This is the standard of care I recently received in America — and the nurses at the hospital were VERY well-trained along these lines. Not once was my request to not offer formula or sugar water questioned. There was also a lactation consultant on-call who came to the room to help with latch and give advice and support. They knew very well that my daughter would lose a significant amount of weight (less than 10% on average, but that’s still a lot), so they didn’t push for supplementation. I’m floored that Japan is so different — I have always admired the medical system in Japan and received excellent care (not OB-related) when I was there.

All that said, even here in America the common fear of nursing moms is that they are not making enough milk. Many mothers I met in my lactation support group (offered for free by the hospital) were obsessed with whether or not the baby was “getting enough” and would do things like buy baby scales to weigh after each feeding or “top off” with formula “just to make sure”. I think a lot of it stems from, as you mention, the lack of familial support many new moms face, a lack of education, and, let’s face it, the CRAZY behavior of newborns. Seriously, if I hadn’t been well-educated as to the benefits of a “virgin gut” and 100% breastfeeding, I would have DEFINITELY given formula — the way newborns act, it’s so easy to think they are tremendously hungry and unsatisfied on breastmilk alone. In reality, the cluster feeding stimulates milk production (so it’s a good thing they nurse a lot); their tendency to wake up easily when they are breastfed protects them from SIDS (so it’s better than the long stretches of sleep from formula feeding); and the fussing helps you identify issues (like foremilk-hindmilk imbalance or food sensitivities). It’s a shame that you practically have to go through it with a child before you realize that it’s totally normal for babies to act like this. But it’s best to remember what some posters above said: if 100% breastmilk wasn’t enough, the human race would be extinct!

I also recommend the Womanly Art of Breastfeeding, Baby Love, and all of the Dr. Sears books — great books!

I refused formula and was ridiculed. I told them not to feed her anything, even sugar water. I can only hope they complied with my wishes… At night on day 2 when my baby was screaming, I was told “that`s what happens when you refuse formula!” All I really needed was a bit of encouragement… Instead though, it gave me more determination to grit my teeth and carry on and show them all.

The following day my milk came in. The nurses were amazed (a little annoyed?). They started obsessing about weighing her before and after feeds. They kept suggesting formula. A formula rep came to my room and gave me a personalized spiel on how “great” formula is nowadays and even has immunity like beast milk(!!!). I threw away the samples and refused to fill in their form, suspecting a barrage of advertising would follow…

Unsurprisingly as a result of my self-taught nursing attempt I ended up with severe nipple pain, bruising and even bleeding. I visited three different hospitals for advice and cream. Eventually a private midwife helped me by massaging my breasts and unclogging some of the ducts. My daughter started feeding better after around 8 days and by 3 weeks I could latch her on without stamping my foot from the pain. Things got better and better after that.

With my second daughter I decided to change hospitals. As soon as I hit the second trimester I asked to speak to the head midwife and went through a detailed birth plan, most of which is run of the mill in the UK, but here needed my doctor`s special permission. I know I came across as the awkward foreigner, but I don`t care. I had the birth I wanted and my baby stayed by my side constantly after she was born. I refused to let her go in the nursery. I allowed them to keep her there for her 20 minute hearing test on the second day and I allowed them to give her a bath at some point. She didn`t have a drop of anything other than breast milk. My milk again came in more quickly than they seemed to be used to and they were amazed at how much weight she gained. It`s truly incredible that medical professionals can be so oblivious to something that should be so important to them: the supply and demand nature of the breastfeeding relationship.

I really want to somehow be able to help other woman who are struggling with hospitals like these, which discourage them and help lead them to believe there is something wrong with their ability to produce milk, when in fact it is the advice they are being given which is likely causing the problems. Breast milk isn`t simply best: it is the biological norm.

I was very sure I wanted to breastfeed exclusively and the midwives supported my decision. But when the nurses took over (from day 2), they kept insisting I should supplement immediately because my son was losing weight. I was pretty surprised they should use that against us because I was well aware that babies will lose some water weight when they are born and should be back to their birth weight about 7-10 days after birth. The midwife who delivered my baby was also aware of this and told me this right at birth. By day 4, my son was a bit over his birth weight.

I refused to supplement with formula and managed to hold them off, but it was not easy and I broke down in tears a few times. They would take my son away for a weigh each time I fed, telling me he was only drinking 18ml, when he should be drinking 30ml etc – so therefore ‘I was not making enough milk’. I felt so alone and constantly worried that I was starving my newborn.
(Note: babies need to drink less breastmilk than formula because it digests better and there is less waste)

It didn’t help that my well-meaning mother-in-law and husband were ignorant about the benefits of breastfeeding exclusively and although they didn’t force me into supplementing, the worry was very apparent – and voiced. The nurses would talk in Japanese to my mother-in-law and husband to let them know that the hospital strongly recommends supplementing, and so MIL and hubby would worry even more and try to talk reason to me.

The hospital made me go back after a week to weigh my son to make sure he was OK, since his crazy mother refused to supplement. Thankfully, his weight gain was in the ‘normal range’.
However, at the one month check-up they said his weight gain was below the ‘normal range’ and told me again that I needed to supplement. With this, I almost succumbed to supplementing but my instinct told me that something wasn’t right. I bought a baby scale with the intention of monitoring his weight myself before jumping into formula. Lo and behold, they had miscalculated his weight and my son was way above the weight they had measured!

I am very glad that I didn’t cave in. I know that formula is not the worst thing that can happen to my baby and that it is not exactly harmful but breast exclusively is definitely better. I also think that the doctors and nurses mean well and aren’t maliciously trying to harm my son but I do wish there was more support for breastfeeding.
I am not ruling out formula for my son forever but if and when I choose to add formula to his diet, I would like to do so on my own terms and with all the facts.

The pressure to supplement was (still is) immense for me and it is taking all my resolve to continue to breastfeed exclusively. The issue is that the pressure is not just put on me, but also on my husband and so he in turn worries and this adds more pressure on me.

Also, breastmilk production works on a supply & demand system in accordance with how much your baby needs. The more the baby drinks, the more the mother produces. By supplementing with formula, you are actually decreasing your supply of milk.

So a note to all new mothers and fathers – Be strong! Try to read as much as you can to stay informed and educated. Make up your own mind based on your research.
It also helped me to talk to other gaijin moms here to get some support. It can be very difficult and emotionally draining not to cave in to pressure when you feel all alone in the battle.

And it shouldn’t be a battle but sometimes it sure feels like it!