Before having my baby, I attended an NCT breastfeeding course where we were told three key things about breastfeeding. That it is (1) possible for everyone (2) free and (3) convenient. However for me, it was none of these.
Instead, what the NCT should have said is that breastfeeding should be possible, free and convenient for some of us. While some others may find it challenging, expensive, and difficult. And if that’s you, here’s what you need to know…
Crucially, that last step was missing from their program and consequently left me rather unprepared for what was to come. It’s not that I relied 100% on the course, but that I mistakenly thought it had covered all there was to know on the subject.
When breastfeeding is possible, free and convenient, it’s amazing, there’s no question about that. However, this post is about when breastfeeding doesn’t go to plan, which, I believe, is more common than some people think.
When breastfeeding isn’t a choice
There are many different reasons why breastfeeding may not work or even be possible. From physical difficulties such as baby’s latch or mother’s milk supply; to social difficulties, such as a lack of breastfeeding support or inflexible work demands; to psychological difficulties, for many women breastfeeding may not be a matter of choice.
While there may be solutions for some of these challenges, they might not always work or be available to every mother. Therefore, assuming that all women can breastfeed is really unfair to those that, for whatever reason, cannot. For these women, breastfeeding may be a personal, sensitive, and even painful topic to discuss.
In my NCT group, I was not alone in my struggles to nurse, while those that could still suffered tremendous difficulties. Ultimately, it wasn’t easy for any of us. In my case, I managed to supply my baby with breastmilk for 8 weeks through pumping. While for another mother, she went straight to formula for reasons of her own. Each of us doing the best we could.
Breastmilk is free, breastfeeding less so
“Breastfeeding is free, my husband likes to say, the way kids are free: it doesn’t cost anything to conceive a child, but rearing one is a major investment. And although a woman’s body can produce breast milk for free, feeding a child that milk for months comes with a lot of associated costs.” – Kaitlin Bell Barnett in The Guardian
For breastfeeding to be totally free it requires two things: (1) for the mother to be with her baby at all times; and (2) To nurse baby directly and successfully from the breast. However, as mentioned previously, not all women are able to nurse directly, while many women go back to work shortly after birth.
In these cases, there is an entire billion-dollar market of products aimed at helping women supply their baby with breastmilk:
- For painful nipples or difficulties with latching, there are nipple creams, breast shields and shells.
- For when mother can’t be with baby, there is a whole range of breast pumps, manual, electric, single, double… to help extract mother’s milk.
- And for when she needs help with it all, there are lactation consultations and breastfeeding support drop-ins.
- …and none of it is free.
I spent nearly £1000 in my 8 weeks of breastfeeding, the equivalent of at least a year’s supply of infant formula. Since my baby couldn’t latch, I bought different brands of breast shields to try make it work, and paid the £115 per visit fee for a lactation consultant to come and help. When nursing still wasn’t possible, I bought a hospital-grade double breast pump (Spectra S1) for £150 to pump milk for my baby, and a pump bra to keep it in place hands-free.
However, I wasn’t comfortable hauling the bulky thing out and about with me, so I invested in an Elvie wearable single pump for £249 to pump on the go. Since I got a single, I also bought some breast shells £12 to collect the milk from the other breast. But when the Elvie gave me nipple blisters, I thought I’d try the widely acclaimed Haakaa manual pump £14, which unfortunately didn’t work at all for me.
In addition to these products, I also got mastitis twice, and badly, requiring me to fork out a few more £100s on a private breast surgeon and ultrasound scan. (I was this close to a breast abscess.) For the mastitis, I also bought the Lansinoh cold/hot breast compress £10 and sunflower lecithin £15 to ease my plugged ducts. (Not to mention the reusable and disposable pads for leaks and awkward nursing clothes for boob access.)
Bottom line, not free.
Why breastfeeding might not be so convenient
When breastfeeding is relatively problem-free, it is very convenient, more convenient than pumping or preparing bottles. But when something happens, it can quickly feel like the least convenient thing in the world. From nipple cracks and blisters to tongue-tie, over or under supply, mastitis and going back to work, no-one can predict the challenges they may face.
Even the NCT’s argument that breastfeeding is more convenient because the milk is always there in your breast is only true for those women with ample milk supply! Especially in the early weeks, many women combi-feed, which means supplementing breastmilk with formula, until their supply is better established.
However, cleaning bottles is nothing compared to the inconvenience of exclusively pumping. This is probably the most exhausting and inconvenient method of breastfeeding. It requires mothers to pump for around 20 minutes every 2-3 hours round the clock for the first 12 weeks before supply regulates.
Yet, regardless of whether you pump or nurse, no breastfeeding mother is immune from the extremely common, yet somehow rarely talked about, ridiculously inconvenient breastfeeding “side-effect” that goes by the name mastitis.
In a nutshell, mastitis is a horrendously painful inflammation and infection of the milk ducts. Key signs are hard and lumpy breasts, pain, redness, nipple discharge and a fever of 39 and over. But the worst thing about mastitis is that it often happens early on, when you’re a new mum and your baby needs you.
How to treat mastitis: Frequent and constant massaging of the breasts; hand express to relieve engorgement; hot compress before feeding/expressing and cold compress after; lecithin supplements; antibiotics if fever over 39; and lots of water and rest.
Unfortunately, there is no straightforward way to avoid it, since it usually happens through the unavoidable. For example, missing a pump, going back to work, or just being too busy and sleep-deprived to realise it coming on. However, the key to keeping mastitis at bay is to keep a soft breast at all times through nursing, expressing and massaging frequently.
Why I Decided to Stop Breastfeeding
My breastfeeding journey lasted 8 weeks, brought to an end as it became too difficult, expensive, and painful to continue. As you can imagine, this was a major disappointment for me. The NCT had said it was possible for everyone, so why not me? I felt like a failure, and so I did everything I could to give my baby my milk for as long as I could, until I couldn’t.
The first time I got mastitis, I was too weak to even hold up a glass of water. My body was either burning up or freezing cold. I was exhausted, in pain, and couldn’t take care of my baby boy. It was the worst feeling in the world. So when I got it the second time, I was more equipped to deal with it, but also couldn’t risk it happening a third. Mastitis took its toll not only on me but also on my husband, who had to take care of us both and still go to work.
The lactation consultant I saw told me to keep going. She told me to keep to the incredibly demanding, exhausting pump-feed-change 2-hour cycle. She also said that as long as I get a cumulation of 4 hours sleep each day, I should take comfort in the fact that only less than that is considered dangerous sleep deprivation. Oh great! Then I assume binge drinking just under the level of alcohol poisoning is also ok?
And that is the difference between a sister and a health worker. My sister took one look at me, broken, exhausted, chained to my pump, and asked me what it would take to stop. I didn’t know. My sister wanted better for me than a life on the cusp of extreme sleep deprivation. She gave me a hug and told me that it was all ok. Ok to stop, Ok to give my baby formula. Ok to get some sleep and take care of myself so that I could be the mother my baby deserves.
The thing about pumping is that it’s not the same for your body as nursing. In fact, one of the best cures for mastitis is direct nursing, while one of the worst things is pumping; because it’s impossible to replicate that supply and demand balance between baby and breast.
So as I followed the advice for pumping with mastitis I developed another problem, milk oversupply. In order to keep my breasts empty to avoid plugged ducts, I had to pump more and more milk. But as the quantity increased, the quality became more and more imbalanced.
My baby had all the signs and symptoms of an imbalanced diet high in sugary foremilk and low in fatty hindmilk that happens with oversupply. Yet the medical and professional advice remained unchanged: continue breastfeeding until at least 6 months.
As a first-time mum, it took me a while to realise the problem. I only suspected and started reading about oversupply around week 7, when it suddenly clicked and finally everything made sense.
Against the advice of breastfeeding and lactation consultants, I followed my mothers intuition and introduced formula into my baby’s diet and the transformation was immediate. My baby used to really struggle with his digestion, as many babies do, making grunting noises and scrunching up his face in discomfort as he tried to poo. For 8 weeks, he also suffered from runny poos and a constant leaky bum.
However, once we introduced formula, he ceased grunting, his poos became pasty and he started emptying his bowels with a smile on his face! After seeing the change in my baby and how much better his system coped with formula compared to my milk, the decision to stop became a lot easier. All that remained was the ‘small matter’ of how.
The lactation consultant I paid to help me, pretty much refused to give me advice on how to stop. So I had to rely on my own research with no professional guidance. I had no idea how long it would take, or which measures would be most successful. So I tried them all, and one week later to my surprise, my milk dried up.
Breastmilk vs Formula
The formula vs breastmilk debate is full of controversies and sensitivities. They even have two opposing slogans: Breast is Best vs Fed is Best. But the truth of the matter is that Doing Your Best is Best, whatever that is.
The WHO recommend breastfeeding until at least 6 months, while the incredible scientific benefits of this “liquid gold” are well documented. So what kind of mother, one might ask, ‘chooses’ to give her baby formula instead of her “magic milk” before 6 months?
99% of mothers in the UK.
According to the last 2010 Unicef infant-feeding survey, less than 1% of mothers were still breastfeeding at 6 months, and just 55% at 6 weeks, of which only 24% breastfeeding exclusively.
The NCT tried to argue that these statistics are a result of advertising pressure from big formula companies, a large percentage of working mothers, and a widespread lack of breastfeeding support.
But honestly, I found the social pressure to breastfeed (exacerbated by the almost daily question, are you breastfeeding?) much stronger than anything influencing me towards formula.
While those stats might be surprising, I think they say two very important things:
(1) Breastfeeding isn’t easy. It’s hard work and takes real commitment. For some it may not even be possible, while for others it may too expensive or difficult to continue for long.
(2) No matter how long you breastfeed for, if indeed you do at all, you’re a star! Please, drop the mum guilt for a second and don’t be so hard on yourself! You created a human, and I don’t doubt that you’re doing your very best to feed your baby human. So forget about what the WHO or anyone else tells you, because nobody knows what’s best for your baby better than you.