Estelle’s baby’s birth didn’t go to plan and they battled with getting breastfeeding started. Here, she writes about their path through a rocky first few weeks.
I had decided long before my daughter was born that I was going to breastfeed: I spent a lot of time educating myself at antenatal classes and reading books, and became a member of the Facebook group Aberdeen and Shire Breastfeeding Support – a support group composed of experienced mums and Peer Supporters. I did not realize at the time that other mothers were going to be the most invaluable resource of all.
My daughter Alexandra was born in November 2013 at Aberdeen Maternity Hospital after 30 hours of labour, including 24 hours un-medicated at home, two hours of pushing, and finally an ambulance transfer to the hospital where I received Pitocin then had an epidural and a forceps delivery. This birth clearly did not go to plan which made me feel even more strongly that I needed to breastfeed my baby to give her the best possible start in life. My husband requested that Alexandra and I had immediate skin-to-skin contact straight after birth as per my birth plan. She was placed on my chest but there was monitoring equipment on my tummy and I was weak and exhausted – I had lost more than a litre of blood, so my placenta was manually removed and we couldn’t delay cord clamping as we’d planned. All this meant that I could not get her into a comfortable position for a first feed.
Alexandra was born wide-eyed and alert, and never displayed any sign of distress throughout the long labour. Once in the recovery room, we remained skin-to-skin for about two hours during which I made several attempts to latch her on. She was showing no interest but I knew babies need time to adjust especially after interventions and drugs. I also knew babies are born with a reserve of fat that allows them to eat very little during their first few days, so I was not worried – yet. In the post-natal ward, midwifes and auxiliary nurses helped me position Alexandra at the breast, but on day two she was still showing no interest in feeding. So, the midwife taught me how to manually express colostrum and feed my baby with a syringe.
By day three, Alexandra had lost 13% of her birth weight and was slightly jaundiced and not feeding. My milk came in and I was taught how to use the breastpump and advised to pump and feed her expressed breastmilk with a cup every three hours, trying her at the breast before each pumping session. When presented with the breast Alexandra would just open her mouth slightly –sometimes not at all- and make no effort to suck, as if she did not know what to do. All my knowledge about ‘waiting for the baby to open wide’ was useless. I knew from following various forums that pain-relief drugs, Pitocin and forceps can all interfere with breastfeeding and that tongue-tie is also sometimes an overlooked reason for breastfeeding problems. I asked the staff about it but no one acknowledged it or checked for a tongue-tie.
I had plenty of milk and Alexandra put a lot of weight back on so she was discharged on day five. The midwife offered me the chance to stay a little longer in order to establish breastfeeding, but I was so exhausted with staying in a ward of six with babies crying through the night, visitors coming all day and the pumping/ feeding sessions every three hours that I declined and went home where I continued to pump. I was a healthy mum with a healthy baby, had had a low-risk pregnancy, yet I had been unable to push my baby out and was now unable to feed her. What could have gone wrong? No one had a clue and by that point my baby was crying at the mere sight of the breast. She could sense my upset and the fact that some nurses had pushed her head to my breast did not help.
After two weeks of pumping Alexandra finally latched on and fed. My relief was short-lived, though, as my nipples became extremely sore after three days, so much so that I came back to pumping but this time started supplementing with formula too as my husband was now back at work and could not help with night-time feeds and pumping anymore. The only thing that kept me going at this point was the continuous support of Janet, the NCT Lactation Consultant to whom I sent updates several times a day by text –she was responsible for the Highland area and her Grampian counterpart was on leave- and who always texted me back with words of encouragements and suggestions. I asked my GP to test me for thrush and started taking antibiotics, but at the end of the third week I decided to go against every Lactation Consultant’s advice and bought a pair of nipple shields. Alexandra took to this straight away and feeding was comfortable again. In the mean time I had asked my Health Visitor to refer me to the tongue-tie clinic where I was told Alexandra had no tongue-tie. I did, however, get recommendations on how to bring up my milk supply and gradually stop formula supplements, and this worked so well that Alexandra was back to exclusive breastfeeding at the end of week four.
For the next few weeks, my baby successfully fed with nipple shields: she put plenty of weight on and my milk supply was never an issue. However I knew something was still not right. Although she was very healthy and alert, I had never seen my baby sticking her tongue out or opening her mouth wide as the other babies did. So, on the advice of mums from the Facebook Aberdeen and Shire Breastfeeding Support group, I decided to make an appointment with Vannin Bloch, an osteopath based in Rosemount. Alexandra had her first treatment at seven weeks old. Vannin felt her neck and jaw and said Alexandra was very tense in these areas and that it was extremely common in forceps babies. Vannin explained that the tension in Alexandra’s neck and jaw made it physically impossible for her to open her mouth fully or stick her tongue out which resulted in difficulties latching on to the breast properly and a lot of soreness for me.
As soon as we went home, both my husband and I noticed that Alexandra opened her mouth a lot wider to feed. I worked on weaning her from the nipple shield during the week that followed, all the while encouraging her to open her mouth as wide as possible. After a week Alexandra was feeding directly at the breast and my nipples were intact. My miracle had happened! Alexandra is now ten months old and still breastfed. I am planning on letting her self-wean when she is ready. Breastfeeding my baby is by far my greatest achievement.
Estelle Muller Girod
This story was originally published in issue 205 of Breastfeeding Matters (Jan/Feb 2015).
Further reading
Nipple Shields
Copyright LLLGB 2016