It doesn’t have to be all or nothing

by Kari Swanson

full term breastfeeding

My daughter was placed on my chest immediately after my obstetrician finished stitching up my c-section incision. She latched onto my breast and started breastfeeding right there in the operating room. Last month we celebrated her third birthday. She knows that babies have mama milk. She also knows that big girls have mama milk until they are ready to stop having mama milk. I expect that sometime between now and the time she is around 5 years old she will gradually wean.

Some might consider the fact that my daughter is 3 and still receiving breastmilk to be extreme, but anthropological evidence indicates that this is biologically normal for a young hominid primate. That being said, it is probably no surprise that I consider myself to be a lactivist. I believe that human breastmilk is the biologically normal food source for human infants and I volunteer as an admin on The Leaky B@@b in order to support other breastfeeding mothers and to help normalize breastfeeding in a culture that has largely lost sight of the real reason women have breasts.

What may come as a surprise to some is that my daughter and my son before her received formula in addition to breastmilk. Why? Because I work full time outside of my home and I am among the unlucky few who truly do not respond well to breast pumps. For whatever reason my body just does not give up the gold for a machine despite my supply being more than adequate. After a time, despite numerous tips and tricks, pumping whenever and wherever I could, I ceased to be able to pump enough milk to entirely meet my babies’ nutritional needs while they were separated from me while I worked.

With my daughter I was fortunate to be able to spend 3 months home with her after she was born, and to spend 3 months thereafter working half time. I pumped at home before returning to work and I pumped before work, during work, after work, and on non-workdays once I returned to work. I had a small stash of milk in the deep freezer when I returned to work, but it was quickly depleted. When I first returned to work and pumped I easily had enough milk by the end of the day to send to the daycare without dipping into my frozen milk stash.

I determined how much milk my daughter needed in her daycare bottles using an iPhone app called “Breast Milk Calculator.” The app uses the baby’s weight, age and number of feedings in the previous 24 hours to suggest how much milk he or she needs per feeding. Using the app I determined exactly how many ounces she needed per bottle. The number of feedings was based on the number of hours she was away from me and how frequently she would normally nurse.

But, just as it had when my son was a baby, my pumping output dwindled over time. Eventually I was pumping less than an ounce per side per pumping session. I used up my entire frozen milk stash. Despite my best efforts at around 6 months I was no longer able to pump enough to send only breastmilk in my daughter’s daycare bottles. So, I sent as much breastmilk as I could and to make sure she had sufficient nutrition I sent formula too.

When my daughter was a newborn she, like her brother, needed supplementation. They both had jaundice and they both lost more than the usual amount of weight after birth. Although her condition was better than her brother’s had been (he was a very sleepy 37 weeker with more severe jaundice), my daughter was also a slow gainer. So, the IBCLC we saw recommended supplementation while I built up my own supply. When my son was a newborn he received formula supplementation, but my daughter received donor breastmilk, or as we referred to it “Auntie milk”—because our milk donor was my sister who was still breastfeeding her toddler son at the time my daughter was born.

By the time my daughter was in daycare full time and my pumping supply could not keep up with my daughter’s demands my sister’s son had weaned. I considered donor breastmilk, but decided against it. My strong, healthy baby did fine on formula, and I felt that the relatively limited supply of donor milk in my area should be available to babies for whom formula was not an option, babies whose mothers could not breastfeed them at all or whose health really warranted the exclusive use of donor milk. So, we chose formula instead.

I already knew exactly what formula I would choose for my daughter if I reached this point, because I had read quite a bit of research about formula before I had my son. I looked up numerous scholarly research articles and reviews of the literature about formula on PubMed. At that point I knew I wanted to breastfeed, but I had been given the somewhat unhelpful advice that my desire to breastfeed and to go back to work full time were “setting [myself] up for failure”. So, in case that was true I did all of that research about formula and based my decision on what I had read. (Bear in mind that my son was born in 2004 and donor milk was not as prevalent, except from milk banks by prescription and at a rather high price.) Despite many assertions otherwise, infant formula is an acceptable, nutritionally adequate alternative to breastmilk and is a much better choice than the milk of any other mammal or milk made from plants.

Eventually both of my babies received only formula in their daycare bottles. Both times the amount I was able to pump became miniscule compared to the amount they needed and the stress and frustration of pumping so little became too much for me, so I stopped. They both did fine on the formula they received part of the time, so I felt comfortable giving them as much as they needed while they were separated from me. My daughter had breastmilk exclusively, either at the breast or in bottles, for more than 6 months. They were around the same age when they started receiving formula alone in their daycare bottles: 7-8 months. Despite this both of my babies continued to breastfeed whenever they were with me. They never experienced nipple confusion, expressed a preference for the bottle, or had nursing strikes. They both stopped receiving formula when they no longer needed bottles at daycare.

So, yes I am a lactivist. I believe breastmilk is the biologically normal food for human infants. But, breastfeeding doesn’t have to be all or nothing.


You can read more from Kari over on her site and enjoy her thoughtful, thorough writing and beautiful photography.


Did you respond well to breast pumps?  Have you had to supplement?  If so, what did you use?  Were you able to supplement and still reach your breastfeeding goals?



  1. Bridget Williams says

    I breastfed, pumped for, and formula fed my triplets. 🙂 I was very lucky to be able to pump tons and tons of milk for as long as I wanted to (I stopped just shy of 11 months). May I ask what formula you decided on and why?

  2. So many things in life are perceived to be ‘all or nothing’ this is a balanced and great look on how you can achieve your breastfeeding goals without making yourself crazy. At about 9 months, with each of my kids, my body stopped responding to a pump. The one who was in daycare got formula at daycare, the other was able to just nurse as I was home. I would love to know what formula you used. SO many have HFCS in them that I would like to know one I could recommend to friends that was a better option. Thanks for sharing your story.

  3. Good for you, and you make such a good point! It never has to be all or nothing, and I’m so glad that you were able to come up with something that worked for you and your littles! And congrats on the extended breastfeeding. I know that can get difficult, mostly just due to other people’s ignorance and their own issues. I breastfed both my girls until they were 2, and I plan to breastfeed my current baby (8 months) until around 2 as well. That is what works for us, but it sometimes gets hard because people start to comment after a year, especially my family. I just smile and brush it off, but it still angers me sometimes!

  4. Crazytwinmomma says

    This sounds just like me. My first were twins and I went back to work at 8 weeks. Around 8 m it was like I just stopped responding to the pump! They got almost entirely formula while I was gone because of it. With my 3rd I worked only nights, so I was able to avoid formula only because she only had 2 feedings while I was gone. My twins weaned themselves at 19m and this youngest is 17m. I’m hoping to make it to 2 with her.

  5. This article came at the perfect time. I have a low supply and have been supplementing since my LO was 4 months. At first I felt really depressed about the formula. I tried so hard with my supply, I tried everything.thank you

  6. I can’t tell you how happy this post made me. I was unprepared for the challenge that breastfeeding truly is and so my daughter has been supplemented with formula straight from the beginning. Eventually (YAY!) we got to the point where she could be exclusively breastfed, but it was only about 10 days before I returned to work full time. Now, she has one 4-5oz. bottle of formula a day and I had been feeling pretty sorry for myself that I wasn’t able to pump enough to completely feed her the next day. Seeing such a “lactivist” having to supplement helps me breathe a little sigh of relief. Thanks!

  7. PS Sorry for the horrible run on sentences. I guess I’m still pretty worked up about the whole thing.

  8. Question for Keri: At what age did you stop providing formula to your children while they’re at daycare? My son is 14 months and while I don’t want to stop nursing him, I’m facing more obstacles for pumping while I’m working and am coming up short on the amount of breastmilk for his bottles. I’ve used almond milk rather than an animal milk when I had to take a recent overnight business trip. But am thinking that maybe formula would be a better option than almond milk? Most people expect babies to drink cow’s milk at this age, but I don’t see the need for him to get milk from another animal. I will consult my doctor at my next appointment, but interested to hear what other extended-breastfeeding mothers, like you, have done.

  9. I ran into the same problem with pumping at work. I was able to pump about half of what he needed during the day. It was frustrating but I stuck with it! Some is better than none! 🙂

  10. “For whatever reason my body just does not give up the gold for a machine despite my supply being more than adequate.” I’m with ya, sister. I couldn’t get any milk out, and I was just doing it to supplement my friend’s very, very low supply after her cesarean birth. It felt awful to not be able to help.

    I’ve read up a lot on weaning and found that many, many tribal societies actually do wean their children earlier than 5, 4, or even 3 years old. 2 years old is quite common. They use a yucky-tasting salve or sauce on their nipples and the weaning is stress-free, harmonious, and fine. I used the same technique on my son at 23.5 months when I had had enough of breastfeeding and he was getting very possessive. He felt my ambivalence and actually was nursing more because of it. I was trying to gradually wean but it didn’t work. Abrupt weaning did.

    Reading your post I do feel a bit guilty for not letting my son wean on his own…although I am fairly certain that he would’ve taken years to do so. Just as we don’t give our children the choice to self potty train (it can go for 5 years too)…but we say when it is time and we guide the process. Those are my beliefs. In my heart of hearts, I know that I had to make the decision for myself and it was a wonderful choice for everyone in my family, especially him.

  11. THANK YOU!!! This was like reading my own story. I have a 15.5 month old and I have never responded well to the pump. (Ameda = really poor, Medela PIS = better, but still poor). For many months I was convinced that I had low supply. I didn’t make sense to me that my son would get more than the pump, now I know better. I stopped pumping at work when he was 13 months old and I have still been able to breastfeed him whenever he wants. I too had to supplement with formula because I just didn’t pump enough to meet his nutritional needs. He also needed formula in the hospital due to low birth weight (however, I wonder now if that was necessary). I never researched formula because I was sure I wouldn’t need it. Wish I had. We ended up going with the brand the hospital gave us. There are a lot of things I would do differently next time, but my 15.5 month old is healthy, happy and still nursing. Your comments were very insightful. Thank you again!

  12. Kari,
    After your research, what formula did you find was best? I am having to supplement as well and would love to knw!

  13. Thank you, all. I am glad that sharing my story has provided support to others.

    Jenny, I stopped providing formula in bottles at slightly different times for each child. My daughter continued to receive formula for slightly longer, because just before her first birthday she had a severe GI virus and lost a lot of weight. Breastfeeding kept her from becoming dehydrated and requiring hospitalization, but once she recovered it took a while for her appetite to return to normal so I continued to give her formula in her daycare bottles/sippy cups until she was about 17-18 months old. After that she switched to whole cow milk.

    To those of who have asked, based on the research I did when I was pregnant with my son I chose a formula that does not contain palm olein as an ingredient. Some research has shown that babies who receive formula with palm olein as an ingredient have lower bone mineral content and lower bone mineral density than babies who are fed formula that does not contain palm olein (see: I personally found that concerning, so I chose a formula that did not contain palm olein.

    You can find formula ingredient lists on the web sites of most of the major formula manufacturers, although sometimes you have to visit the parts of their web sites that they intend for healthcare professionals rather than the sites intended for parents. Alternatively you can read the cans/bottles in the store.

    Please bear in mind that I made the decision that I felt was right for my children. You may read the ingredient lists and believe that there are other factors that are more important for you or your baby.

  14. Thank you! I think if more breastfeeding classes told stories like these more people would breastfeed longer. We had latch issues and still do. 13 months in I still use a nipple shield. She would only latch with the shield and on a boppy. i am fortunate that my daughter is able to come to work with me. My boss was very supportive of breastfeeding. But trying to accomplish this in public was a nightmare. She would throw the shield then we would go wash it then screaming then bleeding sore purple nipples bc we weren’t in the correct position (for her). I also could not pump very much either and as time went on one boob completely stopped working and the other I could only pump an oz on good days. I started to do formula while at work. I would breast feed her in the morning before we left and all she wanted when we got home. Using formula helped me reach my goal of a year. She weaned from bottles around 10 months. I started putting her formula in a sippy cup and she decided it was disgusting. Now she bfeeds in the am and that’s it. Even with all the trials of breastfeeding weaning is bittersweet 🙂