Infant Feeding Hierarchy and Terminology

This post was originally published Feb 16 2010 on cafemom. I'm posting here and now because I'm sorry that I haven't posted this month and it's my apology. Having a newborn and two older kiddos is time-consuming!

As I write this, I realize this is a touchy subject for some. First off, understand that this has nothing to do with the choice you made or had made for you (I have formula feeding friends and no problem with that) nor you as a person; this is only about the substances involved. If you are here to start a debate, please stop reading now.

Fist, we've all heard "Breast is best." That's a universally accepted truth, right? No. Too many people misunderstood that message to think that breast milk must therefore somehow be something more than the norm, so the message has been changed to, "Breastfeeding is the standard."(1) However, even using the original message, we can come to the same conclusion--that cow or soy based infant formula is an inferior feeding method. The formula companies acknowledge this freely (usually when defending themselves in court) despite their advertising. 

So here's we're going to explore the "Breast is Best" language. Best, as we know, in the "good" hierarchy, is the top. It is better than better, which is better than good. Well, infant feeding has a hierarchy as well. (2) It is listed as:

1. Milk at the Mother's Breast2. Mother's Pumped Milk in a Bottle3. Donated Milk from Another Mother
4. Infant Formulas

So, using this, we can apply it to the language hierarchy in which the word "Best" appears. This would mean, mimicking the list above:

Best: Milk at the Mother's Breast
Better: Mother's Pumped Milk in a Bottle
Good: Donated Milk from Another Mother
... : Infant Formulas

Well, what comes below good? Well, automatically, we would say that going down the same catalog, what would come next is either "worse" or "bad" (considering that bad takes the place of good in its pyramid, then is followed by worse and worst). However, I think we can skip the first, but to avoid applying "worst" to the next in the list, let's expand it.

Best: Milk at the Mother's Breast
Better: Mother's Pumped Milk in a Bottle
Good: Donated Milk from Another Mother
Worse: Infant Formulas
Worst: Cow's milk

So, the same conclusions are drawn from either terminology. Even if Breast is Best, that does not make formula "good" or even the next alternative. Although this is the not the first journal to create this hierarchy, another (3) is in reference to preterm infants, which actually lists formula as worst:


Breast is Best, breast is standard. Formula was designed as a medical option for infants who could not breastfeed either due to one of three extremely rare conditions or for the less than 2% of mothers who physically cannot produce enough milk or the less than 5% who, for other medical reasons, cannot breastfeed. Regardless of personal psychological response, the next best option for ALL babies, is the milk from another human mother. After all, why would we equate feeding our child milk produced from this:








As superior or even equal to the milk specifically created for this?:

Photo by of Blessed Life Photography

 Doesn't any healthy mother want the best for their child? So why don't we advocate more strongly to provide alternatives to the "fourth best" AKA worse, option to breastfeeding for mothers who either can't or don't want to nurse their babies? Why do we spend more time trying not to offend their choice to use the only option they believe is viable or obtainable instead of working to give them MORE options? Better options?

If you are interested in being a part of that option, click here to find out if donation is an option for you.



(1) Watch Your Language by Dianne Weissinger
(2) UNICEF, WHO, UNESCO: Facts for Life: A Communication Challenge. New York: UNICEF 1989; p. 20.
(3) Global Health Policies that Support the Use of Banked Donor Human Milk: A Human Rights Issue.
Further reading:
4. Enterobacter Sakazaki and other microorganisms in powdered infant formula
5. What Every Parent Should Know About Infant Formula
6. The Deadly Influence of Formula
7. Human Milk Banking
8. Nutrient By Nutrient Why Breast Is Best
9. Nutritional Information for Human Milk

Katarina's Newborn Pictures

Katarina's Birth Story

"Every pregnancy is different." We remind each other of this fact often, but despite that, still look for patterns in our own to make them more predictable. It's hard waiting and not knowing. This pregnancy reminded me of that very strongly. My body followed its pattern of earlier symphysis pubis dysfunction and earlier prodromal labor--but not earlier labor itself. The baby inside me settled differently, responded to stimuli differently and, in general, was as unpredictable as could be.

I assumed on the 'safe' side, that I would have a day-long labor as I've had in the past. Well, right from the start, my actual labor started differently--it started at night. Around 9:20 pm or so. I just figured it was more false labor, but the contractions were intense enough that after a few hours of it, I texted Tara, my doula and turned on my contraction timer and recorded that they were averaging approximately a minute every 3 minutes.



I danced around to music and sang a little bit. My contractions were only really bearable when I was standing or dancing, so it seemed like the best thing to do. I couldn't get baby to drop and my labor pains moved around into my back a bit and down my legs--things I'd heard about, but never experienced myself before. I figured the dancing was still helpful anyway.

I posted on Facebook a few times, to keep everyone in the loop as promised, then decided I had to have a shower around midnight. I got into the shower and sat down, letting the water fill the tub and rain down warm on me. The contractions broke a little, but did not become less intense. I still felt better for having it. I put on a Poise panty just in case, so I could just go to bed and not worry about making a mess with my water.

I tried to get some sleep, as I'd advised Tara. I had a strong feeling that I was definitely in labor. I'd been tricked once before, so I still questioned it repeatedly, but I wanted to be rested as much as possible regardless. I was very glad I'd made the kids let me take a nap earlier. Off and on, I used the hypnobirthing/hypnobabies wrist drop while breathing through contractions and while I wasn't able to do anything involving the 'hypno' part, it still helped, surprisingly.

I woke up to contractions off and on and started chanting positive messages: "I'm fine." "It's the baby; I'm going to have a baby." "I can do this." "I've done this before." At first, they were just in my head, but I started having to breathe them out as it got harder to tolerate them while being so tired. Eventually, they became verbal and I decided I was too loud and gave up on sleeping, trying to let my family get as much as they could.

Every time I went to the bathroom, it was terribly painful from the pressure of the baby and I finally couldn't take doing it all on my own anymore, so a little after 6am, I called Tara and told her that I needed her. I had tried to make it at least until 7, but I wanted her there as soon as possible and I knew she would take about an hour to get everything ready to go. My bloody show was becoming more and more red and it seemed a good sign that things were progressing.

I called and left a message at the birth center that we were having a baby today, but didn't want to call and wake up Rachel herself when I was so sure I still had half a day left or so.

Tara came and we talked for a little bit, then I dozed on the couch off and on between contractions while she stayed next to me, dozing on the labor ball that I just could not stand to use more than to squish baby down a bit. She helped me get through more intense contractions and I returned to chanting my positive messages when I wanted to scream.

A few times, I did howl and yell, but I tried to turn it into singing, goofy sounds or more positive words when I could. My family woke up and Brandon made the kids breakfast. I was torn between starving and so nauseated I didn't want to eat. Tara had retrieved a bucket, just in case, but thankfully, I never used it. The birth center returned my call to see what was going on, but I wasn't able to talk, so I gave the phone to Tara.

Transition hit hard and fast around 10:45 or so. The birth center called back again and talked to Tara to assess where I was in labor. Tara confirmed that I was definitely in labor and that things were going quickly. Neither of us had really recognized transition yet, but my contractions had doubled and I wasn't tolerating them much anymore. I kept trying to chant my positive phrases, but I was shouting them and crying.

I was afraid of how intense it was getting, flashing back to Naomi's labor. Nausea had taken any desire to eat away and I wanted the birth pool, which I cried into Tara's shoulder as I held onto her and we swayed through a contraction. She called and told Rachel to fill it, who said she wanted to wait and check me first (which I figured, since I'd always had slower labors).

I lost all my positive and started crying that I couldn't do it, things were too hard, it was killing me, etc. and Tara just stayed positive, just as I'd asked and told me I was just in transition and it was almost over. She and Brandon got the girls ready and all the stuff out to the van while she continued to support me every couple minutes in between. Everything seemed to be flying, suddenly.

Then as we were walking me out, I grabbed Tara, falling into a contraction (to which, I had begun pleading and occasionally screaming in shock) and told her I was feeling pushy. It was a strange, half-feeling, but I knew it very well and instead of the joy with which I announced it with Naomi, it was a half-panic. She asked if she should call Rachel to come and do it here, but I was determined to get to the big, blue pool and was sure I could make it the barely 10 minute drive.

Before I could put on my seatbelt, another contraction left me screaming and arching and my water broke. I yelled at Brandon to buckle me in and hurry and that my water had broken. I started apologizing before contractions, because I knew I couldn't not scream through them. But more, 3 minutes into the drive, I was pushing and couldn't stop.

Brandon sped, worrying about being pulled over, but worrying more about not making it to the Birth Center. He kept telling me that he didn't know why I was apologizing, that I was okay. I just kept doing it--it had become a mantra. "I'm sorry, I'm sorry, I'm sorry!" I was writhing in the seat, trying to get away from the intense pressure on my perineum. I knew it was the baby's head and I didn't want to sit on her.

We pulled up to the ramp and Brandon ran out and banged on the door to get the midwife while I unlocked the doors as Tara ran up and unbuckled. I arched away from the seat, screaming that I was crowning, the baby was here, I was going to sit on her! When Rachel opened the door (Tara meant to call her to let her know we were on the way, but things had just moved so fast right before we left, we forgot plenty in the whirlwind), she heard and saw me and ran out, Sheena following behind.

Then she told me what I knew and didn't want to hear--I needed to get out of the van and into the Birth Center. I howled that I couldn't and she argued with me. The second there was a lull, I was being pulled out of the van and supported to the ramp. Due to my weight, I'm always nervous about people supporting me, so I was terrified that I couldn't do it. I made it almost up the ramp and then collapsed onto my hands and knees as another contraction caused my body to push and push hard!

I continued to argue with them that I couldn't get to the door as I tried to do what I knew had to be done. Just a few more feet, but my contrary birthing brain kept arguing grumpily at them (which was how I was able to keep going--that fighting urge).

"It's too cold to have the baby out here!" I heard Rachel say and I forced my hands and legs to crawl me in the door. I chewed Rachel out for not filling the pool for me and yelled that I wanted it. They started filling it while Rachel apologized, pointing out that none of us expected me to be going so fast! Later, when I had access to logic again, I'd know that there was no chance I would ever have got in the water anyway--I couldn't stand up to get in! I could barely move my legs and my uterus had a mind of its own.

I was pestered toward the bed, but I finally called it and just worried about crawling out of my pants and Poise panty (which had contained my entire water mess, hooray!), then lifted up one leg and reached down as I screamed while my body pushed again and I felt something soft and strange, but hard at the same time, coming out of my body.



I wondered if I was feeling buttocks instead of a head and asked what was coming out of me. There was a questioning, "Maybe your bag of waters?" as people shuffled to see, but I just kept wanting to know what I was feeling. Then the rest came out and I realized it was my baby's head just as someone told me that was what it was!

I couldn't see Brandon and I yelled for him and a camera. I had kept meaning to ask for pictures during labor, but it wasn't to be, things just went far faster than I expected. Instead, it was going the way we had hoped (only a little faster at the end than I meant!). Brandon appeared and pictures were taken, though it was Tara taking them.



Graphic pics:
http://i182.photobucket.com/albums/x110/Xakana/Katarina%20Birth/014.jpg
http://i182.photobucket.com/albums/x110/Xakana/Katarina%20Birth/017.jpg
http://i182.photobucket.com/albums/x110/Xakana/Katarina%20Birth/018.jpg


The kids were playing in the lobby/living area of the Birth Center and totally missed the actual birth because I screamed one more time and my baby girl flew out of me. I looked down in shock and couldn't actually comprehend that I was looking at my baby. I was very confused. A closed-eyed baby was in my hand, very still. Someone mentioned that the cord needed to be moved off her neck and it was. I heard someone say it was 11:42 when Rachel asked for the time.

After a moment, I realized that she wasn't moving as they rubbed at her and brought over the oxygen. I rubbed with them and started down, still in shock, responding mechanically. I said, "I had a baby!" in surprise as I finally absorbed that it was my baby in my hand, not breathing. Then she gave some coughs and started writhing as I yanked off my shirt and pulled her to my body, still attached to me. I looked at her ginger hair and grey eyes and noted what a round little chubber she was.



My body contracted again and I felt something coming out. I reached down and birthed my placenta, setting it on the floor. It was still partly inside, so Rachel was looking at it and waiting for it to finish. She said to give a little cough and it would finish coming, but I told her I couldn't do anything right at that moment. My body was tired and barely listening to me, though that was too much to convey.

I felt okay after a moment and gave a little push and the rest came out. I realized I'd had a lotus birth in the back of my mind, but now I was too interested in the baby I was holding. I also noted that my placenta looked to be much smaller than Naomi's.



I mentioned that Lilly should be called in to cut the cord and the girls were brought into the room to see their new sister. Lilly asked a ton of questions as Sheena opened the clamps and scissors kit and we answered her. Lilly cut the cord, though it took her a few tries to get all the way through. I examined it in fascination both before and during the whole process.




The baby had covered one of the towels in meconium shortly after being born but was mostly clean all over from all the rubbing to get her breathing. I was helped to get into the bed and snuggle with my naked baby. She and I just stared at each other for a while. I was super weak from the intensity of everything that had just happened and she was so chill that I didn't offer to nurse her. We just looked at each other, both of us surprised. She was so quiet and calm and we realized her purple complexion on one side was due to a bruise when looking for birth marks (she had none).



Her head was perfectly round, which made sense since she went from feeling high in my belly to shooting through my pelvis in only 11 minutes. Only four minutes passed from us arriving to her coming into the world outside of me. It was an hour before the shock wore off and she and I tried to nurse. I finally got her latched on (her rooting instinct hadn't kicked in) and her eyes went wide and she drank enthusiastically, looking more surprised every time she sucked and got milk.



Time flew by after that and I was only half-aware of what was going on. When Tara was ready to leave, I asked that she stay and Brandon go to Subway to get me my celebratory turkey sandwich that I had so been looking forward to. So she did and took pictures during the newborn exam. Naomi got to trim the cord down and I finally got to find out how much the baby weighed--8lbs, 13 oz and she was 20" long.








I fuzzily did the math at just under 14 1/2 hours from beginning to end.




Brandon and I talked about names (he still had my list on his phone and when he brought up one of my favorites from the old list and paired it with my favorite from my new list as a middle name, I liked the combination) and texted Tara as soon as we'd decided, then I called my mom while Brandon posted on Facebook that we had chosen--without revealing the name.

He told his sisters, parents and one friend who texted with a good story as to why she deserved to know (and hadn't been a pest about it, so he was happy to tell her anyway). He had been pestered severely by coworkers for weeks for a name (that he wouldn't have told them had we known) so he took delight in keeping it to ourselves for most of the day.

I ended up with two stitches, before which, I got up to pee and Katarina Xylia cried for the very first time as she woke up without me. Immediately, Mommy instinct hit and I called out for someone to pick up the baby, but she wasn't totally content until she was given to her daddy (since I couldn't hold her right then). She knew him right away and settled back down.

I ate and was encouraged to nap some more after a failed attempt to go shower. I didn't make it to the shower (nearly fainted) and instead, the pool was filled back up for me to take a bath. It was heaven and I brought Katarina in and we bathed together. The moment she hit the water, she relaxed and slept against me, so content. It felt so wonderful.



I was encouraged to stay a bit longer and nap some more since I was barely able to walk. It took me longer than average to recover, since things had gone so fast after so little sleep and I wasn't feeling my body's cues, so I didn't know when I was hungry and thirsty. Once I was hydrated, fed again (pizza) and napped, I was able to get dressed and walk out, feeling much better. We went home around 7pm and my sister met us at home to make sure that there were two adults to help me into the house in case I nearly fainted again, but I did fine.

My fastest labor, my heaviest baby who was the calmest, most alert newborn baby I've ever seen. My first totally natural birth--it was intense, but amazing and everything went the way I'd wanted (except for the land birth, but that's what I get for hoping for a fast birth!). I'm feeling good and I have a little baby who likes to talk already (and two proud big sisters and a sleepy, proud Daddy holding Katarina as I typed this out).

Going Past the EDD

40 weeks, 6 days

Well, I've done it again. I've got past my "due date." I'm 40 weeks, 6 days today. Baby isn't engaged anymore and she's all stinkery about position. For whatever reason, she doesn't want to come out. Before, I figured it was the stress of needing to move (we moved last week). Then maybe it was how badly I damaged my hip moving heavy stuff, so I went to the chiropractor. While I feel better, my prodromal labor hasn't even really resumed.

Friends and family seem to be convinced that they will be the one forgotten in my slew of updates as things happen during the pregnancy. I seriously post whenever I have a steady stream of contractions and yet, they seem to think they'll miss that ever important "The baby is coming now!" post! Or that I won't make it. I promise, I'll make it or my husband will. And there will be phone calls. And pictures. Come on--I document basically everything!

Here, see? I even document weirdo positions baby gets herself into:

40 weeks, 3 days

While I won't be posting graphic pictures of the birth on facebook, you can rest assured that they will be taken and they will be available eventually. And there will be some gross, gooey ones at least on facebook--just nothing showing my nether regions (which will hopefully be buried in delightfully warm water).

I start NSTs this week. That means that my midwife will strap some monitors to my belly while I chill out and watch to see that baby has good heart accelerations. Not incredibly exciting, but tends to be pretty relaxing, in my experience.

So, just as a reminder: you can't annoy the baby out, but you can put yourself at risk for being bitten. The E(STIMATED)DD is just an average. I'm not overdue until 42 weeks and baby is fine and dandy even then. I am tired and sore, but will not be pregnant forever. Once the baby comes, it will be me plus three.

And there will be pictures. So chill out. After all, I am.

Nightmare Movies from Childhood

So, when I was a kid, I would have called my oldest daughter a wuss when it comes to what scares her in movies. She can barely handle any tension--villains are just awful for her. I've tried to watch a few of my favorite movies from childhood with her to no avail. The Little Mermaid? Can't hold her attention--we didn't even make it to Ursula. Labyrinth?

 

Oh, yeah. Those goofy puppets (to me) are an absolute terror to a sensitive four (now five) year old. Thinking on other favorite movies of childhood, they're basically all out. The Neverending Story, Willow, Goonies, Legend... We were just expected to be tougher as kids in the eighties. No Dora, Max and Ruby, Caillou and the like to give us fun, happy stories without scary bad guys.

These Cracked articles illustrate that: 1 2 3

(the scene with Artax (Neverending Story horse) is definitely one that's never left me. Scary? No. Traumatizing? Well, I still get upset in movies when someone kills a horse--more so than when most humans die.)

I think it was the fear that these kids' movies inspired that led me to love the horror genre. So, what scared me as a kid? Not all are hugely different from an adult perspective, but I at least watched the whole damned movies (and seriously? Who let me watch these? Often, the answer was: my sister, but you'd be surprised how many times it was my mother). I'd never intentionally expose my children to these movies before they're cynical teenagers.

Gremlins



I used to swear I saw the little bastards in the grass at night when I stared out the windows. And I still, to this day, cannot stand open cabinets or closet doors.

Alien



That thing has been haunting my nightmares for I have no idea how long--only that I must have been exposed to it as a very, very young child.

The Gate



This movie is why I will forever hate claymation to the depths of my soul.

Twilight Zone the Movie



Poor John Lithgow. Yes, there were some scary moments with the kid with the mind powers, but nothing traumatized me as thoroughly as the gremlin on the wing of the plane. I seriously want to cry looking that thing up.

Tales from the Dark Side: Seasons of Belief



Not a movie, but I've never forgotten this. I don't think I ever will. Nor will I say Its name.

Child's Play



Really? You need an explanation? I owned this doll and promptly went home, tied her up with a jump rope and lobbed her at the back of my closet, not to look at her again for months. I actually still own her, though she has dreadlocks, no cartridge and no batteries. So my kids can play with her. If she ever talks, I know there's no batteries. Although I always thought Chucky was more of a My Buddy doll.

So, there's a list of movies that terrorized me as a kidlet. What movies haunt your nightmares?