Breastfeeding on the move – literally

photo of woman's legs wearing shorts and hiking bootsI’m a great advocate of the right to breastfeed in public places and get extremely annoyed with people who express their ‘distaste’ at the idea. How ludicrous to deny babies the right to eat outside the house, when it’s fine for everyone else? Nevertheless, with my first daughter it was something I found difficult, so I tended to avoid it if I could.

After my second daughter, A, was born, the issue of breastfeeding away from home didn’t arise for some time. Most of our trips were short, and when they did extend beyond a couple of hours, they were usually to the homes of friends or family where I was perfectly comfortable feeding. On a trip to John Lewis, however, where I ended up sitting in the foul-smelling ‘breastfeeding area’ (right next to the ‘changing area’), rather than the cafe — where I had previously got so stressed my let-down reflex refused to kick in — I decided I really had to sort this issue out.

Although I had taken the first step of realising I had a problem, I made no real effort to confront my fears, and continued to avoid breastfeeding away from home as much as I feasibly could. It’s impossible to predict the appetite of a small baby all the time, however, and when I was walking through a wet field several miles from home, the inevitable happened.

The day had started with pretty miserable weather, but by lunchtime the clouds had cleared and we set out on a 2 hour walk through the countryside confident that we wouldn’t get rained on. I had put A in a Baby Bjorn carrier, and as usual, she went to sleep the minute she was ouside. Just as we had reached the point where we were as far away from the house as we could possibly get, A woke up and started to grizzle. This was something that happened from time to time when we were out, and I carried on walking, thinking that she would just go back to sleep as she normally did.

Unfortunately, she didn’t nod off again. Instead she started to howl furiously, in the way she might if she was hungry. Despite the fact that she had been fed just before we left the house, the intervening hour had been enough to work up a hearty appetite again, and it was pretty clear that I was going to have to find a way of getting some milk down her.

This was easier said than done. I looked around for somewhere to perch, and could see nothing but mud and wet grass. How on earth was I going to get A out of the carrier and successfully latched on whilst standing up, and what was I going to do with the carrier? Then I looked down and noticed that A’s mouth was at roughly the same level as my nipple. I had previously complained about the lack of a vomit/drool barrier between A’s mouth and my chest when using this carrier (as opposed to my previous Chicco one), but now I realised this could be an advantage. After a bit of grappling with the numerous layers I was wearing, I managed to expose enough nipple for A to take into her mouth (which she did, quickly). The whole manouveure was significantly more discreet than it sounds, as most of it was shielded from view by the carrier’s head rest.

I didn’t fancy spending the next twenty minutes standing in the middle of a field (other walkers had nodded politely as they passed, but probably wondered what on earth I was doing), so I took a few tentative steps whilst trying to keep A attached. Providing I did it slowly, walking didn’t seem to disrupt her, and I managed to reach a more plausible resting spot.

I’m now quite happy to take A out in the carrier, knowing I can feed her pretty easily if I need to. Interestingly, the confidence I’ve developed through doing this has automatically extended to other situations, and I recently managed to nurse A through an entire wedding breakfast. Psychologically this was quite an achievement for me, as I knew some of the guests weren’t keen on breastfeeding (‘I was bottle fed and it didn’t do me any harm’ etc.), and I had been dreading the prospect of constantly heading to the loo with a hungry baby. In the end, I just stayed at the table and got on with it. I can’t say the experience was wonderful, but that was mainly because I was sitting on a less than comfortable chair and had to negotiate the meal one-handed. Perhaps not surprisingly, breastfeeding in the John Lewis cafe holds no fear for me now.

Breastfeeding a newborn: round two

The nightmare I experienced breastfeeding my first daughter C is well documented. Although we eventually came through it, the first few weeks were really terrible, and if I’m honest, the first few months weren’t brilliant either. It was therefore with some trepidation that I approached feeding my new daughter, A. Was it going to be as difficult the second time round? I hoped not – if nothing else, the knowledge I’d gained about breastfeeding over the last two years meant I’d at least be better equipped to deal with problems, should they arise.

Several weeks down the line, I’m happy to report that nursing A is going as well as it possibly could. The minor nipple soreness I experienced initially disappeared within a few days, and there has been no recurrence of the cracking, bleeding or fissures I suffered with C. It’s impossible to know precisely why breastfeeding is so much easier with A than it was with C. It could be that my technique has improved through months of practice, so A is simply attached better. It could be that I’ve taken a slightly different approach to latching on, sometimes (though not always) using the biological nurturing method. There are two other factors that I can’t ignore, however, both relating to anatomy.

The first major difference between now and then is that my nipples are a completely different shape. When I first started breastfeeding, they were pretty flat – now they are anything but. The second difference is that I’m feeding another baby. While A’s cute little pout looks very similar to C’s from the outside, inside her mouth could be a completely different shape. Tongue tie is known to affect breastfeeding, but I until recently I wasn’t aware that upper labial tie could as well. I don’t have any reason to believe that C suffered from either of these, but it isn’t impossible that some of the problems I had with C related to the shape of her mouth.

We are told that breastfeeding difficulties are nearly always caused by a poor technique. While helping mothers and babies to latch on more effectively will often improve matters greatly, ignoring the fact that it may be harder for some than for others for reasons outside their control is less helpful. Breastfeeding can be difficult for lots of reasons, and discussing some of these – whilst helping mothers and babies to hone their techniques – may lead to fewer women feeling incompetent, and more feeling empowered that breastfeeding is something they can achieve, even if they have a tough time getting there.

I’m not sure when I weaned my daughter

chocolate cake with one candleShortly after C’s first birthday, I gave up expressing milk during my lunch hour (possibly to the relief of my colleagues, who no longer found ‘mystery’ packages in the fridge). Although it was useful not having to fit a pumping session into a ridiculously busy day at the office, my milk supply took a hit, and it was no longer practical to feed C during the day when I was at home.

Night feeds, however, were still a regular fixture. Breastfeeding C was by far the easiest way to get her to sleep, both in the evening, and when she woke up at night – a frequent occurrence, possibly due to the constant stream of illnesses she contracted at nursery. Part of me was slightly anxious at this state of affairs – what if she couldn’t get to sleep without me feeding her? – but the arrangement was too beneficial for both sides to cause too much worry.

By this point, C was quite happily drinking from bottles (the regular exposure she had to them at nursery meant she now welcomed rather than rejected them)*, so when a few months later she started to appear dissatisfied with the amount of milk she got from me, following up a breastfeed with a couple of ounces of cow’s milk seemed the obvious thing to do. I still continued to offer her the breast, however. I was keen for weaning to be a mutual decision, and didn’t want to stop C from nursing if it was something she still wanted to do.

As time went on, C gradually became less interested in breastfeeding. My breasts were pretty much back to normal, and felt as if they couldn’t possibly be producing milk, although I did still feel a feeble let-down reflex telling me otherwise. My supply had undoubtedly declined, however, and one day, C had her last feed. I think this was when she was around 21 months old, but I didn’t make a note of it, and now I couldn’t say precisely when it was.

I’m glad I can’t remember when we called it a day. Weaning is potentially an emotional event, and just moving on quietly was, for me, the easiest way to do it. Perhaps part of the reason I didn’t give it too much thought was because I knew that my breastfeeding days were far from over. At the time  C stopped breastfeeding, I was pregnant, and knew that in six months time I’d be starting all over again.

*The NHS recommends aiming to wean from bottles at a year. I ignored this advice initially as I couldn’t face trying to get C to drink from a cup when she was half-asleep…

Back online

woman's hands typing on laptopI have been woefully neglectful of this blog over the past few months. I’ve been looking into a great deal of research, but never quite finding the time to publish it. I have, however, finally been shamed into getting it together by a thread on mumsnet.

Thanks to everyone who has posted comments in the meantime – it’s great to have your feedback/input/suggestions.

Breastfeeding and biting

When C was about 2 months old, I exchanged baby-related pleasantries with a lady in a shoe shop. After she had made the standard enquiries — how old was C, what was her name — she asked me whether I was breastfeeding. Although this was a fairly impertinent question, I was still in the midst of 2-hourly feeds, and therefore quite happy to talk to strangers about nursing. She then started telling me about her own grandchild, who was a few months older than C, and teething. I mentioned an acquaintance who’s son had just cut a tooth at three months. ‘That is early,’ she said, ‘and it’ll mean the end of breastfeeding!’

I knew, of course, that it meant nothing of the sort: from a physiological perspective teeth pose no problem at all, and  it is perfectly possible to breastfeed babies who have any number of them. My sister and I were both early teethers, and there was a possibility that C would be too. There was no way I was going to let that stop me from breastfeeding prematurely, and it simply wasn’t something I worried about.

I was right, of course, not to worry about teething and breastfeeding. Unfortunately, that didn’t mean it was going to be quite as trouble-free as I expected. When C’s bottom teeth came through, it was fine — I genuinely couldn’t tell when I was nursing. This is not altogether surprising, as the tongue extends over the bottom teeth during suckling, making biting pretty much impossible. When her top teeth started to appear, she let me know about it, however. Problems ranged from the odd isolated nip, to scraping her teeth along my nipple when she drew it into her mouth, to looking me in the eye and chomping down quite deliberately.

While I could tolerate the first two, the third I found both upsetting and eye-wateringly painful. I also took it personally. I could accept on a rational level that C probably wasn’t trying to hurt me deliberately, but it really didn’t feel like that. Tears and remonstrations followed these early biting episodes, and neither of us was very happy at the end of them.

I searched hard for a scientific perspective on the problem. How common was biting, how long would it last, and most importantly, was there anything I could do about it? Unfortunately, I couldn’t find any research addressing these issues. There were plenty of midwives voicing their thoughts on the issue, but none backing it up with any evidence.

Opinions about the appropriate course of action can be divided roughly into two camps: tell your baby quite clearly not to do it and stop nursing immediately; or pretend it hasn’t happened and carry on. I tried both, and I have no idea which, if either, worked. All I do know, is that after a difficult few weeks of C biting on and off, she finally stopped sinking her teeth in, and hasn’t done it now for several months.

Many mothers find biting understandably difficult to cope with, and view it as a reason to stop breastfeeding, often because it appears to be a deliberate rejection of the breast. I took the view that although this might have been the reason C was doing it, a more likely scenario was that she was ill, tired, irritable, and/or just wanting to try out her freshly-grown teeth. As she’s got older, she indicates that she doesn’t want to feed by pulling away, shaking her head, and in certain extremely cute moments, waving goodbye to me. I’m optimistic that from now on, biting will remain a thing of the past.

Nursing strike: self-weaning or a sore throat?

thermometerSince starting solid food, C had had a remarkably relaxed attitude to breastfeeding: she never gave any indication she actually wanted to do it, but when offered the chance she was always happy to tuck in. This was particularly true when she was ill. Often she would go off solids, but would still be happy to breastfeed frequently, which reassured me she was receiving at least some form of nutrition.

When C was got a particularly nasty cold at around 11 months, I didn’t worry too much about her loss of appetite, assuming that I would be able to top her up with breast milk as usual.  Unfortunately, C had other ideas. After a few tentative sucks, she turned her head and pushed me away with a resounding, ‘no!’ Although part of me was delighted at how well she had articulated her refusal, the rest of me was upset, almost alarmed at the suddenness of it. C had never refused to breastfeed before. Certainly, some days she was keener than others, but this outright rejection was completely new. Although the following morning I managed to feed her again when she was half-asleep, it was the only time she nursed in a 24-hour period.

This pattern repeated itself the following day, leaving me frantic with worry. What had happened to put her off? Was it something I’d done? Was it simply her time to wean? How would I know the difference? Obviously if C genuinely did want to wean, I didn’t want to pressure her to carry on breastfeeding, but as stopping was pretty final, I didn’t want to do it unless I was absolutely sure it was what she wanted.

I was shocked at how C’s nursing strike impacted on me emotionally. I was teary, overwrought and pretty much incapable of thinking about anything else. It seemed important to get it into perspective, however, so I eventually pulled myself together enough to consider the issue rationally. One major clue to the source of refusal was staring me in the face: not only was she shunning breast milk, but she was also refusing bottles, and with the exception of yoghurt, pretty much any food or drink. Whilst this was incredibly worrying in some respects, it did point to the fact that the problem may be less to do with breast milk, and more to do with consumption generally. I then started to think about the nature of her illness, and concluded her symptoms were pretty similar to the ones that I had at the time – a runny nose, cough… and a sore throat. I didn’t know whether C’s throat was also sore of course, but if it were, then it would be a pretty convincing reason for not swallowing unless it was absolutely necessary. The cold I was suffering from had left the roof of my mouth pretty tender too, which, if you think about it, could make breastfeeding particularly unappealing.

I continued to offer C feeds, which she would sleepily accept once a day, and after a week or so she was almost back to her normal routine. I can only assume that the strike occurred because of her illness, and now she was feeling better, she was happy to breastfeed again. Although the incident was traumatic in some ways, it did at least leave me confident that if C goes off breastfeeding because she’s ill, it’s something we can get through, and if she’s stopped because she wants to stop… well, that’s something we can get through too. When the time comes for her to genuinely wean herself, I now think I’ll be able to cope with it a little bit better, and simply be happy that she’s growing up and gaining independence.

Expressing at work and leaving bodily fluids in the communal fridge

man-opening-refrigeratorWhen C was 6 months old, I had to go back to work. Although I was returning full time (a part time position in my job would mean working full time for a lower salary), I was able to spend two days a week working from home. C would go to nursery while I was in the office, and I would juggle her and my job the rest of the time. (I say ‘the rest of the time’ rather than ‘the other two days’ as this kind of arrangement inevitably spills over into evenings and weekends.)

Her tender age meant that milk was still her main source of nutrition, and I quickly realised I was faced with a dilemma: express milk at work, or switch to formula during the day. If I didn’t pump in the office, my supply could drop to the extent that I’d struggle to feed her myself on the days I was a home, and I’d also find it hard to express enough milk to give her for nursery.

I appreciated that pumping at work wasn’t necessarily an easy option, however. The most pressing concern was the location – where on earth was I going to do it? I didn’t really fancy a toilet or shower cubicle, and I couldn’t think of any obvious alternatives. I was aware that recent legislation requires employers to provide a suitable space for nursing mothers to express, but I seriously doubted that this had been tested in my (predominantly male) workplace before. Although I was right about this, it turned out that I needn’t have worried. The head of admin had breastfed herself, and was completely sympathetic to my predicament. Admittedly, she had to think for quite a while before she came up with what was basically a broom cupboard, but as it was a lockable broom cupboard, I wasn’t going to complain.

So far, I’ve been managing to express milk virtually every day I’ve been at work, although scuttling in and out of the pump cupboard makes me somewhat self-conscious, as there is no obvious reason why I would want to spend 20 minutes in there every lunchtime. I question myself regularly about why I’m so worried about being ‘caught’ going in there, and have come to the conclusion that it’s basically because I don’t want to encourage anyone at work to think about my boobs, especially not in the inescapably undignified process of being milked. I don’t mind people knowing I breastfeed C, but I’d rather not have to explain about the pump.

Storing the milk therefore requires a certain amount of nonchalance. Whilst my colleagues are all liberal, intelligent people, I’m not really inclined to advertise the fact that I’m keeping my bodily fluids in the communal food storage area. Instead, I simply walk in each afternoon avoiding eye-contact and put an odd-looking package directly in the refrigerator. (To disguise the bottle, I’ve ended up wrapping it in several layers of plastic grocery bags, and although this does effectively obscure its appearance, it also looks rather strange.) Whether anyone has guessed what I’m doing I don’t know, but as yet, they’ve been too polite to ask.

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