question about breastfeeding education

[salsa]

Hi ladies

I often read about lack of education being a problem in establishing breastfeeding.

Do you mind if I ask whether this refers to education in terms of the benefits of breastfeeding to the baby or whether this refers to how to actually breastfeed and overcome some of the problems many encounter. Or is it a combination of both?

I ask as I had shocking problems breastfeeding, knew all about the benefits but for medical reasons could not continue. I think if I have a next time I will consult a private lactation consultant about what went wrong this time, but I am interested in what you all think.

Thanks

eta I hope this is in the right area, I figure you guys would know most about this topic

[Ca Plane Pour Moi]

I think we are all told the benefits and we are all made to feel bad if we formula feed, so I think it's the mechanics we need to know more about.

Yes, it hurts for the first few weeks.
Yes, bub will latch off ad you'll spray whoever is sat opposite.
Yes, it's tiring to get going.
Yes, you need 2-3 spare t-shirts in your bag at first.

Many people to whom I speak think it's all natural and easy until they have a baby!

[Barb Glare]

HI,
We live in a culture where breastfeeding is not the norm. Although, for the baby, physiologically and biologically breastfeeding is the norm - already one of the many, many mismatches we face!
Education is needed at all levels of society. think about this. You see your parents drive every day of your life (and driving is not instintual!) Many a teenager gets behind the wheel of the car and thinks they will no how to do it. They kangaroo hop down the road, stall on the first hill, mum or dad has to drive them home. It all ends in tears!
Breastfeeding is instinctual - we give birth and put our babies to the breast. Any vet or farmer would know that you don't interfere with a birthing animal, or handle it before it feeds. But there is so much in our society that interferes with this instintual process and means that for so many of us, breastfeeding is something we must learn. Many of us have never seen a baby being breastfed until we have our own - then we expect that we will just *know* how to do it. The whole process of birth (and in fact our lives as women) teach us to deeply mistrust our bodies. We often come out of the birth experience injured or drugged or both - and our babies the same. We have to contend with hospital policies or procedures that aren't helpful to breastfeeding. We have our own inner doubts and those of our friends and family to contend with.
We need education on many levels. Despite feeling sometimes that we have the benefits of breastfeeding rammed down our throats (and remember, breastfeeding is the biological norm - so there are not any benefits of breastfeeding. -it is normal. There are risks associated with artificial feeding) many including health professionals to not understand these risks. There are lots of competing pressures on women - the pressure to "get their body back" and the pressure to go to work (a recent newspaper article in my own town reported that women had been asked by their employers to wean before returning to their employment - not on, but still happens) Women still get *looks* and commnets when they are breastfeeding. so there needs to be community education on this level. Also, there needs to be ongoing support for breastfeeding mothers. To tell mothers they *must* breastfeed without offering them the education and support to do so is the cruelest of all cuts, and I think this is sometimes why people feel the breastfeeding experience is such a painful one.
Warm Regards
Barb

[salsa]

To tell mothers they *must* breastfeed without offering them the education and support to do so is the cruelest of all cuts, and I think this is sometimes why people feel the breastfeeding experience is such a painful one.

Barb you are spot on. I almost had a nervous breakdown with my feeding experience, and I mean that literally. I had no help at all in hospital other than nurses, sometimes midwives ramming his little head on my sore breast. I was sent home with mastitis and told to keep an eye on it, I had to have antibiotics from my GP literally 3 hours after being discharged and had shocking fever and aches throughout my body. While I was in hospital, a very prominant Melbourne private hospital too I might add, I was literally on my knees hysterical with the feeds. Every time I had a feed time come I would buzz for some help and they would swan in sometimes 40 minutes after I buzzed and then walk out on me again.

We had serious issues with attachment and an extremely unsettled baby and me with severe PND and anxiety that I am still seeing a psychiatrist for now and no-one helped us at all.

So I guess for me I don't know what would have helped, certainly someone saying you are doing this right or that wrong and just guiding me would have been a start.

Sorry, I just had to have a little debrief, it still is an emotional thing for me as you will understand.

[Barb Glare]

Hi, Salsa,

You have had a really tough time. I'm glad you felt you could debrief here with us. It's an absolute credit to you that you were able to keep breastfeeding under these circumstances. You might consider writing to the hospital - hard, I know, but they really need to know about your experience so they can change their practices. As time passes you'll make more sense of what happened to you. Seek out supportive people. The Australian Breastfeeding Association is a very fabulous and welcoming organisation where breastfeeding is the norm but there is plenty of understanding of the difficulties mothers face
Regards
Barb

[salsa]

I gave up shortly after Barb and the guilt was terrible. We are good now but I would love if there is a next time for things to be different

[MantaRay]

Salsa, I think that your experience in hospital is unfortunately all to common, and certainly the conflicting advice (often much of it poor) and the lack of support even from midwives are key factors to women being "unable" to bf. In terms of education, there are a few fundamental things I beleive all women should know prior to having a baby (and their partners and families too for that matter). Like most of us, I only found them out AFTER experiencing bfing problems. I really wish there was some way to ensure that we could make the following things known to everyone:

- Midwives are often not trained in BFing and do not always give the right advice
- Certified LCs and the ABA are the best resources for bfing help, support and information
- The ABA 24 help line is available for everyone, members or not
- Attachment can be really hard at first - sometimes there is a physical reason - eg tongue-tie, flat nipples, large breasts etc - sometimes not. There are things that can done be done to help, and attachment does get easier as the baby gets bigger. YOu are not going to be spending 6 months or 2 years making sure you push the right amount of breast into baby's mouth. After a few weeks the baby can attach just fine all by him/herself.
- Any pain experienced in the early days of bfing is common and usually short-lived. As baby gets better at attaching most pain goes away and feeding gets much easier and much more pleasant.
- In the early days it is very usual for baby to feed for a long time and feed often. This helps your supply get started. It does not mean that you don't have enough milk. And it won't be like that for long. Very soon the feeds get shorter and less frequent so you won't be spending all your time feeding for the next 2 years.
- When you stop feeling full it doesn't mean that your supply is low. The full feeling in the beginning is because you have too much milk while your body is adjusting to the amount it needs to produce.
- Babies go through "fussy periods" where they will drink often for a couple of days - even every 1 - 2 hours. This doesn't mean you are running out of milk, it is very common.
- It is largely a myth that you can run out of milk. It is actually very rare to not have enough milk if you are exclusively bfing.
- Introducting a "top up" ff can cause problems and often contributes to early weaning.
- It DOES get easier.

[Barb Glare]

Dear Salsa,
Things will be much, much different next time - for a whole lot of reasons. Mothering your child will teach you so much. Breastfeeding sure is something - but it's not everything - not by a long shot. Please don't waste any time or energy on feeling guilty - as all mothers do - you did what you thought was best (or possibly the only thing) for yourself and your baby.
Warm Regards
Barb

[salsa]

Thanks Barb, it means a lot to hear this from you and I know it was the only thing I could do at the time. PND is a terrible illness and one that I didn't think would affect breastfeeding along with all the other factors.

Thanks for your reply Melanie, I do have flat nipples so hopefully that is another issue I can sort out before "next time". I wish there was a way of everyone knowing what you have listed too, and also I think more support for PND in general would go a long way too.

[Jennifer13]

Hi salsa

Thanks so much for using your experience to illustrate just why and how problems with bfing can come about. I think you are very courageous to ask for more advice on what you should do differently next time. I believe we become better mothers/parents by being able to look at what we've done or seen and find where we might do better next time around.

I think you've helped point out that there needs to be a lot more support around HOW to breastfeed, not whether you should or shouldn't.

[salsa]

for sure Jennifer.

Shoving a babies head on a breast is not at all constructive or educational and I will not tolerate that treatment ever again. Of course suffering from PND and anxiety I just couldn't communicate that while I was in hospital or anything else for that matter.

[fionas]

Hi Salsa

You are not alone. I think my experience was quite similar to yours and I've been thinking about posting this very same topic myself so thank you. I was also in a private Melbourne hospital where a combination of bad advice and then over-zealous attempts by midwives made for a very bad experience. This is what happened to me (I'm sorry this is so long but I REALLY needed to vent):

Did not feed immediately (my choice, was exhausted)
Did attempt a feed within half an hour (not v successful but didn't panic)
Tried again a few hours later (more successful)
Tried again during the night (not v successful so midwife expressed milk for me. From talking to friends it seems that the midwives on night shift are very keen to express for you because it is quicker than spending time showing you again how to attach)
Checked how often I should be feeding (my baby was not waking for feeds). Was told six hourly.
Continued feeding six hourly until late on day 2. We weren't having a great success but it wasn't totally disastrous either if you know what I mean. Sometimes I ask for midwife's help, sometimes not.
Next midwife asks me why I'm only feeding six hourly. I say because that's what I was told and my baby wasn't waking before that anyway.
She says, oh no, you should be feeding 4 hourly at the very least.
Go to four hourly. Now midwives are shoving my babies head on to my nipple about 20 times per feed which is taking at least an hour each time. I'm not too concerned about this, taking a "whatever it takes" attitude. Plus my nipples are cracking. Again, whatever.
Day 3 they do the normal weigh of the baby. She has lost more than 10% of her birthweight. Now it's panic stations. They tell me "you have to feed every 3 hours".
Now, I crack the s***ts. I say perhaps she's lost the weight because you d***heads told me to feed her every six hours for the first couple of days and I've half-starved her. I tell them to talk to my partner, not me, because I'm completely over the lot of them because they can't get their story straight. Midwife tells me I should never have been told six-hourly and I should make a complaint to the hospital.
Midwife gets more senior midwife. I tearfully relay the whole sorry story. She says "oh no, that other midwife was a bit over the top. You don't have to feed three-hourly, feed every four hours."
But, she says, if she hasn't put on any weight tomorrow, we're not discharging you. Now so stressed that next feeds are very unsuccessful. They get me to express, no milk (milk had not come in yet anyway). They say, you'll have to give formula. I say I don't want to. They say they will have to keep me in then. I reluctantly agree to formula to get the hell out of there.
OK, time comes for discharge. I ask for medical records (to arm myself for complaint). At this point they send lactation consultant (surprise, surprise). She tells me I have flat nipples, to use a nipple shield and when I get home to try with a nipple shield, to express after each feed and to supplement with formula. She also says "I always find it remarkable that women have so much trouble with breastfeeding. You don't find that in the animal world." Because she has my breast in her hand, I hold myself back from telling her "well perhaps it's because in the animal world they don't have 15 different midwives telling them 15 different things".

Anyhow, I could go on and on and on obviously but I think that when health professionals are offering women advice about breastfeeding, they also need to consider the mental health of the woman.

It is extremely difficult to be torn between wanting to give breastfeeding your very best shot (in my case what the lactation consultant had recommended it was taking 2.5 hours per feed, every 3-4 hours = exhausting) and feeling that by doing so, you are not bonding with your baby. For the first seven weeks of my baby's life I was totally obsessed with feeding and the 'do I stop expressing or do I give breastfeeding another red hot go". I was not really functioning. I was either giving her a bottle or expressing or reading about how to try breasfeeding again or feeling guilty about doing anything because it meant I wasn't expressing.

I only got 'closure' when I tried my baby on my breast again at about 7 weeks (after not trying since the hospital). She attached very, very easily. I thought "gee, no wonder people who breastfeed can't understand why some people can't". I could see what it should be like. I know it sounds ironic but at that point I forgave myself for not being able to breastfeed earlier and I decided to stop expressing and go fully onto formula. I just could not bear any more obsessing about feeding especially as my supply was down to about 100ml a day and I knew it would be another merry-go-round of medication, very frequent feedings and expressing to get my supply up.

As I said to my MCHN, I was sick of feeling guilty playing with my daughter because I felt I should be expressing.

And as a very lovely counsellor from the ABA told me "there is much more to motherhood than breastfeeding".

But my research won't go to waste. Next time I will be much better educated and will have a much better idea of what to do if we run into problems.

Sorry for the length!

[paradise lost]

salsa, fionas :hugs: to you both. I hear you both. I would say from the level of guilt i have felt myself, and from the guilt i read about here and on other forums, women know ALL the risks of FFing and have it hammered home aplenty. It is the advice on HOW to BF which is missing in education - Barb has it spot on. Also, IMO, there could be a lot better provision at the government level for women who're struggling. I have a freind in Germany, when she started to have pre-term labour on and off in the 26th week the government PAID for a home help for her, so she could keep the baby in as long as possible. Luckily her uterus was irritable but not serius, he came at 40+3weeks, but she had that support the whole time until the birth. If she needed it now she and her baby could go into a rest home for mothers while a home help came to help her partner with the house and the older child - Germany is REALLY family-oriented instead of paying lip-service to being so and then making life with small children difficult/impossible.

My story was different to many because getting started was easier for me. I had done a lot of reading, had an undrugged and un-interfered-with homebirth and was lucky enough to get a very good feeder right from day one. I got to 5 months BFing and was going ok, but then i started to lose my supply.

I was losing my supply because:
My relationship had fallen apart
I'd had to find and move to a new flat with a 4 month old
I had a thyroid problem
I was an exhausted single parent
I was on the mini-pill and it was slowing my let-down

I began to top-up with FF because XP kept "accidentally" leaving my EBM out to spoil and because (i think) of the stress i stopped getting let-down for the breast pump so i was struggling more and more to replace it. When he began using FF all the time (despite the frozen EBM which is STILL in his freezer) i decided to give her it once a day to stop her getting tummy ache from having it for 4 feeds in a row once a week. My supply dropped a bit more. I got iller, i was thin, not horrendously thin but about 20kg lighter than pre-pregnancy and certainly thinner than i'd been since i was 17. I was so tired, my hair came out in handfuls (part post-baby, part thyroid problem - my eyebrows came out too), i had no help. I KNEW how to get my supply back, but i simply couldn't do any of it:

Go to bed for a weekend and feed feed feed - there was no-one to help in the house to make that even remotely possible.
Eat more/better - no time, no money, no transport, no-one to take the baby so i could shop/cook/eat in peace.
Cut out FF - couldn't because of XP
Cut out stress - i had my XP over everyday to see his daughter, so everyday i had to face more mean comments and difficulties, i was waiting for my benefits to be sorted and had no money most of the time, i didn't know how i'd be paying my rent at the end of the month, i was so worried all the time.
Get some help in the house - my mum is dead, the rest of my family are 200+ miles away. I had a few friends but they worked and had their own lives to live. Many of them tried but by chance my main support network had moved away to work elsewhere over the 6 months before dd was born (a time when those i'd been in Uni with were finishing their masters/moving to do their PhD's).
Get well again - my doctor was making noises about lifelong medication but i was concerned about entering into that! I thought perhaps once i'd weaned DD (which seemed to be happening anyway) i might recover. I didn't of course.
Stop the mini-Pill. My new DP (who actually i was only just seeing then and not sleeping with at all) was the only ray of sunshine in my life during that time. Because of how awful it had been with XP when DD was new i was planning on having my tubes tied ASAP but my GP said i had to wait at least a decade (he was right, it was a knee-jerk reaction on my part) and there was NO WAY i was having another baby. I really felt that if i fell PG i'd kill myself.

I knew all the risks of FFing, i knew HOW to BF, i knew WHAT i should be doing to improve my supply and get back on track and i just couldn't do any of it. I kept going to bed for weekends to replenish my supply (and having to get up as much as ever since there was no-one to look after me so i could look after DD). A slight lift by sunday night had vanished again by Monday night and by Wednesday i usually had even less than before the weekend. DD was hungry, dropping weight, not sleeping well and the more irritable she was, the more stressed i was. Round and round and round we went until i just gave up. We wound down to one feed a day and then i dropped that too to see if my thyroid would recover.

When i was BFing everyone was back-patting and smiling, but when it began to go wrong everyone was like "Oh well, just FF, she'll be fine" rather than giving up their own time to help. I think if society in general knew the things which would help nursing mothers do their important job (mothering, not just BFing) more easily a lot more people would be able to successfully BF.

Bec

[salsa]

Thanks Fiona and Hoobley for sharing your experiences too, I am so sorry so many of us go through this. I have found this thread so healing for me and I hope others do too. I am actually going to write a letter of complaint to my hospital today. My baby is only 13 weeks old so it's still a good time I think.