What happens when an Overeducated RN applies Science to Motherhood

Sunday, September 26, 2010

What Junkies and Formula-Feeding Moms Have in Common

They were both duped. One by the corner drug dealer, and one by the socially acceptable huge corporation. Or actually, maybe both by a friend. Regardless-the scenerio is the same. Mr Drug Dealer "Oh come on, you can just try it once, no big deal. If  you don't like it you don't have to do it again. You won't get hooked after just one try. And you know what? This first ones' free-on the house. Check it out. You'll like it, you'll be back".   Mr Formula company might be legal, but it's the same game. "Breastfeeding is best, but just in case it doesn't go well, or you're tired, or your husband wants to help out-here's a freebie. It's on us. And some coupons to buy more. But, you shouldn't use them-because breastfeeding is better. But, you know, in case you want to-our stuff is just as good. It's more like breastmilk all the time."

Mr Formula company even has it a little bit easier than Mr Drug Dealer.  Mr Formula has the doctors and nurses pushing it for them! And the magazines! Mr Drug Dealer isn't having much luck getting Mr Policeman to advertise for him. I have yet to meet a cop with a 'Try the New and Improved Crack-Pipe' Pen. Or nametag clip. Or post-it note. Or cookies for that matter. Not so much with Mr Formula man-he's got every doctor, nurse, medical secretary out there eating his lunch, using his pen, displaying his mousepad-and hocking more free samples. Just to keep you hooked. Just 'in case'.

See, where as Mr Drug Dealer's stuff acts on your brain, and makes you physically want more...Mr Formula Company's stuff acts on your Boobies (yep, your boobies-you gotta love 'em). And that formula drug makes your boobies make less milk. 'Cause when you use that formula, you don't use your boobies, and then they make less of the good stuff. The free stuff. So then next time, when you go to your boobies and ask them for some milk-there isn't enough there! So you have to go and pull out a bit more of that 'free sample'. And then  you might find next time you go to get some free milk from your boobies-there's a bit less there. And pretty soon you find yourself out of your 'free sample' and at the store buying some product from Mr Formula Company. And it ain't so cheap. 'Cause you gotta cover the cost of all the free samples they're giving to the new customers.

Just like with Junkies-there are some mommas who need some formula. Just like some Junkies start out needing pain medication. At first the Junkie just needs a little pain meds to feel better. But, if their doctor doesn't get them the help they need, if they take the easy way out and just write them another prescription, pretty soon they need more and more. Just like some mommas need some formula to get started. But if that doctor/nurse doesn't take the extra time to help that momma pump, look at her diet, see what is going on with her health and her hormones, help her with a plan to get her milk supply up-they're just going to keep throwing a little bit more and a little bit more of a supplement at them. 'Til there just isn't enough milk there to keep up. And then you've got another addict.

Mr Formula Company and Mr Drug Dealer have a lot in common. Neither of them are very honest. Their stuff really isn't safe. It can hurt you. It often does. But they both want you hooked for sure. They both love their repeat customers.

Science is my friend...

Medicine even. Interestingly enough, science-and evidence based medicine has fueled every lovely "weird" decision I have made since becomming a mother. But, you know, breastfeeding has always been the easiest one.

Eons ago, when I was fifteen and dating a much older guy-I met his brother's girlfriend. At the time I met her, that girlfriend was 9 months pregnant, had a headful of dreadlocks, and armpit hair halfway down to her elbows. It was swealtering mid-June. I owe that girl a lot. She went on to breastfeed her baby until she was 18 months old, when and where she needed it. One time that was right inside the door of the grocery store-in winter.  Even more importantly that fascinating girl had a bunch of wonderful friends I got to spend time around, who also breastfed when and where necessary. I wonder sometimes how different I would be if I hadn't been around all of them at that time in my life. Before that I hadn't really given much thought to breastfeeding, or having kids really-but that was my first exposure to anyone close to my age parenting.

Incidentally-that boyfriends' mother and aunt were also breastfeeding thier preschoolers. One while tandem breastfeeding their one-year old as well.

Fast forward eight years and I get to start my very first real life job as a Level III Neonatal ICU nurse. In a unit that just happens to employ one attending neonatologist who just happens to be internationally recognized for her work with breastmilk. Worked with not only some of the coolest nurses I've ever met in my life, but the smartest and most educated IBCLCs. Hardly any of the babies there ever got formula. We went through I-don't-know-how-many gallons of donor breastmilk a week, and almost all of our mother's supplied their babies milk. There were a scant few moms who refused both to pump and to offer their baby donor milk. I do believe they signed waivers.

I went from there to "the real world". Healthy moms with healthy babies in your regular old Labor & Delivery unit. Our clientele there split the way most of the country does now. The educated mothers breastfed, or at least tried, starting in the delivery room. The younger mothers didn't bother. Either because their family/friends/significant other thought it was gross or unnecessary-or because they were getting formula for free. Or both. There were a few who did have life situations making it less than optimal. I wouldn't really want to pump in the bathroom at Taco Bell either. Or keep my milk in the fridge there. But is that that mom?-or society shooting her and us in the foot? See, I argue the latter.

Then, with one more cross-country move, I found the darkside. While working in another high-risk NICU, I came to find a hospital, and an area as a whole who did not value a mother's ability to birth or breastfeed her baby. And definitely not when it was inconvenient for an overworked staff. Whereas the hospitals I worked in before had to work harder to do a 3am C/s, calling in extra staff-here there were scrub techs on call, making it an easy night to drive momma into the operating room. Doctors and nurses alike encouraged mom to skip nighttime breastfeedings. Even when they knew it wasn't right. Nurses didn't start moms who were seperated from their babies pumping. Especially at night, and especially if they could make any excuse for it.

The more I worked in this environment-the less I was a nurse, and the more I was a standby lactation consultant. I spent more and more time helping moms latch, pump, and troubleshoot what was hindering their milk-making or breastfeeding. I got the wonderful experience of observing 'normal' births there. Normal, with their massive, never-ending Pitocin drips, Scalp Electrodes (you would really think mothers would ask about that one-yes, it is twising a metal electrode into your baby's skin), Intrauterine Pressure Catheters (which could tear the placenta from the uterus-causing an abruption, loss of blood from both mother and baby-even death). It was surprising to me that all the healthy first time moms that I worked with, fellow NICU nurses, were all requiring Emergency C-Sections, most for fetal distress. There were very few vaginal delieveries among my co-workers. NO V-bacs. And these were my educated co-workers! The ones being cared for by people who worked the next room over-and they were having such rough births? That just didn't seem right to me.

Needless to say, we all know things have gotten harder and stranger in birth over the last few years. After taking a turn for the better in the 60's/70's/80's-things kind of stagnated, and now in the wake of legal settlements in the millions-doctors are afraid to really take care of their patients in a reasonable matter. In addition to CYA medical care-our consumer society has brought supply/demand to the delivery room. They expect their child to be delivered on their timeline-for whatever one of millions of strange reasons you can just not imagine. And if that doctor doesn't comply? Well, they better watch out-because if things don't go the way Momma or Daddy expect-they are going to hit that MD in the wallet.

Well, that's the lowdown on my background. The rest will make sense in a bit.