Thursday, 26 June 2014

That old CHESTnut...

Here it is. My first proper post about how I'm parenting Aurora. For those on the ball, the title says it all; for those who will go 'oh yeeeah', it's about breastfeeding (BF). I know BF is one of those topics that has been done to death, in the media, on the internet and on loads of useful blogs, but I know many parents, including myself, who just didn't *get* it. So here's my experience so far, with some tips that might help people who struggle, like I did.

For as long as I can remember - before wanting children, before thinking I couldn't have children, before getting pregnant, before the antenatal classes and before the NHS pro-BF barrage of info - I *knew* I'd breastfeed, I just knew it. I knew I'd be able to, even though my mother and maternal grandmother couldn't. I knew I'd be in public whooping them out all over the place, just waiting for someone to make a negative comment so I could deliver a scathing comeback that would leave the nugget speechless while I'd walk away with my head held high (probably with my boob hanging out with a baby attached to it; yeah, right?!). I knew I wouldn't need the bottle-feeding starter kit we'd bought 'just in case', and obviously I was totally cool if we had to use formula. I knew it'd be easy because to breastfeed because, for goodness sake, it's the most sodding natural thing in the world!

What a tit I was.

Aurora being rude during breastfeeding. Charming.
From my GSCEs, to the biomedical science degree, as well as having a general love of science anyway, I have always been interested in subjects like BF and the biology involved. I am well aware of the health benefits to the baby, passive immunity, reducing infections in the baby; apparent reduction in cot death risk; preventing or lowering the risk of constipation; better mental development; as well as the benefits when the baby is older, such as reducing the risk of diabetes. And there are health benefits to the mum too; with studies showing that ovarian and breast cancer is reduced in mums who breastfeed. But we know all this. It's all in the thousand leaflets the midwives give us when we are pregnant.

What are also in the leaflets are lovely twee, hand-drawn images of babies latching on to the nipple. But, there are no pictures of bleeding cracked nipples. The bleeding cracked nipples of a mum with bags-for-life under her eyes, on her tear stained, red, blotchy face… not in the leaflet I got anyway. They don't have lovely pictures of newborn babies who have been crying, REALLY screaming, for so long they are red in the face, hungry and exhausted. With regard to BF leaflets, Tyler Durden says it best in Fight Club: calm as Hindu cows.

The first rule of Breastfeeding club is: you don't tell women how much it hurts...

When Aurora was first placed on my chest when she was popped out of me, I was encouraged to feed her. I had said I wanted to attempt the breast crawl: where the babies are placed on the mother's chest and they wiggle their own way into place. Like little kittens he or she finds the nipz through smell and touch alone. I told the midwives I wanted this. It didn't happen. I wasn't out of it after birth, but I was knackered, in pain and just thought, fine I'll do it at home myself, they have a lot on their minds; it's cool. I got Aurora latched on. I didn't check any diagrams, she just did it. The midwives checked a few times and were really impressed at how she was getting on. Sweet, this is piss-easy, I'm going to be great at this. Tit.

The pain started that night when I was still in the hospital. I was checked on by a few different midwives, all of whom had their own advice on the best position for Aurora and me to be in when BF. One nurse said something about making sure I was getting it right because the nipple could shear off in certain circumstances... er, thanks. I gave birth on the Wednesday and had to stay in overnight so Aurora's blood sugar could be checked, as I developed gestational diabetes. On Thursday evening I was allowed home. This is where the fun began. I think. That time is all a bit of a blur now. All I remember for the first few days is my dad making me a fish-finger sandwich (which I don't think he's ever done in his life, he's just not a fish-finger sandwich type of man... it's weird). It was lovely, well it would have been if it was not stone cold by the time I got to it. The first of many cold meals, I'm used to it now. I remember the first midwife visit and her delight in how well I was breastfeeding, even though I told her it was really sore. It's normal. It will pass. Well done. By Saturday morning however, it was too much. they weren't just sore. They were excruciating. Bleeding. Cracked. Stressed. Crying (Aurora and me). Screaming. Exhaustion. Welcome to breastfeeding.

I'm not a wimp. I don't have a low pain threshold. I had told my husband and my mum (my birth partners) that at most I wanted gas and air during labour. No epidural or other pain relief. I barely touched the Entonox, and just had a local anaesthetic for the episiotomy: I can handle pain. I couldn't handle this. I didn't want to feed Aurora. I wasn't getting that super-duper special bond that is supposed to come with BF. Aurora was latching on fine, just not getting what she wanted. At 4 in the morning on Saturday, I cracked. My husband drove to a 24 hour supermarket and got some formula, while I checked how to sterilise and make up a bottle.

I gave Aurora 75 mL because I knew no better, and she guzzled it, burped and then went to sleep. When I told the next midwife on the second visit (the day after) she said that amount was too much to have given her. No, it wasn't. I think this is what's called mother's instinct. I wasn't gently encouraging her to 'clear the plate'. I wasn't forcing it down her throat: she had what she wanted, what she needed. The midwife did say leave it for 24 hours so I could heal a bit and try to BF again. I did. It didn't work. My milk came in and I was carrying around a couple of leaking boulders. Even though I was full to bursting, Aurora was still not satisfied. The midwife had noted her strong suck when checking her feeding, it just wasn't coming out fast enough for my greedy (read: hungry) little monkey. I persevered though. But not for long.

It gradually got worse and worse. A slight shooting pain every time Aurora latched on. I had noticed a tiny white lump on my right nipple, thought nothing of it. It must be normal, right? The slight shooting pain turned into an immense shooting pain, every time Aurora latched on. It went down my arm, up my neck, into my back; it KILLED me. But it only lasted moments and then it felt fine… until the soreness kicked in again. After a week or so I Googled it: it was a 'bleb', or a milk blister. No one had mentioned these in the breastfeeding session of the antenatal classes. The midwife hadn't mentioned them. I'd never heard of them. It was the thing that was now making me use the bottle more often to feed Aurora. Finally, I gave up. I reasoned that I had tried; she had taken the colostrum and a fair bit of milk. I'd done OK, hadn't I...?

For about a week and a half my husband and I were exclusively formula feeding. Which is nice, Nik had a chance to get involved, along with all the rellies and visitors... nice. Yeah! It was nice. No. It was easier, sure, but now the guilt and disappointment in myself for giving up so easily kicked in. I could blame it on the hormones still occupying the rational part of my head, but now I was crying over not breastfeeding at all. 

Everyone can get involved, even in erm... *whispers* Pizza Hut.
So, what to do? I had to sort the bleb out. I couldn't even consider attempting to start again with the pain it caused every time Aurora latched on: Dr Google to the rescue. I vaguely remember an episode of Doogie Howser M.D., where Doogie pierces his own ear. The advice to remove a bleb is similar to the technique Doogie used to pierce his ear (don't try this at home, kids). I followed the guidance, super carefully, and sorted the bleb out. I also looked into getting an electric breast-pump. After reading through many reviews, I opted for the Medela Swing, and my husband and I went halves. BEST. THING. EVER. 

I started using it straight away and was initially disappointed at the amount of milk I was producing (about 25 ml from both breasts), but then I hadn't been BF for a week or so, and it’s all about supply and demand. I also felt a little bit relieved that I had gone over to formula feeding, as the rate the milk came out was probably part of the reason Aurora was left unsatisfied after hours, and I mean hours, on the breast. I really don't think she was getting enough, as fast as she wanted, when I was BF. 

At the same time as using the breast-pump, I attempted to try and get Aurora back on the breast. I'd read about nipple confusion in babies who had gone over to the bottle, or had been bottle feed from birth, where they can't breastfeed because of the difference between teats and nipples. I had to think tactically: if I catch her when she's sleepy or not expecting it, would she latch on? I could only try. I gave it a go at night time, just before bed, in a calm and quite space, and it worked. She may have latched on fine when she was fully awake anyway, I don't know, but she was using me as a human dummy, I didn't care! Plus, it wasn't hurting. Removing the bleb had worked too! What I also did when getting Aurora to latch on was make encouraging sounds and praised her every time she managed it. It didn't hurt.

It's been about eight weeks since I started combination feeding, and I couldn't be happier. Aurora has formula bottles during the day and one at night, I am producing about 70ml a day through expressing, she is breastfeeding at least once or twice a day, and other people can get involved with her feeding - giving me a break sometimes. I have also successfully breastfeed in public, several times, had an argument about why BF in public is not 'indecent exposure', albeit on twitter, and posted a breastfeeding selfie. But reading back this long post, I might leave all that for another time. 

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