Tuesday, 9 July 2013

Triumphant Tuesday: Breastfeeding Under Medical Surveillance

In the UK there is a postpartum surveillance culture. Throughout their offspring’s early childhood, each mother (it is invariably mothers, fathers fall under the radar) is policed by a team of health professionals who are employed to monitor the adequacy of her parenting. The first year of parenthood is arguably the most scrutinised. An army of midwives and health visitors weigh and measure the child, carrying out various intellectual and physical tests and other ‘risk-assessment measures’. All of this is concealed under the guise of ‘supporting mothers’. However, as you are about to read, far from being supportive, the postpartum surveillance culture is hostile and mistrusting, particularly of breastfeeding. The following story perfectly illustrates the tragedy of this government-sanctioned invasion of privacy.

“In May 2010 my son was born, 3 weeks late due to incompetent staff at my NHS hospital. I informed them several times they had my dates wrong due to when I got my positive pregnancy test.

Disrespectful Birth

The birth was horrific and traumatic and I was treated with huge disrespect. I wasn’t allowed to position myself how I wanted and I wasn’t allowed to remain mobile. I was mistreated by the midwives who seemed to care more about birth figures and getting "it" out of me than my wellbeing and the wellbeing of my son. Because of the induction process and sheer lack of compassion, my son was very nearly killed by them. He was born, after 10 hours of bodged induction, white, freezing cold and with blue lips, blue extremities and was barely breathing. I actually thought, when an uncaring midwife 'plonked' my lifeless, barely breathing, freezing cold baby on my chest, he was dead! He didn't move, he didn't make a sound, he didn't even shiver. 

I asked a midwife if he was dead. She approached me, lifted him off my chest, still face down, listened a short while and said "Yeah, he's fine". No he bloody wasn't! Another midwife took him off me and put him under a heat lamp but she didn't tell me that and I didn't see where she put him. Talk of ICU was mentioned if he didn't 'pink up' within 20 minutes so he was placed back on me and we were covered and left alone.

At this point, my son was desperately trying to feed. I was aiding his latch with techniques I'd learnt with my 1st child who I'd breastfed for 12 months. It seemed to be working because he passed his meconium fairly quickly. For 5 or so hours he fed on and off but I felt something wasn't quite right and requested help. The response I got just angered me. I was already in a rather traumatised state but this nugget from the midwife just toppled me: "You've fed one baby" came the response and she left the room. We never saw that midwife again. My son didn't feed again for another 12 hours.

From then on, we were forgotten about. A cleaner came into to the room to clean it for the next labouring mum and was shocked to see us. We'd already been informed the hospital had no bed for me on the maternity ward and that they needed the labour suit so they were discharging me. I actually begged them not to. I knew something wasn't right and I wanted to stay close to any possible support. "No, we can't do that, we don't have a bed for you, we are over capacity". Why? Why did they induce me, put me through a traumatic birth if they were over their legal numbers? I just couldn't believe it! After being ignored for 9 hours (yes, that is 9 hours) we were finally discharged and sent on our 'merry' way. 

When we got home, all I could do was shake, cry, not eat and not sleep despite being exhausted. I was still trying to feed my boy who was now becoming quite lethargic and sleeping a lot. My instinct took over and I expressed some colostrum (which was bloody hard work) and syringed it to him. It was only a few ml but it was something and I felt I could at least try to sleep.

The First Home Visit

The next day my husband went to pick up our daughter and some food. As soon as he left, as I'd settled down to do a bit of baby-mooning I heard a loud knock at the door. Ignoring my better judgement, I answered the door. It was a community midwife who then launched into interrogation, demanding to know where my baby was. I'd left him in bed whilst I answered the door and it was where I wanted to be, not answering the door. She came in, weighed my son who thankfully hadn't lost any weight since the day before, quizzed me on my feeding and made me feel generally uncomfortable. She was insistent that I took myself to the breastfeeding support group at a children's centre at the other side of the city. I didn't feel like going after the birth I'd had and requested she send a support worker to me which she refused to do. She seemed annoyed at me for not wanting to get in my car, 2 days after giving birth and see a breastfeeding support group - a group I hasten to add, that employed mums who didn't breastfeed for longer than 6 weeks. I couldn't really see how they could help. Perhaps it appeared that the midwife was being supportive but to me it sounded like she wanted me to go so I could hear someone say "Oh you can't breastfeed but it's ok cause bottle feeding is just as good". It was certainly the tone I got from her.

By the point she left I was leaking so decided to feed my baby. There was still a problem with feeding but I didn't know what it was, I couldn't work it out. I wasn’t experiencing pain but he wasn't making the right noises. I expressed some more and syringe fed him again.

The Second Home Visit

My husband returned home and within minutes there was another knock at the door. It was another community midwife. My son had already been weighed and inspected so we didn't need to see this midwife. She wanted to come in but we insisted she left us alone. 

The whole day I was trying to feed my baby, he wasn't feeding properly still and now my husband was getting jittery as to how often I was feeding him. He said things like: "You're feeding him again?" "Does he really need to be fed again?" "I'm a little concerned at how often you are feeding him". I explained to him why but he didn't seem to understand, so I directed him to Kellymom.com to educate himself.

That night, I was restless. My baby was very sleepy, not really making any feeding queues, not producing enough wet nappies and generally not looking very well. I tried using a Supplemental Nursing System but it didn't work. My son would suck the tube but not my nipple. I phoned a breastfeeding helpline to explain this, and following their advice I used a smaller tube. He just did the same thing. We watched YouTube videos on how position the tubes, etc but to no avail. To make matters worse, I was violently allergic to the tape with left huge red blistered marks on my breasts.

The Third Home Visit

The next day the community midwife returned. Our boy had lost weight, not a lot, but enough to prompt the midwife to start pressuring us to give formula. She threatened that if I didn't do what she said, we'd end up in hospital. Basically, she wanted us to use formula so she could go to her next job and not have to worry about helping a mum breastfeed. Naturally, I refused, explained in depth why and asked her to leave. She left, unhappy with our choice and told us someone would be back the following day, the dreaded day 3! Day 3 in the UK is the day when they decide when to send to back into hospital for intervention! 

The Fourth Home Visit

Day 3 came, after a frantic night of trying to feed my boy, I was exhausted, I was emotional and my dreads were confirmed, my boy had lost 14% of his birth weight. I couldn't understand it. He was pretty much attached to me all day and all night for 2 days solid, how can he have lost 14%? The midwife examined me (my nipple was squeezed, with force, which hurt) to see if I had milk (RUDE!) I had plenty! She suggested we go to the medical center and have him weight on freshly calibrated scales. I agreed. What else could I do? 

By the time we'd got there, about an hour later and after what I thought was a decent feed (as he'd produced a good wet nappy) he'd lost another 3oz, according to the freshly calibrated scales! The call was made and we were re-admitted to hospital onto the children's ward. This is where my faith and trust in nurses and doctors dissipated completely. 

Back to Hospital

That evening we were admitted. It was suggested by the doctors that my son was ‘critical’ yet it took them 5 hours to admit us to the ward from triage! I was handed a hospital grade pump by an auxiliary nurse and was told "It's pretty much self explanatory". Was it hellers like! I didn't have a clue what the hell I was doing and because of that, I was getting zero milk out. The milk was there but the pump was too complicated to use without proper instruction. Because I wasn't getting any milk with the pump it was decided by the ignorant doctor that I wasn't producing any milk! I soon put a stop to that stupid assumption. I had had the forethought of bringing my own pump, hey presto, with my manual pump I got 20ml! We gave it to him and he seemed to rally. I continued to use my pump but after that boob busting 20ml I was only getting 10ml. Cue the nurse who bottle fed her son, didn't even bother to breastfeed (from her mouth!), coming out with this corker. "You aren't producing enough milk, he needs 3 ounce every 4 hours, by this stage you would be producing at least 5 ounce" What? Where the hell did she pluck that number! It instantly showed the level of understanding of human lactation, ZERO!!!! The doctors, the nurses and every other sodding person on that ward suddenly knew everything about lactation, when in reality, what they knew was hearsay, old wives tales, advert propaganda and lies. The little ‘information’ they knew they'd got from formula companies. 

By this point, I was pumping, with my pump 10ml every 2 hours. This was enough for my son but it wasn’t enough for the nurses and doctors. Without my consent, written, spoken or otherwise, they fed my son 3 ounce of formula. I explicitly requested they didn't! I threw all the research I could find at them as to why I would rather have donor milk if supplementation was necessary. I showed them that my milk was enough but they just did not listen at all. I have since been told by a trusted breastfeeding activist that them feeding my son formula against my wishes was actually assault. 

I continued to insistent on no bottles when feeding my expressed milk, so a midwife was sent for to show us how to cup feed. I already knew how this worked as I had been doing it at home but due to hospital protocol they had to have a midwife show us. She came, she saw, she left and she was beyond indifferent. I felt low, very, very low. I was being treated like some freak, like some nut-job, like an unstable neurotic woman. The doctors and the nurses treated me with contempt. 

Fortunately, my son gained weight so they sent us home. They didn't fix any feeding problems we had, just sent us home because he'd gained weight. So at home, I expressed a bit and cup fed and tried to feed him myself, which again, I thought was working. I didn't want to express too much because I didn't want to have an over-supply, as by this point, my milk was in with a vengeance!!! However, the boy lost weight again. He was a week old and we were being admitted back to hospital. 

Re-admitted to Hospital

Now everyone was telling me to give up and bottle feed, to just suck it up! How could they say that? Why were they saying that? I had milk and lots of it!!! If I'd have had more sense, I would have created a larger stash at home to call upon when re-admitted!

Back to hospital we went. In came pro-ff nurse (the one that told me I would be producing 5 ounce by 3 days). She had a look on her face of "I told you so" and it made me mad and even more determined. Formula again was suggested and I said, with gritted teeth and anger "Over my dead body". So they wheeled out the hospital grade pump again and left me with it! 

I ended up texting a friend and asking her for help, she lives in Essex, I live in Lincoln, that is a distance of 138 miles! I asked her how on earth this bloody pumped worked. She talked me through it, I wrote it down and then sat and began double pumping. I overflowed the bottle attached to my right breast and filled the bottle attached to my left. I went to find the smug nurse and gave it to her, then walked off! 

Every 2 hours I pumped but by 3am I was exhausted, I was trying to feed my son myself, my pumping seemed to be having the opposite effect to what we wanted and I'd gone from getting a few full bottles to not even breaching the 3 ounce mark. I felt destitute. Maybe they were right, maybe I was having lactation failure. The smug nurse came into my room because she saw my lamp on. I was sat hugging my sleeping boy and weeping. She could see I was at a low point and in a dark place, yet she decided to spew: "Come on now, this is foolish, you just need to give up this stupid quest and just bottle feed him!" There was aggression in her voice, there was condescension and an air of being fed up of this 'silly lactivist'. I put my boy down, I walked up to the nurse and I opened my mouth and began shouting at this woman! It made no odds at this point who she was because what she said was uncalled for! I shouted her out of my room and down the ward. 

The following morning, still feeling very depressed and desperate, a lactation consultant called Emily came to see me. Now I had asked, on being re-re-admitted to see an infant feeding expert/lactation consultant. They sent me the infant feeding coordinator at first, she was an idiot to put it bluntly and again had absolutely no understanding of human lactation; Emily on the other hand was my knight in shining armour. She was very well researched, very well trained and understood everything I was telling her. We established, together through feeding observation, that the problem was not me, not my milk supply, it was my boy. He couldn't coordinate his latch and suck. We decided expressing and cup feeding was the way forward and unlimited access to the breast. She spoke to the doctors and told them to back off and let me find my stride with my son. She noted that the intervention was doing more harm than good and requested I was sent home with daily monitoring. This was agreed. Hurrah! However I was discharged with 6 bottles of formula (why?). 

Once home, I pumped like mad but wasn't getting much from my manual pump. The LC rang me and suggested I hire a double pump. She ordered one to be held for me at the children's centre not too far from where I lived, it's the best £25 I’ve ever spent. 

Irritatingly, the hospital had failed to give me the excess milk I'd pumped whilst in their care so my husband had to return later that day to retrieve it. By this point, my stash at home was dwindling fast so I gave my son some of the formula I'd been given by the hospital. What a huge mistake. He grumbled and griped all night. I was in bits. I hooked myself up to the hospital grade pump and got 3oz both from both sides. It was more than what I was getting from my manual so I was pleased.

Less than 24 hours later I was pumping 8oz from the right, 7oz from the left, no way did he need all this milk so we started bagging and freezing it. When I wasn't pumping, I had him down my top kangaroo style, and to my breast. It seems all cheery now doesn't it? But it wasn't. I was still in a very dark place. I couldn't see an end to endless pumping, sterilizing, and nursing. The lack of sleep was getting to me, and I was ignoring my older child who was in fairness still a baby herself at 19.5 months. Every day I spent hours crying and wasn't eating properly. The daily hospital visits were torture. Finally, they discharged me and I was then put into the care of the local health visiting team. 

The Fifth Home Visit

This is a team I'd encountered problems with during my first child’s infancy. I was very, very reluctant to see them, but they showed up anyway and weighed my son. It wasn't even 24 hours since he'd last been weighed!

My husband had returned to work by this time as his paternity leave was over. Thankfully, my big sister was with me which was really helpful. The HV wanted to see my son feed but I insisted she just weigh him and bog off. Naturally, she wasn't happy but she weighed him and he'd gained. She hadn't been informed by the hospital of how we were feeding him so plotted him down in her notes as ‘fully formula fed’. As I was paying more attention to my baby, my sister spoke up and said "I don't think so luv!" and put her straight. 

Once the health visitor had finally left, I carried on my daily ritual of pumping, cup feeding, sterilizing, and unlimited access to the breast. We had visitors come and go and I would sit pumping in front of them because frankly, it was too much of a ball-ache to move the pump, so yes, I was sat topless, double pumping. 

The Sixth Home Visit

A few days later, the health visitor came back and weighed my son again. He'd gained weight, but the health visitor insisted I show her our feeding method. I wasn’t happy with this and tried to reject, but she was persistent. I felt stressed, I felt uncomfortable, I felt judged! Because I was tense, my son cried and it was just a disaster. I was angry. I wanted this judgemental cow out of my home. She said, "Over the weekend I want you to give him formula." I looked at her and replied "I have a freezer full of milk. I have 8 storage bottles of expressed milk in my fridge, a total of 36oz in my fridge. Why in God's name does he need formula when there is all that milk, MY milk?" She stuttered and spluttered..."Well, if he starts failing, give him formula" and again from me, more angry and annoyed now: "WHY? I have 36 ounces of MY milk, a far superior milk to formula! Why the F* would I give him Sh!t when He has the milk of God's on tap?" She looked at me blank with a shocked expression on her face. I told her to get out of my house and not to return unless she is going to support and encourage this breastfeeding relationship. I grabbed hold of her, baby in my other arm, and threw her out of my door, telling her not to come back ever again and slammed the door. I was livid! How dare she try and sabotage all my hard work? How dare she try and make me feel even more depressed than I already was!! How can these health professionals bash out the slogan 'breast is best' for 9 months during pregnancy and then switch to 'formula is just as good'?! I had spent the first 3 weeks of my son’s life crying for hours on end, crying in the shower with overwhelming despair than no mother should ever have to feel. Why it wasn't this working? Why wasn't my baby latching on and feeding like his sister did with gusto? For this health care ‘professional’ to come to my home and lie about being a breastfeeding supporter! What gave her the right?! 

The Seventh Home Visit

By week 3 of this hell, I was still pumping every 2 hours day and night. I even had avid supporters telling me it was a lost cause, suggesting that I'd done all I could, my baby just wasn't going to latch on and that I needed to switch him to formula. My heart sank, the tears streamed down my face, I sat cradling my little boy to my breast. The midwife and my sister sat entertaining my daughter when finally, after 3 long dark weeks of expressing, of tears and heartache, he latched and fed, taking his first gulp. 

I'd noticed the day before he'd been latching with his tongue to the roof of his mouth (we don't know why) so from then I'd been pressing his tongue down with my little finger on latching, it wasn't successful, or so I thought.

I turned to my sister and I said, "He's latched, he's latched and he's sucking!!! He's latched with that deep latch they're meant to have!!! HE'S LATCHED" I was overjoyed. The midwife was astounded. She had never seen a baby latch on for the first time 3 weeks post partum, mainly because no one had ever gone that far to breastfeed their baby in her midwifery career. My boy latched back on and finished his feed, rewarding us with a big burp and a full nappy. By that evening he refused his first cup feed and from that moment on, Sunday the 7th June 2010, my boy was a fully breastfed baby.

My son is now 3 and still nursing. 

I think it is a real shame that some mothers don't even bother trying to breastfeed. I don't think they realise just what they and their child are missing out on. It's not just about feeding, or bonding, it's the life-long benefits, the essential and vital nutrients that infants are missing out on that they need to thrive at an optimum level. For those mothers that quit early on, I feel sad that they didn't get the support they needed to carry on, that possible problems were ignored by HCP's, that they were possibly bullied into formula feeding without knowing the full facts. I feel angry and sad that HCP's just don't seem to care enough about breastfeeding. Giving babies formula means doctors don't have to address with feeding problems. They use it as a cure-all when it isn't, quite the contrary.

The saying goes "Not everyone wants to breastfeed" Well here's a news flash, not everyone wants to formula feed!”

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wildandwisdom.com said...

I love that final sub title...my son is now 3 and still breastfeeding! Thanks for sharing your story, I love a happy ending. It makes me angry and sad to hear how may hurdles you had to overcome, it takes a strong woman and you really stuck with it.

Fi said...

I've had similar (though nowhere near as horrible) experiences and was bullied into supplementary formula feeding my daughter. I did so because I was threatened with her hospitalisation and iv feeding if her weight didn't come up. As with you, no medical professional showed the slighest interest in finding out why she wasn't gaining when I had milk available. Just switch to formula and she'll be fine! I kept investigating, self-diagnosed an upper labial lip tie, followed online advice about how to get a good latch, and hey presto! My hind milk came in within days (the fore milk had been keeping her hydrated but not providing fat) and she began gaining. I spent the six weeks that it took her to regain birth weight feeling like I was fighting a strong tide of medical interference and the monent that she hit her birth weight I stopped the supplements and went back to fully breastfeeding. On follow up visits I've seen the surprise caused by this - apparently "everyone" switches to formula after supplementing. None of my local child health nurses have ever met a mum who went back to full breastfeeding after supplementing! How tragic! At six months, she's a happy, chubby, fully breastfed bub and hope that she'll continue that way for many years yet.

Congratulations for having the strength to stick with breastfeeding against all that pressure! (And on having a gorgeous, happy little boy!)

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