Breastfeeding: What a difference a year makes
National Breastfeeding week (1st – 7th October) is just coming to an end in Ireland. I was completely unaware of this event last year and I knew next to nothing about the reality of breastfeeding either. This time last year, I was quite heavily pregnant with my son and I was counting down the days left until I was due to go on maternity leave. I was diligently researching birthing options and baby equipment. I was religiously attending every antenatal class on offer from my maternity hospital. Including extra classes from the physio department, and the lactation consultants. I also attended a birthing workshop. You’d think I should have been pretty well informed on all of the important topics after all those classes. Sadly, that was not the case at all. If I had known as much then as I do now, I could have saved myself an awful lot of pain and heartache! I don’t wish to debate breast versus bottle this week. Every parent makes their own choice about what is best for their child in their own circumstances. I would like to talk about breastfeeding support in Ireland. I am apalled at how poor the support is within the Irish healthcare system for those mothers who choose to breastfeed. Especially when the maternity hospitals actively campaign for pregnant mothers to choose breastfeeding.
‘Breast is best’. Every pregnant woman hears this repeatedly ad nauseum. I fully intended to give it a shot and see how I got on. I hoped that it would be one of the least troublesome aspects of the entire birthing and mothering process, but expected that it probably would be the most difficult thing next to giving birth. So I attended all the classes that were supposed to cover this important subject. I did have a vague sense of disquiet following the breastfeeding antenatal classes which consisted mainly of why you should breastfeed, very sketchy directions about how to latch a baby on, and a plethora of leaflets from various groups. “You do a, b, c and then wham – you’re breastfeeding. Yay!”. It all sounded just a little too simple to be a true picture of what was ahead of me. I didn’t really know any experienced breastfeeding mothers that weren’t past retirement age. In fact since my brother had been weaned many many years ago, I don’t think I’d even seen anyone I knew breastfeeding at all. In hindsight, I clearly needed to prepare better, but I was a first time mother, overwhelmed with the mountain of things I didn’t know, but would probably need to survive. And with the harrowing prospect of a baby somehow emerging from my weary body in a few short weeks, I was rather more distracted with how to get him out as painlessly as possible. There was always the slim possibility that feeding him wouldn’t be an issue at all.
I did have every good intention of dragging my expanding pregnant ass along to a breastfeeding support group of some description. But between work, tiredness, other baby preparations, and being too pregnant to drive, I never made it to any of those meetings. None were close enough to be convenient for me. And that, my friends, was a big mistake. One I would deeply regret when I was a little older and wiser in the trials and tribulations of motherhood. On I went, blissfully unaware that breastfeeding rates in Ireland are so shockingly low, or I might have prioritised this a lot higher on my list. Coming from a background where my entire family had been breastfed for some length of time, I didn’t realise that it was no longer the norm. Or that breastfeeding support from the hospitals that constantly proclaimed their breastfeeding friendly status to me might be so woefully inadequate when it came to practical help with the basics of nurturing a newborn. In fact the expert advice in some cases can be detrimental. While there are many wonderful healthcare professionals, there’s a terribly high number who have clearly not been well-educated about breastfeeding. The money spent on advertising breastfeeding in hospitals would be better spent educating their staff correctly on how to give basic support to mothers, when to refer them for more advanced help, and where they can get that help.
Skipping over the trauma of being induced and giving birth, sure enough – this whole breastfeeding lark was much harder than it looked (and it didn’t really look that easy). We did make sure to do skin to skin very shortly after birth, and with the help of a midwife, I did latch my newly born son on for a feed successfully up in the recovery ward. Unfortunately she had disappeared off elsewhere when it came to switching sides, and I failed to manage even with the assistance of another midwife. My first experience of the difference in knowledge and experience from one midwife to the next. No big deal, I had at least a couple of days surrounded by medical professionals to get the hang of it. Right?
I spent a couple of nights in hospital, initially chained to a catheter which really impeded movement. It’s a noisy environment, not very conducive to rest or concentrating on learning a new skill. Nobody told me the night I gave birth that the midwives would be berating me the next morning if I didn’t keep track of wet nappies, dirty nappies, length of time feeding on each side, and quality of feeding. Err… what? I was still working on getting a good latch and recognising it. And every time the shift changed a new midwife would appear to ‘help me’ breastfeed. Each one of them had entirely different notions of what I should be aiming to do, and how I should be doing it. Some were more hands on than others – I had to brace myself for prodding, pulling and pinching. Looking back on my hospital notes later, the sceptic in me couldn’t help wondering if the main priority was to scribble ‘assisted mother with breastfeeding’ or similar in my notes as often as possible. Needless to say I was keen to vacate the premises sooner rather than later, and try and focus on mastering one method by myself without constant interruption. However it took a full 12 hours to figure out the hospital red tape and get the appropriate people to release us. That meant 12 hours of confusion about whether we were leaving soon, and interrupted/missed feeds for both me and baba before we finally got home just in time to collapse into bed.
At 9am the next morning the community midwife was at the door brandishing the weighing scales. Bad news. My son had dropped just a smidgen below 10% of his birth weight. Hospital regulations were that we would have to go back into hospital, but to Crumlin as it was the weekend. Huh? To do what? That made no sense. He lost the weight IN the hospital. After some negotiation over the phone with a paediatrician, we were given permission to wait 24 hours and see if we could increase the weight. My husband was sent out with strict instructions to procure formula and a pump. We were to give my son formula every couple of hours, and pump to get my milk in quickly. Breastfeeding was relegated to being a supplement, than a primary source of nutrition. It was only months later that I understood enough about the process of breastfeeding to realise that not only was there no real cause to worry yet about weight loss, but that this was atrocious advice that would most likely derail our breastfeeding journey completely. But back then I took the ‘expert advice’ and tried to apply it on the assumption that they knew best.
Luckily for me, I fast became uncomfortable with the formula top ups. After just one, my son was even less interested in latching on. So I decided we would only give formula via spoon or syringe, or any other way we could get it in. Hopefully that would help avoid more problems. Luckily my husband was supportive of whatever I thought was the best approach. 24 hours later our son had gained 50g, and we were getting a big thumbs up all round. But the pressure was still on to continue gaining weight at a steady rate. Despite the worry about whether everything would be alright, my instinct was going against the advice we were getting. At that point I decided to focus on the breastfeeding more than the formula top-ups. My milk was flowing like a river (probably through wholly reckless and uninformed use of the pump). As it happened, I just didn’t get around to giving any formula top ups. There was too much feeding going on. I felt a bit guilty, but there was a steady weight gain of 50g each of the next two days so it didn’t seem to be doing any harm. That was enough to take us beyond the remit of the hospital. I was told to wait for my PHN to call and take over the reins.
I hear a lot of complaints about various PHNs in Ireland. How uninformed and unsupportive they are. Happily I got a lovely lady who rang promptly and listened to my tale of breastfeeding woe. “Ah, I think you’ll find that I’m a bit more relaxed than the hospital about regaining birth weight. As long as he’s gained it back in a couple more weeks it’ll be fine”. She kindly called out to the house extra times to weigh him, for the sole purpose of reassuring two parents who were now totally freaked about about their son gaining weight. She gave me what advice she could about breastfeeding in a friendly and calm manner. It didn’t solve my many problems, but it was a huge improvement on the attitude and advice from the hospital. We were no longer under such stress and pressure. I could blindly blunder along trying to get my head around the basics of milk supply, getting a good latch, and those crazy growth spurts.
Our breastfeeding journey has been very bumpy since then. Many many nights of unbearable pain where I wept through every feed, and dreaded the next. A lot of googling random phrases at 3am in the morning, trying desperately to figure out what was going wrong every few days. ‘Mastitis? Tongue-tie? Why had I never even heard of these fairly common things before?!’. It was a long long time before I found the online support of volunteer groups like the La Leche League, Cuidiú, and Friends of Breastfeeding and was pointed to more useful information about breastfeeding. Discovering that there were facebook chat groups in Ireland dedicated to topics like Extended Breastfeeding was somewhat of a eureka moment. Many, many mothers actively breastfeeding and supporting each other through those miserable, lonely late nights. Answering all those newbie questions and correcting bad advice. Better late than never, I started passively absorbing all the information I desperately needed, and that would have made a huge difference to me in the early months.
Breastfeeding has never become ‘easy’ for us, but at almost 11 months, we’re still going. That’s at least 5 months longer than I ever even thought about aiming for, and I’m more confident that I’m doing the best I can for my son. For the week that’s in it, a big shout out to all those volunteers and breastfeeding mothers in this country who are the sole reason why many new mothers struggling with breastfeeding manage to continue, despite poor advice from a large number of uninformed medical professionals. It’s just a shame that so many women feel they have to give up because they haven’t found the help they badly need. While I wish I had known better a year ago, I’m proud that I did manage to persevere through the worst of the nights, when I didn’t know that what I was going through was actually normal. I’m also delighted to see that there is so much valuable support available out there for others who also don’t know any better. Including a new buddy program from Friends of Breastfeeding. My only advice for any new parents to be out there who choose to breastfeed their child, is to reach out to those parent support groups. They’ll make all the difference to your breastfeeding experience and achieving your goals, whatever they may be.