breastfeedingsupport

Our Breastfeeding Journey: From One Mamma to Another

Hear it from the Mammas!

Hi Shilpa, tell us about yourself and your family. 

Hello, my name is Shilpa. I’m a Bangalorean, married to a Chennai boy. We got married in 2016 and were blessed with our darling little boy in March, 2019. We’re currently based out of Chennai.

Can you share with us  your birthing experience? 

I was blessed with an amazing doctor who was extremely supportive from day one and gave me a patient hearing no matter what concerns I had. I had a LOT of concerns and questions, so I was extremely thankful to her and all I did throughout my pregnancy was follow what she said. There were certain reasons due to which I was advised a cesarean section and it was scheduled for when I completed 38 weeks. I had a fairly pleasant experience, constantly reassured by the doctors in the room. After what felt like hardly any time at all, my doctor said, “Shilpa, it’s a boy!”

It was about two weeks post delivery when I was still struggling with breastfeeding that I started reading up a lot more and learnt about the importance of the “golden hour”. I wish I had known about it earlier so that I could have at least asked my doctor about it. How I now look at it is that, though I missed the golden hour, I managed to leave the hospital with a healthy baby and that’s more than I could have asked for.

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Representative photo of the Golden Hour

What kind of breastfeeding support did you receive in the weeks following birth? 

At the hospital, working with my doctor and the lactation consultant and the numerous nurses, I was able to get the latch right after a lot of work. Once I got home, my mom was my biggest support system, guiding me and ensuring I was always well fed and hydrated, she tried her best to get me to rest as well. I think immediately after birth it was more of making sure you are doing it right, how to hold the baby and how to get the latch right. There wasn’t too much information being given on the actual process and benefits etc., as my doctor had already asked me to attend some classes on that.

What are some struggles you have had to overcome in your breastfeeding journey? 

Some of the basic challenges I faced were how to get the latch right, how to get a sleeping baby to feed, multiple feeds at night, handling a cluster feeding baby, and of course the most important one – how to ensure that you build up your supply gradually. 

However, there were a bunch of struggles I wasn’t prepared for. 

  • I was not aware that breastfeeding works differently for different mothers, although it is made out to appear as if it is the same for all.  While I was advised to go get a few classes, all they said was “Latch, hydrate, sleep, repeat, and all will be well”. What they didn’t talk about is the importance of a deep latch, the importance of nursing as and when the baby demands and how that affects your supply.  They didn’t talk about how babies latch for comfort or how long it takes for a new mom to start producing more milk and how the baby really does not need too much in the first few days post birth. 
  • I was also not aware of the link between maternal mental health and breastfeeding. It is incredibly important for a new mom to be made to FEEL comfortable and safe at all times. The reason I highlight the word “feel” is that everyone may be under the impression that everything is well, and the new mom has all the support she needs but it is very difficult to predict what may be going on in her head.  Stress can affect the milk supply and since it is common and normal post delivery, we need to ensure we do what is possible to keep it under control.
  • There always seems to be a lack of consensus between the various healthcare professionals you encounter during your stay at the hospital. In an ideal scenario, the gynecologist, paediatrician and lactation consultant are on the same page. In my case, while the paediatrician couldn’t stop insisting that I probably didn’t have a good supply, and hence instructed the nurses to feed the baby formula, the lactation consultant instructed the nurses to stop the formula. So not only was it stressful but it was incredibly confusing as well, as to who was right.
  • I also had challenges with pumping. The paediatrician insisted that I pump in order to “check my supply”. In case it wasn’t adequate, I was supposed to start the baby on formula. He started with this on day two and would tell me every single time he came to check on us. That was three times a day! When I finally gave in and pumped, all I got was 12 ml. The shock of seeing 12 ml in the bottle got me so upset; I was completely convinced I was incapable of feeding my baby and I had been starving him until then. What I wasn’t aware of at the time was that: 
    1. Pumping output varies for every mom.
    2. Pumping output is not an indicator of supply, what is an indicator of supply is the number of times the baby pees (no input leads to no output).
    3. Supply takes a few weeks to get established, and in the first few days post delivery it is very normal to see lesser output as the milk may not have come in properly as yet. 
    4. One cannot expect much pumping output when you are handling a cluster feeding baby, there needs to be a bit of a break once the baby has been fed. 

Do you feel there is enough psychological support for new mothers who want to breastfeed? 

I think that the lack of awareness about breastfeeding in general poses a huge challenge for new mothers. Some of the questions and reactions that I got from near and dear ones and even strangers made me question if I was indeed doing the right thing.

  • “Are you breastfeeding the baby?” – first of all, it is no one’s business how a mother chooses to feed her baby. She does not really control whether she can exclusively feed the baby, do a combination feed or formula feed. Depending on the person who is asking – it could be interfering or accusatory, or simply uncomfortable. This seemingly harmless question can make a new mom question whatever method she is following regardless of which it is.
  • “Why aren’t you giving the baby formula?” – My response to this has nothing to do with formula feeding, but when a mother is trying to exclusively breastfeed her baby because that is what she wants to do, asking this question in the initial few days can make her question this decision and wonder if she is indeed starving her baby.
  • “The baby is crying again, are you sure there is enough milk”, “he looks hungry” (after a long feeding session), “Oh, is it already time to feed him again”, “Oh the baby is quite lean, we need to make him more chubby” – again, these may be harmless remarks in the mind of the person making them – but they are best avoided. They are not supportive and can make a new mom feel like she is not doing enough/ not doing something right.

How do you think families and society can help new mothers succeed in breastfeeding their babies? 

I think the most important contribution from family would be to help the new mom with whatever she thinks she needs help with. I had a fabulous support system wherein all I did was take care of my baby and everything else was taken care of for me. And to be honest, despite the support, I found breastfeeding incredibly challenging. Families also need to educate themselves on the entire process of breastfeeding in order to be able to fully support the new mom. 

As far as society is concerned, I think there needs to be options to support every kind of new mom. Some are incredibly comfortable nursing in public, and some are not. Every establishment such as hospitals, clinics, restaurants, malls, stores etc. should have feeding rooms that are hygienic and well ventilated, and all workspaces must mandatorily have creches and pumping rooms. In fact my biggest challenge to continuing feeding is that my workplace, far from having a creche, does not even have a pumping room. 

From your experience, do you think breastfeeding is exclusively nutritional or is there more to this connection between mother and baby? 

There is definitely much much more to it than the nutritional aspect. I read somewhere that breastfeeding helps in coping with postpartum depression. But from my experience, I can say it can also be one of the primary contributors for depression. The immense pressure on exclusively breastfeeding or not being able to exclusively breastfeed can both prove to be extremely hard. In the early days, each feeding session was stressful, tiring, just painful. But after ploughing through, almost 100% thanks to my mom, I now love it. And just the look in your baby’s eyes makes the struggle worth it. Now, I know it’s going to be incredibly hard weaning him.

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Representative Breastfeeding Photo

What would you recommend : fixing a time-table from birth or following the baby and understanding their inner clock? 

With a newborn, I was advised to feed every two hours. But back then the baby wanted to feed almost all the time he was awake. So what I did and what I still do is follow his clock. When he was tiny I fed him whenever he wanted or once every 2 hours whichever was earlier. And now I feed him on demand, but the intervals between feeds are still pretty short in my case. Some people say I feed the baby too often, but that’s a choice I have made. 

An important point to be noted here is that the more the baby feeds, emptying each breast fully, the better your supply. This is because the supply comes on the basis of the demand of the baby. The more the baby latches, the better it is for supply.

What are some effective strategies that worked for you with respect to breastfeeding? 

These are some of the things that played a vital role for me,

  • Rest. The more rest (not always sleep, but that’s great of course, if you can manage it) I got, the better my mental state and also my supply. Feed and rest and feed and rest is what I was told. I wasn’t too successful with following this advice, but when I did, it made a huge difference.
  • Hydration. I was told to drink lots of fluids. Especially post a feeding session. Water, milk, juice, soup, porridge. What I do know is that when I didn’t drink enough fluids, I felt a hit in supply.
  • Nutrition. There are plenty of foods that help with lactation and I have almost lost track of all that my mom fed me.  But as someone who had supply issues, it was all of this that got me through. Everyone may not need to follow the path I had to, but a nutritious diet is a must anyway.
  • Stay calm. By nature, this is hugely challenging for me. But I did realize eventually the more I stressed, the less it helped and there was a noticeable difference when I managed to keep myself calm and relaxed.

What would your advice to new mothers, who are anxious about breastfeeding, be? 

  • Read up, well in advance. It’s important to understand breastfeeding before your baby arrives. 
  • Talk to other new moms and ask them about their breastfeeding journey. If you are having a hard time, maybe, someone else went through the same and could have told you what got them through it. 
  • You and your family need to be on the same page, and this discussion must be had before the baby arrives. For this, not just the mom, all those who are likely to be around her in those initial weeks need to read up as well.
  • Get a breast exam by your doctor. That may help you get a head start on preparing to breastfeed. In case of any challenges, they may be able to suggest solutions. 
  • Have a back up plan in case you are unable to follow your preferred method of feeding. When our baby had an accidental fall and hurt his lower lip, he was unable to feed. He was clearly hungry and crying out in pain. I managed to hand express and feed him with a spoon. But, not only was he not used to it, it was also incredibly time consuming and a hungry baby does not have the patience. Thankfully I had a manual pump, but with a crying baby, opening a new pump, washing, sterilizing, assembling and then pumping was all incredibly stressful. I realised it is worth keeping a backup option in mind. Having a breast pump as a backup, keeping it washed, sterilized and ready to use, or knowing which brand of formula you can use as a backup and how to prepare it could be very useful information and you never know when it could help you. 
  • Lastly, try to relax. There is so much thrown at a new mom all of a sudden that it is incredibly easy to get overwhelmed. Keep in mind that the calmer you are, the clearer you will be able to think and nothing beats how good that is for you and your baby.

Preparing for a Child; Preparing for Motherhood

Mamma Love Series

The arrival of a child is one of the most defining moments in a couple’s life. In many ways, it signifies the birth of a family. If a child is born from a loving and trusting relationship, most women look forward to this phase in their lives. But pregnancy is not just about the impending birth, it is also about the huge transition towards motherhood. Many mammas spend a large portion of their pregnancies sifting through umpteen options and information revolving around their unborn baby. A major part of pregnancy thus passes and before they realise it, they are facing childbirth and the inevitable role change. We forget that a mamma is born when her baby is born and needs nurture, comfort and reassurance herself. 

The journey towards motherhood requires just as much thought, time and preparation. A small care package with moral, psychological and physical support can be a source of strength and support during the transition.

Personal Support: Something or Someone to lean on

The days and weeks following the arrival of a baby is often overwhelming for a new mamma. A personal care package carefully put together during pregnancy might come in handy during this time. 

  • A hospital buddy 

The moment a baby is born, the attention immediately and naturally shifts from the mother to the baby. While the whole world spins around the baby, having someone exclusively for the mamma can be just the support she needs. Someone whom she trusts – a parent, partner or friend – who is around and able to regularly check on her can be the emotional nourishment that sees her through those vulnerable moments.  

  • A chore buddy

In many cultures, chore buddies are typically the grandparents of the baby. In some other cultures, friends usually pitch in as much as they can. New parents have a lot to grapple with and in this phase, having to worry about shopping, food and laundry might take a toll on resting and recovering. Planning for a chore buddy during pregnancy might be one of the best gifts a mamma can give herself for the fourth trimester.

  • A reflective journal/ friend

A reflective journal can be a best friend in those initial months. When we want to pour our racing thoughts somewhere, a journal might come in handy. This journal can hold some of those emotions, those overwhelming feelings, joy over small wins, a string of  gratitudes, frustrations and worries. For those mothers who find that talking works better than documenting, reaching out to a friend can lend the same kind of support. Sometimes, talking to someone outside might give just the perspective needed to support their own changing dynamics. Both a journal and a friend can show how far we have come and also guide us when it is time to seek help. 

  • A support group 

The power of a support group in helping new mothers is largely undervalued. A support group is a small group of mothers, all going through or having recently gone through the changes of motherhood. The members in this group often answer and support each other because they are all walking in similar shoes. Finding or creating a small support group during pregnancy might make the journey towards motherhood smoother while also being a source of great strength in the fourth trimester. 

Excerpt from Promoting Maternal & Infant Health in the 4th Trimester: “Mothers may be anxious about their baby for good reason and providers must respect that perspective as valuable and valid. In order to support maternal and paternal role attainment, it is important to affirm and encourage all that is going well with the parent–infant relationship and caretaking. Women need affirmation of their newly acquired abilities as mothers; they are very sensitive to any perception of guilt or shaming.”

Professional support: Reaching Out 

After the high of the birth, most women who have had a relatively smooth birthing experience return home and this is when everything starts to feel real: the cycles of breastfeeding, sleep deprivation, the sway of emotions, soreness, tiredness and the drastic hormonal changes. In most countries, a new mother is typically not scheduled to see a doctor for up to several weeks postpartum. While new parents are swamped with the task of ensuring everything is progressing well with the baby, mothers are often not asked how they are coping with the changes. 

Excerpt from Postnatal Care for Mothers & Newborns: According to the WHO, as of 2013, “at 10-14 days after birth, all women should be asked about resolution of mild, transitory postpartum depression, also known as postpartum blues. If symptoms have not resolved, the woman’s psychological well-being should continue to be assessed for postpartum depression, and if symptoms persist, evaluated. Women should further be observed for any risks, signs and symptoms of domestic abuse. They should be told whom to contact for advice and management.”

Despite WHO recommendations, the reality is that most women are left to navigate the changes in surroundings where symptoms of postpartum blues or depression go unnoticed. Putting together a self-care team prior to the baby can help new mothers know that they do not have to navigate every crisis alone. 

  • Breastfeeding Support 

The uncertainty and questions surrounding breastfeeding are not only plentiful, but emerge in the weeks following childbirth. It might help to see a lactation consultant who can reassure new mothers and help them navigate any crisis that might be brewing in their breastfeeding journey. Sometimes, having a professional perspective from someone who deals with many women going through breastfeeding changes is far more reassuring than talking only to a small group of women who share anecdotes from their personal experiences.

  • Postpartum Physical Support  

Many mammas suffer from postpartum perineal pain and some even develop infection from a cut or torn perineum. They return home after childbirth with little or no information on urinary incontinence, back pain, organ prolapse or pelvic-floor weakness. The toll that pregnancy and childbirth takes on women must never be overlooked; mammas need to feel no shame in reaching out to a doctor or physical therapy for support in  the weeks and months following childbirth.

  • Postpartum Psychological Support

According to the WHO, about 10% of pregnant women and 13% of women who have just given birth experience depression. In developing countries this is even higher, at 15.6% during pregnancy and 19.8% after child birth. So, postpartum depression and depression during pregnancy is all too real! By neglecting this important transition, we put new mothers and babies at risk. If a new mamma feels consistently low, it is important to reach out for psychiatric help. 

Excerpt from Promoting Maternal & Infant Health in the 4th Trimester: “Listening to women and families, whose opinions and needs often go unexpressed or unheard, or both, is foundational to providing high-quality care. Well-meaning providers and practitioners may assume they know what new mothers want and need, and should do a better job of asking them, phrasing questions in a manner that solicits their goals and engages them in program design and development. It is likewise important to honor mothers and fathers as experts about their babies. Truly, no one can know or understand the infant as well as the baby’s primary caregivers.”

The Fourth Trimester Agenda

  • Eat. Sleep. Love.

The fourth trimester to every pregnancy is often the most neglected. A mother has months to prepare for childbirth but soon after the baby arrives, her body goes through a sea of immediate changes necessitating plenty of support and rest. This is a period when the mother-baby dyad must continue to to be looked at as a single entity. The mamma needs external support to sync up to her baby’s schedule, eat healthy, nutritious and simple food, sleep when she feels the need to sleep and have plenty of time to cuddle with her newborn. When this is offered, she has better chances at being able to address the needs of her baby.

By nurturing a new mother, we are not just nurturing the bond between her and her baby, but also supporting the emotional & physical wellness of the next generation.

  • Music. Mindfulness. Positivity 

Being in a positive frame of mind is the best gift a mamma can give herself and her baby. But, it might be challenging to wonder how to keep this positivity alive when the body is going through changes. So, creating a playlist of songs that lift you up or put a smile on your face, collecting a few books that help you be mindful and joyful  and surrounding yourself with people who lift you up are treasures to keep at your arm’s reach for those blue days.

  • Keeping visitors to a minimum

Sometimes, new mothers are faced with a swarm of well-meaning visitors in the days following birth. While this may be just the source of strength for some, some others find that socialising is overwhelming for both the baby and themselves. From the outside, it is important to respect a mother’s wish and honour this space. The time to socialise will come and when you feel ready, you can step out of your cocoon.

  • Making gratitude your friend

Perhaps the most forgotten of all virtues is gratitude – a dear friend to keep close during trying times. Devoting a few moments in a day to just focus on things that are going well can drastically help shift ourselves to a more positive frame of mind. This simple practice can help significantly improve the quality of our lives and also give us perspective when everything seems to be spiralling down.

In The Fourth Trimester Companion, Cynthia Gabriel says, “The work of mothering and fathering is slow paced and repetitive. Parenting challenges can be measured in hours, while joy is measured in moments. If you can believe the difficult moments are just as normal, as necessary as the delightful moments, you will come out of the 4th trimester with more stamina and reserves for the months ahead. 

The fourth trimester should ideally be a nesting retreat for a mamma and her baby. This is a time when we continue to look at the duo as a single unit, depending on each other for physical and psychological support. From the outside, we can offer them plenty of support, understanding and nurture to adapt to their new lives. It takes a village to raise a new mamma and it is the responsibility of all those who surround her to make this beautiful phase as comfortable as possible.