Breastfeeding, naturally

I am an International Board Certified Lactation Consultant IBCLC with a private practice in Harare. I accompany families in their breastfeeding journeys. Some of you will find this funny, breastfeeding can’t be difficult. Some of you will find this amazing, remembering their own struggles or preparing for their own journey.

Today, I would like to take you with me to visit a few families and experience their personal journeys. (All names and cases are made up.)

Meet Patricia, Patricia is a mother of two and pregnant with her third child. She had very little support with her first and could not breastfeed for more than a few days due to extreme nipple pain. Although she is anxious, she would really like to breastfeed this baby, Patricia came to me very early in her pregnancy and we went through her experience to help her make a plan to avoid these difficulties again this time. Patricia attends every support group meeting she can in the next 6 months until I get a message: I’m in labour! She gives birth to a healthy baby and manages to breastfeed him pain free. She needs a lot of support in the next weeks. Having a breastfed baby feels different and new to her. Most of my answers are simply: “Yes, that’s normal.”

Meet Chipo. Chipo had a normal pregnancy and wanted a normal birth but there were complications. Chipo had to have a caesarean, is feeling wounded, drowsy and unsure. Her baby is sleepy and refusing to latch. I visit her in the hospital. We take the time to chat. I am not a doctor, so there is time for Chipo to tell me her story and share her feelings. She tells me how difficult it is to have a non-latching baby, how rejected and overwhelmed she feels, she cries with me a little. The baby stirs and we underdress her and place her skin-to-skin on Chipo’s chest. Chipo looks at me, eagerly waiting for instructions, but I encourage her to wait. We sit in awe observing the little girl wake up and stir, slowly making her way to the breast, licking and exploring the nipple. We almost get worried when she rests. Will she be able to latch? We work with her speed now, helping her when she needs help and being patient. Finally, an hour later she latches and has her first big meal. Chipo is feeling relaxed and tired and both mother and baby take a nap together.

Meet Mary. Mary had her first baby 8 days ago. Breastfeeding was going fine. She was in a lot of pain on her nipples but she thought it was normal. At her check-up the pediatrician noticed that her baby was dehydrated. She was admitted into hospital and her baby was supplemented with expressed breastmilk and formula. Mary is now back home but worried about her milk supply. Her baby is still not feeding well from the breast, quickly falling asleep and still dependent on formula top-ups. First we work together to make the baby latch better, Mary starts feeling much more comfortable. Mary learns how to help her baby get breastmilk better using breast compressions. Weighted feeds show that the baby can get about half of her needs from the breast with the extra support. We start giving the top-up through an at-breast supplementer. This encourages the baby to suckle more. Mary is able to slowly reduce the amount of formula and is fully breastfeeding 2 weeks later.

Meet Liv. Liv had a normal birth and breastfeeding started well. On the third day her baby started getting very colicky, cried for hours, was never satisfied and did not sleep for more than 20 minutes at a time. Liv was living in a supportive household and was encouraged to continue breastfeeding and that all would be well. Weighted feeds showed that her baby could not transfer any milk from the breast. Even with support to the best of our ability there was no transfer of breastmilk from breast to baby. With this new information, Liv started pumping and bottle feeding the baby her breastmilk. Within a short space of time Liv had a normal baby who was content most of the time. Liv continued to pump for her baby who never became a good breastfeeder.

Of course I also meet many mothers who have a good start in their breastfeeding journey, who manage well and succeed in reaching their breastfeeding goals without any or with very little support. And I meet the mothers who could not breastfeed, when we cannot make it work, interventions just don’t take effect or it becomes too hard. But you don’t need to walk the path alone and whatever happens, your Lactation Consultant will make sure that your baby remains fed.

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