Why I Chose to Breastfeed – #KBBF2014

The theme for today in the Keep Britain Breastfeeding scavenger hunt is ‘Why I chose to breastfeed’, which I thought was a great title to write to. The so-called ‘benefits’ of breastfeeding are often talked about when people are trying to explain what’s so good about breastfeeding, and indeed there are many reasons why breastfeeding is a good thing. But I think each individual mum who chooses to breastfeed has particular ones among these many reasons that mean something to her personally. So why one mum chooses to breastfeed (or not) is not necessarily the same as the next mum’s reasons, and that’s why a title that acknowledges a personal story is, I feel, very important when it comes to the ‘benefits’ of breastfeeding.

And for me, this is a very good question – why did I choose to breastfeed? Well, if you’d have asked me this before my eldest son Andrew was born, when I was pregnant with him, I would have said something along the lines of “I’d like to breastfeed because I know it’s the natural way of feeding a baby, but if I hit problems and it’s too hard, then nevermind, I’ll just bottle feed instead.” Only after he was born and I hit major problems breastfeeding did the determination to carry on arise from somewhere inside me (hormones? natural instinct? back of my brain?).

I’ve told our story in full in previous posts, so I won’t go into too much detail here. The best post to read about how our breastfeeding story started in the first months of Andrew’s life is this one. It turned out that I have IGT (insufficient glandular (breast) tissue) or hypoplasia, and would never produce enough breast milk to exclusively breastfeed a baby. It’s estimated that only a tiny percentage of women have IGT, and therefore pro-breastfeeding literature is keen to point out that it is ‘rare’ to be unable to physically produce enough milk to breastfeed. And I think it’s important to point that out, of course, because there are many other reasons why mums might have (or perceive they have) a low milk supply – for example feeding to a schedule (rather than on demand), giving some bottles & skipping some breast feeds, baby isn’t growing the way the charts say they should, breasts don’t leak or feel full once feeding is established etc. etc., when actually things could be done about all of these and the mum could produce enough milk. But for me, it feels disappointing to be among the unlucky few who can’t produce enough milk, even if we try really really hard at doing things to increase our supply (though there is something special about being a ‘rare’ case).

 

However, just because I can’t exclusively breastfeed a baby, doesn’t mean I can’t breastfeed, and between us, Andrew and I figured out how to use a supplemental nursing system (SNS) to allow him to breastfeed as much as possible, whilst getting top ups of formula milk at my breasts. I’ve written more about this ingenious device here. It wasn’t always easy, and combination feeding like this is a bit of a minefield in terms of working out how much supplement to give and managing demand-led feeding alongside scheduled top ups in the early weeks. Many times I wondered why I was bothering to do this, when it would be easier to just give him bottles and give up trying to breastfeed.

So why did I choose to carry on breastfeeding, despite all the struggles? First, sheer determination is something that I’m well known for – once I get my mind set on doing something, I like to see it through, and I didn’t realise just how much I wanted to breastfeed until I started, and then stopping wasn’t something I was going to do without a fight. This is my personality, and I know not everyone is the same, for me it was a very personal choice to continue in this sense. Second, I learned through breastfeeding that it is not simply about getting calories into a baby to nourish them physically, despite how the medical professionals saw it like this whenever we saw them. Breastfeeding is part of my mothering, and I realised that I enjoyed it: I enjoyed being that close to my baby, calming him down when upset, soothing him off to sleep, letting him know that I was there whenever he needed me, and he seemed to like it at my breasts too, even if he wasn’t immediately hungry and just needed the comfort. I wouldn’t have had this amazing mothering tool if I had given up and turned to bottles.

KBB Scav Blue 14

That small baby continued to breast feed, even when he showed interest in solid foods and then took to them very well. In fact, when he got more calories from the solid stuff, the formula top ups went down and eventually he just breast fed alongside solids and water/other drinks. That little baby whom I struggled to establish a breastfeeding relationship with at the start, is now a lively 3.5 year old who still to this day likes some Mummy milk before bedtime, even if just a minute’s worth of sucks. Clearly he doesn’t need the calories in the milk (his appetite for food and drink is healthy!), but clearly he feels the need for the routine and the comfort (and probably the effect of stalling bedtime for another minute or two, he’s a clever chap!), and I’m happy to fulfil that need for as long as he requires it, it’s part of how I parent. I’ve also done the same for his little brother, who is now 19 months old and enjoying breastfeeding before bedtime still, plus the occasional other feed if he’s upset or in the early morning.

As well as the major reasons in my choice that I’ve outlined above, there are several other reasons that I was glad I was breastfeeding, like the antibodies in my milk (both of my boys have hardly been ill at all) and the need to buy less formula which is so expensive and produced by unethical companies. I wish I didn’t have the faff of sterilising the SNS and having to think about how much top up milk (if any) I needed to take out just in case we stayed out longer than I was planning – these are other reasons why I would have loved to exclusively breastfeed, but I didn’t have that choice.

So this is why I chose to carry on breastfeeding, I’m so glad I did – looking back now at how far we’ve come makes all the early struggles worthwhile. I’ll write more about breastfeeding beyond a year, including tandem nursing 2 children, in my next hunt post, so stay tuned 🙂

There are lots of other bloggers taking part in the hunt, so please head over and read some of their posts too. And don’t forget to enter the rafflecopter below to be in with the chance of winning some fab prizes!

Diddle Diddle Dumpling

Keep up with the Jones Family

My baby boy and me

Being Mum

My thoughts on things

 

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

Where to turn if breastfeeding gets tough – #KBBF2013

As I’ve written before, I probably wouldn’t be here writing these posts for the Keep Britain Breastfeeding scavenger hunt if it wasn’t for the support of several people. I know I am pretty determined, so that also plays a role in why I was stubborn enough to plough on in the face of adversity, but I know that it could have turned out so differently had I not met the right people at the right time. I’m going to focus in this post on the people who gave me specific breastfeeding support, but I can’t forget to mention the strong support of my husband Tom and our families, who were very encouraging and helped out with so many things in the early weeks after the birth of both my boys so that I could concentrate on feeding; without them I would have found things much harder than they already were.

When we went back into hospital with Andrew at 6 days old because he was dehydrated as my milk hadn’t come in (and the community midwife team hadn’t had the staff to come and see us between day 2 and day 6, despite our phone calls for help), we were visited on the ward by the maternity hospital’s infant feeding specialist midwife. She was fantastic, and knew just what to say to me and how to listen to me, clearly an emotional wreck, feeling like I’d failed as a mum in less than a week of being put in charge of a baby. She assessed us both and how he was feeding, and she suggested some things we could do – I didn’t feel like she was pressurising me to carry on breastfeeding him, but was offering support if I did want to. It was this midwife who first introduced us to the SNS, which was key in our breastfeeding journey. I will never forget just how important the information she gave us and her ability to listen to my concerns were to us.

After that I started going to the weekly breastfeeding drop-in clinic not far from our home. This is run by volunteer health visitors and breastfeeding peer supporters like La Leche League (LLL) trained mums. Cambridge is probably quite unusual to have a regular drop-in like this almost every day of the week, and anyone is welcome to attend for support. Half the appeal is just to be able to sit down and have a hot drink made for you and have a chat with other mums who are also not finding it all plain sailing. Again, the ability of the supporters to just listen and let you tell them exactly what’s going on is amazing, and the information they give is accurate because they have a special interest in breastfeeding. I found that my assigned postnatal community midwife and health visitor knew very little about breastfeeding, because this is such a small part of their training unless they do more on their own initiative; I had some what turned out to be very inaccurate advice from my midwife, which could have been a lot worse if I hadn’t had access to more accurate info elsewhere.

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 was through the regular drop-in that I got to know a lovely lady who is one of the LLL leaders in Cambridge. She encouraged me to go along to a meeting where I could meet more mums who could offer me support and friendship. So I went along to our first meeting when Andrew was 4 weeks old, not sure what to expect, and we’ve been going pretty much every fortnight for the last nearly 2 and a half years! Before I went I wondered whether I would feel odd in the group as I wasn’t able to excessively breastfeed, but I was soon welcomed into the group and never felt embarrassed that I had to take formula along in my SNS – they were happy to help and it didn’t matter one bit that we had a more unusual breastfeeding story, as everyone in the room had a different story. There was also no pressure to breastfeed at all, they were just there for me if I wanted to persevere, it was my choice.

Now we are very much involved in the group: I’m on the committee, we go to every meeting that we can, and I have been able to chat with other mums who are going through issues similar to what we have experienced and give them some support too. This is exactly what LLL is about – mum-to-mum support. Apart from my milk supply issues, we’ve also had experience of breastfeeding through pregnancy and tandem breastfeeding (I’ll talk about these more in my next hunt post), both of which I’ve been able to share with other mums who are thinking of having another baby. Although I’ve often wished that I didn’t have IGT and had a ‘why me?’ attitude for much of the first half year of Andrew’s life, I have now come to see that I can turn this into something positive by offering other mums support based on our difficult experiences – it’s only because we had issues that we sought support and ended up getting involved with LLL, so if it hadn’t have been for our problems, I might well have not had the opportunity to do this.

invention

It was also through LLL that Andrew’s tongue tie got spotted. One of the leaders noticed his tongue was a little anchored when he smiled at her, and as she wasn’t an expert, she said that it might be worth getting it checked out my someone who specialises in tongue tie snipping. I tried to ask two GPs at our surgery if they could refer us to the nearest hospital with a specialist, but they didn’t want to know (I wrote about this here). So we decided to pay for a Lactation Consultant to come and assess him. She said that he did have a posterior tongue tie, which was quite hard to spot, so she snipped it and things did improve for us as Andrew started to gain more weight from that week on. But it wasn’t just the tongue tie snipping that was good – she spent about 3 hours one-to-one with me talking through all sorts of things to do with our breastfeeding story so far, going into so much detail both in the questions she asked me and the info she gave me. Of course that’s her job and that’s what we paid her to do; I just wish this level of help was available for free on the NHS.

I wouldn’t wish our breastfeeding situation on anyone, I’d far rather not have the faff of topping up with formula, but I do hope that through my writing about it other mums will be encouraged to seek support in places that will really help. Local drop-ins are usually advertised in places like health visitor clinics (or asking your health visitor), maternity hospital postnatal packs, NCT newsletters and children’s centres. Organisations such as LLL, NCT and ABM have details of local groups on their websites. Lactation Consultants are listed by area on the Lactation Consultants of Great Britain website. You might find that your own midwife, health visitor and GP are more helpful and knowledgeable than ours were – it depends how personally interested they are in breast-feeding. I hope this has been informative, and I’m always open to questions about my supply issues, use of an SNS, feeding in pregnancy and tandem feeding.

Today, as well as the main competition with over £1000 worth of goodies in the prize kitty, I have a competition running to win 5 pairs of washable breast pads hand made by the lovely Leah at I Sew Green. Leah is a work at home mum trying to make the world a greener place to be by making all those things you normally throw away. She has some lovely breast pads, cloth sanitary products and cloth nappy-related products that you can see through her Facebook page. To enter both competitions, follow the Rafflecopter instructions below.

And finally, why not pop over to some other blogs and companies who are participating in the hunt….

Circus Queen

Diary of a First Child

The Secret Life of Kate

Oh So Amelia

Hinckley Yummy Mummy

Breast Milk Keepsakes

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 🙂

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.

Mum-to-Mum sharing: at-breast supplementation

In this post I’d like to share my experience of using a little-known ingenious device for supplementing breast milk with formula milk. I haven’t met many mums who have used such a thing, and as far as I can see there isn’t much info out there about it compared to other breastfeeding-related ‘equipment’, so I’m hoping this will be a really informative post for anyone who this might be useful to.

Before I go any further though, let me first talk a bit about low milk supply and the possible need for supplementing with formula. Much of the useful information that I have taken in about breastfeeding has been through La Leche League (LLL), and, more specifically, the book published by the organisation called The Womanly Art of Breastfeeding (which I’ll call WAB for short). The information in this book was written by mums with years of breastfeeding experience, and is backed up by medical professionals and scientific research into various aspects of breastfeeding; plus it is constantly being updated (currently in its 8th edition).

A common anxiety that many mums-to-be and new mums have about breastfeeding is ‘will I (or do I) have enough milk?’ WAB’s answer is that most mums are able to make plenty of milk; some do have difficulty making enough, but often the reasons are fixable if the mum gets the right support and information at the right time. So what might cause a deficient milk supply? WAB puts it like this…. The baby might not be taking enough from the breast (leading to a declining supply because breastfeeding works on the principle of the more milk taken the more is produced); this could be due to issues such as position at the breast, the frequency and length of feedings (not often enough, too short), prematurity, tongue-tie, muscle weakness etc. Or mum might have hormonal issues which lead to lower milk supply, such as thyroid problems, polycystic ovary syndrome and other fertility issues, or structural issues with her breasts, such as previous surgery or insufficient milk-making tissue. There are many possible factors involved, and the combination of factors is different for each breastfeeding pair (mum and baby).

In the case of Andrew and I, there was a mixture of both mum and baby issues which lead to our supply problem (you can read our full story here, but I’ll summarise for you now). I don’t have a huge amount of milk-making tissue, which is evident from the shape and size of my breasts (it is important to note that small breasts does not automatically mean insufficient milk-making tissue, nor indeed does big breasts automatically mean loads of milk-making tissue – there could be lots of fat tissue too which doesn’t make milk; shape is also key in this. For more info, I’d recommend reading p381-382 of WAB or the LLL book Breastfeeding Mother’s Guide to Making More Milk). Also, Andrew was born with a tongue-tie. This was a particularly tricky one to spot, and we didn’t get an official diagnosis until he was nearly 10 weeks old, at which point it was snipped and this did make a difference to his weight gain (the indicator that he was getting more milk).

And finally, before I actually get on to at-breast supplementing after this important deviation into low milk supply, let me mention a few points (from WAB) that might explain why a mum thinks she isn’t making enough milk (when in fact she is). She might not realise that babies need to feed as often and for as long as they do (though they all differ in exact requirements) – what seems like all day every day canbe completely normal. She might have someone else asking her ‘are you sure your baby is getting enough?’ – that’s enough to make any new (or not so new!) mum doubt herself and her instincts. She might not be letting the baby lead the way by letting him/her feed whenever and for however long he/she wants to, and instead following a schedule imposed by herself or a parenting book.

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If you along with your health professionals and breastfeeding supporters have ruled out all the potential causes of low milk supply (actual and perceived), and tried to fix any that could be at play, but baby is still not thriving as he/she should (usually indicated by poor weight gain, at least that’s what medical professionals look for, though there are other things like lethargy, dry mouth/eyes/skin, not reaching milestones), then supplementing baby’s milk intake is a necessity for his/her well-being.

At this point I would like to point out that, despite the impression that some people including medical professionals give, baby feeding does not have to be black and white: either you breast feed (exclusively) or you bottle feed. I successfully combined breastfeeding with formula supplements until Andrew was on a balanced and varied solid food diet, at which point I dropped the formula and continued to breast feed. Don’t let anyone tell you this isn’t possible!!! WAB also makes the same point. Another thing to point out is that there are ways in which mum can try and increase her supply as much as possible, for example by expressing milk to give to baby as well as feeding directly at the breast and taking herbal supplements (I won’t go into this here, but again I’d recommend WAB or Breastfeeding Mother’s Guide to Making More Milk).

One thing that helped us a lot with our supplementing (and increasing my supply as much as possible) was the at-breast supplementer that we were given (and then later bought one of our own) by our local hospital’s infant feeding specialist midwife when Andrew was admitted with dehydration and major weight loss at 6 days old. It’s called a ‘Supplemental Nursing System’, or SNS for short, by Medela. This ingenious device is quite simple really – it’s a bottle, into which formula or expressed breast milk is poured, which hangs around mum’s neck with a thin tube coming out of the bottom that mum sticks to her breast with tape so that the end of the tube sits just on the nipple; when baby sucks on the breast, he/she not only gets all the breast milk available, but also the milk in the bottle via the tube.

SNS (supplemental nursing system) - a bottle that hangs round mummy's neck by a cord, and out of the lid (which is at the bottom when hung) comes a length of thin tubing, which is taped for each feed to the breast, so that the loose end of the tube sits on the nipple. As baby sucks on the nipple, he gets all the mummy milk available, plus the formula in the bottle. Quite ingenious if you ask me!

The reason why I liked this was that Andrew was still breastfeeding all the time that he was also getting the top-up. He did have a bottle every now and then – basically when we were out somewhere that I couldn’t easily prepare and use the SNS – but I would always offer him both breasts first and then the bottle. He didn’t miss out on any of the milk that I was able to make, and I enjoyed the feeling of having him sucking from me and felt like I bonded very well with him in this way. I am convinced that without the SNS we would not still be breastfeeding today, at 16 months! So, ironically, it was a good thing that we went into hospital at 6 days old and were given very good advice by the feeding specialist.

Andrew (4 months) and mummy enjoying a feed, with the SNS around mummy's neck

Sure it was fiddly using the SNS to begin with, and it did take some time to get to know the best ways to use it. Here are some of the things I learnt about what worked for us:

  • If Andrew was very hungry by the time I got ready to feed him, it was sometimes easier to get him latched on first and then stick the tube in at the side of his mouth, rather than try and latch him on with the tube in place at the nipple, as this often ended up with him knocking it out the way during the latching process! Ideally I tried to feed him when he wasn’t already fussing, but this was sometimes impossible.
  • As he got older and I found I needed to support him less than in the early days, I found it easier to hold the bottle or put it down next to me instead of having it hanging round my neck which sometimes got in the way when he was bigger.
  • There are different thicknesses of tube, and working out which one was best at each stage was a process of trial and error: as he got older I thought it was logical to go for thicker tubing to get a faster flow which he could then cope with, but then I realised he got used to that and was more fussy about sucking from me without the SNS (i.e. without the artificial immediate let down of milk), and I reverted to the thinner tubes.

But these issues that we learnt to deal with were nothing compared to the help it gave us, and I would recommend it to anyone who is facing a situation of low supply and the need to top-up. Although we put formula in the SNS (because I was unable to express much with a pump or by hand), it is also possible to put expressed breast milk in it as a way of increasing supply – i.e. you express and baby feeds from you, to maximise the milk output from the breasts.

I’ve tried to remember all the information about low supply and supplementing that I think would be useful for others, but if you have any more specific question, please leave a comment and I’d be happy to tell you more about our experience. For a while I felt like a failure for not being able to produce enough milk and desperately wanted to be able to exclusively breastfeed, but I came (a) to realise that I’m not the only one who struggled with low supply, (b) to accept that this is just the way I and Andrew are (after lots of determined trying to increase supply and put everything right), and (c) to see myself as a breastfeeding mum who gave her baby a bit of calorific help from formula in the early months. Now that Andrew breastfeeds happily without top-ups, but of course a good diet, I’m so happy I persevered through feeling like a failure, because I know now that I most certainly am not! In fact the longer Andrew feeds, the more likely it is that I’ve developed more milk-making tissue to be able to feed the next newborn with less (or no) supplementing. Most of all, I hope that our story inspires others to not feel like a failure when breastfeeding is not going like it does in the textbooks – this is the real world.

Why not hop over to some other blogs and read other mums sharing their experiences? There are some links below, and more on the main website, where you can also find out more about the Keep Britain Breastfeeding Scavenger Hunt 2012. I’m sure there will be lots of other tips and stories to inspire and encourage. Don’t forget to enter the competition below to have a chance of winning the grand prize.

Bumps 2 Babies – The Beauty of Breastfeeding

Mama Geek – Getting Started with Breastfeeding – My Top Tips

Life, Love and Living with Boys – Breastfeeding Friendly Chester, An Update, A Guest Post AND a Competition! – A Babi-Mam Bib-Bob giveaway

Little Scribbles – Sharing

Breast 4 Babies – Ten Things your Midwife or Health Visitor Never Told Me about Breastfeeding and a BoobieMilk giveaway

Diary of The Milkshake Mummy – From One Breast Friend to Another

Blooming Lovely Jewellery has joined the Hunt with their beautiful Bola Pendants

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