As a young Mum in 1988, I struggled with breastfeeding. I’d decided I would feed for at least six months but the time seemed interminable and I nearly gave up. I was recovering from a long, difficult birth and could hardly sit or walk, I had red raw nipples and blocked ducts leading to mastitis. I was confused by the conflicting advise and couldn’t believe how challenging I was finding it. Speaking to a new Mum recently it was disheartening to learn that her story, 36 years on, differs hardly at all!
This blog features a guest ‘tale’ by writer and recent first-time mother, Tayana Simons.
Before having my son in June this year, I hadn’t thought much about breastfeeding. I knew I wanted to exclusively breastfeed and I naively assumed that it would be ‘natural’ and instinctive. I never imagined it would be something I’d have to learn how to do. I’d heard that some mothers experience difficulties but after watching one or two videos, I was confident that I had it in hand. How wrong I was.
After nine weeks of incredibly sore nipples, referrals, consultant appointments, support sessions, relentless pumping sessions and constant dread about the next feed, my son finally got his tongue tie cut (on the third referral after being told twice he didn’t have one!). Two weeks later and I was experiencing the easy, relaxed feeding that I’d never thought would be possible.
Was it just linked to the tongue tie or also related to him getting bigger and being able to latch easier? I shall never know, but the amount of confusing and often contradictory advice I have been given on my breastfeeding journey so far has made me realise that something needs to change.
Shockingly, the UK has one of the worst breastfeeding rates in the world. Despite the NHS and the World Health Organization (WHO) advising that babies are breastfed for two years and beyond, only 0.5% of mothers are still breastfeeding when their baby turns one. The saddest part is that a survey found that 8 out of ten women stop before they want to.
So why do we have such low breastfeeding rates and why do so many women find it so difficult?
From what I’ve learned, I believe it comes down to the following three things:
In the past (and still in many cultures in the world), women would have been exposed to breastfeeding mothers most of their lives by watching their relatives and others in their community.In the UK, most women have not been exposed to breastfeeding regularly. I can’t honestly say that I’ve ever watched a woman breastfeed a baby. Many women feel a societal pressure to ‘cover up’ when they feed their child, and we feel that we must look away to protect their modesty. For most of us this means we’ve never seen the up-close mechanics of how babies attach to the nipple, or spoken about it with a breastfeeding mother.
When seeking help and advice with feeding issues, I received confusing, and sometimes conflicting, advice from various health professionals. This left me very confused and not sure what to believe.For examples, I was told that my son didn’t have a tongue tie, then I was told he might but “it wasn’t severe enough to cut”, then finally I was told he did and it was more severe than had been previously assessed. When I was struggling to feed in those initial weeks and my baby was losing weight, I was put on a feeding plan and told to give him formula until my nipples recovered. Much of the information I consumed lead me to believe that giving formula would be the end of my breastfeeding journey, as it would impact on my milk supply. This was not the reality and only made me feel anxious and guilty at a time when I had no other option. I was told to wake my newborn baby every three hours to feed regardless of when he’d finished his last feed - guidance like this seemed less than instinctive.
The most critical time when it comes to breastfeeding is right at the beginning when you're establishing your supply. This is also the time that you're left with very little support. Aside from having my latch ‘assessed’ in hospital, when exhausted and overwhelmed after three days of sleep deprivation, I didn't have any visit post-birth visits from midwives. Instead to access support, I had to drive 45 minutes to visit the infant feeding team just days after birth, barely able to walk with a very painful birth injury. By that point my nipples were so sore I couldn't demonstrate a feed and they were unable to help with breastfeeding until I could. I’ve been told that previous generations would be visited by their midwives every day in the first week or so after giving birth. They would be repeatedly supported with breastfeeding in the comfort of their own home at the most critical time. Other cultures around the world are supported by members of their family and/or community within the first 40 days postpartum.
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One of the things that I was told by multiple midwives and infant feeding resources is that ‘if it’s not comfortable then it’s not right’. This is all very well except 80% of other new mothers that I’ve spoken to about breastfeeding, DID experience discomfort or even pain in the early days and weeks of feeding their babies. And all of them went on to comfortably breastfeed. Your nipples are not used to being sucked/chomped on 12+ times a day by a hard-gummed, ravenous baby. It takes some adjustment. Add to that sleep deprivation and recovering from birth and for many of us it’s not surprising that breastfeeding isn’t the blissed-out, instinctive bonding experience we were lead to believe at first.
Before becoming pregnant, I had assumed that breastfeeding is something that just happened naturally and instinctively. You point your newborn baby towards your nipple and they instantly know how to latch. This is the picture I’d been painted. However, studies have shown that breastfeeding in primates is actually a learned skill, not something mothers instinctively know how to do.
According to the psychologist Volk A.A (2009) in Journal of Social, Evolutionary, and Cultural Psychology;
“For most mammals, nursing is a relatively straight-forward process that is largely automatic. Primates however generally require learning to be able to successfully nurse their offspring. Humans are no exception, and in fact, appear to require more learning than most mammals due to the novel sucking technique employed by human infants. Social support is also a crucial factor for breastfeeding success.”
Just like the chimps, humans learn breastfeeding by observing and by being helped by older, more experienced matriarchs in their community. This goes some way to explaining why breastfeeding rates are so much higher in countries that have stronger communities/where people live in larger family units.
My son’s tongue tie was ‘assessed’ three times before it was deemed necessary to cut. When we finally got referred to the hospital feeding team, the feeding specialist at the hospital advised me that it was ‘6’ - more significant than previously thought. We have now learned that most midwives aren't qualified to diagnose tongue tie, especially if it is ‘posterior’, as it is not necessarily visible from a visual examination.
When he eventually got the tongue tie cut, after months of painful feeding, the pain went away within a week. However I feel deeply let down and disappointed that instead of referring us to someone qualified to make the diagnosis, several midwives told us that tongue tie wasn't the problem. This added six weeks of unnecessarily painful feeding and stress and could well have ended my breastfeeding journey if I hadn’t persevered.
When the midwives put me on a feeding plan in the week after giving birth, I thought my breastfeeding journey was over. Everything I read online about breastfeeding advised me to keep feeding through the pain so as not to disrupt my milk supply. I couldn't pump either as my milk hadnt come in yet, so I thought my breastfeeding journey was over before it had even begun.
The truth is, giving my baby formula for five days was exactly what we needed to do to give my nipples a chance to recover, and to make sure he could get back to his birth weight. Ultimately it made no difference to my milk supply and we've been breastfeeding successfully ever since.
One of my biggest worries in the early weeks was that I wasn't producing enough milk to feed my baby. Every evening he would feed almost continuously and get frustrated, banging his hands against my breasts and pulling off and crying. At first this led us to top up with a formula feed overnight and then as I got more comfortable with pumping we replaced it with a bottle of breast milk pumped in the morning.
What I now know is that this is cluster feeding and is perfectly normal. A midwife described it as baby ‘putting in their order for the next day’. Even though my breasts felt empty and unable to give him what he needed, he was getting enough. As long as your baby is putting on weight, and producing enough wet and dirty nappies, then they are getting enough milk from you, despite how it may feel in those early cluster feeding weeks.
I went to a local feeding group several times in the initial weeks of challenging feeding. It was actually the woman who led my local group who ended up getting me the referral to the hospital infant feeding team which led to the tongue tie being cut. Aside from suggesting practical solutions on positioning and giving guidance on referrals etc, I found that it was an easy low pressure option for emotional support around feeding and meeting other mums having similar issues.
I joined a local Facebook support group which I have found helpful. Mothers will post questions about issues they are having and other people can post their own experiences and advice in response. Other mothers are often having similar issues and concerns, so you can glean a lot of useful information from these groups.
If you’re experiencing persistent discomfort or issues with feeding then ask your midwife or your local breastfeeding support group to refer you to the local infant feeding team. They are experts in assessing and helping with feeding issues.
Websites such as La Leche League and The Breastfeeding Network have lots of very helpful resources for every stage of your breastfeeding journey.
Did you breastfeed? Is there anything you wish you’d known to make your journey better?
