Newsletter 4 : Happy World Breastfeeding Week!
Reminiscing on my breastfeeding journey and resources for lactation.
It’s the first week of August again - World Breastfeeding Week 2022.
Last August, this was a surreal time for me. My son and I had sorted out our breastfeeding hurdles and settled into a comfortable routine. We’d just begun enjoying our feeding sessions.
I had found a new passion in lactation. I nourished it as lovingly as I nursed my son. Everything I learned was exciting and rewarding.
But that’s the good part of our breastfeeding story.
There was a hard part.
Our breastfeeding journey
I’d learned next to nothing about breastfeeding in med school.
Well, I did learn that it’s great for both baby and mom. But there was painfully little on its practical aspects.
As a natural extension of pregnancy and childbirth, breastfeeding was assumed to occur automatically. And go smoothly for all.
It is indeed so for many moms and babies.
But challenges do occur. And they’re more common than we’d think.
My son was born via forceps delivery, at 37 weeks. He was alert and healthy. There was no skin to skin time, but we did get to start breastfeeding within the first ‘golden hour’.
He was warm, tiny and sucked vigorously. I kept him close to me in the labour room. But that had to change once we got to our room. There were two high, small beds on two ends of the room. There was no way I could sleep safely with my son on the same bed. So my mom kept a watch on him, on the other bed while I tried to sleep. He cried many times and I kept trying to feed him. Nothing seemed to work. By morning, he was just licking at my breasts and not even trying to suck. I was confused and exhausted. He became hypoglycaemic and developed jaundice the day after. He was started on top up formula feeds and moved to the neonatal ICU.
Both of us were miserable staying apart. He’d cry non-stop in the ICU and when he got to be with me, he’d fall asleep after sucking for a few seconds.
My milk didn’t ‘come in’ even after 5 days. I hardly got a drop of colostrum when I tried expressing (I didn’t know the best way to hand express either).
Thankfully, he got better soon and both of us returned home. But now there was an uphill task. Our breastfeeding journey had clearly started off on the wrong foot. And by now, we were both a little wary of it.
We had to continue on mixed feeding with both breast milk and formula. Beyond three weeks most of my social circle (including many paediatrician friends) advised me to give up on hopes of ‘exclusive breastfeeding’.
I kept digging into lactation literature. I realised that I did not have any reasonable cause for a low milk supply. The core issue was probably my son being drowsy and sucking poorly in the initial days.
You see, in lactation supply meets demand. That’s why women can successfully feed twins and triplets while most moms have enough milk for just one baby. If the demand (baby’s sucking and feeding) is too low initially, the supply will be correspondingly low.
But as a growing baby has dynamic requirements, the demand-supply adjustment takes place constantly. The baseline supply is set up in the first three weeks and hence it’s easiest if things are sorted out by then. But it’s not impossible later. It’s just trickier.
The biggest issue with longer time is that babies can get complacent and start preferring the easier feeding methods (breastfeeding is hard work for the little one, compared to sucking from a spoon or cup).
My son was determined!
It was harder for him to relearn sucking at the breast after he’d been exposed to other ways of feeding. I could sense his confusion as he’d feel around with his tongue and lips, opening and closing his little mouth, trying to decide if it’s breast or a spoon he was offered. But he kept trying.
To this day, I’m more impressed with my son’s resolve than anything I did to help things.
From the very beginning, he was certain he wanted his rightful milk. He wouldn’t settle for anything less.
He worked tirelessly on his latch. Adamantly refused expressed breast milk. Promptly threw a tantrum every time we tried to top up with formula feeds.
My husband concluded pretty quickly that he’s taken after his mommy 😉
Finally, after many sleepless nights (nearly 5 weeks) mastering this elusive skill, we made it!
🙌
Am I being cheesy?
Parents are always a bore when they start raving about their children.
But I’m so proud of him!
I just can’t help the raving ; )
This time last year, we were snuggling close, sharing our blissful milk time. Many generous people share stories and resources during the breastfeeding week. I once tried sneaking a peak at them on my phone, while feeding my son. Dare say I was caught red handed!
He snorted angrily, nuzzled deeper into my breast and pushed my phone right off the sofa 🙊
I’ve kept my breastfeeding research separate from my breastfeeding since then!
Good things can come out of hard times
As I delved into the world of lactation, I felt a deep calling.
I got some formal training and now I enjoy every second spent reading, teaching and troubleshooting breastfeeding issues.
Lactation seems pretty far removed from my job as a dermatologist.
On second thoughts, the breast is a skin appendage, most likely a modified sweat gland!
I hope to keep in touch with this amazing field for many more years to come 💗
Five great lactation resources for moms, dads and anyone who wants to know more
La Leche League International was started by seven mothers in 1956, to help other mothers with breastfeeding. They provide breastfeeding education and peer support.
Kelly mom Started by a mom who’s an International Board Certified Lactation Consultant (IBCLC), this website is a comprehensive resource on all things lactation.
Physician guide to breastfeeding Breast surgeon & IBCLC, Dr.Katrina B. Mitchell provides great breastfeeding advice.
Stanford video on hand expressing breast milk
Do watch this 7 min video. Hand expression is a very useful, inexpensive and under-utilised skill. Knowing this early on, could save you a bunch of trouble down the road.
Stanford Short course on breastfeeding (one week) is aimed at new parents and those who support them.
Resources for healthcare professionals
Do check out lactation college, a substack by Dr. Barbara L. Philipp, a Pediatrics professor and IBCLC. She explains scientific concepts in a simple language. The basic version is free.
Lactation education resources provides courses and exam prep packages for the international board certification exam to become a lactation consultant.
The International Lactation Consultant Association membership is very affordable and useful. You don’t have to be an IBCLC to join.
Dr. MILK - I found this one just yesterday. Haven’t tried it out yet. But I’m intrigued by the concept that physician mothers are a high risk group for not meeting our breastfeeding goals (we are indeed!)
The resources for parents are great starting points for health workers, if you’re a beginner on the topic.
Let’s Step up for Breastfeeding 🤱🏻
Thanks for reading!
Talk to you soon,
Swarupa
P. S. I’d love to hear from you! Write to me at swarupa@skinandpsyche.com or get in touch on Twitter.
Excellent and fun to read essay Swarupa! You are on right track, keep going