The fact of the matter is, babies have been supplemented with things other than breastmilk since the beginning of time, sometimes due to cultural influences, sometimes to try to save the baby whose mother was dead or unable to produce adequate milk.  I think that in days past there was probably a lot of familial wet-nursing going on to get babies who were having problems over the hump - moms with copius supplies feeding newborns whose mothers were not producing much yet.  We don't have that as as option much anymore (I think it is still a good one, BTW, although many would probably disagree) and getting a hold of banked milk on short notice is not easy either.  I helped an Amish woman once who had huge nipples which all of her babies had to "grow into" before nursing well - she used a molasses-water pap to feed her babies in the beginning.  While some of these things may not be the best for a newborn to get, there is a history there of supplementing - it is not something solely dreamed up by the formula companies.  Of course, modern times have warped it into something much more - the wholesale non-breastfeeding of babies.  But I think that holding up "nothing but mom's milk" or "only at mom's breast" as some kind of holy grail can be self-defeating in many instances where the mom can see that her baby is not doing well - if no alternative is offered at some point, breastfeeding will end anyways, at the doctor's insistance or as the mother's choice, and it will likely be a permanent end, rather than just a short, temporary setback.

There is, without doubt, an enormous amount of unnecessary supplementing with formula going on in hospitals during the first few days of life - that is due to the warping of the whole childbirth experience in the hospital and the  necessity of moving mothers out in 48 hours.  If there are early concerns, there is no reason why colostrum can't be expressed/pumped and beefed up with a little glucose water if some people are not satified with the volume.  However, if after a few days (weeks) you have a lethargic, almost dehydrated, non-sucking baby, there is not much doubt that there will not be a turnaround until that baby gets something substantial to eat.  Many of us have seen as little as one good feed of whatever is available get a baby alert and ready to go to breast.  I can't imagine that this is even a issue anymore.  If you tell a mom that even one feed with formula is going to mess her kid up for weeks or months to come, it is more likely that once they start supplementing, they will continue because they figure, what's the difference, the damage is already done.  That information, while sometimes useful, needs to be given thoughfully.

What you feed that baby is really the issue.  If breastmilk in some form is not available, then you are pretty much left with formula of some kind.  This is, in fact, what formula is really for - feeding babies who do not have an althernative.  Having lived with a very allergic baby whose problems were indeed triggered by formula given in the hospital, I would opt for a hypoallergenic type for supplementation - not guaranteed to prevent problems, but less likely, in my opinion.  If a mom wants to use any available formula, I will quiz her very closely about allergic-type symptoms or related disease on both sides of the family - if there is any, I am even more strenuous about pushing the use of the more expensive alternative.

No matter how strongly we may feel about the formula industry and its multitude of sins, trying to convince people that formula is some kind of poison is very counter-productive in many instances.  In my classes, I try to emphasize to prospective parents that they need to listen to their inner voices and use common sense when trying to decide what is best for their child.  If common sense and their gut instinct tells them that formula, while not preferable is not arsenic, either, then any respect they might have for my opinions and information will be lost, right off the batt, if I go on a rant about formula.  They do, however, very quickly understand and agree, often enthusiastically, about the hand that corporations have had in undermining breastfeeding and promoting the undue and massive use of formula in modern society.  There is a fine line to be walked between helping moms to understand the real downsides that exist with formula-feeding without closing the door completely and making the mom feel like she is harming her child and failing as a parent if she ends up supplementing with formula at some point for whatever reason.  I think that one of the reasons that physicians sometimes are so equivocal about breastfeeding is because they have seen moms who were devastated when they were unable to be successful (as have we all).  I saw the same thing happen when I was teaching childbirth classes.  Some parents were so invested in the idea of the perfect, unmedicated, unassisted birth being the only good birth for their child, that when complications arose, they were unable to embrace the experience at all - sometimes delaying needed interventions and often holding onto grief and anger for many years.  So we must be careful of the seeds we sow and how we do it.

So I have gone on too long, as usual.  On a brighter note, I hope that you all will be enjoying the holiday season, even in the face of losses incurred (still trying to figure out how we are going to do Christmas without my mom who died a few months ago).  To me, this season is about hope, no matter what your religious background, or lack there of.  The rebirth of hope, of innocence, of a better tomorrow.....

Peace,
Sharon Knorr

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