Wednesday, August 30, 2006


Tandem feeding works well for us, though it's difficult to position both of them to feed together on my actual lap; in bed, Toddler snuggles up beside me and I hold Baby, and in an armchair Toddler stands on the floor and I hold Baby, but Toddler would like to be on my lap.

Engorgement, however, is much easier to deal with with a toddler. I'm leaking far less this time around. It's wonderful.

(I am starving to death. I can't eat enough.)

Breastfeeding "help" in hospital

The first was when I asked a woman in staff clothes - I think she was a Maternity Assistant, not a nurse or a midwife - to help me by giving me a cushion to keep the baby off my wound, and hand me the baby. She wanted me to try the "rugby hold", and I said "It never worked with my other daughter." She argued with me, saying that feeding the baby held in front of me wouldn't work and would cause pain to the wound. When it became clear I was going to try it my way, she walked away. Had I needed further assistance, I would have had to buzz again - as it was I had to position the cushion with one hand while holding the baby with the other, less than twelve hours after abdominal surgery. The good news is that the cushion supported my arm, which supported the baby, and we had a comfortable feed.

The next I don't really remember, but feeding lying down a Staff Nurse reached out and touched my breast to help position it. I don't remember whether I said anything, or what she was trying to do.

After that, my mother and I heard the woman in the bed next to mine having a long argument with a midwife because she and her baby had been just about discharged, gone to change the baby's nappy before leaving, and found crystals in it. This can be a sign of dehydration so they were asked to wait to see a paediatrician before leaving. There was a delay of more than six hours to see the paediatrician, during which time the woman was given no help at all with latching, positioning, determining whether the baby was sucking effectively (you can often tell by looking). She wasn't told that there was a breastfeeding clinic downstairs she could drop in to without an appointment. She wasn't offered a meeting with a lactation consultant. She was just told that the baby could be dehydrated, that this was "because feeding wasn't going well," and that she "had to" wait to see a paediatrician before she could go home. (Eventually, her mother, who is a doctor, came in and got them released somehow, after both parents and the grandmother spoke to the paediatrician - luckily the paediatrician spoke German, because the baby's mother was German and though her English was excellent she was too upset to have to cope with new-baby-panic in a second language. The grandmother's English wasn't as good as the mother's, either).

Later that evening the Staff Nurse dropped by my bed to ask how things were going and I said "Fine," and she asked how feeding was going and I said "Great, she's been on most of the day, really," and I was in the process of latching her on again as I said that. The Staff Nurse reached out and sort of squeezed my breast above the nipple to try to push more if it into Baby's mouth. I said "Please don't," and she explained that she was trying to make sure the latch was ok. I assured her it was fine. She said it couldn't be because the baby shouldn't be hungry enough to suck all day, the colostrum should be enough, and if she was sucking all day it was because the latch was bad. I ended up repeating over and over that I thought the baby just liked to suck. She'd only been born that morning, after all - and that was early. (Latch fine, baby fine, c-section babies are often very clingy and needy the first day because it's a very sudden way to come into the world).

At some point that night someone told me I shouldn't feed her when she started mouthing, I should wait until she "really wanted it" so that she'd "have a really good feed". Er, yeah. Ever tried to latch on a really, really hungry and frustrated newborn? No joke.

And the final straw was at about 1 am. Around 8 pm Baby was declared a bit cold, and they put her on a heat pad under a plastic dome in the bedside bassinet (a whole nother post about the skin to skin thing follows, I promise). At 11 pm I couldn't bear it any more and I buzzed for someone. A midwife arrived, told me to turn on the light - I had no idea how and it took a while to get her to tell me how, turns out there's a button on the buzz-for-a-nurse thing - and asked me impatiently, in a daytime voice, what I wanted. I said "I want to touch my baby." She said:

"What for?"

I said "Because she's my baby," and we had a little argument. She insisted that the baby should not be disturbed, I said I didn't want to disturb her, just touch her, she said that I ought to leave the baby alone and rest... it went on and on. Eventually I said "But how can I rest if I can't touch my baby?" and she gave in. She did a full check of blood pressure, temperature, and pulse, and then tucked Baby in beside me for skin to skin, and I fed her. The midwife asked if I'd fed my other daughter and I said "I still do," and immediately her attitude changed: now I was a Good Mother, a Good Patient, and she was going to be nice to me. She even said she'd make sure I was checked a couple of hours early to get the catheter out before breakfast time.

And a while later the woman in the bed opposite buzzed for her, for help breastfeeding. I don't remember the whole conversation, but the gist of it was that the woman had had trouble feeding earlier in the day and asked for and been given a bottle of formula. The night midwife harangued her about it - strongly implying that she was stupid, repeating and repeating that she was sure to fail if she had given a bottle, that bottles are very harmful to breastfeeding, that she needed to never give a bottle, that she shouldn't have given the bottle... she didn't stop until the woman was crying. And nowhere in the "conversation" did I hear helpful advice, or a question about what precise problem the mother had with feeding, or anything useful or supportive like that.

I was furious, but far too ill and tired to buzz for the midwife to tell her what I thought of her. I wanted to. I almost shouted across the bloody room, but I was too ill for a confrontation at 1 am - I was too ill to hear other people's confrontations, for heavens' sake. And I was sick of being given breastfeeding advice by unqualified people myself, so dishing it out wasn't really a good idea.

Next day I moved to a private room, and we found out that there's a patient-midwives meetings scheme thing to improve midwifery services. I intend to get involved. Hooboy do I intend to get involved.

Tuesday, August 29, 2006

No pain, no gain!

I never had a letdown pain with the new baby. I think it's because letdown pains are caused by the unused milk ducts dilating, like pins and needles are caused by blood returning to parts of the body you've been leaning on.

This baby's latch corrected the lipstick nipple I had from Toddler's poor latch mid-pregnancy when my supply vanished.

There are two places hereabouts where I will soon be in a position to help improve breastfeeding services. First, the midwifery department at the local hospital has invited mothers to provide constructive criticism at a series of meetings; I have emailed the head of midwifery to express interest.

Second, the health visitors, in association with The Breastfeeding Network, are starting a breastfeeding support group / antenatal class. The idea is to let pregnant women and new mothers meet experienced breastfeeders - just ordinary mothers - so that they can see a feed in progress, chat about what breastfeeding is really like, etc. Both are good fora for me to warn women about the anti-breastfeeding attitude in hospitals (breastfeeding "help" in hospital is often actually damaging to the breastfeeding relationship, and even more often murder to a mother's confidence).

Starting to tandem nurse

It started while I was in hospital recovering from my c-section; a Staff Nurse asked me if I'd breastfed my other daughter, and I said "I still do." She was amazed. She asked whether that meant my new baby would be deprived of colostrum. I explained carefully that when pregnant, the new baby took hormonal priority, and the poor toddler had had to make do with dribbles of colostrum for months. So the Staff Nurse grabbed my boob and tried to "improve my latch." Meh.

My toddler came in to see me that afternoon, fewer than six hours after the operation, and I wasn't well enough to feed her, which she seemed not to mind, but it made me sad. Apparently she asked for me that night, too. But the following day she came in and I was able to feed her with her new baby sister; Toddler was propped up beside me on pillows, to keep her off the section wound, and Baby was resting on my arm across my front, while my arm was resting on a pillow, to keep it off the wound. Toddler watched Baby intently and found it fascinating; at one point she even reached an arm over and cuddled her. We took plenty of photos.

After that, we nursed in hospital several times. It was easy, with a limitless supply of pillows, a very firm mattress so that no-one accidentally sagged onto anyone else, and no distractions. It was also invaluable in terms of keeping me in touch with Toddler while we were seperated for the longest times we'd ever been so. I think that hurt me more than her. Her security and self-confidence far outweigh mine.