Just keep boobing!

After a fairly straightforward labour, my first baby was delivered straight onto my chest for some lovely skin to skin cuddles. She didn’t seem all that interested in feeding, the trainee midwife with us got her to latch for her very first feed within the hour of being delivered, but it took a lot of coaxing, and lots of crying, and fussing from her. Once she was latched on she seemed to feed well, and didn’t want to come off at all. After quite some time the midwife took her off so that I could go to theatre to have a nasty tear repaired, leaving her with her Daddy.

I was desperate to get back to have more feeds and cuddles, but when I returned she was fast asleep. I waited patiently, having nice cuddles, but as soon as she woke she was crying, I tried to latch her on, but she’d just get more and more distressed. When I tried to settle her enough to latch she’d fall asleep again. One of the maternity support workers showed me how to hand express colostrum and finger feed it to her. She seemed to take that really well.

I went home that night, and she had still only latched on that one time. I couldn’t get her to stay asleep in her crib, so in desperation and exhaustion we brought her into bed and she slept on my chest. I kept trying to get her to latch on. I knew the theory, but when I tried she just didn’t open her mouth. I kept going with the hand expression and finger feeding, and then on the evening of the second day she finally latched again. It didn’t look like the perfect latch I’d seen in the books but I was so relieved I’d take whatever I could get!

At day five she was weighed and she had lost around 13% of her birth weight. I had the midwives and maternity support workers help me with my latch over the next few days, and things were getting a lot better. She did seem to be getting the hang of breastfeeding, at least compared to the difficulties of the first few days. Now that she had worked out how to latch on she seemed to just feed for hours and hours, dropping off to sleep frequently through each feed. The maternity support workers were concerned about how sleepy she was, and advised me about switch feeding, and ways to try and keep her awake whilst feeding. Once we started switch feeding we got into the pattern of feeding from one side, falling asleep after a few minutes, then I would wake her again, switch to the other side, and again she’d fall asleep a few minutes later. Sometimes I’d switch her ten, twenty times in one feed before she’d properly fall asleep. During a particularly hard growth spurt we kept swapping sides over and over for six straight hours, with the occasional break for nappy changes!

She was weighed again at eleven days and she’d only gained 20g, we were advised to use a syringe to finger feed top ups after breast feeds using preferably expressed milk, or formula. I had already bought a breast pump, so I tried to express but only managed to get a few drops out. It seemed as if there was no alternative but to use formula, so very reluctantly we bought some cartons of formula, and started giving very small top ups after breast feeds.

From this point we had weekly weigh ins. When we had a good weigh, we would reduce the finger feeds slightly, my main aim was to get her off them completely. When we had a bad weigh, the top ups went up again. I was determined to get her off the formula, so spent hours every day attached to the breast pump. I found that the best time to pump was overnight, as it was the only time she went long enough between feeds. I would get up at around two, four and six every night, trying to get up very gently so as not to disturb the baby sleeping right next to me, and then pump for thirty to forty minutes each time. I still couldn’t get much from all that pumping, but by eight weeks old I was managing to get just enough to cover the top ups. These were given two to three times a day, normally by my husband, whilst I got a rare break from feeding. Sometimes it felt that those top up times were the only time I wasn’t breastfeeding or pumping. The other mums I socialised with would talk about how much they could pump, and I would feel like such a failure that I pumped for hours every day, sacrificing precious sleep, to get such small amounts. Despite all that effort and the constant feeding, the sterilising, the painfully slow finger feeds, she still wasn’t putting on weight. Lots of people had watched her feeding, and everyone said she was latching and feeding fine. It felt like there was something very wrong with me that meant she just wouldn’t grow. It seemed as if we had the worst of all worlds, the inconvenience of sterilising you get from bottle feeding, but without the speed of actually using a bottle, the hassle of pumping, the discomfort and never-ending feeding of breast. I spent a lot of time in tears saying that I just didn’t want to do it anymore, that she would be much better off if I just stopped and we gave her formula instead. Luckily my husband knew how important it was to me that I breastfed, and he would encourage me to wait till I had calmed down and then we would talk about it again. Once I’d had a rest, a cup of tea, got back some perspective, I always knew that I wanted to keep going.

I was very lucky that both my Mum and Mother in law had breastfed and were very encouraging, and all my friends had breastfed their kids too. Every body was so supportive and kind to me, and the infant feeding co-ordinator used to phone regularly and ask how we were going, and say I was doing great, and to keep going with the top-ups. I tried not to make too much of a fuss, and was grateful for the help that we had got. We kept going with the top-ups, and the endless switch feeding. There were times when I thought I would go crazy. Also feeding in public was anything but discrete, as I had to relatch her over and over again, but I wasn’t going to let embarrassment stop me!

The weekly weigh ins showed that she had now fallen from the 91st percentile at birth, to the 2nd percentile at eight weeks, when she finally had got back to her birth weight. I got given advice about all the things I could take to up my supply. I was eating lots of porridge, lactation cookies, fenugreek, drinking fennel tea and litres of Tiger Milk, a rather sickly concoction of creamy milk, brewers yeast, and bananas. None of this seemed to be making any difference. We got referred to the paediatrician as a failure to thrive case, but we had to wait till 17 weeks to be seen. In that time Polly at least started following the 2nd percentile line. We carried on with the weekly weigh ins, and if the health visitors hadn’t noticed me at the clinic I would get phone calls asking me where I was. I kept pumping every night religiously, and as she had started following a percentile line I tried to slowly reduce the top ups. I wasn’t being given any advice on the quantities I should give so was really just making it up as I went along. I started freezing any extra milk I managed to pump, and had started getting a small stash collected.

The paediatrician we saw told me that there was no medical reason she wouldn’t put on weight. He said that it was really good that I had kept going with the breastfeeding for so long, but he knew how hard it was to breastfeed, and said it wouldn’t harm her at all if I stopped now, she would already have got al the goodness of my breast milk. He suggested referring me to the infant nutritionist for some advice, which I agreed to.  A couple of days later I saw her for the first time. She said that there wasn’t much point giving expressed milk top ups as my baby should be able to feed from me more efficiently than a pump would manage to get milk, so there didn’t seem much point continuing with those as we were. I said that I didn’t want to give her formula top ups so she advised adding breast milk fortifier to the milk I managed to express. I was sent home with a large box of fortifier to add to six top up feeds every day. I couldn’t bare the thought of giving this to her after I had worked so hard to get her off formula, so instead I went against her advice and doubled the top ups using some of my freezer stash and increasing my expressing overnight. When I told the nutritionist that we hadn’t been giving the fortifier, I got called in to an emergency appointment with the paediatrician that same afternoon. It felt as if I was a naughty school girl being sent to the headmaster to be reprimanded. I was told that I was doing her more harm than good by continuing to breastfeed. I said that I had more expressed milk I could use in the freezer, and they said that while there obviously wasn’t a problem with the quantity of milk I had, they couldn’t determine the quality. They said that there were only three options. We could either start using formula, wean now at 17 weeks onto baby rice, or use the breast milk fortifier for expressed top ups six times a day. I didn’t feel happy giving formula, or weaning early, so I agreed to give the fortifiers as the least bad option. I totally felt as if I was bullied into making a choice I wasn’t happy with at all.

I felt totally conflicted. Obviously I wanted to do the best thing for my baby, but I really didn’t seem to know what that was anymore. My instincts told me that surely breastmilk was the best thing for her, but I worried if I was letting my pride get in the way. I wanted to be the perfect mother, and a big part of that was exclusively breastfeeding. Was my reluctance to give formula more to do with my ego than what was best for my baby? After a lot of discussion with my husband we decided to give the fortifier and see how it went.

We were giving a sachet of fortifier mixed into my expressed breast milk six times a day, after breastfeeds. As we were giving such frequent top ups we decided to give them in a bottle as it just made things much quicker than using the finger feeder syringe every time. I thought by now she would be well established feeding, but I definitely noticed her becoming fussier and less keen to latch on once she was having so many bottles every day. We persevered though, and the weekly weigh ins did start picking up, she started going up the percentile lines at last rather than down.  I’m still not convinced this was all down to the fortifiers. She seemed to be getting better at feeding from the breast. We both finally worked out how to feed in the sling, which made it a lot easier feeding when we were out and about. I had also got better at feeding lying down, meaning that night feeds were easier and less exhausting so we all got more sleep. We started reducing the fortifier top ups without telling the paediatrician, and her weight kept improving regardless.

We started introducing solids with baby led weaning at 25 weeks when she seemed ready. The nutritionist had told us that baby led weaning wasn’t appropriate for underweight babies as they weren’t able to consume enough calories, and there was no way of fortifying the food further like you could with a puree. I was determined to try it anyway, believing there was lots of ways you could give calories, adding lots of good fats like avocado oil, coconut oil, finely ground nuts and seeds, full fat dairy, etc. My daughter took to baby led weaning from the very beginning, eating beautifully whatever we tried her with.

The paediatrician saw us again at 28 weeks. The weigh in now showed her on the 25th percentile, and they felt that was good enough to discharge us. We stopped all of the fortifiers, and all of the tops ups, and she would just breastfeed on demand plus three meals a day, eating whatever we had. She was happy to try all sorts, from squid to steak, aubergine to asparagus. We stayed well away from the scales from that point, but she kept growing out of her clothes far too quickly! We kept going like this, and she ended up feeding until she was just over three years old, and I was 34 weeks pregnant.

I found the whole experience pretty stressful, and spent a lot of time conflicted about what was the best thing for my baby. I didn’t really feel as if the people who were meant to be helping us were really on my side, and they weren’t interested in what I wanted. I found the weekly weigh-ins felt like I was under constant surveillance, never quite doing good enough. Considering how hard I was finding pretty much everything as a first time mum, this added hugely to my general feelings of failure. I am glad I persevered, but it was a very difficult time for us.

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