Little Sunday story time by Charlotte
I was diagnosed with Gestational Diabetes when I was 28 weeks pregnant. I was immediately concerned about how it would affect the baby and began researching ways to limit any risks of him having blood sugar issues once he was born. I controlled my sugars carefully with my diet and asked my midwife about colostrum harvesting. I had read that giving colostrum in a syringe could help if my baby was sleepy or having trouble regulating his sugars.
I began trying to hand express colostrum at about 38 weeks pregnant. I tried every day but was unable to get anything until two or three days before I went into labour at 39+5. I think I only managed to express 3 or 4ml in total but I labelled it and froze it knowing that it would all be useful.
During labour, I was given insulin because the adrenaline had spiked my blood sugars but was also given glucose because I hadn’t managed to eat much so was feeling quite weak. This resulted in a very sleepy baby once Alfie was born a couple of hours later. He was fine other than being very sleepy so we were left to enjoy our time as a new family of three.
After a short while, the midwife helped me latch him on but he didn’t feed for very long and just fell back to sleep.
We knew we had to stay in hospital for at least 24 hours so they could monitor Alfie’s sugars, and decided to make the most of the midwife support with feeding. They came round regularly to help me with the latch but would leave after a couple of minutes and he would just fall asleep. I shared my concerns that he wasn’t waking up to be fed and the midwife showed me ways to try and wake him, however none of them worked for long. I sent my husband home to get the expressed colostrum and I began expressing more into syringes on the ward. I remember feeling incredibly disheartened when I spilt a whole 1ml(!) which had taken more than 5 minutes to get. After that, I asked the midwife to feed it to him as I was worried about wasting anymore.
After two good blood sugar readings, we were discharged the next day and went home to get used to our new life with a little human. I remember being told at antenatal classes that babies need to feed regularly but I didn’t think much of it when he just slept for long periods. When the midwife came at 3 days, she told us that we must wake him for feeds every 3 or 4 hours. We started to get into the routine of changing him before feeds as that was the only thing which would wake him up enough. My husband and I got into this routine; him changing Alfie while I got ready to feed and we just ticked along until the Health Visitor came at day 10.
Her visit changed everything. Alfie hadn’t put on enough weight in the last week and she suggested we start topping him up. She recommended I start pumping to boost my supply and then give him whatever I manage to pump after each feed, even if it was only 30ml. The Health Visitor was also concerned about Alfie’s latch as I was experiencing pain which didn’t subside after the first few seconds and my nipple was a lipstick shape when he was finished. She suggested I go to the breastfeeding drop in sessions at my local family centre.
I visited a few times and was told that the latch looked good and he could be heard gulping down the milk, however the pain was getting increasingly worse. The nursery nurse asked if I had ever seen Alfie stick out his tongue. It occurred to me that I had never noticed it but it was also not something I had ever looked for and wasn't aware it was a symptom of a tongue tie. Eventually, she referred us to have a severe posterior tongue tie snipped. It was really solid and took 3 cuts so it’s no surprise he was struggling to feed effectively.
After the procedure, we were hopeful that everything would settle down and I would begin to find feeding easier. Unfortunately, things only got worse. We had an awful weekend where Alfie wouldn’t sleep unless he was on one of us, feeding was excruciating and I was becoming more and more disheartened at the amount I was able to express with the hand pump. I called my HV on the Monday morning and she sent me to a different breastfeeding group where I met the most amazing people. I walked in practically in tears and left feeling so hopeful and that I could really do this. It was also the first time anyone had mentioned formula to me. The support worker simply asked how I felt about it. She said when she had been feeding her first, if someone had suggested formula, she would have been dead against it but wasn't judgemental at all. I decided then that if it came to it, I was happy to give him formula alongside breastfeeding. The nursery nurse said she would visit me at home to weigh Alfie so I didn’t have to worry about going out and could just snuggle up and focus on skin to skin and feeding.
When she came to weigh him a few days later, we found that he had lost weight despite the top ups, tongue tie and regular feeding. I was devastated as it just didn’t make sense. I couldn’t help but feel like I was failing him. We were referred to the hospital for blood tests and were put on a 2 hourly feeding schedule with 30ml top ups. I started using nipple shields to help deal with the pain as I was feeding him so regularly. This completely changed things and I was able to start enjoying feeding him instead of groaning in toe-curling pain. I also reached out to Maria, having followed her on instagram for some time. Her tips were so helpful and she was really supportive to everything I was doing.
I had been using a hakaa to collect the let down which was enough to give as the next top up. I also ordered an electric pump to try and boost my supply but it took a while to see any decent output. I found it so difficult feeding every 2 hours, pumping in between and then trying to sleep at some point. I don’t know what I would have done without the support of my family. My husband got up at every feed to wake and change Alfie and make sure I had a drink, a snack and the remote control. I never mastered the feeding in bed as both Alfie and I would just fall asleep. It was important to keep him awake as he took so long to feed so it ended up being a 90 minute schedule; 45 minutes to change, feed and pump, and 45 minutes to get him back to sleep, sort out the milk and get back into bed with an alarm set for 90 minutes time to start all over again. It feels strange writing this now as it was so long ago and I can’t remember how it made me feel. I guess that’s the magic our brains do; make us forget all the crazy sleep deprived moments so that we do it all over again!
We had a couple more trips to the hospital as Alfie’s weight gain was very slow, despite the feeding schedule and top ups. He was on the 0.4 centile for a while and didn’t gain his birth weight until he was 6 weeks old. I was encouraged to use formula as I struggled to express enough for the next top up. I began mixing what I managed to express with ready made formula and eventually gave him 60ml top ups.
As soon as Alfie’s weight started improving, we stopped waking him up over night as it was becoming increasingly difficult to keep him awake again. He continued to gain weight despite dropping 2 feeds and we were all able to get a full night’s sleep!
We got into the habit of pumping while Alfie was feeding from the other side and we did this for months. I became a bit obsessed with it and found myself stressing when I was unable to pump due to being out or having friends over, or just when I really didn’t want to.
I made the decision when Alfie was 22 weeks to stop pumping during the day and just pump in the morning to build up the freezer stash. It was actually a huge weight off my mind and meant I could just enjoy feeding. Alfie’s weight slowly improved and he reached the 2nd centile which is where he stayed until he started solids at 6 months. I continued using the nipple shields until I stopped breastfeeding at 8 months. I had been dropping feeds slowly and was just breastfeeding first thing in the morning. It just naturally came to a stop when Alfie became too wriggly and impatient for me to feed him and seemed to be much more calm and focussed when given a bottle. I thought I would really miss breastfeeding but Alfie is still really cuddly and wants to be close to me often. It has certainly helped with the transition.
I feel really proud of myself that I was able to breastfeed for so long. I worried about the nipple shields and the top ups and whether they were good for Alfie or the right thing to do, but it was what worked for us and it meant my baby was fed and gaining weight. The dreaded “failure to thrive” was a scary thing to hear but I have since learned just how common weight issues are for newborn babies. Convincing myself that I wasn't a failure was difficult at times. There were many tears and doubts, especially in the early days but it got easier and easier once I focussed on the fact that Alfie was a happy baby, hitting all his milestones and had regular wet and dirty nappies.
Since starting solids, Alfie’s weight has improved steadily; he is now almost on the 50th centile and I'm much less obsessive about getting him weighed regularly.
I am hopeful that if I have another baby, I will be more confident in my abilities to breastfeed and I'll be able to trust my instincts and my body to give my baby everything they need.