Why I’m writing this
I wanted to write this because my ignorance about breastfeeding at my son’s birth now shocks me. It was the way I was going to feed him - quite literally keep him alive - and I knew basically nothing. Given the problems I had with loss and medically before his birth, I blame this partially on really struggling to picture a successful delivery. But I really should have educated myself more. A lot of the blame lies with me. But as someone that works on services the public uses, I wish more information had been made more available to me before my baby’s birth.
I also now think breastfeeding is a profoundly feminist and important topic we need to be louder about. Not just in terms of accepting feeding in public, or in the same sense we should be more aware and open about most women’s health issues. But preparing new mothers about what feeding entails so they can make informed choices that are the best for them and receive support if they need it. Whilst also recognising a lot of it is luck, and you may not be able to breast feed even if you want to - or you may choose not to if it is unbearable.
Breastfeeding these first ten weeks has been the most physically painful and traumatic experience I have ever been through. I wonder when I say this if people think I am being melodramatic, but I am not. It was worse than my c section recovery. Mentally I struggled with this so badly because I had this picture of it being a beautiful bonding experience between my baby and I. Instead, I remember having to stifle screams at the start of a latch for 30 seconds. Or my nipple covered in blood. Mastitis that raised my temperature, caused my whole body to ache and made me feel like my boob was on fire. Vasospasms that blanched, stiffened and felt like a jolt of lightning on my nipples. Feeds where I could feel cracks aching for the whole hour, no matter if I tried to relatch, but I needed to keep my son fed and alive.
I started writing this when the pain started to subside. Unfortunately, before I have finished it has gotten worse again and my vasospasms have returned. I have actually written this whole post on my phone whilst feeding or being napped on post feed.
What I knew at the start
I guess I had an idea it wasn’t always straightforward. My antenatal class had mentioned cluster feeding for the first few weeks and holding your boob like a hamburger if the baby struggled to latch. One friend had told me for her mental health she’d had to stop. Another said how painful the first few weeks were. Thankfully, a pal sent me silver cups, which were a lifesaver initially (but not always, and I’ll touch on that later).
Breastfeeding can be painful even if you’re doing everything right
One thing I heard repeatedly early on is that breastfeeding shouldn’t be painful. This became a slogan that really grew to irritate me, along with the phrase ’nose to nipple’. I heard both so many times I wanted to scream.
When you repeatedly hear you shouldn’t be experiencing pain and you are, it can be really frustrating. It often made me feel like I was doing something wrong. The NHS seems to say if it is, your positioning is the most likely issue. I had at least 3 lactation consultants observe my positioning, and they were still at a loss for why it was so painful for me. I am not a particularly coordinated person and will not pretend my breastfeeding skills were perfect, but I was trying my hardest to follow any advice I received.
I would have far preferred if I was told more realistically ‘ideally, breastfeeding should not be painful, but it is for many women at first even when they are trying their best. It can be very difficult to breastfeed for some women even if they do nothing wrong.’ I worry in promoting breastfeeding, public sector organisations can actually make women feel more isolated and hopeless about what can be a common experience for many women.
Tongue ties and their treatment are disputed and unclear
One hypothesis for why breastfeeding was so painful for me was that my baby had a tongue tie and jaw tension. The process of getting this assessed was a little tricky - I went to an online clinic that recommended going to a different clinic in person to then be referred go the hospital. In the meantime, at various different clinics professionals thought he most likely did not have a tongue tie. Eventually, at the hospital they decided he did have a tongue tie and removed it.
I think this did help the most severe pain a bit. I have a reassessment next week. I found out tongue ties can grow back, or they don’t even need to be operated on in the first place. It definitely wasn’t a miracle cure like I had hoped.
Your baby can bite the hand that feeds him
I had not realised how animalistic babies could get at the breast! Whilst obviously my poor son is not intending to hurt me, he does regularly tug at my nipples, hit my breasts and make some fairly feral noises. It has not been the peaceful, virgin Mary experience I pictured.
Babies go through weird phases, even with feeding
I had kind of thought breastfeeding and other aspects of baby care would only ever get easier. That was dumb.
The last few weeks, he has started getting more upset at certain feeds, thrashing about and often tugging or clenching down more. I can only guess this is when my letdown is too strong for him - essentially the milk is now too fast for him. He cries, coughs and delatches, and initially I panicked he was going to starve. A lot of his feeds got longer as he got older, before starting to shorten again around week 8. I had again falsely assumed babies only get more efficient and comfortable with feeding. Not that I blame him - this would be even more stupid because, duh, he is a baby.
There is a great variation in how babies feed
Along with the pain, my baby seemed to feed for much longer than average. At 7 weeks, I asked a friend with a 4 week old how long their sessions took - she said 15 minutes. This was about a quarter of the length of at least half of my baby’s feeds. It wasn’t her fault, but I cried. At its peak (so far) I have spent 9 hours a day breastfeeding, with most days hovering more around 7.5 hours. Since week 9, its closer to 6.
All babies are different and I should not compare them. But I have really struggled with knowing if how my baby feeds is concerning or not. I worry about him.
Breastfeeding is mysterious and subjective
There is not much agreement on how to handle the longer feeds. Some consultants have told me its fine, others have said it should be max 40 minutes even in the first few weeks. Given some weight issues early on, I have been terrified to cut feeds off early. I have also worried like most mothers if he is getting enough. Because breastfeeding is mysterious. You cannot see how much they are drinking. Nor can I reliably diagnose myself with an oversupply or know why he gets so upset some feeds.
On that point of varying advice, I have found a lot of breastfeeding ‘rules’ contradictory. It seems like an art, not a science. Whilst there are some commonly agreed laws (like nose to nipple, oh my god) there’s also a lot of difference. This only adds to the mystery.
When is he swallowing enough? How long should a feed be? How often should you feed? Should you wake to feed? Do you always need to burp? Why is he upset on the breast? Do I have an over supply or an under supply? How do I improve it?
From my limited experience, more medical teams tend to be more old fashioned, likely to advise a certain length for feeds, prescriptive times to feed and operate more on tongue ties. They like the cross cradle hold to help get a good latch - the only hold I learnt in hospital. More community based teams, run by the council, tend to be more baby led. Basically, do whatever the baby seems to want to do, as long as they’re gaining weight and getting plenty of wet nappies. They also love the reclined position, which is when you kinda let the baby latch independently. For me, this always looks like booby face trampoline.
As a former early years teacher, this reminds me of the age old debate between teacher led (usually ‘hard’ skills) learning and child led (usually ‘soft’ skills) learning. I would not have guessed it was relevant so young!
Feeding services and support are helpful but disconnected
Working in government, it is also no surprise to me now the disconnect both in theory and in practicalities. I found it very confusing early on who to contact for what and what I was eligible for. I was told only on discharge my midwife postpartum care would be from a different hospital. But I was not eligible for their breastfeeding support. I then found out through my health visitor I could get help from my council’s breastfeeding team. They then advised to go to a clinic related to my initial hospital to get the tongue tie assessed.
I did not know council infant feeding teams existed before this. I have been shocked at the high level of attentiveness, enthusiasm and care from a free service. There are weekly drop ins, numbers to text for advice, calls to help and even one home visit. I tried private lactation consultants later, anything to try to help the pain, but they were not really any better. Whilst I have found breastfeeding one of the hardest things I have ever done, they have helped make it easier. On what I suspect are rapidly decreasing budgets and increasing workloads.
Now my baby is more alert to the world and my husband is back at work, I have struggled to go to the breastfeeding clinics by myself. I have a lot of fear over being unable to feed him in public and hurting him. This has made getting support trickier. For many women in less privileged situations than me, I am sure this is far harder.
There is very little strong evidence about breastfeeding creams or other fixes
When I was trying to cope with the breastfeeding pain, I researched and tried pretty much every option for relief. Hydrogel packs, nipple cream, compresses, silver cups and painkillers. A lot of it was pretty expensive, too.
Unfortunately, there is very little research and evidence specifically into breastfeeding pain and trauma which indicates a lot of these solutions can help. Like many aspects of women’s health, there should be more done. Some can even cause issues in the longer term, such as silver cups indenting into the boob.
Breastfeeding is often hard
I had heard brief comments from some friends that breastfeeding had been difficult, but it was only after discussing it with them after my own struggles that I realised it is most likely hard, at least at first, for the majority of women.
For some it is due to the pain, others due to the overstimulation, perhaps the length of time of feeding and its impact on sleep, the mystery of knowing how much your baby is eating, if they do not gain weight, or the responsibility of knowing you are your baby’s only food source.
I did not realise how many issues there are related to breastfeeding. Partially this may be due to the classic fallacy that natural is best or it would be somehow intuitive. As previously mentioned, I should have done more homework. I had been so focused on the pain and recovery from birth, which luckily for me went so smoothly.
There is not enough support for feeding with formula or with a bottle
Everytime I mentioned or asked about starting using formula with my son, I felt like the professional reacted as though I’d suggested giving him crack cocaine. Nearly all told me it would be my ‘choice’, some stated they could only give advice for breastfeeding and many changed the subject to tell me how great it was that I was still breastfeeding. When at around 8 weeks my baby started refusing a bottle, I was told he was maybe trying to tell me something. From some professionals, I felt as though as long as my baby was gaining weight, they did not care as much about the impact on my mental or physical health.
I understand there is research showing benefits of breastfeeding over formula, but a lot of it is less concrete than it appears. It is a hard variable to control for when you take into account factors like socioeconomic status or why women have had to formula feed. My husband was formula fed whilst I was exclusively breastfed, and anecdotally, we both turned out OK. Fed is best.
Why I am still breastfeeding
Well, I don’t have much choice given he stopped taking a bottle a couple weeks ago. One of the things I find hardest is how I no feel like I cannot decide to no longer put up with the pain. I do wish I had introduced a bottle consistently earlier, because having it as a back up feels so important for other reasons now too. If I get sick or unwell, to attend a friend’s wedding, or perhaps if I want to sleep more than 3 hours at a time.
It is tempting to say I kept with it because I love my son. But that would be bullshit - of course I love my baby, but so do the vast majority of parents who do not breast feed.
Really, I persevered out of a mixture of fear and hope.
I was scared of how his tummy would take formula, of doing something else badly, of being judged, of change, of ruining our bond, of him losing weight, of how difficult formula feeding might be when I was already struggling. And I am scared that all the pain would have been for nothing.
I saw how many of my friends breastfed publicly so easily, happily and conveniently and hoped for that experience. Ignorant of how much older their babies were and how hard some of their journeys were to get there.
There are elements I have loved, like the physical closeness with my son. Being able to stroke his hair. His stretches afterwards. When he smiles a bit and slips off the boob. Or like now, when he has fallen asleep cuddled up next to me.
So, here is my breastfeeding journey (so far - I know I am still a newbie). I hope in sharing this it helps at least one other mother feel understood. Like I did, when I found out how tricky some of my friends had found breastfeeding initially. Or it helps prepare a future parent for what difficulties there can be. But also what support is out there.