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Updated: Jan 13, 2021

It's very rewarding being on the front lines of breastfeeding support; to sit with another mother or parent and talk them through difficult times. To see them go from the early day wobbles to that confident parent they were unsure that they'd become. I love it and can't imagine not doing what I do. I feel so privileged to get to witness this private moment in people's lives. BUT, this blog isn't about me or the breastfeeding supporter that sits with the parent in that time of struggle. This blog is about the people that do all of the work and put in all of the effort, but get none of the reward and never have the opportunity to see all that they do to change lives.


As I write this I think of my husband. There was a time when we were those new parents and I didn't think I could manage the whole breastfeeding thing. We sat side by side on the edge of our bed, me crying that I couldn't do it anymore, and a 4 day old baby crying in my arms frantically trying to latch onto my bleeding nipples. I told him to go get formula, I couldn't breastfeed; I'd failed and I was done. He agreed. He would go get formula, but not now, tomorrow. We had a midwife coming in the morning and we would see what she said, and if I still wanted to then he'd go get formula. I agreed. It seemed reasonable and it was only one night I had to make it through. Now, this might sound mean and controlling, that I asked him for this one thing and he didn't do it, but he knew me. He knew I had it in me and he knew how badly I wanted this one thing, to feed our baby. He was present in that moment and saw the whole situation for what it was, a desperate call for help. He also knew that if I made it through another crappy night that I'd feel better the next day. This was my lowest point and it was the one night that I just had to get through, and I did. But not without his support, and I am forever grateful for this extra push, because it was the beginning of something in me. It still took me weeks to get to a point of not wanting to run and hide every time the baby cried for a feed, but it was never that bad again.


When I sit next to another mother, when I sit next to another parent, that is feeling at the end of the rope, I can empathise because I can understand what it feels like to desperately want that one thing that you feel like you'll never be able to achieve and to not be able to see past the unbelievably exhausting haze that is having a new baby. They eventually find their way through it and to witness it is reward enough for me. It motivates me to keep going. So I do.


However, not once has my husband had the opportunity to witness this. For more than five years now I've been picking up my phone at inconvenient times, ignoring him in the evenings to catch up on messages, walking out of my front door and leaving him with a house of chaos, so that I can help another family. I know that there is value in this, because I see the positive impact it has on that family, but my husband never sees that. He puts in all of the work to support families with breastfeeding, but he never gets any of the reward. I'm not sure he's ever seen the impact his support has had, so I'm dedicating an entire blog post to saying thank you to my husband and to all of the breastfeeding supporters out there who never see all that they do.


This man hasn't only been my biggest supporter, but he's been your biggest supporter, because I couldn't do anything I do without him. I wouldn't have reached my own breastfeeding goals without his support that night, and many more tough nights that followed. I also couldn't walk out of my house to walk into yours if he wasn't behind me picking up the slack.


I won't lie, there has been resentment at my walking out the door on days when everyone is stressed and tired and needing the mother in the house. There have been comments made about not helping my own family, and helping someone else's family instead. They're said in the heat of the moment and I know that if he saw the impact he was making he wouldn't entertain the anger and frustration. He is the man that sat next to me on the bed and he knew the importance of that feeding relationship; he knows the importance of your feeding relationship, but he's never been confronted with all that he does. He doesn't get the thank yous and grateful hugs, despite all that he does for other families. So, I'd like to take this opportunity to say thank you to him, and to all of the breastfeeding support workers out there who don't get the opportunity to see first hand all that they do. Your positive impact on the lives of others is very much appreciated!



 


Her nipples are bleeding, her 5 day old baby is hungry and she's crying because she has had to offer some bottles of expressed milk because she couldn't bare the pain of feeding. She cries and asks if this is the end. All she wanted was to breastfeed, but she can't and she's so upset she isn't breastfeeding like she'd planned to.


Woman looking lovingly at her breastfeeding newborn

This isn't the account of any one mother, but the account of so many mothers that I have sat with. They had a plan that they were going to breastfeed, but their plan looked a bit like what we've idealised breastfeeding to look like, instead of what breastfeeding really is. Her plan involved her sitting relaxed on a sofa with her baby at the breast, staring lovingly down at him, both of them bonding. Because this hasn't happened then she feels she hasn't succeeded at breastfeeding.

But what if she is breastfeeding? What if I said that this, or any of the varied versions of a mother crying and feeling a sense of failure at reaching obstacles so early on, is pretty normal for breastfeeding? I always think of breastfeeding a bit like this... After years of saving money, I've finally taken the leap to leave my job and pack up my car and hit the road for a year long adventure. I have absolutely no plan other than to enjoy this year of travelling, where I intend to take everything as it comes. A friend said they'd done it previously and it was the best thing they'd ever done, so here I go. I get in the car and drive. I get as far as the edge of my town and I'm faced with my first big decision; I have two options. I could take a turn which takes me the scenic route, but then it might take me a bit longer and I don't know what to expect. It's possible it may have nicer views? Or I could go the other way which will get me on the motorway and I'll be able to get farther faster, but includes a toll road. I don't want to spend that money just yet, and I'm not entirely sure it's necessary, so I take the longer unknown route.


About an hour later I find myself on a single lane country track that is flooded with rain water from the day before. I hadn't anticipated it and I was really hoping to get down this road. To turn around would take me longer to get to a pub I was hoping to eat & rest at. I sit in the road for a while and debate whether I can risk driving through it or whether I'd flood my engine. In the end I think it too risky, so I reverse back up and find another way. Only, now even more annoyingly I'm stopped by a road closure going the other way!


A blocked road with a road closed sign

I'm forced to go the only way that I didn't want to go, which was through a heavily trafficked road with lights and little scenery. I had expected that my adventure would involve lots of beautiful sites, not busy towns. With no other choice left, I take the detour and after many hours sitting in traffic I finally get to that country pub where I can take a break to stretch my legs, eat some food, and appreciate the local area.

A few days pass and things are uneventful and I begin to settle and become comfortable with the travel; I begin to enjoy things...until...my check engine light comes on. What?! How am I supposed to deal with this? It's going to cost a fortune and I had so many plans on how I was going to spend this money I'd saved for my year of travel. I'm so upset and decide maybe I should just throw in the towel. This is so frustrating and I feel like everything I worked so hard for is now going to be lost and I'll have to go home and tell all my friends (who had all been really excited for me and threw me a leaving party) that I was a complete failure and couldn't manage it. Before I make such a final decision, I find a local garage to see if they can help. They check my car over and it turns out that because I'd gone in as soon as I had noticed something was wrong, they were able to fix it by replacing only one part and I only had to pay £100 out of my savings. I suddenly felt a huge relief that I was able to carry on with my plans. The rest of the year carried on much the same, only I became more proficient at dealing with the detours and unwelcome surprises. I relaxed more and was able to enjoy the scenery a bit more without worrying about all the problems that might arise and how I'd deal with them. I began to enjoy the journey. We start out breastfeeding with this idea that it's something that we will achieve at some point and that until we get to that point of proficiency, we aren't yet safe to say that we are breastfeeding. However, breastfeeding is not an end point, it is not a destination. Breastfeeding is a journey. You will start out and hit many obstacles and road blocks that mean you will need to make choices. Do you drive through the water; do you grin and bear it and see if you can make it through the painful nipples? Maybe you need to find another way, maybe you end up using nipple shields until you can get help and correct the latch, maybe you take a detour and end up expressing and feeding for a while, maybe you decide you don't want to do it and you go back home. Those choices are yours, and not everyone will make the same choice. The person coming down the road after you may have a truck that can make it through the flooded road, but only to find there's a low bridge they can't pass. Their journey might look slightly different, but it won't be without their own struggles; we shouldn't watch them sail through that puddle and think, "They have it easier." There may be times when you need to find your local garage, or a professional that knows a bit more to help you get back on the road you were travelling, thinks doesn't mean that you couldn't breastfeed, it just means that may be part of your breastfeeding journey. You'll have periods where you relax into things and begin to enjoy it and you may even feel like you'll journey for longer than the year you initially planned, who knows? You just know you feel more confident to take it as it comes and deal with obstacle as they arise. You begin to recognise that in the moment you're a breastfeeding mother, but maybe one day that journey will end and that will be okay, too, because you have made some memories to cherish for a lifetime. Everything about your travels will be completely different from that of another breastfeeding mother, but they are two individual journeys that are different in as many ways as you are two different people with two different babies. So, if you're reading this and you're the mother that has found herself at the flooded road, just remember that this is your journey and you can make the decisions. You can phone someone and talk through your options and see what might work best for getting you to the other side of that obstacle, but that doesn't mean that you are failing or that you are no longer able to continue your journey, it just means that your journey isn't going to be what you expected. But then when is life ever going to go to plan?

 


Here are a list contacts you may want to phone when you need a bit of help:

La Leche League Great Britain National Helpline: 0345 120 2918

Association of Breastfeeding Mothers National Helpline: 0300 330 5453

National Childbirth Trust National Helpline: 0300 330 0700

The Breastfeeding Network National Helpline: 0300 100 0212



Updated: Jan 13, 2021

Fill a room with 100 expectant parents and you can count on about 85-90 of those parents wanting to breastfeeding their baby. They know it's something they want to do and they fully intend to provide their baby with their own breastmilk straight from the source. However, by 6 months, only 1 of those babies will still be exclusively breastfeeding. It's quite a staggering statistic, only 1% of babies is England will be following the UNICEF and WHO recommendations to be exclusively breastfed to six months. You have better odds of getting pregnant from sex whilst using a condom or winning at a game of roulette than you have of exclusive breastfeeding your baby to 6 months of age.

So what determines the lucky 1%? A case can be made for several contributing factors, but for the sake of this article and staying focused on factors that can be managed on a personal level , those things that you can do as a parent to try and increase your chances of a successful breastfeeding journey, lets narrow it down to these two issues: 1) overcoming common obstacles and 2) knowing who to contact for support to overcome said obstacles. As I tell every expectant family I speak to, there is no way of knowing what issues you may face in those early days, but there are a few issues that parents seem to come up against fairly frequently, and if you can rule those things out quickly through being informed, then you may well be on your way to achieving your goal to breastfeed your baby.


Here are three of the most common hurdles parents experience in the first few days of their baby's life:


1. Painful Feeding

How many of us have had this conversation?


breastfeeding parent: "It hurts too much when I feed."

health professional (taking a quick peek over your shoulder): "latch looks good!"

breastfeeding parent: "Okay, so everything is okay?"

health professional: "Yes. It may just take a while for the pain to go."


And so you plod on through gritted teeth and constant toe curling and breath holding until...until you just can't plod on anymore and the pain becomes too unbearable to continue. Should feeding be painful? Sometimes it can be sore to start with while you get to grips with technique, this is a new skill for you both and it can generally take some time to master it, however you'll also want to work with someone who is capable of helping you to tweak the positioning and attachment so that you might be able to achieve that pain-free latch as soon as possible. Just plodding along through gritted teeth and hoping it gets better means you're likely to see an early end to your breastfeeding journey. How does that saying go? "The definition of insanity is doing the same thing over and over again, but expecting different results."


2. Perceived Insufficient Milk Supply

We are often let down by society on this one, because we are completely blind-sided by the length of time that we spend with a baby on our breast. Where do we ever see this portrayed in accuracy? Remember Friends couple Ross and Rachel and that little Emma that hung around for about 2 or 3 episodes and then we never saw her again and Rachel was back to hanging with friends at Central Perk. What about The Big Bang Theory's Howard and Bernadette and their little Halley who we never even get to lay eyes on. It's rare we ever get to see a baby breastfeed, usually it's often just alluded to; we definitely aren't ever shown the extent a baby will be on the breast feeding. Most parents expect to feed their baby and then put them down, getting a bit of a break of about 2-3 hours before they need to feed again, but after a bit of a sleepy start, most babies will stay firmly attached to mum's breast, which can cause many parents concern over whether baby is getting enough milk, or whether mum has low supply. What happens more often than not is that parents begin to offer supplemental milk which can compromise mother's supply. Where it wasn't initially a problem, it now becomes one. Baby can also begin to develop nipple confusion or bottle preference and it can cause difficulties with keeping them happy at the breast.


One of the best indicators of whether baby is actually getting enough milk at your breast is whether enough poo is coming out. What goes in must come out! If you're seeing lots of poos, then you know baby is getting the colostrum and milk to push this out.


Of course, there are times when a baby that is always on the breast may actually be a cause for concern and it may be the case that they are not getting enough milk and require supplemental milk. Seeking knowledgeable support to work this out for your particular family can help you troubleshoot what might be going on and how you might be able to supplement baby, if it's needed, in a way that is supportive of the breastfeeding relationship. You may also be able to develop a plan back to exclusive breastfeeding, where that is your goal.


3. Quick Weight Loss Post Birth

In my experience, this seems to be on the rise. Perhaps it's due to an increase in birth interventions, or various maternal conditions that affect fetal weight, like diabetes or obesity, but we are beginning to see a lot of babies lose a lot of weight quite quickly post birth. It's within the range of normal for a baby to lose up to 10% of their birth weight in the first few days of life, however sometimes they can lose more. Working with someone who has knowledge and experience around breastfeeding, can help you to determine whether there are other risk factors to make this sudden weight loss a concern, or whether all things look normal and baby is likely just finding their appropriate centile on their weight chart.

Parent holding a crying baby

These three issues seem to make up the majority of the concerns that plague parents in the early days of their baby's life. Each of these things can spell out an early end to our breastfeeding journeys or they can be overcome when we are supported by knowledgeable breastfeeding professionals. Which brings me to my next point, who do we ask for help?


The majority of parents will access support from the NHS staff in hospital or from their routine postnatal home visits. Very few parents even realise they can access breastfeeding support via other channels. You may find that you achieve successful breastfeeding without needing to seek out further help, or you may find that you'd like to build a network of professionals and get second, third, fourth,etc.opinions on your breastfeeding struggles. Knowing that you have options and what your options are are key to getting that support that is unique to your family unit and your breastfeeding dyad.


The following is a very brief description of who's who in the world of breastfeeding support. Lactation Consultants of Great Britain have a more detailed chart if you'd like more information. The Baby Friendly Accredited Health Professional

Prerequisites: None required in addition to already being the necessary health professional.


Training/Qualification: Ideally 18 hours of BF education, annual update of 1-6 hours to meet BFI audits.


Scope: Should be able to recognise newborn norms and (in)effective feeding, various risk situations like hypoglycemia, jaundice, NEC, etc. and challenges like mastitis, tongue-tie, weight loss/slow-gain. Knowledge varies according to situations where HPs work specifically. Those working with high risk premature babies, would have knowledge surrounding those specific issues. Those working with older babies/children in community would have knowledge specific to those issues. Work within the scope of their existing employment.


Peer Supporter

Prerequisites: Varies drastically across organisations and regions, but usually need to have breastfed for 3-6 months, and a passion for supporting mums with breastfeeding on a volunteer basis.


Training/Qualification: 16-36 hours of BF education. Continuing education should be provided, not necessary.


Scope: Encourage parents to breastfeed and support basic breastfeeding issues, painful latching, cluster feeding, using a pump, hand expressing. Should be able to recognise and explain newborn norms. Should employ listening skills when speaking with the mother and provide her with information and assurance relevant to her concerns. Complex issues (e.g. weight gain issues, jaundice, tongue-tie assessment, etc) referred to a specialist. Work under supervision and to organisation’s procedures.


Breastfeeding Counsellor

(inc. NCT, ABM, BfN, LLL)

Prerequisites: Fed their own baby for 6-12 months (depending on organisation).


Training/Qualification: Varies across organisations, the average is a 2 year programme of education. Continuing education should be provided, not necessary to maintain role.


Scope: Extensive counselling skills; employ listening and reflection to explore mothers’ concerns and meet with appropriate information to make decisions on how to move forward. Can provide resources to parents, can not do any physical assessments or diagnosis of mother or baby. Refer complex issues of a medical nature. BFCs can work in either a paid or volunteer capacity, varies by organisation. Adhere to the individual organisation’s policies and procedures.


International Board Certified Lactation Consultant

(this DOES NOT include unregulated lactation consultants)

Prerequisites: a mother who is a breastfeeding counsellor with one of the recognised organisations, a health professional working in breastfeeding support capacity, or an IBCLC mentored applicant.


Training/Qualification: Various listed medical and science courses that include, but not limited to, Anatomy/Physiology, Child Development, Nutrition; a health professional would have gathered this through their qualification, a BFC would complete these courses individually. A 90 hour Lactation Course, 1000 hours of lactation specific clinical practice. Must recertify every 5 years and must retake exam every 10 years.


Scope: Any breastfeeding issues, in addition to common norms. They would manage complex situations, high-risk babies, oral assessment, physical assessment of mother, medications (but not prescribing), relactation, extensive knowledge of infant feeding. Some IBCLCs may also have counselling skills as a result of previous qualifications. They adhere to the Code of Professional Conduct for IBCLCs.


A health professional offering breastfeeding support to a couple with a baby.

It may be that you don't encounter any issues with regards to breastfeeding, but statistics show that the majority of parents do encounter them, and knowing who can help you overcome those obstacles is paramount to continuing to feed your baby. Having this knowledge and support is what will eventually get parents on the path to reaching their breastfeeding goals and what will also eventually see that 1% statistic grow to more!


Additional references:




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