Fourth Trimester Series | Anna Barlow


The fourth trimester. Where do I even start?

I have always dreamed of being a mother, but had a feeling that falling pregnant wouldn’t be easy for me. Through my young adulthood I have suffered from recurring ovarian cysts that required multiple surgeries, and although I was reassured by my gynaecologist that I wouldn’t have any fertility issues, I still thought that I would. So, I convinced my husband that we should start trying for a family, based on the above, and of course fell pregnant straight away! Never for a second have we taken this for granted. I had friends going through fertility treatment at the time, and through my experience as a nurse have dealt with women having miscarriages and struggling to conceive a lot. We were extremely grateful.

As pregnancies go, I had a relatively easy one! I was comfortable throughout, kept myself well and active, and worked up until I was 37 weeks pregnant. I guess it’s the nurse in me who was expecting the worst the whole way through, I guess it’s the nurse in me who was expecting the worst the whole way through, always waiting for something to go wrong, definitely expecting to have an awful birth! I guess it’s best to hope for the best but expect the worst, right? I was also well aware of the issues new mums face after the birth too, and I guess to some degree was expecting there to be challenges with this also.

After a relatively quick birth at 39 weeks our fourth trimester began. Hugo was placed on my chest immediately after birth and I was hoping for the ‘magical chest crawl’ where he would somehow find my breast and begin feeding – this of course, didn’t happen! After about twenty minutes of trying, Hugo finally latched for his first feed. I didn’t know it at the time, but this was the start of an extremely difficult feeding journey for us. Following our initial latch and feed, Hugo didn’t feed again for another 6 hours. He then was so sleepy from the birth, that he didn’t latch at all. I had midwives hand expressing colostrum from me into a syringe to give him to keep him going. We set alarms through the night and woke Hugo to feed him. Things seemed to be improving as the night went on, and we were so happy with how he was latching and feeding. It wasn’t until we were leaving the birthing unit when it was suggested to us that Hugo may have a tongue or lip tie due to the damage he was doing to me with each latch. Sure enough, at 5 days old a grade 3 tongue and grade 4 lip tie were diagnosed and treated. I thought that this was going to improve things with our feeding journey, but alas, it did not. If anything, it made things worse. Hugo’s latch did not improve and his weight did not increase as the weeks went on.

We then began our pumping journey. I was feeding, then pumping and giving Hugo expressed milk top ups with each feed to help his weight gain. Slowly, his weight started going up and I thought things were improving. Then my first bout of mastitis hit when Hugo was four weeks old. I was bed bound, in agony, suffering from sweats and fevers and struggling to give Hugo what he needed. The antibiotics seemed to upset him, he wasn’t getting enough food off me and cluster fed for 24 hours straight. At the same time, I was suffering from such horrendous cracked nipples that my midwife was questioning if they were infected as well. The pain was unreal. After all of this, Hugo still wasn’t gaining enough weight. I felt so defeated. Here I was, feeding constantly, pumping when I could – even at 3am, and it still wasn’t enough to sustain my baby. This was when my midwife suggested giving Hugo formula top ups. I don’t know what it is about the word formula, but it instantly makes you feel as though you’re failing. Society has ingrained it in us. ‘Breast is best’. ‘Exclusively breast fed’ (to make us feel as though we are inadequate if our baby isn’t exclusively breast fed). I had literally busted my arse trying everything possible to feed my child, and it just wasn’t happening. 

I fought to see a lactation consultant, and for the first time it was suggested that I have low supply. It’s not something that was ever mentioned to me, and I don’t know why it hadn’t occurred to me? I then began taking every supplement, lactation tea, cookie product known to man. I was pumping around the clock, feeding on demand, and still, it wasn’t enough to increase my supply. Again, I felt defeated. It was then suggested to me by a friend of mine that I should try domperidone. I started on Domperidone and slowly began to wean the top ups that I was giving Hugo as he was gaining weight so well… until he wasn’t. Once again, I was struck down with mastitis and this time it led to a large abscess that needed draining. Hugo began refusing that breast, couldn’t latch properly and we were back to square one. We recommenced the formula top ups after another week of low weight gain, and once again, I felt defeated.

Still now, at 15 weeks old Hugo is mixed fed. I breastfeed him and follow this with a bottle of formula. We tried the supplementary nursing system, but it just made him, and me, frustrated so we ditched it. Bottle feeding is incredible and I realise now that it is a blessing in disguise. It means I get a break and that my husband or the grandparents can feed him and have some incredible bonding time with him as well. It’s taken me this long to accept that actually, formula is ok. Mixed feeding is ok. My baby is happy, healthy and thriving. I can still breastfeed him, have that incredible connection and bond – and I also know that he is getting enough calories to grow and be content. Our fourth trimester has been utterly consumed by feeding issues, pumping, bottles, formula, nipple shields, supplementary nursing systems and more. It’s been hard sometimes to enjoy the journey, but on reflection, it has made me incredibly resilient and I have realised how resilient Hugo is too. I’m not ready to give up breastfeeding, and hope to be able to continue in some capacity for some time yet.

I'm a registered nurse, marriage celebrant and recently qualified reformer Pilates instructor. I live in Thames on the Coromandel Peninsula with my two cats, Bert & Ernie and my husband Richard, who is an incredibly hands on husband and father to our son, Hugo. He cooks, cleans and looks after us both so well!