Sunday, 13 May 2012

Breast is not necessarily best

The subject of breastfeeding has come up quite a lot over the last week, mainly because this month is a massive baby boom for seemingly everybody in my life. So I reckon its time to deal with some demons and get over the whole issue, starting with writing down my own experience.

I had decided that I would "see how it goes" with the feeding thing. This meant that I had read about feeding twins, researched some different approaches and bought a variety of equipment (breast pads, breastmilk freezer bags, bottles, steriliser, formula, breast pump). I had this romantic notion of breastfeeding one baby whilst feeding the other with a bottle of expressed milk and alternating at every feed. I don't think I fully appreciated the all-consuming nature of the early days of breastfeeding and just how determined you have to be to get it established.

Once I'd had my babies by emergency cesarean the midwives gave them to me one at a time and I offered them a feed. As I lost a lot of blood and it took some time to stabilise me this was in the recovery part of the operating theatre, approximately two hours after they were born. Neither baby was particularly interested in feeding. The next opportunity I had to feed them was the following day, so they were about 36 hours old, and they had been given formula through nasal tubes in Special Care. For the next 3 days and nights in hospital I tried to get each baby to latch on individually and then offered them a "top up" bottle of formula every 3 hours. On the last day a bright and cheery midwife pounced on my with a breast pump and told me we were "going to get my milk to come in today". I duly pumped for 15 minutes each side between feeds and over the course of the day produced a measly 1/2 ounce of yellow-ish dribble. I never saw the cheery midwife again.

So home we went and I continued trying to get each baby to latch on every 3 hours and then followed up with a bottle as I had been shown in hospital. I also used the breast pump in between feeds. One of my babies was quite good at latching on, but the other would just get crosser and crosser until we both admitted defeat. I don't really remember ever getting more than an ounce or so each time I expressed and I can't honestly say whether either baby actually managed to breastfeed properly at any point.

The feeding and expressing dwindled over the next few weeks as the babies got a bit more hungry (although they really only got in to the milk thing when they were around 10 months old!), until eventually I stopped altogether at about 8 weeks.

I have since found out that there were quite a few factors stacked against me as a successful breastfeeder:
  • Cesarean section
  • PPH (postpartum hemorrhage) - I lost 2.5 litres of blood in delivery
  • Stress, pain and fatigue
  • Supplementary feeding in Special Care
  • Induction drugs
  • Epidural drugs
  • Lack of contact with babies immediately after birth
  • Tongue tie (one of the twins had a membrane linking his tongue to the bottom of his mouth which made latching on difficult)

Who knew?!

So now I am left with the glorious "breastfeeding guilt" hangover, which is also deliciously linked to my traumatic birth experience and the difficult first few months bringing up newborn twins. No wonder I have flashbacks! I'm dealing with all this a bit at a time and writing about it certainly helps. Who needs a therapist when I can write bollocks and send it out into the ether?

I've looked at a few other blogs about this issue and one of the best I've seen is called Fearless Formula Feeder. She has gathered together some other mums' experiences, and the one below is heart-breakingly common:

"I grieved, and still do grieve, terribly that I couldn't breastfeed my baby. Every time I look at my breasts I am filled with regret and disgust at my own body's inability to do what comes so naturally, what should be so normal. I feel like my body betrayed me. Every time I glance at the pump still sitting in the nursery I am filled with a mix of emotions: anger, guilt, shame, and terrible grief. More than anything I am just SAD that nothing about my son's delivery, his eating, or first few weeks went as expected. I am envious of my friends who breastfeed with seemingly no problems, even after a few initial bumps. I despise envy in myself but I feel it, strongly."

Don't you just want to give her a hug?!

For me, there are three linked issues: having to have IVF, having to have a cesarean and not being able to breastfeed properly. The quote below sums up the impact of the three issues together:

"Women who have infertility issues do have higher rates of breastfeeding difficulties. Infertility plus a cesarean plus breastfeeding problems may be a devastating combination blow to the self-esteem. Breastfeeding problems may hit directly on their deepest fears that their bodies "just don't work right," and "can't be trusted." It may also impact deeply their concept of their own womanhood and femininity."

The common theme that runs through the majority of accounts from woman who suffered with breastfeeding difficulties is regret that they didn't recognise that things weren't working and make an early and informed decision to bottle feed. One mother said that she should have spent those precious early weeks holding her newborn rather than a breast pump. I really admire mothers who realise that the most important part of raising a baby is for both mother and baby to be content and relaxed. I would go further and say that the advantages of breastmilk are completely out-weighed by maternal misery and upset. I just don't think it's worth it.

The doctor quoted here talks a lot of sense:

"But it's important for women to realize that the benefit to baby must be balanced against the stress that is placed on the mother. Of course it is important for mothers to nurse their babies as much as they can for as long as they can, but each mother must be encouraged to do what is best for the mother-child pair as a unit, and sometimes this may mean weaning. Sometimes the baby needs the mommy sane and happy more than he needs breastmilk. If you eventually gave up breastfeeding or pumping because it became too stressful, understand that you made the decision that you had to, and that nurturing your baby emotionally is always more important than its feeding method. "

The big question is how I would feed if I ever had another baby (not that this is in any way in my immediate plans! Strictly hyperthetical). I suppose I would still like to try breastfeeding, even if it only lasted the initial couple of days. I reckon the key time is around day 4-5: at this time the colostrum is finishing and it's what my sister affectionately calls "Jordon Day". Your boobs are massive, hot and painful, feeding becomes difficult, fatigue is setting in, the adreneline from the birth is wearing off and your baby seems to want to feed for hours at a time. If you push through this you come out the other side then feeding is generally established and becomes second nature. However, if pushing through this makes you wish you were dead it's time to stop and reach for the formula. As much as I would hope to breastfeed next time, I equally hope that I recognise when enough's enough.


  1. Having breast fed two singletons I completely agree with you. I was able to breastfeed because I had only one baby at a time, was well supported, and was lucky it went ok. My friend had six months of misery . It wasn't worth it. The main advantage to breast feeding it seems to me, is that it's convenient, which it probably isn't with twins. You can't look at a group of even kne year olds and spot the breastfed babies. So the health professionals should stop the pressure. Mums can apply that in spade loads for themselves...

  2. Well said! It's so refreshing to hear from someone who breastfed that it's not necessarily the best decision for everyone. Too often people think you're bottle feeding because you can't be bothered to breastfeed, or you didn't try hard enough