Part 4: 'Oh dear, something's wrong'

The weekly hospital feeding clinic was thankfully held on Tuesday mornings, so that morning we dragged ourselves back to the hospital, together with the newly purchased Medela Swing breast pump, for advice on feeding and pumping.  The feeding consultant looked at Tommy’s tongue tie, observed a feed (lying down, as I still could not sit comfortably), and then set to work showing me how to use the pump. For this, she insisted, I had to sit up in a chair, so I made myself as comfortable as I could, stitches permitting, and she showed me how to massage my breast and begin to hand express to start things off. Then I pumped – and pumped – and pumped – for about 40 minutes while we chatted, and while she sorted out a referral to another hospital where they would be able to look at Tommy’s tongue.  (At this point I was convinced it was the tongue tie that was causing all of our problems.  Although he seemed to latch well, he just couldn’t be sucking efficiently enough, so I assumed.)  Finally, we looked at the pump and the fruits of my pumping – 5mls – about a teaspoonful.  ‘Oh dear, something’s wrong – you should be able to manage more than that.  I’m afraid you’re going to have to give him some formula, at least until you can pump some more.  Feed him three-hourly, then give him whatever you can pump, and then make that up to 30-60mls with a top up bottle of formula.  You’ve got to let this poor lad know what a full stomach feels like.’  ‘How long do I have to do that for?’ ‘For as long as it takes – until you’re producing enough milk that you don’t need to make up the top ups with formula, and until he’s gaining weight.’

So that was that.  We went home. I gave Tommy a breastfeed, then the teat-full of milk that I had expressed at the hospital, and then finally my mother (who had answered the call and rushed over with some ready made cartons of formula) brought over the dreaded top-up bottle of 60mls of SMA Gold.  ‘Perhaps you’d better give it to him?’, I tentatively suggested. ‘I’ve heard that babies sometimes won’t take to a bottle if they can smell their mother’s breast milk.’  (As if he could smell anything from my woefully dry breasts! – The truth was I just didn’t want anything to do with feeding him that horrible stuff.)  ‘I think it would be better coming from you’, she gently urged.  People say that reaching for formula is the easy option, but that first formula feed was one of the hardest things I’ve had to do as a mother.  I held him virtually at arm’s length, and could barely look at him as he glugged down the bottle and looked full for the first time.  Finally left alone, I found myself kneeling at the side of Tommy’s Moses basket as he slept a deep, full bellied sleep.  ‘I’m sorry.  I’m sorry.  I’m so, so, sorry.’ I repeated as the tears streamed down my face.  I felt as though I’d failed him utterly.

That was Tuesday afternoon.  From then on, until further notice, I was on a strict schedule:  Wake Tommy.  Change nappy so he’s no longer sleepy. Breastfeed for 40-45 minutes.  Get husband to collect the bottles of good (expressed) and bad (formula) milk from the fridge, and to bring up the breast pump pieces from the microwave steriliser. Hand Tommy over to husband who offers first the good and then the bad milk, winds him, and puts him back down to sleep.  Attach breast pump and pump for at least 20 minutes on each side (longer if I can bear it).  Take bottle of freshly expressed milk (5-15mls), breast pump pieces, and the two used bottles down to the kitchen.  Put expressed milk in the fridge and wash and sterilize the used bottles and breast pump pieces.  Set my alarm for three hours since the start of the previous breastfeed.  Sleep for the hour or so that remains (or, if it’s daytime, do such essentials as washing, eating, receiving guests, ...). Start over.  When I can, I read up on whatever I can find online about milk supply, and send my husband out for galactagogues.  I start popping fenugreek capsules and eating porridge, plus (as recommended by the NHS breastfeeding consultant, who says ‘someone told her’ it was good for increasing milk), shedloads of papaya.

I manage to keep to this strict feed/top-up/pump schedule for 48 hours, after which time I start slipping.  Sometimes I let Tommy go for four hours between feeds.  Sometimes my pumping sessions are curtailed or missed completely due to such requirements as eating meals (my husband vetoes my request to be allowed to continue to pump at the dinner table), a visit to my parents (I take the pump, but a 20 minute car journey means the schedule starts slipping and the sessions are not so long as they should be), or a walk to the shops (my husband insists I leave the house for this purpose one day, just to get some air, but all I can think about is the pumping time I’m missing).  Worse than this, the state of my nipples goes from bad to worse – the breast pump leaves blisters around my areolas, and Tommy’s tongue-tied latch means they’re chewed and bleeding badly. My flat nipples have, it seems, been pulled out from all the feeding and pumping, but my right nipple emerges from each nursing session squashed and flat with a horizontal line splitting it across the middle, and eventually the bottom half of my newly formed nipple simply gives up the ghost and falls off.  The up side, if there is one, is that I finally have a use for all those breast pads – they help to keep the blood stains off my bras.