Breastfeeding

When breastfeeding doesn't work out

Here we talk about the experiences of women who very much wanted to breastfeed but were unable to do so. This was either because of unresolved difficulties with feeding or for medical reasons. The reasons why breastfeeding had become impossible included:

Painful breastfeeding
Low milk supply
Having had a caesarean section
Premature birth when the baby needed to spend time in an incubator
Latching problems including babies born with a cleft lip or palate

Ruth’s first son was born prematurely and delivered by C section. While in the incubator he was fed through a tube with Ruth’s expressed milk. She was advised to wait until he was stronger to start breastfeeding.

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Age at interview: 43

Sex: Female

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So, still hadn’t even got to the stage where I hadn’t really even thought about the breastfeeding or, or attempting the breastfeeding because he was in the incubator and I wasn’t allowed to hold him yet. So it was twenty fours afterwards before I actually got to have him out of the incubator and hold him and I did skin to skin contact and put him against my boob and all the rest of it but there was very little interest and it was just basically having a cuddle and I said, “Oh, you know he doesn’t seem to be interested at all.” And they said, “Oh well, you know, he’s still very little and you know, we’re tube feeding him and things like that.

Meanwhile, about sort of, twelve hours before, the midwives had come to me and said, “Well, you know do you want to start expressing some milk?” and to get the colostrum off and stuff like that. And so they’d given me a pump and shown me how to use the pump and I’d started producing colostrum which I’d pumped out and I’d started off producing quite a lot actually. A lot more than they were expecting initially and so from about twelve hours in, I, he was only getting my breastmilk. So he was getting my breastmilk, but he wasn’t actually being breastfed and my, so I, he was being tube fed with my breastmilk. So I wasn’t so worried and they kept saying to me, “Oh, don’t worry, it’ll be, it’ll be a while, you know, he’s a premature baby. Sometimes it takes them a little while to get the hang of it and all the rest of it.” And, you know, while he was still in the incubator, I’d sort of thought, ‘Well you know, I can understand him not really being at that stage to be able to do the feeding.’

But we tried the breastfeeding and the midwife came round and, and you know tried to, but I’m quite well endowed in the breast section and he was so tiny, it just didn’t work. Size wise he was so tiny and my boobs were so big. Actually getting my boobs in to a position where he could get it in to his mouth, actually took three hands and at which stage he was just not, he just didn’t understand the whole latching on process and just, you know, kept trying and you know presenting him with nipple. Doing all the things you’d seen in the books or been told to do and you know the midwife, they, they spent a little time with me. I didn’t have too much help with the breastfeeding in the special care unit but and there was apparently a special care, a specialist breastfeeding nurse in the hospital and they booked me in to see her the following day so that we’d have another go and they just said, “Oh you know, keep taking him to breast and keep trying.” And oh it was an absolute palava, so me and my husband fighting my boobs around this really tiny baby in his mouth and it just, he just didn’t want to put my nipple in his mouth. Or he, he put it in but then just not know what to do with it at all. And this carried on for another three or four days. We had some sessions with, I had two sessions with the breast feeding, specialist breast feeding nurse, which went no better than our self, the ones we’d been doing ourselves or with the midwife and she, she just. He wasn’t having any of it and they said, “Oh, he’s too small, he’s too little. He’s too premature. When he gets a bit bigger, when he’s come off the tube feeding and, you know, you’ve got him home, it’ll be fine. Just keep expressing the milk.”

The lengths of time women were able to breastfeed or to express their milk varied a lot and depended on individual circumstances, but ranged from two weeks to several months. Some women used an electric pump to express their milk – an experience that Ruth and Lizzie described as ‘exhausting’. Ruth tried to breastfeed every time before bottle-feeding but her premature baby refused to breastfeed. Lizzie had such low milk supply that she spent much of her days and nights breastfeeding a baby who was always hungry, slept little and cried a lot. Jessy moved on to formula milk within the first month after the birth of both her children because - unknown to her at the time - she suffered from a condition known as “Raynaud’s phenomenon of the nipple”. Breastfeeding caused her nipples to crack and bleed to such an extent that it made breastfeeding a very painful experience (see Medical conditions that could affect breastfeeding).

Recently, Jessy learned that she has a condition called Raynaud’s that could affect the nipples of lactating mothers. She talks about how it affected her when trying to breastfeed her children.

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Age at interview: 39

Sex: Female

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I only recently discovered - I have problems with my tissue. My tissue doesn’t heal as quick as it should. My blood doesn’t flow, I have a circulatory problems and then it affects, as much as it affects my hands it affects my breast tissue which makes it really painful.

…I was using nipple shields, made of silicon - well, I used them a week after, after seven days just to give it a try because my, at the beginning, my aim was to be able to get him to latch and then I managed to get him to latch properly and then tried different, different position, the rugby ball, the front facing, sideways, every position possible until I found the one, the one that suitable for me that was the rugby ball. But then, I noticed that, that no matter what, how many massages I did, I gave to my breasts they were so sore. My nipples start, start cracking even when I, my, when I was continually keeping, keeping them with nipple cream, like Lanolin cream. I then, I noticed that they start bleeding and they would not stop bleeding the milk was, I tried to press the milk just to carry it, be, to carry on giving him milk [sighs] and the milk looked like strawberry milkshake, there was so much blood in that, I wasn’t able to give him that neither. Then I try to just use the breast that was less damaged for a while and tried to let the other one heal. It, it seemed I was never, ever healing. And then it was that, that feeling of the fire, they were on fire, it was horrible. He felt like, every time they were out, I put him near my breast he felt like he was like a little shark or like a piranha [laughs] like just biting your breast, it was just oh. It was agony, agony, completely agony.

…No it took a while to heal actually. Like, even after when I, with the mastitis, the mastitis last two weeks. The nipples - I have to put these, the doctor look at them and say, “You might have thrush”. So he gave me a cream for thrush. But then in, it was still the blood in the like, you know - it was all, it was all broken, completely broken. I didn’t even, I could see it from above, I just promised myself not to look at it in the mirror because that would make me really freaked out [laughs].

The, the second time or both times?

Both times, but the first time I didn’t, the first time I thought I was going to lose my nipple because the nipple was really coming apart from the breast and the second time it was just the skin was just completely broken and it was blood in my shirts like, I was literally dripping blood.

Ruth says that the health professionals' priority was for her to feed breastmilk to her baby. The use of an electric pump, every four hours for months, gradually made her feel exhausted.

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Age at interview: 43

Sex: Female

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But this pump experience was just, I kept telling myself, ‘It’s only a short-term thing. It’s going to be in the hospital.’ Everybody says “You’ve got to give him breastmilk. He’s a premature baby. He’s been really sick, you know breastmilk is best. Breastmilk is best. You must give him breastmilk.” So as far as the hospital and the nurses were concerned the priority wasn’t me breastfeeding him, it was giving him breastmilk. So there was a lot of emphasis on keeping my milk supply going and my milk supply up, which meant that I had to pump every, I think it was a minimum of every four hours, all the way through the night and all the way through the day to keep the milk supply going because they said, “If you do it less than that, you’re not going to keep your milk supply up for when he gets home and all the rest of it. You want to keep your milk supply up because you might get him breast, you will get him breastfeeding.” There was no question at this stage where they said, “You might not be able to breastfeed him or it won’t work.” Everybody was trying to convince me, carry on pumping and you will be able to breastfeed him…

So I then took this very tiny little baby home sort after eleven days of being in the special care unit and the fun began [laughs]. So I was, I, my attitude to breastfeeding was that I’ve always thought I would breastfeed my babies. There was no question about it, I was very pro-breast feeding. I knew the benefits of it, I knew the literature. I’d read up on it, there was, I didn’t agree with, you know, bottle feeding for the sake of bottle feeding. It was always going to be breast-fed. So with the troubles that I’d had in the hospital and the fact that he just wasn’t breastfeeding and the most important thing was to give him breastmilk, so I took a pump home with me from the hospital. I hired one of these massive great big pump things and it’s not one of your little hand held things. This is a big electronic thing that does a double pump business. It’s like a milking machine, it is, I came to loathe the thing and it had a big stand and it stood in the corner of the room and every four hours out came the suction cups and you had to sterilise everything and clean it all down and then you know, it used to take about it used to take ten/fifteen minutes to prepare everything before you had to do the, do the expressing and then you plugged yourself in to this machine and I did. At night I used to double pump because I was just too fed up with it. Otherwise I’d just do one breast and hold the baby on the other side and give him cuddles and things like that but at night because I’m so tired I just used to do both boobs because if you didn’t do both boobs you’d end up really sore and you risk mastitis and all the rest of it, so at night I did the double pumping. So you’d go and do the pumping for about half an hour and then you’d then have to feed the baby.

He latched well but from the start she struggled to feed him because of low milk supply. Even correcting her baby’s tongue-tie didn’t help.-

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Age at interview: 33

Sex: Female

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I think the, before I had my baby, I went to the, I think they’re called “parenting skills classes” at the hospital. And I went to the one on breastfeeding. And actually what was quite interesting at that point is that there was the implication that you would kind of, as soon as you had that baby, you would be gushing buckets of milk. And it was sort of, you know, you wouldn’t be able to hold back the tide. And it was, and the focus of these parenting classes were more around, “Should you breastfeed or not?” rather than, “Actually, this is how you do it.” So yeah, but the implication was that milk would just come and you’ve actually almost got to stop it, you know. There was sort of, advise you on nipple pads and, actually, if you need to express because there’s too much. And so I think in my head I was expecting there to be loads - of milk. And then in the hospital there just didn’t seem to be anything coming out.

And they sort of said, “Well, it will take its time. You’ll have this, the first—what is it called? “Colostrum”?

Colostrum.

Yeah. “You’ll have that first bit coming through, which is a very different consistency to normal breastmilk. And it could take another two or three days for normal breastmilk to come through.” So you’re sort of going, “OK, well, I’ve just got to wait and see, really.” And because I struggled with breastfeeding, I stayed in hospital for two nights. And then they kind of had to sort of throw us out, but I was completely distressed because, you know, my baby was, wasn’t sleeping, it was constantly crying. But they’re going, “Well, it’s a baby, you know? It’s scared to be out in the world. It’s a baby.” And I was sort of going, “But I can’t see, you know, it doesn’t seem to be happening.” They were like, “But it will. It’ll happen. It’ll happen. It’ll happen.” And yeah, it was just sort of going, “Well, it, you know, OK. I’ll trust them, you know. They’re the experts.” And I can completely understand that actually, you know, for some women it does happen easily and it just didn’t work for me.

So again in the hospital we had to supplement it twice with some formula, because again he was just screaming and screaming and screaming. And [sighs] just you know, I was squeezing, squeezed like a, like, like squeezing, and nothing was coming out of them. So I was sort of going, “Well, you know, but,” and they go, “No, it will kick in. It will kick in.” And so we got home and you, again it, he would, you know, he was I was sitting for hours and hours on end with, with my baby sucking. And everyone kept on saying, he had a good latch on, you know? And it, but I was sort of going, “Well, I’m not sure he’s getting anything.” And he wasn’t sleeping because I guess he was never full.

And then the community midwife comes and visits you at home. And he was, again, crying because he was hungry, we’re assuming. And she sort of looked. She just went, “Oh, I think I’ve seen the problem.” And at that point, they noticed he had 100% tongue tie, so his tongue was attached from right down at, completely really, so that the, the tip of his tongue was attached to the back of his gum. So there was just no way he could’ve been doing that proper sucking movement. And again, the issue was that at that point within the NHS there was only one specialist in this area, and there was a six week waiting list. And we were sort of going, “Actually, we can’t wait.”

So fortunately there is a private practitioner who’s a midwife in one of the nearby hospitals, so we paid for her to come, quite a lot of money, paid for her to come that day to cut this tongue tie. And again, she said, you know, “Your, your nipples are a great shape.” You know, he, because when they cut it, they say put them immediately on the breast because it will sterilize and help it heal. And she was going, you know, “Your, you know, the latch is great.” You know, no worries. But, so, at that point, we thought, “Great, actually.” You know, it was his tongue tie. It was obviously the problem. He wasn’t sucking properly.

But it still continued to just not happen really. Like, they were -there was one awful, awful night where my husband and I were in bed and he was, like, milking my breast like a cow. Like, he was squeezing it, desperate to get the milk out of it to try and feed our baby. And it was just not coming out. So, you know, at that point I was, you know, but the, you know, every time I spoke to the health visitor, “Oh, it’ll, it’ll come, it’ll come. Just be patient. The more you breastfeed, the more milk that will come.” And it, yeah, it just didn’t.

Ruth, Jessy and Lizzie said that their determination to breastfeed despite their difficulties was driven by their own need to do what they saw as one of the main roles of being a mother. Women talked of feeling ‘like a failure’ or feeling ‘guilty’ because they were unable to breastfeed their babies. They felt that their breastfeeding experience was so very different to what they had expected. Looking back, women realised that they had held romanticised views and talked of having idealised images of feeding their babies without a care. An image they said that was somewhat reinforced by the information and advice available. Lizzie said that the parenting class she attended did not even mention the possibility of low breast milk supply but the emphasis was on good latching and the assumption was that the ‘you would be gushing buckets of milk’. Women felt that health information about breastfeeding needs to make women aware that they could face difficulties that could affect their ability to breastfeed.

Lizzie says that the official support saying ‘breast is best’ made her feel isolated and that she wasn’t a good mum.

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Age at interview: 33

Sex: Female

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I wish I’d been more pragmatic. But you’re so overwhelmed and so distressed, and everything around you is saying that breast is best. And I do believe that, and I would’ve done it if I could. And it, it, yeah, and all the support out there, all the official formal support is saying breast is best. And it’s only when, then, you actually sort of scour beneath and you have conversations with other mums, or you look on mumsnet or all those, you know, Internet things, that there’s somebody sort of says, “Actually, yeah, I did struggle.” And I think to have, yeah, I think it’s really important that there is that balanced view of it. “Yes, breast is best. If you can. But if you can’t, then, then, yeah, don’t beat yourself up about it.” I think I just, I thought I was a, I was a failure as a mum. I felt, I felt like I’d let down, and I’d let myself down, I’d let our baby down. I’d just, yeah. The thing that is meant to be the most natural thing in the world and I couldn’t do it. And, yeah. And I, it sounds silly for me. I’ve always, I’ve always been quite pleased with the size of my bosom. You know what I mean, like, I always, you know, I’d buy tops that enhance it or, and so you sort of think, “Oh, you know, they’re actually, the thing that they’re meant for, they’re failing at. You know, they’re, they’re big enough to surely have enough milk in there.” And, but then they’re not to be, you’re sort of going, “Well, how is that possible? How could, you know? This is just meant to happen.” So, yeah, I’d, yeah. It was the most upsetting that, just the worst, yeah. Just, I, and you, you look, I looked for support and I couldn’t find it…

But yes, I did feel like a failure. Yes, I did feel that I wasn’t a very good mum and, you know, I felt that isolated. And, you know, there was some indication but it, for me, it wasn’t an indication of postnatal depression. It was an indication of, there’s this thing that is not working that’s kind of central to all the other things working. So, you know, if it, they always say, you know, “If a baby cries, they’re either hungry, they need their nappy changing or they’re tired.” And I’m sort of going, “Well, I can change his nappy as much as I like, but actually if he’s hungry he’s not going to sleep.” And so it felt like the hunger was just this central point to all of these other things that weren’t going well. And, and so until I addressed that hunger, then all of the other things that are, you know, should happen, shouldn’t. So it was sort of, yeah, just feeling like I had, like I had failed at the, you know, the thing that, the only, the thing that mums need to do without even trying, I was failing at. So how could I be a good mum otherwise? And so you sort of, I just felt a complete mess.

Jessy felt let down by the existing information presenting only positive images of breastfeeding.

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Age at interview: 39

Sex: Female

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In my opinion, and they should let people know because a, I felt, I felt betrayed when you look at the, at the literature, [crying] at the videos, at everything, everyone is like happily. “Oh, yeah, you just pull it out, I go to the park, I breastfeed. It’s like a happy moment and everyone talking about the bonding. And I couldn’t, and I couldn’t - and it made me feel really bad. So I, I still, I still, it does, still makes me sad as you can see. And yeah, I wish they could show the both sides of the coin, like, yes, it’s nice, yes, you bond, but if you can’t then they should give you more support, like, yes you can’t do it, it’s not the end of the world, it’s normal, it can happen. Because that’s another thing, they don’t tell the, it, it doesn’t say anywhere that it can happen.

Lizzie, Ruth and Jessy felt that some of the midwives and health visitors they met didn’t provide the support they needed at the time when they faced difficulties. They said that the importance of breastfeeding the baby was stressed and any difficulties were seen as short-lived. Being told ‘You must breastfeed’, or ‘breast milk is best for your baby’ or ‘the milk will come’ made them feel under pressure and their concerns overlooked. Lizzie said that she now knows that if the milk supply does not increase in the first six weeks after birth, there is little chance that it will happen at all. Maria Z, mother of a baby with a cleft palate said that the midwife was poorly informed to understand the reasons why she couldn’t breastfeed.

Jessy felt under pressure by midwives and health visitors who expected her to continue breastfeeding despite the pain and poor condition of her nipples. Later, a health visitor supported her decision to stop breastfeeding.

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Age at interview: 39

Sex: Female

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And their target was that I was a mum that must, mum must breastfeed, no matter what. Her nipples were bleeding, it doesn’t matter. She was in pain? It doesn’t matter. She was almost getting post-natal depression from all the stress? It doesn’t matter. She must breastfeed. And that’s what, what I felt like it was really terrible. In, in fact I got, they got like, they were turning up at my house, they were calling me, like every so often to check that I was breastfeeding. Then, the last thing it was, the last straw was that they make me pay to a woman to come and give me a personal lesson in breastfeeding.

So I was just like and then and my husband at that time, he stepped up and then he, he basically kicked them out and said, and sat with me and said, “What are you doing? You should stop, this is not good for you”. And then it was lucky when the midwife hand me over to the health visitor, one of the health visitor was really still like pushing me, pushing me, “You must breastfeed, you must breastfeed, you must breastfeed”. But then the second health visitor came to me and say, “Listen, the most important thing is a mummy’s OK. If the mum is not OK, how are you going to look after your baby? So don’t worry, my children grew up in, on formula, OK? And, don’t tell anyone I said it, I said so”. And then it was all, OK so she makes me feel better.

For Ruth the pressure to provide her milk to her premature baby came from herself and health professionals.

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Age at interview: 43

Sex: Female

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The Health Visitor comes and comes and has a look at it when you are at home, especially when you are a first time mum, they come, oh, I think I must have had four visits I think. I think it was about four visits. Lovely health visitor but she again, like the, the nurses in the hospital said, “He’s a premature baby. It’ll happen. Just keep trying, just keep pumping. Just keep going. I mean you’re giving him breastmilk, that’s great. Just keep trying with the breastfeeding. Try every feed.” And again pressure, “Try, keep going, keep going.” And again all the health professionals, incredibly pro-breast feeding and again I have to say my attitude was as well if I can do this, I really want to, do want to get him to breastfeed. But, you know, having to be up every four hours and pump and, and feed the baby and try the breastfeeding every time you were feeding was getting very stressful and I was getting quite stressed about it and you know the health visitor came, she tried to give me some lessons. She tried and couldn’t get the baby to latch on at all. “Oh, no don’t worry. We’ll try again in another week when he’s a little bit bigger.” It was always, “When he’s a little bit bigger, when he’s a bit stronger, it’ll happen. It’ll happen. But in the meantime do, do your expressing because you’re feeding him breastmilk and you must do that. You must have breastmilk for six months.” Hammered in to you every single time you saw any health professional.

Maria Z was asked by a midwife if she was going to try and breastfeed her daughter even after Maria had explained to her that she would need to feed her baby by bottle. The midwives were poorly informed about the ability to breastfeed a baby born with a c

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Age at interview: 32

Sex: Female

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I was asked by a midwife about whether I was going to breastfeed. You know, she kind of looked at me after I’d explained everything to her, and shown her a squeezy bottle, and explained what was going to happen over the next few months, and how the muscles in the mouth were formed and... and she still looked at me and at the end of that she kind of said, “Oh so you’re not going to try and breastfeed at all?” And I just thought, “I’m... I’m not sure that you’ve listened to a word that I’ve said.” And, you know, these people are there to hold people’s hands through a really uncertain time anyway, but when they’re putting pressure onto somebody to do something that’s physically impossible [laughs] it’s pretty, you know, it’s not ideal really.

Lizzie questions the advice telling women to stick to breastfeeding even when, after months of trying, the milk supply doesn’t change. Lizzie was upset when it was implied that she was not trying ‘hard enough’

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Age at interview: 33

Sex: Female

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We went to these breastfeeding groups and they, they are really supportive but there is, there is this feeling that breast is best. And so when you sort of say to them, “Can I supplement with formula? Can I, you know, should I,” and they were sort of going, “No, no. You just need to keep trying. Keep trying. Keep trying.” And you sort of, and I think one, one group particularly, I went to, and, and the basic implication was, I wasn’t trying hard enough. And they were sort of going, you know, “You must try harder.” As if I wasn’t. And at, and at that point I was trying to do everything. I hired a sort of a, I think they’re called hospital-grade breast pumps, because the thought was that actually if my son’s suck wasn’t strong enough or he wasn’t quite latching on, could I stimulate more milk production by expressing as often as I could? And that was, I think, quite tricky for me because he was breastfeeding for sort of probably an hour before then, he sort of at that point had been so exhausted he’d then fall asleep. Although as soon as I moved he then woke up again, so you’re sort of sat on the sofa for hours.

So at that point, I was going, “Well, actually, he, yeah, I don’t want to use up all my milk by expressing and then he needs to feed 10 minutes later. And then there’s not enough in there because I’ve just emptied it all.” But I was sort of going with this theory of, the more it’s stimulated, which they kept on telling, “The more it’s stimulated, the more that will come out.” I was taking fenugreek supplements because they say that fenugreek, it was another way of stimulating it. So I smelt of sort of spicy food for [laughs] for months because of that. And they said, “Oats too, so I was eating lots of porridge and flapjacks.”

And so, you know, it was sort of, you know, the implication I think by, by some of that support network, that I wasn’t trying enough, was heart-breaking because I was going, “Well, what else can I do? What else? You know, I’m, I don’t know how else I can do this.” And so that, I think that was hard to take. And, yeah, I was exhausted. I, my, baby was never sleeping. My husband was exhausted. And my baby was losing weight.

And, but, again there’s a, there’s still this very much on the emphasis from the health visitors and from the breastfeeding groups at children centres that, “Actually, you just need, it’ll happen. It’ll happen.” And you, you know, you’re scouring the Internet going, “What are other peoples’ advice and experience?”…

And, and I think, “Yeah, all these things about, it’s not just about the latch.” It is about, you know, what’s happening in there and how is that production work? And what you can do to stimulate it. And actually at what point do you know that it’s never going to happen, you know? So I battled on for three months to try and exclusively breastfeed. And actually only, it was only afterwards that they say, “Actually, it should’ve come in by four weeks, six weeks.” And you sort of, “Well, nobody told you that.” You know, but at the same time the, it is implied that you will have this flow of milk as, you know, immediately after birth. And I think that it, it does need to be more realistic, that actually, you know, your body is going through so many dramatic changes that it does take a while for this, you know, for your baby to, to learn how to suck effectively. It takes a while for your, for that baby’s suck to be powerful enough. You know, this teeny little human being, and for that he’s got a tiny little mouth to actually suck, suck enough to get some milk out, is, you know, is, is, takes a while. And I think some realistic, you know, timetable of how long it might take. So how long do you have to be patient for and just go, “Actually, we’ve just got to stick this out”? And at what point do you go, “Actually, it’s still not working, so there must be something else that is not quite right,” rather than just that, “Oh, it just takes its time to come in.” And I think, yeah and that for me was the missing piece of information.

Women also received sympathetic advice from health professionals who helped them feel better about their decision to do mix feeding or to stop breastfeeding or expressing milk. Ruth said that with her second son she was encouraged to breastfeed but the emphasis was on feeding the baby well, not necessarily on breastfeeding.

With her second baby, Ruth said that midwives and health visitors supported rather than pressured her into breastfeeding. She also found out the reason why she couldn’t breastfeed both her children.

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Age at interview: 43

Sex: Female

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So completely, it wasn’t, it was a different attitude with the midwives from before on the ward. It wasn’t, “You must breastfeed. You must, you know, you must feed them breastmilk”. It was much, much more open. I don’t know whether that’s down to different hospitals or whether or not it really has progressed further forward than it had done when I had my son five years before because it was five years now the gap between them and or five and a half years. And they were, they said, “Right, okay it’s not working but we, you know, we do have lots of formula here, all different types of formula you can try them. There’s no problem with combination feeding. We’ll, we’ll do whatever we can to help you. It was much more relaxed and there was no, “You must breastfeed and then if you don’t breastfeed, you can use formula.” It was, “We will get you feeding, that’s the most important thing, get the baby feeding, whether it’s breast, or bottle or combination of both. We’ll get the baby feeding and you know, so that you can return back to some normality and be able to go home and all the rest of it.” You weren’t, felt, I didn’t feel like I was being pushed out the door. That wasn’t their objective to get you out the door but I did feel it was a different attitude. Different, much more relaxed to the, to even the idea of combination feeding which was apparently a big no, no before, you know, “No you shouldn’t combination feed, you should breast or bottle. But you don’t do both and it should be breast.” Whereas this time it was, you know, “We’ll feed the baby, basically.”

…So the very nice midwife who I’d seen the night before who was on the nightshift came back to me as promised, as she said and again was with me for a good hour and we tried everything. We even tried nipple shields which are a big no, no. The breast feeding people think they’re absolutely xx and she worked out through you know, working out what was happening, where his mouth was getting in, where he was attaching, where he was sucking that his soft palette in his mouth was really far back and my nipples are not very big. So I’ve got very big boobs but not very big nipples and they just weren’t reaching the area in his mouth far enough back for him to be able to get a decent latch on and be able to suck and draw milk off the breast. Because you needed to get more of the, there needed to be a longer nipple for him to be able to get that action going. And finding that out when I was in the hospital was the biggest relief that I think I’ve had about the whole situation because I suddenly realised it was the mechanics that was wrong. It wasn’t me, it wasn’t you know, it wasn’t my lack of trying. It wasn’t… just the compatibility between my baby’s mouth and where his soft palate was and the size of my nipples. The mechanics just didn’t tie up and that’s why the breastfeeding was not working. Again, she said, “Look we can try again, it’s not a problem. You’re going to be in for another night at least, so we’ll, we will try again but I think it’s not going to work because of the size of the nipples.” She said, “You can try the nipple shields because obviously they make the nipple protrude more and, and look bigger.” But he just couldn’t get attached on there and he just didn’t like the plastic at all. He, he wanted skin, he just didn’t want plastic on there and so that was, you know, I, wasn’t worried at this stage. I hadn’t discounted the fact that I couldn’t breastfeed at this stage and she said, “It might be that you know, when he’s a little bit bigger, you know, couple of weeks’ time, if you keep going, keep encouraging him. As long as he’s still comfortable with the boob, he might go on the breast.” And I thought, ‘But again it was might. It wasn’t keep trying, it will happen. It was it might happen.’ There is an option, don’t discount it but it was, again, there was, there wasn’t that expectation from health professionals, the midwives that I saw and I saw three or four midwives from that ward. It was all very much, “The priority is to feed the baby. It doesn’t matter what you feed the baby on. Yes it’s better to have breastmilk but you know at the end of the day as long as they’re feeding, as long as they’re putting on weight. That’s the most important thing.”

Lizzie’s health visitor noticed her distress and told her to stop feeling under pressure from previous advice.

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Age at interview: 33

Sex: Female

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The health visitor goes, “Are you OK?” I burst into tears. And I was sort of, you know, I was trying to gather it together, and I’m trying to explain why I was upset, and they sort of, you know, sort of did and, you know, “Well, I mean, I’m sure it’ll be, you know, be fine.” And, “Just try harder. And just be patient.” And actually after the third time of bursting into tears, they obviously went, “Oh, actually, I think we might need to pay a bit more attention to this one.” And at that point they did do some more sort of hands-on work with me, and they, you know, health visitors are rushed off their feet. So then they visited me sort of every couple of weeks. And, and at that point, they sort of realised that it wasn’t through lack of trying, that we were, that we were struggling. And they kept saying to me, “Well, who is putting, who is putting this?” And I kept on going, “I want to breastfeed him until I’m six months, breastfeed.” And they were, like, “Well, who is putting this pressure on you?” And I was like, “Well,” I said, “Every advice that there is, is, you know, all the midwives are putting this pressure on. The health visitors say that it should be six months.” You know, because I had diabetes, they’re saying, “It must be six months.” Otherwise, we’re both going to get diabetes and, you know, you’re letting your child die. And I was like, “Everything out there is saying, ‘Breastfeed until six months, at least.’ That’s,” and I said, “That’s where the pressure is coming from.”

And at that point, she said, “Well, don’t. Don’t do that to yourself, you know? It’s not, you, you know,” she said, “A healthy mum means a healthy baby. And if you’re putting yourself under so much pressure, then actually who’s, you know, these people don’t know you. And they don’t know your baby. And you know, we want you to breastfeed for us long as possible, but that for you might not make it till six months.” And at that point, I just went, “[sighs] Oh, thank goodness. Somebody’s understood.”

Women said that, as first time mothers, they felt insecure and relied on others for advice and support. Women like Lizzie and Ruth said that it took time to feel in control and make decisions about what was best for their babies and for themselves. It was usually their partner who supported and to some extent, influenced the decision to mixed feed or change to formula milk. It was the partner who had witnessed the exhaustion and unhappiness caused by unresolved breastfeeding difficulties.

Three months after her son’s birth, Lizzie felt confident again and able to select information that worked for her and her son. She stopped feeling like a failure and became more assertive instead.

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Age at interview: 33

Sex: Female

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“Actually, this is my baby.” And I think that was, it, that was what I think eventually kicked in, was that sense of, “He’s mine. And I’m his mum. And I do know best. And I am actually going to stop, I’m going to take every bit of information I’m getting and pick out the bits that work for me and for my baby.” And I think it was when I had that, “I’m his mum and I’m going to do what’s right for him,” that I think actually, that changed my attitude completely. Rather than feel like a failure, I was like, “The way I’m not going to feel like a failure is if I’m going to take control of this situation and be his mum.” And I think, that’s what I kept thinking. “All these other experts aren’t his mum, you know. I’m his mum.” And so it’s, you know, that I’ll sort it out. And I think it was at that point that I, that things, I started to make more pragmatic choices on, on how, you know, how I was going to feed him. And he got to be a lovely baby after that.

Women faced with breastfeeding difficulties felt there were no places to go to meet other mothers in similar situations in person. In their experience, baby clinics tend to be busy places with overstretched health visitors and they felt baby cafes do not necessarily welcome mothers who are mixed feeding or using baby formula.

Jessy felt ignored at the baby café she recently went to with a friend. She said such places should also offer support to women who couldn’t or wouldn’t breastfeed.

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Age at interview: 39

Sex: Female

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You know you have these baby’s café for people who are breastfeeding and they have issues with the breastfeeding, and they give support to the people who is breastfeeding I think they should, they should also give support to the people who hasn’t been able to breastfeed or the people who chooses not to breastfeed because as soon as you say you’re not breastfeeding like - I had this experience actually last week. I went to this baby café with a friend who had a baby and she’s breastfeeding and I was, I put my name on the list and then they completely ignored me because I wasn’t breastfeeding. But they could have come to me and say, “How are you feeling? Is the formula working? Is there anything we can do?” Because I got so many questions about formula as well. “Which one is the best formula? Which one do you recommend? Which one is, is do you think is, is better for a baby this type, that is a really hungry baby”. Nobody gives you support, it’s like, “Well you’re on your own now, you’re not breastfeeding? Well, pfft, see what you do”. It feels that way and even like when I went to the café and I saw this lady, the lady that I went to workshop, she came to me and say, “You’re not breastfeeding, awh” And it’s like, “What awh? Don’t, don’t treat people like that. Like why would, why would you be like, awh [laughs]. It’s no, it’s not something to be sorry about it like you should…

I don’t know, there are so many questions I had and the fact that I felt ignored, I didn’t feel like - like, brave enough to approach the lady who was leading the café and ask them these questions. But it is a mother and baby place regardless if you’re breastfeeding or nothing, the support should be given. It’s kind of like - This time I haven’t felt so much because I think I’m standing my ground more into the bottle feeding my baby. But the first time, I, there was, every time, people ask me, “Oh, are you breastfeeding?” and I say, “No, no I couldn’t”. “Oh”. And it was this, ooh, this sense of like I was wrong. I was a wrong, a bad mother because I wasn’t breastfeeding. But nobody ask me before why not, or just accept it, it was this judgment thing, this judging. I felt completely judged all the time, [laughs] because I wasn’t breastfeeding, but if you can’t, you can’t.

The women we talked with wanted very much to breastfeed their children. Their experiences illustrate that they didn’t give up easily and went through great efforts to try and breastfeed successfully. This, despite the emotional strain and physical pain/exhaustion associated with problematic breastfeeding. (see also 'Medical conditions that can affect breastfeeding')

Topic added: September 2015.
Last reviewed November 2018.