[Names have been changed to protect confidentiality]

Picture Right: Alice gives "Gilbert" a cup of milk.

When she was pregnant, Jody had hoped to breastfeed. When the breastfeeding support she needed after the birth didn't materialise, she reluctantly decided to bottlefeed instead. Had her baby thrived on formula, that probably would have been the end of the story, but Jody's baby, Amy, did not thrive.

This is the story of how an extraordinary mother helped her baby in an extraordinary way.

Jody had a history of infertility, so Amy was a desperately longed-for baby. The labour was long and difficult and did not go well, ending in an emergency Caesarean under an epidural. Immediately Amy was delivered, Jody was asked if she was breastfeeding.

"I said, 'Yes', but she was not put to the breast straight away, probably because they were cleaning me up and it was early in the morning, about 4.35am, and they wanted me to sleep."

After the epidural and Caesaren, Jody suffered paralysis of her legs for several hours and was in a lot of pain, so she could not sit up or get her baby out of the crib by herself. In fact, it wasn't until 6.30am, when Amy was screaming from hunger, that Jody finally managed to get a nurses attention to get some help with feeding Amy.

"It took me about half an hour to get a nurses attention because I couldn't sit up and reach the nurses switch," she says.

But getting the nurse's attention wasn't the end of the story. Amy was put in bed with Jody, but she didn't know how to position her on the breast. She had read quite a few books on breastfeeding while pregnant, because Amy was a long awaited baby and Jody wanted the very best for her, but none of the books she had read showed how to breastfeed lying down, after a Caesarean.

"Amy was screaming hungry and she was left in bed with me for the rest of the night. She did suck for quite a few hours, on the one side, and I was desperate to get her off and on to the other side, but I just couldn't".

Begging for Help

Jody was desperately tired by this point, but too scared to fall asleep with the baby in the bed with her and her nipple was cracking and bleeding. Looking back, she does not feel the position was correct, leading to damaged nipples preventing Amy from having a satisfying feed. By the morning, Jody had started begging for help with the breastfeeding.

"I asked on numerous occasions, but no one actually came to see me at all and I began to get very, very tearful."

Because of the post-Caesarean pain, Jody couldn't get the baby in and out of the crib, she couldn't switch sides while feeding and she didn't know how to position the baby correctly. She was beginning to despair.

"In the end, a nurse came over to me and said 'Are you trying to breastfeed for your sake or the baby's?' I burst into tears. I went off to have a bath and when I came back, the nurse was bottlefeeding my baby."

Initially, a part of Jody was relieved. It was as if the nurse had made the decision for her and at least she thought, the baby was at last being fed. From that moment, Jody sadly accepted that she would be a bottlefeeding mother. At the time, she was exhausted, in pain and her nipples were hurting. She just wanted to sleep and for someone to take the baby away so she could rest. She was defeated and there was no fight left in her.

Unfortunately, from the beginning, Amy was sick after every single bottle-feed. Jody was told it was because she had swallowed mucous during the birth and not to worry, but she noticed that her baby was being violently sick, bringing up the entire feed and drinking far more formula than she was supposed to be taking.

By day three, when Jody and Amy were discharged from hospital, Amy had broken out in eczema. Jody was told that it was due to her skin "getting used to life outside the womb" but when she took the baby to her GP a few days later, he couldn't believe it: her skin was cracking and bleeding. Jody is a qualified nursery nurse, so she had experience of children with chronic skin conditions.

"I suppose I knew really, at the back of my mind, that something was seriously wrong but the nurses had convinced me that this was just her getting used to life outside and that was what I kept telling myself. I was actually embarassed about other people seeing how bad my baby's skin was. Babies are supposed to have lovely soft, glowing skin, and there was my baby with cracked, bleeding skin and vomiting violently all the time. I felt ashamed."

Losing Weight

Jody was advised to change formula. The eczema did go down a little, but it still didn't really suit her so then began the endless procession of different formulas, with varying results.

"By this time, Amy was not gaining weight at all. In fact, she was losing weight and she looked very pathetic. She was very lethargic but when she was awake, she screamed all the time."

Amy was drinking 14 x 6oz bottles in a 24 hour period, and still losing weight, despite the fact that Jody was pretty sure that most of it was not being vomited up again. Everyone seemed to be at a loss to explain this, including all the doctors. The doctors even recommended solids at 6 weeks old, in a vain attempt to cause Amy to gain weight. Jody didn't question this advice, being desperate for anything that would help her baby, despite the well-known link between early solids an allergies. She now believes this is how Amy was sensitised to highly allergenic foods like eggs and wheat.

"At a few weeks old, my mother gave her egg custard. Her face blew up like a balloon and she was obviously allergic to it."

Eventually, they were referred to a Paediatrician who put the baby on soya formula. But Amy's condition remained much the same: at almost 6 months old, she weighed about 10 lbs (she was 7lbs 2oz at birth). Then they tried the chemical "hypoallergenic" formulae, but the taste was so disgusting, Amy refused to drink it.

"I felt we'd gone down all the normal paths and the doctors just did not know what to do."

At the same time, Jody says she was feeling extremely guilty about not breastfeeding. "I am absolutely convinced that had I breastfed, we would not have had all these problems. Breastmilk is made for the baby, after all. At the time, I just felt so guilty because, as I saw it then, because I had wanted to sleep and because of the temporary problem of sore nipples, I had caused my child to suffer. It was so hard to come to terms with, especially as, at that time, I believed it was too late."

Hope

Jody tried to put this thought out of her mind, until one day a friend was talking about how some women were able to induce lactation to breastfeed an adopted baby, even though they had never been pregnant, through some relatively straight-forwards techniques.

"I thought it was one of those way out American ideas but after we talked about it for a while, I started thinking it might be worth a try."

Jody learned that for women in her situation, it was known as "re- lactation". She learnt it could be very hard work, with no guarantee of success, but the basic principle was that the breasts would produce milk in response to stimulation - ideally, a suckling baby, but a breast-pump or even manual expression could be used, at least every couple of hours.

Knowing very little about the details, but determined to try absolutely anything that might help her baby, Jody began using a simple manual breastpump, every couple of hours, day and night.

"The strange thing was that almost as soon as I knew that re-lactation was possible, my body started to produce milk. Almost as if my body knew that it had to do something for my baby's survival."

Jody read that it was important to have lots of skin-to-skin contact with her baby, so she used to cuddle her baby up in bed with her and use the pump. She vividly remembers that first drop of milk.

"I just couldn't believe it" she says, but it seems to have motivated her to attempt the impossible.

After a few days of using the manual hand-pump, Jody's hand was beginning to tire from the constant effort. She tried a battery operated pump, but it was becoming clear that only a professional grade pump would be up to the task. Luckily, another friend (who had had a premature baby) came up with just the ticket - a hospital grade electric pump that she could borrow as long as she liked. This pump was a great improvement, but without the help of the hormones you have when you have just given birth, Jody's milk supply could only be maintained by constant and frequent pumping, and even then, her yields were not great.

"Every couple of hours I sat there. I didn't go out for weeks and it was over Christmas as well. I felt a bit like a milking machine but I felt the survival of my child depended on it."

Amy Tries Breastmilk

Within days of getting the hospital grade pump, Jody was finally able to give Amy a bottle with 2oz of the precious expressed breast milk.

"She gobbled the milk down and it was the first time she wasn't sick after a bottle in her life."

Those 2oz were an entire days supply of breastmilk but Jody felt that it was Amy's "medicine" and tried not to focus on the amount. However, gradually Jody's supply crept up, until she was able to produce up to 6oz a day, pumping every couple of hours in the day and four hourly at night. I asked if such a little amount could really do anything for Amy?

"It was like a magic potion," recalls Jody. "Her eczema has vanished; her feeding has improved and she has become tolerant to many other foods she couldn't tolerate before; they said she had reflux, but that went the day she had her first 2oz of breastmilk. She went from a very under- developed child to being quite advanced for her age; her speech and mobility suddenly improved and she stopped being either lethargic or screaming, and actually started being awake and happy."

However, there was little support for Jody's belief that her breastmilk was the cause of these sudden improvements. She told her midwife, and initially the midwife was very skeptical and Jody says she "made sarcastic comments about it" but over the following few weeks, the midwife was forced to change her tune.

"She used to insist on Amy being weighed every week, but then her weight-gain took off so she started saying 'How about every two weeks? Or every month?'."

Amy Improves

The professionals couldn't believe the improvement in Amy's general health and were surprised that on the breastmilk, Amy didn't have any more of the chest infections that had frequently afflicted her before. Amy began to accept all kinds of food she previously wouldn't touch. Surprisingly, despite Jody being convinced that her child was ill with food allergies, her doctors will only admit to to an egg allergy. This is despite the fact that her child was showing clear allergy symptoms before any solids were introduced.

In the meantime, Amy appears to have grown out of her egg allergy. Jody cannot understand why, despite all the evidence, no doctor will admit to her that formula is the cause of her baby's illness, but suspects that it is partly due to their ignorance of breastfeeding and of re-lactation as a possibility.

"They think there is formula and there is breastfeeding, and once you stop breastfeeding, there is no other choice but to find a formula that suits your baby. I feel doctors should be aware of re-lactation as a possibility and women should be offered it as a choice."

She believes that she might have been able to get her baby back to the breast properly if she had found out about re-lactation much earlier. "I did try Amy on the breast for quite a while, but she just didn't have a clue and I don't think I could have pursued that possibility for long, psychologically, after all that had happened".

 Although getting Amy properly back to the breast was her ideal, Jody decided to continue using the pump and bottle-feeding expressed breastmilk. She felt she needed to know exactly how much she was producing for her own peace of mind and it was a kind of "halfway house" that both satisfied her anxiety and got breastmilk into her baby.

Sadly, Jody's attempts to pump breastmilk came to a rather abrupt end, after almost 6 months, with a sudden illness that put her in hospital. "It was very, very time consuming and being unwell, I just couldn't continue."

Thankfully, Amy is now able to tolerate goat's milk and is still doing well - a fact her mother puts down to those months of breastmilk. Talking to Jody, I was in awe at her perseverence despite so many nay- sayers, including her doctors. I asked her how she had kept going for all that time, with so much discouragement, and for just a few ounces of breastmilk a day?

"When your child is as sick as mine was, you don't care if it's something you have to do for 24 hours a day. You want your child well and your maternal instincts completely take over. I felt my child was slowly dying before my eyes. I had to do something."

The Future

I asked Jody about any future babies she may have. "Nothing will stop me breastfeeding. Nothing," she says with great conviction. "I would not be prepared to risk the health of any other child of mine."

I asked Jody about the guilt feelings she says she had at the beginning of all of this. "It's made me feel like I've done something for my child that should have been done in the first place. It has definitely relieved the guilt, although I do still feel I should have breastfed. But I know I cannot change that. I am very angry that the professionals let me down."

"I definitely feel I've achieved something. It was really hard work and I do think sometimes at the back of my mind 'I must have been mad!' But I do believe I did my absolute best for Amy and part of me always says 'What would have happened if I hadn't of done it?' and it makes me feel sick to think about it."

Jody believes, rightly or wrongly, that her child may have died. "I don't know if it's me going totally over the top, but I cannot see how she could have survived the way she was going".

Looking at photographs of Amy when she was a few months old, it is hard to say that Jody is exaggerating. I honestly have not seen such a thin and sickly baby outside a hospital.

Today, Amy is a different child. Typing this interview from the tape has been a hard task because of the frequent and enthusiastic "interuptions" from a child who is still slim, but now full of life and energy! The change is so enormous, I tend to believe her mother has somehow pulled off a miracle!

P.S.

Update: After infertility issues, several miscarriages, ectopic pregnancies and the most traumatic and risky pregnancy, Jody gave birth to a second baby girl in January 1999. She was born prematurely at 34 weeks, via an emergency Caesarean she wasn't expected to survive, weighing 3lbs 13oz. Despite serious challenges and health problems, Jody was able to breastfeed her for a few months, and the baby continues to astound doctors. Amy is now a thriving, healthy child who loves reading, drawing, writing and socialising. She has recently been classified as "Exceptionally Gifted" by the Education Authority.

Book recommendation:

"Breastfeeding the Adopted Baby", D. Petersen, available from La Leche League

Breastfeeding Links

• La Leche League, Breastfeeding pages
• Dr Jack Newman's Breastfeeding Page
• Dr William Sears Attachment Parenting Page
• Katherine Dettwyler's Breastfeeding Page

Compiled by Anna Hayward (c) 1997.
Disclaimer: This document has not been compiled by a medical professional. Any opinions expressed are personal and should not be construed as medical advice. I am not a representative of any of the companies discussed, nor do I receive any form of commission.