Is it ever physically impossible to breast feed?

[ThePowerof3]

I know that there can be a lot of mental barriers to breastfeeding but what are the physical ones? Is it ever possible for someone's milk not to come in?

My DS had a traumatic birth (for both of us) yet when I finally got to hold him about 2 hrs later he latched on straight away. It was just instinctive for both of us and he fed from both breast perfectly.

By the next morning (3 hrs later ) he just wouldn't feed. He latched on perfectly but just wasn't drinking. After a few hours. The midwives started to get a bit worried as his temperature was dropping and he was becoming listless. A HCA came over to try and help but he was latched perfectly, he just didn't seem to have the energy to drink.

The only option was to try and pump or give him formula. Pumping didn't work as I wasn't engorged enough so he had formula. Tiny tiny amounts at a time but it worked and we went home later on the next day.

4 days later when my milk finally came in I was in hospital with a post dural puncture and so separated from my baby. It was agony. My breast were so engorged they were rock hard, just turning over in the bed was agonising. Unfortunately as DS wasn't there I couldn't feed him, I also couldn't effectively pump as I had to lie completely prone in the bed, raising my head even slightly caused pain I cannot describe.

So basically it was physically impossible for me to BF but because of a combination of factors and situations. It's not just a simple case of 'are your breasts physically capable of producing and expressing milk or not'. There are countless variables which all play a part.

I could breast feed, but dd2 couldn't. She was born with no suck reflex.

I expressed so that she could be tube fed.

RE the judging of Formula feeding... I am always confused that so many people feel that this happens so much, particularly when it's breastfeeding mothers who get told to leave cafes or get off buses for breastfeeding. Weird.

Also - everyone is different. One person may give up breastfeeding because of a difficult birth experience and others like me manage to keep breastfeeding. Even after days of labour, rough birth and baby in special care for ten days I still managed to get him to breastfeed exclusively (pumping at first) once I was at home.

I tried to BFAR with DS1: started by diligently harvesting colostrum, and managed, over about a month, to collect 30ml. M breasts were bruised with the force I'd had to use in expressing, and I ended up (accidentally) inducing labour at 37wks due to all the nipple stimulation. DS was born by EMCS after a very long labour, and, though I tried to feed him, he was clearly getting nothing. I was also getting sicker and sicker, and, by day 4, was vomiting every time I held him (combination of anxiety and PND). I think my milk probably did come in a few days later (I certainly had engorgement, swelling, hot skin) but by this point I was pretty much bedridden as I couldn't even keep water down, and DS had been given formula as it seemed it was the only way to keep him from starving. MW thought I should have persisted trying to BF, but I honestly think we'd both have been hospitalised. I still feel immensely guilty (failed to give birth properly, failed to feed properly etc etc), and am having all sorts of fears about how I'm going to feed DC2, with whom I am currently pregnant.

Most people were lovely and supportive: they knew how much I had tried to BF, and how much I hated having to FF, but being harangued as an irresponsible mother by random strangers hurt a lot.

I guess for some people it's technically possible but at what price?? If its too stressful or too much of a hassle for whatever reason then on balance it may not be the right option even if theorically it could be done.

"There are countless variables which all play a part."

But don't you have to ask why these 'countless variables' in physical terms seem to matter less than your age, social class, or which country you're born in when it comes to working out the chances of you succeeding with breastfeeding?

I bf my Dr to 10 months when the twins came along after a planned c section I tried I really did I had soooo much milk I could easily pump 18 oz in one sitting but the dt's were both severely tounge tied mw were bringing me the bottles of formula in hospital even the bf advisor who came to the ward ignored me and the twins

So we ended up ff even at age 4 both still have slightly forked tongues :(

DD was born by EMCS, then I got an infection and was put onto heavy duty abs after having 2 lots whilst in labour (Group B strep had been diagnosed). DD was then diagnosed with a tongue tie. All of which added up to her having problems latching on, and possibly lead to me producing no milk and having no milk come in.

I was expressing a bit for the first 2 days then the amounts were dwindling - was told that was because my milk was coming but after 5 days and DD losing weight a new midwife suggested I ff her which she took to like a duck to water. Poor wee sod drank SO much in the first 24hrs of ffeeding!

Fair play to the midwives, they were SO encouraging but I do wish I'd formula fed earlier as it was so miserable for DD, she was constantly crying as she must have been literally starving.

As a mumsnetter, second time mum and peer supporter, when I was told I'd have to stop bfing to take the meds I need, I put up a fight and sorted it out (the meds ARE NOT incompatible with bf by the way, the consultant was wrong. DS2 is still breastfed)

But if I'd not had that training and support, I could have been thinking that, thanks to needing medication, I was one of these women unable to breastfeed.

If doctors don't have the adequate training to give the right answer, they should be referring you to someone who does, not making it up.

Dueling - completely subjective, but as someone who did both, I always felt far more self conscious FF in public. And I was someone who used to BF my toddler on beaches, theme park rides, you name it.

DD was born by emcs, during which I nearly died (thanks to a scalpel-happy surgeon) and lost most of the blood in my body. I needed further surgery under general anaesthetic immediately after the birth to repair the damage (by a surgeon flown in from another hospital as he was the only person they could find who knew how to repair the mess).

I was physically unable to bf for the first 24 hours because I was so weak and unable to hold DD or stay awake. She was fortunate enough to get donor milk during this time.

After 24 hours I was well enough to try to bf but my milk never came in, not even a drop of colostrum, and after 3 weeks of attempted bf I was advised by various people including MWs, infant feeding co-ordinator and lactation consultant, that I should give up as my body had obviously decided not to play ball. This was after trying everything to get my supply going - expressing, herbal supplements etc etc

One mw said to me that she thought that in some cases of severe birth trauma, your body's subconscious self-preservation instinct can kick in - ie, my body decided that its priority was keeping itself alive, not keeping someone else alive, despite what my head and heart wanted it to do. That kind of makes sense to me. So I would say that in some cases of birth trauma, it is physically impossible to bf after.

I fed all 4 of first dc no problem. Premature birth with 5th dc, zero amount of milk, pumped, tool meds, ziltch.

Sorry, this may be long.

First, as someone who also mix fed, I also felt better bfing than ffing in public, but that's about me I think!

I also have breast hyperplasia. With DD I thought feeding was going fine until her weight gain started bothering people. She got back to birth weight at around five weeks and was very slow. My HV diagnosed PTT, and it was the rather unsympathetic lactation consultant at Kings TT clinic who told me I had tuberous breasts and 'wouldn't be able to breastfeed'. Added to that, my HV told me I was starving my baby, so I ended up mix feeding, with largish formula top ups. I live in an area with fantastic support (although sadly my otherwise amazing midwives had never even heard of the condition) with a choice of bf cafes every day, and I saw three very supportive LCs. I also took fenugreek, goat's rue, domperidone, and did endless heartbreaking pumping when I'd get 20ml at most over the course of a day. I felt absolutely dreadful about my 'failure' and in fact have never since been able to think of my breasts as 'proper breasts', even sexually. I can't wear nice underwear without feeling like a fraud.

Reading so many accounts on here really does help. Whoever asked why that would be because so many women ff, it's because lots of them are perfectly happy about that and never wanted to bf. It's different to know about other women who passionately WANTED to and couldn't.

Anyway, I'm now a mother of two and my DS is 11 weeks old, bf with top ups of donor milk from Human Milk 4 Human Babies (a resource worth knowing about), and also still feeding DD, now 2, once a day. I also still cry about my condition about once a day!

I'm also about to start training as a peer supporter. One thing that two LCs have told me is how often women with hyperplasia now have breast surgery, because alongside low supply they can also look rather odd, and therefore present at first sight as 'normal' breasts. It's always worth gently asking, if you know there's been surgery, exactly why the operation was done.

Sorry to rattle on. A subject close to my heart. But just to add, while I wholeheartedly believe in bfing, that is my personal drive. I think comments about it being best for the health of babies is best kept out of online support. It can make women feel beyond dreadful.

ICBINEG
"I have been accused of judging FF mums by:

1. stating the statistical facts on increased SIDS risk of FF"

Why would you even state those facts? Is it even necessary? A mother is struggling to feed her baby and feeling guilty and you announce there is an increased risk of SIDS. That would make any parent feel like utter shit. There is just no need. Never mind being judgy, it's downright cruel!

I couldn't, partly I was so massively stressed (useless dh was leaving and making life even more difficult than when he was around, was basically completely on my own), had terrible pain in my shoulder due to tension all the time which didn't help, and am former anorexic so uncomfortable around feeding. It was the worst experience of my whole life, and I know people laugh when I say that, but honestly it was so truly dreadful I can well up just thinking about it 11 years later.

And the increased "risk" is miniscule.

Vey few babies thankfully die from SIDS.When you factor in the fact that most babies are ff and if you use a dummy,don't smoke,co sleep etc on top your baby is highly unlikely to get SIDS well it's pretty obvious that comments like that from Ice are scaremongering at it's best.

My milk did come in, but it never seemed to nourish my dses. Ds1 was topped up with formula in hospital - they told me he needed it because he was jaundiced and it was getting worse not better, even with phototherapy (i didnt know enough to argue and was so worried about him, that i just did as i was told) so by the time we went home, and I tried to re-establish breast feeding, I couldn't. Even pumping didn't seem to boost my supply, so ds1 was formula fed.

Ds2, home birth, no jaundice, ebf from the word go, dropped 10oz from his birthweight and hadn't regained more than an ounce or two by 6 weeks - despite feeding all day, every day. HV visiting daily/every other day, putting pressure on - "I want him to,have gained an ounce by day after tomorrow" etc, and suggesting I top up with formula. I resisted as I had seen where that had led with ds1 - "Ah, bit I have to think of the baby's best interests" says HV - so I told her to leave my house at once.

Ds2 ended up in hospital with a mild chest infection, but they kept us in because of the weight issue - basically he only put on weight when supplemented, and they weren't going to let us out until he had gained some weight, so I introduced formula, and the bf quickly faded.

With ds3, I mixed-fed from very early on. He was ebf during the day and had a bottle last thing at night, and one during the night. As long as he was getting two formula feeds a day, he gained weight. If he only had one for a few days, he stayed the same weight.

I have come to the conclusion that I make crap milk - skim, where everyone else makes gold top. But over the years I have spoken to a number of people who have given me the impression that I SHOULD have been able to feed them - I had just failed to do something that would have solved it, because 'everyone can breastfeed' - and that left me with a big feeling of failure.

Some people can't bf but their difficulty is so often compounded by hcps who don't know much about the more unusual bf complications.

Rallytog1, your experience sounds so tough and massive postpartum blood loss is a factor that can result in a complete failure of milk production ... Everyone you worked with should have known this and with your situation should have been extra attentive to your problems:(

Stiffybing, I wish you too had met a rather more sensitive ibclc at kings:(
Keep reconciling. With your body, I hope with more distance yet you feel better about it all. You will be so fantastic at supporting the many mothers who find unexpected challenges.

I am among the lucky ones because I did have a sympathetic bf counsellor and was able to continue bf'ing and eventually bring dd back to a healthy weight and then carry on bf'ing.

It is just that the cost to me in terms of physical exhaustion was very, very high. And my health was not brilliant from the start. And I was taking risks with my health through staying on medication that wasn't controlling my BP very well at all.

If I had known that this was only the first stage in a long exhaustion battle with SN, then I would not have put myself through it: I would have said that it is better that I look after myself so I can have the energy to look after dd. She will need a support and advocate for many years to come.

Minifingers Tue 30-Jul-13 14:43:42
""There are countless variables which all play a part."

But don't you have to ask why these 'countless variables' in physical terms seem to matter less than your age, social class, or which country you're born in when it comes to working out the chances of you succeeding with breastfeeding?"

I am Swedish, so grew up surrounded by breastfeeding. Because I had my babies in the UK I refused to top up with a bottle when dd wasn't getting enough, because I had been told this is the slippery slope. So dd got weaker and weaker and that could easily have spelled the end of my bf'ing.

When ds was born and started showing the same weak sucking reflexes I did what my Swedish family and friends have always done: topped up as and when.

They couldn't understand what the fuss was about.

Personally I think most breastfeeding problems are solvable but for some solving them would require so much effort and energy for that mother and baby that the choice to formula feed is the right one for them.

I think we often do write off breastfeeding too soon I worked with a woman who finally managed to get her baby to attach to the breast at four months (and went onto breastfeed for two years). I think as long as you have a well fed baby and keep the milk going, you will get the two together at some point. I think health care professionals often write off breastfeeding by forgetting one of these two points. Pushing breastfeeding which isn't working well until you have a weak and dehydrated baby who needs more intensive help or give a bottle to prevent the above but forget about the keeping the milk going part. Also sometimes successful breastfeeding isn't about fully nourishing the baby on breastmilk, it is about providing a breastfeeding experience for the mother and baby and some of the benefits of breastmilk.

I think it is sad when women feel bad or guilty they didn't manage to breastfeed, for me it means they didn't get the help they needed. I have worked with many women where they have reached the point they are ready to give up and that the energy required to solve this breastfeeding problem isn't feasible for their family and they have never felt bad, sad sometimes but not guilty, they know they have done what they can and that they are making the right decision for them.

Apologies as I haven't read all the replies yet but thought I would share my experiences of my three 'failed' attempts to bf.
Ds1 was born by em c-section after a failed induction and lots of stress. He showed no interest when attempting to bf, never latched on and only opened his mouth when 'forced' to. No milk came in, thi was put down to stress from the birth.
Ds2 tried to latch on but his tongue was always on the roof of his mouth, so the nipple went in under his tongue and when he tried to suck, it was pushed out by his tongue coming down. Nipple shield tried, every position for feeding was tried, nothing changed where his tongue was, it was always at te roof of his mouth, even when not trying to feed. Ended up having to put he bottle in from the side of his mouth in an upwards direction to go over the tongue, then bring the bottle round to the front. It was like this for at least 2 months.
Dd, well no idea, she just wasn't interested. Refused to allow her to have a bottle in the hospital, she was cup fed 30mls of milk at the most in the first 2 and a half days and a few mils of hand expressed colostrum. She was admitted to the children's ward and had lost almost a lb in weight in that time. I gave in and bottled fed her and she was a nightmare to bottle feed to for some reason, infact I was the only person who could feed her properly for a few weeks and after that it was only my mum and dh at a push that could.

It was physically impossible for my baby to bf as he had tongue tie. Unfortunately this was only discovered at 11 weeks following constant bf workshops, appointments & advice from mws, HVs, bfcs & paeds. He looked like he was feeding normally but wasn't gaining weight, no-one could work out why. Five mins with a TT expert and they said he was 'latching' with his mouth and triggering a let-down but his tongue wasn't able to do the necessary action to bring any more milk. Breaks my heart to think of it.

They snipped it and there was immediate improvement but he was so small by then I had to supplement with formula. We mix fed till 8mo. He is now healthy and bouncing (and loves solids!)

During those 11 wks I really believed I was doing something wrong and it wasn't possible not to be able to bf.

I'm a trained bf peer supporter, so had been taught that the amount of women who physically cant breastfeed is minimal. Now of course the figures we were taught may or may not have been biased.

BUT what I do know is that my friend physically can't breastfeed. Her nipples are too big. When she told me I was so confused, and we both thought that the nurses in the hospital where she had her dd1 were making it up. Then she had dd2 in a different hospital and was told the same thing. We were both and I spoke to my bf tutor about it. she said its a real, yet rare problem.

I've since seen friends nipples, and can see the problem.

op enjoy the supporter training, I know I did. And physical barriers were covered on the course I did. (BfN)