To feel that BF could have been better handled? This has haunted me for years(34 Posts)
I read on another thread that new mothers are unable to express milk initially. It has made me wonder about whether the advice I got when DS was born was appropriate.
DS (1st & only Dc) was bprn 3 months prematurely after emergency Caesarian, weighed under 2 pounds, was in an incubator for weeks, had brain bleed.
As soon as he arrived midwives tried to encourage me to express; 'your baby needs nourishment, and that's where you come in. We know it's hard but you have to try, and get the milk flow established while you can'.
A 'Breast is best' poster in my ward underlined the message with a cute picture of a pink-and-white baby (so different from my tiny little scrap of humanity fighting for his life in the neonatal ward).
A breast pump was wheeled into my ward for me to use. Other 'normal' mothers had their babies to nurse; I had a ghastly, cumbersome silver breast pump instead.
By some miracle I actually did produce a few drops which I had to label with DS's name and put in the 'milk bank' (a big fridge). There was only enough to put in the smallest size bottle, DS's name is quite long so I had to write very small. I still remember opening the milk bank door and being astounded at the quantities of milk that other mothers had produced for their DC; ranks of big bottles with the babies' names in big bold marker pen letters. I felt guilty at not being able to 'provide' for DS as well.
I stopped trying to BF the day we were informed that DS may not survive (happily he did) or would be severely disabled (which proved to be the case). I have felt guilty ever since.
I feel that the pressure to BF and guilt at not doing so added significantly to the trauma of the circumstances of DS's birth. Do you think I should have tried harder or do you think this could have been handled better and if so, how?
Apologies if you think this is not an AIBU topic; it may belong on the BF thread but to be honest I am worried about this story upsetting people. I desperately don't want to upset anyone so if you think it will please let me know & I will ask for it to be taken off. But this has haunted me for years and I have never been able to talk of it before.
well my baby wouldnt bf, i asked dh to brin the pump from home, but i was told i couldnt use it as it was brand new and not sterilized, they stuck a bottle in her mouth after 3 days and she never bf
It could have been handled better
The trauma of an early birth for a start is the not the best beginning for breastfeeding
All sorts of things would have helped. Lots of one to one support from a trained breastfeeding professional - but for it to haunt you isn't fair on You or your son. You did your very best in what sounds like awful circumstances.
I'm not sure entirely what your question is.
Did the midwives explain that colostrum is only produced in tiny quantities at first?
I think that you should stop being hard on yourself right now! Absolutely no-one on here has been in your exact situation so they can't say how they would have reacted or what you 'should' have done.
If you gave up expressing because you were concerned about producing enough perhaps the staff could have been more reassuring about that.
How old is your ds?
I'm no expert, but expressing isn't recommended early. However, I think in your instance it probably would be, you would need some sort of stimulation to keep and develop a milk supply and if your Ds (glad he is ok by the way) couldn't feed expressing would do that job. Likewise milk/colostrum is very important for premature babies so I expect they meant the beat for both of you...keeping your supply going and getting the best stuff for your son.
Sorry you had a crappy experience.
You did your best with the support available to you.
And colostrum comes in the teeniest amounts, but that is all they need as their bellies are so tiny...you were not failing by any means...quite normal. My milk didn't come in until day 5.
I had to use an expresser a day or 2 after birth. DS wasn't latching on properly. This was when I was still in hospital. I bought one when I went home as it was much easier
I have not experienced what you did, but I did "fail" to BF after an emergency CS and spent a lot of time feeling very guilty. I felt, for a time that I was not a good enough mother - not only had I not given birth "right", I couldn't feed him. Anyone could be his mother (I felt). I don't feel that now.
So I wanted to respond to your post.
ruby is right. You did your best. I hope you get some answers on here and they go some way to helping you not beat yourself up.
I wouldn't feel guilty at all but you shouldn't have been given a pump straight away - you should have been shown to hand express for the first few days and collect each tiny drop of colostrum with a syringe - it really is tiny amounts.
A pump would then have been good once your milk was in - I did this for my 3 week early baby who was in NICU.
But a 3 month early baby is a different matter and I am no expert but am sure they're often given special formula to help build them up.
You did the best you could under incredibly difficult circumstances
Rita: indeed one of my questions was whether it is normal to produce tiny quantities. The midwives did not explain this. I was puzzled/felt inadequate because I was producing next to nothing. I also wanted to ask whether the pressure to BF was appropriate? This is not a loaded question; I genuinely want to know. Is the best practice to encourage to BF at all costs?
Please, please, do your best to let it go.
FWIW my milk has never come in properly til day 2/3 - if I'd had one of those awful mechanical pumps it wouldn't've happened at all.
I can speak with some authority as DS2 was hospitalised when just a few days old. I tried to BF him around the tubes and wires but it wasn't happening. As time went on they brought me a hospital BP which massacred my nipples. I'd previously been able to express with DS1 and a hand pump (the avent isis). But this time I had scabs instead of nipples and barely any milk. I can see that MAYBE if the baby will be back with mum soon a pump could get things moving but it's not the same - your brain and body know it - there's no hormonal surge or anything and how could you get established with no one-to-one specialist support and while worrying about your baby?
Thank god, nobody hassled me - I suspect the midwives were sticking to their 'script' in your case with not much thought for how different and difficult things would be for you with your baby so unwell.
Additionally, your baby was very premature. Your body wasn't prepared to BF. I know very premature babies can BF but the mothers I know who have been in that situation have all had huge problems and all have at the very least supplemented with forumula.
I suspect too that the midwives were trying, cackhandedly, to make you feel 'involved' in the care of your baby and in the process putting you under extra pressure.
Of course you shouldn't've tried harder. It sounds like you were on your knees as it was. Of course it could've been handled better.
Would you consider writing to the hospital, sharing your experience and asking if they have changed their practises?
Your story is heartbreaking
I don't mean that you upset me, please don't worry about upsetting anyone because I'd guess that you aren't the only person to have felt like this and then kept it to themselves. Your story will probably help.
I think it could have been handled better, and the fact that you are still haunted by this indicates that you could probably do with some kind of post trauma counselling.
The midwives were trying to enable your baby to have the best possible food, so they can't be blamed for that, but it should have been explained to you that expressing is very hard to do. A pump is simply never going to stimulate a boob in the same way a babys mouth will.
FWIW, I succesfully bf'd my 2 babies until they were 9 months old, and even then, never managed to express more than a couple of ounces at best. Usually much less. I tried for hours, using loads of different pumps, and it just didn't work. I don't mean to make you feel bad by saying that, I'm just trying to point out that even when breastfeeding is well established, it can still be impossible to express.
You love your child, and I'm sure do everything you possibly can for him. You have nothing at all to feel guilty about.
Feeling guilty is something that seems to come with Motherhood though, no matter what!
MrsCampbellBlack is right, I forgot about hand expressing. It is important for newborns, and they were prob trying to protect your milk supply as well. So it sounds like they were doing the right thing and the pressure/guilt is coming from you. Hard as it sounds, go easy on yourself as all we can do is our best.
PandaPop: he is 10. As I say this has haunted me, all this time.
DS1 was induced at 37 weeks and was very slow to feed (sleepy due to jaundice). I was advised to hand express into a syringe (colostrum) and at day 3 was provided with a pump once my milk came in. He was then cup fed for a few days until he was strong enough to breastfeed. I don't think I would have had the resolve to carry on if it hadn't been for the support I received in hospital.
I believe (although I could be wrong) that caesarian can cause the milk to come in later than with a vaginal delivery and your early birth may have caused issues too. Yes, I do think it could have been handled better with more support from the midwives/breastfeeding counsellor.
You did your very best under the circumstances and should not feel guilty.
I think it is important to encourage bf, yes. It doesn't sound like they were overly harsh or forceful, just perhaps not enough info and it was the message that you didn't like as against the delivery? The message is what it is though, but they should have explained that colostrum comes in very small amounts.
I don't think the bf poster is relevant tbh.
I agree, encouraging you to breastfeed without providing appropriate support to actually do it is completely unreasonable.
The midwives should have done a much better job in showing you how to hand express, explaining about colostrum, when your milk would come in etc. It's not your fault that they didn't - you did the best you could for your baby in difficult circumstances.
I have had 2 prem babies so know exactly where you're coming from. My first refused point blank to feed once she had grown big enough to try I was in tears as MW and nurses rammed her tiny head into my boob trying to get her to feed in the end I shouted at them all told them to get me some cow and gate before I went mad! 2nd prem I expressed but made hardly any milk, was pressurised to get up every two hours to express I was shattered! Was put on meds to produce more milk eventually she fed naturally then they found out she had milk allergy so was put on special milk!
My experiences of bf have put me off ever doing it again should I have another dc.
It happens too much though - encouragement without support at the right time
DS was born 9 weeks early, I was given a handful of single use syringes (like the ones you get for nurofen etc) and told to express some milk (colostrum) for him. That was the sum total of the "help" I got. Once my milk came in, I switched to using the hosital pump, which was in the neonatal unit - I had no access to a pump on the ward.
Fortunately DS was my 2nd, I'd BFed before and knew a bit about what I was doing. It was also quite a few days before he had any milk/colostrum at all, he was on TPN before that - I would have thought the same would be true of your DS given that he was even earlier? I felt that that gave me a few days to build up the supply so that once he did switch to taking some milk feeds he could have my milk, not formula.
My experience though was almost the opposite to yours - I wanted to BF, and felt that the NICU nurses were quite dismissive of it, repeatedly telling me that I shouldn't put too much pressure on me, expressing during the night wasn't necessary as it would tire me out too much and so on.
Anyway, I guess what I'm saying is that it almost doesn't matter whether the nurses were pro or anti BF, I think the whole experience of having a newborn in NICU, and the psychological effects of being on a postnatal ward but with no child with you, is so stressful that it's natural to feel down, depressed, unsupported etc. Please don't feel guilty about it - you did your best.
Entirely agree with slavetofilofax - I BF DS1 and 2 til well over a year old (though DS1 only morning/eve from 7 months when I returned to work) and never managed to express more than 2oz or so at best - and that took a good couple of hours. I'd hoped to be able to express for DS1 when I went back to work but I couldn't manage it at all. And that was with a healthy baby who was well established at BF. I can't imagine how difficult it must have been for you trying to express in the circs you describe.
I think that you should stop beating yourself about this.
This is now your past but PALS might well be interested and will help you if you want anything doing regarding the hospital.
PALS could take your findings to the Obs&Gyn etc on your behalf. Look into it.
I don't know about extreme prematurity but my experience was that the distress of 3-week-early DS being hospitalised at 5 days old made my milk supply plummet. It never recovered enough for him to be ebf. I don't think you should have tried harder, indeed I doubt you could have. Those hospital pumps are ferocious things and hardly conduicive to establishing good supply. The pro-bf posters are intended to persuade mothers who are in a position to choose. Circumstances meant you didn't have that choice.
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