Friday, 29 January 2016

When Breastfeeding is Hard

Image licensed under creative commons
from PinkOnHead.com
Today I'm writing for those of you who are struggling with breastfeeding.  Those who feel that maybe breastfeeding isn't for you, or that you aren't able to, or are feeling like you are spending most of the day crying about how breastfeeding is going.
We hear a lot about how wonderful breastfeeding is.  I write about it many times; how it is wonderfully bonding; the feeling of confidence as you see your baby grow; the incredible simplicity of a baby falling asleep and resting against your breast.  There is nothing like these experiences.  Every woman deserves to feel this with their baby, but what if that is not happening for you - or not in the way you think it should?  What if your confidence is not actually growing as your baby does? 
Many times when I see mums, it is when they are almost at breaking point.  They are not sure whether they can continue.  The very fact that they call me tells me that they desperately want to continue, but they just can't see a way out of whatever is going on for them.  Often they are being told that a bottle will resolve all the problems.  It will be easier.  It will be better for their mental health.  Is that really true?

"Breastfeeding is natural.  Why can't I do it?"  
What does that phrase "breastfeeding is natural" mean?  Does it mean that on the day you give birth you suddenly know how to breastfeed and that knowledge will equip you for growth spurts and fussy evenings and latching issues and teething and all the things that come along the way?  If that is what the phrase suggests to you as a mother, then I think we should stop using that phrase.  

Parenting is natural.  It is the natural progression once we give birth.  That definitely doesn't make it easy!  It's easily the hardest yet most rewarding thing I have done/am doing.  It forces me to look at myself, to check what I am doing, to learn and try new techniques every single day.  Mothering through breastfeeding has been part of that.

Breastfeeding is instinctual.  There is no doubt about that.  In that way it is the most natural thing in the world. We instinctively lift our babies to our hearts.  Is is a coincidence that is where the breast is?  Our babies instinctively root and latch if we give them the right habitat and triggers.  That doesn't mean that it is easy.  I frequently talk to mums about the process of walking.  Walking is natural, but that's because we've had a few decades of practice.  It's natural to a 5 yr old too, again through practice.  It's natural to a 2 yr old, although their running gait may be not what you will see in an older child - it is still developing.  Is it natural to a 12 month old?  The urge to get up and walk certainly is natural.  The instinct to do it is there, but the process of walking? - usually not.  The mechanics of shifting of weight, of moving each foot, getting the balance, moving the next foot?  That takes some time.  It takes several weeks.  It takes a steadying hand.  It also takes observation.  Those babies are watching us.  They see us walk.  They see the neighbours walk, their siblings, cousins, children in the street, the postman, shop assistants, their peers and even their pets!  All the time everyone around is encouraging our toddler.  They help her to her feet and they are happy to provide that steadying hand.  They praise and 'ooh', and 'ahh' when steps are taken.  They show visible delight on their faces.  When the toddler falls, there is a quick, "oh dear, all fall down" or something along those lines, they pop the child up again and off they go.  No one tells that toddler that it would be easier just to crawl, or to be carried.  No one worries that falling will dent the child's confidence in her ability to walk.  It is accepted as part of the process.  When learning a new skill, gradual progress is what is understood to be happening.  Some days are better than others, but the movement of the skill is forward overall.
There is no other skill where we expect we should have a sudden knowledge and ability, in the way that we do about breastfeeding.  No one expects that they will buy a piano (with no prior knowledge) and be able to play a concerto a week later.  They don't feel they have failed when they can't do it.  No one expects that they will be fluent in another language in a day or 2, even though language is natural.  No one even expects they could run a 5k without a couch to 5k program.  Why on earth do we feel that we are failing if we have problems doing something that we have never done before, rarely see done around us, and haven't really any knowledge of? 

The truth is that everyone struggles in the early days.  Maybe in different ways.  Some may have issues with getting a deep latch.  Some may struggle with the intensity of their baby's needs.  Some may struggle with a sick baby, birth complications or a baby who isn't latching at all.  Others may struggle with family pressures to allow others to feed.  Everyone has their own struggles as the entire family dynamic shifts underneath you while you begin the steep learning curve of breastfeeding and parenting.  Do you know what is the difference between the mums who continue to breastfeed for as long as they want and those who stop?  Support!  
In Norway 98% of babies are breastfed.  At 6 months old, 80% of babies are still breastfed. Norwegian women are no different to women in Northern Ireland.  Ok, there's a possibility they are taller and blonder (have I hit enough stereotypes there??) but their breasts work in the same way to yours.  The real difference is that breastfeeding is normal.  It is seen.  Children, teens and adults see it.  We observe and we learn.  I have never been to Norway but I have been involved in many breastfeeding support groups and what I know is that if a mum hits a problem and discusses with other mums she will hear, "oh yes that happened to me.  This is what helped," or "read this article" or, "talk to this person".  I suspect that culturally you hit a certain point where enough people are breastfeeding and expectations become more realistic and support options more well known.

A message for today
If you are reading this today and you are struggling, I want to say 3 things to you:

1.  Find your network
If your family and friends network around you don't understand breastfeeding and aren't actively supporting you, then expand your network.  If you have a La Leche League group near you, go along.  If you have another breastfeeding group near by, go.  People are often hesitant to go to a breastfeeding group, but again that is just cultural lack of understanding.  You likely wouldn't hesitate to go to a slimming club if you wanted to lose weight, or a running club if you wanted to do that couch to 5k.  At the very least, you'd likely find a running mate.  What you will find at that support group are women - just like you.  Some dealing with the same things, some with different things.  Some who have just entered that phase of easy breastfeeding, some who have been feeding for a long time because once it is easy, it is SO easy.  At a slimming club or a running club you may find women who have had a great week and others who have found it much tougher that week.  What they have in common is that they are working, learning and progressing.  Breastfeeding support groups are the same.  As you go back regularly you will start to see new mums arrive.  You will hear the same words that you arrived with, the same worries and problems.  You will realise that you aren't having those issues anymore.  Sometimes retrospect is the only way we see our progress!
If you don't have a local group near you, find one online.  You will find good peer support online.  You won't get the cup of tea and to actually see mums nursing their babies, but you will find friends and support and a chance to talk about what is going on.  Women supporting each other is a wonderful thing.  We are designed to do it, and we flourish and grow in that environment.

2.  Find your local IBCLC 
Peer support is a wonderful and absolutely vital thing, but if you are struggling, you also need more.  You need someone who can recognise what is causing you to struggle and how to move you forward.  You need someone who will listen to your concerns and will not minimise your struggles, but rather will support you emotionally as well as working on the breastfeeding issue.    An IBCLC (international board certified lactation consultant)  is the gold standard in breastfeeding support worldwide.  An IBCLC will spend time with you, usually a couple of hours, usually in your home, working through your concerns, helping with positioning and latching, working through a care plan and a feeding plan were needed and will follow up with you to see that care plan through.  When we have the NHS it can seem odd to look to the private sector for breastfeeding help, but unfortunately there are very few NHS IBCLCs in the community in Northern Ireland.  Midwives and Health visitors just don't have the same training as an IBCLC, and may not always have the skills to help provide a breastfeeding solution.  An IBCLC generally costs a small fraction of the cost of formula, bottles and teats in the first year and can often help to completely turn things around for you.  If you are struggling, reach out.  You deserve to enjoy this experience with your baby.
(See further information section for how to find an IBCLC)

3.  Reframe the learning process.
A newborn feeds so frequently that if breastfeeding isn't going as you hoped, you are reminded about it over and over and over during the day.  If you are having latching problems or pain, you experience it over and over as your baby feeds.  It is easy, at the end of the day, to only see the problem and to allow the feeling of not being able to do it overwhelm you.  Often mums describe feeling like they are failing their baby.  When you are reaching the end of the day, look back and reframe what has happened that day.  Psychologists describe 2 mindsets which people can adopt:  a fixed mindset and a growth mindset.

Reframe your day with a growth mindset.  If your baby isn't latching, but is taking expressed milk - recognise that your baby is getting your milk, and remember the multitude of components within that milk which is designed solely for your baby.  Your body is making each of those components for your baby.  If your baby is latching but you are in pain, remember that both you and your baby are learning.  Remember that x days / weeks ago you had never breastfed this baby.  Remember that since that time your baby has been breastfeeding.  Realise all that your baby has received at your breast - nourishment, comfort, physiological regulation (heart rate, temperature, breathing), emotional and physical security.  If your baby hasn't been nursing exclusively and that is your goal, set it as a goal that you are progressing towards.  Like any skill, progress isn't always in a straight line but when you look back you see it.  Look back over the last week - do you see a change?  This is still relevant after you have sought out breastfeeding support, as there will still be a period where you are both learning, 
Find the successes in your breastfeeding.  If your baby fed well once that day - that is a success.   If you are still committed to breastfeeding at the end of the day - that is a success.  Concentrate on that success.  A good IBCLC or breastfeeding counsellor will help you to find and celebrate the successes in your day.   Work on the careplan that you have created with your IBCLC and remember that every skill takes practice.  If you worked on new latching techniques in the session give yourself time for those new techniques to become more natural and easier for you.  Everyone falls in the early days, but with the right support it gets better, and better.  

Which step have you reached today?
Image licensed under creative commons from desicomments.com

Give yourself time and be gentle and positive to yourself with your thoughts.  You are not failing.  You are learning.  Together.  


Further Information

Local Breastfeeding Support Groups

Online Peer Support

Find an IBCLC
More information on IBCLCs - http://www.ilca.org/main/why-ibclc/ibclc

Breastfeeding statistics in Norway:  http://kellymom.com/fun/trivia/bf-rates-2004/

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