2012 // A Year in (Part)Boob

13 months in breastfeeding

So, I've thought on and off about writing about my breastfeeding (and formula-feeding) experiences and put it off. Until recently I still felt a bit fraught about the whole subject.  But I do want to share a little about the struggles we faced when it came to feeding Mister G and where we came out as, when we were in the midst of the earliest days,  it felt to me that everything I read reinforced my belief that there was no middle ground (it's breast or bottle and that's your lot, combination feeding too near the start is a one way road to formula) when, in my experience, this simply isn't true.  As in all things, YMMV of course.  This is also kind of long because apparently I still have all the words about it.

If I had known then what I know now, I think I would have saved us from some of the weeks and months of crying and misplaced feelings of failure and inadequacy that came from not exclusively breastfeeding Mister G.

To summarise, we combination fed G (with an unholy trinity of nursing, pumped milk and formula) from 3.5 weeks until he weaned to solids at six months, when I stopped pumping, then we phased out formula and I kept nursing him morning and evening until almost 14 months, stopping just before Christmas.  It was an imperfect solution that turned out just great for us.

I went into childbirth fully expecting to breastfeed, and breastfeed exclusively.  I'm quite hippy about a lot of things and, having read my Active Birth and Ina May books during my three hour baths (memories, like the corners of my mind...), was envisaging an unmedicated, empowering birth followed by immediate latching and a fat, happy baby.  It didn't quite work out that way for me - G was born in an incredible moment both bloody and profound.  I held him skin to skin and we marvelled at this new little creature.

Then I suffered a post-partum haemmorhage requiring a couple of blood transfusions and a hospital stay of 5 days. In the hospital they encouraged me to express colostrum to feed to G with a syringe and I remember how strange it was to see this thick yellow liquid beading as I squeezed, in the days before stuff coming out of my breasts became the norm (..misty water-coloured meeeemories...).

I was pretty anaemic and weak for the first couple of months after the birth and, in retrospect, it seems clear that as this affected my overall health, so it affected my milk supply (or lack thereof).  I didn't make this connection at the outset and if I had I might have been a little kinder to myself and we might not have been so thrown by things not going to 'plan'.

Yes, breastfeeding is natural, but it sure as hell isn't easy.

Or at least, it isn't for everyone - and if it is for you? I'm happy, I honestly am, but that doesn't mean that others' issues aren't real.  Like, I'm not dyslexic, but I don't think for a moment that my Dad can't spell just because he doesn't want to enough, you know?

And even if he just didn't want to, that wouldn't be my call.

But that's not my story, my story is of wanting to, failing to and accepting our compromise.

via gravel and gold

In the beginning we had trouble with G not latching. He was 'sleepy' and wouldn't take the breast when I tried, and every time he woke up he would scream. I was going crazy. He was going hungry.  I took full advantage of the availability of an NHS lactation consultant in our area, having her visit us three times to help with my technique and I visited my local NHS breastfeeding clinic.
We fixed his latch, my nipples were healing and I thought we were doing well. We fed every two hours, for pretty much an hour, I was still going crazy, but you know, he was eating!

We managed this for three weeks, until, at the next weigh in the nurse told us that G was not only not back up to his birth weight, he had actually lost 10g from the previous visit.  She didn't push us, she didn't say we had to, but she did say that we should start to think about supplementing with formula.  I wept (this was a bit of a theme.)

Our NCT teacher was very pro-breastfeeding, as was our hospital antenatal class teacher.  I didn't feel comfortable going to either of them with my issues as I felt embarassed, somehow ashamed. However our midwife, our health visitor and our GP were all supportive of using formula if we wanted to.  I think its worth saying this as a lot of the trauma and guilt I felt came, I think, from my reading and the pressure I put on myself rather than anybody in my real life. That said, I know lots of bottle feeding mothers do experience real stigma.

I pumped and I wept and I wept as I pumped but all I ever managed was somewhere between one and three paltry ounces.  I read up on the internet how to increase supply, I took fenugreek, I drank guinness, I took a 'nursing vacation' (which differed from my regular routine only in that we were in bed rather than on the sofa), I pumped after every feed, I pumped every two hours. I even asked my dad for lactation advice from his days growing up on the farm (don't stress out the cows, if you're interested) And G? Was still hungry.

So, faced with this, watching our beautiful son lose weight, we realised that whilst breastmilk was surely liquid gold, the most important thing for G was that he was fed.

We swallowed our pride and our misgivings, we bought formula, we fed him. 

And almost immediately he started to thrive - he slept, he was awake without crying, he put on weight and slowly, over a number of weeks climbed back up from where he had dropped to the 9th centile to the 50th centile where he was born (with a 90th centile head, yo.) And what's more, I was able to hold him, to cuddle him without crying myself.  For a while, in the dark days, I would tense up just to see PA carrying G into the room. I was able to comfort him without feeling a resentment that he was crying for something I apparently couldn't give him. I was able to be present as a mother rather than constantly berating myself. 

We decided to try and keep up breastfeeding. Nursing at each mealtime and then, when he was tired of the breast, I would pump whilst PA gave him a bottle. The first few days I couldn't even look at him taking the bottle, but then... you know, you accept it for what it is. The first of probably a hundred compromises in the last year, the first of probably a thousand in his lifetime.  I did grieve for what I thought breastfeeding would be, but then I looked at my baby, growing before us and knew that I had done the right thing for us.

Now I was resigned to the idea that mixed feeding was a one way street to fully formula (NOT that there is anything wrong with that. Seriously.) even though I wanted to breastfeed for as long as I could. So much of what I read online reinforced the idea that by topping up with formula, particularly at such an early stage, I would dry up my already struggling supply. And I want to share that this didn't happen. For six months we continued to combination feed, nursing, pumping and bottlefeeding formula and pumped milk. Yes, the amount of formula crept upward whilst, I imagine, my milk supply remained the same. And I suppose the nutritional value he obtained from my partial supply of milk is questionable.  I felt opressed by that fucking pump - when PA was at work I would attempt to pump whilst feeding G a bottle and the tears, holy fuck the tears that accompany spilling a precious ounce of pumped milk.

We were very lucky the whole way along that G seemed not to suffer 'nipple confusion' and to switch happily between the bottle and the breast.

At six months G was well started on solids and I stopped pumping but continued to nurse, supplementing with formula.  Over the next few months he started to eat more and more solids and so take less formula, until, by the time he started nursery at 10 months we were nursing first thing in the morning, he would have one bottle of formula in the afternoon at nursery (with solid breakfast, snacks, lunch and tea) and we would nurse in the evening at home before a solid dinner then bed.  At 11 months we transitioned from the formula to cows milk at nursery and then until Christmas G was eating his regular solid meals plus nursing twice a day. 

I stopped breastfeeding on 23 December when G was 13.5 months. The catalyst for this was being prescribed medication that isn't compatible with breastfeeding, but in honesty I think it was about the right time for us - I might've kept going for another month or two, but G was already starting to show less interest (unless he was tired or sick and boy do I miss that beautiful quick fix solution.  Is it wrong to admit that one of the things I loved most about breastfeeding was the inbuilt easy comforter? He's fussy? stick him on the breast!)

G adjusted well and no longer goes for the boob (although he has developed a new habit of wanting to hold one? poking his hand down my shirt to rest it on top of one breast.) and we are all bright eyed, bushy tailed and getting on with living.

I had such a myopic focus on breastfeeding / bottlefeeding during those early months and I like to keep in mind, as my visiting nurse said, the important thing to remember is

if your child is hungry; feed them

and whether that's breast or formula or our kind of messy imperfect compromise, it's not really up to anybody else how you do that.

<3

here are a few of the things / resources we used:

Breast Pump: The Medela Swing - I really liked this, although if I'd known I would be pumping long term I would certainly have rented a hospital grade pump or at least invested in the double pump. I mean, I felt like a milking heifer anyway, so why not complete the image?  We started with a Tommy Tippee and I cannot recommend - it broke and then the replacement broke too. Lame. 

Bottles / teats: Medela Calma - the teat is apparently supposed to mimic the delivery of breastfeeding to help avoid nipple confusion. I don't know about that, but they do look space age.

Breastfeeding info:  Kelly Mom is an excellent source of all manner of breastfeeding information if that's your thing, and it takes a positive attitude toward combination feeding. 

and, it turns out a baby can be sucking but not really drinking, who knew?! there's some useful info on breast compression to increase flow here

xxppxx