After experiencing baby loss in 2014 I was ecstatic to be pregnant again in summer 2018. I had a relatively smooth pregnancy and I loved knowing that I had a rainbow baby boy growing inside me. When I went into labour, I was excited more than anything and couldn’t wait to meet our son. I knew that I wanted to breastfeed and after a 78 hour labour which ended in an emergency cesarean section, I was more desperate than ever to regain some sense of ownership over my motherhood.
I had no idea at the time that having had a c-section, it might take longer than usual for my milk to come through. I certainly didn't expect it to take five days. I also did not know until months later that the drugs I had been given during my four-day labour had made our tiny newborn baby incredibly sleepy. This meant that he was unable to latch onto my breasts. So, for the first few days of his life, he was fed my painstakingly hand-expressed colostrum via syringe. As I write this, I remember the voice of a particularly brusque midwife chastising me for not feeding my son frequently enough. She was busy and obviously rushed off her feet, but her chiding tone made my newly postpartum eyes swim. I had no clue what I was doing and I needed help.
If you had told me then that I would end up breastfeeding for three years and nine months, I might have gone into labour all over again. The issue for many millennial mothers is that we may be some of the first people within our circle of friends and family to breastfeed. As a consequence, there are huge gaps in the cultural and generational wisdom around us. As a result, when we face breastfeeding challenges, all too often the only recommendation is to stop breastfeeding and, "Just switch to formula."
I believe that there are many occasions when stopping breastfeeding and starting bottle feeding is the best option for a mother and her child - but what if it is not for you? What if you simply need some help to get over the temporary hurdle(s) that you are facing? This article outlines the greatest and most common challenges facing new mothers today and how to navigate them. Breastfeeding can be an incredibly rewarding and empowering experience and it is my belief that every parent deserves support to breastfeed on their own terms, for as long as they choose.
Latching Problems and Pain
If you are experience pain as a breastfeeding mother, it is important to seek advice from a lactation professional as soon as possible. An IBCLC is the only medical professional with over 1000 hours of experience of supporting nursing mothers and so they really are experts when it comes to lactation. Many IBCLCs offer virtual support too if you are unable to find one in your local area. Pain whilst breastfeeding could indicate a number of issues, including: lip or tongue tie; a shallow latch; thrush; clogged ducts or mastitis. These are issues which will not resolve themselves without intervention and so seeking professional help and advice is crucial.
A deep, comfortable latch is an effective one and it is essential for establishing and maintaining your supply. An effective latch allows your baby to remove milk from your breasts efficiently and pain-free. In turn, this signals to your mammary glands to produce sufficient amounts of milk. Some babies latch onto their mother’s breasts immediately with little or no support, but this is not the case for the majority of families. Whilst breastfeeding is natural, it is not necessarily easy and many nursing mothers require support in the early days to help them and their babies learn how to get a deep, comfortable latch.
My top tips for achieving an effective latch are:
• To spend the first ‘golden hour,’ or so immediately after birth skin to skin with your baby.
• To pay attention to hunger cues such as rooting, putting their fists in their mouth, opening their mouth and sticking out their tongue.
• Once your baby is hungry, position yourself comfortably first and then bring them to your breast, rather than the other way around.
• Once seated or lying comfortably, line your baby’s nose up with your nipple and wait for them to open their mouth wide.
• Your baby must not be able to move their head freely and without restriction in order to do this.
• If your baby does not do this, express a little breast milk onto your nipple for them to smell.
• Alternatively, stroke their cheeks, nose and mouth with your nipple,
• Angle your nipple towards the roof your baby's mouth in order to activate their sucking reflex.
Perceived Supply Issues
Many mothers who stop breastfeeding before they truly want to do so because of a perceived low supply. That is not to say that this is necessarily the case, as many families misinterpret normal nursing behaviours. For instance, it is completely normal for exclusively breastfed babies to cluster feed for hours at a time during the first few weeks and months of their lives. This does not usually indicate a lack of milk. Rather, this behaviour stimulates your breasts to produce more milk during growth spurts. I had no idea, for example that when my son latched onto me around day five postpartum and stayed there for almost a full 24 hours, he was simply doing what he needed to in order to stimulate my milk production. Nursing your little one on demand 24/7 is the best way to ensure that your supply milk is enough to meet their growing needs.
This can be difficult for some parents and their families to accept if they are used to seeing babies being bottle fed on a schedule. It can be concerning not to know exactly how much your baby is getting at each feed, but as long as they are producing enough wet nappies each day and they are gaining weight at the expected rate, there really is nothing to be worried about. Guidance as to how many dirty nappies your baby should be producing in the early days varies slightly around the globe. The NHS recommends that in the first 4-6 weeks your baby should have 6-8 heavy wet nappies and at least 2 dirty nappies with soft runny yellow stools in a 24 hour period (1). If your baby is not producing enough wet or dirty nappies within a 24 hour period, or you are concerned about dehydration or weight gain, speak to your Health Visitor or pediatrician as a matter of urgency.
The Formula Trap
The introduction of formula in the early stages of breastfeeding is preferable and necessary for some families, however, if you want to breastfeed exclusively, it can be problematic. A nursing mother’s breasts produce milk on a supply and demand basis. Therefore, if you skip a feed for bottle of formula, your breasts will produce less milk at a slower rate. That is not an issue if it is what you and your family choose, but it may be if you want to breastfeed exclusively.
Combination feeding is a wonderful option for many families and it can work well if you know that once you introduce a bottle of formula at a certain time of day, your milk supply will decrease accordingly. Similarly, it is important to know that prolactin - the hormone responsible for producing breast milk is produced mostly overnight between midnight and dawn. Therefore any feeds which are swapped for formula overnight could have a greater impact upon your milk supply. It is also worth knowing that breast milk is up to 50% fattier overnight. Armed with this information, you can make empowered choices about the possibility of introducing formula without jeopardizing your breastfeeding goals.
Lack of Support
Another common issue for many mothers is a lack of support from their family and friends. It is my sincere belief that most people want the best for you and your baby, but thanks to a lack of education surrounding lactation, there are many misconceptions around breastfeeding. This can lead to family and friends who support breastfeeding in theory, but who offer unsupportive advice which inadvertently sabotages your nursing journey.
My number one piece of advice for anyone who is struggling to feel unsupported on their nursing journey is to seek community. Whether online or in person, find likeminded nursing mothers who you can confide in and learn from. Thanks to social media there are now thousands of established online villages of breastfeeding mothers and parents. Through community you can build your confidence and improve your breastfeeding education too. Once you are informed to make empowered choices for yourself and your family, you can educate your support system too. This blog post talks more about how to cope with unsupportive, unsolicited advice when breastfeeding.
Nursing in Public
Many new mothers feel anxious about breastfeeding in public. If you do, it may help to know that breastfeeding in public spaces is protected by law across the UK and Ireland as well as in Australia, America, Canada and Taiwan. Breastfeeding is also exempt from indecency laws in each of these countries with the exception of the US (where it is only the case in 33 states). Knowing that the law is on your side when it comes to nursing your little one can be a huge confidence booster.
Another great tip for feeling relaxed whilst nursing in public is to wear clothes that help you to feel confident whilst breastfeeding. Whether you choose nursing-specific clothes or not, you can nurse discreetly by wearing a vest too or bandeau top beneath any other top which can be lifted to nurse. This allows you to do so comfortably and without revealing your chest or stomach. Shirts, wrap tops or dresses and button down tops or cardigans offer easy nursing access too. Scarves and muslin cloths can also provide you with coverage, even if your baby won’t accept one being placed over their head.
Remember that whenever and wherever you nurse your child, you are doing so for their benefit and no-one else’s. Focus on them as you are breastfeeding, counting their tiny fingers and toes as you do so and remember that your breast milk will do more for them than anyone’s opinion ever will.
Returning to Work
There is a common misconception that once you return to work you must stop breastfeeding. However this is not necessarily the case if you and your little one want to continue. Here are my top tips for returning to work as a nursing mom:
1) Be fully present rather than checking your phone for updates from your childcare provider every ten minutes. This is most certainly easier said than done, but it will make your working day go by quicker and easier. Focusing your attention at work will help you to be more productive and it will also stop the day from dragging. Give yourself permission to not feel guilty about being by your little one’s side morning, noon and night. Assuming that you do not have pre-existing supply issues, your supply will regulate so that you can continue to nurse around your working life if you choose to do so.
2) Be prepared to pump or hand express for comfort if you need to, even if you do not want or need to pump for your baby. Any discomfort or engorgement that you may initially experience will ease after a just few days as your milk supply regulates. Remember that emptying your breasts completely will boost your milk supply, so only do this if it is intentional. If you want to pump enough milk for your baby to drink whilst they are away from you, you will need to pump at the times that you would normally breastfeed your baby. Store the milk you express in the fridge for use the next day.
3) A common concern for breastfeeding mothers who return to work is that they will not accept a bottle in their absence. It is true that many babies prefer nursing directly from the breast rather than taking a bottle, but thankfully, babies are incredibly instinctive and will not starve themselves. It is possible that your little one will wait until they are hungrier than usual before accepting a bottle, but eventually it is more than likely that they will. In the event that they do not, they can be fed using a free flow cup, teaspoon or beaker instead.
4) Discuss the process of returning to work with your partner and/or your wider support network. Express any fears, concerns or
excitement that you may have honestly. Ask them about their hopes and concerns. Make a point to review your situation regularly and adjust it as necessary. It could be that a shift in one or both of your working patterns could make life much happier for the whole family. Ifyou have a partner, I recommend that you both keep an open mind about what your work/life balance will look like whilst you have a young family. Get in depth advice to help
You feeling confident returning to work breastfeeding with my 45 page guide, here.
Remember that breastfeeding is a dyad, a two way relationship in which both you and your baby have a voice. You may decide that you would like to breastfeed until your child self weans, or you may be ready to stop nursing well before they do. Whenever you decide to end your breastfeeding journey, I hope that you feel empowered and supported every step of the way.
Order your copy of, 'Self Care: The Breastfeeding Edition,' here: www.thebreastfeedingmentor.com/book or if you are ready to wean your little one off the breast before they want to stop, download my 33 page weaning guide here: www.thebreastfeedingmentor.com/weaning
With love,
Danielle
❤️
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