Confessions of a combi-feeder

Before you got pregnant or had your baby I bet you never thought that much about your boobs did you? I know I didn’t beyond a wishful, cursory check every so often that they hadn’t disappeared – though I think my husband would’ve let me know if they had. However once I got that precious, long awaited bfp (big fat positive – positive pregnancy test!) all of the things I’d previously tried to stop myself thinking about came flooding in. What our baby would be like, how we would parent it, what we could call it, how I would give birth and where, whether it really needed so many giraffe based newborn items (answer: yes) and how to feed it.

I set off into a world of the unknown. Ask me about trying to conceive and I could tell you anything: complications, methods that didn’t work, investigations, treatments and all of the rest. Babies, though? I’d never thought that far! I read pregnancy blogs, books, spoke to my newly pregnant friends on forums, lurked in baby aisles in supermarkets, tried to find impartial feeding research, looked at the WHO guidelines, bought some bottles and eventually at 34 weeks built up the courage to go to an antenatal breastfeeding workshop. I’d already decided it was something I’d like to do after scaring myself silly with the cost of formula but I had no idea how to do it. I naively thought out popped baby who was already a fully qualified breastfeeding expert, onto the nipple and away we’d go.

The antenatal workshop was obviously pro-breastfeeding. Formula bad. Boob good. Breastfeeding natural. Breastfeeding painless (ha!). Milk abundant. Yadda yadda yadda. Until it was mentioned…. that’s right. The dreaded nipple confusion. I was perplexed. I’d never once mistaken my nipples for anything other than nipples. Over and over we were told how dummies were the devil incarnate. As for bottles? Well, use one of those and you might as well pack your boobs up and go home Missy! Your baby would never regulate their appetite. Would never be satisfied with your slow flow nipples after the glitz and glamour of a dummy or bottle. No more breastfeeding for you! I came out of the workshop convinced- no dummies or bottles for my baby. It would have free range boob whenever and wherever took its fancy. I put the bottles and dummies that I’d picked up on various shopping trips to the back of my baby shelf and bagged up the steriliser I had kindly been given with them ready for the charity shop once baby was here and we were a breastfeeding dream team.

The problem with babies is that they don’t play by your carefully crafted plans and hopes. They play hard and fast with the rules and laugh in the face of your birth plan. T was born by emergency c-section at 37+1. We knew that she would be earlier than my due date as I’d been having constant growth scans from 24 weeks as she was a growth restricted baby. From 36 weeks we knew that she would be a c-section delivery as contrary to Johnny Castle’s assertion, baby was firmly in the corner of my misshapen womb and was stubbornly breech, shattering all of my home birth dreams. A failed ECV brought on early labour and reduced movements bringing everything forward at an alarming and unexpected speed. What we didn’t know is that breastfeeding would be SO bloody difficult – for all of us!

T was a small baby and, rather unsurprisingly, had an appropriately in proportion small mouth. She struggled to latch on my frankly gargantuan boobs despite all of the contorted shapes I squeezed my poor nipples into. When latched she had neither the energy nor the ability to feed properly. I thought this was normal. I painstakingly hand expressed the liquid gold colostrum and gave it to her in syringes, 0.2mls at a time on some occasions. Not once did I even consider a dummy or bottle to try and get fluids into her. Instead we plugged away for three miserable days until my nipples resembled something that had been through a mincer and feeds had me curling my toes in pain, biting my lip to stop me from yelping whilst my husband looked on, helpless. T’s discharge check-up revealed that we were going nowhere. She surprised all of the doctors by being so severely jaundiced that she was borderline blood exchange and dehydrated to boot. My attempts to breastfeed had failed. Mummy guilt is crushing – standing by an incubator looking at your little newborn under triple lights, dancing along a blood transfusion action line will do things to a hormone addled, sleep deprived woman.

Over and over I asked doctors, nurses, midwives and peer supporters – Should I give her formula? Will it help getting fluids in her? Should I give a bottle? Over and over came the reply that breast was the way to go and to carry on with the 0.2mls of colostrum by syringe whilst they gave IV fluids. T eventually took the question out of our hands. She didn’t want to be in a box without her mangled nipple – so she staged dirty protests, screamed at the top of her lungs, pulled at her IV lines and generally revealed her stubborn iron lady-esque streak. Our lovely SCBU nurse came to us and asked if they could try to use a dummy to calm her as she was so upset. Even then I hesitated. Nothing had gone right up until that point – I desperately wanted breastfeeding to work. The dreaded nipple confusion could take even that most ‘natural’ of things away from me. My husband told them to give the dummy. I am eternally grateful to him!

Once the dummy had been accepted T just relaxed. She seemed to positively enjoy being warm and cosy in her incubator and often looked like she was chilling on a beach in Ibiza. The stress of being in SCBU, the section and the worry of failing at breastfeeding so early on seemed to delay my milk and I couldn’t hand express a drop. T dropped 11% of her body weight and it felt like my fault. I asked the nurses to cup feed T formula and cried while they did. I watched as she polished off the entire cup and resolved to myself that I would never let my baby go hungry again but was unwilling to give up on breastfeeding; if I couldn’t get her interested in feeding off me I could at least still give her my milk. I started to use an electric pump. Anyone who has ever expressed any milk (ebm) would realise the sheer lunacy of giving ebm in a cup – waste a drop? Are you mad? T quickly got the hang of the bottle and we were eventually discharged from the hospital 9 days later with a calculated feeding plan in place.

The disappointment I felt in myself was crushing. I had failed to establish breastfeeding in hospital, I had dehydrated my baby to the point that she became ill and now she was happily accepting a bottle from my husband regardless of whether it had breastmilk or formula in it. I felt like I wasn’t cut out for motherhood as I had failed at this crucial step having already been unable to give her the room to grow or birth her myself. I had so much pinned on breastfeeding, my husband knew it and gave me the support I needed to keep persevering. On discharge my peer supporter called me at home and asked how feeding was going. I explained the situation we’d had and was told by her that if I didn’t get baby on the breast within two weeks of birth then it would never happen. Just what I needed to hear to upset me, rile me up and stoke my inner stubborness. If it drove me insane I would prove her wrong.

I expressed for 11 weeks at home, first using a manual pump, then a single electric and graduating to a double electric when I realised I was spending so much time attached to a pump. My husband fed T while I expressed religiously every 3 hours. Two bouts of mastitis, an infection in my section wound and subsequent courses of antibiotics kept knocking my supply so back to formula we would go while we painstakingly built supply back up. After the third course of antibiotics we came up with our own feeding plan. I was running on empty. My husband begged me to consider combi-feeding in order to allow myself some rest. By week 5 I listened to his logic and we were combi-feeding T. Throughout the day she had ebm in her bottles. Overnight she would have formula while I expressed just once at 3am when my prolactin was at its highest. I credit my husband with saving our breastfeeding journey as I would have been unable to sustain the gruelling expressing schedule. I salute any woman who feeds their baby by expressing – it is double the work of either formula or breastfeeding!

It took us 11 weeks of hard slog to get T feeding effectively from me. Success came after we had her undiagnosed tongue tie revised privately. We had been to our local NHS feeding team a few times as I kept trying to get T to feed from me. Time and time again we failed as feeding was still incredibly painful and I was made to feel as though maybe I just wasn’t cut out for breastfeeding – after all it shouldn’t hurt! Peer supporters came and went – our latch was fabulous. T was just lazy/ I needed to do better/ use this position/ contort my boob that way/ use nipple shields/ don’t use nipple shields. The tongue tie revision changed everything. The first feed post revision was the first time T drank from me for more than one minute. It didn’t hurt, though perhaps by this point all of the nerves in my nipples may have been destroyed. She wasn’t distressed while feeding. At last we had cracked it and the relief was immeasurable. However the early days of T’s weight loss and my vow that I would never have a hungry baby again stayed with me. My husband and I talked again. T had learnt a new skill to feed off me as well as feed happily with a bottle. We were keen for her to keep this ability as it gave us some flexibility and precious baby free time. I had seen how bottle feeding T had helped my husband, mother and mother-in-law all bond with T and I was reluctant to take that away from them. Also – I’ll say it again – BABY FREE TIME!

T is 7.5 months old now. We still combi-feed in addition to solids and whilst I no longer have to express, the inner breastmilk squirrel in me remembers those dark early days of no milk. Every night after T has her nightly bottle of formula I settle down with a cup of tea and my trusty pump for 20 minutes and have a nice relax. This stash enables me to have the odd baby free lie in *bliss*, for my mother-in-law to take T for the day so that I can scrub the house before the chaos of muslins, baby toys and the never-ending laundry consumes us all. Formula saved my baby, my sanity and my breastfeeding journey.

Breastfeeding isn’t always easy. Sure it’s ‘natural’ but that’s of very little consolation when your breastpads are soaked with blood and stuck to you. I’ve had judgement off mums I don’t even know – militant breastfeeding mums unable to understand why I would pollute my baby’s virgin gut with disgusting formula when I can breastfeed, breastfeeding mums in the early days who sneered at me when I gave my little girl her bottles (of breastmilk) in public, and bottle feeding mums who’ve given me the evil eye while I try to wrestle my unwieldy child onto my nipple. At the end of the day we found a method that suits us, that we’re happy with and that T is happy with. I wouldn’t change it for the world- and if we’re ever lucky enough to have a second child I’ll be an out and proud combi-feeder again.

My combi-feeding essentials:

  • A decent electric pump. I highly recommend the Ardo Calypso.

  • Breast milk storage bags; I’ve found lanisoh bags to be the best.

  • Bamboo breast pads – soft, absorbent and reusable.

  • A steriliser. I use an electric steam steriliser but in hindsight I would probably use a cold water steriliser.

  • A bottle that your baby likes – having tried four different types T finally settled with haberman suckle feeders which seemed to reduce her wind discomfort in the early days. However, I wouldn’t recommend stocking up before baby gets here as babies are tricksy- they probably won’t like *those* bottles that you’ve so painstakingly researched…

  • Formula dispenser – we fill this up every couple of days and it makes making up formula far less faffy.

  • Support – without my husband I wouldn’t have managed to get to 6 months, let alone be carrying on still. Peer supporters, midwives, health visitors and other mums can all be useful sources of information.

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