Sunday, 30 June 2013

My breastfeeding journey

As I've spent the last week helping locally with Breastfeeding Awareness Week I thought I'd share my breastfeeding journey with you. 

When we started trying to build a family I had just turned 29, we’d thought about it for years and were very ‘active’ in trying to conceive. Unfortunately this wasn’t to be and before long we were at the hospital receiving various cycles of IVF. I was 35 when a cycle finally worked and we were expecting our first baby. I felt that we’d tried so hard to have a baby that we owed it to ourselves to be the very best parents we could so I read a great number of books on pregnancy and early baby-hood. When I learnt that breastfeeding could potentially reduce the chances of developing food allergies I knew I had to breastfeed. I have a number of food allergies myself and felt that anything I could do to spare my child from these was well worth doing.

We went to NCT antenatal classes and while ‘breast is best’ was constantly repeated the actual focus of ‘how to breastfeed’ was probably only one hour of the course. I expressed concern to my sister (who already had children) who told me not to worry and that mum would ‘sort me out’ as she had done for her.

When my baby was born, I had a difficult time in getting her to latch on. I’d had an induction and an epidural as well as some gas and air and had eventually delivered my baby by ventouse. No-one had explained to me that anyone of these procedures might make the early stages of breastfeeding difficult and added to this I have very flat nipples (everyone was calling them ‘inverted’ but I now know they were just flat) and even my mum couldn’t get me breastfeeding.

My problems were exacerbated by a migraine at 24hours post delivery where I could barely lift my own head never-mind concentrate on feeding my baby. I was heartbroken when the nursery-nurse took Rosa for a blood glucose test, told me her glucose was dangerously low because I was starving her and immediately ‘administered’ 40ml of formula.

I decided to go for a shower at this point. Once in the flow of water I let the tears run, I was still blubbing when I stepped out and cursed myself for crying so much my feet were getting wet. When I finally dried my eyes of course I found that it wasn’t my tears making my feet wet it was my milk. I remember just then I heard a baby cry out side and my milk stopped dripping and started pouring, I could have filled a teacup a metre away. I put my clothes on as quickly as I could and went out and told the nurse that there was no way I was starving my child and demanded she get me a breast-pump.

In no time at all I had produced 40ml of breastmilk and came to a deal with the nurse, I would pump for each feed, I would show her or a colleague that I had produced at least 40mls. They would then test her blood sugar and then I would feed her my milk from the bottle (no one ever mentioned cup feeding and I certainly didn’t know about it).  If we passed 36 hours without going under a particular level of blood glucose I would be allowed home, where I already had a breast pump, bottles and a can of formula (which I’d bought just in case). I gave up on direct breastfeeding at that point I just wanted to get home. Once at home my mum and a number of good friends tried to help me get her to latch on instead of bottle-feeding expressed milk.

My mum suggested stripping baby down to her nappy as she’d been told to do with me. We mistakenly thought this was because warmth was making her sleepy, we didn’t realise it was skin-to-skin contact that was needed so I kept my nursing vest on. It was a very hot summer so I was even feeding in the direct line of a fan, just to try to keep her awake to feed. It sort of helped but the breakthrough came when a friend who’d had similar problems told us where we could get some nipple shields from. My husband and mum (who had suggested shields from the start) were duly dispatched to the shop and came back with some silicon ones. I have to say that at that point those shields saved my breastfeeding relationship. Baby liked the shields and I found I could control the mess they made (they filled up and dribbled in no time) with a well-placed towel.

I always intended to come off of the shields but again I was let down by poor advice as everyone, midwife, health visitor, my mum and many others suggested ‘cutting the shield down’ with a pair of scissors slowly making the hole bigger. Baby out rightly refused to let them back into her mouth once she realised they had been cut as try as I might the cutting always left sharp edges. The friend who’d originally told me about them admitted she’d never come off of them either in her 6 months of breastfeeding and so at about six weeks I resigned myself to using them for the rest of our breastfeeding. That was when I went to my first La Leche meeting.

Another girl from my NCT antenatal group had had problems with her baby too and had already sort out their help. Problems largely solved she had been invited to the meeting and wanted a bit of moral support going in so I said we’d go too. I have to say that first meeting was a bit of a shock, I’d rarely seen a sling before, and I’d certainly never seen a child over six months being breastfed, seeing a 3 year old do it blew my mind! However I was willing to admit the children all seemed very happy and healthy and the welcoming friendship of the other mums encouraged us to go back for the next meeting.

It was on my third meeting that I discovered ‘The Breastfeeding Answer Book’ had a section on shields. I learnt then that the ‘cutting down advice’ applied only to rubber shields and not silicon and that if I wanted to wean off shields then what I needed to do was essentially put a piece of sterilized cloth in the shield to make it more difficult for her to get the milk and then show her how easy it was to take it straight from the breast. I gave it a go and got into a terrible mess, milk everywhere, a rather sore nipple and a screaming daughter. Subsequently I gave up on the whole idea and decided I would continue using the shields.

La Leche changed how I felt about long-term breastfeeding. When I went back to work I carried on feeding baby when I was with her and I had wanted to carry on feeding until she was 2 however I also wanted a larger family and we had a time limit (at that time they would only keep frozen gametes for IVF for 5 years and we were already 2 and a half years in). My IVF consultant was not particularly understanding about my wish to continue to breastfeed but I thought we’d come to an arrangement where we would try implanting during a ‘natural cycle’ without medication. However that message didn’t get communicated to the staff and in the hospital on the day of the transfer I was suddenly given an injection and my breastfeeding abruptly stopped.

I was in pieces (well I just been given a syringe full of hormones!) and I called several LLL leaders who did a brilliant job in counselling and encouraged me with the thought that a sudden stop in breastfeeding can lead to an element of ‘super fertility’. Whether it was that, luck, brilliant fertility treatment or a mixture of all three I don’t know but 2 weeks later the pregnancy test said positive and it all seemed worth it.

When my second baby girl was born I thought I would be able to crack the breastfeeding quickly and settle down to two years of feeding. How wrong I was. She just wasn’t the same child as my first and clearly hadn’t read the books I had, on top of this I had terrible SPD and many health professionals were telling me that to continue breastfeeding would just continue the SPD. Thank goodness I didn’t listen to that advice. However after less than a week of trying to feed both with and without nipple shields my nipples were exceptionally painful and I made the decision to just feed with shields. Quickly the pain dissipated and I resigned myself to never doing ‘normal breastfeeding’, except that once again she had different ideas.

When she was about 6 weeks old I settled down to feed her when her big sister wanting help with a book, interrupted me. As I leaned over her she very gently helped herself to my uncovered nipple, I didn’t even realised she’d latched on until I leaned back. She looked happy so I pulled her a little closer and let her continue. At the next feed she just pushed the shield away and we’ve never looked back.

I had intended to feed her for just the NHS recommended 2 years but as ever she felt differently and I realised that I could just let her ‘self wean’, so that’s what we did.

On the eve of her third birthday she decided she was a big girl and wouldn’t have ‘num-nums’ any more. By the evening of her birthday my breasts were nearly bursting so I decided to hand express into the sink, she quickly realised this was a waste and said she would help me by feeding! Shortly after this however I decided I’d just had enough of the constant night feeding and negotiated a deal with her that she would have extra playdoh time with mummy in return for not feeding at night. (It wasn’t exactly a reward system, I explained I just couldn’t cope with the lack of sleep and that everyone needed a ‘happy mummy’.)

When she was about 3years 8 months I developed ‘nursing aversion’ but after working through my feelings decided that if I could drop the evening ‘going to sleep’ feed (which by now was actually hurting as she had a tendency to chew as she went to sleep) I could carry on.  However this really was the beginning of the end.

Daytime feeds quickly disappeared and in the early mornings she would complain ‘there’s not really much there any more mum’. Again as she approached her birthday she told me that once she was 4 she would be a big girl and wouldn’t need it any more.

Just before her birthday we went on holiday. In the evening we let the girls stay up late and consequently mornings got later and later. In addition to this the gite had a satellite dish and the girls found a kids channel they loved. In the end it seemed breastfeeding just couldn’t compete with ‘The Winx Club’ and she stopped climbing into my bed for a morning feed. When we came back to the UK she did climb in on a few mornings, even on her 4th birthday she wanted ‘num-nums’ first then presents, but I think I’ve only fed her two times since and on both times she told me there was no milk coming out. Recently she told me she thought it had stopped because it knew she was a big girl.

Looking back on the early days of my breastfeeding I clearly had an over active milk ejection reflex which was pumping out such a large amount of milk it was making my babies gag. The nipple shields didn’t sort out my perceived flat nipple problem, they slowed the milk down to a flow my babies could cope with. Biological nurturing would have been a great alternative (the ‘up-hill’ position slowing the milk down) and that together with skin to skin that would have helped to stimulate my baby to feed. Looking back at pictures of my first girl I can see how her head was so pulled out of shape by the suction, I bet it really hurt her to move her head at all. If the me now met the me then I would have had me expressing small amounts of colostrum before the birth to cup feed baby when she arrived. (It was a planned induction and epidural, it could have been anticipated that these would cause problems).  I’d also have suggested biological nurturing or cup-feeding when I had the migraine and I think that showing me how to feed lying down would also have helped a lot. Finally I’d have thrown away the Gina Ford and Claire Byam-Cook books and introduced Dr Sears and the Womanly Art of Breastfeeding a lot earlier. Of course hindsight is a wonderful thing.

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