Looking for something?

Loading...

Saturday, 22 October 2011

Breastfeeding a new baby and looking after a pre-schooler...


Not so long ago a breast feeding mother wrote to one of the media doctors asking for advice about mix feeding her new baby because:
'I am finding it hard to give my toddler enough attention due to the long time it takes to breast feed' .
I complained to the PCC over inaccuracies in the published reply, and won a small amendment to the article (although there are so many other unhelpful myths perpetuated in the piece it still has the potential to wind me up!). 

In my complaint I included a number of alternative suggestions I felt the doctor might have made which might have helped the mother to continue to breast feed whilst also enabling her to meet her toddler's needs.  At the time of my complaint the suggestions were - for me - simply 'hypothetical' ones, though.  I had never actually put them into practice.  I always knew breastfeeding my second child whilst being a SAHM looking after a 2.5year old would be tough at times.  

I totally relate to the mother who wrote the letter - I'm not going to lie - it's been a challenging few weeks here (hubby is out a LOT!) and though we've just come through the 6 week growth spurt I'm well aware that we're not out of the woods yet!  There have been tears, and some exhausted mornings the thought of many long hours alone with two has seemed unbearably daunting.  I've lost my temper and I've not been the parent I want to be.  I'm sure it will happen again too. 

Still - would any of this be easier if my newborn was being formula fed?  I very much doubt it.  To begin with, there are no guarantees that my baby would be 'settled' on formula, and bottles need careful preparation as well as washing and sterilising.  Giving a baby formula doesn't magically make them an 'easy' baby, and young babies require a lot of time and attention regardless of what you feed them.

Setting aside the risks associated with formula feeding, what would stopping breastfeeds mean in practical terms for my family?

Well, you can set a bottle down.  Now I know that technically I could pause a breast feed to do something with my older child (to wipe a bottom for instance), but in reality that interferes so much with the process of breastfeeding (the milk ends up everywhere, the baby takes in air, you know the deal), that I don't stop and get up in the middle of a feed it if I can possibly avoid it.  With bottle feeding you can just set the bottle to one side and calmly answer the door/ phone. Obviously, if you bottle feed other people can feed your baby if you want/ need them to.

Those are just two examples of where I consider breast feeding to be more demanding than bottle feeding.  

Bottle feeding is generally considered less 'bonding' than breast feeding, though.  In general I think this is probably true (a piece about ways to make up for this is here) but I'm going to be really honest:  a lot of the time when I'm feeding my new daughter I'm not gazing down at her adoringly, luxuriating in our wonderful bond and the miracle of life...  Some of the time I'm barely registering the feed!  
I only get to ENJOY breast feeding when my older girl is in bed or being entertained by someone else!  I feel very guilty about this, but it's just the way it is - our days are very full on.  Breast feeding is very functional a lot of the time. 

So I'm not really able to be as attentive as I would like most of the time -  BUT - from my new daughter's point of view, breast feeding ticks many important boxes that bottle feeding would not.  My younger daughter is getting all-important skin to skin contact with me.  I look at her frequently (sometimes just to check her latch!).  She's also being held in my arms, and of course, she's getting the best milk there is.

What would happen if I decided to do some or all formula feeds so that I could give more attention to my older child?  Well, I can only tell you that I suspect I would probably set the baby down a whole lot more.  Of course I'd TRY not to, but ultimately I know that many people end up coping by sitting their babies in a chair for some of their feeds.   That means less time being held, and potentially no skin to skin contact whatsoever.  The advantage?  Well, it's possible that she would go longer between feeds and those feeds might take less time.  I'd also be able to give her to someone else to feed.  But at what cost to my youngest child?

Currently, with all the distractions and other 'mothering challenges', breast feeding is making me a better mother.  Not in the holier than thou sense - not at all.  Breast feeding is simply forcing/ enabling me to give my baby more of what she needs (the skin to skin, the holding, the eye contact, the protection against her older sisters bugs which she gets from the milk!) - and all whilst I'm not really paying full attention.  
Sharing the feeding responsibilities may be a relief sometimes, but if you see the logic in 'attachment' theory (and I do), then from the baby's perspective it's really not ideal.
  
Despite the guilt that comes with splitting your attention between children, the idea that a younger child should be denied breast feeding because you have an older child who also needs your attention is just crazy to me. 

In our bottle feeding culture everyone is more than familiar with many ways to keep a younger baby entertained which leave mum hands-free.  Even pretty young babies can do circuits of bouncy chair/ play mat/ moses basket/ chair swing etc.  Most mothers-to-be have at least one or two of these items on their shopping list.  I did too

Then I learned that my refluxy baby cried in the bouncy chair, screamed on the play mat and point-blank refused to sleep in the moses basket.  Hmmmm.

Next time around rather than bother with/ waste more money on any of these (and I'm not saying they don't have their place), I opted for just one amazing, multi-function product which:
  • leaves your hands free
  • soothes a fussy baby
  • creates a warm natural sleeping environment
  • does not require batteries or electricity
  • doubles as a nursing cover (if you like)
  • gently rocks your baby
  • helps to regulate their breathing and body temperature
I could go on....  The product is (of course) a decent sling.  

It has been a total life saver.  I honestly have no idea how anyone (breast OR bottle feeding!) copes without one when they have an older child/ children.

So my number 1 top tip for surviving breastfeeding when you're looking after other children is GET A SLING!  Good information about how to choose and use a sling is here
I learnt from experience to choose a sling which will keep the new baby upright.  I tried a ring sling with my first child but she never settled in it because she tended towards a reclined position.  Upright positions like the 'cross carry' are great because they really help to minimise any infant reflux.  You can even learn to nurse in one - and I advise it!    This is a helpful video showing how to tie a stretchy wrap so you can breastfeed 'hands free':



Learning to use a sling can be a bit challenging in the beginning, but help is out there - make contact with other sling-wearing mums and learn from them.    It's really important to choose a sling which supports your baby correctly and distributes their weight effectively.  Using a sling means you can do more with your older child, as in my experience the younger one will sleep MORE snuggled up to your chest.  Sibling rivalry reduced.  Result!

Ask around and you'll get a range of other suggestions as to how to cope when breast feeding a new baby.  I read about making a box for my older child full of special, interesting things to keep her entertained whist the new baby nursed.  Well, I'm sure it works for some people (so by all means give it a go!), but to be honest it just didn't cut the mustard in our house....  

So here is my 'new baby' survival guide:
  • get a sling and practice using it
  • pay a trip to the local craft shop and fill your trolley
  • buy yourself a stand up dust-pan and brush (no more hands and knees to sweep up!) - here's one
  • try to get out somewhere most days - it helps to tire the older child out.  It is hard in the early weeks though - so make arrangements with family/ friends whenever you can
  • make your health visitor do some work!  In the UK Home Start offer free support and practical help to families with at least one child under 5.  Ask them when and where the mother and baby groups are too.
  • do your big shop on-line and have it delivered - you can top up locally through the week.  I figure the small charge for delivery is worth it because it is practically the same in petrol these days....
  • play-doh should never be underestimated - get a good set of doh-cutters
  • a nursing box works for some people.  Put special toys, books, games etc into a box to be opened only when baby is feeding
  • involve the older child in small jobs to help you - and thank them for helping!
  • once feeds start to become more predictable you may be able to co-incide at least one of them with your older child's snack time.  Perpare a snack-box in advance and then both kids can eat together!
  • make one of your trips out to the library and then read the books to your older child when you're nursing - that way you've always got something new to read.
  • download some children's music onto your ipod (ear plugs for you are optional!)
  • there are some great toddler apps for smart phones which are also very educational.  Don't judge me..
  • Cbeebies is not the devil - you're doing your best!
The early weeks are tough - but I'm fortunate in that having breast fed before,  I now know that this newborn time is really very brief.  It doesn't last forever and far too soon my new little daughter won't need me half so much.  I know that it's worth persevering with.  In the meantime my elder daughter has learned some really important things I think.  Not least that it's possible to share, but also that breast feeding is normal.

A wonderful friend of mine breast feeds twin boys whilst also looking after her older daughter.  During one of my 'guilty' days she reminded me:
'my daughter wants me, but the boys need me'.
And she's right - my older daughter is well adjusted, she's confident, and I am sure that being breastfed has a lot to do with that.  I feel I now owe it to her little sister to give her the same secure start in life.


Do you have any tips for nursing whilst looking after a pre-schooler?

Monday, 10 October 2011

The first breastfeed.

Lots of mums start out intending to breastfeed their babies.  Sadly though, only a minority end up doing so for more than a few days.  How can mothers-to-be improve their chances of getting breastfeeding off to a good start?


Top of the list when it comes to starting out right is having skin to skin and giving the baby access to your breast as soon as possible after birth.

A study undertaken in 1990 showed that 24 out of 38 mother/infant dyads who had immediate contact after birth were breastfeeding effectively within 1 hour.  Pairs who were separated (20 minutes after birth for a 20 minute duration) fared very differently.  Only 7 out of 34 suckled effectively.  (Righard and Alade


The study recommended that:
'contact between mother and infant should be uninterrupted during the first hour after birth or until the first breast-feed has been accomplished'.
Interestingly the same study also recommended that the use of drugs such as pethidine should be restricted due to their sedative effect which impedes newborn suckling.  Other studies identify the same problem concerning the use of pethidine.    

The relationship between early initiation of breastfeeding and sustained breastfeeding is also strong.  
This WHO document states that: 
'Early contact increases breastfeeding both soon after delivery and 2-3 months later.... As little as 15-20 minutes of contact in the first hour may be beneficial... skin-to-skin contact should start as soon as possible after delivery.'
Studies done into 'breast crawl' show clearly that the newborn has a strongly developed instinct to nurse after birth.  After unmedicated births, babies are hormonally programmed to be alert, and this is the ideal time to initiate breastfeeding.

This is a subject which is close to my heart.  My first child was delivered by ventouse after becoming distressed.  I had taken pethidine twice during the labour, she was badly positioned in the birth canal and I had been pushing for 3 hours.  My baby was not breathing properly, her cord was cut immediately and she was taken to neo-natal within minutes.  I wasn't able to breastfeed her for 11 hours.  


We missed all that important early skin to skin contact, I wasn't shown how to express milk and my daughter was given formula milk without our knowledge or consent.  All this makes me even more thankful that we were able to breastfeed at all.  


Often when a mother and baby are separated in such a way breastfeeding is massively undermined and never recovers.  Mothers frequently encounter poor breastfeeding support when their babies are in SCBU despite the risks of formula feeding - especially to preemies.  With good support it doesn't have to be this way.  
'kangaroo skin-to-skin contact, peer support, simultaneous breast milk pumping, multidisciplinary staff training and the Baby Friendly accreditation  of the associated maternity hospital have been shown to be effective.' 


This is a picture of our first breastfeed:






With baby number two I was determined not to be separated from my child at any cost.  I had our second child at home into water.  For the most part I used natal hypnotherapy as pain relief and a small amount of gas and air at the end.  No pethidine!  My baby breastfed within minutes of her birth, and before her placenta was delivered.  We had a physiological third stage and delayed cord clamping.  It was a world away from my previous experience.  This time my baby was attached to her placenta - not to a machine.  I was later able to witness her 'breast crawl' for myself (something which, sadly, her sister never did).  Seeing a helpless newborn's intact instincts at work like that is really quite amazing. 






Gradually the idea that mothers and their babies should be allowed uninterrupted skin to skin contact straight after birth is becoming a reality.  This is thanks in no small part to the UNICEF/ Baby Friendly Initiative.  Having your baby in a place where they will receive skin to skin contact straight after delivery gives you and your baby the best possible chance of getting breastfeeding off to a good start.


However, myths abound about what is, and is not possible when it comes to that all-important first feed!


Some members of DBM have kindly given me permission to share photos of their first breastfeeds.


Think you can't breastfeed straight after a c-section?  Think again!

image © Sophie Malcolm Kempe


Vicki's baby breastfed twenty minutes after being born:





Emily breastfed her newborn just after her VBAC.




Rachel also fed her newborn straight after birth:



Tricia breastfed her brand new daughter Sofia whilst still 'rigged up':



Emma's daughter Florence initiated their first breastfeed after a 'quick, stress and drug free, natural delivery':



And Sarah expressed her milk for baby Sophia who was born at just 30 weeks gestation.  Initially Sophia was fed through a nasogastric tube, but:  
'I made it known I was eager to put her to the breast...  The nurses kept saying it wouldn't be worth it yet as she was too premature to have the 'suck, swallow, breathe' instinct, but I was adamant!  So, when she was exactly 2 weeks old (or 32 weeks gestation) I finally got my wish after the paediatrician said it would do no harm.  With the nurse's help I got her in place and straight away she latched herself on, requiring no help.  After a second she started to suck.  The nurses all seemed to stop what they were doing and the doctors doing the ward round all came to look.  They were all astonished.'




For me, the look of determination in this little lady's eyes says a lot.  Babies want to breastfeed! 

So if you're having a baby and want to breastfeed - don't be scared to put your baby to your breast as soon as you possibly can!  Use your child's natural instincts to help you on your way.  And remember - even if the circumstances of their birth aren't 'ideal' - it can still be done!

Massive thanks to all the mums who sent their precious pics to me for this blog.