Training to be a BF Support Worker....BF & non BF mummys what are your biggest concerns? Feedback appreciated.

[clouiseg]

I am Training to be a Voluntary Breast Feeding Peer Support Worker for the La Leche League.

Just wanted to put my feelers out and see what the general (and most common) concerns are in the real world?!

I BF dd1, FF dd2 and mixed fed dd3. Have had cracked nips, poor latch, mastitis, the works!!

I am volunteering to help other mums and mums to be both in the home and in the Post natal wards (plus lobbying to offer antenatal support before LO's arrive!).

The only problem I have faced, is that in my very small group of fellow trainees, 99% have found BF a breeze with little or no difficulty. I feel that gaining a realistic picture of worries, concerns, anxieties or even just opinions would enable me to give the group an insight into what it is like to struggle to BF at times.

Any comments, input or funny stories would be much appreciated!

Thanks, Claire. xxxx

I'm not a lot of help, I was lucky to have two very east to feed DC. But, I think a lot people get very worried (often unnecessarily) about weight gain and if the baby is getting enough milk (IMHO weekly weighing plays a big role in this). Many mums aren't aware of the BF growth charts either.

I had thought that it was going to be a breeze but it definitely wasn't with DS. To start with at least - once we had got the hang of it (say after about 2/3 weeks) we were away.

After those 2/3 weeks it really was as simple as popping my boob in DS's mouth but how did we get there? And why was it so hard to get there?

I am now pregnant again and am v anxious about how round two will go. I think for me what I would have liked first time round (and in fact now for second time round!) is good support to help me with latching and general guidance on positions etc. But mostly what I would like now are good indicators of how much a newborn feeds and when to be worried etc. I had a terrible time in hospital with the nurses telling me that I was obviously one of those people who couldn't bf (total crap in retrospect) and topping DS up with formula willy nilly. I really wish that I had the facts (which I still don't have) so that I could have told them to press on.

I think for me, it was that my expectations of bf'ing did not meet the realities (I didn't use MN then ). I thought that, not only would it be better for baby etc., but I also thought it would be much easier and less hassle than FF (not sterilising, preparing bottles etc.).

The fact was, for me, it was really time consuming. The cluster feeding in the evenings was a particular nightmare. I did stick with it and enjoyed lots of aspects but I think it would have been easier if I'd have known in advance how difficult it would be.

I am concerned about how I will manage with dc2 - especially if he cluster feeds at around the same times as dd did. I'm just not sure how logistically I am going to cope with tea time, bath time, bed time etc. with dd if dc2 is constantly feeding at that time

My problem was that ds just wouldn't suck, the latch was fine but he just wouldn't do anything when he was on the breast. My milk never came in but maybe thats normal if the baby isn't sucking, I tried expressing but couldn't get any milk.

For me it would have helped if I had access to a breastfeeding counsellor earlier, I requested help a few hours after ds was born but it was 48 hours before the counsellor came to see me and then she never had the chance to talk to me because she was nabbed by the woman in the bed next to me who had no problems and was just fishing for compliments.

I eventually got to see a breast feeding counsellor a week after ds was born but by then he had lost loads of weight (went from 6.14 to 5.14) and was being supplemented with formula. The breast feeding counsellor said that the latch was fine but that ds most likely wasn't sucking because he had got used to sucking a bottle which gives immediate results. We perserved for a few weeks but the damage had already been done.

I'm pregnant now and I'm thinking of seeing a counsellor before the birth, is this a good idea? Also was thinking of requesting on my notes that I want to see a bf counsellor within a few hours of the birth, is this feasible?

Sorry to hijack the thread!

norktasticninja you are spot on. Mummys out there who are BFing, there is a separate weight chart for BF babies and FF babies. But some people will tell you there is not! Ask your HV, it should be in your red book. Weekly weigh ins are as much of a hindrance as a help! They can cause you to miss the fact that baby is thriving and become a "weightwatcher"!

stillstanding I agree that the first few weeks are often the most difficult, and there is a severe lack of support at present. Hence why we are giving up our time and being trained to fill the requirements.I was in the same boat, no support in the interim. I believe it can taint the whole experience.

Sadly BF seems to be public knowledge, as do the benefits. But acheiving the "perfect latch" or correct positioning is not as easy as people assume! It may be worth calling your local HV in advance and asking them if they have a peer support programme in place. It does depend upon which county you are in. Here in Lincolnshire they are rolling out the service across the county as there is crucial need for it.

And yes, I have also been a victim of the "you cant BF" or "lets just top up with formula" cycle. I will raise the subject at my meeting tomorrow and post the response our Lactation Consultant gives us.

xxx

I was hooked up to industrial strength milking machine while ds was in nicu for a month. After this I just couldn't bf. Was made to feel utter failure.
Would have loved support, instead was pilloried and just lied in the end to say I was when I wasn't!
Second time around managed it for 3 weeks.To ut it bluntly, It made my skin crawl. I think I have a deep phobia of it, possibly induced by first time experience?

DD had a mild tongue tie. This was diagnosed a couple of days after she was born, but we were told that it was too mild for them to consider having it cut. I struggled at first, but because it wasn't agony and I didn't have any damage to my nipples I grinned and bore it. I nearly gave up a number of times, expecting it to get more comfortable after two or three weeks. What kept me going the most was someone on here saying that it had taken 8 weeks until it was comfortable for her. It took me exactly the same amount of time, and then I really started to enjoy it, but had I not known that it could take that long, I might easily have given up earlier. I also realise now that I could probably have pushed to have the tongue-tie cut.

It's a great shame that this isn't part of the post-natal checks on the baby, particularly since the NHS professes to be so keen to encourage women to bf - I really think a huge number of women would be more likely to continue if tongue tie was diagnosed and dealt with. It seems to be quite a controversial issue, and I'm really not sure why so many health authorities make it so difficult. I believe it is the case that the severity of the tongue tie is not always proportionate to the level of pain for the woman, either - so saying the tie is mild is not relevant in terms of successful bf outcome.

So, what I'm trying to say is that diagnosis of tongue tie, and the knowledge that it might take longer than you are expecting to become comfortable are the two things that were most important for me.

Also, following on from what Tillyscoutmum says, I think women really really need to know how much time it takes up in the first two to three months, too, and that cluster feeding in the evening is normal. And not to feel bad about being tied to the sofa and expect to get things 'done' when the baby is tiny. The only thing you need to get 'done' in the first few weeks is feeding and bonding with the baby, anything else can wait! (not to say you can't bond if you bottle/ff, btw)

And I totally agree with the above re. 'weight watching'. DD lost over 10% of her birth weight and took 5 weeks to get it back. She was fine, though, lots of wet nappies, very alert, etc. I am small and she was fairly big at birth, so she was clearly just readjusting from 75th to her rightful place in 25th centile! I think it's useful for women to know all the signs to look for to know that their lo is ok with their breast milk, and that it is 'good enough' - it's not just weight that tells you your baby is getting what they need. And those old charts are ridiculous!

Daisyj, I would be wary of the whole tongue tie thing. When DS was struggling at the beginning I had a series of people strolling in and saying (after barely a look at DS) that he had a tongue tie. My dad (who is a doctor but not remotely in this field) examined him and said it was absolute bollocks. My GP confirmed that he didn't have one. The midwives were just keen to have something to blame for the fact that DS wasn't feeding and tongue tie is a very easy one. Which is obviously not to say that some babies don't have them but I do think it can be an easy scapegoat.

There is no separate chart for bf and ff babies, sorry. The chart issued in May this year is for all babies from birth. It replaces the older chart which was also for all babies.

The difference is the older chart was built from data on babies who were likely to have been formula fed, and the newer one comes from data on solely breastfed babies.

The charts are more or less the same for the first 6 months or so. Then they start to look a little different.

I agree that too much emphasis on reg. weighing is useless.

Th guidance issued to HCPs with the charts says there is no benefit to frequent weighing (unless the baby has a problem). Once the birthweight has been regained, weighings should not be more than once a month in the first 6 mths and once every two months in the second 6 mths.

stillstanding - I tend to think like you that tt is over-diagnosed in some places. It goes from obvious tt being missed, to every other baby being diagnosed!!

I think that as daisyj says, women need to know that their milk is 'good enough' and that they are producing enough milk for their baby. So many women I know stop breastfeeding as they believe that they are not producing enough milk as their baby feeds a lot or cluster feeds. From what I have been told, this is normal and to be expected in the first weeks. I also know women who have been lead to believe that in the first days when their milk hasn't come in yet that they need to formula feed to make sure that the baby doesn't starve! Surely this will just affect their supply and lead to problems.

Tillyscoutmum, don't worry! I've got a 2.5 yr old and a 6 week old who cluster feeds around meal times and early evening (how do they always seem to know you are just about to sit down and eat?!!) You just get used to doing things one handed with the baby latched on!! I just prepare as much as I can while the baby isn't feeding or is sleeping, then the rest I can manage while there are gaps in between feeds and I can sit at the table with DD while she eats and I can carry on feeding!! You'll find a way to do it all!!

Just thought of something else, not sure how relevant, but I could certainly have done with some support in this area!

I was shocked at how some people view breast feeding and how others can try to influence you into bottle feeding for their own comfort. I come from a family of bottle feeders, and I must stress that I don't see anything wrong with that as I think every mother has the right to choose how she feeds her child, but I was upset at my family's reaction to my breastfeeding. I leave the room IN MY OWN HOUSE so that they don't feel uncomfortable when I feed, and I've had comments on how if I FF DCs would go longer between feeds and over night (not always the case, I think) and also horrible comments refering to the bitty sketch in Little Britain . I think that in someone who was perhaps wavering as whether to BF or FF, it could be the thing that sways them and if they really wanted to BF, but did not have the support, it could cause them to feel guilty.

Sorry for the rambling post , but this was something I was not prepared for when I was pregnant with my first child and found very difficult, especially as I found BF difficult. With my 2nd who is only 6 weeks old, I've come to accept it and just get on with it behind closed doors (and in M&S cafe!! )

I found breastfeeding to be VERY painful to begin with, and IME this is very common.

What I found UNHELPFUL was being told that it shouldn't hurt if you are doing it right because (a) thIs tends to make you feel like a failure; and (b) if you have cracked and bleeding nipples even a perfectly latched baby is going to smart slightly.

what I found HELPFUL was my wonderful midwife who didn't have any magical answers, but visited regularly and was supportive. Despite the fact she was no doubt extremely busy, she spent time with me and never made me feel she was itching to get out of the door. This really did make all the difference, and is the reason that i am sitting breastfeeding my 4 and half month DD as I write this reply.

I also found it helpful to know that other people experienced pain for quite a while, but that it DOES get better. My breasts didn't really stop hurting completely until about 10 weeks. If I had believed that pain was only attributable to poor technique I would have probably given up.

I think that part of the solution to sore nipples is just giving it time, I honestly don't think my latching is any different now from those early weeks, but one day i just noticed it wasn't hurting so much anymore. Mothers need reminding that the baby is a novice too, and you both need time to settle in to it. I think I probably wasted a lot of energy trying to get that elusive perfect latch which was going to solve all my problems.

I sometimes joke that I was doing it right all along and it was just DD who was cocking it up! And I really think there is quite a bit of truth in this (sorry DD!)

Good for you clouiseg for training to be a bf support worker and good luck!

tiktok - could you explain a bit more about there not being separate charts? I was told that there was and the chart in my daughter's book says "breast from birth" at the top. There is also a footnote indicating that the pre-term weights are taken from data "From the 1990 weight chart..irrespective of their method of feeding"

Clouiseg I think that it is brilliant you are training to be a peer supporter especially as you have endured problems with bf. I have always found bf hard and although all the bf counselors I have seen have been great all of them never had any bf problems and I found it really hard to identify with them.

My BF history: DS1 (bf for a few weeks then mixed for 4.5m) DD (bf for a few weeks then mixed for 3.5m) DS2 (bf so far for nearly 14 weeks, longest yet)

My concerns with bf have been:

1. what do if if baby just doesn't latch (took 5 days w/DS1 and I needed a LC to come out and help me)
2. do not top up (eps w/ff) if the baby is not gaining fast enough. Any gain is good and wet/poo nappies + happy baby is a good indication you are doing a good job.
3. expect clustering - I started doubting myself when we went through this with DS1 (and topped up) but just fed and fed with DS2 and reminded myself I wasn't "out of milk".
4. know the signs of mastitis and thrush asap and how to manage it.
5. tongue tie
6. learning to feed without pillows and trying diff positions once feeding is established
7. remedies for cracked nipples (knowing all of these in advance for my 3rd DC is helped me continue to feed.

Good luck with the training.

PS) My HV did tell me that BF charts were being introduced to the red books, is that not correct then?

Clouiseg I think that it is brilliant you are training to be a peer supporter especially as you have endured problems with bf. I have always found bf hard and although all the bf counselors I have seen have been great all of them never had any bf problems and I found it really hard to identify with them.

My BF history: DS1 (bf for a few weeks then mixed for 4.5m) DD (bf for a few weeks then mixed for 3.5m) DS2 (bf so far for nearly 14 weeks, longest yet)

My concerns with bf have been:

1. what do if if baby just doesn't latch (took 5 days w/DS1 and I needed a LC to come out and help me)
2. do not top up (eps w/ff) if the baby is not gaining fast enough. Any gain is good and wet/poo nappies + happy baby is a good indication you are doing a good job.
3. expect clustering - I started doubting myself when we went through this with DS1 (and topped up) but just fed and fed with DS2 and reminded myself I wasn't "out of milk".
4. know the signs of mastitis and thrush asap and how to manage it.
5. tongue tie
6. learning to feed without pillows and trying diff positions once feeding is established
7. remedies for cracked nipples (knowing all of these in advance for my 3rd DC is helped me continue to feed.

Good luck with the training.

PS) My HV did tell me that BF charts were being introduced to the red books, is that not correct then?

I was very worried about my sore nipples, and it was quite nice to find out that there was nothing wrong with them, my latch was fine, they were just undergoing a bit of normal soreness before they hardened up a bit.

Thrush was our BIG problem, so I'd like you to know lots about that (I'm talking about thrush that went on for 6+ months).

That you don't have to take abs for mastitis. You can just ride out a mild bout. This might have helped avoid catching thrush in the first place. I had mastitis mildly a few times with DS2, but just waited a few days, and it did improve. Of course, there will be other terrible times, when you definitely need the abs.

I wish somebody had physically showed me how to hand express with DS1. After the birth of DS2 (who went to SCBU), I told a MW I couldn't hand-express. She knew I was desperate to bf DS2 (bf DS1 to 22m), and he was already 12 hours old and hadn't bf. She showed me exactly where to put my fingers by expressing some milk for me. I was doing it completely wrong before, but still getting some milk out, so I didn't know I was doing it wrong. DS2 latched on himself 12 hours later, but due to being able to handexpress, never had any formula before bfing from source.

Alternative help methods (silverettes, savoy cabbages, breast nurse cool packs for engorgement), importance of drinking and eating properly..that's all I can think of for now. Good luck I'll hopefully be starting my training in January.

I hated the fact that even though I clearly found bf hard, distressing and massively uncomfortable everytime I saw a bf councillor/HV/ midwife they told me to "just keep going for 1 more day" AAARRRGGGHHH. This went on for 3 weeks - consequently, if we are lucky enough to have DC2 (we are trying...) I WILL NOT BF after the first 24 hours. Absolutely no way. Please don't pressure new mums - just be there to support them which ever way they want to go.

i would like you to know, or have immediate access to, someone who knows about methods of enhancing/ encouraging bf in ex-scbu babies who have been tube fed, esp those with weak suck or poor oromotor skills.

big ask, eh?

(oh, and all the usual stuff )

I have had 3 DC BF both Dds and didnt really have any difficulties apart from my nipples adapting and it being sore for the first week. However with Ds who is 12 weeks it was a nightmare.I had bleeding nipples and I screamed everytime I fed him for the first week or so. He was diagnosed with a mild tongue tie and I went privately to get it snipped.Otherwise I couldnt have continued it was just too painful and I hated the thought of feeding him which was just awful. I fed him immediatley after the snip and I noticed a difference in his latch immediatley I was quite shocked by this.His technique was completely different and my nipples repaired within days.

it is such a simple procedure and it should be supported. So many people I have spoken to since have said that they gave up BF because they couldnt cope with the pain.That makes me feel sad when it could have been resolved so easily.

whitebean, you obviously had a very similar experience to me. I second what you say about the baby learning, too. That's a really useful thing to remember.

Re. tongue tie: I understand what people are saying about diagnosis/misdiagnosis - however, I know that dd has one, as it runs in our family - my mother and I both do, and I still think it's useful for people to be aware of, even if it is difficult to diagnose correctly.

Also agree about the use of expressing to help baby with initial latch after milk comes in. I was crying and leaking for 12 hours with a wailing hungry baby before we managed it - if I'd managed to express earlier I could have avoided the distress, I think.

powdoc: there were some charts that came out which were bought by a handful of PCTs about four years ago, and they were called 'breastfed from birth'. They were issued by the Child Growth Foundation. They were based on a small sample, and never had any official endorsement. No one should really be using them now - there's no need, the new charts have much more validity and are meant to be used everywhere.

Hope this explains it. Sounds like your PCT might have been one of the few.

Breastfeeding was a nightmare at first for us. I'd read all the stuff and gone to a class, been told how sucking is instinctive for babies, if you stroke above their lip they'll open their mouth, etc. Nope, not DS. Put him to a breast and he'd clamp his mouth shut. Occasionally he'd fall asleep.

I was quite angry at the time that no one had really said beforehand how difficult it can be, and that it quite often doesn't come naturally, for the baby or the mum. I brought it up at a postnatal group, and another mum agreed, and the nurse said they weren't allowed to tell pregnant women it could be hard, in case it put them off. But surely that makes mums more likely to give up, as they don't realise it's perfectly normal for it to be difficult?

I also hated the advice that if it hurt, you should take them off and then get them latched on again. I know for most people that's right, but though DS started feeding at a week old, it was literally about three months before he'd do it easily each time. I remember sitting in bed feeding him at about 2am, sobbing in agony. It had taken me about half an hour to latch him on, him crying in hunger, me exhausted - there was no way in the world I was taking him off again.

What did really help was the wonderful midwives who visited after the birth. They never suggested giving up or trying formula, they were totally positive about how they were going to help me to feed him. And told me about other babies they'd seen that had been the same, and that they'd got the hang of it eventually. That reassurance was wonderful.

Interesting. Thanks very much. Does not surprise me that my PCT made the duff purchasing decision!