Wednesday, 15 June 2016

Breastfeeding - the first week.

When people have babies, to the outside world there are lots of beautiful pictures and tales of perfection. We aren't going to lie, having a newborn is pretty amazing! He is just gorgeous, we spend hours on end just staring at his perfection, and neither of us have ever felt a love quite like it. But we wanted people to know that sweetness and cuddles isn't all motherhood entails, so will be posting some stories of the other side of life with a baby! 

Breastfeeding our baby was a given. There was no discussion to be had, no decisions to be made, long before Sarah and I even discussed us creating a family, I knew that when I did have a baby, I would breastfeed. However, what is rarely discussed, is how difficult breastfeeding can be, and how much hard work it requires.

I guess I knew I kind of had a head start - working as a midwife for 10 years meant that I had first hand experience of breastfeeding support, from the importance of skin to skin to that initial latch after birth, the notoriously difficult second night, when all babies want to do is nurse, engorgement problems, low supply, difficult to latch babies - I had been there, done that, and had an answer to every problem. 

When Oskar was born he didn't make a huge effort to feed at all. He had a beautiful, peaceful birth, and went to his Mommy for skin to skin straight away. He came to me as we got in to recovery, and as soon as he looked a little bit interested, I put him to my breast. He had a couple of attempts at suckling but nothing too major, but he was working quite hard to breathe, and was then taken off for antibiotics to be started, so that was the end of that for now.


I was very glad at this point that I had started to express colostrum in pregnancy, and we'd brought it in to hospital with us. The idea behind this was that if Oskar didn't feed straight after birth as we'd hoped, we already had milk for him. I expressed some colostrum with Sarah's help in recovery and we gave him that. He had about 3.5mls in total, the average for a newborn at this stage is about 1ml, so I was relieved and proud that he'd had a decent feed, even if it wasn't strictly "breast feeding".


We were transferred up to the ward a couple of hours later and Sarah had to say goodbye and leave us there. Throughout the night I struggled to get Oskar in and out of his cot, and desperate to not lose our feeding relationship right at the very beginning, I held him skin to skin for most of the night. Occasionally he stirred a little and I offered him the breast, but he was never awake enough to want to feed, so every hour or so I expressed off more colostrum, and anything I got I gave to him. I was so exhausted by about 6am I also used some of the syringes of milk from pregnancy. 

Throughout that first day Oskar was held close to either me or Sarah in skin to skin. He slept all day long, not opening his eyes once, so every couple of hours we continued to syringe more colostrum in to his mouth, and he gladly swallowed it. Into the next night this is how we continued - he slept, I expressed, we syringe fed. I knew he was getting an OK amount of milk, and I knew at some point he would be alert enough to feed from me, so we just continued on. Even if secretly my heart was breaking a little that even that dreaded 2nd night experience, the one where I prepared for a feedathon and absolutely no sleep, just didn't happen for us. 

On day 2 the paediatrician thought Oskar looked jaundiced. The midwife "caring" for us told me it was because he had yet to breastfeed, so I needed to give him formula. I cried. And cried and cried and cried. I was doing my best for him - I wasn't allowing myself to sleep for more than an hour at a time so that I could wake up and express off more millilitres of precious colostrum. I was devastated that my best wasn't good enough. The midwife told me not to cry, because I needed to focus on my baby. She handed me a bottle and teat, and told me the infant feeding support midwife would be along shortly. I didn't give him that bottle. I got up, went in the shower, and told myself I could do this. We could do this. I decided to try and express as much as I possible could, as the milk was really started to flow from me, and asked for a feeding cup to express in to. The infant feeding support midwife was wonderful. She told me not to give him any formula, and congratulated me on him only having my milk thus far, despite his sleepiness. She congratulated Sarah for her support of me, as so many partners would at his point have agreed that formula was the way to go. And she gave me a Medela breast pump to try.


I got 5mls of liquid gold that first time, and my god I was so proud! We poured it in to a cup and offered it to Oskar. Unlike the syringe, Oskar had to work a little harder for the milk from a cup, as he needed to use his tongue to lap it up, but he took the milk Sarah offered to him. We discussed the plan for the day with the midwife - express every 2-3 hours, and give to Oskar via syringe or cup depending on how much we had. If he looked alert enough, breastfeed on top. We spent the whole day like this - skin to skin, expressing, cup feeding. At the end of the day Sarah had to go home again, but just before she left, our beautiful boy opened his eyes! I am not exaggerating when I say this was the first time - he had literally slept from birth. But he opened his eyes and looked straight at her, and stayed awake and alert enough for her not only cup feed him a decent amount of milk, but for me to then put him to the breast. He latched on after a few minutes, and fed from me for around 10 minutes. My nipples felt like he was trying to saw them off, but he was feeding, so I didn't care! 

Day 3 and Oskar finally got the all clear to come off antibiotics and for us to go home providing his latest round of blood results came back ok. More sleepiness, more expressing, more cup feeding, but we were going home. By this point I was getting around 10mls of colostrum each time I pumped, and whilst this isn't a lot of milk in terms of a formula feed, I knew that colostrum was packed full of sugar and fats, and this tiny amount would be enough to keep him going. 

Our first night at home. Sarah and I agreed that I would just breastfeed him, every time he looked alert enough to feed I would just offer him the breast, over and over again. I didn't have a pump at home, but I knew I could hand express if I needed to, and we had brought the cup home too. But once 10pm rolled around and we were all preparing for some much needed sleep, Oskar woke up, rooting. After some perseverance I got him to latch on to my breast, and sat there gritting my teeth as again it felt as though he was cutting through my nipple. I knew from experience that this kind of pain meant an incorrect latch, but he was feeding, and as painful as it was, I just wanted so much to breastfeed him that I let him carry on. Throughout the night we went from one side to the other. I found that feeding him under my arm like a rugby ball put less pressure on my very painful c-section scar. In the morning I was so proud that despite the pain, we had managed a night of plenty of breastfeeds and no cup, I felt like we were getting somewhere. 

Day 4. Our first day at home. Oskar slept for most of the morning, and we let him. We had been reminded to feed him on demand, and as he wasn't demanding, we didn't feed him. At lunch time he had a short 5 minute feed, but he seemed to be struggling to latch on, as my breast were so engorged from the fact my milk had come in. The midwife came to visit and commented on how jaundiced he looked, but as per the plan from the paediatrician was happy for us to leave checking his blood levels again until the following day. She suggested I express off the milk whenever I was able, and give him cup feeds if I couldn't get him on the breast. The only problem being we didn't have a breast pump. We had planned to get one eventually as always planned for me to express and Sarah to feed him on occasion, but we'd never got round to buying one as presumed we wouldn't need it for the first few weeks. A quick text to a few friends later and we were offered two - one manual one that day and an electric one similar to that I used in the hospital the following day. We accepted both! The manual pump arrived with a huge box of cakes and a card a couple of hours later, and I expressed off some milk for our sleepy boy. This time I got around 70mls of milk - it was clear my milk had changed from colostrum to full milk due to the huge increase in volume and the change from yellow to white. We decided at this point to give Oskar a bottle; he needed to get some milk in to him and was far too sleepy to attempt to breastfeed. We had bought special bottles from Medela, a company who specialise in trying to help women to breastfeed, so Sarah tried him with one of those and whilst still very reluctant to feed at all, managed to get some milk in to him. We used Medela Calma teats, which are ideal in switching from breast to bottle and back again. 

We continued this for the next 24 hours, taking us in to day 5. He fed occasionally from the breast overnight but I really struggled to get him to latch at all, and when he did the pain was becoming almost unbearable. It's times like this I am grateful for my high pain threshold but even I was getting to the stage of not being able to bear it any more. The breast pump wasn't helping much either, it too felt like it was tearing off my nipples. If I'm honest, around 4am, exhausted, emotional and in pain, the option of formula feeding him now entered my mind. We had two small bottles of "in an emergency" formula milk in the cupboard, and the desire to not have to put this hungry mouth to my breast anymore almost took over. But I handed him to Sarah, made a cup of tea for us both and tried to get some perspective. I could do this. We could do this. Sarah reminded me of the advice not to give up on a bad day, as you would surely regret it in the morning. She reminded me of how much I want to breastfeed him. She told me she believed in me. We all got some sleep.

The following morning the midwife came to see us again. First of all she performed the bilirubin test to check on his jaundice levels, although the results wouldn't come back until later in the day. Then she weighed him - weight 3080g. Birth weight 3500g. Babies are "allowed" to lose up to 10% of their weight. Oskar had lost 12%. Readmission to hospital was advised. We decided to await the outcome of his bilirubin test before making a decision on going back to hospital, as we strongly felt that being back on a noisy, hot cramped ward would not be the place to establish feeding of any kind. I cried so much. I had tried so very hard to do the best for our son. I wanted to breastfeed more than anything else, and yet he had lost so much weight by 'only' having my expressed milk that we were now facing an admission to hospital to correct it. We needed to get more milk in to him. I needed to be able to get him on the breast more, and I needed to express more milk.

My parents were here at this point, and asked if there was anything they could do to help. No mention of formula from them either - although we all knew at this point it may have been an easy solution to the problem, it remained the elephant in the room, they knew just how important to me him having my milk was. I asked them instead to go to the nearest Boots and buy some nipple shields from good old Medela! Nipple shields are contoversial in the breastfeeding world - they can reduce supply, they can stop babies latching properly. But currently my baby wasnt latching at all, so it was better than nothing. They bought them, we tried them, and on he went! And fed for around 45 minutes.

Throughout the day Oskar got more and more sleepy. It wasn't a surprise then that the bilirubin result came back above the line for phototherapy, so they suggested again that we were readmitted to hospital, and we agreed. It was almost a relief in a way, given that we were now struggling to get him to wake up enough for a breast or bottle feed. Jaundice makes babies very sleepy, and yet they need to feed in order to poo and clear the jaundice out of their system.

We got to the hospital about 10pm, and were met by a lovely midwife who hugged us both and made us a cup of tea. She told us how amazingly we had done, and reassured us that it only takes 24 hours of not really feeding for babies to lose that much weight, and with the jaundice too, and the resultant sleepiness, it was no wonder Oskar needed a bit more help. She reassured us that this had happened despite us doing our absolute best for him, not because of. Oskar was commenced on phototherapy and we were given a strict feeding plan - express with the hospital grade electric pump every 3 hours, plus breastfeed whenever Oskar wanted. He needed to be taking in 50mls of milk every 3 hours, and if I wasnt able to get enough breastmilk then formula was strongly recommended. The first time I pumped I got 65mls, and each time following that I met his requirement. So again we managed for Oskar to only have breastmilk. Still one of my proudest achievements.

The next 36 hours or so passed by in a blur of 3 hourly pumping and Sarah bottle feeding it to him as I pumped more. I offerred him the breast at every opportunity. With the nipple shields he got better at latching, and whilst I was still in a ridiculous amount of pain at each feed, he was feeding more and more, so I was able to relax, and with it my mik was able to flow.

On Saturday morning, at a week old, he was weighed again. He had gained 100g (3.5oz). We had done it. He had turned a corner and was starting to regain some of the weight he had lost. And with it, and the bilirubin in his blood starting to come down, he became more and more alert. We were able to begin to see his beautiful eyes more, and he had more time of just lying awake, watching us, following our faces. A week old, and despite the most difficult of starts for our little man, he was beginning to get better. I knew that my determination to only give him breastmilk was almost an obsession at times, but it was the biggest thing I could do for him. I couldn't clear the jaundice, I couldn't stop an infection if he had one, but I could give him the very best food to help him on his journey. And with the incredible support of my wife, and awful lot of tears and rather a few sleepless nights, we had managed it, Oskar was seven days old and exclusively fed on breast milk. Although we are still struggling with getting him to latch, we definitely feel that breastfeeding is possible, whereas a few days ago we were seriously doubting that! 

We want anyone struggling with breastfeeding to know, you are not alone, and you have not failed. The guilt of not being able to provide the best for your baby can be awful, but there is help and advice out there. The 'best' for your baby is a fed and happy baby, with a happy, peaceful mum. An NHS survey stating that 81% of women aim to try breastfeeding their baby, and 69% breastfeed at birth. However after one week this number drops to 49%, and after six weeks, to 23%. 1% are still exclusively breastfeeding after six months.

We plan to visit our local breastfeeding support group on Friday, and aim to utilise as much of the support available as possible. Breast feeding mamas, we salute you - it is no easy feat! More to follow as we work through week two....


1 comment:

  1. Wow!!!

    Firstly I am so proud of you both for not giving up on something you wanted to achieve. The support you two have for each other is amazing.
    Secondly I had noooo idea that breast feeding could be so difficult & so painful which makes me first point mean so much more.

    I am so glad that you are sharing this journey with us. He is a handsome little man & I think not only is it good that you're sharing your stories with us but that when Oskar grows up he'll be able to read back to see how amazing his mothers truly are & what his life has been like.

    Love Coco
    Cocochatter.blogspit.com

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