Thursday 25 August 2011

When Not to Breastfeed

I have met a new mum to premature baby on twitter this week, and we had a brief conversation about breastfeeding. I mentioned I regretted ever allowing bottles, and she said that she'd stopped expressing as her supply was low. I wanted to write about when it isn't working, and this post is primarily for mothers of premature babies. I have written a lot about my sadness about not being able to breastfeed, but my personal feeling is, breast is not always best as a sole source of nutrition for premature babies, in particular for IUGR babies.

It's fairly universal that when your baby is born you will be encouraged to express milk. This encouragement can come across as pressure. One of the reasons that there is a lot of pressure is that breast milk has been linked with preventing some pretty nasty infections such as NEC (necrolitising enterocolitis), however, have said that, babies on breast milk can and do still get infections. It's not a guarantee that your baby won't get sick, but it may help. Joseph had NEC and was breast fed.

It's also proven that expressing breast milk can help the mother feel that she is doing something productive and helpful for her baby, at a time when she cannot do much else, so on that level at least trying is a great thing.

I've mentioned on previous posts that some of the medications used, particularly for pre eclampsia but for other conditions of pregnancy can and do affect supply in some women. Magnesium sulphate, in particular, can cause supply drop often weeks or months down the line. I think its always good to try and express if that is what you want to do, but knowing that this could happen really helps with guilt, it did with me. I had no option but to go on magnesium sulphate and I believe the treatment I had saved my life, and now, looking back, I am grateful that I could express for as long as I could.

Having a baby in NICU is terribly stressful. Milk production is very much hormonal and stress can cause your milk supply to diminish or stop. And that's unfair, but its ok. I don't think its worth upsetting yourself more by continuing to express if you are under immense stress and its not happening. Some women find expressing relaxing, it gives them time out, and they feel they are doing something productive, however others find it completely stressful. I remember toward the end getting so frustrated, I had blood coming from my nipples, I was in pain, no milk was coming out, and I just thought "this is not helpful to anyone".

I think the best we can do, as mothers with babies in special care, is make an informed decision. In my case I looked at the big picture. My supply was diminishing to the point where I was unable to express, my baby was not permitted out for long periods of time to try and establish feeding, I'd had a large amount of medication and on top of all this, my baby was not growing sufficiently on breast milk alone and required fortification.

Looking at the big picture, it was wise to make the decision I did, to stop breastfeeding and introduce formula. It was a very difficult decision to make, but it was the best one.

No one can make the decision for you as to whether to stop expressing or breastfeeding, the best thing you can do is collect as much information as you can, and to listen to your own heart.


  1. As always lovely a cracking post. well written and highly informative x x x

    hope alls well x

  2. Well written. I expressed for two weeks before my milk dried up mainly due to stress. We then went to donor milk for a short time.
    When I had k I breastfed and donated to the milk bank to repay the help they had given r

  3. Good post Kylie! If breastfeeding works, great, but if it is causing you to stress out, become depressed and making life unbearable for you and the little one, give up. And most importantly, DON'T FEEL BAD ABOUT IT! I don't think you can tell the breastfed kids from the bottle fed ones, apart from the nappies.... I'm sure it doesn't make a difference to their university scores, school abilities, or agility in football. It is really not worth bashing yourself over the head if breastfeeding is not happening. Having babies in NICU is hard enough without worrying about supply as well.

  4. I never intended to breast feed but with Blaine's early arriveal I found myself really pressured by thr NICU nurses to express, and of course I wanted to do all I could. However my milk just hadn't come through- I was only 24 +5days but the nurses pressured me so much. I took domperidome tablets to encourage my milk supply and managed a few ml a day for about 6 weeks. I never produced enough for full day's feeds so they always had to top it up with formula.
    The pressure from the nurses plus the natural stress I was under did not help I'm sure.

  5. I never intended to breast feed but when Blaine arrived early I was under massive pressure by the NICU nurses to express. Of course, I wanted to do all I could so I did try but my milk just did not come though - I was only 24 +5 days. I took domperidome tablets to encourage milk supply and it did help a bit. I managed to express just a few ml a day, after a lot of time expressing. The natural stress I was under plus the massive pressure from the nurses did not help and I managed to offer up my few ml a day (topped up with formula) for about 6 weeks.

  6. Thanks for the post Kylie! I'm a mummy to a beautiful boy born @28 weeks. I manages to express for nearly 4 months but it was such a struggle. For most of that time Jacob had to be suplimented with formula or donor milk. I found the support by the nicu staff poor and insensitive and I felt that because I wasn't producing enough, I was missing out on precious time with my very sick baby boy. The pain of undiagnosed thruch in both breasts didn't help either! I am however an advocate for domor breast milk for preemies. So much so that I have made contact with the scottish baby and todler show to ask them to have the donor milk bank at teir next show.

  7. yes that's a great point, it wasn't an option on our unit. I'll definitely be posting more on milk banks

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