My second son was a normal pregancy until, at 33 1/2 weeks we discovered that my fundus had shrunk 2 cm over a 2 week period. After a Non-Stress Test and High-level Ultrasound, we discovered that the amniotic fluid was almost gone, the cord wasn’t feeding him anymore (it had a backflow), and he was tiny. They did an emergency C-section within 45 minutes. He was born 2 lbs 10 oz. I started pumping right away, and saved up tons of colostrum for when he was ready for his first feeds. After a few days of ventilators, a shot of liquid surfactant for his lungs, etc. we started focusing on his food situation. From the beginning, his only source of food was sugar water through an IV, and he lost 10 oz, dropping to just 2 lbs. When he was ready, they introduced a gavage tube (naso-gastric) and started with 1 ml at a time of colostrum. After some setbacks and tummy troubles, we worked our way up to the point where we could take out the IV and just keep increasing the tube feeds, a little at a time. We also finally got to start practicing breastfeeding! At first we just let him suckle and explore, but once he started trying to actually eat at the breast, it was pretty obvious that we’d be needing the shield again. We could only breastfeed a couple times a day, because it wore him out a lot more, but at least I knew that all his bottles were my milk. For awhile they had to add HMF (Human Milk Fortifier) to his bottles, to bulk up on the particular nutrients that he needed extra of, and to add calories. We finally got to take him home at 5 weeks old, still weighing less than 4 lbs. At home, I just kept pumping, nursing, and gradually reducing our bottle usage, and within weeks, he was all breast. We also used the nipple shield till about 3 months, just like with my first. He’s still very happily nursing at 20 months old, and he’s still tiny (almost 19 lbs), but his growth curve is steady and normal… just way below the charts, since he hasn’t done a “catch up” growth spurt yet. But he’s thrived on my milk, and is developing wonderfully.

Hamish was born after a long, 38 hour labour that ended in and emergency C section and a hemorrhage on the table.

Over the first two days in hospital I actually thought breastfeeding was going okay.  By the third day it became apparent that his attachment was not right. He was going yellow from Jaundice and my nipples were super sore and sensitive. The pain was unbearable every time he sucked. Numerous midwives and LC’s tried to help but every time he went on, no matter what position he was in, even when it looked like it was right, it was complete and utter agony! Eventually a nurse had me express so that he could get some fluid, the unusual thing was even on the pump it was agonising. There was clearly no friction on the  nipple, yet the pain was awful. She told me that it must be my nipple tendons stretching out, as I have very flat nipples.

So with this in mind I kept feeding him through the pain, thinking that he must have been on correctly even when it was hurting. I was sent home from hospital everyone thinking we were fine. We weren’t fine at all and I was becoming more and more emotional as the pain continued. I couldn’t stop crying and I was so worried that everyone would think I had postnatal depression, I felt like a complete failure and started to feel like I didn’t really want to be a Mum at all and that I had made a huge mistake.

After only 2 days at home my nipples had scabbed over so badly that they were completely hard and brown. I couldn’t handle him sucking any more and I moved him on to expressed milk in a bottle. This to me felt like I had descended into the depths and couldn’t believe that I was unable to make it work. I was unable to express without blood coming out of my nipples, mmmm, pink milk! I remember one day when I had the nurse visit she convinced me to have a go at feeding him again. Poor little fella was so confused about being constantly taken on and off that he would scream and scream and the next time he came off so did the scab and I could see it sitting on the back of his tongue as he wailed with his mouth wide open before he swallowed it. I just wanted to curl up, put the pause button on and sleep for a few weeks, then press play and start again.

So we continued to express and bottle feed. The scabs healed fairly quickly but the pain I was still feeling was terrible. No one could tell me why, until one day my lactation consultant asked me if I had any spasms in my nipples? I said no, not really understanding what she meant by spasm. I felt periods of intense pain between feed but didn’t know this is what she meant. Anyway so she then said “oh it’s just that there is this thing called Nipple Vasospasm where your nipples go white and you have these spasms which can be very painful”. The bells started ringing and I explained to her that I did get this blanching of the nipple and had done all through my pregnancy. In fact my nipples had always been very sensitive.

Nipple Vasospasm is the same thing as Raynaud’s Phenomenon, which is when the blood vessels constrict, which can cause a lot of pain. People often have this in their fingers and toes when it is cold. I myself have it in my toes and as it is hereditary most of my family have it also. Unfortunately I get it in the nipple as well. So this explains the pain. The poor attachment is then caused by the fact that I could not tell if he was on correctly. It hurt either way. Sometimes I would pull him off thinking he was on wrong and my nipple would be a beautiful shape, other times I would think I was only feeling the pain from the spasm and he would be totally mincing me up!

I tried all of the recommended supplements and techniques that are supposed to help and  was even prescribed medication. Nothing put a dent in the pain. Sadly I continued to express and bottle feed, every week thinking it would start to ease. After 10 weeks of this I had all but given up. I purchased a double electric pump, which cut my expressing time down by almost two thirds and formulated my plan.

In order to keep going I decided that I had to have an end in sight. I decided that if I could express full time for 6 months and store any extra I could get out in a deep freeze, then after 6 months I would introduce a formula feed at night. I would continue to express as much milk as I could and then hoped that by about 10 months old I would have enough stored milk to feed him through he was 12 months old. This plan made me feel as though I had some kind of control over the situation and made it easier to deal with. Luckily I had no problems with milk supply and it simply pored from me. My stores started to mount up and I felt for the first time a sense of success over the breastfeeding process.

When Hamish was about 3 months old he started to sleep very badly. I became more and more tired, stressed and run down. It was then that I began to have problems with blocked ducts and an oversupply of milk. Nearly every single feed there would be blockages. Some would come loose at the next expressing session and others would stay put for days. The pain was great and I began to feel very sad that I was hating the whole process again. From time to time I would still try and give Hamish a feed. He was a good boy and would usually oblige. Often he was able to loosen a blockage that the pump could not and my beautiful husband and I gave him the name, ‘The Lumpinator’! No matter what I did I was not able to feed in any ongoing way. I tried to feed him once a day every day but this rarely worked for more than 2 days in a row and frequently there were weeks and weeks between him feeding from me.

For some reason my boobies just had no system to the amount of milk they would make. It seemed that the more tired I was the more milk they would make. The lumps and blockages were continuous and very painful. When he was about 5 and a half months old I came down with my first bout of Mastitis which saw me in hospital for 2 nights on intravenous antibiotics. After this episode the incidence of blocked ducts was reduced by quite a lot and I wonder if I had a very low grade infection that whole time? A few weeks after that, for some reason, my Vasospasms started to become slightly more mild. I was able to feed Hamish once a day every day for a couple of weeks. I was so happy and from then on I slowly introduced more and more feeds. Over the next 3 months I increased his breastfeeds till I was only expressing last thing at night and first thing in the morning. I can’t tell you how much this improved my life. I wasn’t tied to home every few hours in order to express and I was feeling like a real breastfeeding Mother. I think the act of Breastfeeding was a huge part of what I thought being a Mum was.

Since Hamish was 9 months old, I have been feeding him all on my own. He is 14 months old now and I can’t tell you how happy I am. I have had 2 more bouts of mastitis but nowhere near as serious and only several blockages. I still have the Nipple Vasospasm but it is so much more bearable than it used to be. I still experience pain when I am feeding him but the spasms between feeds are so much less and over all I am able to do it with very few problems. During all of my problems I felt very helpless, I had much support from my partner, Mum and friends but deep down I really felt a failure. Now that I have some hindsight I see that what I did was a really good thing for Hamish and I am so proud of myself. There were many times that I wanted to give up but I am glad that I was determined and continued to success. I am also thankful and proud of my little boy who was always so flexible, swapping from bottle to boob and back again, and who will now not even take a bottle.

However then it all went wrong. With my first pregnancy I had a complete placental abruption.  Basically my placenta fell off and our little boy died.  He was 36 wks gestation and just lovely.  It was a hard to cope with and made even harder by my first experience of lactation – which was to suppress it.  Most people that have such a huge bleed don’t even get their milk in.  Mine was there in buckets.

Life settled a bit and I became pregnant 6mths after Liam’s birth.  Due to my history and Liam being 36wks I booked for an elective caesarean at 34 weeks plus 6 days.  This of course would result in the baby going to the Centre for Newborn Care (CNC).  Not that I really cared about that but it was going to be odd given that my husband worked there permanently and I also did casual shifts there.

My booked LSCS (lower segment caesarean section) was on time, a blessing for someone who doesn’t do the whole fasting thing very well.  I tend to get very cranky.  I had a spinal – similar to an epidural.  That went well pain/feeling wise. Although the wardsman seemed to think bending over a baby wasn’t difficult and wanted more bend!!  The block went right up to my arm pits, making it quite difficult to breathe. Oliver was fine as he came out and I was able to see him briefly.  My husband whisked him off to the isolette to keep him warm (with stories of cold babies ringing in our ears) and off they went to the CNC.  

I took a while in recovery as the block just wouldn’t go.  My left leg was numb for 8hrs.  I went back to the ward via the CNC.  I couldn’t believe my eyes that there was Oliver.  I had wanted to get him out for a breastfeed but he was having problems breathing and was needing O2 and in an isolette. Nothing unusual for a LSCS and a boy. Visiting the CNC post delivery was fantastic. There is nothing worse then arriving in your room post delivery with no baby.

Back on the ward the midwife got me to express. Well that was fun: lying slightly propped, so bombed on pain relief I couldn’t focus or speak without slurring, trying to capture colostrum. Most of it ran down my hands but we got a bit and my husband Mick took it up to the CNC.

The next day I went up to the CNC in a wheelchair. I had given up on the IV pain relief by that stage, so I could use my brain. Oliver was looking much better, off O2 and in an open cot.  

So we had a go at breastfeeding. Trying to attach a very small baby (he was 2.4kg) was tricky and time consuming.  He had no idea and didn’t think a nice wide mouth at all necessary.  It also turned out he was just too small to suck hard enough to draw out my inverted nipples.  Luckily for me there was a lactation consultant on.  She came and assessed the non attaching feed and suggested using nipple shields.  Once I started using nipple shields it all fell in to place. Oliver was able to attach and suck well. It was certainly not comfortable feeding, in fact down right excruciating would be a good term. Sucking basically rips all the tissue attachments that keep the nipple in. I screwed up my toes and breathed deeply.  Feeds hurt the most at the start and then settled to a dull pain which I could cope with.  

I found feeding problematic in that it was hard to get everything organised post caesarean – pillows, baby, the towel to catch vomits (his) and leaks (mine and his), nipple shields (those things are tricky to get on and then just as you’re ready they fall off). The lack of privacy didn’t help either. My top was always in the way and really I would have liked to just get rid of it. Nevertheless once I was set Oliver fed well. He was getting more than enough milk, even though it took an hour each time.  Oliver also vomited lots.  He had reflux and didn’t like formula.  Once I had enough breast milk happening the volumes of his vomits decreased.  I later discovered that he didn’t tolerate cow’s milk anyway.  Custard, cream, cow’s milk all led to vomiting. 

To start with Oliver only breastfed twice a day because it he was too tired to do more. Being under phototherapy for 24hrs didn’t help either.  To start with Oliver breastfed once in the morning and once in the evening – as far apart time wise as we could manage. The rest of the feeds were via the nasogastric (NG) tube, a tube through the nose into the stomach. I expressed each time he didn’t breastfeed and was having a hard time keeping up with the volume required. Babies in the CNC receive set volumes calculated on the baby’s weight.  It is very disconcerting to know exactly how much milk you need to produce.  And the likelihood that you will immediately produce this much is very slim, particularly with first time breastfeeders.

Expressing was a bit of a shock too.  I seemed to need to express every time I turned around.  I’d go and visit Oliver and need to express, I’d finally make it back to the ward only to realise I needed to express. I was OK up in the CNC as the expressing room was quite close.  However on the ward the room where the pumps were kept was way down the corridor.  Then the pump had to be returned after use in case someone else needed it.  It all turned out to be an awful lot of exercise for someone who was supposed to take it easy post caeser.  Then of course was the added extra that I’m sure those pumps were an instrument of torture.  For the first time breastfeeder the suction on pumps is so strong.  I couldn’t turn it down far enough and so gritted my teeth and screwed up my toes again. A lesson on how to hand express to start with wouldn’t have gone astray.  I had a picture of Oliver to have with me when expressing.  Although I think the pain associated with pumping probably negated any good psychological effect the photo may have had.

Of course once I really got into breastfeeding I could have used a pump with suction twice as strong.  I remember shocking a newly breastfeeding mum with turning the suction and rate right up before I’d even started.  She didn’t believe me that she’d get there too.

I spent most of my day in the CNC.  It was easier then going up and down and doing lots of walking.  I would nurse Oliver and read in between breastfeeds and tubes – tubes being feeds via a tube into Oliver’s stomach. The CNC was busy as usual, so I did most of the NG tube feeds. I mean I’d had the practice before.  I also took Oliver down stairs with me frequently. So much so that the other parents were questioning why I could do that and they couldn’t. They didn’t seem to understand really that we both worked in the CNC and it really did make a difference. 

The expressing room was also an eye opener regarding what the parents knew about babies other than their own.  Basically they knew most of the information that they could understand – and all this with out having asked the babies parents. Also there was a lot of gossip and discussion about how stupid it was they couldn’t look at other people’s babies and had to leave during handover.  There was no recognition of confidentiality at all.  It wasn’t all mothers but a majority.  I just sat and listened and got out quick. 

I was discharged on day 6.  Oliver stayed for 14 days.  We could have taken him home a bit earlier but I had a panic attack about coping with breastfeeds and tubes and expressing.  

Once I was discharged I got lifts back to the hospital and stayed until someone could pick me up. My husband Mick had gone back to work at this stage so I would go in with Mum at 8.30 and come home with Mick at 9.30pm when he finished his shift.  Between not being able to drive and trying to get in enough suck feeds so we could go home I ended up staying at the hospital for 14 hrs a day.  Not very restful.  I would however manage to fit in 3-4 breastfeeds each day. To go home with the neonatal early discharge program the baby needs to have 4 sucks feeds and the parents be taught to do the rest with tubes. The tubes weren’t an issue but those breastfeeds were hard to get in.  I could have agreed to a bottle at night but I really wasn’t keen to do that. I can see that if I had other children at home I may have gone with that option in order to get home though.

We were booked in with early discharge program. They would come and do 2 tubes a day, check and weigh the baby.  It’s a brilliant service and means you get the baby home much more quickly.

Finally on a Tuesday I had had enough of being in hospital and at work with my baby. We were booked to go the next day, that being when early discharge program could fit us in, but I wanted out NOW.  Mick was on a morning so finishing at 3.30pm so we went home with him.  I was lovely to be at home.  Straight away everything was easier.  I was able to do alternate tube breastfeeds that night.  The only unfortunate thing was when my milk came in there was masses of it. So I still had to express once I’d breastfed.  

Having to breastfeed or tube and express every 3 hours was mind numbing. I had a sheet of paper with feed times, which side and how much, written down. Otherwise I had no idea what was happening. The alarm clock was also a life saver. Once Oliver was only having the odd tube feed things were a lot easier. I wasn’t so tired and just breastfeeding meant a lot less cleaning, sterilizing etc.

Oliver was a keen breastfeeder and we got the hang of it reasonably quickly.  I had masses of milk so I never had a low supply issue even though I used nipple shields for 4mths.  In fact he was such a pig he would vomit because he drank too much and then vomit from his reflux.  Very very messy and meant lots of clothes washing.  After a week we did away with the NG tube. Oliver helped by pulling it out.  He continued to grow well and we were discharged from early discharge program.

My next baby Sophie was a different ball game.

With my 2nd pregnancy I had used a manual pump to express at home and I wasn’t going to do that again.  So very early on I found out about hiring pumps. The person I spoke to suggested expressing prior to the baby’s birth.  Given I knew she would be early it seemed like a good idea.  I expressed once a day the week before my booked caesarean. I managed to express 100mls.  It was quite amazing how quickly I had milk given the few times I expressed.

On the day of Sophie’s birth Mick took the breast milk round to the CNC.  They were all very impressed.  

Funnily enough Sophie was also born at 34+6 wks gestation.  She only had problems with maintaining her temperature and was in an isolette on and off. The temperature was partly to do with her size.  Sophie was only 2kg. 

The block from the spinal with Sophie’s caesarean was much lower, only to my belly button to be exact.  This was on the painful side during the delivery.  Though it also meant I was out of recovery visiting Sophie with in a couple of hours.  Sophie was wide awake looking round.  So she was popped out and put to the breast.  My position, lying fairly flat wasn’t optimal but she knew what to do and managed to lick and have the odd suck. There was milk going everywhere so we were both fairly wet by the time she finished.

Back on the ward I hand expressed 20mls of milk to the astonishment of the midwife. The next day the milk had gone and the colostrum was back.  It only took 2 days for my milk to come in though.  So Sophie didn’t ever have any formula.

Breastfeeding this time round was so much easier even though I had started to wonder did I still know how to feed a newborn. But it was fine.  Sophie knew what she was doing.  I knew I needed to use nipple shields and I remembered all the positioning and attachment. Of course I wasn’t learning everything from scratch.  And any privacy issues didn’t concern me, having breastfed all over the place with Oliver I was used to it. All I wanted was to get home. 

One of the other things I remember well was that I was starving.  I am always hungry when pregnant and it increases when I’m feeding. I wasn’t able to walk the distance to the café post-caesarean, Mick only came in, late in the afternoon with Oliver. And my sister had just had her baby so my visitors were a bit light on too. There just wasn’t enough food in the place. I was glad to get home and be able to eat lots!

On Day 6 I was discharged home and Sophie came too.  She was still having issues with her temperature so we had to check that frequently.  She also was only having 2 breastfeeds a day at the start.  Meaning I had to tube 6 feeds.  Thankfully she progressed quickly to more breastfeeds. We came home again with the early discharge program follow-up. We were discharged from the early discharge program after 4wks.  About the same time as Oliver even though he was in hospital longer. 

It was exhausting doing that many tube feeds and I had a major oversupply issue.  I had to write everything down again. Sophie only fed from one side, and then I would need to express the other for comfort.  It took about 4wks to decrease my supply to Sophie’s needs.  She continued to fed on one side at a time for about 6mths till she grew a bit more.

When Sophie was 4 weeks old I realised she had a tongue tie.  Enough to make her tongue a bit heart shaped.  This really didn’t seem to affect us.  It remained there until she got her bottom teeth at 12 months and cut the frenulum. 

So the same age babies in the CNC and 2 very different experiences. 

I continued to feed Oliver with no real problems till he and I weaned at 19mths when I was 18wks pregnant.  Sophie after a great start had lots of different issues cumulating in breast refusal at 17mths.  She completely stopped, going from 5 feeds plus a day to zero.

So back to me. During my pregnancy my mother was determined to educate me about the benefits of breastfeeding.  As well as talking to me about her own experiences she strongly encouraged (nagged) me to join a volunteer-run breastfeeding association because it had given her much-needed support when she was breastfeeding my sister.  I eventually joined up and went to a few meetings and a breastfeeding education class while I was pregnant, and even though I had a good idea that it may not be easy to start with, by the time my little boy was born I was determined to breastfeed him.

In the beginning I was totally unco-ordinated, my nipples were sore, and when my milk came in I was hugely and painfully engorged with a ridiculously strong letdown. If I didn’t have my baby positioned right milk would flow out his nose, or if he pulled off spluttering, milk would squirt across the room.  I had so much milk.  I soaked through breast pads constantly, and had to wear them until he was 6 months old to stop myself from being embarrassingly wet-fronted.

Despite my initial extreme engorgement I didn’t develop mastitis… until he was 5 months old when I noticed a hot, red patch on one of my breasts and I felt sick and feverish.   I went to the doctor and he diagnosed mastitis, prescribing a course of antibiotics, which cleared up the mastitis beautifully, or so I thought.  A few days after I finished the antibiotics I developed mastitis again, this time in a different part of my breast.  I went back to the doctor and was prescribed the same antibiotics.  The mastitis again cleared up quickly but returned, this time in the other breast, a few days after I finished the antibiotics.  This pattern continued until my baby was 11 months old, so for 6 months. 

The strangest thing about this mastitis was that it never seemed to be the result of a blocked duct (I felt my breasts and there was never a definite hard area, but tried massaging down to my nipple anyway) and was always in a different position from the previous time.  It was also never painful to feed from the affected breast, thank goodness.

After 6 months I finally thought to ask my doctor for a different type of antibiotics but he refused to prescribe anything other than the original ones.  That was the last time I saw that doctor.  I found a new doctor and he prescribed a different type of antibiotics, saying I should never have been on the other ones for mastitis as it was well-known that they often didn’t work.  I started taking the new antibiotics and changed from using regular to antibacterial soap in the shower.  The mastitis cleared immediately, I continued using the antibacterial soap and the mastitis never returned.  I’m still not sure if it was because I finally got the right sort of antibiotics, or that I disinfected my breasts daily with the antibacterial soap.  Whatever the reason I’m glad it never came back.

During the time of my recurrent mastitis it would have been easy to say that breastfeeding was making me sick and wean my son, but I was convinced of the health benefits of continuing to breastfeed him, despite the mastitis, so continued to do so.  I am really happy that our breastfeeding relationship was not cut short by illness, and was able to conclude naturally when both of us were ready.

When I gave birth to her she was put on my chest immediately to help the process along so that breastfeeding would come easily. But from the very start we had problems: I had flat nipples and she had a tongue tie. We had her scheduled to have a frenotomy and till that happened I expressed (at that stage colostrum) and fingerfed her. On day four my milk came in – with a vengeance. I had way too much and my daughter couldn’t even begin to empty my supply. So my breasts were never fully drained and for that reason I got mastitis. I still expressed milk and fingerfed her the milk. I expressed every three hours around the clock. For at least a week I expressed around two litres of milk every 24 hours! I filled my freezer with my milk till there was no more space. I filled my fridge till I had no more containers. I could have supplied the whole neonatal ward with my precious breastmilk! But at the time all I could think about was how engorged my breasts were – they were in almost constant pain. Not least because of the mastitis.

The doctor even managed to give me the wrong anitbiotics so I had to go back and get different antibiotics when my fever didn’t subside and the pain wasn’t going away in my breasts.

All along I was expressing every three hours and fingerfeeding my daugther all the milk she could possibly dream off. She gained so much weight in the early days – so that was a good thing! She did get an upset tummy from all that milk though, which resulted in her being very unsettled.

When the day came for the frenotomy the surgeon said that her tongue-tie wasn’t severe enough and she wouldn’t cut it. However, coupled with my flat nipples she still couldn’t latch on properly. I had set all my hopes up for this frenotomy. I had thought to myself that as soon as she would have that done she would be able to latch onto my breast and my supply could begin to settle to her demand instead of me expressing so much milk all the time. And this hope was shattered when the surgeon wouldn’t cut her tongue tie. I felt so lost.

We then decided to stop the finger feeding and start using nipple shields – with that my daughter could at least drink the milk straight from my breast. I still had way too much milk, though. And because I still had mastitis and was on antibiotics, I got thrush – oh the pain. (Lactation consultants know that women have thrush when they mention pain that’s similar to being cut with a razorblade or broken glass!) Anyway, she fed using the nipple shield and I would express milk to drain my breasts to get rid of the mastitis. But in order to decrease my supply I was informed to express as little as possible. This meant that my breasts were engorged and painful most of the day and night. I thought it would never end. The lactation consultant said that supply would meet demand around 6 weeks, but I couldn’t even think that far ahead, I was so frustrated.

My supply did decrease over the following weeks and I remember the first day I didn’t express at all. That was such a victory. And then the next big milestone was the first night I slept without soaking myself completely in milk because of the engorgement and oversupply. Through the first weeks I had soaked many a jumper and bed sheet with my milk. Everything in the house, even the washing coming straight from the washing machine, smelled of stale milk. Yuk!

Now my daughter is 11 weeks old, my supply meets her demand beautifully. We still use the nipple shield because she still can’t latch on properly, but we’re working on getting rid of that. There’s no more mastitis, no more thrush. Her weight gain has settled as well and she doens’t get an upset tummy from too much food any more.

Breastfeeding is finally a really enjoyable part of the day, my breasts are finally comfortable 95 percent of the time. My daughter and I have come a long way! A journey that I couldn’t have made it through without the help of my husband or the fantastic lactation consultants at the hospital. They were so informative and helpful and understanding. But it truly has been a rollercoaster this whole breastfeeding business and I began to understand why some women give up. However, it truly is worthwhile sticking with it. I know how good it is for my baby and the closeness I have with her through feeding her my own breast milk is truly wonderful!