Breastfeeding toddlers & beyond: not as weird as you might think – #KBBF2014

The theme for today in the Keep Britain Breastfeeding Scavenger Hunt is “Breastfeeding Beyond a Year”. I still remember the feeling when Andrew, my eldest son, got to his first birthday and was still breastfeeding. At the time I wrote a blog post on it called the not-so-crazy world of toddler breastfeeding. After all the struggles we’d had in the early weeks and months (as I explained in my last KBBF post, I have IGT – insufficient glandular tissue – so can’t exclusively breastfeed a baby), I could hardly believe that we’d got to 12 weeks let alone 12 months. But he was still keen to feed, or nurse would be a better term as it really wasn’t about the food anymore but about the comfort and routine. And I always said that I wanted him to decide when to wean and it wouldn’t be me who would initiate the weaning process. So we carried on beyond the time that most mums I knew were breastfeeding.

Apart from his lack of interest in weaning, there are other good reasons to have carried on nursing a toddler (and now preschooler). I think that it’s helped in the fact that he’s still hardly ever been ill. Nursing has been fundamental in his daily bedtime routine for a long time, along with a bath and reading books. He likes to have that routine and I think it has helped him know that it’s bedtime before he could understand properly what was going on. Nursing has also helped when he’s been upset or tired over the years, to calm him down, though these days he only really has some milk before bed.

 

When Andrew was around 13 months old, I found I was pregnant again. This brought with it all sorts of thoughts and feelings about breastfeeding, for example: I had bad vomiting and nausea throughout the pregnancy and wondered if I had the energy to carry on and how I should initiative weaning in that case; I wondered if Andrew would self-wean anyway, as many do during the pregnancy of a sibling; I wondered if/how it would work out with tandem nursing if he did want to carry on. I wrote about these thoughts at various times in my weekly pregnancy diary blog posts, such as this one.

Well we both made it with the breastfeeding through pregnancy thing, and when Joel was born, we became a tandem nursing family. I had lots of support from my local LLL group, and one leader in particular had gone out of her way to help put me in contact with another LLL leader from elsewhere in the country who had tandem nursed with IGT. She made the good point that the toddler is an excellent breast pump substitute in terms of giving the breasts extra stimulation after the newborn feeds (of course you can’t get the milk back from the toddler though, like you can from a bottle of pumped milk, and give it to the baby, but I never got much from a pump anyway.)

As Andrew was basically down to just having one feed before bedtime, I made sure that Joel had had good feeds himself up to that point, and then he had time with Daddy whilst Andrew and I had milk time. He probably was getting very little actual milk by that point in the day, but as he’d nursed through pregnancy, when milk supply drops naturally even in mums without IGT, he was used to that. He just liked the time with me, and I think the tandem nursing helped him accept Joel into the family, although he was young enough to not really care that much anyway. Sometimes Andrew would ask for milk while I was sitting feeding Joel in the day – an increased interest in nursing can happen with older siblings, even if already weaned, so he wasn’t unusual in this, and would usually be happy with a few sucks from the other side, just to mark his ground more than anything I think. There weren’t many times that I would actually have one feeding from each side at the same time – tandem nursing refers to breastfeeding 2 (or more) children in the same time period, not necessarily precisely simultaneously.

Joel seemed to get more breast milk than Andrew did at the same age – I could tell partly from the fact that he needed less formula supplementation and partly because his poos looked so much more breastfed than Andrew’s ever did pre-solids! Many mums, with and without IGT, report increased milk supply with subsequent children. So even if Andrew was taking a little of the shared supply when Joel was a baby, I was happy that over the span of their nursing years, they were getting their own fair share.

Before I knew it, we somehow managed to get to a whole year of tandem nursing; it dawned on me that I was tandem nursing 2 toddlers, and nowadays a toddler and a preschooler.  Neither of them nurse for very long these days, but both of them still enjoy Mummy milk before bed. I think Andrew is slowly on the stopping straight because he doesn’t ask for it every day now, but I’ve heard that this is how self-weaning at this age can happen – a slow process that you look back on and can’t pin point an exact time that they stopped, the breastfeeds just go down from once a day to once a week to once a month etc. We often joke that at this rate, Joel will stop before Andrew, because he’s probably less interested in it than Andrew was at this age, but who knows! (Only they know.)

I look back now and can’t quite believe that I’m sitting here writing this, given our shaky start in the world of breastfeeding. But I’m glad that we persevered through the hard times to get to this point. When I think about how much breast milk that my boys have had over their nursing lives, it’s probably similar to how much some babies had who were exclusively breastfed for the 6 months that is seen as the ‘standard’ amount of time to breastfeed for. Some people may think that breastfeeding or nursing toddlers is weird, and pre-schoolers even weirder, but it works for us and I’m happy to carry on for as long as they require, which may turn out to be not much longer.

Others who are writing about breastfeeding beyond a year today include….. (please go and visit their blogs too).

Sorry about the mess

Circus Queen

Hex Mum

My thoughts on things

Baking Betsy

And another WAHM like myself taking part in the hunt is

Cherub Chews

a Rafflecopter giveaway

3 year breastfeeding anniversary

It’s been a loooong time since I last wrote a post on breastfeeding. I’ve been meaning to for a while, but other posts and other things in life have pushed it down my priority list. When Andrew turned 3 a few weeks ago, his birthday marked our 3 year breastfeeding anniversary, and that, I thought, deserved a write up of my thoughts.

Breastfeeding has become so much part of our daily family life that I often don’t think about it, it’s just something we do day in, day out. Not that I want to belittle it, actually it means a lot to me, but it’s certainly not something I stress about like I did in the early weeks, and therefore it doesn’t take up much of my brain space day to day. It’s only when I deliberately reflect on how far we’ve come that I realise just what an achievement it is to be sitting here writing this.

If you haven’t read how our story started, you can find it here. At less than a week old, I was having to supplement Andrew with formula, and in my new-parent-world-just-been-turned-upside-down-with-a-newborn state I had no idea how long we’d be able to carry on breastfeeding. Just getting to 3 weeks seemed like an impossible task, let alone 3 years. But we were blessed with good info from knowledgeable people – Cambridge is a great place to have a baby in terms of volunteer support networks in the early weeks – and a supportive family, and week by week we survived and Andrew began to thrive.

I was particularly grateful to have been shown an SNS (supplemental nursing system) by a specialist midwife in the hospital, and to have been given a new one when we ruined the original in the microwave steriliser – it was a local La Leche League (LLL) leader who rallied around at the weekend to find an ex demo one with a retired midwife colleague of hers. Without this, especially in those crucial first weeks of trying to maximise my milk supply, I know we wouldn’t have carried on anywhere near this long.

Once the hardest struggles were over, by around 6 months into his life, I decided to let him wean when he wanted to, and to my surprise, he was keen to continue even when he was well and truly eating solid foods in the later half of his first year. By his first birthday he was usually breastfeeding twice a day – once first thing in the morning and once just before bed.

Just after Andrew turned 1, and we were celebrating a whole year of breastfeeding, I found out I was pregnant again. As my milk supply had never been great, I was convinced that he would self-wean with the inevitable dwindling of milk production in pregnancy. But again he surprised me, and wanted to still feed up until and beyond Joel’s birth.

Breastfeeding was generally much easier the second time around, because I knew what I was expecting and was fully prepared. Or so I thought, until Joel had jaundice and was a very sleepy baby who needed much more encouragement to feed in the early weeks. But at least I knew who to turn to straight away for useful info and help from personal experience. He soon grew out of the sleepiness and has continued to breastfeed until now, over 1 year into his life. Like Andrew at this age, he usually feeds once first thing and once just before bed each day.

So here I am, still breastfeeding a 3 year old and a 15 month old. Andrew now only has about a minute’s worth of sucking before bed, and to be honest I think it’s just another one of his bedtime stalling tactics, knowing he can get an extra few minutes up with me and out of his room. But I said he could self-wean, and that’s what he will do one day, whatever his reasons currently are for continuing to breastfeed. We have joked that Andrew will probably outrun Joel in his breastfeeding stint, mainly because Joel is going through a biting phase (something that Andrew never did), no doubt linked to teething, and some days I wonder if my yelps will put him off for good. Who knows how long the biting or the breastfeeding will go on, but it’s up to him, with some gentle teaching from me that biting really isn’t on.

BM keepsake

As we were approaching Andrew’s third birthday, I did something that I’ve been contemplating for a while: I bought a Breast Milk Keepsake. Claire, fellow mummy blogger with twin boys just a little younger than Andrew, has figured out a way to take pure breast milk and shape it into beads in various shapes then set them in resin to make pendants and other jewellery. All I had to do was provide 30ml of my milk and choose which design I wanted – I went for 2 stars to represent my boys, on a purple background in a 25mm silver pendant. This is the perfect way to represent the achievement that our breastfeeding journey has been, and I am so pleased with the result. I now have something tangible to remember our years of breastfeeding once they eventually wean, and a pretty piece of jewellery to wear that is also meaningful.

The keepsake arrived on the date that was exactly 3 years since we had to go back into hospital with Andrew and our future of breastfeeding looked bleak. As I held it in my hand and looked back to that day 3 years ago, I couldn’t quite believe how far we’d come and if you’d have said to me then that in 3 years time I’d be holding one of these, I would never have believed you.

Disclaimer: I received no incentive to write about Breast Milk Keepsakes, all opinions expressed are entirely my own and honest

World Breastfeeding Week

It doesn’t seem long since it was the UK Breastfeeding awareness week back in June when I wrote a few posts for the Keep Britain Breastfeeding Scavenger Hunt. Here are the posts I wrote if you missed them or would like another read:

What I love about breastfeeding

Where to turn if breastfeeding gets tough

When will I stop breastfeeding?

According to the World Breastfeeding Week website, this year’s theme is ‘Breastfeeding support: close to mothers’ – to highlight the importance of peer support for breastfeeding mums, which is key in trying to increase the number of mums who continue exclusive breastfeeding beyond the first few weeks after birth; many who hit issues don’t have the information and support to know how to overcome them. This kind of support used to be provided by the extended family, and still is in some cultures, but we no longer all live in the family communities that we did a few generations ago, where grannies, aunties, female cousins etc. would have all been there surrounding the new mum with support, particularly for things like breastfeeding.

I’ve said it before in previous posts, but I’ll say it again: support from other mums who are breastfeeding or have breastfed their children has been essential in our breastfeeding journey. So much so that I don’t think we would still be breastfeeding today if I hadn’t have come across our local La Leche League (LLL) group through going to one of the breastfeeding drop-ins in Cambridge. It would have been very easy for me to give up back when Andrew was tiny, and be part of that statistic of mums who no longer breastfeed after a few weeks. (Fair enough I didn’t manage exclusive breastfeeding anyway, but that’s a different matter and one that I have no control over.) By going along to meet-ups and talking with others about their experiences, I knew that I wasn’t alone and there was always someone I could ask for accurate information based on research, or who would just listen to me if I was having a particularly hard week. That’s the kind of support I needed and was so glad I found.

Having found this support myself, I am always keen to shout out about how important it is to find the support of other breastfeeding mums who know what it means to breastfeed successfully, in case you come across issues. In hindsight I wish I had sought a support group when I was still pregnant with Andrew, and therefore I would have already known where to turn when things got tough, so this is what I now suggest other pregnant mums do too if they are keen to breastfeed.

It’s not the case that everyone will have issues, but even if you don’t then it can’t harm to get to know other new mums too, especially if you are worried about feeling isolated after having a baby. What I like about LLL is that it’s not just about breastfeeding: it’s about mothering in general, and breastfeeding as an important aspect of that. So even if you don’t hit specific breastfeeding issues, it’s still lovely to meet up with other mums who are all different but who share a broadly similar way of parenting their children.

We go along twice a month to the LLL meet-ups that we’ve been going to since Andrew was just 4 weeks old. Now that I’m successfully breastfeeding two boys without any major issues ourselves, I see my role as a supportive one – I chat with other mums and in particular with those who have low milk supply concerns. I have thought about doing some from of peer supporter training myself, but at the moment I don’t feel I would have enough time without dropping one of my other voluntary roles (Editor of the local NCT magazine and Founder of Nappyness library and meet-ups). For now I feel that the less formal support that I can offer at LLL meet-ups is playing an important role in itself.

To draw this post back to a global perspective, World Breastfeeding Week also reminds me that in some ways we are fortunate in this country when it comes to breastfeeding. We may not have the extended family and community support these days, but we do have some fairly strict laws on formula marketing and we have safe drinking water supplies to make up powdered formula. I am glad that formula exists, because without it (or donor breast milk, but that’s a whole other post to write!) my boys wouldn’t be here. But I wish we had been able to get it on prescription as a medical necessity and I do not agree with the motivation behind the multi-national companies who sell it – that is to make as much money as possible, regardless of what that means for babies.

In many countries across the globe, formula is promoted much more ruthlessly than here and the mums who buy it often have to use contaminated drinking water to make it up and/or water it down because it’s expensive. It would be much better for their babies if they were breastfed and the mums had the support needed to do that. For these reasons I believe it’s important to raise awareness of breastfeeding on a global level during this week.

I don’t think that this post will make a big difference in the grand scheme of things, but as breastfeeding is a topic close to my heart, I can’t not write my thoughts down for this global awareness week.

Just one more thing to add is that Breastvest, who I ran a competition with during the national awareness week in June, are running some offers again this week. They’re selling off all their limited edition colours for £10 each to make way for the Autumn/winter 2013/2014 shades, and they have a 20% off promotion code: WBW20. If you’re interested, why not head over and take a look!

What I love about breastfeeding – #KBBF2013

It’s the start of National Breastfeeding week, and that means the start of the Keep Britain Breastfeeding Scavenger Hunt! You can find out more about the hunt in general and where to find more posts from participating bloggers on the main hunt website. The idea is that you read blog posts to find out more about breastfeeding, and there you will also find ways to enter individual competitions as well as the main prize draw in which you can win lots of breastfeeding-related and general baby goodies.

For my first post I’m writing on the theme of the ‘benefits’ of breastfeeding, or, as I prefer to think of it, simply what I love about breastfeeding. Breast milk from mum is the normal food that human babies are biologically designed to eat for the first months of their life, so it makes sense to think of this as the norm and instead what might be the ‘disadvantages’ of formula milk which comes from a cow (or soya bean).

For those of you who haven’t followed my breastfeeding journey until now (there are plenty of older posts on the blog in the ‘bump and breastfeeding bits’ if you’d like to read about it), I have actually had to supplement my own milk with formula milk for both my boys as babies, more for my first (Andrew, 28 months) than my second (Joel, 7 months). This is because I have hypoplasia or insufficient glandular tissue (IGT) in my breasts to make enough milk for a baby before they eat solid food. This was diagnosed my a Lactation Consultant, and is not just to do with size but rather shape of breast too. I have still managed to breastfeed though, mainly with the help of an at-breast supplementer (the SNS) – Joel, although he has had a fair amount of formula over the past 7 months, refuses to take a bottle (like many exclusively breastfed babies) and has had all his intake of milk directly at the breast. I’ve written about this before in various posts (if you search ‘SNS’ on the blog they will come up).

First time........ Second time
Andrew……Joel

There are many things I love about breastfeeding, all of which have encouraged me to carry on in the face of struggles with IGT and the faff of having to supplement. Before I had Andrew, I only thought of breastfeeding as a way to feed a baby, to get calories into them so that they grow. Of course this is a part of it, but for me the things I love about breastfeeding are the non-nutritive bits!

As I sit here and type, I have a baby snuggled up to me, half asleep, half sucking, all cosy and content. This is a lovely feeling, and I feel as though I have a very close bond with my two boys which has been formed over time whilst feeding them. Even when I was struggling, I couldn’t imagine not having a baby sucking fro me for much of the day (it’s a great excuse to rest on the sofa when you’re shattered!) My toddler still doesn’t think he is too old for Mummy milk, and I love the time that he takes to snuggle up to me before bedtime because we can reconnect after a busy day during which he is very independent. Even though I spent a lot of time feeding his newborn brother in the early months, the fact that he could still have some Mummy milk meant that neither he nor I missed out on some quality time together when there was a new person in the mix. And I’m sure that tandem feeding (not often at exactly the same time) has helped build a bond between the two brothers so far.

One thing I didn’t expect to get through having kids was better quality sleep. For most of my adult life before children, I wasn’t the best sleeper – it only took a small (or big) amount of stress such as worrying about my studies, exams or work and I would have sleepless nights, lying in bed awake for ages and not finding it at all easy to drop off. Of course my boys have had me up in the night many times, but the difference is that when my head does hit the pillow I’m out for the count until I’m next woken up. We know that the hormones released when a mum breastfeeds help her to get off to sleep, and I am convinced that this has been responsible for such a big shift in my sleep.

Well done! You've found another hunt logo - you can enter the competition again at the bottim of this post.
Well done! You’ve found another hunt logo – you can enter the competition again at the bottim of this post.

It is noticeable how little my boys have been ill. They’ve had minor colds like we all do, but they’ve rarely had temperatures – I think we’re only on our second bottle of paracetamol and ibuprofen suspensions in nearly 2 and a half years of having children. We’ve hardly ever needed to go to the doctor with them, and when we did it was more to be cautious with little ones and they didn’t feel there was much they could do. We do mix with lots of other children as we go to lots of groups, and Andrew went to a childminder for 11 months when I went back to work part-time before having Joel. Breast milk has antibodies which I as mum produce that then get passed on to them as they feed. These help their own developing immune systems to fight infections quickly and effectively. No matter what claims formula milks make about what they contain, they cannot contain this living stuff! The way I look at our situation is that I’m providing the immunological help and the formula is providing the extra calories that I cannot physically produce enough of.

There are also some longer term reasons why breastfeeding is good for both me and my boys, which are nice to think of even if they aren’t tangible on a daily basis. The more I breastfeed, the lower my risk of developing breast and cervical cancers. Breastfed babies tend to have higher IQs than formula fed babies, are less likely to develop allergies, and are less likely to become obese. Of course this is a generalisation over a whole population – my husband Tom was bottle fed and has always been a tall beanpole despite having a large appetite, probably because he is very active and as a family we are very active too, which will no doubt influence our boys’ weights.

These are the main reasons why I love breastfeeding. There are others that I can think of, but the fact that I’ve had to supplement with formula means that I haven’t been able to enjoy all of them. For example, breastfeeding is convenient as there is no faff of sterilising and making up milk and getting it to the right temperature – you just latch baby on and away you go, which means it’s easy to go out without having to think about how much milk to take.

I’ll be back with another post on Tuesday, but for now I’ll leave you to read some posts by others and have a go at entering the main competition below. Don’t forget you can also still be in with a chance of winning a Breastvest here.

Life with Pink Princesses

In the Playroom

My Thoughts on Things

The Secret Life of Kate

Life, Love and Living with Boys

Pixie Pants Cloth Nappies

a Rafflecopter giveaway

Breastfeeding the second time around

It occurred to me the other day whilst feeding Joel that I haven’t blogged much about our breastfeeding experience in the first 5 months of his life. Before know it, and before I can cover the kitchen floor in some kind of food-repelling forcefield, he’ll be sampling some big boys’ food, and slowly the amount of milk he will require will decrease. Not that this necessarily means the end of breastfeeding him – I’m happy to carry on until he wants to stop, and his big brother is still going at 26 months. But this has made me look back on these past few months and reflect on what it’s been like breastfeeding my second baby and how it has differed from our experience the first time round.

I think the main reason I haven’t blogged loads about it has been that it has gone much more smoothly. It’s just fallen into place and fitted into our lives in a much more normal way than when Andrew was a baby, so it hasn’t crossed my mind often to blog about it. The two main reasons why it has gone so smoothly this time are: (1) I was much more practically and emotionally prepared for what was to come – I’d done it before and knew what to expect, including knowledge of my hypoplasia and low supply and being prepared with an SNS (or 2!) in the flat; (2) I had a support network already in place for if things got difficult and I needed useful and accurate help – this came in handy when Joel was readmitted to hospital with jaundice, and when I’ve come into contact with health professionals worried about his weight.

I only started blogging when Andrew was nearly a year old, but if I had have had a blog back in his first 6-ish months, I imagine I would have been doing weekly (or more frequent) updates about how breastfeeding was going and how we were finding our way along a very bumpy path. Some days I was very positive and felt like things were going well, and then I’d have bad days when I’d question why on earth I was doing this when it was so hard and I couldn’t see the bigger picture. Of course there have been difficult days when feeding Joel, but overall they are been much fewer and much more manageable than last time.

First time........ Second time
First time…….. Second time

One of the biggest helps this time is that I am an expert on our SNS! (Read all about what it is here). It took me a while last time to figure out various things about it, such as the fact that powdered formula made up with boiled and cooled water flows more easily through the tubes than the instant formula. Also I wasn’t confident enough to use it when we were out (other than at breastfeeding drop-ins or support groups), so Andrew was used to taking both breast and bottle for usually only one feed a day, and we didn’t go out to that many groups until he was about 5 months anyway – for the first child you can fit in around them much more easily than for the second. But this time, right from the start I’ve been more confident, and as we’ve needed to get out to groups to amuse Andrew, the SNS has come with us (though Joel rarely feeds when we’re out these days, but he did when younger).

This has meant that Joel has never had a bottle. In fact I tried to give him one a few times at around 3 months when I was worried that he was having to work too hard at the SNS and I wanted to compare flow with a bottle, but he refused to take one, no matter how many different things I tried (me/Tom, day/evening, warm/cold, 2 different brands of teat etc.) I think it’s pretty amazing that a baby who has quite a lot of supplement on top of breast milk is behaving like many exclusively breastfed babies do in this respect. And when I eventually did trick him into taking an ounce before he realised and spit out the teat, the flow was about the same rate for bottle and SNS, so my concern was quietened.

On the matter of supplements, how much is he having compared to what Andrew had at this age? The answer is I actually don’t know for sure. I didn’t write down what either of them have had as it’s just one more thing to think about. But it feels like Joel has needed less supplement over the first 5 months than Andrew did, which suggests that I have been able to provide more milk myself this time. The fact that we had to finish off some of Andrew’s feeds with a bottle as he was on a lot of top-up by this age, whereas Joel manages it all in the SNS very comfortably, also suggests that he’s needing less top-up as the second baby.

I should also say here, as an update to my previous post on weight watching, that at his last weigh-in a few weeks ago, Joel had put on a lot of weight and had gone up on the infamous centiles, so the health visitor at the clinic didn’t even say when I had to bring him back next to be weighed – this meant a lot to me, and took a lot of stress away, as we’d always been told to go back either fortnightly or monthly; the ball’s in my court now and I can decide when to next have him weighed.

When I reflect on breastfeeding Joel, I think about how much I learned from doing it before with baby Andrew. The first time around I just had to find my way as we went along, whereas the second time around I feel that Joel is benefitting from things I already know. In other aspects of being a baby, I sometimes feel like Joel is getting a rougher deal being the second child – he’s put down more often than Andrew was and has to share my attention; but then I think about the deal he’s got with breastfeeding, and I realise that he’s experiencing a mummy who is much more on top of things. First and second (and third etc.) children are all going to have different experiences, and that’s not to say that any are worse off than others, they are just different.

So all in all, as we approach the 6-month mark, when our society says that the end of breastfeeding a baby is in sight, I’m feeling very happy with where we are and how well we are doing. Plus I’m looking forward to the next stage when breastfeeding really isn’t all about calorific intake and the non-nutritional aspects like closeness, calming him down, getting him to sleep, immunological protection etc. become even clearer. Stay tuned for more updates as (/if) I remember to write them – I’m aware that I haven’t talked here about Andrew’s nursing at the moment.

My matching boys :)
My matching boys 🙂

Beginners breastfeeding – essential info and (not-so) essential kit

This post started life as a paragraph in the essential baby kit list that I recently posted, but it got too big so it warranted its own space. The essential things you need to start breastfeeding are not kit but rather accurate info and helpful support. All the kit you really need is a pair of breasts! There are, however, some bits of kit that you may end up finding useful or they may make life easier once you’ve got going. This post has two parts: first a list of essential info to get breastfeeding off to a good start, based on my experience of having one baby and then doing it better the second time around; and second my take on the bits of kit that you may like to get at some point.

First of all though, as I said in my kit list post, of course I don’t want to assume that everyone will breastfeed, but I would highly recommend at least trying it, based on the info that I know. You may decide for whatever reason to feed formula in bottles right from the start; i personally don’t have experience of exclusive bottle feeding, so I’m not an expert on how much kit you need for that. But I do know what it’s like to supplement with formula from a week old, which did involve bottles with Andrew, though not with Joel (at least he won’t take one at 12 weeks without a lot of persuasion – I do use them to mix up powdered formula sometimes rather than do it directly in the SNS which can be fiddly), so I have some idea of the faff in terms of kit compared to breastfeeding. I can say that if I didn’t have to, I wouldn’t go through all this faff!

Tips for getting breastfeeding off to a good start:

  • Let baby feed as soon as possible after birth: If possible, hold your baby snuggled up to your chest without your top on straight away after birth, so that yours and baby’s skin are touching and they can latch on to your breast as soon as they like. Of course if there have been complications with either of you in the delivery, such as a c-section, or baby needs urgent medical attention, you might not be able to do this. Skin to skin with Daddy is always an option if you are not well enough to do it yourself. I was blessed with two very fast and uncomplicated births, after which I was able to pick my baby up and have him on my tummy/chest immediately afterwards – they both rooted towards my breast within minutes of being born and had their first feed. The soonest possible that first suck is, the better for breastfeeding, but don’t worry if you get separated and the first possible opportunity is later than straight after birth, it’s not a disaster for breastfeeding – just take the first opportunity you have to get your baby latched on for their first feed. Some babies are less good at latching on by themselves than others, so if they don’t seem interested, get help from someone who knows what they are talking about with breastfeeding.
    A sleepy moment – he spent the night after the birth feeding and sleeping, next to me the whole time, skin to skin.
  • Let baby feed whenever they want for however long they want (aka demand feeding): If you take nothing from this post other than this bit of info I’d be a happy bunny! It may seem like baby is feeding all the time, but in the first few days that’s a good thing – baby is sucking to stimulate your milk production and help get your milk to “come in”. If you try and feed to a schedule, or think about timings like ‘he/she only fed 10 minutes ago, he/she can’t be hungry again yet”, then you risk interfering with your body’s natural mechanisms for producing enough milk, and you’ll probably stress yourself out in doing so.
  • Lots of skin to skin: Holding your baby with both of you unclothed so that your skin is touching is important not only straight after birth but also in the early days and weeks, and beyond in fact. It helps to stimulate your milk production via the hormones that drive it. A few hours after Andrew was born and he’d fallen asleep after his first feed, which was pretty long actually, the midwife dressed and swaddled him because she said he needed to keep warm as his body wasn’t good at regulating temperature yet, So I did what she said and he slept swaddled in the fish tank cot next to my bed all night whilst I lay there staring at him! Since then I learned through getting accurate info based on research from my local La Leche League (LLL) group that lying with baby skin to skin in those hours after birth is better for both of us, because my body heat helps to regulate baby’s body temperature, and it helps stimulate the start of milk production. So after Joel was born, I refused to let them swaddle him (not that they tried this time, maybe having read my birth plan requesting them not to!), and we lay skin to skin all night, during which time he fed and slept in alternation. We also spent a lot of time skin to skin at home, putting a blanket over us snuggled on the sofa. We still spend every afternoon whilst Andrew is napping together skin to skin on the sofa.
  • If baby seems very sleepy, wake them up: This seems so wrong – let sleeping babies lie, says everyone. But if baby is very sleepy in the early days, they are missing out on enough sucking to stimulate your milk to “come in”, potentially making it slower and not as plentiful. It could be that they had a difficult birth, or are jaundiced, or have some other underlying reason to be sleepy. There are some simple things you can do to encourage them to feed more often (like I did with Joel as he was jaundiced and very sleepy): remove layers of clothing; have skin to skin time with no clothes |(at the risk of me sounding like a broken record!); change the nappy if they’ve fallen asleep at the breast – if they want more it’ll soon wake them up; tickle their feet and cheeks whilst feeding; talk to them; put them down in the middle of the bed.
  • Limit cuddles with other people in the early days: You’ll probably have a queue of visitors at your door, either at home or in hospital, most of whom will no doubt want to cuddle your new little bundle of cuteness. It’s fine to let them, of course, but be careful that baby actually gets to be with you for the majority of the time and doesn’t spend the day just being passed around Uncle Tom Cobley and all. The best thing that visitors can do is help you in other ways, like bring you hot meals, fill up your drinks bottles, do the washing up, the laundry, clean the bathroom, empty the bins and so on and so on. Your parter can be a real support by kindly pointing this out to visitors for you.
  • Rest, and don’t try to do too much too soon: I think these days there’s quite a lot of pressure to appear to be super-mum and be back on your feet, out and about doing all the stuff you were doing before baby arrived. But giving birth is one massive ordeal that your body goes through in order to produce said bundle of cuteness, so you need time to recover physically as well as helping your body to get on with the next stage – producing lots of milk. Spending all day in your pyjamas and sitting on the sofa or in bed is totally fine, nothing to feel bad about. If, like me, staying inside the same four walls all day can make you feel cooped up and a bit cabin feverish, a gentle short walk or drive (as the passenger) somewhere calm can help, but don’t go anywhere that you find stressful (for example, supermarkets). The word ‘babymoon’ is worth remembering – treat the first days and even weeks if you can like a honeymoon with your baby, doing nothing but focussing on them and yourself.
  • Eat and drink enough: Make sure you drink to thirst and eat to hunger. Not drinking enough leads to dehydration, and drinking more than what you feel thirsty for can actually be detrimental to milk production too. I find sports cap bottles of water are handy – no risk of spilling and you can open them with your teeth when you hands are too full to unscrew a bottle top. Eating a good balanced diet is essential, and it’s not a time for dieting to try and shift the ‘baby weight’ – you gained that weight for a reason, and over time, maybe after several months, with breastfeeding it will come off as it is used in making milk. As I was so sick and nauseous throughout my pregnancies, my appetite was limited and I couldn’t keep much down to begin with, so I didn’t put on any weight. But whilst breastfeeding I have found myself ravenously hungry and have definitely consumed more food per day than I ever did in pregnancy and before having kids – I’m sure this is my body’s natural way of saying ‘come on, I need stores of energy to make this milk, and I didn’t get them in pregnancy’. I find that I’m particularly hungry overnight, so I have a box with snacks in next to the bed and I munch through them during night feeds. Some foods, such as oats, are supposedly good for helping milk production, so I eat a lot of porridge, muesli and flapjacks!
  • Make sure feeding feels comfortable: Breastfeeding should not feel painful. The first few days of having a baby sucking on your nipple can feel a little uncomfortable until you’re used to it, and particularly the first minute or so of a feed can feel uncomfortable to begin with, but if you experience real pain or prolonged discomfort, there’s something wrong. Often this can be fixed by adjusting the latch and baby’s positioning, and sometimes it is due to the baby’s tongue being too anchored to the jaw – this is ‘tongue-tie’ and can be fixed by a simple snip of the ‘frenulum’ holding the tongue to the bottom of the mouth – I blogged about this before. Ask someone who knows about breastfeeding to spend time watching you feed so they can check the latch, and if you suspect tongue-tie (see my previous post on it), find an expert who can assess it, which may mean contacting a private lactation consultant if your GP won’t refer you through the NHS.
  • If in any doubt, ASK FOR HELP: Don’t hesitate to get help, no matter how small or big you think your concern is – the earlier issues are picked up, the easier it is in general to sort them out, and small issues can quickly spiral into big issues if not dealt with. Although the obvious people to ask may be your midwife team or health visitor, they are often very busy with big caseloads and overcrowded clinics to spend time with you, and they don’t actually get a lot of specialist training on breastfeeding. Local drop-ins and support groups such as those run by LLL and NCT are often better places to get more personal and detailed support. It’s a good idea to look for your local support groups before baby is born, so you can build up a support network before you need it, if you end up needing it, and if you don’t then you can still go along and meet with other breastfeeding mums anyway. It’s much easier to pick up the phone to someone you’ve already met a few times to ask for help when you’re an emotional wreck than it is to phone just a name and number on a leaflet.
  • Believe in your body: I’m a rare case (always like to be different I do), and unless like me you have a specific reason to doubt your breasts, it is likely that you are physically able to produce enough milk IF ALL THE CIRCUMSTANCES IN THE EARLY DAYS ARE FAVOURABLE (that’s a big if – see all of the above!) And even if it turns out you can’t produce enough milk for whatever reason, there’s no reason you can’t continue to breastfeed just like we have using the SNS.

Kit that may be useful once you’ve got going:

The one piece of kit that you do need is a good bra (or 4! – they get dirty with milk and sick pretty quickly). Although it’s not essential that you get nursing bras which open up with a clip to allow you easy access to each breast for feeding, it does make life easier in the early weeks, and you need to get new ones based on your postnatal bra size anyway. The question is when to get fitted.  Most sources I read said that you can do this in late pregnancy and just allow for a bit more room in the cup size for when your milk comes in. I did this in pregnancy with Andrew, but then my breasts didn’t actually change much at all due to the hypoplasia and lack of fullness with milk, so they ended up being a bit big. With Joel I waited until he was about a week old to get fitted more accurately. I know I’m unusual though to not have experienced a sudden increase in breast size when the milk comes in.  I found that Karen at Boobie Milk has some good tips on her website and blog (she organised the breastfeeding scavenger hunt that I took part in back in June).

I’ve heard that breast pads are often essential for breastfeeding mums particularly in the early weeks once the milk has come in, as many mums are prone to leaks, and pads can be popped in the bra to soak up any excess. Again I never experienced this, and not all mums do. I seem to remember getting some free disposable ones in the various Bounty packs that I was given in pregnancy with Andrew. If you find you get through lots, there are washable ones, and I’ve seen some lovely soft and luxurious looking ones on various cloth nappy websites such as here.

Some mums I know have recommended breastfeeding pillows for easier positioning in the early weeks. These are usually u-shaped or v-shaped, to fit around your body so that you can rest baby on them to get them at the right height and position to latch comfortably. I just used an ordinary cushion in the early days, and soon found that I could just hold my baby without the need for extra support (it did help I guess that neither Andrew nor Joel were that heavy for their age). So I don’t have any particular specialist pillows to recommend myself.

You may see breastfeeding chairs advertised, which are usually a rocking chair in style and often come with a matching footstool. I never even contemplated one of these as we don’t have room for any more furniture in our flat, and they seemed like a lot of money for what they were, though I guess it’s the kind of thing you could get secondhand if you were more inclined to hunt out a bargain one than I was. I’ve found that the sofa we have now is actually very good in terms of height and squishiness for feeding – my knees are high enough as it’s quite low to the ground, and it has a firm back but soft-ish cushions to sit on so I don’t slide down too much. When I was feeding Andrew as a young baby, we had a futon, which was great for height, but for some reason I kept slipping down it and gradually hurting my back; this got a lot better when we swapped the futon for the new sofa.

You may also be aware of breastfeeding covers that look a bit like a short apron, which you hang round your neck and it hangs down over baby, covering you and them whilst they are feeding. I personally think that no mum should feel forced to cover up whilst feeding her baby – would people expect me to cover my toddler and me up when I give him a sandwich when we’re out? However, I do understand that a mum may not feel confident about her own body, or may feel happier covering up rather than not for reasons other than being forced to by other people. In that case I see the benefit of a cover. I’ve never felt I needed one – a positive thing about having hardly any breast tissue (gotta look on the bright side and all that) is that it’s not hard to feed discreetly anyway, but maybe I would feel differently if I was better endowed. I’ve just always worn clothes that help in me feeling happy about myself and how much is visible to others if they are bothered by it.

Talking of clothes, there are special breastfeeding tops available to buy, but I’ve not got any, because I found that certain styles of ordinary top do perfectly well and are generally cheaper or in my wardrobe anyway. There are two basic options: pull up a top and feed from below it, or pull down or unbutton a top from the top and feed from above it. I’ve found the first option to be most successful, but I know plenty of mums who do the second option. For the pull up option, empire line tops work well, which are fitted at the top and then flow down nice and loosely, so they give you lots of fabric to pull up. If you’re particularly worried about exposing a post-natal wobbly tummy, then you can wear a vest underneath – get one with adjustable straps and set them to the longest possible (you may need a bigger size to get enough length on them) so that you can wear it below your breasts to just cover your torso so they are available for feeding without pulling the vest up. This is not so practical in summer though. For the pull down option, tops and shirts that unbutton at the top are good, or something with enough stretch to pull down and go back into shape afterwards so it doesn’t end up sagging and not covering you when not feeding. I love those big flowy cardigans that come down to your thighs and have no buttons, as you can wrap it around yourself and baby, particularly in winter if you have any bare skin exposed to the cold when you’ve pulled your top up with no vest underneath.

Andrew (4 months) and mummy enjoying a feed - this was a hot day in early summer, so I had just a vest top on, nothing special, and just pulled it up to feed him.
Joel (6 weeks) feeding whilst we had lunch out - the cardigan is very useful for wrapping around us both in winter, as it was when this was taken.

Even if you intend to give breastfeeding a go, you may be thinking about the possibility of expressing some of your milk to give in a bottle – maybe your maternity leave is quite short and you want to carry on breastfeeding when back at work, or maybe you’d like your partner or another relative to be able to feed your baby sometimes, such as overnight. I would say that it’s a good idea to wait until your milk supply has been established, so at least 6-8 weeks, before you start introducing expressing as an alternative to baby-led feeding at the breast, because it could interfere with your body’s natural ability to produce enough milk based on your baby demanding all they need by sucking at the breast. However, there may well turn out to be specific reasons why you would express before this age, such as your baby won’t latch properly or they are separated from you due to being in neonatal special care, and you need to express to build up and keep up your supply during the lack of contact with baby.

if you do decide to express for whatever reason, you’ll need the following…

  • breast pump: If it’s just a small amount of expressing, you can actually be very effective at getting milk out just with your hands, so a pump isn’t necessary. But for whole feeds worth of milk, a pump makes sense. Manual pumps require you to pull a lever by hand over and over again to pump, so again, they’re more for smaller amounts of pumping otherwise they get tiring, but they are cheaper than electric pumps, If you end up doing a fair amount of pumping, you’ll probably think that an electric pump is worth investing in. They range from small portable ones with battery or mains options, to hospital grade ones that you can hire. Some come with one pumping piece, some come with two so you can do two breasts at the same time – useful if you’re pumping with little or no time with baby at the breast. Over time, the effectiveness of the pump decreases, so it may not be worth getting a secondhand one. I was given a secondhand one that hadn’t been used much, and I compared how much I got out with what I got out using a double hospital grade pump that I hired for 2 weeks when Joel was born – there was no difference, so I carried on using the single one I’d been given before Andrew was born, but it could well have been different had the pump been used more. (I pump sometimes to try and increase supply, though I don’t have much time to do it now with a toddler as well, so I mainly do it overnight.)
  • bottles: Breast pumps come with at least one bottle, attached to the pump via a length of tubing. You’ll probably need to get more than this, because by the time you’ve filled, emptied, washed and sterilised, it’s handy to have a few. I would always buy new bottles. There are a few bottles marketed at being shaped such that they are closer to the shape of a breast and therefore make it easy for the baby to switch between bottle and breast. We have a few of these as well as a few with the more traditional teat shape, and Andrew managed to switch fine between bottle and breast with both sorts, and his latch onto each teat shape didn’t appear to differ. That said, he took a bottle as well as the breast from a week old, whereas an older baby might do one or both of two things: refuse to take a bottle in the first place because they’ve got used to the breast and prefer that (this is what I’m now finding with Joel at 12 weeks); get used to the easier flow of the bottle and start getting fussy at the breast.
  • steriliser: There are two basic ways of sterilising – steaming in the microwave and bathing in a chemical solution (Milton fluid). I only have experience of the microwave method, but find it pretty easy, and you can pick up secondhand microwave sterilisers at a good price at, for example, nearly new sales or through friends.

Phew, another post to rival my kit list in length! We were discussing amongst a few of us at our breastfeeding support group the other day how hard it is to reach mums when they really need help in the first week of baby’s life – antenatal classes are OK for theoretical info before baby arrives, and support groups are fine if mums having problems make it along, often not in the first week. So even if this post helps just one mum at the time she needs it most, I’d be very happy.

Breast versus bottle: not a simple dichotomy

Picture the scene…. A good friend and I meet up for lunch in a busy cafe, we both have small babies, hers just a few weeks older than mine (and my bigger little man is off running around the shopping centre with Daddy having wolfed down his lunch already). Once we’ve ordered and our food arrives, our babies also decide that they are now hungry, so we each set about feeding them. I set up my SNS which contains a couple of ounces of formula and my baby latches on to me and begins to feed, taking in whatever breast milk I am able to produce as well as formula which is necessary to make sure he is getting enough to satisfy is hunger. My friend gets out her bottles of expressed breast milk and her baby latches on to the teat, which is something he had massive difficulty doing on to her breast as a newborn, hence her decision to express her milk and feed it via a bottle.

There we were, both feeding our babies in our own way, both happy, relaxed, feeling like we were doing nothing unusual, just fulfilling our role as mum to our own baby. It struck me how there was a huge irony in this situation: I was feeding formula at the breast and my friend was feeding breast milk with a bottle – it seemed so weird that we’d both ended up at this point, rather than the classic breast milk at the breast and formula milk with a bottle scenario.

This is actually another lunch out that we had recently, but it illustrates my SNS feeding in a cafe. It could also serve as a caption competition.... Tom and I have some very interesting expressions here! (I think Andrew took the photo, with Grandad's help)

On my way home as I was pondering, a question came to mind that appeared in an issue of a breastfeeding magazine that I receive as a member of La Leche Laegue (LLL). It asked whether, if these were the only two options available, I’d rather feed my baby formula (only) at the breast (if that were possible) or breast milk in a bottle. The point was whether the act of feeding at the breast, and the closeness and bonding that comes from this, was more important to me than the properties of breast milk such as the antibodies it contains that formula doesn’t. When I’d first read that, it made me think – which would I prefer, that’s a tough one! I like both bits of breastfeeding, the physical contact and the milk itself.

And actually, although obviously I would have loved to be able to exclusively breastfeed my babies, I’m grateful that the arrangement we’ve come to, through much persevering in the early weeks of Andrew’s life, allows us to have both. For us it’s not just a simple dichotomy like the question in the LLL mag asked, because my babies do get breast milk at the breast, as well as formula. Reflecting again on this after our lunch reminded me to be grateful for what we do have rather than feel annoyed at what we don’t have. My friend and her baby are lucky that he gets all the goodies in breast milk and doesn’t need formula milk which is expensive, produced by ethically unsound companies and at the end of the day isn’t human milk designed for human babies; but my babies and I are lucky that they both latched on brilliantly to my breast within minutes of being born (though Andrew needed some help to be more efficient at sucking by having his tongue tie snipped later at 10 weeks) and have never struggled to stay latched for comfortable breastfeeding.

As my friend said, we are both doing the best we can for our babies given our circumstances. And that is right – although our breastfeeding problems have been very different, we have a lot in common. We have both had feelings of failure in the past, that we had failed at our role as a mum because we were not able to do the ‘normal’ thing of (exclusive) breastfeeding (at the breast). Both of us have suffered, mainly emotional pain for me as it dawned on me that I wasn’t physically able to produce enough milk for my baby and had to figure out how and if I could continue breastfeeding at all, and both physical and emotional pain for my friend who desperately wanted her baby to be able to latch comfortably for more than a minute at a time and urgently sought help from health professionals whose care they were in. We both have the faff of sterilisation and having to remember and gauge how much milk to take out with us.

But both of us have come to realise that we are not failures, and that our decisions on how to feed our babies are in the best interests of our babies considering the experiences we’ve been through, and we are giving them all they need for the best start in life. The same goes for all other mums I know personally, whether they have breastfed (exclusively/ partially/ at the breast/ via bottles) or formula fed; there is a story behind every decision on how each one feeds/fed their baby. When I think about how many mums I know who have breastfed with no major problems, it’s quite a low number given how many started out trying to breastfeed.

Not that I want to put pregnant mums-to-be off, but I think it’s important to be realistic about it, and equally say how important it is to get good support, preferably set up and in place before baby arrives so you know who to turn to if you do encounter issues. Accurate information and knowledge of breastfeeding, as well as sensitive emotional support, are key to overcoming challenges, and we are very blessed that we found it at the right time. Before I had a baby, I thought that feeding one would be a simple black and white decision – breast or bottle – but since I had my first baby, I’ve come to learn that it’s a much greyer picture than that. And my friend and I painted some of that (positive) greyness one lunch time in a busy cafe, where there could well have also been a mum feeding formula milk via a bottle and a mum breastfeeding in the classic way (I didn’t notice, it was too busy and I was more interested in talking to my friend!)

Milk-making flapjacks

As I was flicking through our Cook with Kids book by Rob Kirby, I came across a recipe for ‘super fit flapjacks’. Instead of just being oats, butter, sugar and syrup, these included various dried fruits and seeds. I didn’t actually have many of the fruit and seeds in the recipe, but it inspired me to make some flapjacks with some of the unusual dried fruit – golden berries and cranberries mix – that I bought recently because it was on offer in the supermarket and the seeds that I had in the cupboard – sesame and caraway.

In a previous baking blog post, I wrote about the fact that caraway seeds are supposed to be a galactagogue – something that stimulates breast-milk production. Oats are also supposed to be a galactagogue, hence the name for the flapjacks that I ended up creating. As well as being good for milk making purposes, flapjacks are in general a good source of energy, particularly with the dried fruit and seeds in, and energy is something I really need at the moment. I find that I get peckish in the night with all the feeding Joel does, so these are great to nibble on in the early hours. The high seed content makes these like a cross between sesame snaps (though softer) and traditional oaty flapjacks. 

Even if you’re not trying to induce or increase lactation, these flapjacks are a delicious treat and will keep you going if you’re in need of energy for another reason. Here’s the recipe if you’d like to have a go. It’s very easy and it took Andrew and me about 10 minutes to make plus cooking time.

Ingredients

  • 125g brown sugar
  • 90g margarine
  • 90g honey
  • 175g oats
  • 100g dried friut (I used 60g sultanas, 40g mixed cranberries and golden berries)
  • 100g seeds (I used 60g sesame seeds, 40g caraway seeds)

Method

  1. Start by lining a square or rectangular baking tin with greaseproof paper.
  2. Put the oats, fruit and seeds in a big bowl, and stir until well mixed.
  3. Melt the sugar, margarine and honey in a bowl in the microwave or over a pan of boiling water on the hob.
  4. Add the melted ingredients to the dry ingredients and stir until well combined.
  5. Pour the mixture into the prepared tin and bake in the oven at 160ºC (fan) for about 10-15 mins until golden on top.
  6. Remove from the oven and leave to cool completely before cutting into squares, as the flapjack needs to harden as it cools.
  7. Store in an airtight container (next to your bed if you’re me!)

2 weeks old: jaundice and getting breastfeeding off to a good start

2 weeks ago about now we were not long home after a less than 12-hour stay at the local Birth Centre. Time has flown by, although strangely it doesn’t seem to me to have gone as fast as Andrew’s first 2 weeks did. For Tom, though, it has gone faster, and this afternoon is his first afternoon back at work – handily his first day back is a Tuesday and he only works a half day, so we are being broken in gently to his return to work. Andrew is napping, so I won’t notice Tom’s absence fully until tomorrow, when I’ll have to ‘go solo’ with 2 little ones all day – eek!

Andrew dishing out one of his lovely kisses when he fist met Joel....

So what’s happened already in 2 weeks since Joel’s birth? Well we had a trip back into hospital when he was 3 days old, because he was quite highly jaundiced. As we’d had to do this with Andrew too at 6 days old, though his problem was dehydration not jaundice, we kind of knew what to expect and were not quite so shocked. One of the hardest parts for me going back in was being away from Andrew for 2 days and one night (except a couple of visits to the ward), but I knew it was the best place for Joel to be and I couldn’t be there for both my boys at the same time. I also felt better this time knowing that his jaundice was nothing to do with my milk supply (which the dehydration had been) – it would have happened regardless of how he’d been fed.

We didn’t know it at the time, but apparently they take jaundice very seriously in Cambridgeshire these days, as there have been a couple of cases that were missed early and the babies developed serious complications from it. Jaundice is caused by a build-up of a substance called bilirubin in the body which is deposited in tissues such as the skin, gums and whites of the eyes and gives them a yellowish colour. In a newborn it is as a result of many red blood cells being broken down in one go – the baby needed these extra cells in the womb as there was less oxygen available than in the real world, and after birth the extra ones are broken down and excreted from the body. If a baby’s liver can’t do this fast enough (because it’s still not mature enough), the bilirubin level can get very high, and if it gets too high this can lead to it being deposited in the brain tissue and causing complications like deafness and cerebral palsy.

Joel’s bilirubin level wasn’t allowed to get that high, as he was treated with phototherapy and food. Phototherapy is basically like a sun bed that he lay on with blue lights underneath him and blue lights over the top of him. The light helps to break down the bilirubin so it can be excreted. He lay there with no clothes on, except he had to wear a cute little eye patch to stop the lights damaging his eyes – he hated it though and kept pulling it off whenever he woke up! Initially he was allowed to feed on demand from me and therefore spend some time away from the lights, but then his bilirubin level increased again and the doctors decided that he needed to be constantly on the lights, so they fitted a naso-gastric tube and fed him vast amounts of formula through it. Having milk is also effective in treating jaundice, because it makes baby poo it out and that’s how the bilirubin is excreted; breast milk is more effective than formula at this, but at 3 days old, even if I was normal and didn’t have insufficient glandular breast tissue to exclusively breastfeed a baby, my milk wouldn’t have already ‘come in’ and be there in vast quantities. (You know you’re a parent when you don’t bat an eyelid at writing the word ‘poo’ in a blog post!)

The good thing is that Joel responded well to the lights and milk treatment and after 12 hours on the lights he was allowed to breastfeed on demand again and was well enough to get out of hospital after just one overnight stay. I think it helped our case when I explained to the doctors that I was willing to supplement with formula given my previous breastfeeding experience. Plus they saw me using the SNS (supplemental nursing system) that I’d taken in with us in case we needed it, and could see that Joel was feeding well with it.

.... and another at home with Granny 🙂

The hardest thing since coming out of hospital the second time has been how sleepy Joel is. This is a common side effect of jaundice, and I’ve been told that jaundiced babies sometimes take a few weeks to really wake up. But even before we went back into hospital, Joel seemed like a much more chilled out baby than Andrew was, so it could partly just be his personality too. You might be wondering why sleepy means hard?! Surely that’s a good thing, right?! Well not if you want to establish a good breast milk supply and in particular if you have supply issues anyway like I do. I’m having to wake him up for feeds, especially overnight when it’s the best time to stimulate my supply when the hormone prolactin is highest. I’m often feeding him in just his nappy so he’s nice and cool so less likely to drift off to sleep, and he’s next to my skin to help stimulate milk production. I also find myself tickling his feet and changing his nappy during feeds to try and wake him up. This is such a culture shock for me having fed Andrew as a baby who was always so active, awake and keen to tell me when he was hungry.

But he’s already showing a few signs of being less sleepy and I feel like I have much more knowledge and support with breastfeeding this time, so I’m working hard doing everything I can to get things off to a good start. I’m expressing after feeds (though not getting loads out, as I’ve never managed to get loads out with a breast pump – by hand I get more), taking a herbal supplement that is supposed to boost milk supply, eating lots of oats (porridge, flapjacks etc.), drinking fennel tea, resting when I can and, of course, using the SNS to top Joel up with formula so that he gets as much from me as possible. All this effort seemed worth it this morning when he was weighed and his weight had gone up to beyond his birth weight! Hooray! This means a lot to me because Andrew took ages to put weight on in the early weeks and weight was a constant worry for us.

Talking of Andrew, I can’t leave him out of this post. He has been a star in welcoming his little brother to our family. He’s been dishing out lots of kisses of his own accord to Joel (and us) and has carried on as normal being his happy little self, except he doesn’t seem so little any more! As I’ve spent much of the last 2 weeks holding Joel, whenever I have held Andrew for a moment, he feels and looks absolutely massive to me. Of course so far Andrew has had at least Tom around and often another person or more as we’ve had lots of help from family visiting, so the real test of how he copes with having to share my attention will come in the next week. But I’m optimistic from the signs so far.

It’s been nice to sit and write something (the skill of one-handed typing whilst feeding is like riding a bike – never forgotten), though I feel that my head is still quite all over the place and this post is more muddled in thought than usual. I thought it would be good to share our experience of jaundice, as it’s something I’d heard of but didn’t realise was so common and often required such hardcore treatment – about 60% of babies get it, and I can’t help but wonder how many mums of jaundiced babies end up giving up breastfeeding because their supply never really gets going before the formula is introduced and baby is so sleepy that they don’t feed enough. I did also write Joel’s birth story 2 days afterwards so I didn’t forget anything, but it’s still in rather note form and needs some editing to make it publishable; I’ll post it when I get round to it. Anyway, I’d better get back to some more resting on the sofa whilst Andrew is napping and Joel is feeding 🙂

A bit red faced - matches his tomato babygro! I think he's going to be a blond boy like his daddy was.

Pregnancy diary: week 31 – breastfeeding update

I thought it was about time that I wrote a pregnancy post with an update about how breastfeeding Andrew is going and my thoughts on how it might go once baby is here. In early pregnancy, I wrote about my thoughts on nursling (self-)weaning. I then wrote a sort of update at 21 weeks, but I hadn’t come to any firm conclusion about how or when I would initiate weaning if Andrew didn’t self-wean. I guess I was trying to leave it as long as possible, to see if Andrew would self-wean, even if right at the last minute. Well he’s still going strong (as strong as he has been for the past 6 months), and feeding for about 20 minutes first thing in the morning and about 20 minutes last thing before bed, plus the occasional feed in the day if he’s upset or grumpy for some reason (for example, teething).

I’ve been reading the book Adventures in Tandem Nursing on and off for a while, so I now have lots of info about breastfeeding a toddler in pregnancy and once the new baby is born. This has been very helpful, but since I know that we’re a special case, given my hypoplasia (insufficient glandular (milk-making) breast tissue), I wasn’t sure that all of the info was completely applicable to us, because it doesn’t specifically mention mums with hypoplasia. So I decided that the best thing would be to get some expert advice, more than is available in books.

Andrew reading up on tandem feeding with the book Adventures in Tandem Nursing 😉

I spoke to the leaders at my local La Leche League (LLL) group where we’ve been going since Andrew was just a few weeks old. They have been an amazing support to us, and I knew they would do everything they could to help us with this situation too. One leader in particular was very helpful. As we talked and she helped to unravel my thoughts by asking me specific questions about what I was thinking, I came to the conclusion that I wasn’t against tandem feeding in itself, but what was stopping me from thinking it was possible for us was my hypoplasia and the memory of awful supply issues that I had when Andrew was a baby. (If you’ve not read from the beginning of our breastfeeding journey, you can find it here.) I realised that IF supply wasn’t an issue (a big IF) then I’d have no hesitation in tandem feeding both Andrew and baby – I was up for that. But of course, like I said, it’s a big IF, because it’s likely that supply will be an issue again with baby. My concern would be that Andrew, although he’d help make more milk by feeding (the more he takes the more I make), would also take milk, and I wouldn’t want him to take what would be better drunk by the newborn.

My helpful LLL leader understood what I was telling her, and agreed that it’s an unusual situation to be in – there can’t be many mums out there who have hypolasia and are considering tandem feeding, or are actually tandem feeding. She recognised that our unusual situation went beyond what she had personally read as part of her LLL leader training and experienced with other mums through her role as an LLL leader. So she offered to post our question to the online national forum of LLL leaders, to see if anyone else had experienced a similar situation, either themselves as a breastfeeding mum, or from other mums they had met through their role as leader. What was our question though? Essentially it boiled down to: Is it possible to tandem feed with hypoplasia?

Within a couple of weeks, I had three very helpful leads as a result of my leader’s post to the national leader forum. One was from a mum who hadn’t had supply issues herself, but who had recently been to a conference for lactation consultants (people whose job it is to support breastfeeding mums), where there had been a paper on insufficient glandular tissue and possible ways of helping increase supply. The main focus of her emails to me was on herbs that act as galactologues (substances that help increase milk supply in breastfeeding mums). She gave me some links to resources on these, including those that are apparently safe to use in pregnancy, because relatively few of them are. I’m not entirely convinced about taking herbs in pregnancy, because Andrew is still feeding now and helping to keep my supply going, and the herbs are pretty expensive to keep taking every day over extended periods. As money will be even tighter once I leave work, I have to weigh up all the pros and cons of dealing with supply issues.

Another email correspondence I had was (indirectly via my LLL leader) with Diana West, author of The Breastfeeding Mother’s Guide to Making More Milk. She’s done some research herself into insufficient glandular tissue, and, as you can tell from the title of the book she wrote, is an expert on supply issues in general. Nothing like going straight to the top lady for advice! Her reply was very to the point: in her opinion it is possible for a mum with hypoplasia to tandem feed, though she would need to take some steps to make sure she is making as much milk as possible, such as taking herbs, expressing and using an at-breast supplementer if supplements are needed for the newborn – all the stuff you can read about in her book, which was relevant to me as a first-time mum breastfeeding just one child; the toddler would also help to boost supply. She said there was no reason that I couldn’t be treated like any other tandem-feeding mum and any other mum with low supply, in terms of the support that my LLL leaders could give me. That was encouraging!

But even more encouraging was to hear from an LLL leader who’s a mum who has personally experienced tandem feeding with hypoplasia. She gave it a go, and it worked out well for her and her children, who have a similar age gap to the one that Andrew and baby will have. She said that she definitely noticed that she had more milk with her second baby, though it’s hard to tell whether this is just the result of having a second child (generally mums have more milk with subsequent babies) or whether the breastfeeding toddler actually helped improve her supply even more than if she hadn’t have been feeding still. She also gave me some tips on herbs that she used, and told me that she always made sure that the newborn fed before the toddler did. Like us, she used a supplemental nursing system (SNS) in the early months for both babies, and she said that with her second baby she stopped using it a lot sooner than with her first, because her supply was better. She said that her toddler acted like her ‘breast pump’, by feeding after the newborn to remove even more milk from the breast so that more would be made for the next newborn feed. One thing that she highlighted, as I often do, is that breastfeeding is not just about food, and that the tandem feeding was a way for her children to bond with each other, and it helped her toddler through the transition of having a new baby in the family.

Bump looks big in this! I think it's because it's a flow-y top though, because I don't think I look so big in a more fitted top. Lots of people are telling me that I look very 'neat' or 'small' for over 30 weeks!

So my assumption that it’s not possible for us to give tandem feeding a go due to the hypoplasia and supply issue has turned out to be wrong. That’s not to say from what I’ve heard from these contacts that it would be easy, but I’m not one to avoid a challenge just because it sounds hard. I would never have continued to breastfeed Andrew if I wasn’t determined, despite how hard it was, to give him as much of my milk as possible, and in the end we’re still going now at 19 months. When I think about how much milk he’s had from me over those 19 months, I bet it’s not actually that far off what some babies get in 6 months of exclusive breastfeeding who are then weaned onto formula. Breastfeeding in early pregnancy was tough too, because I was so sick, but we’ve got through that and I’m feeling much better and glad that I was able to persevere in the hard times when I really didn’t feel like letting Andrew feed.

You can probably guess that my thoughts are now not so focussed on the necessity of weaning. My current thinking on breastfeeding is that I’m happy to let Andrew continue, if he wants to, and see where we end up. If he self-weans before baby arrives, that’s fine; there’s still plenty of time, given that weaning in pregnancy can be quite abrupt, and who knows what he’ll be like next week even if he’s going strong now. Or if he’s still feeding when baby arrives, that’s fine too. As he is pretty predictable in his feeding pattern (i.e. twice a day for main feeds and occasionally other small ones), it should be fairly easy to judge when to offer the newborn the breast before allowing Andrew to feed. If the newborn is anything like Andrew was, for which of course there is no guarantee, then he/she will feed most of the day on and off anyway, inter-dispersed with lots of activity and alertness; it would be harder if he/she is a sleepy baby, as I would then need to be more watchful as to when he/she needs to feed, especially in relation to Andrew. Or if Andrew decides to self-wean once the newborn is here – maybe because there’s less milk for him? – then that’s fine too. If breastfeeding helps him to accept the new baby and not feel jealous or like I’ve got less time for him, then I’m definitely up for tandem feeding as a means of meeting the needs of both my children.

It’s a nice feeling knowing that I have so much more info and support for breastfeeding already in place this time. At 31 weeks of pregnancy with Andrew, I had barely even thought about reading up on breastfeeding and was just getting round to booking my place at an antenatal breastfeeding workshop, which in the end was OK, but didn’t give me any info other than the textbook case, which of course we turned out not to be. I look back and wish I’d been more aware and able to get more info and support antenatally with Andrew, but it’s one of those things that is easy to say with hindsight, and Tom has reminded me that we did our best with the info and knowledge we had at the time, and that’s all we could do. At least this time we have been given another chance to learn from our first experience.

That’s all for now, except to say that this week saw Tom and I celebrate our 4th wedding anniversary. It’s amazing to think how much has happened in those four years, and I can’t believe that there are now nearly 4 of us instead of the 2 who started a journey together on our wedding day four years ago. Andrew is definitely a mixture of the 2 of us – I love looking at him and thinking of how he has bits from me and bits from Tom. I’m looking forward to discovering in what ways the new baby is another mixture of the two of us 🙂