Caring for a baby – feeding and settling

Many parents, particularly mothers, talked about what it was like caring for a baby. Feeding and settling (sleeping and crying) were key issues which often posed significant challenges for many new parents. In relation to feeding, parents (again, mostly mothers) talked about difficulties learning to breastfeed, pressure to breastfeed, and support for breastfeeding and bottle feeding. In relation to settling, parents talked about teaching their babies to sleep, and the impact of crying. Twins and babies with reflux posed particular challenges.

Feeding

Most mothers we spoke to were in favour of breastfeeding and said before having a baby that they intended to breastfeed. However, many were surprised to find it much more difficult than they had expected. Elizabeth echoed many mothers when she said: 'breastfeeding didn't come naturally to me, and my perception of what it would be like and the reality were very different. I thought you just put them on and they suck away, and for some women it is like that and for me it didn't work'. Several women felt that they were not given 'realistic' information about breastfeeding during pregnancy, including Sara L who felt the 'half an hour' on breastfeeding with 'the crocheted breast and the doll' in her antenatal class was inadequate preparation.

A few mothers found that after 'a bit of getting used to it', breastfeeding went well. Alice, a young mother of one, said: 'During my pregnancy I thought, "Oh no, I don't know if I'll do it." And I ended up breastfeeding and it was amazing. It was the best thing I could have done'. Sarah M described having a 'beautiful breastfeeding experience' with her second baby.

Other mothers experienced challenges while learning to breastfeed. These included not being able to get their babies to 'attach' properly - often leading to nipple pain and trauma, milk supply problems (too little or too much), babies not gaining weight quickly enough, white spots on the nipple, breast abscesses, nipple thrush, vasospasm, babies having a cows' milk protein allergy, lactose intolerance, gastro-oesophageal reflux or a tongue tie, and mothers experiencing mastitis.


Michelle decided to formula feed her baby as breastfeeding was very difficult. While she regretted 'missing' the 'bonding experience' of breastfeeding, she said both she and her son were 'happier' bottle feeding.

Some women were surprised by how time-consuming and tiring breastfeeding was, especially when feeding through the night. As Louise said about her first baby: 'She was feeding eight times a day at the start and she would take an hour to feed. So that's an eight hour day that you're doing. That's pretty full-on, and there's not a lot of time for anything else'. Several mothers commented that a benefit of bottle feeding was that other people were able to feed their baby, allowing the mother time to sleep or freedom to do other things. Melanie found exclusive breastfeeding exhausting and felt if she had done mixed feeding she might have been more rested and it would have helped her bond with her son.


Melanie, a mother of one who experienced postnatal depression, breastfed her baby for six months. She found it made her 'exhausted' and wondered if mixed feeding would been less tiring.

Some mothers felt that their difficulties breastfeeding were made worse by perceived 'pressure' to breastfeed - from health professionals, the Australian Breastfeeding Association, family members, or even from themselves. Elizabeth who 'struggled' with breastfeeding for six months and was 'much happier' when she gave up said: 'There's a big message now - "Breast is best" and you have to breastfeed and it was a big decision to not do that. You felt like you were poisoning your baby by giving them formula [laughs]'. Other parents commented on their impression that breastfeeding was part of being a 'good mother', including Melissa who described feeling she was seen as the 'bad mum' in her mothers' group as she bottle fed and had an elective caesarean.


Elly described feeling 'angry' and 'disappointed' when she couldn't breastfeed, as had thought it was something that was meant to 'come naturally to women'.

Women who experienced challenges with breastfeeding described various strategies for overcoming these. Most frequently mentioned were the use of nipple shields or creams, mixed feeding (breastmilk and formula), block feeding, expressing or weaning. Some women with low milk supply said they did mixed feeding, while others who weaned their babies because of problems with breastfeeding said in hindsight they wished they had tried this. Often they had refrained from this due to health professionals' reactions. Joanne recalled that: 'one time in the very early stages I mentioned to one of the nurses that [partner's name] had done a bottle for me overnight and I'd got a bit more of a sleep. And this nurse nearly fell off her chair saying that I was going to dry up, and not to make a habit of that'.


Beth described the difficulties she had breastfeeding her baby as a result of 'oversupply' and how she resolved these.

Many mothers discussed expressing breastmilk and their reasons for doing this, including to increase or reduce milk supply, to allow other people to feed their baby, or because breastfeeding was too painful or their baby was not able to attach. As expressing was even more time-consuming than breastfeeding, the decision to express usually reflected a strong emotional commitment to feeding one's baby breastmilk. For Susanne, it was also about making up for her 'failure' at breastfeeding. She said: '[Expressing] just made me feel like, 'Yeah, I'm doing what I'm supposed to do. A baby's supposed to have breast milk'. There's so much pressure to breastfeed, so much pressure and it just doesn't matter. But I think for me it really mattered because I needed to get some respect for myself back'.


Fred talked about the positive impacts of being able to bottle feed his baby breastmilk his wife had expressed.


Georgia called the period during which she was expressing and bottle feeding her baby her breastmilk her 'three hour life'.

Several mothers described seeking or receiving support for breastfeeding from lactation consultants, GPs or breastfeeding clinics, as well as support from family members or friends. Rumer appreciated a friend's advice 'to try and stick it out for six weeks and then if it's still not working give it up' while Joanne was grateful when her mother would sit with her while she was breastfeeding in another room as she initially was uncomfortable feeding in front of others.

Nellie who experienced a breast abscess and other complications was critical of the lack of support for her desire to breastfeed among health professionals she encountered: 'Whenever I saw a health professional the message was wean, wean, wean and nobody took into account that I felt very attached to the idea that breast feeding was what mothers did and I didn't want to bottle feed'.


Louise reflected on the difference between information about and support for breastfeeding.


Deb struggled to find support for breastfeeding at the regional hospital she gave birth at.

For many mothers the decision to wean their babies was difficult, particularly if this took place earlier than desired. Maree described it as 'heartbreaking'. Others who had found breastfeeding difficult described mixed feelings of both 'relief' and 'guilt'.


Due to low supply, Zara had to wean her baby at six weeks. This was a 'huge relief'.

Settling

Teaching babies to sleep and coping with their crying were other challenges many parents faced. Some described their babies as 'easy' and were able to get them into a routine relatively quickly.


Matthew said as a single parent who needed to go back to work it was important that his daughter learned to sleep from a young age.

For others this was more difficult, and created considerable distress for several families. Parents who co-slept with their babies often found it hard to establish a sleep routine for their baby, and parents of babies with reflux had to deal with unsettled sleep along with significant amounts of crying (and sometimes vomiting). Beth described her baby as waking up 'a billion times a night' and being unable to nap easily during the day.


Kirsty's described the impact of her baby's wakefulness on her and her relationship.

A few parents talked about attending a sleep school (early parenting centre) to try to help their baby get into a better sleeping pattern. This helped some parents, while others felt the 'teaching to sleep' methods used by sleep schools did not suit them or their baby.


Nellie's experience at sleep school with her first baby led to her accepting she had a 'wakeful' baby, and deciding she needed to find a way of parenting that fitted with her 'personality and values'.
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Feeding and settling issues were more complex in families with twins. Jane bottle fed her twins after researching her options: 'The thought of tandem breastfeeding, that was another one of those shocks - I saw that and then just got up from the computer and walked away and I don't think I looked at the computer for about three or four days. I just couldn't face the idea of tandem breastfeeding. That was just too frightening I think'. Kahli talked about the challenges of managing her baby twins waking at night while sharing a house with her mother: 'if it was just me I could let them cry [laughs] but at night time when other people have got to go to work and stuff it makes it a bit tricky'.


Andrew said his wife's experience initially breastfeeding then bottle feeding their twins had made him realise that 'quality of life' and being able to 'function' as a parent were more important than whether babies were breast or bottle fed.