Breastfeeding a second child after a challenging experience first time round

If you had a very challenging time establishing breastfeeding with your first child, it’s understandable if you feel trepidatious and worried about what breastfeeding second time round might be like when you become pregnant again or even when you’re trying to conceive. Recently a member of the Facebook group NWL Breastfeeding posted the following:

‘Hi all! I’m hoping to get some experiences from mums who struggled with breastfeeding their first child but had a much easier time second time round. I really struggled with daughter as she had a tongue tie. I struggled with low supply so had to triple feed for a long time, pump in the middle of the night until about 7/8 months, take domperidone until she was 15 months and do formula top ups until around 10 months. We are currently trying to conceive for a second however my husband is very stressed because he says we cannot go through another feeding journey like our first. I'm hoping to reassure him that it will be much easier next time round. Thanks in advance!’

This post got many replies, which I’ve copied below, all from members who had difficult experiences first time round, but found breastfeeding went more smoothly with their second child. This confirms what I have observed in almost 20 years of supporting new parents, which is that the majority of women who have struggled first time round but persevered, even for just a short time, have an easier and more straightforward experience with their second child. There are several reasons why this is the case.

• Mature breastmilk tends to come in faster with second and subsequent babies and most women have a more generous supply.

  The mammary gland “remembers’ the first pregnancy and starts making milk more quickly second time around. In addition, many second time mothers have a larger breast storage capacity http://www.nancymohrbacher.com/breastfeeding-resources-1/2016/6/16/breast-storage-capacity meaning their 2nd baby will naturally go longer between feeds. The fact that mature milk comes in faster and that second time mothers have a more generous milk supply and larger breast storage capacity was confirmed by a study in the Lancet (see below).

B.L:

‘This was us: tongue tie, low supply, domperidone, pumping in the middle of the night (just a few months but still), power pumping sessions, finger feeding, you name it! My husband and I were both agreed that we would not have done it again the second time around if it was that hard, but I started way more prepared than the first time: assessed for tongue tie on day1, saw a lactation consultant on the first day home and of course more experience. Ironically, I had an oversupply with my second, but everything was straightforward and 8 months in and still happily breastfeeding my chubby little one!’

E.S:

‘This post could have been written by me. I tried EVERYTHING to increase my supply with my first. It became my full-time job. Second time round has been completely different, it’s been so simple and straightforward. His weight doubled within 2 months. My advice though would be to see a lactation consultant you know and trust a day or two after the baby is born so you can check latch and tongue tie.’

• Second time round you are a more experienced and knowledgeable breastfeeder.

  You know about normal baby behaviours and the importance of attachment and positioning, and you are more experienced parent. You know what to expect, which tends to mean you’re more confident and less terrified about being responsible for the survival of a tiny human. And even if it is challenging to begin with, you know that things are likely to get better.

 H.N.M (in the photo above with her 2nd baby):

‘My first wasn’t as challenging as your experience though I struggled with poor latch, sore, bleeding nipples, flat nipples and a tongue tie. I pumped in addition (and I never produced very much either!) till I could breastfeed directly for a while to manage the discomfort and get the hang of it. I had the support of an IBCLC lactation consultant during this period. I am still breastfeeding my now almost 3-year-old.now have a 5-week-old and it’s been totally different! This baby has a very long and free tongue and could open wide straight away! I have lots of milk compared to the first time as is expected. Weight gain has been more straightforward too.

 What’s also the case is I know what to expect, where to get help if needed and what is normal for a baby that has made the whole process much more relaxed! I’m sure that emotional surety makes most of the difference to be honest, even if there were breastfeeding challenges second time around! Good luck!’

E.W:

‘I had such a hard time with my first: constant pain every feed for four months. Tongue tie but even after it was divided, it didn’t fix it right away. My second (on the other hand) it was a breeze. He still had tongue tie but because of all of the training I had on positioning I never felt pain with him.’

S.C.E.C:

‘First born:

Feeding was SO painful. Tongue tie cut in first week but no difference. Meant we combi-fed for first 3-4wks (formula + expressed) until I'd confidently built my supply through pumping and then switched to exclusively pumping until 16 or 18wks. At this point I was able to nurse and would only occasionally pump.

Second born:

Still painful for first circa 4 weeks (tongue tie cut first week) but not as excruciating and I knew that I could struggle through, and it would pass because of my experience first time around. From about 8 weeks pain free even with a terrible latch. Cranial osteopath for first 6ish weeks.

I was still really annoyed, and a bit upset that my journey 2nd time wasn't "easy" - particularly since I fed my toddler for about half my pregnancy, so it's not like there was a significant gap in feeding, but it was certainly significantly "easier". I also have a big over supply this time. What I would say as well, is your mental resilience and just general emotional capacity to deal with any challenges the second time around will be so much stronger.’

• You know it’s important to ask for help in a timely fashion, and who to go to for that help.

A.E:

‘This was me! I had a terrible time with my first - tongue tie, low supply, formula top ups, domperidone. My second had a tongue tie in fact even worse than her sisters but I was able to immediately recognise it and Dr Sharon Silberstein was able to see her within 3 days of being born. She was exclusively breastfed and she never had a bottle. She's still an avid feeder at 20 months with no signs of wanting to stop. I knew what to look out for, knew so much more about latching and breastfeeding in general and my supply was more generous. A difficult first journey does not make a difficult second journey! Good luck.’

L.C:

‘This was me! Triple fed my first until 8 months, hated it and looking back it really impacted my mental health. My second one had a tongue tie and ruined my nipples at first, but I had it cut, and it’s been really successful so far! We’re 9 months in and exclusively breastfeeding and it’s so much easier.’

• Every baby is different – some just take to breastfeeding more easily!

M.C:

“My situation was similar to yours and I took a high dose of domperidone for 15 months with my first after triple feeding.  I am happy to report that my second daughter Annie Rose is nearly 5 months old and breastfeeding has been a breeze.  I am tandem feeding with her sister and also just dropped off some milk to the milk bank (I pumped for 2-3 mins at the beginning when I was feeling engorged and ended up with a freezer full of milk).  Annie is a different baby and her latch was excellent from birth (my first was pre term and jaundice etc) - Annie jumped straight on after birth and would stay there actively “nursing”.  I also expressed colostrum when pregnant to take to the hospital which I think helped see me through those initial days… I think I only used 4mls in the end but it was a nice feeling of security. I remember trying to express colostrum post birth with my first and it was so stressful and I didn’t want to relive that.  I stayed in hospital for 3 nights following my c-section and my milk came in in day 3.  The midwives were asking me to time and record my feeds etc and on day 3 Annie Rose had been on the breast for 16 hours and they thought I was a little crazy and kept offering to take her and put her in the bassinet.  She wasn’t unsettled but she was really working hard to bring the milk in and I was pretty determined also.  The midwives kept offering me a dummy and saying they can get a bottle if I want a break which was a little annoying because I knew she was just doing her thing to bring in my milk… the milk came in at about 4am and she took a big drink and then passed out asleep.  I then got up and danced down the halls and ate 3 sandwiches 😂.  So my tips are: (1) harvest colostrum, (2) take lots of snacks to the hospital as waiting for hospital food takes ages and I was ravenous, (3) there was an IBCLC on the ward so I asked her to check latch and positioning a few times a day, (4) I booked an IBCLC visit for when I got home, (5) I did skin to skin with Annie Rose all day - come to think of it, I don’t think I have ever had a top on in hospital 😂.  It’s been said many time before in this group to not let your experience with your first baby dictate the experience with your second and I can say firsthand that I am living proof of this. It’s such a relief! 

The other thing is that when you have a c-section it is not possible to turn and get your baby out of the bassinet in the hospital.  Don’t be afraid to ask the midwives to keep coming back to pick up your baby and hand her/him to you - don’t wait for a time that is convenient or think that you won’t bother them just yet.  Just keep dinging that bell!”

S.W:

‘I didn’t have the same challenges as you first time around but struggled for other reasons - a lack of support, difficulty latching and positioning, and not understanding my supply. I combination fed from 2 weeks - initially just one bottle but my son increasingly showed a preference for a bottle and he stopped nursing altogether from 12 weeks. It was altogether a negative experience. I expected exactly the same with my second child and this time had the bottles and formula at the ready with the intention of combi feeding from the outset. Things were totally different the second time around. She latched well, felt comfortable in my arms, and we were both so happy (& well supported by this group!). She refused the bottle from the word go and she finally weaned onto a cup at 18 months. I guess there are no guarantees, but I don’t think you should expect that you will have the same experience twice.’

J.T:

‘I could have almost written this myself. My first kept falling asleep (despite breast compressions) and had a poor latch which shredded my nipples. I was so desperate to give him breastmilk, I pumped around the clock for 8 months, took the max dosage of domperidone & used donor milk kindly supplied by Hearts Milk Bank. It had a huge impact on my mental health & my husband felt it too. I felt guilty for spending so much time with the pump and less time with my baby. There were a lot of tears.

Second time round, I agreed with my husband that I would try my absolute best to exclusively, but if it didn’t work, I would be mentally okay with combi-feeding. Leading up to the birth, I prepped with both Cordelia Uys and Sherridan Stymest IBCLC and went to the hospital armed with colostrum, silver cups & nipple shields. And formula if I ran out of colostrum and couldn’t pump enough. This time, I spent the 3 days in hospital topless doing skin-to-skin. All was well until she was diagnosed with jaundice & was sleepy. I had to start pumping to top her up. It felt like dejà vu and I felt defeated. I remember Sherridan saying she’s a different baby to my first and we just need to get over the jaundice (I read a lot of posts here about successful breastfeeding journeys with jaundiced babies). Very slowly but surely, after 6 weeks & with Sherridan’s support, we started dropping the top ups and my pump is now gathering dust. I still take a small dose of domperidone, but that’s just for my peace of mind.

 While there are no guarantees your second breastfeeding journey will end up as you planned, you are so much more knowledgeable now and can prepare for any potential challenges. I have also found parenting easier because I’m more relaxed which has also helped with my breastfeeding journey. Wishing you the best of luck with your conception & breastfeeding journey.’

• It’s not uncommon for 2nd time mothers who had a traumatic experience first time round to find breastfeeding second time round a healing experience.

L.S:

‘This was absolutely me! Horrible time with my first. Second is 4 years old and still feeding. I actually found the second a very healing breastfeeding experience for the trauma I held after my first.’

Some thoughts from two IBCLC Lactation Consultants:

Emma Pickett IBCLC Lactation Consultant:

‘Stephanie Casemore has written a book called ‘Breastfeeding take two: Successful Breastfeeding the Second Time’. It’s a bit old now but it discusses emotions and reflections in an interesting way.

I think one point to make is that your husband is hoping to protect you (I’m hoping it’s that, rather than just protecting himself), but that ‘protection’ could do more damage. Not trying at all could potentially put your mental health at greater risk. I sometimes find mums have trauma re-surface. A second experience can mean repair and healing.

 Second time around is never the same. From a low supply point of view, you form prolactin receptors on top of the ones from first time around. Supply is often improved. You will know what support you need from the first minute.

It can also bring up some difficult feelings if you know you tried really hard to give your first child breastmilk but the second doesn’t get any access. And if that wasn’t YOUR choice, that could hit harder than you might expect.

The second time around might feel scary but there is no option that guarantees zero stress.’

Wendy Lever IBCLC Lactation Consultant:

‘One of my favourite group of women to work with is second time mums who had similar experiences to yours the first time around.

The vast majority of them have a fundamentally different experience second time around. They have support in place from even before baby arrives, they have experience as a mum, and we work immediately towards a sustainable breastfeeding relationship (whether that's exclusive breastfeeding or mixed feeding depending on their goals and/or situation).

As Emma says, most women who struggled with supply will have more milk with each subsequent birth.’

Links:

Breastfeeding, Take Two: Successful Breastfeeding the Second Time Around by Stephanie Casemore, published Gray Lion Publishing, 2011 

Lancet Study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(01)06126-8/fulltext?dialogRequest=