What kind of postnatal support is most helpful to a second time mother who would like to breastfeed?
Compiled by Cordelia Uys, February 2021
A member of a large online breastfeeding support group (for which I’m a member of admin) recently asked the following question:
If you are planning to breastfeed, what kind of support would you find most useful in the first 3 months? A maternity nurse? A night-nanny? A doula?
We are expecting baby #2 in the summer and I'm not very sure if my mum will be able to come help out (she was here for 3 months with baby #1 and was a lifesaver). I exclusively breastfed my daughter, and we struggled with sleep deprivation for a long time. This time around I may need to go back to work a bit sooner, and my husband is a LOT busier with work and can't do as much at night, so we are looking for some support.
I'm not very sure what kind of support would be most useful if you're planning to do responsive feeding. And I never had much luck pumping last time so not sure bottles would really work.
Responses:
KS: Great question, also curious to see responses as we’re in a similar position. I’m considering a Snoo but still in two minds as they are not cheap or guaranteed and not sure where it fits into my parenting philosophy (though I’m giving more weight to my own sleep this time as I’m definitely a better mother with a touch more).
Original poster: It's tricky finding the right balance, no? I do feel like it might be better for my mental health to try to get a bit more sleep this time around. But at the same time, I don't know if it makes sense to change too much either.
Cordelia Uys: Many congratulations on your pregnancy. One thing I think it good to bear in mind with a 2nd baby is that in the vast majority of cases breastfeeding is much easier to establish if you've breastfed first time, as you will have so much experience. In addition, 2nd time mothers tend to have a considerably more generous milk supply. For me, the biggest and most important difference was that I wasn't so terrified by the responsibility of caring for a newborn. In terms of support, I would without doubt recommend a postnatal doula as their role is to support the mother in whichever way she finds most helpful. I think of a doula as a rent-a-mum but without any of the baggage that sometimes comes with one's real mother. Maternity nurses and night nannies are there to take care of the baby, and if you'd like to establish breastfeeding, this can actually undermine the breastfeeding journey. I can't tell you how many times I've spoken to women whose breastfeeding journeys have been derailed by their maternity nurse, especially since they rarely understand how breastfeeding works (even when they say they do) and they often try to persuade mothers to put their babies in a routine. In the early days, what new mothers need is to be able to spend the majority of their time in skin-to-skin contact with their baby and have someone who takes care of all their other responsibilities. So extra hours from your cleaner if you have one, someone who will do the cooking, and a nanny to take care of your older child if you don't have relatives available to do that. Re night nannies: night feeds are essential for establishing a good milk supply, babies need to breastfeed frequently at night in the early days and separating mothers and babies at night will almost inevitably have a negative impact on milk supply, not to mention bonding. And of course, it's not recommended to start pumping before around 6 weeks if breastfeeding is going well, as this can put a new mother at risk of blocked ducts, mastitis and oversupply.
Original poster: That makes sense Cordelia, thank you! And seems to fit in with what we were thinking as well. My husband and I were discussing it, and while some of our friends and family had great night nannies, we weren't sure what they would be able to help us with if I'm breastfeeding. I'll keep that in mind about postnatal doulas (although I am really hoping my own mum will be able to have the vaccine and come before baby arrives).
Cordelia: Of course, your own mother would be by far the nicest option! Fingers crossed.
Admin team member: Cordelia has written literally everything I was thinking as I read your question! I tried to hire a night nanny with my firstborn, and the first session, when after the baby arrived just for a quick hello (before I had established breastfeeding and etc etc) was such a disaster I terminated the agreement on the spot. Everything I then learnt about breastfeeding and bonding, and all my motherly vibes, screamed against it. It was such an expensive mistake!
I definitely think a doula to take the load off you is the way forward and I hired one for a few sessions with my second child. It was perfect, she cooked, she tidied, she held the breastfed and settled baby whilst I went for a hot shower, it was exactly what I needed. I had my cleaner come twice a week instead of once (a luxury but if you can afford then do it!). And for the first few months I was much more relaxed about the time my older kid reached childcare because morning routines were nuts.
Sleepless nights will be tough, but the idea is to maximise sleep wherever you can, even if that means a little extra childcare for your first so you can nap with baby. I just heard an excellent session by Helen Ball, a baby and breatsfeeding sleep expert and the most resilient mums who found baby’s sleep least problematic are the ones who recognise they will have disturbed sleep, and find the best ways to cope with it. So by asking these questions you’re already well on the right track. Good luck!
EH: I was the one asking the same questions a couple of months ago My #2 is now 3 weeks old, my first born is 3.5 years old, and I have a very busy working from home husband. I echo what others have said about a postnatal doula, we have a really amazing one - during a typical 4-hour visit she makes a meal for the family (plus breakfast/tea if she comes in the morning), does some light tidying up (makes beds, folds laundry), helps with my daughter’s bath and baby’s bath, holds the baby while I shower, etc. What I found especially useful is that she gave me lots of tips about my own recovery - for example how to tie the pelvic support belt, nutrition tips, etc. She also helped with breastfeeding positioning and latch, dealing with engorgement (some doulas are also trained as lactation consultants or they can at least signpost effectively). And one other thing is that she listened to me for an hour as I narrated/processed my labour & birth experience... It was very therapeutic for me. For the moment though I’ve paused her visits because to be honest the baby still sleeps a lot, and my other daughter is at nursery so I’m finding myself having quite a bit of time (so far!) and I actually don’t need that much extra help. But definitely worth having a doula to set you up in the first weeks, and care for you, while you recover and figure out what sort of baby you have (how he/she sleeps, are there any issues feeding, etc.) and what exact help you need longer term. It’s hard to determine that before you’re actually in the situation, I think. In my experience at least that turned out to be the case.
RF: How old is your elder child? I’ve found the biggest help is our au pair getting our 3-year-old to nursery in the morning so I can have a lie in with the baby and recover a bit from the night waking for feeds.
Original poster: My elder one will be 3.5 when the baby arrives.
RW: I wanted some support and didn’t sort it out in time, and I regret it now. So if you do choose a doula, get in there early! So many were so booked up.
Admin team member: We had a nanny for the oldest. She would do the pick-ups from nursery and also take her out so I had exclusive time with the baby. Co-sleeping made the nights much easier too. If you don’t want an someone in your space all the time this works really well. She can also help with tidying and cooking etc if needed taking strain of from you. When you go back to work, she could take baby for nap walks and bring her to feed if you are working from home.
KL: We live overseas with where live-in nannies are common. I recently had my third baby and went back to work early.
I found help during the day (for the elder siblings + around the house) more of a priority as I had to wake up to feed all night long regardless so any quiet time during the day was a luxury.
Co-sleeping worked really well for us, and then when my son (#2) started the ‘party all night’ phase my sleep-like-a-rock husband kindly slept with him so I could ‘relax’ with #1. Now with 3 kids, it’s husband with #1 and 2 and I’m with our 3 months old.
ES: With my second I had a full-time nanny for my first and it was a game changer. She would take care of my house, my 3-year-old and I could just spend time with the baby (we also organised food for the first month, so we didn’t have to worry about that either). On occasions she would also take both out for a walk so I could have time for myself or have a nap. Together with the fact that I was more confident it was a much easier experience. Totally amazing.
EP: Having had our second just before the first lockdown, I would echo what other people have said above. We have a nanny who is amazing and would look after the baby so I could have a bath or drink a cup of tea whilst it was hot, and she feeds and entertains my eldest, does a load of laundry etc. Having the nanny has also meant an easy transition back to work as I am working at home, so she just brings her to me when she needs a feed and I take myself off video on my teams calls! We also have a weekly cleaner which I personally find invaluable. Re the poor sleep and a husband with a demanding job - I have that challenge too so no magic answers unfortunately, I have a sofa bed in the baby’s room so we can co-sleep if it’s a really rough night, and a plentiful supply of coffee, biscuits and a daily walk also help. Plus, I order a takeaway when I’m too exhausted to cook dinner. Hope that helps and good luck.
JR: I had a night nanny for a couple of nights and would echo what others have said. She didn’t understand that I wanted her to wake me when the baby needed feeding so fed the baby expressed milk instead of waking me. Which meant I woke up super engorged and needed to pump to make sure I didn’t impact supply and because the baby was full and sleeping. Other than that, it did take a bit of the stress of being on tenterhooks waiting for the baby to wake, so I probably did get better sleep those nights, but I still wouldn’t repeat the experience if I had a second!!!
KS: I didn’t have any insights to share but have now asked our cleaning lady (who we love & trust) if she can come more regularly to do a combo of cleaning/baby cuddling so I can go for a walk/shower/sit on Facebook for an hour etc. We’ll also have our son continue with his nanny 4 days a week. And my husband says he’ll do all the cooking, but I’ve also got my favourite COOK meals ready to go!
Original poster: Such useful suggestions, thank you! Sounds like a full-time nanny for the eldest is the best idea. We currently have an afternoon nanny who is great at entertaining her but is not someone who can do the morning drop-off or is keen to do tidying/cooking etc. I might look into a full-time nanny closer to when baby will arrive who is happy to do the housekeeping while my elder one is at school.
What is normal sleep webinar by Prof Helen Ball: