Becoming a mum: breastfeeding

Arthur is feeding in the sling as I write this – as he does most mornings in fact before drifting off to sleep giving me the time to get some writing done. He’s fourteen months old now. If you had asked my pre-baby self whether we’d still be breastfeeding at this point I would have thought it highly unlikely. My goal was a year, at the very least six months – though at the beginning of our breastfeeding journey even that seemed insanely ambitious.

I knew I wanted to breastfeed even before I got pregnant. My mum had breastfed me and my three brothers so it seemed like the obvious thing to do. Add to that my preference for food that is local, organic and unprocessed wherever possible and my aversion to washing up which made the endless sterilising and preparation associated with formula feeding particularly unappealing and it seemed a no brainer. What I had no idea about was just how difficult it could be.

At the breastfeeding class Leigh and I attended, diligently focusing on how to get the correct latch and marvelling over the video of the newborn baby crawling up its mother’s belly to help itself to milk, I asked what problems we might face and if the class leader had any tips to overcome them. My concerns were brushed off though – breastfeeding was the most natural thing in the world, we were told, just follow the guidelines we were given and we’d be fine. Retrospectively, having faced considerable challenges myself and heard all of the different problems faced by my mummy friends, I think we were being fobbed off. There was such a focus on persuading us to breastfeed – though no-one in that room really needed persuading – that the class leader didn’t want to say anything that might put us off. It’s a shame she couldn’t have treated us a bit more like adults really – it certainly would have made me feel like less of a failure in those first few weeks, and might have helped me identify what was going wrong sooner.

I had no idea anything was wrong at first. We had a near perfect home birth (you can read about my birth story here), and though it was past the end of her shift the midwife stayed to make sure Arthur latched on for his first feed. She was happy he was doing ok, and I was floating on a wave of exhaustion and oxytocin, just relieved he was finally there. We all settled to sleep soon after midnight, and we were grateful that he chose to sleep through until eight the next morning.

In fact I think I had to wake him then. I felt a little guilty as we’d been told to make sure he fed every three hours – but we were also told our baby would let us know when he was hungry. Advice about waking sleeping babies varied enormously – and as, by my mum’s account, I had been a very sleepy baby too, I wasn’t all that worried about it. It makes me shudder slightly thinking about it now – no-one had been able to explain to me previously why it was so important that babies were fed every three hours, even if they seemed to want to sleep, but my subsequent research taught me that his blood sugars had probably been dropping dangerously low, and if I’d left him to rouse himself he may not have woken up at all.

The next couple of days passed in a blur. Midwives came and checked on us all, asked about the feeding. I said I thought everything was going ok but I couldn’t really be sure: I had no idea what it felt like to have a successfully feeding baby attached to my breast, so I had to accept their reassurances that the latch looked fine, that it would be easier for me to feel what was going on when my milk came in. I remember feeling very out of my depth, had the sense that something wasn’t quite right but didn’t know what. Arthur was so sleepy, would spend hours at a time at the breast but never seemed to be satisfied. But I just put this down to him – to both of us – needing to learn how to do this breastfeeding thing properly. Clearly it wasn’t going to be quite as natural and easy as people made out.

The first sign that there really might be something wrong was on day three – New Year’s Eve, and Arthur’s due date. After the midwife had weighed him she looked concerned, and said she was really sorry but she was going to have to call the Special Care Baby Unit and we should get ready to go in. He’d lost fourteen percent of his body weight – nearly half a kilo – and this had set alarm bells ringing.

Our families were beginning to gather at our house to see in the New Year as we left for the hospital that afternoon. Even in my worry I was well aware of the irony – we’d had a successful home birth three days early and now, on Arthur’s due date, we were heading to the hospital anyway. I remember shouting instructions at my sister in law to sterilise the brand new breast pump as we left – the midwife had said we’d almost definitely need it on our return if I wanted to continue breastfeeding.

I was hooked up to an industrial breast pump as soon as we arrived at the hospital – we didn’t even make it out of the waiting room. The doctor and nurses we met were surprised to see that I had ample supply – apparently the usual result of that initial test in our circumstances would be little or no milk being produced. A nurse came and sat with us and cup fed Arthur with my milk, the rest being labelled and put into a fridge for later. Next came a barrage of tests for him, during which we were transferred to a bed. I started getting ridiculously antsy at this point – I really don’t like hospitals. Even my relief when the results of the tests came back showing no major underlying concerns was short lived when they said Arthur and I would need to stay in overnight. I know I should just have been grateful he was ok, but I really, really wanted to go home! In the end, after Arthur had consumed enough of my expressed milk to bring his blood sugars up, a combination of my tears and Leigh’s persuasive powers meant they taught him how to cup feed and let us go. We were under strict instructions to feed Arthur every three hours, topping up after each feed with expressed milk in a cup, and to come back in the morning to get him checked over again.

cup feeding

The check on New Year’s day showed that the new approach was beginning to work – he’d gained a little weight overnight, and they were happy for us to continue with regular home visits. So began a gruelling regime of breastfeeding, expressing and cup feeding every three hours. The whole process took at least two hours, so none of us were getting any sleep, and whilst Arthur was very slowly beginning to put on weight this was clearly not sustainable. When my milk properly came in it just seemed to make things worse: my breasts were so painfully engorged no matter how many cold compresses and cabbage leaves I applied, and Arthur would just cry and fuss when I tried to feed him, pushing me away but at the same time not wanting to be anywhere else. He made a clicking sound when he tried to feed, and was very colicky indicating he was taking in too much air.

The midwives were at a loss as to what was going wrong – they were convinced my latch was effective, and just said I should persevere. I’d begun to spend every spare minute researching our symptoms online, and ordered a book which was to become our bible – ‘The Womanly Art of Breastfeeding‘ from La Leche League. From this I deduced that there were two possible causes for Arthur’s inability to feed – oversupply, or maybe a posterior tongue tie. He’d been checked for the latter twice already, but it still seemed a very likely explanation. I followed the advice for mitigating the difficulties of oversupply, and went to an appointment with the hospital’s breastfeeding specialist armed with my new knowledge.

She listened, and agreed that a tongue tie was likely. And in fact was able to attempt a frenulotomy then and there: we’re lucky that our local hospital has been a centre of research for tongue tie and its impact on breastfeeding. She warned us that Arthur’s frenulum was tricky to reach so she many not be entirely successful – and in the end referred us to a Max Fax specialist to complete the procedure the following week.

Even once the problem had been identified and dealt with it took us some time to get breastfeeding comfortably established. Arthur was clearly able to latch better after the second frenulotomy, but he was still taking in air and still needed supplementing with cup feeds to get the milk he needed. I decided to try to improve his latch with nipple shields. Several people had warned me off them, but I figured it was that or nothing. Feeding was starting to get incredibly painful, and the shields protected me as well as giving Arthur something he could quite literally latch onto more easily. We ended up using the nipple shields for a couple of months, and at several points I despaired of ever being able to just breastfeed naturally. We no longer needed to supplement though, and gradually we used the shields less and less, until one day I realised we hadn’t had to use them at all.

For me, breastfeeding has been a really important part of becoming a mum. I understand now how difficult it is, and feel very strongly about women needing accurate information and honest advice before and after birth. With the issue of tongue-tie being in the news a lot recently I hope people will be quicker to diagnose and treat it – I know that on the scale of things Arthur and I were lucky to get the help we needed so early on, but even those couple of weeks felt like an eternity, and had a huge impact on our ability to get breastfeeding established. If I hadn’t have been so stubborn I think I probably would have given up. And whilst I totally respect the choices of women who decide not to breastfeed, I think it’s very sad if our society can’t support those who want to nurse their baby to follow through on that decision.

feeding 14 months

Looking at Arthur today it’s hard to believe that we ever had a problem at all. By the time he was six months old his weight had shot up from the seventh to the ninety-first centile. Breastfeeding finally did feel like the most natural thing in the world: no faffing around with bottles and formula, and I had the ability not only to feed him with my body but also to comfort him and soothe him whenever he was upset or in pain.

Now Arthur enjoys a wide range of solid foods, but shows no sign of being ready to give up nursing. It frustrates me occasionally – he won’t take milk or even water really from any other source – but I only have to think back to how close we came to not being able to breastfeed at all to be grateful that I’ve been able to nurture him for this long and to hope we’ll continue on this breastfeeding journey for a while longer yet.

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