I'm muddling along breastfeeding my 6 week old. We had a horrendous start, I would scream with pain through feeds, I felt detached from my son, wasn't bonding and refused to feed him by the end of the first week. He ended up half formula/half boob fed for a week until I realised I did want him entirely breast feed and worked really bloody hard to achieve this.
What would have helped? I don't think the extremely pro bf hospital and midwives could have done more. There was a bf support group in the hospital and trained staff on hand. Every mw specifically asked how bf was, if I needed help. I was visited by a bfc to check I was happy with bf and time was spent talking me through positions. At the colostrum stage we seemed to be doing ok and were discharged less than 24hours after birth.
Where I needed the help was day three onwards, at home. I was so ill when my milk came in, slightly delirious and shivering under a mountain of blankets. Bf went downhill from then on with most feeds feeling like broken glass being dragged through my breasts and much tears from both me and the baby. The mass of support that I hadn't really needed at the start had gone at the point when I needed it most. I strongly feel more help needs to be given a few days after birth in a familiar and safe place (e.g home). Telling me I could take myself and my newborn back to the support group at the hospital was no good when I was refusing to get out of bed, let alone leave the house.
My hospital did have a policy of staying until bf was established but, as already mentioned, hospitals are fairly grim places. I slept on bedsheets completely saturated with my blood that a HCA declined to change on the grounds she was far too busy. There was no chance I was staying a second longer than necessary so I said whatever they needed to hear to get discharged.
Other help: I think we need to stop seeing bf as something only for the mum to concern herself with. Educating the support she has - partner/family -is just as important. There was no information for my partner, when it went wrong he spent hours educating himself on the MN bf boards and kellymom and this was invaluable in supporting me. We were lucky that we could afford for him to take three weeks paternity leave and we had this time for both of us to work on bf. Again the value of paternity leave shouldn't be underestimated and it really is disgraceful to only offer a few days paid leave.
More realistic preparation is essential, I could have done with the knowledge that childbirth isn't the handing back of your body if you bf. It wouldn't have put me off, just made it easier to deal with. Acknowledgement that is does hurt, is uncomfortable but does get better with perseverance, we should be telling all new mums and their partners to allow at least 6 weeks to get it established.
Finally, I know HVs get a drumming on MN but I'm fairly sure mine is single handedly responsible for putting an end to bf for many women in my area. She presented herself as the complete antithesis of the hospital and mws. She was very dismissive of the mws, told me not to let them bully me into bf. My baby lost weight (as expected!) and she suggested a bottle top up. I told her bf was grim but she did no more than wince at my cracked, bleeding nipples and give me a leaflet on safe bottle sterilizing. Advised me that really bf was only needed for 6 weeks. No wonder my boy was on formula a day later.TRAINING, training, training is needed, or take away their involvement in feeding. If an HV can visit every mum a few days after birth why can't a trained feeding expert also?
I had a real want to bf my child and the determination to do so. We have done it alone though and its been hard. Perhaps we should be targeting the women that do want to bf instead of the refuseniks, as the want alone is not always enough to succeed.