I have been avoiding talking about breastfeeding, partly because it is such an emotive issue causing arguments as soon as you even open your mouth and partly because I didn't trust myself to write evenly on...well, such an emotive issue! But with National Breastfeeding Week just behind us, there's been a lot of chatter about the issue and I have a particular experience so I am going for it. Sorry for the length of this post.
My first baby was born last summer. I fully planned and looked forward to breastfeeding. After he was born, I thought he had latched on nice and quickly and had a little drink but it became apparent over the first day that he wasn't feeding. He wouldn't open his mouth at all to latch on. I was left alone for several hours after the birth and when I asked if it mattered that the baby just slept and didn't want to feed, I was told it was fine, he was tired from the birth and I should get some rest.
It wasn't fine. He didn't feed that day. He didn't feed within 24 hours. We spent most of the first night trying. I tried hand expressing to feed him with a syringe, but got very little colostrum out, even by colostrum standards. The second day was no better, he literally wouldn't open his mouth. Staff started to talk about formula top ups and as I wasn't producing colostrum, and he wasn't latching on I didn't have much choice. Feeding became syringes and cups of formula, interspersed with failed direct feeding sessions.
I can't now remember exactly when the expressing machine appeared, but it was probably day two or three. It didn't work, nor did the hand expressing. He wasn't even taking much of the formula. Day three saw us going home, the staff saying they'd let us go if we had an expressing machine. Now, looking back, I am shocked by that (I was desperate to go home and 'be normal' but I should not have gone, I know that now).
Home was no better. The baby didn't feed. My milk came in day four and I instantly became horribly engorged. Massive, rock hard, and very painful. Our hand expresser was useless. The midwife brought me an electric expresser on day five, but by that time my breasts were probably thinking there was no baby to feed.
Feeding attempts were awful. The midwives spent hours with us each day which was great of them, but the comments of 'we really need to get this baby feeding now' did not help. I wanted to scream at them that my every moment was about trying to get the baby to feed and how could they not think that? Occasionally he would get some kind of latch and get a bit of milk, but if it lasted a couple of minutes that was it. The advice seemed to change each day and rocketed between not topping up at all to motivate him to feed from me, to topping up if he seemed hungry still after trying the breastfeed and everything in between.
Feeding attempts were also excruciating. We never once got the latch right. I had cracked, torn and black nipples. Painful just doesn't come close. Lansinoh cream was helpful but nothing could solve how to let the nipple heal while still trying to feed.
He also didn't open his bowels after day four, everyone told me it was because he wasn't eating. And of course he lost weight. As each day came with no change, I would ring the midwife helpline and they would send someone out. I felt like a burden, a failure, and I was scared. I was getting virtually no milk with the expressing machine, so I had to top up with formula which I hated.
On day ten I had a joint visit from the midwife and the health visitor. I reported the baby seemed to have fed a little better that morning, but he weighed in at 10% less than his birth weight. They said technically he should go to hospital but they would just persevere with what we were trying at home so we'd wait a bit longer and see how it went. It went badly. He went downhill that day, lethargic and finally throwing up green bile. It was enough. That night we were back in hospital and the following day transferred to Cardiff Children's Hospital.
At eleven days old my baby had emergency surgery for Mal-Rotation of the Small bowel. His bowel wasn't fixed properly and had twisted 180 degrees, shutting down the oxygen supply to his bowels and closing his digestive system. No appetite to make him feed, the little bit of food backing up through his closed off system into his stomach, and finally coming up in the vomit. The surgery went fine, he was very lucky and his bright blue oxygen starved bowels pinked up by the time they had finished so he didn't have any bowels removed.
It was quite simply the worst night of our lives, but he is now fine, bonny and bouncing. I wish I could say, however, that as he recovered from the surgery and went back onto feeding by mouth instead of a tube, he latched on eagerly and we launched into being a lovely happy breastfeeding duo.
My supply, despite continuing to express throughout this time (in all, the baby was off direct feeding due to surgery for six days, sitting on top of ten days of virtually no direct feeding) was non-existent. We went home after ten days in hospital having satisfied the hospital we could feed him adequately but this was - out of necessity - combination feeding.
I could have given up and just bottle fed him. It would have been easy and I wouldn't criticise anyone for making that choice. I just wasn't ready to stop trying. I remember one Friday afternoon, when he was about 10 weeks (yes, this went on a LONG time) we spent three hours solid trying to breastfeed, him stopping and starting, still wanting to try, but never getting satisfied. Having to top up after that felt like a kick in the teeth. I was in tears as I fed him the bottle. My sister begged me to give up, but I just couldn't. I felt like I hadn't tried enough, hadn't expressed enough, hadn't put the baby to the breast enough to stimulate supply. Ridiculous I know, but trauma is a powerful thing and I transferred a lot of grief from what we went through onto my performance.
That day was my breaking point. I told myself we would have one last try and then that would be that. I went back to basics. I read and reread the Sears breastfeeding book, looking at the pictures of successful latch-ons. And then I read about the Sears lower lip flip. It changed everything. The baby still didn't open his mouth well,but with this technique I learnt to open his mouth wide while getting him on, and also to roll his lips out further without breaking his latch. The pain went, it literally just went. At 11 weeks, we had learnt how to latch on. Now we could breastfeed at night instead of faff with bottles, and we just (just!) needed to up the supply.
For several reasons (not the least of which was helping my husband run our business which meant I wasn't always available at feeding time), I couldn't make this my only task. A wise midwife told me to bide my time and I might find one day I had the time to focus more on it. I also still had to top him up pretty much every feed to satisfy his hunger which of course creates a vicious circle of confused breasts. I was only my stubborn streak made me continue to try breastfeeding. I wouldn't recommend combination feeding to anyone as it seems designed to torment the mother, but it was what I chose.
By sixteen weeks I would say we could latch on confidently. If I am honest though, all autumn I felt that I was indulging myself that I was breastfeeding, when in reality at least 75% of his milk probably came from the formula bottle. By early winter, just before we started Baby Led Weaning that was edging down towards 50%. He to solids very enthusiastically so we now had a three point feeding system. Even thinking back to it now is exhausting. But.
But. In early February, when the baby was coming up to 8 months old, I realised that the bottles of formula were being pushed aside after only a few sucks, and he was asking to breastfeed more. One day I simply didn't offer him a bottle and we have never looked back. My milk supply improved week on week and I have never felt since that day that I didn't have enough to offer him.
He has recently turned one and he has a great appetite for solids. We are also still breastfeeding and we both love it. It is easy, convenient and bonding. It is everything I imagined it would be. It was invaluable a few weeks ago when a combination of sick bug and hot weather destroyed his appetite for three weeks, apart from milk. It was incredibly hard getting to this point and that makes it even more precious.
I consider myself lucky, which might seem odd considering this tale I have just recounted, but I do. I am lucky that persevering worked out for us, I know it doesn't for everyone. I didn't know in the early days that it would happen this way and if, in my former childless days I had read this I would have been horrified at the apparent self-torment. But for me, the torment of not thinking I had done enough would have been worse. And despite how hard it was, I would do it again in a heartbeat.
I wouldn't have missed this experience for anything. I always fed my baby, one way or another, but now feeding is a pleasure as well as a necessity.