Natural doesn’t mean instinctual
My low milk supply breastfeeding journey (popcorn at the ready, it's a long one)
I watch her eyes open on top of me with her red and white knitted hat in the Labour Ward. She is stunning. Dark hair. So delicate. Deep down I always knew it was a girl.
Next thing a midwife is rubbing my breast to get baby to feed. She massages and squeezes me until baby took a bit. The squeezes were painful but I didn’t care. Then they took her away from me again. I notice I desperately need her back on top of me for endorphins. I begin to feel a lot of pain, I beg them to have her back to help me. Deep down I still feel this is where it all began to go wrong for our breastfeeding journey.
That unnecessary hat, all the unnecessary separation and disruption of mother-daughter dyad. Disrupted. I have no recollection who put the hat on my baby. The why “baby get’s cold” in the Labour Ward. The thing is we need the smell of our babies head for oxytocin to continue. For breastfeeding to initiate. For the placenta to expel. It’s a lovely delicate cycle with intricate flow of hormones. If you read my birth story, you’ll know they cut my baby’s cord straight away and removed her from me. Then brought her back.
I had PPH and I feel like I had my baby on top of me for 15 mins if not less. My yellow notes say it was 45 mins. I still can’t tell. I am rolled to theatre for suturing my 3b tear. My last vision was my husband continuing skin-to-skin as the double doors slowly shuts away from sight. It was a bit scary going into theatre by myself, but I kept my headphones playing affirmations and relaxations. Their familiarity helped.
After theatre I see baby with my husband he tells me it must have been 2 hours. I feel weak, I hear them say I might need a blood transfusion? They tell me to rest. But I can’t sleep. All I want to do is hold my baby but I can’t pick her up from the hospital crib as I agreed to an epidural before going to theatre. I literally can’t move my legs. It’s a horrible sensation to not be able to move myself independently. I hate this after effect of the epidural, could this be another culprit for what was to come?
They begin to ask me how I’m gonna feed her and I tell them I want to breastfeed. I have an inverted nipple from a previous breast infection and what it seems like no milk? Is my body at fault? Many breastfeeding midwives come and go squeezing me, massaging, forcing baby on. My baby just screams for being woken up and undressed. They put pressure on me in what you want to do next?
I want to breastfeed I continue to insist.
The reality was I didn’t know what my options were. I didn’t know breastfeeding could be a problematic. Isn’t this meant to be the most natural thing in the world? In fact I don’t know what’s going on. I cry with sadness as they suggest cup feeding her formula. Need to feed her somehow so agree to it.
The thing is I was going to a breastfeeding clinic, at the hospital on a Monday. I wanted to learn how to collect colostrum due to my gestational diabetes but baby beat us to it when my waters broke on Saturday night and she arrived on Sunday afternoon.
I kept insisting I want to breastfeed so they give me their electric pump. They tell me to pump every two to three hours.
Pumping
It hurts like hell. I can’t tolerate the machine for more than 10 mins at a time. I try as much as I can but nothing comes out.
A midwife tells me I have to get on with it, do a whole cycle which is an hour long and need to pump every two to three hours.
“The 10 mins aren’t gonna do anything!”
I burst into tears because I don’t know what’s going on. Because I don’t know how it all works. Because all I want to do is feed my baby “naturally”. Because I had no idea anything could go wrong. Because it’s so painful. Tears roll down my face as I put on my headphones and try KG Hypnobirthing techniques I learnt for birth. Which does help at least takes the edge off the after pains that comes with it too.
I can’t even remember when, maybe it was my second day in hospital at what must have been 3am. I saw this tiny bit of colostrum in the pumping machine. A few drops of my own golden liquid. I am SO happy, SO proud. I go to get a syringe and carefully collect all of it. Afraid to spill any drop. I filled less than one syringe. But it was better than nothing.
Baby still doing ready made formula by cup. Increasing the amount everyday. We give her the colostrum. Until they put pressure again saying she’s gonna need more than a cup. So my husband bought bottles and I’m left devastated.
I continue to use the machine every time she feeds. Again only tiny bits come out. But it went from one syringe to two. Though pumping still painful, I seem to be getting used to it.
We’re discharged from hospital but still bottle feeding. I love my girl even more when giving her the bottle she holds her middle finger to it! I know I will go out of my way to make this happen. Baby was with me in this.
We buy an electric pump, still small amounts of milk coming out but I can see a bit of an increase. I’m tolerating the pain much better now. But my milk is well behind her bottle at this stage. The bloody machine didn’t even last a day when it breaks. I get angry and burst into tears. Ended up talking to my Hypnobirthing facilitator and she kindly gave me a manual pump as a present. She told me she found the manual ones better. Once I tried I agreed. It gives me more control to speed up or slow down if it hurts. I set up several alarms every three hours to pump, whilst my husband does most of the bottle feeding. I start to feel a bit jealous he’s holding her more than me.
First week in the issue that baby was super drowsy and sleepy.
Not sure if because she arrived at 37+2 weeks. Sometimes she wouldn’t even wake up to feed. We used the tricks the midwives in the hospital used to wake her up. So whenever I placed her on breast she either screamed or fell asleep I felt completely rejected. Why did she hate my breasts so much? Doesn’t she like me? Is it because I’m not holding her enough?
I breakdown a lot during the initial appointments as I’m told a range of things. The most painful one to hear was that maybe my breasts are not mature a condition known as hypoplasia—underdevelopment or an incomplete development of (in this case) breast tissue—that may mean I can’t breastfeed at all. There are various other medical conditions that mean you cannot physically breastfeed. That hit me like a ton of bricks.
One thing the consultant realises is that my supply is low.
The consultant suggests I go on Domperidone—the side effect of this anti-nausea medication is lactation. I agree to it. I also take fenugreek and eat foods that improve lactation like cornflour porridge, dark chocolate, lactation smoothie powders, whatever is meant to help milk supply.
In the meantime my family and friends are giving me advice.
“Be careful she doesn’t get used to bottle”.
“She’ll get confused using bottle and boob”.
“You’re too gentle with her. Need to be stricter”.
“Force her on, even if she’s screaming. It’s for her own good”.
The first time I did that I hated it. She hated it. My husband hid himself in a room. As baby screamed onto my breasts for the suggested 20 minutes. I felt horrible. I was desperate.
Second week in I reach out to the breastfeeding class instructor from NCT. She emails back and agrees when I say it doesn’t feel right to force her. My baby is delicate and force doesn’t suit her. So she told me to have her on breast when she’s not hungry, when she’s calm have relaxing music make it a good experience. Which I do and I’m pleased she’s not screaming at it. I squeeze a bit of milk into her mouth she’s ok with it. But still not enough milk coming out.
Pumping became everything. First for 5 minutes, then 10 minutes, then 15 minutes then even 20 minutes each side. I see an increase from 5 ml, then jump for joy as I see 15 ml for the first time. Then see 30 ml. Then see 60 ml. Collected throughout the day. I loved adding a Hakaa to collect any let down from the opposite side I wasn’t pumping! Overjoyed when I caught up with bottle. The pumping and the skin-to-skin kicks in. Milk has a good increase.
Three weeks in, I’m freaking out I’m running out of time.
“She’ll never take breast after bottle feeding” said a relative trying to be helpful. But of course it’s a lot of pressure on me. As I watched baby down a bottle so quickly. It was clearly all so easy. So in my head I’m running out of time it’ll be a month of bottle feeding the week after.
When I go back to feeding clinic I say that and the lactation consultant tells me “I don’t want to be unrealistic that might happen”. It breaks my heart, that’s not what I wanted to hear. But main thing is that baby hasn’t been losing weight.
We can feed her my milk at least with the pumping. But that wasn’t enough for me. I always saw myself breastfeeding. Maybe it’s cultural thing, growing up in Brazil in the 90s I saw how breastfeeding was the norm. I believe there was a campaign before I was born that Pelé’s mum said she breastfed him and breastfeeding took off nation wide!
As the world’s leading child health organizations, UNICEF, WHO and the International Pediatric Association, had uncontested scientific evidence that breastfeeding was the best nutrient for infants, and that exclusive breastfeeding for the first six months and continued breastfeeding for up to two years with gradual introduction of healthy weaning foods protected children from infection, malnutrition and common childhood diseases.
With rare exceptions, all mothers are capable of breastfeeding which has many lifelong advantages for infants as well as for their mothers and society as a whole.
With such arguments UNICEF convinced Pelé to be its champion for breastfeeding. It helped prepare an attractive poster that was plastered all over the country in which Pelé’s mother was shown patting her famous son on the shoulder and saying: “Of course, he is the best football player in the world. I breastfed him!”
This poster became the centre-piece of a breastfeeding promotion campaign that led to a dramatic increase in exclusive breastfeeding to almost 40 percent within a few years. The lives of thousands of Brazilian children were saved and health of millions improved as a result of this campaign.
[Source: ibfan.org]
The Brazilian side of my family was encouraging for me not to give up, even though all had their opinions good or at times not so helpful. My godmother decided to gift me – my cousins doula to do a Skype consultation to help. The doula suggests I talk to a post-natal psychologist, I did two sessions that changed my entire perspective and breastfeeding expectations. In hindsight everything that I spent or was gifted towards me and my mental health and physiological birth knowledge were the money best spent and the most valuable to my Matrescence—my birth as a Mother.
She questioned if I’m expressing and baby is getting my milk what’s the problem? I tell her it’s too much. It’s so difficult. I hated sterilising bottles, having to heat up milk, I felt like a milking cow, always pumping, I can’t fit more skin-to-skin, I wanted to feel the bond, it’s something I’ve always wanted. I want to know what breastfeeding feels like. What’s the sensation of the suckling? And for my baby to have all the benefits of this incredible magical liquid that change and adapts to their needs.
The psychologist was the one that made me realise that it did matter so much to me and that was ok.
She made me realise that breastfeeding is hard work, she burst the unrealistic bubble I had about it: “Natural, doesn’t mean it’s instinctual or instant”
My father then tells me my mum breastfed me for a short while, then I went to a wet nurse. Due to an infection she got. My mother never told me that. I don’t know why nobody had told me anything about breastfeeding until I started talking about my struggles.
No wonder... I had an unrealistic expectation. I am still shocked about the lack of dialogue about it. I don’t understand the secrecy. Is it shame? Is it fear to scare others? It might be hard to hear – but at least it would’ve given me a more realistic idea.
I confess to the psychologist in my head giving up is NOT an option! But I understand that breastfeeding is a journey, it’s not gonna happen in an instant. It can take time and a lot of hard work. Which finally took all the pressure and stress off me.
She also told me to not take it too personally in regards to the rejection I felt. To understand that baby and I are still learning. Baby needs time to learn to latch. I need time to find positions and techniques to support the latch.
The increase in my milk supply next time I go to the clinic is good.
So is my mentality. We cheer at all small steps I make. Consultant manages to latch baby and she feeds for a straight five minutes. It doesn’t hurt. It’s everything I thought it would be. She looks up into my eyes on the laid back position.
I feel her suckling and I know that’s what I really want to do.
Ok, so now we know she’s not tongue tied, she can latch. Plan is to keep trying at home. Which I still struggle between the pumping but I somehow manage. Most of that credit goes to my husband who took on everything else to help.
Four weeks in she latches again and feeds for 5 to 10 minutes. Baby shows more interest in breasts and I figure out I can only do this when she’s calm after a bit of formula but not fully fed or she’ll sleep. Consultant tells me to keep practicing at home.
“Milk is there and she wants it”.
Positions for breastfeeding
I try to learn to do laid back nursing. Initially only the koala (or straddle) hold is how I get her on. Hold baby straight and place her on my thigh... baby head leans back a bit and she attaches, once on I then lie back.
Eventually we kind of manage without the koala hold but then the pain begins.
I know she’s not latching properly. It hurts but I keep her on because I want her to feed. I’d take her off when I couldn’t take the pain any longer. She only feeds off the left side too. Screams at the right (inverted) side. I come to terms she may only feed from that one side. Again something else I never knew it can happen. I try nipple shields which helps bring nipple out a bit. So does pumping.
At five weeks we are phasing off formula. In fact she pulls a disgusted face if we had to top up after my milk. I am happy about that!
I think that was the toughest week. I go to hospital clinic to try learn cross cradle position. The laid back is not very practical in public.
There I do it perfectly. Amazing latch no pain just feel the suckling of baby. I love the flutters, I love the gulps from the let down I am in cloud nine.
Then I manage again in Mothercare store!
Only when I get home I can’t seem to do properly anymore.
I get by over the weekend, but I feel sore. I wish baby would take the other side to give me a break. So I find another drop in clinic, I learn I wasn’t holding her head properly. Do it a few times there successfully. I am puzzled at how hard it is. Baby’s hand gets in the way, so I need a hand for that. Then I need the other hand to hold her head. Then can hold the breast in place and I feel like I don’t have enough hands for all this. None of the online videos I saw had the baby flapping hands around, getting it in the way. None were screaming with hunger. Head moving in weird different directions.
But as soon as I get home I seem to lose it again. She falls asleep on breast then loses the latch. So I stay with the toe curling pain because well... she’s feeding. Even though I’ve been told to take her off. Sometimes I left her on because the latch was so strong I couldn’t take her off. Other times I left her on because it took so long to latch at all, I don’t want to start from scratch again and get her angry. I was lucky I didn’t get nipple damage, please stop if it hurts a good latch shouldn’t hurt at all!
So I look for another drop in clinic. I get there, but no one from breastfeeding there today. I am so upset and in pain by then. They get my details and tells me about this amazing consultant she’s the best. They ring me same day but that doesn’t change anything.
Day after I go to a different drop in centre and meet the consultant everyone told me about.
She watches us at first then explains to me baby has a high palette. Must keep hold of baby head for deep latch. I’m still in so much pain even after all her tips.
I ask if she’s feeding enough. She explains not to worry about how long baby feeds. Sometimes baby may just want a drink and be on breast for a shorter time. Or she might want a big meal and feed for longer.
That same night I try to put her on breast but can’t handle the pain any longer.
I burst into tears and for the first time think “I can’t do this. I just can’t. I can’t take the pain anymore”. Then another part would think “this is what you wanted, stop complaining”.
I seek help online too. Messages on Instagram all helps me emotionally during the early hours. Maria Betsworth, Milk Making Mama was the best. I learnt masses from her account.
I return to original consultant I’ve been seeing on the Friday. I have the same meltdown in front of her and she reminds me what a long way I’ve come. She tells me how I’m at the stage all mums come across. I’m just a bit behind. It’s ok. You could be sore from baby drawing the nipple out. She teaches me the flipple technique. I feed baby there twice then find a new set of determination among the pain.
I tell my husband that day I’ll express but I need to heal. So took a day off. Day after on the Sunday I put all the techniques together, flipple, keep holding her head for deep latch and we manage it. Things start to turn around I start to feel more good latches than bad. She no longer needs formula six weeks in. I am proud of baby and myself. We can and are doing this!
Around seven weeks in I notice baby knows how she should latch. They told me to still try placing her on the other breast. Though initially no interest. The usual screaming displeasure. All of a sudden whilst trying she started taking the right side too, I am SO proud of her yet again. Baby has not let me down! Then it started to hurt again I think it’s the drawing out of the nipple again and it’s starting to not hurt anymore.
I did have comments of “She’s feeding again? Your milk is not sustaining her”. I end up educating them that my milk is all they need and baby is the one who knows if she’s hungry or not. If it’s just thirst or a meal they need. Their stomachs are smaller. My milk is digested quicker. I have gone from not knowing anything to learning on the job, reading, asking questions, attending every single clinic I could find within my local area. I know new challenges will arise as we continue full steam ahead on our journey. I’m glad I didn’t give up even though it felt like all the odds were against me at the time.
I am so grateful for all the support that I found offline and online, they were all invaluable.
Then three months down the line, I notice that I am still bleeding fresh blood. I mentioned to the NCT mums I met for coffee weekly and they all said they stopped bleeding a while ago. So I go to my GP, he refers me for a scan and hold and behold. I had retained placenta and my body was trying to get rid of it on its own. I had several scans to see what was going on until it got rid of all of it. I then learnt that is another cause for low milk supply! Which totally makes sense now.
I stopped pumping once breastfeeding was established but carried on using the Hakaa to collect milk from the let downs of the opposite feeding side. So my husband and mum could do some feeds. However baby decided at five months (or so) it’s better straight from the tap and she started to reject the bottle. It’s funny as she grew, how she was then able to keep the latch even at the weirdest positions like standing up, rotating almost upside down.
We continued to breastfeed for just over two years! Unfortunately I got aversion after that – but that’s another story, for another day.
When my girl grows up and have kids of her own, I will make sure to tell her about these struggles that can be part of a breastfeeding journey. I don’t want to hide the reality from her, like I felt everyone hid it from me.