Are Lactation Consultants Anti-Formula?

I cannot tell you the number of times I've made a home visit and midway through the conversation, the client sheepishly admits to hiding infant formula and bottles in a cabinet beforehand. It doesn't surprise me when this happens, but it does disappoint me, because parents should never be made to feel  ashamed about infant feeding choices.

Visit any parenting message board or due date club and you'll find that shame does abound. Either through passive-aggressive comments, or through one's own perception of how others may view their choices. 

Feeding and eating are intimate experiences. People from all cultures have broken bread together to forge bonds and solidify relationships. Pregnancy and breastfeeding are each particularly emotional just as they are physical, as a mother literally gives of her own body to nourish her child(ren). It's no wonder discussions around infant feeding become super-charged.

Feed the baby.

Ask any lactation professional and they will tell you the first rule of infant feeding is simple: Feed the baby. When working with families who want to breastfeed, our job is to help each mother-baby dyad reach their goals. Sometimes compications can arise and feeding baby directly at the breast is delayed or simply a work in progress. In those cases, we share options with the client and develop a feeding plan. Expressing milk via hand or pump (or ideally, a combination of both) is necessary to build a mother's milk supply when her infant isn't able to breastfeed well, and we can supplement baby with mom's own milk. If a woman is unable to express enough colostrum or milk for her baby, we can explore the use of donor milk or infant formula supplements. 

Supporting the client's goals.

I've been directly working with breastfeeding clients since 2008, doing so in a variety of settings- WIC clinic, hospital, and private practice- and alongside families from a wide range of cultural and socioeconomic backgrounds. Some women have great family and workplace supports for exclusively breastfeeding for as long as they desire. Others have to return to work or school within weeks of giving birth and prepare for combination feeding from the start. Some choose to formula feed from birth. And some find their journey a complicated series of feeding interventions and try to keep an openmind about how things may unfold. 

All of these are valid choices and experiences. I once believed it was my job to educate expectant parents to death, drilling them with all the benefits of breastfeeding in an attempt to convince them to do it. But it isn't. Sharing evidence-based information and educating as needed and requested? Absolutely! Trying to talk parents into feeding one way when they have thought it over and made their decision? No.

​What is my job is to have a conversation about what their feeding goals are and craft a feeding plan that suits their needs. Sometimes that feeding plan includes formula, whether by choice or necessity, and I'm comfortable with that. There are times when that means I pop in a clinic room or hop on a phone call to counsel a formula feeding mom on managing breast engorgement, or to answer her questions about appropriate feeding amounts.

And there have been difficult moments when I have needed to sit with a family in a clinic room and bottle feed an underweight newborn while helping the mother begin pumping. It's hard when plans suddenly change and a family finds they need to feed formula when they wanted very much not to. I understand those feelings very well myself, but you know, I've also been grateful in those moments because formula filled a gap where a baby desperately needed nutrients and we needed time to build a mom's milk supply so she could feed her own milk.

How I and other IBCLCs feel about predatory formula marketing practices is a separate discussion and not one I'm delving into in this post. But that doesn't reflect my opinion of families who choose to feed formula or my attitude about utilizing it as a tool to meet a baby's nutritional needs. 

You don't need to hide the can and bottles.