What do you wish a bf supporter in hospital had told you/done?

[FourArms]

I'm coming towards the end of my bf peer supporter course, and soon I'll be volunteering on the postnatal wards at our local hospital.

So... if a bf supporter had been available in your hospital, what would you have liked them to have done/told you/showed you?

I was v.lucky with DS1 and DS2. Although there were slight issues with both (c/s with DS1 and a spell in NICU for DS2) they were both v.easy to bf and it came very naturally to us all from feed one. We did have problems once we were home, so I have a lot of experience with these, but not much for problems in the early days.

Any thoughts will be gratefully received!

That all babies are different....DC1 was a fab efficient, 10 mins feeder, every 3-4 hours, latched on straight away and never looked back for 8 months. DC2 was horrendous and never seemed settled when feeding, would feed for seconds/minutes, then fall asleep, then want more an hour later, all day and night - gave up after 4 months.

I'm terrifed as to what the next one will be like

What I would have liked to be told/shown but found out from experience:

Wake your baby that first night/day to feed to minimise jordanesque engorgement even though you're desperate for a sleep.

Be prepared for truly horrible marathon feed the second night or so and growth spurts thereafter.

Use your hand to squeeze your breast into shape to help fit more than just the nipple into baby's mouth and generally hold things in place. You can always stop holding once baby has the hang of it.

Hand express, even just a little, in shower or bath to enable baby to get a grip

How to feed lying down. 3rd DC and still struggle.

It hurts at first, a lot sometimes, even if you have a good latch and even if it's your third baby.

How bloody hard it can be to breastfeed.

Also, that if you've had a c-section, are stuck at home unable to drive, your partner /husband has returned to work, and can't get to the breastfeeding drop in centres, that counsellers from the health visiting team can help and can come to your home.

I had several days feeling like I wanted help but couldn't get to it as I wasn't allowed to drive. Then one evening I felt like I couldn't endure the pain for even one more feed. It was only when I saw the midwife a couple of days later that she said she would send someone out to help. I wish I had known this before.

About moist wound healing, that sorted me out when nothing else did.

I wish the BF supporter at hospital wasn't too busy. I felt sorry for her as she was trying to help me but she was in a rush. I felt uncomfortable. She was well meaning but she wasn't helpful when she was in such a hurry. I wish she could stay and talk to me properly for a couple of minutes.
The most useful advice I've got was from my lovely mw. She said bed sharing was ok as long as we follow the guidelines. It made bfing much more easier both for me and my baby.

not read all the posts on this. I would say that the single most life enhancing thing I did was learning to breastfeeding lying down in bed. I wanted to do this from the start and was not confident, so I asked the midwifes and breastfeeding support people to help and they were great. I was lucky in that I had a C section and ended up being in hospital for 5 days and I started trying on day 3 and by day 5 had mastered it.

It was a life saver With DS2 I had a C Section again and big problems with my milk not coming in and from day 1 I just took him into bed with me and pulled the cot against the bed so he wouldn't fall out. As an " old timer" the midwifes in the hospital didn't make me put him back in his cot at night. I ended up being in for 6 days that time and it meant we got lots more sleep!

One of the most helpful things someone said was another new Mum before I gave birth, "Even if you're doing it right, it's still hurts!". Not sure if it's true, but it helped me to feel that I wasn't doing it all wrong and just had to push through the discomfort.

Talking to friends of mine, I am shocked at how many first time mums expect breastfeeding, because it's natural, to just 'happen' and that if it's uncomfortable of difficult then they give up and think they can't do it. I think reassuring them that problems are really normal and generally it gets a lot better after a while, would help. I have also surprised people by explaining how clever the body is - it's amazing how many people don't know that breastmilk is made on demand and that your body can even produce it at specific times etc. I think people need to be inspired to breastfeed.

When I had dc1 14 years ago I had a lovely MW who showed me a few tips. I also had a great baby who just sort of knew what to do and latched on great and fed wonderfully, never needed lots of winding, mum's hangup from bottle feeding us and winding us till we were sick?
When I had dc2 he was a very picky feeder, never comfortable at the breast, only with a bottle, always had wind and we struggled to get him full. Tiredness didn't help, nor did having 2 dc's. Luckily the MW showed me ways to interest him, rubbing his cheek with my nipple, expressing some milk before the feed so he could taste it as soon as he latched, different ways to hold him. Unfortunately they didn't work but at least I had been offered support.
With DC3 (18 mth) I was offered very little help and I think that was mainly down to the fact she was DC3. I still struggled but again I had a baby who seemed to know what to do and still loves bf now at 18 months old. If anything I am finding it hard to wean her off.

Sonmetimes the best support is just support, someone to watch you feed and so you know they are on hand if you need them.
MW 'shoving breasts in babies mouths' do not know what they are doing and should have the guts to tell you they aren't sure of how to help before guiding you towards someone who does.

I havent read other posts but I am so grateful to the midwife who showed me how to side feed lying down. It wasnt on the antenatal BF course and I was in quite a lot of pain after the labour, plus DD was feeding constantly (16 hours non-stop on day 3!!) I still BF lying on my side now (16 months on). Oh and definitely Lansinoh and that it's available on prescription.

Sorry haven't quite managed to read the whole thread but would be v useful to have advice on what to do if baby won't latch on at all because of flat nipples. I never even realised I had this 'problem' until ds was born and spent a miserable time in hospital trying to get him to feed. Nipple shields didn't work (but interesting to hear from another poster about how rubber ones worked instead), but one midwife lent me this (then) new product called latch assist from lansinoh. I don't know if this is now more commonly available, but basically it looks like one of those old-fashioned bike horns with the rubber ball you squeeze, but smaller, and this helps draw the nipple out before a feed. Managed to finally get him latched on with this and used it for about a week until my nipples started to stick out more. Sorry if you've heard of this but if not might be worth bearing in mind!

Oh, and the early signs of severe engorgement/mastitis would be good to know. I didn't realise that getting the 'shivers' was a warning sign - had about three episodes of this then got full blown mastitis which was horrendous.
HTH

i haven't read the whole thread so i'm probably repeating but i had excellent bf help in edinburgh with dd1, lots of no nonsense help with correct latching and positions post cs. if i said 'yes, i'm fine. i've bf before' they would insist i demonstrate and offer advice
many times mw/bf counsellor explained and demonstrated in detail how to check latch correct and never seemed to tire of answering questions or pre-empting them. never made me feel embarressed by touching my breasts and showing me exactly what to do. even helping me hand express when horribly and painfully over engorged

i was shocked at how little assistance i was given with dd2 in york as i had such a good previous experience to compare with. never once did mw even look closely at latch, even when i asked for help i was repeatedly told from afar 'you're doing fine', 'you'll work it out!' if i had been bf for 1st time i would definitely have given up and felt a failure.

so to summarise my best experience has been no nonsense hands on demonstration and encouraging support

I had loads of support with DS2 - because I asked for it up front, after having huge difficulties with DS1.

I wish I'd been told that pain does NOT always mean baby isn't latched on properly - I had agonising letdown pains, and only managed to struggle on for 6 weeks with DS1, assuming I was just doing it wrong all the time. I also had PND, which didn't help.

Knowing I could very easily give up much more quickly with DS2, and wanting to give him as much as I gave his brother, I asked for help before I even gave birth - my advisor was fantastic, gave me all the encouragement, support and advice I needed - and plenty of choices too. Though DS2 had some formula most of the way through, we made it through to nearly 2 years before he gave it up himself altogether. That included a 5 day feeding break where I expressed and fed pink milk while my nipples recovered.

My feeding advisor was Collette at the Horton in Banbury - she was fantastic.

By the way - also, bringing the baby to the breast never worked for me. Both boys seemed to hate being pushed around and just shoved their heads back against my hand. So I brought the breast to the baby with DS2 and he latched on fine.

I'd echo much that has already been said.

It does hurt in the beginning and expecting it not to means that you just feel like you're doing it wrong if it doesn't feel comfortable to start with.

The first 6 weeks is a real milestone. I spent the first few weeks going from day to day, then week to week i.e. "I'll just try it for one more day, then see how I feel". After a week, "ok, I'll just keep going for one more week, then I'll re-evaluate again"

Success in expressing can really depend on the pump. I had loan of a fab one from local hospital, so my advice to OP would be to know what resources are available.

Nipple Shields - I apparently have very flat nipples. Didn't find out till midwife said "you'll have serious problems feeding with those" (Thanks for the help!!) Afterwards a more patient midwife explained what I could do and encouraged me to use nipple shields and where hubby could buy some (they had some you could buy in the maternity unit - v helpful). In the meantime dd was getting very jaundiced, so they also helped me cup feed formula. So, like others have said, I think it's important to know that a little bit of formula in the first few days will not prevent you from mastering the breastfeeding.

10pmish feed - In my experience, this feed is when I felt I didn't have enough milk for dd and yet it's the feed when you want to 'fill-up' the baby, in the hope they'll settle for a good few hours sleep. I found expressing in the morning, when I seemed to have lots of milk and then letting dh use this expressed milk to 'top-up' dd after I'd fed as much as I could at 10pm helped us.

I also went to a breastfeeding group every week, which is where I met people who are now good friends. It was in same place as baby clinic, so partly just a good chance to get out and about in the first few weeks. If, OP, as a peer supporter could attend these groups, let new mums know about them, or even set one up if there are none it would probably be a good experience.

best of luck - sounds like you'll do a fab job.

I wish someone had told me that if you are lucky enough to bf a baby that sleeps well.... my ds slept 10 hours at 5 weeks old as he was a huge baby ..... your period is likely to return. ALso that if your period returns your supply may well tail off at the beginning of your period and baby may be fussy as the taste can alter!!!

Also some reassurance that bf a big baby is possible.... ds was 10lb 11ozs and still ex bf at 13 weeks...... never thought i would get here.

Help with positioning a big heavy baby when you have big boobs would be good too as i nearly gave up due to being unable to feed discreetly hen out.... now i dont really care who sees or doesnt see.

also when all the visits from midwives and health visitors have dried up the odd bf reassurance visit would be good!!! esp around the 12 week mark

I think peer support is a great idea. As a midwife in a baby friendly unit we are very supportive of this. Try to encourage woman to attend bf workshops or breastfeeding support groups antenatally as then they surround themselves with like-minded people. It is amazing how many woman choose to follow outdated advice from friends or older relatives!!

Also as a bf mother, it is sooooo hard to remain polite/calm when people choose to give you uninvited advice on breastfeeding (even though i was a midwife).

It is great that peer support can give such quality/time to mothers. Just a shame that the NHS cannot afford more midwives so they can spend as much time doing this.

to please PLEASE check for tongue tie! Other kids merrily BF till 1 1/2ish. DD2 had the most horrendous probs. Everyone kept telling me I was expecting too much, she was still a very small baby, some children take longer to get the hang of it etc.
It was only after being admitted to hospital with really bad mastitis and speaking to an older bf counsellor there that she diagnosed tongue tie and everything fell into place.

DD was 11 weeks old and was constantly hungry, extremely windy and sicky with green foamy nappies. She would cry with hunger and latch on avidly then arch on and off the breast screaming with pain/frustration. She also frantically tore at her cheeks where her jaw muscles were cramping from trying to feed - she's now 16 weeks and the scars are still faintly visible.
Feeding consisted of me closeting myself in a darkened room with no distractions and repeatedly gentling her back on to agonisingly sore breasts until she had taken just enough to quell the hunger pangs and would refuse any more - this usually took 40 mins during the day and 20 mins at night and would happen every hour around the clock. I had repeated bouts of mastitis, looked like I had a braful of raw mince and felt like I was stuck in a waking nightmare. She was referred to a tongue tie clinic by the bf counsellor pulling some strings (they're only allowed to carry out 5 procedures a month for some reason) and after an incredibly straightforward and painless procedure she fed without screaming for the first time. You could see the dawning amazement in her eyes, I'll never forget the expression on her face.
The midwives at the clinic told me she had a really thick tie and only 15 per cent mobility in her tongue. We were all in tears.

Since then she's gone from strength to strength and is an absolute joy. It's wonderful to see her enjoying life and be able to engage with the world and her siblings at last. I can't help feeling regretful that her early weeks were so awful and mystified that something so simple yet so crucial to a baby's wellbeing is not routinely checked at birth.

As a footnote we have discovered that DS (8 yrs old) also has a tie but much more mobility so no feeding/speech probs. His is pulling the gums away from his lower teeth and he has had to have 2 fillings in his top molars as he cannot use his tongue to clear food from this area of his mouth.
As his tie was not snipped as a baby, he will have to have a general anaesthetic and speech therapy to get it sorted.

Sorry for the long post but it's the first time I've set this all down and I'm simply amazed that no one checks for tt at birth. If I could show you a before and after vid of DD feeding you would be amazed at the difference it has made.

All's well that ends well and I'm not one for going on a crusade against well meaning, overworked healthcare profs but we saw so many midwives, bf cousellors, gps and hvs without anyone picking this up. If you could save one other mum and baby from going through this (especially a first time mum) I'd be thrilled.

Great thread, not much more to add other than if you're on a quiet postnatal ward advising a lady how to bf, try to refrain from loudly commenting on her large nipples like my mw did with me, as while I'm sure it was a fair and valuable comment about possible problems with latching on, the new dad sitting 5 feet away behind the curtain didn't really need to know about my chapel hat pegs.

I had no problems breastfeeding but I wish I'd had more advice on expressing. It was so difficult. I had to figure it out all by myself.

I was lucky in that a midwife spotted DS's tongue tie on day 4. It was sorted within the week. It was long enough to do some serious nipple shredding though so god only knows how you kept going so long, babywrangler. I couldn't have done it.
Anyway, haven't read the whole thing so I'm sure it's been said already but... I think it would be great to help women have more realisitc expectations of bfing and generally looking after a small baby. Stuff I wish I'd known was that some/ lots? of babies feed much more often than every 3 hours and much more randomly than certain baby books may suggest; that the first few weeks you need to feed, feed, feed and then feed some more to build supply; that you never really run out of milk even when you think you're empty; and that although it can be really hard at first it will get loads easier.
If I'd known the above there would have been a lot less tears the first time round!
I have to say the midwife support I received in hospital and once home was really, really good. Wish it was the same for everyone.

I'm pretty sure that this has already been said, but knowing that bf babies feed CONSTANTLY in the early days would have made me much more prepared. I had awaful probs for the first six weeks, sorted out by a bf counsellor and local bf groups. But if I'd known that feeding for hours and hours was normal, I maybe wouldn't have felt so overwhelmed.

I second the post re; tongue tie. Ours was sorted pretty early (4 weeks)but I've met mums for whom it was spotted much later and so bf was pretty much scuppered.

And if tongue tie is diagnosed and treated, that the change and relief may not be instant, as was suggested by the consultant and bf counsellor at the clinic. I was at my lowest ebb in the two weeks after the procedure was done as I was STILL in awful pain, really wanted to give up for my sanity but felt I couldn't as I'd put my baby through surgery. Then it improved.

That expressing can get you through really dark days. One of the local bf counsellors suggested I have a day or two just expressing to give myself a break. It was WONDERFUL.

Make sure people are encouraged to use all the specialist community help, as just having the visiting MW glance at your positioning and saying it's fine is not good enough.

finally that bf is tough and takes a huge commitment. We got there and I'm still ebf at 5 months, my previous plans to move to formula at 6 mnths have been cancelled, but bloody hell in the early days I think I was only a whisker away from PND because of feeding difficulties.

People like you are ESSENTIAL, thankyou!!!!

Having read this discussion yesterday, I've come back on to add my comments about tongue-tie and now see that several posts were added on the subject yesterday!
I had feeding problems with DS and got very sore within a matter of days so my HV suggested I go to a local BF clinic. They instantly spotted that my Son's tongue was 95% tied and he therefore had no chance of feeding properly. He had it cut a few days later and it literally took seconds, bled for a minute then he was feeding from me. You do have to work at correct latching on afterwards as their position has been wrong previously. However, I carried on going to the BF clinic and they were wonderful. I strongly recommend that any new Mums wishing to breastfeed find a clinic in their area.
When I had my Daughter, I asked the Midwife immediately whether her tongue was tied (as it is more likely if their sibling has had tongue tie). It was tied so I went straight to the BF clinic and got a referral and hers was cut at 2 weeks old. The clinic were able to show me how to rugby ball feed her until the op and that really helped me not to get so sore.
I am very grateful that the problem was corrected early on for my children as it can cause speech problems later on and having the op is more traumatic for an older child. Given the problems that it can cause, I think it should be a routine check by Midwife/Health Visitor/BF supporter. It would prevent heartache for so many new Mums who then go on to give up breastfeeding because they think it's not working.
I'd also like to add that some women have a slow 'let down' but it doesn't mean that breastfeeding isn't possible. My HV noticed that my Son drank the foremilk for 10 mins then fussed and screamed and this was because my hindmilk took time to come down. I had to keep putting my 2 back to the breast until the milk came down and then they were off again. It was obviously good quality milk as they both thrived - it just took a while to come in!!!

FourArms - this is a wonderful thing you are doing and something I have considered because of the difficulties I had. Maybe once my 2 are a little older I'll look in to it!

I was not natural for me, but I couldn't get them out either! Battled on with bf - a year with second child but feel that bf made the first few weeks with my first baby awful. We eventually did both with him but I sometimes wonder if it was worth it. Its a partnership and if you are unhappy yo won't enjoy this wonderful time. The only reason I managed it with second was that I knew what was coming and he was a natural feeder.

That it can be harder after a tarumatic section (like you body doesn't get all the right messages and you are so tired it can't do it)

Take some lanolin cream into hospital.

Have a hand pump ready for first few days - engorgement, yuk

That giving the odd bit of formula whilst your bleeding nipples heel is not the end of feeding

That doing both can be great

That it can still hurt in the first fortnight, even if your doing it right.

That you need to feed them all the time for the first couple of days to 'bring you milk in'. After milk established then look at routines if thats your thing. Relatives can be annoying on that one