Sunday 26 June 2011

My breastfeeding story

I am one of three sisters 

We were all breastfed and a big thing wasn't made of it, it was just the natural thing to do. So I always imagined that I would do the same for my children.


This is a photo of me and Abigail, moments after birth and she was placed on my tummy. In antenatal classes, I learnt about the instinct for newborn babies to move up your tummy, heads bobbing, moving in the direction of one or the other boob to feed (I now think that the change in areola size in pregnancy helps provide a visual target for their limited vision, that only can recognise high contrast images). Soon after being born, Abigail quickly fed (I didn't know what I was doing but she instinctively did, I just let her move and feed). This was extremely reassurring - I should just trust in the reflexes of the newborn, developed through years of evolution, and she'll know how to feed and get what she needs from me.


In this photo, I (and my husband) was exhausted after an intense induced labour, only relieved by the epidural which allowed delivery to finally happen (Abigail was trying to be born, but was lined up wrong, and only by me relaxing after the epidural, could she line up again properly and the rest was pretty fast!). Unfortunately, a few hours after this photo, Abigail had to be rushed to the incubator(?) twice for oxygen, due to mucus in her chest that was affecting her breathing (blue lips). Because of this, she was transferred to the Derby hospital neonatal intensive care unit (NICU) for monitoring for 24 hours. I was on my own, Abigail was on her own too. The nurses told me to visit her every 4 hours to feed her and rest in between. To begin with, I was asked to express manually, so that they could feed her with a syringe. This was no dignified experience, but after labour, it didn't really matter, especially when I knew the colostrum was so important to her start in life. I didn't really know how to express manually, so a straight-talking midwife/nurse (I can't remember) did it for me, kneading me like a goat. It was quite a strange, emotional time. 

Later, I was allowed to go down to the ward to see her, and try to feed her myself. Because of my epidural, my legs weren't working yet, so I had to be wheeled in a wheelchair. My first breastfeeding experiences were of her in a fragile state, being handed over by the nurse and asking if I was doing it right. I am so grateful to Abbie for having her reflexes and mostly just feeding without me having to do anything except hold her close. When she had finished, (I can't remember if it was Abbie or the nurse who indicated this), I had to put her back in the container she was laying in, go back to be, to be woken up again in another four hours.

You're doing really well

After she was given the clear, I spent another night in hospital with her. She spent nearly all of that time feeding and trying to feed. I moved her from one side to the other, exhausted and worried because surely there wasn't any milk left? I called the nurses/midwives every so often to ask if I was doing things right and what was going on because I didn't think I had any milk in me to feed her, so was everything ok? I didn't really get any reassurrance, they mostly said "You're doing really well", "Keep going", "You just have to keep feeding her". One midwife assistant told me she never breastfed her baby, she used formula, that she doesn't understand why people breastfeed because there is no milk in the first few days, so it's a better idea to use formula because there's milk straight away... Not the most helpful thing to hear when you've barely slept for 48+ hours and nobody is really explaining what's happening, just plugging the pro-breastfeeding NHS mantra.

Luckily, I was determined to breastfeed - I believed that it was the right thing to do, so even though I didn't really understand what was happening, or if I was doing things right, as long as the midwives were happy, it can't be bad. I just would have been much more relaxed if I knew more about the biology behind the how the feeding works for newborns and newmums.

Home visits, checklists

When we got home, I fed Abigail. The daily midwife visits (different ones each time, each with differing advice on positioning for feeding) gradually helped me to figure out how to feed Abbie more comfortably, and to feel like I was doing it properly. One visit in particular, really helped things click properly. After that I could just get on with it. My impression was that the midwives and health visitors were bogged down with checklists, box-ticking, red-tape, and tended to have memorised answers to your questions, so you didn't always feel listened, or answered to, in your time of a need for information. This was rather stress-promoting. And confusing-promoting.

Some good news was that Abigail did not lose any weight after birth (A weight loss of 5% in the first week of life is considered normal for the bottle fed infant. A loss of 7% is average in the first week for the breastfed infant*). She stayed on the 50th percentile for most of the time that I weighed her (I checked more regularly for the first 6 months). I must have been doing something right.

* = The most common theory for newborn weight loss is that babies are born with extra weight to help with the stress caused by labor and the transition to extrauterine life. Also the extra fat stores are there because mother's mature milk does not come in for 3-5 days.

We turned to baby books. Bad idea. 

We had been given a few books: A breastfeeding book that had been endorsed by Kate Winslet and Kate Beckinsale, (oo err, have not got it now so can't remember its name) and The Baby Whisperer by Tracy Hogg.  They were all talking about being able to distinguish babies' cries, from hungry cries to tired cries etc. all I knew that she was crying, I could not tell the difference! They also said about feeding them, then putting them down to sleep for a few hours, feeding every couple of hours or so. But Abbie would scream every time we tried to put her down in the moses basket, and seemed to want to feed every 20 mins, not every few hours. We were in a spin, we had no clue. 

Bullet points would be good and about 10 rather than 200 pages, for sleep deprived new parents, who just want somebody to tell them what to do! In retrospect, I should have read the books before I had my baby, not after. The only information I was gathering when pregnant was about labour pain relief and the kit you need, not what it is you do with them when they arrive.

The only bit of sense I got, was a text from a friend who had recently had her second child. I said that Abbie was feeding all of the time, all day. She said "...and? It is normal, just feed her". Rather than, "do this, do that", I realised that all I needed to do, was to let Abbie dictate. If she cries and has a clean nappy, not too hot or too cold, she is probably hungry. Try and feed her. If she wants it, she'll feed. Then she'll fall asleep.

So then I spent most of my time feeding Abbie, or holding her while she snoozed on me. I got used to making sure I had the remote control and a drink to hand. Otherwise we went for walks in the buggy, or B drove her around the peak district so that I could get some sleep. 

Co-sleeping

At night time, she continued feeding. I first started to feed her sitting up, like in hospital, then putting her in the moses basket afterwards. But she barely settled, so I'd sit up in bed, trying to keep my eyes open, holding her, feeding her if she wanted to. I soon realised that it wasn't really safe. I had barely slept for a week and holding her sitting upright was not really working. Instead, I lay down on my side, arm under my pillow, and fed her as she lay next to me. I co slept mostly for the next 6 months. It meant that I could get alot more rest, and was alot more comfortable than before. I believe that the comfort and rest I got from this approach to night time sleeping and feeding allowed my milk production to keep going and my stress down. I never worried about suffocation as I made sure the Abbie was in the middle of the bed, no heavy duvet over her (a baby sleeping bag instead), and my hand under my pillow to prevent me moving about at night.

At hospital, I had to fill in a questionnaire about my status  - did I smoke, did I plan on co-sleeping etc. I said no to co sleeping. They said I was low risk if I did want to co sleep but that they don't usually recommend it. I agreed, saying that I didn't like the idea of it either. It is strange what preconceptions you have before you are actually there, doing it. I never imagined I would co-sleep, or what a difference it would make to me. I would recommend it. For it making night-time feeds so much easier, and for the closeness you feel together - the bond really grows when you are next to your baby, listening to each breath. We ended up putting Abigail's crib alongside our mattress (B took one side off and the mattress was the same height as our bed), so we made a co-sleeping crib. Although the plan was to move Abbie in and out of bed between feeds, in the end it was much simpler to have her in bed with us / me. Abbie tended to be on the outside of the bed (with a bed guard being the crib), me, then B.

During the day, my weekly meets with my NCT friends was a big help. We all (mostly all) were breastfeeding too. All being able to talk through our questions and things we'd learnt and found that help or didn't help, really gave me a chance to smooth out all of the confusions and uncertainties. My husband and I  both gradually understood more about how things worked. Abigail gradually fed less frequently (I later realised that this was because her tummy grew, so her hunger was sated for longer between feeds) and she fell into a pattern of a feed in the morning, nap mid morning, feed at lunch, nap after lunch, feed on waking, feed before bed, then one or two feeds at night. 

By the time Abbie was 6 months old she slept through the night. By the time I started work when she was 9 months old, I fed her in the morning before work, when I got back from work and before bed. Then feeds reduced to first thing in the morning and before bed. Then by the time she was a year old, it was just one feed before bed. Then after a period of "don't offer, don't refuse" (thanks to reading the very useful and sensible Sears and Sears Baby Book), she was weaned at about 14 months.

A word on expressing

Although I thought it was something I should do, I later gained enough confidence in feeding that I wasn't really that bothered. The whole sterilising and preparing and BORING expressing was a waste of time when I was finding it easy to just feed. It almost felt like I was imitating the very thing I didn't want to do anyway (formula feeding), precisely because it was creating a whole lot of fuss that would never be needed if I just fed her naturally. I also found expressing very fiddly and alot of work, for not much milk at the end of it. My husband felt exactly the same. We faffed about with expressed milk at two weddings when she was 3 and 4 months old, but after that, forgot about it. When I started work, I asked my health visitor about providing the milk for nursery during the day. She said that it would be fine for her to have water during the day, along with meals, so this helped the decision more.

This was just our situation though, I'm sure other Mums have found expressing works for them and their situations, I was just very pro everything natural and less enthusiatic about the plastic stuff if there was a perfectly good system in place already.

It is no fuss and it is easy

So now, I feel completely differently about breastfeeding to when I began. It is no fuss and it is easy. I just wish that I was given clearer information about how to feed and how it works (that it is ok when your baby demands to feed (a) when at first no milk and (b)when your milk comes in, practically all of the time! The health professionals should be more careful about what they say to new mums too. Unfortunately, the choice of to breastfeed or formula feed seems to be very personal and so an emotive subject, making it difficult for everyone to be objective and unbiased when giving out advice.

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