A couple of friends of mine had babies last week; child number 3, for both of them, and boys, for both of them. We've known each other for a few years now; the three of us met at our NCT antenatal classes before our first babies were born nearly six years ago. So neither of my friends are what you might call novices at this baby-rearing lark.
I visited one of them yesterday afternoon, and she told me how for the first couple of days after her son was born she had trouble breastfeeding. This was not unexpected, it hadn't been plain sailing with either of her two older children, but she wanted to persevere because, like many of us, she believes that breast-feeding is the best start for her child.
After 3 days, however, her son had lost 8% of his bodyweight, and was starting to look jaundiced. She mentioned this to the NHS midwife who visited her on Friday afternoon. Should she start supplementing with bottles, she asked? Oh no, came the reply. You're not at the thresh-hold at which we advise that. Somewhat relieved, my friend thought she would ask just one more question; what is the threshold at which you suggest supplementing? 10%, came the answer.
OK, well, what if he continues to lose weight and becomes more yellow over the weekend? Do you have a number I can call you on? No, I'm not working this weekend. But if you call the switchboard they will have a chat to you and if need be will advise you to go to hospital. Otherwise I'll see you early next week.
Hold on a moment.
Now, my friend has no truck with statistics and government initiatives. 2% was not a big enough margin for error as far as she was concerned, and the first thing she did after the midwife left was to sterilise some bottles and get ready to supplement her son after feeding him herself, if need be, which she felt was necessary that same evening. All's well that ends well; he took the extra, her milk properly came in over the weekend, and he's now an entirely breast-fed baby again.
Now I know that there are people out there who will think my friend was potentially slowing down her milk-production by introducing the odd bottle like this. And I know too all about the studies listing the valuable nutrients and immune system being passed from mothers to babies in their milk and about 'breast being best' for babies.
But here's my question. What if my friend had not been a confident, well-informed 3rd time mother who decided to put her son's health above any WHO initiative that the local midwife service was working towards, waiting instead for the visit 'early next week' before taking any more action? And what if she had given birth in the depths of winter so that in our dim Northern light, spotting that her son was turning a little bit more yellow than he should do was not so easy?
How far might it have gone?
Jaundice is relatively common in newborns, especially boys. It happens when, for one reason or another, their bilirubin levels get out of control and their body is unable to flush the toxin out of the system - and not getting enough milk can contribute to this. Jaundice is so common, in fact, that many people think of it as a simple condition that simply fades away after a couple of weeks, and usually that's just what happens. But if it's untreated or gets out of control, jaundice can affect a baby's brain and can lead to hearing loss, learning difficulties and late development. (Check here for more information).
So jaundice needs to be taken seriously. And where might this midwife's lack of concern about the combination of jaundice and weight loss in my friend's baby have led?
Might it have ended up with her son suffering severe jaundice and being admitted to hospital again less than a week after he was born?
Might he have had to - at 8 days old - lie naked on a hospital cot with a canula in his heel to pump fluids into him, all the while criying piteously because his foot hurt, and he wanted a cuddle but was not allowed to be picked up because he needed maximum exposure to the UV lights that shone in his newborn eyes 24 hours a day?
Might he have experienced proper hunger because his tummy was empty but he was not allowed to be fed by mouth because the doctors needed to know exactly how much fluid he was getting through the IV?
Might it have ended with his mother's milk production being totally decimated through the shock of the whole experience, consequently meaning that he became an entirely bottle-fed baby, after all?
And in case you think I'm being needlessly dramatic, this is exactly what happened, to us. So please forgive me if I don't toe the party line on this one.
Breastfeeding - at ANY cost? I don't think so.