Breastfeeding. How important is support?
It’s postnatal Day 2, her nipples are sore and starting to crack (this is normal in the first few days if you have never breastfed before- they need to get used to it initially.) We always used to say to new breastfeeding mums- imagine sitting playing with your nipples all day- they’re going to be sore by the end of it, as they’re not used to so much ‘attention’! However, with good positioning and attachment and plenty of Lanolin based nipple cream, your nipples soon get used to breastfeeding and there should be no pain or discomfort when breastfeeding. If your nipples have cracked severely and are bleeding though, I would get your midwife to have a look, as this may be a sign of poor latch or other issues like tongue tie.
As this first time mum has no family or friends that have experienced this, she may think this is not normal and her peers and family will most likely encourage her to give up and bottle feed. She also doesn’t have a support network of mum friends and this so so important! I talk to many mothers who stress the importance of their mummy whats app groups, where they are able to very openly share:
-“Are everyone’s nipples sore or just mine?”
“-Have your haemorrhoids gone back to normal yet?”
“-My baby seems to have been feeding on/off for 4 hours now- help me!”
It’s a times like these, where you’re at breaking point that support is most crucial! It doesn’t necessarily need to be in the form of having your midwife or a breastfeeding support worker at your door (as lets face it, with all the cutbacks and understaffing that is never going to happen!) It could be just a few kind words of reassurance that you’re doing a good job and that certain things are normal.
Cluster feeding I think is the biggest one here. Nearly every week at my local mother and baby group I have women say to me, “my baby won’t stop feeding, they seem to be on me all the time.” At such times, more often than not, it just takes a reminder from me that their babies may be cluster feeding because they are feeling a little unwell, for example. Or, that they are going through a growth spurt, or maybe that it is hot outside. We often forget that babies go to the breast for not just their meals but drinks too. So when it’s hot your babies will probably be demanding the breast more but these will most likely be shorter feeds, where they are wanting the watery milk at the start of a feed.
Unfortunately breastfeeding support is somewhat a postcode lottery and often support seems to get pulled from communities where it’s most needed.
Mary Renfrew, an author of the ‘Paying mothers to sustain breastfeeding’ study, said: "It can be particularly difficult for women to breastfeed without strong family and community support, because of strong societal barriers."
Public Health Minister, Joe Fitzpatrick also comments on the recent influx of funding to improve Scotland’s breastfeeding rates. “It is vital that mums are well supported throughout their time breastfeeding, especially where they may be experiencing difficulties, and this additional funding will help with some of the common issues they may face early on.”
On the contrary to our initial scenario, travel to a different town and for the women living there, breastfeeding is the norm; their mother and grandmother both breastfed, they have grown up with breastfeeding women around them; friends, sisters and cousins. Here breastfeeding cafés thrive and mothers confidently breastfeed in public - it’s second nature. Sue Ashmore, Director, Unicef UK Baby Friendly Initiative, describes how to help overcome this.
“At a micro level, women need to be helped to build 'a village of support' around them. During pregnancy the mother needs to be helped to explore what her support network could look like; be it a partner, a friend, her mum, dad, cousin, step-mum, acquaintance or another local mother who is breastfeeding or has breastfed.”
The most frustrating personal experience I’ve had in relation to support was this. (Pseudonyms have been used to maintain patient confidentiality.) I was looking after a lady on shift who’d told me that she really wanted to breastfeed but her son was somewhat of a reluctant feeder. I don’t know what it is about baby boys but they always seem to pose a problem! She was Day 0 postnatal, following a normal, vaginal birth. As part of the Baby Friendly guidance, for healthy term babies that have experienced no complications at birth and have no other factors that could put them at risk, (infant of a diabetic mother for example,) it is fine if they don’t feed effectively in the first 24 hours. This is because they have plenty of fats and placental reserves.
However, breastfeeding works on a supply/ demand basis. Therefore, I explained to Sunita* that we should try baby at the breast 3-4 hourly and whenever he showed signed of wanting to feed. When we put him to the breast he wouldn’t latch on and showed little interest. So I taught Sunita* how to express milk by hand. If you want to know more on how to do this, please watch my ‘how to hand express’ video by clicking on this image below.
(Video From Lotus Maternity. Opens In A New Window)
I sat with her and syringed her colostrum as she expressed and we gave this orally to baby. We did this together throughout the day.
I then went into the bay to see Sunita* as it was time to have another go at feeding. It was visiting hours now and her husband was sat at the beside. I introduced myself and explained the work we had been doing with hand expression and encouraging baby to breastfeed. And he said to me, in front of his wife, “why don’t you just give him a bottle and then we can go home.” I shot some serious daggers his way and responded, “well Sunita* has told me this morning that she wants to breastfeed, if we give a bottle this will be counterproductive to initiating breastfeeding because of teat confusion and formula will also affect supply and demand.”
His response to this was, “well I don’t see the problem, I was bottle fed, as were my siblings and cousins.” I explained the options and that I felt Sunita* should stay another night to get the feeding support and I would not be happy to discharge either, as baby hadn’t had a proper feed. I wasn’t on shift the following day but I can bet that she went home bottle feeding, as she hadn’t got the support from her husband. Who in reality should have been the most encouraging and respectful of her choice to breastfeed.
To finish here are a few tips on how to improve your support network if you plan to breastfeed:
-Educate people antenatally.
Not everyone is aware of the benefits of breastfeeding, so encourage family and friends to learn more about it.
-Explain to partners, friends and family members exactly why you want to breastfeed.
-Find out who your local La Leche League supports are.
-Join local mum groups or if you would feel more confident meeting new mums in person first, apps like Mush and Peanut offer a way to connect with local mums in your area. This is particularly of benefit if you haven’t done antenatal educational and/or exercise classes.
-When feeding in public, look for posters or signs on the doors of establishments that say ‘Breastfeeding friendly’ or ‘Breastfeeding is welcomed here.’ If it’s your first time going out with baby- strength in numbers! You will feel more confident and relaxed publicly feeding with someone else. Our unique, luxury range of UK made nursing wear is also designed to help mothers breastfeed in public with confidence and complete discretion, so check that out too!
-My final point is one that my community midwife mentor told me, which has stuck with me and what helped her to carry on breastfeeding in those early days. And I will share it with you now: Don’t keep formula in the house, as the temptation is there then and when you’re desperate it’s hard not to cave. Most people live within a reasonable distance of a 24 hour supermarket, so if you do really need it, it’s always available.
I do hope this was helpful. Albeit quite extensive but there is so much to discuss!
My next blog will be exploring ‘Education’ and the role that plays with infant feeding choices.
Until then, Olivia x