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Staying in Control – Nicola’s story

Posted on April 2, 2010
Filed under: Breastfeeding while on medication, Expressing, Latch problems, Low supply, Low weight gain, Nipple pain, Nipple shields, Psychiatric illness, Working mothers

This is a story about breastfeeding. Like all stories, it needs a context. So this story starts 12 weeks before I started breastfeeding, in March 2009.

I had been sick for months and putting on weight. I had a thyroid problem, but it was getting worse and I had started to suspect that I had some kind of gut problem, so I went for an ultrasound.

“Oh, you’re pregnant,” said the technician.

“What?” I asked, leaning over to see the monitor, shocked and somehow expecting to see a jelly bean foetus in a blur of undefined body tissue.

“Here,” she said, turning the monitor towards me, “here’s your baby. Did you really not know you were pregnant?”

I couldn’t answer because there was a ribcage on the screen, and it wasn’t mine. I didn’t really have a giant stomach tumour or an immune system disease. I was 28 weeks pregnant. There was a whole baby inside me, well developed enough to survive if it was born that very day.

I don’t need to tell you that I was in a lot of shock for the next few months. I hadn’t planned or intended to have a baby. On the one hand, my fiance and I were planning our wedding, paying our mortgage and in good jobs, so we were in just the right circumstances to have a baby. But on the other hand, I was studying, had travel plans and was on medication for Obsessive Compulsive Disorder.

As soon as I knew I was pregnant, I stopped taking the Pill (yep, still on it and everything happening as usual) and my antidepressants. By the time I went in to labour, I had all the usual worries and fears of a very pregnant woman as well as increasing anxiety due to the OCD.

At that stage I still hadn’t decided whether I would breastfeed or not. I hadn’t decided anything much! Apart from repainting the spare room (my fiance insisted that if the walls were still magenta, he wasn’t doing any night time nappy changes in there!) and reading as much as I could about childbirth, I hadn’t been able to really face the reality of a baby. I hadn’t even turned up to the breastfeeding antenatal class.

On top of that, I really don’t like my breasts being touched, never mind sucked on and chomped on! But I hadn’t decided to go for bottlefeeding either, because it seemed selfish to me to not even give it a try. I had had 12 weeks of feeling guilty over all the things I had done to my baby already – drank at parties, flown to Seoul to eat street food and hike around the city at -12C, taken my Pill and my antidepressants and stayed out dancing all night. Not to mention not loving my baby or talking to it at all! I felt that I owed it to this baby to make up for six months of unintentional neglect.

I was so proud of myself that I lasted 18 hours into a 24 hour labour before having an epidural, and my little boy was born in the early hours of the 3rd of June. Just like every mother, I promptly went into shock, adrenalin taking the place of exhaustion and I happily let the midwife help my baby attach for the first time. It wasn’t too bad, certainly not yukky like I expected, and I decided that for now, I would try breastfeeding.

Four days later when I left the hospital, Dominic had a name but he still hadn’t had a proper feed. We had tried with every different midwife giving us different advice. I had refused to let him be bottlefed, but had learnt the uncomfortable art of hand expressing so he could be syringe fed some colostrum. I had a little bit of success using a nipple shield, and of course when my Mum came to see us Dominic would attach and drink like a little angel, meaning Mum was reassuring me that he was just fine. The midwives were getting worried because Dominic was sleeping for 7 or 8 hours overnight and not waking up for a feed because he wasn’t getting enough milk to get any energy. So I was pretty stressed by the time I took him home.

Over the next few weeks, my nipples cracked and bled, becoming more and more painful. I was starting to dread every feed, and Dominic still wasn’t getting much milk. We hired an electric pump from the chemist, and it was pretty clear that I was producing hardly any milk. In an hour I could manage perhaps 10mL or 20mL and it was scarcely less painful than feeding him myself.

We had many visits to the local clinic, where the nurses ranged from kind to brilliant, and they were all encouraging, but nobody had the magic solution I was looking for.

Some time in the third week, as I sat on the sofa, both of us crying our eyes out, my wonderful fiance went to the kitchen and made a bottle of formula. Dominic had his first bottle feed with Daddy. I felt a huge pressure had lifted and I realised that if Dominic and I were crying and dreading our feeds, we couldn’t possibly have a good relationship.

So for the next few weeks, I would feed Dominic a bottle whenever my nipples felt too sore to feed comfortably. And a couple of times a week, Daddy would do bottle feeds overnight and give Mummy a rest. My fiance really treasured those times with his little boy, and he delighted in sending me out to do the shopping or visit a friend while ‘the boys’ had ‘boy time’ together.

I was really lucky at this time because my Mum, my sisters-in-law and some of my aunts are very very pro-breastfeeding. They were encouraging me to keep on giving it a go, when I felt I could. My sister-in-law in particular said to me that I should stick to it for six weeks, using formula and expressing to help, but that if I managed six weeks, I could be satisfied that I’d done my best. So I persevered with nipple shields and Lansinoh, and fed Dominic at least a few times every day. During this time I also had Maxolon prescribed by my GP to try and increase my milk supply, which was still very poor.

At the same time, Granny and some other aunts had bottle fed, either from the start or from a few weeks in, and they were quick to point out that there was no shame in deciding not to breastfeed.

I had encouragement from both sides of the bottle/breast divide. And I had it fixed in my mind that if I persisted, even just once a day, until the six week mark, I could then hang up my maternity bras and pat myself on the back.

One evening when Dominic was about four weeks old, I was giving him a pre-bed cuddle when he threw up all over me. Not unusual for Dominic, he was the spewiest baby I’d ever met, but this time it had blood in it. It seemed far too much to be from a cracked nipple, so I shouted for my fiance. We bundled Dominic into the car and rushed off to casualty. Being such a tiny baby, he was attended to instantly, with specialists being hurried out of bed and all the nursing staff fussing over him. It seemed that he had reflux, and that he had thrown up so much that he’d irritated his throat to the point where it was bleeding.

After this drama, as well as combining bottle and breastfeeding, we were now adding reflux medication and formula thickener to our repertoire. That worked straight away, and Dominic’s paediatrician even gave me permission to take my OCD medication while breastfeeding, so ‘anxious cranky Mummy’ and ‘crying spewy baby’ almost overnight became ‘happy Mummy’ and ‘contented baby’.

Suddenly making it to six weeks didn’t seem like such a big trial: I would just keep on rubbing Lansinoh on my nipples, using the nipple shields and topping up with a bottle of thickened formula. I could do this!

Then one day, when he was about six weeks old, Dominic just… latched on! All by himself! No nipple shield, no careful inserting of nipples, no aiming. Within a day I was breastfeeding at every feed, and topping him up with a bit of formula a couple of times a day. Within a week, my nipples were completely recovered and I hardly ever needed any Lansinoh. ‘They’ were right, once breastfeeding worked properly it didn’t hurt at all.

We continued with mainly breastfeeding and a little bit of bottlefeeding until Dominic was six months old. Doing both meant that I could go out to a party and leave Dominic with his Daddy or his grandparents for a few hours. I would still be home within a few hours because my breasts would be huge and leaking everywhere, but at least I knew that if he was hungry, Dominic could have a bottle. On the other hand, breastfeeding is so much more convenient out and about. I could just find a comfy spot and breastfeed any time Dominic was hungry or stressed, and stay out as long as I wanted without worrying about running out of bottles.

I was due to go back to work at the start of January so I started to offer him a bottle for his feeds during work hours, followed by a breastfeed top up, so that hopefully when I was due to go to work I could send him to daycare with bottles of formula. My Mum was very positive about managing part-time breastfeeding as she continued with morning and night feeds for some months when weaning my sister and I. But Dominic had other ideas. Over the course of a week he completely dropped the breastfeeds and had his last breastfeed on Christmas Day. It wasn’t our best feed. I was engorged and a bit sore, and spent ten minutes persuading him to suck just a little bit so I could relax and enjoy Christmas lunch!

At first, we continued to cuddle Dominic during his bottle feeds so that he did not miss out on the closeness he had experienced with breastfeeding. But he decided very quickly that he prefered to lie on his wedge pillow and hold his own bottle, in fact he insisted on it! So these days we sit with him and read a story instead. At ten months, he is a happy, healthy, well-adjusted baby. And as they say, you can’t tell whether he was breast or bottlefed – just that he is well-loved!

I’m really proud of myself for sticking with the breastfeeding for six months. I feel like I gave Dominic the best possible start in life. I managed to balance the nutritional benefits of breastmilk with the benefits of having a calm, relaxed Mum at mealtimes. When Dominic was born, I felt I’d had very little choice, and therefore very little control, about having a baby. With the support and encouragement of my friends, family and clinic nurses, I felt in control of my body and chose to stop breastfeeding when it hurt too much, and persist again when I felt ready to, while still giving my baby the best care possible.

The biggest barrier I faced was the idea that breastfeeding is ‘all or nothing’. That might be true for some, but it doesn’t have to be. If you are finding breastfeeding a struggle you often receive advice that points you to either breastfeed in agony or bottle feed exclusively. You don’t have to do that. You can mix and match, try different things, and work out your own perfect balance.

Here is a list of things we tried, which all more or less worked (and were undertaken with the supervision of a paediatrician):

* Breastfeeding
* Breastfeeding with a nipple shield
* Hand expressing
* Pump expressing
* Using Maxolon to help produce more milk
* Lanolin for cracked nipples
* Bottlefeeding expressed breast milk
* Bottlefeeding formula
* Thickening formula to reduce reflux
* Using a dummy
* Breastfeeding, with a top up of thickened formula at each feed
* Breastfeeding, and topping up once or twice a day with formula
* Having Daddy, grandparents, godparents and family do bottlefeeds
* Dreamfeeds, where you feed the baby right before you go to bed to increase your chance of a longer sleep
* Bottle handles, because Dominic insists on holding his own bottles
* A kidney shaped pillow to breastfeed on
* A wedge pillow to bottlefeed on (once Dominic decided cuddles were not happening during feeds)
* A variety of bottle and teat styles, and now a variety of sippy cups, straw cups, pop-top drink bottles, regular cups etc. In short, Dominic will take the food however it is dispensed!
* Early start on solids (Farex) to help with reflux, while continuing to breastfeed.
* Cabbage leaves while I was weaning
* Hand expressing while I was weaning
* Pleading with Dominic to please have a little bit of a drink so Mummy was less sore (didn’t work terribly well, but I gave it a try!)
* Your obstetrician and psychiatrist will probably defer backwards and forwards to each other, neither wanting to say that it’s ok or not ok to take your medication while pregnant. Get in touch with a paediatrician as soon as you can, and talk to them about it.
* For any OCD mummies out there, start out by not caring which breast the baby drank from last. It’s only going to end in tears because one night you WILL be too tired to remember and you don’t want to get yourself in a state over it! I’m not a ‘germ phobe’, I’m a counter and a worrier, so I haven’t had as many problems as I expected.
* If you have a mental illness, be extra aware of the possibility of postnatal depression. You probably already have a support network set up. Tell all the midwives and nurses about your mental illness and how it might affect you as a parent. I did, and got lots of extra help in the hospital and at the clinic.
* Only listen to family, friends, midwives, nurses and doctors who said things we liked and encouraged us to find the best solution to our feeding problems without pressuring us.

Filed under: Breastfeeding while on medication, Expressing, Latch problems, Low supply, Low weight gain, Nipple pain, Nipple shields, Psychiatric illness, Working mothers

Comments

One Response to “Staying in Control – Nicola’s story”

shez on May 13th, 2010 11:24 pm

hi there, i stumbled across your story from the diaper decisions site as had saw a pic of some cute clothes and clicked onto the pic and it came to this page.

I just love your story, i have 2 sons 3 1/2 and 3 months, I didnt realise how much i loved feeding my first boy until i had stopped, it broke my heart.

with my 2nd bub i really am enjoying it more and got all soppy when i read the part about your last breast feed, it really is final isnt it lol

anyway just wanted to say that its a great story…

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