Breastfeeding a baby with slow weight gain – Michelle & Beaulieu

Beaulieu was born in 2014 (3 days late), weighing 7lb 2oz. His birth was a straight forward 12 hour VBAC [vaginal birth after caesarean] delivery. We were sent home from the delivery room 4 hours after Beau’s birth - at this point he hadn’t fed and I had noticed he was tongue tied - both of which the midwife and senior midwife were not concerned about; when I asked her about this she said “you’ve (breast)feed before so you know what you’re doing” and “tongue tie doesn’t always cause an issue with breastfeeding” so off we went.
 

The first few days at home were a bit of a blur, but the one thing that sticks in my mind is that he just wouldn’t feed, at all, instead he slept all day and all night, the “perfect” baby. This became a constant battle, of trying to wake him and force him to feed. By day 2 he had developed a cough, junky eye and jaundice; when the midwife came out she said all is normal and to just place him by a window for him to get sunlight (for the jaundice). When I mentioned my concerns over his lack of interest in feeding she wasn’t concerned. This was echoed by my GP at 3 days, and midwife at 5 days for blood spot and HV for new baby check. In 5 days we had seen 3 different healthcare professionals, all were unconcerned by Beaulieu’s lack of interest with feeding, his constant desire to sleep, his cough, junky eye and jaundice. At day 3 his umbilical cord nub also fell off which I was told was normal. His weight at this point was classed as steady; he had only lost 6% of his birth weight. We continued plodding on seeing healthcare professionals every 3 days, until Beaulieu reached 14 days old, and this where the story really begins....

We set off for a routine weigh-in at the hospital, this was to be our last weigh-in, we were expecting to be signed off by the midwife afterwards. It was an ordinary day and we had planned to go to church straight from the hospital. It’s these days that hit you the hardest, the days that you just don’t expect to be told that there is something wrong with your beautiful baby boy, especially when all your concerns are being put down to normal behaviour.  During the weighing the midwife raised concerns that Beaulieu had not regained his birth weight and we were sent down to the paediatric department for review. Whilst on the Paediatric unit they acknowledged our concerns over his cough and suggested that this was the possible cause of the poor weight gain. To help with improving the weight gain we were advised to express and top up 30mls after every feed, a follow up weigh-in was booked for 3 days later.

We returned for weighing and this time he was admitted due to further weight loss. As soon as we were admitted it was apparent that the staff were not Breastfeeding Friendly. The first nurse who looked after us constantly pushed for formula and questioned my desire to breastfeed. They seemed to think that formula would be the solution to all our problems.  When I questioned this they couldn’t justify their reasons, apart from we need babies to put weight on quickly and it’s clear he isn’t getting enough from you.   I stood firm and asked for support with the breastfeeding that was in their eyes clearly failing and causing him to starve.  They offered me a breast pump, but they declined my request to see a Breastfeeding specialist or Breastfeeding Network Peer Supporter.  I was also told that if it was apparent that I had a ‘friend’ in to give support they would be asked to leave. One Consultant in particular was adamant that the tongue tie and cough were not contributing to
Beauliue’s poor weight gain and lack of interest in feeding.
 

By now Beaulieu was still only feeding every 4 hours or so for 10 mins at a time. During a feed he would fight and dribble milk constantly – to the point I would have to change him after every feed as his vests and tops were soaked with milk.    I could also pump 120mls in 10mins so to me it was clear there wasn’t an issue with the amount of milk I was producing, but more that Beaulieu simply couldn’t swallow.  During our stay it became clear Beaulieu had a chest infection, conjunctivitis and an infection in his belly button where his cord had fallen off so early.  He was given a 5-day course of antibiotics to clear the infections, and to help with the poor weight gain he was put on a feeding plan, and he was not to feed from the breast at all. I was to express every 60ml feed until his weight gain had stabilised. This is something I did for 4 months.

During those 4 months Beaulieu was re-admitted 4 times with 3 separate chest infections, Rotavirus and viral gastroenteritis, he was tested for cystic fibrosis but thankfully this came back clear and his tongue tie was divided. Our longest stay on the ward was 2 weeks. Each time we were admitted my choice to breastfeed was questioned, every feed was to be given either via NG tube or bottle and night feeds were always given by the nursery nurse on duty, as I (apparently) needed my sleep, exclusive breastfeeding was not something that was an option. I even heard a conversation between a nurse and a student nurse that every breastfeeding mother that comes in should be discouraged from breastfeeding as the staffs’ main aim is to ‘get babies up to weight and the best way to do that is to introduce formula’. For me this was truly shocking, how could a Health Professional ignore a mother’s desire to breastfeed, and more importantly why are they ignoring the medical benefits of breastfeeding? Something I brought up with them each time they pushed formula upon me.  Finally, Beaulieu started to gain weight at a rate they were happy with and we were discharged with no real reason as to why he was so ill in the first few
months of his life.
 

The lack of support and knowledge that I experienced during the first 4 months of Beaulieu’s life is the reason that I have set up a branch of the hospital breastfeeding campaign in Hampshire. It is also the reason I trained with the Breastfeeding Network as a peer supporter as I didn’t want anyone else to go through what I went through. I want to improve the quality of care and knowledge on paediatric wards. Although my case is over two years ago, I still see and hear regular stories of poor breastfeeding knowledge and care within the paediatric departments and mothers who are being advised to stop breastfeeding prematurely.