When I was pregnant with my second son, I decided that I would try my best to breastfeed. Breast is best, after all—and who wouldn't want the best for their baby? I had been unsuccessful the first time; my milk never came in and I started supplementing early with formula. Ten days postpartum I was diagnosed with retained placenta and endometritis, requiring readmission to hospital for intravenous antibiotics. I gave up on my dream to breastfeed, and I felt so guilty. I felt like I had let my baby down, that I was missing out on a magical bonding experience and wasn't experiencing motherhood to the fullest. I can remember every comment that midwives, doctors and health-care assistants made. Some were kind and told me to forgive myself, to look at my thriving baby; others reminded me that breast was best. It broke my heart to keep hearing that.
My negative first experience is probably what drove me to push through the barriers with breastfeeding when my second son was born. A lactation consultant called me ‘bloody minded’ (in a positive way!) and I think that sums it up.
After a speedy labour I was presented with my second baby, Jacob. Breastfeeding didn't really happen that day, and as we were only in hospital for 10 hours I didn't have a lot of hands-on help. The midwife was lovely, but very busy, and the baby was too sleepy to really attempt feeding. There was no opportunity to be taught any techniques by my midwife, although she was clearly very skilled.
Going home that first night, I lay in bed and watched several YouTube videos on latch and positioning, which really helped. The short feeds Jacob had were already uncomfortable, and I knew that most of the time this was due to latch issues.
We pushed on, and on day 5 Jacob had lost 7% of his body weight. I was feeling positive as my midwife told me this was well within the limit of 10%. Later that day, however, I started passing large clots. I knew from my previous experience of endometritis and retained product that this wasn't a good sign, so I told my midwife. She was amazing, and got me in to see my GP that day. The GP wasn't concerned as I was well in myself, but advised me to monitor the situation. Later that night I passed more clots, so went back into the labour ward with my baby. We were still breastfeeding but I was in excruciating pain and had excoriated nipples. Jacob was feeding all the time, for hours at a time; if I took him off, he'd scream.
My bloods were taken and I was started on prophylactic antibiotics. As my inflammatory markers weren't raised, I was allowed home, with a follow-up scan the next day. This showed that I had retained products of conception, to be treated conservatively to see if I would pass them myself while on the antibiotics.
I was still struggling with breastfeeding. Jacob was attached to me constantly and, worryingly, he'd continued to lose weight. At every feed he made a clicking sound with his tongue, and my nipples were bleeding. He ended up losing 10% of his birth weight. I never saw my milk or leaked, and when I expressed I just got drops of colostrum. My fantastic community midwife said she felt that Jacob had an anterior tongue tie, and referred me to a lactation consultant.
I did some research around tongue tie and supply issues, and found the two often go together. It made sense as to why Jacob wasn't feeding effectively and why it was so uncomfortable for me. I was informed that in my area there was a 6-week waiting list for tongue tie division. Another option was to go to King's College Hospital, London, but I felt that option was impossible for us with our newborn. Doing my own research online during one of our epic feeding sessions, I discovered a local consultant who offered the procedure privately. Fortunately, the consultant was able to do the tongue tie division when Jacob was 10 days old, after we had seen the lactation consultant.
During this time, I also looked into why my supply issues may be so poor. Jacob was feeding up to 18 hours a day and still losing weight. I was told it could be that he wasn't effectively asking for milk due to his tongue tie, but it could also be due to my retained products. Further scans had shown that I was passing the retained products naturally, but as it was a process I was advised to stay on the antibiotics for a total of 12 days. The community midwife had mentioned the antiemetic domperidone and I found information on it and spoke to my GP. The GP had no experience in prescribing domperidone to improve lactation but trusted my research and knew that I was being seen by a lactation consultant. I ended up on domperidone 20 mg three times a day. I found it effective at boosting my supply, and at one point I was so dependent on it that if I was late with a dose it would affect the next feed. It wasn't until Jacob was 5 weeks old that I felt we had finally cracked the supply-and-demand aspect of breastfeeding. I started leaking milk around this point, and Jacob was far more satisfied after feeds.
So with a mixture of a tongue tie, retained products and low supply, the early days of our breastfeeding journey were not easy. The days were often filled with doubt about my supply, and real worry about Jacob's weight gain. If it wasn't for a few key health professionals who gave me confidence and encouragement, I wouldn't have managed a few weeks breastfeeding, let alone still be breastfeeding 5 months on.
A low milk supply can be incredibly hard, especially when the baby seems unsatisfied. I believe that early use of domperidone helped immensely, as did the tongue tie division. Knowledge was definitely power in my situation, and having the skills to navigate my way around the NHS and private health care was priceless.