Bottle Feeding

As with many parenting issues, the pendulum of public opinion swings from one extreme to the other over time. In the breast versus bottle debate, breastfeeding is enjoying a renaissance, and ads in magazines, bus shelters and on television can be seen encouraging breastfeeding as the optimum (the only?) method for feeding your baby. So much emphasis has been placed on promoting breastfeeding in recent years that it has become virtually impossible to find information on how to effectively bottle-feed your infant.

My own feeding story began with a strong motivation to breastfeed our twins exclusively for at least six months, more likely a full year. Thanks to the availability of material through a comprehensive public health campaign and my friend Carole, a committed breastfeeder, I had stocked up on all the pro-breast propaganda, and was convinced that anything other than exclusive breastfeeding would constitute my complete failure as a parent. So persuaded was I that I was rather rude to a woman in my office who gave me a “starter kit” of bottles as a shower gift a month before the arrival of our twin boys. How dare she jeopardise my plans to give my little babies the best start in life! Didn’t she know that studies show breastfed babies are healthier, happier and smarter? Obviously, we wouldn’t be needing any bottles in our home.

It wasn’t long after the birth of our little ones that I realized this was a more complex issue than my pre-purchased nursing bras and perfectly sub-sectioned breastfeeding information binder could address…

As per our carefully constructed birth plan (of which we had distributed multiple copies to any and all health-care providers we came into contact with throughout the pregnancy), Alex and Simon were placed on my body within an hour of their birth by Caesarean-section, where they quickly snuggled into my chest (skin-to-skin, just as the literature had suggested), and began rooting, as predicted. Simon even found a breast and immediately got to work. Great, I thought, he’s a ‘boob man’! This is going to be a cinch!

By the end of the first 24-hour period, however, both boys were still losing weight, and things were getting pretty sore at the feeding trough. Furthermore, Alex and Simon were doing lots of screaming and crying. And by now the novelty of the birth had worn off for me, and the early effects of sleep deprivation combined with major surgery had definitely kicked in. Yes, I was feeding often, yes, I had several people “check the latch”, yes, I continued to breastfeed and hope for the best.

When my physical pain became so unbearable that I tensed up all over at the mere thought of feeding, I began applying various ointments and magical creams which my breast-militant friend had procured from Dr. Jack Newman, guru on the womanly art. But I didn’t quit. Yet. I did all the “right” things—I learned how to feed from a little cup so that the boys wouldn’t suffer “nipple confusion” by using a bottle. When another nurse arrived at shift change, she suggested we try finger feeding with a tube, since that would help the babies developed the suck reflex for when I was ready to let them back on the real thing. In the meantime, I was advised to pump, since it would be gentler, less painful, and would encourage my milk to come in. I did so every two to three hours.

The tube/finger-feeding business was a complicated affair, and required many skilled hands and about 35 minutes per baby. Then there was the pumping to keep up between finger-feeds. We proceeded for another 24 hours. Sleep deprivation consequently grew worse. Post-partum depression set in and was joined by tremendous guilt when we finally gave Twin A the first bottle of formula (oh how he sucked it back, the poor starving child!)

Finally, on Day Four, we elected to move entirely to bottles, despite the damage this would inevitably incur on our psyches and our wallets. While my dear husband fed the boys each a bottle of formula and then wheeled them in their bassinet down the hospital hall for a little “walk”, I slept for a glorious three hours. Delightful! The road to recovery could begin. When hubby returned, I was awake enough to count my babies’ fingers and toes for the first time since their birth several days earlier. They each had twenty in total. Now I knew.

The following weeks were difficult ones, as readers who have recently gone through the birth and early parenting of multiples can surely relate to. In addition to the chaos of bringing home more than one baby and acclimatizing to the accompanying lack of sleep for the next six months, there was the unexpected twist of having to learn about bottle feeding: Buying formula (thank goodness for those crack-open, ready-to-feed cans—they are worth every extra cent on the line of credit), washing and preparing bottles (wisely, we had kept the unwelcome shower gift from a month ago and now my husband scrambled to find where we had stashed the box we never thought we’d use) and calculating how much formula to feed….

But another, more disturbing aspect complicated our early months as parents, and that was the barrage of uninvited comments from strangers with regards to our feeding methods.

Once a judgemental non-parent myself, prone to give dirty looks to bottle-feeding mothers on the bus or subway, I now found myself the object of scorn for precisely the same reason: I remember attending a baby shower for a friend of ours with a singleton when our boys were about three months old. While we were there, it was feeding time, and out came the bibs, burp cloths and bottles. As my husband was warming the formula in the kitchen, I wandered out to the garden with one of the babies. Immediately I was surrounded by aunties and grandmothers who wanted to meet “the mother of the twins”. I patiently answered the usual battery of stupid twins questions, and was mid-sentence when one old battle-axe called out in a rather loud and matter-of-fact voice, “you’re breastfeeding of course”.

I should have ignored her or told her as politely as I could that it was none of her business. But that pressure-induced guilt inside of me welled up, and I felt compelled to explain myself.

“Actually, we’re not,” I responded tentatively.

“Oh?” was her open-ended reply.

“Yes, well, we had a lot of trouble at the beginning.” I continued, “having twins posed different challenges than I had anticipated.”

“My niece had twins, and she breastfed for months and months”, responded the battle axe.

“I had a C-section, so there were come complications”, I meekly offered.

Wouldn’t you know it, the battle axe’s niece had also had a C-section, but of course she had had no trouble at all with breastfeeding. I burst into tears and rushed back into the house, where my husband took one look at me and was ready to kill someone. Instead, we fed the babies (bottles), packed up, and went home.

This emotionally draining experience and many others prompted me to do some research around bottle/formula-feeding so that I could do it “right”, and also so that I could be armed with data, should I need to defend myself in the future. When we had first come home from the hospital, I had called our public health nurse, who naturally knew nothing about bottle-feeding, though she did encourage me again with the breastfeeding, reminding me that it really was best for the babies. I then looked up bottle-feeding in one of our baby books, and found a chapter on how to sterilize bottles and prepare formula. (Already figured that one out from the instructions on the package.)

Finally, I stumbled across a glorious little book called “When Breastfeeding is Not an Option; A Reassuring Guide for Loving Parents” by Peggy Robin.

The more research I did on breast and formula/bottle feeding, the more I began to wonder: “Is breast really best?”

At issue are the claims that breastfeeding increases intelligence, lowers incidence of childhood illness and increases the mother-infant bond. I can assure you that our rocky but determined beginning did little to increase any type of bonding as I was so exhausted and freaked out, I barely knew which end was up on my babies! As for the other two claims, I began to have my doubts on their simplistic validity. After all, the baby formulas of today are scientifically formulated to emulate breast milk as closely as possible. All include essential nutrients, vitamins and minerals, and many now boast DHA and other ingredients hitherto only found in breast milk. In fact, the more I looked into the studies on breastfeeding and its positive effects on babies, the more I questioned whether it was the breast milk itself, or the act of cuddling and holding a baby close (which could easily be done with bottles) that caused the benefits in question.

In particular, I was intrigued to learn that infant massage, which has been studied in the West since the 1970s*, claims to produce similar benefits to breastfeeding: Weight gain (especially in preemies), neurological development, decreased hospitalization and improved digestion are all qualities noted in children who have experienced habitual infant massage. Perhaps most exciting for parents of multiples is that unlike breastfeeding, infant massage (and bottle-feeding) can be done by both parents and other care providers, a real advantage with more than one baby in the mix. (Why wouldn’t you want to sharethe joys and burdens of feeding more than one at a time with willing helpers?!) Indeed, other than the antibodies found naturally in breast milk, I really couldn’t find hard data that proved the superiority of breastfeeding as an act in itself for the babies.

My research aided me in charting a course that would best meet the needs of my family, and my husband and I made a pact when we moved to bottles: As often as possible, the babies would be held and cuddled when being bottle-fed. We wanted to emulate the physical closeness of breastfeeding as much as we could, and so we wanted to learn to bottle-feed well, to become “bottle-feeding experts”, if you will. (We also began incorporating a daily regime of infant massage into the bath time/bedtime routine, and I am convinced that it was this daily opportunity for bonding through physical touch that helped Alex and Simon grow healthy and strong, and assisted us in growing more attached to our new babies, despite various other challenges.)

Having lived through this new parent experience, I am concerned now with the multitudes of mothers who—for whatever reason—do not end up breastfeeding, but have little support in alternative feeding care. Sure, the formula packages include instructions on how to prepare the formula, but there is little guidance on how to lovingly administer the bottle to your baby. Did you know, for example, that you are actually supposed to hold the infant slightly upright when feeding, in order to prevent ear infections? And knowing what we know about the benefits of skin-to-skin contact in newborns with their parents, why not bottle-feed naked? (In a warm room with a blanket, of course, and perhaps not publicly!) The emotional high that comes from snuggling with your little ones while you feed not only transfers to the babies, but also builds confidence in the parent who knows she has fed her babies competently.

One of the many reasons I decided to become a prenatal instructor was so that I could present objective, comprehensive, research-based information on feeding options to parents expecting multiples. Don’t get me wrong—I’m all for breastfeeding, when it’s a good fit for a particular family. But the first few weeks and months of life with new twins, triplets and more are so wrought with anxiety, I feel it is important for parents to be knowledgeable about some different feeding scenarios, so that whichever option or combination of options they choose for feeding their little ones, they will be confident in the knowledge that they are “doing it right” and that it is good for their babies.

Breast- or bottle-feeding shouldn’t be a decision based on pressure from those around us. Every parent is an expert on his or her own family, and has the responsibility and the right to make an informed decision about how best to meet the feeding needs of their newest family member(s). And now that we have more comprehensive data on different factors that can impact newborns’ physical and emotional health, I hope that future public health campaigns and also individuals who mean to help will focus on supporting all appropriately-researched feeding methods to the best of their abilities in order to provide the best start for our youngest members of society and their emotionally vulnerable and sleep-deprived parents.

* for more information on infant massage, see the work of Vimala McClure and others