, and high sugar diets that can promote insulin resistance.
It is harder than ever to protect the natural progression from conception to birthing to postpartum health, but we often need reminders that the complexity of the reproductive process is exquisite and ultimately adaptive for mom and baby.
There are a lot of things working against mom wanting to exclusively breastfeed… We’re told to wait eight hours after having one drink to nurse, for example. Sometimes you don’t plan ahead, don’t have extra milk stashed, so you tell yourself it’s okay to give formula this one time. It’s especially that way when you’re not always with your baby.
Our horrible maternity leave system is another contributor. I had the choice between returning to my job which offered no opportunities to pump, or live in poverty for months and scrape by on public assistance. I chose to stay with my child and breastfeed no matter what. A lot of people would look down on me for my decision, and too many mothers can’t afford the sacrifice. Too many mothers believe commercial formula is appropriate for a baby.
I hadn’t started learning about real food when my son was born nine months ago, but I saw someone mention open gut on babycenter and that was enough to convince me my son would never get that. Even though I ordered a breast pump a month before my son was born, I didn’t get it until several weeks after. I went back to class when he was two weeks old, and the first time I came home to him having obviously cried for hours because I didn’t leave enough milk. Poor angel. There were so many times our family could have turned to formula. It would have solved problems in the short run, but my son’s health took priority over all.
Hi Kelly and Sarah, very informative article.
I don’t know if it is appropriate to ask my question here, but I’ll try.
I breastfed my first baby 3 years, then I fell pregnant with the second one. I had to start working when she was 10 months old (now she is 13 mo). She goes to daycare, and I’m expressing and giving her breastmilk. Unfortunately, my supply is decreasing and I’m running out of stores. I estimate, that probably in a month time I’ll have to supplement her. So is raw organic etc cow’s milk safe and good enough for her or it’s better to prepare the home made baby formula of the WAPF? She is not eating much solids, so I think I can’t leave her with just water and other foods just yet. Thanks!
I think breastfeeding does play a big part in how the woman feels. It’s part of our make up when we have a child. It’s the design. I remember with my first I “wanted” to breastfeed, but with lack of education, not seeking support, a horrible birth experience, I did not follow through. I felt formula would be just fine, it sounded easy and was all over the place. Free and shoved in your face. I came home with formula from the hospital, had formula mailed to me. It was SO easy! I felt, if I couldn’t breastfed I’d just formula feed.
The first year of motherhood was the hardest year of my life. My child could not poop on his own for 11 months. I think it was GREATLY due to formulas. Had I continued breastfeeding I am confident he would have not had all the issues he had. Not to mention I would not be as stressed out about motherhood and feeling like a failure. It was HARD to not breastfed. I was in conflict with myself. Emotional and depressing completely!
With my second two children that followed, I vowed to breastfeed. I did not care WHAT happened, formula was out of the question. I WOULD breastfeed.
Granted I had to change a few eating habits, as my second born was sensitive to corn and broccoli, but once that was out of my diet life with him was a breeze!
With my third, she was sensitive to dairy and nuts. It was hard! She had diarrhea constantly! but once my diet was changed, she turned into the happiest baby on the planet.
Depression was not in the cards with my second two children, but it was HEAVY with my firstborn. Granted, being a first time mother was hard in and of itself, but when I introduced formula it became the hardest road of my life.
I think support and education are SO important for breastfeeding. Having been on both sides I can see how one might feel when wanting to formula feed, and I can also see how much life truly IS better all around with breastfeeding.
I was very blessed to be able to breastfeed my 2 boys both beyond 2 years of age. It was incredible and I’ll definitely do it again with the 3rd. I would like to ad to the list of things that hinder women not meeting their breastfeeding goals. Unexperienced lactation consultants!!!! Almost all the advice I got in dealing with low supply from lactation consultants was to pump between feeds and take medication to increase supply…. Oh dear, what tragic information is given to new mums. I finally fought and figured out on my own after a 6 months struggle with the first that I did not have any low supply at all, and I was just being fed the industry chain of information. I’m not sure that breastfeeding long term has helped my metabolism bounce back though, still struggling with dry skin that I never had pre pregnancy. Following Matt Stones breastfeeding advice next time and getting my metabolism on fire and focussing on omega 3 fats. There is so much we know about breastfeeding now and tonnes of great researched info available particularly on Kellymom.com. I’m not sure that I’m really commenting in line with your blog here but just blurting out the comments as they flow. Anyway, I hope that moms to be will at least check out Matt Stones breastfeeding advice and let their bodies work the way they were designed to. As for depression, I’m sure I would have been severely sad if I had not met my breastfeeding goals. I guess that counts as depression. So I would have to second the theory that breastfeeding could counteract depression…. Yes what a great commonsensical thought 🙂
By any chance do you know where I could get this super cute sling? I’m needing one that I can nurse with. Thanks!
It looks like a Maya Wrap. They sell them on their website, but they used to also have a pattern and sell the rings so you can make one yourself.
Wow, I had no idea the number was as high as 50%!! Looks like more than ever the choice to breastfeed is more of a fight, really. I like to say I was lucky to breastfeed both my boys (one to age 3, another to age 3.5) but maybe luck had little to do with it. I prepared both physically and mentally for BF before I became pregnant and all the way through pregnancy. As I had a homebirth (another choice – though I admit not for every mother), I did not have to deal with hospital, NICU, nurses, etc. I had no formula (would have made the raw milk version if I needed it). I did have support at home and I had a place and time to pump at work (both jobs, with slightly different situations).
I hope your article encourages more women to read up and study – yes, study! – breastfeeding and make it a conscious choice to do this for you and your baby. For those who can’t, I hope they are able to make the raw milk formula and avoid the many pitfalls of commercial formula-feeding. Sorry, didn’t mean to ramble!!