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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.

Do You Know This Man?

8 Apr

This one…

Well, yesterday, I didn’t.

The morning started off fairly normally. I was feeling a bit queasy, but a quick Google search revealed that hCG levels (the evil hormone that makes baby grow and Mum feel ralphy) climb again at about week 27. Hello, textbook pregnancy!

It was such a gorgeous day out – I was really looking forward to heading out to the top of the hill, and giving the dog a good walk. And with a view like this, who could blame me?

Upon returning to the car, I felt a bit detached from myself. I moved my arm across the steering wheel and made myself jump, as if I wasn’t expecting it there. My eyeballs were crackling, like I was struggling between the bright heat of the sunshine and the dark coolness of inside the car. I figured I was just a bit tired and hadn’t been drinking enough, got home ok, and started catching up on my Google Reader. Midway through commenting on a great post about celebrating our bodies – sorry Katie, I never finished the comment! – everything just went really, really fuzzy.

I sat still for a while, just staring at the wall. I have a recurring issue with pins and needles down my right side every few months or so, and so this started and my tongue went numb. I had a play on Twitter – maybe 140 characters would be easier to process! Yes, I have social media addiction issues. No such luck. I spent the remainder of the time until Patrick got home trying to understand why the word “afford” kept on giving me red squiggly lines every time I tried to include the letter p.

Patrick called NHS Direct and they rather alarmed us by insisting that they send an ambulance. In the meantime, I decided to try reading something again and picked up a magazine with Daniel Craig on the cover. When I read his name, it just didn’t sound right. I knew who he was – his name was right on the tip of my tongue, but I was certain that Daniel Craig wasn’t it.

The paramedics arrived and ran all sorts of tests – blood pressure, following things with my eyes, and pushing their hands up and down with mine. When Patrick gave them his name, that didn’t seem quite right, either. No major issues were found, and I had already started to feel less brain-dead, but as I’m a big fat pregnant lady and my blood pressure was slightly elevated (what can I say? I get Event Horizon flashes every time they put the cuff on) I had to go and see the doctor today.

Despite looking about fifteen, and wearing an outfit that proudly proclaimed that she was now in Sixth Form and wouldn’t be wearing uniform any longer, the doctor I saw today was absolutely lovely and seemed very proficient. I feel myself slipping into that godawful “nobody who has not given birth can possibly know anything about anything” attitude from time to time, and need to really, really check myself to make sure that doesn’t progress any further!

My blood pressure had come back to normal, and other pre-eclampsia tests came back clear. Pre-eclampsia was a bit of a concern for me, as the idea of bed rest for the next three months sounds like *hell*, and I had learnt, forgotten and re-learnt that my Mum had been a sufferer during her first pregnancy. I always remember the story of her having to switch to black coffee instead of Tab (retro!) because she didn’t like it that much, so it’d force her to cut back her caffeine intake. She’s now a ten-cup a-day lady! Pre-eclampsia could still happen, I guess, but every week that progresses before it does is a bonus. I love few things more than snoozing in front of the TV, but I spent three weeks doing that in 2009 and too much of a good thing is possible.

The official diagnosis is… Unsure. It could have been a migraine; it could have been dehydration; it could have been nothing at all! All I know is that I’m going to up my water intake and dial back my work a bit. I’ve been really reluctant to hand over my tasks to my colleagues, but it’s going to have to happen. In the meantime, I’m going to have to spend more time with my baby girl and enjoy some of this beautiful sunshine.

A Year Ago, Part Two

6 Oct
Carrying on from A Year Ago, Part One

The doctors decided that they were going to sedate rather than anaesthetise me – I’ve had a few operations before, but this was something new! The doctors told me that they’d probably have to intubate, just to be safe, and honestly I was quite scared. I have a horribly sensitive gag reflex – it’s a standing joke that when I see things like bird or dog poo, or – thanks to living in studenty areas – the occasional pavement pizza, I struggle to keep my breakfast down.

I can only compare the procedure experience to some kind of Beatles music video – everything was pink and floaty, with lots of voices murmuring as if they were underwater. There was a lot of tugging at my face, and I remember them struggling to replace the drip and stabbing me repeatedly in the foot!

I came to in intensive care – while I’d been under, they’d struggled to get the tube down my throat, and had to perform an emergency tracheotomy. I am not certain if it’s a reaction to sedatives, but I’ve always found waking up from surgery a distressing experience. I feel like all I want to do is cry and cry – and bless the poor nurses having to deal with me threatening to sign an AMA (discharge against medical advice) form if they didn’t let me go. All this while being hooked up to a drip and numerous other devices, with a bit of plastic tubing holding the hole in my throat open, and two bags to collect the products of the surgical drains. What can I say, I’m dramatic when medicated.

Intensive care really lives up to its name. Anyone who thinks that we’re hard done by with the NHS, think again – I’m talking at least one nurse per person, the whole time. My parents and Patrick were so impressed by the nurses – not only did they provide excellent care, but they kept everyone fully informed and just made the whole experience less crappy. The original plan was to keep me in intensive care for at least three days, but I was moved to a regular Ear, Nose and Throat ward after just one. All these years that I’ve spent being pissed off at my body, hating flabby belly and dimpled thighs, and it turns out that it’s absolutely state-of-the-art when it comes to what really matters – keeping me alive and healthy.

I spent a further four days in the ward, but it felt like so much longer. My tube came out, and taking that first breath through my mouth again was the strangest feeling. If you start to swallow, try to take a breath in, and release the swallow to let the breath in, you’ll feel something similar.

The weirdest thing of all was my complete loss of the ability to taste basic flavours. Patrick brought me Marmite sandwiches and marshmallows – I still couldn’t open my mouth very wide, so I had to rip the marshmallows into small pieces to fit them into my mouth. Unfortunately, the marshmallows tasted of nothing but egg, and the sandwiches, well, nothing. I lost a stone and a half over the whole experience, simply due to getting bored of eating! It almost makes me wish that my sense of taste was something I could switch on and off – hovering at a post-wedding comfort weight of 195 lbs is not something I want to do for long.

Before they let me go home, they had to remove the surgical drains. Surgical drains are little bits of thin plastic, almost like an inch-long drinking straw flattened out, that they stitch in place at the site of infection, to encourage the pus (I warned you, didn’t I?) to drain out of your body. They attached really attractive bags to collect what came out, as can be seen in this delightful picture:

I carried on with the Lucozade after I came off the drip, in an effort to get some calories in while I wasn’t eating, and Patrick was horrified to notice one of the bags filling with an orange liquid. It turned out that, due to logistical complications, whatever was in my mouth was seeping out through the holes under my chin! Rather disgustingly, once the drains came out, I was able to squirt water from the holes. It would’ve been a great party trick, but alas! I am all healed up now.

Speaking of the drain removal – what an ordeal! The first came out fine, a junior doctor with far too much make-up snipped away all the stitches and pulled. The second one… Less so. She snipped the stitches and started to pull… And pull… And pull. Owwwww! You know the hideous scene from The Grudge (later parodied in some kind of Scary Movie) when the girl without a lower jaw appears? That’s what I was thinking about. I was thinking that this Doogette Howser in false lashes and inch-thick foundation is about to rip my frickin’ jaw out.

Thankfully I kicked up a bit of a fuss, because when a lovely nurse came to give it a try, she noticed an additional stitch that was still attached, and managed to sort it out. If that dreadful woman had continued pulling, I dread to think of the damage that could’ve been done. Maybe not as bad as this…

But still.

The nurses were awesome. Most were West African, a few were Eastern European, and fewer were English. I guess the X Factor generation thinks that nursing isn’t glamourous enough, but really, what job is? To be as chipper and hard-working as those ladies were every day, in the face of so much sickness – not all of which is going to get any better – is pretty darn cool. There could be improvements to the banter – being told “free wax on the NHS” every time I had my bandages changed began to grate the more sensitive my poor skin became!

I took a further three weeks off work after coming home, and Patrick was just so good to me – keeping on top of the housework, buying me grapes that I would slice in half to eat (my jaw flexibility took some time to recover) and letting me take the best position of the sofa so that I could sleep with my torso upright. I honestly don’t know what I would have done without him. If we were testing out the “in sickness and in health” vow in advance, he’d have passed with flying colours.

A strange thing about the healing process – they don’t actually stitch up the tracheotomy site once they’ve taken out the tube; they just let the skin sit back together and heal itself. The skin on top of the site is quite thin, and I can feel the ridges of my trachea more clearly than at other points on my neck. That may sound weird, but I’m a bit of a geek when it comes to that sort of thing – I am fascinated by how we work. If it weren’t for the pay, the hours and the six years of university, I’d have loved to be a doctor!

So, fast-forward to today. I have scars, but I’m amazed at how proud of them I am; how little I wanted them covered up on my wedding day. I am a non-smoker, and I honestly never thought I’d be able to say that. There’s nothing quite like a morphine clicker to get you through nicotine cravings! Patrick is a non-smoker, too, so not only do I have the gift of life, but I have the gift of him by my side. 

I thank God for my sister-in-law – at what stage would most of us call for an ambulance for ourselves? I’d feel so foolish unless I could see blood. There’s some nerve damage on the left-hand side of my face, and for a few months, the bone could be seen where the drain had been. All in all, I’ve been so lucky.

A Year Ago, Part One

29 Sep
I know that I should be writing up my wedding about now, but I thought I’d deal with the ugly before I got started with the pretty. I must apologise to the squeamish, as I’m not holding back on the gory details.

On 7 August 2009, exactly one year before our wedding day, I was recovering at home from a wisdom tooth extraction. It had started off pretty normally for dental work – sleepy, swollen and making the most of the pretty, pink ibuprofen pills I’d been given. The extraction itself had been quite unpleasant, with the rude dentist actually yelling at me to open my mouth wider, and telling me not to be so stupid when I said I felt a sharp jab during the procedure, but it had been nice and quick, so I just grumbled to myself that thank heavens that was the last tooth that needed to be removed.

I’d summoned up the strength to walk to the tube station with Patrick, thinking that the fresh air and a bottle of Lucozade would make me feel better. Due to my inability to swallow, I hadn’t been able to eat – nor barely drink – anything except for a plate of gnocchi the evening of the extraction, so I was starting to go a little crazy! I made it to the station, but took 30 minutes to walk the half mile back to our flat.

The swallowing thing began to get worse – I had to go to the bathroom every twenty minutes to spit out the saliva that gathered in my mouth. As I hadn’t spoken since Wednesday night, I sent the dentist a slightly frantic email (specifying my inability to speak) with the general message of “is this normal?”. No response. I forwarded the message again, with “Please can someone contact me. I’m starting to get really worried.” Yeah – I’m really embarrassed about that now! They then started to call me – clever.

I decided enough was enough and texted my sister-in-law, asking her to take me to the hospital. She drove me to St George’s, Tooting, where I used my handy notepad to explain my situation. An older couple sat opposite us were drinking delicious-looking bottled water and eating sweets, and just watching them actually made me cry – I was so thirsty and weak. I was sent to Radiology for an x-ray – I feel like a bit of a regular there, what with Patrick and his rugby injuries – and they tried to fit my swollen, Coulthardesque face into the machine, but to no avail.

They put in a drip to rehydrate me, but had a little trouble getting it in place, causing my sister-in-law to come over all queasy at the sight of my blood. The doctor came out and explained that the swelling was down to an infection, and that they were going to put in some drains to clear it out. Patrick arrived just in time to give me a last kiss before I headed off into surgery.

Today’s photo – a pic of all the girlies at my hen do in April – a fab weekend!!

Coming up…

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