I feel so confused and jumbled, don't know whether to breast feed or not-please help!

[nanski]

Dear All,

I have a four year old son and when i was pregnant with him I was pretty sure that I didn't even want to try breastfeeding. Since I live in Cyprus this tends to be the case anyway; they are not as pro breastfeeding as is the case in other countries.

But, although the nurses at the hospital tried to talk me out of it (they were already giving him formula anyway) and my paediatrician advised angainst as my son was small I did have a go. I didn't have a clue though and after those around me (in-laws who also never breast fed) made me feel like I was starving my son I quickly gave up.

Now, I am 5 weeks from giving birth once again. Things have changed a bit here; there are now organisations with lactaction consultants that will offer one-to-one help with breastfeeding. The thing is, and I don't know if anyone can understand me if that I kind of fall into two camps.

I have lived here for 10 years and I guess although I am definately British I have taken on board some of the cultural ideas that I guess I may have found odd had i stayed back home. Now here, when you have a baby at a hospital firstly practically everyone pays to go private (or has private healthcare) so you have your own gynae and you stay in a private room etc. It doesn't mean that you are treated especially nicely though-some of the nursers were complete cows when i had my son. As it is the norm to pay you don't get the red carpet treatment if you know what I mean. Now, when you have the baby it is taken to the nursery to give mum a chance to rest. You can request for the baby to be brought to your room but if the nurses see that you have many visitors (which will definately be the case since there are no set visiting hours and it is common to have 30-50 visitors ofer a 5 night stay) they will take baby back to the nursery. I do not have a problem with this. I adore my son and I hope to adore this baby too but I have no problem at all with him being taken care of by trained maternity nurses along the hallway. There is video link on the tv should you wish to watch your baby.

The reason for this ramble is that I attended a breast feeding lecture and those that gave the talk were wonderful and encouraging and an expert will even visit me in the hosptial to help get me started. However, they insist that I have to ask for baby to be in my room at all times (I can request this). This frankly scares me a bit. I am almost sure to be having another c-section, how can I cope. I just feel that of course everyone cares about the baby, but I am all alone here (no family). C-section is major surgery. The reason they give for having my baby with me 100% is partly becuase they think it abhorrant for baby to be in a Nursery (this support group is run by either non-Cypriots or those raised in other cultures and have returned) and also becuase they say that baby has to be put onto me every hour in the first 2 days.

They also said that if I have a c-section with general anesthstic (my preferred choice) I will find it very, very hard to breast feed sucessfully. They say that baby should be put onto me immediately after birth and so they recommend a c-section with an epidural. I had a great experience of epidural with my son but tbh I am petrified of needles and the only reason i found the strength to have one then was that I was having contrations and was therefore in pain!! I really don't think I can go to the hospital and have an epidural cold, without feeling any pain. I wish I could, but I am so frigtned of needles. So what should I do?

If I go with the rooming in I am worried that having to call the nurses each and everytime to not only take me to the toilet etc but also to call them hourly in the begining to give my baby to me to breast feed (especially during the night)is going to make me unpopular in the clinic. Since I am not from here anyway I tend to have a need to make people like me anyway; I don't want them to dislike me and be horrible. The bf experts were reminding me of the money that I am paying to stay in the clinic but I know how the nurses are. They are not pro breastfeeding.

Sorry that this was such a long post but basically I would love to know if any of you think I could 100% breast feed by the time I leave the clinic even with a c-section and general and if I can avoid bf every hour in the first two days.

Many thanks.

Nanski

Hi,

It is normal to feel trapped between 2 camps by your description. In the UK this is common and the 4 breastfeeding charities are geared up to counselling women on making informed choices on how to go move forward from where you are. the Association of Breastfeeding Mothers has a yahoo group which you can join from anywhere in the world so you may want to visit their site at www.abm.me.uk and do that so you can ask one to one questions to a counsellor via email. And of course there is always Mumsnet!

The reason why rooming in is advised is not necessarily because the advisors think that keeping a baby in a nursery is abhorrent, it is because babies need to breastfeed little and often in the first few days after birth. Their tummies are the size of a Malteser at birth and i think by day 7 is only the size of a pingpong ball. Having a baby in a nursery means taht you would not be able to feed on demand if you are relying on someone to bring your baby to you. You can respond a lot faster (to get someone to come lift him out of his cot and put him at your side if you can see/hear him stirring.)

I understand your concern about the c-section and anaesthetic. I am not an expert here but yes babies who have been born with this sort of anaesthetic are sleepier so it takes more patience and work to get them to feed effectively in the first few days and you will be relying on the assistance of the staff to get feeding going as often as is necessary. But, it is not 'nearly impossible' to do. With the right knowledge and patience, it is certainly doable.

for example, you can quickly be shown how to feed lying down which is an amazing skill for later on when you get home, c/s or not. it just takes getting the right knowledge now so that you and your can be proactive in what is needed from others to get you to do it effectively at first.

I will link a couple vids for you in a bit.

shows the response times depending on where your baby is sleeping. notice that the mum feeds her baby lying down on her side so it won't affect a c/s scar.

another one don't know if all those pillows are a help or a hindrance but if I am paying out of pocket, I would certainly be ringing and telling the nurses exactly what I needed them to do to help me along hte way.

this video is good as it gets a good view of a feed. notice the rhythm of the baby's sucking when he is actively feeding. a great thing to learn to look for in the early days.

aha! it is the baby's stomach is teh size of a ping pong ball on day 3. how convenient as this is normally when milk comes in.

Would like to say that a friend recently had a baby by emcs under ga and has gone onto successfully bf, was hard work and I think she does give some ffs but mainly bf. She does post here on MN so hopefullly she may see this and share her experience.
Deinitely agree you need your baby with you and is there any chance you can keep visitors to the absolute minimum?

Oh my baby was also quite small 6lb6oz, but he is exbf and is thriving quite happily and gaining weight at great rate of knots.
I think those sort of comments are directed at mums of big babies too!!

Nanski
Hello, I live in France and it seems that attitudes are quite similar to the Cypriots from what you have said. I had twin boys 5 years ago, I didn't even attempt to BF as they were quite poorly and transfered to another hospital for 5 days. I had a CS. When they did come back to me they were taken away at night so I could get some rest. I was very poorly and not sure I could even have sat up to feed them properly. Plus the nurses were a nightmare (private too)there were two who were really nasty. Anyway, I digress, I had another baby boy last year by CS. This time it was in a very progressive hospital, my husband was allowed during the CS and they let the baby stay with the mother afterwards unless she is complete shattered. Even though I was very sore I was so happy to have him with me and really cherish the time. The nurses helped me feed him and change him when I couldn't get up or felt tired. I didn't BF but that is very personal choice and not because I had a CS. I completely understand your fear of needles, if you are happier with a general then go with it. I understand about the nurses thing and not wanting to upset them - I am exactly the same! However, I think if you are pleasant with them they generallly come round. If not then ask to see a doctor, I so wish I had first time round. Maybe your DP would help you with some of practical things like changing baby and going to the toilet? Good luck with everything

Nanski, just a thought, but could you try to have an epidural and if it is too much for you, have a general? There are needles involved with both though and you have had a good epidural experience with your son, so hold onto that thought, maybe, while you're having it sited?

What sort of antenatal care do you have? Has anybody who will be looking after you discussed feeding with you?

hi nanski,
you should definitely breastfeed if thats what you want to do. I know its easier said than done, but its your baby and none of the nurses' business what you do. They are getting paid to do a job and just as you feel you dont want to upset them/go with the norm, they should be respectful of your wishes. I know you're afraid of needles but if you didn't look could you not have a spinal block instead of an epidural? This is what I had so its just a one off anaesetic instead of the tube being connected to your back. Being awake during c-section will definitely help with establishing breastfeeding. I asked for loads of help off midwifes (manchester, England) and got it so I know i was in an easier position. coulnt get comfy lying down to feed but as i had loads of pain relief, didn't feel pain in first few days anyway! Once home one of those triangle cushions really helped (atually 2, one behind my back as well!)still use one to lie my 6 month old on now. lots of luck X

Hi nanski

It sounds as if you have thought a lot about your options, and about what is best for you and your child.

I just wanted to second kiskidee's information about the baby needing to feed very regularly during the first few days. I was very surprised at how often my baby needed feeding at first, although it soon becomes less frequent. I think it would be quite hard to feed as frequently as the baby wants if s/he is in a different room to you. Having baby near will also help you begin to learn his/her 'hungry' signals - the nurses may not be as sensitive to this as you are, so may not bring the baby to you to be fed as often as he needs.

It is hard, I think, to be reliant on nurses etc when you are usually an independant person. However, it sounds to me like you know breastfeeding is something you would really like to do, and something that would be good for your baby.

It sounds to me like you are already a hairs breadth away from not breastfeeding and establishing breastfeeding can be difficult, painful, inconvenient even though you go on to breastfeed happily once you are through the initial tough bits. I think you are sounding defeated already and so won't make it past the sore boobs sore nipples inexperienced baby part anyway. So I would stop torturing yourself and get on with a happy pregnancy and successful childbirth.

I must say that IME a newborn doesn't want to be fed every hour - from my memory they sleep quite a bit in those first couple of weeks. I fed mine when they wanted it ...

If you can swing your state of mind around to a more positive one than I of course think BF would be the way to go. You have heard of all the upsides at your lecture, but your experience and therefore comfort is with the bottle - human nature.

But think of all the time and energy you would save your post C section self if you didn't have to make up bottles, heat up bottles, sterilise bottles, buy formula - afterall breast milk is just THERE

Good Luck with whatever you decide.

Fantastic links from kiskidee.
That's the best position after a C section as you are not pulling on any muscles.

Your baby can stay close to you in the bed and you have minimal lifting to do.

You should go for it and see how it goes.
Keeping your baby near you is probably best as they will probably give him bottles in the nursery. Why don't you just let them have baby say midnight to 6/7 am to catch up on sleep and room in the rest of the time?

Don't agonise over nursing care that you can not control (understandably you may be too tired to constantly argue with nurses)
A couple of bottle will certainly not prevent you from BF. Even a week's delay/mixed feeds until you go home won't hinder your capacity to BF when back home.
Just BF as often as you can when in clinic.

And it's not every hour, maybe every couple of hours. They sleep a lot (at least the first 24 hours).

take care.

If you get an attitude from the night nurses, tip them. Sadly corruption goes a long way in that sort of environment.

nanski, there's some good info already for you here.

I'd add that UNICEF's Baby Friendly Initiatuve (google it) has 10 points which maternity hospitals need to adopt to support breastfeeding - and they are all research based. So keeping babies in the same room as mum is essential, for instance, day and night....without this, you will reduce your chances of breastfeeding, simple as.

You don't have to 'put your baby on you' every hour. In fact, it's best to be close to your baby (in bed, if you can) so you can respond to feeding cues and give your baby the skin to skin contact that facilitates bf. This might mean your baby feeding off and on in a way which is not really like 'feeding every hour' but which may be like what's called 'cluster feeding'.

There is no need to be concerned about a baby being sleepy for days after a GA - the baby doesn't get much of the GA anyway, as he is born some time before you come round from the GA (kiskidee, are you sure babies are sleepier for days after???). When you are free of GA effects and quite conscious, then it is out of your milk. Don't let that put you off bf.

Hope mumsnet can help you with more info if you need it

Re the epidural - I am also terrified of needles (not phobic, but find injections/blood taking very hard) and had a spinal block whilst not in labour. It wasn't nearly as bad as the drip that went in my hand, which I would think you would have to have for a general as well. There was a sharp scratch in my back, which was the local anaesthetic going in (the lovely nurse held my hand through that), and then the spinal just felt like someone pushing on my back. I didn't see anything at all. Might be worth talking to other people about their experiences and think about the ga.

It probably would be much easier to bf a newborn when they are right beside you all the time, but equally it is likely to be hard in the first few days/weeks while you are recovering. You should probably be prepared for it to be a bit difficult, but you have nothing to lose from giving it a go. Good luck and hope the nurses are lovely!

I don't have any advice about bf after cs, but I can say that while it is obviously much better to avoid the bottles (and not give in to pressure), bf is not doomed if some bottles are given at the beginning. We went from 4 weeks of mixed feeding to then exclusively bf until 6 1/2 months and ds1 is still bf and will be three soon.

I wouldn't attempt to 'avoid bf every hour' or put any kind of timescale on it, actually. As tiktok said, it is important to be able to respond to cues to establish bf successfully. The baby might want to be feeding more or less cnonstantly, and he might not. When I am asked how often I feed ds2 in a day I honestly have no idea, because he has short and frequent feeds, sometimes coming on and off very frequently. Babies aren't born with (as my grandmother would have said) clocks in their stomachs.

I'm an expat too (am in Germany) and I know how it can make your position trickier, but in the end (IME) you will feel better with going with what you want and not trying to make them like you.

I think not rooming in would just be an enormous hassle when establishing bf tbh.

Thank you so much for your kind responses. Thank you for the link kiskidee, it does look very good. Thank you all too for not being judgmental as well.

Slim22, such a good idea of yours to have baby with me during the day but in the nursery from midnight until 6am. Brilliant. Perhaps that will be a good comprimise becuase honestly I cannot control how many visitors will come the first couple of days so really i won't get much chance to rest during the day because they will stream in and out so it will be hard to rest.
Then I could see how it goes; having my baby next to me during the night is I guess better than constantly being shook awake by the nurses to go to the nursery. Especially as the rooms are on three floors and I may not be lucky enough to get a room on the same floor as the nursery. That has really perked me up. Tipping them sounds like an idea too!

Dear hunkermunker, I may ask the lady who did my epidural with my son whether she would come to this hospital (I am at a different one now). Perhaps she could give me something to relax me before I have the needle? I didn't know anything about a spinal block - how is that different from an epidural?

My husband called my paediatrician (it's a diffeent one than we used for my son as we have moved areas). I didn't know her stance on bf. The previous one was anti and tbh I think a lot of them are given so much stuff from the pharmceutical companies that's why they often push the bottle feeding. Anyway, this lady is pro breast feeding and she agreed with what you have all posted; that even with a c=section with a general etc I could do it. She said that she will tell the nurses to bring my baby to me hourly, and she will be visiting the clinic daily anyway so I could leave the bullying to her!

So I feel a lot more positive now.

Thanks again and I shall let you know how i get on. You never know, perhaps I will go into labour and have a natural birth this time which would be fantastic.

Have a great week.

Nanski

Fantastic. Happy to see you being so positive. You'll see. Everything will be just fine.

I think you should stop asking people about BF when you already know they are going to discourage you.
Do your thing.

Good luck and keep us posted.

hi, an epidural is constantly feeding you with anaestic but a spinal is a one off injection. i thought most women who were having planned sections had spinals as they know how long its gonna take/when anaestic will wear off but those who've maybe already gone into natural labour and had an epidural would continue with this if they needed a section. i could be wrong. anyway, i had spinal and it was fine (but i can understand you being afraid of needles)
good luck
zim

Dear Zim and slim22,

Thank you. Ok, i will ask about the spinal block then. It sounds good. I do still prefer to avoid the needle though but people have told me that if I have a general I will wake up in considerable pain from the c-section. Is this true? I was ok with the epidural. I felt pain only when I tried to move, not when I was lying down. Plus they put a catheter so that I didn't need to ask the nurses to take me to the toilet. My doctor has said that if I have a general she will not put a catheter so I will have to go to the toilet the same day after the operation. I think I need to discuss all this with my doctor.

have a great week and thank you.

Nanski

Hello Nanski

I think there may have been a misunderstanding between you and your surgeon - you would certainly have a urinary catheter if you were under GA. Maybe she thought you meant an epidural catheter, which wouldn't be needed during GA?

If you wish, you may read about the procedure for a c-section here

With regards to pain, bf etc. from my own experience, I had an emergency c-section (spinal block) for my first baby (5 wks early) he was taken to SCBU almost immediately - I expressed and stored colostrum and then milk whilst he was nil by mouth for 5 days and we eventually managed to bf for 18 months. I had morphine and coproxamol and quite bad pain when moving, but it was managable.

My second was a planned section, again spinal but with premeds - my dd was with me all the time - I was lying down for my first feed and most subsequent ones. My dd was put in bed with me, and I only buzzed for help during the night when she needed changing on the first night when I still had a catheter. Pain was a LOT less, no morphine, only volerol and coproxamol. I could walk the next day once the catheter was out.

I fed on demand, it was easy to see her feeding cues once I learned because she was with me all the time. I never got the chance to learn with my first as he was apart from me in SCBU (for 3 weeks)- he ALWAYS had to cry for a feed. Milk came in on 4th day, the night before it came in was when she was feeding hourly. It wasn't bad, I was lying down for feeds and I didn't have to get up as she was with me in bed.

What I must say though, is it really, really helps if you have supportive people around you for bf, your partner especially. There's some great advice on here - slim22's suggestion about putting baby in the nursery for the night for you to catch up on sleep on is something I hadn't considered, and nice if you can sleep! Personally I was too excited to sleep anyway and just half dozed with my lovely new baby all snuggly next to me!

*volerol = volterol

nanski - for what it's worth, I had had my baby privately in the uk (and despite the popular lore it's not red-carpet here either). I was in the hospital for 2 nights in a private room, and my baby spent time both in my room with me and in the nursery. It's a bit of a blur now but I remember bringing the baby to the nursery when I needed a rest and the nurses bringing the baby back to me when the baby was hungry. We had no problem establishing breastfeeding with that setup. Although I guess it's worth adding that it seemed that it was the expectation among the nurses and midwives was that I would breastfeed, so maybe they were more efficient in bringing me my db than they would have been if the default to be bottlefeeding.

I'd suggest you take advantage of the opportunity to have privacy in your private room and really limit the number of visitors you have.

Hi there, I was in a similar position to you 7 mths ago (tho in the UK), my son was 3 and a half and I had an emergency CS with him and breastfeeding got off to a bad start and only got worse (I gave up after 9 wks). I really didn't want to BF but felt it was necessary for my new baby to give her a good start (an entirely personal opinion).

Anyway, the birth went the same way and I had another ECS but with epidural rather than spinal tap (like last time) - I am needle phobic but was in alot of pain and was pretty desperate so gritted my teeth with the whole needle thing.

The midwife latched my daughter on an hour after birth in recovery and DD had a 40 min feed. I truly believe this was the most important factor in my still breastfeeding 7 mths later. I kept her with me the entire time (I did "nursery" with DS too) and just got care assistants in to change nappies and bring her to me as needed.

I also found the recovery from the second CS way easier, I had the catheter out in less than 24 hrs and was up and about very quickly (tho very gingerly).

Take from this what you will, I think being clear in your own mind about how you want your birth experience to be will help you get through it.

Thank you girls for your further replies. Dear hoppybird, yes my gynae definately said that she would not put a uninery catheter in unless I had a c-section with an epidurul. She just said that I would be able to go to the toilet the same day and if not a nurse would put one in after (ouch!). When I see her again next thursday I think I am going to have it out with her. This whole birth is going to cost the equivalent of Stg2,400. We will get half back on insurance but still. Why am i so timid to put my point across?! I know that for the docs they are devilering babies all the time and I guess she has her reasons for avoiding a cathether (to reduce the chance of infection perhaps?).
It sounds as though even if you do have a difficult birth you can still establish bf with a bit of will and patience.

Dear oilandwater, god how i wish i can reduce the number of visitors to the hospital. Also I am anxious that the extended family will camp out daily at our house once we get home from the hospital as they did when we had our son. I will never forget my son crying and me trying to get him on latch on (I had never been shown properly at the hospital) and it was so stressful. My mother-in-law was shouting that I was starving the baby and she was just standing in our bedroom looking at me. But, positive vibes. This time I have found out some information and with the help of the kind lactation consultant (who will come to our house) and the fact that our paediatrician is prp breastfeeding things should be ok.

Have a nice day.

Kind regards,

nanski

This is my first post, probably make more when I've read the whole thread.

I've had a general and I really don't advise it if it's avoidable - I was 31 weeks and having rapid progression with a footling. I had gone from 2cm to fully dilated in an hour, they needed to get her out and fast.

Because I had a general I was in a lot more pain than most after a section because as soon as I woke up I had the pain, whereas normally you recover a bit before you can feel what's going on and the pain isn't so bad.

It has messed my head up not being at her birth, I don't look at her as being mine and I have PND.

I also don't take the anaesthetic well, which comes from Mum, none of us do, so I was quite ill from that for the first week. Obviously that's a personal thing, though.