In this final part of my Survival Series I discuss my thoughts and advice on surviving the first 8 weeks of breastfeeding. I started the series with my tips for new mums surviving life with a newborn, then shared some baby behaviours that you can expect in those first 8 weeks. Now I am writing this at 15 weeks postpartum, I can recall just how tough those first 8 weeks really were and I hope that by sharing my story, along with some survival tips, it can help other new mums to know they are not alone and that there is light at the end of the tunnel!
Breastfeeding is a BIG DEAL…until it isn’t
In my final trimester with Rowan, whenever anyone asked if I would be breastfeeding my go-to answer was that I would try. I was acutely aware of the constant juxtaposition on the topic of breastfeeding: there is a strong expectation that women breastfeed their baby, but there is an understanding that not every woman, or baby, can or wants to do it. So in my head I knew I wanted to try, but I also knew there was a chance that, for some reason I, or my baby, may struggle and not be able to carry on.
My main motivations for wanting to try breastfeeding were:
- It is free
- It is convenient
- It provides bonding opportunities with your new baby as well as all their nutritional and immune system needs
My main fears were:
- The pain and stress it can cause
- Conditions such as mastitis and blocked ducts
- That the amount or quality of what I was producing wouldn’t be good enough
But my journey into breastfeeding started even before my son was born, with something I had no idea I would be doing but I am glad I did: hand expressing colostrum.
Hand expressing colostrum
I started hand expressing in my third trimester. Due to a diagnosis of gestational diabetes, I was advised by midwives to collect colostrum after 37 weeks gestation (expressing can cause cramping and contractions so you don’t want to risk getting those while the baby is still considered pre-term). The reason behind this advice was that, should my baby have low blood sugar when he is born, and I am unable to feed him straight away for whatever reason, there is a store of that precious colostrum on hand to give to him to help stabilise his glucose levels.
So I dutifully learnt how to hand express and produced a zip-lock bag full of 3ml syringes with varying amounts of colostrum in each (when I presented this to the midwife on arrival at the hospital, she was amazed at how much I had collected!). I was glad that I went through this process as it helped me to ‘get to know’ my boobs and what they were capable of; and, though squeezing your own boob is a very different sensation to having a baby suck on it, I learnt how much ‘force’ it took to get just a few drops out, but that over time and with practice, it got easier. It was one of my first realisations of just how amazing our bodies are, and I was hopeful that I would make a success of breastfeeding my baby.
The first five days
From my personal experience it took five days for that initial ‘toe-curling’ pain to ease away. It was an intense few days which, when I look back, was mercifully short, but during that time it felt like forever!
In the hospital
The first time I breastfed was about an hour after my cesarean when I was all stitched up and back in my room. The midwife wasted no time in getting Rowan onto my breast and he took to it straight away. Thanks to the surgery, I was still numb from the chest down so I didn’t feel a thing – which was great! But of course that meant I also couldn’t move so for the rest of the night the midwife would come in regularly and take him from his cot to my boobs and back again.
After this first night the midwife told me Rowan had the best latch for a newborn she’d ever seen, and he became known on the ward as being a ‘good feeder’. I was proud, if a little clueless since I had nothing to compare him to! But despite Rowan getting that ‘perfect latch’ straight away, once the anesthesia had worn off, I felt the full force of the pain of starting to breastfeed.
The next night in the hospital was miserable. Whenever Rowan started crying I would pick him up (with great difficulty given the pain and weakness in my abdomen) and feed him. He basically would not be put down so I ended up spending the whole night trying to feed him despite it being agony. The other women on the ward were also struggling and took up a lot of the midwives’ attention so I (foolishly) decided not to ask for help until about 3am when I, and Rowan, were at the end of our collective tether. The midwife, who was the same one who had looked after me and Rowan the night before, said something I found very reassuring:
The advice always says breastfeeding is not meant to hurt if you’re doing it right – but that’s rubbish. You’ve got something with an extremely powerful suck on your nipples for hours and hours a day and, guess what, it’s going to hurt! But there will come a moment when your body adapts and suddenly the pain is less and, eventually, goes completely.
And she was right. How can it not be painful the first time you go through something like that!? So although I was left not knowing when I might get that relief, at least I was reassured that there’s nothing wrong with that pain and that it will go away.
When the baby first latches on they suck very hard to get the milk to flow and I’ve seen this initial moment of pain described as ‘toe curling’ – well it’s just about body curling! I would often have to breathe hard through these first few seconds like I did with contractions. After the milk is flowing the baby sucks a little less hard so there is some relief – again, like when a contraction ebbs away. A good latch is when the baby has a wide open mouth with their head slightly tilted back and you can only see the edge of your areola. If your baby’s latch is not quite right, i.e. they don’t have enough breast tissue in their mouth so your nipple is taking the full force of the sucks, that can be one of the most painful sensations and your knee-jerk reaction is to pull away. But my goodness is that suck strong! So the most painful sensation is when they’re still sucking and you’re trying to pull them away and your nipple gets stretched longer than you thought it possible for a nipple to stretch!! That’s why it’s called a ‘latch’, because once they’ve latched on to your breast there’s almost nothing getting them off again!
So one tip when trying to readjust your baby’s latch during a feeding is to bend your little finger and work this into the side of the baby’s mouth to break that almighty grip. It takes a bit of (painful) trial and error but it is much better than just pulling away! And the good news is that, as your baby gets more experienced and your milk starts to flow better, that initial suck becomes much less intense and your toes can begin to uncurl!
When your milk comes in
My milk came in on the third night after Rowan was born. I had read about this moment as being potentially painful as your breasts suddenly expand with milk and become engorged. Sure enough, I went to bed with my breasts feeling not much bigger than before giving birth and woke up with what seemed like an increase by at least two cup sizes! They felt hot and swollen and when one was being used for feeding the other would join in and start leaking! When they got particularly big I sometimes thought Rowan’s little mouth wouldn’t be able to get a good latch! In a strange way, though, suddenly the pain of the latch was made somewhat more bearable by the relieving sensation of the milk let down and the breast emptying.
When coping with the pain of engorged breasts you can use either ice packs to help cool them down or, as I found more relieving, a hot water bottle. I found the warmth alleviated the pain more and I used a mini hot water bottle tucked under my arm to hold onto for warmth and comfort. I have been fortunate to not experience mastitis or blocked ducts, but if you think you might be experiencing those symptoms speak to your GP or health visitor as soon as you can.
The next 7 weeks
After those first five days of intense pain, the sensation of breastfeeding became more bearable. There were other things, though, that I began to struggle with and I had to endure them for a lot longer.
Once the worst of the nipple pain was passed I was left with a constant tenderness. I was not at all prepared for the fact that your nipples suddenly want to be on constant high alert! Which means they stick out for your bra or t-shirt to brush against and the sensation of anything touching them was almost unbearable. I also found this tenderness was much worse in the evenings, when my body seemed to have used up all its reserves of strength and could no longer keep the pain at bay. This, of course, was then timed with Rowan’s cluster feeding, so just when he was demanding more and more food I was on the brink of tears from soreness and fatigue. In fact, I thought I might have developed thrush because the stinging was just as described when I researched those symptoms. Fortunately, though, Rowan didn’t have any of the signs himself and, when I spoke to a health visitor about it she agreed it was more likely to be the aches and pains of breastfeeding a newborn.
To try to help the nipples along in getting used to breastfeeding you can use nipple cream. I had two different types: one by Mothercare with vitamin E and olive oil which was given to me by a friend and Lansinoh Lanolin which was recommended by a midwife. Both creams were great though the Mothercare one was easier to use as it was more creamy whereas the Lanolin was almost like a wax until it warmed up a bit (but I did feel more ‘protection’ from the Lanolin). You can apply these to your nipples and areolas and leave it on even when breastfeeding. They create a barrier from moisture as well as containing healing ingredients to help the tender skin recover. I found these very useful in the beginning to keep my nipples from getting damaged and to encourage the skin to adapt and become more resilient.
The only way I could deal with the increased discomfort in the evenings was to give myself a break completely and use formula. My husband and I soon got into a routine whereby, when he got home from work, I would feed Rowan one or two more times before heading off to bed. My husband would then use bottles of formula to keep Rowan fed until about midnight when he came to bed and Rowan went in his Moses basket. This way I got the chance to get some sleep and give my boobs a rest. I often had the hot water bottle too to help soothe the nipple tenderness. So if you’re feeling that horrible pain and tiredness in the evening, don’t feel guilty about reaching for the bottle – the formula bottle that is!
Also, when I became concerned about thrush I started taking Yakult pro-biotic drinks to try to restore some ‘good bacteria’. When you have a cesarean you’re sent home with an intense antibiotic regime which can give your own healthy bacteria a battering. I can’t say whether or not the Yakult prevented me from getting thrush but I figured it couldn’t hurt and it was at least something I could do pro-actively to look after myself!
I had bought a couple of nursing bras in a medium size before giving birth and for the first few days they were fine. When my milk came in, however, I was in desperate need of the larger size! I have a pair of nursing bras from M&S and another pair from H&M. The Marks and Spencer ones are more like a sports bra which I prefer to wear when I feel I need more support, while the H&M ones are more of a normal t-shirt bra which are better when I know I might be breastfeeding in public and I want something less bulky and easier to clip and un-clip.
I found myself needing to wear a bra almost all the time because otherwise my nipples would be free to rub against whatever top I was wearing! But the frustrating thing with nursing bras is they mostly don’t have under-wiring to make them more forgiving, but this means they lack a bit of shape and support.
My advice would be to shop around properly for nursing bras, even before you have your baby (because afterwards the last thing you want to do is go to the shops to try on bras!). Get at least one cup size up from your normal bras and play around with fabric to find what will be most comfortable against tender nipples!
Another thing I wasn’t prepared for was just how hunched over I would become as I began breastfeeding. My posture was already suffering from the cesarean surgery and my body had not developed the muscles in my arms and back that is required for carrying and breastfeeding a baby. It was all too easy to round my shoulders to try and get the best position for Rowan to feed, and it took weeks to try and break that habit and remind myself to sit up more.
The main thing that helped me get my posture back was using a nursing pillow (I discuss my favourite one in my Newborn Essentials post). By using the pillow to help take the weight of Rowan I could then maneuver him into a better position where I wasn’t so slouched over. Of course, just getting my strength back with a few week’s recovery time helped enormously, but next time I’ll try harder to keep a better posture from the beginning.
Milk supply and pumping
This was one of my biggest worries in the first 8 weeks with my new baby. Was I producing enough milk? Is he satisfied after a feed? Is he crying because he’s always hungry? These questions raced around my head almost constantly and created a very negative feeling about breastfeeding. It was in these moments I would consider stopping breastfeeding altogether and just go onto formula because at least with a bottle you can see how much your baby has drunk. When your breasts feel empty and sore and your baby just keeps crying no matter how many times you’ve swapped them between boobs, it can be soul-destroying. I would use apps to monitor how long I was feeding for but still it was difficult to find the reassurance that I was doing ok.
The only ways to know you’re giving enough milk is that the baby is having regular wet nappies and they are gaining weight. Still, even when Rowan got back up to his birth weight after 10 days – a clear sign that he was getting enough food – the doubts were still there. The only thing that kept me going was the thought that it is very rare that a mother does not produce enough milk (a condition called mammary hypoplasia) and that Rowan was just doing what newborns do best – demanding food all the time – to enable him to have that insanely fast growth.
I tried pumping with an electric pump in those first few weeks because it supposedly helps to increase milk supply. The problem with pumping in the early days is finding the time to do it. It’s a bit of an art form, getting a pump to work, and it can take a long time to get much from it. I only found it useful a few weeks on when my milk supply was stable and feeding was more comfortable – at which point pumping felt unnecessary! Now I only use it if I’ve had some time away from Rowan and I need to alleviate any engorgement! (The pump I got was the Tommee Tippee Closer to Nature one and it’s been great for me).
Beyond 8 weeks
From 6 weeks postpartum I definitely felt an easing up of the pain of breastfeeding. In fact, I was contemplating seeking out a lactation consultant at the local breastfeeding group when suddenly it became just that bit easier and I had some energy and strength restored. Then at 8 weeks postpartum I actually started to enjoy it. I truly believe it takes your breasts at least 6 weeks to adapt to their new role – yes breastfeeding is natural, but it’s not necessarily instinctive. It is something you and your baby have to learn to get the hang of, and the physical toll it takes on your body should not be underestimated. BUT – there is light at the end of the tunnel when it becomes pain-free, easy, relaxing, enjoyable and you and your baby can feel confident that you’ve got it figured out.
So what are my motivations and fears about breastfeeding now at 15 weeks postpartum? The best thing about breastfeeding has to be the comfort in provides my baby. When he is crying there is no more powerful feeling than the need to comfort and console him, and my breast is the most calming place for him. I believe this is the biggest thing that kept me going throughout all the struggles – the speed at which I could provide instant comfort and relief for Rowan just by whipping out a boob!
And my biggest fears? Well, I no longer feel physical pain, I don’t worry about producing enough milk (he doubled his weight in three months!) and I’ve been very fortunate not to get mastitis or have blocked ducts (though this could still happen!). So my only concern now is thinking ahead to weaning and what that will be like!
I wanted to finish this post with a comment on bottle feeding. Though I am glad I have persevered with breastfeeding because it did work for me and y baby, the main message to remember is fed is best – there is nothing wrong with bottle feeding. In fact, I am happy to use combination feeding as it provides the best of both worlds:
- We can use a bottle in the evening to fill Rowan up to help him sleep longer
- When we go out somewhere and I don’t want to rely solely on breastfeeding in a public place if it’s easier to give a bottle
- I know that Rowan will take a bottle (no nipple confusion here!) which will be crucial when weaning him
- He can be fed by someone else to give me a break and give someone else the chance to enjoy feeding him