Tuesday, 15 January 2008

Without A Clue....

Enterobacter sakazakii

I was out shopping this afternoon, at Milton Keynes. My toddler, who has been ill for a week or so, was happy to be out and about, but a bit clingy. Clingy on Dad, actually, and he wasn't letting Dad out of his sight for a moment, so I distracted him with a huge bag of crisps, in order to let Dad go off for a moment and do some shopping.

Yes, I am that sort of mother. You will be too, if you read this and think "That's shocking!" :-)

So we were sitting there, with me playing "heavily distract" when a nice young Mum comes along, baby in sling in front of her, hands filled with lots of plastics bags, and sits down beside us. Baby is grizzling, and Mum says "Yes, yes, I'll feed you in a minute!"

Now, I wasn't expecting her to have a breastfeeding baby. She was clearly in her mid to late 30s, and very well turned out, but I didn't expect anything other than formula fed. I know older mothers tend to be, I know middle class Mums tend to be, but I had no expectations at all. So I schooled my face to keep smiling and not react, when the bottle came out of the bag, and was plugged in without heating etc. And out it came, and yes indeed, pre-made up bottle, almost empty, and in it went. Baby guzzled down hungrily, and we carried on chatting. Mostly about my little one being grumpy, as he'd been ill, and just talking about baby stuff. Her little one had had a bit of a tummy upset last week too. I refuse to look at the bottle, and smile and carry on lightly chatting.

I will not react. I will not react.

So we keep chatting, and I keep eye contact and smile, and we talk about toddlers... and the bottle is finished. But she has another one... and she brings it out. A bottle of cold water, obviously had been boiled once, but now stone cold. And then she brings out the pre-measured powdered infant formula container, and pours it into the bottle, and shakes vigorously.

I will not react. I will not react. I WILL NOT REACT.

She keeps shaking it and shaking it, and my skin starts to crawl up my scalp. My blood pressure starts to rise, and I can hear my little voice starting up. "You have got to tell her."

But I can't. I cannot react, I cannot tell her. She doesn't want to know. If I tell her the truth, and mention the bacterial contamination in powdered infant formula, and that she has to use really really hot water in it to lower the risk of the baby getting sick... she will call me a boob nazi. She will be shocked and insulted that anyone could tell her such a lie. The easy, smiling eye contact we have going, will be shredded, and I will be a nasty obnoxious person trying to make her feel guilty.

No, I won't, I don't want to make you feel guilty, I want to let you know what risks you are taking... please, please don't put that bottle in your baby's mouth. Please don't!

And in the bottle goes, and I feel sick, totally sick. I keep smiling, and chatting, and act like nothing has happened, and all along, I'm praying my Hubby comes back RIGHT NOW and we can move on. I can't keep smiling in this lovely woman's face, and not keep thinking about what she's doing, and how she doesn't know how much risk is involved every time she does it.

I hate that we can't tell people. I hate that so many people don't know. I hate that the information on what's really in formula tins, is so poor, and the entire cultural minefield is so intense, that just to speak the truth, is to be the enemy.

I hate that when I visited a friend in hospital, with her 3 day old, and she was having to supplement as she'd has the usual standard of maternity ward breastfeeding help (ie, appalling, abysmal, designed to make her fail)... that I was the only one who told her she had to use pre-packed sterile liquid formula for the first 8 weeks. I hated that I had to listen to her explain that the midwife had said this wasn't true, as all formula is sterile.

I hated that I went out in the car and bought enough liquid pre-packed for at least two weeks, so at least baby would be safer whilst my friend tried to recover from the shocking 'breastfeeding help' she'd received.

I detested that I then had to send her the link on how to prepare powdered infant formula safely, when the baby reached eight weeks old. I hate that she now feels unease whenever she uses the formula she has no choice about, as there is no human milk bank to offer her.

I hate that formula marketeering prevents human milk being donated to women such as my friend. I hate knowing she has to use powdered infant formula, and I had to spell out the risks, so she could do so as safely as possible.

I hated leaving that mother and her baby, in the shopping centre, and not being able to tell her. I hated that I couldn't speak up for the baby, in case I upset the mother... I don't know her. I have no right to impose... she hasn't asked me...

At least my friend knows how to minimise the risks. I feel I failed that mother today, as I left her without a clue.

How did we end up like this? Women, mothers, completely disempowered from the truth, the facts. Utterly ignorant of the risks. Yet, when a newborn dies, the courts say, you can't sue... everyone knows the risks.

No, we don't know the risks. NO ONE knows the risks.

And one of the reasons why no one knows the risks...is that we've all been gagged, on some strange altar of "don't make women feel guilty." Why on earth should any mother feel guilty... if they don't know!

And how come I can't tell them... in case they feel guilty.

Reductio ad absurdum.

So, I didn't tell.

Now I feel guilty.

You can't win, you can't break even, you can't get out of the game...


Alison said...

Dear Morgan -

Your impassioned post was one of the most moving I have ready in a long time. I nursed my beautiful little boy (my 1st) for 4 years. After that, I felt as if I should have gotten a prize, I was so proud of myself. Then, I had #2. A beautiful homebirth with a low intervention midwife. No ultrasounds, the whole crunchy 9 yards. It was amazing. When the baby was 9 weeks old, we lost my stepdaughter. In the following months, I began to struggle (me, STRUGGLE!) with nursing her. She napped for hours, I accepted it, grateful for the rest from the trauma of burying a child. And so, due to massive stress and a baby who never met a crib she didn't love, my milk supply diminished. So I pumped, and took herbs, and drank beer. Tried a bunch of things, though not with the force of will I should have, to be quite frank about it. Once she was 8 months, and clearly losing weight, I gave in. I did. And it was HORRIBLE. Totally traumatic. Here I was, a doula, childbirth educator and wanna-be IBCLC giving my kid FORMULA. My husband had to teach me how to make it, because I was so clueless. And he gave the first bottle because I was crying so hard.

Now, to add insult to injury, I realize that I didn't even know the real risks of powdered formula! No one, not ONE health official or friend, mentioned it. No one. I wish someone had said something about boiling the water, and the temps needed. Given me a link to this website. So sad ....

I was not comforted by the BS you hear from people, either. "Oh, my Johnny bottlefed, and now he's a Rhodes Scholar!". Whatever, lady. I could care less. I will NEVER stand up and say to other women, "I formula fed, and look how fabulous my Miriam is! She's reading at the age of 2 1/2!!!" (Which she is.) WHO CARES?!?!?!? Who really gives a damn? How about the bonding? How about the loss of health protection? How about the loss of my innocence? It matters. It matters to both mother and baby, and it is FAR from inconsequential.

In the future, if I have any friends who bottlefeed, I will step up and talk about how they can reduce the risks of PIF. It's the moral thing to do.

Happily, I have since given birth to another baby, also a lovely homebirth without all the typical hospital insanity. This time, I was ready. I bored my friends to distraction talking about latch. I woke the kid up (also a sleepy baby) with the regularity of a damn egg timer. I showed my latch to more midwives and IBCLC's than I care to imagine. I made sure she coslept every night. I ate like it was going out of style, and I refused to feel guilty.

As a reward for my efforts, I have a beautiful, beautiful baby girl named Chana who breastfed exclusively until 6.5 months, then dabbled in food a bit. Now she loves table food. But she loves her mamas' milk more, and every night, as I watch her little hand pat my breast as she nurses, I fall in love with her all over again, and feel only gratitude for the gift of healing she gave me. Miriam (we call her Mimi) is a strapping little 2 year old, a fiery version of my husband. And she knows that babies get "nanas". We don't put down bottles, but I did feel a lot better the other week when she raised her shirt to nurse her doll, and put my pump parts to her own chest, informing me that she was going to "pump" for her dolls.

Love your blog!


Morgan said...

Dear Alison,

Thank you so much for sharing your story with us. Also accept my condolences on the loss of a child. Such fear in my heart, just writing those words. No parent should bury a child. Full stop.

Also, thank you for your story on your having to use formula unaware of the risks. I think it's really important that women express their anger over this subject, and let others know how they feel about not knowing the truth.

My own experience was not as traumatic as yours, but could have been. My husband had a heart attack, when we were on holiday visiting relatives, when my baby was three months old. We'd never been apart, my baby and me, and I had to watch my cousins walk down the long hospital corridor, with my precious son, and disappear round a corner. I had his disapearing head on one view, and the crash team working on my husband in the other. I was torn in two.

My cousins took my little boy to their home, whilst I stayed on at the hospital, and gave him formula. Or tried to. He wouldn't touch a drop. Something I am so grateful for now, but at the time, was just another huge stress. They brought him back to the hospital, screaming in hunger, three hours later.

I did have some frozen milk in the freezer at home, hand pumped drop by laborious drop (I don't expess well) - as I thought I was going back to work. But it was 350 miles away, and no way of getting it up to us. We were quoted 500 pounds to courier it overnight! I'd banked down from expressing to go on holiday, and can't hand express at all - it just wasn't feasible for me to express in any fashion in the conditions I was in. And why do that... after all, that was what formula was for, emergencies!

The hospital didn't want my baby in there. They felt the risk of infection to my baby was too high, and we then had to do a dance, whereby I drove between my husband and my baby, back and forth, back and forth. It was a 30 minute drive. It was a nightmare, although it did keep me busy!

My family continued to try and put formula into him, with my blessing - for I didn't know. I had no clue to the risks, especially to a baby under 6 months old.

I didn't know about the bacterial contanimation. I didn't know about what it would do to his virgin gut. I didn't know that he might starting projectile vomiting from reaction to cow protein.

This is why I am so grateful he refused it utterly. For that was just what I needed, in those hellish days, a husband on a heart monitor, and a baby vomiting distressed and crying. I don't know if I could have coped, if he'd then gotten sick enough to need hospital himself - something that happens all too often, without us connecting the dots.

I know people whose infants have been in hospital on drips for dehyrdration, as they have a 'tummy bug'. And they are feeding them powdered formula with cold water in the nights - just like this lady, boiled earlier, and left to go cold - which formula companies actually tell you to do.

When I think of what could have happened with my little boy... I go numb. I know the risks are low - but not low enough. Not when it's your baby.

I didn't even know the risks until much later. It was maybe 6 months later, before I read an article that gave me a hint about the truth. I went from shock and disbeleif, to absolute fury. How can anyone not have told me? I sat in UK ante-natal classes, and discussed healthy feeding, with my midwife and my Health Visitor, and they didn't tell me? No one told me!!!!

I put my baby's health at risk, at the most stressfull moments in my life, when I needed support... and I didn't know.

The irony was he was in more risk from infection from the bacteria in the formula, than he was from picking up bacterial infection at the hospital.

I should have just slinged him, and kept him with me, and we would all have benefitted from his smiles. In my sling, not touching anything, he would have been far safer than he was, in my cousin's kitchen, having a formula bottle pushed on him.

He never took the bottle again, and the EBM was finally thrown down the sink, many many moons later.

In terms of your story, what strikes me hardest, is that if it were not for formula, you'd have had human milk to give to you little girl. This part seems to be the hardest part for some people to understand - that formula prevents human milk getting to babies who need supplementation. That in a world with no formula in it, there is plenty enough milk for all babies, when they need a bit more than their Mum can provide at that moment in time. But the formula marketeers have done their job too well, for many people do beleive we 'need' formula.

Well, I needed it like a hole in the head, at that stressfull time, had I but known it!

Again, thank you for sharing. :-)