An Open Letter to Postpartum Health Professionals

Dear Midwives, Nurses, Obstetricians, Paediatricians, General Practitioners, Doulas, Lactation Consultants, and any other health professionals associated with women who have just given birth…please, please listen to the women you are caring for. We know that women all over the world have babies every minute of every day and you have probably “heard and seen” everything, and are confident that your advice and opinions are “evidence based” and steeped in much experience compared to our own seemingly minimal knowledge. We know that more often than not you mean well. But please do not diminish our individual experiences and ignore our own intuition as mothers. Please listen to us. Please hear us.

My first daughter, Lani, was born in March 2017, and whilst I hate the term ‘breastfeeding journey’, ours was generally a wonderful experience. Lani took to breastfeeding like a duck to water and despite around two weeks of some discomfort whilst my breasts and nipples adapted to breastfeeding, it was largely a pain free experience and something I enjoyed navigating with her.

Fast forward to July, 2019 and the birth of my second daughter, Nandi. I was very conscious of the fact that every baby is unique and I could have a very different experience breastfeeding my second child, but I also knew that I had a fantastic experience the first time around and I was hopeful it could be similar this time. However, from the very first (midwife assisted) latch just moments after she was born, I knew it felt different. That first feed was not without pain, yet the way she latched was technically good. I shrugged it off and reminded myself that newborns have to learn to feed as much as we have to learn how to feed them.

Unfortunately though, feeding went swiftly downhill.

Despite being strict in taking her off if I felt the latch didn’t seem ideal and then putting her back on, even when I was confident the latch was technically good, feeding was increasingly painful.

I stayed in hospital for 4 nights with her and she cluster fed all 4 nights, from around 11pm to 6am, with no more than 20 minutes between feeds. It was brutal, absolutely excruciating. It felt like a shark was feeding from my nipples! After our first full night when I realised the pain was beyond anything I experienced with my first daughter, I mentioned to one of the nurses how excruciating it was feeding her and I questioned if there might be a lip or tongue tie as her tongue felt like sandpaper alight with fire against my nipples. The nurse had a look and noted that she did have a short tongue connection but when she put her finger in her mouth she said she was curling her tongue around her finger well and her suck felt strong. No kidding! Her suck was unbearably strong!

Nonetheless she said she would have the hospital’s Lactation Consultant come and see me, and I was hopeful that I might get some decent support and advice from her.

When she did come and see me she too noted that Nandi had a short frenulum, but she advised that it should stretch over time and that “it’s dubious if tongue ties are even a thing”. I was surprised to hear her say this when I had a number of friends who had ties revised for their children and anecdotally had all noted a significant improvement with the pain they had previously experienced with feeding.

Instead, she showed me an alternate feeding position to “improve the latch”. Whilst the feeding position was uncomfortable for my back and required me to use both hands for the entire feed (which was going to be unsustainable with a toddler at home who I would need to keep a hand free for) I conscientiously gave it a go.
It helped ever so slightly, but incredibly briefly, and unfortunately the pain persisted.

I continued to tough it out and kept being reminded “she’s learning to feed, it will get better”. But on our last night in hospital the pain was so intense after hours of cluster feeding, I sat in the bed holding my baby, an absolute sobbing mess, and feeling incredibly alone. Through my tears I woke my husband and choked out that I couldn’t put her on me again. He immediately jumped up, went to the nurse on shift, and got some formula. He sat up with Nandi for her next two feeds, giving me the physical and emotional break I needed at that moment.

Once daylight broke I resumed breastfeeding her, but I continued to feel dreadful anxiety at the thought of putting her on my increasingly damaged nipples again. Nonetheless, I persevered and braced myself for each feed, gritting my teeth, curling my toes and trying my best to keep the rest of my body as relaxed as possible so she wouldn’t feel the tension.

I reiterated to the nurses before I left the hospital that I felt like something wasn’t right, but the rhetoric remained that she was still learning to feed and that it would get better. I conjecture that because Nandi hardly dropped any weight before leaving hospital and because my nipples weren’t immediately bleeding (trust me that came later!) they probably assumed there wasn’t really anything wrong. But I knew without a doubt that it never felt like this with my first daughter and whilst Nandi was getting what she needed from me, she was destroying me in the process. My intuition was strongly telling me something was amiss.

We went home and I continued to feed her through the pain. But within the first week home I employed a private Lactation Consultant to come out to the house. She too noted a short tongue connection but was confident another alternate feeding position would improve things. The new position seemed to help to some degree, albeit briefly again, but it was very much baby led. This is ideal in theory and in my perfect world, but I just could not fathom having her bobbing around on my breasts and potentially not latching properly when my nipples were SO raw and damaged. When I say damaged I mean they were bleeding and my left nipple had what appeared to be a hole in the side of it. Ultimately the pain worsened again and it was now inconceivable to feed her from the breast. I turned to pumping and fed her my expressed milk, which also wasn’t without pain due to the damage to my nipples, but it was far better than direct breastfeeding at that point.

When Nandi was about 3 weeks old I finally managed to get an appointment to see another well known Lactation Consultant in our area. She confirmed that my daughter did indeed have a 95% tongue tie with very little vertical or lateral movement. I cried when she confirmed this, as I finally felt heard. She told me how proud I should be that I had put in so much effort to continue feeding her through what would have been such terrible pain and that she had kept up such a healthy weight.

The Doctor at the surgery revised her tie there and then and her feeding instantly became pain free. The difference was truly indescribable.
Nandi is now 4 months old, a very healthy 7.6kg, and we continue to breastfeed.

Don’t get me wrong, I have no issue with formula (in fact we give Nandi one bottle of formula at night to give me a break, and I am a firm believer in ‘fed is best’), but I also knew what a great experience it had been with Lani and I was determined to give the same opportunity to Nandi if I could. I am positive though that had we not revised Nandi’s tie, I would have likely stopped breastfeeding far sooner than I would have wanted to.

It disappoints me that the majority of the health professionals I encountered following Nandi’s birth either batted away my concerns as if I was maybe a ‘worrisome first time Mum’ who they thought might be mistaking discomfort for excruciating pain, or openly refuted my thoughts on what the problem might be. Interestingly, it seemed to be the same people who would be inclined to push breastfeeding who didn’t provide adequate support when I was telling them there was an issue that could have ultimately stopped me breastfeeding.

I thank goodness I wasn’t a first time Mum in this case, and I knew from experience that breastfeeding could of course be a pain free experience! In this instance I felt like my pain was ‘normalised’ by these health professionals, as if it is just part of the process. Yes, it certainly takes time for your breasts and nipples to adapt to feeding, but it is NOT meant to be excruciating.

So to all health professionals associated with looking after women following child birth (and for whom I do indeed have a lot of respect!), please, please listen to us, and support us when we are telling you that we believe something is not right. Whilst we know that there can, and often is, inevitably some pain after giving birth (in many ways!) please don’t normalise the idea of agonising pain being part of postpartum life and feeding.

Yours sincerely,
A Mother.