Why Breast Isn't Always Best

baby being breast fed
baby being breast fed

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"Do you think they're trying to tell us something?" said my husband, waving a fan of five identical bright yellow NHS leaflets in his hand. Each one had "Off To The Best Start" written in bright letters across the top with a cartoon image of a woman breastfeeding underneath.

The leaflet was show-stoppingly bright, but what was written inside was plain black and white: mother's milk contains the nutrients your baby needs to protect him against disease. Formula milk doesn't. Breast milk: Good. Formula milk: Bad.

"No pressure there then," we joked.

To add to the pressure, we were living in the organic-baby-yoga capital of north London, where bottles of formula were talked about in hushed and disapproving tones and treated like contraband. If they were being consumed at all, it was behind closed doors under the cover of darkness.

But none of this mattered to me. Our son, Elliot, then two days old, was breastfeeding successfully and I loved it. I was a bona fide member of the breastfeeding elite. My baby was surviving on my milk and it was the best feeling in the world. How could anybody possibly think it was difficult?

Then everything changed.

In that first week, I got mastitis, which transformed my breasts into a pair of canon balls and made it impossible for Elliot to latch on. The GP told me to breastfeed through it, but that was easier said than done. The pain was excruciating and the more I winced, the more Elliot struggled.

The midwife, who would not be able to 'sign us off' until Elliot was back to birth weight, had a different idea. She suggested giving him formula top-ups after every feed until the mastitis had cleared. I was devastated by this as I had been so intent on exclusively breastfeeding. The thought of giving Elliot formula so early on made me feel wracked with guilt, no thanks to the aforesaid pressures.

I was also worried this would affect my milk supply but she assured me it would be a temporary measure and I could return to exclusively breastfeeding once he was back up to birth weight.

I cried as I gave him that first bottle but sure enough he got straight back up to birth weight and I was free to go it alone and return to breastfeeding. And therein lies the problem.

The first problem was that Elliot started crying – for up to seven hours at a time. And not just in the evenings, as is usually the way with colic.

The second was that he started to drop down the weight chart. He plummeted from above average to the bottom line of the graph – only just within the bounds of healthy – his ribs visible like a xylophone.

Something was not right here. Surely there was a problem with the breastfeeding.

I called hospital helplines and breastfeeding helplines, went to drop-in breastfeeding clinics, read books, talked to my midwife, talked to several health visitors, watched videos online, visited three GPs (including two paediatricians), spoke to breastfeeding specialists but all I got was "keep persevering with the breastfeeding".

Even at the weigh-in clinics, nobody would acknowledge that there was an issue. "Oh, he's fine, he's only dropped one 'percentile' on the chart since the last time," I was told repeatedly.

"He's only dropped one percentile since last time, but in total he's dropped several," I pleaded. But they didn't seem concerned.

One day, I broke down and sobbed in front of the entire clinic, at which point I was quickly squirreled away into a private room with a health visitor. After telling her the story, she looked at the chart and said bluntly: "Your baby needs to gain weight. Alternate between bottle feeding and breastfeeding."

I told her this went against the advice of every other expert I had spoken to, and insisted on seeing my GP (a paediatrician) for a second opinion. Five minutes later, I was in a room with the paediatrician who told me to ignore the advice of the health visitor as this would affect my milk supply. I was so confused and all this against a backdrop of Elliot screaming.

I just wanted my baby to be happy and healthy.

Desperate, I decided to give the mixed feeding a go but nothing changed. Eventually, after four and a half months, I threw the towel in. I called a new health visitor who I'd heard great things about and told her the whole sorry saga.

What she said made complete sense. Her theory was that introducing formula top-ups early on when my milk was only just coming in had set my milk levels too low and Elliot had been struggling to get enough from me. When I told her I was thinking of giving up the breast, she congratulated me for trying so hard to do the right thing and assured me that my baby had been lucky to be breastfed for so long and that there was no shame in switching to formula.

The shame of 'giving in' was soon eclipsed by a feeling of elation as two miraculous things happened: Elliot started gaining weight and the relentless crying stopped.

I'll never know whether Elliot spent all those months crying because he was hungry. But what I do know is that I can't look at pictures of my own son from the first few months of his life because I can now see how thin he looked. I also know that the pressure on NHS employees to promote breastfeeding doesn't seem to take into account the myriad scenarios in which a woman cannot breastfeed.

Nobody would argue that breast is NOT best – that formula is better than breast milk. Of course breast is best. It contains all the right nutrients in the right quantities. But the problem is breast milk and breastfeeding are two different things. And if there are difficulties with breastfeeding, as there were for me, your baby could be getting less than the required amount of breast milk, which means less than the required quota of nutrients.

In that instance, "just keep breastfeeding" is at best inadequate, at worst dangerous advice. And "introduce formula top-ups" is not something you can just flippantly toss into the mix.

The most important thing is that your baby is being fed. Modern formula is not the 'poison' breast-feeding militants would have you believe. It is a valuable and life-saving substitute for the real thing. But there needs to be enough advice for women to make informed decisions based on a thorough knowledge of all of the options – and that includes the 'F' word.