Why Formula and Nipple Shields saved Breastfeeding for us!

Heidi Skudder Breastfeeding

A whole month has passed since our little man arrived, and it now feels like we are getting into our own rhythm, so time to sit and think about our journey from birth until now, with one of the biggest things of course being feeding!
The big and sometimes controversial subject of how best to feed your baby is of course one of the main areas of focus in the run up to birth and in the early weeks after. Having worked with hundreds of Mum’s on breast and bottle feeding issues, I was very sure from our booking appointment onwards, that we were likely to go for combination feeding – giving breastfeeding a good go but acknowledging that Daddy needs to be involved too, and also that I would like our baby to take a bottle for the simple reason that I didn’t want to get to a few months in and have a baby that refuses formula or a bottle itself – I have seen this happen too many times and know that introducing a bottle from the early days can stop this from happening. This was my plan!
One full on induction birth later (more about that another time!!!), and I had a beautiful baby boy in my arms, who we already loved dearly but who just would not open his mouth. Aside from the very first latch post birth, for the first 72 hours he was just not interested in opening his mouth, let alone latching onto the breast, and so began our slightly tricky journey into breastfeeding. Very sadly, we didn’t get that golden hour or in fact much skin to skin and quiet time after birth at all, as I sat on the bed for four hours post birth with midwives and doctors coming in and out to manually try to remove my placenta, whilst I sucked on gas and air trying to keep the pain away. This meant that our “latching on practice” at birth was limited, and then I was taken off exactly four hours post giving birth to theatre, where I had a spinal block for my placenta removal. Therefore, leaving Daddy in the driving seat, with an unsettled and hungry baby who had no Mummy to suckle on to and snuggle with! As I was wheeled out off to theatre, I gave the instructions to my husband Rowan to “just feed him” – as we had packed some of the mini newborn formula bottles into the hospital bag.
The Use of Formula
The decision to give formula at such an early stage is one that is not looked upon very favourably by many midwives in hospital or indeed breastfeeding counsellors working within the NHS/NCT and other similar organisations. All of the midwives that cared for us during the birth and afterwards were absolutely amazing and we cannot fault the incredible service we had in hospital. There is however, something very obviously disappointing to many of the staff on the postnatal unit, about choosing to give formula early on and the advice or care that then follows.
I went into feeding with an open mindset, and the idea that “fed is best” in that, if my baby wouldn’t breastfeed, I would happily offer formula. Our little man was born at 8lbs – so a healthy weight and clearly already with a healthy appetite too. He also had a traumatic time stuck in the birth canal, and was also on antibiotics for an infection picked up during birth – so this was not a situation where I was willing or happy to just sit and wait for my milk to come in whilst my baby unhappily rooted around but just couldn’t latch or take anything from my breast. Not only for his health, but for my health and recovery too – I hadn’t slept for two days, and had a long and traumatic time on the induction drip, with a trip to theatre afterwards too. I simply could not hold my baby in my arms all night long for fear of dropping him. I was already passing in and out of sleep whilst talking to Rowan, let alone trying to stay awake all night to feed every hour or so. It was a decision that I took with confidence, and have no regrets about looking back – we slept that night (although not for long on a ward of course!), and both recovered quickly from our infections, which I don’t believe we would have done as quickly if he hadn’t been fed.
Pump, Pump, Pump
Of course if you do opt to give formula early on and still plan to breastfeed, you do need to still try and get the baby on the boob and also stimulate so that your breasts know they need to produce something. Initially I was hand expressing, but really very little was coming out colostrum wise (we did syringe feed this to baby), and I was aware that I could be in hospital for at least another few days, so I asked several times to borrow a breast pump to start stimulating. Unfortunately, I wasn’t able to get hold of one, general consensus being you don’t need to pump/it will affect your breastfeeding and also that there were none available. So, off went Rowan to a local pharmacy that hired out hospital grade pumps, and he bought this into hospital so I could get on with getting my milk in! I pumped every three hours for 10-15 minutes, from the end of day two, and continued to do so until day four when he finally got onto the boob thanks to a little bit of reassurance from a very clever lady Geraldine Miskin.
My milk supply today is now really very good, and I don’t doubt that this was mainly due to working hard in those early days to get my milk to come in. Had I have not pumped, and waited for my baby to become interested in the boob, my milk would have struggled to come in so quickly and he would not have been stimulating the breast enough to get what he needed – simply because he physically wasn’t able to! The pumping didn’t end when he got on to the boob either, each feed became long, he would go on to both sides for around 20 minutes at a time, and then he would be given a top-up to satisfy him (still not being able to get enough from breastfeeding), and then I would pump again to collect the extra milk that he needed. This cycle took up to two hours each time, with an hour then in between for us both to sleep before I woke him again. Needless to say, this was a seriously exhausting time, this cycle continued for two weeks before we then had his tongue tie cut, which was a revelation in terms of his feeding – feeds then took up to an hour only and no top ups were required either! At this point he was able to regulate my supply, which was there for him to regulate because the milk was all there and ready.
The Nipple Shield Myth
The early days were tough as I could sense my baby was not happy. I had asked the midwives at the hospital whether an induction could be the reason he seemed to be all tense and not opening his mouth but the consensus again was no, and that I just needed to keep putting him to the boob. My gut instinct told me differently. I have been in to hundreds of homes to help with feeding, and of those many many newborn babies who are only a day or two old, and I could tell that something just was not right with my own little man. My instinct told me he was unhappy, that he wanted to feed, but that he just physically couldn’t. I started to think about ordering nipple shields to see if those would make a difference, but a lot of the breastfeeding guidance online suggests that these can interfere with breastfeeding. Day four comes and after an hour of fighting my baby to get onto the boob, him crying, me sat in tears telling my husband I couldn’t do this anymore and I decided I would rather give it a go, than have a baby who doesn’t breastfeed at all, so once again off went my husband to Boots to buy “nipple shields” – something he says goes down as one of his most awkward moments!
Nipple shields were a revelation – within moments he was on the boob, sucking with milk pouring down his chops. I cried with happy tears, and he glugged as if his life depended on it. It felt like it has finally clicked, and we had a lovely time of enjoying this new found skill. I was still concerned though that this was somehow not the right thing to be doing, and although I was “following my own advice” I started to doubt myself and ended up calling a wonderful lady called Geraldine Miskin, who does amazing breastfeeding support, and who I knew wouldn’t judge when I said I had given formula or wanted to combination feed, and who called me as soon as I sent out my desperate email to ask for help. The phone call was only short, but in that time Geraldine reassured me that I was doing absolutely everything right, that I should keep pumping, and not worry about him being on nipple shields if that meant he was feeding, and essentially just empowered me to feel like I was doing the right thing. Geraldine also spoke about induction births causing baby to be very tense, with the tongue and neck muscles being particularly tight, so recommended cranial osteo which we booked immediately. I am so grateful to Geraldine for her time spent listening to me and reassuring me, and only wish that more women had access to this when they are struggling, rather than the guidance that often recommends not to pump, to use nipple shields, or to give any formula, which often just ends up with an unhappy and hungry baby, a stressed out mummy, and little to no milk supply.
After a wonderful high of having my baby on the boob, I then soon began to feel once again like there was still something not quite right. He was still coming off of the boob unhappy, and he also still needed topping up at the end of the hour of feeding, even if he seemed to be drinking well. My nipples started to get very sore, and bleached in places, and we then went downhill significantly with our confidence having thought that things were sorted. I asked each midwife that came to check his tongue, as I still felt that this was tight and tongue tie was in the back of my mind. Each of them mentioned a possible minor one, but nothing that should affect his feeding. Finally, on day ten, we had a wonderful midwife come and visit who sat down and told me that I simply couldn’t go on feeding/pumping/topping up for two hours at a time, every three hours, and that I should go with my gut and go ahead with the tongue tie appointment I had pencilled in with The London Tongue Tie Clinic, that coming weekend, when he would be 13 days old.
Tongue Tie Experience
Upon arrival at the clinic, we were assessed and it was confirmed that he had a 50% anterior and posterior tongue tie. This is a significant tie, and one that could affect speech and feeding moving forwards, as well as breastfeeding in the early days, so we made the decision to get it cut. Any parent who has experienced this will know that it is a little heart breaking, and there is nothing more emotional as a new parent than leaving your baby in a room where a painful procedure will be carried out, on their own, before they are then rushed back to you screaming until they get on to the boob. However, the relief was immediate – for both mummy and baby. We had our first feed with no nipple shields, and with no pain! We left the clinic with a huge smile on our faces, and a slightly unsettled baby but one who would then go on to be able to breastfeeding super effectively and with no frustration and probably pain that he had been experiencing before. I will be writing more about our experience of tongue tie in the coming weeks, but for now it remains one of the best decisions for us, alongside the pumping, and has helped us on our feeding journey to now be breastfeeding quickly, and effectively with both mummy and baby feeling much more content and happier for it.
One Month in…
Its now been just over a month since our little man made his way into the world and it feels like a whirlwind. We still have our good and bad days, and having sorted the tongue tie, we have still had wind and pooping issues that go alongside the feeding – which means that for now I have given up dairy, we are using colief at feeds to keep his digestion of lactose down. I am also keeping a close eye on reflux symptoms which seem to come and go, but which are not serious enough to need to do anything about just yet. These things seem to come to a head in my experience by around week 6, so we have a few more weeks to go before we decide if anything needs to be done about the reflux (or whether he just grows out of these uncomfortable days – fingers crossed).
I have always believed in feeding a baby from the beginning, and also always felt uncomfortable with the pressure on mums to breastfeed without necessarily being given the right guidance and support, which I always aimed to try and help my clients with. It has been emotional but amazing to go through the breastfeeding journey, which has not been simple or without its challenges, but the important thing to emphasise is that by doing many of the things that you are advised not to do as a breastfeeding mummy, it’s actually led us to now have a very comfortable and pleasant breastfeeding experience where I could exclusively breastfeed if I wanted to (we are sticking with our evening bottle of formula for the exact reasons we had at the beginning).
So to all those mum’s to be and new mum’s who may be struggling with knowing what to do, my advice would be to have an open mind and know that there are so many ways to help yourself and your baby become a good breastfeeding team. It doesn’t always just naturally happen, and you have to put effort and time in to it so that it becomes your full time job in those early weeks, but it is possible! You CAN recover from birth whilst your baby is fed by your husband, and baby will not learn to only take a bottle and get nipple confusion. You CAN use nipple shields without them affecting your supply. And you CAN pump to stimulate if your baby is struggling to feed. These are all things you CAN do, and things that could well save you giving up on breastfeeding, or save you from having a miserable time when you could otherwise be having a better time of things. Fed is definitely best, but fed and happy with no tears and some sleep to go with it is an even better option!