bottle feeding - the guilt

It took a while to settle into bottle feeding. There are lots of hassles as you can't simply put the baby to the boob and have an instantly satisfied baby! Instead there were the dos and don't of making up bottles to get my head around - how to heat them up, whether to keep them in a fridge in advance, use of a microwave, taking bottles out with me, sterilising, which formula to use, and so on, all while looking out for new signals of hunger to prevent unnecessary crying! 

I'd just settled in to it when I had a wave I guilt over me. At the mums and babies group some mums were breastfeeding babies older than Hugo. Although some were also bottle feeding, I just felt disappointed in myself. I hated sitting there bottle feeding and was thinking that I should have carried on and persevered. It wasn't as bad for me as for some people and looking back I had thoughts that I could've made it work. I was also thinking that it would've got easier, which is possibly true, but how could I ever know?!

The truth is yes I could perhaps have persevered, but would I have been happy? Would I have even made it to that group if I was as tired as I had been? Probably not. I wouldn't have had as many happy times as I've had I'm sure.

Before I breastfed I hadn't quite realised just how much is would stop me from doing as much. Not because I was afraid to breastfeed in public, I truly mastered that, but because of such frequent, long and tiring feeds.

I breastfed that night thinking I'd start it up again, but was instantly reminded of the reasons that I'd stopped. My boobs were very sore and starting to bleed, my arms were incredibly achy from trying to hold him in position to get a good latch, and he simply wasn't as satisfied as with a bottle and wanted another feed straight away.

Instead I thought I'd try to get as much expressed milk as possible so that I could at least be happy that he was getting breast milk. I borrowed a friends electric pump, but couldn't get as much as I did with a manual and realised that even with the manual I was getting a lot less than before. I'd just been so busy that my supply had diminished as I hadn't been able to keep on top of expressing.

So, to cut it short, my breast milk has pretty much dried up. I feel very frustrated at myself as I so wanted to breastfeed for longer, but I need to think of the positives and the healthy, happy little boy I have.

breastfeeding - the struggle

Breastfeeding really has been a rollercoaster that starts and stops, jerks forward and back with lots of upside downs along the way. 

Pre-tongue tie

Hugo was latching on well but he was feeding really frequently - up to 18 times a day! I coped through the days of building the milk supply, but on other days, unless we were out or he was asleep he’d want to do nothing but feed and the evenings were particularly exhausting. I felt like things should have calmed down so thought about how I could encourage him to feed less frequently and for longer each time.

I realised that he was falling asleep on the boob. I tried to wake him and keep him going so that he'd take more, but despite me trying to wake him and keep him going, he’d fall asleep and then want more not long after. I think he had to work doubly hard because his tongue-tie made it harder for him.

The bigger he got, the more difficult it was to keep him in a good position and he was also very wriggly, perhaps sometimes out of frustration. His latch also got gradually worse and I was constantly having to re-latch him. The more tired I was, the less mental and physical strength I had to constantly take him off the boob and re-latch him, so sometimes I'd let him feed with some discomfort. Because of this my nipples have become red and tender so breastfeeding has become more and more unpleasant.

I built up to the tongue-tie in my head and coped with the discomfort and exhaustion, hoping that things would improve after the tongue-tie snip.

Post tongue-tie

The doctor told me to re-train him to make sure he didn't fall asleep at the boob, but that's pretty difficult in practice! To start with I thought things had really improved as I was encouraging him to feed for longer, the latch felt good and there was longer between feeds, (apart from the first day of constant feeding to re-build the supply) however his latch soon went back to normal, as did his habit of falling asleep on the boob.

I feel like the tongue-tie snip came too late, as he was already in his own routine. I did everything I could to wake him but he went back to feeding little and often and his latch started hurting. I was becoming exhausted and didn't have the energy to hold him up properly and support him in a good latch. 

After a week of persevering after the tongue-tie snip and a month of breastfeeding, Adi and I decided that we should introduce the bottle for some feeds before I hit rock bottom. We intended to mix breast and bottle if he would swap between both, so that Adi could do the odd feed and give me a longer break to help with my tiredness and breast discomfort in the evenings. We also thought it may help us to ensure he had a good evening feed, being able to see the amount of milk he was taking.

He took the first bottle of expressed milk really well and went back to the breast very easily for the next feed so we will see how it goes mixing both.

tongue-tie

Hugo was born with a tongue tie. It's something that affects 1 in 10 babies and is more common among boys. 

Midwifes used to check routinely when babies were born and simply tear the tongue tie themselves using a nail or such like. Obviously this led to infections and so now it's done using a sterilised pair of small scissors. It's an incredibly simple procedure.

My midwife noticed the tongue tie on her first visit - the day after Hugo was born. She said that this could be affecting how easily he was able to latch on to the breast so could make breastfeeding more difficult. She referred us that day and said it should be up to 10 days for an appointment. 

10 days later and we were still waiting for a letter or phonecall. Breastfeeding was indeed difficult because he struggled with his latch and my boobs were starting to get very tender. He was having to work harder at the boob so was sleepy and taking a long time at each feed. I was constantly re-latching him and this was the only reason that I was able to last so long, as I didn't put up with pain.

It can make is near on impossible for women to breastfeed when a baby has tongue tie and the professionals were astounded at how well I was doing. It's therefore incredibly frustrating that throughout the pregnancy and birth, all health professionals in the nhs are guided to drill in to you the importance of breastfeeding, yet they can't do a simple snip of the tongue as a routine post-birth check which could make all the difference.

When my health visitor came on the 10th working day since the referral she called to follow up and gave us a number to call as well as a number for a complaint which she advised us to do. 

We called the following week and were told that there was a delay due to the one(!) doctor in the region qualified to do the procedure being off sick. They had apparently had a 'crisis' meeting and were holding extra surgeries to keep up with the demand. 

We were booked in for the following week - so Hugo was 3 weeks and 3 days. That's 3 weeks and 3 days of unnecessarily frustrating feeds if the procedure could be done at birth.

The doctor was an hour late, but luckily Hugo is a very content little man! I was getting stressed as I hated the idea of inflicting any pain or discomfort on to Hugo. I needn't had been, as he barely flinched. He was understandably a little resistant as the doctor and nurse opened his mouth, but the snip lasted a couple of seconds and he didn't feel a thing. The doctor simply dabed it with a cotton wool pad to soak up any blood and passed him back to me.

I was led into a room to breastfeed in private and the doctor advised me to make sure he doesn't fall asleep at the boob, to rid of old habits. He was able to latch straight away and I saw signs of improvement, but was just relieved that he wasn't in pain and could feed. 

Adi and I are fully intending to do something to help put tongue tie on the agenda. Something so simple can be all the difference between breastfeeding and not. Tongue tie can also lead to speech problems, yet is often not picked up until such a time, when the procedure does become a bigger thing and inflict pain. 

Why can't all babies be checked for tongue tie by the doctor who does the routine post-birth check? Why can't that doctor be trained to do the procedure? Why isn't there more than one doctor able to do it in my region? Why does it take so long for the referral? Why do different regions have different standards, with some refusing to do it all together unless it affects speech?

Answers on a postcard. 

breastfeeding - the gush

Just when I thought I'd cracked the colostrum, the baby had to re-learn everything when the milk came in as the density of my boobs and feel of the nipple changed. It was an incredibly difficult night, for hours no matter what I did, he could not latch.

The feeling of not being able to feed your baby, when you can see they are hungry is awful and incredibly frustrating. It tests your limits. I think Adi was ready to crack and if we'd had formula in the house we'd definitely have used it, but I'm so glad we persevered. I rang the F.A.B. helpline and they reassured me that I was doing everything I could and it was probably the tongue tie, which made Adi and I consider snipping it ourselves! 

In the end Adi was able to take the baby and calm him while I used a hand express pump (invaluable) to express some of the milk, which helped to soften them as they were rock solid, and get the flow going. I also had a sleep which gave me the energy to try again. When I did Hugo latched on straight away and fed well. To help me and Hugo, I was very conscious to remain calm and keep my heartbeat steady even when he was struggling and I was exhausted. Having the support of a partner was invaluable, as he simply wouldn't have settled had I not been able to pass him over away from the smell of milk at times.

I kept massaging the boobs between feeds to loosen them as they were hard and lumpy, and fed little and often (on demand) which helped to establish the milk supply. This stage was the most painful, but only the pain that all women experience as their milk is 'letting down'. 

Then, just as we thought we'd cracked the milk, it would appear that my body was just teasing. The milk comes in gradually and each feed is different from the one before. Suddenly my boobs were less hard and lumpy and just huge and soft, full of milk which was leaking everywhere! The milk flow was far too fast and too much for baby to cope with! I used the hand pump to express to help get rid of the access fluid to make it easier for Hugo.  For a good few feeds we seemed to have cracked it with me expressing a little before if I felt the boob needed releasing.

Finally, the milk flow settled and he got used to feeding without me needing to express before. By the end of the first week I was still taking it a feed at a time, but he was latching well and the milk supply had settled. 

breastfeeding - the colostrum

Just like my desire to have a natural birth, I had a real desire to breastfeed. Formula is a wonderful substitute for those who are unable to breastfeed, but if possible, I wanted to do what nature intended.

I myself have a weird relationship with milk. I have an intolerance to cows milk but do have the occasional goats milk. I'm not convinced we (humans) are designed to drink milk at all after our mothers. The idea of giving my baby something unnatural, unless I had to, was therefore something I didn't want to do when he was so little. 

That is until he starts teething, which is perhaps natures way of saying that he shouldn't be guzzling at my boobs for much longer! 

Although I knew that I wanted to breastfeed, the idea of a baby suckling at my sensitive, big boobs wasn't appealing. I was really unsure if I'd be able to get used to the feeling and was half expecting to give in at the first hurdle. Added to which, the copious amounts of stories about the baby not latching on properly and causing bleeding and bruising petrified me. Formula was always going to be a good alternative if I needed.

Because of these stories, preparing for breastfeeding became my main focus in pregnancy. It was the initial reason for attending NCT classes and my main reading topic. I am pleased to say that my research and determination has paid off (for now!).

I decided not to buy any emergency formula so that I wasn't able to give up easily. I ensured that I had the support of my husband and that we together would set out to try to make it work. In my head, if the baby was hungry and my colostrum had come in, surely there would be a way for him to feed. As a back up there was always a 24hr asda not far away in the worst case scenario!

Latching on:

While in hospital I struggled to latch the baby on, but with the help of the F.A.B. breastfeeding specialists and lots of different positions I managed to successfully feed. The research I did really helped as I knew instantly whether the pain I was feeling was normal or due to him not being latched on properly, because of the positioning of his chin and lower lip. 

As he was so sleepy on the first day, there weren't many issues as he didn't require much, so although I wasn't fully confident, we went home knowing that I had fed him and therefore should be able to feed him again.

The first night was difficult as the positions that had worked in hospital weren't working as well at home. I managed to feed lying on my side with him lying next to me, but then that wouldn't work the next time, I'd try the cross-cradle, but that wouldn't work again, rugby ball hold, same again and so on. 

He was also sicking up lots of mucus, which he would have swallowed during the birth, so over the first 36 hours or so he wasn't taking much down until he'd got rid of that. 

The midwife came the following day and I was really anxious. Although he had taken some colostrum it felt like he wasn't able to take all of the colostrum that he needed. Because you can't tell how much colostrum/milk breastfed babies are taking, the anxieties are heightened. 

The midwife helped position him and reassured me that the positions I was using and the latch were right, but discovered that he had tongue tie which could be restricting him. Because of this we hand expressed some colostrum and fed him with a small spoon to ensure that I knew how to do this if he wouldn't latch when the midwife wasn't around. 

The midwife meanwhile referred him to have the tongue tie snipped, which can take up to 10 days. (More of that in another post).

Later that morning one of the F.A.B. specialists popped round to see how I was getting on. She again reassured me that the positioning was perfect and he fed well. She also reminded me that his stomach was the size of a marble, so it may seem like not much was taken, but he was fine. 

The following day both the midwife and another F.A.B. lady came. I'd had a successful night of feeding and seemed to have cracked it but accepted their support anyway, as I was taking things feed by feed. The F.A.B. lady gave me a great tip to help him breath through his nose, which was to lift his legs high to ensure he was horizontal. The lady in the hospital had said to use a hand on the boob, but that had actually been hindering the latch, without me realising. Each woman has tips on what has worked for them and others they know, so it pays to accept all advice, whether or not it works for you. 

So, thanks to the incredible support of the F.A.B. breastfeeding charity and my midwife and husband, we cracked the first stage - colostrum, which meant that no matter what came next, he'd had the most beneficial first feeds.