COMBINATION FEEDING: THE BREAST OF BOTH WORLDS

14:32 Hayley Brockie-Dunlop 0 Comments

ESTABLISHING BREASTFEEDING AFTER A TRAUMATIC BIRTH

One of our first cuddles

“The trick is to make sure you have no bottles in the house,” the health visitor proudly pronounced at the tail end of her first visit while I was heavily pregnant. She’d asked me whether I intended to breastfeed my baby - my first - and this was her top tip to ensure I wasn’t “tempted” to fall into the clutches of formula. “To be honest I’d rather be prepared in case breastfeeding doesn’t work out, so I’ve got some already,” was my reply. Her reaction? “Put them in the attic so they’re out of reach!”

I was taken aback. It had been a nice, chatty visit up until this point and suddenly I felt I was being judged for having bottles in the house. Goodness knows what she would have said if she’d known I also had some formula on standby. I’d heard that some health visitors and midwives could be quite pushy about breastfeeding but this was the first time I’d experienced it first-hand. Thankfully at that point my skin was thick enough to put it to the back of my mind, knowing that we were bound to need the bottles at some point. Plus we’d got them on a great Black Friday deal, and I’d be damned if her negativity was going to put a dampener on my bargain high!

Fast forward a few weeks after the birth of our baby boy, and my thick skin had been well and truly eroded. The mere thought of having no bottles in the house and having to make my husband endure the awkward trip up to the attic to retrieve them doesn’t bear thinking about. You see, it doesn’t matter if you have the best of intentions when it comes to breastfeeding, because for some new mums - including me - circumstances conspire to prevent you from even having a bash at it, for a while at least. 


I’d had no specific birth plan - I just wanted our baby to arrive in the world as safely as possible. I felt well-prepared having nailed my hypnobirthing breathing techniques, and had attended an ‘
active birthing workshop’ with my husband in addition to NCT antenatal classes. Perhaps it was the hypnotherapy talking but I was genuinely looking forward to the birth - I was fascinated by it all and couldn’t wait to meet our little boy and spend those precious first hours with him and my husband as we all got to know each other. The only thing I was wary of - as well as the pain, of-course, was anything to do with blood or bleeding. Oh dear.

As for breastfeeding... well, according to the NCT session I’d attended, chances are the baby would somehow climb up my chest and latch on to my boob naturally, and that would be that. I figured it probably wouldn’t be quite that easy but I didn’t dwell on it and hoped it would somehow just work out. We’d downloaded a couple of films to watch while I was in the early stages of labour, packed some nice snacks, had taxi companies on standby and my hospital suitcase by the front door. We were sorted. 

MY PESKY PLACENTA

At 5am on 1 April my waters broke at home, and just seven hours later our beautiful pink squirming ball of a son, Elliott, was placed on my tummy in the birth centre of Lewisham Hospital - those films we downloaded remain unwatched! The birth had been by no means easy, but it passed by in a time-has-no-meaning haze and was, thankfully, straightforward. However, what followed was anything but.

It all kicked off when my entire placenta decided it wanted to stay put. So, despite the best efforts of the medical staff, not long after our son's arrival I was yanked away from our little family cocoon and whisked up to theatre for an emergency operation to remove it. Those precious first few hours together were lost forever. I’ve since learned that my placenta was so firmly attached to the lining of my uterus that it would have been impossible for it to detach naturally (so much for it being “cleanly expelled” as per my hypnobirthing CD). The medical term for this is a “placenta accreta”; when the placenta is attached to the myometrium (the muscular layer of the uterine wall), as opposed to the outer layer.

What I didn't realise at the time - I had my eyes closed for most of it - is that I was effectively bleeding out because part of the placenta had come away, leaving an open wound inside of me. I lost four litres of blood in total and had to have a transfusion (anything over three litres is classified as a massive obstetric haemorrhage) and a balloon inserted into my womb to stem the bleeding.

I woke up that evening in recovery, delirious and scared for my life, and without my baby who was being cared for by my parents while my husband stayed by my side. I was moved to the high dependency unit where I stayed - without my son - for three nights.

With all of this going on, any intentions I’d had to breastfeed went out the window for the first 24 hours. Indeed, I didn’t even have the chance to try. My parents fed him formula on the maternity ward while I focused on getting better. I was terrified of falling asleep so kept myself awake by talking - literally nonstop all night - about trivial things to keep my mind off what had happened, but once the adrenalin fell away and the reality of my ordeal kicked in - I’d effectively been in a life-threatening accident - I was distraught. I needed to be with my baby and I needed him to know that I was his mum.

The most obvious way to do this was to give breastfeeding a go. Thankfully he was allowed on to the ward for sporadic visits and crucial skin-to-skin time and - incredibly, with the help of a midwife and the hospital’s breastfeeding counsellor - the first time I attempted to breastfeed him it worked. It wasn’t at all how I’d imagined it, and he would still get all his proper feeds from formula for a while to come, but he was latched on well and we were together.

On the fourth night I was moved to the maternity ward where I stayed for a further five nights in the same room as my husband and our baby (I ended up having to have a follow-up operation to remove some bits of leftover placenta). Because of the invasive nature of the procedure, combined with a second degree perineal tear and the effects of the blood loss, I was immobile, in a lot of pain and completely exhausted, unable to do even the most basic things to look after my son. I lay in bed crying with frustration, with a cocktail of alien hormones racing inside of me making sleep impossible, while my husband did everything.

The only thing I could even attempt to contribute was the occasional breastfeed - one or two a day - which took a lot out of me with feeds lasting up to an hour. But I persisted. It wasn’t that I was obsessed about him getting breastmilk instead of formula, it was about being close to him to make up for the time we’d been apart.

My milk gradually came in after a couple of days on the maternity ward but none of my nursing bras came anywhere close to fitting. There I was, barely able to get out of bed in what felt like the hottest room in the world, with full, heavy boobs and nothing to support them (I was finally told about this bra). It was tough going.


GOING HOME

Returning home was a heartbreakingly dark and miserable day; I had zero energy, was suffering from flashbacks and felt as if I would never be myself again, let alone ever be capable of looking after my child. My parents took a photo of my husband and I crossing the threshold with our new baby and I look dead behind the eyes, and that’s how I felt - hollow. Instead of joyfully showing Elliott his home - a moment I had looked forward to so much whilst pregnant - I took him to his little room, sat on the nursing chair and wailed with him in my arms. But as the days went by, and I finally managed to get a bit of sleep, I gradually began to feel better, stronger and - crucially - happier.

Breastfeeding remained a struggle. Elliott had always favoured one side, but he began to refuse the other side entirely. By this point breastfeeding was probably accounting for around a quarter of his feeds. “We can get you exclusively breastfeeding in no time at all!” the health visitor chirped during her first visit upon my return home, as I wept in bed with her perched at the end of it. But I didn’t need smiles and encouragement at that point, I needed someone to show me what to do. A solution. And when none of that was forthcoming - I was in no physical state to even attempt to visit one of the local breastfeeding cafes - I was on the verge of giving up entirely, despite speaking to an NCT breastfeeding counsellor on the phone who explained that it was possible to feed from just one side if I wanted to.

What turned it around for me was when I finally managed to get him to latch on the other boob. A no nonsense midwife came round for a check-up and quickly manhandled Elliott into an alternative position (which I’ve since learned is the rugby ball hold). It was exactly what I needed and, with the help of a breastfeeding pillow, he finally starting feeding happily from both sides. The NCT also referred me to someone who’d gone through a similar experience to me a number of years ago, who also happens to be a breastfeeding peer supporter. She encouraged me to try breastfeeding whilst lying down for the night feeds, which took a while to master but does make a huge difference in terms of conserving energy.

My husband returned to work, and breastfeeding slowly accounted for more and more feeds per day, until he was down to just two bottles of formula, both given by my husband before and after work, allowing me to get extra sleep. I made progress every day, and set myself small goals. One day I would put a load of washing on, the next I would get as far as actually hanging it out to dry, and the next I would put my contact lenses in. They sound like tiny things but each day I felt more capable, until I finally made the huge step of leaving the house with Elliott on my own for the first time to meet up with my NCT friends. I felt triumphant.

Leaving home alone with Elliott for the first time

Ten weeks on and I feel like a “normal” mum. My iron levels are back to where they should be, I’m getting out and about, my baby is happy and thriving and I’m still almost exclusively breastfeeding. I pump once a day in the evening to keep up my supply to make up for the formula feeds my husband still gives him, and we’ve consequently got a decent stash of breastmilk in the freezer for those days or evenings I venture out alone.

I really feel like combination feeding is underrated and never discussed as an option during any antenatal conversations. We kind of stumbled across this method of feeding in light of the circumstances, and I wish someone had said from the start that you don’t have to choose one or the other, you can do both.

And I think that’s what frustrates me most about my experience. Don’t get me wrong, the medical care I received from everyone I encountered was exceptional, but when it came to seeking help and support, you have to be extremely self-motivated, at a time when you probably have the least amount of energy in your life. It was me who called the NCT breastfeeding helpline, it was me who asked my local Facebook mums group for nursing bra recommendations when all I got was a blank look from the midwife in the hospital when I asked her for advice, and it was me who sought advice from other mums who’d been through similar experiences (I’ve since learned about the Birth Trauma Association - no one thought to tell me this existed while I was in hospital).

It feels like it’s been a long road but I’m breastfeeding, Elliott’s putting on weight, and we’re all happy. And when I see his gorgeous blue eyes and cheeky little face looking up at me during feeds, I’m so glad I was able to make it work. And you know what? We’ve used those bottles every single day.

Elliott - happy with boob or bottle!


This blog post was originally posted on Another Bun.

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