Breast, bottle, both: am I failing if…?

Dear Momma,

Ask yourself a few questions and notice how fast the answers come. When did the baby last eat? Which side, and how long? How many ounces went in, and how many came back out over your shoulder? How many wet diapers since this morning?

Now try these. How many times did you sing to the baby today? How many times did you kiss the top of their head?

Nobody counts those. Feeding arrives with the numbers already attached, and once a thing comes with numbers, doing it starts to feel like being checked. It’s also claimed by everyone with an opinion. It uses your body. And it comes back every few hours, day and night. No wonder it turned into the place where you decide, privately, whether you’re any good at this.

The guilt runs both ways

If you stopped breastfeeding, or never started, you may carry the guilt of the one who didn’t. If you’re still breastfeeding and it’s hard, you may carry the guilt of the one who can’t stop. If you do both, you may get both at once.

Notice that. If every possible choice comes with guilt attached, the guilt isn’t telling you that you chose wrong. It’s telling you about the pressure you’re under.

Two measures

Here’s where I stand, said plainly, once: what matters is that your baby is fed. Breast milk, formula or both, from the breast, a bottle or a pump. If your baby is fed safely and growing the way your pediatrician wants to see, you’re doing the job. And if you want to breastfeed, it’s worth real effort and the right help.

So every feeding plan answers to two things:

• Is the baby fed? Not perfectly, not by one particular route. Fed.
• Are you still standing? Can you sleep some, heal, eat, and feel something other than dread when the baby starts rooting?

Any safe plan that meets both is a good plan. A plan that misses one is the plan to change, however good it looks from outside.

Beside those two measures sits the medicine: whether your baby is growing, whether something needs treating. That belongs to your pediatrician and a lactation consultant, and you ask them. The plan is yours, built around what they tell you. The medicine is theirs.

Use it tonight: the decision to leave alone

Tonight, you have one job: get this baby fed, by whatever safe route costs you least, and let that count as a good feed. The breast, if it’s bearable. Expressed milk, stored the way you were shown. Formula, made exactly as the label says. Powdered formula isn’t sterile, so if your baby is very young, was born early or has health problems, ask your pediatrician how to prepare it, and never make formula at home from a recipe. Using more than one in the same day is a good day, too.

Then somebody feeds you: water within reach, something you can eat with one hand, and the baby held by someone else for ten minutes while you stand under the shower. If there’s no one, set it up yourself before you sit down: the glass, the snack, the phone charger, the burp cloth.

What you don’t do tonight is decide whether to stop. A decision about the next six months, made between feeds, on three hours of sleep and in pain, comes out the shape of tonight, not the shape of your life. Write the question on the back of an envelope, so it has somewhere to sit that isn’t your chest. Make the plan tomorrow, in daylight.

One exception to waiting. Call your pediatrician today if your baby is feeding much less than usual, isn’t waking for feeds, has far fewer wet diapers than usual, or seems unwell. If one breast turns red, hot or swollen, or gets very sore, call your own doctor, and see them if it isn’t easing within a day or two. If you feel feverish, achy or like you’re getting sicker, or it’s getting worse, get seen today: your own doctor, or urgent care if you can’t reach them. If you feel very unwell, go to the emergency department. If breastfeeding hurts all the way through the feed, or has started to crack or bleed, ask for a lactation consultant this week. And if your baby seems seriously unwell, call your local emergency number now.

And when tomorrow comes, set a limit before you need it. Decide what would make you change course and when you’ll look at the plan again. Decide what sends you for help right away, whatever the date: pain that’s getting worse, a baby who isn’t feeding well, or dread before every feed. The point isn’t to quit sooner. It’s to make sure that whatever you decide, you decide it on purpose.

One thing the limit doesn’t cover is you. If feeding has become something you dread every few hours, or you’ve felt low, anxious or not like yourself for two weeks or more, that’s not a question for the plan. Talk to your doctor, your midwife or your baby’s pediatrician this week. You can say, simply, “I’ve had a baby and I’m not feeling like myself. I need help.” If how you feel frightens you, call sooner.

Fed baby. Standing mother. Breast or bottle, whichever gets the baby fed tonight.

— Momma

This letter draws on However You Feed Them, the Baby Guide to feeding: for the most counted job you’ll ever do, a feeding plan you choose, a limit you set, and an answer for every comment.