Breastfeeding

How to wean a stubborn baby

My 18-month-old can ride a balance bike and work the TV remote, yet still feeds with the frequency of a newborn and the agility of a gymnast.

Weaning my first baby was easy. I caught a stomach virus from his daycare when he was 16 months old, spent two miserable days hugging the toilet, and when I finally emerged pale, shaky, and questioning my life choices, my son had replaced me with a bottle. 

I’ve had no such luck with my youngest, who is now 18 months old, can ride a balance bike and work the TV remote, and still feeds with the frequency of a newborn, but the agility of a gymnast.

“So… Do you think you’ll quit breastfeeding soon?” older family members will ask me as they watch my toddler barrel roll across my torso, taking my now four-inch-long nipple with him in his teeth. 

“No. I love the tender bonding too much,” I’ll respond drily as my son round-kicks me in the face.

For parents who chestfeed their babies, deciding when and how to stop can come down to personal preference, finances, circumstance, fate, and the child’s willingness to give it up. Some babies will make the switch to bottle or sippy cups easily, as if the last several months of lactation and bonding meant nothing to them. And others will spit their cow’s milk right at you then wrestle you out of your shirt.

There’s no “right” time to wean. The World Health Organization recommends exclusive breastfeeding until six months, and continued breastfeeding until age two or beyond. But many children start attending daycare between 12 and 18 months, so your nursing sessions will be winding down (or decreasing in frequency) naturally. And sometimes, you’re just feeling done, regardless of the reason—but your kid remains stubbornly latched.

Don’t despair. Here are six tips to keep in mind as you begin to picture what weaning will look like for you and your child. 

1. Communication is key 

Waiting until the child is older can actually make weaning easier, thanks to the ability to communicate with them, set rules, and make it more of a mutual exchange, says Calgary lactation consultant Natalie Borden, who is also a certified birth and postpartum doula. Communication is key, whether you have the time to wean gradually or need to do make a more abrupt change.

Ottawa mom Mary Ann Lalonde took a slow, graduated approach when she felt it was time to wean her toddler, Naomi. She replaced their four feeds a day with a cup of milk instead, one at a time, starting with milk before naps when Naomi was around a year old. She spaced each swap by at least two weeks, until all that was left was the feed before bed, which she continued to offer for several months. When she was ready to cut the bedtime feed, Lalonde would offer one breast only, followed by a cup of milk. 

“I would just say, ‘Would you like more milk?’ And then offer the cup,” Lalonde says. After four nights, she only offered the cup (no chestfeeding). Naomi was fully weaned by about 16 months of age.

At first, Naomi would point to the chair where they used to nurse, as if to say “No, we sit there and we do this now,” Lalonde says. So Lalonde made sure to give her lots of cuddles and stories as Naomi sipped milk from her cup.

“It’s been almost a month now, and she doesn’t point at the chair anymore,” Lalonde says.

2. If possible, go gradually

Borden, the Canadian Paediatric Society (CPS), and La Leche League International all recommend a gradual approach, like Lalonde’s, for a smoother transition for both the child and the parent. You could start with limits, such as only feeding in certain locations or at certain times of day. You could also distract your toddler with a walk or playtime during times when they used to have feedings, she added.

Start by trying to drop the feeds they have the least interest in. Usually, these are the daytime feeds (not before a sleep), Borden says.

That said, while most experts recommend a gradual approach, it’s not always possible or desirable. Some parents swear by the Bandaid trick with older children. This involves covering up your nipples with bandages and explaining to the child that you have an “ouchie” and can’t nurse. Communication with your kiddo (explaining your ouchie) is what makes this abrupt method possible, but remember to take care of your breasts, watch for signs of engorgement or blocked ducts, and express milk if you have discomfort.

Know that more abrupt approaches to weaning can lead to feelings of depression, as well as risk engorgement and even mastitis (a breast infection), says Borden, though all lactating people are different. 

“Just because we’ve decided we’re not offering milk anymore doesn’t mean the body has realized that,” she explains.

Some parents may cut daytime feeds when they return to work, but plan to keep chestfeeding in the morning or evening (this is also known as partial weaning). Pumping or expressing milk during the day can alleviate breast discomfort during this period, and help maintain your milk supply for nighttime feeds.

3. Don’t offer, but don’t refuse

Often, the easiest and gentlest approach to weaning is “Don’t offer, but don’t refuse,” Borden says. For instance, if you would normally feed your toddler in a rocking chair, you might avoid that part of the house so the child isn’t as tempted, or have a non-nursing partner or caregiver rock them to sleep or put them down for their naps for about a week instead, if possible. 

And if you’re in the habit of volunteering milk before naps or at certain times of the day (as in, saying “Time to nurse!” instead of waiting for them to ask), stop offering. Your child might surprise you and not even notice! If they do ask to nurse, you could try distracting them with an activity, walk, or snack.

The “don’t refuse” part gets a little trickier if your child is in the habit of nursing to sleep or always wants milk before a nap. If you decide to try giving bottles or sippy cups, the CPS recommends letting the non-nursing partner offer it, giving the baby lots of cuddles and closeness during this time, and watching for the cues you might unknowingly send your baby.

If your baby or toddler relies on nursing to fall asleep, or go back to sleep at night, you may want to consider a gentle form of sleep training as a starting point before weaning.

4. Make your body less available

Some experts advise lactating parents to stop wearing nursing bras and tops with easy access or slide slits—it’s a gradual approach that works well in combination with others. Borden agrees, adding that she would sometimes wear turtlenecks or layers when weaning her kids. “If they could see my neck or my chest area at all, it was like an open invitation.”

You may have heard other chestfeeding parents talking about going on a long-weekend trip without their baby or toddler in order to fully wean, but again, experts generally recommend a more gradual approach unless you’ve already cut most of their feeds. Plus, your baby may just want to start nursing again when you’re home, and then you’re back to square one.

5. Shorten your feeds

Another option is to shorten your feeds and cut your kid off after one or two minutes. This will also bring down a parent’s milk production, and ultimately make breastfeeding less enticing for the toddler, Borden explains.

You may even find your child start preferring a bottle or sippy cup as your supply gradually decreases.

6. You can say “No”

If chestfeeding is becoming a negative experience for you, remember that you can say “no” when your kid indicates they want to nurse. In fact, some parents find that putting boundaries and limits on the feeding relationship increases their positivity toward it, says Borden. “When they’re 18 months old, you don’t have to accept it every single time the baby wants to feed,” Borden says. 

Nursing a toddler can be exhausting, physical work. They twist, they turn, they demand, they whine, and they eventually learn how to unclip your nursing bra. (Just me?) But nursing doesn’t have to be all or nothing. Establishing rules and limits can flip that power dynamic and put you back in control, if you want to keep going. (And if you don’t, that’s OK, too.)

My 18 month old will soon be starting daycare, so I’ve started saying “no” when he sprints toward our nursing chair, shouting “DIS! DIS! DIS!” at all times of the day. But at night, when he smells like baby lotion and his curls are still wet from the bath, I hold him close as he chugs away at my nipple. I remember that this precious time won’t last forever, and as he somehow contorts himself into a handstand while still latched, I thank god for that.

Breastfeeding

Can you overfeed a baby?

Parents often worry whether their newborn is getting enough milk, but can you actually overfeed them? Here's what you need to know.

By the time my daughter was a few weeks old, anyone who picked her up knew to first grab a blanket and take cover. She spit up constantly, which I hadn’t experienced with my two older kids. I worried that she was taking in too much when she fed, and then I worried that she was tossing most of it back up. Her paediatrician reassured me that her healthy weight gain and happy demeanour were signs she was getting enough to eat and she’d likely outgrow it. Luckily, she did by the time she started solids.

Feeding a newborn, whether by body or bottle, can bring up a lot of questions about timing and quantity, especially when you factor in issues like fussiness or spit up. New parents worry about everything from overfeeding their babies to their little ones going hungry. Here are some common questions about feeding and how to know your baby is getting what they need.

How often should my newborn be fed?

On average, a full-term, healthy newborn baby needs to follow a cue-based chest- or breastfeeding schedule of a minimum of 8 to 12 times in a 24-hour period, or take 2 to 3 ounces of pumped milk or formula every 3 to 4 hours. As your baby gets older, the number of times you nurse in a day will decrease because they’re getting more milk at each feed, while the amount of milk per bottle will increase. It’s important to remember that this can vary depending on each baby’s individual needs. And don’t force them to finish every feed—sometimes your baby won’t, which is fine, as long as they are hydrated and otherwise feeding well.

First-time mom, Trisha Muldoon, from Hamilton, Ont., says she benefited from her son Bertie’s* short stay in the NICU, because she learned how to decipher his hunger and fullness cues. While staying in one of the parent care rooms, she juggled breastfeeding, pumping and bottle-feeding, and received good guidance from the staff when it came to knowing how much to feed.

“The nurses showed me how to slow down his guzzling at the bottle to make sure he wasn’t getting too much [and to learn how to recognize signs that he’d had enough],” says Muldoon. While she initially needed some extra reassurance when breastfeeding, because she couldn’t see the volume he was getting (a common worry for nursing parents), she quickly learned that it was more important to recognize the signs that he was full.

So how do you know when your baby is full? What are the signs?

Quite simply, your baby will tell you. “Watch your baby’s responses before, during and after being fed,” advises Andrea Firmani, an infant feeding coordinator at St. Paul’s Hospital in Vancouver. A baby can push the bottle away or turn their head away from the chest or breast. They may fuss, begin to squirm, arch their back or decrease the frequency of sucking and swallowing with longer pauses between each. A satisfied baby will show signs of relaxation in their hands (opening from a closed fist), closed eyes, lengthening of their arms and legs and an overall calmness.

Muldoon knows it is time to end a feed if Bertie starts to push his arms into her chest or squirm. But she also knows he’s full and content when his eyes roll back and his tongue begins to flutter at her breast, which is a sign that the baby has fallen asleep.

Can you overfeed a baby?

Babies are actually very good at self-regulating their intake, meaning they eat when they’re hungry and stop when they are full. But there are some differences between nursing and bottle-fed babies, explains Firmani. A baby who is fed at the chest/breast knows when to pull away or stop sucking, whereas a bottle makes it more difficult for your baby to control the rate of flow and amount of milk they consume. There might also be a tendency for parents or caregivers to coax a baby into finishing the bottle, rather than following the baby’s fullness cues.

What are signs that a baby is overfed?

Gassiness, burping, gagging or choking, fussiness, irritability or vomiting (a forceful flow that shoots out inches rather than dribbling out of the mouth like spit up) right after finishing a bottle could be indications that your baby is being overfed. “We don’t worry about chest- or breastfed babies,” says Firmani, since they’re better than bottle-fed babies at regulating their own feeds.

It’s quite common for both bottle-fed and nursing babies to spit up in the first few months, which is generally not a cause for concern. Oftentimes, spit up or reflux happens because of a still-developing digestive system that causes the baby’s stomach contents to come back up into their esophagus. Typically, once the muscles mature, it remedies itself. If you are worried about your baby’s weight gain or diaper output, or if they seem uncomfortable after their feeds, it’s a good idea to check in with your baby’s care provider.

If baby spits up, should I feed again?

When your baby spits up it can seem like they’ve lost the whole feed, and parents often wonder whether it needs to be replaced right away. But if your baby appears content and settled, Firmani says there’s no need to worry. “Take some time to clean up and take a break from the feed. Your baby may show signs of hunger and want some extra milk or be happy to wait until their next feed” she explains. No matter how you feed them, it’s best to follow your baby’s cues regarding hunger (stirring, rooting, hands in mouth). And remember, spit up always leaves a wet spot much bigger than the actual amount that came up.

What is paced bottle feeding?

Paced bottle feeding is a method of feeding that mimics chest- or breastfeeding. As the name suggests, it involves regulating the flow from the bottle to pace the feed and give your baby better control. This helps them learn to recognize feelings of fullness. “If parents are bottle-feeding either formula or breastmilk, it’s important to use this approach,” says Firmani. By moving away from the traditional cradle hold previously associated with bottle-feeding to a more upright position, your baby has a better ability to regulate how much and how quickly they’re drinking.

“Sitting up in a chair with the baby up against your body allows them to control their sucking and gives parents a good vantage point for noticing when the sucking and swallowing is beginning to slow,” explains Firmani. Muldoon watched the nurses in the NICU using the technique. “I learned to take breaks by pulling the nipple out of Bertie’s mouth or burping him throughout his bottle feeds.”

Signs baby isn’t getting enough

The good news is you’ll be taking your baby to the doctor often in the first few weeks and months, and they’ll be following them closely to make sure their growth is on track. In the meantime, keep an eye on whether there is an adequate number of wet and poopy diapers.  For the first four days of their lives, babies that are fed breast milk typically have one poo diaper for each day of life (one on the first day, two on the second day and so on). After day four, you can expect approximately 3 to 4 stools daily (formula-fed babies can have less). When it comes to wet diapers, babies typically have one wet diaper for each day of life for the first four days and then 5 to 6 (or more) wet diapers every 24 hours.

It is normal for newborns to wake up frequently to feed and connect with parents in those early weeks, so again being mindful of those hunger cues is important. If your baby isn’t getting at least eight active feeds with lots of sucks and swallows in a 24-hour period or doesn’t have an adequate number of wet or poopy diapers, get in touch with your care provider. Dehydration is rare, but can occur. If your baby hasn’t had a wet diaper in more than 6 hours or seems excessively sleepy (more than usual) or irritable, or has a dry mouth or eyes, get in touch with your healthcare provider. Remember, disposable diapers are really effective, so parents can use a couple of tablespoons of water to help determine what a sufficiently wet diaper should weigh.

* Names have been changed

Breastfeeding

It's Black Breastfeeding Week—here's why that matters

If you felt supported when you looked for breastfeeding help, have you ever considered whether that might be partially thanks to the colour of your skin?

For many, breastfeeding isn’t easy. Those who want to do it usually require support, understanding and education. If you were able to find those things and nursing went well for you, have you ever considered whether that might be partially thanks to the colour of your skin? The fact is, there’s wide racial disparity in the rates of people starting and sticking with breastfeeding, and that’s not OK—which is why Black Breastfeeding Week was created. (This year, it’s August 25 to 31.)

Eden Hagos is a Toronto-based public health promoter with a focus on maternal health through an anti-racist, intersectional approach. Her academic work and advocacy is guided by her experience as a Black mother of three, soon to be four, who has been breastfeeding for over six years. We asked Hagos why breastfeeding advocacy is so white, what that means for Black people, and how Black Breastfeeding Week helps.

What are the particular challenges of being Black and breastfeeding?

There are many factors that make breastfeeding challenging for Black folks. The following is neither an exhaustive list, nor are the factors true for all individuals.

To begin with, the historical oppression of enslaved Black women as wet nurses throughout North America continues to impact the way that breastfeeding is viewed in some Black communities, and thus may result in less social support for breastfeeding parents, and increased stigma towards breastfeeding or full-term breastfeeding.

One of the most significant factors of course is the institutional racism that Black birthing people experience. During pregnancy and labour, Black birthing folks face higher chances of experiencing obstetric violence. Immediately postpartum, when breastfeeding support is most critical, Black parents are less likely to be offered support from a lactation consultant and are more likely to experience pressure by health-care providers to formula feed. All of these can discourage breastfeeding and decrease success rates with establishing breastfeeding.

There’s a perception that Black women don’t or won’t breastfeed. Why do you think this is?

I think the only real explanation for that perception is racism. The truth is that Black Canadians are more likely to initiate breastfeeding than any other race. The evidence shows that nine out of 10 Black birthing parents initiate breastfeeding.

However, in the general Canadian population, including Black Canadians and all other races, fewer than one in four babies is exclusively breastfed to the recommended age of 6 months. This points to a need for more support for breastfeeding folks, because as we know, community support, employment equity and good maternity leave policies all increase rates of exclusive, full-term breastfeeding.

Breastfeeding advocacy is white-female led, and the lactation field is overwhelmingly white. Why is this a problem?

The over-representation of straight, cis, white women in this field, as in any other, is exclusionary. Black parents deserve to be supported by other Black parents. When I was a new mom, I joined a number of parenting groups where my infant and I were the only Black members and I always felt uncomfortable. I was fortunate because I finally found a La Leche League that had a Black peer supporter who invited me to my first meeting, and I have since introduced her to other Black moms. She, along with the other parents, have helped me through so many breastfeeding challenges throughout the last four years, and I believe all Black parents deserve to find culturally appropriate support from other Black folks.

The Black community is resilient and culturally diverse, and this diversity is often not reflected among breastfeeding advocacy, nor among breastfeeding professionals such as lactation consultants. This lack of representation is problematic because it continues to perpetuate the myth that Black folks don’t breastfeed. Additionally, the lack of Black lactation consultants means Black parents are less likely to receive care that centres their culture. And finally, anti-Black racism from lactation consultants of other races could result in worse care for Black folks.

Why is Black Breastfeeding Week important?

Black Breastfeeding Week is important because it encourages breastfeeding among Black parents, and it also celebrates it! The week sees social media flooded with stories and images of Black experiences of breastfeeding. It also centres the work of Black folks, including birth workers, lactation consultants, parents and breastfeeding advocates.

The reason that I am participating in Black Breastfeeding Week is the same reason that I share photos of my children breastfeeding on my social media. As a veteran Black mom who has breastfed three children, breastfed through numerous pregnancies, tandem nursed toddlers and newborns, and breastfed a child with food allergies, I choose to share my experiences to encourage others, and to show that while breastfeeding is not easy, it can be a rewarding experience.

Black Breastfeeding Week, which is international, highlights events across Canada and the US that centre and celebrate the experiences of Black folks. It also provides community grants for those who wish to host events, and this year there are numerous online events every day up until August 31. Visit blackbreastfeedingweek.org more information, including resources for Black folks seeking information and support about breastfeeding.

Follow Eden Hagos on Facebook or IG @Blacktivistmommy

This article was originally published online in August 2020.

Breastfeeding

What is night weaning, and how do you do it?

Is it possible to stop nursing at night without changing your breastfeeding relationship during the day? Tired moms want to know.

Carrie Ford-Jones is now a mom to eight kids (including 10-month-old triplets!). But when she had her very first child, Dylan, she was determined to do everything by the book—literally. When her baby books said it was time for him to start sleeping through the night, she dutifully started to cut out his nighttime feeds. She worked hard to keep him on a schedule, too.

“I felt like I was always trying to make sure we could check off the next milestone,” she says. “He was about five months when I decided to sleep train and not feed at night, because the paediatrician said I didn’t need to anymore. But I made myself crazy trying to track the number of feeds and worrying that he should be learning to sleep through the night.”

Newborns need to be fed around the clock for the first few months, but will eventually be able to go for longer stretches without food. Of course, many sleep-deprived new parents would like those stretches to happen overnight. Getting a baby to stop breastfeeding, chestfeeding or bottle feeding overnight is what is meant by the term “night weaning.” (It has nothing to do with starting solids, or weaning from the breast entirely. It just means not nursing or bottle-feeding between the hours of, say, 8 p.m. and 6 a.m.)

Why do some parents want to night wean?

Azura Goodman, a Hamilton, Ont.-area registered nurse and lactation consultant, has supported parents through the night-weaning process. Goodman says there are many reasons a body-feeding or bottle-feeding parent decides to night wean.

“People are returning to work, or they notice their mood is impacted by their lack of sleep because when you’re sleep deprived, your fuse is shorter. Some parents might be managing a perinatal mood disorder like depression, anxiety or OCD. And then sometimes parents simply know they’re just not getting the amount of sleep that they need.”

Keep in mind that “sleeping through the night” doesn’t necessarily have to be a solid eight-hour stretch. Infants between between four and six months old, for example, shouldn’t be expected to sleep longer than four to six hours in a row (though of course some “unicorn sleeper” babies do, even without sleep training).

Babies are on individual trajectories, with some able to sleep longer stretches at an earlier age than others, regardless of how they’re fed or put to sleep for the night.

When are babies ready to night wean?

Amanda Jewson, a sleep consultant in Stratford, Ont., sees this over and over again with the families she works with. She tells her clients not to compare their babies to others because there are many reasons why an infant may still need to wake to feed. In fact, she doesn’t recommend night weaning at all until a baby is at least four months old. “At that point, between four and six months, we would still be looking at one or two night feedings halfway through the night,” says Jewson. “Once a baby is six months-plus, as long as the baby is gaining on their own growth curve, we could start looking, ideally, for a 10- to 12-hour stretch overnight.”

Both Goodman and Jewson stress that parents of infants should check in with their baby’s doctor before deciding to cut out any overnight feeds. “A baby’s typically ready to night wean if they’re having great feeds during the day and their feeds at night seem to consist of non-nutritive, shallow sucking, which is a pacifying type of behaviour without a lot of milk transfer,” Goodman explains. The baby should be gaining weight appropriately and have no feeding issues. It’s true that weight gain, development and feeding patterns are highly variable from infant to infant, but four months should be considered the absolute minimum age to begin to consider night weaning.

The ideal approach to night weaning should be a gradual one. Cutting out one night feed at a time, over the course of several weeks, is easier for both the breast-or chestfeeding parent, and  the baby.

“If you have the luxury of weaning gradually, please do so,” says Goodman, “because this helps prevent engorgement, which can lead to plugged ducts and even mastitis. Whereas if you give your body the time to accommodate those longer stretches, it’s easier.”  

Of course, we don’t always live in an ideal world. Sometimes a baby needs to learn to go without feeding at night rather suddenly. “If you’re going through something challenging, like loss or divorce, or mental illness or physical illness, then there are ways of night weaning all at once and making sure your baby is fed enough during the day,” says Goodman.

Parents should also keep in mind that night weaning doesn’t always follow a linear progression. Goodman stresses that a sick or congested baby will need to feed overnight for extra fluid. And if your baby has their routine disrupted by travel, holidays or teething, expect some temporary night waking as they work through that.

Sometimes, the real question is whether the parents are truly ready to night wean. Personally, I enjoyed partially co-sleeping with my first baby, Colum, for more than a year. But by the time he was 15 months old, he was waking up more often than ever during the night, and would only settle back down at the breast. I was over it.

“Is he going to outgrow this?” I asked our family doctor.

“He won’t want to sleep with you by the time he’s a teenager,” she told me. “But if you want night weaning to happen sooner, you need to do something about it.”

How do I night wean?

For many babies, sleep is closely linked to feeding because it’s how they’ve always fallen asleep. We all have bedtime routines that set the stage for a good night’s sleep and help us drift off, explains Jewson.

“When babies or children are waking frequently throughout the night, there’s probably something behaviorally happening on the onset of their sleep—whether that’s feeding, rocking, patting, hushing or something else,” she says. If your baby always falls asleep with a nipple in their mouth, then whenever they stir at night, they’ll want that nipple again.

After reading up on baby sleep, I realized that Colum first needed to learn to fall asleep without breastfeeding. I’d feed him one last time before bed, but then put him down before he was fully asleep. It was horrible at first. He was too young to understand what was going on, but definitely old enough to be mad about it.

I ultimately wound up staying in the room to help him settle back down to sleep by rubbing his back, reassuring him with a sing-song voice, or even picking him up and pacing if he was very worked up. It was hard, and it took several weeks, but he did gradually start to fall asleep more easily and wake less frequently. By the time he was 18 months old, I could read him a story, kiss him goodnight and walk out of the room while he was still awake. My fellow mom friends could hardly believe it.

If you’re hoping to cut down on nighttime feeds for a younger baby, Goodman suggests unrestricted access to feeds during the day, following the baby’s cues. You can also offer the breast hourly in the hours leading up to bedtime, and do what’s called a “dream feed, in which you offer a sleeping baby the breast just before you go to sleep yourself.

Bottle feeding parents can take a similar approach, except they’re able to measure the amount of pumped milk or formula to make sure the baby is taking in enough during the day. The idea is to offer enough food during the day, without overfeeding or forcing feeds.

In many cases, a breastfeeding parent may be returning to work and needs to start getting solid sleep overnight. In that case, says Goodman, you can “pump through the day and have their care provider use that pumped and stored milk to give one extra feed. Or instead of timing out the feeds, offer a bottle whenever the baby might be hungry.” That way, if the baby is still waking at night and wanting to feed, you can at least be sure they have gotten the nutrition they need during the day before figuring out another way to help them back to sleep.

Is night weaning the same thing as sleep training?

The short answer is no—they’re not necessarily the same thing. But they often go hand-in-hand because so many babies are used to the “wake, suck, doze” routine. That means in order to sleep train, and get more sleep for yourself, you’ll also need to night wean.

The truth is that no matter how you cut it, night weaning (and its counterpart, sleep training) are not fun.

“Parents want an easy way to do this where the baby doesn’t cry or isn’t upset, and that’s very unlikely to happen,” says Jewson. Instead, she helps parents come up with a plan during the day so they are prepared to deal with a crying baby at night. Jewson encourages staying in the room and reassuring your baby while they try to settle down. She tells parents to use their intuition and not be afraid to try different things like a quick cuddle, rubbing their back, talking or singing. Some families find it easier to send in the non-nursing parent at night when they’re night weaning, but it’s really about trial and error.

Jewson does warn that if you end up consistently replacing feeding with another behaviour, like rocking or singing to get your baby back to sleep, you’ll just have to do that in the middle of the night instead, which might actually be more taxing than nursing.

If the prospect of a good night’s sleep isn’t worth the stress of night weaning and sleep training for you, that’s OK, too. Jewson agrees that many families don’t mind co-sleeping or getting up to feed a baby at night. If night feeds and interrupted sleep is working for you, you don’t have to night wean at all.

“I think as long as a parent is coping, has a great relationship with their child, is not feeling resentful, and everyone feels rested, then it doesn’t matter. Independent sleep will happen eventually. Or maybe it won’t—but there’s always the opportunity to make a change.”

By the time Ford-Jones’s third child was born, she had given up on parenting by the book. As a more experienced, confident mom, she trusted her own instincts and gradually decreased the frequency of night feeds in a way that felt right for her. “I don’t think the night weaning and scheduling made any of my babies better or worse sleepers,” she says, in hindsight. “That was dependent on their personalities.”

With her 10-month-old triplets who still wake at night to feed, Ford-Jones says she actually cherishes these last quiet moments with them. They do tend to wake up a different times, which is exhausting, but there’s an upside: “This is my one-on-one time with those babies. I’m not at a playgroup, or in the car. I can just enjoy each baby, one at a time.”

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Breastfeeding

Donating my vaccinated breastmilk gave me hope during lockdown

This simple act helps researchers learn more about breastmilk antibodies and makes me feel like I'm doing something that matters.

I love maternity leave, but staying home during a pandemic with my baby and preschooler for more than a year left me with a weird sense of nearly-constant helplessness. Playing with my kids and binging Netflix after bedtime was lovely, sure, but I didn’t feel like I was contributing to the larger world. It was not until I had my “Covid baby,” got vaccinated, and had the chance to donate my breast milk to an antibody study that I finally felt hope. 

I got my first dose of a COVID mRNA vaccine in April, when my son was 10 months old. I was so heartened to see so many new parents lining up for their vaccines, with their babies in tow. These tired young moms and dads were getting vaccinated for their own protection and for the public good, even when it wasn’t an easy system for anyone to figure out, and even when the lines were long. 

The second that vaccine was in me, I felt like I had a superpower. I could finally do something to keep my baby safe. Soon after, I jumped at the chance to participate in a post-vaccine breastmilk antibody study through Mount Sinai Hospital in Toronto.

The milk study I joined was geared towards finding out if antibodies to SARS-COV-2 are secreted into the breastmilk of those who are recently vaccinated. They’re also interested in understanding when antibodies first appear in a nursing mom’s breastmilk, and how long they continue to be present. 

After receiving my first dose of vaccine, I hand-expressed (I hate pumping) 15ml once a day for seven days. I used the provided droppers and vials to split up each 15ml, then did this once a week until four weeks after my second dose. It’s all in the freezer in marked orange biohazard bags (appetizing!) and they’ve provided a UPS label to speed ship it all back to the milk bank when I’m done.

Honestly, participating has been liberating. For the first time, I finally feel like I’m doing something concrete—something that matters. 

a mom holds her child outside while posing for a photo

Photo: Courtesy of Laura Cockburn-Tulk

I did see lots of judgement and uninformed comments online, criticizing nursing moms for getting vaccinated at all, and suggesting donors and study participants like me are using their children as “test babies.” While those fear-mongering types were judging other moms, spreading misinformation and prolonging the pandemic, I felt like I was literally squeezing out a little hope each time I sat down to hand-express. I was finally making a tangible contribution to this global crisis, instead of just following the news and infection rates.

And now we know—spoiler alert!—from all the other studies going on that the emerging evidence is encouraging. Vaccine ingredients are NOT found in breastmilk, but antibodies ARE. And it’s accepted that getting the vaccine while pregnant or nursing is safe, and even recommended: babies of vaccinated moms have been born with antibodies, and babies breastfed by vaccinated moms may gain some protection, too. 

In fact, I know some vaccinated parents are even pumping in order to restart lactation, so they can give their child their post-vaccination milk. Some moms on maternity leave are delaying weaning to offer some sort of protection to their babies. And I’ve heard of others regularly giving their older children pumped milk mixed with chocolate milk, to give them the only protection (other than masks and isolation) they can, until vaccines for kids are available. 

Contributing to science in this confusing time—helping us find answers and the path out of this pandemic—was very cool, in a science-nerd way, and it was comforting. It was a way to do my part for the common good, and it gave me a sense of momentum during the miserable third wave this past spring. I also felt a little less scared nursing my sweet-smelling baby in the middle of the night, thinking of new variants and their unknown impacts or long-haul ramifications, knowing he was a little more protected. And it felt like together, we were getting one step closer to returning to normal life. 

Breastfeeding

It's time to add “chestfeeding” to your vocabulary

I know we're all used to saying “breastfeeding,” but as a lactation consultant, I believe that inclusive language is vital.

Last month, in my first virtual meeting with a new client, I asked them how they identify and what they call their anatomy. Their baby was three weeks old. They were surprised I even asked them, because ever since conceiving, all of their other healthcare providers have failed to do so at each opportunity. The client shared that they identify as non-binary and refer to their feeding anatomy as their chest (not their breasts). They then got a bit flushed and choked up, and I began to think, as their lactation consultant, Maybe I messed up. But no, as it turns out, this parent was getting emotional because they finally felt seen, for the first time. Being acknowledged in this way brought up the pain of the countless times they weren’t able to express themselves, their identity and their needs.

The parenting sphere can be wildly heteronormative, which can make queer parents feel invisible and unwelcome, over and over again—often unintentionally. Simply by being curious and asking two super simple questions, I made someone’s experience as a sleep-deprived new parent a hell of a lot more meaningful.

I know that breast/chest/bodyfeeding may not roll off the tongue, but the story above illustrates why this language revamp is vital. 

So wait, what is chestfeeding?

Good question! Chestfeeding or bodyfeeding can refer to feeding your baby milk directly from your body. This term is used by people who don’t identify their anatomy with the term “breast.” Some people prefer to say chestfeeding, and some say bodyfeeding. They are fairly interchangeable, though many non-binary people, trans folks, women and men may prefer one term over the other.

Some people may also use the term chestfeeding to refer to using a feeding tube attached to the nipple, also known as a supplemental nursing system

Why do I use the term chestfeeding or bodyfeeding, along with breastfeeding, when discussing the transfer of human milk?

The short answer is, so that everyone is included, as they should be. Full stop.

With the addition of chestfeeding or bodyfeeding alongside the word breastfeeding, I widen the scope of who I’m talking to; I include all parents who are feeding their little ones in this way rather than narrow in on one population. It’s a small gesture that can make a huge difference. I’m in no way interested in being a discriminatory gatekeeper to health services, and language really matters in this situation. So I make the effort to let people know that I work for anyone who needs help with infant feeding.  

Who is a chestfeeder?

Anyone can use this term. However, those who prefer the term chestfeeding or bodyfeeding are often non-binary or trans people who may not align with the term breastfeeding due to their gender, or who may have a dysphoric relationship to their anatomy. To many, it feels more neutral than “breastfeeding” or “nursing.” Chestfeeders can also be cisgender women (those who were assigned female at birth, and identify as female) who have a complicated relationship with their mammary glands, perhaps due to past trauma, which leads some to assign different language to their chest.

Chestfeeding can also refer to cisgender men or trans women who use a feeding tube at their nipple to provide their babies with milk (whether formula, their partner’s human milk or donated human milk), or to those who are able to lactate and feed their infants human milk. (Yes, those assigned male at birth can sometimes lactate.) There’s also the ability to soothe an infant without milk: When our daughter was born, my partner, who has had top surgery, was able to comfort her with non-nutritive sucking. 

Why should I care?

Being a brand-new parent is hard. We’ve all been there—and it can be rough! Being a newbie is not always fun, and it renders a lot of us quite vulnerable. Now imagine, you’re a new parent looking for educational material and support around infant feeding because things aren’t coming together, and you’re panicking. When you start searching online for a lactation consultant or support group, and everything you come across doesn’t resonate with your experience, you might feel pretty alone, unseen and unacknowledged. So now, in addition to feeling panicked about your feeding situation and infant’s health, you feel unwelcome by the community at large. All parents deserve expert, relevant support at their most vulnerable times no matter how they describe their anatomy.

What if I feel that the term chestfeeding or bodyfeeding undermines my own experience of breastfeeding?

Without sounding too harsh, this isn’t about you. You don’t have to begin referring to your own feeding experience as chestfeeding if you don’t want to. You can continue referring to your own experience in any way that you want—no one is trying to shift this or take that away from you. But the terms bodyfeeding and chestfeeding can be used in addition to breastfeeding.

However, when discussing this type of feeding in general, it’s best practice to include everyone who may be in the room. If you’re with a group of parents, let’s say at a parenting group, why not use language that validates how someone moves through this experience? This will acknowledge that you welcome them into the space. Also, hot tip: don’t conclude that just because someone is female presenting (in your opinion) that they must also identify that way. Wait to hear how others refer to their own experience and their own bodies prior to assuming and failing to use inclusive language.

It’s OK if this is news to you—I didn’t start off knowing this stuff, either.

I’m a queer mom, but when I met my partner, I had never dated a woman. I wasn’t well versed in inclusive language and I didn’t have a great grasp of the history of LGBTQ2S+ people. Through life experience, enrolling in LGBTQ2S+ inclusivity courses for healthcare providers, and listening to stories of lived experience, I slowly came to a place of better understanding, compassion and fierce allyship. The queer population has faced undue hardship and discrimination historically (and currently) and the last thing they need is to feel unseen and unwelcome when they begin the challenging transition from non-parent to parent. It may sound like a cliché, but learning inclusive language is a journey, not a destination, and I am still travelling. 

It is totally OK to be curious.

If you’re interested in learning more about the experiences of folks who chestfeed, great! This is the best way to normalize and incorporate this concept. Seek out the stories of parents who chestfeed/bodyfeed. The lived experience of others will bring this to life a heck of a lot better than I can. Even though I’m a queer breastfeeding mom, a lactation consultant with a very inclusive practice, and a registered nurse (I work in community health), I still have not lived this experience myself. So listen to the narratives of badass parents who have, and try to understand their realities.

What you might find is that—spoiler alert—they have a lot in common with you. All parents are tired; we’re all looking forward to 8 p.m. when the kids are finally tucked in; none of us feel like doing the dishes; and we’re all just doing our best. Chestfeeding parents are on a very similar journey to you in a lot of ways—they just use a different term to describe how they feed their babies. It’s truly No. Big. Deal.

Happy feeding!

Breastfeeding

Why I don’t plan on weaning my 4.5 and 2.5 year olds any time soon

In my house, the kids decide when they're ready to stop nursing.

Before my first was born, I read three breastfeeding books cover to cover. I’d graduated from college when I was five months pregnant and I spent the next five months turning motherhood into my new course of study. I soaked up as much information as I could, and thought I was ready to ace this test. But as it turns out, within hours of giving birth, nursing felt clumsy and painful and I couldn’t remember a word of advice I’d read.

I knew it wasn’t supposed to hurt, but I couldn’t remember what I was supposed to do if it did. In those first few days, I swore loudly every time my little piranha latched on and I could barely keep my eyes open through her endless feeds.

But as the days and weeks went on, it got easier. Time and practice helped, as did the lactation consultant with whom we scheduled regular visits.

Slowly, I stopped worrying whether she was getting enough milk—she clearly was, given her growing rolls and how content she looked after a feed, eyes rolling back in her head and milk dripping from the corner of her mouth. I didn’t have to watch as carefully for hunger cues anymore, I just unconsciously noticed her subtle signals and began to lift my shirt without thinking about it.

Breastfeeding became my super power, solving every problem that arose throughout our day. Tired or cranky? Boob. Sick or teething? Boob. Rolled off the sofa and hysterical? Boob, boob, boob.

Everything I had read had extolled the virtues and health benefits of breastfeeding past infancy. But that’s not really why I continued nursing through solids, her first birthday, a second pregnancy and in tandem with her new baby sister.

I stuck with it because it just worked. It wasn’t something I had to think about too much. I loved how nursing continued to meet her needs as she grew. New situations or overwhelming crowds? Boob. Clinginess as my belly grew with a new baby? Boob. Toddler tantrums, mishaps and boo boos? Here, have a boob.

Contrary to what I’d heard, I never found that nursing made her any more clingy. She was born clingy, but I saw how the security she found at my breast helped her adapt to changes and gave her confidence to try new things on her own.

After all the pain and stress we’d overcome in the beginning, it felt silly to just stop when we arrived at an arbitrary milestone. She clearly still adored nursing and I would have felt terrible taking that comfort away from her. Weaning just didn’t seem worth the stress or hassle it would have entailed.

I decided to get pregnant with her sister when she was a year old. The baby fever had been mounting as her infancy came to a close and I wanted my babies close together, so she’d have a built-in playmate.

I developed horrible perinatal anxiety in my first trimester and some suggested that I wean her, to take some pressure off of myself. I couldn’t bear the thought. I didn’t want my pregnancy to take anything away from her and besides, breastfeeding her had become my lifeline. As I waited for my new antidepressant to take effect, nursing was the only thing I felt well enough to do for my daughter. It was something only I could provide and I could do it from the couch.

As the pregnancy progressed, my milk supply dried up and nursing became painful again, but she still enjoyed “dry nursing,” and I still didn’t want to take it away from her. It was uncomfortable and at times made my skin crawl, but this still felt more manageable for me than the stress of weaning her before I believed she was ready. As she grew older and more active, nursing was our quiet time together. I could lie down and watch Gossip Girl while she nursed, without her getting into trouble or making a racket.

After I gave birth to her sister, she visited me in the hospital. I had someone else hold the baby when my toddler arrived, so that she and I could have a moment together first. We were ecstatic to be reunited after 30 hours apart, and she went immediately to my breast. I was still producing colostrum, but all the pain and aversion I’d felt in pregnancy had dissipated. Soon, the baby fussed, so my mother helped me latch her on to the available breast. My toddler balked at this and insisted on using the breast her sister was on. We switched around and I told her if she wanted to nurse, she had to share now. She wanted to nurse, so that was that.

My colostrum began to transition into mature milk the next day, and I arrived home the day after that. This first time she nursed and milk came out, she was all shock and aw, popping off again and again to squeal, “Mulch? Mulch!!”

While it might sound overwhelming to some moms, tandem nursing has come easily and naturally for me. I have loved being able to occupy my toddler while nursing my newborn, by just letting her join in. It helped her adjust to her sister’s arrival, since she was never displaced and they were able to bond with each other at my breasts. As they got older, they started holding hands while nursing.

Over the years, nursing has evolved. By the time my eldest daughter was a year and a half, I knew she was no longer dependent on nursing for nutrition, so I was able to begin setting boundaries and no longer nursed her every time she asked. She was usually willing to wait.

I sent each of my daughters to school when they were two years old. They both transitioned just fine to going without breastfeeding throughout the school day, but continued to nurse frequently in the evenings and on weekends.

When we were in lockdown last year, my older daughter, then three, wanted to nurse all day long, but this no longer worked for me. I had gotten used to having a break during school hours. So I set limits, explaining that she could nurse for ten minutes a day. I let her choose how many nursing sessions could make up those ten minutes and when she wanted them. She wasn’t ready to wean and still loved nursing through the day and night, but happily obliged, especially once I added in a sticker chart (if she listened nicely to our new nursing boundaries, stopping without a fuss once the timer I set went off, she got a sticker at the end of the day.)

Now they’re 2.5 and 4.5 years old, and back in preschool most of the day. I nurse them for a few minutes on the couch while they watch cartoons before school and a few minutes after school. I still nurse my little one to sleep and they’re both welcome to climb into my bed to cuddle and nurse when they wake up at night, since I’d rather them join me than have to get out of bed to offer comfort in their rooms. I only recently stopped nursing my eldest to sleep, so my husband could take over bedtime with her.

I know that some may consider my kids a little “old” to be nursing and that nursing older kids, much less tandem nursing them, is relatively uncommon. Still, to us it’s just a small part of our day to day. Over the years, I’ve connected with so many tandem- and toddler/preschooler-nursing moms on social media and have found that it isn’t nearly as rare as I’d once thought.

I’ve always been a big proponent of nursing in public, as it makes life easier and the more people see breastfeeding, the less of a big deal it becomes. This hasn’t changed as my children have gotten older. I’m still happy to nurse them at the mall or on a park bench and, to my surprise, I’ve yet to receive a negative comment or sideways glance about nursing my toddler or preschooler. But as they’ve grown, it hasn’t come up as much—when we’re out in the world, there are far more fun and exciting things for them to do, so they’re less interested in cuddling up to nurse.

I also know this isn’t for everyone. I do it because it’s important to me to follow my kids’ leads and offer them nutrients, antibodies and comfort at my breast for as long as they’ll take it. I’ve kept at it this long because nursing my kids a couple of times each day isn’t a big deal to me, so weaning has never felt worth the effort.

It’s no longer because a book I read five years ago said that it’s best and, honestly, it never really was. I’ve come to believe that what’s best for our kids is honouring our own needs and desires, so we can show up and care for them with our fullest selves.

People often ask when I plan on weaning and the answer is both “I don’t,” and “I already am.” Nursing is a relationship and one that I’ve been a part of for nearly five years. It’s ever-evolving as they grow, and I grow with them. There’s a constant give and take.

I don’t see weaning as something that happens in a day, but as something that happens over many years, starting with the introduction of solids and ending with the last perhaps bittersweet nursing session. Whenever it happens, it won’t be based on some arbitrary standard or life event, but because my babies and I are both ready to leave nursing behind and move on to the next stage.

Giving birth

Is getting rid of hospital nurseries unfair to new moms?

"Rooming in" policies are supposed to encourage breastfeeding, but in the hours following childbirth, many moms report feeling like their needs don't matter.

When I had my first baby, it went well, all things considered. I was induced at noon, gave birth 15 hours later in the wee hours of the morning, and my beautiful little boy went right on my chest, snuggling in and latching. I remember him just gazing up at me endlessly, taking in my face. Eventually we were moved to a private room, and I went to a breastfeeding lesson just down the hall, before the grandparents arrived to meet him. Through all the commotion, my blissed-out baby boy slept soundly, swaddled in the bassinet beside me, just like I’d imagined he would. 

That night, I sent my husband home, after watching him restlessly toss and turn on the recliner in our room. (He’s 6’4″.) “You go home, check on the house, get some rest, and come back in the morning,” I said. “I’ve got this!”

Cue the narrator: I did not, in fact, have this. 

My baby, like many, “woke up” on night two—he was alert, hungry and very pissed off about not being in his warm, snug womb. He cried incessantly unless I stood up and swayed him, back and forth, back and forth, back and forth. (This “night two” phenomenon—when the baby becomes more alert, and the mom’s milk hasn’t come in yet—is so well known that it was actually written up in the booklet the hospital had given us after birth, but I had been too distracted to read it.) 

After an hour or two of the swaying, I decided I needed a break and walked out to the nursing station to hand off the baby. To my surprise, the nurse I found didn’t take him—instead, she gave me a warm blanket to swaddle him in, patted me on the shoulder, and said, “you’re doing all the right things.” 

So I returned to my room. It was now 30 hours and a labour away from the last time I’d really slept, I was bleeding profusely, and I was again swaying my little baby, back and forth, back and forth, back and forth, back and forth. The shadow from the hall lights flickered on and off of his face, and he blinked up at me, silent, but very awake. 

A thought hit me: Was this what motherhood was going to be? Me, doing whatever this baby needed, no matter the mental-health costs to me? (Spoiler alert: Yes—for the next little while at least.)

When I told my own mom about all this, she was shocked at how different my experience was from how she was treated when she’d given birth to me, in the 1980s. Back then, she’d stayed in the hospital for five days, and every night the nurses whisked me away to the nursery so she could rest, bringing me back to breastfeed twice. When they got home, my parents gave me a bottle of formula every night, just in case my mom wasn’t making enough breast milk. 

This generational switch has happened in response to mounting evidence that supports what’s called “rooming in”—where mom and baby are kept in the same room—and promoting exclusive breastfeeding. That means more support and encouragement around breastfeeding, not having nurseries available to healthy infants, and a lot of grumpy babies on night two.

During COVID-19, it’s also gotten harder: most hospitals allow birthing people only one support person, and no visitors. That often means moms can’t have a doula, or your own mom, as well as a spouse. At times, COVID restrictions have also dictated that both mom and their partner are not allowed to even leave the hospital room—no going to grab food, no smoke breaks, no in and out privileges. The pandemic has also raised the bar for when a baby would be sent to the nursery or taken care of at a nurses’ station.

Postpartum people are also getting sent home from the hospital faster—the average stay has dropped by 30 per cent since the pandemic began. 

The Baby-Friendly Hospital Initiative, which was started by the World Health Organization in 1992, has also helped push these changes forward, well before the coronavirus hit. Twenty-nine hospitals across Canada are certified as “baby friendly,” meaning they follow the 10 rules set out by the WHO, including training staff to help mothers breastfeed, ensuring moms are told the benefits of breastfeeding, rooming in, not giving pacifiers, encouraging feeding on demand, and doing skin-to-skin after birth. And hospitals with this designation have to refuse money from formula companies, refrain from advertising formula, and cannot offer it unless it’s medically necessary. 

This could be seen as shifting birth back to where it should be: not unnecessarily separating moms and babies, and supporting breastfeeding as the default way to feed a baby. Many moms love it, in fact. When I asked for thoughts on a few Facebook groups for parents, one mom replied, “You try and take my child out of my room after giving birth and I’ll wrestle you to the ground, grannie panties and all!”

Another said that after doing a lot of research while pregnant, she went to her doctor with a list of evidence-based requests, like doing skin-to-skin, and was reassured to hear that they were all standard at the hospital she was going to. 

But others, like me, have a more mixed experience. Alli Glydon, a mom from Calgary, is one. When she gave birth, she had a scheduled C-section because her baby was breech. She ended up having a reaction to the spinal block they gave her, and was violently ill for eight hours afterwards. 

Then, she had trouble breastfeeding, and the nurses encouraged her to wake up every couple of hours to hand-express a few drops of colostrum to give her baby. She would later find out that her baby had a tongue tie, small mouth and high palate, which was why nursing was so difficult. Additionally, Glydon had low supply and Reynaud’s syndrome, which can make nursing incredibly painful. 

“My daughter was obviously hungry—she was rooting and wouldn’t latch at all—and I couldn’t hand express anything beyond one to two drops of colostrum. The nurses were taken aback when I asked for formula, and it took a long time to come—like more than 30 minutes,” she says. “I felt like I had to beg for it.” 

Talia Bender, a mom in Vancouver, also had a negative experience. After a 25-hour labour, she was moved into a room with her baby. That night, when she was on her own (her husband was home with their older kids), she was exhausted and nursing the baby when they both fell asleep. “The nurse came in and yelled at me, saying, ‘This is so unsafe,’” she says. “And it’s like, I can hardly walk, I just pushed a watermelon out of my vagina, and we both fell asleep because I’m so exhausted. And you weren’t here!” 

Bender says she feels like leaving moms alone like this, postpartum, is abnormal. “When you think about birth in the past, you had midwives and your family and a support system; all the women would be there to hold the baby, and let the new mother recover,” she says. “Now we have hospital births and families live all over the place, and there’s so much pressure on the new mother, and so much disregard for the recovery process.” 

The question of whether the Baby-Friendly Initiative has gone too far has been making headlines lately thanks in part to a U.S. organization called Fed is Best. Founded in 2016, Fed is Best argues that hospitals are encouraging breastfeeding over health, and putting babies at risk of dehydration, jaundice, hypoglycemia (low blood sugar) and hyponatremia (low sodium). 

“There are billions of infants who require formula at some point during their first year of life,” says Fed is Best co-founder and physician Christie del Castillo-Hegyi. “To hide that and give parents an illusion that exclusive breastfeeding is possible, natural, easy and ideal for all infants, without any evidence, and no parsing out or informed consent of the harms—it has created a public health catastrophe,” she says.

Through its website, Fed is Best collects and publicizes stories like that of Landon, a healthy baby who died at 19 days old of cardiac arrest from not eating enough. “If I had given him just one bottle, he would still be alive,” reads the heartbreaking headline on the story. 

In a 2016 JAMA Pediatrics publication, paediatrician Joel Bass also raised concerns about the unexpected consequences of rigidly enforced baby-friendly practices, including the focus on strict breastfeeding exclusivity. Bass says every hospital should have a nursery for healthy babies, so moms have the option to send their babies there to rest, and that offering a small amount of formula in the early days of life isn’t likely to impact breastfeeding success. 

He also points out that while many breastfeeding-friendly hospitals still discourage pacifier use, newer evidence shows that it doesn’t interfere with breastfeeding—and may even encourage it—and that putting babies to sleep with a pacifier can help prevent Sudden Infant Death Syndrome (SIDS). 

But others point out that the Baby-Friendly Initiative does allow for formula when medically necessary. “There are babies that need formula—there are medical reasons for supplementation—and it’s perfectly fine,” says Hiltrud Dawson, a nurse and lactation consultant who works for the Baby-Friendly Initiative of Ontario. “I believe that babies are given formula when needed.”

It’s also important to remember that when it comes to following up with babies who are losing weight after they leave the hospital, Canada has a much better safety net than the U.S. does, says Merilee Brockway, a registered nurse and lactation consultant who studies the effects of human milk on babies. That includes babies seeing their doctor or a public health nurse within a week after leaving the hospital—that’s when a newborn is weighed and professionals help parents make sure breastfeeding is on track. 

Because of the time crunch in getting mothers home, parents are also not always sent home with enough information, says Dawson. In response, her group helped create a card with information for new moms about how to make sure their baby is getting enough— including how many wet diapers they should look for, the change in baby’s poop, and that their babies should gain weight from day four onwards. They should also have a strong cry, be active, and wake easily.

If your baby is getting enough, there do seem to be benefits to not offering any formula at all, says Brockway—even if this isn’t exactly helpful information for new parents who are already stressed enough about exclusive breastfeeding (EBF). “We can see significant differences in the gut microbiome after even one formula supplementation,” she says. Researchers have indeed found a connection between the gut microbiome and issues like asthma and obesity—but there isn’t enough research yet to confirm exactly how that connection works, or how much formula-feeding would affect it.

Brockway adds that there is also lots of evidence about how mom’s mental health is important to raising a happy, healthy baby—and that if mom is really suffering under the strain of trying to breastfeed, that can be reason enough to supplement. And she says some health-care professionals can be a bit “fanatical” about encouraging moms to breastfeed. She would like to see the mantras of “breast is best” and “fed is best” replaced by a new one: “informed is best.”

“We have really high breastfeeding intention rates and breastfeeding initiation rates in Canada. Most moms want to breastfeed. But breastfeeding can be really hard, and if you have a difficult labour, or if mom’s sick, it gets to be really really difficult,” she says. “We need to be able to say, ‘Are we forcing mom to carry on this path?’ We need to respect maternal autonomy.”

Breastfeeding

Why is breastfeeding so bloody hard?!

Nursing your baby can feel like the Mount Everest of early parenthood, but many moms agree it gets better with time.

Between latching and tongue-ties, too much milk or not enough, engorgement and leakage, and will-breastfeeding-make-my-boobs-sag worries, there was no shortage of breastfeeding questions among the new moms I’ve talked to. Some sobbed through cracked nipples, clogged ducts and mastitis, and tried everything from cream to compresses to cabbage leaves in order to ease the pain. It may be “natural” (whatever that even means), but breastfeeding is often the Mount Everest of early motherhood (without the satisfying selfie at the end).

New-mom challenges like breastfeeding are amplified by the sheer pressure of it all, says Elana Sures, a Vancouver-based clinical counsellor in private practice. “If it’s not going well, a lot of moms leap to, ‘I’m failing, there’s something wrong with me, my poor baby.’”

Many moms say nursing gets better with time (and supportive lactation consultants) and becomes a cherished, beautiful thing. But others received less support or were shamed when they wanted to stop nursing (despite all the online efforts around #normalizeformula and #fedisbest). Moms need emotional support, sound advice and zero judgment, whether they use breast, formula, pump or some creative mix of them all.

As for the question “Why is breastfeeding so hard?” It’s a brand new skill that you’re trying to learn while you’re tired, overwhelmed and responsible for a tiny human’s every single need. Give yourself a break.

If you’re looking for additional breastfeeding support, here are some online resources:

1.) Go to todaysparent.com/breastfeeding for articles on just about everything, including combination feeding (bottle + boob), and videos about how to get a good latch. (We’re on YouTube, too!)

2.) The MyMedela app (Android and Apple) offers a 24/7 lactation consultant add-on option. A one-month, three-month or 12-month membership includes live breastfeeding support via video chat, at various price points.

3.) Check out KellyMom.com for evidence-based breastfeeding info. The site is run by a lactation consultant with a science background, and is a trusted go-to resource for moms on staff at Today’s Parent.

4.) The International Breastfeeding Centre website, which is affiliated with the Newman Breastfeeding Clinic in Toronto, is also a great site to bookmark. Visit them at ibconline.ca; the library of videos under the “Info & Videos” tab provides examples of what breastfeeding looks like as an infant grows, and demonstrates the difference between nibbling and “good drinking.”

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