Formula as Medicine…. time to make an empowered choice

The other day, a young mother visited my clinic and her baby was nearly 4 months old. Baby weight was just about 1000 gms of gain over birth weight over 4 months. She was well educated and realized that the baby was not gaining weight well. She was sensitive and overwhelmed when she spoke to me. She told me she belonged to many breastfeeding support groups. I felt she was under immense pressure to ‘perform’ - to build up her milk supply and felt she had to race against formula milk.

This is race of unequals and we know who wins!

When we set mothers against a race with infant formula, we are in essence saying you are not good enough and your body is not capable to produce enough milk. All this - without any evaluation of normal function of the baby’s suck. It is easy to lose focus when we have conversations like these. We are giving this more power to the debate of formula Vs Mother’s Milk. This often leads to rendering a new mothers’ life into a frustrating, relentless routine of pumping using a breast pump. It is a vicious cycle that is hard to break. Sometimes mothers take the risk to deal with severe low weight gain than to race with infant formula.

We do not equate Food and Medicine. And sometimes medicine is critical - especially when the first line of support to sustain breastfeeding has failed due to poor clinical support. That is what infant formula is – a medicine (temporary). We just need to set its place as ‘medicine’ (temporary) while working with undivided attention to restore breastfeeding.

The moment this mom felt she was no more racing against infant formula she felt a huge sense of relief and was now willing to evaluate the situation more objectively. She was more than ok to begin formula to allow baby to catchup while she supported her baby to restore normal breastfeeding.

The problem is women’s experiences are often belittled - either by supporting her or by not supporting her. I have had so many young mothers tell me that their pediatricians who say that they are great advocates of breastfeeding, ask them to exclusively breastfeed the baby. If the mother says that she is unable to do so because the baby is not latching or feeding enough, immediately they are told to learn to deep latch the baby. These mothers break down and say – ‘how can I get my baby to deep latch when baby refuses to even latch in the first place!’ Then the very same doctors say “Well, if you cannot deep latch and don’t know how to latch your baby either express milk or give formula.”

This is a complete paradox of moral and ethical complexity laid down in front of already exhausted and birth-abused young mothers.

These are the so-called supporters of breastfeeding! This is clearly a failure at multiple levels starting from fundamentally not acknowledging the women’s experiences and compounded by poverty of clinical skills to support them.

I feel infuriated when I keep hearing that we must ‘see and acknowledge an apple as an apple’. Sadly, this does not align with the noble cause of supporting breastfeeding.

There needs to be a shift in understanding. This shift will break many mothers free from this bondage of formula. In the name of a noble cause, we may fail to acknowledge real issues with undernourished babies. Misdiagnosis and failure to support a failing baby is not noble at all.
More than 90% of these cases are due to medical negligence and errors. These errors premature weaning (which is needless) and failure to breastfeed.  These cases expose the grotesque levels of incompetence in this matter.

​The silence over this is both deafening and alarming.