Should I delay supplementing with formula after giving birth?

Should I delay using formula to feed my baby after giving birth? After giving birth to my last child, I was pressured into signing an agreement saying I would delay supplemental feeding, even if I was unable to produce enough breast milk or any at all. I was hesitant to sign and was very confused.

Although most mothers attempt to breastfeed after giving birth, it is not an easy task. According to NPR, researchers at University of California Davis Medical Center found that 92 percent of 418 first time mothers surveyed said they had difficulty breastfeeding three days after giving birth.

The women reported challenges with getting the baby to latch onto the breast, or other feeding issues like nipple confusion, when a baby may prefer a bottle. Others cited pain as a deterrent and some said they were worried they were not producing enough milk.

Breastfeeding experiences like these are common. Breastfeeding is usually recommended for the first six months of a child’s life, but only 13 percent of women exclusively breastfeed their child during this timeframe.

Many women also experience delays in milk production. Johns Hopkins Medicine states that factors like severe stress, surgical delivery, bleeding after birth, obesity, infection or illness with fever, diabetes, thyroid conditions, or strict or prolonged bed rest during pregnancy can delay milk coming in.

Milk supply responds to demand, meaning a mother will produce milk based on how often it is expressed — either through natural breastfeeding or by hand. An effective way to produce more milk is to continue breastfeeding even when supplementing with formula. Johns Hopkins explains that in cases like this, a mother will often start to produce larger quantities of milk around seven to 14 days after giving birth.

Many studies have shown the health benefits of breastfeeding to be superior to those of formula feeding. This evidence has caused a shift in clinical practices in the U.S. That’s good, as many years ago, U.S. hospitals assumed every woman would use formula, and they undermined women’s efforts to breastfeed. But now that many hospitals encourage mothers to avoid formula, women may end up feeling guilty if their baby needs supplemental formula, even for a short time. Some women have found that they need to supplement with formula temporarily and they deserve support, too. The “consent” forms used by some hospitals are experienced by women whose babies need supplemental formula as guilt-inducing and coercive. That’s wrong.  Just like it was wrong to force women to use formula back in the 1950s and 60s.

Researchers have also identified risks associated with the absence of breastfeeding. The National Center for Biotechnology Information explains that infants who are never breastfed have increased risk of infectious morbidity, including middle ear infection, stomach flu, and pneumonia, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. If an infant is premature, not receiving breast milk is associated with an increased risk of necrotizing enterocolitis, a disease that affects the intestines and causes inflammation that can ultimately destroy the wall of the bowel. Mothers who don’t breastfeed also have an increased risk of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, and the metabolic syndrome (which raises the risk of heart disease, diabetes, and stroke).

Still, it is never acceptable for a hospital to force a woman to delay supplementing with formula, in the misguided hope that pressuring a woman to delay supplementing will increase the likelihood that she will breastfeed successfully. There is no shame in delayed milk production, nor is there shame in facing challenges with breastfeeding. Supplementing with formula is a safe and sometimes necessary method of feeding babies.


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