Tuesday, 4 February 2014

Triumphant Tuesday - A Dad's Eye View of Breastfeeding

Studies show that when a nursing mother has a ‘significant other’ who is educated about and supports her choice to breastfeed she is much more likely to be successful at it. For many mothers, this significant other is the baby’s father. What role can Daddy play? Let Dave, a first time dad, guide you through the breastfeeding journey from a man's perspective.

Dave and his partner Lucy had done a lot of reading about breastfeeding, and spoken at length about the benefits.  For them, it was a no-brainer that breastfeeding was the best for their baby. Dave had been told that his support as the father was instrumental in successful breastfeeding, but he didn't realise just how true that was, until he embarked on this epic journey...  

The birth

Our son's arrival into the World was a dramatic experience for me.  As a first-time Father, my job was primarily to drive the first-time Mother (Lucy) the 22 miles to the hospital in time for the midwives to do their thing, ad for me to time the gaps between contractions, and to reassure my labouring partner that all would be well.

In the early hours of the morning, we carefully drove on icy roads (it was about -4.5C outside) towards the hospital.  About two minutes into the journey, the "Check Engine" light illuminated on my dashboard and I could feel all was not well with the car.  Somehow, I managed to keep this information from L as she contracted regularly beside me, and we proceeded on fewer cylinders than is normally recommended for a car! We made it in the end, the birth went better than we’d dared to hope in the midwife-led unit’s birthing pool (rather than in a frosty lay-by!), Edward was born and he looked just perfect.

Mother's instincts kicked in immediately, and L held our new son to her chest in the pool as the umbilical cord slowly pulsed the last of its goodness into our little boy.  Once it had stopped completely, I had the honour of severing the slightly crunchy tube that had been nourishing him for the previous 9 months.  Shortly afterwards, I held him from the first time.  I'd never felt so proud as that moment - of E, and of L (and, let's face it, of myself!)  What a team!


Immediately, it was clear that E was very eager to feed and had very strong suction (as evidenced by the hicky he left while sucking in the wrong place, that stayed for weeks!) However he tired very easily and slept a lot.  We kept asking the midwives to check his latch and tongue, but they seemed to think he was OK (apart from one, who merely said he had "a quirky tongue").  We didn't think too much of it, but later down the line we discovered through our own research that he had a posterior tongue-tie with corresponding lip-tie, and that it was seriously affecting the effectiveness of his feeding technique.

Latching problems

Feeding was tricky, as he just wouldn't seem to latch properly.  Again and again L would try to bring him to the breast, but the position never seemed quite right, and he'd unlatch himself quickly.  Occasionally he'd suck for a while, but he usually soon gave in.  Various midwives would come in to help position him, to show us tips on how to get him to open his mouth wide and so on, but it felt very tricky and E simply didn't want to open his mouth wide enough. They would also come in to help L hand-express little golden drops of colostrum into tiny syringes, which we'd drip into E's mouth, and he'd always lap it up - he simply couldn't get much from his Mum himself.


By the evening, the midwives were starting to worry.  They checked his blood-sugar level and showed us how it had been falling.  We were told it was getting towards dangerously low levels and that we should try to give him some formula to get his blood sugar levels up again.  E was still very drowsy, and fairly unresponsive, so we reluctantly and tearfully agreed to try it, because we were scared of the consequences of doing nothing.  If he couldn't stay awake, he'd never feed and it'd just get worse and worse.

We watched in aghast as the midwives tried to bottle-feed formula into our baby boy.  We had so wanted him to be solely breastfed, but that decision seemed to be out of our hands at this stage.  We hadn't slept, his condition was deteriorating and experts were telling us this was the right course of action, but it didn't feel right.

E didn't want to suck on the bottle and didn’t swallow much of the formula, clearly disliking the flavour.  He was jaundiced and sleepy, but they insisted on trying.  E never took to a bottle and, to this day, has never had a proper drink from one (despite us trying once with EBM).  He vomited repeatedly and it was a heartbreaking experience.


Later that day, E's blood was tested, and his protein levels were found to be elevated, indicating an infection of some sort.  We took him down to the ICU to have a cannula fitted, to allow them to give him antibiotics, and had to endure the hardest hour and a half of our lives.  The doctors really struggled to fit the cannula.  Every vein collapsed when they touched it, and despite enormously bright lights shining through his arm, it took ages to get a good fit.  L and I were there the whole time, supporting each other and trying to calm E's cries by letting him suck on our fingers. One of the nurses asked if we had a pacifier for him, but we didn't because we didn't think it would help with his feeding.  It took several doctors and numerous attempts to get it right, and it was really traumatic for us all.

They took blood cultures to look for infections, and gave him the first of a course of antibiotics (to be administered at 12 hour intervals, day and night, for 5 days).


Even with E being so sleepy and poorly, L still managed to do her best to feed him regularly as well as giving him syringes of colostrum.  It was emotional to watch the struggle.  We had been led to believe that breastfeeding was totally natural and should be easy.  We had also been told that any pain meant something was wrong, and L took that as meaning that she was doing it wrong, rather than there being a physical problem.

Leaving them at the hospital 

After 20 hours in the hospital, I had to leave to go home, feed the cats and get some sleep. It evoked mixed emotions. I was obviously exhausted and elated to be a Father, and looking forward to sleeping in my own bed, but it was really difficult to leave the two of them alone in the hospital.  I knew L wasn’t a big fan of hospitals, having had some bad experiences in the past, and with E not being 100% well, it was definitely a real worry having to leave their side.  Add into that the complication of having a sick cat at home, and having to take her to the vets every day or two that week, and it was a very stressful, busy, complicated time. I kissed L & E goodbye and drove the long journey home, wondering how their first night would go together. By the morning, I'd found out.  The pair of them had had a very difficult night, with E crying incessantly, and not feeding properly.

I was back and forth to the hospital a lot over the next few days, trying to spend as much time as possible with E & L, whilst also caring for a sick cat and trying to snatch a few minutes of sleep here and there.  Sometimes the antibiotics went in easily, other times the cannula became "stiff" and needed replacing.  During this time, L also picked up an infection, so the two of them were trying to recover together.

The doctors decided to X-Ray E's chest, to check for liquid on his lungs.  There was a little, but this was apparently consistent with the infection they were treating. The cultures were inconclusive, which meant that it was nothing too serious, and after narrowly avoiding a lumber puncture (something his mum had had before and so desperately hoped he wouldn’t need) he began to pick up.  After that first night, we were reassured by a different midwife that the best thing for him was breast milk and, somehow, L managed to get him to feed...albeit painfully for her.

Helping to lighten the load

On one occasion, when things had been particularly difficult the hospital let me sleep in the chair overnight, and I did everything I could to try to lighten the load on L.  I would change diapers (cleaning up meconium with cotton wool and water is basically impossible, I soon discovered!), I would make sure L had water and snacks when she wanted them, I’d call the midwives whenever she had a concern, I would accompany them both to all the appointments at the special care unit and would push the crib around the hospital to give L a break. Also, more generally, I just tried to be supportive and keep L’s spirits up by “normalising” the situation as much as I could.  Being there as a family and learning to be parents together was actually really lovely, despite the difficulties. I strongly believe that fathers have a very important role to play in “cheerleading” for breastfeeding, and making sure that the Mother knows they are 100% behind them in trying to do the best for the baby. I think too many Dads think it’s not their problem, or just don’t do the research beforehand, and so don’t realise what a precious gift Mother’s milk is to their child.

Nonetheless, feeding was still difficult, and she found herself with lumpy breasts as a consequence of E's poor technique. Watching L and E struggle was one of the hardest things.  I knew how much L wanted to breastfeed, and we’d been led to believe that it should be straightforward.  We had been told that “if it hurts, there’s something wrong”, which L had internalised as meaning she was *doing* something wrong, rather than there being an external issue.  I did my best to try to memorise all the tips and tricks the midwives were telling us, and small corrections to positioning, which might make things easier, but it was heartbreaking to see them struggling with such a basic human function.

Home together

Before we were allowed to leave the hospital, we had to check E's weight.  He'd dropped about 6%, which was perfectly OK over that period.  They checked his blood again and the protein levels had fallen, whilst the sugar levels had risen, so they allowed us to go home very nearly a week after we first arrived.  L was packed off with a selection of medication and we began the long journey home.

Tearful feeds

Over the next few months, feeding was extremely difficult, and L was in tears at every feed.  Feeds frequently took an hour, every other hour.  E was suffering with bright green poos and painful wind, was making “clicking” noises as he fed and was simply unable to latch well.  Often, he would open his mouth wide, try to latch, slip off the nipple very quickly and then fall asleep before getting a good feed – waking up a short time later wanting to be fed again.  It was exhausting and excruciatingly painful. Some days it all seemed too much for L, and she considered using formula, but we both knew in the cold light of day she’d regret it, so we managed to get through the dark moments together.

While this was going on, we also struggled to get E to sleep anywhere but in our arms, so we couldn’t even sleep when he did.  We spent the first month of his life taking shifts to get any sleep, but L never got more than an hour or so here and there before E needed to feed again.  She basically spent the first six weeks on the smallest amount of sleep possible to function.  Looking back now, I don’t know how she survived.  Having a baby that had so much difficulty feeding and wouldn’t be put down to sleep took its toll and we decided to try co-sleeping as a way of getting some rest.  It was - and still is - a big help!

Formula banned

We knew something was wrong and, after seeking help online, we were advised to see an IBCLC.  E was less than two weeks old when we first saw the lactation consultant on Boxing Day, and she confirmed our fears by diagnosing a Posterior Tongue-Tie and High-Arch Palate.  She was partially retired and couldn’t refer us to a specialist, but she suggested seeing our HV or GP, which we did…again and again.  Each in turn failed to see an obvious problem with E’s tongue (or his lip, as by this time we suspected a lip-tie as well) and we were repeatedly told that he was gaining weight so there wasn’t an issue. Health Professionals seemed totally cold to the effect the feeding difficulties were having on L and were unwilling to help her as long as E was thriving. We battled on as a family, refusing to “give in” and move to formula top-ups no matter how much pain L was in.  We both decided not to even have any in the house, but I was worried about how hard it was getting for L to feed our child naturally.

Our first family walk, with E snuggled close. One of the few times in the first three months, that L felt comfortable leaving the house.    

Pain hard to bear

It was clear that the pain was getting worse.  L would cry with pain before, during and after every feed. She is no stranger to pain either, suffering and coping with chronic back pain for 8 years prior to starting our family, but even so it was hard to bear. L was suffering lipstick-shaped nipples after a feed, blisters on the surface and a milk-blister, too. Her nipples didn’t have time to recover between feeds and to top it all they began to “blanch” at the slightest provocation. A drop in temperature, the lightest touch of clothing, or even a passing breeze if they were left exposed to the air would result in painful spasms.  It became a total vicious cycle.  Her nipples would spasm during feeds, reducing the milk flow considerably resulting in more pain and an even more frustrated baby. Often, mid-way through a feed E would “flick” his tongue enormously powerfully against the surface of L’s nipple in a desperate attempt to elicit milk, sending a paralysing bolt of pain through her whole body and making her literally jump in shock.

We did talk to a GP about vasospasm/Reynaud’s syndrome, but she knew nothing of the condition, offered treatment for thrush (which L didn’t have) and sent us back to the feeding clinic we’d gone to on E’s first day for help with positioning.  We went back there when E was a few months old and L was suffering from a blocked duct/early-stage mastitis that had occurred a few times by then.  They finally spotted the tongue-tie and referred us to the specialist we needed.

The whole process of feeding and nurturing our beautiful boy was a million miles from what either of us had imagined when we had, on so many occasions before he was born, discussed him being breastfed.  It was soul-destroying and so difficult to witness L’s suffering and E’s frustration at having to fight for his food.

No snip

When E was around 6 months old, we visited the tongue-tie specialist.  She confirmed the diagnosis immediately, saying E had an "obvious" posterior tongue-tie, but there was a problem.  By this stage, E was older than 6 months old and it was too late to have the tie snipped without going under general anaesthetic, which we weren't prepared to risk without knowing more about whether the tie might affect his speech later on.

Somehow, through sheer will and determination, and no end of painful shallow latching, L has managed to breastfeed for 12 months so far (and apart from the midwives attempts with FF it was exclusively for the first 6 and a half months) and she intends to continue for another year at least, leaving it up to him to decide when he is ready to stop.  I'm in awe at her staying power.  It hasn't been easy.  Far from it.  I'm so proud of them both, and the role model L is being to young E at this early age.

E is now thriving on his breast-fed, cloth-nappied, sling-carried, baby-led-weaned lifestyle.  Although feeding always regresses during growth-spurts and E's latch deteriorates even further, he still manages to get the milk he needs at the expense of L's nipples!

A dad's thoughts on public breastfeeding

L even happily breastfeeds in public, which is lovely to see. I’m extremely proud of her.  She started off very wary, as you might expect, but is now very happy to find a quiet corner when we’re out and feed the little chap.  She continues to do so to this day (although, these days he’s often far too interested in all the exciting novel sights and sounds to drink properly when we’re out, but that’s a different issue!)  I think it’s important for other women to see breastfeeding as a normal, natural thing to do, and I think that L feeding E in public (and he’s a big 13-month old now) can play a big part in reassuring others to do the same in the future.

Donating milk

Earlier this year, L decided to donate milk to the milk bank for sick and premature babies at the hospital where E was born.  She had got the idea from speaking to the breastfeeding coordinator when E was only a few days old, but had been delayed in starting due to the difficulties we were having with breastfeeding.  I can't imagine having the capacity to give so much to strangers at a time when L is already giving so much to E.

I have heard it said that Fathers need to be able to bottle-feed their babies in order to bond with them and feel involved in their upbringing.  This has not been my experience at all.  Through playing with him, cuddling him as he sleeps, soothing his tears, carrying him in the sling and generally being there for him, I feel totally “bonded” and “involved” with my year-old son.  Not being able to stick a plastic bottle in his mouth hasn’t affected that in the slightest.

Fingers crossed our second year as parents goes a little more smoothly than the first, but I couldn't have wished for E to have a more loving or selfless Mother, who always puts him first, even when times get hard. Our lives have been totally turned upside-down, but we are so happy as a family that we've managed to support each other and get through this first.

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