Emma's story - breastfeeding a 35 week old baby

No one expects their motherhood journey to begin in the NICU, but that’s where Emma found herself, after the birth of her daughter Maya, by c-section due to placenta previa. At 35 weeks, Maya did not have a fully developed sucking reflex, and so they began a process of tube feeding, formula, pumping, and eventually breastfeeding. Emma’s determination shines through this story, especially as she faced the additional challenges of overstimulation and feeling touched out because of her autism. Now at 5 ½ months, Maya is exclusively breastfed and beginning to explore the world of food.

My new book, ‘Supporting the Transition from Breastfeeding: a Guide to Weaning for Professionals, Supporters and Parents’, is out now.

You can get 10% off the book at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Twitter @MakesMilk and on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com

Resources mentioned in this episode - 

@‌jessurlichs poet and author of Beautiful Chaos 

For information on autism and breastfeeding, look for the work of Dr Aimee Grant online and the Autism from Menstruation to Menopause project - https://www.autismmenstruationtomenopause.com/ https://www.youtube.com/watch?v=DDhlZ5Lu4wk

Anna Wilson IBCLC - https://wiloaklactation.co.uk/

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

This transcript is AI generated.

[00:00:00] Emma Pickett: I'm Emma Pickett and I'm a Lactation Consultant from London. When I first started calling myself Makes Milk, that was my superpower at the time because I was breastfeeding my own two children and now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end, and I'm big on making sure parents get support at the end too.

Join me for conversations on how breastfeeding is amazing, and also sometimes really, really hard. We'll look honestly and openly at that process of making milk, and of course, breastfeeding and chest feeding are a lot more than just making milk. Thank you very much for joining me for today's episode. I am looking at Emma.

Emma is from Gloucestershire and she's the mum of Maya, who's five and a half months old. And as you'll have seen from the title of the episode, Maya was born at 35 weeks. So we're going to be talking about the experience of breastfeeding a premature baby and what it's like giving birth at 35 weeks and the experience of breastfeeding after NICU and, and Emma's had some challenges along the way and she's very kindly going to share those with us.

Thank you very much for joining me today, Emma. Thank you for having me. Pleasure. So, so Maya's 35 weeks when she was born. Did you know that you were likely to give birth prematurely? Was that something that had been in the works for a while or was it a shock? It was a bit of both. 

[00:01:29] Emma: Uh, I had something called placenta previa, and I had had a couple of, um, heavy bleeds prior to that point.

So she was almost born at 31 and then 33 weeks. I then had a section scheduled for 36 weeks. But yeah, we didn't quite get that far. So it did result in an emergency section, but I think because I knew that I was going to have to have a section anyway and because I'd been in and out of hospital and prior to her being born I was in for two weeks, it wasn't a surprise as such.

But when you kind of do a July baby, you don't expect to have a May baby. 

[00:02:05] Emma Pickett: Yeah, 

[00:02:05] Emma: that's for sure. 

[00:02:06] Emma Pickett: Yeah, um, yeah, that sounds like a scary few weeks towards the end of your pregnancy. I'm sorry you had that experience. So for anyone who doesn't know the science, placenta previa, tell us what that means. Um, it essentially means that 

[00:02:19] Emma: the placenta does an implant where it's meant to implant.

Um, so instead of, uh, implanting in the stronger muscles higher up in the uterus, I think that's the right term. It, um, it goes in, um, the ones that are at the bottom that are actually weaker. In my case, the placenta was abutting the cervix, which means the placenta was actually touching the edge of the cervix.

Um, and where you then get, you know, things rubbing and stuff like that, then it can cause bleeds, unfortunately. Placenta previa generally, um, some people, well, quite a lot of people have it at 20 weeks. But then by the time of birth, it does tend to move. So it's only 10 percent of cases where it doesn't move.

Um, so I was just quite unfortunate and a lot of people as well, they don't have the bleeding. But again, I was unfortunate in that respect where I did have quite a lot of bleeding, um, especially kind of post 27 weeks in pregnancy. 

[00:03:18] Emma Pickett: Yeah, yeah, that's I'm sure that was that was tough. Were you working at that point or were you were you encouraged to rest?

What do people say to you when you are experiencing those late bleeds? 

[00:03:28] Emma: No, they actually kind of say to keep going. But I did. So up until 31 weeks, the bleeds have been quite small. But then at 31 weeks, I had a very large bleed. And at that point, I chose to kind of not go back to work. So I took sick leave because it was obviously very.

Traumatic on my, like my mental health as well as my body. And I think I was just too scared to do anything at that point. I did come home, but I just didn't really want to go anywhere because I was so afraid of, you know, it happening again. And unfortunately, then I did have another big bleed when I was at home alone, which was quite traumatic.

And then I had to be kind of blue lighted to the hospital as well. So, yeah, I'm so sorry that must 

[00:04:17] Emma Pickett: have been scary. 

[00:04:19] Emma: Yeah, it wasn't nice. Um, but I think I just kind of want to reassure if anyone's listening to this that has got placenta previa and hasn't yet had the baby. Um, it is quite uncommon for that to happen, you know, and, you know, Obviously, you know, you need to get to hospital, but chances are, even if you do have the bleed, it will most likely be okay.

Um, so yeah, it's scary because obviously you don't want to have blood gushing out of you. But yeah, it's, um, fortunately we're okay. 

[00:04:51] Emma Pickett: Both of 

[00:04:51] Emma: us. 

[00:04:52] Emma Pickett: Beautiful Maya is in the house, very happy at five and a half months. So yeah, you obviously had her healthy and at the end, which was great. But you, you suspected then you might be giving birth early and obviously 31 weeks and 33 weeks and 35 weeks are very different experiences.

If she'd be 31 weeks, that would have been a very different story. Did you do any reading around breastfeeding premature babies? What were you thinking about in terms of your sort of breastfeeding education at that point? 

[00:05:18] Emma: I actually had no clue to be honest. Like I had done quite a lot of prep for birth and everything related like that.

So I did some hypnobirthing and, uh, but I hadn't really thought about breastfeeding. I think it was one of those things that I just kind of took for granted that I'd kind of just be able to do because the women in my family have got quite a good history of, you know, being milk cows, as they say. Okay.

And having like quite a lot of milk supply, but yeah, I have no idea. And then my was then born at 35 plus two. And I think something that a lot of people wouldn't know is that when they're inside the womb, they don't even develop a suck reflex until about 36 weeks. So that was quite a surprise to me, you know, like.

You expect your baby to come out and to at least be able to try to feed them yourself. But actually Maya wasn't able to, to suck until she was like a week old or so. Um, so that was really hard to have to see her be tube fed. 

[00:06:18] Emma Pickett: So she was born with a C section and then she was taken away to go into NICU.

And is that something that people had sort of talked to you about already and you sort of knew it was likely to happen? 

[00:06:29] Emma: Yeah, we had had, um, when I'd almost had her at 33 weeks, we had had somebody from NICU come to see us as a paediatrician. And then I think a couple of days before we had her, we also did a tour around NICU.

So it wasn't a surprise, but it was still obviously quite hard. Okay. You know, I was quite lucky in the respect that when she did come out, she did cry. So, you know, it was positive and I got to have almost a minute of delay call clamping and, um, got to have her to my chest, but not, not fully because I was a bit woozy, but I was lucky in that respect.

But then, yeah, I was then separated from her for like four or five hours, which is. That's obviously not what anyone wants. And I don't actually know exactly what happened, um, kind of in terms of why she then ended up on CPAP. It's something that I'm still kind of waiting on sponsors about from NICU. For anyone who 

[00:07:22] Emma Pickett: doesn't know, tell us what CPAP is.

[00:07:24] Emma: Yeah. So, well, to be honest, I don't, I know it's just a breathing machine. Like I don't actually understand that much. And to be honest, I feel like when she was in NICU. Things were not maybe explained that clearly to us, you know, why things were being done. And I think I was kind of out of it anyway. Um, on goodness knows what medication, so I don't know that I was necessarily absorbing it anyway.

But essentially, my understanding is she just needed help to breathe. 

[00:07:52] Emma Pickett: Okay. Um, and you've requested some, well, not necessarily to be honest, a lactation lady rather than a baby lady, but yeah, it sounds like they felt she needed some assistance with breathing and obviously she was in an incubator and you know, had tubes and things, which must have been difficult to see and, and so you've requested some further information, have you?

You've put in a request for notes and a bit more detail. 

[00:08:14] Emma: I've requested to have a, um, Like a debrief. I've had one on my actual pregnancy and birth, but not on that yet. So it's something I need to chase, but 

[00:08:25] Emma Pickett: yeah, 

[00:08:26] Emma: it takes 

[00:08:26] Emma Pickett: a while. So you mentioned about her not having a developed suck reflex and I think, yeah, I mean, I think it's important to highlight that little babies obviously would be very different and there are different kind of levels of energy and, and, you know, some, some babies as, you know, as young as sort of 33, 34 weeks might be starting to show interest in the breast.

And licking and nuzzling and, and other babies will take a bit longer to get things up and running. Um, so you, she was tube fed, so that would be an NG tube through her nose into her stomach. And were you able to express what was happening with your supply? 

[00:08:58] Emma: Yeah, so I was able to, um, but I wasn't able to get as much kind of expressing as what, um, she possibly needed.

So then I was kind of told, right, well, we need to top her up with formula. Um, choose a brand and it was kind of like no other conversation around, was there any other option? 

[00:09:18] Emma Pickett: So no one mentioned donor milk as a possibility? No, 

[00:09:21] Emma: and I think in hindsight if I'd been offered that I would have chosen that personally.

But I think the impression I was given was because she wasn't that unwell, she didn't need it. Or something. I know that sounds a bit 

[00:09:33] Emma Pickett: No, that is sometimes what hospitals will do. They'll sometimes prioritize it for the smaller babies, but you know, as you, as you suggest it should be, it should be a choice.

I wasn't even given an 

[00:09:42] Emma: option. Like it was just kind of, we're going to give her formula. Choose a brand 

[00:09:47] Emma Pickett: is an interesting one, isn't it? I mean, choose a brand when you, you know, you've never fed a baby before. And as you know, actually all, all brands are required to be the same in terms of minimum content, nutritional content.

So choose a brand is a odd question to put to someone in your situation. I would've thought that they'd have like one standard brand and they'd say to you, listen, you know, the types of brands don't vary. So you, they just 

[00:10:11] Emma: listed, listed like five brands. And I was like, right, okay. I dunno if we're allowed to mention brand names, 

[00:10:16] Emma Pickett: don't mention a brand.

No, let's not, let's go give Formula Brands any promotion. 

[00:10:20] Emma: No, but so you just 

[00:10:21] Emma Pickett: pick one that seemed like a name that was, felt familiar or seemed like a good idea? Yes. And, and that was what was put in into her and G tube. 

[00:10:28] Emma: Yeah. And in hindsight, I really wish that actually they'd given me other options because.

Yeah, we went on to have quite a lot of issues with formula. But yeah, I mean, it is what it is. At the end of the day, she needed feeding. Um, she got a bit from me. She managed to have quite a lot of colostrum, which was good in the first couple of days. 

[00:10:46] Emma Pickett: Brilliant. 

[00:10:46] Emma: Um, 

[00:10:47] Emma Pickett: so had you done any antenatal expressing?

I'm guessing that was recommended really probably because of where you were in your pregnancy. So the official recommendation is not to do antenatal expression until 36 weeks and, and I would have thought probably because of your pregnancy they were not advising you to do any earlier. Um, but you were able to do some expressing straight after she was born, were you?

[00:11:08] Emma: Yeah, I was, um, so they had me hand expressed for, I think, at least 24 hours, maybe. After my section, I was so wiped out that I was kind of laying in bed and I just asked one of the midwives to do it. And that's something, you know, for people to know if, if you need help, they will help. Because especially after a C section, you're probably not really in the right state to be kind of doing something like that.

Um, cause it is pretty exhausting, hand expressing colostrum, you know, it takes a long time and you don't necessarily get a lot out. And so it gets a bit frustrating and especially when you're exhausted anyway, but it's definitely worth doing. And then after, I think it was 24 hours, they then said, right, you can use an electric pump now, which again in hindsight, I don't know if that was the best option really.

[00:12:00] Emma Pickett: You'll get, you'll get different advice from different places, but usually if you're physically able and maybe it's because you weren't that you weren't given this option, we normally would want you to be pumping within about six hours of birth. Um, um, so, so you hand express first and then you would pump to stimulate and bring in your milk supply because we want your milk supply to get those signals to be up and running to be able to provide for, for Myra in the future.

They usually, even though you're only producing colostrum, we would still. Get you using a double pump ideally within the first six hours of birth. But it probably was, it's probably because they felt you needed to recover. I'm guessing that was what was going on there. So you started pumping and she was in NICU and you were somewhere else in the hospital.

Is that Yeah, I, I 

[00:12:48] Emma: was like going down to see her, like fairly often, so I was, I was in hospital, like I stayed in myself for, I think I was discharged three days after her birth. So I would go and like spend the majority of the day with her in NICU and then go back up to the maternity ward. But yeah, it was hard and I was just very tired.

And to be honest, I don't remember a lot about those days. It's, they all kind of blended into one. Yeah, not very nice days, unfortunately. 

[00:13:19] Emma Pickett: Yeah. When you say not very nice, what makes you say that? What are you remembering? Well, nobody wants to see their 

[00:13:27] Emma: baby kind of in an incubator, do they? Um, especially with all the kind of things up their nose.

And I mean, she had cannulas in her little hands and like in her elbow and she was having to receive sugars and it's just a lot of wires to be coming out of something so fragile, you know? Um, I don't think anybody. imagines that that will be their start to motherhood. And yeah, it's just been well premature today, actually, as well.

And I just want to highlight that as well. And that was a couple of days ago from when we were recording this episode. And I think it, it really is just It's very tough to be in NICU with your baby. You don't, you don't accept it. And nobody accepts that. Nobody wants that. 

[00:14:11] Emma Pickett: Yeah. So you're recovering from your birth yourself.

You're seeing her, you know, looking fragile and feeling that disconnect because she's physically in that space. Were you able to hold her? What was her condition? Were you able to do sort of, sort of skin to skin? 

[00:14:26] Emma: Yeah. No, we were quite lucky in that respect. Um, so I was able to hold her and they would also like have me kind of try and like put my breasts to her mouth.

But yeah, she, she was very weak. She didn't spend a lot of time awake. Uh, and she had absolutely no interest in the breasts at that point. So yeah, yeah, it's, it's quite crazy now to me how not with it she was, like when now I know how she is, like, I think I didn't know that newborn babies weren't meant to be like quite so out of it and like asleep constantly.

[00:15:04] Emma Pickett: And when you look back on those times, do you have memories of sort of the support you were getting from staff? What kind of conversations are you having about getting breastfeeding started? 

[00:15:13] Emma: To be fair, the The hospital were fairly good. Um, they had a, uh, breastfeeding specialist. So she came quite a few times just to try and work with me and stuff.

But I think because she didn't, Maya didn't have the suck reflex, there wasn't really a lot anyone could do about it until that started to develop. And yeah, sometimes they would just kind of have me shove my boob in her mouth and, um, yeah. Obviously, it wasn't doing anything because she didn't have a reflux yet, uh, reflex yet.

And yeah, I suppose I didn't really know what was normal and what wasn't. And yeah, sorry, I don't know. 

[00:15:53] Emma Pickett: Yeah, were you getting any support around the pumping? So they said right after 24 hours, get pumping. Were you given guidance about how often or? Yeah, 

[00:16:01] Emma: it was just every three hours, like day and night. I know that you don't like the whole every three hours.

Oh no, 

[00:16:07] Emma Pickett: for pumping it's definitely need that. Pumping is a different story. So when you're pumping in, in, um, you know, in NICU, you need to have that regular pumping schedule and get the support to do that. When you say, I don't like the three hours thing, that's just, you're probably referring to my article about feeding intervals.

So when we're responsively breastfeeding, it's a different story, but when we need to get milk supply up and running, that schedule can be really helpful. So So when you were back up to the maternity ward, you were taking the pump with you pumping when you were separated overnight. 

[00:16:34] Emma: Yeah. And I actually had my own pump, which was, um, I think, I don't know if it was yourself or Lucy Weber that's recently done an article on it.

And it was like a wearable pump. 

[00:16:45] Emma Pickett: Yeah. Lucy did a post about wearable pumps the other day. Yeah. I'm guessing you're referring to the article where she said, if your milk supply is an issue, wearable pumps are probably not your first choice. Yeah. 

[00:16:57] Emma: And I feel like. Had I been encouraged to maybe stick with the hospital grade ones, at least for the first week or two, it probably would have helped me get my supply up to where it needed to be, rather than the wearable one.

Um, I think maybe that's a lesson for people to take away from, from this. Yeah, I'm glad you mentioned that 

[00:17:15] Emma Pickett: actually Emma. The wearable ones are very popular, getting a lot of publicity and lots of people think they're sort of necessary for a breastfeeding journey, but there's something that size just hasn't got the quality of motor that the larger pumps will have.

So it is difficult, particularly when you've given birth to a premature baby, it's even more important. that the pump you use has got that robust motor that's really going to be able to drive that frequent milk stimulation. But having said that, you obviously got to where you are now, you are breastfeeding now, so you didn't, you didn't ruin everything or whatever the word is, you obviously, so you, even though maybe you look back with some regrets, obviously you, as you probably know, we only do what we can at the time with the information we're given and and that's the information you had.

So how long was Myra in hospital? She was in NICU for 

[00:17:59] Emma: 11 days. Um, so Yeah, she, I think it was after about a week, she then kind of started to develop the septum reflux at which point the feeding specialist, I think she was a breastfeeding specialist, gave me some nipple shields, um, to use because my nipples were too big for her mouth.

So then we started using those and it seemed to go pretty well. 

[00:18:23] Emma Pickett: Um, okay. So I'm a bit confused. Help me out when you put a shield on, doesn't that make them even bigger? Well, I don't know, 

[00:18:29] Emma: to be honest. Like, that's just what I was told. So I think, no, I think what it was as well, there wasn't the length, but I think she needed it to be a little bit longer to stimulate the, is it the top of the palate or something?

Um, again, I'm not the expert. You are. Yeah. I 

[00:18:43] Emma Pickett: mean, some, sometimes we do give shields for premature babies just because when a baby's feeding with a nipple shield, they don't have to create negative space in quite the same way. They had to create negative pressure in quite the same way. It's a little bit easier for milk to be transferred if a baby doesn't have that strong suck.

So I wonder whether that was maybe it, um, Probably, but I was given the correct information. You were told it was something about your nipple shape. Yeah. 

[00:19:07] Emma: I was also told that it was completely normal, that it was toe curlingly painful. And I was like, no, it's not. I've been told it's not normal for it to hurt because I was already following Lucy at that point.

And I know that actually it shouldn't be painful. And so I kind of. kept going to like correct it and fortunately then I got to the point where it wasn't painful. Um, and I'm quite grateful for that. I've never had touch with much pain with breastfeeding and I think that's why I've been able to continue as long as 

[00:19:36] Emma Pickett: I have.

Um, yeah. Toe curling is not a word we want to associate with breastfeeding. That is not a good combination. So you're in hospital. Feeding with a shield and it's super, it may be, to be honest, it might have been painful because of the shield. So if you were told you had big nipples, it was the wrong 

[00:19:51] Emma: size. I was 

[00:19:52] Emma Pickett: going to say, if you had a big shield on top of a big nipple that wasn't the right size, it may well have been that that was why you were in pain.

So then they sized me up. 

[00:20:01] Emma: Okay. Yeah. And then it was, it was a lot better then. And then, yeah, like we got home and it was absolutely fine. We were then breastfeeding, like Maya was having formula. Um, anything from like every couple of days to like at one point, I went a week with no formula, just exclusively breastfeeding.

So it was going really, really well. And then around four weeks, she, or five weeks, maybe she developed silent reflux. And I don't know how many weeks she was, but we had a, a incident where I think I had not long fed her, and she then couldn't breathe. She had milk pouring out of her nose, and it was really terrifying.

For anybody that's ever witnessed silent reflux, it really is very scary. We then obviously called an ambulance, waited half an hour, they still didn't show up, and I think Maya might be hungry. That's okay. 

[00:20:57] Emma Pickett: Do Maya, do come in, Maya. Not that you can hear me. Hi, Maya's dad. Hi, Maya. Oh, Maya's a button. Hello, Maya.

Look at you. I don't podcast. No one else can see her. Trust me. She's absolutely gorgeous. Um, so Maya, we're just talking about the time you scared mummy with your silent reflux. Um, but through no fault of your own. I mean, when your baby can't breathe, that is obviously super frightening. How long was she not breathing for?

I'm not asking you to remember exact moments. Did it feel like 

[00:21:29] Emma: She couldn't breathe, breathe properly for about half an hour. And then the ambulance still hadn't shown up. So then we just decided to drive her up to A& E ourselves. Um, she was obviously getting breaths in, but it wasn't enough. Um, so then, yeah, obviously they then assessed her, said, yeah, silent reflux, which we already knew.

Um, cause I had kind of already been doing some like researching and stuff. Um, so the doctor had already diagnosed silent reflux the day before. and prescribed some, um, uh, medication. I don't know if I'm allowed to say what that was on here. Yeah. Yeah. So is that Gaviscon? Yeah. Yeah. Which is the devil, like, well, in my opinion, in my opinion, tell us why it was the devil.

Um, it really badly constipated her, um, to the point where she was actually in so much pain with constipation. So, yeah, that really did not work very well for us. I think what people don't 

[00:22:22] Emma Pickett: realize about Gaviscon is it literally is just a thickener. That's all it is. So it's going to thicken the milk and it's going to thicken everything that goes through their system and it's going to make the stools firmer and harder and more difficult 

[00:22:33] Emma: to pass.

She was in a lot of pain with it, unfortunately. She then got moved to a macrosol, which she's still on to this day and that helped. I think what I would also note kind of around this kind of time period, I. I had like a bit of a mental breakdown, uh, sadly, because I was just struggling so much. I think with the reflux, cause I was blaming myself and, you know, I was struggling with the cluster feeding and I was thinking, and I think a lot of people go through this.

I don't have enough milk supply because she was constantly feeding. And I think you get in your head, like, I don't have enough to keep up with her. And actually that, that probably wasn't the case. Although that being said, I did have an infection. I was on medications. antibiotics, all these different things.

So actually it could have been the case that I maybe wasn't supplying enough. And I don't know, 

[00:23:25] Emma Pickett: you're going through so much. I mean, who knows? One of the things is you can sort of look back retrospectively and wonder what was happening and you may never know. But, but one thing I'd say is you're recovering from your birth.

You're recovering from a traumatic end of your pregnancy. You're recovering from seeing a baby and Nikki, there's so much going on. So when you say you had a breakdown, was there one particular day where It all kind of came to a head. How did that work? 

[00:23:48] Emma: Yeah, it's kind of difficult to talk about, but I, I will talk about it in case it helps somebody else, but I'd been having a couple of tough days and I think it's also because I'm autistic.

Um, I was struggling with the amount of stimulation and the noise and the touching, and I didn't want to hold her some of the days, which is obviously really upsetting to speak about now. Yeah. And the one day my mum had her, um, and I just walked out and left my phone at home and stuff. Um, so then my mum called the police because obviously she was worried about me, which then resulted obviously them coming and, um, A lot of intervention.

Uh, and that was a really hard time. Yeah. Thank you for sharing 

[00:24:35] Emma Pickett: that. I know that's not easy to talk about, but I really appreciate you sharing that. So, when you, when you left the house, did you, were you going anywhere or you just needed to leave? I 

[00:24:43] Emma: just got in the car and drove. I didn't go far, but I just needed to get away.

And then I just sat in the car and just cried and cried and screamed. And, um, yeah, it was, Yeah, pretty horrific, but I think when I look back now, I can see how physically unwell I was. And I think that then combined with the lack of sleep just pushed me over the edge a little bit. And if anyone else is listening to this and feeling that way, it will get better.

I promise. It's obviously still hard to discuss, but yeah, if that helps somebody else, like just know, you know, you're not alone. And, um, what then happened was my husband then, um, essentially took over nights. Um, he had to take an extended leave of absence from work so that he could essentially look after Maya.

And my mum was also coming every day to like essentially look after me. So he had to look after Maya, my mum had to look after me. I managed to continue breastfeeding in the day. Although there were a couple of days where I, I just really struggled to touch her or like be touched and I even struggled to express because I just didn't want to have the, the stimulation.

So yeah, at that point, we relied quite heavily on formula. Um, and I think that made me feel even worse about myself. Um, I also had a lot of half anxiety for Maya, like when she was dealing with the reflux issues and, um, unfortunately, like quite a lot of medical professionals just told me to give up with breastfeeding.

But I'm stubborn and I said no, I said I don't want to because it didn't feel right for me. For me, I felt like I wanted to continue. And because I knew that that was what was best for Maya in the long run. 

[00:26:28] Emma Pickett: Were you getting any specialist of mental health support at this point, or were you referred to the mental health team?

[00:26:33] Emma: Yeah, no, I was already under the perinatal mental health team anyway. Um, shout out, they were amazing and they really were. They gave me a lot of support from around 30 weeks or so in pregnancy. Um, so yeah, they really gave me a lot of help, but I think my issue is more with feeling like I was constantly having to advocate for Maya, um, with her health issues and not getting the support that I felt I needed and not necessarily getting the support with the feeding.

I think fast forward on essentially she was still having issues, she was still on the omeprazole. And then when she was around, I think, 11 weeks, I listened to your episode about the, um, faltering growth and I listened to that and I was like, gosh, that sounds so similar to Maya. Um, and that lady's, um, I think she was a doula, wasn't she?

Her little boy turned out to have tongue tie. So I thought, you know what? I'll just take her for a tongue tie assessment. I'll request that just to rule it out. So then when she was around 12 weeks, we went and saw a IBCLC at the hospital called Anna. Anna Wilson, and she then took a look and she was like, no, it's not a tongue tie.

But then she asked me to show her how I was feeding. And bearing in mind at this point, like, every feed was like one and a half to two hours. Like every one to two hours, I was exhausted. That's intense. I was absolutely exhausted. And 

[00:28:03] Emma Pickett: hearing what you were saying earlier about your autism as well, um, Emma, I just want to, I mean, that's a lot of touch, that's a real, that's a lot of stimulation, isn't it?

I mean, I think one of the things, if you're comfortable with that, I'm going to suggest it. I put in the show notes, some resources around autism and breastfeeding. So Dr. Amy Grant is a great source of information and there are actually websites created to help people who have autism and autistic parents who are breastfeeding.

Yeah, I didn't 

[00:28:27] Emma: know that. Wish I did. Wish I'd known that then. Not that there's 

[00:28:31] Emma Pickett: a, not that there's one solution for everybody, obviously, because they're, it's a diverse group of parents, but, but there are specific issues for autistic parents around breastfeeding that can be helpful. Um, did you, did you have any, did you find anything that helped you with that sense of being overstimulated and that excessive amounts of touch?

Did you find any tricks or any things that made it easier for you? 

[00:28:53] Emma: Sadly not. Um, I, and I think I just used to get very frustrated because as I say, I would literally be sat on the sofa the majority of the day feeding. Um, and it never seemed like she was satisfied. And then she obviously had the faltering growth as well.

So she wasn't gaining a lot of weight and she dropped from like the 50th to the second percentile. Um, so yeah, it was a really, really challenging time. 

[00:29:20] Emma Pickett: A little advert just to say that you can buy my four books online. You've Got It In You, a positive guide to breastfeeding, is 99p as an e book and that's aimed at expectant and new parents.

The Breast Book, published by Pinter and Martin, is a guide for 9 14 year olds and it's a puberty book that puts the emphasis on breasts, which I think is very much needed. And my last two books are about supporting breastfeeding beyond six months. and supporting the transition from breastfeeding. For a 10 percent discount on the last two, go to Jessica Kingsley Press, that's uk.

jkp. com and use the code mmpe10. Makes milk. Pick it, Emma. 10. Thanks. When you spoke to Anna, the lactation consultant, And she said, she said tongue function was okay. Did she, did she identify anything else specifically around your feeding that was an issue? 

[00:30:18] Emma: She did. And now, uh, we go back to NICU, where I was introduced to nipple shields.

And essentially what had happened is, I assume post birth my nipples have been quite swollen and obviously mine was very small. Fast forward to when I was like 12 weeks postpartum, my nipples had shrunk, mine was bigger, and essentially the shield I had was way too big. So you were still using a shield at this point, but it 

[00:30:47] Emma Pickett: was no longer the right size.

So for several weeks, who knows how long you've been using the wrong size shield, which is going to affect milk transfer massively. 

[00:30:54] Emma: I think since about seven or eight. since about four or five weeks, like when she started with the reflux, I think that's when the issue probably started because I can kind of tie it to when her then faltering growth started.

So Anna sat with us, um, for about five, 10 minutes, corrected it. Show me how to feed without the shield. Um, and then from that point we didn't use it again. Her feeds went from one and a half hours to two hours to like five to ten minutes. Wow. Okay. 

[00:31:22] Emma Pickett: So this is a bit of an advert for using A, the right size shield and B, getting the right support.

Yes. So just, just that very short interaction with Anna just completely transformed your experience. And I wish 

[00:31:34] Emma: it happened sooner. I really do because that was life changing for me because from that point. I was actually able to start getting out and like going places and doing things because I wasn't sat for one and a half, two hours every time feeding her and worrying and, and then her weight started going up.

gaining. So she went from gaining like two or three ounces a week. She went then to gaining like six, seven ounces a week. So it was like double, like instantly. Such a 

[00:32:00] Emma Pickett: difference, isn't it? 

[00:32:01] Emma: Yeah. Gosh. Well, I'm so glad 

[00:32:02] Emma Pickett: you met Anna when you did, even though it wasn't necessarily several weeks before that, but a long time you must've spent struggling and those very long feeds with that minimal milk transfer must've been so disheartening.

How did it feel to finally be off the shields? Physically, did it feel, obviously it was a lot quicker, so the feeds were a lot more, 

[00:32:21] Emma: It took me a bit of time to like, feel like confident with it because I was panicking, right. She's only fed for 10 minutes, surely she's still hungry. So it took me a while and like having then a couple of weigh ins to kind of confirm, okay, she is gaining weight now.

That's what I needed then to kind of solidify, okay, actually, you know, this is working well. Um, and in terms of the actual, how it felt physically, it was fine. I have absolutely no issue, um, with feeding. Like it doesn't feel overstimulating really now, and it probably helps that it is so much shorter. I mean, don't get me wrong when she kind of gets the end of the feed and then decides to start using me as a dummy, that's not comfortable.

Um, but that's how I then know, obviously, to break off, um, the feed. But yeah, it really was life changing and we're now, what, about 20, I think she's about 24, 25 weeks. And we slowly kind of, from that point, cut down her formula. So for a while we were, Giving one or two bottles in the evening because I thought, oh, that will help her sleep through, which I know now is a bit of a myth.

Um, and about, I think, five, six weeks ago now I cut it completely. So now I'm exclusively breastfeeding, which is, has been my goal all along. Yeah. Oh, Emma, 

[00:33:42] Emma Pickett: you're a legend. You are. All the things you've been through. I mean, all the things you've described happened in just five and a half months. I mean, all the different things you went through.

Yeah. What an intense year you've been through, um, you mentioned obviously that really tough time for you in terms of your mental health and your mum looking after you. Did that gradually change or do you, what's happening now with how you, how you're feeling and are you doing any nighttime care for Maya at the moment?

Oh 

[00:34:09] Emma: yeah, yeah. No, my husband actually only ended up having her for about a week. I think I just really needed time to like reset, get some rest. Like I don't think I'd have the time to recover from my C section because actually, and this is something we didn't mention, um, When Maya was in NICU, I actually stayed in with her.

So I didn't even, and to be honest, I'm glad I didn't have to leave her there, but I didn't even have that time where she was in NICU to actually rest and recover. So I was, you know, three days after my section, I got discharged, put in NICU, and I was looking after her 24 seven from that point. And my husband wasn't there either.

Like, I mean, I had a bit of help from the nursery nurses, but yeah, I just think really, I didn't have the chance to recover from my C section. When you think about what a massive surgery a section is, it's crazy really that we're expecting women to like go straight into like looking after a baby and having no sleep when they're actually recovering from major surgery.

It's, it's mad. 

[00:35:09] Emma Pickett: It really is. And when, um, you did, you got rid of the shields and you weren't feeding with the shields anymore, did her reflux, reflux symptoms get any easier? I'm just wondering if there may be a connection with, with the shields and the latch and the reflux symptoms. 

[00:35:24] Emma: It's improved a little bit.

Um, but unfortunately, unfortunately she is still on the macrozole. Um, we have tried to kind of bring her off it a couple of times. But yeah, she still needs it. Um, and I think I just got to the point where I decided just to accept that because trying to find the answer was driving me insane. I was really made to feel like I was crazy by my doctor, like GP practice and everything.

Um, because I was literally there like a lot. Like there's something wrong with my daughter and nobody was listening except for my health visiting team. My health visiting team were amazing. Um, but I do think, you know, in hindsight, somebody should have referred, even if they didn't think it was a tongue tie, like maybe referred for a tongue tie check earlier.

And I think, you know, As a mum, or even as a parent, like, you know in your gut if something's not right, and I think that would really be my biggest takeaway is like, trust your gut, because I knew something wasn't right. And yeah, getting that then corrected was like, wow, I knew something was wrong and thank God I listened because now I'm, I can live.

I went from like, not. basically not being able to live to like living overnight. It was crazy. 

[00:36:37] Emma Pickett: Yeah. Wow. And so now you're feeding directly on the breast. You just have short feeds. What does a typical night look like for you at the moment? 

[00:36:45] Emma: Well, we've just kind of been going through the four month regression at the moment.

Um, so that's not been so much fun, like, but I mean, compared to some people, it's not been too bad. She wakes maybe two or three times a night. Last night, it was more like five or six. Um, yeah, last night wasn't a great night. Um, but she, she's, I think because she's doing all these skills and stuff, you know, sitting up and, um, rolling and talking.

It's, yeah, I think she's just. Going through so many changes that she's just not going to sleep that much right now. 

[00:37:23] Emma Pickett: Yeah, that lovely developmental phase where they wake up so often because they find themselves in the middle of a roll or, you know, they're kicking a leg or something. Yeah, milestone wakings are not easy, that's for sure.

No. So you're not far away from starting solids. How do you feel about that journey? 

[00:37:39] Emma: Well, we actually started three days ago. Well, no, sorry, two days ago, um, because she was showing all the signs of redness. I discussed it with my, um, health visitor and they, they obviously still said we'd recommend you wait, um, but actually we made the decision to kind of start.

She's had broccoli, carrots, and, um, cauliflower, and she has guzzled them down and cried when I took them away. Oh, wow. Okay. She's absolutely obsessed. Oh, brilliant. Yeah, so I feel good about it. I mean, I know that that may then change her relationship with breastfeeding. Um. Hopefully 

[00:38:16] Emma Pickett: not just yet. Hopefully not.

No. That's, yeah, that's what you, actually, I know you know this Emma, but I can't switch off my lactation consultant brain. If she's a guzzler that you have to just be careful you don't let her go down the road of dropping her milk feeds because we don't want her breastfeed to reduce at five and a half months.

So, so you might have to say, sorry, love, I know you like the broccoli, but we need to hold on a little bit longer. Oh, I did. She was 

[00:38:37] Emma: fuming. Yeah. Um, I mean, to be honest, I think more of it went on her face than in her mouth. Um, but yeah, she's really enjoying it and she's really thriving now. And I think I sometimes sit down and I look at her and I'm thinking, Wow, I did that, you know, and like my body has grown her.

My body's provided her with the majority of the nutrients she's had. And I just think it's so rewarding now. Um, I'm getting some breast milk jewellery made as well. 

[00:39:08] Emma Pickett: Aw, 

[00:39:09] Emma: lovely. Um, yeah, and I'm just really proud of myself. And I think, I wasn't intending to come on a podcast, you about doing a podcast episode about NICU, and you were like, Oh, well do you want to come speak to me?

And I thought, You know 

[00:39:24] Emma Pickett: what, if it helps someone else, why not? Um, Oh, I really appreciate you. I know I've slightly put you on the spot there. You're like, let's have an episode about this. And I went, yes, come and do it. Um, but yeah, I wanted to hear your story and I, I really appreciate your honesty. And I think, I think talking about autism and breastfeeding is super important as well, because it doesn't get a lot of discussion.

And I don't think people necessarily realize what that feels like that sense of being overwhelmed and 

[00:39:47] Emma: even pregnancy as well, like actually being autistic and pregnant is. Where you would like, especially when you have. a bad pregnancy, it can be a real challenge. So yeah, I mean, if you have anyone that listens to this and kind of wants to speak to someone who's been through it, you can obviously pass on my details to them.

That's very kind 

[00:40:05] Emma Pickett: of you. Yeah. Yeah, I appreciate that offer. And as I said, I'll put Amy Grant's resources in the show notes, and there's a website about autism and pregnancy and new parenting, and I'll put that in the show notes as well. What's your plan for breastfeeding? Where would you like to end up?

[00:40:21] Emma: Um, I don't know. I think, um, the thing for me at the moment is I meant to go back to work when she's around 10 and a half months. So still a while. But I'm obviously going to have to then figure out how to like pump and stuff at that point because actually when I pump, I don't get a lot off. 

[00:40:37] Emma Pickett: So Lucy, Lucy Webber, who I know you follow, she does workshops and going back to work.

Yeah, I've seen. Check out her workshops. I do one to one support, but you may not need that. To be honest, it's, I don't think it's once you know how you're going to schedule things and if she's 10 and a half months old and she's a solid lover and the trajectory that you're on, she may well be at that at that point.

So you may actually be able to breastfeed just when you're with her and when you're not with her, just food and water. That's all possible. Lots of people are doing that at 10 months. It only works if a child is really into their solids at that age, but if they are, it absolutely is possible. So even if you don't necessarily pump a lot, you may find that that's not necessary.

Yeah. I'm not much of a fan of pumping 

[00:41:20] Emma: personally, um, it is just a bit overstimulating, but yeah. And I mean, absolute worst case, give a formula again, but I, my goal is not to do that. Um, just for personal reasons and yeah, she does get more like an upset stomach with formula and stuff. But that's a completely different tale.

But yeah, my goal really is to actually continue until she, um, what's it called? Um, natural term, like until she's ready to stop, um, not necessarily out and about, but in the evenings and stuff, if she still wants to feed to sleep and have a cuddle, like I'm happy to do it until she's ready to stop. Whether that be like two or five, you know?

Brilliant. And especially like seeing as I've seen your resources about actually how important it can be still, um, yeah. I don't know if you can hear her in the background. I can hear her. I think she's getting a bit too loud there. I'm going to 

[00:42:12] Emma Pickett: let you go because we've had all the, uh, we've had the, before you go and, and see Maya.

She's shouting me.

So before you go, you've mentioned Lucy, are there any other resources that you found really helpful? Anything particularly around maturity or anything else you found useful? 

[00:42:33] Emma: Um, actually there's a, it's not, um, a, um, breastfeeding resource, but there's a lazy on Instagram that does like poems about breastfeeding and, um, motherhood and she's got a book, what's it called?

Um, you probably will know it when I say it, uh, Beautiful Chaos. Have you heard of her? Um, her name is, um, Jessica Ehrlichs. Okay. She's Australian, um, but she has a, an account. Yeah, it's just Jess Ehrlichs. So that's U R L I C H S. Um, she does like poetry and stuff. Um, and actually there's just poems that at times I think, I wish I'd seen that when I was younger.

In this part of postpartum or they're just really touching so anyone who kind of really finds power in words like I would definitely look that up it's given me strength in some hard times. Um, 

[00:43:38] Emma Pickett: oh, that's lovely to hear. So, so yeah, Jessica Earli, I will, I dunno if I've saying her name right, earli, I don't have to say it to be honest.

We'll put that in, I'll 

[00:43:45] Emma: share in her profile to you. Yeah, 

[00:43:46] Emma Pickett: well I'll put that in the show notes too. She's actually on TikTok as well and she reads the Prime on TikTok, so 

[00:43:51] Emma: Yeah. Yeah, that was how I found her actually, because there was one on there and I dunno, it just made me cry 'cause it was so beautiful.

And um. Even if someone's not into poetry, like, I would still kind of say have a look because I do think it's, yeah, she's just amazing, really. Oh, 

[00:44:08] Emma Pickett: that's 

[00:44:08] Emma: lovely. And if anyone's kind of in Gloucestershire, Anna Wilson, who was my IBCLC. Um, I know that she does do private, um, private consultations too. Um, I would definitely like recommend her.

She's, uh, Will Oak Lactation Consultancy. She really, like, changed my life. I can 

[00:44:31] Emma Pickett: hear, I can hear how key that one conversation with her was. It was incredible. That turned you around completely. Um, but I'm, I'm glad to hear what you said earlier, though, that you feel proud about yourself as well. I do. Yeah.

You are the one that did this. I'm a young one that went through all these challenges and came out the other side and 

[00:44:47] Emma: it's out of pure pig headedness. Like that's why I was just like, no matter how many people told me I couldn't do it, I was like, well, I can. Like, I can do it and I will do it and, you know, proof's in the pudding, isn't it?

[00:44:59] Emma Pickett: Definitely. And you have a gorgeous pudding downstairs. Yes. But also, I mean, you're a real story about how not getting the right information can just sabotage a journey. I mean, those wrong size shields, if you'd carried on like that, you probably wouldn't be breastfeeding now. So I'm so glad you got the right support in the end.

[00:45:15] Emma: I think there's a lack of breastfeeding support post NICU. I think that is something that actually needs to be talked about, and probably just post birth in general, but really, like, for a NICU baby, my opinion is that if someone's choosing to breastfeed, they should probably have access to an infant feeding specialist, at least for like six to eight weeks after birth.

Yeah. Because it is a completely different process to maybe a full term baby. Um, I mean, my opinion is that obviously everyone should have Um, access and yeah, like we were lucky because we were able to afford to pay for things like osteopath and stuff to help with reflux, but a lot of people don't have access to these things.

It's really frustrating, but I think the work that you guys do like yourself and Lucy, um, is also really priceless. I've had a lot of information and knowledge from you guys. And I think sometimes seeing your posts is like kind of helped me to know actually. Being persistent is the right option here, and it's worth sticking it out because these are all the benefits it can give to my child.

So thank you as 

[00:46:22] Emma Pickett: well. Well, that's kind of you to say. Well, thank you so much for sharing your story today, Emma. I'm gonna, I'm gonna let you go and see your delightful twin, and I'm so grateful for your honesty and openness. And, and yeah, I'm sure things you've shared today will, will connect with people for sure.

Yeah. Congratulations on your breastfeeding journey. Let me know how things carry on. I will do. Thanks.

Thank you for joining me today. You can find me on Instagram at emmapicketibclc and on Twitter at makesmilk. It would be lovely if you subscribed because that helps other people to know I exist and leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast.

This podcast is produced by the lovely Emily Crosby Media.