Sunday 27 November 2016

The bittersweet decision to cease breastfeeding

I always knew I wanted to breastfeed when I had children and my stubborn desire to do so was the only way I was successful. Breastfeeding with my son had a very difficult start, as I've mentioned in a previous post, and I could easily have switched to formula if it hadn't been for my excessive determination. My success at breastfeeding has been such a positive in what has been a difficult year, heightened when a health visitor (who has the role of breastfeeding specialist),  told her trainees just how impressed she was with me, that it was an extraordinary feat for me to be exclusively breastfeeding after the complications I experienced during the birth.
So the fact that I have breastfed my son for over a year, is something I am immensely proud of.

I am one of the least judgemental people, I do not intend on telling anyone what they should or should not do in any area of their own lives.  I believe every mother can make their own decisions in whether or not they choose to breastfeed, it is a very personal choice that should suit each individual mother. My initial and ongoing experience of breastfeeding was, at times, incredibly stressful and I could go as far as to say a contribution to my postnatal depression, it was definitely a factor involved in my sleepless nights and it was the reason I could not go out socially in the evenings for a very long time.

So if I start from the beginning. My first attempt at nursing my son was when he was literally minutes old. The health professionals had delivered my baby, stitched me up and dealt with the first massive haemorrhage I had. After all that drama they left the room and let us have our first experience as a family of 3 and I decided to take an inexperienced shot at nursing. I had not a clue what I was doing and just placed my son near my boob and hoped he would figure it out. To my amazement he did! I had no way of knowing whether he was getting anything but he seemed to be doing the right action. It was during this feed though that I felt a pressure, not dissimilar to the pressure I had experienced during labour. It was another haemorrhage, enough to take me over the edge, a significant loss of blood that I would require blood transfusions and to drop my blood pressure so low I was on flat bed rest for over 24 hours having my observations taken every 15 minutes.

In hospital I got absolutely no guidance with breastfeeding,  I had no idea if my son was getting the good stuff or not. I was not told in hospital that my experience would be affecting my milk supply. Being on the high dependency unit their focus was me not my newborn. They were even encouraging me to allow them to top him up with formula so I could get some much needed rest. I refused.

A few days at home and I was getting upset because my son was asking to feed ALL the time day and night, he was very frustrated and I was feeling very sore. I very nearly caved, holding a bottle of prepared formula, but I did not give it to him. The Midwives at my 10 day check felt his feeding was excessive and suggested some expert advice. We  went to the breastfeeding clinic and spent 1 hour being hysterical. They were doing their best to help, trying to teach me how to get him to latch properly, explaining he was not feeding because he was not taking long enough sucks but lots of little ones.  On reflection this is probably because I wasn't producing enough for him (which is actually very unusual and something mothers believe is happening when it is not). However shortly after that my milk supply did come in and nursing began to work well.

I gained so much confidence, I picked subtle tops and nursed in public regularly. I only ever had one negative experience in public and even then it was only a look and not a nasty comment. My son, after an initial drop in weight, has gained weight really well. He started on the 75th centile, dropped to the 50th and then gradually worked his way up to the 91st centile!! The health visitors are happy with him.
My son took to breastfeeding so well that he refused milk in any other way. For months and months we tried to get him to take expressed milk and even formula from almost every brand of bottle in existence. We never really succeeded. I missed out on many social events including a friends wedding for this reason. I never got any me time.

Night time and a serious sleep deprivation, regular night feeds, my partner not being able to help with this, and comfort feeding (it took me a fair while to realise the difference). Breastfeeding was one of several factors that led to a "bad sleeper".

Then there was the agony of mastitis. A blocked milk duct. My first experience of this was over the Christmas period. Red, hot, solid, tearfully painful boob, high temperatures and feeling rough, just what I wanted at Christmas time when the GP surgeries are closed. Nursing on that boob (which is encouraged) was excruciating and eventually I had to get an out of hours appointment on a bank holiday, down at the hospital for antibiotics. Fortunately I never got it like that again,  I recognised the signs early, and on 2 future occasions self managed the problem.

When I was diagnosed with PND, I was prescribed antidepressants. This, I was told, had a risk of side effects to my son due to being breastfed. My GP encouraged me to stop breastfeeding. I refused to stop and so I refused to take them initially due to the risks to my little boy. Once my son was feeding less frequently I started on a very small dose but continued to refuse to up my dose as prescribed. My GP clearly felt I needed to up my dose for my recovery but breastfeeding meant that morally I couldn't,  I was putting my son first.

Much of what I have written seems negative and not great for selling the benefits of breastfeeding, plus I have already suggested that my choice contributed to my post natal depression so why did I continue feeding for over a year? Because I LOVED breastfeeding! Despite all the significant hurdles we had to get over, I would not go back and change my decision.  Stopping breastfeeding would have been more of a contributory factor in my PND than continuing. During a year that I was feeling like a failing mother, my success at breastfeeding my son was something I was most proud of. Many mothers with PND report a lack of bond with their baby, this was far from how I felt, breastfeeding gave us the most amazing bond, I loved our closeness,  I loved knowing I was giving him a great start in life in terms of nutrition, immunity and all the other many benefits of nursing. My health visitor confirmed my suspicions and reluctance to stop by citing research that showed depression worsens in those women who cease nursing before they feel ready.
Before I had my son I decided I wanted to aim to breastfeed for 6 months, 1 year later and I now feel ready to switch my son onto cows milk. I knew with my son that this would be challenging based on our bottle experience but we have slowly been introducing cows milk since 10 months under the guidance of my health visitor to ease the transition once I chose to make it. Today is the 4th day that I have not breastfed. It is a bittersweet feeling. I already miss it, especially our bedtime routine and actually having boobs. But I was ready, my decision has not affected my mood, I was able to attend my best friends 30th birthday night out and now I can up my antidepressant medication to the dosage my GP has recommended without any worries that they will affect my son. I can take the next step in my recovery.

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