Interview 49

Age at interview: 34

Brief Outline: Caesarean section, cracked nipples, blocked ducts and mastitis. Breastfed exclusively for 26 weeks before introducing finger foods. Trying to cut out night feeds.

Background: At the time of interview, this 34 year old, White British woman was breastfeeding her 7 month old son. Previously a mortgage administrator, now stay-at-home mum, she was married to an energy assessor.

More about me...

This woman is enjoying motherhood and wishes that she had become a mother sooner. She says that she feels as if she has been “let into one of life's big secrets”. She lives in a satellite town away from family and friends and is one of only a few women in her area who are breastfeeding so it has been hard to find local support. She travels to another town about 15 minutes drive away for support group meetings. She is keen to support other local women who wish to breastfeed their babies. She gained a lot of her knowledge from the internet prior to the baby's birth and learned to discriminate between various websites, identifying other peoples' opinions and experiences from factual information. She had one very special night in the hospital when she had skin-to-skin contact with her baby and just fed him all night. She hardly noticed her milk coming in the next day. For her, overcoming the problems that she had was just part of breastfeeding. The important thing was that she was feeding her baby herself. She was determined to exclusively breastfeed her baby for twenty-six weeks, in spite of advice to introduce baby rice when the baby's weight gain plateaued just before that time. Her mother was very supportive and even sent her a congratulatory card when she achieved that goal. She expressed breastmilk and stored it in the freezer so that her husband or other relatives could feed the baby occasionally.

Her baby took quite a while to suck after a caesarean birth.

Well after I left the theatre, you know, they’d stitched me up and everything, I’d lost quite a lot of blood, I’d had a very big blood loss so I spent, I lost track of time, I don’t know how long I was in the recovery but it seemed like quite a long time and nobody had said, “We’ll try and feed your baby” or anything it was me that was lying there I said, “Shouldn’t I be trying, you know, shouldn’t I be thinking about trying to feed this baby now?” and they said, “Oh yes well there’s no hurry” and I was like, “Well, you know, I’d rather sooner than later” but he wasn’t interested at all he was just dozy and sleepy and no wonder, after [laughs] him being, being pulled from this nice cosy bed. Then the first, for about twenty-four hours he seemed to be able to latch on okay but he wouldn’t suck, just wouldn’t suck at all, and the longer that the time went on I was getting more and more worried, you know, ‘cause they lose weight very quickly and I was getting more and more worried about him not eating and being taken away [laughs] and fed formula. I seemed to be obsessed with them feeding my baby formula. And then I just kept trying every half an hour or so, of latching him on and I actually said to him, “Come on now you’ve got to suck, you’ve got to suck come on, you know, you’re doing a good job just suck, just suck” and he did, he did he got the hang of it and we haven’t looked back.

 

How long did that take him do you think?

 

Maybe thirty-six hours.Yeah from.

 

So quite a while?

 

Quite a while yes, quite a while

The internet was particularly important for information and contact with other women via a forum...

I was very lucky when I was first pregnant I stumbled upon a parenting website with an enormous forum, and there's some fantastic advice on that for breastfeeding and I was reading that maybe the last four or six weeks before the baby was due, and that gave me a good idea of some of the things that could go wrong and some of the things that might happen during the early days.

So you just happened to put something in Google and come up with that site?

It was when I was first pregnant, so I started posting on the, the forum they have a thread for each month that the babies are due in and I, I started posting on that, I think I was like ten weeks pregnant, so everybody all followed each other through the, through the processes but there's a whole wealth of other information on that site as well.

And you could share your experiences with other women'

[Mm-hm].

'and vice versa?

Yeah.

Was there any technical expertise or help on that?

Well that's one thing that I felt that I really needed to be careful of because it was just people posting, you know, everyday people, some who thought they knew it but didn't, but there are, now that I've increased my knowledge about breastfeeding I know that there are some people on there who talk brilliant advice, really good sense, and very sensible stuff, but, there's some rubbish on it as well, so it's knowing how to sift through it and take, take what you want from it.

So how do you do that?

Well I just did it by reading and reading as much as I could, mostly on the internet but reading websites from breastfeeding support groups who, you know, are, know what they're talking about, like La Leche League and there's another website called KellyMom.com, I don't know if you.

Is that a Scottish website?

No I think it's American.

Called?

KellyMom.com, and once you start looking at these websites you see these recurring themes coming up and coming up and coming up, you go well if all these breastfeeding experts are saying that this must be how it is, so from that I could then sift through the, the posts on the forum and, and work out what was what.

Okay so that was one criteria for reputability?

[Mm-hm].

Anything else that you look at in a website?

I just had to bear in mind that if people were posting what they said they had experienced that's what they've experienced you can't, you can't argue with that at all, but it's when people are stating facts, just to me if something didn't sound right I would go off myself, and would read up on one of these other websites, that I knew was giving the correct information.
 

Her baby's weight gain slowed at about four months of age which she thinks is typical of...

What about his weight and his growth?

Well he, I've since found out that he followed a growth pattern which is very typical of exclusively breastfed babies, round about four months, for I think seven weeks he put on, I think he put on eight ounces in seven weeks something like that, which of course the graph in the book goes up and his just.

Plateaued?

Yes actually. And I wasn't going to go to the clinic and have him weighed every week because that would just, you know, it's just another source of something to worry about, but we were having baby massage classes and the babies were all naked and they said well we'll weigh them all seeing they've got and I just didn't want to say, 'Oh no I don't want him weighed' so every week, you know, it was like, 'Oh he's put on a gram this week' [laughs], you know, not, not quite but. And the health visitor did, I think he was about twenty weeks and she started saying, 'Well, you know, perhaps you should think about baby rice' and I was adamant that he was going to be exclusively breastfed for twenty-six weeks, he didn't need anything else other than breastmilk until twenty-six weeks. Baby rice has got fewer calories in it than breastmilk does, so I didn't understand why she was suggesting that I expose him to a potential allergen before the twenty-six weeks and I just ignored her. And then, I think twenty-four, twenty-five and twenty-six weeks he put on, I think he put on a pound in a fortnight just on breastmilk.

How did that make you feel?

[Laughs] smug [laughs].

She discussed unhelpful attitudes towards breastfeeding and some ways of encouraging and...

We were talking about how isolated you are actually in your breastfeeding with only two mothers in the district feeding'

[Mm-hm].

'and how there are a lot of areas where this is quite common, why do you think... Why do you think it is that some areas are not very, that not many women feed in some areas?

I think there's a range of reasons, I know a lot of people if they've never met anybody or never known anybody else that breastfeeds then they wouldn't really be inclined to, to even try it. And I think as well my mother told me something a while back, she said in her day it was only very, very poor people that breastfed because there was this, you know, powdered milk that you could buy and there's the whole thing about having the money to buy the powdered milk and if you were seen breastfeeding you couldn't afford to buy the powdered milk, now I know that's not how it works now but, I think that might be something that's been passed down.

These things become quite entrenched don't they?

[Mmm].

People never re-visit the beliefs.

Yeah and there's a whole lot of, 'Well I was formula fed didn't do me any harm' and so it goes on.

Do you have any ideas of how health professionals or voluntary workers or anybody else like that might break this cycle, and help these women who perhaps are not aware of all the choices that there are for them?

I think there does need to be more support for women who are, who are planning to breastfeed, I don't know the numbers but I think there probably are quite a lot of woman that try it and then they run into problems and who do they turn to? And, there are a lot of very good health visitors but I believe there are some as well that are, are maybe not quite so clued up on breastfeeding. And it just needs these mothers maybe a referral to one of the breastfeeding groups and a breastfeeding counsellor, or in fact for there to be breastfeeding counsellors available in the hospitals at the very beginning and for people to be able to be educated about it. All the information is out there if you look for it, but it's a case of the information is no use if people don't understand it and know how to apply it to their own circumstances. So I think maybe, more information for pregnant women and I don't know what I'm trying to say, more information for pregnant women and possibly sort of newer mums who are maybe two and three months down the line coming talking to pregnant women, and just to show them that, you know, well, maybe, oh I thought I would try it and here I am still three months later, that sort of thing I think would be good to, to encourage, to encourage people.

Now I'm aware that you accessed the web'

[Mm-hm].

'and quite, quite a lot'

[Mm-hm].

'that's not always available to other people is it? And as you said'

No.

'they may not know how to apply what they find on the web to their own situations. 

[Mm-hm].

Oh I don't know what I'm trying to say [laughs].

Yeah because I mean I think, you know, leaflets and things about breastfeeding, they sort of tell you how the perfect breastfeeding would go and then there's maybe a little bit saying problems yo

Understanding her let-down reflex and how it worked helped her to mimic the baby's action when...

Something that mystified me [laughs] and I found it got much easier once I understood how it worked was the whole thing, I kept reading about, let-down, and I was like well what is that? What does that mean? How does that work? And I finally figured it out and then it made expressing easier, it made feeding easier once I figured out that the baby sucks for a little bit and then the milk is let down and then they do the big long sucks, because you read, I read stuff about the baby does short sucks and then long sucks, and I was like oh why, what's this all about? And once I figured it out, that to me was the key and if I'd known about that earlier on it would've made it easier for me.

So can you describe that for me again clearly'

[Mm-hm].

'how you understood it eventually? As, what is the let-down?

Well [laughs], if I explain it, it might be all wrong [laughs].

Try.

Well my understanding of it is the baby does short little sucks and then the milk is forced from the back of the breast to the front and the baby then starts getting big glugs of milk, in my particular case I think I have quite a slow let-down the baby has to suck and suck and suck for ages and then I can feel the milk letting down, so when I was trying to express I'm pumping and pumping, it said on the pump, do six short pumps and then do long pumps, and I was like doing this and nothing was happening, nothing was happening, nothing was happening, and then when I figured that out, I was like right you need to make your pump mimic the baby, and then I was much better, able to do it because the baby had to suck and suck and suck for a long time because of my slow let-down, and once I figured that out I could start expressing, and once I could start expressing I could have like one feed off, you know, my husband could do a feed, and I could just sit and watch [laughs]. You know I got one feed off but then I got very wise to having my husband do the feeds because when he was doing the feeds [laughs] I had to go and wash the dishes [laughs] so I would much rather sit and feed the baby myself [laughs]'

So there was method in your madness [laughs].

'than wash the dishes [laughs] yeah so.

Could you feel your milk letting down?

Yes.

What's it feel like?

Just sort of tingly, quite tingly and my breasts feel like they're going harder, I don't know if they are or not, and sometimes if I'm very, very full, it's actually almost a little bit painful. Oh, I've got a text message and sometimes when I get a strong let-down I'll leak milk out the other side but now that I know what's happening it doesn't bother me at all.

She made sure that she fed her baby with his chin towards the area of the blocked duct in her...

It was, it seemed quite obvious to me I had a lump in my breast visibly you could see it was a funny shape and there were little lumps under the surface, just like little peas, and then.

All in a row, or?

I can't remember I think there were just odd ones here and there, I don't really remember, and it just made sense to me that this was swollen up because there was a blockage so I did the thing where you, I ended up in this ridiculous position because the baby's chin has to point to where the, the blockage is, and I ended up, he was lying flat on the bed and I had to go on all fours over him [laughs]. And I knew that I had got him in the right place because he fussed, and fussed, and fussed, he was obviously getting nothing out, but he kept at it and then he unblocked it and that night I took him and we co-slept, and I did feed him off both sides but I put him more on the side that had been blocked and it was fixed by the morning.

Did you know, was it sort of like an instant thing, ah that's been relieved or was it just because he'd fed so much you think that must have done it?

By the morning I knew that my breast was back to normal but there wasn't a moment where I went, 'Oh right that's it' I'm very lucky I can actually sleep when he's feeding, and once he got passed a certain age he was able to just pop on and off, on and off himself, so quite often I don't really have any idea how long he was feeding for or what he was doing [laughs] or anything so it helps me catch up on my sleep.

Okay, did you do anything else for that blocked duct like massage or heat compresses or feeding in the bath or anything like that?

No I didn't, I tried the chin positioning thing first and, I didn't notice the blockage until bedtime and then I thought, 'Well, you know, if this feeding all night doesn't help then I can move on and try some other things'.

Footnote' Changing the relationship of the baby to his mother's body will improve mastitis if it improves attachment and therefore milk removal.

On the third night in hospital she had a special night of skin-to-skin contact with her baby and...

I don't think I got any sleep at all on the third night, I just stripped him to his nappy, and I just put my curtain round, took my top off and we just cuddled in, skin-to-skin and it's so hot in the hospitals [laughs] that I didn't need to worry about the baby getting cold or, or anything. And the nurses kept coming by and, you know, 'You still awake? You still feeding? Have, have you had any sleep?' and I almost felt the, like they were getting me into trouble for being awake all night, I think that was me, I don't think it was, I don't think it was what the nurses intended, but I sort of felt like oh, you know, oh gosh, my baby should be sleeping through, you know, he's three days old [laughs]. But it was lovely, it was so nice and, I've done lots of skin-to-skin ever since then but that was the nicest time I've never managed to get that same, it was just wonderful, yeah.

Just the, recognition that this is it, this is reality now'

[Mm-hm].

'this is your baby'

Yep.

'and this is us and'

Yeah.

'time without interruptions without other people, the quiet of the night.

I think that's because there had been two other girls in the ward, it's a four bed ward, there had been two other girls in the ward, and this, but this was the first night that it was just me and my baby, and it was lovely.

And the next day your milk came in?

The next day I went home and, and it seemed that, that my milk had come in, people had said, 'Oh you'll feel your milk coming in it tingles and your, your breasts grow really hard and it's sore' and this and that and, well maybe it was but I'd either didn't know what I was looking for or it wasn't sore or, there was just too many other things going on for me to notice.

So, it was just a natural progression for you in fact it wasn't a momentous event?

No not at all, it was only when he was feeding and I could see milk leaking down his mouth I was thinking, "Okay there's milk there now' [laughs].

Do you think this might be a consequence of having just fed for that whole night that it just all flowed through smoothly?

It could be but I'll never know will I?

Well you might with another [laughs].

Well [laughs] yeah, [mm-hm].

It maybe.

Aye.
 

She was sent home from the hospital with a "goody bag" of painkillers and was confused about what...

I came home from the hospital with this big, like a goody bag of painkillers [laughs] and, each one had directions on the packet, take so many within so many hours and, I left the hospital late morning and I'd already taken some painkillers that they were handing to me, so I had to phone them up and say, 'What have I had today already?' and I didn't know could you take this with this? And could you, you know, and I said to my husband, 'I can't do it, I can't do it, I can't work it out' I just couldn't, my brain just would not work and he said, 'Well look you take this one, you take this one' and I said, 'You do it'.

Yeah so I said to my husband, 'Please you do it I can't cope with this, you do it' and he made a little chart on the computer and filled in right you can have this at this time and this at that time [laughs], and because I don't even remember how many different painkillers I had but they didn't really seem important either I was just so focussed on, I have to feed my baby. Other people can change his nappy, change his clothes, wash him, do whatever, I must feed my baby and I was just very single minded about it.

An invaluable piece of advice from a midwife allowed her to feel comfortable feeding all night....

I knew that they don’t just latch on, you know, some of them just latch on straightaway, but I knew that, you know, the baby has to learn as well. If I didn’t know that I could’ve panicked, you know, and the whole thing could have gone terribly wrong. And on the third night in the hospital I got an invaluable piece of advice from one of the midwives. She said, “Now this is a very difficult night”. She says, “Your milk isn’t in yet, the baby’s getting really hungry, the baby’s just going to want to feed all night long”. Now if I hadn’t been told that I would be thinking, “There’s something wrong with the baby, the baby’s crying, the baby won’t settle, the baby won’t, you know, blah-blah, help, help me” but what I did, I was lucky enough I had the whole room to myself that night. Everybody had, the other two girls had gone home, and the baby and I had skin-to-skin for the whole night we just cuddled in and he just fed and then I think the next day my milk came in, and if I hadn’t had that piece of advice from the midwife things could have been very different I think.

 

So that night you were prepared then to just feed all night? Were you sitting up or did they teach you to feed lying down so you got some rest?

 

They showed me, they tried feeding lying down but I found that quite difficult because I didn’t know what I was doing and the way that you’re told to latch the baby on the chin first and then, you know, the nose to the nipple and I just couldn’t figure out how to do that lying down, and also I didn’t have any milk in so my breasts were very soft and saggy and it was just, it just seemed impossible, you know [laughs].

 

Impossible.

 

Yeah so I was propped up with a whole load of pillows and I was comfy enough and I fed him, rugby ball under my arm because my wound was too sore, and looking back it was probably quite a difficult way to do it but it was the only way that I could figure at the time.

 

I just get the sense from what you were saying that that was quite a special night for you?

 

Yes it was, it was a special night.

 

Okay [laughs].

 

I didn’t realise it was that special [cries].