Welcome, Readers of October’s Carnival of Breastfeeding! After you read this, check out the other posts on this month’s theme of “What I wish I’d known” linked at the bottom of this post.
I have many regrets about the sequence of events that occurred in the hours following my son’s birth. Not about the birth itself. I knew that a natural, unmedicated birth was the best for my baby and for breastfeeding, and with the help of my husband, a doula, and a supportive obstetrician, I had an amazing experience bringing my baby into the world.
I planned to take him in my arms immediately after he emerged, offer him my breast, and hold him on my chest as he slept. I would keep him in my room instead of the hospital nursery, nurse as much as he wanted, and not allow anyone to give him a bottle.
But when my son was born, he had some difficulty breathing and was taken to the Neonatal Intensive Care Unit for the next 6 hours. He was fed a bottle of formula, and he refused to breastfeed. Our breastfeeding experience turned into a disaster, and it took 4 months to get on track.
Why the first hours are so important
The early hours of breastfeeding shape the baby’s breastfeeding habits and begin to determine mother’s milk supply. Early breastfeeding is crucial to breastfeeding success. Babies are born with the instinct to latch on and suck. When the baby follows his instinct to latch onto the breast and suck, he is rewarded with his mother’s comfort, warmth, familiar smell, and those first precious drops of breast milk. If not given the opportunity to nurse from the start, this instinct and baby’s alertness fade as the hours go by. Studies have shown that even brief separation of 1/2 hour can cause latching problems for some babies. The baby needs to learn how to latch on and suck. Introducing a bottle during this sensitive time teaches a baby a way of sucking that doesn’t transfer to breastfeeding. The latch is more shallow and the milk flows faster. When they try this latch on mother’s breasts, it doesn’t remove milk effectively, can hurt the mother, and it’s frustrating to both mother and baby.
A mother’s breasts have milk from the very start, but they aren’t pre-programmed with the amount to make. Milk is produced in very small amounts in the first day or two after birth, and if the breasts aren’t stimulated and emptied in that time, they don’t get the message that more milk is needed. More milk is produced in response to the baby emptying the breasts. The more the baby nurses, the more milk will be made. Early breastfeeding turns on the milk machine and helps to ensure a plentiful milk supply.
Here’s the kicker. I knew all this before having my baby. I had just completed my Certified Lactation Educator training for my job. But when things didn’t go according to plan, I gave up. I thought that once we got things sorted out, we would be able to pick up the pieces and catch up. But once enough time passes, correcting breastfeeding problems and increasing a low milk supply becomes an uphill battle. I learned this the hard way. Now I know there were things I could have done to prevent (or at least minimize) the problems we had.
3 Things I wish I had known, and acted on.
1. When it comes to feeding, you have the right to question doctor’s orders.
The nurse initially said that my son would need one hour of NICU observation. Then his pediatrician ordered, by phone, 6 hours, as a precaution. Was this really necessary? When I visited him in the NICU, the nurses said he was doing great. Many times I have wondered if I could have challenged that order from the pediatrician. After all, it was my own child.
Then the pediatrician ordered a bottle. Why? Babies don’t normally need their bellies filled in the first few hours. Giving him that bottle may have interfered with his ability to nurse at the breast. I’ll never know if that played a role in our troubles, but the chances are good that it did.
2. When my baby wouldn’t latch on for hours after birth, I should have pumped.
I didn’t ask my nurse for a breast pump because I was trying nonstop to breastfeed. But he was barely taking it. When the lactation consultant finally came to my room, 12 hours had gone by. She was unable to get my son to take the breast, and when she tested his suck, he failed miserably. She concluded that he was still recovering from the head trauma he had during birth. She brought a breast pump and told me to start pumping.
But I couldn’t bring myself to use it. I was afraid that if I pumped, he would be even less motivated to learn to breastfeed since I’d have less milk stored up. That, and I was terrified of the breast pump. I don’t know why. It seems silly now that I’ve pumped at least a thousand times.
3. If breastfeeding isn’t going well, get help ASAP from a lactation consultant (IBCLC)
The sooner you get professional help, the easier it is to fix the problem. The breastfeeding help you receive just after birth may not apply to any problems that arise a few days later. The IBCLC I saw, at 5 weeks postpartum, told me the age of the baby is equal to the amount of time it will take to correct a breastfeeding problem. If she sees the baby at 1 week of age, it will usually take a week to fix the problem. If the baby is 5 weeks old, habits are more deeply ingrained and the milk supply is more established. It’s going to take longer to teach the baby a new way to latch, or to build mother’s milk supply.
My advice to moms-to-be
So if you are planning to breastfeed some day, plan to breastfeed from the very beginning. Here are some good tips to get breastfeeding off to a good start. Tell your partner, your doctor or midwife, and the nurses. Make sure the pediatrician you choose is supportive of breastfeeding, because they have a lot of influence over your baby’s feeding. And if, for some reason, you cannot breastfeed right away, find out your options. Talk to a lactation consultant, and get that milk flowing.
A final word
I struggled with my son’s refusal to latch and low milk supply, among other complications, but eventually, with a lot of work and support, we overcame our difficulty. A bad start doesn’t mean breastfeeding is doomed to failure. Under the direction of a lactation consultant, we used nipple shields, a technique of syringe and finger-feeding to teach proper latch, a contraption that delivered supplemental milk through a tiny tube at my breast while he nursed, and I took herbal supplements to build my milk supply. I had to pump several times a day in addition to nursing in order to stimulate higher milk production. I did all of this, trusting that it would work, and in the end, it did. By 3 1/2 months, breastfeeding was easy and comfortable, and by 4 months we were off all supplements and he took nothing but the breast. We’re still happily nursing now at 10 months. It was worth it. But when the time comes for my next child, I’m going to make sure we get off to a good start!
Other Carnival of Breastfeeding Posts:
Fancy Pancakes: Wish I’d Heard More Good Things
Hobo Mama: What I wish I’d known when I started breastfeeding
My World Edenwild: What I Wish I’d Known Then: A Poem
Happy Bambino: I wish I had known then…that it wasn’t up to me alone
Three Girl Pile-Up: 4 things I wish I’d known about breastfeeding
Birth Activist: What I Wish I Would Have Known About Breastfeeding
Breastfeeding Moms Unite!: You Don’t Have to Grin and Bear It
Momma’s Angel: What I Wish I’d Known Then– My List For Next Time
The Starr Family Blogg: I Wish I Would Have Known
Whozat: If I’d Known Then
Massachusetts Friends of Midwives: What I wish I’d known back then about breastfeeding
Fighting off Frumpy: When Breastfeeding Feels Wrong
Breastfeeding Mums: 15 Breastfeeding Facts I Wish I’d Known as a First Time Breastfeeding Mum
Cave Mother: Nursing Wisdom
Breastfeeding 1-2-3: Trust Yourself and Your Body
Blacktating: Breastfeeding is Life Changing
MumUnplugged: Breastfeeding: What I wish I’d known then
WOW! I am so impressed with your dedication. Your baby is very lucky.
I wish more people knew just how helpful lactation consultants can be. A good one can get pretty much anyone breastfeeding! (That said, one once did give me bad advice, so like with all doctors, a second opinion can be essential.)
Your point about making sure your baby is with you as much as possible in the first day is one I’m going to work harder at next time, too. I don’t think I nursed enough in the first 24 hours, and I think it made my milk come in more slowly.
great advice! Well written. Wish I’d had this info. in 1980!
I love this post because it shows that even the most educated moms can encounter breastfeeding troubles and have difficulty speaking up for themselves. Birth and the post-partum period is such a vulnerable time for women. Thanks for speaking out.
Thanks for this post. I had a similar experience after an unexpected c-section and didn’t know to question the practices even though I knew better. Luckily we had a midwife who consistently questioned the orders in the NICU, brought in donor milk to supplement our preemie, got an NG tube instead of a bottle (to supplement while on the breast), got a pump for me and pushed us to do ALL the feedings for the week our baby was in the NICU. The nurses and doctors often told us to take it easy, rest and not worry about pumping or the bottle but the midwives advice paid off and we didn’t have trouble feeding.
Your point that sometimes being educated about breastfeeding is a salient one. I knew everything there was to know, just when a medical professional tells you your baby HAS to have formula because his blood sugar is dangerously low and you don’t want him to end up in NICU, do you?, even those of us with the strongest resolve will give in. This is why it’s very important to find out how breastfeeding friendly your hospital and OB are before you go to give birth. Also, have a support person with you who can question your doctor’s advice, because you may not be up to it after the birth.
You’re so fabulously dedicated! Most people (read: I) would have given up under those circumstances. Kudos for sticking with it and for the fact that it PAID OFF!
This post has some wonderful advice – and some definite inspiration.
My oldest daughter went straight to the NICU after birth and was there for a day and a half. when I first went to see her, they didn’t want me to try and nurse her, since her oxygen sats were a bit low. I didn’t know the first thing about how to latch on a baby (and not to mention that I was reeling from a difficult birth/c-sec), so I just held her but didn’t try and nurse. By the time we did try–about 12 hours later–she was having none of it. I was fortunate enough to have enormous help and support and was able to turn things around, but I still wonder if I had tried to latch her on right after birth if things would have gone differently….
Thanks everyone. It sounds like it’s a too-common experience to have a bad start breastfeeding and insufficient support from doctors and nurses.
Melodie: “a vulnerable time for women”…. so true. Some of these details in my postpartum experience are embarrassing to me, and so many times I’ve wished I could go back in time with the strength and conviction that were lost after all those hours of laboring and pushing.
Elita: thanks for the point about a support person. I bet if my doula had been able to stay longer, she would have spoken out against the bottles (she was upset when she visited the next day and found out) and she would have made me start expressing milk. Husbands/partners are wonderful for support, but mine wasn’t comfortable questioning the doctor, or telling me what to do. From his perspective, I was supposed to know what I was doing regarding breastfeeding and he trusted me to make the right choices.
VULNERABLE. Yes. That word also jumped out at me when reading the comments and rang SO true.
I need to do more research before the next baby about some of the things you guys are talking about- low blood sugar, NG tube, etc, just in case.
Great post. My youngest was born at what we thought was 38 weeks but she acted more like a 36 weeker. She hardly nursed AT ALL the 4 days we were in the hospital. I had successfully nursed my first for 10 months so I knew what I was doing. The LC at my hospital told me that she would get me a nipple sheild but that she really didn’t think that it would help. We used the nipple shield for 21 days and on the 22nd day of life she wouldn’t nurse with it. Something clicked and she got it. We continued to nurse for 16 months.