Breastfeeding needs a gritty reboot

I'm old and fat and had c sections but still managed to breastfeed fine BUT had I been told "oh no you are going to find this so hard" I'd potentially have been put off and not tried. That's why I'm not sure telling women it's really hard before they actually try is a good idea. I'm not saying gaslight women who do end up finding it hard but it can be very different for different people.

Agree post partumn rest and recovery is SO important.

It's hard to find completely up to date stats but if you compare like from like then lots of countries, including Norway, have far higher rates of any breastfeeding at different points.

Interestingly whilst I was looking at all the different stats it seems breastfeeding increased in the covid lockdown. Maybe the pressure of less to do/ less visitors?

Agree with this. My baby latched brilliantly, right in the delivery suite. Everyone thought breastfeeding was going fine for me. And I panicked and worried as I watched her get skinnier and skinnier, and she fell asleep more and more. I was told a hungry baby wouldn't sleep. I was in hospital for 4 days, and never saw a fully qualified midwife.

Well it turns out when they finally weighed her on Day 5, thay starving and dehydrated babies do get weak and sleep all the time.

When she got out of NICU and I did research, it turns out that I have ALL of the risk factors for low milk supply. A midwife friend who is an infant feeding specialist tells me I should have been referred to her team for advice before I even gave birth.

I'm still breastfeeding my nearly 3 year old, but we've had to combifeed all the way through. I will never make enough milk to keep a baby alive.

Luck is a huge part of it, and that isn’t acknowledged in the promotion either. If you are reasonably young and fit, no other medical problems and have a straightforward pregnancy and birth your chances of being able to BF successfully are considerably higher.

Conversely if you are older, have other health conditions, end up having a CS or a difficult birth involving blood loss then your chances are already significantly lower as biologically your body will struggle to make the milk (and, let’s
face it, in the past you would have been unlikely to have been pregnancy or survived the birth so you wouldn’t have been BFing).

After that it becomes more vital to have a good postnatal experience with support to rest and sleep on the postnatal ward. Because recovery from the birth is also vital for supply.

They’re not comparing like with like though. EBFing can be defined as nothing other than breastmilk in the first six months or only breastmilk in the previous week. Big difference especially if you’ve needed to supplement early on

Not true. Low supply is caused by a wide range of things from a temporary delay in milk coming in thanks to haemorrhage at birth, to insufficient glandular tissue, and endocrine disorders such as diabetes and PCOS.

Women need to be aware of this.

@HeyThereDelila your MW was right, everyone's dealt a different hand. I feel for you, I remember living a weekend hour to hour waiting for a Monday tongue tie appt. Longest weekend ever but for us it was a turning point. I also remember everyone else had bottles in the waiting room there. So much for BF is free and convenient hey?! Huge congratulations on your new arrival and best of luck for Tues.

It absolutely isn't largely down to luck. I would say it's due to a combination of realistic expectations, supportive partners and family members, and correct and early support from health professionals.

Hard agree, it was pretty horrific for me!

Thank you so much @RightOrAMeringue! I appreciate it.

Now just hoping the engorged red breast on the right doesn’t develop mastitis…

Pumped amounts are not the same as how much a baby would feed from you though. A babies mouth is far more effective than a pump. People pump and panic they have a poor supply but actually there isn't a correlation.

If you are talking about the UK then I don't really recognise that portrayal of breastfeeding in this country! I definitely don't think it's normalised feeding in public here and most of my friends who needed support paid for private lactation consultations or a private tounge tie cut as the NHS wait was too long. We literally have one of the worst breastfeeding rates in the world. It can't be that our bodies are so different to women's bodies in Norway where they have much higher rates for example? It must also be something to do with perceptions of breastfeeding and the fact we don't look after women in post partumn properly.
I think it's fine to acknowledge women may have difficulties and troubleshoot them if needed or offer alternative pathways. I don't think highlighting the "negatives" of breastfeeding is the answer!

YANBU, thank you for this thread. I’m 2 weeks pp and had to drop breastfeeding down to just one feed a day on the left with nipple shields thanks to tongue tie and a baby treating my nipples like a dummy. Agony. Engorgement and lots of pain. Getting tongue tie cut on Tuesday then will try and rebuild supply enough to give, say, 3 feeds a day. Will do the rest wity formula.

I’m knackered, recovering from birth and need to protect my mental health from the PND I had last time, so am not going to crucify myself over this.

If it makes anyone feel better - I saw the midwife today who was lovely and said she couldn’t even breastfeed- she said whether you can or not is largely down to luck. It made me feel a hell of a lot better.

Thank you for this brilliantly helpful thread, OP.

It's actually extremely uncommon to physiologically not be able to produce enough milk.

Usually supply issues are there because of things like the top up trap.

There needs to be far more awareness than it doesn’t always work, not everyone can produce enough milk and the reasons why. It turned out I was highly unlikely to be able to EBF, but nobody mentioned anything about milk delay or low supply at the THREE HOUR BFing antenatal class I did!

What I really needed to know was the risk factors, how to safely supplement ie make up formula, sterilise etc.

We live in a country with a huge amount of support for BFing - welcoming public spaces, loads of promotion, facilities, BFing support all over the place - but virtually no information publicly available about the negative aspects and potential problems.

Milk sharing is also a common and ancient human practice. I can imagine babies whose mothers had really significant lactation problems probably didn't survive, but there might also be a cohort where the mother produced some, not enough and the babies survived when another lactating woman in the hunter gatherer band did a couple of top up feeds a day which got them over the line.

That's true, but I've ready many accounts as well of poorer people having their sisters or other family members come and feed their babies because they were unable to do so. Wet nurses who would work for free essentially. People who were desperate would also resort to goat milk or fortified water if they had no other option.

My point was more to do with acknowledging that even in a context where breastfeeding was the norm, knowledge on how to do it was prevalent and there wasn't an easy/cheap and healthy alternative there were still a portion of women who couldn't. So modern women who struggle/can't is to be expected and the messaging could acknowledge that breastfeeding isn't something that works for all mothers and that's OK.

Absolutely

I did all the extra NCT classes for breastfeeding, read up on it and still ended up at 3 weeks postpartum sobbing to a midwife support worker. She basically said why are you putting yourself through this with the lack of sleep and soreness etc? We introduced a bottle of formula in the evening so I could get some sleep. Even went along and checked the latch. I saw so many people watch her feed and not one person picked up that she had tongue tie except my health visitor. She admitted she hadn't the training so could be wrong but she said it was very obvious. Once it was snipped we managed to feed better and we switched the night feed back.

I am frustrated that this information was never provided at the beginning to what should have been looked for. I could have so easily given up.

Wet nurses might have been used where a mother died, but I believe it wasn't considered seemly for aristocratic women to do it.

I find it interesting how many people have interpreted "if it hurts then investigate latch/tongue tie/technique etc" as being victim blaming. It might be due to how those individuals were treated when they did seek help but to me it seemed like a neutral "let's just see if there's anything that can be done to reduce the pain" rather than "it's your fault and here's why".

I do believe there should be messaging that also clarifies that for some women it is just painful/can't be remedied - e.g. my mum had inverted nipples so struggled and chose formula instead which makes perfect sense for her situation.

The existence of wet nurses proves that there have always been a portion of women who couldn't breastfeed, so it's evident that it's not a path for 100% of women. As long as the baby is fed and the mother is mentally and physically well it doesn't really matter for most cases - although in areas where water supply/adequate storage for formula and funds to buy it are scarce then promoting breastfeeding makes sense (admittedly doesn't really apply to the UK thankfully but explains why the WHO advocates for breastfeeding milk so strongly)

I agree. The mantra that it shouldn't hurt and if it does you are doing it wrong needs to be banned. I bf two babies I nearly quit the first time. Second baby I knew what I was doing but it was still excruciating for the first 6 weeks. I knew I had a good latch. Midwife insistent baby had no tongue tie just like the first time. So I have 2 theories, firstly that newborns are the problem with their dyson like suck and it takes them a few weeks to chill the fuck out and realise they don't need to try and suck your nipple odd. Or alternatively the post birth hormones are designed to make it mega painful because you are so bloody knackered and if it didn't hurt then new mothers would fall asleep and their baby would be eaten by wolves...or the modern day equivalent. In fact I think both could be true.

The UK likely does have lower rates than most countries, but I can't say I'd feel particularly supported as a mother and a woman in some of the places with the highest ones either.

Yes my DS would have fallen into that category as he had formula in the NICU but he was EBF from coming home to 15 months.

I still think the rates in the UK are very low compared to world wide though. I think low breastfeeding rates often reflect a culture that's quite unsupportive of mothers in general.

Things might have changed since I had my baby, but I was very aware of how difficult and painful it was for some people when I gave birth, was very ambivalent about whether or not to try it for that reason right up until the last minute, and was pleasantly surprised to find that it wasn't too bad. I think perhaps social media algorithms have a lot to answer for?