Archive | December, 2011

In Which Becca Discusses Boobs, Again

18 Dec

Breastfeeding – it’s a contentious topic, and rarely boils down to a simple choice of “breast or bottle?”. It’s an issue that can attract sneers; ultimate female bonding; and a good deal of humour. Here’s how it happened for us.

After Barney was born, I was just desperate to take him home, but needed to show that I could feed before I was allowed. The nurses just force your nipple into the baby’s mouth – a great way to encourage nipple rejection, but not particularly effective in encouraging feeding. Unfortunately, it seems to be a side effect of the government’s targets to increase the number of breastfed babies. Hmm… Someone needs to tell them about that!

Despite pursing his lips most of the time, he managed to get a 20 minute feed, and I manually expressed some milk and fed it to him using a syringe. We were free!

The first night, he was so quiet – we just figured he was exhausted from the ordeal of labour. We fed him small syringes of manually expressed colostrum and thought things were going fine. Then the midwife showed up for her surprise, unannounced check-up.

Unfortunately, my usual midwife had gone on holiday and the other one in the area came along. I’m sure that she’s a perfectly nice person, but I will always associate her with this time. She said that he was malnourished and dehydrated, and that the oh-so-cute hand shaking thing he was doing was actually a sign of low blood sugar.

Fuck. Talk about a punch in the throat. There are thousands of people who really shouldn’t have children, but who do. We became those people. We had failed to look after our baby. She said that if we didn’t get his weight up by the end of the week, he’d have to be readmitted. I felt so awful. We ended up heading to Tesco (eek!) to buy formula (double eek!). We broke out the bottles we had bought “just in case” and he started to feed like a dream. Poor, dear, hungry little boy. Thank God, by Friday he was just about in the safe weight zone.

I began pumping with the occasional-use electric Medela pump we had inherited from Patrick’s cousin’s wife, and feeding him using the bottle. I don’t remember very much about the frequency of my attempts at feeding, but every time I tried, he would either purse his lips and turn his head away or take it in his mouth and cause blinding pain from not being latched on correctly. I called the breastfeeding consultant from our antenatal classes, and the phrase “chocolate teapot” truly made sense to me. I almost feel like you shouldn’t be permitted to do that job unless you have been through some kind of personal connection to feeding issues. I felt like she had breastfed her own children perfectly easily, and then just taken a course on the issues. She wasn’t able to offer any advice except “keep trying”.

The breastpump simply wasn’t adequate for full time, and the morning after falling asleep while pumping and spilling milk all over one of the motors, I called my Dad. He had been waiting to hear what “new parent” gift to buy, and was slightly bemused but glad to learn that a good quality, daily-use breast pump would be extremely gratefully received. It certainly made the process more comfortable and efficient. I even treated myself to a Pumpease bra, so that I could easily work, do laundry, etc while pumping.

His feeding wasn’t perfect, and I still longed to breastfeed. The more I read and heard about tongue ties, the more it seemed to me that that was the problem. He dribbled his milk excessively from the bottle, he chewed me to pieces, and he suffered from trapped wind. I told the midwife, who said that she’d refer me to the tongue tie specialist. Nothing happened. I spoke to the doctor – still nothing. I attended the health visitor clinic in tears and she phoned the specialist then and there – he was seen the next day. This was early August by the time I was able to get the help I needed. The doctor was brilliant – the process was quick and easy – and like so many medical professionals I have spoken to, expressed her dismay at the bad science thrown around with regard to breastfeeding. She particularly noted that beyond the colostrum stage, there was very little additional benefit to the baby from breastfeeding, and that most of the statistics ignored the correlating factors that influence a person’s health, like parents smoking, later parenting choices and the baby being born with illnesses.

He latched on almost immediately after the procedure! It was incredible – I felt so happy and proud. Unfortunately, an ulcer formed on the snip site, and he began to chew my nipples again.

A few weeks after his tongue tie was snipped, I felt a blocked duct in the other breast. I began expressing religiously in order to clear it. I wound up with something pretty hideous – a nipple blister. It was truly one of those “how spectacular and yet gross is the human body?” moments. Thankfully, the qualities of breastmilk are such that anything awful that happens to your nipples heals itself pretty darn quickly.

We made the decision around this point that I would stop expressing. Barney had had only breast milk for the first three months of his life (except for those first days), and the time that I spent hooked up to a machine was time that I wasn’t cuddling and playing with him. We decided that I could be a “better mother” by feeding him formula and giving him those extra four hours a day of attention, face to face.

The lump didn’t shift. I was on the lookout for the next symptoms of mastitis – flu symptoms – but they didn’t come. I saw a nurse, who didn’t check me over, but gave me a course of antibiotics. Halfway through the course, Barney started latching on and feeding properly! It was a dream come true, but every time he punched me in the boob, I was in agony. A Friday night Google search led me to a site that compared blocked ducts, mastitis and breast abscesses, and all the detail pointed to the latter. We made the decision to go to A&E.

We were early enough to beat the Friday night drunks, so we were seen quickly. The doctor was blasé. He said that it was definitely an abscess, and that he would book me into see the surgical assessment team on Monday. He said that it would possibly burst, but that I could manage it with gauzes and dressings that he would give me to take away. I asked about scarring, and he said “well, none of us are going to be wearing bikinis any time soon”. In my hospital-induced befuddlement, I just took that. A more together me would have been furious! What right does he have to decide who needs to avoid scarring and who doesn’t? He then went to speak to the registrar, who told him to aspirate the abscess.

That was the single most painful experience of my life. I can only compare it to having an enormous, deep and painful spot being squeezed. I told Patrick not to look – I hated the idea of him seeing something so repulsive happening to his wife’s body! He didn’t listen, but thankfully as a proper grown-up, he can handle such things. I married extremely well.

I was then bandaged up and sent home until Monday. Over the weekend, it had refilled, and I saw someone at the emergency clinic. Unfortunately, he was a doctor, so he wasn’t particularly interested in cleaning me up or replacing my dressings. He reluctantly provided me with the things I needed, and just sat there as I changed them myself. I made what I now feel to be an error, and used an alcohol swab to clean the wound. More agony. I was thinking “disinfect”, when what I probably did was kill off more skin cells.

On Monday, I was taken to the breast centre, which is the most efficiently- and thoughtfully-run department I have ever encountered. They performed a scan to identify the depth of the abscess, and learnt that it was dumbbell-shaped – a pocket at the surface linked to a larger pocket of infection underneath. Because of this, it was necessary to operate under general anaesthetic to remove the abscess. The surgeon was female – I don’t know if that made a difference, but there was more of an understanding for my desire to preserve some aesthetic than there had been with the A&E doctor. It certainly shouldn’t be that way, but it was.

I stayed overnight, expressing to ensure that no further blockages arose. The wound, which was stitched up, opened. I haven’t encountered anything more scary than seeing a dark, open hole in my body. I am not a beautiful girl; certainly not bikini-ready, but the idea of looking like someone who has had botched plastic surgery was so upsetting. Once again, the breast clinic staff were incredible. The were reassuring and comforting, and I was referred to a tissue viability specialist, who confirmed that the cellulitis that had caused the surface damage was now clear. She worked out a programme involving surgical-grade honey and seaweed packing – and leaving the wound open – to try and minimise the damage. The reason that they left the wound open was so that any remnants of the infection (which had been thoroughly removed underneath) could get out. Apparently, this results in a smoother scar, while full closure could result in rippling of the stitch line. They also told me that I could come back to see a plastic surgeon if I felt unhappy with the scar.

My milk production had been hit hard by being ill and stressed – and, I should imagine, a section of breast tissue having died. I gradually began a process of building it up again. I couldn’t bear to go back to expressing. It wasn’t awful while I did it, but once I stopped, it became awful, if that makes sense.

Kellymom and just about every breastfeeding resource provides a good deal of advice on how to boost your supply. Pumping between feeds is one of them – something we had already decided was not beneficial to the family. Feeding regularly is another – this was something I was able to do during the day, but as Barney had started sleeping through the night from that Friday in A&E, it seemed absurd to wake him for a feed that had now seemed to become all about me and nothing about him.

Not supplementing with formula is a big rule of theirs. I will never understand how anyone who has tried this can – in their right non-prolactin-addled mind – recommend it. A hungry, crying baby is a soul-destroying thing, and to deny a baby food (yes, he’s at the breast, but nothing is coming out) just does not make sense, for the baby or for the rest of the family.

Over the course of a few weeks, I managed to get to the stage where I was feeding myself for 6/7 of the 8 feeds he had a day. I felt so proud – I was winning! – but I was exhausted. He was waking up two or three times in the night because he just wasn’t getting enough food during the day. He began to get more interested in his surroundings than feeding. The experts recommend feeding in a quiet space, but he seemed to be distracted by me more than anything. Some feeds would go “suck suck suck… Smile for ten seconds” on repeat. That was absolutely heart-melting, but not good for feeding. He would be hungry again thirty minutes later, but my boobs had been given the “no thanks, no milk needed here!” message and began to slow down.

It was at this stage I had a hormone-related brain fart. I convinced myself that I had just let pumping slip. I literally could not remember the reasons why we’d decided that I should stop! I became convinced that I was just lazy, that I couldn’t be bothered, and that my baby was going to die of cot death or some other formula-related risk, all because I was a shit mother.

I expressed my self-disgust at being so lazy to Patrick. He was flabbergasted! “Do you honestly not remember? We discussed it at length – we decided that him moving onto formula was the best thing so that you could spend more time with him! It was only after you discovered that he was latching on that you decided to try the breast again!” Oh. Right.

So, there we are. As of now, he is getting one breast feed in the mornings, and a couple in the day if the need arises – I’m engorged; he’s upset and needs comfort, etc. I know that this will result in my milk drying up, and I’m not quite ok with it. I don’t know if that’s because of the hormonal effect, or if it’s my crazy tendency to take mean things that people say online to heart, but I still feel like something has been stolen from me, or that I have thrown something away. I tried to explain it to Patrick – it’s like a vasectomy. I may know that it makes sense, but something important is gone, and once it’s gone, it won’t come back.

Essentially, my six-month-old son has had three months of pure breastmilk (minus days three to five). He had one and a half further months of 75% breastmilk. After that, he had at least two breastfeeds each day. By most people’s standards and the government’s tick-boxes, that’s a breastfed baby, and I believe that our care and attention have and will continue to minimise the risks that are associated with not being breastfed.

The majority of studies will agree with this – I am yet to see one that concludes that the “risks of formula feeding” (a misleading phrase used by every pro-breastfeeding website) are directly attributable to what is being fed. Most acknowledge that correlation does not mean causation, but every single pro-breastfeeding site still uses the statistics as if breastfeeding is some magical elixir that is solely responsible for the reduced incidences of SIDS, diabetes, gastro-intestinal disorders and obesity that breastfed babies encounter.

I hope to exclusively breastfeed any future children we might be lucky enough to have. I also hope to spread the word that just because something is natural does not mean that it is easy, and that you have to fight and stomp your feet to get the help that you need if you wish to continue. I support the work of the awesome community at Fearless Formula Feeder, who are all about helping families work out the best way to feed their babies. All any parent really wants is happy, healthy children, and it’s important that they are given the adequate support to try and make that happen.

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