what is going on with breastfeeding these days?

Thirty years ago, a friend pumped for her preemie twins in NICU at least four months and after heroic efforts finally got them to latch on and nursed them till they finally weaned themselves. What she would have given for one of those fancy new pumps!

I’m 65. My friends breast fed, pumped for bottles, used formula, and nursed/supplemented formula. Some fed on a schedule and some on demand. Some weaned on a schedule and some didn’t. All those babies turned out great.

One of my favorite memories is from a meeting of my neighborhood new mothers support group. A woman nursing her three year old, listened with sincere supportive smiles as another woman excitedly told her about just going back to work after her former boss offered her one of those too good to turn down offers. “It’s wonderful. I can sit down and have an uninterrupted cup of coffee. I hand the nanny a bottle on my way out the door in the morning, and she has baby fed and ready for bed when I get home”

I had my first 34 years ago and pumping was a nightmare. It involved a suction cup and a plunger. You really needed three hands to extract any milk at all.

I have the good fortune to sing in a 100 voice women’s chorus (when there’s no pandemic.) Last Christmas a young chorus member who had twins was backstage wearing a bra-like device that used batteries to pump both breasts at one time, leaving her hands free to apply her stage make-up. I was so impressed.

^^^Oh yeah . . . . Pumping with the plunger in the stall in the ladies room, then keeping it cold in a musket bag (from LLBean) along with some ice packs. Those were the days . . . .

This is NOT NOT NOT a breast vs. bottle subject. Rather…as the title says…it’s about breastfeeding. Mostly on demand (which I did) vs. on a schedule which DIL is doing per lactation consultant.

Yes! She didn’t get great support in hospital at all. And the pumping…wow. It’s amazing these days.

Here’s the Current AAP Statement on breastfeeding: https://pediatrics.aappublications.org/content/129/3/e827.full#sec-19

“On-demand” feeding is briefly mentioned but it is in the hospital/newborn section.

There are reasons that a lactation consultant might suggest a schedule, but it is my belief that scheduling breastfeeding is more the exception than the rule…from my very basic research, AAP, WHO and LLL (La Leche League) all recommend breastfeeding on demand.

         An LLC might write a schedule for a mum that really doesn't understand some newborns might feed too infrequently. Many women do not understand the basics of their anatomy and physiology and that demand drives supply. Also LCs are are not all licensed and educated, they might be self designated. 


           Drs know diddly squat about BFing, like nutrition, it isn't their thing. It is shameful how good LLCs are not standard consults for ALL new mothers. You would have thought with a good midwife based system in UHC that the UK and Australia should do better, but really, they don't.  

What I’ve observed based on my experience (30-some years ago) and my DIL’s (over the last couple of years: Big change (for the positive) - pump technology! Still the same (in both our experience) regarding scheduled vs on-demand: If baby is obviously hungry before it’s “time” then on-demand. If baby is sleeping soundly after 4 hours in the middle of the day, then “schedule” kicks in!

Thanks for clarifying that your primary interest is schedule vs. on demand. I looked at it as more of a general question, though I didn’t believe you were wanting to get into the breast vs. bottle debate.

I would have guessed that the current thinking would lean towards on demand, so I was a little surprised your DIL’s LC suggested a schedule approach. I guess it could actually be variable, depending on baby’s particular habits/sleeping patterns/weight, etc.

With my first baby, in the hospital, the housekeeping person was more helpful than the lactation nurse.

Third child was in a NICU with posters about breastfeeding but they did everything they could to get in the way. There was no place to sleep so I spent the night on a rocking chair and they found me a cot. They told me I needed to “learn to separate.” I did not leave the NICU but was discharged myself.

I told them no bottles, based on the advice of my midwife. I pumped one night and realized (I was tired) that that was for a bottle ! So I stopped.

On the third day they finally let me hold and nurse the baby. They had been telling me she would be too cold, but I said she would have a hat on, a blanket and be next to my skin. It was blissful for both of us.

Then the nurse grabbed her away, took all her clothes off including diaper, so she was naked in the cold air. So they could weigh her and document how much she took in.

Hospitals are obsessed with documentation. Thank God I didn’t go into nursing. The nurse herself was appalled and told me she would never do that again.

Most of the babies left the NICU on a bottle. One mother was doing all kinds of desperate things to try to get nursing going again. I am glad to hear that sometimes this works.

I have to say I do not understand pumping. What is the point? I see nursing as a relationship, a dynamic thing, not just putting it in a bottle. I would probably use formula if I worked. I was at home with a kid with a disability so I just nursed until they were eating.

Breast milk is thinner than formula so I think feeding on demand is healthy. Breast milk is fattier at first, when the baby first latches on, and gets thinner, like skim milk as a nursing session goes on, so they can continue to nurse as long as they like.

Of course many of us know that many cultures do that. Childrearing in general is different in various cultures. Methods to get kids to sleep are a related topic. Nursing on demand, family bed, baby-led weaning are all part of one approach, often after natural childbirth. It’s a stereotype, but true.

Of course, I know plenty of families that bottle fed from the start and have great kids. I am sure they had more freedom and ability to work than I did.

There are many reasons to establish schedules. It’s really a personal choice.

What is going on with childbirth by the way? It seems induction, epidurals and C-sections, including scheduled elective ones, are on the rise and in some ways breastfeeding trends may follow.

Sorry for all the tangents. I have wondered about this exact topic as well. It looks like pumping is a big part of breastfeeding now and I never did it.

Interesting that you think doctors (pediatricians) don’t know “diddly squat” about breastfeeding…considering that 62% of pediatricians are females.

I can see a mom being told to feel “at least” every 3-4 hours, depending on the size and age of the infant. But to not feed any more often than every 4 hours? That’s just wrong and I can’t imagine an LC saying that. Maybe for a baby with reflux to avoid overfeeding? But not as a general rule, I wouldn’t think. Individual situations and LCs may vary.

62% of pediatricians are females.<<<<<<

Many, if not most, females do not understand breastfeeding. If we really did, we would have breast milk banks and no cows milk formula. The real obstructions to BF are social, financial, educational, cultural. We don’t prioritize women and children. Career peds are not BFing on demand when they are back at work full time.

Ok then… :slight_smile:

But one more thing…career “anyone” is not breastfeeding on demand with a present breast when they are back at work full time. However they may be providing plenty of breast milk to the child’s caregiver to give on demand.

I just think rice cereal is sort of unappetizing - hadn’t even thought of the arsenic angle. I just thought the Germans were actually offering babies foods that tasted good instead of super-bland and starchy. I’d never really thought about how so much of what we think is right and wrong for babies comes out of our culture.

I think the most amazing story I ever heard was a nurse who managed to breast feed an adopted baby.

I breastfed both kids (sometimes also using formula or pre-pumped milk from freezer). For me it was just easier … but it helped that with each baby I was on leave a few months and then worked part time a few months. At the time, many but not all of the new moms I knew were breast feeding.

With my oldest in Germany I had six months of paid leave. We then came back to the US where it took me about a year to find a (part time) job. I breastfed that kid until the day he turned four - though the last few years - it was just a night cap or first thing in the morning.

My second kid I was only home for six weeks, but my boss wanted to be a grandma so bad she suggested bring him to work. (I was still working part time.) He came for about nine months, but once he started crawling, it became impractical. I really thought that kid was going to go to kindergarten nursing.

Neither kid will admit to remembering nursing. :slight_smile:

One thing that is new or newer is employer support for pumping at work. We have a lactation room (although no one is there now due to required working at home) that is needed by those who work in cubicles.

Not much to add, but as a former La leche member who wanted to be a lactation consultant, enjoy the discussion. I nursed all of mine, twins included, for a long time, and loved taking in all those calories that were then used for milk production. Shocking that NICUs are not more understanding of breast feeding routines. I am of the pump in the bathroom with a hand pump generation, and am glad employers finally are more supportive. My observation, is that evidence aside, most women nurse as long as those in their immediate group of friends, and that time period varies widely based on microculture of the social group.

Just have to say, because it’s ancient history and nobody but me cares, that my first stopped nursing and started walking the same week. 15 months. Hello, your baby is gone and your toddler has arrived. And my second nursed until he was old enough to say, “there’s not very much milk.” And I said, “do you want me to get you some from the refrigerator?” And he said, “yes.”