Interview 06

Age at interview: 40

Brief Outline:

Mixed breast and bottle feeding because the mother haemorrhaged badly after a Caesarean Section and was very ill for a long time. Expressing didn't improve milk supply.

Background:

At the time of interview, this 40 year old, White British woman had a son aged 3 years whom she had breastfed for 6 months. A teacher, she was married to a university lecturer.

More about me...

This woman agreed to be interviewed because she says that she is a good example of combination feeding actually working. She was very ill at the time of her baby's birth and for a long time afterwards. No amount of expressing improved her milk supply so she and her husband used top-up feeds of formula. This gave her the added advantage of allowing someone else to feed the baby when she was unable to do it or needed to rest. It also allowed her husband, who did everything for the baby while she was ill, to experience feeding as well. Because she is in a wheel chair, she has extra help in the house but still considers herself the 'hub' of the home. Being in a wheel chair did not affect her ability to breastfeed. However, her most important breastfeeding aid was a U-shaped bean bag that enabled her to have the baby on her lap for feeding while sparing her arms from his weight. She is very proud of having breastfed her baby. The formula top-ups gradually increased in volume and number so that by the time she returned to work when the baby was six months old, he was completely weaned from the breast. She says that it was very important to keep things in perspective even though she wanted to strive for perfection.
 

She practised mixed breast and bottle feeding as a result of being very ill at first and introducing a bottle of formula. Her consultant recommended regularity.

Well because I took warfarin at the time then it was actually heparin when I was pregnant, but my heparin levels weren't checked and I was over-herparinised so my blood was eight times too thin, so then I started to bleed or whatever it was internally and I had to have the caesarean opened up again, and it all had to be pumped out. So I think a double caesarean was part of the reason that my milk didn't come through, I mean, in the hospital it was quite challenging in that I was there for about ten days after the baby was born and there were other mothers who were breastfeeding, apparently really easily and I was thinking 'I don't seem to be able to get enough milk here' I now understand that I was actually so ill and so weak, so I think I lost two stone after the birth, I just lost weight really quickly and I just didn't have enough to make milk and to keep myself going. I didn't realise that at the time though. Perhaps if there were to be another time then I'd be easier on myself, more understanding but there was a, there was one night in the hospital I remember it distinctly, when the baby wouldn't stop crying and my husband was in the hospital with me and we were going up and down the corridor trying to soothe the baby and I eventually went to one of the midwives and said, 'Look what do you think?'. And she said, 'Well I think that he's starving actually, I think he's really hungry, he's trying to breastfeed off your chin at the moment,' [Laughs]. And I had him over my shoulder and he was trying to breastfeed off my chin, so, I just didn't have enough milk at the start so we needed the formula and then because my husband was able to do that and it was quite nice for him, so we just left it like that and perhaps twice a day he'd have a formula feed rather than a breastfeed.

Certainly my consultant said it was the most positive thing, the best thing I could do for the baby. He also said that giving the baby a routine was the best thing I could do for the baby, and also for us. And I think that was very true so that's something that, now, if the, if the child wakes up in the night then he's not happy about it so he's used to his twelve hour sleep now and that's it. Which is fantastic for us actually, fantastic. But I think that was something that was established very early on. We needed because of our circumstances, we needed to know when he was going to sleep, and when he was going to be awake, and we had to establish that from a few weeks old.

So how did you establish that routine? Can you remember?

I used to wake him up so that he didn't have too many hours sleep at that time, so he'd then perhaps have two hours awake and eventually have another sleep and then a little bit of time awake, another sleep, so I don't know anyone else of my friends who's done it like that actually'

So how frequently'

'but for us that was great.

'do you think you were feeding, breastfeeding during the day'

Well it certainly'

'when you came home?

'was more than every four hours. So, you know, I mean that was a problem at the start that I was so weak and I was also doing feeds as well.
 

She thinks it is important to keep things in perspective and realise that you may not get it right all the time.

Yeah about keeping everything in perspective then my son is only three but now things, I don't remember things as being particularly difficult. So you asked me about weaning before and I was actually quite thrown because I thought, 'Oh I don't remember that being particularly hard' I remember being a bit organised in that I had a list on the fridge that I'd got from a book and I'd copied it out dutifully, and there were loads of things on this list, and it said that he could have baby rice for a few days and then he'd go on to the vegetables, and fruit, different kinds of things, and as he didn't react then I'd tick them off and do combinations of things. But as far as that all being difficult, then I suppose I think perhaps after all that I'd been through then that didn't really seem like a big deal. And again my priority has always been how can I do the best for him? Which is why I pursued the breastfeeding and I suppose there was, you know, bits of guilt in me at the time thinking, 'Oh why can't I do one hundred percent breastfeeding? Why have I got to do formula?' but looking back I think that was all because I was in a little, a tiny little vortex that going smaller, and smaller, and smaller, and more concentrated, but after a few months then the picture gets bigger, and bigger, and bigger, and things slip back into place and become more normal.

So what would you say to someone who feels that they are in that vortex that you describe?

I think to not eat yourself up, to give yourself a break and to think, 'I'm doing so, so well', I think that's the thing. It's maybe a women thing, a woman thing as well, to give yourself a pat on the back and actually acknowledge, because there are two schools of thought. When I was little, when I was a baby then it was formula is the best thing, now I know that breast is the best. I think if breast can be a big part of your baby's life then you're doing a fantastic job, but if it gives you a break to give a little bit of formula then you're not actually harming the baby, of course you're not, but if you need to give a little bit, then you should do it.

Do you think there's something in women that makes them strive for perfection?

Oh I think there definitely is, and producing a baby, then you've made something that is so perfect, then you want to get everything right for it, you want to do the best, it's an extension of you, you want it to be perfect. But the baby is also a bit of a spanner in the works as well because, you know, things happen and you learn things in the first few weeks of having a baby and you think, 'How come nobody ever told me about that?' so the best nappy cream, and the best teething gel, you know, things now that friends say to me, 'Yeah but what's the best in that?' And I'll just tell them what I think and they'll go, 'God how come nobody ever told me that?' So it's almost, when you're in the first few months of motherhood it's like a whole new world, and, so it's not like when you get a job because you're sort of sharing that, with other people, it's really quite a, it's a very, very special time and I wouldn't have missed it for the world. It's very beautiful but with that also comes stress and striving to do the best and maybe not getting it right all the time.
 

She needed practical assistance around the home and said that a crescent shaped beanbag was the best aid for breastfeeding her baby.

I think because I was so ill and I had a nine unit blood transfusion, and I was just exhausted. And I'd lost, I think during the pregnancy I'd gone up to maybe eleven stone and I came out of hospital and I was eight and half so it just dropped off me really, really quickly and then because the Caesarean had been opened for a second time, then it actually didn't clot so the wound was open for three months and had to be dressed every day.

How did that affect your breastfeeding?

Well I had to, I had a big pad over it almost like a sanitary towel and then a beanbag. And the beanbag was great actually because it meant that the baby could get in the right position quite easily without too much effort from me.

What about lifting the baby and doing things with the baby?

No I was very weak, so it was another way of being close really and I think that's why, that's another reason that I persevered.

So what sort of assistance were you getting at the stage?

It was mainly my husband at that stage he was on sabbatical so he was around more. Yeah.

And he did everything else for baby and you just fed?

I fed and nursed and was just there all the time but as far as dress, dressing, bathing and nappie's then I couldn't do it.

Was this solely because of the Caesarean and the weakness?

Certainly I could do more before the birth; I was more capable before the birth.

How long did it take you to recover?

Probably about six months, I think the weight had come back within six months and I would be back to sort of ten stone something like that.

And by then were you doing things normally for the baby yourself or was your husband still doing it all?

No we then got help because my arms have actually never returned properly but that's probably something that's, I'll never know really whether it's my condition or whether what happened at the birth was a catalyst I don't know.

Do you want to tell me about your condition?

Yeah, I've got a condition that we thought it was MS [multiple sclerosis] for many years and then it transpires isn't MS because I don't have the lesions on my brain, on my spine, so there appears to be a thinning at the base of my spine and whatever that is, obviously is now moving up my spine, as my arms are now weaker.

So what does this mean for you in everyday life?

So it means that I am, I think I'm the hub and I pass jobs outwards, so people have roles and I get support in the house from people who I employ to do cooking, and washing, and cleaning. So I still feel very much like it's my house, and I'm the mother, and I don't know what it would be like if it wasn't, you know, I've never experienced, obviously before the baby was born then I was doing more myself, you know, I was essentially running the house as well as working but now it's a bit different.

Are you still working?

Yeah, I still work, yeah.

What is it you do?

I'm a teacher in a secondary school.

And you're in a wheelchair?
 

She used infant formula ‘top ups’, but is pleased that her son was essentially breastfed.

He was, he was breastfed in the very first few hours and then I became very ill after the caesarean so he, I think he perhaps had an ounce of formula in his first twenty-four hours and then that really kept going with an ounce of formula until he was six months old. By six months old I think he was perhaps on twelve ounces of formula but that would be two bottle feeds and then the rest would be breastfeeding by me.

So you were putting him to the breast regularly?

Yes, too regularly really, as in trying to make more milk, then it seemed to, you know, it was, it seemed to be almost constant at one point which of course I wasn't then giving myself any chance to have a rest. I think that's why we needed the ounces, or the two ounces of formula during the first few weeks, when I came out of hospital my health visitor was very supportive in working out a combination plan so that the baby would put on weight.

Can you remember what that plan was?

It involved three ounces of formula.

Every feed or?

No.

Once a day?

Twice a day. So it would be once at night. So something like seven o'clock at night and seven o'clock in the morning and all the rest of time he was fed by me, and he did put on weight quite slowly, to start with, but I've spoken subsequently to other mothers who've breastfed and they've said, 'Oh he seems to have put on weight just the same as my son did'. And I think I was quite ignorant about how much more slowly breastfed babies put on weight than formula fed. But also I think the charts in the little health books that the kids get, I think that they are based on formula fed babies, so inevitably you're not going to be at the fiftieth percentile. My child was born at the twenty-fifth percentile and dropped after two weeks, less than two weeks, but certainly at two weeks he was on the ninth percentile. He didn't go below the ninth but it was quite, quite slow for him to come back up.

Was that seen as a problem?

Yes.

With what consequences?

That he wasn't getting enough food that he wasn't growing quickly enough. And I do [pause] I do think that as far as I'm concerned that after I'd had the baby then I, throughout pregnancy, I'd been in this sort of, 'Well health professionals know best and I'll just do what they say' and, which actually in other walks of life, you know, I take my own decisions really, but it was a time when I'd sort of resigned myself to, 'I don't know much about this'. If I were to do it again then I'd certainly trust my own judgement, more, and go with what I thought was right.

Because I'd have thought, 'I'm not doing the best for my baby'. By doing, so it felt okay to, it was almost a, the formula for us was a saviour to have that extra top up definitely, and I think that's all it was actually a top up [pause]. I can't remember what I was going to say, the formula was a top up.

A saviour for feeding in public?

Yeah, it was a saviour for at the end and the start of the day that would be our end and our start and that was fine, and we knew that that's all it was. But essentially our child was breastfed and that's the way I'd like to remember it really. But I'm honest enough to admit that if we hadn't have had the formula then we just, I don't know actually what would have happened, I'm sure he wouldn't have starved but perhaps it would have been at a greater cost to me.