21 Things I Wish I’d Known Before Becoming a Breastfeeding Mum in England
Breastfeeding was never meant to be a solo project but the village it takes to raise a child is no longer where most of us live. All parents want the best for their baby and most women are aware of the benefits of breastfeeding, but for something so often called natural, breastfeeding is really hard work in 21st century England where women’s and mothers’ voices are so often not listened to.
During pregnancy I was so focused on informing myself about giving birth that I forgot to learn anything about breastfeeding. Now 9-months into my breastfeeding journey, here I share 21 things I’ve learnt from my own experiences and those of friends, together with the wonderful volunteers at the Association of Breastfeeding Mothers. Many times while writing this article, I thought “I don’t want to put people off” but perhaps it’s this honesty I was missing which led to surprises. All mothers require robust, ongoing, and non-judgmental support, the availability of which may contribute to the UK (and the US) having some of the worst breastfeeding rates in the world. Read on to learn about the rollercoaster you’re about to jump on and identify who around you will be on hand to support you with non-judgmental compassion.
This article provides general information and discussion about breastfeeding and related subjects. The information and content provided in this article are not intended and should not be considered or used as a substitute for medical advice, diagnosis or treatment.
1. The term “cluster f**k” is derived from “cluster feeding”
Cluster feeding is when baby is attached and feeding CONSTANTLY for days and nights at a time. If you’re lucky, it may only last for a few hours at a time. A baby constantly feeding is often NOT a sign of hunger or insufficient milk, it is the normal and appropriate signal from baby to body that it’s time to increase milk production — your body knows what to do. If, on the other hand, feeds are painful or baby has low weight gain, it’s worth getting your latch checked by somebody trained in lactation. My baby fed for over 24-hours in total during his first week of life.
2. Donating and sharing breastmilk is a thing
If for some reason a mother’s milk is not available, then the next best option is another woman’s breastmilk. Donated milk is considered a medicine for premature babies and the survival of some babies in neonatal intensive care units depends on it. Some women have an abundance of breastmilk and want to help others. Some women build up a stash of breastmilk and then need the space back in the freezer. Milk banks screen and pasteurise donated milk and are the official and safest way to get milk to babies who need it. Look for your local milk bank here. However, there are more mothers who want breastmilk for their babies than the milk banks can supply which is why informal milk-sharing networks — such as Human Milk 4 Human Babies — are in demand. Members can donate or receive milk on a system based on trust.
3. Feeding a baby formula is NOT failure
I don’t know how many days old my baby was when I was devastated after so little sleep and a baby that seemed permanently stuck on me that I finally crumbled and agreed for my partner to offer a bottle of formula. I could barely bring myself to watch, crying, as I felt I’d failed at the first hurdle. Baby glugged it down and immediately fell asleep for four hours, allowing me some very-much-needed rest. An increase in the stress hormone cortisol can slow the let-down of milk, and if the milk isn’t let down, the milk isn’t used, which in turn tells our body it doesn’t need to produce milk. Those first six weeks are really about survival. There are plenty of women who include the occasional bottle of formula in their breastfeeding routine or who ‘combi-feed’ — a combination of breastfeeding and formula. Others are able to return to exclusive breastfeeding after combi-feeding. The various reasons so many women in the UK choose to discontinue breastfeeding do not mean mothers who feed their baby formula have failed nor are they deserving of judgement or blame. Go make her a cup of tea and offer to do the washing-up instead.
4. Full-term healthy babies have enough reserves to last a few days
Babies are born with a good amount of fluids on board as well as extra reserves of glycogen, their main energy source. Mothers’ milk usually takes a few days to come in, before which mums’ breasts produce thick, golden, concentrated magic called colostrum. In those first couple of days when you are exhausted and vulnerable from giving birth and worried if baby is getting enough food, the answer is likely Yes. In 2014, an abandoned newborn was found alive after six days with no food and water. If your baby is happy, healthy, and not showing signs of distress, they are probably happy, healthy, and not distressed.
5. Some newborns are sleepy relaxed babies who might not wake to feed
My baby was so relaxed in his first couple of days, he slept almost the whole day and night. I thought “if he’s hungry, he’ll let me know”. He also fell asleep quickly while feeding. It’s likely this contributed to his weight loss. Current advice is to wake a baby every 2–3 hours for a feed until they are back up to their birthweight. Running your fingernail softly along their feet, switching breasts when their sucking slows or they get sleepy, and breast compressions can all encourage baby to actively suck and swallow.
6. Some doctors/midwives readily encourage ‘topping up’ breastfeeding with formula…..
It is normal for babies to lose weight in the first few days and breastfed babies lose more than formula-fed. What percentage loss is considered ok varies by hospital or trust and a 2008 review found insufficient evidence to answer how much weight it is normal for breastfed babies to lose. Despite giving birth to a perfectly healthy baby, within four days of giving birth I was advised by a doctor in the hospital to add 60 mls of formula to ‘top up’ each of my breastfeeds as baby had lost over 10% of his birth weight. Given that I was expressing about 1ml of colostrum at the time and a newborn’s stomach is about the size of a grape, 60 mls sounded like fattening up a Christmas turkey. A friend was given a feeding plan within 24-hours of giving birth to a perfectly healthy baby with no complications or weight issues, combining formula and breastfeeding for the first five days because baby was seemingly constantly feeding and unsettled after feeds. It was only through seeking advice with local super-hero volunteers of the Association of Breastfeeding Mothers that she learnt baby had a significant tongue tie which needed cutting. As well as going against National Institute for Health and Care Excellence (NICE) guidelines, formula is often promoted without a medical need.
7. …while others don’t listen to mothers wanting to offer formula. Nipples don’t need to toughen up — our support network does.
On the flip-side, other women who are suffering with sore or bleeding nipples, recovering from birth, or any other number of reasons, have been told to ‘carry on’ breastfeeding rather than offer formula. Listen to mothers! Sore, cracked or bleeding nipples are a sign that something needs checking and you will benefit from support. Midwives, doctors, and health visitors may or may not have much specialised training on breastfeeding and associated issues such as identifying tongue ties. There is a National Breastfeeding Helpline you can call from 9:30am to 9:30pm on 0300 100 0212. You can look for an International Board Certified Lactation Consultant (IBCLC) online or nearby, or reach out to your local breastfeeding group. Whereas google can lead you anywhere, all of these networks can support you to make informed, evidence-based choices about you, your baby, and all of your feeding choices. Breastfeeding should not hurt. If it does, get tough on seeking human support to help you find what’s right for you and baby.
8. Your boobs may feel like explosive boulders when your milk comes in…
Woooahhh your boobs suddenly feel like they’re made of concrete, double in size, ready to explode. Your partner may feel very pro-breastfeeding at this point. “Hooray my milk has come in!” might well feel like “Aaaarrgghh my milk has come in, how can I get relief?”
9. …. and they might not
Everyone (my best friend, my sister, and the internet) told me that the concrete-boobs-feeling would certainly let me know when my milk had come in. Three, four, five days passed, still my boobs felt normal. I did my best to express what I could which seemed so little and took so long. Despite knowing deep down that everything was fine, the fear that the doctor had instilled in vulnerable me on day four was still stewing. Sleep deprivation is a highly concentrated worry-fuel. “What’s wrong with me?” I couldn’t help fretting as I wondered why on day 8 my milk still hadn’t come in. “What is it that’s making you think your milk hasn’t come in?”, ABM super-hero to the rescue once again. Not all women experience the concrete boobs feeling — milk can come in without you noticing it.
10. Feeding formula to baby will slow down establishing mums’ milk supply
The more milk that comes out of your breasts, the more milk will come in. Babies, especially hungry ones, are the most efficient removers of milk. After being told to top-up baby with formula I asked in The Village Facebook group “Won’t it mess up the rhythm between me and baby?”
YES IT WILL.
Expressing breast milk, by hand or with a pump is another way of removing milk to ensure supply but you might not have the time or energy when caught in the whirlwind of newborn parenting. The fantastic news is that bodies are amazing and it is possible to return to exclusive breastfeeding after combination feeding or even after a gap. Relactation — getting the milk flowing again — is also possible.
11. Breastfeeding is a skill both mum and baby need to learn, maybe more than once
Like most skills, there are some people who will pick breastfeeding up seemingly effortlessly and others who, despite their best efforts, may not progress smoothly at all. Days after giving birth, I cried as I sat on my hurting bum as baby spent the whole night switching between my breasts. It took me a while to figure out lying down breastfeeding which became my preferred position for a long time as I often suffer from lower back troubles. There are various positions you can breastfeed in and what suits you may change as you and your baby grow together.
12. Some breastfeeding mothers exclusively pump
Not all breastfeeding mothers nurse their babies. Some mums choose to exclusively pump. Some reasons for this may include a baby that refuses to nurse, wanting to provide baby with breast milk but not wanting to nurse, or physical or medical reasons. It is damn hard work and like all mothers, exclusive pumpers need good quality, compassionate and informed support, not judgement.
13. Cutting a tongue-tie doesn’t solve everything immediately
A tongue tie — when tongue mobility is restricted by a tight or short frenulum — can affect feeding whether at the breast or bottle. If it needs to be cut — a frenotomy — the inside of baby’s mouth will heal very quickly but baby and mother may need to learn once again how to latch properly, which could take a week or two. Don’t try to do everything alone — with guided support you can get through it — there may be more than one factor at play.
14. Pumping does not necessarily save time
Pumps have on-off switches but boobs do not. While breast pump manufacturers may claim that discrete design will allow you to pump while doing other activities, or that it effectively mimics babies’ sucking rhythm, don’t believe all the marketing hype. Babies are super-efficient milk removers and no amount of design can really get close to the range of sensory stimulation, the human interaction and oxytocin flow of a suckling baby. For your milk to start flowing, you may need to be relaxed in a quiet, calm environment (good luck!), looking at videos of baby or imagining them feeding. Avoid checking how much milk is coming out. Sometimes a minor mechanical issue with the pump will slow or stop it working but it will work again when dis- and re-assembled. Or not. Add to this the time it takes to sterilize all the parts of the pump, storage bottles, and feeding bottles and you soon realise that if it was such a simple time-saving solution, every mum would be doing it.
15. Pumps are definitely not one-size fits all
You wouldn’t walk into a shop and expect the first shoe you see to magically Cinderella-fit your foot. Similarly, not all pumps are made for the same size breasts or nipples. It might make sense to measure your nipple and buy an extra insert. I don’t like the word ‘flange’ but this was the name of the part I needed — I didn’t like the price either. Even the smallest flange I could buy was for a nipple a few millimetres larger than mine. To try before you buy, ask your midwife or health visitor if you can borrow a pump from the hospital or look into renting one.
16. Breastfeeding is hungry and thirsty work
Breastfeeding mothers need approximately 300–500 calories extra per day and may drink an extra litre of water. Make a breastfeeding snackbox and have a bottle you can drink from that you can knock over without breaking or spilling. If you’re with a breastfeeding mother, offer her food and drinks!
17. You can drink some alcohol
You’d need to badly fail a blood alcohol breath test before your baby experiences significant side effects. Baby’s age, mother’s weight, the quantity of alcohol and whether or not it’s consumed while eating are things to consider. Don’t sleep in the same bed as baby when you’ve drunk alcohol. It takes a few hours to get rid of the alcohol in your body from drinking a glass of wine; as alcohol leaves the bloodstream, it leaves breastmilk too.
18. Breastfeeding is not necessarily free
“Yay! Free food for my baby!” I thought. While I have minimized the amount of money I’ve spent on baby-stuff and have brought used goods as much as possible, I’ve spent over £300 on pumps, nursing tops, bras and bottles. Buying two new Elvie stride pumps will set you back £300 whereas renting a hospital-grade pump might cost around £50 per month.
19. Breasts have different storage capacities which affects feeding frequency.
While it is better to imagine breastmilk as a flowing river rather than a finite lake, different boobs have different storage capacity for breastmilk. Bigger boobs do not necessarily mean bigger storage capacity. A smaller capacity means that baby will nurse more frequently and that the breasts may feel uncomfortably full (engorged) more quickly.
20. The World Health Organization recommend breastfeeding until at least aged 2.
This may come as a surprise to many in the UK where breastfeeding rates are some of the lowest in the world and plenty of people are ready to voice their views on when it’s time to stop. The last (and now discontinued) UK Infant Feeding Survey (2010) found that of the 94% of mothers who tried breastfeeding their newborns in the first week, only 42% of mothers were exclusively breastfeeding by 4-months. Data on combi-feeding wasn’t provided and I can’t find what the rate was by 2-years old. This was an improvement on previous years then funding was cut for future surveys.
21. Breastfeeding isn’t just feeding
Some women say that at times they have felt they are being sucked at like a human dummy but this is the wrong way around; dummies/pacifiers were invented as a non-human nipple. Among its long list of benefits, breastfeeding offers comfort, security, pain relief and immune support and the benefits go both ways. Each time a baby nurses you get a hit of the hormone oxytocin and a 2022 systematic review found that mothers who do not exclusively breastfeed are at much higher risk of developing post-partum depression (remember, that isn’t their fault: perhaps they have felt like a failure due to being unsupported and judged about their decisions). Whatever the cause of distress, breastfeeding is brilliant at quieting a crying baby. The German word for breastfeeding — stillen — means to quieten and soothe.
