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Lizzie

Age at interview: 33
Brief Outline: Lizzie had gestational diabetes during pregnancy and believed that breastfeeding was crucial to protect her son from developing the condition in later life. She held the view that breastfeeding was the most natural and hence, uncomplicated thing to do. Lizzie never had sufficient milk to satisfy her son’s hunger. Feeding on demand, using a breast pump did not stimulate her milk supply but only feelings of exhaustion and of failure. After three months she started to top up her breastfeeding with baby formula. She continued to breastfeed with both breastmilk and formula until her son was five months.
Background: On maternity leave, works full-time for an international charity organisation. Married with a one eight-month-old baby son.

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When Lizzie got pregnant, she had an idealised expectation of motherhood and breastfeeding in particular. All the information she got from the parental skills classes, from midwives and health visitors and her own reading made her believe that breastfeeding was natural and therefore, an uncomplicated thing to do. She very much wanted to breastfeed her child but from the maternity hospital onwards she started to experience problems. In hospital, she noticed that she did not have enough milk but was reassured by the breastfeeding expert that after the colostrum, her milk would come; that breastfeeding would stimulate more milk. The main message was ‘it would come’.
 
Back at home, she continued breastfeeding but her baby wouldn’t settle down. The baby was latching well but the health visitor noticed that he had tongue tie - something that Lizzie points out should have been picked up in the hospital. She and her husband were relieved to have found - what they thought - was the answer to the breastfeeding problem. The hospital’s waiting list was for several weeks and they decided to pay for a private midwife and have their son condition corrected.
 
Breastfeeding difficulties continued however, because Lizzie did not have enough milk to satisfy her baby’s hunger. Breastfeeding wasn’t the experience she had pictured in her mind. Instead, she spent long hours during the day and night breastfeeding her baby who slept very little, and cried a lot. Health professionals continued to tell her that her milk ‘would come’, that she had to persevere and try and stimulate her breast to be able to have more milk. To that effect, she hired a breast pump and at night – because she read somewhere that milk production is at its peak at night - she would sit pumping her breasts. She also used the pump in between feeds during the day. This lasted three months during which the family was exhausted and in despair. Lizzie felt a deep sense of failure.
 
At the baby clinic, and after she had cried for the third time, the health visitor started to pay more attention to her and to do regular home visits. She was asked to fill in a questionnaire because they assumed she had post-natal depression. Lizzie accepts that some of the questions described how she felt at the time but she also knew that her problem wasn’t depression, but exhaustion, and feeling like a failure for being unable to breastfeed her baby.
 
A conversation she had at the baby clinic made her reassess her situation. The GP told her that it was not a disaster if she didn’t manage to breastfeed for six months; that the gestational diabetes she had during pregnancy didn’t have to affect the health of her child; that the baby wasn’t going to become diabetic just because he didn’t breastfeed for six months, that a healthy or unhealthy diet throughout his life were more crucial determinants for the onset of type 2 diabetes.
 
After three months, Lizzie felt in control and started making choices based on her baby’s needs. She started to top up breastfeeding with baby formula and her baby – now satisfied - changed from a miserable to a happy one.

Lizzie’s advice to health professionals is for them not to be so ideological about breastfeeding. From her reading and experiences of other mothers, she knows that if the milk doesn’t come in the first six weeks it is unlikely to come at all. She would have liked to have been told this so to have made informed choices earlier without feeling guilty or a failure. Sharing realistic expectations and experiences before birth would help to prepare mums better.
 

He latched well but from the start she struggled to feed him because of low milk supply. Even correcting her baby’s tongue-tie didn’t help.-

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I think the, before I had my baby, I went to the, I think they’re called “parenting skills classes” at the hospital. And I went to the one on breastfeeding. And actually what was quite interesting at that point is that there was the implication that you would kind of, as soon as you had that baby, you would be gushing buckets of milk. And it was sort of, you know, you wouldn’t be able to hold back the tide. And it was, and the focus of these parenting classes were more around, “Should you breastfeed or not?” rather than, “Actually, this is how you do it.” So yeah, but the implication was that milk would just come and you’ve actually almost got to stop it, you know. There was sort of, advise you on nipple pads and, actually, if you need to express because there’s too much. And so I think in my head I was expecting there to be loads - of milk. And then in the hospital there just didn’t seem to be anything coming out.
 
And they sort of said, “Well, it will take its time. You’ll have this, the first—what is it called? “Colostrum”?
 
Colostrum.
 
Yeah. “You’ll have that first bit coming through, which is a very different consistency to normal breastmilk. And it could take another two or three days for normal breastmilk to come through.” So you’re sort of going, “OK, well, I’ve just got to wait and see, really.” And because I struggled with breastfeeding, I stayed in hospital for two nights. And then they kind of had to sort of throw us out, but I was completely distressed because, you know, my baby was, wasn’t sleeping, it was constantly crying. But they’re going, “Well, it’s a baby, you know? It’s scared to be out in the world. It’s a baby.” And I was sort of going, “But I can’t see, you know, it doesn’t seem to be happening.” They were like, “But it will. It’ll happen. It’ll happen. It’ll happen.” And yeah, it was just sort of going, “Well, it, you know, OK. I’ll trust them, you know. They’re the experts.” And I can completely understand that actually, you know, for some women it does happen easily and it just didn’t work for me.
 
So again in the hospital we had to supplement it twice with some formula, because again he was just screaming and screaming and screaming. And [sighs] just you know, I was squeezing, squeezed like a, like, like squeezing, and nothing was coming out of them. So I was sort of going, “Well, you know, but,” and they go, “No, it will kick in. It will kick in.” And so we got home and you, again it, he would, you know, he was I was sitting for hours and hours on end with, with my baby sucking. And everyone kept on saying, he had a good latch on, you know? And it, but I was sort of going, “Well, I’m not sure he’s getting anything.” And he wasn’t sleeping because I guess he was never full.
 
And then the community midwife comes and visits you at home. And he was, again, crying because he was hungry, we’re assuming. And she sort of looked. She just went, “Oh, I think I’ve seen the problem.” And at that point, they noticed he had 100% tongue tie, so his tongue was attached from right down at, completely really, so that the, the tip of his tongue was attached to the back of his gum. So there was just no way he could’ve been doing that proper sucking movement. And again, the issue was that at that point within the NHS there was only one specialist in this area, and there was a six week waiting list. And we were sort of going, “Actually, we can’t wait.”
 
So fortunately there is a private practitioner who’s a midwife in one of the nearby hospitals, so we paid for her to come, quite a lot of money, paid for her to come that day to cut this tongue tie. And again, she said, you know, “Your, your nipples are a great shape.” You know, he, because when they cut it, they say put them immediately on the breast because it will sterilize and help it heal. And she was going, you know, “Your, you know, the latch is great.” You know, no worries. But, so, at that point, we thought, “Great, actually.” You know, it was his tongue tie. It was obviously the problem. He wasn’t sucking properly.
 
But it still continued to just not happen really. Like, they were -there was one awful, awful night where my husband and I were in bed and he was, like, milking my breast like a cow. Like, he was squeezing it, desperate to get the milk out of it to try and feed our baby. And it was just not coming out. So, you know, at that point I was, you know, but the, you know, every time I spoke to the health visitor, “Oh, it’ll, it’ll come, it’ll come. Just be patient. The more you breastfeed, the more milk that will come.” And it, yeah, it just didn’t. 
 

Lizzie says that the official support saying ‘breast is best’ made her feel isolated and that she wasn’t a good mum.

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I wish I’d been more pragmatic. But you’re so overwhelmed and so distressed, and everything around you is saying that breast is best. And I do believe that, and I would’ve done it if I could. And it, it, yeah, and all the support out there, all the official formal support is saying breast is best. And it’s only when, then, you actually sort of scour beneath and you have conversations with other mums, or you look on mumsnet or all those, you know, Internet things, that there’s somebody sort of says, “Actually, yeah, I did struggle.” And I think to have, yeah, I think it’s really important that there is that balanced view of it. “Yes, breast is best. If you can. But if you can’t, then, then, yeah, don’t beat yourself up about it.” I think I just, I thought I was a, I was a failure as a mum. I felt, I felt like I’d let down, and I’d let myself down, I’d let our baby down. I’d just, yeah. The thing that is meant to be the most natural thing in the world and I couldn’t do it. And, yeah. And I, it sounds silly for me. I’ve always, I’ve always been quite pleased with the size of my bosom. You know what I mean, like, I always, you know, I’d buy tops that enhance it or, and so you sort of think, “Oh, you know, they’re actually, the thing that they’re meant for, they’re failing at. You know, they’re, they’re big enough to surely have enough milk in there.” And, but then they’re not to be, you’re sort of going, “Well, how is that possible? How could, you know? This is just meant to happen.” So, yeah, I’d, yeah. It was the most upsetting that, just the worst, yeah. Just, I, and you, you look, I looked for support and I couldn’t find it…
 
But yes, I did feel like a failure. Yes, I did feel that I wasn’t a very good mum and, you know, I felt that isolated. And, you know, there was some indication but it, for me, it wasn’t an indication of postnatal depression. It was an indication of, there’s this thing that is not working that’s kind of central to all the other things working. So, you know, if it, they always say, you know, “If a baby cries, they’re either hungry, they need their nappy changing or they’re tired.” And I’m sort of going, “Well, I can change his nappy as much as I like, but actually if he’s hungry he’s not going to sleep.” And so it felt like the hunger was just this central point to all of these other things that weren’t going well. And, and so until I addressed that hunger, then all of the other things that are, you know, should happen, shouldn’t. So it was sort of, yeah, just feeling like I had, like I had failed at the, you know, the thing that, the only, the thing that mums need to do without even trying, I was failing at. So how could I be a good mum otherwise? And so you sort of, I just felt a complete mess. 
 

Lizzie questions the advice telling women to stick to breastfeeding even when, after months of trying, the milk supply doesn’t change. Lizzie was upset when it was implied that she was not trying ‘hard enough’

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We went to these breastfeeding groups and they, they are really supportive but there is, there is this feeling that breast is best. And so when you sort of say to them, “Can I supplement with formula? Can I, you know, should I,” and they were sort of going, “No, no. You just need to keep trying. Keep trying. Keep trying.” And you sort of, and I think one, one group particularly, I went to, and, and the basic implication was, I wasn’t trying hard enough. And they were sort of going, you know, “You must try harder.” As if I wasn’t. And at, and at that point I was trying to do everything. I hired a sort of a, I think they’re called hospital-grade breast pumps, because the thought was that actually if my son’s suck wasn’t strong enough or he wasn’t quite latching on, could I stimulate more milk production by expressing as often as I could? And that was, I think, quite tricky for me because he was breastfeeding for sort of probably an hour before then, he sort of at that point had been so exhausted he’d then fall asleep. Although as soon as I moved he then woke up again, so you’re sort of sat on the sofa for hours.
 
So at that point, I was going, “Well, actually, he, yeah, I don’t want to use up all my milk by expressing and then he needs to feed 10 minutes later. And then there’s not enough in there because I’ve just emptied it all.” But I was sort of going with this theory of, the more it’s stimulated, which they kept on telling, “The more it’s stimulated, the more that will come out.” I was taking fenugreek supplements because they say that fenugreek, it was another way of stimulating it. So I smelt of sort of spicy food for [laughs] for months because of that. And they said, “Oats too, so I was eating lots of porridge and flapjacks.”
 
And so, you know, it was sort of, you know, the implication I think by, by some of that support network, that I wasn’t trying enough, was heart-breaking because I was going, “Well, what else can I do? What else? You know, I’m, I don’t know how else I can do this.” And so that, I think that was hard to take. And, yeah, I was exhausted. I, my, baby was never sleeping. My husband was exhausted. And my baby was losing weight.
 
And, but, again there’s a, there’s still this very much on the emphasis from the health visitors and from the breastfeeding groups at children centres that, “Actually, you just need, it’ll happen. It’ll happen.” And you, you know, you’re scouring the Internet going, “What are other peoples’ advice and experience?”…
 
And, and I think, “Yeah, all these things about, it’s not just about the latch.” It is about, you know, what’s happening in there and how is that production work? And what you can do to stimulate it. And actually at what point do you know that it’s never going to happen, you know? So I battled on for three months to try and exclusively breastfeed. And actually only, it was only afterwards that they say, “Actually, it should’ve come in by four weeks, six weeks.” And you sort of, “Well, nobody told you that.” You know, but at the same time the, it is implied that you will have this flow of milk as, you know, immediately after birth. And I think that it, it does need to be more realistic, that actually, you know, your body is going through so many dramatic changes that it does take a while for this, you know, for your baby to, to learn how to suck effectively. It takes a while for your, for that baby’s suck to be powerful enough. You know, this teeny little human being, and for that he’s got a tiny little mouth to actually suck, suck enough to get some milk out, is, you know, is, is, takes a while. And I think some realistic, you know, timetable of how long it might take. So how long do you have to be patient for and just go, “Actually, we’ve just got to stick this out”? And at what point do you go, “Actually, it’s still not working, so there must be something else that is not quite right,” rather than just that, “Oh, it just takes its time to come in.” And I think, yeah and that for me was the missing piece of information.
 

Lizzie’s health visitor noticed her distress and told her to stop feeling under pressure from previous advice.

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The health visitor goes, “Are you OK?” I burst into tears. And I was sort of, you know, I was trying to gather it together, and I’m trying to explain why I was upset, and they sort of, you know, sort of did and, you know, “Well, I mean, I’m sure it’ll be, you know, be fine.” And, “Just try harder. And just be patient.” And actually after the third time of bursting into tears, they obviously went, “Oh, actually, I think we might need to pay a bit more attention to this one.” And at that point they did do some more sort of hands-on work with me, and they, you know, health visitors are rushed off their feet. So then they visited me sort of every couple of weeks. And, and at that point, they sort of realised that it wasn’t through lack of trying, that we were, that we were struggling. And they kept saying to me, “Well, who is putting, who is putting this?” And I kept on going, “I want to breastfeed him until I’m six months, breastfeed.” And they were, like, “Well, who is putting this pressure on you?” And I was like, “Well,” I said, “Every advice that there is, is, you know, all the midwives are putting this pressure on. The health visitors say that it should be six months.” You know, because I had diabetes, they’re saying, “It must be six months.” Otherwise, we’re both going to get diabetes and, you know, you’re letting your child die. And I was like, “Everything out there is saying, ‘Breastfeed until six months, at least.’ That’s,” and I said, “That’s where the pressure is coming from.”
 
And at that point, she said, “Well, don’t. Don’t do that to yourself, you know? It’s not, you, you know,” she said, “A healthy mum means a healthy baby. And if you’re putting yourself under so much pressure, then actually who’s, you know, these people don’t know you. And they don’t know your baby. And you know, we want you to breastfeed for us long as possible, but that for you might not make it till six months.” And at that point, I just went, “[sighs] Oh, thank goodness. Somebody’s understood.” 
 

Three months after her son’s birth, Lizzie felt confident again and able to select information that worked for her and her son. She stopped feeling like a failure and became more assertive instead.

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“Actually, this is my baby.” And I think that was, it, that was what I think eventually kicked in, was that sense of, “He’s mine. And I’m his mum. And I do know best. And I am actually going to stop, I’m going to take every bit of information I’m getting and pick out the bits that work for me and for my baby.” And I think it was when I had that, “I’m his mum and I’m going to do what’s right for him,” that I think actually, that changed my attitude completely. Rather than feel like a failure, I was like, “The way I’m not going to feel like a failure is if I’m going to take control of this situation and be his mum.” And I think, that’s what I kept thinking. “All these other experts aren’t his mum, you know. I’m his mum.” And so it’s, you know, that I’ll sort it out. And I think it was at that point that I, that things, I started to make more pragmatic choices on, on how, you know, how I was going to feed him. And he got to be a lovely baby after that.
 

Lizzie says that, at her breastfeeding class, breast milk was talked about only in terms of being plentiful. She didn’t expect to have any problems regarding milk supply.

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I think the, before I had my baby, I went to the, I think they’re called “parenting skills classes” at the hospital. And I went to the one on breastfeeding. And actually what was quite interesting at that point is that  there was the implication that you would kind of, as soon as you had that baby, you would be gushing buckets of milk. And it was sort of, you know, you wouldn’t be able to hold back the tide. And it was, and the focus of these parenting classes were more around, “Should you breastfeed or not?” rather than, “Actually, this is how you do it.” So yeah, but the implication was that milk would just come and you’ve actually almost got to stop it, you know. There was sort of, advise you on nipple pads and, actually, if you need to express because there’s too much. And so I think in my head I was expecting there to be loads - of milk. And then in the hospital there just didn’t seem to be anything coming out. 
 

Despite her efforts, Lizzie didn’t manage to increase her milk supply. This resulted in a breastfeeding experience that became increasingly stressful and exhausting for both mother and baby.

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So when I was exclusively breastfeeding him, and that was probably for three months when it was just breastfeeding, and he very rarely slept, particularly during the day, unless I was breastfeeding him. So he just, it, when I was feeding him, he would possibly be feeding for an hour or more. Swapping breasts all the time. And not sleeping. It was only at the points when he’d obviously got to the point of complete exhaustion because he’d been sucking for an hour, that I would then have him, I’d be on this sofa and propped him on a cushion that he would eventually then just fall asleep. But was such a light sleeper because as soon as he woke up he was, you know, as soon as he sort of stirred, he was hungry because he wasn’t full. And that, yeah, I sort of then had to, I was sort of pinned to the sofa for hours and hours and hours. And it, just at some, you know, you sort of go, “Well, you know, I need the loo but I’m not going to move. I’m not going to risk it because he’ll wake up and then he’ll have to feed again and I know I can’t do it and...” so my, it was just, yeah, so he did, he very rarely slept.
 
And at night, probably I was at night managed to get him to sleep for maybe an hour and a half probably. And then he’d want feeding and then I’d feed. I’d be breastfeeding him for sort of an hour and a half. So it was, it was, it was physically exhausting. And my husband was brilliantly supportive and he would sometimes, when I just needed that break, would, would take [son] into another room and sort of just try and just distract him and play with him. But he just wasn’t having any of it, you know? He was hungry and that’s what he wanted. And even sometimes it was sort of going, “Actually, even if the comfort of breastfeeding, even if there’s very little coming out, makes him feel a little bit better,” and again, if he fell asleep, so then sometimes he did fall asleep for me in bed and went sort of sit there awake, not daring to move because I was just like, “Oh, I’m going to have to breastfeed again if he wakes up.”  
 

Lizzie says that she and her husband were exhausted and struggled to be a parenting team. After three months of unchanged low milk supply she decided to start mixed feeding.

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And my husband was, did his best. But, you know, I mean, he had a fortnight as his paternity leave and then my mum came down to stay with us for that third week. My dad has multiple sclerosis and so he had to be put in respite care in order for my mum to come down. And so it just meant, you know, that’s complicated in terms of getting my mum to stay, but she kind of rescued us for a week. But yeah, my, you know, my husband would, would find me, like, pressed up against the window when he came home from work because I was just so desperate for, to hand over this screaming baby to somebody else. And I could just feel that I could detach myself from this baby that I couldn’t make happy. And sort of, you know, my husband would come home and, and I said, “Just take him for half an hour. Even if he spends that half an hour screaming.” I just, I was going to stand in the garden because I just, was just, yeah, was a complete mess. And my husband would you know, got up at six in the morning, do a full day at work, and come home to be handed this screaming baby. And it just, I just needed that half an hour. And then I’d go, “OK, right. Let’s start again.” And it just, yeah, it was just never, it just felt never-ending, I guess, at that point. And, yeah, I think my husband and I really struggled to be this parenting team at that point because he, we were just so exhausted. We had nothing left to be able to support each other and we couldn’t support, you know, we felt we couldn’t support ourselves. And everything was being, you know, focused towards our baby. And it was on my shoulders to fix it. I think that was the hard thing, is that, you know, my husband could be supportive, he could try and rock our, rock our baby to sleep, he could, you know, look after him, he could make me a cup of tea, but actually the only person who had the solution was me. And actually the solution wasn’t happening. And, and I think that was the awful thing, is that me to sort this problem out. And I couldn’t. Tried everything and I couldn’t.  
 

Lizzie’s message to new mothers is to do what works best for them and the baby and not to feel ashamed if breastfeeding doesn’t work out.

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I would say for - I would say don’t be ashamed of it. I think I felt ashamed that I couldn’t do it. And felt that - yeah, that I wasn’t a good enough mum. And I think, don’t ever, ever think those thoughts because you’re a good mum if you find a way to keep your baby happy and healthy. And I think, for me, I would still encourage women to do as much breastfeeding as you can, but to recognise that if it’s, if it’s not enough, then there is no harm, I feel, in topping up with formula. And that’s we did. It was definitely a, we didn’t replace. We topped up. So I would breastfeed. If he was still hungry, I’d, the, he’d then bottle feed. And that worked for us. I think after a while we then, as he needed more food because he was growing, we then did it so I then alternated feed. So I then did a, I did a breastfeed and then the next one was a bottle feed, next one was a breastfeed, next was the bottle. And we did that for a bit. And eventually it got to the point where I was just giving him one breastfeed in the morning. So it’s sort of going, start to recognise what works for you and feel confident enough that you’re a good enough mum that that’s, you know, you know how to keep your baby happy. So don’t feel that - feel that you’re letting your baby down. I think you’re, yeah, you’re doing the best for your baby by making sure they’re, they’re happy and healthy. However, whatever milk source that might be.
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