Sunday, 25 October 2015

Breastfeeding: Early Days with Mia, some tips, combination feeding, mum guilt and more.

As promised, I am going to talk more about my breastfeeding experience with Mia. From day 1 till now (14 weeks). You can read about my story with Zachary here, which was totally different, yet similar in some ways. It's a long one, so grab a cuppa!

If you've been reading my blog for a long time or at least 3 months, you will know that Mia was born prematurely, at 35 weeks when I went into labour due to undetected severe gestational diabetes and even more severe polyhydramnios (too much fluid around baby). When they said she was going to be big, I thought - 8lbs at 35 weeks would be big. Nope - 10lb 10oz! Off the charts! Her insulin levels were really low at birth and she needed help breathing as a preemie so she had to be take into intensive care asap. I was in another world with all the drugs in my system and I wasn't given a breast pump or an opportunity for skin-to skin till the next day, so I missed out on the important hours together, which are crucial for establishing a good supply.

As soon as I got the hospital grade Medela Symphony breast pump (provided by the hospital) a day after Mia was born, I started expressing every 2 hours, even at night. I had an alarm set to make sure I do it. It wasn't easy, as I was recovering from labour and c-section so I was exhausted and in agony, but I soldiered through it.

It was heartbreaking not having my baby with me and not being able to breastfeed her. Pumping is hell at the beginning, because most women only have drops of colostrum in the early days, so you end up hand expressing into a tiny cup and then transferring it into 1ml syringes, Colostrum is like liquid gold, so it's super important to do it! I did really well with the colostrum and Mia got lots of the tiny syringes from me when she was in the incubator. I also pumped for 15 minutes every 2 hours after hand expressing to stimulate milk production. Nothing was coming out for 2 days at all, but I got about 1oz every 2 hours on day 3.

I was determined to still breastfeed, because it was important to keep Mia healthy and ensure slow weight gains, so I kept pumping for the full period of  Mia being in the hospital which was 13 days. She was tube fed at the beginning, for 9 days (mixture of Aptamil and my expressed breast milk). I was pumping 1 oz from each boob every 2-4 hours, sometimes longer because of hospital trips. I only actually breastfed her once in neo-natal and a couple of times in transitional care, At that point, I thought I will just have to express and feed her my milk with bottles, but...I noticed that she preferred being breastfed and started latching on like a pro from the first feed! I was amazed and sooo, soo happy! After crying my eyes out about not getting a chance to breastfeed, I was now able to do it!

We got home when Mia was 13 days old and she was bottle fed 50% my milk, 50% formula. By that time, I had to give my hospital grade Medela back and only had a hand held tommee tippee pump to express with. 

The reason why I was  bottle feeding with expressed milk for the first two weeks, was because we had to know how much milk she's getting due to her weight loss in the early days and to make sure she's not being overfed either, as she was still off the charts in weight, height and head circumference. Tricky one, even doctors didn't know what to do and we were basically told to go with the flow.

When my health visitor came for her first visit I told her that I planned to exclusively breastfeed and asked for advice. She encouraged me to try for a couple of days and see how Mia's doing and if she's content. If it wasn't for her encouragement, I wouldn't be confident enough to do it. I was also encouraged by Mia's consultant at the hospital. There was no harm in trying to ditch the formula totally for a couple of days, as Mia was closely monitored by many professionals who were there for me.

I was worried that she will starve, because I don't have a lot of glandular tissue in my breasts, hence why my capacity is so small. The size of your boobs has nothing to do with your supply. Women with tiny boobs can have lots, women with huge boobs can have much less. I produce small amounts often, so baby will feed frequently. I have tried every possible magic potion that is meant to help with boosting your supply and it didn't work. I just wasted money on special teas, Fenugreek, non alcoholic beers etc. My breasts are just not great at producing milk... Grrrr...

Anyway... I started feeding her on demand and she was very content with just my breastmilk. By day 3, she started to act like she's really hungry in the evenings so I gave her 3 oz of expressed breastmilk and she took it all. I would pump with my TT pump after each feed to boost my supply, which meant pumping about 15 times a day... so yeah... it was HARD!!! I would only pump an oz from both boobs after a feed, so it was almost pointless!!! That's why I get so upset when some mums tell me that they couldn't be bothered with breastfeeding because they had too much milk. I literally cry inside and it ruins my day. Advice - if you have too much milk - donate it to a milk bank - premature babies need it desperately and it's an amazing thing to do.

Around week 4, we were breastfeeding on demand, with a couple of small top-ups a day (6-8 oz a day in total). Mia isn't too greedy to be honest. She's more of a snacker, so I knew she won't take too much for the sake of it.

It all changed when I was offered a Double Medela Electric Breast Pump for review and became a Medela Mum! I literally cried happy tears, as I wasn't in a position to buy one at the time. I will review the pump separately soon. As soon as the pump arrived, I started pumping after each feed to stimulate my breasts to produce more milk and properly drain them. Doing that ensures maximum milk production. With my small capacity and not enough glandular tissue, it will never be as much as most mums get, but after 2 weeks of pumping after each feed with the double electric Medela, my supply increased enough to be able to ditch all top-ups except one 4oz bottle in the evening! Awesome! I was soooo pleased!

It's been the same for the past couple of weeks and I still breastfeed Mia on demand. This means no routine, but I really don't care, as it's really important to me to breastfeed her for as long as I can. My supply is now 'established' as much as it can be, still not huge amounts etc, but almost enough, We're at 90% breastmilk and 10% formula, so I am happy. Despite her frequent feeds during the day, she usually only wakes up for 3 feeds at night (12, 4 and 6) and then goes back to sleep till 9-10. Fab! On bad nights, she wakes up every 1.5 hours, but that doesn't happen to often. Mornings are my favourite, because we just stay in bed and breastfeed for hours.

Considering how hard the start of our journey was, Mia being tube fed and being separated from me for almost 2 weeks, my ridiculous breasts etc, it is a miracle that I can still breastfeed her at 14 weeks! My health visitor is really proud of me, I am proud, hubby's proud and I hope I get to enjoy this amazing experience for at least 6 months. 12 months would be my dream! 

I feel like I deserve a medal or something, but hey... mums don't get medals... It has been a really hard journey and I could have gave up from the beginning, but I persevered and it worked. There was no pressure on me from anybody really, it was my decision. I got great support from my health visitor who gave me lots of encouragement, but never pressured me.

Sooo... Here's the advice I would give to new mums who want to breastfeed.
-feed as soon as you can, with lots of skin to skin
-feed as often as you can in the early days to build up your supply
-if baby isn't latched on properly, try again and again and again. It shouldn't be painful.
-if baby's not latching on, express the colostrum into a cup and feed baby with syringes (provided at the hospital)
-ask for help from midwifes, health visitor, lactation consultant, breastfeeding support group
-don't be scared or discouraged by horror stories. Everyone's experience is different. Remember that most mums can breastfeed exclusively and have a good supply.  For all you know, it could be amazing from the beginning, with no problems at all. 
-give yourself at least 4 weeks, before you give up. 
- your milk can take over a week to come through - mine took 10 days to start flowing! 
-if your milk takes long to come in, offer baby a bottle to make sure they don't starve. Always consult your HV, ask for extra visits if you need them. 

If you have problems with baby not latching on properly (Zac had a problem with that) or you know you can't continue exclusive breastfeeding, consider combination feeding. I hate the attitude professionals have towards it, but they have to understand that some mums simply don't have enough milk, but still want to breastfeed!!! It's better to combination feed, than stop breastfeeding completely, so why isn't there any help with it? Sooo annoying! What's working for me now, is feeding on demand and giving Mia 1 small bottle at night time. 
With Zachary, I breastfeed exclusively at night and in the mornings and breastfed on a schedule during the day with top ups after each feed + expressing after each feed (I did that for 6 months). Some mums alternate between breast and bottle to give their breasts time to fill up again. I might actually try that and give Mia more time between feeds, as she feeds very frequently now. Whatever works for you! After all - mother knows best! 

If you can't breastfeed for whatever reason (poor latch, pain, work etc), but you have a good supply, you can pump exclusively and just feed baby expressed milk. Some mums have an amazing supply, but baby has problems with latching on. In that case, expressing won't take you long at all and you will still be able to give your baby the best start in life.

If you're not lucky enough to have a good supply, but you still want to give your little one some breastmilk, express as often as you can for as long as you can, until your milk dries up. Again, it's better than no breastmilk at all and it is the only option for some mums. It's exhausting, but you will feel like you're still giving them something from you. It helps to feel less guilty. 'Mum guilt' is a horrible feeling. And if you find it too exhausting, don't be too hard on yourself. Longs you know deep down, that you did the best you could - you're awesome!

Speaking of mum guilt, I know that what I am about to say is silly, but I know that many mums feel the same way. I feel ashamed when I buy formula for top-ups in the supermarket. I know I shouldn't feel ashamed, but I do... It's ridiculous, isn't it? I think it's because breastfeeding is sooo soo important to me and I can't get over the fact that I have to give Mia some formula. There is nothing wrong with formula, yet sometimes I feel guilty about it. It was the same with Zachary. I want to wear a disclaimer on my forehead - I am breastfeeding, but this is just for 1 top-up a day... I wish people didn't assume that someone just gave up for no reason. Most mums try their best, but it simply doesn't work out.

It's normal. When all you want is for your boobs to do their job and make milk for your precious baby and they fail you, you will feel sad and jealous of mums who have a great supply. You will probably cry, you will pray to have more milk. You will ask 'why me?'. You will try every concoction that promises to boost your supply. You will feel anger when someone says that they have a great supply and they simply can't be bothered to breastfeed. It's normal to feel this way.
When I gave birth to Zac, I had a mum in my ward, who was leaking lots of milk and she was swearing at midwives asking them to give her something to 'stop this f**** milk, because she doesn't want to f***** breastfeed', while I sobbed behind the curtain because my baby was starving... I felt like it was unfair. Why don't I have milk, when she has loads and she doesn't even want it. Well, life is unfair and we just have to get on with it. Some lovely mums I talked to couldn't breastfed at all, because of a poor latch and other problems and they dreamed about feeling the closeness and the bond. All they could do was express as much as they can and bottle feed. Are they worse mums? NO! They should be proud! You can still feel close to your baby when you bottlefeed, they will still look into your eyes and you will spend quality time together with lots of cuddles and kisses. 

I hope you found this post interesting. I am not gonna lie. In my case, breastfeeding has been really hard with both of my kids, but I am doing the best I can. I will forever be envious of mums who have a never ending supply - they are sooo, sooo lucky! I love how breastfeeding helps me bond with Mia and the sound of her suckling is the sweetest sound ever, especially in the middle of the night, when I have more milk. Oh, it's soo lovely!

And do you know what never fails to put a huge smile on my face? Seeing a mum breastfeeding their child. It's the most natural thing in the world, nothing to EVER be ashamed of in public. I personally love breastfeeding anywhere! That's what boobies are for! With naked women in magazines and on billboards being a norm, having half a boob out to FEED YOUR BABY should never ever be frowned upon! EVER! I actually see many people smile when they see me breastfeeding in a park etc, that's a normal reaction :)

Keep your eyes peeled for more breastfeeding related posts coming up:
-My breastfeeding essentials
-Medela Breast Pump Review
-Medela Electric Breast Pump giveaway

Sorry if the post was hectic, I could ramble about breastfeeding all day :)


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