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hospital baby

When breastfeeding doesn’t come naturally

Throughout my pregnancy, my visions of breastfeeding my little girl involved Miss E being cradled comfortably in my arms just like the mothers and babies in the pro-breastfeeding posters and it would all be blissfully easy. The most natural thing in the world they reckon.

As an aside, in these visions I would also look like an ethereal nature mama always wearing a beautiful chiffony flowing dress in soft pastel colours with perfect skin and a flower crown atop my long tresses of hair.

In reality I had hormonal acne. I mostly wear the same breastfeeding-friendly top (which I bought multiples of – all in black as it was the only colour available and hides spilled milk well). Post-partum hair shed left my ‘flowing tresses’ looking unkempt, stringy and always that little bit frizzy (a semipermanent mum topknot has solved this). And our first few months of breastfeeding involved painfully sensitive nipples and being bent over Miss E as we both struggled to learn how to do this ridiculously simple yet complex task – usually in the dark on my own with my boob getting cold as she was a July winter baby.

hospital baby

Breastfeeding struggles

I’m generally a bit of a jack-of-all-trades so I’m not used to being terrible at doing things. I always knew breastfeeding would be a decent learning curve but the reality of it is that it’s been one of the most bloody difficult things I’ve ever had to do in my life. Breastfeeding didn’t come naturally to me and I’m pretty sure that if we were out in nature and it was a matter of survival of the fittest, neither myself nor Miss E would have come out on top.

We have had more problems with breastfeeding than I thought were possible. But despite all that, we are still breastfeeding, and I’m damn proud of it – I almost feel like a soldier who has made it through a war. Though technically we’re still in the middle of it.

Don’t get me wrong, this isn’t to take anything away from mamas who opt out of breastfeeding early on; everyone has their threshold and above all I’m a firm believer that babies need a healthy and happy mum first and foremost. The choices I’ve made are because of what I want for my child and have been down to my personal preference and tolerance level.

If there are mums out there who are having a rough experience but want to continue breastfeeding, I hope this is helpful in some way.

When breastfeeding goes tits up

We managed to limp along, despite Miss E making a ‘clicking’ sound which I later figured out was her trying to stem an oversupply issue combined with a poor latch. However, by the time she was three months old, I’d had mastitis twice. The first time, I didn’t realise that your milk ‘came in’ and when my boobs went rock hard a few days after baby arrived I didn’t know what to do with them. Poor bubs couldn’t get a decent latch because of it, and the telltale red streaks and feverish chills set in shortly afterwards (all the while, my expensive breast pump sat unused in the corner of the room; if only I’d known it could have saved me all the trouble by clearing out the ducts!). Antibiotics cleared it up and despite feeling a little the worse for wear, life went back to normal.

The second time I’d had to go on antibiotics again for another reason and this resulted in nipple thrush (WTF. Who even knew this was a thing?) which caused oral thrush for Miss E, led to cracked nipples for me, which in turn led to mastitis round two.

We made it through again but I was beginning to feel beaten down. I arranged to see a Plunket lactation consultant to check our latch and somewhere between that appointment and observing a friend feeding her bubba, something clicked. Breastfeeding suddenly became easier and things went swimmingly for several months.

Not-so-normal breastfeeding issues

I’d had a lump in my boob since my teens and during the end of pregnancy/beginning of breastfeeding it grew enough that the breast specialist wanted it removed. It was the same dud boob that had the two lots of mastitis, possibly because the lump was putting pressure on the ducts. I was warned that a lactating boob can potentially have more complications post-op, but in the week following the operation the lump had been confirmed as benign and everything looked like it was healing up well.

Then milk started flowing out of the incision once the steristrips came off – a rare complication of surgery called a milk fistula where a milk duct redirects through the path of least resistance; in this case the incision rather than the nipple. This would happen every time I fed Miss E, regardless of which side I fed her on and I was advised it would prevent the wound from healing properly until I stopped breastfeeding completely.

Within another week, I’d managed to get a decent infection that resulted in a breast abcess (another rare breastfeeding complication) and a three-night stay in hospital which resolved through IV antibiotics and a fine needle aspiration.

When the decision to wean is taken out of your hands

The hospital saga left me feeling exhausted and somewhat defeated again, but the desire to continue breastfeeding Miss E and her stubbornness at refusing to take a bottle still made me determined to find a way.

Official medical recommendation was to take milk suppression tablets and fully wean which would allow the fistula to heal. As I dislike medications enough that I don’t even like to take over-the-counter painkillers, I hardly wanted to take a tablet that would cause my hormones to drop away so suddenly. I also felt like my emotional attachment to breastfeeding was strong enough that I would be at risk of depression if I stopped cold turkey.

I consulted my breast surgeon, the hospital doctors, my husband, my mother, my mother-in-law, friends, a hospital lactation consultant, La Leche League leaders, and did as much online research as I could.

I’m well aware that internet searching medical advice isn’t ideal, but when you want to make an informed decision and few professionals are willing to give you specific alternative recommendations, you’re left with little other choice.

I arrived at the decision to naturally wean off the ‘dud’ side to allow it time to heal up (a possibility I wouldn’t have known about had I not Googled it). As much as I want to keep breastfeeding, I am practical and realistic enough to know that I’m still at risk of reinfection as long as I have a milk fistula/open wound. That and I don’t want to end up in hospital again.

I cut out the night time and comfort feeds. With Miss E being 7 months old, these aren’t technically necessities and would allow the fistula a better opportunity to heal. I also did my research and bought goat’s milk formula for combination feeding if my milk production was inadequate, and am continuing to feed her on one side only. We’re a little over one week after being discharged from hospital and so far things seem to be healing well.

If you want to keep going

If you are struggling with breastfeeding but are determined to continue, arm yourself with as much knowledge as you can and remember to make the health and safety of yourself and your baby your top priority.

If it’s a specific, outside-the-norm problem, get second, third and fourth opinions from specialists, GPs, lactation consultants, La Leche League meetings, and mums on online forums who have been through similar issues.

You will end up with a lot of conflicting advice and you will likely find people unwilling to make specific recommendations. All medical professionals will say you shouldn’t Google medical information, but with so few having accurate and up-to-date knowledge of lactating breasts in combination with their medical knowledge it can get extremely frustrating.

I’ve been told I can’t just feed off one side (what happens when a mum has twins?) and that the milk fistula won’t close up until I finish breastfeeding (it already did, that’s why the abcess occurred because the infection had no outlet). I’ve also been told it’s impossible to dry up one breast (even if not, I’m sure I can get pretty darned close).

We’re still waiting to find out whether my decisions will ‘fix’ things, but for now it feels like I have made the right choices. Just know what is right for you and your baby, and find the best options to keep you both healthy – physically, mentally and emotionally.

Image / NZ Real Health

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