From bottle to breastfeeding: a hard journey to contentment
If breastfeeding doesn’t work out at first, it is possible to relactate and try again at a later stage
Cliona Kelly breastfeeding baby Aoife. Photograph: Dearbhla Kelly
Cliona and Sue Kelly with their daughter Aoife. Photograph: Dearbhla Kelly
Most people are unaware that it is possible to relactate and breastfeed a baby who has been formula-fed. In fact, I found out about it only by chance, so I thought that telling my story would help others, and even be beneficial to adoptive mothers who would like to breastfeed their babies.
I formula-fed my baby girl, Aoife, after unsuccessfully trying to breastfeed her in the first few days. I was convinced that I couldn’t breastfeed so when she was five days old, I was persuaded to use formula in the hospital.
I had had an emergency Caesarean section so it was difficult to find a good feeding position, and Aoife also had difficulty latching on. I was never happy with the decision and got really upset whenever I saw anyone breastfeeding her baby.
When Aoife was about four weeks old, my pregnancy yoga teacher mentioned that I could relactate and try breastfeeding again. I had assumed that once Aoife was on formula that that was that and also that once my milk was gone, it wouldn’t come back.
My wife, Sue Kelly, and I arranged to see a lactation consultant privately. She diagnosed Aoife with posterior tongue tie, which can’t be seen easily but should have been checked for in the hospital.
We made an appointment with the lactation consultant at the hospital to have Aoife’s tongue tie snipped the following week.
We also brought Aoife to see a cranial osteopath, who helped her move her head more freely. Babies born by Caesarean section sometimes need this because they haven’t had the experience of coming through the birth canal.
ExpressingMeanwhile, as I had no milk, I hired a double electric pump and started expressing around the clock, including during the night.
At first, I was getting nothing at all, but I kept going and gradually started producing milk in very small amounts. I took domperidone (Motilium), an over-the-counter anti-nausea/heartburn medication, which has the side effect of encouraging lactation. I took the Indian spice fenugreek, which is renowned for increasing milk, and ate and drank lots.
We also did a lot of skin-to-skin contact with Aoife to help bring on my milk and give her positive associations with my breasts.
I started going to a breastfeeding support group, which was a great help once I got over my initial fears of being the only one there bottlefeeding my baby.
When Aoife had the tongue-tie snip at six weeks, she was able to latch on immediately with the help of nipple shields, which was the most amazing feeling.
She was also a noticeably happier baby after the snip, and the colic that had plagued her for the first six weeks vanished overnight.
Syringe of milk
However, I still didn’t have much milk and it was slower to come through than she was used to on the bottle, so she needed to be enticed on to the breast with a little syringe of milk at the nipple.
She wouldn’t stay on for long so I also had to use a supplementation nursing device, which is basically a tube going from a bottle of formula or expressed milk to your nipple. When the baby suckles, they get milk from the tube but their suckling also stimulates your breasts to produce more milk.
The device was a hassle to use and I hated it, but it did work. After about three days my milk started to come through properly. We no longer needed to entice Aoife with a syringe of milk.
It still wasn’t easy though and I had good days and bad days, when Aoife wouldn’t latch on at all. I found it difficult to know exactly how much milk she needed, even though I was feeding her on demand. I nearly quit several times, but support from my wife and breastfeeding peer-support groups helped me hugely.
You need a lot of support and you need to accept that your baby will be attached to you 24/7 for a few weeks. Often, women give up just before it is about to get easier.
I feel that antenatal classes are overly positive about breastfeeding: there isn’t enough emphasis on what you can do when it doesn’t work.
I’m also sorry I didn’t make contact with a breastfeeding support group and/or a lactation consultant when I was pregnant. If I had, I would have been able to make contact with them in the early days for advice and support.
However, all that said, once we got the hang of breastfeeding, I realised how much both of us loved it. This was a great motivator to keep going.
Gradually, over the next few weeks, Aoife fed more and more from me and needed less and less formula and expressed milk.
By the time she was 12 weeks she was exclusively breastfed. At 16 weeks, without any prompting or persuasion, she latched on by herself without nipple shields, so we were able to continue without them.
She is now 26 weeks, still exclusively breastfed, and gaining lots of weight. She feeds for much shorter times now and I feed her lying down at night time, which is easier for me.
She’s a busy and energetic baby at this stage. I still go to the weekly breastfeeding support group as there are new things to learn at each stage.
We’ll start feeding her solid food when she’s six months but I plan to continue breastfeeding her for as long as I can and for as long as she wants. It was such a struggle to get here but I’m so glad we did. It was absolutely worth it.
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Timely treatment for tongue-tie
Tongue-tie (ankyloglossia) is thought to affect 4-10 per cent of newborns and presents one of the more common difficulties associated with breastfeeding.
A tongue-tied baby may be unable to latch on to the breast properly, often causing the mother pain and giving the baby a variety of difficulties.
The baby sucks in air, experiences digestive issues, and this can result in poor weight gain or failure to thrive.
In Ireland, babies are not automatically checked for tongue-tie at birth, and diagnosis is usually confirmed only after breastfeeding issues present themselves.
In light of this fact, it seems significant that Ireland continues to have the lowest breastfeeding rates in Europe.
However, tongue-tie is not just a breastfeeding issue. It can affect the bottle-fed baby too, where it often disguises itself as infant reflux.
Problems related to tongue-tie, meanwhile, can extend beyond infancy. If problems with swallowing persist, introduction to solid food can be hampered as the infant struggles to push food to the back of their mouth to chew it.
An already inflamed digestive tract becomes more sensitive to food allergies.
In childhood, severe tongue-tie may affect speech development and, in later years, their confidence and their oral sexual expression through kissing.
Treating tongue-tie in the early months of infancy is far easier than in later childhood or adulthood.
Before a child is six months old, tongue-tie division (frenuloplasty) can be performed in a matter of minutes and without anaesthetic.
After six months, a general anaesthetic is advised. Even so, maternity hospitals in Ireland do not currently offer treatment for tongue-tie.
Treatment has become more available in recent years but there are still only six doctors in the country who offer tongue-tie division to babies.
Neuroplastic surgeon Dr Siún Murphy has recently opened a specialist treatment suite at Blackrock Medical Centre, where she is assisted by a lactation consultant to advise on breastfeeding issues.
An expert’s guide to relactation
Relactation is not something many women in Ireland do, according to Maura Lavery, breastfeeding consultant at the Rotunda Hospital in Dublin. It is possible but requires time and patience.
“It can work for a mother who has stopped breastfeeding due to illness, such as mastitis, a breast abcess or unresolved nipple pain – or if the baby is ill,” she says.
If the mother has stopped breastfeeding for two weeks, it will take about two weeks to restimulate milk.
“The key is to offer the breast first at every feed, and to express milk as well. The baby can be gradually weaned off formula,” says Lavery.
Feeding aid A supplementer can offer extra milk to the baby through a fine tube placed beside the nipple.
“The mother can then regulate how much milk the baby is getting through this feeding aid, which can have expressed breast milk or formula in it,” says Lavery.
All the same advice applies to mothers who are relactating as to those who are breastfeeding.
Have lots of skin-to-skin contact, get plenty of rest, eat healthy foods and drink when you are thirsty.
Lavery adds that it is possible for an adoptive mother to breastfeed but it is unlikely that she will produce enough milk to breastfeed exclusively.
“It takes a lot of patience and determination, and the mother must have realistic expectations.
“However, she will have all the benefits of skin-to-skin contact.”