Wow! It’s hard to believe that we are already at week 10. It’s almost the last week, as week 12 is a review session – and I am unable to make it to that one. After that, we have a graduation!

This week’s session was a bit odd. There was a lot of material that the instructor was expected to cover, but much of it we have already covered. One aspect for discussion today was, ‘making breastfeeding work in everyday life’, which was actually the title of week 8.

However, we did have another lively and informative discussion and I am finding myself more confident about asking our instructors for more detailed information. It’s as though I have a small foundation of knowledge and experience, now that it has been organised and digested, and I am ready to build upon that.

This week’s session was titled ‘Breastfeeding in Different Situations’, so we were looking at some of the circumstances that can arise unexpectedly and others that it may be possible to prepare for.

Firstly, our instructor emphasised the importance of new mums finding out as much as they can about breastfeeding antenally and seeing a mother breastfeed if possible. It is also important that new mums are aware of the choices and support available to them in those first few days of their baby’s life. This requires good antenatal care, perhaps with classes in breastfeeding. Our Sure Start centre now offers specific breastfeeding information sessions for antenatal parents, because the 4 antenatal classes just don’t give enough time to devote to breastfeeding.

Armed with this knowledge, mums are better able to understand how breastfeeding their newborn might work, but of course not everything can be planned for.

A few of the unexpected scenarios we discussed were:

Separation of mother & baby and the importance of breast pumps, rest and fluids for mum;

Jaundice in the newborn and the knowledge that breastmilk is superior to formula for treating jaundice, despite the perception of hospital staff;

Illness in the mother and the necessity to keep mum & baby together as much as possible;

Cleft lip and/or palate and Down’s syndrome and learning to breastfeed. These conditions present quite a challenge to breastfeeding, though, as always, breastmilk is superior to formula for feeding babies. Down’s syndrome babies are often able to breastfeed successfully and mums can look for the usual indicators to assess the progression of breastfeeding (changes in stools over the first week, weight gain, wet nappies, content baby).
Cleft lip and/or palate can cause serious difficulties for any method of feeding and cleft palate may make breastfeeding directly impossible. However, expressing is the very best a mum can do for her baby in these circumstances and mums should be given the facilities and encouragement necessary to express in hospital.
It is common now for mums to be aware of cleft lip and/or palate from their ultrasound scan and by the time baby is born, mum will already have received the date for the baby’s first operation. This gives the mum the opportunity to plan a little.
If expression and feeding by bottle, syringe or cup is initiated at birth, it may still be possible to begin breastfeeding directly later on – after surgery. Our instructor mentioned how it is still important for these babies’ mums to know that skin-to-skin contact benefits their baby and that they can offer their breast for comfort, even if they are not actually breastfeeding. I thought that was a great idea, though something I would never have thought of!

Here is another great cultural obstacle in breastfeeding – parenting even – I think. It would seem strange, maybe unacceptable, to offer our breast to our non-breastfeeding baby to comfort them, but why should it? Why is that any different to offering our little finger to suckle on, or to cuddling?

It was interesting to discuss some of the situations that are new to me, but I think what I really got from this week’s session was the need to empower us all.

Many of us will have experienced being told by a doctor, or other health professional, that we must do a particular thing, without being told the most important thing of all – that we have a choice.
My partner and I certainly went through this when our eldest was born. We felt pushed into allowing procedures to be carried out that we weren’t comfortable with and we didn’t think were necessary.

However, four years ago, our second son was seriously ill with meningitis. We were fortunate to have a patient paediatric consultant who wanted to inform us at every step – nevertheless, he had procedures which he felt were necessary. My partner & I found confidence and support in each other and we asked questions frequently and held up procedures when we were not convinced, or when we saw that our son was distressed. Our consultant was very surprised by our attitude, but also very supportive.
The end result was that our son probably went through as many procedures as he would have anyway, but we understood why each one was being performed and when we took our son home, we knew that we had done the best for him.

I would like everyone to be aware of their choices – and to be aware that most decisions don’t need to be made instantly. Feeling part of the decision making process has helped us to overcome the trauma of what happened to our son, leaving us without feelings of guilt.

Juno