Sunday, March 22, 2009


I am a big believer of the benefits of breastfeeding. I really do think that breastmilk provides babies the best possible start in life. In fact, I so support breastfeeding, that I helped create an informal milk bank for women who are unable to produce their own milk, regularly donate my milk to families in need and am working toward becoming a certified lactation consultant.

All that being said, even more than I advocate breastfeeding, I advocate healthy babies and well-rested mothers. Currently, I am working with a family with a 12-day old baby. For the last twelve days, the mother has been actively trying to breastfeed her daughter. But, no matter how often she put her daughter to her breast, her daughter was not gaining weight and the pediatrician (not to mention the parents) were getting worried.

Part of the work of a doula is to assist with basic breastfeeding issues. I watched the mother attempt to feed her baby and saw her wince in pain. We worked together to adjust the baby’s latch and used pillows to support the baby, but no matter what we tried, the mother would cry in pain (literally, her eyes would well with tears) whenever she put the baby to her breast. We adjusted the way the mother held the baby, but that did not offer relief either. The baby’s father admitted that when the baby cried at night, the mother would offer the baby a pacifier rather than deal with the pain of breastfeeding.

The introduction of a pacifier worried me: Newborn babies nurse every 90 minutes or so and skipping night feedings not only affects the mother’s milk supply, it also means the baby was not getting the proper nutrition. Part of the work of a doula is to know when you are in over your head and I referred the family to a Board Certified Lactation Consultant. By the time the mother met with the lactation consultant, mastitis (an infection of the breast) had developed and the mother was in extreme pain.

Normally, one of the remedies for mastitis is to have the baby nurse as long as possible on the infected breast. This does not harm the infant and the flowing milk often relieves the mother’s pain. But in this case, the lactation consultant and I came to the same conclusion – the emotional issues surrounding breastfeeding were too much for this mom to handle. Instead of finding the act of breastfeeding to be a bonding experience, the mom would come up with excuses to avoid having to feed her baby and dreaded even holding her baby for fear that she would need to nurse.

This morning, the lactation consultant recommended that the mother begin to offer her baby formula. This would eliminate the mother’s pain (both physical and emotional) and allow the father to assist with some feedings and give mom a needed break. I was not present when this recommendation was made and the mother called me in a panic after the lactation consultant left. She was consumed with guilt over what she perceived to be a parenting failure.

Some reassurances can be done over the phone and some require face-to-face interaction. Given the mother’s fragile emotional state, I decided to drop by for an hour or so. We spoke to length about the importance of just holding and bonding with the baby and, more importantly, how the baby’s lack of weight gain signified a potentially serious underlying problem that had to be remedied. I told the mother that offering her baby formula did not make her a bad parent and that the healthiest and happiest babies came from parents who were themselves happy and healthy. Tonight, the mom’s mission was to go to bed at 8pm and not wake up until she felt ready. Tonight, Dad would handle all feedings (with a bottle and formula).

I really do hope that the mother gets the rest she needs and realizes that by not breastfeeding she is not causing any kind of lasting harm to her baby. In fact in a situation like this, it may be the best parenting decision she can make because it will be one that will allow her to spend time holding and just getting to know her baby without fear.

And all babies really need to be healthy, smart, happy people is (to steal from Hallie’s Development Movement instructor, Dionne) is good nutrition (in whatever its form) and a loving caretaker. Here’s hoping that the mom understands that for her, formula will help her to offer both of these things.


  1. Sara,
    Though I was saddened to see you weren't blogging any longer at A Musing Farf, I was very happy to see the link to this new blog!

    Though I only know you in the 'blogging' way, I think that the women you are working with now are truly blessed to have someone as concientious and caring as you to look to for guidance.

    I'm trying to get back into my blogging gig, tough now that I work full time, but I'm giving it the ol' college try.

    Best to you,
    (formerly, 'peggy, as she is')

  2. You are awesome, and I'm linking to your blog on my pot about doulas at BlogHer today! I wish every new parent had someone like you in their lives.