“The Power of The First Hour” – inspiring or terrifying?

As my little girl in the photo is coming up to five years old, I thought I’d share again one of the first moments of meeting her and how it still makes me feel now…..

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This is a photo of my first ever feed.  What do you see (apart from the carefully placed ‘x’ to preserve my daughter’s modesty)?  A loving first moment between a new mother and her baby?  Yet another lactivist exposing herself and wanting to show off how great she is?

This photo doesn’t make me feel good.  It makes me cringe.  Not because of my greasy hair, man arms or post baby belly.  Because, knowing what I know now, it is no wonder I had the difficulties I did with breastfeeding.

Save The Children have brought out a document which promotes breastmilk as a superfood, specifically colostrum.  Colostrum is bloody marvellous stuff.  “The most potent immune system booster known to science”.  Of course it is – it comes out of a woman (feminist hippy, get back in your cage!)   They have estimated that 830,000 infant deaths could be avoided if they…

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Damned if you do and damned if you don’t

To be quite honest, I never really thought I would breastfeed. Ever. I don’t really know why. Maybe it was because I had always had hyper-sensitive nipples and the thought of a baby sucking on them was akin to a horror vision. Or maybe it was because everyone I knew with a baby was bottle feeding. I didn’t even know I had been breastfed for a while, because mum always talked about the different flavours in formula you used to get back than. So my mind was, in a way, pre-programmed to bottle feed.

And then I weed in a plastic cup, put a stick in it and watched two blue lines appear. My whole world changed. Hubby and I were ecstatic.

The further along in the pregnancy I got, the more I felt I didn’t have a clue about how to feed a baby. As explained before, bottle feeding seemed to be the natural thing to do. I should also add that I’m not originally from the UK. My husband and his family (English) had strong view points about bottle feeding and I found myself under quite some pressure to breastfeed. All the leaflets and information handed out in the antenatal classes and at midwives’ appointments were about breastfeeding – bottle feeding was only mentioned as an after thought. Not one word about the fact that some women cannot breastfeed, for whatever medical reason (neither of my sister-in-laws could with their first borns), or do not want to breastfeed, for perfectly valid reasons. Not one word about there sometimes NOT being a choice, and all these implications of you being judged as a mum already, before the little one is even finished baking. I felt that this was an extremely intimate business everyone else should keep their nose out of. That included family members, as well as health professionals.

I felt pressure was added, because I felt my husband expected me to be the same mum that his had been to him. Expectations of others, but I guess mostly of my own making were weighing down on my shoulders before the little one even was born. And as I was sitting in pregnancy yoga, listening to the birth stories of the “goddesses” who had come to class to show off their babies, popping on their newborns in front of everybody as if it was the easiest thing in the world, in crept the ultimate fear that I was not carved out to be a good mother after all.

What really, really irritated me and does to this day is how patronising the information provided was. “If you don’t breastfeed, you’re a bad mother. If it hurts, you’re not doing it right.” (Poopage squared.)

I decided that I would give breastfeeding a go. I was convinced I would end up giving the little one formula though.

Then I was in hospital, all alone with my little shrivelly newborn after hubby had to go home. No midwife, no nurse there to advise on breastfeeding, they were short staffed. All I knew was “tummy to tummy, nose to nipple”. And it worked, despite it being toe-curling. In comes the night shift midwife and tells me off. “You’re not doing it right.” Heard that so often after that from health visitors, nurses, doctors, midwives, breast support group volunteers.

Because what happened after that first “you’re not doing it right” was that I panicked. I had just given birth, something I never thought I would survive because I am a wuss, and I was so happy and proud looking at that little bundle. Feeling like I had done something really right. And that comment burst that bubble, made me feel like a loser, a bad mother, and we hadn’t even left the hospital yet. So I tensed up, got nervous. And my girlie felt that and reacted to it.

So I  tried out their advice. Even got my husband to look at my boob sideways to tell me if the latch looked anything like in the brochure they had handed out in the hospital. I tried out all the positions, all the tips and tricks, whilst desperately thinking: “I hope my baby won’t starve because I can’t do this right”. Oh, how I wanted to give the little one the bottle! I remember lots of tears, breakdowns, sore, cracked, bloody nipples, dread of the next feed, engorged breasts, sitting on the couch with the breast pump to give my nipples a break, more tears, awful arguments with the hubby, because he dared to suggest to take the baby off the boob and latch her on again, because that had been the professional advice.

And quite honestly, I would not have persevered without my husband. I can tell you he had to endure many, many tantrums. Tears streaming down my face because my nipples were so, so sore and the little one had decided now was a good time to bite down on them with her gums or to pinch them – and he supported me. He consoled me. He was sweet, understanding, driving-me-up-the-wall-understanding actually. He offered to go make a bottle, but I wanted to NOT give up.  And I cannot tell you why.

Breastfeeding hurt, for me. For a long time. We’re talking months. No tongue tie (much to the dismay of the volunteer at the breast feeding support group), just me being absolutely shaken in my confidence. Almost four weeks into the boob drama I went back to what I had done in the first hours, when my girly and I had been alone. And it worked! I think it hurt, for one because there are only a gazillion nerve ends in your nipples, and for another, I had always had extremely sensitive nipples.

I did give my milk-monster the odd bottle (either expressed or formula), simply because sometimes my nipples were so sore (hello growth spurt) and I had had another meltdown that I just needed a break. And she still latched on fine. Things eventually became easier. And after a few months my nipples became “iron nipples”.

The maximum I initially thought I could bring myself to endure was 3 months. I stopped breastfeeding when the little bear was 10 months old. I actually was a bit sad when I looked down at my baby, breastfeeding her for the last time, but I knew the time was right, she was ready to move forward.

Throughout these ten months I was criticised for breastfeeding my child at all. I was criticised for daring to give her formula and not just exclusively breastfeeding. I was criticised and ridiculed for breastfeeding for “that long”. And not by strangers. Oh no. By family members and friends. All of them mothers themselves. People who should have the most insight and understanding were the harshest critics, had the strongest opinions, trying to impress them onto a new mum. Well thanks a bunch for the support, dudettes.

I was lucky enough to be able to breastfeed. And it was the way of feeding my girlie that worked best for the both of us – and that really is the only thing that counts.

 

Toxic milk

I don’t often delete comments. In fact, I’ve only done it once before. Recently, that increased to two. The comment in question was in reply to a lady who mentioned she was feeding her four year old.  It read that she should be ashamed that she is *still* feeding her daughter as the toxins from her breast milk would likely cause autism and she hoped that her daughter turned out ok.

This angered me on many levels. Numero uno: she was only commenting to give unsolicited bollocky advice and not to say how great my blog is. Numero duex: for those that know, my boy has autism; I have found approximately several hundred reasons to blame myself for this and didn’t need another one.

It isn’t the first time I have heard about ‘toxins’ in breast milk and my own tits and teeth research showed up articles on the presence of mercury in boob juice which directly correlates to the number of fillings one has (nowt to be concerned about. Read here for more info). So what toxins are found in nipple-knocker-glories? Well….

A study looked at breast milk from two areas of America, North Carolina (5 samples from a milk bank) and inner-city Baltimore (8 samples from 3 non-smoking women collected over 3 days).  They were analysing for volatile organic compounds, like chemicals found in petrol and refrigerators.  MTBE (an additive used in unleaded petrol), chloroform (by-product from water disinfection processes), benzene (pollutant from anything that smokes) and toluene (car pollution, paints, adhesives and thinners), were all found in small amounts in the breast milk.

A simulated test, looking at exposure to an infant from a breastfeeding mother that may work in a paint shop or dry cleaners, for example, demonstrated that “perchloroethylene (dry cleaning chemical), bromochloroethane (was used in fire extinguishers but not any more), and 1,4-dioxane (in everything that foams) exceeded the U.S. Environmental Protection Agency non-cancer drinking water ingestion rates for children.”

During a 20-30 year period, organochlorine compounds were measured in human milk from women in Stockholm. It showed that a large proportion of the volatile compounds had significantly decreased over that time. However, PBDEs (used as a flame retardant in building materials, electronics, furnishings, motor vehicles, airplanes, plastics, and textiles) doubled in a five year period, demonstrating a direct correlation with the increase in environmental contamination from pollution.

Fifteen breast milk samples collected from women living in the city of Taranto, in Southern Italy, between 2008 and 2009, were tested for a number of chemical by-products that may be polluting the atmosphere. Four of these samples showed dioxin weekly intake values 10-40 times higher than is recommended by the WHO.

Do these studies make me want to beat myself with a stick and move my family to an oxygen tent in Frieburg, Germany (apparently, it’s very clean there)? Not really.  In fact, it makes me just emit a ‘meh’ sound with a slight shoulder shrug.

The first study was a very small sample and not really representative of a general population. It also found that inhalation exceeded the ingestion amount by 25-135 fold, meaning regardless of how a baby is being fed, an infant will be inhaling far more rubbish from the atmosphere. I suppose that does make Frieburg slightly more appealing.

The second study was a simulated study. No milk was actually analysed and, again, it doesn’t really apply to the general female population. However, it is perhaps something that women that do work in hazardous conditions should consider? More research is needed to look into whether the precautions taken to protect employees from harmful chemicals are enough to stop any contamination to their breast milk. If it isn’t, than the precautions aren’t good enough full stop.

The Stockholm study was concluded in 1997. In 2001, The Stockholm Convention on Persistent Organic Pollutants was signed by 50 UN states and became effective from May 2004. It’s aim is to eliminate or restrict the production and use of persistent organic pollutants. No further long term studies into PBDEs in breast milk have been conducted since 1997, so although we can’t assume it has automatically improved with the environmental treaty, looking at the data from the same study which showed a significant decrease in other compounds when other measures were brought into practice, it is not a stupid assumption to think that The Stockholm Convention has improved matters with all things mammary and milky.

The final study was the most recent, published this year. It was a small sample taken from women living in Taranto. Taranto is a large commercial port with well developed steel and iron foundaries, oil refineries, chemical works and food processing factories. I’m not sure what the autism rates are like in Taranto, but I can’t remember seeing any headlines about it. Again, a baby, regardless of how it is being fed, will unfortunately be inhaling the detritus being hosed into the atmosphere, and Taranto is not your normal suburban town.

A headline that made the rags recently was ‘Pollution Linked to Autism’. Scary stuff. WebMD then printed an article which cited expert opinion on the research which basically says, pollution may be a risk factor involved in autism for those living in polluted areas of the world, but it is by no means a cause.

Another hypothesise is that the growth factor IGF, abundant in breastmilk, is a possible autism suppressor and future treatment. However, the wonderful *inserts sarcasm* Dr Mercola has reported that we are consuming too much IGF as it is abundant in other food sources which is potentially causing us to be more autistic. *Scratches head*

From what I know about autism, it is a 50,000 piece puzzle of which we have only managed to create a third of the picture. Many pieces are still missing and we can continue to speculate, hypothesise and cogitate: vaccinations, too much TV, heavy metals, smoking, pollution, formula feeding, breast feeding, laughing too much, not enough tickles, watching Mary Poppins too often (I seriously thought Dick Van Dyke’s cockney accent may have turned my boy a bit wrong in the head).

After all I have read on this subject, it is, at least, one less stick I won’t be beating myself with.

Keep an open mind

Before I had my children I like to think I kept an open mind regarding breast feeding. When I was pregnant with my first baby, Max, I bought both bottles and breast pads; a feeding bra and a breast pump, formula and breast milk storage bags – I was prepared for whatever the feeding fairies threw at me!

My mum is a devout breast feeder – she even breast fed her adopted daughter, no less than 4 years after her previous biological child was born (yes, really!). She couldn’t understand why I’d prepared for both eventualities. “But breast feeding babies is the most natural thing in the world!” she would lament whist looking at my freshly purchased box of bottles like it was an unexploded bomb. “So is making babies” would be my retort, “but that doesn’t mean I want to do it every few hours, in front of all and sundry!” We agreed to disagree. But the truth was, the idea of having a baby drink milk from my breasts was more than a little disturbing. One night in my late pregnancy whilst lying in bed, I thought my husband had dribbled on my side of the bed in his sleep. Alas, to my utter horror, after waking him up to yell at him, I realised it was in fact milk, coming out of me! I was mortified! My point is, I believe having a baby changes everything, not just in a can’t-go-down-the-pub-anymore way, but in the way you see yourself, the world and everything in between. I don’t think anything can prepare you for the momentous shift in perceptions, any more than you can prepare for the way it changes every minute detail of your day-to-day life. Basically, I didn’t know how I would feel once the baby was born and I stayed true to my pre-marriage commitment phobic life – I decided to wait and see.

It’s at this stage I need to write a quick paragraph about my labour. I realised that this is when my feeding story actually began, but when I started to write about the labour, it took on a life of its own in a hundred-page biopic that could rival ‘war and peace’ (I evidently have some labour-related PTSD issues!) So, as succinctly as I can manage, here are some things you need to know about my labour that led me to my feeding conclusion.

My midwife was evil. I had a very long, pain-relief free, end-stage labour due to Max being back-to-back, or, to use its (oddly) proper name, face-to-pubes. I tore like an old sock (grade 3, surgery required to put me back together). Evil midwife grossly mismanaged my placenta delivery, wrenching it so hard from me I screamed – note: she wrapped it twice around her hand before pulling so hard with both hands that she visibly shook. I had a postpartum haemorrhage (undoubtedly caused by said evil midwife’s wrenching of my placenta). After removing my placenta said evil midwife sat in the corner of the room, with her back to me, blissfully unaware that I was bleeding to death.

Once the crash team eventually burst into the room, the doctor had to pummel insanely hard on my uterus to make it contract (he pressed so hard his entire forearm disappeared into my copious post-baby rolls of spare skin). This didn’t work so I had various drugs pumped into me intravenously into each arm. When calculating my blood-loss (‘only’ four pints) they missed the whole ‘slab’ of congealed jelly blood that I’d unknowingly been sat on, and the pools of it on the floor, and the stream of it that my mum had caught on her jeans as it was running off the bed! So subsequently I was not bestowed a blood transfusion. Instead I was gifted with severe anaemia, a hideous two night stay in hospital (more on that little gem later!) and a catheter, which I point blank refused to have, to which evil midwife told me “not to be so silly” and without consent, inserted anyway. I think you’re pretty much up to speed from here, and so I will continue with my feeding story.

As I was saying, I didn’t know how I’d feel once I’d had my baby, but when the midwife handed him to me for the first time, and he was all snuggled up on my chest, skin-to-skin, under my men’s XXL t-shirt purchased especially for the occasion, it was (urgh, most over-used phrase relating to breast feeding on earth coming up) the most natural thing in the world, to latch him on. So I did. Simple. The end. Sadly not though. That last bit was true. I did latch him on and he fed beautifully and I was insanely proud to be doing something that just hours before I’d been so sceptical about. But this is when my labour story and feeding story become entwined.

When I eventually got to the ward and I began giving Max another feed I encountered the most excruciating pain of my life. Forget labour pains, this was far worse. In my ignorance I had not known that when you breastfed, your uterus contracts. And my poor, battered and bruised uterus that had received the pounding of its life just a few hours previously was having a serious workout! I held Max to me, while writhing in pain; through tear-filled eyes I looked down at my toes, twisted and curled in agony. It was everything I could do not to wrench Max off me and fling him down the bed. I know, harsh, but when you burn yourself you drop the saucepan, you don’t hold it even tighter.

Right then my natural instincts couldn’t have cared less about breast is best, they were just screaming out to stop the pain. So I did. Not fling him down the bed. But I did take him off my breast. And of course he was not happy with that arrangement. So I tried again. Maybe this time it would be better I thought. But then and every subsequent time it wasn’t. I was sobbing by this point, in both pain and anguish. I called the midwife. It was still the small hours of my first night. When a midwife appeared and I said I was struggling with feeding, without a word, no introduction or anything, she marched over, grabbed my nipple in one hand, Max’s head in the other, and merged the two together. She then turned tail and left. I continued sobbing miserably. That was the entire extent of my breast feeding support. The next day, I found another midwife and told her about the pain I felt when I fed. Her solution – to bottle feed of course! So, in order to settle a very unhappy baby and give my uterus a break I reluctantly agreed to a bottle. And, what can I say, it achieved both goals. Happy baby, happy mummy. And yet, I was only happy with it as a temporary measure, I wasn’t ready to give up breast feeding yet, this was purely a short-term thing, I told myself. My remaining time in hospital followed in the same suit as my labour; I won’t go into details here but it was a miserable affair, I was treated appallingly and I was so elated when I finally got to go home.

Once home I decided it was time to try again with feeding. My uterus had settled down and was much less painful, however, I know this sounds incredibly naïve but I genuinely had no idea that I wouldn’t start producing milk until five days after giving birth. It was just logical – you have a baby, you have milk; I still can’t get my head around Mother Nature’s somewhat lackadaisical approach to milk production. But anyway, I kept trying with breastfeeding whenever Max demanded a feed, very important I learned, for getting that lovely stuff to arrive in your breasts. But when it got too much and he was screaming hungry in the small hours I caved, and gave him a bottle. Maybe it was a catch 22 in that by giving him bottles I was delaying my milk arriving, who knows.

It was now my first night home, Max was 3 days old and we were settling down for another sleepless night when I was gripped by yet another stabbing pain across my middle. I was stood up at the time and was literally doubled-over in pain. Ok, so this is new, I thought. This wasn’t my uterus and I didn’t have Max latched on either. And this pain did not let up. It got worse and worse as the night wore on. I cried so hard, I was so angry at yet more pain and when my husband took Max to give him a bottle I cried even more. “I just want to look after my baby”! I sobbed, broken hearted at what felt like yet another failing as a mother.

Having had his appendix burst as a child my husband feared the worst and called a doctor. He’d wanted to call an ambulance but I begged him not to; I was devastated at the thought of ever going back to hospital. I was exhausted. I’d had no sleep on the ward, I was still severely anaemic, the stitches on the patchwork quilt that was my nether regions were giving me serious gip and it looked like I wasn’t going to get any sleep that night either! The doctor arrived and examined me; he tested my urine and concluded that I had a nasty urinary tract infection. At this point I was enraged; this was the exact reason why I had refused a catheter! As a former employee of the NHS I knew that they were responsible for the majority of hospital acquired infections and not least UTI’s. And then came more bad news; he had to prescribe me both broad spectrum antibiotics and a powerful, targeted one too, ‘Metronidazole’ – in his words “nasty stuff”. I could not breast feed. Except, this news didn’t come as bad news at all. Relief flooded me; I could stop agonising over breast feeding; I had a valid, bona fide reason to not do it. The hideous mismanagement of my labour, the haemorrhage, the anaemia and the bruised uterus weren’t enough to justify quitting, but this, this changed everything. This put my baby at risk, this wasn’t about my own pain or discomfort, this was about Max; I needn’t feel guilty for quitting anymore! The doctor explained I could pump to keep my supply up and then try again after, but ‘hell no!’ was my main thought to this, I’d had enough! I knew I was quitting; throwing in the towel, giving up, whatever you want to call it, I was fully aware that I was choosing to not breastfeed because quite simply, it had become too hard.

Two days later, ironically, I got my Dolly Partons! Milk seemed to ooze from every pore, but I just ignored it; strapped them up tight against my chest and carried on, to be honest, without a flicker of emotion, with no regrets. I was done with breast feeding.

The end.

Nope, sorry, there is still more to come!

I was on the antibiotics for 10 days, my breasts were back to normal, in both size and milk production and Max was very happy having his bottles of formula milk. And I loved it too; true to his (later discovered) personality, Max loved routine, and he fed regular as clockwork, 3 ounces, 3 hourly; I knew exactly how much he was getting and how often, and his weight echoed this – he stayed perfectly on his 50th centile line. As a new mum, all of these things were incredibly reassuring and I knew I’d made the right choice in giving Max formula. Or so I thought. Some time later, when Max was about three weeks old, I woke in the night in a cold sweat. I was consumed with one, single thought – I need to breast feed my baby! I cannot explain where it had come from, but I was feverish, in a blind panic, how could I have been so stupid, how could I have not breastfed my baby!? I threw myself out of bed and not having a clue what else to do in the middle of the night, I ran a bath. When I was letting my milk dry up, having a bath had always made it flow out of me, it hadn’t done that for a while but it was worth a try until I could speak to the health visitor the next morning. I sat in the bath squeezing my nipples, trying in desperation to get something for my trouble but nothing came. I wanted to run back to bed, jump on my husband and start making another baby, just so that I could breastfeed. It was like a temporary insanity had come over me, I was possessed by the realisation that I may have missed my chance.

As soon as it was light I woke my husband to tell him me and Max were all packed and ready to go to my mums – if anyone knew how to turn back the clock on this one, it was her. My husband was surprised but supportive, as he always is of my many hare-brained ideas. Once at my mums she was brilliant, having breastfed all six of her children (the adopted one being the sixth), she really knew her stuff. In her breastfeeding heyday she produced so much milk that the local hospital sent round a special van to collect it for the NICU babies.

Our first objective was to find out how long the nasty antibiotic could stay in my system. For some reason, this proved to be no easy task. It seemed that as soon as you mentioned breast feeding to health professionals, they got an image of law suits, poisoned babies, death, disease and all horrors flash before their eyes and no-one was prepared to commit to when it would be safe. And so, not wanting to pose any risk to Max, for now all I was armed with on my mission was one, rather pathetic manual pump I had bought oh-so many moons ago when I had lived in blissful ignorance of all that had befouled me over the previous three weeks. So I pumped, and pumped until my hand was blistered and my nipples were raw. After about two hours I had produced about half an ounce of a very thick, creamy looking substance. It certainly bore no resemblance to the almost transparent, watery stuff I had previously produced, and yet I had never felt more proud of anything in my life. I decided based on various responses that when I was a full two weeks clear of antibiotics I would try latching Max on again. I’d like to reiterate for the benefit of people who feel that breast feeding should be about what’s best for the baby, how content Max was on formula. He was getting predictable, regular feeds, his weight was very steady and healthy and he was showing no signs of having a compromised immune system from not receiving the ‘benefit’ of my milk. In a nutshell, the only voice screaming about breast feeding was my own, and I was very aware (and felt dutifully guilty) that I was doing this purely to fulfil my own needs.

I did promise myself (and Max too) that I would not do anything that might upset him, his weight or routine. So just before he was due a feed I would make his bottle ready but then latch him on to me. I was so proud of him for happily switching from a nice, easy rubber teat with a plentiful supply behind it, to pulling with all his mite for very little in return on my withered mammary glands. At first I just kept him on a few minutes each side and would then give him his bottle straight after. Gradually I increased the time he was on me, and my guilt over doing it for selfish reasons diminished when he showed how happy and content he was on the breast; often he would doze off, something he had never done with a bottle, and it was wonderful that he was able to do that.

Over the weeks that followed, I barely left the house, days were spent either with Max latched on or with me hocked up to my newly purchased electric pump. Everything I did I saw as an opportunity to get my flow up – I ate like a horse, I drank gallons of water and languished in hot baths, squeezing my nipples throughout. I would always still give Max a bottle after every feed from me, because I knew in my heart of hearts, I was not up to full capacity, but what I did notice over time was that I never needed to increase the amount of formula I gave him. When I first started out he was on 3 ounces and that stayed the same, so whatever else he needed, he was getting from me. His weight remained beautifully on his ‘line’ and I think we were both overjoyed to be getting the best of both worlds.

I’d always thought my perceptions would change after my baby was born, I saw the birth as the defining point in this shift, but actually what happened was my baby was born, my perception changed and then a series of events happened to change my view of breastfeeding one way, then another and then another. I breastfed my second baby 100%, with a minor exception during the miserable five days it took for my milk to come in again, and I feel no shame in admitting that. Formula is not poison. This sounds like I’m joking, but honestly, I do genuinely believe that some people actually think this is the case. It is made by very clever boffins and is packed full of essential vitamins and minerals and I object strongly to the idea that by formula feeding my baby I was harming him in some way.

There are many benefits to formula feeding, and there is no reason why it should be frowned upon. Equally, I no longer find the idea of breast feeding disturbing. It is a beautiful thing and of course is brilliant for babies’ health and immunity, and establishes a bond too. On the whole I do not like the idea of extremes. To say ‘breast is best’ is a bit too extreme for me. Likewise, to not even entertain the idea of breastfeeding is also too extreme. Despite everything I went through with Max and then Poppie who followed, and despite saying ‘having a baby changes your perception on everything’, I am sticking to my pre-baby guns: you have to just wait and see how you feel and do what you think is right for you and your baby at any given time. And always keep an open mind. The end. I promise, this time!

Let me stress, not to stress!

So after a miscarriage and what felt like a million months of pregnancy and endless antenatal classes, I finally had a birth plan that would mean I could be totally in control of my perfect birth, relaxed in the comfort of my own home.

I hated hospitals and had learnt all about the importance of my hormones and how being relaxed was key, so thought well I won’t be relaxed in hospital so planned a home birth; I had the pool ready and everything.

I went into labour on a Wednesday night and the midwife arrived Thursday morning when contractions had got really strong and painful. After she examined me she broke the news I was only 1cm dilated! I could have hit her!! How is that even possible I said as what were my contractions doing? She explained how my son was back to back and so my contractions were not dilating my cervix. I cried and cried and she kept saying how I needed to relax!

Time went on midwives came and went as their shifts finished and after 28 hours of no sleep and full on strong contractions, the 4th midwife decided at only 2cm I was not going to be able to deliver without help and so would need to be admitted – my worse fear. I cried all the way to hospital I didn’t even have a bag packed! Friends and family kept texting waiting for news and I could not believe that having a baby could take more than 1day! On tv they pop babies out!

I arrived at hospital and they carried out tests etc and then found they had connected the machine up for twins and as I was only having one baby the readings over 2hours were all inaccurate – this did not help my relaxation! After breaking my waters they found muconium in my waters and were concerned my baby was in distress, we were now over 48 hours of labour. They gave me drugs to induce and speed up the contractions and then finally at 10pm ish on the Friday night they said the news I was desperate for…10cm you can start pushing!

After pushing for dear life for an hour they sent for assistance and the room filled with Drs etc and they decided to use ventouse to assist, however, this popped off his head twice scaring my husband and I thinking they had pulled his head off! They then used forceps and said with the next few pushes we will ease him out! Well I pushed, they pulled and after 58hours of labour he flew out and gave me a very bad tear! The shock that he was here and the stress and exhaustion of not sleeping meant I didn’t really want to hold him. A midwife shoved him on my boob in the rugby position and then I was whisked off to be stitched up, the whole time I was so anxious and exhausted and I was so gutted things had gone so horribly wrong.  It was not the calm enjoyable birth I had planned. I just wanted to go home and be left alone, not poked or prodded. I felt isolated and alone.

My birth was considered traumatic.

We got home and had our gorgeous boy weighed. He had lost weight and the midwife said she would be back the next day. She told me to hand express to help get more milk but I had no idea what that meant or how to do it.

That night my baby did not stop screaming I did not know what to do. Is this what babies do? Everyone said they cried but he seemed to only scream when I put him on the breast?

I phoned the out of hours Dr as I knew something wasn’t right and went to the hospital. I waited ages and the Dr said he would refer me to paediatric Dr on A&E as I didn’t want to just give him formula which was his advice. We waited all night to be seen, still with a screaming baby. The Dr came, watched me feed and said latch was good but to be sure they sent me to the children’s ward where I was then watched at every feed to check his latch. All day the nurse came and went. Again they said the latch was ok so sent me home. The midwife came again on day 5 and he had lost 17.5% of his birth weight and we were rushed to neonatal ward where we were told he was clinically dehydrated as my milk had not yet come in.

I was devastated and angry and felt I had let him down and the doctors that I had seen had let me down. He was given a gastro nasal tube and fed formula while I tried to build up my supply through double pumping every 2 hours day and night. I was in a room by myself and my husband was not able to stay. I now had about a week of literally no sleep! I was exhausted and could not stop crying. My milk only dripped out as I pumped and I felt like it would never stop but slowly they decreased the formula top ups as my supply increased.  I left after days of pumping with a breast fed baby! It was hard work and my supply was always low so I had to feed him every 2hours for nearly all of the time I breastfed him. This took ridiculous amounts of commitment but my husband was so supportive and helped me get rest when needed. I am proud to say I breastfed him until he was 19 months and he woke a lot at night as he needed regular night feeds.

I had many health professionals say that I shouldn’t be feeding him at night but I knew he was waking with hunger; he would take big gulps every time he woke and thanks to the brilliant support of my local breastfeeding support group, they reassured me some babies do need a lot of night feeds and it’s ok. It was so great to not feel like a failure.

I felt so unsure of what had gone wrong and why my milk had not come that I was inspired to join the breastfeeding support group and get some training. It was brilliant and frustrating I had not known some of it beforehand! After this training I still wanted to know more so started the breastfeeding practitioner training which was incredible and talked about the power of the hormones. I then realised my stressful labour could have been the cause of my lack of milk, that stress effects your milk.

I then fell pregnant again. Great I thought, this time I know stuff like the importance of skin to skin, which my husband had done with our son, and to really be relaxed after birth so it will be fine. I had to have a planned C-section after the trauma of the previous birth and so I felt more in control, prepared and relieved that at least I know I won’t be shattered when my baby arrives and I would have had some sleep the night before….

So, they struggled to get the spinal in and this made me anxious to tears. After 45 minutes of what was supposed to take 2 minutes, they nearly gave me a general anaesthetic which I really didn’t want as I wanted to be awake for his birth! They did finally manage the spinal and the C-section went well. “Phew,” I thought. I spent all of recovery doing skin to skin and when I returned to ward I also carried on with him on me and offered the breast all the time. I was not going to let this one lose weight!

Got home had him weighed… Bum, he had lost weight, but only 8%. Not to worry till 10%!

The next day 14.5%. I cried and cried and felt like a complete failure again! Not just to my baby but also to my toddler who I was going to have to leave again.

This time I knew what to expect and knew they would have to top him up.  I really didn’t want them to use formula and I knew there was no donor breast milk in the hosp so I rang my friend and she gave me some of her expressed milk from when her baby was 4 months. I arrived at the hosp with my hungry baby and my friend’s milk. We were sat in the assessment room and he fed from me and seemed content. I then expressed to try and encourage my supply and was getting a few drops. I was so encouraged as I saw those tiny drops as I knew there was hope. I had done it before and could it again, it would just take time. However, this was all going on 3 days before Christmas and I did not want to be in hosp and miss Christmas with my toddler plus in 5 days my brother was getting married! I didn’t want to miss that either! Agggghhhh!!!

 

As the pressure mounted, the drips slowed. The doctor came in and said, “you will have to stay in.” BOOM! My milk stopped just like that. Shut down, turned off, nothing. I could not get a drop from either side and I could not stop crying. To make matters worse they said I could not use my friend’s milk as it had not been screened. I argued that I knew her and was happy to take what they called the risk. We toiled with the idea of tipping her milk into my pump and saying it was mine but felt too dishonest. I cried so much and my midwife was kind enough to give me a parent room so my husband could stay. I bed shared, fed him like crazy and argued with every health professional for me to go home as I could continue the top ups at home. They prescribed me Domperidone to help with my supply.

Eventually when he had his hydration levels up and the top ups were minimal, I came home 4pm Christmas Eve. I didn’t care about presents or the food or the Christmas Day swim, I just wanted to be home with my boys.

The days continued and I expressed after every feed to increase my supply and topped him up using 2 of my friend’s expressed milk they both kept bringing over. It was the kindest gift I had ever received and made me feel so loved and supported. I used a supplementary system which was a bottle with two tubes, one which taped to each nipple so as the baby suckled he got my milk and my friends at same time. No bottles. No confusion. No extra time. It was brilliant.

I made it to my brother’s wedding and slowly my milk increased and I no longer needed my friend’s milk.  I was also able to come off the Domperidone.

Having done more research, c-sections can also delay the milk production plus the added stress so trauma and stress affected my milk supply both times!

So my message would be to try and not to stress! My milk came and I had a very low supply first time but I still managed to exclusively breastfeed. 2nd time my milk came in and I pumped like crazy, fed all the time for 6 weeks and established a great supply and this baby will go 4 hourly!!

The key is the first 6 weeks; to establish supply, feed your baby whenever he/she needs and don’t look at the clock. It can be a lot but its worth it!!!. And relax! The power of your hormones is incredible – they can help make milk but can also stop it!!

I have since been asked, having given birth vaginally and c-section, which is the best way to have a baby? My answer is adoption!!!

However you have your babies, or feed them, they are totally worth it!

Mother knows best

092

I had a mixed feeding bag with Ezra’s older brother but achieved breastfeeding happiness in the end so was confident about feeding him myself too, however, it hasn’t been as straightforward as I’d anticipated.

He popped my waters the week before his planned section so we were a bit flustered on his arrival but he was happy and healthy enough. I, on the other hand, was having a spot of bother. The recovery room closes at our local maternity hospital at 9pm and as it took them quite some time to finish rummaging behind the blue screen I wasn’t out until 9.10pm. This meant I was deposited back onto labour ward where the poor midwives had to look after me as well as all the ladies pushing their babies out the proper channels. No worries, I was sore but coping and managed some skin to skin. I did have an initial moment of complete panic as he seemed completely unable to latch and I didn’t know what to do. It was as if my world was crashing down around me, I was failing, he was going to starve, we were all going to die but a passing midwife shoved my breast into his face in the brusque manner some have and we achieved feeding. Apocalypse averted.

Then my spinal block wore off.

There was nothing between my nerve endings and whatever had gone on behind that blue screen and I have never been in so much pain in my life. I couldn’t hold the baby let alone feed him and he spent the next couple of hours tucked up his Daddy’s scrubs while they both dozed on the sofa in the corner. (Actually, he is a real Daddy’s boy and I’ve often wondered if it’s a result of all the ‘power of the first hour’ type stuff. They bonded anyway.) My anaesthetist had gone home (of course) so someone else had to be procured. Eventually a lovely lady sat by my bed with a syringe of morphine in each hand and just kept shooting it in until I regained consciousness and stopped weeping with pain. I was hooked up to a pump of the good stuff and spent the next couple of days fairly spaced out. If you came to see me then I thank you and apologise if I don’t remember it.

Meanwhile, back on the ward…we all know breastfeeding can hurt to start with and I was prepared for that but either I’d forgotten or this was a whole new level of pain. And I was drugged to the eyeballs remember? My nipples were bleeding already (thank goodness for Lansinoh), he was feeding ALL THE TIME but never seemed satisfied and it was so much harder than I remembered. I asked whether it could be a tongue tie as his teeny tiny tongue could hardly poke out of his mouth and it was heart shaped at the end. I was assured he was fine. I was given this assurance many times by multiple midwives and health visitors despite his lack of weight gain.

I couldn’t understand what I was doing wrong and why I was failing at this feeding lark until I went to our local Bosom Buddies and their resident expert said she thought I was right. (HUGE sigh of relief and a massive shout out to Mrs N!) On the strength of her expertise our GP referred us to the clinic, they confirmed he was tongue tied and snipped it on the spot! He was nine weeks old. I was told at this appointment that ‘many women find it more comfortable straight away’. To put it mildly, this was NOT my experience. We had to completely re-learn how to feed and that wasn’t comfortable and it took us another couple of weeks to really find our groove but once we’d cracked it we’ve never looked back. He’s 15 months old now and latches on like a dream.

Now, that would be a good place to leave our story, you know, like in ‘The Sound of Music’ when they should have stopped at the wedding? But sadly for us there’s more. Although The Snip made it possible for us to feed without pain my poor little baby was far from comfortable. He would have screaming fits day and night, had epic reflux and was not a happy chap. I’ve been told that reflux is ‘just a laundry problem’ but Ezra’s pain had nothing to do with the washing mountain. Having been down the food intolerances path with his brother I went on an elimination diet and within 3 days of cutting out dairy he stopped screaming completely and his reflux improved dramatically. He does seem to be very sensitive, a couple of squares of chocolate in the evening for me and the next afternoon he’s screaming in pain, so I don’t test it any more. When Ezra was about three months old we saw a paediatrician who diagnosed him officially. Although I do miss cheese I’m getting pretty good at dairy free cooking now and breastfeeding is for such a short time really that I think it’s worth the sacrifice.

Sadly, that feeling was not shared by our Health Visitor at his 12 month check up. Despite thriving on my dairy free milk (he’s only on the 2nd centile but he’s healthy and happy and someone has to be there!) we had one of those circular conversations where you just can’t find common ground…

HV: So, what does he drink?

Me: I’m still feeding him myself.

HV: Ok, but what is he going to drink now?

Me: Well, he’s dairy intolerant (you’d know that if you’d read his notes) so I’ll keep feeding him myself for now.

HV: Yes but what are you going to feed him?

You get the idea! This went on for an intolerably long time until she recommended a special formula costing £50 a box but I could get on prescription if I was quick. When I expressed concerns over what it was made from she assured me it was ‘completely synthetic’. Er…no thanks!

I understand that health professionals are overworked and underpaid and I hold out hope that there are a whole load of gems out there. We did have one wonderful midwife who taught me to feed lying down, for which I profusely thank her! On the whole though, we have had some dreadful advice and it has been Google, my Mother and our own determination which has kept us going. My husband and I recently stood in the reception area of our local clinic looking at the ‘who’s who’ board and to us it read like ‘wanted’ posters for crimes against new Mums and breastfeeding. We stood whispering to each other, ‘Is that the one who told us to put H. on the bottle?’ ‘That’s the one who told me I had to get dressed first thing in the morning days after my section.’ ‘That’s the one who offered me sleeping tablets when I asked for help.’ ‘Which one said…’ Again, you get the idea!

I guess what I’m trying to say is that if the advice of the professionals doesn’t ring true to you absolutely get a second opinion, it made ALL the difference for Ezra’s tongue tie. We found the Bosom Buddies to be absolute lifesavers, you ladies are AMAZING!

Now, if I could only get him to sleep…

One year older and decades wiser

Many families celebrate each birth month of their little ones. I see the pictures of their babies on Facebook, with cute little handmade signs next to them: One month old, two months, four months, ten.

Me? I celebrate the months of breastfeeding. Today we are at 16 months and counting, even as I enter the second trimester of my pregnancy now. Like birth months and raising babies, our breastfeeding journey has had its up and downs.

Like many (most?) first time moms, I had some strong convictions and preconceived notions about breastfeeding. I was convinced formula would be harmful to his delicate digestive system, that my son would have a dairy allergy because I did (he doesn’t), and that the introduction of bottles would cause nipple confusion and/or breast milk supply issues.  I was so determined to EBF – exclusively breastfeed.

I vowed to breastfeed until the age of one, in accordance with the American Academy of Pediatrics’ recommendation of “exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer.” After the age of one, we would stop – although at the time, I had no idea how to wean or even that I would have to wean.

Yes, I was a crazy and naive first-time mom.

Granted, our situation was a little different than most. Evan was born with a cleft lip, and later on we found out a submucosal cleft palate as well. He was one of the tiny minority of babies born with cleft palates who could actually breastfeed.

Looking back, I feel our success was both due to luck and knowledge. As for the knowledge, I relied heavily on the websites of La Leche League and even more so on Kellymom. Fenugreek was what got my milk to come in the fourth day – this I am sure of. I had taken it the night before, becoming more and more worried that my son wasn’t getting anything from me, and the next morning I was engorged. It was truly a magical moment for me.

I had also encapsulated my placenta, which was supposed to help with milk supply, and I had taken the pills daily in the first couple of months. I drank plenty of water and ate as much as I wanted.

I’ve been asked if I had a lot of support breastfeeding. I feel like I did, yet at the same time I didn’t.

I had the full support of my husband. Perhaps he was just a clever man, however, as my fear of bottles meant that all feedings, day in and day out, nighttime, daytime, every two hours, every hour, twice an hour – these all became my responsibility. He was in charge of keeping a steady supply of food and water for me, which he did well for the most part.

I had the support of my parents, who were hundreds of miles away, but were my quiet cheerleaders. I had to support of my in laws as well, although my mother in law did unnecessarily and often touch my boobs. She was always worried that in their engorged state, my breasts would suffocate tiny Evan. They didn’t (surprise!).

My mother in law desperately wanted Evan on a bottle. I don’t know if it was because she knew after four kids of her own, how tough it was to be exclusively breastfeeding, or if it was because she yearned to feed him herself. Maybe it was a little bit of both; I don’t know. I bit my tongue, and kept on.

As a new mom, you know, every little decision seems to be one of immense importance with far-reaching consequences. When we realized Evan was a fussy baby, or what Dr. Sears calls “a high needs baby,” I began to obsess over the idea of a foremilk/hindmilk imbalance. I researched gripe water as well as all the ingredients, herbs and preservatives found in all the different brands of gripe water I came across. I polled my friends on gas drops vs. gripe water and called the pediatrician.

I also started a food diary to figure out if something I was eating was causing him pain after breastfeeding. I cut out dairy, onions, and alkaline foods like tomatoes. I then even cut feedings from one boob thinking that positioning him on that side was causing him to suck in too much air through the cleft in his lip and thus giving him gas. I became even more staunchly opposed to bottles. Looking back , it was a classic case of DMF.

Cutting out feeding from one boob caused me to be lopsided. Like extremely lopsided. Like one side of my body was significantly weightier than the other side.

Still, we carried on.

We breastfed through D-MER: dysmorphic milk ejection reflex. If you have D-MER, you’ll know it, even if you (like me) didn’t know there was a term for it. It’s this awful, terrible feeling that you get while breastfeeding, especially during letdown. Fortunately, it eventually went away and I no longer get it.

We breastfed through mastitis and thrush. Through other illnesses by both mom and baby. We breastfed in restaurants, on the plane, in an aisle at Target, and in the backseat of a jeep in Nicaragua while we went on our first vacation with Evan. Apparently no one uses car seats there – I was told a Nicaraguan car seat is your lap.

We breastfed through a lip repair surgery at five months, and breastfeeding was our saving grace then. We breastfed through a lip palate surgery at 12 months, but the pain from the surgery coupled with my attempts to breastfeed resulted in a near two week nursing strike.
evan

The nursing strike and the sudden reduction in demand caused me to become seriously depressed. Apparently weaning and depression in mother is also common, and backed by science, but I didn’t know about it. After I found out about it, I felt better because I knew there was a reason why I was suddenly having mood swings and crying. We spent $200 on a pump to keep my supply up during the nursing strike. We talked through my depression. At the end of it all, although my supply suffered, we did get through it.

We got through numerous periods of teething and biting, and now we’re working on supply issues again as my pregnancy progresses.

Do I wish I would have done things differently? Yes and no. Sometimes I wish we went on a bottle, just because I would have a lot more freedom and a little bit more sleep, as least I’d like to think that. Sometimes I wish I could stick to a weaning schedule and successfully wean him, because I’m not enjoying breastfeeding as much as I used to. Actually, to be honest, I’m not really enjoying it much at all anymore.

But this entire breastfeeding journey – which is still ongoing – has taught me so much. That’s why I wouldn’t trade it in for anything. I’m more open-minded and have willpower I never believed I could have. I believe there are multiple ways to feed your infant and some just as good as others. I am more patient now than I am judgmental. I learned to never say never, and I’ve fed Evan his share of Enfamil and Similac, albeit from a straw or a cup. These are just the things breastfeeding has taught me, which when it comes down to it, are the survival skills you need for motherhood.

Now that I’m a year older and feel decades wiser, let’s see what happens when #2 comes around. Maybe we’ll do a bottle this time.

A change of heart

Danielle & Landon http://www.theralphlaurenandruskjuggle.wordpress.com

My journey with breastfeeding hasn’t been an easy one, It took me a long time to come to terms with the idea that it was something I wanted to do. My mum never breastfed me and I just didn’t see anyone around me breastfeeding, it wasn’t like it is now, where its a little more acceptable, and women who are breastfeeding no longer have to be housebound hermits.

Its not that once I began feeding, five weeks ago, my second baby, that feeding was a struggle or that feeding was hard or strenuous or overly time consuming, not at all, in fact quite the opposite. It’s been a breeze. It was the journey it took for the idea of breastfeeding to become an acceptable notion in my own head.

To me, and bear in mind this was a totally obscure idea in my head, in no way do I think this correlates to breastfeeding mothers. But I thought breasts were a purely sexually derived object and that having a child ‘hang off one’ was a gross feat. I don’t think I even allowed myself to consider the idea, of course afterwards follows a few other negative connotations, that of saggy boobs, how often breastfed babies wake up each evening and the inconvenience when one goes out in public of finding places suitable to feed your child. This idea has completely and irrevocably changed in my mind, now I can only think the most positive things in my head. And maybe it was my age, maybe being pregnant at 18 (by choice may I add, as my partner was 26) I hadn’t allowed myself to steer away from those teenage notions of over sexualised EVERYTHING. Maybe I wasn’t exposed to it enough, and at that time in my life, well quite frankly I had a life, after Landon, my firstborn had arrived everything changed, my life and all aspects to it had become completely Landon-Centric. I no longer purchased even the odd gossip magazine, no it was parent and baby magazines, and what became important to me was becoming a competitive mother. I wasn’t going to do anything by halves, again please understand I am most likely completely nuts, this is fine, as long as I’m a good mother with it. That fear runs through my mind constantly.I will never allow anyone the chance to think my skills as a mother are lacking, because I’m on the ball all the time, I mean, I’m even doing a child development degree.

You would think that this would mean that at this point surely I knew that breast was indeed best and that next child around I would be open and keen to breastfeeding. No I probably wouldn’t have, I would probably be sat now in my kitchen making formula bottles for Wyatt (Second baby, see 5 weeks comment). But the opposite, I’m sat pumping on one breast with my beloved medela and on the other I have a child, hanging off my nipple, that image I decided was ‘gross’. What changed my mind, and I am not afraid to admit was not the benefits for my child, but a hint of my selfishness. Wyatt was an unexpected baby, and my wedding was already booked, I heard that breastfeeding helped to aid weight loss, yes, how fickle of me to change my mind based on the sheer fact that I may be able to get into my dress a little faster. Even then I was going to exclusively pump as I didn’t want to latch feed.

Of course let me tell you what happened, Wyatt was born, skin to skin occurred and he found his own way to my breast and I didn’t stop him, in those loving moments, those precious minutes after delivery, a c-section in my case, I could do nothing but just love him. So from then we started to breastfeed and only in those first two days did formula fill in the blanks where my colostrum was not enough to settle him, with continued latching a few days in and my milk came in, in abundant levels. We are now almost five weeks in and have exclusively breastfed all the way. I say it with such pride, and it’s not because I’ve now turned on formula feeders, not at all. Feed however you wish and whatever way makes you happy. It’s the pride I take in the fact that I managed to turn my own opinion so upside down. So I am glad I discovered that breastfeeding would help you lose weight because now my baby has a great start, with a little more immunity protection.

Now I feed in public, at home, expressing my milk and latch feeding and I am taking steps to become a lactation peer supporter to help other mothers, and especially young mothers and let them see that breastfeeding can be ‘cool’.

A little on the ‘bond’ and ‘attachment’, firstly, I do not believe that bond and love are correlated, you can love your child and have trouble establishing a bond, or query the level of attachment and still think your child means the world. And I can’t really explain the difference without feeling a pang of guilt. But the bond came quicker and found us much easier than without breastfeeding, that closeness really just fuelled it instantly. I didn’t have any trouble bonding with my first formula baby, I never once thought or worried about attachment, but that feeling you get when you know you have bonded is immense and unforgettable, and it did indeed occur much quicker with breastfeeding. That’s not to say its the same for everyone but it is certainly how I felt. And it shouldn’t be the breasties vs. the bottlies. Again its how you feel comfortable, but I am so glad I let my guard down and gave breastfeeding a go. The best decision I ever made, and you know what I don’t even care how my boobs turn out, I can always buy some of those, I can’t buy a better start for my baby.

I hope everyone’s journey in breastfeeding has been as wonderful and even as cathartic at my own. I can safely say I’m finding it easy to rave about it as I haven’t had any real problems with it, its been plain sailing. Sharing experiences here briefly would be wonderful if anyone has had a similar journey or change of heart.

An epic journey

Baby Number 1….

I had a perfect pregnancy and a natural, pain-relief free labour followed by the delivery of my beautiful 8lb 4oz boy at 41+3 weeks by ventouse straight onto my stomach. We had our first blissful breast feed straight away followed by me having a third degree tear surgically repaired. The tear gave me no problems afterwards and so continued a lovely breast feeding relationship until Charlie self-weaned at 1 year old. He’s now 4.5 years old and I’m very thankful for the support from my husband and midwives that enabled Charlie and I to have this great start.

Baby Number 2: A whole different ball game…

I had a very eventful pregnancy to say the least – a potentially fatal (for the baby) blood clot under the placenta which caused some massive bleeding in the early days; gestational diabetes; severe polyhydramnios (excess amniotic fluid); a three day stay in hospital at 28 weeks for steroid injection therapy to ready my baby’s lungs for premature birth incase I couldn’t hold all the fluid to term; my waters breaking in the night at 31 weeks, flooding my parents’ house and the ambulance (or so it seemed!) while my husband was blissfully unaware and unreachable at Glastonbury festival and then another three day stay in hospital for antibiotics (to limit the chances of infection setting in) and monitoring. During this time, the baby’s heart rate kept dropping because his head was pressing on the umbilical cord, so I was prepped for an emergency c-section. Luckily, they used an internal manipulation technique to try to move him off the cord in a last ditch attempt to avoid the c-section and it worked, so things settled down a bit!

Suffice it to say that none of this was helping me to prepare for birth and breast feeding as I had with my first. However, breast feeding was never really far from my thoughts – obsessed much?! At each new medical development thrown at me in the pregnancy, I researched the difficulties I might encounter and how to avoid them – breastfeeding after c-section, breastfeeding a baby born to a diabetic and also breastfeeding a premature baby. I learnt that if you give birth prematurely, your milk changes to match the needs of your baby and that, as with a full-term baby, nothing can match breast milk in terms of nutrition, prevention of illnesses (such as necrotising enterocolitis – a horrible illness that is common in premmies, especially formula fed ones) and reparation of possible damage inflicted upon babies who are not in the optimum environment. I knew that breast milk was arguably more important for a premature or sick baby than a healthy, term baby, yet still, my research had shown that shockingly low numbers of babies in NICU were breast fed and the dire statistics were depressing – why were so many premature babies leaving NICU being formula fed? I remember crying to one of the nurses as we were shown around the NICU that (amongst the other things worrying me) I desperately wanted to breast feed my baby and, against the odds, give him some semblance of the bright beginning his brother had.

In the ambulance after the birth
In the ambulance after the birth

Finally, at 32 weeks pregnant, I gave birth to my 8 week premature baby within an hour and a half of being discharged from hospital on my lounge floor with my husband and 2.5 year old (plus the 999 man on speaker phone) as the midwives! Max was beautiful and thankfully was making some very quiet attempts at crying. I spent a long time with him skin to skin under my top, on my knees and still attached to him (again, thankfully, as it was a further half an hour before he was given some oxygen) before the ambulance arrived, and with it, a sight for sore eyes – a qualified midwife, who was fantastic and took charge of the floundering paramedics! Max was doing great in the ambulance and lulled us in to a false sense of security to the point where I asked, very naively, if I could try to breast feed him! The midwife said that we’d better let him concentrate on breathing for a while – he was blue and had an oxygen mask on at the time, so fair enough I suppose!

Anyway, on arrival at the hospital, Max was taken straight to NICU and so began our 6 week NICU journey. It was the worst and best time of our lives – the best, only because we had Max – the worst, for obvious reasons. It’s heartbreaking seeing your tiny baby (4lb 9oz) in the incubator, with wires everywhere, knowing that they should still be inside and with you at all times, hearing your voice, comfortable and warm in the absence of pain and hunger. You feel helpless and useless and, I suppose, a little redundant. This last point brings me to the whole breast feeding issue again – I felt that pumping milk for Max was the best thing I could do for him and me. Without it, (in my mind) he wouldn’t get better and I wouldn’t have a purpose. It was something I could do that nobody else could.

Max in NICU

With this in mind and colostrum ready and waiting as soon as the placenta had been delivered, I started pumping. Max spent the first few hours of his life on a ventilator and then was in oxygen in his incubator so we were unable to hold him until about day three. During these three days, I hand pumped like mad! I was well supported with this by the midwives and NICU staff and, for the first twelve hours or so, I took numerous little cups of ‘liquid gold’ in for them to put down Max’s nasogastric (NG) tube. After that point, however, the liquid gold was a little less forthcoming and I was feeling the stress more and more as I could only get a couple of drops out at a time despite pumping for ages. I tried an electric pump but I still could only get a few drops and these were wasted as they got stuck in the pump tubes. The little I got hand pumping was soaked up with a cotton bud and I desperately wiped it around his mouth, as they began (without telling or asking me) to give Max formula – I asked for donated milk, but with no milk bank, what else could they do? I felt better knowing it was only temporary though and sure enough, my milk came in on day three. This coincided with us getting to hold Max for the first time! It was very emotional and from then on, our moments of kangaroo care were everything to us. The second time I got to hold him, I was allowed to try our first breast feed. I was told not to expect much as Max probably wouldn’t be able to coordinate his suck-swallow-breathe reflex or be strong enough to latch. However, he latched straight away and began sucking! Everyone was really shocked and from then on I asked constantly to feed him myself. This is where the staff became slightly annoying to me – we were limited on time to hold our baby and I was denied the chance to feed him myself regularly because they always ‘wanted to see how much he was getting’. This all seemed very backwards to us, but they were the experts so we reluctantly did as we were told.

My first cuddle
My first cuddle

My pumping schedule was very strict. My pump went everywhere with me when I wasn’t at the hospital (I was discharged a week after Max’s birth) as I had to pump at least every three hours. Little did I know at this point that this was to be my routine for the next six weeks! Although I was a slave to the pump when I would rather have been a slave to my baby, obviously, it felt good to know that Max was thriving on my milk, and for the first ten days of his life, this is what he did. It was strange however that Max was unable to poo unless given a glycerin suppository and the poor little thing was having one of these every other day and still not much was coming out. On day ten, Max went into respiratory distress and was back on the cpap ventilator – horrendous! They suspected an infection but none of the tests confirmed anything but antibiotics were started none the less and within a couple of days, he was off the machine and seemed to be recovering. The NICU staff were medically excellent, but it became clear, at this point, that their knowledge of breast milk and breast feeding had a lot to be desired. As Max’s recovery had become unpredictable, they put a lot of pressure on me to have him on formula rather than breast milk. Max was still having difficulty with pooing and had begun to have a distended stomach and was being sick a lot after feeding. I asked if he could have a bowel blockage and they said that it would have been spotted on stomach x-rays he’d had previously.

I arrived one morning, when Max was about two weeks old to find that, without asking or telling me, they had replaced my milk with formula. Nobody appeared to think that it was a big deal until I broke down in tears. I was told that they thought Max may be dairy intolerant and was reacting to the cow’s milk protein in my milk (from my diet). I wanted to go dairy free but was strongly discouraged – apparently, the supplement pills I’d have to swallow were unpleasant and as big as my head (or something like that) and the diet was painstakingly difficult to stick to (it isn’t) and plenty of amazing hypo-allergenic formulas were available for Max apparently. I stuck to my guns and they reluctantly sent a nutritionist to see me (who was brilliant) and I started a strict dairy free diet.

Max appeared to be getting worse and as the formula wasn’t making a difference my husband and I pleaded with them to put him back on my milk which I knew would be more gentle on his tummy. I was also worried about NEC considering his stomach issues made him vulnerable and formula feeding makes the odds of suffering from this terrible illness much worse. They kept saying no to my milk, the reason being that you can’t experiment with a premature baby. We agreed, and therefore couldn’t see why they were willing to give him second best in terms of nutrition, for the very same reason!

Max was still in discomfort and his stomach had grown large and tender and bowel loops were visible through his skin. He was still unable to poo and was now vomiting green sick after each tube feed. X-rays showed air in his stomach and inflammation of the bowel wall. He was started on another antibiotic, made nil-by-mouth and moved to a single room because of the extra care he needed. It was a very worrying time and from my research, I could tell that he had the beginnings of NEC. I knew that a premature baby’s risk of developing this horrendous disease, which kills off parts of the intestine and, if untreated, leads very quickly to death, was due to forcing milk feeds on an under-developed gut and that also, formula feeding a premature infant increased the risk of developing NEC ten-fold compared to his/her breast fed counter-parts. My husband and I were very upset, but ultimately, they reassured us that they had spotted it very early on and that the treatment would work and his bowels and his life would be saved. After days of Max being on TPN (Total parenteral nutrition – a long line inserted into his heart with lipids and fats etc being fed directly into his blood stream) only, he began to show signs of improvement. It was hard to watch him go hungry though. The lipids had ensured that he was putting on weight and he was starting to look chubby, but one of the hardest things was having kangaroo care. It was lovely to hold him once again after not being able to for a while, but he would root around for a nipple in hunger and I was told that I couldn’t feed him. This was heartbreaking.

It had now been two weeks since I had been dairy free and Max’s paediatrician, who was now on holiday, had assured me that at this point, my breast milk would be the best thing for him as it would nourish his bowel. NICU, however had other ideas. I’m sure the reason for them continuing to push formula onto Max was purely because in the short term, they wanted him to be better and it was a measurable, and let’s face it, typical way to feed premature babies, get them fat and therefore to happily leave the unit. To begin with, the staff appeared very sympathetic but I was made to feel selfish, like I was putting my need to breast feed before Max’s needs. In my mind, these needs were one and the same thing.

It felt like I was battling with them and comments from the nurse in charge began to feel very much as if she felt she had to be cruel to be kind – “most mothers would have just accepted what I’m saying and their baby would be on formula by now.” “We need to do what’s best for Max.” etc. There appeared to me to be no reason for keeping him on the new formula; the amazing, magical neocate which is an elemental (pre-digested) artificial milk which allows the nutritionist to add and take out vitamins and minerals according to the baby’s needs, but they insisted. Well, guess what? I have a predigested milk that automatically adjusts in it’s mineral and vitamin content right here ready and waiting. The only difference is that it has bowel reparative and protective qualities; is free (neocate is ridiculously expensive) and is specifically adapted to Max’s needs in particular with many other ingredients impossible to replicate and many which are very beneficial for his long term health as well as the short term. Not to mention the other psychological and emotional benefits my baby would have, long term if we could ensure a breast feeding relationship now.

They were determined though, and neocate was started, and worse, we turned up one morning when Max would have been about 37 weeks gestation to find they had given him a bottle, again without asking or even telling us. To some, this may seem trivial but I was beside myself and my husband was angry too and he told them so. Finally, the nurse in charge let her true thoughts come out – “You need to stop this now, you will never breast feed your baby, even Dr.__ (Max’s paediatrician who was on holiday) agrees. There comes a point where it is cruel not to allow a baby to suck when they’re getting fed!” I was given a bottle of neocate and told to feed him. I did so, crying the whole time, but strangely, although he must have been hungry as he was still on a very limited food intake, he wouldn’t drink from it! The smell of him, that I must have subconsciously been sensing, was gone and was replaced with a horrible smell of fish and chips. It was on his clothes and skin and breath (he was still being sick a lot), and while the nurses laughed at the fact that this artificial milk made him smell like he’d been eating battered cod for his dinner, for me, he no longer smelt like my baby. I kept pumping my milk, despite the stress taking it’s toll on my supply and knowing that everyone at the hospital, bar my amazing husband, believed it to be a futile activity.

Finally, when the nurse in charge decided to have her first holiday in years (maybe we had made her feel like she needed one, who knows?!), one of the consultants decided to explore reasons other than a dairy intolerance as to why Max still wasn’t improving. After examining the x-rays and discussing his symptoms he decided that Max had a bowel blockage! I couldn’t believe that this was being looked into now, when I had suggested that just under a month ago. Max was transferred to NNU in Southampton by ambulance the next day for a possible bowel operation to extract the blockage.

The first thing they did at Southampton, which is a breast feeding friendly hospital, after his observations and tests, was to ask if I wanted to feed Max myself. I think you can guess my answer! They asked if they could see him breast feeding!!!!!! They watched once, and then I was left to do his next three feeds myself. They said that breast milk was best for him, especially if he could extract it himself at the breast! They congratulated me on continuing to pump, and while they couldn’t criticise the other NICU medically, they said it was a huge decision for a hospital to take feeding away from a mum and baby who so obviously wanted to breast feed and asked me to leave pumped milk for him! Over the course of the next four days, they gave him a blood transfusion of haemoglobin as he was dangerously malnourished and had a very low red blood cell count. The action of breast feeding, plus my milk by NG tube and a simple enema led to the blockage of old poo coming out and he was then referred to as ‘an enthusiastic pooer!’ His mustard yellow, plentiful nappies were a sight for sore eyes and he was transferred back to the original NICU, fit for discharge!

We were cheered by everyone on our return to NICU and I handed over the unopened tin of Neocate to the nurse in charge who commented that Max would still need top-ups as all preemies do once discharged. I didn’t really care if that happened, as long as he was getting my milk too, and spent the next three days rooming in with Max who constantly fed to increase my low milk supply. He was on me solidly for three days and nights, only stopping feeding to sleep on my chest every now and then. Far from questioning that behaviour, as I did with my first, I lapped it up and loved every moment! The staff checked on us regularly and administered his iron and vitamins etc but pretty much left us to it. On day three, they weighed him to discover that he hadn’t lost any weight (they are expected to lose it due to the calorific expenditure in controlling their own body temperature and also from suckling by themselves). He had initially been on the 75th centile at birth but due to large portions of time being nil-by-mouth or on restricted feeds, he was now on the 9th centile and was maintaining this. He had pretty much settled down with feeding and sleeping and we were discharged, exclusively breast feeding!!!

Max continued to gain weight well, at times, reaching the 25th centile but at his cardiology check-up in Southampton, they discovered that the innocent murmur was actually pulmonary stenosis (thickening of the artery from the heart to the lungs) and that blood flow was compromised to his lungs. The stenosis was in an unusual position and so they referred us to a geneticist, because his height had also been dropping down the centiles (it’s now off the bottom of the chart). I won’t go into too many details but the first year of Max’s life was amazing, but also the hardest of times. His dairy intolerance was ruled out as a cause of the bowel blockage at 6 months old and so I reintroduced dairy in my diet and did baby led weaning with him at 8 months old, including dairy, which caused no reaction – he loves his food! We have faced agonising waits to see geneticists where various genetic conditions were suggested, tested for and eventually ruled out.

Max was slow with his gross motor milestones caused by low muscle tone and eventually started seeing physio and speech therapists and orthotics (he has a brace on his right leg to hold it into the correct position). He sees cardiology regularly, although his heart condition has thankfully improved due to a cardiac procedure to widen his pulmonary valve at 11 months old (another time when I was thankful for breastfeeding as the nil-by-mouth before operations doesn’t apply as strictly to breast milk). We are pretty convinced now at 23 months old that Max has a condition called Noonan Syndrome which causes, amongst other things, pulmonary stenosis, short stature and low muscle tone and also polyhydramnios in pregnancy, sometimes leading to prematurity. It also can cause complications with the GI system, such as slow bowel motility and, surprisingly, an inability to tolerate oral feeding until about the age of three, due to severe reflux and a compromised ability to co-ordinate sucking, swallowing and breathing. Because of this, these children are often pronounced failure to thrive and suffer dramatic weight loss because the fats they can digest most easily are in breast milk and the majority cannot breast feed or have been put on formula for various health reasons in hospital. How ironic!

Despite all of this, Max is a gorgeous, happy, delightful little boy, who, along with his brother, is the light of our lives! I think it is unnecessary to say it, but I’m convinced that Max’s good health and weight gain is partly due to breast feeding (especially knowing what I know now about Noonan Syndrome), so thank goodness we persevered through the NICU experience and are still going strong with it at 23 months!!!

My two boys
My two boys
Charlie 4.5 years, Max 2 on Thursday
Charlie 4.5 years, Max 2

The difference between night and day

Having been there, done that; just as naively as I thought the first time round, I would squat in a bush, sneeze out a baby and suckle it for exactly 6 months before weaning onto food and never use a bottle or formula, I had the preconception that having used my boobs for nutritional sustenance before that it would be easy peasy lemon squeezy second time round.  That, and the labour and delivery would be quick and I would DEFINITELY get my home birth.

Seven days past my due date, I got impatient.  After suffering with SPD from 22 weeks, I wanted the boy out.  Didn’t care how.  Just out.  I tempted fate by having a family day out at the local theme park without wearing a massive incontinence pad just to will on my waters breaking in the most humiliating way, preferably in front of a load of horrified tourists.  Didn’t happen.

Fist ready to punch the next midwife that told me I was still only 2cm dilated
Fist ready to punch the next midwife that told me I was still only 2cm dilated

So I went for a sweep.  Painful.  Then I had another one.  Less painful but no signs of dilation and the midwife told me that his head was no longer engaged and just bobbing about in my pelvis.  Plus, there were no local midwives on call that evening so should I go into labour, they’d be no home birth.  Bollocks.

Well, after several thousand years of stop-start labour, I was only 2 cm dilated and desperately wanted someone to put me out my misery.  Despite that though, I DID manage to have a water birth (climbed in 2 seconds before he popped out – I was that determined to have SOMETHING on my f’ing birth plan) and so it all began once more.

Despite trying not to be anxious, and thinking I wasn’t, looking back I was definitely anxious.  I kept latching him on not really believing that he was feeding properly and even though he seemed fine, I wasn’t convinced.

Perfect ‘laid back’ breastfeeding brought about by exhaustion.

I was released from hospital quite quickly, much to my delight and high on the adrenaline of actually pushing him out my v-hole, I made plans to visit relatives hundreds of miles away.  Despite only being a few days old, I thought I could handle it and it would only be a few days.  Slowly, my sitting-bolt-upright-whilst -folding-my-nipple-and-pushing-it-in method didn’t work.  The boy became increasingly frustrated, as did I and he stopped asking for feeds, preferring to sleep instead.  It started to take 2 hours to latch him on.  Fortunately my husband and family were around to keep my little girl entertained, but I was having to lock myself away in a relative’s bedroom, with a screaming baby, whilst I cried and became angry just desperately wanting to feed my baby so I looked like I knew what I was doing.  He seemed to have a teeny, tiny mouth with no real desire to latch, preferring me to just drip it into his mouth.  “Bloody lazy boy”, everyone said.

After one particular night, the boy had slept 8 hours without a feed and showed no signs of feeding. I phoned a helpline who gave me some lovely, calm advice.  They told me that if he didn’t latch on, that I should give him a bottle due to his newborn age and risk of dehydration.  I can’t actually remember whether I expressed or gave him formula but I remember caring a lot less than I did with my first.  It was just about feeding, not about how or what.

Two weeks past and some days I felt I had it cracked with 24 hours of brilliant feeds but then the next day it would all turn to crap again.  My husband was due to return to work and I felt that I just wouldn’t be able to maintain this level of difficulty latching once he’d returned to work as my little girl would also need my attention.  So, I rocked up at my local bosom buddy group, the same one that sorted me out with my first and told them, if they didn’t get the boy latched on today, then it was game over.  I was turning to the dark side.  After an hour or so of poking and prodding to get the boy to wake up, they told me that when the baby looks like they’re dreaming and fluttering their eyes, that it is in fact a feeding cue, so to just try and latch him on without him waking.  They helped me get him into the laid back boobing position so I was more slouched on the chair, his tummy was on me and his feet were on my lap.  This was so he could use his stepping reflex to push up towards my nip, which in turn made him open his mouth wider and bang.  On.  Latched.

They warned me that once his appetite started to return, he may cluster feed for a few days.  Yep, he certainly did and I wasn’t engorged like last time.  I felt like I hardly had any milk compared to my hard, pulsating bosoms post baby #1.  So I tried to feed and feed and feed but the other option was calling me.  Feeling less desperate to not let anything other than boob juice pass his lips, I topped up with formula.  He didn’t die.  That made it easier.

Definitely not on a pillow.  That would be against the rules.
Definitely not on a pillow. That would be against the rules.  Also wearing his sister’s hand me down.

Slowly we started to become in sync with one another.  We both got better at it and I was less anxious about co-sleeping so I moved the husband out the marital bed and the boy and I slept entwined, blissfully sleeping and feeding.   The boy always seemed to have horrendous snot issues at night though and would often wake up with a start and scream.  He would also cough and cough so he would either sleep upright on me or on several pillows (despite the advice against pillows).  I would douse them liberally with Olbas oil, like holy water, and became paranoid that the house wasn’t clean enough, that the dust was aggravating his airways.  I took him to the doctors who diagnosed viral asthma and gave me an inhaler to use at night.  He was four months old.  I needed more sleep, not less and trying to hold a spacer over his face, maintaining a tight seal and spraying mist into his lungs at 3am was not my idea of more sleep.

Fortunately, I started chatting to one of the other mums at boob group who suggested looking into dairy intolerance.  Dairy intolerance?  But I’m breastfeeding?  Surely that can’t be right?  She sent me the link to the KellyMom website and sure enough, it described my boy.  So I cut out dairy and it was pretty much instant.  No snot rattle.  No coughing.  No waking up like a fire alarm.

I went back to work sooner than I’d hoped but the boy took to bottles ok which was a massive relief after the bottle disasters with baby #1.  That too was probably down to getting advice on how to introduce a bottle properly as opposed to trying one, baby rejecting it, buying another, baby rejecting it and so on and so on.

The down side to this was that he started to chew the teats once he’d finished and so transferred that habit to my nipples.  It happened a number of times over a few months where he damaged my nipples so badly that I couldn’t feed and would express and decant until they healed.  I became more and more anxious about the biting and if I missed a feed because I couldn’t express at work or I was too busy dealing with the girl, my supply dramatically decreased and would take days of pumping and feeding to get it back up again – that increased the biting. So the last time he bit me was around ten months and I decided then that I was close enough to the twelve month mark.  I would express and decant permanently and then wean just like the girl did.  The only problem being is that the boy couldn’t have dairy.  And despite expressing three to four times a day, sometimes 12 ozs a time,  I couldn’t keep up with his demand.  He was a milk fiend.

Around 11 months, I’d gone from expressing 12 ozs a session to 2 ozs.  I think stress played a big part in this. I started taking Domperidone which was a life saver.  I was able to pump enough milk to sate the boy’s ridiculous milky appetite and could keep going until I could wean him onto an adequate dairy alternative.  I finally stopped expressing around 14 months and the boy spontaneously grew out of his dairy intolerance a couple of months after that.  I hated making the decision to stop expressing because it was entirely mine.  I’m still in denial about it now and tell people I’m breastfeeding.  Seriously annoying that I’m also putting on weight again as I can’t maintain my one-cake-a-day-to-reward-myself habit now I’m not burning off the 500 or so calories.

Thanks to the ladies at boob group, I decided to train as a peer support worker myself and this is what I have learned:

  • Although it is not recommended to pump like you’re supplying milk for the local orphanage (like I did the first time round), it can help to boost supply in the first 6 weeks when it is important to establish your milk supply.  Had I known this, I would have definitely kept on feeding as opposed to topping up and I would have also expressed more when he was sleeping 6-8 hours at a time in the early days.
  • Giving formula in the first few weeks can lead to food intolerance due to changes it makes to the gut.  Had I known this, I wouldn’t have been so lazy and boobed more or expressed more which would have helped my supply and may have avoided his dairy intolerance.
  • Had I known that leaving him to chew his bottles when he’s finished a feed would have led to my own nipples being chewed off, then I would have used a cattle prod to make sure he didn’t do it again.
  • Feeding cues – there are lots of them and baby doesn’t always need to be ‘awake’ to feed.  Had I known this I wouldn’t have wasted so much time videoing the boy ‘dreaming’ and actually tried latching him on.
  • The laid back feeding position and the importance of the feet.  The stepping reflex has a remarkable affect on the baby’s ability to latch and can sometimes be the key to enabling a problem-free boobing experience.  Had I known this, I wouldn’t have spent so many stressful hours trying to reduce the size of my nipple by pinching it into varying experimental shapes to fit his tiny mouth.

Despite the difficulties, I loved boobing my children and have some wonderful memories of milky cuddles.  It will be something I will always cherish and be proud I persevered.

After months of only being able to eat the cone, he can finally get his chops around an icecream
After months of only being able to eat the cone, he can finally get his chops around an icecream