One woman's story and journey to exclusive, extended expressing supported by Jane Palmer as her Lactation Consultant and Midwife.
Written by Anna Russell
When I was looking for a midwife for my homebirth, it was extremely important to me that my midwife be a Lactation Consultant being as my first baby (hospital born) never latched to the breast and support was not available to me. I left hospital with my baby being fed by expressed milk and supplemented with formula. After 5 weeks of expressing, great stress, sleep deprivation (all which equated to a low supply), and an Early Childhood Nurse who told me to give it up, I did exactly this and fully formula fed my son. This was a decision have regretted ever since.
My second child, a daughter (also hospital born), was unnecessarily supplemented with formula in hospital but breastfeed to 12 months. Pure determination and stubbornness on my part got us through the first few rocky weeks.
With this, the birth of my third child and my first homebirth, I was determined that this baby would be exclusively breastfed for an extended period of time and with the track record of the last two children, I wanted to do all I could to make this happen by surrounding myself with the right support structure.
I met Jane Palmer in her monthly parenting group at the time we decided to try for baby number three. Jane was everything I had hoped she would be, a gentle woman with a calm presence, a highly skilled and experienced midwife and a lactation consultant.
My third child Ben, was born at home nearly six months ago now. Jane was the midwife of my choosing for this pregnancy and birth. Ben was born into water, he was so calm and content from the start, I really couldn't have hoped for a better birth experience.
Upon initial examination of Ben (who wasn't looking for the breast within the first hour or two of birth), Jane found him to have no sucking and rooting reflexes and a high arched palette. Ben was not at all interested in the breast when Jane left us for the night nor was he interested the following day. Nearing 36 hours after birth, he had still not fed but was perfectly happy and content. At this point Jane was doing her postnatal check and gave me my options being to use formula or source breast milk elsewhere as he needed to feed and we were both becoming quite concerned at his lack of interest. I choose to feed him breast milk from another woman, an ex-client of Janes who's medical history she knew intimately.
Ben would not take a bottle due to having no sucking reflex. We had to finger feed him and syringe feed him in 5ml lots. I hired a hospital grade pump and got to expressing.
By the end of the first week Ben would take a bottle and by the end of the second week he could latch to the breast. Ben lost a lot of weight during the first two weeks of life (12% of his total birth weight) which was of great concern to both Jane and myself. Jane brought a set of good quality baby scales for me to keep at my house so I could keep track of Ben's weight. I did this for over three months.
Jane spent days researching options for me to get Ben the help he needed as it was out of the scope of a Lactation Consultant. My path was to consult a children's GP which is pretty much where my path ended with a recommendation to move to formula but Jane found Speech Pathologists who specialised in infant feeding as well as contacts at the Children's Hospital feeding clinic. Unfortunately none of the specialists could see me quickly so I had several weeks (and in some cases months) to wait for appointment times.
At about two and a half months, Ben seemed to have improved in his feeding. He was feeding at the breast full time and not complaining of hunger and was gaining weight in small quantities. When I saw Jane at this time, she wasn't convinced all was well and asked me to look at the infant growth charts. I was astounded to see that Ben was off the charts underweight. Needless to say, I paid a visit to my own GP, got medications to help with supply, a Paediatrician referral and got pumping.
By the time my appointment came with our Paediatrician six weeks later, Ben was back on the growth charts albeit at the very bottom. The Paediatrician's diagnosis was that Ben was "happy to starve baby" being a baby who does not complain when they are hungry and one who is quite happy to feed until just satisfied. This coupled with a high palate and, according to our Osteopath, a weak suck meant that Ben had been becoming malnourished but was quickly back on track again and had put on enough weight that our Paediatrician was satisfied with his gain and could not suggest any thing further than what I was already doing.
Somewhere in the fourth month of Ben's life he decided he preferred the ease of a bottle and would not go back to the breast. Even with an emergency appointment with a specialist consultant who has been heavily involved with infant feeding for over 20 years and who was recommended by the Children's Hospital, Ben would not go back to the breast. This was a time of great turmoil and doubt for me but I made the decision at the time to try and get to at least six months of feeding Ben exclusively on breast milk.
It is now nearly six months since Ben's birth and despite all the issues we have had with Ben's weight and his feeding and breast refusal and nearly giving up on countless occasions, the formula tin I brought at 10 weeks for when the expressed milk runs out still remains unopened in the cupboard. For six months I have met Ben's feeding needs with expressing which is a huge accomplishment and one I am extremely proud of - I am two weeks off meeting my six month exclusive breast milk goal and still not ready to give up giving my baby breast milk.
Jane still continues to support me today and takes the time to ask how Ben's feeding is progressing. I am extremely grateful to Jane for understanding how important this was to me, for never pressuring me to continue or to quit as other professionals have done, for going beyond expectations with research, for purchasing the scales which gave me peace of mind and for just listening to my frustrations even this long after she stopped officially supporting me as a midwife. If I had turned to formula in the early days I have no doubt that Ben would now be fully formula fed. I credit my success in reaching my six month goal to Jane's support, understanding, the options she gave me and the resources at her disposal. My pregnancy and birth were smooth sailing, my postnatal period has been emotional and physical turmoil. I am extremely grateful for the love and support provided to me by my midwife for an extended period of time when I needed it most.