Two journeys, two continents, Enriching!: Breastfeeding Journey

Asha DSouza is a Stay at Home Mum (SAHM) of two, daughter aged 6 years old and son aged 21 months. She has done her post-graduation in Business Administration. Asha was a Background screening and Information Security professional before she had kids. She is currently a co-admin on one of the largest breastfeeding support group, Breastfeeding Support for Indian Mothers (BSIM).

1.Asha, tell us about your experience with the first latch.
My daughter was born in Bangalore in 2011. I had a severe case of hyperemsis gravidarum until the 8th month of my pregnancy. It was so bad that I could not even keep my own saliva down and my esophagus had corroded due to the constant vomiting. I was forced to leave my job as my health condition did not permit me to continue and have been a SAHM ever since. My daughter was born vaginally on her due date. The staff at St. Philomena’s hospital, Bangalore, where she was born (it was the same hospital I was born as well!) was quite supportive throughout my pregnancy and my breastfeeding journey. My daughter latched on within half hour of birth and there was no looking back. I had initial issues with the latch and positioning, but the lactation counsellor (LC) at the hospital guided me well. At no point was formula suggested and for that I am grateful. I’m glad I changed hospitals early on my pregnancy.

2. It’s amazing to have found a very supportive hospital during your pregnancy and delivery. Was the same support extended by your daughter’s paediatrician too?
On my daughters 6 week checkup, the first paediatrician who weighed her felt I needed to top her up with formula as her weight gain wasn’t satisfactory. It was a big blow as all I did was breastfeed my daughter; her pee and poop count were good as well. My mother was very supportive and assured me that it wasn’t needed. Nevertheless, I had constant doubts and bought a can of formula. When I offered it to my daughter she promptly threw it up. I resolved to change paediatricians and I found one recommended by a friend. He assured me that my baby is doing fine and top-ups aren’t necessary. I threw the can of formula and proceeded to exclusively breastfeed (EBF) my daughter until she was 6 months.

3. The WHO and most doctors now strictly advice breastfeeding till the first 6 months. But unfortunately, till a few years back, a lot of new parents were easily pressurised into starting solids as early as 3 months. Did you feel the heat too?
I was pressurised by “well meaning people” to start solids/cows milk at 3 months as my milk “won’t be enough”. At that time, support groups were not in existence or I wasn’t aware of any; I did not own a smart phone either. I had not researched anything about breastfeeding during my pregnancy as the thought did not even occur to me. Most of what I followed was based on my instincts. I chanced upon Kellymom when my daughter was a couple of months old and that became my breastfeeding bible.

4. Breastfeeding, although the most natural thing, comes with its own set of struggles. How was it for you?
Breastfeeding was a very lonely journey, there wasn’t even a smart phone for entertainment so I read books while I breastfed. I learnt the art of lying down and nursing only when my daughter was about 4 months old. It was a saviour since, and I wished I had known it existed earlier. Prior to that, I was constantly sleep deprived with all the night waking. Also, for someone who struggles with back issues, sitting up and nursing was a nightmare. My daughter would refuse to go to my husband at nights so I stayed up and recited songs in my head so that I don’t fall asleep. Unfortunately, my daughter hated sleeping and still does. She would not nap for more than 10 minutes at a stretch.

Once solids were started at 6 months, things didn’t change much, she preferred breast milk to solids and it continued well into her second year. My husband gifted me my first smart phone when my daughter was 10 months old, on our wedding anniversary. I was able to research more easily then. After 2 years of breastfeeding, I had enough and desperately wanted to wean her especially at night. All my attempts were futile and I did not have the heart to see her cry so much. I started accepting the situation and was assured by my parents that she will wean when she is ready (I myself weaned at 4 years of age).

5. The WHO recommends a minimum of 2 years of breastfeeding. How old was your daughter when she weaned? Tell us a little about extended breastfeeding.
At 3.1 years, my daughter night weaned. When she was 3.4 years old we moved to Australia; and at 3.8 years she completely weaned. Her last feed to go was the morning after wake up. She never asked for it again. This made me feel very sad and I was afraid of losing that precious bonding. But we connected in so many other ways; I co-sleep with both my children. I hadn’t met any other mums who were breastfeeding older children. I wasn’t ashamed to tell people I did but many a times came across expressions of shock, amusement and even disgust. Someone close even remarked that my breasts would start sagging bad and my daughter would get too dependent on me. It only strengthened my resolve to continue on our journey. Breastfeeding comforted my daughter, it also forced me to pause and smell the roses.

6. Your son’s delivery was a little hard on you guys. Tell us more.
Two months after my daughter weaned I fell pregnant with my son. I had severe nausea throughout the pregnancy but never the same as with my daughter. Life was tough in a new country, without support and with managing everything alone. My pregnancy was pretty much uneventful and I was all prepared for a natural birth; even hired a doula second time around. I didn’t do any reading about breastfeeding as I was confident with the experience of my daughter. At 32 weeks and 2 days, I went to visit my General Practitioner (GP) as I had a severe headache and a vomiting bout the previous night. My BP was at 220/110. I was immediately asked to go to the hospital. On reaching there, I was monitored and put on meds. It took a few hours for my BP to come to normal but then the baby’s heart rate started to decelerate.

There was no warning with the pre-eclamsia and no enough warning that I had to be rushed to the operation theatre. Before I knew it, my baby was out and taken to the NICU. I barely got to look at him. In addition to being premature, he was also low birth weight (LBW). Being a mum with so much breastfeeding experience, one must think it was a piece of cake, but guess again! I wasn’t prepared for a premature birth and neither had I ever pumped or hand expressed. Within an hour of my surgery, I was briefly taken to visit my baby in the NICU and was asked to hand express my colostrum. I was exhausted and overwhelmed by the events of the last few hours; we also had to move houses in a week. It was terrible timing and here I was asked to hand express.

7. How did you go about with hand expressing and pumping?
As much as I tried, I could not do it as I had no strength or the know-how. My husband was a rock; he had to look after my older one, shuttle between the house and hospital. He was the one who helped me hand express colostrum the first few times; the midwives showed us how. I still barely got anything but I knew every little drop was important. 9 hours after my surgery, I was made to get up and take a shower. Then I would go to the NICU every few hours to do kangaroo care and deliver my milk, which was on another floor. On day 3, I was given a hospital grade pump and started pumping every 3 hours around the clock. I wasn’t allowed any pain medication after my surgery because of the high BP. I was in a lot of pain but didn’t give up. My mum advanced her ticket and arrived 3 days later. She stayed with us for 6 months and took care of me, my kids and all the household work.

My son was in the NICU for a month and I spent all day there only returning home to sleep. After a day of pumping and kangaroo care, I had to continue throughout the night to keep up my supply. My husband did the research on pumps to purchase and bought me one for home use. It was tough for him to shuttle between office, hospital and home. I missed my daughter and she missed me too. I longed to directly nurse my son. Every day at the hospital, I saw new parents taking their newborns home. Tears would well up in my eyes as I couldn’t do the same. I learnt all the things the nurses would do like check the monitors, change his probe, change his nappy, check his temperature, etc. When they saw me they would confidently leave his cares to me; they become my second family. When the time came to leave the NICU it was bittersweet. I was happy to go home but also missed the family I made there. I was also afraid of taking care of my son without the confines of the sterile environment and the monitors to track his progress.

8. How did you get your son back to the breast and wean him off the bottles?
The day we went home I slept next to my son for 6 hours straight with exhaustion; he didn’t wake up for a feed. I was still pumping then but also started getting him to breastfeed directly. My husband helped with washing and sterilising the bottles and teats, and the night feeds. Within another month, I stopped pumping and went cold turkey on the bottles. My son also preferred feeding directly. With him, I’ve realised the value of directly nursing as opposed to pumping and I rarely complain about night waking.

I have immense respect for exclusive pumping mums as I know how hard it can be. I EBF’d him for 8 months though I was advised to start solids much sooner. I owe his good health to the goodness of breast milk. I am currently breastfeeding my 21 month old son and will continue to do so until he decides to wean.

9. Did you face any latch issues since he was nursing directly after a month?
Initially, when he started to latch it was extremely hard as there was a NG tube running through his mouth. They couldn’t put the tube through his nostrils as they were still too tiny. He would fall asleep almost as soon as I would latch him on. I persisted with plenty of skin to skin and trying to latch often. Once they moved his NG tube through to his nostrils it became a bit easier but his suck reflex wasn’t strong enough. Once we went home I followed the same routine of skin to skin and plenty of latching. I soon went cold turkey on the bottles, even before his suck was strong enough as I was confident he was a fighter. He showed great survival instincts even at that age! I kept monitoring his pee counts and milestones and he didn’t let me down.

10. Both your children were born in two different countries, in fact continents too! How would you compare the experience and the services in all aspects?
I have always nursed in public for both my children and have not really had negative experiences, be it in India or Australia. I’ve never used a cover or special clothing either. The few times people stare at me, I return the stare with a smile. I’ve nursed on trains, buses, auto rickshaws, in concerts and other public places without issues. Since my daughter turned 18 months, I’ve not had house help so I pretty much don’t have the luxury of not nursing in public, more so since my son was born.

With regards to medical support, I’ve been lucky to find good doctors both in India as well as Australia who have been supportive of my breastfeeding journey. But overall, I would say Australia is more supportive as my consent was taken for everything, at every step of the way, including the time when I had to have an emergency c-section or the midwife had to touch my breast. Also, the support and care received from a public hospital in Australia is unrivalled by even the top most hospital in India and it is all paid by Medicare. In general, the support for breastfeeding diminishes post the 1 year mark in whichever country, but I really do not discuss breastfeeding or nutrition in length with my doctors; it is always on a need to know basis.

11. Both journeys have been poles apart and overwhelming in its own way. Did you suffer from post-partum depression (PPD)?
PPD was more apparent after the birth of my son, especially due to the situation. I’m battling it, and talking about it to another person, be it a friend or family member definitely helps alleviate the symptoms. I advise friends with PPD to always seek the help of a counsellor. For me personally, helping other mums on their journey is like a balm to my wounds; it gives me hope as I know I’m not alone.

Breastfeeding as natural it may seem is not always a bed of roses. When you think you have it all figured out, you are suddenly hit with a growth spurt, illness or teething and it throws you off balance. What I’ve learnt is to take each day as it comes, as tomorrow may be very different from your today. I’ve definitely found breastfeeding easier the second time around despite my NICU experience maybe because I’m more confident and have humbled my expectations.

12. Through your two journeys, when did you stumble upon BSIM, and how did you become a co-admin? What advice would you like to give new Mothers?
I discovered BSIM when my daughter was 3 years old. I was ecstatic to see that there were so many other mums like me who followed natural term weaning. I soon started answering queries and was first asked to be a peer counsellor before I joined the admin team over a year ago. There is so much I learn from the group, the team and my fellow admins every day and it’s a joy working with them. The best part is that there is no judgement and everyone is open to learning and re-learning things.

My advice to new mums would be to follow your instincts and always do your research before following anything even if it comes from a top medical professional. The internet is full of well researched peer reviewed articles which are easily accessible. Trust your body, and your baby; no man made formula can supersede millions of years of biological evolution. Also always remember, when the going gets tough, the tough gets going!”