My baby daughter has turned one, and I’ve stopped breastfeeding her. I can safely say that this is the only thing about our nursing experience that has gone as planned.
This is what I imagined. Newborn squirming instinctively to the breast, preferably still in the birthing pool, and latching instantly, successfully, and painlessly. (That’s what we saw in the video in our antenatal class, right?) Me radiant and energised. Milk surging in after a couple of days and remaining abundant. Baby immediately thriving. Me the earth mother, effortlessly drifting with baby and boob from café to home to park. We might introduce a bottle of expressed milk after a while, but only so that my partner could get involved and I could get out and exercise of an evening.
This is what it was actually like. The baby latched pretty well (when we finally got the skin to skin, and that’s another story but let’s just say no water and whale music was involved). However, that turned out to be a mixed blessing, since it was the start of five days in which midwife after midwife glanced at us, proclaimed all to look great, and brushed off the fact that little A. was soon crying all night and most of the day. We thought we had a “difficult baby”. We didn’t: we had a sunny little poppet, only she wasn’t getting any milk.
Cue a lot of tears. Hers. Mine. Both. Bad advice at a crucial time, when an inexperienced midwife was unconcerned by a lack of wet nappies. Then two fraught, horrible days back in hospital when the problem was finally picked up. Formula. Lots of it. (I didn’t even know about donor milk then, and I’m not sure I could have got any in time if I did.) Lots of expressing. Blood tests – hers. Hysteria – mine – and more blood tests to check kidney function as we waited a desperate 24 hours for her to pee. (I never thought one of my all-time best moments would involve urine, but that’s what motherhood does to you.)
By this stage, A. was six days old and I had never felt so much love for anyone in my life. But I had barely slept since two days before she was born and I had also never felt so much guilt. I cried helplessly, unstoppably, wishing I could go back a week and do better by her when she came out this time. (By which I mean supplementing before she lost 13 per cent of her birth weight, and was borderline dangerously dehydrated.)
She emerged from the neonatal unit a transformed, happy baby, with parents a world more experienced: more besotted with her than ever, but also painfully aware of just how frightening this business of keeping a child alive can be. Then came the long, slow process of trying to sort out the milk supply. The exhausting routine of breast, bottle, expressing, made possible (i.e. reduced to only an hour every three hours) only because I had first her dad, then my mum, then my mother-in law, to do the bottle bit. Visit after visit to the breastfeeding clinic. Bleeding nipples, cured by the truly brilliant biological nurturing position. Oral thrush, cured – eventually – by time. (Turns out £40 silver nipple cups were a waste of money. Who knew?)
And still the guilt. A double whammy of it, since I managed simultaneously to feel terrible for not realising she was getting dehydrated (for six months I couldn’t bear look at her early baby pictures, because I would just think of how we were starving her, and not realising), and more mildly bad that I was giving her formula.
I tried trick after trick to get more milk. Cereal bars and water at every feed. Cup after cup of breastfeeding tea. (I think it helped.) Breastfeeding cookies. (No discernible difference. They tasted nice, though.) And, slowly, things improved. From three to six months she was, at last, an exclusively breast milk baby, and I loved it even though I was expressing at least twice a day to keep up with demand. (If that sounds in any way heroic, it’s not: try my friend who exclusively pumped for 21 months to feed a baby who couldn’t latch.) From six months, as the amount I was having to express went on going up, I figured I’d given it a good go, and supplemented again with formula. So all in all, the closest I’d been to an earth mother was when I was eight-months pregnant and my brother-in-law said I looked like I’d swallowed a planet.
Why am I saying all this? Certainly not to put anyone off breastfeeding. Despite everything – perhaps in a weird way because of it – I’m very glad I persevered. I don’t need to go over the health benefits because they are now, fortunately, so well-documented. But there’s also the bonding: when you get it cracked, it really is uniquely wonderful. More prosaically, it can also be a whole lot more convenient. Just ask anyone who’s done the never-ending round of sterilising, warming the milk, throwing it away if the baby turns out not to be hungry, carrying sterile bottles around, carrying milk around, and generally having to be far more organised than is feasible on four hours sleep a night.
So I’m still very much pro-boob. I just I think it’s time we were more realistic – and a great deal more open – about how tough it can be. We’re not Victorians now, and pregnant women are told the grisly truth about labour. (Although some birth preparation methods are more truthful than others. Sensations? Like hell they are!) So why aren’t we warned that breastfeeding, rewarding though it can and probably will be, can be an emotional and physical nightmare to get off the ground?
Because it’s not just me, although it wasn’t until I was floundering myself that I realised quite how un-unusual I was. With a social circle packed with newish mums, and the lack of reserve that comes with going through birth (almost) together, I can now honestly say I know more women who have seriously struggled with breastfeeding – supply problems, latching problems, both – than have found it completely straightforward. I can’t think, offhand, of anyone who didn’t give it a try, but I do know some mothers who decided – contrary to their own hopes – to stop altogether, and many who ended up combination feeding. (Yes, breast milk is wonderful. But so is having a mother who isn’t attached to the expresser every three hours, who has had a bit of sleep, and who can focus 24:7 on being a mother.)
Two things stick in my memory about the breastfeeding “expert” who came to one of our antenatal classes. One is that she spent a lot of the time talking to the dads. (Why, exactly? I still don’t get it.) The other is when we asked about women who couldn’t breastfeed. She said that could only happen if you didn’t have the mammary glands. Not wildly helpful. So here, with the benefit of hindsight, is the answer I wish we’d been given.
Yes, some women do have supply problems: a long or difficult labour can delay your milk coming in, as can stress. (And, quelle surprise, if you are tired from an epic labour and worried to death that you aren’t feeding your baby enough, you’ll be more stressed than ever.) Don’t despair, though, because even if you do have to supplement initially, you can still breastfeed. Breast-bottle confusion is nothing like as prevalent as it’s made out to be (it’s a myth, according to our neonatal doctor) and expressing really can boost supply. That said, for some women it’s a long old haul. If that’s you – and you’re not superhuman – you’ll need help.
It’s not as though there’s no support out there for mothers when they are struggling. For us, there was plenty: breastfeeding counselling in the excellent neonatal unit, then a free breastfeeding clinic. But the fact that the probability of problems is built into the system for after the event just makes it all the more puzzling that there’s so little acknowledgement of it beforehand. (Very possibly, moreover, there still isn’t enough support: based on anecdotal evidence from elsewhere in the UK, there may be a postcode lottery here.)
Of course, they (by which I mean the major providers of antenatal classes) have their reasons. They don’t want to put people off. They flag up all the advantages, and rightly so. I can see that some women wouldn’t even try breastfeeding if they were told too much up front about supply delays, tongue tie, cracked nipples, and babies screaming with hunger and frustration because they just can’t get the milk. But if the aim is to get mums not only to try but actually to carry on breastfeeding, surely it would be better to have them fully armed not only with all the many good reasons for doing it but also with the likely problems and some realistic advice on how long, and how much extra support, it takes to overcome them.
My other reason for writing this is that it’s all too easy to judge women who have switched to bottles. I should be clear here. We should be glad and proud that we are an increasingly breastfeeding-friendly society. All credit to the campaigners who have worked – and continue to work – towards that. The conduct of regressive companies or individuals is appalling. (Sports Direct, shame on you.) The conduct of certain big-name formula manufacturers, pushing their wares indiscriminately in the developing world, is of course, unspeakably awful.
But being breast-friendly doesn’t mean making bottle-feeding mothers feel as though they’ve failed. In almost a year of breastfeeding, I was only once made to feel awkward: on a busy commuter train from London to Reading. But in yummy mummy cafes, I found myself constantly – stupidly, irrationally – wanting to justify myself for not exclusively breastfeeding. Especially if I happened to be the only bottle among an ocean of breasts, I wanted to print a T-shirt saying “I have tried to breastfeed”, or “She gets my milk as well”, or even (later) “This is expressed milk.”
Quite possibly the disapproving looks were a figment of my paranoid imagination, but the fact I was paranoid is a product of what I was taught to expect of myself. As with the sought-after intervention-free labour, we are presented with an ideal but not as an ideal: rather, as something we can all live up to, if we only push ourselves hard enough. This completely ignores the fact that it’s not a one-size-fits-all option. If we had only “natural births”, we’d have a lot more naturally dead mothers and babies. If all babies had only their own mothers’ milk, some wouldn’t make it through the early weeks. And while some women are very open about their drug-and-intervention-filled labours, there’s a lot less said about the decision either to combination feed, or to stop breastfeeding altogether. In my experience, that’s never a decision lightly made, never a selfish one. It’s certainly not something for which a new mother – already juggling with a morass of challenges – should be judged.