Human Milk for Human Babies

"Breast milk is not a scarce commodity, it's a free-flowing resource."
Emma Kwasnica

I've recently become involved with an amazing group, Human Milk for Human Babies, formerly known as Eats on Feets Global.  This is one of the most amazing movements, and I am incredibly honored to be a part of it.

There are mommies like me who can't breastfeed their babies, or mommies who breastfeed but don't make enough milk.  When I was hospitalized, my breastfed baby needed food.  Formula is food, but not the food I would have chosen for him - breast milk is a superior food, made for baby humans.  Cow's milk is made for baby cows, and doesn't offer the same benefits, especially in a baby's GI track - which is of particular concern to me, since IBD can be hereditary.  I reached out to my local milk bank - but I found out that not only is the milk $4 per ounce ($120 a day!!), we couldn't have it, even if we wanted it.  My baby was healthy and full-term.  So, David got formula - and I'm glad it was there.  It was not an easy transition - his tummy was upset, and he really hated the taste.  But, food is food, and he eventually adjusted.  He's done well on formula - he's healthy, strong, and smart.  As my readers know, I don't have anything against people who choose formula as their baby's food.

If I'd had a choice at the time, though, I wouldn't have chosen to feed my son formula.

I learned about Eats on Feets through you, the readers of this blog.  I became friends with Emma Kwasnica, the group's founder on Facebook, and I was blown away by her passion and dedication.  At one point, she posted an amazing photo - a friend of hers was suddenly hospitalized, and she nursed her friend's baby while she was incapacitated.  The picture brought me to tears.  One image encapsulated the philosophy of milk sharing - that in an emergency, women could rely on each other.

Emma nursing a hospitalized friend's baby.  Don't like to see boobs?  Read this.

This is the heart of milk sharing and milk donation - that in an emergency situation, mothers who want their babies to be exclusively breastfed have that option, even if real life circumstances don't allow for it.  If a mother wants to use formula, fine by me - but if she doesn't, there should be a way for her to find an Emma!

Eats on Feets has become "Human Milk for Human Babies", a name that better describes its mission and can be translated across the globe (there's even a chapter in Kuwait!).   Mothers like me can meet local mothers like Emma, who have a surplus of milk to provide.  Not necessarily boob-to-mouth; most donation happens with the help of a pump and a freezer.  Some mamas overproduce, and they have mountains of bags of milk stored, more than their baby can consume before it expires.  Thanks to HM4HB and other milk-sharing connections, that milk can find its way to a local baby in need.

One of the coolest things about this is that HM4HB is not just getting babies milk, it's helping women connect and become friends.  While you can use milk sharing networks to just get milk and move on, I'm amazed at the real life connections that are happening.  Donor and recipient mommies are getting to know each other, having coffee, setting up playdates, visiting each other's homes.  There is a community growing as a result of the sharing.  Unlike donating to a milk bank, donor mommies can often hold the babies their milk is feeding, watch them grow and thrive on the precious gift of liquid gold.  In a world where technology so often distances, this is creating a village where none existed.

Are there risks to milk sharing?  Yes, of course.  There are risks to everything in life.  There are risks to formula-feeding (I fed my kid bugs, thank you Similac).  HM4HB isn't promising a risk-free solution, just a forum in which parents can have a choice - an informed choice.   Previously, the only choice moms like me could make was which brand of formula to buy.  Now, we can choose if we want to go check things out on the donation road.

As a recipient, ultimately, you trust that the woman who is donating is healthy and living a healthy life.  If she's breastfeeding her own child, you simply trust that she cares about her own baby enough to avoid things that could make her milk dangerous.  You can pasteurize the milk at home (instructions here), and many recipients ask for copies of their donor's prenatal medical records or request additional screening for safety.

Check it out!  If you have milk to donate, wouldn't it be nice to know exactly where that milk is going?  If you really hate feeding your baby formula, why not explore donated breast milk as an option?

Human Milk for Human Babies - Website
Find your local chapter here
Frequently Asked Questions

Avoid formula "like the plague"?

I don't know why I read everything that comes across my facebook feed, but I have a rather unquenchable thirst for knowledge....so I do.  Even stuff that I know is going to "get my goat", and boy did this one! 

100 Reasons to Avoid Formula like the Plague

First, it made me incredibly sad.  I had just finished giving David a bottle of formula; I don't have a donor right now for breast milk, and our family decided that we would only take breast milk donation from people we know well (which is 2 awesome ladies with small freezer stashes).  There is another local baby, newborn and sick, who needs the milk more than my healthy horse of a toddler. The last comment had me crying into my colt's feather-soft hair as he slept in my arms.

"When you don't breastfeed you increase many risks and the child will never know it's true potential."

I cursed my body.  I hated my body for its failure.  I cursed my own inability to stay healthy enough to continue breastfeeding my son.  I kissed his petal-soft skin and tears ran down my face as I considered the list and its comments.  What if it's true?  What if my baby boy will never reach his true potential because my body failed him?


Then, of course, my brain kicked in.


You see, what this list forgot (and the list is not necessarily accurate or 100% truthful, I'll address that later) is that a healthy mother, in both mind and body, trumps every single reason on that list.  I am not a formula pusher.  I am a lactivist, truly told.  I don't think breast is "best"; I think it's "normal."  That is a very, very important distinction.  If you can breastfeed, you should.   If you don't breastfeed because you want pretty boobs or you want to party or because it's simply "convenient", I don't have a lot of respect for your choice.  Sorry.  Doesn't mean I don't respect you, or that you're a bad mother, it means we disagree.


Cesarean section is not "normal".  Vaginal birth is.  Does that mean vaginal is best in every situation?  No.  Everything is relative.  Guggie Daly, bless her amazing and insightful heart, wrote a wonderful piece recently about the need to end the Breast is Best campaign.  I agree with her for all the reasons she mentioned, plus one.  


I didn't take the medicine I needed after my son was born because of lists like The Plague.  I almost DIED.  I needed 2 blood transfusions.  I almost had my large intestine cut out of my body.  My large intestine is still bleeding, a year later, because I actually did avoid formula like the plague.  Smart?  No!  Stupid!  A miserable, sick, barely human breastfeeding mother is not ideal.  Dead mommies don't make milk, duh. 

I am not the only one.  I know 3 other mothers who also avoided medicine that was incompatible with breastfeeding, and who suffered serious health consequences as a result.  One was suffering from PPD, and it got so bad that she attempted suicide and had to be committed.  The low-level antidepressants she was taking weren't working, and the next level meant she couldn't breastfeed.   She avoided formula "like the plague", and slit her wrists.   I'm not making this up.


See, the funny thing is, when you've just had a baby, you just might not think straight, and lists like this haunt you.  I didn't.  Others didn't. 

I am an active member of many online mommy communities.  Lately, I have seen a number of mothers with supply problems, who are trying everything they can to raise their supplies, discuss giving their young babies cow's milk or soy milk, believing that it's healthier than formula.  There is a label now on the soy milk we purchased at Whole Foods - "not to be used as infant formula."  Why, do you think, does it need to be there?  It's not there for the mother who doesn't care what goes into her baby.  It's there so people know that other milks are NOT a viable alternative to breast milk or formula.   

Formula, while deeply flawed, inferior and imperfect, is better than giving a 3 month old baby cow's milk, which is made for baby cows, not baby humans.  Soy milk in particular is exceptionally dangerous for infants, lacking vital nutrients which are necessary to healthy development..


Don't avoid formula like the plague.  Don't avoid it like it's poison.   It is neither plague nor poison.  Avoid it if you have a breast milk alternative, be it pumped or from the breast.  Avoid it as a sub-normal, vastly inferior alternative and don't kid yourself that it's "just as good" as breast milk, because it's not.  It's not close to breast milk, no matter what the formula ads tell you.  But don't avoid it to the detriment of your own health, mental or physical.  Babies need a healthy mother more than than they need her breasts. 

[Related: this whole conversation goes away (or mostly goes away) if mothers who can breastfeed do, and if mothers who can donate do, and if mothers who can't have access to that donated breast milk.  Please support breast milk donation!  Check out Human Milk for Human Babies on Facebook!]

How to Support Breastfeeding without Demonizing Formula

The most positive changes made in the world are not against something but for it.

It can be very tempting to further the normalization of breastfeeding by demonizing formula, or worse, by demonizing formula-feeding mothers.  It calls to you.  The information's right there, and, if you breastfeed, it makes you feel better about yourself and better about your struggles and your hard work to bring it up.  I remember!  It's so tempting to respond to the Similac recall with "Serves you right, you should have breastfed" or "Boobs don't have bugs, this is mom's fault."  Formula sucks.  The educated, informed women who read this stuff already know that.  Most of us tried to breastfeed, and we hate that we're giving our babies crap. 

Attacking formula-feeding mothers is incredibly detrimental in a number of ways, but the biggest one is that you potentially lose very strong allies by doing so.  Me, for example.  My nursing in public post has now been read by over 30,000 people in a month (squee!).  That's good for breastfeeding. We all need formula-feeding moms on the side of babies and boobs.

Some of the strongest advocates in the intactivist movement are mothers who circumcised their first children.  Marilyn Fayre Milos, for example.  Some of the strongest advocates for gentle discipline are those who chose corporal punishment first.  Some of the strongest proponents of natural birth are those who experienced an over-medicated labor or an "unnecessarian".  Many cloth diapering mothers chose cloth because their babies' bottoms reacted badly to disposables.

Many lactivists have never fed their babies an ounce of formula, and some (certainly not all) really seem to enjoy making that fact very known.  They should be proud, but sometimes comments cross the line.  Formula-feeding mothers are referred to as "lazy", "selfish", "lame", "stupid", "irresponsible" and worse.  I'm not pulling this from my own imagination; I am a member of many natural parenting groups and have seen all of these accusations in the last month.  I am not an advocate for formula-feeding, any more than I am an advocate for cesareans.  I believe that supporting breastfeeding means supporting breastfeeding.  No more, and certainly no less.

So, if you want to be a lactivist without pissing off us lazy, irresponsible mothers who didn't try hard enough (ha-ha-ha-ha-ha), what else can you do? 

How to Support Breastfeeding 

Without Being a Boob

Support nursing in public

I've talked about this one a lot.  'Nuff said.

What you can do: If you are a breastfeeding mother, unashamedly nurse in public.  If you can't, thank or at least smile at women who are.  Tell the nursing mama that she's welcome to nurse in your living room if she wants to, and she doesn't have to cover up if she doesn't want to.  If someone brings up the topic of breastfeeding in public, make your views known, don't stay silent.  If you see a nursing mother being asked to leave a public place, come to her aid and fight the flight attendant for her.  Support laws that protect nursing mothers.

Support longer, paid maternity leave

Compared to the rest of the developed world, the USA has an embarrassing maternity leave policy.   There is no paid maternity leave on a national level.  FMLA guarantees 12 weeks of time off every 2 years, without pay, but only if you work for a company with more than 50 employees (in the same state) and have worked there for at least a year.   Unpaid.   If you work for a small company, just got a new job, or (gasp) have another baby less than 2 years after your last, you're likely out of a job, permanently, if you take leave at all.

Some states extend temporary disability benefits for 6-8 weeks, at a paltry 60% of base earnings, with a low cap.  Other states provide nothing.  A well-off family can budget for this time, but eventually, the savings run low.  A single mother who works at a small company has no real choice - either she goes on welfare or goes back to work.  A two-income family, living paycheck-to-paycheck may have no choice at all.

Conversely, Norway and Sweden offer 13-16 months of paid maternity leave at 100% of base earnings.  The rest of Europe averages between 16 and 26 weeks (6 months), also paid at 100%.   Maternity leave in most of these countries is compulsory - you can't go back to work 3 weeks after your baby is born, even if you "want" to.

There is a direct correlation between the length of maternity leave and breastfeeding success. 

• University of California: "A maternity leave of < or =6 weeks or 6 to 12 weeks after delivery was associated, respectively, with a fourfold and twofold higher odds of failure to establish breastfeeding and an increased probability of cessation after successful establishment"

• University of Melbourne: "Mothers who returned to work full-time within three months of birth were twice as likely to have stopped breastfeeding by the time their baby was six months, than those who were not employed.  Mothers who returned to work full time between three and six months of birth were three times as likely to have stopped breastfeeding by the time their baby was six months than non-employed women."

When Canada extended maternity leave from 6 months to one year, they saw a large increase in infants who were successfully and exclusively breastfed.

What you can do: Contact your congressional representatives - both senators and representative.  Contact your local state representatives and senators.  Let them know that you support paid parental leave and extension of FMLA to include all employers and employees, and to extend to at least 52 weeks.

Support certified lactation consultants

 Poor medical advice for breastfeeding is pervasive through the system.  Certified lactation consultants can save a breastfeeding relationship.  Unfortunately, they are expensive to hire, and their services are not usually covered by medical insurance. 

A lactation consultant can take a mother from the brink of quitting to a healthy, happy nursing relationship.  She can save damaged, bleeding, painful nipples.  She can fix bad latches and bad positioning, she can un-advise against bad advice.  She can make magic happen - if she is given the opportunity.

The average visit to a lactation consultant costs $250-$300 - and while it's certainly cheaper than a year's worth of formula, to the low-income mother on unpaid maternity leave, it might as well be a million bucks.  After all, formula is covered by WIC.  LCs are a luxury that many women cannot afford.

Further, they're not that easy to find.  Sure, if you're part of the AP community, you know the names of a few off the top of your head - but where would the average mother get this information?  I hadn't heard of lactation consultants until I started to really research...and not all mothers research.

What you can do:  Call your insurance company and ask if they cover lactation consultants.  If they don't, ask why not, and ask how you can complain in writing.  Make sure your pregnant friends know the names of LCs in their area.  Provide a list of LCs to your local hospitals, visiting nurses associations, YMCAs and OB offices.  Post the date and times of local LLL meetings on community bulletin boards and in supermarkets.  Provide that information to teen mother support groups.  If you are a LC, consider donating some of your time or offering low-cost services, even on a group basis to low-income mothers.

Support gentle birth

Getting a good start at breastfeeding is so very important.  Maternity leave, lactation consultants, and pediatrician support only work if a mother begins her breastfeeding relationship right.  Baby-friendly hospitals are a start.  Baby-friendly hospitals aim to have a 100% breastfeeding rate, and they educate staff appropriately.

1 -	Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 -	Train all health care staff in skills necessary to implement this policy.
3 -	Inform all pregnant women about the benefits and management of breastfeeding.
4 -	Help mothers initiate breastfeeding within one hour of birth.
5 -	Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 -	Give newborn infants no food or drink other than breast milk, unless medically indicated.
7 -	Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 -	Encourage breastfeeding on demand.
9 -	Give no pacifiers or artificial nipples to breastfeeding infants.
10 -	Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

I'm going to add on steps 11-20:

11 -	Limit interventions in labor to those that are truly medically necessary for the health of mother and baby.
12 -	Do not circumcise baby boys or girls for non-medical reasons.
13 -	Encourage mothers and babies to attempt the "breast crawl" after delivery.
14 -	Teach baby-wearing
15 -	Provide safe co-sleeping guidelines
16 -	Arrange for lactation consultant follow-up home visits after discharge.
17 -	Provide midwifery care for lower risk births.
18 -	Provide prescriptions for breast pumps to be covered as durable medical equipment by insurance
19 -	Encourage immediate and prolonged skin-to-skin contact, as well as a gentle post-birth environment.
20 -	Skip the hospital  If you are low-risk, try to give birth at home.

What you can do: If you gave birth naturally or gently, tell your birth story.  Support home birth.  Support midwifery.  Contact your local hospital and ask if they have been certified "baby-friendly" by the WHO.  If not, ask why not.  Drop off breastfeeding information at your local maternity ward and at your OB's office.   Support the right to genital integrity and openly oppose routine infant circumcision. 

Support the re-education of medical professionals

The worst breastfeeding advice I have ever heard came out of the mouths of medical professionals. 

• "Only feed for 10 minutes on each side, any more is unnecessary." 
• "Only nurse every 3-4 hours, any more and he's using you as a pacifier."
• "We have to give her formula until your milk comes in."
• "You can't have a glass of wine if you're nursing."
• "Pregnant women's milk is not good for older babies.  You need to wean."
• "After 6 months, there is no nutritional value to mother's milk; it's just for comfort."
• "One bottle of formula won't hurt anything."
• "Breast milk doesn't have enough vitamins.  You need to give your baby vitamins unless you formula-feed."
• "You can't breastfeed if you take_____ medicine" (without checking if it is actually true)
• "Your baby isn't growing fast enough.  You need to supplement with formula."

Sometimes, there is a real, medical reason to stop breastfeeding or supplement with formula.  That is rare - but the majority of women trust their doctor over their own gut feeling or their own research.  Medical professionals need to be educated on the facts.  More breastfeeding relationships have been ruined by pediatricians, nurses and obstetricians than all the free cans of formula in the world.   One bottle of formula *does* harm a nursing relationship.  Nursing on-demand really means on demand!  It is so hard to question your child's doctors.

Every new breastfeeding mother I know has worried, "how do I know my baby is getting enough food?" especially because all newborns seem hungry all the time.  One statement from a doctor about low percentiles or supplementation can be the beginning of the end of a healthy relationship.  Doctors need to be educated about alternative ways to increase supply if there really is a problem - and need to realize that formula should be the last resort, not the first reaction.

What you can do: Talk to your pediatrician about breastfeeding.  Invite local pediatricians to attend LLL meetings.  Encourage your local hospital to adopt baby-friendly policies.  Make sure every pregnant woman knows how to find accurate information.  Bookmark KellyMom.com on her computer.  While you're at it, send the link to your pediatrician.   Write to the AAP whenever you hear a doctor saying something untrue about breastfeeding, to encourage further training.

Support nursing rooms in workplaces, schools, and public buildings

Nursing rooms are common in Malaysia. 

Not all women are comfortable nursing in public.  Nursing rooms are a wonderful amenity that should be as available as bathrooms.  Many laws (but not all states) require that nursing mothers be provided a clean, safe and comfortable place to pump in the workplace....but this is rarely true.  Most moms end up pumping in bathrooms, spare conference rooms, supply closets or cars. 

Schools are especially key - not just for the teachers, but also for the students.  Breastfeeding rates among teen mothers are appalling.  Not all mothers are happily married stay-at-home mommies.... in fact, most aren't.  Supporting nursing and pumping means supporting it in high schools, Walmart break rooms, and your local fast food joint.

What you can do:  If you work, ask your HR department about space for nursing mothers.  Contact your local high school and encourage the school to set aside a room for mothers to pump or nurse.  Ask at your local government building.

Support breast milk donation

There are real, undeniable, and unavoidable reasons that breastfeeding may not be possible, including but not limited to:

• Death or incapacity of the mother
• Inability of the mother to produce sufficient milk, due to PCOS, insufficient glandular tissue, mastectomy, etc.
• Adoption of a child (before re-lactation or if it is not possible)
• Medical conditions that require unsafe medication to manage

Babies should be able to drink human milk, even if their mothers can't provide that milk to them. 

Unfortunately, "official" milk banks are extremely selective and extremely expensive.  I contacted two when I had to stop breastfeeding, and I was told that milk was reserved for sick babies, and that even if they had some, the price for the milk was $3.50 an ounce and not covered by insurance.  For a baby who eats 32 ounces a day, that is simply impossible - and we are a well-off family.

Between then and now, a new organization has come onto the forefront, Eats on Feets, which will connect nursing mothers with women like me, who need donated milk for our babies.  It's still in its infancy, and private milk donation has a long way to go toward being socially acceptable again, but it is a place to begin.  Right now, there is less milk than women who need it.  

What you can do:  Donate any extra milk you have.  Support Eats on Feets.  Talk about breast milk donation, and challenge gut reactions that it's "icky."  If your local EoF is active and has milk available, reach out and let folks know it's there for the taking.

Support media exposure of breastfeeding

1977, Buffy explains breastfeeding to Big Bird.

Bottles are everywhere.  Every time you see a baby on TV, you see a bottle.  Children's cartoons are filled with bottles, but nursing is taboo.  This is an echo on nursing in public, and all the same reasons apply.  Normalizing breastfeeding means that it has to make its way onto television.

What you can do:  Contact PBS and ask them to run another special on television.  Every time you see a baby bottle on TV, comment online at the station and on facebook/twitter.  If you do see nursing on TV, send a compliment (I sent one to the director of  "Four Christmases", which was the first movie I've ever seen with casual nursing and lots of breastfeeding mentions without being a movie about babies) 

Oppose Unethical Marketing of Formula

Haha, exception proves the rule, right?

Yes, the whole point of this article is not to demonize formula or formula-feeding moms. Demonize the mainstream formula companies as much as you want.  Go for it.  Thanks to these jerks, babies all over the world die, and I fed my kid bugs, while they profit massively.

Formula companies advertise *everywhere*.  Boobs don't get glossy ads in Parents' magazine.  Formula companies are regulated in what they can say, but boy, do they squeeze close to that edge!  "Closer than ever to breast milk" is such a misleading statement.  I can make Coca-Cola "closer" to breast milk by adding DHA and probiotics.  It doesn't make it close.  Obviously, Similac is a better choice for your baby than Coke.  BUT, the difference between formula and breast milk is as far the difference between formula and soda.  

Especially abhorrant are the advertisements in developing countries, where a lack of access to clean drinking water makes formula truly life-threatening.  If you don't have clean water, breast milk is vital to the survival of babies, yet companies like Nestle see opportunities for "new marketshare" and plaster with this messaging.

Even the "Breast is Best" campaign is tainted by formula marketing.  It insinuates that perfect moms breastfeed, but who's perfect anyway?  Breast isn't just best - it's NORMAL.  It's what babies should eat, absent extenuating circumstances.  Ads plastered on TV, in magazines, in doctors' offices and in hospitals make formula seem like the normal choice.  Breast milk isn't a "nice option" like organic foods or designer baby clothes.  It's necessary, normal, and appropriate.  It's how babies were made to be fed.  It's how moms were made.

What you can do:  Boycott Nestle.  If you subscribe to any magazines that advertise formula, write to them and ask for "fair and balanced" advertising that encourages a one-to-one ratio of breastfeeding and formula references in their publication - or better yet, ask that they not advertise formula at all.  If you see coupons or advertising at your doctors' office, ask your doctor why they are advertising formula.

So, are you ready?  This is the harder road, but it's the one that makes a difference.  Invite your formula-feeding friends (if you have any) to join you in a fight for mothers' and babies' rights.  There's a lot of us, and we can actually make something happen....if we don't spend our time pointing at each other.

Moms with IBD: All About The Meds

This isn't as universal a post as my other stuff, but hopefully it will be helpful to those who find it relevant.  This is directed at mothers or would-be mothers with Ulcerative Colitis or Crohn's Disease.


When I was pregnant with my son, I didn't realize how much my (then latent) Ulcerative Colitis would affect my pregnancy, delivery, and recovery.  The information online is patchy at best, and every doctor seems to have differing opinions on how to treat UC or Crohn's in pregnant and breastfeeding patients, or in those who are trying to conceive.  It was difficult to put everything together, and there is a lot of bad information out there.  I was going to put this all in one post, but it's too much.  This post is about medication.  See Part 2 about additional concerns during pregnancy and breastfeeding.

I'm not a doctor.  This is the internet.  Don't be stupid.  Talk to your doctor about the best courses of treatment for your disease, and work with your doctor to assess the risks and benefits of any treatment.

Q: "Should I take medicine for my IBD while pregnant/breastfeeding?"


A: Work with your doctor(s).  Flaring while pregnant or lactating isn't good.  If you're pregnant, being malnourished can harm your baby.  If you're lactating, it can severely impact your supply and your ability to be a good mommy.  Don't neglect your own health because you're afraid of the medication.  Try non-medical stuff, but don't end up in the hospital (like I did) because you fear the necessary medications.

ALL ABOUT THE MEDS
I'll start here because it tends to be the thing weighing most on mommy minds.  Let's start with the safest ones, then go up from there.

Safe(r) for Pregnant and Lactating Women

Probiotics 
If you're not already taking these, I highly suggest that you start.  There have been numerous studies that show a strong positive relationship between IBD remission and the use of probiotics.  You can start simple - Kefir (sold at your local grocery store) has high levels of "good" bacteria.  Many folks make their own.

For supplements, the "top dog" is VSL#3, which is available online.  Alternatively, you can try Acidopholus, available at your local pharmacy or health food store.  Get the highest count you can, and keep the pills refrigerated for longest life and potency.  There are no known negative side effects to probiotics; even if they don't work for you, there is no risk in trying.

Vitamin D
I have done a good amount of research, and found that vitamin D deficiency can also contribute to possible flares.  I take 1000-2000IU of additional vitamin D in the summer and 3000-4000IU in the winter.  If you spend a lot of time in the sun, or eat a good amount of foods containing soluble vitamin D, you may need less.

Fish Oil/Omega3
Be careful to look for oils that are mercury-free.  Omega-3 fatty acids can really help your digestive system stay in balance.   If you're not flaring, you can get this from fish and some meats, but if you're flaring or pregnant some of these may be off limits.  Fish Oils also provide DHA and EPA, which reduce inflammation and are also good for the baby's development.

Folic Acid
You may not be able to take a "regular" prenatal vitamin (see below), but folic acid is of vital importance to your baby's health.  Ideally, you should start taking it before you are pregnant.

Vitamin C
Always a good choice.  Again, there have been studies that suggest improvement in IBD with increased vitamin C, and it's also good for the baby (some studies have even shown a link between increased vitamin C and lower SIDS risks).  It supports natural tissue growth and healing - you need healthy tissue and healing, right?

Potassium
If you get cramps (muscle, stomach, whatever), potassium can really help.  Flaring IBD can inhibit your body's natural processing of potassium, so you should pay special attention to this if you have diarrhea or vomiting as a regular symptom.  You can either take a supplement (I did), drink potassium-rich drinks (I kept a bottle of Gatorade in the bathroom; every time I ended up in there, I'd drink it), or eat potassium-rich foods like bananas, avocados, and potatoes.

Prenatal Vitamins - proceed with caution.
Many women with IBD are sensitive to the increased Iron in prenatal vitamins.   You may want to consider an iron-free multivitamin or a combination of other vitamins rather than standard prenatals.  There's a lot of (usually good) stuff packed into a prenatal.  I personally found it better to take everything seperately than in one package.  Less convenient, certainly, but easier on my system.  I find that I am very sensitive to all of the metals (zinc, copper, sometimes magnesium).

Dietary Stuff
This could be really long, but I'll keep it short.  Most doctors say diet doesn't have much to do with IBD.  Pretty much every patient I know wildly disagrees with their doctor on this matter.  Frankly, I think it's ridiculous to ignore diet as a part of treatment!  Personally, I'm very sensitive to sugar and white carbs, popcorn, nuts, and any oil but olive oil or butter.  Other people have other things.  One neat trick - right before you eat something, take your pulse.  20 minutes after eating (and relaxing), take your pulse again.  If it's much higher, you may be sensitive to that food.  Also notice if you feel flushed or anxious; these can also point to sensitivity.  Eliminate or limit the "bad" foods and you'll feel better.

PRESCRIPTION MEDS - LOW(ER) RISK
Many medications for UC and Crohn's are relatively safe during pregnancy (Category B-C).  

Lower risk doesn't mean no risk. But, flaring during pregnancy is certainly something you want to avoid.  You need to work with your doctor to determine what level of risk is acceptable to keep you healthy without causing risk to your baby.  Healthy mommies make healthy babies. 


Mesalamine - Pregnancy Category B
Rowasa, Asacol, Lialda, Pentasa, Apriso, etc.
If you have UC and it affects only your lower colon, the least dangerous (and often most effective) of these are suppositories and enemas.  Ick, yeah, but because they are applied directly to the site of inflammation, very little of the drug enters your bloodstream.   Lialda has the highest dosage of mesalamine per pill, at 1.2g per tablet.

Mesalamine is "bowel-specific", and even taken orally, only a small amount enters your bloodstream.  It does cross the placenta, but studies have not proven any evidence of harm to the baby (note: evidence of harm does NOT mean evidence of NO harm). There have been a few studies that showed a slight risk of cleft palates, but they were not statistically significant.

Mesalamine does pass into breast milk; there is potential that it may cause loose stools in your breastfed infant if they are sensitive to the drug, but most babies do not have a problem with this.   

If you are on Mesalamine as a maintenance drug, your doctor will likely suggest that you stay on it during your pregnancy and while breastfeeding.

Sulfasalazine (Azulfedine)- Pregnancy Category B
Similar to Mesalamine, this is considered another "ASA" med and has similar risks and benefits.  It is often used if you (or your baby) are sensitive to mesalamine.



PRESCRIPTION MEDS - MEDIUM RISK

Prednisone - Pregnancy Category B/C
This is a love it, hate it drug.  The side effects of prednisone are long, very real, and very serious - to you.  Being on prednisone sucks.  Flaring can suck more.  Long-term prednisone use causes adrenal dependency (it's hard to get off of) and even short-term, it causes insomnia, irritability, swelling, weight gain, headaches, and a slew of other annoying, destructive, and frustrating effects.  

That being said, it is probably the first thing your doctor will prescribe if you're suffering from an acute flare (bleeding a lot, really sick).  It works.  I sincerely hope you don't need this drug.  If you do, try to get off it as quickly, safely, and carefully as you can.  Prednisone should only be used in pregnancy if it is necessary, and if there is no safer alternative.  Flaring is not good for you, or your baby, either.  You need to carefully weigh the risks and benefits with your doctor before deciding if it is right for you.  The more you have to take, and the longer you take it, the greater the risks.  A 5mg dose is not the same as a 60mg dose.  Your doctor should prescribe the lowest dose that will control your flare.

There is an increased risk of cleft palates in babies whose moms took prednisone during the first trimester.  During the second and third trimester, there is an increased risk of low birth weight, and taking it in the third trimester has been linked to increased risk of preterm labor. Flaring IBD in the second and third trimester can also cause low birth weight and preterm labor - studies were not always able to determine if the cause was prednisone or IBD.

Prednisone can increase your risk of developing Gestational Diabetes.  If you are undergoing long-term prednisone treatment, your doctor or midwife will probably have you do the glucose challenge testing several times during your pregnancy.  Prednisone also decreases your ability to fight infection.

It is extraordinarily dangerous to stop prednisone abruptly.  If you are on it and want off, you need to work with your doctor to taper carefully.  Just stopping prednisone can cause adrenal failure and even death.

Prednisone has not actually been assigned a pregnancy category by the FDA.  Some brand names are B, others are C.

Other Corticosteroids (endocort, prednisolone, cortisone etc) all have similar side effects and risks to Prednisone, but they don't always work as well.  Some can be prescribed in enema form, which carries the lowest risk but also the lowest reward.

PRESCRIPTION MEDS: UNKNOWN RISK



Anti TNF Inhibitors: Remicade, Humira, Cimzia, Tysabri (aka Biologics)
These are scary drugs, big guns.  If you are on them, or your doctor suggests going on them, you need to do your research.  I am on Remicade, and it's right for me right now - but I'd be lying if I didn't say that it scares me to be on them.  Nothing else works for me; it's either Remicade or remove my colon.  Some people have chosen surgery over them.  With Crohn's, it may be biologics or the hospital.

Anti-TNF inhibitors (all varieties) suppress your immune system.  They all cross the placenta (when you're on them, so is your baby).  There have been very few studies on how they affect babies.  You will need to discuss this in depth with your doctor, ideally prior to becoming pregnant.  We're delaying our try for the next baby for a few years, until I can get off Remicade, or until better studies are available.

There may be increased risk of birth defects, an increased risk of miscarriage (maybe because IBD affects your body, who knows), but ultimately, not enough studies have been done to determine if they are safe or not.  I know a few people who have been on these during pregnancy and it worked out very well for them.  Here are some things to check out:

Remicade: http://www.otispregnancy.org/files/infliximab.pdf
Humira: http://www.otispregnancy.org/files/adalimumab.pdf

On the plus side, both Humira and Remicade seem to be safe for breastfeeding.  The molecules are huge and do not appear to transfer into breast milk.

EDIT: New research is ongoing, and it appears that Remicade is relatively safe during pregnancy.   I am trying to get copies of these studies, but I am told that the evidence is pretty clear, and that Remicade is being downgraded to category B.  The risks in smaller studies appear to be lower than the risks of corticosteriod treatment (aka prednisone).  It is important to note that no long-term studies have been done;  of Remicade has been linked to higher risks of certain cancers, and it is unknown if these long-term risks also pass to babies.

PRESCRIPTION MEDS: VERY HIGH RISK



Naltrexone - Category C/D (depends on brand).  Known to cause birth defects, smaller risk than the meds below.  May cause PPD and may disturb bonding with your baby.  Does pass into breast milk and may cause developmental delays, however, it may be possible to breastfeed on this drug.  More research needs to be done.  If Naltrexone is on your table of options, get to know Dr. Google.

Mercaptopurine (6MP) - Category D: It says right on the label that 6MP shouldn't be handled by women who might possibly be pregnant.  There may be extreme circumstances that warrant its use, but I would not personally take it while pregnant or breastfeeding in any circumstance.  It causes known fetal harm, including increased risk of miscarriage, birth defects and still birth.  It is also NOT safe for breastfeeding.  You will have to choose between breastfeeding and 6mp - I had to give up breastfeeding to stay healthy.

Azathioprene - Category D: Again, not safe for pregnancy or breastfeeding.  Causes known deformities and increases risk of fetal death.  Do not breastfeed if you are on this drug.

Methotrexate - Category X: REALLY bad.  MTX is used to treat ectopic pregnancy and causes early abortions.  This is the "abortion pill" used in clinics.  Do not take methotrexate while pregnant or breastfeeding under any circumstances.   If your doctor suggests it, find another doctor immediately.

Thalidomide - Category X.  Known to cause extreme birth defects.  Not safe for breastfeeding or pregnancy.  Also should not be used in the weeks prior to pregnancy, since it has a long life inside your body.  If your doc wants you on this while pregnant, seriously question their medical license.


OTHER MEDICATIONS

Metronidazole (Flagyl) - Category B, BUT.... the use of this drug in pregnancy is very controversial.  The FDA has given it category B, which is a "safe-ish"category.  There is evidence of toxicity in animals, but not in people. It definitely causes problems for baby mice, rabbits and rats, including cancer.  It has not been shown to do harm to humans, but there is real cause for concern, and a campaign to change the pregnancy category by some doctors and patients.  Breastfeeding is also not recommended on this drug - "pump and dump" for 24 hours after the last dose.

Ciproflaxin (Cipro) - Category C.  Oddly enough, the research on Cipro shows less evidence of harm than Flagyl, but it's got a higher catogory.  Who knows... anyway, breastfeeding is safe on Cipro.  There is a slightly higher risk of joint problems in babies whose moms took Cipro.

Sedation (for colonoscopies etc): Every doctor seems to use different drugs for sedation during procedures.  All of them have some risk for pregnant women.  Lactating women should pump and dump for 24 hours following sedation.   If you're going to undergo endoscopy or colonoscopy and want to be sedated (I'll write about that tomorrow), this is a good site to check out:
http://www.sedationfacts.org/sedation-complications/sedation-pregnancy

Pain Meds
Technically, the only "safe" pain medication during pregnancy and breastfeeding is tylenol.  Vicodin (hydrocodone) is sometimes prescribed if your pain gets out of control, but there are very real risks, including dependency and difficulty breathing in newborns, if taken close to delivery or for long periods of time. Other pain medications should be avoided.   When my pain got really hard to handle, my doctor suggested that I take Tylenol PM - the PM is Benadryl.  Really, look it up.  Sleeping through pain is better than being awake for it, if you're the sort of person that gets sleepy on Benadryl. 



Phew!  I think I covered most of the meds.  Feel free to comment or add your information!  I will happily edit any misinformation (again, NOT a doctor) and add anything you believe is relevant.
 CLICK HERE FOR PART 2

Nurse-Ins are for EVERYONE

Often, the only outspoken lactivists are mothers who are currently nursing their children, or have nursed them in the past.  The lactivist community is strong, but insular - demonstrations are often nurse-ins, and understandably, conversation in lactivist groups tends toward the ins-and-outs of being a nursing mother.

Breastfeeding is more than a mom's issue.  It's an everybody issue.

Right now, there's a controversy spreading on Facebook, across the internet, in cafes, stores and churches.  Facebook has recently banned a number of users for posting photos of themselves breastfeeding.  They have deleted an event for a national "Nurse-In", which calls for mothers to post breastfeeding pictures.  Why?

"It's obscene."

I cannot breastfeed my son.  I'd love to post a picture of our brief nursing time, but alas, I didn't capture one at the time.  My husband can't breastfeed, my mom is way past that, and I don't have any friends who are currently breastfeeding their kids.  Nonetheless, I support nursing moms, and their right to feed their babies wherever and whenever the baby needs food.

So, why would I care?

"OMG, I DON'T WANT TO SEE YOUR BOOBS!"

Nursing in public prevents angry, screaming babies.  I hate listening to babies cry hysterically.  It's the worst sound in the world - give me fingernails on chalkboard any day.  Every instinct in my body drives me to find the sound of the screaming child and fix it.   Evolution or God made people that way - we react strongly to the sound of a distressed child, our hormone levels changing, anxiety activated.  When I hear a truly upset baby, all I want to do is help.  If the child is hungry, the solution is simple - feed the baby.   I'd so much rather round the aisle in Target and see a nursing mom than have to hear her child screaming across the store.

Once upon a time, I traveled a lot for business.  When you board a packed plane, there are a few things you dread having in the seat next to you.... a smelly person, an exceptionally large person, and above all else....please.... not a baby!

Well, on one trip, I approached my seat and found a mother with her 18 month old son in her lap.  It was a 4 hour flight, and I was dreading every minute.  We took off, and he started to holler - ear pressure is no fun.  His mom made eye contact with me, popped out her boob, latched him on, and smiled.  I smiled back nervously...did she just do what I think she did?   Her son looked up at me past his mom's nipple and grinned.  I was a little shocked, but there was no screaming.  We chatted on and off during the plane ride, and every time the little one got fussy, she nursed him and he relaxed.  What a pleasure!

That was my first real experience with nursing.  At 23 years old.  What, you say?  It's not a typo.  I understood that, theoretically, women could breastfeed their children, but I had never actually seen it.  For realz.

"OMG, MY KID CAN SEE YOUR BOOBS!!"

I was 23 years old the first time I saw a mother nurse her child.  My mother breastfed me for a few weeks until her doctor told her that she didn't produce enough milk and I was going to starve.  She believed him, and formula-fed me and my younger brothers from then on.  Some of my earliest memories were of bottle-feeding my youngest brother.

I have dozens of cousins, and a large, close family.  During my childhood in the 80s and 90s, either none of them breastfed their children - or if they did, they did so in secret, hidden away in the spare room with the coats.  I never saw it, not once.  My baby dolls came with bottles.  Cartoons showed babies being fed with bottles.  I was raised to believe that's how babies are fed.  With a latex nipple on a tube.

So, when it came time for me to have children, I did research - and found out that breastfeeding is not just best, it's normal - it's how babies are supposed to eat.  All the time.  Babies were made to breastfeed.  Breasts were made for making milk.  Not filling out a bikini top.  I knew it was the right thing to do....but I didn't know how to do it.

I took a class. I read books.  Then it struck me - this is a normal thing to do.  Why did I have to take a class to learn how to do the "football hold"?  Why did I have to take a class to show me how to latch a baby on my breast?  The answer is simple - I had never seen it, up close and personal.  Is it any wonder how difficult breastfeeding was for me?

If you want to know why so many women attempt to breastfeed and fail, I would say to look there.  They didn't learn how, when they were 10 and first learning how to care for infants.  Why can't fathers support breastfeeding moms and give advice?  They never saw it, in real life or on TV. 

I later found out that 2 of my aunts did breastfeed my cousins.  They did it in spare bedrooms or the bathroom, because they were told or led to believe that nursing was "indecent" and "obscene." So, at the multitude of gatherings, all I ever saw, and all that millions of American children have ever seen, was a mother either bottle-feeding or sneaking off quietly to some dark room, away from the action, to perform this "disgusting bodily function."


Here's the truth.  Babies don't come with bottles in real life.  They come with boobs.  We are mammals, and mammals breastfeed their young.  Duh.

"OMG, CAN'T YOU COVER UP??"

You don't ask the mother cat with kittens to "cover up" - right?

So, here I was, an expectant mommy, and I bought a nursing cover.  I'm sorry, these things are stupid.  If you're a breastfeeding dummy like me, nursing isn't "instinctual."  It's hard!  Getting the right latch is hard.  Getting the kid on the boob is a challenge at first.  Doing it blind is damn near impossible.  Yeah, yeah, some nursing covers have a hole at the top you can look down through - but their purpose is to reduce sight of breastfeeding.  Right?

Ok, let's see how a new mom, who has never actually witnessed a nursing mom do her thing (because it's gross and indecent and should be done in private only), attempt to get a proper latch with a cover.


Instructions for ensuring a proper latch:

1- The first step to a proper latch on is getting baby to open WIDE!  Brush baby's lips with your nipple to encourage him to open wide, as if yawning.
  (Oh yeah, sure.  I'll see his wide-open mouth with my x-ray vision.  With a cover on, I'm going to brush her nose with my nipple, not her lips!)

2 - Once baby's mouth is open wide, quickly pull him onto the breast by pulling the baby toward you with the arm that is holding him.  Make sure you move the baby towards you, and not move yourself towards the baby.
(Sure, no problem.  I'll just hope I'm pulling him in the right direction, and try to accomplish it one-handed, so I can keep this blanket in place....)

3 - The baby's gums should completely bypass the nipple and cover approximately one inch of the areola behind the nipple.  Make sure the baby's lips are everted.  Some baby's will tighten or purse their lips, especially the lower one.  If the lower lip is inverted (turned in), try simply pressing down on baby's chin to evert the inwardly turned lip.
(Forget x-ray vision.... now I need x-ray vision and a friggin MIRROR!)

 4 - Note how the baby's lips are correctly everted, and the mouth is open wide.  Also notice how much breast tissue has been taken in, almost the entire areola is in the baby's mouth. 
(Hmmm... can't see that areola through the blanket, can I?)

 That is mostly a "beginning" problem... what about later on?


I absolutely love this YouTube Video of an older baby's reaction to being covered...



See?  Not always easy.


Plus, returning to my point above, if nursing moms always cover up, little boys and girls have to learn about breastfeeding from a BOOK. 

Babies are people too.  They deserve to eat when they're hungry. and they deserve to enjoy their meals without a blanket over their heads.  Pretty simple stuff.

"OMG, CAN'T YOU JUST FEED IT PUMPED MILK IN A BOTTLE??"

Sigh.  Again, a dumb idea from someone who's either never breastfed, or someone who never had problems.

First, when babies are super-little, bottle-feeding can cause "nipple confusion".  Just like it takes a mom some time to figure out how to breastfeed correctly, it takes babies some time.  Artificial nipples work differently than boobs.  They have one hole, boobs have multiple holes.  Breastmilk flows at different rates during a feeding, bottles flow at only one speed - fast!  Babies have to work at the boob.  They just have to open their mouths with a bottle.  If you introduce a bottle before a baby is fully established with breastfeeding, you can actually sabotage the breastfeeding relationship.  

Not all babies will take a bottle, either.  Choice #1 - food from the source, at the right temperature, starting out light and progressing to a thick, sweet dessert as the meal progresses.  Great company, skin-to-skin contact, and just the right fit.  Choice #2, your meal all mixed up, shooting out fast, either too hot or too cold.  Sure, it's still a steak dinner with cheesecake, but you're getting it through the drive-through.

Not all moms have a strong enough supply to pump and feed their baby the old-fashioned way.  To pull this off, she has to make enough food for breakfast and lunch at the same time, but still have enough in the "fridge" for lunch later on.  Pumping's not easy, either - you don't get the same amount from a machine as you do from a baby.

Even if Mom does become a pumping pro, it can change her supply to the other side of things, with engorgement and overproduction.  If you think nursing in public is gross, just wait till she whips out the pump!

NEWS FLASH: Breast milk is not shelf-stable.  It's milk.  Hello.  It has to be refrigerated once it's been pumped out.  So, if Mom's away from a fridge for longer than a couple hours, it's the boob or nothing.   And we're back to the screaming baby.

"CAN'T YOU JUST GO IN THE BATHROOM??"

Right.
'Cause that's a nice, safe, clean and comfortable place to enjoy a meal.  

Did we forget?  Babies are people, too.

So, nursing moms, keep it up. Whip it out.   
Feed your babies.

Nurse in public.  In church.  At the store, in an airplane, in the playground, at the mall, at Christmas parties and birthday celebrations, in line for Santa, at a restaurant.  You're doing what's best for your baby, absolutely.

Just as important, you're showing that little girl at the next table over how to do it right.  You're teaching your nephew how to become a supportive father.  You're reducing noise pollution.  You're improving the public health.

You're saving the world, and I'm more than happy to hold your cape.

The "Lemonade" of Formula Feeding

Sometimes, life gives you lemons.  When it comes to breastfeeding David the 9th, I got a big old pile of lemons.  I breastfed him for 2 months, but had to stop due to my own life-threatening medical issues.

If I could control the universe, I would still be breastfeeding my son. Even with all these "honorable mentions." I wanted to breastfeed him SO badly that I ended up in the hospital! I will probably always feel guilty that my health cost my son and I our breastfeeding relationship, and if I could, I would be breastfeeding now, despite its challenges.

This is not a list of "10 reasons not to breastfeed", although it could be read that way. I try to live by that silly saying, "if life gives you lemons, make lemonade" - this list is my lemonade.

It is meant to be lemonade for other women like me who constantly feel guilt or sadness over feeding woes, to not just come to terms with formula-feeding, but enjoy what we have. I hope breastfeeding moms can appreciate this in the spirit in which it was written.  My next post will be all about why I support nursing in public and why I'm boycotting Nestle.  I plan to breastfeed my next child, if my body will allow it.

Also - because the subject has come up - I contacted 2 milk banks and found that not only was the milk $3-$4 per ounce,  it was only available to the sickest preemies.  My son is healthy, and I did not qualify.  I also posted on MilkShare's board, and sent money for "shipping" to someone who never sent me any milk.  That scared me off of milk donation from strangers; if I couldn't trust someone on the board not to steal my money, how could I trust them not to do drugs, drink, take medicines, or eat onions and garlic?  I don't have any friends or family who are lactating.  In addition to better support for nursing moms, I would deeply appreciate open access to clean, safe, donated breast milk.  I would much rather be using that than formula. 

The Lemonade of Formula Feeding

We all know that “Breast is Best”, but for some women, myself included, it’s either not possible or not appropriate, and we instead feed our babies formula.  The benefits of breast milk are well-documented, there’s a ton of information online about the benefits, and I am in no way underplaying them.  I support breastfeeding moms.

Nonetheless, when I stopped breastfeeding, I was pleasantly surprised to find that there are real plusses to formula feeding for my family – and while they might not stack up, they certainly are worth honorable mention. 

A note – many of these benefits can be achieved with pumped breast milk, and should be if it is possible.  A little bit of breast milk is better than none at all; if you can feed your baby breast milk, please do!

1. I know exactly how much food my son is getting.

I constantly struggled with supply while breastfeeding.  My son always seemed hungry, and there was no easy way for me to tell if he was getting “enough”.  I counted wet and dirty diapers, but I never felt confident that he was getting enough food.   Pumping yielded 1-2oz per breast, but I was regularly told that pumping was a poor indicator of production.  Once a week, we went to the doctor for a weigh-in, but these results were varied.  I tried every method known to raise my supply with no luck (herbs and galactalogs and 9-hour pumping/nursing sessions, you name it).  I probably had these supply problems because of my serious health issues.

With formula, I know if he is getting enough to eat; there is no fear of dehydration or poor weight gain due to poor supply.  I know if he’s only had 2oz and will be hungry again soon, or if he’s filled up and will be good for a while.

2. Daddy can feed the baby.  So can anyone else.

My husband was happy when I stopped breastfeeding for a number of reasons (mostly because I didn't die), but one of the biggest was that he was able to feed our son.  When we switched to formula, we went to a split-night system; from 2am to sunrise, he was the “primary parent”.  I got to catch up on sleep, and he was in charge.  No handing baby to mama with “he’s hungry”; there was no excuse.  He became a better parent and a better husband.

Feeding my son is now a community activity.  He has been fed by his great-grandfather, his 8-year-old cousin, and our minister, and it is a joyful experience for everyone.   It is absolutely a bonding experience – not one that is restricted to just mommy.

3. I can feed my baby anywhere.

I support nursing in public - anywhere.  Unfortunately, not everyone else does (though they should, prudish morons).  I can happily feed my son in a restaurant, park, church, or anywhere else, and the only funny looks I get are from people who think formula is evil.  I did nurse in public while I was breastfeeding, but I was always (unfairly) uncomfortable exposing my breasts for the world to see, even if it was only an inch.   The bias against breastfeeding isn’t fair….but it’s nice not to have to deal with it.

It may seem a small benefit, but I can also feed my son in a moving car (while someone else drives, obviously).  This may seem trivial, but when you’re 30 minutes from your destination and stuck in traffic, it is a lifesaver!  I can mix up a bottle in the middle of a store without looking for a place to set up.  It is very convenient.

4.  I can eat or drink whatever I want. I can take whatever medicines I need to take.

If my son develops a food sensitivity or allergy, I will simply switch to a different formula.  If I want to have a margarita night with the girls, I can, without fear of damaging my baby or having to ‘pump and dump’.
Most importantly for me, I can take the medicines I need to take to stay healthy.  Not all medicine is safe for breastfeeding mothers, and there is not always an adequate alternative (in my case, I am on 6-mercaptopurine, methotrexate and Remicade, category X drugs that pregnant women can't even touch).

Mom’s health is more important than her boobs.  Period.

5.  I have more freedom.

I can work outside of the home, and I don’t have to take 3 pumping breaks in my car.  I can head out to the grocery store to pick up eggs without looking at the clock.  My husband and I can go on a “date night” and leave baby with his doting Grammy without worrying about pumping or supply. 

6. My boobs don’t hurt.

I read everywhere during my pregnancy, “if breastfeeding hurts, you’re doing it wrong.”  Then I actually did it, and found out that the books were lying.  Breastfeeding was excruciatingly painful.  My nipples bled, blistered, and literally fell apart – even though our latch was fine.  My breasts would become engorged and ache.  I had bouts with thrush, clogged ducts and mastitis.  It wasn’t always painful – I had a lovely 2 week stint before my hospital stay where I didn’t cry during feedings – but I spent 2 months in hell, literally screaming when he first latched on, dreading his hunger cries.

There is no pain in feeding formula (unless you count the emotional pain, of which I've had a LOT).  None.  I was delighted to see my son’s first teeth, not terrified!

7.  My boobs don’t leak.

I made a quick trip to the store while breastfeeding.  A baby cried in the next aisle over, and I soaked through my nursing pads and straight through my shirt.  I was horrified, and my husband told me not to worry at all… it really was not a big deal. 

I’m still glad I don’t have to worry about leaking through my white shirt during my next performance of “Messiah.”  I also don’t leak anymore during sex.

8.  My son sleeps longer and better.

There.  I said it.  I know, research shows that on average, breastfed and formula-fed babies sleep the same, but my baby slept better with a full belly of formula.  Again, this was probably because of my supply problems, which most moms can work through with proper support.

The first day that my son was exclusively formula-fed, he slept through the night.  8pm until 6am.  Previously, he was up every 2 hours like clockwork.  We thought it was a fluke.  It was not – unless he is teething, in a growth spurt, or otherwise upset, he sleeps “like a baby”, and that phrase is no longer a sick joke.  So – not only does he sleep better, but obviously so do his parents!

9.  Formula’s not that expensive.  For me, it was cheaper than breastfeeding.

Luckily, my son isn’t a picky eater.  He likes Target Up & Up Organic formula, which costs $15 per can when you buy in bulk.  Each can makes about a week’s worth of bottles, for a cost of around $2 a day.  We spent $30 on bottles, for a total annual expense of $760, or less than my daily visit to Starbucks.  If you’re eligible for WIC, formula is even less expensive (though in my opinion WIC should also cover any and all breastfeeding expenses and it is a travesty  that they do not).

Conversely, I spent $350 on a breast pump, $50 on the special bottles that work with it, $600 on 3 visits to a lactation consultant, $90 on prescriptions for thrush and mastitis, $50 on lanolin creams and special ice packs, $30 on a breastfeeding pillow, and $200 on nursing bras and tops, for a whopping total of $1360.  I spent this in 2 months.

10.  I am a happier, healthier, and better mother.

This is the biggest and most important benefit for me.  Instead of being sleep-deprived, in pain, and anxious, I am confidently enjoying being a mother.   I do not dread feeding my son; I look forward to it.   I am healthy, taking the medicines my body needs to be strong.   I am enjoying him more, and I am a better mother for it.  I thank formula for saving my life, and for improving its quality.



UPDATE: I have reached out (thanks to the wonderful commentators on this blog) to my local Eats on Feets organization, asking for donor milk.  No bites yet, but I am hopeful.  Huge thanks to Emma Kwasnica for her hard work in creating this new organization - I look eagerly forward to seeing this take off.

My Breastfeeding Story

My Story: The Lactivist with Broken Boobs

I have severe ulcerative colitis, which has been flaring since October of 2009, when I was 18 weeks pregnant with my son. Ulcerative Colitis is an auto-immune condition that is similar to Crohn's Disease. For reasons unknown, my immune system sometimes attacks my lower intestine, causing ulcers, bleeding, and severe diarrhea (gross, I know). I had been in remission for 3 years, but it came back. I was able to manage it while pregnant with steroids that are moderately safe for expecting moms.

Then, my son was born. We initiated breastfeeding right away - we were even able to do the "breast crawl", which was one of the most amazing things I've ever seen. I had trouble with latching, but we dealt with that. I ended up with a clogged duct and then mastitis, but we dealt with that. Both my son and I got thrush, but we made it through. I believe in breast feeding. I believe in the benefits of breast milk, and I did all the research. Come hell or high water, I was going to breastfeed my son and give him these magnificent benefits.

When David was 3 weeks old, my flare went from bad to worse. I was in the bathroom 20+ times a day. I was bleeding profusely, and when I wasn't nursing, I was curled up on the bathroom floor. I hid how bad it was from my husband, friends and family. I knew I should tell my doctor how bad things were. I knew I needed help.

I also knew that the only "breastfeeding safe" drugs for UC were the ones I was on - the ones that were failing. I knew they'd make me stop breastfeeding, and the guilt of that was terrible. My doctors had made it clear that the next step was to the big guns, drugs usually used to treat lukemia and an immune suppressant given by IV, both of which cross into breast milk. One drug is so bad that women who might become pregnant can't even handle it - they can't even touch the pills.

I believed that David would be at risk for infections, for sicknesses, for obesity, have a lower IQ, bond less with me. I figured, if I could just hold out a little longer....maybe it would go away.

2 weeks later, I passed out in the bathroom after a nursing session with David. When I came to, my husband and sister-in-law rushed me to the emergency room. I was barely coherent, but I argued with them both that it wasn't serious.

My body had gone septic and I was very, very sick. I was in the hospital for 8 days. They treated me with hefty antibiotics and steroids, and had me on massive painkillers. Breastfeeding was totally off the table, for good.

My husband, suddenly the single father of a 5 week old baby, had to switch to formula immediately to nourish our son.  Even with all I'd been through, the first thing I tried to get when I was coherent was a pump so I could keep up my supply. My husband was so angry; he felt that the pressure to breastfeed almost cost me my life. He and my doctors all made it very clear that what my baby needed was ME, not my boobs.

The entire experience was horrific. I never should have attempted to breastfeed, and I should have gone on the stronger meds right away, as soon as he was born. I put my own life in danger, but I really believed all of the research (and frankly, propaganda) that formula-feeding my son was akin to child abuse. I was convinced that giving up breastfeeding meant that my son would be at a disadvantage for his entire life....and it would be my fault.

I am now on those scary medications that are keeping me moderately healthy and out of the hospital. My son is thriving on formula. He is bright and wonderful and strong. He has never been sick. I still feel guilty sometimes, but I know, beyond a shadow of a doubt, that formula is the right choice for us, and that it's a blessing. 100 years ago, one or both of us would have died, plain and simple.

I firmly believe that breastfeeding is important and should be supported.   Nonetheless, those who say formula is the devil just haven't done the research behind the REAL reasons some people switch.  It's rarely about wanting to party or wanting pretty boobs, in my experience. Life's just not that simple, and sometimes formula is the right choice from the very beginning.

Do you have a breastfeeding story to share? I'd love to hear it!