Sunday, April 12, 2009

Secrets of the Baby Whisperer: be careful - bad breastfeeding advice

During my quiet moments in the past week, I finished reading "Secrets of the Baby Whisperer" by Tracy Hogg. I'll tell you this: I'm endlessly grateful that I've read this book now, when the blur of those first weeks as a new parent is over, and not before Shira was born or in the first few days with her

Tracy Hogg is a strong advocate of scheduling from the earliest days, and her manner of writing is so authoritative that it actually borders on unpleasantness at some points. There is, however, some useful advice in the book, specifically about baby body language and interpreting signals such as different types of crying. After reading and observing Shira, I realized that many times, I miss early signs of tiredness, which eventually makes going to sleep more difficult. If only for this, it was worth reading. As for scheduling, we have a very simple, loose daily rhythm which works for our family. Since each baby is an individual, I cannot agree that a three-hour schedule will work for each and every baby, even if they are in the same age and weight category.

What I do take a strong point against, is Mrs. Hogg's attitude about breastfeeding. These days, no health professional can be openly anti-breastfeeding - not when the World Health Organization states that "Breastfeeding is the ideal way of providing young infants with the nutrients they need for healthy growth and development". But Mrs. Hogg is obviously not pro-breastfeeding, and the advice she gives in her book might in fact be dangerously disruptive to establishing a successful nursing relationship.

Disclaimer: I have no intention to start a breast milk vs. formula debate. I'm not saying there is never a time and place for formula. I realize that in some cases, women are indeed unable to breastfeed. In other cases, breastfeeding is not recommended for medical reasons. Finally, it's really none of my business how each mother feeds her baby, and the last thing I'm interested in would be to make anyone feel guilty.

However, I believe that someone who calls herself a lactation consultant is supposed to be more, let's say, enthusiastic about breastfeeding. Yes, formula - when made and used properly - will provide the necessary nutrients for normal development, but breast milk is significantly superior. Tracy Hogg implies that there is only a slight advantage to breast milk over formula, and talks a lot about the difficulties of breastfeeding - this alone might be enough to create a very skewed view for a new mother.

Tracy Hogg actually believes that breastfeeding is no more than "the latest trend"; this is, of course, absolutely laughable - there is a reason why the Almighty created women with two breasts. Women have been breastfeeding since the beginning of time. To support this ridiculous statement, Mrs. Hogg mentions that after World War 2, almost an entire generation of mothers chose not to breastfeed. Are we supposed to believe that God's gift of breast milk is somehow less valuable, because a generation was fooled into making a short-sighted choice?

Her section about breastfeeding is literally bursting with examples of women who, for various reasons, couldn't or shouldn't breastfeed. From reading Mrs. Hogg's book, you'd think that inadequate milk supply is a very common problem, while actually, in many cases what is mistaken for "low supply" is no more than unsuccessful attachment to the nipple or slow flow of milk. Mrs. Hogg suggests pumping as a way to make sure a woman's breast milk supply is adequate, while for many women, pumping might be very ineffective, thus creating an unjust sense of insecurity about "inadequate" milk supply. Isn't there more common sense in observing weight gain and especially satiety signals - which is supposed to be Mrs. Hogg's specialty?

My impression is that Tracy Hogg's attitude about breastfeeding is that it's nice, but not important enough to work hard for. Again, whether to breastfeed or not is every mother's individual choice and no one else's business. But a lactation consultant, in my opinion, is not supposed to hint that almost any and every reason - from sore nipples to body image or simply convenience - can and should override the enormous benefits of breastfeeding. She goes as far as suggesting that breastfeeding your baby can make the older siblings jealous, and this, too, is a point against breastfeeding - as if a baby who is not breastfed will not demand the same amount of attention!

Tracy Hogg discards the "myth" of nipple confusion, and strongly promotes the use of pacifiers from the first weeks of the baby's life. She also supports introducing a bottle in the first two or three weeks of the baby's life, to make sure that the baby won't refuse a bottle later on. She strongly discourages non-nutritional suckling which many babies do at the end of a feeding. Now, I don't believe that the mother is supposed to constantly have her breast out and in the baby's mouth, but Mrs. Hogg fails to mention that additional breast stimulation is important to maintain an adequate milk supply.

Much of Mrs. Hogg's advice is clearly more compatible with formula feeding. For example, if it seems that the baby needs more nutrition during the day, Mrs. Hogg might suggest, "add 30 ml to each feeding. Of course, it's more difficult if you're breastfeeding..." - why not suggest an appropriate solution for a breastfeeding mother, such as feeding on both sides (if you're feeding normally on one side each time), feeding for a longer time, or even feeding more frequently?

The fact is, breastfeeding isn't always easy. For some women, it might involve an entire range of challenges, from sore nipples and mastitis, to worrying because your baby isn't growing as fast as your friends' babies who are given formula. Most breastfeeding problems can be solved. Much can be done to boost a mother's milk supply. Perhaps her nutrition isn't adequate - this can be easily corrected. Perhaps she will have to express the milk left after each feeding - my mother did this, and ended up with enough milk for two babies. It will, however, take commitment and hard work. It's a matter of attitude: do we see formula as a last resort, or as a convenient solution of any and all breastfeeding problems?

Also, Mrs. Hogg believes that babies should be weaned by the time they are one year old. She describes a case when a mother was still breastfeeding her two-year-old - in her interpretation, it sounded almost like a tragedy. Of course, a two-year-old is usually exposed to a wide range of foods, but why automatically exclude breastfeeding from the equation?

As a conclusion, some sections of this book are helpful, but you really need to be careful about what you read, and not take anything for granted. Eat the fish and spit out the bones.

39 comments:

my3sons said...

Great post. I agree with you 100%! I breastfed all three of my sons until they were 15 months old. I never had any "problems" with any of them. I also think that most of the people that give up on nursing do so because they aren't getting the help they need. My sister "tried" to nurse her first child (before I had any). It didn't work out for her and she stopped early on. After I had my first, she had her second. I had already been nursing for a while and helped her. She was so happy to be able to get through it and was disappointed that she didn't have the help with her first child. In my circle of friends I was the first person to breastfeed. Now almost 9 years later it seems like most moms are doing it. I think that is great! Times have changed and most moms are on board with the benefits. Thanks for a great post today! Katie

Civilla said...

Funny that she would be a lactation consultant.

Tereza said...

I dislike parenting book simply because it's all the authors opinion and not neccessarily what will work for my family!!!!!! Good for you for not "giving in" eventhough your a new mom~~~this is part of the reason i read your blog:) eventhough I have 9 children I enjoy that you do what works for you and what you believe to be right:)

A Marriage After His Heart said...

anna,
thanks so much for this post. my precious gracielyn was born Wed and although I breastfed my older two, there is a 7yr age gap and this breastfeeding experience has been polar opposite from my other experiences. My nipples are sore. My breasts are engorged and my 4 day old is an agressive feeder and rooter. We can hardly get a sucessful latch because she is so agressive. I actually called the hospital nursery at 4am to see if it would be okay to give formula for just 24 hrs while my nipples healed. For whatever reason I woke up about 9 after trying a bottle feeding with a stronger determination to tough it out and breastfeed my baby. This post today just confirms that the Almighty will give us what we need if we consult him first. Through my tears I prayed and asked him just to heal me and give me the strength to feed her the way he designed... and I am trusting that we will successfully get through these first few trying days.

Ganeida said...

Her advice seems terrible for a *lactation consultant*. I breastfeed 5 ~ including twins & a positive outlook is terribly important to success, especially if there are difficulties.

Mrs. Anna T said...

A Marriage After His Heart: hang in there! Those first few days were so difficult for us as well. My nipples were terribly sore - it took time to get a proper latch. And when Shira nursed, I had contractions - it was my womb returning to its normal size. It hurt so badly, but it was all worth it.

Mandi said...

Actually, the "enormous" benefits of breastmilk are greatly exaggerated. The actual studies show little to no advantage for breastmilk over formula in all of the many areas of a baby's development. The differences in breastfed and formula fed infants are statistically insignificant across the scientific literature. Certainly the normal, healthy nature of breastfeeding should mean that it is the default setting. But the advantages to the baby of breastmilk are so minor that a mother should never be pressured into breastfeeding if it is significantly detrimental to her own wellbeing.

While you disagree with this author's message it might be just the understanding voice a worn out, hardworking and conscientious mother needs to hear. When I was exhausted after three weeks in and out of the hospital with a tiny jaundiced baby, engorged breasts, poor letdown, 10 pumpings a day I needed to hear that it was ok to give up trying to breastfeed. When my little five pound boy couldn't get any milk out and we would both be crying and frustrated hour after hour it was very nice to hear a reassuring voice tell me that breastfeeding was best but I had to do what was best for us here and now.

I wish I could have breastfed, it certainly would have been cheaper, but I'm so grateful to live in a time when well-balanced and nutritious options are available and when dissenting voices can be heard.

Katy said...

You are so right! My supply quickly dried up with Baby #1 (because of a thyroid condition know one thought to check). Many of these "schedule books" are dreadful. Some days my little one wanted to eat every hour...others every three. I went with what she needed. As I look forward to Baby #2 I am all about reading Dr. Sears.

SBCE said...

Don't underestimate the influence of others if you are pregnant interested in breastfeeding.

My husband was willing to support me in whatever feeding method I felt was right.

My aunt, a retired labor and delivery nurse, sent me a stack of breastfeeding books as soon as she found out I was pregnant which convinced me of the superiority of breastmilk over formula.

Many friends, relatives, and my own mother breastfed.

Finally, the hospital where I delivered (DeWitt Army Hospital) by c-section was very pro-breastfeeding. The first feeding was about two and a half hours after delivery.

I could not have done it without the support of others.

All of us breastfeeding moms can be a support for others.

Ace said...

Hi Anna,

Glad you were able to have such great discernment. A Mother of five recently told me with a straight face (she was serious) that she weaned all her kids by one years old because it was a scientific fact that the breast milk turned to water after that. I think my face said it all and she could not tell me where I could look up that scientific fact, just that someone had told her. After I got over my shock I laughed hysterically and told her she was wrong that I had nursed well passed two with my first and could PROVE I had MILK not water in my breasts AND that the milk in the breast my newborn (at the time) was drinking was different (in color and thickness) than the milk in the breast I reserved for my toddler. She refused to see it. Ah well.

Your right, throw out the bad! God knew what He was doing and thank you very much, He knew to give EACH baby the right Mama who would give PERSONALIZED care to EACH baby. Too many "parenting" books are by Nannies who have never had children, Doctors who have never nursed and people who are stick their kids in daycare the first chance they get.

I would rather get advice from stay at home/homeschooling Moms (otherwise known as soldiers in the trenches) any day!

Glad you are all doing well!

BTW, Lansinoh makes a GREAT cream/gel for nipples that will eliminate the pain AND is awesome for diaper rash.

You may need it if you are pregnant and still nursing your first.

Many Blessings :)
Ace

Rosemary said...

Excellent post Anna!

A Marriage After His Own Heart, hang in there. The getting started period can be painful, but babe and you will soon work it out.
If there is a La Leche League in your area, they can really help you through this time and offer you good advice. Don't be afraid to give them a call.

Jessica said...

I read this book, too, when my little boy was only a few months old. I didn't care for it, either. Such a strict approach to scheduling doesn't work well for our family. Fortunately, I was very convinced before my baby was born that breastfeeding was the only choice for me. And I knew that a strict feeding schedule can be harmful to the milk supply.

Beth M. said...

Thanks for this review Anna! I've heard this book mentioned/recommended before, so it's nice to know a little more about it. You've given me enough details to know it's not something I care to read or recommend.

Jacqueline said...

Anna,
I read this book years ago and I totally agree with you 100%!!!

Wonderful post!!

Rina said...

Anna,
I also read that book. Unfortunately, I read it back when I knew NOTHING about children and took Tracy's advice to heart. I stopped feeding my baby whenever she cried and started feeding her according to Ms. Hogg's instructions. Long story short, after a few months of this, I was literally starving my baby. When we went for her well baby visit, her weight was nowhere near where it was supposed to be, and her head circumference was alarming. Needless to say, we abandoned Ms. Hogg's advice immediately but it was too late. We were forced to supplement with formula and later our daughter had to go through both physical and speech therapy and I'm convinced that her lack of nutrition during those crucial months had something to do with that. I agree with you that Ms. Hogg's advice about body language is great, but her advice on breastfeeding is HORRIBLE. I'm glad you were wise enough to see through it and that you're warning others.

BellaMama said...

That is quite amazing! I'm still laughing at breastfeeding being a newer trend!!
And the fact that studies show that children who are breastfed and for over a year have a higher I.Q. and are above the averages in all areas!
I stopped reading such books, they are rarely helpful (except for the one tidbit-was it truly worth the whole book?!).

There is this woman who has figured out baby language (all the sounds and babbles) which turns out to be a universal language. I found it extremely helpful in actually hearing what the baby was saying he needed! www(dot)dunstanbaby(dot)com
click on your country then on the "Oprah" button & see her part of the show!
I've written out the cue sounds and translations and have used them for the last 2 babies!

The contractions while nursing are afterpains that I've heard are worse with each baby. Having had 6 children, I think it's always been pretty bad for me just about equally with each child and the pain subsides daily the first week and becomes tolerable in the second week, then gone. I don't use pain killers, I take lots of calcium, magnesium and msm (methylsulfonylmethane) as well as continued drinking of Red Raspberry Leaf and Nettle Tea. That's for me, just wanted to share in case it would help you too!

~Blessings!

Bethany Hudson said...

Anna- thanks for this! Of course, you know how I feel about breastfeeding :) And, though I never mentioned this in my own article on the subject, I did have some struggles with breastfeeding: sore nipples (in the beginning) and two bouts of mastitis (which I have learned how to avoid in future). That said, it never even occurred to me to give up--because I KNEW how important breastfeeding was to my daughter's health and to our relationship. It makes me sad that so many women are given false information as "experts" attempt to make things easier for formula-feeding mothers. I admit there is a lot of unnecessary guilt being put upon the shoulders of FF moms by some in the BF circles, but this cannot negate the facts: breastmilk is best. Not everyone can breastfeed, but most can. Just because we are honest about that does not make a mom who has to formula feed a "bad mother," but she at least deserves to be an informed mother.
~Bethany

Mrs. Anna T said...

About the afterpains: it helped to remember that they are a GOOD thing - the doctor who checked me at the release from the hospital literally could hardly believe I gave birth only 3 days before.

Mrs. Anna T said...

Mandi,

There is a difference between being understanding when a mother cannot breastfeed, and discouraging breastfeeding, or worse, suggesting practices that might undermine breastfeeding for someone who CAN and WANTS TO breastfeed.

Truly, if I tried to set a schedule from the earliest days, and gave a pacifier and a bottle when Shira was just a few weeks old, I'm not sure we'd make it even to this point of 3 months.

Mrs. Anna T said...

... To sum it up: if you don't breastfeed, for whatever reasons, it's no one else's business; but if breastfeeding is important to you and you want encouragement and good advice, don't rely on this particular book.

Terry @ Breathing Grace said...

There is one reason why I would suggest that breastfeeding in superior to formula feeding:

It's GOD'S designed way to feed babies. As you said, Anna, there will alwyas be challnges for some mothers and mothers who cannot breastfeed for various reasons. But to imply that the best isn't the best because it isn't the best WE can do is rather silly, IMO.

But like Civilla said, funny that this author is a lcatation consultant.

Mrs W said...

I'm kind of in between here, having had to formula feed my two babies and being treated like utter trash from nursing Nazi's for doing so. They even went so far as telling me, while I was still suffering from post partum depression, that giving my child formula was child abuse! Ridiculous. At least I was giving my baby the nutrition it needed not like another mom I know who was so hung up on the breastfeeding philosophy that she nursed even though her baby was losing weight and getting sick. The philosophy meant so much to her that she starved her baby for it. To me, a philosophy is not worth starving my precious babies for.

God's original design was breastfeeding, there is no argument there. My argument now would be that just like everything else, breastfeeding has come under the curse of sin, and therefore, while breastfeeding is always best, as things degenerate, it is not always possible.

I also believe "nipple confusion" is a myth. My sons both knew what was breast, what was bottle, and what was pacifier, they weren't confused at all. I think this is a story that breastfeeding nazi's (you don't sound like you are nazi-like about it Anna...thank-you!) made up to try to make formula feeding moms feel even more guilty.

I don't like the idea of breastfeeding a toddler. I am not going to outright say it's wrong, but it is something that is disturbing to me in this day and age and there is no way I would want to do it.

Mrs Jamala...nurse if you can...it is awesome and definitely best, but don't let those nazi's make you feel guilty if you can't or simply choose not to nurse, either. It's YOUR choice.

Melissa said...

That's great that your little one is sleeping so well at night! What a blessing! Our little boy who is the same age is only now starting to sleep 5-6 hours. Do you have any advise or tips that might help?

I nursed my first son until he was two years old and we loved it. And now that i'm nursing his little brother he's not jealous at all!

CappuccinoLife said...

I had similar thoughts when I read that book.

Being committed to exclusive breastfeeding, and having already done that with 2 kids, I knew that what I was reading was not going to work in a good way for breastfeeding.

Bethny said...

Anna,

Thanks for sharing this interesting review about this book. Almost makes ya wonder if she was hired by Enfamil or ProSobee to write the book! Oh, and the horrors of nursing beyond one year! I have nursed anywhere from 12 mos. to 3 years with my 5 children, depending on the child's needs. To her book, I say "Posh!"

Mrs. Anna T said...

Melissa,

I'm afraid it's not something we did or didn't do; the dream feeding certainly helps to get more hours of sleep each night, but even without it, Shira will give us 8 hours of sleep.

Anonymous said...

I can see that you've already received a great many comments in response to this post. May I throw in my own comment that it seems so contradictory that the author of the book you've reviewed is a lactation consultant.

I agree that breastfeeding is not always the easiest thing to get the hang of at first. I am, however, SO GLAD I did not give up when I had troubles.

As you so rightly pointed out, Anna, women who breastfeed are not part of a "trend". It's simply a natural & normal way for babies to be fed.

Brenda

Michelle said...

Wow - if you found Tracy Hogg's book to be unpleasantly harsh, don't ever, ever read Gary Ezzo's Babywise. It needs even more of a good dose of discernment.

I didn't remember her book being anti-breastfeeding, but, like you, I took the good and spit out the bad. The best things I learned from her book were that "A crying baby does not equal a bad mommy" and how to more easily recognize the signs of tiredness so I wouldn't have to constantly worry "Is she eating enough?" - my baby girl is my happiest baby yet and she's got her routine down pat :)

Blessings mama - I hope your passover was good as well.

sewbusy said...

Thank you so much for all the info. I have considered reading the book but don't think I will waste my time. I am still happily nursing my 18 month old girl and hope to be doing it for a long while yet!

Persuaded said...

you wrote:
"To support this ridiculous statement, Mrs. Hogg mentions that after World War 2, almost an entire generation of mothers chose not to breastfeed."
oh my gracious... did she also note the huge increase in the number of overweight children? and adults for that matter? i don't think the link between rates of bottle feeding and obesity can be ignored.

it sounds like rather an odious book to me.

Gombojav Tribe said...

I don't understand why nursing past a year old is upsetting to people. I have never heard or read any rationale that made any sense in regards to early weaning.

I've breastfed all my babies as long as they wanted. The shortest was one year. The longest was 2 1/2 years.

Every child is so different and develops so differently, at their own pace. Respecting that rather than some arbitrary calendar date for weaning only makes sense.

When travelling and going to developing countries I've always felt very confident that my nursing babies/toddlers would be happy and healthy. I could visibly see how powerful my breastmilk was as the baby would be the only one not getting sick!

Unlike one reader above, I think the benefits of breastmilk are not over-stated. I feel that most of the time they are grossly under-stated.

A child of the King said...

Great post Anna! It is good to read an honest appraisal of a book like that!

Mrs. Anna T said...

Daja, I think it's some sort of a cultural thing. In Jewish tradition, a mother is considered "nursing" until her child is two years old. Mothers of young children are released from minor fasts for that reason.

Mandi said...

@Gombojav Tribe

You may "feel" that the benefits are under-stated but an examination of the large, controlled, double-blind studies that have been done, about the relative benefits of breastfeeding over formula-feeding, show either none, or statistically insignificant differences between the two.

Weight gain, IQ, bonding, development, immunities, etc, are very nearly identical between breastfed and non-breastfed babies when you control for other factors such as daycare, birth-order, parents economic situation, etc. There seems to be a slight advantage accruing to breastfed babies but it is very minimal and can be compensated for if a mother cannot reasonably handle breastfeeding.

I'm not anti-breastfeeding. But this has become another stick to beat mothers up with and we all need to be understanding and considerate of those who's decisions we don't agree with.

I haven't read the book but Hogg's position (as stated by Anna), that breastfeeding is nice but not necessarily worth working hard for, is a defensible position. Speaking anecdotaly, I fought hard to be able to breastfeed my first. Three weeks of stress and a sick baby wasn't worth it. Switching to a bottle was a huge relief for both him and I. Again I tried with my second, but when he began to get ill with jaundice too, I switched to the bottle immediately and he avoided the more serious complications my elder son had. Theoretically I could have kept up pumping for several more weeks and maybe got them reattached to the breast or I could have continued pumping and bottle-feeding the breastmilk but that double duty was just too much for me.

So for some the "work" of it is worth it, for others it isn't, but a clear understanding of the actual stakes in the game will be better for all mothers trying to make that decision.

God's Dancing Child said...

I like reading all sorts of books. I enjoy reading reviews as well. This was a good review!
It sounds there's not a lot of meat on this fish... lol

Mrs W said...

Mandi, thanks so much for telling the truth against this kind of utter snobbery!

Karen said...

Wow that is truly something. I've never heard of a lactation consultant who called breastfeeding the "latest trend". That's crazy! All the lactation consultants I'v ever met have been extremely helpful and supportive.

My babies never could go on a schedule. I've gone thru so much stress trying, I've just given up and things are much better. I do look forward to the time I can get off of baby's schedule and back on mine! I've at least been able to introduce a somewhat rigid nap-time! Thank God for His wisdom in making babies need more sleep than adults!!

tubal reversal said...

its extremely informative post. Most obstetricians recommend that women preparing to conceive visit the gynecologist to talk about everything from diet to genetic risk factors and healthy pregnancy. For women with a chronic illness, such as psoriasis, prepregnancy is a perfect time to talk about treatments that will be safe during pregnancy and breastfeeding. Thanks for sharing.

Anonymous said...

This is a wonderful post about the studies done about the benefits of breastfeeding. It is clear and informative and breaks down a mammoth study completed in 2007. The post is pro-breastfeeding, but allows that not everyone can nor wants to breastfeed. And that is OK.
That being said, let's not toss around incorrect information about breastmilk benefits. As I always tell my husband when we disagree, "Do the research!" before giving out information. (Especially to a new mom!) We who have stuck it out through feeding baby #1 know how hard it is. But if you know the true benefits, you can often tough it out and soon reap all the rewards!

http://www.phdinparenting.com/2009/05/14/the-scientific-benefits-of-breastfeeding/#.UDbtFNCe6bk