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By Lisa Lactivist, on July 25th, 2012 I discovered the Baby Greenhouse forum after I had suffered two miscarriages. I was 22 and didn’t know much about babies or pregnancy. I had no particular opinion on whether I intended to breastfeed or not, when (and if) I had a successful pregnancy.
One night there was a thread on Baby Greenhouse discussing the Nestle boycott. I read with interest and someone posted a link to a document containing official World Health Organisation research on breast-feeding and their policy on advertising and marketing of formula milk. It describes in detail the *actual* benefits of breastfeeding and the shocking statistics about the health effects of ‘not’ breastfeeding, according to the WHO research. It explains that due to pressure from American formula companies, some of the ‘scarier’ statistics were removed from a health campaign heightening awareness of the risks of ‘not’ breastfeeding. The reason given was that it “..might make (formula-feeding) mothers feel guilty..”
From the second I read the stats I knew I wanted to breastfeed. Up until that point all I’d really heard was ‘Breast is best’. I’d read all the usual stuff that you read in magazines, NHS leaflets etc. None of it really had that much of an impact. But this did. I was shocked. That this vital information would be down-played for fear of upsetting people…?? I couldn’t get my head around it.
With my third pregnancy I researched online and in books for information on breastfeeding. I read all the breastfeeding posts on BGH that I could find! I felt strongly that I wanted to do this for my baby and for myself.
Finally in December last year my dream came true and my baby girl was born. Unfortunately she was very ill. She had risky but life-saving surgery performed in the womb at 32 weeks gestation, causing me to go into premature labour and she was born by emergency c-section at 34+4. At this point I wasn’t really thinking about how I’d feed her – I was more concerned whether she would live or die .
When it became clear that she was going to recover and come home, I started to think again about the reality of caring for her. I knew that I still wanted to breastfeed, but the odds were against us. We had been separated for the vital first few days of her life (she on a ventilator, me immobilised from the section). We were unable to have skin-to-skin contact because she had a chest drain inserted which meant that she couldn’t leave the incubator. I was able only to hold her head and stroke her skin through the ‘port-holes’. I couldn’t smell her. I couldn’t hear her cries without bending myself at a 45 degree angle (!).
I looked into ways I could *try* and get breastfeeding established. I expressed milk every 3 hours to feed to the baby through her nasal-gastric tube. Beginning to express milk when I had no baby to stimulate me naturally was hard. And painful. I found the act of expressing more painful than the seven hours of contractions I’d had whilst in labour. At points I felt like giving up. But I kept going and eventually got used to the electric pump.
The premature baby charity Bliss had information about using a dummy to stimulate the baby’s sucking reflex whilst they received their tube feeds. The baby would hopefully begin to associate the ‘sucking’ with the feeling of a full tummy. I spent every day at the hospital, using the dummy with every feed. 12 hours from 9am – 9pm until my feet were sore and my back ached. I was completely exhausted, people kept asking me to take a break, have a morning off. I couldn’t bear to.. Every minute that I was awake and not there I felt ill. I had asked the nurses to use the dummy when they did her tube feeds overnight but I knew from observing them that they are often very busy, and doing this every hour on the hour might not be practical for them.
She spent 2 weeks in Intensive Care with some terrifying moments, including a collapsed lung before she was finally able to move out of an incubator into a cot. On the 21st December at 16 days old she was ‘allowed’ out to try sucking at the breast. I was over the moon when she began rooting around and after a few attempts she latched on. That night at home I cried with relief. The weeks of pain and emotion and uncertainty had been worth it. It is one thing to try breastfeeding and have it not work out: at least you know that you *tried*; it is quite another to not even have the *chance* to do it.
I was allowed to stay over at the hospital for the next two days with the baby in order to get breastfeeding established. Again it was difficult because suddenly I had the responsibility all to myself – DP wasn’t allowed to stay and I felt under incredible pressure. Of course I had put *myself* under this pressure but I knew that my reasons were good. After two days and nights of this, she had gained weight. Clinically she was given the OK to go home and that meant we could have her home with us on Christmas Eve.
Breastfeeding at home was harder than it had been in hospital. As she gained weight she needed to feed for longer. Her sucking became practised and STRONG! I had a cracked nipple on both sides for about two weeks. The pain of feeding through a cracked nipple was almost unbearable. I screamed and shouted and gripped the couch, but somehow we managed it. Through all of this, the only thing that kept me going was my determination. A determination which was brought about not by any health advice I’d received from doctors or nurses or midwives or friends or family, but from reading a post one night on Baby Greenhouse!!
My opinion on breastfeeding now is that more should be done in this country to encourage women to try it. I am sure there are thousands of women / girls who choose to bottle-feed because they investigate the options and bottle-feeding seems the easiest and most practical. The health benefits of breast-feeding *as advertised* by our health authorities are simply not ‘strong’ enough to outweigh the practical benefits of bottle-feeding. Even the midwife simply said “We don’t ask how you’re going to feed your baby, we only say that breast is best. It’s your decision.” This, of course, is true. But my personal opinion is that there is a responsibility on our healthcare providers to properly advise on the pros and cons of both methods. My honest opinion is that bottle-feeding *seems* to be easier because I like the idea of the baby’s Dad and other family members being able to do some (or all!) of the feeds. If I hadn’t read this document I would probably have decided to bottle-feed. And I do *not* blame anyone else who thinks this way. I blame the Government or NHS or whoever it is that doesn’t provide sufficient information for us to make a properly informed choice!
Please please please let me stress that in no way do I think formula is “poison”. I think formula is a perfectly acceptable substitute for breast-milk, when breast-feeding has not happened. Particularly if for medical reasons – HIV, milk doesn’t come in, low pain threshold etc. But I do believe that we should be encouraged to *try* it.
The reason I posted the article was in the hope that I’d reach someone who was like me two years ago.
copyright Mhairu Hamilton
By Lisa Lactivist, on May 25th, 2011 Aunty Lactivist is all of us, so if you can help at all with words of wisdom, links to other sites or yor own experience please leave a comment.
Dear Aunty Lactivist
Can you point me in the direction of some research or guidance please about skin to skin contact straight after a c-section. I KNOW the benefits but need something more definite than my fluffy explainations. I suppose I am really thinking of early establishment of breastfeeding, rather than waiting the hour plus they say.
A
By Juno Charlett, on November 25th, 2008 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
By Juno Charlett, on November 17th, 2008 This week’s session was about ‘Understanding Baby Needs from Infancy to Toddlerhood’ and it was reassuring to realise that we were all aware of almost all the information that we discussed – particularly regarding new babies.
However, there were a couple of points raised that I found especially interesting and I would like to learn more about.
Firstly, the subject of weaning onto solids. Having had five children over a nine year period, I can vouch for the fact that recommendations on weaning have changed dramatically! With my eldest, I wanted to exclusively breastfeed for as long as possible, but I found an overwhelming amount of advice to begin solids, to help my baby sleep better. The earliest recommended time for weaning then was 14 weeks and so that is what I did. Well, my boy loved food, but he didn’t sleep any better! You’d think that I would have learned from that experience, but I ended up following the same advice not once, but twice, more – with no.s 2 and 3! With my third, I had already heard that WHO were advising six months exclusive breastfeeding and I was crushed when the GP advised weaning at 4 months to help his reflux (as well as his sleeping, which it didn’t).
With no.4 I dug in my heels. Despite poor weight gain and reflux which put no.3 in the shade, I breastfed exclusively for six months – and I did the same with no.5.
So I was really pleased to find that the current Health Authority advice is a definite trend towards ‘baby-led weaning’. That sounds more natural to me, although I hardly know what it means. Wait til six months, offer finger foods (if baby will take them)…. This is all so different from the advice in baby books 11 yrs ago! Can anyone out there tell me anymore?
I had a bit of a Eureka! moment when I was thinking about this the other day. When I began this course, I didn’t think that I had had any particular difficulties breastfeeding. However, I have come to a realisation. It’s been a long time since I felt the need to ask advice about parenting – mainly because I have found I can quietly discover things within a book, without having to consider refusing the advice of the person I have asked, if I didn’t like the sound of it. Thinking back to that time when my eldest was not sleeping well and I was looking for a solution, I was met with the advice to begin solids from both health professionals and relatives and, although I wasn’t happy about it, I followed that advice (and actually felt more disappointed when it failed). It only just occurred to me this week that that advice is the same as saying that my breastmilk was not enough for my 3 month old baby and that if I had stopped to think about how capable my body would be at providing milk for twins, I would have seen how ridiculous that was. I never really saw that as a breastfeeding difficulty, but of course it was. In fact, the difficulties with sleep and my eldest became such a problem for me that I embarked on sleep-training when he was 5 months old. He slept through the night within 3 days and I was incredibly relieved, but that, combined with his early weaning and love of food, led us down the path of reducing my supply. I wasn’t aware of it at the time, but when I fell pregnant when no.1 was eight months, he no longer showed any interest in breastfeeding – although I would have happily continued through my pregnancy.
The other discussion I found fascinating was about ‘nursing-strikes’. I have read a little about this. On occasions a baby may refuse to breastfeed – and this may continue for up to four days! This is obviously very distressing for the baby’s parents and we were given some advice on how to support a mother through a nursing strike:
We must reassure mum that it will pass;
Bottles and dummies should not be offered (in fact, nipple confusion can be the cause of a nursing strike);
Mum should express, to keep up her supply;
It is important that mum rebuilds her baby’s trust with calm, peace & quiet, skin-to-skin contact and avoiding separation from her baby, if at all possible.
There may be other ways to get the baby interested in feeding again, for example: attempting a feed when baby is very sleepy, trying different positions and walking with or rocking the baby.
There are many things that can cause a nursing strike. For example: fright, illness, teething, distractions/interruptions, long separation from mum, a change in routines and arguments or disruptions in the house.
Have you experienced a nursing strike? Did you manage to overcome it? Please write a comment if you can.
Finally, we talked about instances where we had met a new mum experiencing difficulties and had not found a way to help (or, had been that new mum and had not been able to get help from other experienced mums).
I fall into the first category, as I found it extremely difficult to pinpoint the problem when my relative was having difficulties breastfeeding – and my frustration was compounded by the huge changes that would occur in just 24hrs. 24hrs is such a long time in the life of a newborn and his mum, but a mere blink of an eye to the rest of us!
Our instructor reassured us by saying that for breastfeeding difficulties involving newborns, it is vital to spend lots of time with the mother. Only by doing this will we develop a full awareness of the difficulties the mother and the baby are experiencing.
I am sure I must be more prepared for my role of supporting breastfeeding than when I began this course, but I still worry that I might be met with that situation again – where I don’t know what I can offer to help. At least I am aware now of the team of people who can be called upon to help alongside myself.
Juno
By Juno Charlett, on October 27th, 2008 The topic for discussion this week was ‘Basic Breastfeeding Management’, which I imagined to be full of the core elements of the peer counsellor’s ‘tool-box’, I guess – and I suppose it was, but I was surprised at how much of this ground we have already covered. Nevertheless, we did, as always, have some interesting discussions along the way.
So we talked through a variety of factors important to establishing a confident breastfeeding relationship between mother and baby.
Many of us have experienced circumstances with our own babies that help us to understand how frustrating it can be for a new mum who feels things aren’t going well. It’s great that we can use that awareness to help new mums identify what the difficulty is and, most importantly, offer some solutions so that breastfeeding can continue.
We have been told how important early skin-to-skin contact is in establishing breastfeeding and our instructor said that she believes most mothers are given the opportunity of that experience now.
I was thinking about that myself recently, as the first two of my babies had a remarkably different start to the other three, even though they were all born at home.
My eldest was born after a ‘textbook labour’ – a big, healthy baby. I held him, skin-to-skin, for a couple of minutes, during which time it became apparent to the midwives that he was slipping away. He was then taken from me to be resuscitated – which took over half an hour – and then rushed to hospital in an ambulance. I didn’t see him again for an hour or two and didn’t hold him again for several hours. However, at 20 hours old, he decided a drip was not enough and began sucking his fists urgently. Breastfeeding began then and continued (in abundance!) for 8 months.
No.2′s birth was a little different. The two midwives in attendance were obviously uncomfortable with a home birth following our traumatic history. At the appearance of meconium in the amniotic fluid, they urged me to hurry up – completing the second stage in 10 minutes flat. They then took my baby’s temperature and dressed him before giving me the opportunity to hold him. Although I began breastfeeding as soon as possible, I was not as responsive to his cries and did not strive to keep him close to me all the time in those first few hours. He didn’t feed as much, he slept more and consequently he lost more weight and became more jaundiced than his siblings. As it happens, he has also experienced more health problems than his siblings too. However, we did establish breastfeeding well and we continued for 14 months.
It was interesting to hear that lack of the skin-to-skin experience at birth has been shown in research to lead to a greater weight loss and more jaundice – in common with my experience.
The positioning and attachment of the baby can also make a huge difference to the outcome of breastfeeding and we were asked to always consider checking attachment in our roles as peer counsellors, because it is such a common issue leading to difficulties.
As we talked about it, I was reminded of the huge difference in feeding a newborn to my current experience of feeding a toddler – and how easy it is to forget how awkward those first few feedings can feel.
We each talked about the most comfortable positions we had found and I was surprised by how many had used the ‘football hold’, as well as the traditional cradle-hold and lying down. The ‘football hold’ was not one that I remember using much myself, but other mums described how useful it was in feeding a struggling baby – and I could really understand the need for an alternative position. I do remember using swaddling in those circumstances, but there was often a hand popping out of the blanket and getting in the way.
I also found it hugely beneficial to use a sling – especially with my youngest, who always wanted to be carried or fed when I had to do something else.
As well as the different positions, we were reminded that the baby needs to be at the right height to suckle comfortably and most of us remembered using lots of pillows and cushions in the first few weeks. In fact, with my boy being so big now, I still sometimes settle down on the sofa with a pile of cushions, so we can be really comfortable.
We also discussed the importance of feeding on demand. I suppose this is one of the main aspects of breastfeeding which remains at the mercy of our cultural expectations. Lots of the mums in the group knew other mums who, despite adhering to all the other recommendations, felt it was important to feed by the clock. This had led to difficulties with some, but one mum in our group said her son naturally fell into a pattern of feeding ‘on time’ and she found that it didn’t interfere with continuing breastfeeding.
The importance of focusing on the baby’s cues is well-documented. In the early weeks, the mother’s body is responding to the baby’s body by producing more milk, the more the baby feeds. Restricting feeds at this time could lead to a reduction in the mother’s milk supply. Not only that, responding to baby’s cues is part of the dialogue between mother and child that goes beyond the breastfeeding relationship.
However, some babies do settle into a routine early on – and that just goes to show how different babies can be. My babies have differed enormously. My 4th baby rarely cried, sucked her thumb and slept through the night from 9 weeks. Of course we put it down to our fantastic parenting skills – and then we had no.5! He has been the opposite in all those respects!
It is because of those differences that we are encouraged to ‘watch the baby – not the clock’. Although we might want to guide them towards a routine that suits us and our families eventually, at first we must establish what their needs are and how we can meet them.
I feel very optimistic when I hear about this growing trend towards listening to our children, rather than controlling them. I know it isn’t as widespread as we would like it to be, but it is a positive step in a new direction.
Next week, we have a break for half term, so it’ll be two weeks before my next post, but please come back with lots of comments – it always makes for really interesting reading.
Juno
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