Coral's story - 'uni-boobing' after duct surgery

Uni-boobing - feeding on just one breast - is more common than many of us think. Whether through child-preference, injury, or as a result of surgery, like my guest this week, it’s absolutely possible to exclusively breastfeed on just one breast.

My guest, Coral, had duct surgery due to unexplained bleeding and a family history of breast cancer, in her twenties. Although she was told she probably could still breastfeed, it wasn’t until her son, Rowan, was born that the reality of exclusively breastfeeding him was revealed. She persevered through tube feeding, combined feeding and very frequent feeds with determination. Rowan is now two years old and still nursing.

My new picture book on how breastfeeding journeys end, The Story of Jessie’s Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children’s Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.

You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

During our conversation, we mentioned -

Breastfeeding After Breast and Nipple Surgeries https://www.bfar.org/index.shtml

My article Breastfeeding: The dangerous obsession with the infant feeding interval - Baby Friendly Initiative https://www.unicef.org.uk/babyfriendly/breastfeeding-the-dangerous-obsession-with-the-infant-feeding-interval/

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

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 am 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 talking to Coral.

Which is a great name. You don't hear many corals in the world these days, but I'm talking to the lovely Coral who is from Derbyshire. She's slap bang in the middle of Nottingham and Derby. And as you have seen from the title of the episode, we're gonna be talking about breastfeeding after duct surgery.

Very specifically duct surgery, not red reduction surgery, not enlargement surgery. We're talking about duct surgery. And if anyone comes to this episode, because this is their experience, I'm very much hoping they will find a home here and get some useful information and some useful insight. Thank you very much for joining me today, coral, to share your story.

Thank you 

[00:01:24] Coral: for having me. It are we surreal, but happy to be here. 

[00:01:28] Emma Pickett: Oh, you're very welcome to be here. Surreal. I dunno if that's a good thing or a bad thing, but I I will assume a, it's a good thing. Good, good. It's 

[00:01:34] Coral: a great thing. I love your podcast and it's weird that I'm gonna be on it, but hopefully it'll be useful for some people who might find themselves in a similar situation to.

That's the 

[00:01:45] Emma Pickett: key. I mean, I'm very happy to do episodes that are quite niche in a way because, you know, not everyone is going to have had duct surgery prior to giving birth and having their jar and breastfeeding. But actually sometimes it's those niche people who need the most help to feel connected and, and get information because you're googling away and, and you'll get to lovely resources about breastfeeding after surgery that won't necessarily be directly relevant.

And, and I even if only one person's experience is, is helped by this podcast, that's a win as far as I'm concerned. And also by you sharing your story, you know, we're helping breastfeeding supporters and health professionals too. So, so I really am very grateful. So let's talk about the, the fine details of your surgery, if that's okay.

Yeah. So I've put, put in the title Duct surgery, but it's actually give us the proper, full medical name of what happened to you before you had your baby. 

[00:02:35] Coral: There's a few things that it can be called. What is like documented was that I had a hadfield's procedure. 

[00:02:41] Emma Pickett: Hadfield. Like the astronaut Hadfield. Okay.

Yes. I don't think he's the surgeon 

[00:02:45] Coral: that 

[00:02:46] Emma Pickett: named after himself. That would be, that would be surprising. PE people can multitask, but Okay. Yeah. So ha hadfield's procedure, did you say is what it's called? Yes. Okay. Sometimes 

[00:02:54] Coral: it's called surgery. Um, but I think it's technical name is either a total duct excision or a sub areola duct excision.

[00:03:03] Emma Pickett: Okay. 

[00:03:03] Coral: Which just means the portion of my milk ducts under my nipple was removed. 

[00:03:09] Emma Pickett: Okay. 

[00:03:10] Coral: And it wasn't the surgery that I was planned to have, um, but it was a potential risk that I was going to have a, a surgery called a microdiscectomy, which is where just one duct is removed. Um, and it was a risk that they were going to need to remove.

More of them and that's what ended up happening. 

[00:03:28] Emma Pickett: Okay. So on one breast you had mm-hmm. This particular surgery that removed more than one milk duct. Yeah. And this happened a couple of years before you, you got pregnant with your son, so just to, yes. Just to jump to the end, you've got the lovely Rowan who is two and he's just about Yes.

Well, he's Robert recording this. He's just about to turn two, he'll be two when this episode goes out. You're still breastfeeding him, so spoiler alert. Mm-hmm. Breastfeeding worked out. We did, but, but two years before you gave birth to him, this was what you were faced with needing to have this surgery.

Yes. What led up to that? What were, what were your symptoms? What was going on? 

[00:04:01] Coral: What? It was very sudden, um, I literally went to go and have a shower, took my top off, brushed, brushed my boob, and noticed it was really wet. And my first thought was, oh, I'm lactating. Am I pregnant? What's going on? And then I looked down and it was blood, which is.

Slightly terrifying. Um, and I sort of gave it a bit of a poke and when I poked it, more blood came out. 

[00:04:24] Emma Pickett: Oh gosh, that's scary. 

[00:04:25] Coral: Yeah, so I um, rang my GP in a bit of a tears. This was like four o'clock on I think a Friday potentially. Like it was, you know, like terrible time to call a gp. I was just in bits on the phone like, I think I need to see a doctor.

I don't know what's happening. I think I'm someone who's quite breast aware. We've got breast cancer in the family, you know, so I will check. But you always expect that there's going to be like a lump or 

[00:04:50] Emma Pickett: Yeah, yeah. Some 

[00:04:50] Coral: pain or, um, like an indent. Those were the things that I'd always been looking for and I never, ever thought or never thought to expect blood coming outta my nipple.

So I rang the GP and they were brilliant and they got me in super quickly. And they checked me out and they decided that the combination of, um, the symptom, I only had bleeding from the nibble. So I didn't have any pain. I didn't have a lump, didn't have anything. It was just, just the bleeding and it wasn't going away.

They said that combined with, I've got immediate family history of breast cancer as well. So my mum had breast cancer. Okay. And so did my granny. So that combined meant that I got, uh, referred into hospital on like the urgent two week wait pathway. 

[00:05:30] Emma Pickett: Okay. 

[00:05:31] Coral: So I got sent to, um, sent to the clinic in Derby to have the full works examinations that they do to try and figure out what was going on.

Which is quite an experience in itself. Yeah. And it's quite daunting. Um, 

[00:05:46] Emma Pickett: so you were in your late twenties at this point when you were Yeah, I was. When, when this happened, I was 20. And you obviously No breast injury. Nothing had caused it. It literally came out of nowhere, out of the blue And it and was cancer.

What, what was being thrown around? Is that, is that what you were worried was going to be the diagnosis? I 

[00:06:01] Coral: mean, I think I was a bit concerned about it. I knew that age was in my favor because obviously it's less common the young you are. But my mom had it in her forties, which is I think also considered like slightly on the younger spectrum for having breast cancer.

And I think that was just always in the back of my mind. I knew, I knew that we didn't have like a genetic, like a strong genetic link. It's not, we're not got BRCA or anything like that. Um, but I knew that that played a, played a part. And obviously you're going to a clinic where they do diagnose breast cancer and they're working with a lot of women with breast cancer.

And you go in and there are people there having treatment, all different stages of their journey that I was sat next to a woman who was so nervous, an older woman, and she, she had a lump and it's very much there, you know, there are posters on the walls about support, about, this is where you can go to get like wigs and things like that.

And it's really in your face. That is, this is, yeah, this is what they're checking for. Um. So I think I felt, I felt okay. I'd seen my mom go through it, so I knew I could get through it. I knew kind of what the process was a bit. Um, I'd been along with her to some appointments when I was younger, so I kind of knew a bit of what to expect.

But nothing really prepares you for, you know, you've got, they, you have to undress from the waist up and they give you a little dressing gown to put on. So you're sort of walking around this clinic and your little dressing gown and um, you know, there's looking after your dignity. Um, but then you sort of walk into this dark room and like, okay, we're gonna do an ultrasound now.

And you go, okay. And okay, so just take your dressing gown off and there's four people you've never seen before in the room. And you're like, no, actually no. Do I have to. So it's, it's very surreal and a bit of an experience, but everybody was super kind and super professional. And I ended up having an ultrasound because I learned that um, they don't often do mammograms on like younger women or young people with younger breast tissue because it's not very helpful for seeing anything.

[00:08:08] Emma Pickett: Okay. Presumably if you were bleeding doing, doing a mammogram on a bleeding breast, that could have been quite messy and quite uncomfortable. I'm guessing if you were pressing it, lots of blood was coming out. I'm guessing a manag mammogram is not a first choice option. Yeah. 

[00:08:21] Coral: Yeah, I didn't think, I think this, it wouldn't have been useful anyway, so I had the ultrasound and then I had like a physical examination with a consultant, um, and a nurse was there as well and that one did end up being messy, which was slightly horrifying because she asked me to press to like show where the blood was and I didn't know how nipples can act and things at the time.

I hadn't breastfed at the time and it was quite dramatic the result. And luckily my nipple chose. The direction of the wall, not her face. Oh wow. Okay. So those of us who've 

[00:08:55] Emma Pickett: lactate and have known the distance, milk and travel, we we're talking about that sort of experience, except it was black. Yeah. Okay.

Yeah. That's scary for you, Carl. That is a scary experience. The whole thing is scary, but I'm glad that you say that. People were kind and supportive. 

[00:09:09] Coral: Yes, they were brilliant. 

[00:09:10] Emma Pickett: So you had the diagnoses or the diagnosis with this lovely team and, and what did they come up with? 

[00:09:16] Coral: So they didn't actually find anything on the ultrasound.

They couldn't see. Anything. So they weren't a hundred percent sure what was there. But the most common cause of what I had is something called an Intraductal. Papilloma. 

[00:09:28] Emma Pickett: I was just gonna, I was just gonna ask you about that. So they're little warty, little warty things. Yes. And anyone who's done the I-B-C-R-C exam will go, oh yes, intraductal Papals.

So tiny little watts that grow inside the duct. Mm-hmm. And if they break off, you can get blood vessels that are gonna be broken and bleeding can happen. I mean, nipples can bleed for surprising reasons, obviously, where most of us are used to nipples bleeding because of positioning and attachment issues and, and damage.

But you can sometimes get internal stuff that happens. And the introductory papillo is one of the most common. We also get something called rusty pipe syndrome and, and there can be blood coming out of nipples for different reasons, but, um, you, you were super sensible getting it checked out. Obviously you weren't lactating, so you had even more reason to think this, this is not normal, I need to go get some extra help.

So they thought it might be this little watery thing. I hope you don't mind me calling it a watery thing, but it might be That's fine. It might be the little watery thing that had broken off and caused the bleeding, but they weren't a hundred percent sure. They couldn't guarantee that was it. No. 

[00:10:26] Coral: Um, and they said this is by far the most common cause, but we have to be honest that there is a very small chance that it could be something.

They didn't say cancer, but cancer was heavily implied. So it could be pre-cancer or cancerous, but whatever it is is so small that they couldn't really image it on ultrasound to be a hundred percent sure what it was or where it was. So they offered me a surgery called a micro doctorectomy, which is where um, just the top portion of the affected duct is duct is removed.

And they said I didn't have to have it because they, they did ask me, do you want to have children? Do you want to breastfeed? Like that was a really big part of the conversation with this consultant. And I said, yeah, I wanna have kids. Like we wanna start trying soon, but I don't know anything about breastfeeding.

Like I guess I want to like, I'm not like dead set on it. And to me, having seen what my mum went through when I was a kid, to me it was more important to rule out the risk that there could be something nasty there than it was to be a hundred percent certain I could breastfeed from both sides. 

[00:11:30] Emma Pickett: Yeah. 

[00:11:31] Coral: That to me was the more important and the more important factor.

And my mom was very on board with that decision. My husband was very on board with that decision as well. And with a micro doctorectomy, there's a whole spectrum of outcomes from it in terms of breastfeeding. So it can either not affect it at all, it can partially affect it, or it can. Really like you, you just can't breastfeed from that side at all.

They said it sort of depends on the number of ducks you have because yes, you can have different numbers of ducks, so I guess it's a different percentage. I'm 

[00:12:01] Emma Pickett: glad you mentioned that, Carl. That would be taken out. Lots of people don't realize that, and in fact, no. It wasn't so long ago that if you picked up a medical textbook it said everyone's got roughly 20 milk ducts.

That's literally what would was said in kind of the Grey's Anatomy type medical textbooks, and it was only really in the 1990s when sort of mainly Australian researchers got out the ultrasound gear and started to look inside breasts. We realized that somebody who's healthy lactating might have only four milk ducts and somebody else might have 20 milk ducks.

Average is about nine, but if four to nine is possible, you can see having duct surgery really can make quite a significant difference. But in the world where we thought everyone had 20 milk ducks. You can imagine how everyone was a lot more, Hey, doesn't matter. Let's just snip a few milk ducks. Let's remove a couple.

Yeah, it's not gonna have an impact. I'm actually quite impressed that at this stage, even though, you know, you weren't necessarily thinking about trying for a family just yet, somebody sitting down with you and talking about your breastfeeding. Because quite often we hear stories of people having breast surgery and it not really being a conversation and people having, you know, cosmetic surgery and someone's not really sat 'em down and talked about the consequences of cutting intercostal nerves and adjusting milk ducts.

So it's good that you're having this conversation with somebody. Is anyone at this point telling you, by the way, you can always, always breastfeed from the other side? Was that even on the cards, that conversation? 

[00:13:18] Coral: Yeah. So they said, well, you can breastfeed from the other side. Like that won't be affected, but you might not be able to from this side.

[00:13:26] Emma Pickett: Okay. 

[00:13:26] Coral: There wasn't any more of it than that. I think it was kind of a, this could have impact your ability to breastfeed. If you didn't do it then it wouldn't kind of, it was a bit more concrete like that. 

[00:13:36] Emma Pickett: They didn't really, and to be fair to them, they, you know, they didn't really have the ability to go into much more detail than that.

Not knowing what they were gonna find and not knowing, you know, how many milk ducks you had, et cetera. And, and what was going on for you. So you just opted to have the micro version of this surgery. And as you've touched on before, once they actually had you on the operating table, that wasn't necessarily what happened.

So what, what, yes, what, what went ahead. 

[00:13:58] Coral: So I ended up having the, um, like full duct excision. So that means that they took out the top portion. Of all of my ducts. The way that my consultant explained it to me, which I dunno if this works on a podcast warmup, but it's a really good way to explain it, is if you take, um, all the fingers on one hand and put all your fingertips together 

[00:14:16] Emma Pickett: Yep.

[00:14:17] Coral: Um, and so that your fingertips are the nipple down to your first knuckle. 

[00:14:21] Emma Pickett: Yep. 

[00:14:21] Coral: That's 

[00:14:21] Emma Pickett: where I had removed. So on all. So if it's like a flower petal, you had all the center of the flower removed essentially. 

[00:14:29] Coral: Yes. But my 

[00:14:29] Emma Pickett: nipple is intact. Okay. So your nipple's still there. Externally, the nipple still there doesn't look like a breast that's necessarily had anything done externally, uh, internally, but underneath there are no ducts that lead from the main part of your breast to the endings of the, where the nipple is.

Is that a way of describing it? Yes. Okay. Yes. That's what happened. So if it was almost like if it was an umbrella, the whole central core of the umbrella has been sort of taken out all the little spines of the umbrella. Yes. Yes. And is that because when they looked there they were, they were finding more evidence of bits and bobs, what was happening?

Do you rem, did they ever talk to you about why that decision was made? 

[00:15:06] Coral: So they explained it was a risk on the day of my surgery again, and they basically said, we'll try and identify the duct again during surgery. That, and so they sort of make a best guess of where it's Okay. So they couldn't work out exactly 

[00:15:19] Emma Pickett: which duct had the thing in it.

That makes sense. 

[00:15:21] Coral: Yeah. So there's a thing that can happen when you go under anesthetic where the muscles around your nipple contract and they said, that happened to me. Um, and so nothing, nothing was happening that they couldn't, I. They couldn't figure it out. So they took out all, which I fully consented to before I knew that was a risk.

[00:15:37] Emma Pickett: Yeah. So sub OLA refers to the fact it's the, all the ducts under the ola. So, you know, we've got the nipple, we've got the ola, which is the kind of colored, pigmented area around the outside of the nipple. All those ducts around that ola were removed. And then a obviously means taken out, removed. Mm-hmm.

And total is presumably the word that means all of them. 

[00:15:57] Coral: Yeah. 

[00:15:58] Emma Pickett: What was the scar situation? What was the incision situation? Was it a circular incision? Was it, was there one entry point? 

[00:16:04] Coral: It's a crescent shaped, um, scar under my areola. 

[00:16:08] Emma Pickett: Okay. 

[00:16:09] Coral: So, uh, like a sort of Yeah. Half moon, smiley face, just round the edge of the areola.

Okay. Um, very, very little scarring. There was very little recovery from it. It's a very quick surgery. I think they do it in about 30 minutes. Wow. Okay. So the main recovery really was recovery from the anesthetic, you know, and all the cocktail of drugs that they give you. I didn't need much pain relief.

Okay. I didn't need much follow up in terms of bandaging or anything. It's a very, very small incision. 

[00:16:34] Emma Pickett: Okay. So, anyone who doesn't know much about breast surgery, if we, if we cut a milk duct over many years, milk ducts will sometimes do what we call recanalize and kind of join back together. And sometimes in pregnancy that, that's, that process might even go more quickly.

But we're talking about, you know, 10 years, 12 years. Eight years. And you were two years between surgery and having Rowan. So it would be really unlikely for your ducts to have repaired in that time. 'cause it take, it takes a long time. Yeah. 

[00:17:08] Coral: They hadn't, they absolutely hadn't. 

[00:17:09] Emma Pickett: No, no, I, I wouldn't have expected them to.

You'd be kind of in the, uh, in the Miracle department if you had, if it had happened. Um, and the Crescent being in a sort of smiley face position. So they didn't necessarily cut the, the nerves then by the sounds of it. Did you lose sensitivity on the nipple? Do you mind me asking? 

[00:17:24] Coral: I didn't lose any sensitivity.

Nerves were meant, never mentioned. Okay. Um, it's more sensitive, but I think that's more to do with the underlying breast tissue. So after the surgery, I never had like breast pain in like the lead up to my period or anything until I had the surgery. And then the side where I had surgery, I would always get breast pain.

I'd be like, oh, my period's coming in the next couple of days. And when I found out I was pregnant, the same again, I knew I was pregnant because, well, one of the reasons because that boob was hurting more, but then nothing, nothing on the nipple. It was more a deeper pain. 

[00:17:57] Emma Pickett: Okay. Okay. So you had the surgery and um, you know, it sounds like you were, had a really good team that really talked to you about your options.

Nothing was a shock. Nothing was unexpected, which is great. Nope. And then you started to try for your family and you got pregnant with, with Rowan. Yep. And then during pregnancy, presumably started to think about breastfeeding and, and Yes. What was running through your mind at that point? 

[00:18:21] Coral: I wanted to give it a go, but I think I sort of, I had a lot of, um, wrong assumptions about what it was gonna look like.

I thought I probably wasn't gonna be able to, even though they said, oh, you'd still be able to feed on the other side. I didn't, I couldn't get my head around it. I didn't know that breasts operate independently. 

[00:18:40] Emma Pickett: Oh wow. Okay. So even though they'd mentioned in the preparation for surgery, you'd be able to breastfeed on the other side, that hadn't really sunk in.

You actually thought that there were a double unit as it were. Okay. So that is super important information for everybody to know that breasts operate completely independently. It is possible to have one breast that is absolutely not functioning at all. Uh, it's one breast that's completely underdeveloped.

You might have something like Poland Syndrome, whatever the reason is for not having a functioning second breast. You can absolutely lactate just from one side. And, and lots of people will also be familiar with the fact that sometimes older nurse lings start to develop a side preference anyway, and over time you end up only feeding from one side.

So, so what I call uni boobing, not necessarily my term, but, but uni boobing is surprisingly common. And I did a, I did a survey about it, um, before I did a talk once and asked a large Facebook group, you know, how many people were uni boobing? And it was, you know, good 20% of people were only breastfeeding from one side.

Um, really not unusual for it to be that, that way going. But you, in pregnancy, you were nervous that breastfeeding might not work out at all. 

[00:19:47] Coral: Yeah. Um, my midwife, she, she was the one that told me, she was like, you do know they operate independently, like. You'll, you'll be okay, but you're just gonna be wonky.

And I still, I still just couldn't believe her. I just thought, oh no, it's probably not gonna, it's probably not gonna work, but I'll try, but it's probably not gonna work. And she told me everyone prepares for the birth. They don't prepare for breastfeeding. Yeah. And so she was like, if I can give one bit of advice to you, having recently had kids myself, it's prepare for the breastfeeding.

So I tried, I went to a couple of like, workshops that were sort of available through sort of local NHS trusts. I did one through NCT, I did a bit of my own reading as well. So they have access to an ebook in one of the, um, trusts near me. And I read the breastfeeding chapter, but I remember getting really overwhelmed with, it's a lot of information in one go and also getting c.

Not upset, but a little bit nervous every time I saw like problem solving bits, it's like what you can do if you have this issue. And it was often try the other side. Yeah. And I thought, but what, I'm not gonna be able to do that. So like, what, what can I do? And whenever I was in a workshop, I'd sort of, you know, put my hand up at the end and be like, I've had this surgery and I, I've seen this advice.

What kind of things can I do? And nobody really knew. They would say, oh, you'll, you'll, you'll be fine. You might be all right. Because, you know, people have twins and can like, they get a boob beach and they're fine. But it wasn't necessarily that it was, I, I literally don't have access to two. 

[00:21:20] Emma Pickett: Yeah, yeah.

Yeah. I can, I can feel how isolating that must be when all the information is like, oh, you must offer both sides and it's really important to, you know, move from one side to the next for the baby's eye development and all this sort of stuff that you hear people talk that shame. Yeah. You hear all this stuff being emphasized.

Yeah. Just assuming that you don't exist in the world and I'm. I'm gonna guess, I know the answer to this question already, but did anyone talk to you about what would happen in the first few days after your milk comes in? No, and I was terrified. Can I guess what's gonna happen? So this is my guess, and you tell me if I'm wrong.

When someone has had that kind of surgery, that's not going to stop their milk coming in. So all those cells at the back of your breast in the, in the LOEs and the, and the alveoli are still gonna do all that lovely milk synthesis and you're gonna get the next stage of Lac Agenesis, but there's no exit strategy.

So you could have a quite uncomfortable engorgement, I mean really, really uncomfortable engorgement. Nothing you can do about it, you cannot express or anything. You've literally just gotta wait for it to pass until those cells realize that they're not needed and eventually, you know, involute and, and calm down and stop producing milk.

But, you know, potentially you could be in a lot of pain in those first couple of days and, and with all and all you can do is cool compresses and pain relief. And did anyone talk to you in pregnancy about how what might happen. No, 

[00:22:38] Coral: no, that wasn't really, wasn't really mentioned. And I remember having some conversations with my mom.

Well again, I think this is where my assumptions came into it and not fully understanding quite the two breasts operating independently, um, scenario. We kind of assumed that it wouldn't necessarily stop and it would be an ongoing problem. And what if they had to gimme something to stop, stop my milk production because it was such an ongoing problem on my operated side.

So we kind of just assumed the worst. We knew that it was gonna produce milk and it wouldn't come out, but no professionals ever had that conversation or sort of gave an indication of what that would look like. And um, yeah, flash forward I did get incredibly engorged and I was in hospital at the time 'cause we were in hospital for seven or eight days after I had row.

And um, I ended up on antibiotics because they thought it was mastitis because I ended up with a really bright red 

[00:23:35] Emma Pickett: okay. 

[00:23:36] Coral: Lumpy section. I was very uncomfortable. 

[00:23:40] Emma Pickett: Yeah, I'm so sorry. I mean, I, I don't necessarily know if knowing in pregnancy would've helped that, but it would've been great if someone had sat you down and go, right, you are gonna get engorged.

Almost certainly. And actually, let's see that almost as a positive 'cause That means your body can make milk and actually it's not gonna go anywhere. And that's gonna feel annoying and wasteful and disappointing, but actually this shows that milk synthesis is happening. But we just need to get you comfortable.

So we need to talk about cool compresses, anti-inflammatories, and nothing that will stop you lactating on the other side. And then you need lots of extra help to really make sure that you are positioning an attachment. On the good side, if, I hope you don't mind me calling it the good side, the, the milk, the lactating side.

You know, you really need to be confident more than more than someone else possibly. You really need someone to help you with positioning on that side. So you feel really good about what Rowan's doing on that side. And, and someone talk to you about what milk transfer looks like. Someone talks to you about how you might pattern your feeds in the day.

You might need to feed a bit more frequently than somebody who can offer the second side, oh yeah, that happened. But other than that, it doesn't. Doesn't mean you won't produce the same amount of milk in 24 hours as someone feeding on two sides. You just might need to feed a bit more. And then if something goes wrong and you are sore and uncomfortable, that's stressy.

'cause you don't have the second side to offer. That's the scary bit. Yeah. I want to tell you about my brand new book called The Story of Jesse's Milky. It's a picture book for two to six year olds, and I wanted to write a book that was about weaning, but also not about weaning because breastfeeding journeys end in all sorts of different ways.

So Jesse's story is presented as having three possible endings. In one ending, his mom is pregnant and Jesse's going to share his milk with a new baby. In the second, his mom is getting really tired and it's time for some mother led weaning. And in the third, we see a self weaning journey as Jesse's attachment to breastfeeding gradually fades.

There are beautiful illustrations by the very talented Jojo Ford, and the feedback from parents so far has been so lovely and touching, and I'm really excited to share the book with you. If you're interested in my other books for Older Children, I have the Breast book, which is a guide for nine to 14 year olds, and it's a puberty book that puts the emphasis on breasts, which I think is very much needed.

And I also have two books about supporting breastfeeding beyond six months and supporting the transition from breastfeeding for a 10% discount on the last two. Go to Jessica Kingsley Press, that's uk.jkp.com and use the code. Mm MPE 10 Makes Milk picket Emma, 10. So you had your birth and the fact you were in hospital for a while.

Do you mind me asking, does that mean things were a bit tough during the birth? 

[00:26:21] Coral: So it wasn't as a. Well, it kind of was as a consequence of the birth. That's how it started, but not from my side. So it was a long and difficult labor and as part of that, there was meconium in my waters. So they initially kept us in hospital because they needed to check, make sure Rowan didn't get an infection.

Um, so for like 24 hours afterwards he needed to be monitored to make sure that he was okay. They didn't initially tell us they were gonna do that. They just sort of moved us up to the postnatal ward. Um, and I thought we were going home later and, uh, yeah. And then they were like, no, we have to monitor him for this infection.

And I was like, okay, that's fine. I guess this is my worst nightmare, but that's fine. We'll make it work. So we were initially there for that, and then after that 24 hours, he just didn't feed. So we first tried to breastfeed on the labor ward. Um, the midwife sort of, it wasn't how I thought it would be based on all the workshops I'd been to.

She kind of roughly grabbed Rowan's head and sort of like shoved him and. I thought, oh, this isn't the sort of like soft, natural experience I was expecting. I'm so sorry. And he didn't, he didn't latch. He didn't latch there. But unfortunately, I think it was documented that we had had a successful breastfeed on the labor ward.

So then going onto the postnatal ward where they were understaffed going into the night shift, completely full ward. So I think what happened was it's been handed over that we're just here to monitor this infection. She's had a successful breastfeed and we were kind of just left to it, but we kept sort of trying, but he was very sleepy and we didn't know what we were doing.

And I'd collected a lot of colostrum before and we were like, should we be giving this? We, how much should we be giving? And there was not really any like clear answers. Um, and so by the time that they were like, oh, well he's not got an infection, they were like, oh, but he's not feeding at all. And they said, how much has he had?

And we said. Nothing, we can't get anything in him. We can't, he's not breastfeeding. He won't latch. Or if he did kind of latch, he would just immediately fall asleep and stay asleep. And we couldn't, we just couldn't get these like little syringes of colostrum in them either. He would just lose all tension in his mouth and it would just, would dribble out.

Um, we didn't have the neck. And so then they were like, oh, we really need to look at this and this amazing, amazing midwife called Kate was like, we need to get fluids in him now. And she's like, how much colostrum do you have? Where is it? And I was like, I was like, got about 40 mil. And she's like, we need all of that right now.

And we had this little production line going, um, where I would defrost it in my hand and then uncap it, give it to her. And she just had the knack of just getting it in the cheek and getting it in him. And she was like, we need to get as much fluid in him as we can right now. 

[00:29:03] Emma Pickett: How old is he at this point?

Do you remember? What day was this? This was the next day. So 

[00:29:06] Coral: this must have been on day. Is, do you start on day zero or day one? So, 

[00:29:11] Emma Pickett: yeah. So if, if you've given birth, my understanding is the next day is day one, and if I've got that wrong, someone can con that's, that's how I would describe it. Okay. So Kate sounds like she's a no-nonsense woman.

She wants to Yeah. But the way you're describing it, it doesn't sound as though she frightened you. It sounded as though you, you appreciated her taking that lead and, and using that. Oh, absolutely. Yeah. Using that sort of, um, initiative. Yeah. And you talked about frozen colostrum. Does that mean you did some antenatal expressing?

[00:29:36] Coral: Yes, I did loads because I was so nervous about how it was going to go. Um, as soon as I got to the, I can't remember if it's 36 or 37 weeks now where they say like, yeah, give it a go. Yeah. 36 usually. Yeah. I went in very enthusiastically with it and I actually really enjoyed it. Good. It was quite fun. Um, the sort of collecting the little syringes and I, yeah, I think I got about 40 mil.

[00:29:56] Emma Pickett: That's brilliant. That's amazing. And you need, and that's, you really needed that, didn't you? That was brilliant. Just because of having had that knock at the beginning and, and worrying about whether breastfeeding is gonna work out. How good for your confidence to have all that being produced during pregnancy?

That's fantastic. 

[00:30:10] Coral: Yeah. I did think if nothing else, he's had that at that little bit at the start. So she did that and then we kept trying to breastfeed, but he'd already got to the point where they were going, he's a bit jaundiced. Um, so they did the heel prick on him and confirmed he was sort of borderline of like needing treatment.

He ended up under the lamp and he wouldn't take a bottle either. He was just too sleepy to have any fluids, so he ended up. Being cut fed, which was so stressful because they don't let parents do it. 

[00:30:43] Emma Pickett: Yeah. 

[00:30:44] Coral: So any control you have over feeding your child is put in the hands of very, very busy staff who are absolutely brilliant, but they've got like tons of other parents and babies to be looking after.

[00:30:57] Emma Pickett: Did they explain to you why they didn't want parents to do it? Did anyone talk to you about that? 

[00:31:02] Coral: Yeah, because they're worried that people will go home and then feed at home and they said it's not safe for parents to do it. Like you, you have to be trained to do it and they, it's not the preferred way to feed and they wouldn't want parents to keep doing it.

So we kind of just accepted that, 

[00:31:17] Emma Pickett: which is all you can do in that situation. Yeah. If that's what you're being told by medical professionals, it's not your job. You haven't got the energy to battle against that. But we do know that parents do cup feed at home. We do know that, that if the risk we're worried about is aspiration IE breathing in milk.

That can happen when babies are breastfeeding. That can happen when babies are bottle feeding, they splutter. The milk comes out again. But yeah, I appreciate that it takes a bit of time for a hospital necessarily to, to get on board with that and to feel confident with that. Things like syringe feeding, finger feeding, cup feeding.

Parents are doing that all over the place. So you were still in hospital at this point? Your engorgement about to arrive any day now? Not there yet. Yeah. Okay. So you're watching someone cup feed, you've gotta wait for someone to come and cup feed him. Mm-hmm. And you are, and you can see he's hungry. You're worried about getting fluids into him because of his jaundice and, and did he eventually start taking bottles?

How long did he cup feed for? 

[00:32:09] Coral: He cup fed for, I'm gonna say it was about a day until there was a night shift where again, another really on midwife who, I can't remember her name because by this point I'm so sleep deprived and so unwell. I can't remember her name, but she was like, he's not getting better.

He's not getting to where we need to be. I think we need to tube him. And that's putting in an NG tube to feed him. Um, and I think he'd potentially. Taken a couple of bottles at this point, but it wasn't enough. And she said it's really unusual for a baby that he was a week late. And she said, usually this is, it's sort of preterm babies.

They get tubed. But she said, I think from my experience, this is what we need to do to get him what he needs right now. So he had a little baby m gm and then there was this whole complex system set up of like, I can't fully remember it, but putting it in a syringe and then you have to do something with the vacuum so that it like trades properly.

Yeah. So you're, so you're, you're 

[00:33:08] Emma Pickett: checking that the stomach acid isn't coming back out, so you, so you're checking that the stomach acid is coming back out? 'cause if stomach contents doesn't come out, it may be the tube is in the lung. I think that's what's going on. Yes. So you do a little pre-check and then when you realize the tube is in the right place, then you push the milk through.

Did you, did you get to do that? Were you actually feeding. 

[00:33:28] Coral: Yes, theoretically. So they did teach us how to do it. Um, and at this point we got sort of put under the care of the, they're called the transitional care team in that hospital who usually help futon babies that are going from tube to being tube to not being tube.

But we got their help as well and they did teach us how to do it. My husband took to it better than me. I was just too sleep deprived to understand all the different steps I could do the pH testing. And then when it got to actually the steps of doing the milk and the connecting, I couldn't do it. So my husband did a bit of that.

Um, and they helped us out as well. And at this point as well with, um, doing what I think is called triple feeding, but at the time it wasn't called that. It was, it was like you are on a protocol. It's protocol feeding was what it was labeled as. 

[00:34:13] Emma Pickett: Okay. I was about to ask you actually what was happening with your milk supply.

So if he's not directly feeding yet. Mm-hmm. And obviously we need that, the breast that is gonna be working and doing all this hard work, we really need it to be switched on and getting that stimulation so. You were, you were given a breast pump in hospital and you were told to Yes. Get pumping, which is good news.

[00:34:31] Coral: Yeah. I would pump and then every time it was every three hours we had all this like paperwork to fill out, to document exactly what he had had and via what route. So every three hours we'd spend 10 minutes trying to breastfeed and then we would tube feed him and then I would express. So it was just that cycle, like okay.

For a few days. 

[00:34:58] Emma Pickett: Okay. And then breasts that had had the surgery, engorges coming along, you've got the redness. Mm-hmm. And, and you were given antibiotics 'cause people were worried that you might have had mastitis symptoms. Yeah. I'm guessing in a way, knowing that you'd had the sort of full excision, am I saying that right?

Exci excision in a way? Excision in a way that was, it was kind of a clear cut for you. Like you, if you'd had the micro version, I guess you might have been thinking, is there gonna be some lactation? Should I still be pumping that side? Yeah. But in a way it was clearer for you. I mean, or do, or do you feel, looking back, that you'd wish that you did have some option of lactation on that side and that what I'm saying isn't, is not really fair?

[00:35:35] Coral: It, I mean, it would've been handy, but I think, yeah, I think I would've been, yeah, probably a bit confused, like you say, not quite sure what I would've been able to do. I think it would've helped being able to sort of at least leak a bit or express a bit to relieve it. But yeah, it was very clear in my mind.

I absolutely can't do this. Unfortunately, it wasn't very clear in the minds of a lot of the professionals that I was working with. And it wasn't really handed over well, it didn't seem like it was being handed over. 

[00:36:02] Emma Pickett: You kept having to have the same conversation over and over again. 

[00:36:05] Coral: Yeah. Um, and they'd go, well, can't, can't you just express a bit?

And I'm like, no, nothing's, nothing's coming out there. Or like when they're trying to do my 10 minutes of trying to get Rowan to latch and feed, um, they go, oh, well why don't we try the other side? And I'm like, I can't do the other side. And so it was over and over again and, um. They were absolutely brilliant on that ward.

Like, like 99.9% of the staff were so brilliant, but they just didn't know anything about the surgery or the, the impact, and I wouldn't necessarily expect them to 

[00:36:36] Emma Pickett: Yeah, no, I hear what, I hear what you're saying, but the mental load of having to repeat that information right at the moment when you're feeling tense, you know when a baby's not latching on Yeah.

You're already feeling a bit anxious. There's already a, you know, a bit of adrenaline going around. You're trying to locate your oxytocin to have to repeat that again. Just immediately sort of distances yourself from that professional and puts a kind of wedge between you to have to repeat that story again.

Mm-hmm. It's, you think, wouldn't you that on your notes, there should be a big old sticker that says don't ask about the other side. I mean, if you'd had a mastectomy, um, you know, and reconstructive surgery, I'm sure they, that would've been filtered through more clearly and that information, you know, would've been more obvious.

There needed to be something didn't there that just immediately meant that people knew straight away or something on your chart that was like one side only. Um, yeah. 'cause that's dull to have to keep talking about that. I guess people were probably confused because if they saw the, the engorgement, they thought, oh, it's a lactating breast.

That's 

[00:37:32] Coral: your milk there. Yeah. And it exactly, it would, so it's not 

[00:37:35] Emma Pickett: reconstructed. It's not, you know, there's, there's, there are cells there that are making milk. Let's just get it out. But it's still exhausting having to repeat that over and over again. Did it actually turn into mastitis? Did you have any symptoms?

[00:37:47] Coral: In retrospect, I'm a bit skeptical because I've had, I had mastitis since on the other side, and that was a very different experience. I think in hospital, the main symptoms were, it was pain and then part of, uh, my boob got very red and hard. It was like they had like the sort of the wedge and so they, they did put me on antibiotics for that and then they were monitoring me for a fever that never came.

Whereas when I've had it, since it started with a fever and I felt really fluey for a couple of days and then I got the pain and all the other symptoms and then it was like. This is mastitis. Whereas in hospital, that wasn't what happened. So, okay. In retrospect, I'm like, oh, did I need those antibiotics? I don't know.

[00:38:29] Emma Pickett: I mean, maybe they were preventative. Who knows? I mean, yeah. So that particular, not that by the way, not that we advocate giving antibiotics preventatively, but maybe in a way you can look back on it positively if you need to, to sort Yeah. Write that history for yourself. But what was happening to that breast is the cells were going, come on, take the milk out, and then going, oh, it's not gonna happen.

Okay, fine. No problem. We'll, just, we now need to slow down production. We now need to, you know, we accumulate the, the feedback inhibitor of lactation, which is this whey protein and the prolactin receptors are distended and your body gets the message lactation is not needed on this side. So it gradually starts to calm down.

Do you remember how long it was before that side became comfortable? No, I don't really 

[00:39:11] Coral: remember. Um, I think I would say maybe about like a, a week and a half, maybe like 10 days. Okay. After Rome was born, when Roman was 10 days old. I think it had calmed down. 

[00:39:22] Emma Pickett: Okay. So that side had got the message lactation wasn't needed.

Yeah. And the other side was revving up. Yeah. Did you end up being really lopsided? What did you look like physically? Not at first. So for the first two months, 

[00:39:35] Coral: you probably wouldn't have really noticed any difference. Especially not if I was wearing a bra. But then since and now, yeah. Incredibly lopsided.

Um, I would say I've probably ended up about double the size on the side that I feed from and if I was full, maybe even triple. 

[00:39:52] Emma Pickett: Okay. 

[00:39:53] Coral: Um, I don't think it helps. I've had a bit of weight loss with breastfeeding as well, so, and including from the side I don't feed from. So I think that side is smaller than how I started, but now it's, it's, it's hard, it's hard to remember what my body looked like before.

[00:40:05] Emma Pickett: Yeah. But 

[00:40:06] Coral: yeah, very. And that may not be 

[00:40:07] Emma Pickett: what happens forever, by the way. I'm sure you've, I dunno if you've spoken to anyone else who's done single-sided feeding, but you, you absolutely can Even up afterwards. So lots of, lots of uni boobers, um, end up even up over time. So don't feel that this is necessarily what life will be like forever.

If, if that is something that that matters to you. So Rowan was eventually cleared of his jaundice and yeah, the NG tube was taken out and mm-hmm. Tell me about the early stages of successful breastfeeding. When did things start to turn around? 

[00:40:35] Coral: So the first successful feed was actually in hospital. It was on the day we went home in the morning.

He just latched and started like suckling, like, like, it was nothing, like, it was no big deal that like the whole week before hadn't happened. He just did it one morning. Yeah. He was on there for like 45 minutes and I was, this is amazing. I think we've just, I think we've just done it and then he didn't do it again for a full 24 hours.

Um, but he did that once and then, um, we got discharged and then I think we were still kind of doing a bit of combi feeding. He was having a bit of bottle, bit of trying with me, and it wasn't until, I think we'd been home for maybe a full 24 hours. So by this point he's day nine. That was when he properly started regularly breastfeeding off of me, which was also when I was first seen by the community infant feeding team.

So they came out to my house. We were discharged on day eight, I think. Um, and she gave me a call on day nine, which I didn't even know was gonna happen. She just did it. Um, and sort of said she was gonna come around and gimme some support. And she said that, uh, where I am in Derbyshire, uh, the infant feeding team can only support you, um, up until day 10.

So she was like, we've got two days 

[00:41:53] Emma Pickett: puffing 

[00:41:53] Coral: si 

[00:41:54] Emma Pickett: about how nonsense this stuff is. Yeah, she was really frustrated by it. Yeah. I mean, you'd really think, wouldn't you wouldn someone be in the hospital for that amount of time? And if someone is only gonna be single-sided feeding, let's make exceptions people come on.

Okay. Sorry. That's me being a bit petty. Keep going. 

[00:42:08] Coral: But yeah, she was, she was incredible and she, she wouldn't have even called us on that day had she not chased the hospital because she'd not had any referrals. And she went, this is a bit odd. And she rang at the hospital and uh, told, oh no, we've, we've got four families for you to see.

She like, I better get on it. And um, her name's Suzanne and she's absolutely incredible. She phoned me up and she was around a couple of hours later and she saw me feeding. She had a student with her and I would say it was like a properly like pivotal moment in our breastfeeding journey because she was the first person that just said to me, she's like, you've got it.

You're doing it. Like he's latched. He's in a good position. You can hear that he's taking milk in. You are doing this. You're going, you're going to be fine. I'm just like, I'm so grateful that she pushed for that. And she came and she said that and she said, oh, do you want me to come back tomorrow? Um, on day 10 for our last day?

And I was like, yes, please, please come back. Please check. And she'd given me like a bit of advice about how I was holding him and like, make sure you support your arm because your arm's gonna get tired, the amount of time he's on there and stuff. But she's like, but you know, you're a natural. You've got this.

Like it's happening. Oh, yay. And so she came around the next day and everything was fine the next day. And then that was, that was it with that team. So it was very fleeting that I got to see her. But she was incredible and she made a massive impact. And then longer term, because we chose to give birth in a hospital that isn't, wasn't in dha.

We gave birth in Nottingham. We also had support from the team and the hospital, the infant feeding team, like going on for the next few weeks. They didn't have a deadline. Um, so I think we went in a couple of times to check how things were until Rowan was maybe about four weeks old. And then that was the end of the support.

And by then he was regularly feeding. Well, it was really hard, but he, he was, 

[00:43:55] Emma Pickett: when you say it was really hard, in, in what way was it really hard? You mean he was still sometimes not wanting to latch? 

[00:44:00] Coral: No. So the latching was fine. It was so, I remember the frequency was a big thing. Okay. People had warned me about cluster feeding, but I thought it was like an evening into nighttime thing.

Rowan would cluster feed from 10 11 in the morning to about seven o'clock at night and it was like intense, like long feeds all that time not coming off of me and I didn't, I didn't know it could be like that or it would be like that. He was also, he just, he was always a bit unsettled and we never really did figure out why, 

[00:44:36] Emma Pickett: but weight gain was okay.

Nappies were okay. Weight gain was fine, no concern. Weight gain was always 

[00:44:39] Coral: fine. 

[00:44:40] Emma Pickett: Were you still combination feeding at this point? No. Okay. So we stopped combination 

[00:44:45] Coral: feeding. We definitely stopped by two weeks. 

[00:44:48] Emma Pickett: Okay. I would say. So let's just take a moment to say you were breastfeeding from one side. You were exclusively breastfeeding from one side after two weeks.

Mm-hmm. I mean, that is, I. Pretty amazing, isn't it? I mean, actually it's not, it's, it's normal. It's standard. It should, absolutely possible. I say it's amazing, but actually it does take dedication. That took a huge effort from you. After all that time in hospital, you must have been super exhausted and the protocols and the NG tubes and worrying about the engorgement and the possible mastitis.

There's a lot on your shoulders there, but you, you, I hope you feel really proud of where you got to after all that challenge at the beginning. Yeah, what an amazing place to get to breastfeeding from one side exclusively. What an achievement that really is. Oh, thank you. But I guess possibly the frequency of feeding may have been a little bit influenced by the fact you're only on one side.

Just because although we produce enough milk in 24 hours, storage capacity is an element that does influence the intervals between feeds and there's nothing we can do about that. That is just our anatomy. See, I didn't know that. Yeah, so I wrote an article that's on the UNICEF baby friendly website, the UK Baby Friendly website, which talks about feeding intervals and the obsession with the feeding intervals.

And in that article I talk a bit more about storage capacity. So when breasts are not containers that fill up, they are rivers and streams, but there is an element of the storage capacity making a difference into terms of what a baby might receive within certain time interval. If you have a smaller storage capacity or are only feeding on one breast, the chances are you will need to feed a little bit more frequently.

And that might have been what was going on for you. Did he carry on doing that cluster feeding for a while? How long did that go on for? 

[00:46:32] Coral: Oh, a long time, I think until at least he was eight weeks. 

[00:46:36] Emma Pickett: Okay. 

[00:46:37] Coral: And I was obsessed with trying to find a pattern to it. I think because we'd had that sort of like protocol feeding experience early on where it was like every three hours and like you say, the feeding intervals that they say aren't necessarily like what should be happening naturally.

Um, and they knew about responsive feeding, but I think because it'd been drilled in my head every three hours, every three hours, eight feeds every three hours. Gotta make sure. 

[00:47:02] Emma Pickett: Oh gosh. Okay. And 

[00:47:03] Coral: I'm, I, I would get really like anxious if. He wanted to feed after an hour or after two hours, because I'd be like, 

[00:47:10] Emma Pickett: well, what's wrong?

Oh, coral. That is, so, that is, so often what happens, people absorb that information of three hour intervals as being a guide for a sleepy baby or a maximum interval. And they, so that, and that becomes almost written in as the aim, you know, the ideal. Yeah. And if a baby feels more frequently than that, you think something must be wrong.

And that's just so, so not the case. I mean, frequent feeding is, is so much more common than feeding three early, not many breastfed babies are gonna be feeding three hour, truthfully. They're gonna be fluctuating during the day with intervals at different lengths, at different times. And if we don't know that you're, you constantly feel as though you're failing every time a baby wants to feed after a shorter interval.

[00:47:51] Coral: Yeah, 

[00:47:52] Emma Pickett: I've described it as that, which is again, what the, what the article I was talking about is all about, I'm trying to reassure people that that frequent feeding is absolutely normal. Not least because breastfeeding's not just about milk, it's also about connection and emotional connection as well. So you, you'd had the support from the team in Nottingham mm-hmm.

But not necessarily a lot of support to, to help you get through this, this stage and make you understand that frequent feeding is normal or did you get to a place where you realized this was his pattern and that's okay. 

[00:48:21] Coral: I think I got to that place myself through like your Instagram. I follow Lucy Weber as well, and I think just like educating myself and like seeing other stories.

Eventually I realized, oh no, this is quite normal. Probably quite late. I probably should have should've known a bit earlier. I wish I'd read different resources going into it and 

[00:48:42] Emma Pickett: had known earlier. Lucy Weber's book on the fourth trimester is brilliant. I really recommend that to anybody in the early stages of breastfeeding and, and you know, she's just really good at normalizing what babies do.

Yeah. So I'm glad you got there in the end. Yeah. Yeah. She's fantastic. I'm glad you got there in the end, but that's, that's a lot of stress time. That's a lot of time when you hadn't realized that this could be normal. And did you have people around you saying, oh, coral is this really good idea, maybe you shouldn't be breastfeeding?

What? What were the people saying to you? Yeah, I think a 

[00:49:11] Coral: lot of people around me were questioning whether I should keep going because they saw it had such a big effect on me, especially with the way that your hormones are. I'm trying to process the birth and the hospital stay as well, which was absolutely, well, nobody anticipates that that's how it's going to be.

At the start, I would get to about four or five o'clock every day after Rowan's been on me for about six hours and just break down. Like I would just lose it every day. And so people around me would see that and they'd be like, you might need to accept that you can't do this. I think they found it really hard seeing me like that and feeling helpless, like they couldn't do anything and were like, almost if we, if we could give a bottle, it would take it away, kind of.

But I kind of got crazily tenacious. And like, there is no other option. This is what I'm gonna do. But I was also like really beating myself up about it every day, like for a while it was really tough. 

[00:50:06] Emma Pickett: When you say beating yourself up about it, what do you mean? You mean feeling like things weren't going well or what was going through your mind?

[00:50:13] Coral: I think I've described it as like feeling like I'm failing every day. Like even though the metrics are all right, like his development is normal, his weight gain is normal. I've not got any pain. The latch is fine. Just feeling like, well, I'm not doing it right, am I, I can't be doing it right because this is, this is a lot, it's too much.

I'm not, I've not got this blissful newborn bubble that 

[00:50:38] Emma Pickett: everybody talked about. I mean, so it's the frequency of feeding that's making you feel like that? Mm-hmm. But you also mentioned him being unsettled. Maybe that was part of it as well. Did you ever get to kind of the bottom of what was going on there?

[00:50:49] Coral: No. No, not really. Um, I think. Like a lot of parents, we were prescribed Gavascon at one point. There was concern. It might be reflux because it sort of, it seemed like there might be some kind of position post feeding would affect things. But we try that. But it wasn't, that didn't help. It wasn't that so, no, we never really did.

I've always said that I think in reality, Rowan had a preference for the left side, and all he got was the right. 

[00:51:19] Emma Pickett: Wow. That's a, that's a big statement. What makes you say that? Did he ever try and latch on on the other side? 

[00:51:24] Coral: Um, no, not as, not, not when he was little. Now, yes, now he was very curious, but no, not, not, not them.

I don't think he even knew the other side existed maybe until he was. About eight months 

[00:51:38] Emma Pickett: old or so. Yeah. So you're describing a very tough few weeks and Yeah. And you know, and emotionally that you are obviously putting an enormous amount of pressure on yourself in, in a way that was sort of amazing and impressive, but also very, very intense.

And I can imagine people were worried about you. Um, and it's also very isolating to be at home breastfeeding all that time, even if you're not in pain, even if the latching is working, even if the nappies are great, it's still, it's a very intense day. When do you think things started to feel easier? 

[00:52:11] Coral: So the cluster of feeling definitely happened till at least eight weeks.

I think by three months I was feeling more settled with it. And I dunno if that was just the frequency had died down a little bit, or I'd sort of come to a place where I was more accepting and able to regulate myself better through it. So I would say three months. 

[00:52:30] Emma Pickett: Okay. 

[00:52:30] Coral: And certainly by the time I got to four months, which was when I got mastitis again, I was in a place where I was like, I don't wanna let breastfeeding go any breastfeeding.

Like, I'm obsessed now. 

[00:52:41] Emma Pickett: Yeah. 

[00:52:42] Coral: I can't imagine anything without it. 

[00:52:44] Emma Pickett: Yeah. I mean, on a very practical point, if you have a history of breast cancer in your family, you breastfeeding on that side is actually very, very sensible because we know it's gonna be reducing your risk of developing breast cancer. You know, premenopausal breast cancer.

Um, and every year that goes by, you know, that percentage difference is, you know, noticeable, quite significant. So you got to the three month mark, things starts to feel a little bit easier. Maybe if his unsettledness was about digestion, we sometimes get a little bit of a developmental phase where digestion becomes a little bit easier and that little swing to muscle, the top of the stomach tightens and things get a bit more straightforward.

Had you met anyone else single-sided feeding at this point? 

[00:53:22] Coral: No. And I still, I still haven't. To be honest, I wasn't trying to look, I was so absorbed in my own world, I didn't really look anymore. I'd been pointed to the, um, breastfeeding after reduction Facebook group, um, because I think that technically covers duct surgery as well.

Although when I've been on there, I've not seen anybody. I was talking about duct surgery. It's mostly reduction and as far as I can tell, it's, I think it's international as well. Yes. So I think there's a lot of, there's a lot of American, uh, parents on there. I never really found anybody through that. Plus I'm not, not great on social media, so I'm, I'm not one for like building connections or like putting myself out there and making buddies that way.

Um, I went to local, um, breastfeeding support groups a couple of times, but I kind of basically just went at that offloaded, cried and left. Yeah, so I, I've never met anybody else who was in a similar situation. I know that they exist though. People have told me. They go, oh yeah, like, my friend's done this.

Or like, my, my friend and her baby just always had a preference for one side, or like, my friend had twins and so I know that they're there, but I've not personally met them. 

[00:54:29] Emma Pickett: Yeah, they definitely are there. I've met lots of them, so I know that they're definitely there. So you got through these early months, things got a little bit easier around three months.

[00:54:38] Coral: Mm-hmm. 

[00:54:39] Emma Pickett: Were you using formula at any point during the mastitis when you had this mastitis episode? How did things go on in terms of volume of milk production? You just were able to carry on, were you exclusively breastfeeding? 

[00:54:49] Coral: I just carried on, I was exclusively breastfeeding. The only time that Rowan would have formula, um, was if I needed to leave him for any reason, and then my husband would give him, um, some formula sort of in that situation because I, the reason the mastitis came about was because I got to three months and thought I need to have a little stash in case I can't be there.

And I, um, I did seek some advice and it, the advice was, do not try to express too much. So I did, I think just every three days. I did once in the morning and that coincided with Rowan sleeping through a couple of nights and ah, 

[00:55:26] Emma Pickett: okay. 

[00:55:26] Coral: Bam, got mastitis. So, um, I stopped expressing on top of feeding I would express if I was apart from him and then keep that milk, but I wouldn't do any extra expressing and then he would get formula instead if there wasn't any in reserve.

[00:55:42] Emma Pickett: No, that makes sense. You're worried about triggering mastitis again, which I totally understand. And fast forward, he's two, you are still breastfeeding. Yeah. What were some of the challenges in those after that early period? How did things develop? Oh, teething 

[00:56:02] Coral: was such a nightmare. Um, yeah. Rowan turned not to be a biter in like a big way.

So every time that he has had new teeth coming through, just his insides of his canines, it's not been so much of a problem with the molars. But first of all, his latch changes. So then we have to make changes with positioning and stuff to account for that. Um, because that gets really uncomfortable. But then also he just loved to buy when his like front teeth came through.

He just loved it. And I was doing everything I could to like, sort of teach him not to do that. But I ended up with a lot of sores around my nipple. I remember going to the GP in tears, like, I don't wanna stop breastfeeding, but like, how can I make these go away? And I think, so that was around maybe he was about eight, 10 months, um, for a couple of months.

I continuously had sores on that one side, and obviously I couldn't use the other. Yeah, no, I mean, there was no relief thing. 

[00:56:55] Emma Pickett: That is the thing. I mean, everyone who's listened to this, who's experienced a bit of biting, and by the way, for anyone who's not got to this stage yet, it is not universal. Not everybody's a Rowan, no offense to lovely Rowan.

Um, lots of people, no, he's absolutely wonderful for people are never bitten at all. But when you are bitten, you can, you know, worst case scenario is you might rest that breast for a little bit and use the other side that was not available to you. So you are really stuck in terms of using that breast with that, with the sores.

And I, I guarantee people are listening to this are thinking, good Lord, this one is amazing. Th the, your cha you know, two months of sores and, and, and things not healing and you kept going. That is someone who is absolutely dedicated to breastfeeding. I mean that is, I 

[00:57:36] Coral: dunno what came over me to be honest.

But yeah, we did try, um, me expressing, 'cause I could do that a bit more comfortably, um, and then give it to him in a cup. But he just. Wasn't into cups, he wanted boob. And by that point, I'm very much like, this is my superpower. This is how I get him to sleep. This is how I get him to settle. 

[00:57:56] Emma Pickett: Yeah. 

[00:57:57] Coral: I, I felt so powerless 

[00:57:59] Emma Pickett: without it.

Any, any tips for preventing the biting? Did you have anything that worked? Anything that made a difference? 

[00:58:04] Coral: Not really. The best advice I saw was, um, on Lisa Weber's page, which was anticipating when it would happen. Yes. And getting him off before it would happen. Um, which was often towards the end of a feed when he got a bit bored.

Yeah. And like the milk had slow down. So I would Yeah. Try and like get him off before that happened, because that would be one of the worst. Biting was, 

[00:58:24] Emma Pickett: yeah. I mean, if to bite, usually a baby's got to adjust what they're actually doing. 'cause if they're in the milk transfer mode, the tongue is over. The lower incisors, you know, they're focusing on moving their tongue in this kind of wavelike motion.

To be able to bite. They often have to literally move their jaw, retract the tongue to be able to bite down. And around the sort of 8, 9, 10 month mark, you'll quite often see it, what you might describe as a glint in their eye as they're actually thinking about it. Thinking about doing it. Yeah. So, so is sometimes it means that we can't read books, we can't be on phones.

We've got to observe them and watch what they're doing. And if we see that little jaw shift, that's the time to break the latch. And, and that may feel not instinctive. If you're used to trying to get, trying to get 'em to stay on as long as possible, you may need to end the feed a little bit sooner. But yeah, the main reason for biting is about flow.

Having slowed down or a baby saying, no, I'm not interested anymore. Not saying this was your story. It's also just if anyone else is listening, it's also just worth looking at your positioning attachment because if you've gradually stopped having your baby, tilting their head back, if you've stopped worrying about a nose to nipple, if they're just kinda slurping on, um, and they haven't got that lovely chin contact, that also is gonna cause biting to increase in risk.

So, um, it's worth just recapping all the positioning attachment stuff as well. So it gradually stopped happening. He gradually stopped biting. Yeah. And tell me about a typical day now as, as a 2-year-old, how's his breastfeeding pattern now? 

[00:59:48] Coral: Uh, so typical day now depends how he is overnight. So if he feeds to sleep around 5:00 AM he won't want a feed when he wakes up.

But usually there's a feed when he wakes up, he'll feed to sleep for his nap at lunchtime, and then sort of after dinner until he goes to sleep. Very variable. It could be like just one feed gets him off to sleep, or it could be as soon as dinner's over. He just wants to feed continuously for a couple of hours until he's eventually asleep.

And then he'll wake up like maybe one or two times overnight as well. We've recently been working on putting boundaries in, um, on feeding, because I was getting a bit overwhelmed with, um, him requesting a lot in between things. So really, yeah, just been trying to be a bit more boundaried and communicating clearly with him.

Like, not now, but you can have this now. This is the next time we'll breastfeed just because I needed it for my sanity a bit, I think. 

[01:00:42] Emma Pickett: Yeah. 

[01:00:43] Coral: So, um, that's where we're at now. I didn't really have a, a plan of how far I was gonna come initially. I got to one year and after all that biting, I was like, I'm weaning at one year.

Like that's what's happening. And I thought that's what everybody did as well. And so I was like, well, I've got one year now we wean. And it didn't, it didn't happen. I was really struggling. I I hadn't really thought it through properly. Um, and then it sort of kept going and I was like, but then actually how am I gonna get to sleep if I can't restfully?

And how am I gonna like comfort him and. What am I gonna do, decide when he's sick and he won't have anything else, but he'll always have boob and I'm like, I've got this way to like guarantee getting like this really nutritious fluid into him. Like why am I so quick to throw this away? 

[01:01:25] Emma Pickett: Yeah. I mean, it's the best rehydration solution, so you don't wanna stop that unless you really wanna stop all that.

And it doesn't, doesn't sound like that's where you are right now. So you're leaving it open, you're just waiting to see how things feel. 

[01:01:36] Coral: Yeah, I think, I mean we'd really like another child, um, as well, which is kind of why we've started with boundaries, but then we might have to wean them a bit more, both to try and conceive, but also I don't.

I have no idea how tandem feeding would look with one boob if it would even be possible. 

[01:01:49] Emma Pickett: So that's a very good point. That is a very good point that we might be getting to a point where if that is gonna be more challenging For sure. You literally, obviously literally can't tandem feed, but you could, I know he could have a second go after baby every time, but it's, it's definitely harder isn't it, to think about the logistics of what that might look like.

You mentioned that he was interested in the second side sometimes and asking about it. How do those conversations go? 

[01:02:15] Coral: I just tell him, I just say that booby doesn't work when, when he sees it. Um, he'll often, like if he's pulling my top up, he'll be like, there's another one there. So sometimes he might, if he's in the night and he's a bit confused 'cause I lie down in his bed with him to feed him back to sleep.

Sometimes he tries to go for the other one just 'cause he is lost his way a bit in the dark. Um, and I sort of have to direct him away. I just go, no, that booby doesn't work. Um, this is the side that does work. Although interestingly, I have started leaking from that side. Oh my goodness. I know. Which is 

[01:02:43] Emma Pickett: really exciting.

Okay, so forget what we just said about tandem feeding. So your ducts maybe are now, what, four years on from surgery? Yeah, nearly four years. Maybe those ducts are starting to connect again. Maybe. I dunno. But I don't wanna, you say maybe, where else is the leaking coming from Coral? I don't wanna get my hopes up that it would be like fully functional.

But you literally fine. Can't be, if leaking is coming outta that breast and it and it looks like milk. It seems like milk. 

[01:03:07] Coral: Yeah. 

[01:03:08] Emma Pickett: Yeah. I mean it's, it, it may well be that you have some ducks of joints back up again. 

[01:03:14] Coral: Yeah. And my GP did say to me, 'cause I had the tiniest, tiniest bit of leaking and never again at my sort of like six, eight week check.

And I remember sitting to my gp, what is this? And he told me about the recanalization. Can, I'm not saying it right, canalization. No, you said it perfectly. Yep. Yep. Oh wow. Um, and he said, yeah. So when you are feeding. Like he said, it was the prolactin, like the hormones from your feeding will like accelerate the Yes.

[01:03:39] Emma Pickett: Yep. 

[01:03:39] Coral: That happening. And I didn't know that was possible, and I think it's absolutely incredible that our bodies can do it. But yeah, I guess that that's continued to happen and it never happened again until maybe a month ago, and I realized after a feed that I was wet on the other side 

[01:03:54] Emma Pickett: side. Okay. Yeah.

Gosh. Well maybe that's a conversation have with your doctor and just see what, what, what they say. Maybe there's a way to investigate and, and find out what's going on. But it's, I mean, with another pregnancy and another phase of that postpartum period, the chances are that that would accelerate even further.

So, so watch this space is what they say and the conversation, like he know, he knows what happened. Yeah. Wow. Okay. Brilliant. Thank you so much Coral, for sharing your story today. I mean. I so often talk to people who are inspiring. You are absolutely inspiring in terms of your determination and all those weeks and weeks and weeks of cluster feeding and, and just really being focused on making this work.

Um, and I'm just really grateful that you are willing to be so open and so detailed about what you went through. Um, because I think it's, even if someone doesn't have a particular history of, of your kind of surgery to just hear that uni booming is possible and just single-sided feeding is possible is, is really important.

So, so maybe we need to call this episode uni booming after duct surgery and people will Yes. Let's call it that. Um, is there anything we haven't talked about that you wanted to make sure we mentioned? 

[01:05:00] Coral: No, I don't think so. Let me check. Can I check my notes? Yeah, please 

[01:05:04] Emma Pickett: do. Yeah. 

[01:05:06] Coral: Oh, I do have a really good tip.

Oh, a really good tip for uni boobers. Okay. Let's hear it. It comes to swimwear because, so I, I wear a sort of prosthetic beanbag on my other side to sort of level me out most of the time. Obviously if I go swimming and I don't wanna look super wonky, but I also want to be able to potentially be able to feed, you have a tricky situation of finding appropriate swimwear.

So what I found was a post-surgery cozy. So you need a post-surgery one because then it's got a pouch to hold a prosthetic, but with a zip down the front, which is like incredible. So if everybody else is wondering like, how would I approach this, this situation of like, I wanna be able to feed while swimming, but I also like, wanna look, wanna look my best, um, then yeah, a post-surgery swimsuit with zip down 

[01:05:54] Emma Pickett: the front.

Cool. Thank you for the tip. So would, so these are, when you say post-surgery, you mean swimming costumes designed for people who've had mastectomy and are sort of maybe single sided? Yes. Um, yeah, but the zip sounds like the key bit that makes mm-hmm. Makes it super useful for breastfeeding. Thank you very much.

Practical tip. Thank you. Cool. Okay. I'm so grateful for your time. We are gonna put in the show notes, we'll put, we'll put a reference to the BFAR website in case someone might find that interesting. 

[01:06:20] Coral: Mm-hmm. 

[01:06:21] Emma Pickett: But I think really the main message is uni boobing is normal. It is part of breastfeeding. You are not alone.

Breasts operate independently. It absolutely can work and you are definitely testament to the fact it can. And yeah. Hmm. And who knows what might be hap happening in your future. You might end up be breastfeeding on the other side in the future. Who knows? As every year goes by, that canalization can can go further forward.

So let's see what happens. And fingers 

[01:06:45] Coral: gets crossed. I'll have to relearn it all over again. I dunno how to do this with two penis. It's gonna be really weird, isn't it? The other rather arm 

[01:06:51] Emma Pickett: is gonna be up doing stuff. Well, let know what happens. I'll be curious to see how, how things go. And even if you don't end up producing a full supply on that side, which may be what happens, even if you just did a little bit of feeding on that side, um, that still would be, be something new and something a bit different.

Give you some options. Yeah. Thank you Carl. Much appreciated. Thank you for having me.

Thank you for joining me today. You can find me on Instagram at Emma Pickett Ibclc and on Twitter at Makes milk. 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.