Sienna was born on 21st November 2017 during an almost home birth from which I decided to transfer as after hours of second stage, she did not appear to progress through the birth canal. I am not quite sure why but it resulted in a forceps delivery which left her with some bruising and swelling on her face.
We were lucky as she was born with a great Apgar score and stayed with me the whole time, yet I could tell she was struggling to latch from the very beginning. We stayed in hospital two nights and during that time, she never latched very well and each attempt was a struggle for her and for me. Midwives helped me hand expressed colostrum which we fed her with a syringe. Needless to say I did not get much sleep at all during our stay, Sienna was constantly crying and I was feeling very helpless and confused as to her inability to latch. It was very trying especially after an overnight labour, yet I did not receive enough help at the hospital and I did not know it at the time.
My hospital notes states that we have been advised to stay an extra day as Sienna could not feed, yet the next day, I did not receive visits from lactation consultants or anyone to help truly assess the situation and put a care plan in place. I really wanted to insist on this but as all of this was so alien to me and I was so tired that I did not think to push for more help. This would be my first advice regardless of where you birth, if you want to breastfeed, prepare a list of emergency contacts and make sure you get all the help you can even if you need to ask again and again!
I remember as we left the hospital, one midwife told me: “expect to feed around 3am” and I thought: “well my baby does not even know how to feed yet”. I left and went home thinking that once we would be home, relaxed and warm, my milk would come and she would finally get it.
None of this happened, Sienna continued to struggle and was spending all her time trying to feed, I was hand-expressing and feeding her with a syringe, I was getting 10 ml at a time and it was more or less non-stop. After a chaotic night where my partner and I feared for her, we received the visit of the midwife who alerted us that Sienna had lost too much weight and who told us we had 24 hours to reverse the tendency or she would be hospitalised. This was so traumatic for me as I felt I was failing my child, I so wanted to give her the best and yet we were struggling so much. The same day, a friend of mine who is an osteopath visited us and released some of the trauma Sienna experienced during her birth. She then latched on and I felt like we had made it, yet I soon found out that she was not able to stimulate a let-down reflex and would not know how to carry on feeding once the milk had stopped coming out on its own.
Enter, my doula Tricia who really saved the day! She was full of practical advice and made sure Boz & I were properly equipped to face this situation. That day, we bought nipple shields and a breast pump and I started to express after a feeding attempt whilst my partner was giving her some milk with a little cup. For as long as possible, we tried to avoid bottles but we soon had to try it as we were so exhausted and Sienna would struggle with the cup and syringe, it was taking so long to feed her and she needed to put weight on to avoid going back to hospital.
As we were struggling as new parents to come to a good way to feed our child, I felt very isolated as I received negative comments about our attempts to feed her. I was told that breast shields and breast pump kill supply and that I was basically heading towards formula and I was a bit silly to carry on. I was criticised for letting her at the breast for very extended period of time as if I was spoiling her when the poor wee soul was trying so hard to master feeding. It was such a hard time for us all. Eventually, as my partner would soon have to return to work, we needed a better plan that I could follow when alone too so we called a lactation consultant who came to assess Sienna and put a plan in place called active management.
Active management is hardcore. In order to ensure that Sienna was getting enough milk, I had to offer her the breast for 15 minutes on each side (providing that she would latch and stay for that long, switching as often as possible between breast if she was losing her latch (think every 2-3 min)). Then I would express to empty both breasts and stimulate production for around 20 minutes whilst topping her up with expressed breast milk. By that time, we were roughly a month in and we were using bottles to give her the supplement. With hindsight, I think I should have used a supplement nursing system so that Sienna would have received her milk whilst at the breast and I would have lowered the probability that she would develop nipple confusion yet at the time we were very much in survival mode and I felt it would have been overwhelming to add yet another prop to my arsenal.
After seven weeks off, Boz returned to work on the 9th January and it was time for me to carry on with active management alone. By then we were mix feeding as I had not have a chance to build a big back up of breast milk and we would sometimes run out. The first time we gave her formula, days after birth, I remembered crying next to her as Boz was feeding her, I felt that I was failing my daughter and I was really afraid she would develop eczema as a result (Boz has eczema and asthma). It was such a strange feeling and I believe that the “Breast is best” campaign contributed to my feeling of failure as I am not anti-formula feeding at all, some of my nieces and nephews were formula-fed and I never thought twice about it but I had built this idea in my head that if I were not breastfeeding her she would get poorly and seeing her trying to feed so hard yet not managing it broke my heart too.
We carried on like this until 17th March 2018 (116 days after she was born). One day before that day, Sienna received her immunisation, she refused the breast afterwards but as this was happening from time to time, I did not panic and bottle fed her instead. During the night, she would usually breastfeed (whereas for comfort or hunger I am not sure) and it was sometimes possible for me to feed her at 1am and 3am without the need for a bottle, I would then get up and express and prepare a feed which she would have around 5am. It was exhausting but we had a routine and things were fine. I was resting in the morning and going out in the afternoon. During that night, she refused to latch and started crying, arching her back and throwing her fists towards me anytime I was trying to put her near my boob. At first, I thought she was in pain because of the immunisation and we gave her a bottle instead. The second day and night, it was the same, she would either take the breast 2 min or scream at it. One of my closest friend was visiting at the time and I just gave her bottles and expressed instead as I could not face how angry and upset Sienna was getting.
When my friend left on the Sunday, I completely lost it and felt like Sienna was rejecting me, again I felt like such a failure, I was upsetting my baby who was clearly not wanting to breastfeed and I felt like I was assaulting her by insisting. This was the worst point of my breastfeeding journey and during the following days, I tried to feed her again (took a bath with her, lots of skin to skin, all the good stuff) but she was not latching or when she was, she would bite rather than suckle. Eventually, I could not face trying anymore as I was feeling too awkward trying to offer her the breast. However, I did not want to stop giving her breastmilk and continued expressing. Yet as she was no longer at the breast, I had suddenly became the sole guardian of my supply and I had to adapt to Eping (exclusively pumping). At first I was getting around 600ml of milk a day and was generally expressing first thing in the morning, noon, 4pm, 10pm, 4am which I later discovered was not often enough to build my supply. It took me a while to familiarise myself with the practice and I was so close to stopping so many time. Until Sienna was 8 months old, I expressed every day at 8, 11, 13 17, 22, 4am, I then dropped the 4am session as she was sleeping through and I had enough.
Fast forward 10 months and I am still going! My supply has not disappeared as I was told it would by family members when I first used a breast pump. Around 750 hours of pumping, 250 liters of milk expressed, liters of back-up in the freezer and a strong healthy happy baby who still gets my milk at 14 months of age, morning, afternoon and evening! I am only expressing 3 times daily these days and my supply has dropped significantly so Sienna just gets what I produce as I produce it. She waits next to me as she knows I will fill up her sippy cup with milk! She loves it so much, it keeps me going. I had planned to stop when she turned 1 but could not bring myself to do it so now I just go with the flow!
A massive thank you to Laeticia for writing up this information for us about Eping (exclusively pumping). I’ve been in such a privilege position to watch her through this experience as her doula and friend and see her absolute determination to give her daughter breastmilk. There are so little resources on exclusively pumping that I asked her to write up her experience. Thank you!
There’s a few things I wanted to highlight. First, so much antenatal breastfeeding education is very poorly done that it teaches about the MECHANICS of breastfeeding – ie benefits, latch etc but there’s very little out there which ever discusses what’s difficult about breastfeeding and how to solve them including the massive emotional journey. It’s almost as though we should never be discussing why breastfeeding MAY be hard. It’s maybe here that women are failed in many ways. We know that breastfeeding is the biological NORMAL way to feed your baby but it’s definitely not always easy and I’ve yet to meet a first time mum that found it super easy straight away.
It’s so important to be set up BEFORE you even start breastfeeding to know where to go to get help and it’s the first part of the breastfeeding bundle success strategy is about doing your RESEARCH BEFORE you have your baby so if you need help you can access it quickly.
We also must start to recognise the women are traumatised by their breastfeeding experience – Laeticia is not alone here in using those words. This is so under recognised sadly. There’s been a massive discussion this week on Radio 4 about breastfeeding experiences which I’ve loved listening to and would HIGHLY recommend. If you have had a difficult experience and would like to get support, do get in touch.
I’m so thrilled that the biggest honour of all is that Laeticia became a doula and is now supporting women in Edinburgh for birth work. If you are in Edinburgh you can find her on her website and facebook page.
If you are pregnant and would like to really support your breastfeeding experience – take a look at the breastfeeding bundle.