Wednesday, 30 May 2012

The great unsaids - bottle feeeding

I'm still harping on about breastfeeding and bottlefeeding I'm afraid, not least because it's been in the news again recently with the Time Magazine cover of a mother feeding her three year old.

Before I had a baby I was a little judgemental about those who did not breastfeed. I wondered why they didn't just try harder or persevere, why they put their own needs - for sleep, for comfort, for convenience, for sanity - before their babies.

Then I had a baby and breastfeeding did not work immediately. It never worked to a point of exclusivity and we've (mostly) happily mix-fed from week 1. But I was at the hospital where I had my daughter the other day and saw one of their breastfeeding posters and I remembered something a midwife had told me when my daughter and I were there in the days after her birth. The midwife was en route to a party to celebrate a new breastfeeding policy they had just implemented in which they would not just actively encourage breastfeeding, but discourage bottle feeding to the point of not helping a mother bottle feed.

Even then, befuddled by birth and parenthood, I knew this was a bad idea. Not the supporting breastfeeding, but the other side of it. Amongst the mothers I know most want to breastfeed if possible - who wouldn't after seeing all the breast is best messages - and at least half have struggled. But to only emphasise the positives of breastfeeding instead of helping parents do whatever it is they decide to do, has bad repercussions.

First, it makes mothers feel like failures by suggesting we do not want the best for our babies. And second, it stops the dissemination of information telling us how to safely feed our babies formula.

In the nearly eighteen months since I became a parent I am still yet to find comprehensive science-based information on making a bottle. Instead we had to find our own way.

For example, a health visitor told me to boil water for my daughter's bottle then let it cool for half an hour. Using half an hour cooled water would, she explained, sterilise the milk powder the water was poured onto. Now I'm no scientist but I know this is utter bollocks. Perhaps making up the milk and boiling it would sterilise it (and I suspect it wouldn't - any chemists out there know?), pouring lukewarm water onto it will not. Plus doing this in the daytime is just about okay if you do not leave the house, but are you really going to do it in the middle of the night when you have two hours of sleep at a time? I suspect there is more danger to the parent in handling boiling water while half asleep than there is to the child in having a made up bottle kept in the fridge for a few hours - but the problem is we just don't know because no one tells us.

Another example is sterilising. We steriled my daughter's bottles, of course we did. First in a saucepan. Then in a steriliser. Then the dishwasher. Then the microwave. Then with sterilising tablets. (Not one after the other of course - I mean these are all techniques we have used). Now we give them a jolly good wash using washing up liquid and water. But you know, you decant the milk powder into the bottle using a measuring spoon that lives in the box of powder. A spoon you touch with your (usually, but not always, clean) hands. Are you meant to sterilise the spoon then?

Here are four simple measures I want for new parents who choose (or don't choose) to bottle feed:

1) Clear scientific guidance on how to make a bottle, both in an ideal world, and then also in the real world where you leave the house, are exhausted, need a bottle immediately to placate a screaming child and the fuse blows on the steriliser.

2) Reassurance that above all a well fed baby is a happy baby. Happier than one screaming for milk that isn't there, happier than one digesting blood from cracked nipples, and happier than one with  a mother so tired she can barely hold the baby to her breast without falling asleep.

3) An end to the misinformation about milk production. It will not dry up if you miss one feed. Probably not if you miss several feeds. Not if you feed from the same breast twice in a row. Not if your baby sleeps for five hours in a row. Not if you have a glass of wine. Not if you have two glasses of wine.

4) Perhaps the most important - messages that those who bottle feed love their babies just as much as those who breastfeed.

Only when this is done will we be able to have a sensible conversation about feeding our babies.

Related post: The Truth About Breastfeeding


  1. Loved reading this post and thank you for some lovely points. I ended up having to bottlefeed after problems with my milk supply. I encountered so many heart breaking emotions, lactation clinics where the midwives said letting my son scream with hunger was better than putting a bottle in his mouth and several times I received insulting comments about "how selfish I was to bottlefeed" from strangers when feeding my son in public. Thank you for this refreshing point of view :)

  2. "Perhaps making up the milk and boiling it would sterilise it (and I suspect it wouldn't - any chemists out there know?)"

    Boiling the milk would definitely sterilize it. But I think it might make it gross. (Denature all the proteins and get that skin on top.)

    I reckon if the temperature of the somewhat-cooled milk is about 65 degrees (hot but not scalding) that would kill or inactivate most microorganisms. (Not all, but most of the ones that hang about in kitchens.)

    I would think that the major thing is to clean the bottle so that there's not residue in it that fungus and bacteria could grow in, and that as long as you're not licking the spoon and putting it back into the milk powder, or storing it in a hot humid room with the lid off where it gets moldy, it's probably not a huge deal that it's *sterile*, as such.

    I'm also mystified by the moral panic over not-100%-breast-feeding. I mean, my a lot of mom's generate bottle fed (I was bottled fed bc my mom didn't like nursing) and while, ok, that's not the ideal thing and there were lots of classist stupid Technology Is Better things going on about breastfeeding at that time, it's not like the Western world lost two whole generations due to this travesty ... Sure, breast is best, but a lot of this stuff is just reactionary.

  3. Actually, that health visitor was in fact accurately giving the WHO's recommendations on how to prepare formula.

    Now, the question is whether this is necessary for babies who are full term and not immunocompromised. I doubt it is, but it is the official rec.