In a continuation from the pregnancy diaries, Suzie and A return, six months into the journey.
For the most part, I have made my peace with the fact that I wasn’t able to breastfeed beyond five weeks. I have the odd pang when I see someone snuggling with their baby and feeding so cosily, but then I have to remember that, except for the first couple of weeks, it really wasn’t like that for us. I have to remember the excruciating pain, the dread I felt about feeding him, the crying – both him and me, the tension – both him and me, and the reflux that made him throw the whole feed up again anyway. I feel a lot of bitterness about the fact that I wasn’t able to continue. I was so sure I would exclusively breast feed until six months; I knew lots of people don’t manage to, but I genuinely assumed I would be one of the ones who could.
Once we’d got the hang of breastfeeding in hospital (he was in Special Care so we were in for five days – my milk came in by the end of the third day) it was great for a little while. We had to use nipple shields as I struggled to get him to latch in hospital and when I dissolved in tears one night, a nurse suggested I try a shield. It worked – he ate – so I saw it as the answer to all of our problems. For a little while it seemed so easy. He cried – I put him to the breast – all sorted (with the small palaver of getting a sterilised nipple shield in the right place while Millar screamed blue murder!) What I didn’t realise was that it had all started to go wrong way before this – before I even gave birth, in fact. My advice to myself should explain.
- Get treated for thrush immediately. As I had gestational diabetes last time, I will almost certainly get it again. A passing comment from the midwife when she was examining me barely registered, but she noticed that I had a bit of thrush (sorry for TMI!) I thought no more of it. But what I didn’t know is that thrush thrives in sugar and therefore I was bound to get it while I had gestational diabetes. I hadn’t had any symptoms, so hadn’t realised. I also didn’t realise that through giving birth, I had almost certainly passed it to Millar. When he began to breastfeed, he passed it back to me. That first week or so of pain-free breastfeeding was just lulling me into a false sense of security. I started to get terrible stabbing pain, just behind my nipple when I fed, particularly on one side. It got worse and worse.
I assumed it would go – I had no idea it was thrush. It didn’t go. A friend noticed after a couple of weeks that Millar’s mouth was rather white. I did a bit of googling of thrush in breastfeeding and nearly cried with relief – it described my pain exactly. What I didn’t realise is that thrush is really really hard to get rid of. It doesn’t like being got rid of. So the pain stayed and got more and more excruciating – so much so that I would cry throughout a whole feed every single time I fed. I’d then cry between feeds because I was so dreading him waking up and wanting another one. So… my advice to myself next time, is get treated for thrush before giving birth. And get the baby checked as soon as possible for it. If in doubt, get the doctor to prescribe thrush treatment as a precaution because once it sets in, it’s here to stay.
- Don’t be too quick to use nipple shields – get someone really knowledgeable to help with the latch as soon as possible. I discovered too late that there is so much help out there. I had two amazing breastfeeding support workers come out to my house and spend an hour and a half watching me feed, looking at my latch and positioning and just slightly correcting things. Things a book or website or youtube video could never tell you. But by then, I was in so much pain with the thrush that little they said could really help. Next time, I will get a support worker to come and see me within the first week. It will make a huge difference. Nipple shields were great while they worked, but they added to the stress of feeding and they are a breeding ground for thrush too – apparently even sterilising doesn’t always get rid of it. They can also rub, which they did on the side that became very painful, and then thrush can thrive in the wound.
- Ignore the hospital when they try to instill a rigid ‘feed every three hours’ routine. We were in special care for nearly a week and they were very regimented. They were obsessed with how long I had fed for each time, as Millar was losing weight. I was later told that length of time has nothing to do with it. I was desperately trying to get him to feed for halfan hour on each side at every feed, in the hope that he would then last until the 3 hour mark when the hospital thought I should be feeding him again. It was so stressful. I had no idea about demand feeding – I didn’t realise that I could feed him whenever he asked and that he could stop when he wanted to. I used to strip him down to a nappy in every feed as he was falling asleep and this was ‘feed time’ so he had to feed. Why did I put myself through it?! We would both have been much happier if I’d just let him sleep, then fed him when he woke up again. This ‘every three hours’ idea led to me being advised to top him up with formula as he was still hungry. I didn’t realise that what I needed to do was breastfeed him more! My milk supply was still sorting itself out and formula top ups should not have been necessary.
- Recognise the signs of mastitis early on. I woke up one morning with boobs like rocks – I thought I needed to express, so snuck off to do so, but expressing was painful and even after getting a large amount of milk, they were still really solid and sore. I assumed it was linked to the thrush so battled on, but when I went to a weigh in clinic with Millar later that day, I was in so much pain I could barely speak. I started shivering uncontrollably and sweating and the health visitor saw that I clearly had mastitis and it was bad. She had to ring my partner and get him to come and pick me up as I couldn’t drive – I couldn’t even lift my arms above my waist. At home, I just curled in a ball and cried. My partner had to look after Millar – I couldn’t even pick him up. The only way to relieve the pain was to lie totally submerged in a hot bath and hand express into the water. I did this for hours at a time! I should have realised there was a problem and next time, if I’m unlucky enough to get mastitis, I will go to the doctors and get antibiotics at the very first sniff of it. They were amazing and worked wonders within 24 hours.
- Recognise reflux early on. Not all reflux is a baby being sick. I had never heard of silent reflux. He started being sick when we both got so tense through pain that we were rigid by the end – of course his poor little tummy couldn’t keep it down. But acid reflux is incredibly painful. A baby can scream in pain between feeds and I now know that this was the problem – he didn’t need a top up formula feed – he wasn’t hungry, he was in pain. Next time I will know these signs much more quickly.
- This is personal to me and my gestational diabetes, but next time I will try to express some colostrum in the weeks before the birth. There are arguments for and against this, but as Millar’s blood sugar was under scrutiny due to my GD, the lack of eating anything for the first few hours (he latched on but I’m sure he didn’t get anything) led to his blood sugar dropping, his transferral to special care and then being tube fed formula which started us off all wrong. If I could have expressed just a little bit of colostrum and frozen it, he could have had that in those first few hours and we might have escaped the trip to special care before my milk came in.
- And sort of hand in hand with the last one – I will not be having pethadine next time. I had two shots of pethadine during my labour, one quite close to the end, and it made Millar incredibly drowsy and lethargic. He didn’t have much hope of feeding effectively – he could barely open his eyes. Not to mention the horrible effects I experienced with it – falling asleep between contractions and being really confused about what was going on. Pethadine gave me very little pain relief and was just another hurdle in our breastfeeding journey that I could have done without.
- And lastly – I will try really hard to not put too much pressure on myself next time. If, even following all of my advice here, I still can’t breastfeed next time, it will not be the end of the world. Millar is a happy, healthy, inquisitive baby, who is not putting on too much weight – he has followed the 75th centile since he was about two weeks old – and we have a wonderful, close bond. I regret a lot of things to do with our breastfeeding experience, but I did the best I could – and what more can a mother do?!