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!

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!)

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.