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Breastfeeding

Variations of the breastfeeding experience

A variety of health organisations (such as the World Health Organisation (WHO)*1, the UK Department of Health, NICE (National Institute for Health and Clinical Excellence) and the UNICEF Baby Friendly Initiative) recommend that a baby should be exclusively breastfed for the first six months of their life. This means that babies need only breast milk and not other liquids or solids of any sort. The WHO definition of exclusive breastfeeding includes giving babies expressed breast milk, although some authorities make a distinction between exclusive breastfeeding (feeding only at the breast) and exclusive breast milk feeding (feeding expressed breast milk via a syringe, cup or bottle).

There were several variations of the breastfeeding experience that the women talked about, including expressing breast milk and feeding expressed breast milk to their baby; donating expressed breast milk to a milk bank; mixed feeding; supplementing breastfeeding and using a dummy or pacifier with a breastfed baby.

Expressing breast milk
Most women we spoke to had expressed breast milk for one reason or another, some regularly and some occasionally, and found it useful and relatively straightforward. However, others said that they had never expressed, could not do it, did not enjoy it, found it painful or uncomfortable, or found it a real 'faff' and just another job to do. Some women expressed breast milk for their sick baby. One woman expressed for ten months to feed her baby with a cleft palate and another expressed for ten weeks until her baby learned to breastfeed. For these women, expressing was important as it enabled them to give their baby all the benefits of breast milk and avoid using infant formula.

 

She expressed long-term for her baby with a cleft palate. She talked about the experience of...

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Age at interview: 36
Sex: Female
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So basically I [sighs], the first day, the first few hours I started expressing so I don't know where that came from, I think maybe I just knew because I'd read stuff, or it might be that there was someone key there at the hospital who got me going. I do remember being left to my own devices to a fair amount and it was one of those big old-fashioned pumps with the big glass chamber and I didn't know that it was a good idea to do a bit of hand expressing first or a bit of massage to help the milk flowing. I knew I had to make volumes, I had no idea how little colostrum there was in the first few days and so I, overdid it, I basically tried too hard before my milk had come in. And I think it was the first night or the second night I was in, I'd made myself sore in a way that you never should with a pump because you should never pump at a level where it's painful it should just be until the milk flows. I know this now but I didn't know it then and that's when my big sister came into play, she was in my room gone midnight helping me because I basically I'd got sore nipples, I thought I'd blown it, that was my attitude I think it was probably maybe day two or day three, that feeling, you've blown it, you've wrecked it, it's gone, you've got the, you know, you've got sore nipples, they're scabby, they're painful and you're not going to be able to ever express or breastfeed again. So but she got me back on track and for a few sessions I used the hand pump which just gave me a bit more control but then I learnt actually, I don't know how early on, but fairly early on that double pumping was the best way.

What do you mean by double pumping?

By double pumping rather than feeding, breastfeeding, sorry I should take a step back. When you've got a baby who cannot breastfeed, you can give them your milk by expressing it for them and it's called exclusive expressing, and it means that you are taking milk from your breasts using a pump as often as the baby would feed. And if you do it as often as a newborn would feed then your milk will come in the same way and you will be able to have enough milk for that baby for as long as you want to express for.

So how often is that?

So, about eight or nine times in twenty-four hours I was expressing and it was really important that I did one in the middle of the night, because that's when the prolactin levels, the hormone levels are highest, so sometimes a bit of a killer when the baby was sleeping to wake up and express but I really knew how important it was. and I discovered that double pumping was better than single, so rather than expressing off one side and then expressing off the other, it's better for yield and fat content if you can express from both sides at the same time. I guess a Mum who's feeding for twins, she makes enough milk for twins and it's probably sending all the right signals to the body. And if your baby isn't feeding from the breast they're not stimulating the nipple in the same way and they're not going you, you need to help your breasts in every way they can so double pumping is something really important. I mean, I was very lucky because had my first at a hospital which has a milk bank in, so that there's a lot of experience there and I was able relatively early on to tap into that. a tough decision was, before my milk came in, I was making from the very first day, but we're talking five ml's, ten ml's, twenty ml's I've got all the charts, I've kept them all.

Can you remember what that looked like, that colostrum?

Oh yes, I used to call it, 'Gold dust', I used to call my colostrum gold dust because it was, and it was like gold dust in every way, it looked gold, it

 

For Ruth the pressure to provide her milk to her premature baby came from herself and health professionals.

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Age at interview: 43
Sex: Female
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The Health Visitor comes and comes and has a look at it when you are at home, especially when you are a first time mum, they come, oh, I think I must have had four visits I think. I think it was about four visits. Lovely health visitor but she again, like the, the nurses in the hospital said, “He’s a premature baby. It’ll happen. Just keep trying, just keep pumping. Just keep going. I mean you’re giving him breastmilk, that’s great. Just keep trying with the breastfeeding. Try every feed.” And again pressure, “Try, keep going, keep going.” And again all the health professionals, incredibly pro-breast feeding and again I have to say my attitude was as well if I can do this, I really want to, do want to get him to breastfeed. But, you know, having to be up every four hours and pump and, and feed the baby and try the breastfeeding every time you were feeding was getting very stressful and I was getting quite stressed about it and you know the health visitor came, she tried to give me some lessons. She tried and couldn’t get the baby to latch on at all. “Oh, no don’t worry. We’ll try again in another week when he’s a little bit bigger.” It was always, “When he’s a little bit bigger, when he’s a bit stronger, it’ll happen. It’ll happen. But in the meantime do, do your expressing because you’re feeding him breastmilk and you must do that. You must have breastmilk for six months.” Hammered in to you every single time you saw any health professional. 

Other women expressed as a way of dealing with engorgement, slow let-down or low milk supply in the evening or to build up or maintain their milk supply or to stockpile expressed milk in case of later need (such as returning to work - see 'Breastfeeding and working'). Although in some cases, such as engorgement, expressing helped women with their milk supply, several women felt that continued expressing had the opposite effect of unbalancing their supply. One woman called it “madness” when she realised that her husband was giving their son a bottle of expressed breast milk while she was actually expressing. “Why am I doing this … when I could be breastfeeding him”, she said.

 

She began expressing to deal with engorgement and mastitis and continued to do so for six months....

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Age at interview: 35
Sex: Female
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I was expressing first thing before I fed because my breasts were really hard and I was told the reason I had mastitis was because my breast was too hard and the baby couldn't latch on, so I was expressing a little bit, then feeding him, and then, you know, wait until the next feed.

And you got up in the night to do that expressing?

I had the breast pump next to me and I was just throwing away the milk that I was expressing so it was yes, it was quite a, you know, quite a lot of things to do but I got really good at it, I could do it with the lights off, and, you know, I knew how to put the breast pump together in the dark [laughs], you couldn't learn this sort of thing, there are all lots of little parts and things but I knew how to do it very well and it was, I had to start it with a, I would sort of take a mechanised, you know, battery one because there were, I knew the suction was better, in fact, I didn't like that because it was making a noise and then the batteries would run out and you would have to charge them, it was quite something, so I bought a hand pump that was very good and I got on quite well with that.

Very time consuming?

Yes and totally, I think I was just creating more problems'

No wonder'

'doing it.

'you were so tired.

So, I yeah, it was. I had a lot of milk yes, I had, you know, I had to express a little bit out because that was going, with my first experience with [son], it was to, it's so totally different thing that happened and I have a feeling it might be because I was expressing from the word go and I kept it going, and in fact I was probably creating more milk than [son] needed and in fact, I probably would have been better off putting up with the engorgement just for one day and then letting it die down to what [son] needed as opposed to just expressing all the time which was just, you know, the, creating an imbalance really between his amount and the production of the milk, but you, I know that in retrospect and with the experience of it, at the time I was a beginner and I just believed what people said and I think had a lot of quick fix advice, 'Just express a little bit dear and you'll feel better', and, I, you know, I think that was the wrong thing to do, so with [son] I kept on feeding, expressing, storing milk, it was just, you know [sighs], really complex sort of experience and until he was about seven months I really struggled with it you know.

So how long did you continue this expressing for once he was fully feeding?

Totally for about six months, you know, I was, I just [sighs], it was quite, quite a struggle really I always had too much milk, I was always uncomfortable in fact.

Why did you continue to express?

Because I was told that the engorgement it would be, that the baby wasn't latching on because my breast was too hard and that I should take a little bit off first and then put him on the breast. So I was expressing first and then feeding him, and then I would do that again, you know, express a little bit off my breast and then feed him, and then, you know, I just found that I always had too much milk, it was too much, and then I was told he was not latching on because the breast was too hard but also because I had too much milk so it couldn't come through the flow, so I had to take a little bit off, but I think it was just a vicious circle, just, you know, total sort of, it was the wrong way to go about it. so that was, I, you know, t

Sometimes the women's reasons for expressing were more social, including enabling their partner to take part in feeding, or enabling them to go out for an evening and leave a bottle of expressed breast milk for a babysitter.

Some women used hand expression or preferred a manual pump. A few said that they were put off by the noise of an electric pump or that it made them feel a bit 'like a cow'. Others recommended electric breast pumps as faster and more efficient. Some women preferred to express from one breast at a time, some expressed from both at once and others expressed from one breast while the baby fed at the other. A few women said that they had adapted a nursing bra to enable them to express from both breasts at once and keep their hands free for doing other jobs. A few women said that understanding how their let-down reflex worked helped them to mimic it with their breast pump and be more successful with expressing (see 'The sensation of breastfeeding'). The women fed the expressed breast milk to their baby using a variety of techniques, including nasogastric tube, syringe, cup, bottle or Lact Aid® (a breastfeeding supplementing system). 

 

Giving breastmilk to her premature baby was the priority for Ruth but the use of an electric pump every four hours for 4 months was exhausting.

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Age at interview: 43
Sex: Female
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So I then took this very tiny little baby home sort after eleven days of being in the special care unit and the fun began [laughs]. So I was, I, my attitude to breastfeeding was that I’ve always thought I would breastfeed my babies. There was no question about it, I was very pro-breast feeding. I knew the benefits of it, I knew the literature. I’d read up on it, there was, I didn’t agree with, you know, bottle feeding for the sake of bottle feeding. It was always going to be breast-fed. So with the troubles that I’d had in the hospital and the fact that he just wasn’t breastfeeding and the most important thing was to give him breastmilk, so I took a pump home with me from the hospital. I hired one of these massive great big pump things and it’s not one of your little hand held things. This is a big electronic thing that does a double pump business. It’s like a milking machine, it is, I came to loathe the thing and it had a big stand and it stood in the corner of the room and every four hours out came the suction cups and you had to sterilise everything and clean it all down and then you know, it used to take about it used to take ten/fifteen minutes to prepare everything before you had to do the, do the expressing and then you plugged yourself in to this machine and I did. At night I used to double pump because I was just too fed up with it. Otherwise I’d just do one breast and hold the baby on the other side and give him cuddles and things like that but at night because I’m so tired I just used to do both boobs because if you didn’t do both boobs you’d end up really sore and you risk mastitis and all the rest of it, so at night I did the double pumping. So you’d go and do the pumping for about half an hour and then you’d then have to feed the baby…
 
So you know this is a month on from having the baby and still not breastfeeding. And still getting the message through from health professionals, “You must breastfeed. You must give him breastmilk. You must, you will get there, he’s just small. He’s just premature. It’ll happen.” you know, so first time mum, being a little bit naive and you know, I would count myself as quite a, you know, intelligent vocal person normally but, you know, this is my first baby. I’m a little bit hesitant about knowing what I want to do. I want to do the best for my baby so I follow their advice and I keep going and I keep going and I’m pumping and I’m getting tireder and tireder because I’m up all night pumping and then you know without, and my husband feeding the baby, you know we’re doing it in shifts as we go along. But, you know, that two o’clock in the morning and you’re just sitting there pumping. I mean, I lost a lot of weight when I was pregnant which is unusual but I did lose a lot of weight. But at that 2 o’clock in the morning feed I’m sitting there and I’m eating half a packet of chocolate digestives biscuits because I’m stressed and bored and tired and when you’re tired you eat, you want to eat sugar and you want to eat crap. So, you know, I ended up putting all the weight I’d lost when I was having the baby back on again over the space of six months I think.  

Donating expressed breast milk
Several women talked about voluntarily donating breast milk. Some did it to help newborn babies who, for some reason, were not able to have their mother's milk and others did it because their own baby had been the recipient of donated breast milk from a milk bank and they wanted to 'repay the debt' (see 'Breastfeeding in special circumstances'). One woman said that a friend had offered her frozen expressed breast milk when her son was refusing to breastfeed. She didn't use it but would have if she had needed to.

 

She expressed every evening after her daughter had gone to bed so that she could donate breast...

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Age at interview: 34
Sex: Female
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Since we've started on solids I wanted to make sure that any milk, any excess milk that obviously [daughter] might not be having now I didn't want to just lose it and I'd heard of a milk bank for [major hospital]. Which is when you express milk for premature babies, they come and collect the expressed milk, they put in their freezers and obviously they, they may sell it on to other hospitals and they may use it for their own baby unit and so that's what I started to do. I phoned them up and the lady came to see me and she's lovely, absolutely lovely. Do a blood test, like you do when you're pregnant, I think it's a bit more intensive because obviously they've got babies that they're going to be feeding the milk with and I was given a pump and some bottles. And basically every night when my daughter's gone to bed I have a bath, I then express for maybe twenty minutes, half an hour whilst I'm watching TV, and just bung it in the freezer. And then when the lady's in this area she'll give me a ring to see if she can collect some or I give her a phone call and she comes down and collects the milk that I've stored for them. So I feel I can do my bit [laughs] but obviously you know that's fantastic stuff for babies because not all mothers are able to breastfeed or not able to feed straight away especially when they're premature and they might have lots of things wrong with them. You know, they say breast is best and if I can help out a newborn baby with a bit of breastmilk then I'll do that.

Are you using an electric or a hand pump?

The pump that I use is a hand pump I get on fine with it, it's not a problem. I have used an electric one with [daughter] but that didn't happen for very long because it was just too much that I was doing but I actually prefer the hand one because it's just smaller, I haven't got a lead across the room, I just bung it in one of those microwave sterilising bags and pop it in there for three minutes, take it out, sit down in the lounge, watch the TV and just do a bit of pumping, it's no problem whatsoever.

And is this purely voluntary or are you paid?

This is purely voluntary you don't get paid for it no.

Mixed feeding
One woman talked about what she called “combination feeding”, which was a mixture of breastfeeding and bottle feeding, that she did on a regular basis right from the start. It worked for her because she had been so ill at the time of birth that she was unable to produce enough milk for her baby (see 'Feeding patterns in the early days').

 

She used infant formula “top ups”, but is pleased that her son was essentially breastfed.

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Age at interview: 40
Sex: Female
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He was combination fed. He was, he was breastfed in the very first few hours and then I became very ill after the caesarean so he, I think he perhaps had an ounce of formula in his first twenty-four hours and then that really kept going with an ounce of formula until he was six months old. By six months old I think he was perhaps on twelve ounces of formula but that would be two bottle feeds and then the rest would be breastfeeding by me.

So you were putting him to the breast regularly?

Yes, too regularly really, as in trying to make more milk, then it seemed to, you know, it was, it seemed to be almost constant at one point which of course I wasn't then giving myself any chance to have a rest. I think that's why we needed the ounces, or the two ounces of formula during the first few weeks, when I came out of hospital my health visitor was very supportive in working out a combination plan so that the baby would put on weight.

Can you remember what that plan was?

It involved three ounces of formula.

Every feed or?

No.

Once a day?

Twice a day. So it would be once at night. So something like seven o'clock at night and seven o'clock in the morning and all the rest of time he was fed by me, and he did put on weight quite slowly, to start with, but I've spoken subsequently to other mothers who've breastfed and they've said, 'Oh he seems to have put on weight just the same as my son did'. And I think I was quite ignorant about how much more slowly breastfed babies put on weight than formula fed. But also I think the charts in the little health books that the kids get, I think that they are based on formula fed babies, so inevitably you're not going to be at the fiftieth percentile. My child was born at the twenty-fifth percentile and dropped after two weeks, less than two weeks, but certainly at two weeks he was on the ninth percentile. He didn't go below the ninth but it was quite, quite slow for him to come back up.

Was that seen as a problem?

Yes.

With what consequences?

That he wasn't getting enough food that he wasn't growing quickly enough. And I do [pause] I do think that as far as I'm concerned that after I'd had the baby then I, throughout pregnancy, I'd been in this sort of, 'Well health professionals know best and I'll just do what they say' and, which actually in other walks of life, you know, I take my own decisions really, but it was a time when I'd sort of resigned myself to, 'I don't know much about this'. If I were to do it again then I'd certainly trust my own judgement, more, and go with what I thought was right.

Because I'd have thought, 'I'm not doing the best for my baby'. By doing, so it felt okay to, it was almost a, the formula for us was a saviour to have that extra top up definitely, and I think that's all it was actually a top up [pause]. I can't remember what I was going to say, the formula was a top up.

A saviour for feeding in public?

Yeah, it was a saviour for at the end and the start of the day that would be our end and our start and that was fine, and we knew that that's all it was. But essentially our child was breastfed and that's the way I'd like to remember it really. But I'm honest enough to admit that if we hadn't have had the formula then we just, I don't know actually what would have happened, I'm sure he wouldn't hav
 

Maryam was studying at university and her milk supply was low, so she opted to mix feed her children.

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Age at interview: 33
Sex: Female
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I breastfed all of them, some of them really I mixed up with the bottle feeding but the first one really I did mix because I didn’t know, I haven’t got any experience and I noticed I don’t have much breastmilk, although I didn't know because I was 20 and I came here and I have no friends just me and my husband so we haven’t got any experience and nobody like advised me to use or bottle feeding.
 
Okay.
 
I only breastfed my child at that time and I noticed he’d cry a lot so I didn’t know like maybe he hasn’t got enough milk, I didn't really know really.
 
I just noticed my breastmilk is not much really, I didn’t use breast pad, yes so that was there reason. The second one then I got friends and they advised me to use the mixture of milk, the bottle milk, that’s what I did and I was studying at that time, yes so I decided to mix feed. And it was okay really for her although she has allergy, even the doctor didn’t know she has allergy, if I give her the, milk she started vomiting.
 
Okay.
 
Yes so at the end of the day they just realise that she’s got allergies and so they have to like start giving me like soya milk for her…
 
And how much breastfeeding were you doing around that time?
 
I am doing okay I think every three hours I gave her the breastmilk yes it was okay for her but if I give her the [formula] milk then she’d start vomiting, but I didn’t know really I thought like maybe it was just a colic, I didn’t know like she’d got an allergy at that time.
 
So did they put her on soya milk?
 
Yes it was okay then she stopped vomiting.
 
You remember how old was she?
 
About, I think 7 months that was the time that they realised that she’d got allergy.

Supplementing breastfeeding
Although current guidance is that babies should be exclusively breastfed for the first six months, some women we spoke to had introduced occasional bottles of infant formula. Both medical and social reasons were given for supplementing breastfeeding. Many babies were introduced to formula in hospital because of low blood sugars, jaundice or delay in beginning to breastfeed. Others were given infant formula later because of weight loss or slow weight gain (see 'Monitoring baby's growth'). The social reasons for introducing supplemental feeds of expressed breast milk or infant formula included allowing the father or other close relatives to experience feeding the baby (see 'Changing family relationships with a breastfed baby'); returning to work (see 'Breastfeeding and working'); attempting to get the baby to sleep longer, especially at night*2; giving the mother a break; “socialising” a clingy baby; feeding the baby in public or because it was seen as a “natural progression” from breast to bottle feeding. Other supplements given to breastfed babies included honey on the tongue at birth, cooled boiled water, dioralyte for diarrhoea and a cinnamon, aniseed and rice water mixture for colic and, for a child over one year, a mixture of breast milk, infant formula and cow's milk to tempt him to take cow's milk. While some babies took a bottle without fuss several women said that their baby did not want to feed from a bottle (see 'Breastfeeding and working').

 

She struggled to get her baby to take a bottle when she wanted to gradually wean her from breast...

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Age at interview: 35
Sex: Female
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We, I had real problems with [laughs] with weaning my little girl because she wouldn't take to a bottle, I'd made a mistake in that she hadn't really had a bottle for the first five months of her life, because I'd not got on with expressing the first time round, the second time I didn't really bother very much. And circumstances hadn't arisen where I was away from her, so she was exclusively breastfed for five months, and then being the personality that she is wasn't about to just suddenly transfer to a bottle thank you very much because it suited me [laughs], and we had real battles with her for probably about a week trying to get her to literally take a teat into her mouth, which was very frustrating because I was approaching the point where I needed her to because I wasn't going to be there all the time. So that's a lesson that I've, I learnt from my experience with my little girl that it can be very useful to at least expose your baby to a teat early on so that they will take breast and bottle without all this screaming the house down for hours on end [laughs].

What did you do, and how did you?

I tried everything, I mean I must have bought so many different makes of teat thinking that maybe one would be more palatable than another, none of them were. I mean I remember horrendous times when I left her with my husband and expressed milk in a bottle thinking if he gave it to her and she was really hungry she would take it and she just wouldn't, she's a very determined little girl now, we now know [laughs] she's two, but it's amazing that even at that tender age she showed those traits.

So it wasn't what she wanted to do at all?

Absolutely not. and in the end what broke the cycle was that one night she woke in the night wanting milk and I was determined that I wasn't going to give her the breast, it was about six months and it was at the point where I wanted to stop her night breastfeeding anyway. And so I had a night where it was a battle of wills really, and it was the only way to do it and eventually she was so hungry that she did eventually take the teat, and from then on she was okay with it, but it took a very unpleasant sort of set of, incidents like that, distressing for both of us [laughs] to actually persuade her that that's the only way she was going to get the milk, so I would certainly not go down that road again [laughs]. I think this time I'm, you know, I'm going to make sure that the baby gets a bottle of expressed milk sort of early on, though probably once breastfeeding's well established, just sneak the odd bottle of expressed milk in, to make sure that they have felt it in their mouth and realise that they can still feel fulfilled from having milk that way.

What happened to your milk supply with this sudden, dramatic weaning?

I'm not sure it was sudden and dramatic, the weaning itself wasn't particularly sudden I did it gradually as I did with, with my older child, it was just that the milk would be through a bottle instead, to try and introduce the bottle.

So you were expressing to put milk in the bottle?

So I almost had a two stage weaning process. The first stage being to get her to take milk from a bottle and the second stage being to then reduce my supply once she'd accepted the bottle.

And replace your supply with infant formula?

That's right.

Where do you think this idea of expressing breastmilk or needing to express breast milk to put into a bottle and

 

Maryam breastfed her first baby for a year and the second one for ten months. But infant formula is used at night or when out in public places.

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Age at interview: 33
Sex: Female
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And with your first son for how long did you breast feed him?
 
About a year.
 
About a year?
 
Yes but the second one was ten months.
 
Okay. So you breastfed the second one for ten months?
 
For ten months and then I stopped yes.
 
So were you giving the baby formula at a particular time during the day or night?
 
Yes just sometimes I give her before we go to bed because I make her formula I give her before we go to bed.
 
Okay.
 
And if I’m out you know I don’t like to breastfeed outside so I give her the bottle.
 
Okay. Why? You don’t feel comfortable?
 
I don’t really feel comfortable to just open my breast in the public really.
 
Okay yes. Okay so it was just a kind of at night or when you had to go out?
 
Go out yes.
 
Okay but otherwise you breastfed?
 
Yes all the time.
 
And what happened with your third child?
 
My third one I was in Uni so from the day one really I start with milk.
 
With breast?
 
With baby formula and breastfeed, breast milk as well. Yes because really I was in Uni and I was in year two, level two which was really hard for me, I can’ just breastfeed him I have to leave him with, my mum and my friend as well so I have to teach him really there. You know sometimes it was hard for him to start, you know, sucking the bottle because I realised with my second one it took her ages before she start sucking the bottle so that’s why I started the early age. Since from the hospital anyway I started giving him the formula yes.

A few women worried about nipple confusion and the baby refusing to breastfeed once they had tried a bottle*3. Others said that giving a bottle had been detrimental to their breastfeeding and resulted in early weaning which they regretted. Some women agonised over introducing infant formula.

 

In desperation, she gave her baby artificial milk which made her baby sleep but quickly led to...

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Age at interview: 39
Sex: Female
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I remember it precisely it was six weeks, and I mean it was the middle of the night and it wasn't the done thing in the Middle East for women to be out on their own and I remember thinking, she was screaming, my husband was sleeping, bless him he'd probably done, I don't know, an eighteen hour day or something and I'd gone into the sitting room to feed her, I couldn't get her to settle and I remember taking the baby to him and saying, 'Right that's it I'm off to the garage' and off I went, across the road, by myself, in this sort of Middle Eastern nightdress thing that I really shouldn't have been going out in, I just turned up at the garage and bought some local artificial milk, gave her eight ounces and she slept [laughs]. And, you know.

How did that make you feel?

Actually, I think probably pleased because it was the first decent sleep I'd had, I think I recall that she slept for four or five hours and I remember waking up in a terrible panic the next morning, both of us did, because we both slept, my husband and I and thinking, 'Oh my God something's happened', because she'd never slept like that before. And, I think in terms of feeding, if I'm really honest, that first artificial feed was the beginning of the end for breastfeeding because then you very quickly learned to associate that artificial feed equals baby sleeping, breastfeeding doesn't. So I did continue to, you know, to try and express and feed her myself but if I'm really honest the breastfeeding and expressing got less and the artificial feeding got more. I mean weight gain and things hadn't been a problem so it wasn't like I suddenly ended up with a big chubby baby then, you know, and all our problems were solved, because I still had, you know, the overwhelming problem of being lonely and on my own, although that's about that stage at where I'd been able to start driving the car again and getting out and about, probably slightly before then. But, I did, it did mean that, when I sort of reviewed how I felt about breastfeeding first time round, but I did feel quite guilty about it, and you kind of watch things like is she going to get eczema and other such things and no she never has but you, I did feel that I'd failed her really in terms of not having fed her for as long as (a) I wanted to, and (b) I thought I would. I just had this kind of idea of myself as a mum that, you know, I'd still be breastfeeding at a year and, the, how I was going to manage expressing my milk when I was back to work full time, well I never got that far did I, you know, had this sort of pump and all the stuff and buying daft things like the bags for freezing my breastmilk, I think they went in the bin but, so, I had this image of myself, how I was going to do and I do remember feeling very disappointed that I didn't do as I was going to do, if that makes sense?

 

She thought that buying an expensive breast pump would make her life easier. That didn't help so...

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Age at interview: 30
Sex: Female
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Formula I started about eight weeks as well, about nine weeks.

And this was infant formula through a bottle?

Through a bottle, yeah.

And he hadn't anything before that?

He had, no, no formula, nothing at all, but I did try expressing but the burning pain was there and it was just taking too long, it took me an hour to express about an ounce.

And were you doing that by hand or was it a pump?

Electric pump.

Electric pump.

Yeah. It was just too hard, too difficult and the pump it was very painful as well, that's another thing I thought buying a pump, spending so much money on it would make my life a lot easier but it wasn't at all. So that was no good, but with the milk that I collected from the breast pump I gave it to him in a bottle which he took straight away. So seeing how quick and easy it was to feed him from a bottle, it just made things worse really, so to take a break I bought some formula, well the first time I went to buy the formula, I picked it up from the shelf and I had to put it straight back down I just felt that I was betraying him, and I just couldn't go ahead with it, so I went home and I cried again [laughs], but then I finally gave up and bought some formula so I was giving him formula twice a day, just at night time and in, and during the day I think it was just to get myself a bit of break. So the pain went away and we were happy but then this little one here started getting very lazy, and because, what he was doing was he was breastfeeding but only the foremilk, so when he had to put the effort in he didn't want to, so I had to top it up with the bottle which I assumed was okay, but then his poo started going green and that's when I gave up, I thought he's not breastfeeding, he's not feeding properly from my breasts and it's not doing him any good at that point, and so we gave up and he was ten and a half weeks. I regretted it, I regretted putting him on the bottle because I thought if he hadn't been on the bottle he would've still [pause] been able to breastfeed. I felt really, really bad about it, I don't know why, I just felt as if I was letting him down.

What most of the women who supplemented their babies and then continued to use infant formula seemed to have in common were unresolved breastfeeding problems, particularly pain and underweight babies.

Using a dummy or pacifier

The use of dummies (pacifiers) was a controversial issue, sometimes with the same reasons being given for and against their use. Some women said that they never used a dummy because they were concerned about the effect it might have on breastfeeding and on the shape of the baby's mouth and later speech development. Some women encouraged their baby to suck his/her thumb or finger in order to comfort themselves. Others introduced a dummy for a variety of reasons that included allowing the baby to soothe, comfort and settle itself; providing an alternative to comfort feeding especially when the mother felt drained and needed a break from having the baby at her breast; and instead of thumb-sucking that may have affected the baby's jaw development and proven difficult to discourage later on. Several women spoke of their baby having sucked their thumb or fingers while still in the womb. One woman said that her friend called her a “human dummy” because she fed her baby for comfort as well as hunger and another said that giving a dummy would have been for selfish reasons so she couldn't do it.

 

She used a dummy with her first two children but not with her last two.

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Age at interview: 37
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Did I ever use dummies? With my first two I did use dummies, I found that my daughter was quite a sucky child, so I did introduce the dummy. Again before she was born they were able to show me on the scan where she was sucking her thumb so whenever she was born I did discover that she was a sucky child, so again I did introduce the dummy.

By sucky child you mean that she needed a lot of sucking?

Yes she did.

And she couldn't get that on the breast, enough?

No. She would've used her thumb.

Was that a problem?        

Well, I had it in the back of my mind that sucking her thumb would have maybe proven difficult later on whenever she would've had teeth, so I, that's why I sort of gave her the dummy so she wouldn't be sucking her thumb quite a lot, so she, she would've used the dummy, she would've used the dummy a lot, so she did. It was actually quite hard to get her off the dummy because she would've sucked quite a lot.

So when did you use it, what sort of times did you give her the dummy?

Probably after a feed whenever I discovered that she would've been sucking her thumb I would've given her the dummy, so I did, she would've, she would've looked for the dummy actually quite a lot as well.

And did that help her to go to sleep?

Yes it did help her to go to sleep, yes, it was one thing that she looked for, you know? Maybe it's because I maybe didn't really know an awful lot about dummies so I think I'd really just gave it to her so to speak. Now with my second, again I sort of thought with the dummy I'll give the dummy but my second son now was, was a good feeder but I just really gave him the dummy at, at night time, you know, and then with my third well I introduced the dummy but I sort of got, so not really wanting it so I thought, 'Right, okay, if we can do without the dummy, great', with the fourth I just didn't, I just didn't introduce it because with the third and discovering that it didn't need, didn't want the dummy I thought, 'Oh great', you know, 'look what I've come, I've come through a year of not needing the dummy, a good sleeper, a good feeder, so why have a dummy?', again with the fourth I just didn't introduce it at all. I thought if I could just go through what I went through with my third it would be great so I didn't introduce it at all, and thankfully everything's been grand, I've had no problems.

So what are the advantages and the disadvantages of using a dummy?

Well with a dummy, to me, I would've thought, 'Now are they hungry or are they not hungry?', with the dummy being in the mouth all the time it was sort of hard to tell whether they wanted to feed or not, so with having no dummy I found when they would've cried, looking, snuggled in looking for the breast, I knew that's what they wanted, whereas with a dummy it was hard to tell, you had to go and take out the dummy to see if the baby wanted the breast, wanted a feed or not. So, I do, I definitely would say if I had to start all over again I don't think I would even introduce a dummy of any kind, at all, because I think that you can get confused between the dummy and the nipple. Again the latching on could be a problem with just sticking the dummy in, just opening the mouth, breast like, like again that may have been a problem with my daughter, with her being the first, the dummy and the latching on of the nipple, because with the dumm

* Footnote 1: In 2001, the World Health Organisation issued a global public health recommendation which said that babies should be exclusively breastfed from birth to six months, and then breastfed together with age-appropriate, solid foods for two years and beyond.

*Footnote 2: Supplementing a baby with infant formula (whether standard formula, 'follow-on formula' or 'hungrier baby formula') at bedtime to make them sleep longer is not recommended. In the early weeks, the introduction of infant formula will decrease the likelihood of the confident establishment of breastfeeding. The production of the non-standard infant formulas is simply a marketing gimmick. 

* Footnote 3: Artificial nipples, such as bottle teats and dummies (pacifiers), have been associated with incorrect sucking technique and refusal to breastfeed in some babies but there is very little evidence for this belief. The concept of 'nipple confusion' is widespread but largely anecdotal at this time.

Last reviewed November 2018.
Last updated September 2015.

 
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