Interview 24

Age at interview: 31

Brief Outline: Ceasarean section with first baby, nipple shields, abundant milk supply, mastitis. Has breastfed toddlers and tandem fed new baby with toddler.

Background: At the time of interview, this 31 year old, White British woman was breastfeeding her 4 month old son. She also had 5 and 2 year old daughters, both of whom she had breastfed. She was a student and her partner was an investment banker.

More about me...

A medical student at the time, this woman had no knowledge of breastfeeding prior to her first pregnancy but fervently wishes that she had seen more people breastfeeding, that she had known that the way you position a baby at the breast is important and that she had been given more assistance in hospital after the birth. She feels that she went home not knowing how to latch the baby onto the breast and that led to many problems. Her abundant milk supply also caused several episodes of mastitis with this and subsequent babies, especially when she was tired and run down. Because of all the difficulties that she had with this first baby she realised that breastfeeding wasn't “the easy, natural thing” that she had expected it to be. She became very interested and did a lot of reading and internet searching for information about breastfeeding. For useful information, she thoroughly recommends the book “Bestfeeding' Getting Breastfeeding Right for You' An Illustrated Guide” written by Mary Renfrew, Chloe Fisher and Suzanne Arms and published by Celestial Arts, Berkeley, California in 1990. She also thinks that it is essential to have the face-to-face encouragement and support of women experienced in or knowledgeable about breastfeeding and that just reading a book alone is inadequate. She wishes that there had been a Breastfeeding Clinic nearby when she had her first baby and that she had known about breastfeeding counsellors and support groups such as National Childbirth Trust (NCT) and La Leche League (LLL) or other organisations like the baby cafés where mothers can go for informal breastfeeding advice. She thinks that once it is properly established “breastfeeding is the best thing, it's enjoyable, the babies love it, it is a really good experience and a big part of being a mother”.

She had a caesarean section with her first baby and a water birth with her second, after which...

I went for an ultrasound scan which estimated the baby was going to be ten and a half pounds or, four and a, four point six kilos or something. And they said “right you, you really can’t have this baby naturally, or at least you could but it’ll be dangerous so you have to have a caesarean or an induction tomorrow, but we recommend a caesarean”. So I hummed and hahed for all of one evening, I was really kind of put on the spot and went for a caesarean, so I had an elective caesarean, I didn’t have any labour at all, so I think in retrospect that wasn’t a particularly good start for things because I, I’d felt this was a bit sprung on me and I hadn’t expected to have to have a caesarean and I, certainly hadn’t expected to-to not have any labour at all, I mean one minute I was pregnant, the next minute a baby was pulled out of me and, you know, and then so they put the baby with me about, once I’d been sewn up and, sort of moved out of the operating theatre in to a kind of side room, they tried to get the baby on the breast, but it wasn’t really successful, I mean I don’t, I don’t think I really knew what to expect, you know, what it was for a baby to latch on I didn’t really know, but I got the feeling it wasn’t really working exactly. 

With baby number two, I’ve felt two things about that baby that when I was pregnant that, one that I did not want to have another caesarean as a matter of course, and secondly that I wanted the-the breastfeeding to go better this time and not to have all the kind of traumatic stuff about, you know, that we’d had with the first baby. So I was quite determined to have a natural birth and, for that reason I didn’t want to have the baby at hospital in the end and I had midwife, midwifery care rather than just consultant care that I’d had with the first baby. And, I think the support that I got from them helped me to feel more confident about breastfeeding as well when the baby arrived and in fact I did have a, a vaginal birth with the second baby, and that went really smoothly and it was a really much better experience than it had been first time round. And so when I had a water birth and I, when I’d had the baby the first thing I did more or less, once the baby, you know, had kind of opened her eyes and, was put her on the breast, and she just took it better, I won’t say perfectly, but she kind of knew what to do, whereas the first baby there’d been a big gap between when I’d had, when she’d been delivered and when, I’d actually first tried to feed her, plus it was not in a very nice environment the first time it was in the kind of brightly lit on a hospital trolley, whereas the second time it was, the lighting was dimmed, I was in a pool, I was just with two midwives and my husband, and it was a much, much calmer nicer atmosphere. And I also think my nipples had [laughs] been slightly pulled out or protruded, or whatever you wanna say, because I’d fed the other baby for as long as I did and I think that helped too. Also I knew better about how to position a baby and that sort of thing, and my midwives were really, really helpful this time. So she just kind of worked it out quicker and I was more confident, although I won’t say it was perfect because when I got back home I, I’d, ‘cause I didn’t have a home birth I had her in a birth centre, I still had problems thinking that, you know, the latch wasn’t quite right and, I was still a little bit worried so I, this time I thought ‘right I’m gonna get somebody who knows what they’re talking about round to my house’ like I had done the first time, so there was a woman in the local area who, who was a, ex-midwife and a breastfeeding counsellor and she came roun

She advises health professionals to encourage women and women to find someone who they know and...

What would you like to say to health professionals?

I suppose I would say to encourage women as best they can to try breastfeeding, to keep at breastfeeding, to try and help them resolve problems that are bound to come up for a lot of women, not to think that it's the best thing to do is to, to give up. I mean I do know lot of people say that their health visitors have said, 'Oh the baby's not gaining enough weight' and as a result they've given up breastfeeding and then afterwards they've regretted it, and wished that it hadn't come to that. And I'm sceptical that that's always the best solution, I don't think that, I think there's a lot of fuss about weight gain and in some cases it may be warranted but I think in a lot of cases it may not be and it's caused women a lot of anxiety and I suppose in the early days it would be good if there wasn't lots of conflicting advice, it would be good if you had someone that you knew and trusted that could help you and you didn't just sort of get one person coming in for two seconds and then another person telling you something completely different. I think there should be more Breastfeeding Clinics, if only there were.

Breastfeeding was a big part of being a mother and she wished that she had seen more women...

I wish I had seen more people breastfeeding, I wish I had known that the way you position them is important and the way you put their mouth to the breast is important, you can't just sort of put them on willy-nilly. I wish I'd known that it wasn't going to be easy straightforward, I mean I know for some people it is, but I would say the majority of people I know have had quite a lot of problems beginning breastfeeding. So maybe I wish I'd, armed myself in advance with a few books or maybe gone to some kind of breastfeeding workshop or classes or something. I really wished there'd been a Breastfeeding Clinic in London where I had my first baby, there is one where I live now, which has helped, helped me with my second baby, I should have mentioned that I, that I did go to see them and they were very good at telling you how to latch the baby on and encouraging you to keep persevering even if it was difficult. I think the encouragement and support from people who've breastfed themselves or who know, know a lot about it is one of the most important things. I wish that I'd had more family who'd breastfed or, more friends, I think if I had then I would've known what to expect a bit more with the first baby.

What would you like to say to a newly pregnant woman?

I'd like to say that if, once breastfeeding has been properly established it is the best thing, I mean it's enjoyable, the babies love it, it's a very good experience all round it really is a big part of being a mother for me. But it can be tough in the early weeks and to get all the support that you possibly can from people who've been there and who've, because I think there's no, there's actually reading books is fine but there's no substitute for hands on, someone who can actually pick up your baby and show you how to position it, and can also kind of hold your hand and give you that support and that encouragement to keep on going and not to say, 'Oh well perhaps you better try a bottle then', because once you start going down that road it's difficult to come back.

Her baby had not breastfed properly on discharge and it was only after readmission to hospital...

What sort of help did you get at that stage?

I think a, a midwife sort of had a quick look at the baby, you know, and said, 'Oh maybe do it a bit like this' or, but not, not a whole lot to be absolutely honest, plus I was on a high from having had the baby and, you know, I was medicated and, and so I probably wasn't, you know, it wasn't my main consideration at that point I was showing the baby off to my dad who'd come down to visit and that sort of thing, and I suppose it was only really kind of maybe that night when I started to really try hard to, to feed the baby, and I, you know, it doesn't, wasn't working very well and, I mean I, I know people sort of complain about having sore nipples and bleeding nipples and things like that but it, with me it was actually that the baby wouldn't even latch on at all, really. So there wasn't much pain it was just simply that she would just kind of go, 'ah ah ah' like this and, and not really attach to me at all. And I was in hospital for five days in the end and, and I was worried about the baby having low blood sugar 'cause there was some sort of issue about this because I, had possibly been diabetic in the pregnancy and, so they were worried that the baby's blood sugar might drop, and so they were then wanting her to feed, and I felt she wasn't feeding properly and I was getting quite distressed about this, and worrying about, you know, was the, was the baby going to, you know, collapse from dehydration or a lack of sugars or whatever. And I was I think, I was getting more and more het up really and then, eventually they were going to, they wanted to discharge me from the hospital and I wasn't really happy to go because I felt that the baby wasn't feeding and I wasn't really happy to go home knowing that I couldn't feed the baby and, and they kept saying, 'Well why don't you just take her a little bottle of formula', one of these little ones that the hospital had stocks of, and I, maybe, you know, I was being kind of over the top about it but, but I really didn't want her to, I think I'd read somewhere that there was a link between cow's milk and diabetes and there's a lot of diabetes in my family and I was worried about that so I didn't want her to have formula so I was determined to try and make this breastfeeding thing work. But it just wasn't, and she wasn't, and she was crying a lot and, and then she was sleeping for hours on end, I think probably because she wasn't getting enough milk, and I eventually I could feel my milk coming in but that was only because I had been expressing on a [sighs], big sort of, you know, metal breast pump thing from, that the hospital had given me and cup feeding her because it was the only way we could really get the milk into her, or, I don't know if we syringed it, no I think it was with a little cup, we sort of sat her on my lap and poured it into her mouth, 'cause she just wasn't feeding at all off the breast. And, and I actually remember saying to the paediatrician or, or, the day we were going to be discharged, I, we had a follow-up appointment on the Tuesday and this was the Saturday, and they said, 'Are you ' I said, 'it, if I don't, if the baby doesn't feed between now and Tuesday will she die?' and in retrospect I think that's very, really bad that I was leaving hospital thinking that my baby might die because she wouldn't have fed.

When I was about to go home I, I said to the paediatrician that I was worried that the baby wasn't feeding, well and, or at all in fact, I felt, and if by, and this was a Saturday, and if by Tuesday she still hadn't fed would she die? And they said, 'No, no, no she'll be fine, she won't die'. But I don't think I should've discharged feeling like that about my baby [laughs], and to my knowledge there was no breastfeeding counsellor or anybody with that kind of role in that hospital at that time, wh

She was relaxed about weaning but does feel a bit guilty about weaning her first baby to get her...

What I have had is that kind of comment that sounds friendly and well-meaning along the lines of, 'Oh are you still feeding that? when are you going to wean, when are you going to?' it's almost like people want you to give up, I don't know why.

How do you deal with those sorts of comments?

I've just tended to say, 'Well I'll just see how things go' and, you know, there's no particular reason to do it now and I don't want to cause a lot of distress to the, the baby when, or the toddler when, when they're obviously wanting it and enjoying it still and it's not really any big deal to me to I mean as I've said the only time when I thought, 'Right I'm really going to wean this toddler now' my first daughter was when I wanted another baby, and I know this is not the case for all women but I hadn't had the return of periods at that point, I imagine because I was breastfeeding, and so I thought, 'Well I want a sibling for the baby so'.

Were you aware of the contraceptive effect of breastfeeding at that stage, did you know anything about it?

I realised, yeah that breastfeeding was going to suppress my periods for at least for, for a short while but it carried on and on and I didn't, and I suppose that was the reason I didn't, they didn't come back for as long as they didn't, but I was still feeding a lot at that point, I mean that it wasn't just one feed a day I was still feeding six times a day or something probably, on and off.

Okay so how did you handle the weaning?

I think it was, it was something she didn't want to do so there was a little bit of guilt, I felt a little bit guilty doing it and I was very much saying, 'Well you're a big girl now' and, you know, obviously by this point she was also drinking all sorts of things and eating everything and, you know, and I really got the feeling that it was more for comfort than for nutrition at this point, so I think I just sort of distracted her really, when she would come to feed I would say, 'How about a story?' or we would, you know, get up and off the sofa and go and go off and do something and, but I remember our last breastfeed quite clearly and I, you know, I feel sort of quite, you know, emotional when I think well that was the last time that she fed.

Did you cut out one feed at a time or anything like that?

I don't think it was as kind of planned as that, I suppose by that point she was more snacking than having really great gulping feeds apart from at bedtime when she still would, and no, first thing in the morning actually was the biggest feed for a long while and I think it was when I got rid of that one it's almost like all the other ones fell away by themselves.

And any problems with milk supply at that stage as you're slowing down?

I think I must have been cutting down gradually because I didn't find any engorgement or mastitis or anything then, it must have just sort of happened quite slowly and without any kind of massive cut off.

She had an abundant milk supply, frequent bouts of mastitis and occasional blocked ducts. She...

What didn't go smoothly was that I did get mastitis six or seven times.

So can you describe mastitis for me?

It usually started with a little red patch on my breast that would be kind of hot and, and a bit painful to the touch and then quite quickly I would develop a sort of flu like feeling, a fever and shivery and really feeling quite ghastly actually. And it would usually be when I was very tired, run down, it would, always seem to happen on a Friday evening or so when I'd had the week with the baby on my own and [partner] had been at work and also it was, I suppose related to the breast not draining very well sometimes, I seemed to have a lot of milk and the baby wasn't very efficient at, at suckling even though we'd sort of managed to get by. 

So what did you do when you noticed these symptoms?

I went to bed really, I felt so horrible that's all I could do and I think I took, ibuprofen or paracetamol or something to try and bring the fever thing down, and then just trying to get the baby to feed as much as possible off the breast which had the mastitis. And then when she wouldn't I would express or if, or if she'd already fed and was full I would express, I had a little hand pump and I remember sitting in the bath 'cause hot water was really helpful and putting a, a kind of hot flannel and, and it would sometimes come out that way, and sometimes I would see [pause] one of the things I found helpful was to sit in the bath and, and put a hot flannel on top of the breast and, and often just the warmth of the water would make the milk start to flow, and I remember kind of seeing it kind of swirling around in the water and knowing that it was coming out. And so, and oh, and sometimes I think I had a hot water bottle wrapped up in a cloth or something and put that on, and I did notice sometimes that I had like a little white blob on the nipple, which reading up about it seemed to be that that was sort of dried up milk that was blocking one of the, the holes, and sometimes if I could get that to kind of go then that would, that would relieve the blockage and then.

How did you get that to go?

Once, I'm sure this is probably not very good I popped it with a sterile needle that I'd burnt in a, in a flame, and then whoosh all this milk came out and it, and it went down. And I just think just a lot of expressing sometimes kind of helped them to, to pop as well. And I did also have antibiotics on occasions as well because sometimes it just wasn't going with the kind of measures I was using at home.

So you didn't always use the antibiotics?

The first, no I didn't, I sometimes did and I sometimes didn't.

How long did you leave it before you decided you needed antibiotics?

I usually left it about twenty-four hours or so I'd say.

So if you had no improvement within twenty-four hours'

Yeah.

'you knew you needed antibiotics?

I think that's what I was tending to do yeah. I mean I've actually had it with each baby in fact, all three of them, and for instance with the most recent baby I've had it three times in, about the space of, five or six weeks. And the first time I got through it with no antibiotics, the second time I did take the, some antibiotics because of, it wasn't going after twenty-four hours, and then I was still on the course of antibiotics when I got it the following weekend, in a different

Her baby was having just as much breastmilk as ever plus some solids. Her day became more...

I started my daughter on solids when she was about seven months old, which was later than a lot of people did because the recommendation then was four months, but by then I think I'd become so interested in breastfeeding, having had so much difficulty in the beginning and realising that it wasn't at all the easy natural thing that I had expected it to be that I'd actually ended up reading, I'd got a really brilliant book, presumably I can't plug books on this [laughs].

Yes you can.

It's called, 'Bestfeeding' by Chloe Fisher well she's one of the authors there's several authors and this was a really comprehensive book with tons of really useful information, anyway so I got very interested in, in breastfeeding as a whole subject, and one of the things that I had read was that in fact they thought it was better to wait to introduce solids at six months which now has become the official guidelines and I think at the time I must have got it off the internet or something. So I did wait until she was fully six months and a bit more in the end, before I did.

How did you know she was ready for solids?

I hadn't felt she needed them beforehand was the main thing, there was no sign that this baby was desperate to eat food, but I felt, my own point of view, that once she could sit up on her own that was quite an important thing, I didn't want to be sort of feeding her in a bouncy chair, I felt that she should be able to sit up on her own and by seven months she could. Plus, I suppose, she just seemed that much older and able to sort of manipulate objects better and I felt that, you know, putting a spoon in her mouth she wouldn't just sort of poke it straight out like, she would have done as a very small baby when, because I tried having a, I tried using a dummy on occasion and it just come, got poked straight out and so they, they didn't, it's as if they didn't want anything in their mouth, and then by seven months everything was going in the mouth, they were exploring and, she was exploring and, I felt she was ready for that and I remember once I gave her a bit of papaya or something to lick and she seemed to be quite excited by this when she tasted this fruit that she hadn't tasted before and I thought, 'Oh maybe, maybe she would like some then'.

What sort of things did you give her?

Pureed pear, mashed banana, one of my friends suggested something of mixing avocado with banana which sounds absolutely disgusting but it's really, really nice and sort of creamy and really quite yummy, so she liked that, and I suppose pureed carrots.

So did you set up a pattern of feeding, did you breastfeed and then give her a solid feed, or did you give her solids and then breastfeed, or did you do them at separate times, how did you do that?

Initially breastfeeding was still very much her main source of food and I never felt really that I reduced that very much, maybe it was, very subtly reducing and I didn't realise but it felt as if she was having just as much milk as ever plus some solids. And we probably just started by having one meal as it were a day and then it was two and then eventually she would be having three. I mean I quite like the fact that it introduced more, a bit more of a pattern to the day, because I think before I'd very much fed on demand and there wasn't, I hadn't said, 'Right I'm going to feed on the clock at this time and that time' and so the, our days became a bit more structured after we introduced solids, but she was still feeding a lot and at that, actually at that point she was still waking at night for feeds as well.

What's your partner's role in all of this?

I think if, for him it's been a big learning curve just like it has been for me, I mean I think he went into fatherhood not knowing anything about breastfeeding and not really having any, assumptions about it I think, but he was very supportive of what I wanted to do and I think he, obviously felt that breastfeeding was the best thing for the baby as well. But I think when, when we had this disastrous situation with our first baby it made us both feel that this was something really important and that we really wanted to make sure that when we had future babies that, that we were able to for them to be breastfed if we could.

I've had other people say to me that they're quite keen to introduce a bottle early on so that the father can feed the baby as well, do you want to comment on that?

Well we haven't used a bottle, I mean we did actually try with the first baby once we knew the breastfeeding was okay and it wasn't going to be a problem any more and she just wouldn't take it and we, so we just gave up and, and I, I actually, no I must have tried it on each baby occasionally and it's never managed, I've never, they've never taken it, so, but they've never really needed to either. And I don't think a father feeding a baby from a bottle is the only way that a dad can bond with, with the baby they can cuddle them, they can talk to them, they can sing with, to them, they can take them for a walk in the pushchair, there's so many different ways, I don't think feeding is the only way, plus I've always found that once they do become about one year old suddenly they're talking, they're, they become so interactive it's like a whole new world opens up and they really start to notice dad in a big way then as well and, so, I think when they're very little there is a really strong bond with the mother and they, the bond with the father gradually develops over time and gets stronger and stronger and stronger until, you know, at the age of five or something there's not much difference between the parents. But I don't think my partner feels that he's missed out at all.

Her attitudes towards her breasts have changed since she has breastfed three children. She is...

I think my attitudes to my breasts have changed since I've breastfed, especially now as I've fed three children for as long as I have done. I think that when I was younger I did see them purely as sexual things that gave me pleasure, that gave my partner pleasure and I suppose like a lot of young women, I wanted them to look good in nice bras and you know have a good cleavage and all that, and actually you know, I do now see them as having a kind of dual role, they are something that has really been a big part of bringing up my children, they have nurtured them and it is quite an amazing thing when you think that you've literally kept another human being alive with something from your body. And I think in the early days of having my first baby I thought that this was maybe a big responsibility and was I up to it, but when I realised that I was, it became something I was very proud of, so now I'm very proud of what my breasts are able to do, just like any other woman's breasts, but you know, the fact that they have fed a baby. 

I think my sex life has been the same and I don't think he's felt, you know, deprived or, I think the only other thing was in the early days when we first had a baby, firstly your very tired anyway and that sort of thing puts a bit of a dampener on things but I think that there's some kind of hormonal thing that goes on and it means you're slightly less interested in sex, your libido goes down anyway, but that does recover. I found round about the seven, eight month mark that I've felt more or less back to normal again.