Interview 33

Age at interview: 35

Brief Outline: Water birth, easy breastfeeding with first child. Sleep deprivation and mastitis with second. Weaning to bottle at six months in order to go back to work.

Background: At the time of interview, this 35 year old, White British woman was expecting a baby in a couple of days. She had a 3 year old son and a 2 year old daughter, both of whom she had breastfed. She was a married, management consultant.

More about me...

This woman's first baby was born in water and they stayed there while he nuzzled around and found the breast. Later, at home, she was amazed at how much time it took to feed a newborn baby. After feeding, her next priority was to get some sleep herself and often days passed just doing nothing more than that. This was hard for her because she is an achievement-focused person who likes to cram lots of things into each day. Eventually she realised that breastfeeding her baby was the most important thing that she could be doing and relaxed. Her son sucked his fingers from birth and never used a dummy. As a result of this, she encouraged her daughter to find her thumb for comforting herself. She moved her babies out of her and her husband's bedroom to their own room very early on because the babies were affecting their sleep. Both babies were weaned to formula at six months old when she went back to work. Once again, she had trouble slowing down when her daughter was born and juggling the needs of a newborn and a small toddler got into a vicious cycle of unsettled baby-sleep deprived mother until she was able to readjust her expectations of herself. Her mother and sisters were supportive and helped her to get things back into perspective. She thinks that she has learned her lesson and will slow down when the third baby is born.
 

She valued the advice and support from her family more than her health professionals, who may not...

What would you like to say to health professionals?

I mean my experience with health professionals has, has generally been supportive around breastfeeding, I must say that I didn't turn to health professionals for support in my situation because I had more significant people in my life who I had relationships with, my sisters and my mum, my sisters mainly, who could provide instant support or words of encouragement or advice at any time of day or night, in a way that just isn't possible from somebody who you've only got a professional relationship with. So it wasn't that I didn't trust or value the professional's point of view it was just that I had people whose opinion I valued more. I found it very difficult to take advice from people on breastfeeding who've never breastfed, and I do think there's an issue with that. Because you can read however many books and leaflets you like and know the physiology of the breast and the developmental benefits and so on, but if you've never actually done it for weeks on end, I find it very difficult to understand how you can provide real support. And so on a couple of occasions with health visitors I had who had no children for instance, that their, their words fell on deaf ears really, they didn't bear any validity for me because I just didn't feel that the person could possibly have an idea what they were talking about. So to health professionals I would say that if you've got experience that can really be helpful to share, but if you haven't got experience of it then maybe it's best helping the person to find a more appropriate person to advise them really.

She was amazed and frustrated by how much time it took to feed her newborn baby until she...

Well my husband was the main support, at home, in terms of just being around and like doing everything that wasn't related to the immediate needs of the baby which obviously I, I was the [laughs], was the one who was needed to do that in terms of feeding. And I suppose it's amazing how much time feeding a newborn baby takes, that's amazing I think when you get a newborn baby home you just have no appreciation of the drain on time, you know, you'll be sitting for hours on end feeding, and so nothing else gets done. And then when you're not feeding, once you've sorted out everything else that the baby needs you're tired because you're not getting much sleep, so the second priority after feeding the baby make sure, making sure he or she's okay is to get some sleep, and so literally days can pass and you don't do anything else, and that's a revelation really I think when you first have the first child. And for me it was quite frustrating because I'm the sort of person who, I cram, lots and lots of things into a day and get a sense of achievement from having done a lot in a day, and so to actually get through a day and feel I haven't actually done anything apart from suckle this baby and maybe have a sleep was quite difficult  to get used to.

So how did you reconcile that difference?

It took time, it took a long time, you know I'd say several weeks really, before I realised that this was actually the most important thing I could be doing, and that it wasn't doing nothing, that it was actually growing this baby and that, that was my prime role at the time.

So this was your day's work?

Exactly.

And you had to be satisfied that you'd done a good job?

Yes that's it, but it's a really big mind shift, and it's not something I give, I think people tell you beforehand [laughs], and maybe it's not something that everyone experiences I think some people are quite happy to sit on the settee for six hours a day, or some twelve hours day but it's not easy to read I don't find when you're breastfeeding, you know, I tried having phone conversations while I was breastfeeding and that didn't really work either it seemed to sort of unsettle the baby, and, you know, it's how do you hold the phone and, I found that I actually needed to concentrate on what I was doing even when it became second nature, it was different if I was trying to do something else at the same time, as breastfeed, if I wasn't concentrating on that mainly, the feed didn't work as well. So whether that was the baby picking up the fact I wasn't giving it my full attention, or whether it was that my mind was occupied elsewhere I'm not sure but, there was definitely a link, and so really you're left with trying to just sit and, think [laughs], which suits some people but is more difficult for others.

What about television or the radio?

Yes I mean television, to a certain extent, but I can't watch anything on television I'm not a sort of person who can just sit and watch, I need to actually want to see something. And in night time feeds I did actually used to listen to the radio, with my first child that was.

Her exhaustion affected her milk supply. She needed to call on family support and slow down. She...

Second time round was, was a very interesting experience I learnt a huge amount from breastfeeding the second time. Having done it once I was confident that I knew what I was doing I had however under-estimated I think the, the difference in demands that would be on me in terms of breastfeeding, with a very small child around at the same time, and so my little boy was nineteen months old when I had the second child [sighs], oh and everything started off okay, with breastfeeding, but I did have really quite significant problems in terms of sleep deprivation, I was absolutely exhausted [laughs] by about week four when my little girl was born just because of the demands of having a nineteen month old at the same time. And, I got into a bit of a vicious circle of finding it difficult to sit and breastfeed while my little boy was needing attention, and so when feeds weren't happening, doing a lot of activities with my little boy, getting extremely tired, not having the chance to sleep in the same way that you do when you only have one. And physically just being exhausted, and then probably about week six or week seven just finding that the baby wasn't settling at all and so I was getting more and more tired, and eventually I concluded that the tiredness was actually affecting the quality of the feeds that I was giving to the baby. So she wasn't settling, so I wasn't resting, so the quality of the milk was getting worse, and she wasn't settling, and I wasn't resting, and it was a cycle that I got into which was horrendous. By about week eight I was at the point where she was, she was hardly sleeping for more than an hour and a half at a time, she just was, was obviously not happy.

What was happening to her weight at this stage?

Well I don't know because I didn't actually get her weighed, that was different experience with, with the first one I, I'd, I lost sort of, I lost interest and faith in the whole weighing [laughs] procedure I just sort of, my personal view is that too much emphasis is put on weighing babies at that very early stage and for me it started to be counterproductive in terms of my own feelings about nurturing and nourishing my baby. And I could see that he was thriving despite that fact that he was towards the lower end of the spectrum in terms of weight. But there was this constant reference to the sort of [sighs] point on the chart that he was at, and I didn't feel it was helping me or him to be constantly told that he was still only at the eighth centile and so I stopped having him weighed and with my little girl.

So how did you tell that he was okay?

Well I had plenty people who knew about babies like my mum and sisters, reinforcing that, it was more with our little girl that I literally didn't ever take her to be weighed. If a health visitor called round and wanted to weigh her that was fine I wasn't going to say no, but I wasn't going to just make a special trip to go and get her weighed because, I didn't see the point. 

Ok, right.

So in terms of her weight gain, I wasn't really sure whether she was okay or not but she was developing in terms of, you know, starting to be more aware and holding her arms out and grabbing things and the, the milestones that you look for, and so I didn't have any particular concerns about the fact that she was undernourished as such, it was just this cycle of not sleeping properly and my physical deterioration really and an onset of mastitis which didn't help.

Tell me a bit more about mastitis.

The mastitis manifested itself through me feeling just very, very unwell very, very suddenly and I'm the sort

Her breasts became so full during a meeting that she had to go and express some milk. Eventually...

I did express milk with my little boy, my first child. 

How?

With a hand pump, yes I did because I went back to work when he was six months old, and I was still partially breastfeeding at that point and so I need to, to be continuing on with, with stimulating my supply of milk, and I remember [laughs] several incidents, sort of at work, trying to express milk and transport it on the train and.

Such as?

Oh, I remember going to have a meeting with, with my boss before I actually returned from maternity leave in the preamble to going back and, it was a meeting with some quite senior people in a hospital, it was with a couple of chief executives from the NHS, and I was absolutely full of milk and I, you know, I had to go off into the Ladies and try and decant some of this milk off, while they were sorting out the tea and coffee. And as these things happen of course, you know, I spilt it and started leaking and, it was not an ideal situation but it was just the stage my body was at really, I wasn't quite at the point where the supply was reducing down. So yes I have, I have some memories of, of that and then with my little boy he did have milk from a bottle, expressed milk, I think probably from about four months, but only very occasionally when I wasn't literally physically there. I think I had one night at the theatre once and I left my mum with a bottle of expressed milk, that sort thing, but it didn't happen very often and I actually found expressing a real phaff [laughs], I didn't get into a very good routine with it at all.

And how did he take to the bottle?

My little boy took to it okay I think because we introduced it relatively early, we didn't have any problems with him on that score.

Right. So you went back to work at about six months?

Yes just part time.

How did you organise that?

We, in terms of breastfeeding I basically weaned him off breastmilk, pretty soon after I went back to work, because my work is not local, it's around the country and it means me being away from the house for twelve or so hours a day, on the days that I did work, and so it just wasn't practical to be trying to keep my supply going with such a sporadic sort of working pattern, and I figured I'd given him the first six months of breastfeeding which for me was, was the most important thing really and that any advantages beyond that were, were sort of diminishing in terms of the benefits he would get, so my decision was to just stop. I went back to work when my little girl was six months old, again'

Again.

'the same.

And how did you manage that?

By that time I was actually working a period of notice out, so I was only, I was only working sort of two days a week to finish my contract, because I then went self-employed which was more flexible for hours. And so it wasn't as if I was going back to a very, very sort of busy time at work it was actually going back to serve three months notice, and whilst I was busy it, it was a different sort of pace really.

Right. So did you give your notice and decide to go self-employed because it was more flexible for the family, because it was easier to work that way?

It was a variety of reasons, it was mainly to allow myself to determine when I worked and to give myself the freedom to work le

She moved her babies out of her room early and went through to feed them because they disrupted...

How did you arrange the nights?

The nights were, characterised by the baby waking up and me actually physically going to the room where the baby was, 'cause we actually only had our babies in our bedroom for a very short time because we found that it disturbed us too much. And so I took advice around the, recommendation that you keep your child sleeping in your bedroom for six months, which is the sort of recommendation in terms of Sudden Infant Death Syndrome, that's one of the factors that has been shown to be significant in the research, so I actually spoke to the, the SIDS people about, that and why that was a factor, before making my decision to actually move the baby out of our room, against that advice because it was actually affecting our sleep so much having the baby in the room. So I would, I would go and breastfeed in the nursery, and so my husband would, would continue on through the night as if nothing was happening, and I'd be doing the sort of the ferrying up and down the corridor [sighs].

How many feeds a night do you remember in the early days?

In the early days my little boy would feed two to three hourly. So by the time you've changed him and got back to sleep, you're getting pockets of an hour's sleep at a time, an hour and a half maybe. And as I would say that was fairly typical with my second experience as well in the very early days.

So did you nap during the day to try and make up'

Yes.

'the sleep deficit?

Yes, I mean my, my as I said my husband was around, but then when he had to go back to work I had fantastic support from my Mum, and some of my sisters were able to help out as well, just in terms of, of sort of, sort of being there as moral support really, on the end of the phone or, or actually being here.

How long did that every two to three hour feeding during the night go on for? When did the baby start to stretch out a bit at night?

It's very hard to remember the first one [laughs] actually, I would say probably after about six to eight weeks it would, it went a bit long, you know, the time in-between would be longer between the feeds, but I was certainly up once or twice a night for at least four or five months.

She struggled to get her baby to take a bottle when she wanted to gradually wean her from breast...

We, I had real problems with [laughs] with weaning my little girl because she wouldn't take to a bottle, I'd made a mistake in that she hadn't really had a bottle for the first five months of her life, because I'd not got on with expressing the first time round, the second time I didn't really bother very much. And circumstances hadn't arisen where I was away from her, so she was exclusively breastfed for five months, and then being the personality that she is wasn't about to just suddenly transfer to a bottle thank you very much because it suited me [laughs], and we had real battles with her for probably about a week trying to get her to literally take a teat into her mouth, which was very frustrating because I was approaching the point where I needed her to because I wasn't going to be there all the time. So that's a lesson that I've, I learnt from my experience with my little girl that it can be very useful to at least expose your baby to a teat early on so that they will take breast and bottle without all this screaming the house down for hours on end [laughs].

What did you do, and how did you?

I tried everything, I mean I must have bought so many different makes of teat thinking that maybe one would be more palatable than another, none of them were. I mean I remember horrendous times when I left her with my husband and expressed milk in a bottle thinking if he gave it to her and she was really hungry she would take it and she just wouldn't, she's a very determined little girl now, we now know [laughs] she's two, but it's amazing that even at that tender age she showed those traits.

So it wasn't what she wanted to do at all?

Absolutely not. and in the end what broke the cycle was that one night she woke in the night wanting milk and I was determined that I wasn't going to give her the breast, it was about six months and it was at the point where I wanted to stop her night breastfeeding anyway. And so I had a night where it was a battle of wills really, and it was the only way to do it and eventually she was so hungry that she did eventually take the teat, and from then on she was okay with it, but it took a very unpleasant sort of set of, incidents like that, distressing for both of us [laughs] to actually persuade her that that's the only way she was going to get the milk, so I would certainly not go down that road again [laughs]. I think this time I'm, you know, I'm going to make sure that the baby gets a bottle of expressed milk sort of early on, though probably once breastfeeding's well established, just sneak the odd bottle of expressed milk in, to make sure that they have felt it in their mouth and realise that they can still feel fulfilled from having milk that way.

What happened to your milk supply with this sudden, dramatic weaning?

I'm not sure it was sudden and dramatic, the weaning itself wasn't particularly sudden I did it gradually as I did with, with my older child, it was just that the milk would be through a bottle instead, to try and introduce the bottle.

So you were expressing to put milk in the bottle?

So I almost had a two stage weaning process. The first stage being to get her to take milk from a bottle and the second stage being to then reduce my supply once she'd accepted the bottle.

And replace your supply with infant formula?

That's right.

Where do you think this idea of expressing breastmilk or needing to express breast milk to put into a bottle and