Mummy can’t breathe

Mummy can’t breathe

Hi all – it’s been a long time – I wrote this over a year ago, and it has been sitting in my drafts gathering virtual dust. At the time it was incomprehensible that the coronavirus would continue to cause chaos in our lives. I’m sharing this because the story might resonate with someone, but also because I think it is time and a story that needs to be told.

On my first mothers day I woke up in the morning unable to breathe. After almost of week of feeling poorly with a cough and on/off high temperatures (? spiked by watching the news) I was sitting with my 9 month old baby singing nursery rhymes, and I couldn’t get past the “Old” of Old McDonald had a farm without gasping for air. You don’t need to be a medic to know that this state of breathlessness is not normal, so, reluctantly, I called 999. As I gave my name and address, I profusely apologised for “wasting their time” and, whilst struggling to speak still managed to say

“I’m (gasp) sure (gasp) its (gasp) nothing”.

A couple of hours later I was being blue lighted through the empty inner London streets in the back of an ambulance with a Respiratory Rate of 44, Temperature of 39.6 degrees Celsius, and an oxygen saturation around 85% – worse than a lifelong chain smoker (for the record, something I am not). When the ambulance crew arrived it was plain to see I was seriously ill – yet even with all my years of training and expertise I refused to go to hospital, because I refused to leave my baby. She needs me, I kept saying. We had not been even an hour apart since the moment she was born. Shes breastfeeding. “I can’t leave her” I gasped, over and over again. To this day I’m very thankful to the paramedic, whose name I cannot remember whom casually said “hey I tell you what – just come with us, let us check you out in A&E, make sure everything is OK and you will be back home in a few hours”. Obviously that was a lie, but one of those little white lies that saves lives that sometimes we have to do.

The next 4 days was a blur. I was placed in “isolation” – alone in a large magnolia coloured room with a small window that faced a red wall. Nurses came to check on me regularly, albeit from a distance covered head to toe in personal protective equipment. I was placed on oxygen therapy and given antibiotics. I was in such a septic rush that I didn’t pack anything in my hospital bag but some old pyjamas, a gym t-shirt (?), a small bottle of holy water from my mother that I’ve always carried with me whenever I travel, and a portable phone charger which was only 10% charged itself. I used my phone sporadically, only to face-time my daughter for a few seconds at a time before her naps. I didn’t pack a breast pump, the thought hadn’t even crossed my mind – until a few hours later when I was struggling with engorgement and doing my best to hand express into a kidney dish through the night to stop myself getting mastitis on top of everything else.

A few days later with improved oxygen saturations I was allowed to leave hospital as I was mostly better (on retrospect not fully recovered by any means – but I think they gave me the benefit of the doubt being a “sensible” doctor, whatever that means…)  I was told a few times that I should stop breastfeeding and be separated from my baby for a number of reasons – “coronavirus could be in the breast milk”, “you could harm your baby”, “you could infect her” , “the antibiotics might not safe” , and possibly the most patronising “well you have had a good run”, all of these claims totally false and founded in fear rather than facts, and although I knew it was false with my clinical expertise I was too weak to argue with them at the time so chose to save my (much needed) breath.

As soon as I came home, I gave my daughter a huge hug and she went straight back on the breast like nothing had ever happened. Since then so much evidence has come out about the benefits of breastfeeding and its immuno-protective qualities – something that needs to be shared more and one of the reasons I have chosen to share my own dual patient and professional experience. I have also written to our government and with organisations behind the scenes to support the often neglected needs of breastfeeding women admitted to hospital and separated from their children, both on a practical and emotional level.

It took some time to recover, but I am thankful to say that from a physical perspective I am back to normal and honestly it is a wonderful feeling to not only be alive, but to be able to breathe, talk and sing with ease again. Being unable to breathe is so anxiety-provoking, not surprising as the breathing control centre, stress and anxiety are intricately linked by the vagus nerve. Deprivation of the breath of life also conjures images of death – since writing this original article, the world witnessed the tragic murder of George Floyd in 2020, repeatedly stating “I can’t breathe” to his oppressors, igniting the black lives matter movement for the next generation.

Psychologically speaking, I also feel very well and grounded – but even the process of writing this has raised a lot of questions for me; how mothers/daughters/women in caring roles default to “putting others needs before their own”, and how the line between doctors and patients is truly blurred in times of sickness and health. These questions are something I explore a lot with my patients, so pertinent in the perinatal period, but maybe we can talk about that another time.

I’m thankful to my husband whom looked after our infant alone in lockdown without any support from family or friends during that first (of many) lockdowns. 

I’m thankful to the lady on the end of that breathless 999 call who told me to take care of myself.

I’m thankful to that paramedic that told me a white lie.

I’m even thankful to the junior doctors whom did countless arterial blood gases on me (with and without local anaesthetic).

I had to make a split second decision about coming into hospital, and I’m thankful I made the right one.

.. and even though its taken me over a year to gain the courage to do so – I’m thankful I am able to share my story.

An ode to breastfeeding

An ode to breastfeeding

Hi everyone

Well, hello from the “otherside” – apologies for the radio (blog?) silence but for good reason – I am officially a mother now to our beautiful baby girl born six weeks ago – she is absolutely precious and what a month it has been. I have so much to say and so much to tell you – but have to grab the few peaceful minutes here and there whilst my newborn naps (as I am sure many of you will understand).

Whilst on maternity leave one of my resolutions is to write more on the blog, I want to continue to embrace the dialogue surrounding maternal health, with the added bonus of sharing my own “lived experience” which will no doubt accent my academic understandings.

The go to first topic to discuss would be around my pregnancy and labour experience – but I will intentionally leave this for another time, as I feel a pressing need to give attention to something very rarely talked about in clinical settings – and that is the topic of breastfeeding. It is something I know quite a lot about from a medical perspective, and was kindly invited to speak at the Great Britain Lactation Consultants conference last year on the use of medication whilst breastfeeding, however only recently have had first hand (breast?) experience of.

There is often so much emphasis placed by staff and patients alike on the birth experience (and yes, I have seen laminated birth plan 5000 word essays) but by doing so its almost like focussing all your energy on planning the wedding without giving a second thought to the aftermath of having a happy and healthy marriage.

The topic of feeding your child is complex – specifically the intention to breastfeed and the emotions evoked when this is not as easy as one hopes/assumed it would be. Nursing your child carries a heavy psychological weight. It is associated with being a bountiful women able to nourish and provide for her baby from her breast, with any deviance from thus idealism deemed as defeat with feelings of failure, guilt and shame… emotions I have often seen women in clinic struggle with, and many have told me the stress  of which triggered their postnatal depression. There is also an additional dichotomy women face of being divided in their position between the maternal and the sexual – with the depiction of breasts throughout modern history as erotic rather than a practicality perpetuates this (often collective societal subconscious) conflict. I remain in awe how a woman can be half naked exposed on a massive billboard on a train platform, marketing, well, anything (don’t you know sex sells, darling) yet a woman trying to breastfeed her child on same platform with a fraction less exposed skin will face all sorts of spoken and unspoken commentary. This manifests itself in those same feelings of guilt and shame, except this time when needing to nurse.with a third of women feeling embarassed to breastfeed in public .

 

Although it is well known that breast feeding has a range of benefits for the child, The UK interestingly has one the lowest rates in the World, with only estimated 1% of mothers exclusively breastfeeding at 6 months postnatal. I would recommend everyone to check out the great baby friendly initiative from UNICEF if this is something of interest to you – as they are championing change in attitudes towards breastfeeding on a societal and political level. The Lancet also published a fantastic comprehensive series on breastfeeding with an interesting economic analysis, with a noted difference through rich and poor, in sickness and in health – with rising popularity (and prices) of substitute milk formula, preferred by many lower socio-economic communities as breastfeeding is becoming to be seen as “primitive”. Since becoming a mother of course I have naturally become interested in the activity that takes up most of my day, but there is so many opinions and conflicting information on the subject – and then theres the pumping and expressing..

 

                    ... dont even get me started on expressing and the world of breast pumps!

 

All of that is fascinating in theory – but what about in practice? I put myself to the test and just had my first experience of trying to breastfeed alone in public – in a busy Starbucks no doubt (insert despair emoji here).

It was all going so well, until the little one started screaming and there was no where to hide. I suddenly felt all eyes on me, and a sense of “why can’t you control your baby  – you are ruining our afternoon coffee”. I then realised this was my moment to fly the #normlisebreastfeeding flag – so i sat down, got my big muslin shawl and tried to console my newborn, but i couldn’t get comfortable as she continued to scream and i got so frazzled trying to not expose myself i ended up getting tangled with my head under my scarf ! when i managed to detach myself I realised my “quiet corner” was in fact in front of a full glass wall, with plenty of onlookers witness to my meltdown. Just before I tipped into full panic mode I decided to try make a gracious exit – but the pram got stuck in the doors as the entrance wasn’t wide enough – i pressed the disability button (for wheelchair access assistance) but the baristas paid no attention to me or my screaming newborn. Eventually a man helped by unlocking the double door and I RAN as fast as my buggy would allow.

Although on the surface it wasn’t the best experience and the young women next to me gave me and my screaming daughter a disapproving stare – I am glowing with pride for leaving the house alone with my newborn for the first time (after an emergency caesarian section) and for managing to overcome my fear to feed her in public.  I still have a lot to learn, but I feel proud I did my tiny part in challenging societal assumptions and normalising the highs and lows of breastfeeding! I am a huge advocate of the movement “fed is best” , rather than the “breast is best” mantra many women have grown up with. Breastfeeding of course has a wealth of benefits, but none of these matter if you are either unable to physically breastfeed or the perfectionist pursuit is causing nothing but stress and anxiety (both of which will rapidly cease your milk supply anyway!)

However a women chooses to feed her child through breastmilk, formula or a combination of both – it is our duty (as health professionals and members of society) to empower them and eachother to create a space (physically and emotionally) that is safe for families to nuture their children. I have learned so much in these short 6 weeks, and will continue to advocate this issue with a passion as I believe it is a womens basic human right. I think we also need to do a better job of preparing women in pregnancy for the reality of life in the immediate newborn period, because it is not all cute baby clothes and cuddles (although there is a lot of that!).

What are your thoughts on breastfeeding ? have you had any experiences of nursing in public? do let me know in the comments below or on twitter

Much love

Cx