Tuesday, 19 March 2013

Triumphant Tuesday: Breastfeeding a Baby That Won’t Latch

In general, a baby who won’t nurse, can’t nurse. As a parent, your goal is to identify why baby can’t nurse and either remedy the problem, work around the problem, and/or preserve your milk supply until the problem remedies itself (Kellymom 2011). But what if you have health professionals breathing down your neck, firing comments at you that suggest your baby is starving, that you must have postpartum depression, and that formula is necessary? You are about to read the story of how one mother unlocked the secret as to why her baby was refusing to nurse, all whilst under a torrent of bullying from health professionals and family members.


“My son was born by ‘emergency’ caesarean after induction at 42 weeks, I say ‘emergency’ as I have since discovered the reason was rather dubious (I was at full dilation and pushing, they said my son was in distress - apgar of 9 indicates he wasn't) but I digress. In recovery I was helped to give him his first breastfeed, well the midwife held him and put my boob in his mouth as I couldn't hold him as I was shaking so much with the after-effects of all the drugs that had been pumped into me.

Here is a photo of our first feed in recovery (and the only breastfeeding photo I have). Little did I know that this would be his only successful breastfeed for over a week, it brings tears to my eyes looking at it:



We then tried on our own but he failed to latch. It probably didn't help that I was anaemic during pregnancy and lost a pint of blood in surgery but wasn't given any iron tablets until I specifically asked for them.

Formula by Duress


After a while, the midwives did the heel prick to check his blood sugar. He was 0.1 under what they wanted him to be, I was guilted into giving him formula top ups. I hobbled up to the ward and kept attempting to feed him, with a whole range of midwives, nursery nurses and feeding advisors shoving my breast in his mouth, it was horrendous. The experience was so distressing for my baby that it got to the point where he would scream whenever we tried to feed.

There was however one lovely nursery nurse who seemed to understand how important BFing him was to me and she spent lots of time showing me how to hand express colostrum, then at 3 days postpartum arranged the double breast pump. By this stage the head infant feeding advisor had told me my baby would starve if I didn't give him formula, so he was getting colostrum by syringe and then cup fed formula. I spent a lot of time crying. Eventually, to get out of hospital I put him on bottles and was pumping and giving him expressed colostrum by cup.

Skin to Skin


When we got home I pumped every 2/3 hours, day and night. My baby was still so traumatized by the manhandling that occurred at hospital that whenever I tried to get him to latch he would scream. I took the decision to stop trying for a day or two and implement the biological nurturing approach. We did lots of skin to skin and a couple of times he latched on whilst we were sleeping. The first two weeks of my son's life were totally unlike how I had imagined. I didn't enjoy it at all, spent a lot of time in tears, developed ductal thrush due to the antibiotics I had to take for a postpartum infection. To be honest I felt like a complete failure. I had planned a natural birth using hypnobirthing and ended up with every stage of induction, epidural and caesarean section. To be unable to feed him on top of all this was unbearable.

Unsupportive Parents

My parents were concerned about the effect all of this was having on me. Plus my Mum had failed to breastfeed me, being told she didn't have enough milk (back in the wonderful 70s). I guess my Mum probably felt guilty that she didn't try as hard to keep me on the breast as I was for her grandson. It doesn't help that she was a midwife in the 70s when breastfeeding seems to have been seen as inferior and she was very pro formula.

Nipple Shield

It wasn't until day 10 that one of the community midwives helped us to latch with a nipple shield (It had been tried in hospital previously but it hadn't worked so I hadn't been encouraged to continue). I will be forever grateful to this midwife for her support.

Whilst the nipple shields got us breastfeeding successfully, I still had supply issues as his weight was not increasing at the appropriate rate. I pumped religiously after feeds and give it as top ups. The head infant feeding advisor informed me that my son had a slight posterior tongue tie but that it wasn't enough to cause problems feeding - REALLY?? So failure to latch resulting in failure to thrive wasn't a feeding problem?

Pro-Formula Health Visitors


In fact, my biggest problem was the health visitors! They told me that my baby was starving, that he needed to feed. In a feigned attempt to appear understanding they would say, "I know how much you want to breastfeed but how long are you going to keep doing this when he's getting so upset". These are the same professionals who had told me to stop using nipple shields as they were the cause for his failure to gain weight, despite his inability to stay latched without them; the same professionals who kept suggesting that I had postnatal depression because I was upset every time they weighed him and gave me a telling off; the same professionals who told me to give him formula. However by this point he wasn't getting any formula, because I had found sites like The Alpha Parent and other sources of advice designed to encourage breastfeeding rather than meet the Healthcare professionals need for the figures to match the graph.

I put my foot down at this point and demanded a referral. Finally, when my son was 8 weeks old, the HVs reluctantly agreed to let the paediatric dentist assess him.

The Snip

The dentist was horrified when I told him of our experience and angry that the decision had been taken for him not to address the problem. He agreed there was a slight posterior tongue tie and snipped it there and then. Within 2 days my son was feeding without the nipple shield, it was fantastic! He gained 1/2lb in a week rather than the 1 or 2 ounces he had been gaining previously.

However due to the horrendous start we had to breastfeeding I still had to battle low supply. I took fenugreek, ate lots of oats, kept myself hydrated, continued pumping after feeds, anything I could do to nourish my son myself. It was very hard work but I couldn't give up, he deserved the best.

The Effect of Pregnancy on Nursing


When he started solids I stopped pumping so I could spend more time with him. This must have triggered ovulation because after a little oops I fell pregnant. I managed to keep breastfeeding going until I was 5 months pregnant but when my milk turned to colostrum (which occurs around the 5 month mark) he began to self-wean. He stopped breastfeeding a lot sooner than I would have liked but once the baby is born I will see if he wants to feed again and if not he'll get breastmilk in a cup or on his cereal. I am thankfully having a HBAC (Home Birth After Caesarean) so I don't have to go anywhere near the people who screwed up my first few weeks of motherhood!

I am proud that I managed to persevere but angry at the lack of support given when things don't go smoothly. Without them, the community midwife and the internet my son would probably have been a formula fed baby. The thing with breastfeeding is you assume it will come naturally to you both. Antenatal classes generally skirt around the issue of problems that can occur.



UPDATE:


“Cassandra Ann has arrived!

Breastfeeding has been a lot better this time. I immediately asked for the midwife to check for tongue tie - they confirmed she had one. This time instead of a posterior tongue tie, we had a classic tt with heart shaped tongue which was a lot easier to get diagnosed and it also had less of an effect on feeding (although it was excruciating after the first day, with bleeding nipples etc) I chased up her referral and it was snipped at day 4. Being better informed has really helped our breastfeeding relationship get off to a more positive start! My supply is great, milk came in at day 3 as opposed to day 4/5, she sleeps way better and I feel so much happier.





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6 comments:

Unknown said...

Good for you. This is a very encouraging story

virtue said...

I'm so glad your story has a happy ending! Your babies are so adorable :)

The beginning of your story sounds like mine. The midwives in the hospital left finger shaped bruises on my breasts from grabbing them and trying to force them in to my son's mouth. We were both traumatised by that and not even a nipple shield helped him latch. His tongue and upper lip ties were finally diagnosed when he was 19 months, long after I gave up exclusive pumping.

I wish I had known everything I know now... it would have been so different.

Bree Banks said...

Congratulations on your perseverance! Our story was similar, and also a success. We did tandem nurse for about 3 mos (and would have continued longer...). Hope that breastfeeding is going well for all of you!

Melanie said...

Sorry to hear about your rocky start - great ending to the story though! Parts of my story are very similar and I really felt for you. I'm really pleased that things are going better with Cassandra and you were able to get help for her tongue tie much earlier :)

Carys Alun said...

My experience with my firstborn is similar, except I had a traumatic birth and have inverted nipples. The health visitor was appalling, standing over me as she instructed me to make a bottle for my 'scrawny, pigeon chested' baby. I still had latching issues with my second, but expressed like a loony so that she could have the milk. Guess what happened thanks to the expressing. My nipples stuck out properly, and here I am, a happy and confident breastfeeding mum.

Well done with your perseverance, and for sharing your story. Congratulations on your children. They look perfect.

Fi said...

I had a very similar experience with my new daughter. After a c-section, I was producing colostrum and thought she had a good latch (checked by hospital midwives and lactation consultants) but she dropped weight and kept dropping. When she had dropped 14% of her birth weight my health visitor sent me back to the hospital. They glanced at her (alert, hydrated and good colour) and said she was fine - didn't even pick her up out of the carrier. Two days later she'd dropped another 30grams, which crossed the hospital 15% loss guideline. Then I had the hospital insisting that she was seriously ill, dehydrated and having kidney damage (based on the number - they hadn't seen her!). I wss told she had to be admitted to hospital, put on intensive formula and a drip. I was furious - how could they say this when two days ago she was "totally fine" with almost the same weight? I insisted on another option and was told my milk wasn't enough. I had to stop bf and formula feed her or I was neglecting her and could be reported. (gotta love that support)

Anyway, I ended up formula feeding her plus breastfeeding her (full time for each so she had a bottle every 4 hours plus bf on demand in between so about 6 hours daily) for three weeks. Gradually her weight increased. Meanwhile, I was taking prescriptions to bring my milk in, pumping to stimulate it, making lactation cookies. You name it. It was hard, I had bleeding nipples, exhaustion, 2 blocked ducts. But I had to persevere because I knew the importance of the bf relationship.

Plus I started researching. There had to be a reason why she seemed to only be getting fore milk, not hind milk... No answers from the docs or nurses (just switch to formula - you've failed at bf. A lot of women do)

Finally I found clips of babies with upper lip ties. Found descriptions of the shallow latch that this can cause and how it can fail to trigger hind milk. Looked at my daughter and noticed that sometimes her top lip rolled under during bf and the seal became loose at the sides. So I checked and she has a prominent frenulum but when I asked, I was told it didn't affect nursing. But I started to flange her lip out wider when latching and in three days i could feel the difference in let down and milk volume. She started to gain weight normally and, at 3 months, is excusively breast fed again.

I absolutely believe that the lip tie was the problem and that, rather than provide actual diagnostic support for bf, the medics choose to push formula as a quick fix.

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