Friday 15 December 2017

Our breastfeeding stories: 'I was told by a colleague that breastfeeding a child past the age of four months is disgusting'

From nursing in public to choosing to breastfeed beyond a certain age, Jen Hogan talks to two women about their experiences, and what did and didn't work for them

Stock image
Stock image

Jen Hogan

Boy or girl? C-section or vaginal? Bottle or breast? Once baby is born, the many questions follow. The method by which a baby is fed can sometimes be a divisive and emotive subject.

Mums who bottle-feed and mums who breastfeed can feel pitted against each other to some extent, while feelings of guilt can creep in for mums who are experiencing difficulties or have an inability to breastfeed.

It's an already vulnerable time for a new mum, and understanding and education are more productive tools than preconceptions and mummy wars.

'Breast is best' may be the mantra but Ireland continues to have one of the lowest rates of breastfeeding in the world. With only 56pc of new mums even beginning to breastfeed and numbers dropping steeply by the time their babies reach three to four months, it seems Ireland is still a long way from viewing breastfeeding as the norm.

My own breastfeeding experiences were and still are positive ones, thankfully. The biggest surprises for me were definitely the lack of awareness about legal rights and entitlements and varied views on socially acceptable breastfeeding time-frames.

My youngest is 18 months and still breastfed. I was told by a colleague that breastfeeding a child past the age of four months is disgusting. While her comments didn't bother me, because I felt confident in my choices, her words might have stung a little more had I been a first-time mum. My employer was incredibly supportive and allowed me to work my breastfeeding break entitlements around a pattern that suited me best, albeit that the initial application caused some confusion as the person handling it had never dealt with a similar request before.

There is a statutory entitlement to all women in employment who have given birth in the last six months to avail of an hour per day breastfeeding break. The manner in which this hour is taken can vary. Some employers extend the entitlement to breastfeeding breaks up until the child is aged two, reflecting the World Health Organisation's recommendation that children be breastfed until two years of age. Part-time workers can avail of the breastfeeding breaks on a pro-rata basis.

Legal entitlements go beyond the workplace, however, and some confusion still seems to exist about where a mother is allowed to breastfeed her child. Pope Francis recently made headlines when he encouraged mothers to breastfeed their hungry babies in the Sistine Chapel. While many applauded his words of encouragement, it seems a pity that they were necessary at all. In Ireland, women are legally entitled to breastfeed in all public places.

Melissa Ryan from Dublin is a mum of three: Kaelan (12), Nathan (10) and 14-week-old Charlie. She is currently breastfeeding her youngest son, having bottle-fed her eldest two boys. "I tried to breastfeed my first but found the first 24 hours just too painful," Ryan says. "I wasn't prepared for it. I was completely overwhelmed with him being the first child and I decided no I can't do this, just give him a bottle."

The midwife obliged. "There was no encouragement, no 'come on let's work on this', no help - just ok, 'what formula dos you want to give him?'."

She was determined to breastfeed Charlie but describes the first three weeks as "torture". "I was just adamant that I wasn't going to give up," she says. "The breastfeeding groups in the local health centre were good, not necessarily the nurses themselves but the other mothers. They were able to give me great tips on compresses, Lansinoh nipple cream and 'breast angels' (nipple shields).

"There were times when I was sitting on the sofa with my toes curled, crying with the pain. Between having thrush, the baby having thrush in his mouth, and having mastitis twice, it was really hard. It's hard to get your head around the cluster feeding and growth spurts. If you've bottle-fed a baby before, it's hard to get used to how much more regularly a breastfed baby feeds."

But she found the benefits outweighed the negatives. "The bond and closeness is just amazing," she says. "It's not that you love your breastfed child any more than your bottle-fed baby, it's just a different kind of closeness. They're so reliant on you that you have them to yourself that little bit longer."

The mother of three has found she has received mixed messages from the professionals. A public health nurse encouraged her to introduce bottles of formula to increase her baby's weight, while a lactation consultant suggested she feed her baby expressed milk only so that she can get an idea of how much her baby is consuming.

She also found herself put under pressure to stop, even though she herself has put no time restrictions on it. 'You've given him the best start, would you not make life easier on yourself?', is a comment she frequently hears, and often from family. "I think it's down to the fact that this is new to them, they've never had anyone breastfeed," she says.

While Ryan had initial worries about feeding her baby in public, she has no problems doing so now and describes it as "second nature".

Pamela Cullen, a phlebotomist (someone trained to draw blood from a patient) living in Offaly, has three children, all of whom were breastfed.

"I always wanted to breastfeed my children. My mother was worried about the commitment involved but I think that's just a mother thing and a general lack of understanding because breastfeeding is not our cultural norm," she says. "My first experience of breastfeeding was not easy and wasn't helped by a midwife who told me that being obsessed with breastfeeding wouldn't help. I wasn't obsessed, I just wanted to persevere. It was definitely easier the second and third time around."

Breastfeeding in public, however, was an aspect that Cullen struggled with. "I never breastfed in public. It's not that I don't agree with it, it's just on a personal level I felt very exposed and vulnerable," she says. "It would have been much easier if I could have managed it but I coped in my own way".

She continued breastfeeding when she returned to work, finding it difficult but not impossible, saying: "My babies refused to take bottles of expressed milk so timing of feeds was everything. I had to make sure my children were established on solids, as well as possible, before my return."

Continuing to breastfeed her children until they were two provoked some strange reactions. "I always pointed out that no-one would bat an eyelid if a child still had a bottle at two, so what was the big deal? Other people's opinions on it didn't bother me. I did what I believed was best for my child."

The Lactation Consultant's View

Nicola O'Byrne, lactation consultant at breastfeedingsupport.ie says there are multiple reasons for Ireland's low breastfeeding rates, including not enough time given to the mum, not enough midwifery staff and not enough lactation consultants for when there is a problem.

She explains how the biggest fall off in breastfeeding usually happens in the first three to four weeks. It takes for to six weeks for the mother's milk supply to build up. "What happens in that time dictates the supply the mother will get and how well the baby will feed. That's where the major work needs to happen in supporting the mothers in that time," she says.

Attending breastfeeding classes ahead of the birth can be hugely advantageous, O'Byrne believes. "It gives parents an idea about how often they need to feed. Women who might have issues can have them flagged - for example things like inverted nipples. It doesn't mean you can't breastfeed, it just means you might need extra help in the early days. For the dads, the classes give them a chance to be involved and see the normality of it."

Unlimited feeding is the best tool for increasing milk supply, says O'Byrne. "The most important thing to learn in the hospital is when the baby is actually feeding and when they're not. Knowing that when your milk comes in, it will build up and up every day is important. You don't get your full milk supply until four to six weeks. The amazing thing is that when you get to your full milk supply, the volume doesn't change for six months."

If you are worried about your supply, O'Byrne advises getting your baby weighed. "If you feel that every single ounce of that weight has been really hard work then ask someone to do a full assessment, someone to watch your whole feed, see are you changing sides often enough," she says.

When it comes to the claim that 'breast is best', O'Byrne says that "if a baby could choose, they would probably choose breast milk". There are times, however, when stopping is the correct option. "If a mother has postnatal depression and she really wants to stop, that's absolutely the right thing to do but if she has postnatal depression and she doesn't want to stop, it could make her worse." Doing the right thing by mum results in doing "the right thing for baby also. Interaction with her baby is the most important thing for long term health". As for the ability to breastfeed O'Byrne states that "the amount of women that actually, physically cannot breastfeed at all would be very, very small. Then there are women who have medical reasons and cannot breastfeed. Apart from that there are some mothers who will have trouble building up a supply. That doesn't mean that they can't breastfeed, it just means that they can't exclusively breastfeed and I think that's where it's all getting mixed up.

"Feeding past the age of one does have big benefits from an immunological point of view as the child is still getting antibodies in the milk."

Mum and baby benefits

Dr Georgina Connellan GP lists some of the health benefits breastfeeding provides, to both mother and baby

Mum

● Oxytocin encourages the uterus to return to its normal size more quickly

● The hormones oxytocin and prolactin reduce maternal stress and help aid mother and baby bonding

● Breastfeeding can help with weight-loss after pregnancy

● Reduced risk of both breast and ovarian cancer

● Reduced risk of heart disease

● Lower risk of developing Type 2 diabetes in the years after delivery

Baby

Breastfeeding offers protection against:

● Gastrointestinal infections and diarrhoea

● Middle-ear infections

● Urinary tract infections

● Necrotising enterocolitis in premature babies

● Late-onset sepsis in pre-term infants

● Type 1 and Type 2 diabetes

● Lymphoma, leukaemia, and Hodgkin's disease

Breastfeeding also reduces the likelihood of childhood obesity

Irish Independent

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