Breastfeeding Problems

Breastfeeding is such an emotive issue. I need to say right here that if you, having looked at the information and weighed up your options, feel that formula is the route for you, then that is absolutely your business. Your baby, your body, your choice! What I do resent is that so many of us are currently failed by the system. A system that pushes breastmilk as the gold standard, and then fails to adequately teach, support, and enable us to provide it! Breastfeeding problems are all too common. While the solutions are often simple enough – you have to know where to turn for GOOD advice.

I think most women want to at least try to feed their baby themselves. Even if only ‘to see how we get on with it’! We all know how beneficial it is. But if it doesn’t click straight away, then it’s just another time when we’re left feeling like failures, that our body has betrayed us, and then feeling guilty.

If you want to breastfeed – and it’s not going smoothly, read on!

A toddler is copying her mum breastfeeding.

What to do?

Firstly, get help with problems sooner rather than later.

You may initially think all hope is lost. Maybe you can’t get your baby to attach, or worry that you aren’t making any/enough milk. Maybe you’re finding it really painful. The longer problems persist, the more likely they will become permanent, but in a QUARTER of women milk can take longer than 3 days to ‘come in’ – sometimes up to 5 days. This may seem like forever! It’s actually pretty rare for someone who’s just had a baby to not make enough milk for their child – it’s just not as instant as tv shows and films (and others’ experiences) might have us believe.

The sooner you can get help, the sooner you can begin to establish a nursing relationship that works. Even if it doesn’t, there are ways to rectify to problem, or even re-lactate, weeks, even months down the line, if that’s what you want.

In breastfeeding – remember – demand creates supply!

Breastmilk works on a demand leads to supply system. The more you take from the breast, the more you will make. Draining the breasts frequently (whether by nursing or expressing) is absolutely the key to success.

It’s one of the reasons newborn babies feed so often!

Some midwives can be very keen to see your baby gain weight ASAP. This is often not perfectly compatible with the early days of nursing. Weight gain from breastfeeding vs formula can be more gradual, and you may feel pressured to ‘top up’ with formula. But if you don’t keep the demand on your breasts to produce, there will be a reduction in your supply.

If your baby isn’t demanding/taking it, that doesn’t mean you can’t stimulate production in other ways. You can try hand expressing or machine pumping, and breast massage to encourage the milk to flow. You can always freeze it for use later!

https://www.nhs.uk/start-for-life/baby/feeding-your-baby/mixed-feeding/how-to-express-your-breast-milk

If you are supplementing with formula on medical advice, remember that ANY breast milk is good milk, and the more you take, the more you’ll make. You can still build up to an exclusive breastfeeding relationship, if that’s your goal. It may just take perseverance, determination, and support over a few weeks.

I don’t think I’m making enough?

A newborn’s tummy is tiny. Really tiny. Often said to be about the size of a marble – and not one of the big ones! You may worry you’re only making a few drops of milk, but in reality, that’s all your baby needs.

If they seem to want to feed often, then that’s perfectly normal! We’re conditioned from tv/films to think that a baby feeds and then sleeps for hours. This is very rarely the case for a newborn! Babies top up little and often to begin with. They will gradually settle into a more established pattern with longer intervals as they grow.

If you’re concerned that you don’t seem to produce much when expressing, don’t fret! Not being able to express much/any milk is a red herring. As with most things, it is a skill that needs perfecting, and our bodies have developed to provide milk to a baby, not a machine! Looking at your baby or photos/videos of your baby can help stimulate the ‘let down’ reflex, meaning you express more easily, but it doesn’t work for everyone.

If your baby seems content after feeds and is making plenty of wet nappies, that’s your best guide.

The only exception to this would be if your baby seems to want to feed ALL the time and never really seems contented after a feed. This might suggest that there are some issues with latch and attachment, and would warrant some input from an expert.

Who should I speak to? Where can I go?

In an ideal world, midwives, hospital staff, and health visitors would be expertly trained in the art of breastfeeding. In an ideal world they’d have all the time in the world to help and support you to do it in an easy, pain-free way.

Sadly, this just isn’t the case in the UK right now. Breastfeeding is just one very small element of their training, and unless the Health Care Professional (HCP) in question has a personal interest, or has undertaken additional training, they (with the best will in the world) are NOT the best people to help you here, if breastfeeding is your goal. But there IS support out there.

For a helpful pdf on the different types of breastfeeding adviser available, click on this leaflet produced by the Lactation Consultants of Great Britain:

Peer supporters

For most issues, a peer supporter will be enough to help you identify and fix the issue and get you back on track. These are people who have usually breastfed themselves, and who have undertaken additional training in common problems like positioning and attachment and can give you some much needed support and reassurance. Just Google “breastfeeding support” or “breastfeeding cafe”  + your area, or call the National Breastfeeding Helpline between 9.30am and 9.30pm.

International Board Certified Lactation Consultants

At the other end of the scale are IBCLCs. They are the absolute Oracle on breastfeeding advice. You can find your nearest one here:
http://www.lcgb.org/find-an-ibclc/

These are people who have undergone EXTENSIVE training in all aspects of breastfeeding, are regulated by the International Board of Lactation Consultant Examiners and are required to re-certify every 5 years, with continuing education annually. They are the professionals, know about all sorts of breastfeeding complexities, including babies with additional needs/complications, breastfeeding after breast surgery, how to manage with inverted/flat nipples/large breasts, feeding multiples, tandem feeding of babies and toddlers etc etc; a lot more than just the common problems faced, and you will be in no better hands.

Many are employed by healthcare trusts and if you’re lucky, will run a clinic or baby café somewhere near you where you can seek out their advice for free.

If you wish to hire them professionally to support you, you’re looking at around £100 for a 1.5-2hr home visit.

This seems like a lot, but remember, you’re employing someone with degree-level specialist training and continuous professional development to give you the benefit of an in depth one-to-one consultation. If money is tight, ask if there are options, some IBCLCs offer discounts and even pay-by-instalment plans!

Even so, if you weigh the cost of a consultation against the potential monthly costs of formula feeding (and that’s ignoring all the non-financial benefits breastfeeding brings!), it can be a good investment.

If you seek out one of these lovely people and they aren’t able to help you (incredibly unlikely), then you will be able to rest knowing that you truly did everything you could.

I’m so confused! The breastfeeding counsellor is saying one thing, but the midwife is saying something different!

Yup. Welcome to parenthood! I’m afraid this is how it works. You’re almost guaranteed to find at least one school of thought (and usually many, many more!) on how to do everything. I’m afraid this is where you have to decide on what you want to do/try and do your best to block out all the rest as white noise.

Do what feels right to YOU. Do what you want to do. Don’t let friends, family, midwife, or a bossy celeb tell you how to raise your baby! These decisions are yours and if you just ‘do as you’re told’ then you may come to regret not following your instincts later.

All mums are different. All babies are different. Do what feels right for you right now. And if it stops feeling right, do something else. Relax. You got this.

I always think – these kids are 50% me and 50% my husband. If it feels right for us, it probably is…

How to do it?

I’m not going to go into the mechanics of breastfeeding here – that’s for another post and there are many resources on the internet to help with that. I will say, that for positioning and attachment I particularly found watching instructional YouTube videos helpful.

I’ve already posted some links above, but here are some trusted resources, since I haven’t got round to writing a BigBirthas guide to setting up a home dairy yet!

https://kellymom.com/ – a great, really helpful, encyclopaedic site covering all aspects, from an IBCLC (Breastfeeding Oracle) and mum of three living in the US.
https://breastfeeding.support/breastfeeding-with-large-breasts/ – another encyclopaedic site by an IBCLC, this one is based in the UK
http://www.plus-size-pregnancy.org/NursingWhenWellEndowedFAQ – Another US site, the page is quite text-heavy, but lots of really useful info about strategies and techniques to help bigger mums.

Good luck!