Let's Talk About Formula

What's with mom guilt, anyway? As women, we are made to think that we should have this mothering stuff down to a science and that it should all come naturally. 

This holds especially true with breastfeeding. There are so many things that can go wrong and yet we are expected to know what we are doing even if we’ve never done it before. Hence the guilt, right? 

According to the CDC, as many as four out of five moms start out breastfeeding, but only half are breastfeeding by six months of age and just a third are still breastfeeding at the 12-month mark. According to research conducted by lactation-pod company Mamava, 42 percent of moms end up supplementing with formula at some point in their baby’s first year. 

So what’s the deal? Is breastfeeding something that mommas can actually succeed at? At what point is it ok to call it quits? Is formula really that bad?

Our guest today is Florida-based IBCLC Oneida Segura. In addition to being a lactation consultant, Oneida is also a Registered Nurse and has worked with new mothers in a breastfeeding, health, and education capacity for decades. She has three girls, one beautiful grandbaby boy, and she is proud to service the Spanish-speaking community in South Florida as well as breastfeeding moms around the country.  

We hope you love today's episode all about formula feeding!

Transcript

Amanda Gorman: 0:00

[Intro] Breastfeeding Unplugged. Welcome. Welcome. Welcome mamas and mamas to be. A podcast dedicated to helping moms navigate their way through the tricky world of breastfeeding. Breastfeeding Unplugged. Hi there mamas and mamas to be and welcome to another episode of Breastfeeding Unplugged. I don't know if this rings true to you, but when I was breastfeeding my two children, I remember feeling a lot of guilts. As women, we are made to think that we should have this mothering thing down to a science and that it should just all come naturally. This holds especially true with breastfeeding. Am I right? There are so many things that can go wrong. And yet we are expected to know what we're doing even if we've never done it before. Hence the guilt. Right? If moms are made to breastfeed, then why do so many struggle? And when it all becomes too much? Why do we beat ourselves up about it? If you're like me, you know that what all this really feels like and that you and I are probably not alone. According to the CDC, as many as four out of five moms start out breastfeeding, but only half are breastfeeding by six months, and just a third are still breastfeeding at 12 months. According to the research conducted by a lactation pod company, Mamava, 42% of moms end up supplementing with formula at some point in their baby's first year. So what's the deal? Is breastfeeding something that moms can actually succeed at? And what, at what point is it okay to call it quits? Is formula really that bad? Our guest today is Florida based IBCLC Oneida Segura. In addition to being a lactation consultant, Oneida is also a registered nurse and has worked with new mothers in a breastfeeding health and education capacity for decades. She has three girls, one beautiful, grand baby boy. And she is proud to service the Spanish speaking community in South Florida, as well as breastfeeding moms around the country. So welcome to the show, Oneida.

Oneida Segura: 2:22

Thank you for inviting me.

Amanda Gorman: 2:24

Of course, we're thrilled to have you here. Before I dive into my questions, I'd love to hear you tell a little bit about your background and how you got started as a lactation consultant.

Oneida Segura: 2:34

Well, 30 years ago, I have my first baby. And I struggle, as you said, a lot with breastfeeding. And I felt guilty and I didn't find any support. My pediatrician was just telling me to drink a cup of wine because I was too tense. And I don't like to drink. So that advice didn't help me a lot and like you have to be something else that, you know, mommies get help and support with this task. So I was very frustrated. And by the time I got my second baby, I had to give myself a little bit more. And I found that it was you it was support that it was La Leche League. And I was like, why the pediatrician even told me at least that, that I could ask another mom or somebody else with the difficulties that I have. So I said I would like to be able to help mommies. And I became a lactation consultant and a registered nurse and started working with quaner mommies and postpartum and helping them get that support that education that I didn't have. Because I feel like you know, if somebody had helped me, my story will have been very different. So when I help a mom and and she accomplish her goals, that is like the world to me, if it's only one mom that breastfeed because my intervention it made my day. So that's how I started with my own experiences.

Amanda Gorman: 4:22

I love it. I love it. And I hear that quite frequently from our team at Nest Collaborative how they initially became lactation consultants was through their own experience breastfeeding, positive or negative. So thank you for sharing that. So let's start. I'd like to talk a little bit first about breastfeeding and formula feeding. Most moms get just kind of thrown into breastfeeding as soon as their baby is delivered. And we hear people tell us all the time that breast is best and and we know breast milk is is the best nutrition for baby. But what do you think the major advantages and disadvantages might be for breastfeeding.

Oneida Segura: 5:04

Well, advantages, it has all the advantages, right? I will define the benefits of breastfeeding as in one phrase, you know, human milk for a human being. But it's also a personal decision. It doesn't work for every mom. Like, not all woman wants to be a mother. The majority wants to have a family and be a mother. There is someone there's some woman that doesn't want to be a mother. So breastfeeding is also like that. It does have to be that desire plus dedication, but the mom has to be something that work for now. Not feel pressured by society or feel pressure by the medical community, because you have to do that. It's something that you have to come natural for demand desire, like she decided to become pregnant, she should be desiring to breastfeed too. So so mom's struggling a lot and unfortunate, so healthcare professionals, make the mother feel guilty if she decided not to, um, is not right, we need to respect the mother's decision. There's mothers that don't want a baby on the breast. They don't want to breastfeed, even if they have plenty of milk. And it's hard to judge that because sometimes we don't know, in the past of their mother, what happened. There's mother that had been sexually abused. And they don't want a baby in their breast because it make them retrieve that bad experience. So it could be physical, it could be psychological reasons. It could be work reasons. This could it could be many reasons. So we have to be gentle and identify the mom's desire first, and then counseling. Yes, always breastmilk will be the best. But if it doesn't work for the mom, it doesn't work. And it's okay.

Amanda Gorman: 7:11

Yeah, no, I I think that's super helpful. And, you know, we face you know, women coming from all situations, backgrounds, areas at at Nest Collaborative. And I think collectively, we agree that education and information is key. But that's our job. And once we've delivered the information and the education, it's about helping mom do what she's decided to do. So I think you're spot on. So let's, let's paint the picture of of what those first few days for the moms that decide to initiate breastfeeding. What those first few days and weeks with a newborn look like, you know, what common issues do they run into when they're feeding for the first time?

Oneida Segura: 7:56

Yes, mothers need to understand that breastfeeding is not just natural. Did you have a baby, you have words, and you put the baby in diapers and oh wow everything goes? Well, it's gonna be difficult. And there's a lot of things interfering with breastfeeding. So it could be medical procedures. If the mommies receive tons of fluids, her nipples can be swollen, and they look like they're flat or inverted. And then we have healthcare professionals telling the mom oh you cannot breastfeed because you have like nipples, or inverted nipples or whatever. And, and sometimes those comments are, have have good intentions, but it's telling the mom you don't have the equipment to do the job. So I start getting the mom like, I cannot do this, you know, instead of being supportive and said, you know, let's try it. Let's see. You know 'cause things will get better. So that is why they support at the moment surround herself around healthcare professionals, family, friends, is so important because it's very sensitive. Timing after you deliver, your hormones are crazy. You have those mood changes. You have a new baby that you never have somebody to take care of 24/7, you have two or three days in labor or pre labor, you might have a C section or you might have to push for a long time. So all the things need to be taken in consideration not just putting the baby at the breast. Is the ma- mom physically able to put the baby at the breast as soon as the baby's born? Ideally, yes, we will like that the baby come out of the womb and go to the breasts and nursed perfectly fine, but it might not be feasible for some moms. They might be too tired. They might be exhausted, they might, I they're even hungry because they're not eating for, when you for 48 hours, probably, depending on how long they were was. So it's just being gentle. And I tell moms, you know, breastfeeding is not a destination. Breastfeeding is a journey is not a destination. So you're going to breastfeed this baby as long as you want. You don't have to do it in certain time, immediately, or whenever somebody else says. Give yourself time. Time to know your baby. Time to bond with your baby. So for me, the first thing you have issue happen is the skin for skin. For that mommy and the baby is hard to knowing each other start bonding, and then we can get the baby to the breast.

Amanda Gorman: 10:48

That's great.

Oneida Segura: 10:49

So in the first days, just be patient, just work with your baby. Do a lot of skin to skin when is possible. And and just start knowing that this is a new skill, the baby has to learn how to breastfeed, a mother has to learn how to breastfeed, okay, and they just sometimes need time, ideally, and a lot of babies can just be born. And they are those babies that we call barracuda, they come to the breast and. And they are like I don't need no teaching. I don't need nothing. I know what to do. But we have other babies who are more[unknown], and they're one need some help. And they don't want to do the job or there might be some sleepy babies. So when mom feel that pressure that she had to feed that she had to feed the baby that she had to feed the baby doesn't make things worse, because now she's very anxious. And now she doesn't know what to do and the baby's not cooperating. And, and we are telling them, oh, baby's gonna lose too much weight, and they're making things worse for her because now she thinks that the world is gonna end or she's a bad mother and we should avoid that.

Amanda Gorman: 12:05

Mm hmm. Absolutely. And that's what lactation consultants are here for is to help moms, you know, like that, get through those first few days. Let's talk a little bit about milk supply. I think just about every mom is worried that her baby is hungry after a feed or wonders if the baby got enough milk. How do you know if you're producing enough?

Oneida Segura: 12:33

Well, in the first three to five days, mom has been no colostrum and colostrum is producing very small amounts. So baby need small amounts to eat. So putting the baby at the breast, and mommy knowing that breastfeeding should not hurt so that she is getting the baby's getting a good latch, that baby will transfer the colostrum that the baby needs. If talking about a healthy baby, that's all the baby needs. And how do we know that, because baby's happy, baby is eating frequent, and the diaper output. Baby sleeping, babies poop. And when we weigh the baby, baby lose weight. That is normal up to 10%, 7 to 10% of the birth weight in the first days of life. But baby need to start with gaining weight. And that's how we know the mom is breastfeeding and baby's getting the nutrition that the baby needs. If the baby has a problem, maybe have any condition that baby might need additional supplementation more than colostrum can provide. That time then the mother can substitute her breast milk, not substitute I supplement the baby with in this case will be formula. But the idea of those first day to for mom to maintain her milk supply is that the baby need to be supplemented in the first week of life. We should be doing it with artificial supplementation with supplementation methods and not just a bottle so the baby can be supplemented with a spoon, a syringe, with a cup, and continue being at the breast. So let's see that a newborn has low blood sugar and mommy start breastfeeding giving the colostrum that we know it will increase the blood sugars of the baby but the baby is still is not recovering as fast as we would like to see. We can give five or 10 ml of formula in a syringe and put the baby back to the breast to get their colostrum. The baby will recover faster and mommy's maintaining the breastfeeding relationship, and mommy is maintaining her milk supply. So what happens sometimes in the hospital is when we tell the mom that the baby needs to be supplemented, and we start giving formula, mom forget to put the baby back at the breast. And that's when milk supply issues come. Baby's not latching correctly. And baby is skipping meals at the breast. And all the problems can come after that.

Amanda Gorman: 15:35

I think you bring up a really good point. Certainly I didn't know. And I think a lot of new mothers know that there are alternative ways to feed an a newborn, whether it's breast milk, donor milk supplemented or formula, such as on your finger, or with a spoon, or with even a little medicine cup, or like you mentioned a syringe. And how using those methods can be very, very beneficial for maintaining, you know, a good breastfeeding regimen and supply. So thank you because that that was certainly new to me when I had my first child. So if you have a mom who indeed is not producing enough milk, what do you do? Can you give us your top tips for increasing milk supply?

Oneida Segura: 16:29

The first, I would like to find out if there is a reason why she's not producing. So doing an assessment, what is going on. If it's a medical condition, that mom may have a hormonal or endocrine problem that is not allowing her to produce enough milk, or it's just because the mommy is not removing milk. So milk production is [unknown] by milk removal. So the more milk is removed from the breast with a baby or a pump, the more milk demand we produce. So she's not producing really what is going on, because we know the reason we can find a reason most of the time, then we can target the reason and increase her milk production. But skin to skin, if it's this is a newborn baby, stimulate milk production and how baby come down and go to the breast more common. Relaxed, frequent feeding, that we make sure that baby is transferring milk. Because there is more the status that I'm breastfeeding for 45 minutes for an hour, every two hours. I'm like oh my god. That baby might be on the breast for that period of time, but it's not getting milk from the breast. So being at the breast is not the same as eating at the breast. So we need to teach the mother to make sure that she knows the size that the baby is transferring milk. A mother that says okay, I breastfeed for 45 minutes and then the baby take a bottle of breast milk or formula two ounces. I'm like your milk supply is gonna be reduced because you are not removing milk. Baby is not getting to[unknown]. So finding the cause can help the mommy understand what the plan of action is gonna be. And just telling her to pump might not be the solution. So we really sometimes we as the healthcare professionals, lack of that time to say oh you just need to pump. I have a mom the other day crying telling me her story that the lactation consultant told her at the hospital to pump every two hours. Okay, well done solution, that's the solution problem be solved. When I talked to the mom she said physically, I cannot pump every two hours because I only have one hand. I like oh my god, you see. So sometimes when we give advice, we really have to look at the whole picture to make sure that this is possible. So how this mom felt when she was told you need to pump every two hours and she couldn't do it because she only have one hand. So that's why we this this is a delicate environment where we are counseling these mommies but we really need to make sure that we are targeting the problem and we are knowing what is really gonna work for the mom.

Amanda Gorman: 19:56

Everyone's individualized. You know this is such great information that you're providing and I hope that it's it's sharing with the moms and moms to be who are listening how much information there is to know and learn. And, and certainly empowering moms to not to hesitate to reach out for help with consultants early. You know what something that I know you do with us at Nest Collaborative is really emphasize the importance of more proactive engagement with lactation consultants, not waiting until there's a big problem, or you have an infection, or babies lost weight. That that there's so much to learn and know and mom shouldn't be expected to learn it all from a book or learn it all at once in the hospital. That that really engaging and getting guidance throughout the entire journey is so helpful. So thank you. It's been really interesting, everything that you've shared so far, and I still actually have a ton of questions to ask you. We are going to take a very quick break, and we'll be back with Oneida in just a minute. So stay with us. Like many of us, I've been trying to use less plastic in our household. I just tried Shambar, a new sulfate free shampoo and conditioner in a bar and it blew me away. Here's what I loved about Shambar, no yucky stuff, no synthetic fragrances or harsh color fading sulfates. As a mom, it feels good to know that I'm using a safer product, that my hair is healthier, and it's saving me more trips to the salon for coloring and more highlights. Each Shambar replaces two 18 ounce single use plastic bottles. It's a family business and for every order, they donate a month's worth of soap to a family in need. What a relevant give back to make sure all families have the resources that they need. A win win. Get your first bar absolutely free when you use the code first free all one word. F-i-r-s-t f-r-e-e on one of their flexible, cancel anytime, super easy subscriptions. Find out more at Shambar.com. Welcome back mamas and mamas to be. It's Amanda and I am here with IBCLC Oneida Segura, talking about breastfeeding versus formula feeding and how moms can make the best decisions for themselves and their little ones. Oneida I know that breastfeeding can be very hard and very emotional for the new mom. I have so many friends who say it was probably the toughest part of those first few months with their little one. So when should a mom reach out for help if they're struggling both physically and emotionally.

Oneida Segura: 22:38

Ideally, mom will have their support system set up before she deliver. So ideally, if she had been [unknown] can help a lot because now she knows what to do. And she knows who to reach when there a problem arise. So as soon as the mom have a problem, and I get these every day consulting with a mom, and we ask how is the latch and the mom said the latch is good. How are your nipples? My nipples are sore, crack, and bleeding. I like the latch is not good. Not have a good latch if you having such problems. And how long have you been having these problems for three weeks for one month for two months? And I call them that they are [unknown]. How can you have this problem for so long before you reach now for help. So moms should be reaching out for help before they have the baby. You build a support system. And i- immediately after these babies born and she's having problems when I do prenatal education, I tell mums, you know, you might not be able to retain everything we're talking about in this class. But at least I want you to make an effort to remember one thing from our conversation. Breastfeeding should not hurt. And pain is your guide that there's a problem that need to be solved immediately. And I did it myself with my first baby. I have my baby on my breast and he hurts. I was seeing the stars. And I said okay, it's fine. As soon as my baby's eating, I'm okay I can tolerate the pain. That's fine. I didn't know that when he hurts, maybe it's not eating and problems start arising because now the baby's hungry all the time. And now you have these babies crying all the time of hunger and your nipples are getting more sore, and crack, and bleeding, and falling off. Terrible things to happen. So moms need to understand that breastfeeding should be pleasant is is an enjoyable thing to share with you baby. You're sharing a meal, you are bonding with your baby, and you should not be in pain. So pain is[unknown]. If you hurts, you need to find help immediately. Wow, boy, all the problems that will come after.

Amanda Gorman: 25:26

Absolutely. I know a lot of moms who really beat themselves up when they do have to supplement for one reason or another, or even just switch entirely to something other than their own milk. Why do you think, you know, formula has this bad reputation?

Oneida Segura: 25:46

Well I don't think formula have a bad reputation. Breast breast milk is breast milk is best. And formula is an artificial, nope, this is a supplement. But again, it's the choice of the mothers how the baby's going to be fed. If baby need to be supplemented, ideally, mommy can supplement with their own milk, she can pump, and provide that nutrition for the baby. But if that doesn't work for the mom, the best thing after breastfeeding, after breast milk, then it will be formula. So the mother cannot breastfeed for one reason or the other, then the choice will be a donor milk that might not be feasible. And then formula. But I don't think it's because they have a bad reputation it's because formula can't provide the nutrition that the baby needs. And there's no doubt about it. But breast milk provides the immunity, the protection, the energy. Breast milk change with time to adapt to the baby's nutritional needs, breast milk change flavors, depending on what mommy's eating so it stimulate not just not just not providing the nutrition but also stimulating the other senses. Babies can have better speech, because they use all the muscles in their mouth to to breastfeed so babies are more intelligent when they are fed with breast milk because it has certain enzymes and proteins and nutrients that work directly in a human brain that formula cannot do that. So is the benefits of breast milk. That formula is not comparable. But in the nutrition part, if the mom cannot have breast milk then formula is a substitute.

Amanda Gorman: 28:06

Wonderful. Thank you. You know, just to wrap up, I'd love to get your three top tips for any mom who has had it up to here with breastfeeding. What would you tell her?

Oneida Segura: 28:21

Um, I will ask what what do you want to do? Breastfeeding is more also than just nutrition. There's more there's they might not have a whole milk supply. But they can still put that baby at the breast and enjoy the pleasure of feeding her baby, even if the baby might need to be supplemented after. So depends on what the mommy's goals are. I will tell them enjoy your breastfeeding journey in any way that you can. If it's exclusively breastfeeding, or if it's partially breastfeeding, whatever works for you. When I'm consulting a mom and she's crying, and she's not sleeping, and she's miserable. I said breastfeeding is not working for you. So you really need to enjoy your baby. And I asked the mother what is the most important thing at this moment. And they are like, that I want to breastfeed exclusively. And I say no. The most important thing is that you are healthy to take care of your baby, and your baby is healthy. And how you feed the baby will become in a second place. So let's take care of you because you're crying, you're not sleeping, you're not eating, you're not taking care of yourself. And if you get sick, then you're not gonna be able to take care of your baby. So let's take the nutrition and the feeding part and put it aside. And now let's concentrate on you and your baby to be able to enjoy this time together to be able to remember, when your baby was two weeks old, when your baby was a month old, how you enjoy those moments. And if breastfeeding in this case is interfering with that joy, we need to find alternatives, and give yourself permission that is, okay, you're breast feeding for some work for you and your baby, you might work for another baby when you have another one. But let's put in perspective, what is more important than your family than just breastfeeding is not all or nothing. So when moms relax, when the mom know that, she can do all the things, that's really my work better for the mom. Because now she's taking the pressure that she's putting on herself. And maybe some of the problems is because of the stress that she needs. She's not sleeping, she's not eating, she's, you know, mentally, if we don't take care of also the mental health with a physical health, and then they're going to be also misbalanced there. So we need to preserve mom emotional state, and be able to take care of her baby, and not just concentrate on the breastfeeding part.

Amanda Gorman: 31:43

Absolutely. And such an important point in preserving mom's mental health because plenty of moms do struggle with that postpartum. So thank you for bringing that to the table. This really has been an interesting conversation. And I think you've helped debunk some information about breast versus formula feeding. But I know you've also probably put some of our listeners minds at ease. So I know that as mothers we have this pressure to get it right all the time and do what we think is best and breastfeeding is certainly one of those parts of being a mom that can be incredibly daunting mentally. So thanks for clearing the air and giving mom's all some breathing space. We loved having you Oneida so thank you and in addition to being an IBCLC with Nest Collaborative, Oneida is also a native Spanish speaker, which is such a comfort to our Spanish and Latina mommies. How can our listeners reach you if they're looking for help?

Oneida Segura: 32:46

At Nest Collaborative.

Amanda Gorman: 32:48

Yes, please do. We love having you on our team at Nest Collaborative. You've been such a wonderful gift. So thank you so much for coming on today's show.

Oneida Segura: 32:58

Thank you for inviting me.

Amanda Gorman: 32:59

Of course. Well, mamas and mamas to be that is today's show. As always, we're here to give you all the support that you need to make sure that your breastfeeding journey is a success. If you have a topic that you'd like talked about, we are all ears so send us a message on Instagram or Facebook@breastfeedingunplugged, or visit our website at Breastfeedingunplugged.com. It's been awesome sharing this time with you. Until next week. It's me Amanda saying boo bye.[Outro]