Family Experiences

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I was born and raised in the GTA but currently reside in BC where I have had my 2 children. I have not been able to exclusively breastfeed either child past 1 week due to dehydration and jaundice. I sought all the help I could with both babies which included multiple ICBLCs, drugs, supplements, focusing on hydration and good nutrition, involved pumping schedules, chiropractors and Pediatric dentists. In the end I have no explanation why I could not feed my babies breastmilk. Donor milk is available by prescription only and I did not feel right taking that limited resource from sick babies when mine were healthy. Informal milk sharing amongst peers carried too much risk as I did not know anyone able to share personally. Formula is why my babies stayed healthy. It's not as good as breastmilk and the impact of the statement is that I did not provide the best nutrition to my babies in their first year of life. I'm glad my story is not the norm and that most parents can breastfeed with the proper supports and protection from marketing. I do want to bring forward my case though because I suspect there are many more of us than is known. We aren't diagnosed. We are left with guilt, deep disappointment, shame, fear and more as a result of the perception of failing our babies. Until we can identify why some women can't breastfeed despite all available tools, support and motivation we shame them with messaging such as on this site and we don't deserve that. Why is every article about how bad formula and it's industry is? Could we not expand the topic to exploring why some women can't breastfeed when they want to? Focus on in home supports, home visits, rental fee for breast pumps and access to ICBLC covered by medical, and access to specialty care for the thankfully rare case such as mine would go a long way. When we tell women that "breast is best and if you can't you are doing something wrong or not doing something right or you aren't working hard enough or you are merely seduced by the convenience of formula how can we not expect post partum depression, anxiety, poor bonding and partnership stress? please let's consider that there are those out there that need formula for their babies despite their deepest wishes to feed them at the breast. I would love to see more research into the actual prevalence and mechanisms of true low supply so that others like me can have more than hoaky blogs and contradictory info to guide them.

- 2023-04-04

Our Response

Thank you for taking the time to share your experience with breastfeeding challenges and your desire for more research into the prevalence and mechanisms of low milk supply.

It sounds as if you worked very hard to provide your babies with human milk and it is unfortunate that you did not receive the support and help that you needed. It is very concerning that you experienced “guilt, deep disappointment, shame and fear”. Low milk supply is a complex topic and parents experiencing this need individual assessment and care by skilled health care providers.

Although you currently reside in British Columbia, there are mothers throughout Canada who can identify with your experience.  We encourage all people who experience breastfeeding challenges to seek professional and/or peer support as soon as they can and for as long as they need.  Sometimes consultation with a few different people is needed.  One answer does not fit all!

Health Canada, the Canadian Paediatric Society and the World Health Organization/UNICEF recommend exclusive breastfeeding for the first six months of life and continued breastfeeding for two years and beyond.  The use of human milk substitutes is sometimes necessary, and the Baby-Friendly Initiative acknowledges and supports this. BFI endeavors to assist all mothers/birthing parents to choose the optimum way to feed their babies based on their own circumstances The Breastfeeding Committee for Canada is the authority that maintains the implementation, assessment and monitoring of BFI in Canada and is committed to the protection, promotion and support of breastfeeding and informed decision-making regarding the use of human milk substitutes.

The Ten Steps to Successful Breastfeeding in Canada were updated in 2021. Step Two states “Ensure that staff have the competencies (knowledge, attitudes and skills) necessary to support mothers/birthing parents to meet their infant feeding goals.” Health care providers who work with families around infant feeding are expected to have the knowledge, skill, and attitude to facilitate informed decision-making and the competency to support the informed decision made by the mother and family.  A person and family centered approach to care is essential in health care and is supported by the BFI.  The unique needs and strengths of the mother/family need to be at the center of care and a mother/ family should feel respected and not left with a sense of “guilt, deep disappointment, shame, fear and perception of failing our babies” as you have described.  We are saddened that this is what you experienced and agree that more work needs to be done.

Thank you again for sharing your experience. We will take into consideration your suggestions regarding messaging to parents.

I had a homebirth with midwives, and it went quickly and without complications. I was lucky to avoid a lot of the stress related to Covid19 while giving birth and in the first few weeks postpartum, because I had access to midwifery services and community-based care. That said, when it came to lactation support after I was discharged from midwifery care, my experience was definitely adversely affected by the pandemic. I had hoped to see a Lactation consultant or community health center nurse in the early postpartum period, but at the time only virtual visits were being offered. Looking back now, I should have taken advantage of a virtual visit because that still would have been very helpful. Instead, I sort of "suffered in silence". While I had no issues with the latch, I had an issue with an oversupply of milk. Obviously, I'm grateful that I had sufficient milk for my baby to grow and thrive. But, it was painful and frustrating to constantly get blocked ducts, engorgement (for weeks!) and I got mastitis three times in the first 6mo. The oversupply issues persisted for months. Next time, I will be way more proactive about seeking support and hopefully that will be easier without a pandemic.

- 2021-05-05

Our Response

Thank you for sharing your experience with BFION. We are sorry to hear about how difficult the first months of breastfeeding have been for you and hope that things will continue to improve. Congratulations for persevering!

The COVID-19 pandemic has been very difficult, especially for our most vulnerable populations including mothers and babies. The Baby-Friendly Initiative recognizes that many mothers need extra support to meet Health Canada’s recommendation to breastfeed exclusively for the first six months and then add solid foods and continue breastfeeding for 2 or more years.  Step 10 of the Baby-Friendly Initiative focusses on the importance of ensuring that supports are made available to mothers at all times, including having a breastfeeding support plan in place for emergencies such as the current pandemic.

Some Ontario resources include:

  •  offers 24/7 telephone support through Telehealth -1-866-797-0000, as well as a list of resources in your area
  • Some public health units, community health centres and physician offices offer telephone, virtual or in-person support
  • Mother-to-mother support groups offered through La Leche League, community health centres and other organizations

It may be helpful to contact your health care provider to provide feedback, by sending a letter, about the support they are giving and whether you considered it helpful so that, going forward, they can provide more effective breastfeeding services for their clients. Thank you again for taking the time to contact BFION. We hope that you will encourage other moms to reach out for support, even if the support has to be virtual, so that every mother is able to meet their breastfeeding goal.

I am a midwife with privileges at a BFI hospital. I am disappointed to see excessive amounts of formula being fed to term babies with and without risk factors for hypoglycemia. My most recent experience was a term baby with several risk factors and who demonstrated initial hypoglycemia, who was given 28 mL formula every two hours after delivery until blood sugar stabilized. The baby's mother was instructed not to put the baby to the breast, despite her desire to breastfeed and ability to independently latch the baby. The parents were instructed to keep the baby wrapped up rather than placed skin to skin and the mother was not supported to stimulate the breasts through hand expression or pumping at this time. This approach, which favours excessive amounts of formula over evidence-based interventions such as skin to skin or breastfeeding support in favour of long term infant feeding outcomes, does not account for neonatal physiology, CPS guidelines, or parent choice about infant feeding.

This is not the only experience I have had of nursing staff at this hospital practicing non-evidence based and non-breastfeeding friendly practice. The unit protocol for monitoring of hypoglycemia (which is applied to LGA, SGA, IGDM, and any babies who experienced significant resuscitation, ie. more than 20% of infants) maintains that parents are not to feed babies when they are demonstrating hunger cues, but to wait until after the nurse has taken the baby's blood sugar (every 2 hours). This is contrary to the CPS guidelines on hypoglycemia, which recommend that "frequent (on demand) breastfeeding should be encouraged for at-risk infants, and, if they are being formula-fed or supplemented, the volume of enteral intake should be adjusted based on an infant’s size, chronological age, and gestational age." I hope that BFI will investigate and revoke their status if they are not found to be upholding the expected standards.

- 2020-07-02

Our Response

Thank you for your submission. It is wonderful to hear of your knowledge and support of the Baby-Friendly Initiative and there are certainly many important reasons for not giving supplements to any baby unless there are medical indications. Putting baby skin-to-skin immediately after birth until at least the end of the first feed or for as long as the mother desires, feeding on cue, and keeping mother and baby together can go a long way in preventing hypoglycemia in newborns by minimizing crying, keeping baby warm and enabling responsive, cue-based feeding. If the baby is unable to feed effectively, it is important for mothers to be able to hand express their colostrum for their baby. It is the best supplement!

Step 2 of the BFI 10 Steps and WHO Code Outcome Indicators for Hospitals and Community Health Services states: Ensure all staff, health care providers and volunteers have the knowledge and skills necessary to implement the infant feeding policy. BFI designation is based on outcomes that are measured during an External Assessment by a team of qualified assessors. Facilities are expected to maintain practices that are consistent with the Ten Steps and submit a BFI Interim report that describes any changes in practice and current breastfeeding rates every 2 years. BFI designation is valid for 5 years.

Although a facility achieved BFI designation at a point in time, sometimes practices change for a variety of reasons. One common reason is staff turnover and practices that are not evidence based can start being introduced (or reintroduced).  Delayed orientation, a lack of continuing education and refreshers, and even employee self appraisals and the development of learning goals all play a role in maintaining the implementation of BFI practices. It sounds as if you are a great advocate for your clients and it can be very frustrating when mothers are given care or information that hinders their ability to breastfeed exclusively.

The goal of BFI is to have a minimum standard of care that is improved over time. To maintain BFI designation, a healthcare facility must be assessed every 5 years.  It sounds as if the hospital you are working in has a great core of people that are passionate about providing the best standard of care for their patients. We suggest that you share your concerns with them and perhaps even consider becoming involved in a BFI workgroup or committee at the hospital. You would be a valuable addition and could help make a positive impact on the care perinatal patients receive.

The Provincial Authority for The Baby-Friendly Initiative

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