September 08, 2018

If you have read our blog called Summertime Secrets (here) you will know the difficult and emotional journey that we have all been on as a family in the last few weeks.

This update/blog is aimed at my breastfeeding journey. I know it's a little strange to put a blog about breastfeeding on what is essentially a pet website but we have always been clear that we are not your average pet shop! And if I can help anyone else who ever finds themselves in the strange circumstances we did then it's worth me leaving this little breadcrumb for Google to find.

Call it what you want, re-establishing breastfeeding, changing from bottle to breast, boosting supply, stimulating for supply and demand, this sort of looks at it all but my purpose is to write it in an honest, open way that provides encouragement, looks at things from a different perspective and isn't just full of the normal keyboard warriors who simply say 'YOU NEED TO PUMP' because for me that was one of the most frustrating and upsetting things that I could hear.

It was so easy first time!

When Erica was born it was so simple. I always knew I wanted to breastfeed and although I hadn't set my heart on it for either Erica or Summer (because as we have learned with Summer’s arrival in the last few weeks nothing is ever certain), I knew that if I could do it I knew I would. Why? Honestly, I'm not actually sure. Partly because the evidence does seem to show that it provides baby with so much more than any manufactured formula (I found this quite an informative list of benefits) and the way I instinctively live my life has for many, many, years has been to choose natural over manmade alternatives, I figure that if it’s naturally provided by nature then it must be there for a reason.

I fed Erica exclusively until she was about 15 months old, she latched on from the moment she was born and we never looked back. I did at the start get intensely sore nipples (too much info? sorry!) and then we got caught up in all the nursing people offering help on latches etc which just stressed me out because actually Erica and I were just fine, my husband said to me 'ignore what they are saying, you are a fantastic mummy and you are doing great, you and Erica know how to do this so trust that'. He was right, our position and latch was great, it was just the hormones in my body making them sore and nothing to do with positioning, latching etc and after a week or two it all went away.

My Breastfeeding Style

Is it even possible to have a breastfeeding style? I don’t know but if it is then this was (and still is) mine.

With Erica I never once pumped or expressed anything, after she was born if she needed feeding she went on the boob no matter what time of night or day, pumps scared me, they were so mechanical and to be honest it just looked like an odd thing to do and uncomfortable too. The thought made my boobs quiver, and the milk run and hide! For such a gentle, intimate thing my body and brain just couldn’t deal with anything other than skin to skin latching – it’s just who I am, it doesn’t mean it’s right or wrong, it’s just how I deal with things myself.

I’m quite a grounded person who likes routine and structure but fundamentally mixed into that is a strong 'mother nature' and 'earthy' side that almost listens to the ground and air around me following gut instincts, in fact my mother in law thinks I might be a little bit psychic! For me feeding a baby with breastmilk couldn’t be more of a basic instinct, an urge from deep within almost as strong as the urge to push baby out!

We always fed in private too, I was never a mummy that wanted to sit in a cafe and feed, to me the moment between Erica and I always felt so intimate that I didn't want to share it with anyone else other than my daughter and husband. So we would go back to the car for feeds or find really remote areas on country walks where it could be just us. Of course it is absolutely everyone's own choice of how and where to feed, I'm not judging, but for me personally I needed that private little bubble where it was us together in an intimate moment which was just ours to share - but it's this feeling which probably made what happened when Summer was born more complicated.

Breastfeeding when Separated from Baby

Summer was taken from me within 20 minutes of being born, initially just to be weighed but after complicating factors she was never returned to me and we were separated for almost 2 weeks. Anyone breastfeeding will know that it can make it very difficult to keep and maintain a milk supply when not with your baby and especially for me considering how natural a process I find it and now that had all been taken away leaving nothing else other than mechanical, cold hard facts about expressing, pumping, supply, demand and things I had never really had to know before. I didn't want to know them now either, I had been through enough and just wanted her back.

Within 12 hours of her birth I had midwives telling me I had to express. Even as an experienced feeder though I really had no idea what it meant or why I needed to do it. Supply and demand had never been an issue before because I had all the supply Erica needed, my milk arrived day 3 or 4 and I never questioned how much was there as Erica thrived and developed so happily.

A midwife showed me at about 11.30pm that night after they transferred me from delivery to recovery what to do, she grabbed a syringe and told me to squeeze and she gathered the colostrum into the syringe. I was to do this myself every 4 hours... but as my health rapidly deteriorated and my hands and arms became attached to multiple canulas I found it increasingly difficult to do. Plus at this point, I fully expected to be reunited with Summer within 24/48 hours and so thought I would be able to feed normally.

Then things got worse, as my ulcerative colitis flare really took hold and I found myself in the bathroom in a very weak state at 2am. The on-duty midwife didn't have any understanding of what it meant and that I was having such a serious flare, in fact she couldn't have cared less about what was happening to me at that moment, leaving me to have a shower multiple times throughout the night in an attempt to keep my wound/stitches clean, keep the bathroom clean myself and deal with removing my support stockings while also dragging a catheter around with me! 

Instead what my midwife did was to shout through my door, 'oh Amy, don't forget to express, the Special Care Baby Unit (SCBU) have been on the phone to say your daughter is hungry and you need to be doing it 8-12 times a day'.

It was like a knife being ripped through me. Knowing I was really unwell and that something was really, really wrong inside me (my health was shortly to deteriorate further) but that I wasn't providing for my daughter, that just made me feel awful. I was hallucinating at this point due to what was happening to my body, I almost collapsed multiple times in the bathroom but pride prevented me ringing the bell because of the state I was in, I was weak and at 2am in the morning, completely alone. Somehow I came out of the bathroom and expressed, I managed to fill the two syringes with colostrum and buzzed to ask a midwife to take it down to SCBU for Summer.

From this moment on, for the next two weeks, my breastfeeding journey was literally hell. It's the only way I can describe it.

You must Express! Supply & Demand don’t you know?!

It was so difficult to express, eventually, after I repeatedly told the staff I was unwell the doctors started to come. Over the coming days, they were there frequently and before I knew it entire mornings or afternoons had passed and I hadn't even had a chance to think about expressing milk let alone actually finding time to do it. The doctors would leave and if I was lucky I’d be there when lunch or dinner came in because having not eaten a meal in over a week I had to do what I could to look after my own health.

Each day that passed I felt weaker and I was only expressing once or twice a day. Every so often I was asked if I wanted to try a pump but as a very private feeder I didn't want some stranger seeing everything and showing me this scary machine. I literally couldn't cope emotionally nor physically. Hand expressing at least meant I could be in private and in some way get some sort of 'brain trick' of skin to skin contact, even if it was just my own skin.

My eyes couldn’t focus properly on the syringe to be able to gather what was coming out and perhaps I should have by now been using a pump but we kept thinking Summer and I would be reunited imminently and everything was becoming so overwhelming that it was too much to consider by then.

My husband had started to try and help me by this point, he could see how much I was struggling to physically manage and he knew how important breastfeeding ultimately would be to me. Bless him, he sat beside me with the syringes as I couldn't hold them anymore, he even had a go at squeezing!

But the inevitable began to happen and my supply began to dwindle. Lack of contact with my daughter (we spent a few hours together over 2 weeks), zero skin to skin and my own poor health were all impacting my milk supply. The last few days I spent in hospital my husband arranged for me to use a hospital pump, someone came to show me how to (thankfully not with an actual demo!), although by this point being hooked up to an ECG I had cables everywhere along with canulas, so using the pump was almost impossible anyway. My birthing injuries also made it too painful to sit upright so gravity wasn't on my side either.

I tried my best to express. With the pump literally, nothing came out, not even a single drop. If I hand expressed I was able to squeeze a drop every time, just a few small drops, no more, but at least I knew there was something still there. Time was running out fast and if I wasn't with Summer soon in a natural environment that suited my own breastfeeding style I knew it was game over.

I couldn’t turn something so soft, gentle, intimate and instinctive into what felt like a cold, empty, mains-powered 'pump sucking baby replacement' machine 8-12 times a day and not forgetting twice at night!. All of this while wondering if the doctors were keeping a secret from me that my heart was actually in more trouble than they were letting on and were these my final few days where I’d never go home with my family (although at least the Ulcerative Colitis was improving!)

Feeling like a Bad Mum

As I sit and write this I am suddenly struck by how strange I find all the advice I received, I say advice, what I mean is midwives just repeating themselves over and over saying, 'it's all about supply, so express 8-12 times a day, and don't forget to do it twice at night too'. I have lost count of how many times I heard that and being so desperately unwell myself it was the least helpful thing I could have heard. Nothing was really explained, the logic/reasoning behind how it all works, just this same sentence over and over.

It made me feel like a bad mum time and time again. I don’t think I will ever forget the midwife telling me at 2am my baby was hungry and I had to express 8-12 times a day (having previously been told 5 times a day by a different midwife). Nobody at that NHS Maternity Unit truly understood how unwell I actually was, every other mum was expressing, so why wasn’t I? I started to feel like I was a failure but more as a victim of the dreadful circumstances I found myself in, there really was nothing more I could do. At the time I think I tried to mostly block it all out although I was aware of the general feelings and it's only looking back now I am home and can think about what happened that I know how low it made me feel.

I couldn't physically do it but no one seemed to understand that.

I couldn’t pump, my supply was nearly gone and even though I did all the ‘look at photos of your baby’ 'watch videos while you express that your husband takes of Summer in SCBU' when he visits her, because I was so unwell and emotionally exhausted it wasn't helping.

Besides which I was now also stuck on a medical coronary care ward with male staff (nurses, porters etc) coming into the room without knocking which didn't really make me feel confident and relaxed while expressing. Don't get me wrong, they were lovely kind and just doing their job but it just made it all even more awkward and pressured.

One Last Fight - Grit, Determination & Gumption!

Despite being so unwell I somewhere found a resolve inside me. One last fight, I wasn't going to be beaten.

I remembered a Facebook Group a friend had told me about a few years earlier where the members all preferred natural remedies/treatments and I figured there would be some breastfeeding mums there. I put up a post one night, around 11 pm, asking for advice about milk supply and how to boost it, hoping for some moral support and encouragement that it was possible I could turn my dwindling supply around and that it wasn’t already too late.

But what happened? I was gutted to get the normal responses that I had seen littered all over advice forums from about 90% of people simply saying 'pump, pump, pump'. I could have got that advice anywhere, in fact I already had from the midwives and 'Dr. Google'. People didn't seem to understand my situation in terms of how unwell I was and while I appreciate the fundamental principles (now I understand them better) of supply and demand I really don't think for me it would have been as simple as that (not forgetting my physical limitations of being able to even use a pump!).

A few people were more gentle and understanding, they encouraged me and said I could do it, understanding how unwell I was, and so I used my frustration with the 'pump, pump, pump - 8/10 times a day' responses to fortify and build on the last bit of fight I had left to hatch a plan.

It was another long and restless night in the hospital but this time with a steely determination and resolve that this one last thing that I could have wasn’t going to be taken from me like so many other things had due to complete staff failings that had resulted in my boobies now only containing a few drops. I’d been robbed of everything but by heck this was the last straw and I wasn’t having it!

By 4am I knew I could do it. If I thought about Summer I could feel that delightful and familiar tingle that I used to get when feeding Erica. People often describe it as little electric shocks in your nipples which might sound almost painful but actually, it's the most lovely tingly feeling you could imagine like soft, feathery pins and needles filled with love.

My boobs were almost literally aching to feed her but I needed to be able to do it in my way, in my natural surroundings, it was the only way that for me it was going to work and my poor husband got a phone call waking him up at 6 am to tell him what I was thinking too!

My Solution to Success for Summer and Me

Nine times out of ten I create my own path.

I work differently to other people. My needs and thoughts and the way my body responds to things are never within the 'normal range'. In fact several of my blood test results even when so unwell came back completely normal and I was told that for me to be able to describe some of the symptoms I was having relating to certain aspects of my health was incredibly unusual and showed I must be really in tune with my body and “very sensitive to understanding and feeling it”.

So how was I going to fix this breastfeeding problem? I needed my daughter, not a pump. For me a pump was never going to be the answer, it wasn’t something I could get an emotional connection to and even if after days/weeks of using it my body started to respond and give the supply I knew my spirit, soul heart and body wouldn’t commit fully and that it, therefore, would never fully work.

The day I was discharged I knew I had a decision to make. I either had to find a way to be with Summer within the next 24/48 hours or else I had to resign myself to the fact I wouldn't be able to feed her and that she would have to stay on her bottle with formula milk.

The Turning Point

My plan when I was discharged was to go home for that night and get out of the hospital environment. I hadn't even had a proper shower since giving birth 2 weeks previously and I was starting to find the hospital environment claustrophobic and beyond stressful, I needed to start to find me again.

Had they decided Summer had to stay in SCBU for multiple days after I had the option to 'bed in' there within a little side room, not something I was really comfortable with, there still seemed an immense lack of privacy and I was (and still am) so unwell that in all honesty, I didn't feel safe without someone to look after me and to make sure I didn't do anything stupid.

My real plan was to bring Summer home to me, to our bed where I could get to know my own daughter and pull myself back to when Erica was born bringing back all those happy memories. Those memories would help create a positive bubble while I got to know Summer and just finally being with her in itself after going through such a traumatic time was so wonderfully amazing that it was enough to help boost supply.

Well my plan worked, we got Summer home the day after I was discharged.

Whether you call it re-establishing breastfeeding or establishing it from scratch I don’t know but we were on our way.

So how am I doing it?

Well just as with everything else I'm following my own rules and doing it my way! I’ve found my gumption!

Everyone said I must pump... have I? No, not really! Summer is a much better pump than any mechanical device so the rule is simple, if she needs feeding she had to go on my breast first (and even if she doesn't need feeding she can be on there too for comfort etc).

All the advice I'd seen had said that babies are much more proficient at getting the milk going than a pump and she had already shown me she could latch so I knew that wasn't a problem, I just needed her natural instinct to encourage her suck reflex and my girl has been a star. I latch her before almost every bottle and although there was hardly anything there for her in the beginning, she had the instinct to try and that got my oxytocin and milk supply going.

It was clear she wasn't getting enough when we first got home as she would come off and start fussing or crying instantly so then she got her bottle, we didn't prolong anything nor make it stressful or unpleasant, if she was on for just 30 seconds that was fine, as long as she wanted to and then no more.

One week on and where are we now? I can feel my supply has dramatically increased. The nursing specialist at the hospital said she thought it would take about 2 weeks for anything to change... well Summer and I have worked together and somewhat smashed that into the back of beyond.

I can now audibly hear her gulping when feeding for sustained periods of times and on several occasions, she has either happily fallen asleep on me while feeding or slowly slipped herself off and dropped into a happy sleep using my boob as her pillow!

The midwives who have visited our home and health visitor have all offered nursing support or clinics I can go to but I'd told them all that I'm sure given everything people would expect me to be screaming for help but if there is ONE thing I am confident about it's this. I know a good latch, I know when my baby and I are in sync and working together so out of everything this is the one thing I feel in control of and happy about.

Bottle VS Formula

We have noticed some clear differences between Summer's bottle formula feeds and breastmilk feeds most notably that after a formula bottle she seems really windy and is often sick too. When she is breastfeed she is significantly less gassy and we don't really need to wind her after a feed either. 

The other difference is in Summer herself and how she feeds. It's definitely taking her a little time to adjust to the difference in bottle and breast. A bottle gives her an instant reward, the milk comes straight away and consistently without her having to do anything like wait for milk let downs from my breast - she has definitely had to learn to be a little more patient although one of the biggest challenges seems to be that she often falls asleep while latched rather than actually feeding!

Being careful and Cautious over Summer’s weight

This isn’t a game. We are doing this very carefully and getting Summer’s weight checked as frequently as possible.

When she was on her bottle alone we knew exactly how much food she was getting and had we experienced a more normal start to life my milk would have come in after 3/5 days like normal and we would have known I had a full supply to feed her and there wouldn’t have been any concerns.

In the early days of latching her on to me and having been advised it would take about 2 weeks to see any difference in my supply, we had no real way of knowing if she was getting enough other than if she gave us cues she was hungry.

If her weight had dropped we would have had to rethink what we were doing or how we were doing, especially with her being 5 weeks early, but my confidence that we could do this has so far been well rewarded and at the three weight checks she has had in the week since coming home she has put weight on each time and is now above her birth weight.

It means she is getting enough from the breastfeeding combination because as it currently stands we haven’t had to increase the amount of formula in each bottle and we are giving slightly fewer bottles too.

However, if anyone else is ever in this situation I would also urge you to monitor baby’s weight closely and if you have any concerns always contact a professional for advice immediately.

What about the pump?

Ugh these bloomin pumps! Well yes we did buy one because everyone rammed it down our throat that 'I MUST PUMP'.

We got the Lasinoh 2 in 1 Double Breast Pump, Mains & Battery Powered here. We knew nothing about pumps and it was Leigh who jumped on a website with next day delivery after a pleading text from my hospital bed at 11pm as I began to formulate my plan. He ordered a brand name we knew, that it could function as a double pump, had good reviews, was mains powered and battery too! and was hospital grade. I could have rented a hospital one but I wanted to do it my way, with my own things and nothing to ever remind me of my experience in hospital ever again! I have the most amazing husband in the world don’t I!

Have we used it?  Since being home for a week I have used it 3 times.

The first time was a couple of days ago as a 'getting to know you' event, understanding how strong it was going to pull on my nipples and what they would be able to tolerate. I think we got something like 5 or 10ml. The day after I used it again because I am struggling with my energy levels to be awake at night for feeds but we really want to stop giving her formula, that time I got 30ml in total so we saved it to add to an overnight bottle. Today the third time only that I have used it, so I don't mean the third day of pumping 8-12 times, just literally the third time I have used it in total, I expressed 60ml which is now sat in the fridge and ready to help with an evening feed.

But it's really not about how much I can pump because Summer can get a lot more than any pump. The good news is that It means my milk supply has dramatically increased and even after Summer has been latched and feeding for 15/20 minutes I can still continue to squeeze more milk myself by hand.

It also helps demonstrate how quickly my supply has built up and that doing it my own way has worked for us which I hope can give confidence to any other mummies out there if you feel it might be the right path for you.

I can't see myself continuing to pump once I feel back to full health, I suspect revert true to type and enjoy booby cuddles at every opportunity! but for now, perhaps the pump and I can if not be friends be good acquaintances instead. It allows me to sneak in some extra stimulation and while I am doing my best to give Summer one night booby feed (the milk is quite different at night) I can't yet manage the full sleep deprivation that comes with breastfeeding and my own recovery, so Leigh is there to help with a bottle which soon will always hopefully contain breastmilk rather than formula.

(read here for some interesting facts about night feeds, also breastmilk at night contains calming properties but morning milk has our equivalent of 'get up and go' caffeine so early evening expressing for night feeds seems to make the most sense).

Summer Success!

Yes! that means I have gone from one week ago today being able to hand express ONE single drop of milk per boob every 4/5 hours to expressing 60ml of milk (30ml from each boob) in one sitting – incredible huh! So it can be done and the midwife who told me as she left me on the coronary care unit who kindly said 'you are at high risk of your milk drying up' may have been right (not exactly helpful or supportive though!), but Summer and I, with Leigh's incredible support, don't give up easily and together we have got this.

I’m not saying ignoring the professional's advice is necessarily a good idea but sometimes you have to follow what’s in your heart and your gut instincts, just every so often the saying ‘mummy knows best’ really is true.

I hope writing my story can help someone, even if it's just one person who stumbles across this from an internet search. I don't think I necessarily fit the typical breastfeeding story but I hope it can give some other mummies some confidence and encouragement because breastfeeding really is truly amazing.

In fact, as I sit here typing this Summer has woken up hungry and as Leigh carried her over to me while I whipped a boob out he took one look at me saying “your boobs look much bigger”!