To think that the medicalisation of birth is responsible for decline in the sucess of bf

[pigletmania]

My ds is going to be 4 weeks old on Friday and when he was born he was latching on really well, of course he had colostrum which is more fatty, the MW came the next day to look at him, examined his boy bits and was concerned about the colour of him balls . To me they looked fine, and FIL whI is a GP was with us, examined him and said that it was fine, just skin pigmentation was a little darker. Anyway the MW called the hospital and we had to go in to see the Paed, who examined him and said he was fine, he then wanted to do blood tests on ds as he was concerned that he might be deyhdrated. The results came through saying that he had jaundice, low sodium levels and that i had to top up with EBM or formula, anyway because he had a bottle at such an early stage ds now prefers the bottle to my breast. I was told that if i did not give him top ups he would be admitted to hospital where they would give them to him anyway. I wish that they would have just left us alone to get on with it, my milk would have come in and he could have been fine.

I have to pump off his daytime feeds, at night when i am asleep he has formula as i dont want to pump late at night. If it was not for that interferring MW I am sure that he would still be bf now. In ds first 2 weeks of life we had MW coming twice a week to do blood or we were in and out of hospital. Ds also had light therapy which meant that i could not demand bf him, but either had to pump off my milk for him in hospital or give him formula. Sorry for the rant

To cut a long story short, I felt that medical interference hampered bf. I still offer him my boob but he takes a few sucks and falls asleep. there is a local bf support group that i will go to and see if that will help. I guess that i will just have to keep pumping for 9months to 1`year like my sIL did to ensure he gets some of my milk.

I had a similar experience in hospital when having my DTs. Girl twin very small and was taken away to SCBU, fed formula from day 1 without any discussion about using donated milk. Boy twin lost 11% of body weight by day 3 so they referred me to a paed who talked me into givin formula top-ups.

Am convinced if they had just given us a chance and waited for milk to come in I would be EBF now, instead I am combination feeding, every feed takes about 1 1/2 hours as I bf then ff for every feed, am trying to cut out as much of the ff as possible but its very hard to try and increase milk supply back up, and they have got very accustomed to short bf followed by big bottle!

Can't wait to wean them so I can hopefully replace ff with solids and continue bf.

I really think it varies from baby to baby. I had a uncomplicated VB and really struggled with establishing BF (gave up at 8 weeks after combo-feeding), whereas a friend who had a horrendous birth (ending in EMCS and made to give her DS formula very early on) still managed to establish BF and is going strong 8 months later.

We both had hospital births. Personally I think I'd have been more stressed at home because of the lack of midwives to show me what to do!

I think its ignorance of breastfeeding rather than medicalisation that has caused your problems. Without the existance of special care units there would be no baby to breastfeed. If premies need top ups then cup feeding or syringe feeding is better than a bottle.

If you contact La Leche League then they may well be help you wean your baby off the bottles. There are ways that you can increase your milk supply. You can buy Frenugeek supplements from a health food shop.

I think in my experience it was the pain relief that had a direct effect on my success in the immediate hours after the birth, although this in part was related to how medicalised each birth was, as with my first induction it was long with a cascade of intervention, thus required more pain relief, and with my second it was short with minimal intervention and very little pain relief.

This was also affected by my confidence levels and my birthing partner.

And of course by the baby I had, my first was big and hungry, I was tired and frightened, and my birth partner was inexperienced and ineffectual, my second was a quick and easy birth, with a great birth partner who was able to support me and help me to go without the pain relief for a lot longer, I was a lot more confident handling my child and she was smaller and had a blooming great latch.

So I think it can be one of many factors, and since it can affect lots of other things it's probably quite a big factor, but it's not to be held entirely responsible for the decline in successful BF, there are a myriad of other reasons why it's unsuccessful or even untried.

YABU. Your baby was sick. He was dehydrated and had jaundice. Sure, you could perhaps of pushed through but what other damage would you have done in the interests of BF? I'm sorry you're finding it hard now and you should keep persevering, but I don't think you should be blaming doctors and midwives for wanting to protect your ds.

Another thing that's good for boosting milk supply is domperidone - found in the indigestion/reflux remedy Motilium. Midwife recommended it and I got GP to prescribe (he'd never heard of that before)! I did try fenugreek as well but it gave me headaches and didn't seem to do much for milk.

By the way I do sympathise with the frustration you seem to be feeling towards the medical establishment, but for a different reason. I was told for the 1st 24 hours that BF was going really well and that everything looked right. Then DS became floppy, lethargic, was passing urates... and suddenly BF was going badly and clearly had been from the start and he needed formula immediately.

I was so angry at the midwives for what I perceived to be their mistake - I couldn't understand how they'd thought it was all fine until it wasn't, IYSWIM. Completely wiped out my faith in anything they said after that, which was probably unfair of me. I suppose that rationally I was upset at the situation and needed someone to blame....

OP, you should be able to find a good bf counsellor via the local bf group, or if not by looking for an independent lactation consultant, who can support you in improving your bf situation, but you are doing great currently ensuring he gets EBM. Keep persevering until you find someone that can give you the help you need.

I agree that it is ignorance of the many nuances of bfing that mainly contributes to people giving up or not even starting bfing. I did a workshop before giving birth to DS1 ran by the local bf group & altho it didn't seem like all that at the time it was well worth it in hindsight. All postnatal wards should have a lactation consultant who sees every woman - the MWs don't know it all wrt bfing. I shared a room on the postnatal ward when I had DS2 recently & the other mother had a baby who wouldn't feed - I heard successive MWs come in & tell her all completely different things & only eventually did one of them consult the lactation consultant who at least was consistent.

Good luck - I think the most important thing with suceeding in bfing along with good support is the desire to do it & you are well on track with that!

reallytired don't get me wrong, I am eternally grateful for what the SCBU did for DD, just that it would have been nice to have been given the option of donated breastmilk rather than formula, and to give me a chance to try an establish bf with DS rather than going straight onto topups.

Without medical intervention they would not have been born at all (IVF, ELCS due to breech position, born 3 weeks early due to IUGR), so I guess I really wanted to ebf perhaps to compensate for all the intervention.

Btw have tried fenugreek to no effect, and expressing every 3 hours but not much time to do so with two little mouths to feed as well!

piglet, I think from what you say that with the best of intentions, the midwife you saw early on made a wrong call, and this led to a huge sequence of anxiety and interventions which did not help your breastfeeding. Another midwife might well have decided that because ds was feeding well, things could be left another day or so. Your ds was not dehydrated, and jaundice and low sodium neither with obvious symptoms are not usually considered to be urgent (I am not medical - this is just my understanding. Your FIL might be able to confirm this).

Having said that, not all babies who have bottles early on then go on to prefer them to the breast, but that again was made more difficult for you, because of the struggle to feed him responsively as you had planned.

It's great you still offer him your breast, and my experience would suggest that direct breastfeeding might still happen for you :)

Sounds like the problem was not medical intervention as such, but that noone supported you in finding ways to feed him that would ease later breastfeeding.

I gave birth in a bf- friendly hospital and when dd was struggling to feed she was given donated breastmilk out of a cup rather than a bottle specifically to support my wish to breastfeed. It was very much centered around respect for my wishes and an assumption that bf (unless the mother makes a different decision) is a default position that you have to be prepared to support. And throughout there were midwives on hand explaining what was happening and how that could be made to work for us. That's what you should have had too.

ceeveebee I agree with you about donated milk. I did donate for six months with ds. Donating milk is a lot of work and expensive for the hospitals. I had a lovely lady come out from Queen Charlottes to hemel to see me every month to collect my milk. Donated milk is truely liquid gold.

There aren't enough donors and nothing done to encourage donors to come forward. I find it sad that doctors have to decide which premie to give donated milk to. Its almost like deciding who to give a life saving blood transfusion to. Especially as donated milk dramatically increases the odds of surviving in the the very small and sick premies.

I think that nurses and doctors do their best, but they don't always have enough training in breastfeeding. I was lucky that my son was cup feed when he needed formula supplements.

Do you think a nursing supplementer would help. A trained La Leche League councellor would show you how to use it. It would allow you to give formula top ups, but your breasts would be simulated to produce more milk.

I think you have very right to feel angry.

piglet You must feel so frustrated and that the system let you and your baby down. I felt the same when some young upstart paediatrician was tube feeding my hour-old daughter formula in SCBU while I leaked colostrum all over the bed in the recovery room

I think it's important to make a distinction between over-medicalisation of birth and over-medicalisation of the newborn phase. My birth was highly 'medicalised' in that I had a planned c-section, with resultant quick cord cutting, cleaning before I held my babies, no skin to skin until in recovery etc. I don't think this had a detrimental effect on my breastfeeding relationship with either of my babies, and though not my idea of a great birth, it was medically the right decision.

I think the immediately newborn phase is much more critical. Once the birth is done with, however it happens, there is an opportunity for medical professionals to help get breastfeeding off to a good start. This would include not giving formula instead of readily-available colostrum (in my case) and perhaps a more considered evaluation of jaundice and milk choices in yours.

I can see from the passion in your post that things were not handled well in the immediate newborn phase. However I think it important not to make this about medicalised births, as a medicalised birth doesn't have to compromise the breastfeeding relationship.

I am so sorry that things didn't work out in the way you had hoped, and WELL DONE for providing what breastmilk you can for your little one

Thanks reallytired, the supplementers look really interesting, might give that a go!

Agree with above posters, it is lack of bf support that is the issue not medicalisation of birth. I think its all about 'efficiency' - They need you to prove you can feed either by bottle or breast before they can discharge you and its quicker/easier to give a bottle than to assist with establishing bf.

The impression I get of breastfeeding in the UK is that many medical professionals are very quick to spot the slightest problem and recommend - no, insist - that FF is the only option as a consequence. I think in certain other European countries with much higher BF rates paediatricians/midwives/HV would possibly do more to ensure exclusive breastfeeding, which is seen as a more valuable thing in itself for a baby's health. I had a lot of problems feeding DD1, who lost a fair bit of weight at the beginning, and I'm sure in the UK I'd have been pressured into supplemental feeding. As it was I was encouraged (by my doctor, midwife and lactation consultant) to keep on going and DD was just monitored for wet nappies and other signs of dehydration, and in the end we managed nearly 6 months before weaning and 13 months in total. In fact we never used formula once.

Thanks happy and tiktok in fact everyone who has replied to this. Sorry for the slow response my computer has been playing silly buggars today. Tiktok you hit the nail on the head, there is an over quickness to recommend bottle when mabey it can be left for a little bit, my milk came in soon after. At least he is getting my milk but from a different source, i do like it when he feeds from me even if it is for 5-10 mins. I know i should be glad that he is healthy and fine, i guess also HP have to cover themselves in case things go wrong