what do you REALLY want to know about breastfeeding?

[LizaJ]

I had an absolute nightmare breastfeeding for the first 8 weeks and got really fed up with the fact that my experience was so different from the one portrayed in a lot of the 'official' information from the NHS etc. Being a nerdy scientist by trade (and therefore having free access to medical journals), I started to look into what the actual, clinical research says about breastfeeding, and was amazed by some of the inaccuracies that are out there.

I have been sharing the info in a blog, but so far I've only really written about the things that have affected me. I was wondering what breastfeeding topics other ladies would like to know 'The Truth' about..?

I'm fair too drosophila and wondered if that was a factor. I've written about the available research, although it's pretty inconclusive. Infection generally isn't an issue in human mastitis as it is in bovine so it isn't a problem to feed from the affected breast (although GPs often get this wrong).

There is quite a bit of work looking at depression/bf pain, and at least one study (which I've yet to read properly) looking at traumatic birth. I think the relationship between these things is quite complicated, but it would be useful to have a better understanding of it.

Fantastic thread and blog - I'm forwarding it to all the pregnant women I know to help them know ahead of time what lies in store and what to do about it.

A topic that I was trying unsuccessfully to find research on is feeding honey to under 1s. Everywhere you look it says not to, yet the rates of infection with botulism appear to be tiny, except in California. You wouldn't expect to ban your newly mobile child from playing on the ground for fear of picking up the bacteria that causes it, so why deny them the other benefits honey conveys? If it's all dependent on the balance of bacteria in the gut, then a breastfed baby should be at virtually no risk. Why instead do they not publicise the symptoms of infection so if babies pick it up via any source it can be recognised and treated? End of rant! Be delighted to know on what basis the 'ban' was put in place.

I'd like to have known that BF a premish baby was going to be a bit of a nightmare and that nothing they said about the 'normal' instincts of the baby would be right.

He's only just started rooting on his own and he didn't want to know about BF at all for the first week!

I thought it was me but having spoken to others it's quite normal for a near to term but prem baby to go through this!

Dawnxx

Drosophila, I've just had mastitis and as I was expressing to leave some for DS (11m) for the day, I thought I'd better check if it was OK so tasted some. I thought it was saltier than normal but not nasty and neither he nor DD (3y, "still" breastfeeding) have shown any sign that it's off the spectrum for them. DD's not slow to say if something's not nice.

Drosophila, forgot to add earlier that your description of symptoms sounds quite like candidiasis - towards bottom of page, section titled 'Candida in the Digestive System'. If so, no wonder things seemed tough.

Explanations about the different types of pain/reasons for the pain etc.

Top tips for getting shot of thrush/mastitis/blisters etc.

Just wanted to say, LizaJ, that your blog is fabulous! I could have done with reading it when bfing DS.

Here in Mexico we have no bf counsellors and no help whatsoever. My Ds's pediatrician in the hospital prescribed formula milk to be given every three hours after birth (which the nurses duely did, despite the fact that I insisted on feeding him before each feed). He later was surprised a week later to see that DS had put on weight and said to me that I'd have to ff since I obviously wasn't going to have enough milk for him. Three months later he practically fell out of chair when said i was still exclusively bfing.

I had self-taught all I could from MN and the KellyMom page and was very lucky not to run into any problems. However, pg again I am back to researching all I can, since I want to be able to do on my own again. Your page is great!

PS. I never ever mastered feeling lying down, sideways or with DS on my tummy. He never could latch. I always had to be bolt upright. Am I the only one? All the stuff I seemed to read told me that lying down was the easiest position.

It's interesting that lying down didn't work for you Catitainahatita. There is very little research looking at positions, but it isn't surprising that different people may prefer to do it different ways... I think this might apply to latching on as well. I suspect my problems might partly have been caused by me trying to do it the way I was 'supposed' to rather than the way that was right for me. This is only my opinion at the moment, I hasten to add!

Dawntigga, a friend of mine is having a very similar experience. Whilst there is lots of info about feeding term/v preterm babies, there is hardly anything talking about the period in between, when research has shown even babies born between 37 and 40 weeks are more likely to have feeding problems than those born after 40 (due to immature sucking/rooting reflexes etc). I'll be writing about this soon.

Interesting point about the infant botulism beanbearer. I think there is evidence that food (including honey) only causes a minority of cases, so publicizing symptoms might be useful full stop, but this isn't something I know much about.

I'm always on the lookout for solutions to bf problems SOLOisMeredithGrey! I think it's important to tackle thrush soon, as GPs often don't seem to know what to do about it...

Lying down didn't work for me either. But then dd was so crap at breastfeeding that I literally used to have to jam her to the breast, and then (at the HV's suggestion) keep pinching her to wake her up. Those were the days. Not.

About the trauma of a medicalised birth leading to problems bf'ing, I think it may well be true, but would depend on how traumatic you found the birth experience. I found my emergency section far less stressful than my previous vaginal birth and also found breastfeeding easier after the section, but it was the second time round and ds was stronger and healthier than dd. So probably not a lot to do with the type of birth, more about whatever stress levels it might lead to. I did give up bf'ing around the 6 months mark, but that was for unrelated medical reasons (I needed to go on beta blockers).

it would be nice to see a bit about cluster feeding in there. that was the one thing that really made me feel like i was failing at bf. around 3 months he started feeding all evening, coupled with the fact that my boobs felt empty.

i did end up giving him one top up bottle a day at that time which continued until i gave up at 8 months. mix feeding worked out ok for me (although next time i'll know it's coming and avoid introducing formula at that point), however, i have since spoken to lots of people who hve told me that their supply started to 'run out' describing the cluster feeding and soft boobs. i have been able to say to them that this is how a baby increases your supply and it does end if you persevere but it's definitely the most common reason that i have come across for people giving up. the feeling like you don't have enough milk is horrible.

oops forgot to say that i really enjoyed reading your blog

I'm relieved to hear that lying down didn't work for you either Cory, I felt slightly worried at first when the only way I could get him to latch would be to swaddle him as tight as I could and clamp him to my breast in a vice-like grip with his feet sticking into my lap. It certainly didn't feel very natural at the time. Also I would have to stop half way through undress him and wake him up/change his nappy etc otherwise he would fall asleep and not finish.

By the time he was three months he could do a variety of positions, but I was most disappointed on the not lying down. Even though we co-slept, we had to get completely out of bed and find the chair.

I ended up cluster feeding pretty much every evening for the first 6 months (wanging a nipple in C's mouth was the only way to keep her quiet - I'm amazed she isn't the size of a house) so I experienced the empty breasts thing quite early on, but I can imagine it being really quite distressing if it appears from nowhere... yet another thing that is never 'officially' talked about.

Interesting to hear your comments about giving birth, cory - it fits with the experience of some of the other mothers I've met. My friend who had a traumatic vaginal delivery said she just couldn't face bf, whereas I know several emergency section mothers who found it quite straight forward.

Are there any studies on the immune response after MMR of babies "still" breastfeeding compared to the majority who are not? If it did make a difference it might prove a strong motivation for many to keep going past 6 months. Or at least a silencing reason to pass on to disapproving relatives.

There's a link from Kellymom to a Swedish study: "The vaccine response to poliovirus, diphtheria and tetanus toxoids in relation to protein intake was studied in infants, either breast-fed or given low (1.1 g/100 ml) or conventional (1.5 g/100 ml) protein formula... the breast-fed group had significantly higher antibody levels than the two formula-fed groups together... Breast-fed infants thus showed better serum and secretory responses to peroral and parenteral vaccines than the formula-fed, whether with a conventional or low protein content."

There is a study documenting a different immune response to the MMR vaccine in breastfed children, but I think the babies in the study were classed as 'breasfed' as long as they had been for 6 months (rather than still were at the time of the vaccine)... still, good news that an initial 6 months of breastfeeding is still boosting the immune system later on!

p.s. I am a big fan of MMR - Ben Goldacre of Bad Science has written some excellent stuff about it that should hopefully convince any doubters out there.

What a good idea and interesting addition to kellymom, my BF bible!
I am interested in knowing about BF and slow weight gain.
I can't seem to find anything about this.
I have not had any BF problems really, compared to others here on MN anyway (well, apart from the shock of cluster feeding at the start and a wee bit of discomfort for the odd day here or there, and leaky boobs...)but my 7week old DS is between 9 and 25th centiles for weight/height and head is at 2nd centile. I worry worry worry worry. He takes both sides, feeding well for about 45 mins every three hours day and night, so of course my logic (flawed or not) says that maybe my milk isn't good enough...which I'm afraid to mention to anyone incase they agree. So, something on milk quality and growth would be very very helpful.

I have also bookmarked your blog - thankyou, wished I had it first time round!

I never mangaged the BF in public thing either and your expereince sounded just like mine, DS was (is) very impatient and would wriggle & scream as he waitied for his milk to come through and I would get very embarresd, I wanted to be able to just get baby out, stick him on the breast and drink my coffee as sirenely as the other coffee shop mums!

I would like to know if you can succesfully mix-feed and how, (expressed milk or formula) as I found last time it interferred with my supply even though I replaced bottle feeds with expressing.

This is a timely suggestion TamTam - I'm expressing for C while I'm at work, and currently struggling to keep my supply up. ho-hum.

logrrl, I agree there isn't much info on this out there on slow weight gain - will investigate. Out of interest, have you been told by anyone you actually need to worry? Speaking as a non-expert, it sounds as if you might actually be doing fine..?

I would really like to know more about extended breastfeeding. DD has just turned one and I seem to be the only (weird) one in town breastfeeding a toddler. Even when I go to breastfeeding groups, most babies are below one. Friends with babies of similar ages have all stopped breastfeeding. I would like to know:

1. Will toddlers who are used to breastfeeding to sleep be able to self-settle and at what age?
2. If I were to stop breastfeeding, how do I get her to sleep or comfort her when she is upset? At the moment, if she is really upset about anything, the boob will calm her down.
3. How can I ensure that she takes enough fluid / nutrients when she is unwell, if she is not breastfeeding? When she is unwell, she may refuse fluids / solids but never the boob. In fact, she would want to breastfeed all the time. Breastfeeding has become such a strong part of my identity to her (I think) that I don't know how to go about weaning her from the breast. Some info on that would be useful too.

I think you are doing a wonderful job with the blog.

I know where you're coming from mummy2rachel. C hasn't yet turned one, but I'm already getting the weirdo vibe. I've just written about what happened to me at the weekend. Extended bf (along with pretty much all the things you mention, as I imagine they'll also apply to me and C) is definitely something I'll be looking at in more detail.

Great blog. As someone with a baby with reflux (who's not very keen on the prospect of giving up cheese & chocolate!) I'd be interested about effects of diet on breast milk - if allergies (to e.g. dairy) are proven and how common they are. And also just more generally - does having a very calorie rich diet mean your milk has a higher fat content, how much and how long does it take for caffeine/alcohol to be present etc..

mummy2rachel - I don't want to clutter up this thread, but come and join us on the extended breastfeeders thread

We can help you with your questions

I don't know whether anyone has already mentioned this but I would like to know more about frozen breastmilk. Breastmilk changes according to the baby's needs, age, etc. Have also heard that BM becomes more 'watery' when the weather's hot to prevent the baby from becoming dehydrated. So what happens if you use frozen BM after say one month. Your baby might need a different composition of milk by then?

I would like to know why, when I was ill with a tempreture, my let-down reflex failed? Luckily DS who was only having a midnight snack wasn't too bothered and after 10 minutes of fruitless sucking, fell off my nipple and back to sleep. It was really odd, however, and it kicked in again the following morning.

I'd also like to know about thrush. I got it several times and the first time was because I had taken antibiotics after my C-sect and had a cracked and bleeding nipple. But then I got it again, and again, and again. Not fair!

I suspect that maybe it had something to do with the tempreture I do my laundry at. Hmmm. Here I am trying to save the environment and wash at 30 degrees whilst thrush bugs are having a party in my washing machine. Since washing at 40 degrees I have had no more problems with it. Coincidence?

I also suffer from Reynauds in my fingers so I'm wondering if I suffer from it in my nipples too? Maybe it is more common than people think-it would certainly explain a lot of unexplained pain on feeding.

I want to know why oh why oh why I kept on getting mastitis over and over again. I did everything by the book, saw so many bloody midwives, HVs, bf counsellors, GP, hospital doctor. I got oodles of advice on MN and from books and from friends. Yet still I got mastitis pretty much constantly while bf-ing both babies (my right breast has never been the same, actually...it is a sad, droopy sack after coping with so many horrible infections).