Gabrielle's story - tandem feeding and the protection of breastfeeding

This week I’m speaking to the lovely Gabby from Edinburgh about her experiences with tandem breastfeeding her two children, who are three and a half years and 10 months old. Gabby discusses the practicalities and challenges of her tandem feeding journey, including co-sleeping, night weaning, and dealing with her eldest child's sleep apnea. She shares her struggles with breastfeeding her younger child, who initially refused to latch due to her infection, and the steps she took, including seeking professional help, to successfully re-establish breastfeeding. Gabby also talks about her health conditions, including Ehlers-Danlos Hypermobility Syndrome and Ankylosing Spondylitis, and how breastfeeding has proven to be protective for her own health.

My picture book on how breastfeeding journeys end, The Story of Jessie’s Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children’s Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.

You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com

Resources mentioned - 

We talked about Carla Rodrigues https://www.latchworld.co.uk/

Stretched to the Limits by Rachel Fitz-Desorgher https://www.hachette.co.uk/titles/rachel-fitz-desorgher-2/stretched-to-the-limits/9781839972492/

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

This transcript is AI generated.

[00:00:00] Emma Pickett: I am Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself makes milk. That was my superpower at the time because I was breastfeeding my own two children, and now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end, and I'm big on making sure parents get support at the end too.

Join me for conversations on how breastfeeding is amazing and also sometimes really, really hard. We'll look honestly and openly at that process of making milk, and of course, breastfeeding and chest feeding are a lot more than just making milk. Thank you very much for joining me for today's episode. I am going to be talking to Gabrielle.

Gabby, do you prefer being Gabrielle or do you prefer being Gabby? I think I'm usually Gabby. Yeah. Okay. Gabby, spoiler alert, she's here already. Gabby, who's talking to me from Edinburgh, and we're gonna be talking about her tandem feeding journey and all the different challenges that she went through and the way that breastfeeding has protected her health and the health of her children as well.

So tell me about your little people, Gabby. So I have two children. 

[00:01:19] Gabby: Um, the eldest is, uh, three and a half, and the youngest is, uh, 10 months and a bit, uh, so about two and a half years apart. And yeah, they're both still feeding. Uh, that's, that's kind of what we are here to talk about. Um, and they're very different in temperament as well.

Um, so my eldest is kind of more intense, very kind of vivacious. Um, and my youngest is kind of more calm, uh, but both very. Gross motor skill orientated, which makes for fun, fun feeding challenges. And, 

[00:01:58] Emma Pickett: uh, 

[00:01:59] Gabby: yeah, that's, that's 

[00:02:00] Emma Pickett: us. Okay, so let's start by talking about the tandem feeding. 'cause that's something I love talking about and I think anyone who's thinking about tandem feeding really loves to hear practical day-to-day stories.

So, so tell me about a typical day right now. How often is your three and a half year old feeding? What does a typical 24 hours look like? So are you all co-sleeping or are you sleeping in separate places? We, we are all co-sleeping, uh, 

[00:02:23] Gabby: not entirely through choice. My oldest has kind of gone through aggression, ended back in our bed recently.

Yes. So my eldest was fed completely on demand until I was pregnant, and then I started really putting some boundaries in. And so I night weaned him when I was pregnant. And, uh, then when my milk changed in pregnancy, there was a point where I thought he was gonna self wean. Clearly the taste changed. And for a couple of days he didn't have any.

And then he asked to go back to it. And then when the baby arrived, he wanted it all the time. Okay. And that was a mix I think, of the milk coming back and of him seeing the baby nurse all the time. 

[00:03:03] Emma Pickett: Yeah. And maybe a little bit wobbly after arrival of baby and wanting to connect to you as well. So, so you thought he'd self we that's, that's an interesting story 'cause I think it's not unusual.

A lot of people see their children going right down to the absolute minimum of feeding every, only for 

[00:03:15] Gabby: like a couple of days really. So it wasn't, I was under no illusions when the baby came, that he wasn't self. We, there's a couple of days where the taste changed and he'd turned it down and then he decided he'd have it anyway.

It was better than nothing. Yeah, exactly. 

[00:03:29] Emma Pickett: What was, what was your night winning experience like? Tell, tell us how you went about doing that. Where, at what stage in your pregnancy did you do that? 

[00:03:36] Gabby: I did it um, I think quite early on. 'cause I'd also been quite unwell in the start of my pregnancy. And I just needed something, and this is also to put it into context.

My eldest was still, he wasn't just feeding the night, he was feeding like every hour. Okay. So my eldest didn't sleep. He was up every hour, every night for two and a half years. And at that point I just needed my partner to be able to settle him. I needed to not feed if I was gonna be the one to do it. I just needed a bit more rest.

So it was kind of combining with the start of pregnancy. We, we, we knew we needed to do that. Um, and actually I think for me, generally, I had been very led by him about nighttime and sleep. 'cause we knew he had sleep apnea by that point. And so I hadn't gone for any kind of parent led interventions or whatever because I really felt that he's essentially waking up in a panic 'cause he can't breathe.

[00:04:28] Emma Pickett: Yeah. That's not something 

[00:04:29] Gabby: he can deal with on his own or, or whatever. But I think I got to that point where it was like, I'm pregnant. My body's gonna go through this huge change. I also need to kind of protect myself to some extent. And that meant not, not feeding in the night. So he's what, two and two and 

[00:04:41] Emma Pickett: a half at this point?

[00:04:41] Gabby: Two and a quarter, two and half or something like. And I would just explain it to him and I did it. Uh, I didn't send my husband in, I did it myself. I went in, at that point he was on a floor bed in his own room. We would occasionally, one of us would end up sleeping on a futon in the floor next to him. And yeah, it was just kind of explaining through the night.

Every time he woke explaining he couldn't have milk, milk had gone to sleep, milk wouldn't be there until the morning. I can't quite remember the details. I do remember there were a couple of rough nights where he was pretty upset every week and then he kind of got on with it. Okay. 

[00:05:12] Emma Pickett: Couple of nights isn't as terrible as some stories I hear.

So the thing with my 

[00:05:16] Gabby: intense toddler, it's actually quite surprising. He sort of has a very strong initial reaction, but he doesn't have as much perseverance to it as you might expect in an odd way. Like he sort of adapts quite quickly, I think is what it is. So he, um, yeah, and that actually was really positive in and of itself 'cause it showed me that when I do need to lay down boundaries, he will adapt to it quite quickly.

So it also, the moment where I night weed also cemented my desire to try tandem feeding. Because it made me realize that if I found it too hard, once the baby was there, I would be able to make further changes. I had that con kind of confidence of knowing that I would be able to wean the toddler if I needed to or if I wanted to.

[00:05:53] Emma Pickett: Yeah. Yeah. That's, that's really positive to hear. So it was ultimately your decision and he would be okay if you had to change your mind after baby was here. It would not be the end of the world. So worth trying. Um, exactly. And I, and I think probably his response is so positive because of your communication skills.

Let's, let's say that, I mean, the fact that you were really sitting down with him and helping, 'cause I listen to your podcast a million times. Well, that's before checks in the post Gabby. Yeah. But, but your, your communication skills has nothing to do with me. You, you'd spoke to him, you made it really clear.

He understood. You checked, he understood. That has to help, that has to help with him realizing, okay, he's going to protest. He might have a couple of difficult nights, but ultimately he gets it. You've explained it to him. He understands where it's coming from and that it's not changing. Was he still waking after youe when, sorry, you're gonna say something?

No, well, he's, 

[00:06:40] Gabby: he's wasted for juice a little bit, it seemed as a result of night weaning. Um, I know that's not always the case, and I had spoken to a holistic sleep consultant and she had said, you know, it can, it cannot. So I didn't have any expectations around that. I just knew that I needed to not have to feed and for it not to be me if, if need be as well.

Um, and I think from that point in my pregnancy, after he'd understood the weaning park, my husband started taking more of the lead in, in, um, supporting our toddler at night. 

[00:07:09] Emma Pickett: Okay. So even if sleep didn't miraculously improve, you didn't have to necessarily be the sole parent at nighttime. So that made a difference too.

[00:07:16] Gabby: So, yeah, for my rest, 

[00:07:17] Emma Pickett: one thing that 

[00:07:18] Gabby: I only put together more recently is, um, so we were in a situation with his sleep apnea. So, so I don't know how much you know about it, but essentially the way it goes in the UK at the moment is, uh, you see a consultant, they ask for a sleep study because for sleep apnea, what you tend to do with kids is take adenoids and or tonsils out.

[00:07:35] Emma Pickett: Okay. 

[00:07:35] Gabby: And because that's surgery, you don't wanna do it unless you have a good scientific rationale. And the kind of golden standard is to do a, an overnight sleep study, either at home or in the hospital. And if that shows that a kid does have sleep apnea, then you definitely operate. Otherwise, you're more in a let's wait and see if they grow outta it.

If their airways, um, get bigger naturally as they grow, if they kind of sort it out on their own without surgery. 

[00:07:59] Emma Pickett: So sleep apnea, just to make it blooming obvious sleep apnea is you stop breathing at nighttime for short periods of time. Yeah. Is that what happens? And then yeah, you suddenly stop breathing again.

You might 

[00:08:10] Gabby: notice as a parent are pauses in breathing, snoring, lots of mouth breathing, very frequent wakes others that aren't kind of officially on the Simpsons list. But anecdotally I've had from others when my experience like a really sweaty head, like when your baby wakes up with their head drenched in sweat sort of thing, lots of drooling, uh, a bit later swallowing, a bit of difficulty transitioning to solid foods.

More kind of sensitive to certain textures when they're talking. That sense of like nearly like a plumb in the mouth kind of sound to their vows. And with my eldest, one thing that we didn't notice until later is he had a constant runny nose, like from six months onwards, constant cough that never went away.

And after his surgery when he had his adenoids and tonsils taken out, he finally had this bit gross to talk about. But he finally had a boogie because he finally had enough circulation going, egg circulating it dried out to dry out 

[00:09:04] Emma Pickett: bogies. Yay. 

[00:09:06] Gabby: It would never really put that together. But another symptom, which is quite common, is delays to growth because they use up a lot of calories at night breathing.

And we'd never had, in those early months of health visitor check-ins, he'd always been growing brilliantly. I, I mean, I happened to have a large supply, I happened to have an oversupply. I think that's linked to, to another condition I have called either Danlos. He was, he was always tracking his weight.

His growth had been fine. Yeah. But then by the time I went to see the doctors, the health visitor visits had stopped and I was saying his growth is fine, he's tracking fine. And then two and a half years later on his surgery date, he like dropped down like four lines. And we hadn't even noticed because he wasn't having regular visits at that point.

He wasn't being weighed regularly. And actually I think that tipping point where he started to fall down is when I night weed because, and this is why I talk about it protecting him as a, as a small baby, comparing how he feeds at night to my current baby. My eldest would have large feeds every hour, big let down.

And actually now I can piece it back together and see that he was trying to make up those calories at night that he needed to breathe. 

[00:10:22] Emma Pickett: Yeah. And 

[00:10:23] Gabby: that's why as a new, or my analysis is, that's why as a newborn and a baby, he wasn't falling down those centiles. He was keeping steady because he had. All of that extra milk keeping, keeping him up there, making up that, that calorie deficit.

Yeah. 

[00:10:37] Emma Pickett: So, so he did have the surgery and, and how's that, how did that go? How's did, how did it affect his feeding? How did, tell us about the experience of having that surgery. 

[00:10:46] Gabby: Well, he'd already been n at that point, so it didn't really affect his feeding. But over time before the surgery, he used to sound like Darth Vader at night.

Like actually take the sound of Darth Vader, that was what my toddler sounded like, asleep. So after that, a, we saw a lot of improvement with his sleep, with his overall wellbeing. He put on a lot of weight very quickly. Um, but it didn't really affect his breastfeeding. I think at that point he'd kind of made up some of the other differences.

It did affect his kind of attention skills, his kind of, his ability to, his development seemed to like kind of take off, uh, quite a bit after that. 

[00:11:24] Emma Pickett: When you had the surgery, you'd had al already had your youngest by then, so you were. 

[00:11:29] Gabby: No, we specifically pleaded, we'd gotten to the point where we said we have to get this done before the baby arrives.

And we'd actually started putting together a plan to go do it privately in England, because none of the Scottish hospitals, private hospitals operate on kids under the age of three. But in the end, I had managed to plead with the ACTU and we got given a cancellation slot in the summer before. So I was kind of seven or eight months pregnant when he had his surgery.

[00:11:53] Emma Pickett: Okay. Gosh, that's a, an intense final month of pregnancy, helping him through the surgery and everything. 

[00:11:59] Gabby: And actually, this is a funny one for you, Emma, but I am convinced that one of the reasons that he recovered so well from his surgery, um, 'cause he didn't even need all of the morphine that the hospital gave us, is that he was having colostrum at that point.

Yeah, that makes sense. Which is the best antibacterial like. Directly on the area that he'd had surgery on. So yeah, 

[00:12:23] Emma Pickett: bathing all those lovely membranes with exactly what you need to protect against infection disease. Brilliant. Yeah. Okay, fantastic. So we, we sort of skipped the bit at the very beginning of his breastfeeding experience.

So it sounds like you had overproduction pretty early on and you always had quite a lot of milk. Did you have any other early breastfeeding difficulties with him or was it pretty 

[00:12:41] Gabby: good? Oh, I had huge aversion at the start and I really remember saying to my husband, you need to make me feel like I can give up at any point in time 'cause it's really hard.

Like you, I can't be feeling pressure from you to carry, you know? Um, and we introduced a bottle really early, um, and that was fine. And yeah, I had a over he, he was incredibly refluxy and I think it was just one of those things where. I kept saying, oh, well, you know, he's already three months already, four months already, six months.

He's probably not gonna feed for that much longer. It's probably not worth getting a lactation consultant in anymore. And obviously if I'd known 

[00:13:17] Emma Pickett: he was still feeding now, I would've done it. You know, it's amazing to think you had a version in the first few weeks and months of feeding a newborn and now here you are feeding him at three and a half tandem feeding.

So I'm, I take it your version went away, otherwise you, you were, I think I 

[00:13:32] Gabby: just kind of got more comfortable. I think I'd built in a lot of, I'd added in a lot of psychological stuff about me. There was some stuff around, he was induced for being too large. And I had this thing about kind of, there's some things to do with my own mental health journey and the role of food and, and the role that parents play around food, which are quite complicated.

And I think this role of the, of the mother who loves through food production was bringing up a lot of difficult things for me. And it took me a while to kind of get used to the idea. And he always had a really strong latch and it, and it was quite painful and my letdown was painful and it just took a lot of getting used to, I think.

[00:14:13] Emma Pickett: Okay. 

[00:14:14] Gabby: And yeah, he was very, very refluxy. And I think, again, that's one of those things with your first child, you kind of get gaslit a bit by the medical professionals. Not on purpose, but they go, oh, you know, it's probably a small amount of vomit. And you go, well, I guess you, you know best. It probably is a small amount of vomit.

Now that I've been around so many more breastfeeding babies and, and, and, and my second, I'm like, no, no, that was whole feeds. Like every third feed he threw up, I was probably making three times more milk than he was actually needing or digesting. Yeah. 

[00:14:46] Emma Pickett: So that was connected to your overproduction possibly?

Is that what you're suggesting? Yeah. Which, and which some people think, oh, well it's, that's the nice kind of reflux, isn't it? That's not the disease, that's not the scary reflux. But actually when it is vast amounts of liquid coming up, you know, ev multiple times a day, that is incredibly stressful. And it's, it's demoralizing.

It's 

[00:15:04] Gabby: also, it's a lot of washing. Like, yeah, I had to get changed multiple times a day. I would be drenched multiple times a day and the smell, and I've kind of forgotten it all now. 'cause it's you. That's what you do, isn't it? You forget the difficult bits 

[00:15:17] Emma Pickett: and you get cold and they, and they get, and they're cold and rashes.

Especially if you're in Scotland, it's not like you're living in The Bahamas. I mean the, you know, wet fabric against skin is horrible. Quickly. Um, yeah. Yeah. Tough going. Tough going. So, so when little person, when little person who's now 10 months was born, tell us about those first few days of newborn and older baby feeding, older child feeding.

'cause people are often really keen to hear what those early days were like. Did you need to put some boundaries in place? Were you able to kind of meet his needs in a way that felt comfortable for him? How did you find it went once, once new baby was born? So the first five 

[00:15:51] Gabby: days were pretty much textbook as, um, as everything I would've wanted was just incredible.

It was this real high. We had a fantastic birth baby came out, I was confident he was calm. We had a slightly delayed first feed 'cause I had quite a lot of bleeding and I was a bit out of it. Um, but just felt like such, um, easy feeds went well. We came home quickly. Siblings met, that all went well. He wanted to touch him, to cuddle him.

He wanted to strip his hair while he was feeding. And they fed together and my toddler held his hand while they were feeding to, you know, all of that. Kind of like as, and I could tell that this sense of feeding together, we are the same. We share our mother, you know, it was all helping with all of that and that was going so beautifully.

[00:16:42] Emma Pickett: I have a horrible feeling there's a but coming here 'cause something's going to happen after day five. 

[00:16:48] Gabby: Yeah. And to be honest, I don't really know when it started. I've got a few theories, um, on day. The first thing is my milk came in on time, which the health visitor and the midwives were kind of astounded by, 'cause I had lost quite a lot of blood and so they were expecting it to be late.

But I guess the toddler was kind of pulling quite a lot 'cause he was delighted the milk was back and so it, it, it came in just fine. And, and I think also I'd listened to one of your episodes about reflux, I think that you did with Alice about reflux and tandem feeding and all that. And it had been kind of at the back of my mind.

Well, I know I might get oversupply. If my toddler can help take the edge off that for the baby. Great. And the baby always had a kind of much weaker latch than I remember the first one having. And just the way that he would suck felt much weak, much gentler, but he's gentler soul anyway. So it was kind of hard to tell whether that was inefficient feeding or a different style or a different kind of muscle tension arrangement, whatever.

Whatever we want to call it. I guess in those first few days, maybe when they fed together, the toddler would get the let down and that would help out the baby. And then there was one day where the baby just screamed all day long and nothing, we did seem to help and every feed was a struggle. And he'd refuse it and refuse it until he was starving.

And then we'd managed to get a feed in and then we went overnight one night where he, I tried to wake him to feed him after six hours, you know, he was gaining weight fine. So I kind of wasn't that worried about him going longer periods at night. I tried to wake him up to six hours. He completely refused it in the morning.

Again, wasn't having yet, at which point we phoned the midwifery team and they said, you know, we really think you should give him a bottle now. He hasn't had anything for 12 hours. And I've kind of gone back and forth since about was that the right decision? Did we, you know, should we have fought better? I do think the midwifery team had kind of put us at the bottom of the priority list.

It was, it was a busy autumn for them, and clearly baby was gaining weight fine. If he couldn't be breastfed. They weren't that invested in it, I would say. He 

[00:18:57] Emma Pickett: wasn't attaching at all. Was he coming on and then coming off straight away? 

[00:19:00] Gabby: Exactly. Yeah. Yeah. Screaming off and, and it, and it, it turned out I was starting at that point to develop a a, an infection, awo infection.

And I didn't know at the time, but a couple of days later, my toddler said The milk's too hot. And so one of my, one of my theories as to why Baby started refusing the milk is 'cause my body temperature was getting higher. And so it was, yeah, I mean, I got fevers that week of over 40 degrees. So if the milk was over 40 degrees, that would've been very hot for a five, six day old baby.

But we don't really know what happened to this day. And after that first bottle could not get him to feed for maybe a month, it took a month. He was exclusively on express milk. 

[00:19:45] Emma Pickett: Gosh, Gabby, that's an intense month, especially when you're discovering you have an infection yourself, so you had to have treatment for your infection.

[00:19:51] Gabby: I went back into hospital. I, mine was quite serious actually. And that, and I think there was a bit of a system failure because I got, I was having these terrible fevers, you know, like 40 degrees, felt so unwell and got, uh, kind of merely discharged by midwifery despite knowing about these symptoms. Um, until I end up texting my friend who's a, an obstetrician who said, go back to labor ward right now.

And in a way, the fact that he was just on bottles was kind of good at that point because I was able to be on hospital on my own for 24 hours when I was on the kind of, I had, um, antibiotics on IV and I just wasn't well enough to look after him. So, but I was okay to pump. So those 24 hours while I was in hospital on my own helped me kind of build up.

But they did create afterwards a bit of a kind of separation anxiety that I had of being apart from him. Not at the time, but, but afterwards. How did your eldest cope? He was absolutely brilliant. I, it was really hard for him, I'm sure. And he was allowed to come visit me in hospital. Actually, one of the things is I was, looked like I was developing mastitis in hospital as well.

So I, they were keen to get him in to help with that 'cause he was latching on and the other one wasn't. And, but I was also keen that they let me go home so that I could. Have the eldest one feed and not not have issues compounding sort of thing. But I was also at a real low, kind of emotionally at that point where I was in hospital.

I was really struggling with the idea of the baby, not latching, not feeding. This idea that, I know you've had other people who tend and feed discuss this, but this sense of like if you're first feeding journey goes well, you sort of don't expect that you're gonna have any problems. You sort of think, oh, well I know what to do.

So, and I was having breakdowns. 'cause in hospital I was having to cancel the appointments that I'd made with lactation consultants thinking, oh, this is my window. If I don't get it, get him feeding now. You know, I'm having to move all of these appointments to later. Is that going to affect his ability to, but actually looking back, one of the fantastic things I had is because my toddler had fed loads and loads and loads and loads, I had a great supply already.

It was really easy to pump more than enough, more than what I needed for the baby. And there were, there were kind of no concerns from that, that side of things. Yeah. Um, but I just remember the sense of, oh, my eldest got this thing that's supposed to be the best and my youngest might not get that. And also really selfish things like, how am I gonna deal with an 18 month old toddler who's waking through the night if I can't just feed them back to sleep?

You know, and how am I gonna parent without, you know, someone who's fed a child that late? It's kind of becomes your parenting like superpower. Yeah. And you think, how am I gonna parent 

[00:22:34] Emma Pickett: without it, you know? Yeah. And, and also on some sort of primeval level, that feeling of a rejection even, you know, why is he not feeding what's, what's going on?

Yeah. Um, even if your logical brain knows, you know, obviously he's not able to consciously reject me. It can, it can feel very rejecting and you're missing out on, you know, those oxytocin surges. But luckily because you're feeding your eldest, that's probably protective against the worst of those depressive symptoms.

And I was emotionally low and I was 

[00:23:00] Gabby: a bit scared of the baby as well. This sense of like. Which is why, in a way, when I went to the hospital on my own, it felt like a bit of a relief, which is strange to to say now, but that is how I felt in, in that sense of like being scared or having aversion towards the baby because he couldn't breastfeed.

And I even having in some of my moments thinking, well why am I taking all this leave? Why can't dad to take the time off and I'll just go back to work? You know, this baby doesn't need me specifically, which is obviously not true. But in the moment, like you say, 

[00:23:31] Emma Pickett: yeah, your brain's protecting itself 

[00:23:33] Gabby: and also these absurd moments.

'cause after I came home from hospital, uh, my toddler developed RSV the following week. And so he was not eating any solids and feeding like all the time, which at the time I thought, great, this is dealing with my supply, whatever. I don't mind, there's plenty of milk to go around, but I was just in the situation of having, being my third trimester, feeding a toddler while giving bottles to the baby and it just felt.

Kind of absurdly wrong. I 

[00:24:03] Emma Pickett: How did you fit in your pumping? What was your kind of pumping routine? If I pumped 

[00:24:05] Gabby: too often, I just had much more milk than I ended up throwing loads away. 'cause it sat in the freezer for six months. And, um, I, 'cause you know, I was reading, oh I need to pump regularly and stuff, but if I pumped regularly, I just had way too much.

So I ended up just pumping twice a day was enough. 'cause I'd get two, three bottles each time. So I would, I would make sure I did one at night still, especially 'cause my toddler wasn't feeding in the night. But other than that, quite quickly I realized that I could really keep it to a minimum. 

[00:24:31] Emma Pickett: Okay. For anyone listening, pumping three times a normal No, no.

Yeah, please don't do that. Normal Gabby makes a lot of milk. Um, but obviously this is also about the fact you were tender fitting as well, which was helping to maintain your production. Your and your prolactin was still getting all those lovely surges. 

[00:24:45] Gabby: In the end. We did get the baby back on the boob and um, we did that.

Tell us that that happened. So that was 

[00:24:52] Emma Pickett: a month. How did that happen? Well, 

[00:24:54] Gabby: there's a whole point where, to be perfectly honest, I was too scared to try. There was also a lot going on. Like I was in hospital, the toddler got SV the toddler then got admitted with pneumonia. Like there was quite a lot going on.

Okay. Which meant that we didn't exactly have the head space. And then I was sort of stressing out that like, oh, I've missed the window and, and maybe he'll never go back. And, and I sort of had to kind of built it up in my head. But while I was kind of angsting over all of that and refusing to try, I did have a consultation with an excellent lactation consultant.

I did take him to, um, uh, an osteopath, uh, for kind of tension. And again, these are all the tools that I would never have known to do if he hadn't to been my second. If I hadn't spent two and a half years following lactation consultants and breastfeeding experts on social media and supporting friends, I had a friend who was a, a peer volunteer who came around my house to talk to me.

And, you know, all of these tools that you don't have when you're a first time 

[00:25:52] Emma Pickett: parent. So the osteopath trip identified tension as being another factor as well, possibly leading to some of that breast fusion. Yeah, and 

[00:26:00] Gabby: that was one of my early theories. And the lactation consultant also thought that was what I was quite lucky.

'cause our local lactation consultant is also the tongue tie expert. And she came in person and did a full feeding assessment and a full oral assessment. And she agreed that kind of tension was there. And I could see that in, um, just the way he held himself at the breast and the way he dodged back and the way I couldn't ever quite get him in line.

I can't quite explain it now, but, um, I couldn't ever quite get him in line the way you are supposed to advise to, to feed. And so I, I kind of knew that was part of the picture and I'd had quite a fast delivery. So again, I knew all of these things, but a delivery can mean, this can mean that, you know, so I, I had all of these tools of places where to look and I was able to action those.

There just aren't things that you know how to do when you're a first time mom. And, and this is why it is really important for me to tell the story. Like if I didn't have a toddler creating the demand, if I didn't have all that knowledge, he would never have made it back onto the feet. Yeah, I mean, 

[00:26:57] Emma Pickett: definitely what you're saying about the tandem feeding.

If you, he probably would've lost weight because he, he wouldn't have been benefiting from the tandem feeding and, and your eldest producing the letdowns YY you know, he then would've stopped breastfeeding around the same time and, and you wouldn't have been able to maintain your supply. He wouldn't have come back on the breast.

He would not be breastfeeding today. Uh, and unless for by some miracle. 

[00:27:16] Gabby: And I remember calling a friend who's really dogged and had a first like that and did manage to get him back on the boob, asking her how she'd done it. And she talked to me about triple feeding and it being a kind of 24 7 job. And she said to me, don't try and do that.

You won't be able to with a toddler. 'cause, 'cause her, her now toddler is same age as mine. And yeah, I just wouldn't have been able to. Um, and she said, actually, even for a first timer doing that. Kind of ruined her life for three months. Yeah, 

[00:27:46] Emma Pickett: that's, that's hard to hear. Triple feeding is no fun for anybody.

It's tough, tough, tough. I want to tell you about my brand new book called The Story of Jesse's Milky. It's a picture book for two to six year olds, and I wanted to write a book that was about weaning, but also not about weaning, because breastfeeding journeys end in all sorts of different ways. So Jesse's story is presented as having three possible endings.

In one ending, his mom is pregnant and Jesse's going to share his milk with a new baby. In the second, his mom is getting really tired and it's time for some mother led weaning. And in the third we see a self weaning journey as Jesse's attachment to breastfeeding gradually fades. There are beautiful illustrations by the very talented Jojo Ford, and the feedback from parents so far has been so lovely and touching and I'm really excited to share the book with you if you're interested in my other books for Older Children, I have the Breast book, which is a guide for nine to 14 year olds, and it's a puberty book that puts the emphasis on breasts, which I think is very much needed.

And I also have two books about supporting breastfeeding beyond six months and supporting the transition from breastfeeding for a 10% discount on the last two. Go to Jessica Kingsley Press, that's uk.jkp.com and use the code. Mm PE 10 makes milk picket Emma. 10. So he came, so you had the appointments, he came back on the breast.

Was there like one day of, or was it a kind of a gradual process? 

[00:29:20] Gabby: So. The lactation consultant kind of introduced us to a kind of supplementary nursing system. We tried that a couple of times. It was really fiddly we couldn't get it to work. We kept getting interrupted with these different hospitalizations for me, for the toddler, for la, la, la, la, la, la.

And it sort of felt like a month had gone by and we hadn't touched it. And my husband was about to go back to work, and I was just thinking, you know what? It's just, it might not happen. Oddly, it was once I accepted the idea that it might not happen, that it did, or that it was able to, like, I firmly believe that like I had such a built up, such a big psychological block to the point that like I saw a woman in the GP surgery breastfeeding her baby and burst into tears and you know, that sense of like, I'd created such a thing for myself that it was so sore, so difficult.

And the irony of that is I then met that woman at a baby group and she was giving her baby a bottle. So in that moment I'd be like, you can exclusively breastfeed. It looks so easy for you. It's so unfair. And she wasn't even exclusively breastfeeding, she was mixed feeding. She had her own feeding challenges.

And so that sense of like, when you're in the darkness of this early weeks, everything is so big. And I think the difference is this time I did at the back of my head, have that perspective. And so did my husband of, you know, this is also the first few weeks. These are, this is hard. This is, you know, you're going to feel like this.

You're not always going to feel like this. But yeah, there was a point where I sort of got to the point where this might never happen. And then I got myself organized. I think I pumped with him in the carrier. I started thinking about what maternity leave could look like on exclusive pumping. I started thinking about.

You know how I'd managed the logistics. We sorted out all of the kind of bottle cleaning, you know, we had our system in place. So can I 

[00:31:08] Emma Pickett: just ask you for a second, Gabby, in this period you mentioned there was a phase where you didn't try at all. You didn't, you obviously there was a lot going on, hospitalization, older baby being not well, and then after that you started to try, but it still wasn't working.

I'm just wondering. 

[00:31:22] Gabby: Yeah, so I tried after the lactation consultant, I, I tried a couple of times with supplemental nursing system, but it was, so, like for those of you who don't know, you basically, um, have a tube that, uh, you put the kind of bottled milk into, um, that you attach the nipple. And the idea is you teach the baby, um, that they, uh, can get the milk at the breast by making it easier to get this through the tube, but it kind of slips around and falls out and it's a real faf to get in place.

I mean, you know what it's like holding a squirming baby, let alone trying to get, you know, and I think it's great and I, I'm sure it works for people, but. But I think what what helped is, um, lactation consultant was actually pretty confident that we would make it work, but we just weren't, we were struggling to devote time to try.

And then I remember a few times kind of getting to the point of letting him suck for comfort. So he'd find the boob and suck a bit for comfort. And I was like, well, he's not getting any milk, but that's all right. Because that's still something, some kind of familiarization some. And I tried nipple shields and I, I can't quite remember what I tried.

And then there were some days where I just didn't want to try because every time it felt like that rejection, that, that kind of, um, and I think it, it was that point where I got to the point of working out what motherhood would feel like with exclusive pumping. And then one evening, I can't remember why, but we just tried and something happened and we, and it worked.

And every now and again, it would work once and then I'd try and take, keep the pressure off and keep my hopes down and just. Yeah, I got, and I think I got to a point where I just went, well, we'll just play around with it and it doesn't matter if it works or not. And that's when we really saw progress, which also coincided with the point at which we'd had five, six sessions with the osteopath.

She was seeing some real progress. So to a certain extent, you could argue that we wouldn't have made any progress earlier, 

[00:33:12] Emma Pickett: even if we tried. It's one of those kind of, you never know, you throw all the variables at the same time and you dunno what's making the difference and, and who knows it. Well, 

[00:33:21] Gabby: it was coming and then one evening it 

[00:33:22] Emma Pickett: just, it 

[00:33:23] Gabby: just worked.

And the next, the next evening I said, well, you know, why don't we just try and do the nights without bottles? They're in the fridge. We can go get them if we need to. Let's just try and do the night. And he did the whole night. And then I said, well, let's just keep going. And, and that was it. And, uh, fast forwards to, um.

Seven months later when this child has to go to nursery and won't take a bloody bottle. 

[00:33:45] Emma Pickett: Oh no. So did he, did he not take bottles? So after that, did you just stop bottles completely? You were sick and tired of pumping? 

[00:33:50] Gabby: Well, we sort of didn't mean to because I always thought, you know, it is good to be able to, to mix and for daddy to give express bottles, especially.

'cause like you say, I'm really lucky to be able to pump very easily. I'm is very much something that I am aware is a huge privilege. And some people it's time consuming and painful and all the rest of it, but it's sort of just life is busy with two of them and it and there and, you know, uh, maybe I wasn't very good at making sure there was always milk that was in date in the fridge.

And, and maybe he, um, I think also maybe he doesn't like frozen milk. I have this spirit that won't take if it's been frozen. Yeah. But he would take it cold from the fridge, so, okay. When he was 

[00:34:28] Emma Pickett: a newborn, he drank it cold from the fridge. So who knows? But bottle refusal can start at any age. And in the first three foot months when they're taking a bottle, that's often because of the sucking reflex, which is an involuntary reflex.

And once that reflex goes. You can get a bottle refusal happening at any point. So it doesn't, it's not necessarily because you didn't carry on bottle feeding or you did something wrong or the milk was the wrong gonna milk. It could have happened anyway. Um, so when you did start nursery and he wasn't taking a bottle, how did you respond?

[00:34:55] Gabby: We just went to, uh, uh, to be honest, I just passed him over. He was nine and a half months. I said I had planned to set some time aside to try and leave him with dad, with a, you know, supply of milk for them to figure it out. But in the end I just said to Natalie, look, I dunno if he'll take it. Here it is.

You figure it out. Try a bottle, try a sippy cup, try and open cup. You know, at that point he was drinking water from open cup and Yeah. And eating food 

[00:35:20] Emma Pickett: presumably. So if you can eat food and drink water, you're fine. I was just quite 

[00:35:25] Gabby: relaxed about it and I knew as well. Again, you know, from our experiences of, uh, our first children going back with all of my friends that, you know.

Some of them took express milk in their childcare setting. Some of them didn't, and the milk supply was completely fine. Having them feed six times a day when they were with us and not at all when they were at nursery, and it's completely fine. Yeah, that's a really important, so I also just wasn't worried about it as well.

I think I was also just in the end I was like, well, do you know the, the nursery staff are gonna have to figure it out anyway. 

[00:35:54] Emma Pickett: Yeah. 

[00:35:55] Gabby: You know, just 'cause it works with daddy doesn't mean it will work with them anyway, so they might as well figure it out themselves. 

[00:35:59] Emma Pickett: Yeah. And if, and if it never happens, he'll be okay.

'cause he'll just take milk when he is with you. 

[00:36:03] Gabby: Oh, he's, yeah. He seems to be drinking some. I'm not exactly sure. I think he has it in his zip pickup cup, but the, the bottles that I send come back empty so it's going somewhere. I love your 

[00:36:11] Emma Pickett: low back approach. Okay. So we've talked about how your eldest is protected through his sleep apnea by your breastfeeding.

And your youngest is protected by the fact you're tandem feeding and that's kept the supply going. I'm just wonder you wondering what your eldest was thinking when his little sibling was rejecting breast milk? He, did he ever say anything about that? I wonder what that felt like for him. No. I, the only thing is he told me the milk was hot.

But that was the early thing of like that. Exactly. Does Sherlock Holmes was working out what was going on? Yeah. Yeah. One time he must have thought, what's wrong with you mate, come on. This stuff is great. Come on. So I might wonder whether that suddenly felt a relief for him when he started. And also 

[00:36:46] Gabby: what was so strange is because he caught this RSV infection, then had bats a pneumonia, et cetera.

'cause he was quite unwell. He was feeding like, as he's only source of nutrition, the oldest at this point. So I was kind of had this toddler feeding all the time. And then so after everyone got better and we all got back to kind of normal, I started introducing more boundaries with my eldest. And to be fair, he will still often ask to feed when he sees the baby.

But I, I'm just quite firm, I say. Some of the things that I picked up from you, but other things around, well, you know, you can have all of these things, maybe can only have mommy's milk and, and you, you know, you have mommy's milk at bedtime and in the morning, but, uh, we don't have mommy's milk when we're out and about or only baby has mommy's milk at about.

And 

[00:37:30] Emma Pickett: he's been okay with that. 

[00:37:31] Gabby: He's been mostly okay with that. But one of the funniest things was when we gave baby his first taste of real food, it was like mashed carrots or something, whatever it was. And my eldes was involved in helping to feed him 'cause he thought it was hilarious. The next day he asked to feed and I said, well, you know, baby can only have mommy's book.

And the toddler looks at me and goes, 

[00:37:52] Emma Pickett: he had carrot receipts, he had carrot. I was involved in the process. 

[00:37:58] Gabby: I saw it. You know, like, don't try and bullshit me that he only has mommy's belt. 

[00:38:04] Emma Pickett: Oh, bless. Aw. Very logical. Very sensible. Yep. Mash carrots. No, you can't argue with that. And I, I was just gonna go on to say that the, the third part of the story is that continuing to breastfeed has been protective of, of your health as well.

Now you've talked about a couple of conditions. What are you comfortable talking about? Tell us what your situation is. 

[00:38:22] Gabby: Yeah, so I, I have two, uh, uh, chronic conditions that are kind of more or less controlled. So I have EAM loss, hypermobility syndrome, which is a connective tissue disorder. Basically my body produces, certain proteins are just a bit more stretchy than the average body.

And so the most obvious thing that is just being really bendy and having bendy joints and cliquey things, and, uh, being able to do lots of party tricks. And, um, typically like me, people who have this condition have been attracted to things like dancing or acrobatics or things that require flexibility, but it also affects the, uh, lining of your.

Bowels and your veins and your skin and all sorts of things. So, um, it typically can come with some kind of dizziness, pots type symptoms or some IBS type symptoms. And it can cause, uh, quite fast births because the way that the, um, tissue of your birth canal stretches will be a bit different. Um, but as you can expect, there's not huge amounts of research.

And, um, anecdotally, uh, someone who's published a book on, uh, she's a midwife who has this condition. She's published a book called Stretch to Stretch To the Limits. She says that anecdotally she has noticed it's correlated with large milk supplies. So I wonder there's there something in the milk duct tissue that means that it's, um, 

[00:39:52] Emma Pickett: well maybe the ducts are widening more and milk is flowing faster and baby's receiving milk more quickly.

Who knows? Okay, interesting. 

[00:39:59] Gabby: Who knows? And, and yeah, and quite a fast let down as well. Um, so it could, it could be what you're describing. And then I also have ankylosing spondylitis, which other than being a mouthful is typically the only type of arthritis that affects, uh, young people. Um, and I've had symptoms since I was 17, but it took me about 10 years to get a diagnosis because every time I went to see a health professional, they went, oh, you're just hypermobile.

You need to strengthen you, you need to stretch less and strengthen more. Um, but turns out arthritis is actually an autoimmune condition whereby your body kind of attacks healthy tissue, thinks there's an inflammation, and it's so thinks there's something attacking. It creates an inflammation to fight off an imaginary attack.

And I have it in my sacroiliac joints, um, which means that in my first pregnancy. I had really bad symptoms and I actually didn't know if it was my disease or pelvic girdle pain because it was impossible to tell them about. 

[00:40:55] Emma Pickett: Okay, let me ask a dark question. Where are those joints? You, I'm guessing they're somewhere around your spine 

[00:40:59] Gabby: Lower.

So sacroiliac joints are the joints that attach your hips to your spine. And so they're those two kind of bottom of your hips and where the hips join the spine. Ouch. Yeah, and I, and I have had at some points in matter of pretty debilitating symptoms, so not being able to walk and, and I think that the chronic inflammation can create deformation in, in the bone and the joint as well.

And I think really severe forms of it, your joints can kind of end up fusing together. Um, in an odd way, those two conditions kind of counterbalance each other. So one of the things about having these types of arthritis is you lose a lot of mobility. I have more mobility than I need to begin with, so. I actually end up being sort of Okay.

Um, but they're flares, which is what you, you call them when you get a kind of episode of pain and, and, and symptoms, uh, have been pretty bad. About five years before getting pregnant, I started, uh, taking immunosuppressant medication, which is really successful for me. It completely got rid of all the symptoms.

I wasn't able to take it at the end of pregnancy. Um, and then with my first, um, I didn't take it for six months or so 'cause I just didn't have any symptoms and I didn't need it. And then I went, uh, back on it after that. And I did find the side effects much more noticeable with a toddler in my life. Um, so obviously it's a, uh, you're suppressing the immune system so it doesn't attack things.

It doesn't need to, but it's also generally less able to respond to things. It does need to. And when you have a little person. Whose, um, mode of greeting other people is licking them in the face. Mm-hmm. Uh, they bring back a lot of lovely things for you to get. And if you're immunosuppressed, those tend to be a little bit, a little bit rougher Right.

Than usual. Did 

[00:42:43] Emma Pickett: you, did you find it easy to get the support to continue breastfeeding? I know some people struggle to, to find specialists who are breastfeeding supportive, even though research suggests that breastfeeding is beneficial for autoimmune illness. Sure. 

[00:42:56] Gabby: It never came up. Okay. I, I, because I, you've, you know, you've been telling me about, um, other patients, you're supporting it, it just never came up.

My specialist couldn't care less, I guess my, they just told me the medication was safe to feed on and I just got on with it. There was no, it just wasn't a, yeah, it wasn't a sore point at all. Yeah. I do remember, I think it was my rheumatologist telling me to night me when I told her I was tired, but I just sort of ignored her, you know, that was the.

Uh, the long and the short of it. And I think that was more provided as personal advice than as medical advice, you know? Yeah. That on 

[00:43:28] Emma Pickett: the way. So you've been through two pregnancies, obviously a double lactation experience on with these conditions and, and alongside having medication. I mean, I'm obviously you are one person, I'm not gonna write a research study on you, but do you find that your symptoms are alleviated by pregnancy?

Yeah, so actually 

[00:43:46] Gabby: coming up to my second pregnancy, I asked for a review 'cause I just, I'd basically, I'd end up not taking the medication. 'cause you can't take it when you have a cold or a cough or whatever because if you get worse and then it becomes an infection, you don't want your body to be kind of riddled with immunosuppressants.

And so because of life with the toddler, I'd found I'd not taken it for months and months and months and I was completely fine. So I then went back to them and say, well, you know what, what do I need to take in? And I ended up kind of coming to an agreement with rheumatologist that I could sort of take it as and when I needed it, which is not how it's supposed to be taken 'cause it's supposed to have a preventative effect.

Um, and so I think I took one dose at the end of my second trimester, second time round, and I hadn't for months before, and then I haven't taken it since, basically. And I have noticed that, um, the, the, there's clearly some kind of sweet spot where there's a level of lactation, which suppresses symptoms.

'cause you know, with my first, I started getting symptoms around six months, a couple of months ago where I had a few niggles. But that's basically been it. I've not had any pain, I've not had any serious discomfort. And in previous discussions with my rheumatologist, she has said that she, anecdotally, again, has seen that breastfeeding can suppress symptoms for some people.

But equally, uh, delivery can cause a huge flare because as you can imagine, you, you, when you're pregnant, your body suppresses your immune system a little bit. So some people find a relief of symptoms during pregnancy. And what, uh, I had discussed with my specialist was to expect things to be bad after delivery, potentially.

But there isn't a huge amount of research. I've tried to do a brief literature research review just before coming on here, and there's articles that say both one thing and the other. So it, it's hard to pull apart. I'm finding, I'm finding, I mean, you've, 

[00:45:31] Emma Pickett: I think you are definitely the expert in your condition, but I'm finding research to saying that people are self-reporting reduced symptoms when they are breastfeeding.

Um, and, and yeah, there's a new study that just came out in March, 2025 that, that describes that. And then we've got a big study from about 10 years ago, which also found a relationship between reduced symptoms and breastfeeding. So I think that's definitely a, you know, I'm not gonna say that's a universal experience for everybody, 'cause lactation is variable for everybody, but there does seem to be that relationship which would fit with what you are saying.

Um, if you notice when your lactation drops below a certain threshold, your symptoms are worse, that would certainly fit with what the literature say, says. 

[00:46:11] Gabby: And, you know, I love to theorize about this sort of thing, but the way I like to imagine it in my head is, um, autoimmune conditions are the body saying, I don't have anyone to fight.

Give me someone to fight. I need something to do. And if you're breastfeeding and putting all of those immune benefits into your breast milk, your body's busy doing that. So it doesn't have the energy to fight imaginary. Oh, I like that 

[00:46:29] Emma Pickett: logic. Invasive, just like the business about, we've all got allergies because we're too clean.

And, and I dunno if you've read, read this research about know 

[00:46:38] Gabby: Exactly. It's totally unscientific me. Little people are meant to have worms to, that's the other one. 

[00:46:41] Emma Pickett: Toddlers and young children are meant to have worms, and if they don't have worms, they get peanut allergies. That's the very simplistic description.

But, um, yeah, uh, I mean, autoimmune is, is a very clever immune system going, Hmm, I'm bored. Um, what can I do? Uh, yeah. Yeah, that makes good sense to me. So, 

[00:46:58] Gabby: you know, I do send me those studies 'cause I'm currently, uh, building a bit of a case study to take to my rheumatologist, which I, I'll discuss in a minute.

But, but there are also studies that say that, uh. Rheumatoid arthritis can be worse with people who breastfeed. And I think there's some theories about the prolactin having an impact on the joints as well. So it's not quite that clear cut. I think there are clearly, um, some evidence going both ways. Um, and, and just a lack of research and understanding.

As you can imagine, it's a complex picture and there's different rheumatological conditions. There's also some research that shows that breastfeeding in general for more than four months halves your risks of getting any kind of arthritis. Uh, but then I also found studies that say if you are predisposed to getting arthritis, you're more likely to get it in the postnatal period.

So again, I think murky, uh, to say the least, but, but certainly just talking from my experience and my specialist saying anecdotally, she's seen that pattern there, there's a level of lactation which suppresses, uh, and manages, uh, my condition. So this is what I'm proposing to do next. Em, and you can tell me if you think this is completely mad.

I don't particularly want to feed my child past four. I think I'm getting to the I'm, I'm done, uh, phase of life and we've talked about it and I feel that he really understands that. I can't quite remember when it came, how it came up, but basically since the day after his third birthday, he's talked nonstop about his next birthday.

And so at one point in one of those conversations, I introduced the idea that he might be all done with mommy's milk after his next birthday. And now whenever his next birthday comes out, he'll tell me when I'm four I'll be all done with mommy's milk. And we've talked about how the baby might still have mommy's milk until he's four, but that the eldest will be all done with mommy's milk.

Then he's four. And I really feel that he gets it. The other day when he was feeling a bit poorly, I can't remember why it came up, but as he explained it to me, his voice broke. 'cause he said, I'll be all done with mommy's milk when I'm four. And I asked him if that made him feel sad. And it's that moment when I think he realized.

I now feel completely comfortable with the idea that I might be reading him at that point. It's not what he wants, but that moment where you realize that it still means the entire world to them. Yeah. 

[00:49:12] Emma Pickett: Yeah. 

[00:49:12] Gabby: And I think that's something that following you and engaging with some of the content you promote has been really helpful to help me see that point of view as well.

'cause often, not that it devalues my own experience and my need to set boundaries, but um, to honor that and to know how to honor that for him. 

[00:49:28] Emma Pickett: Yeah. I think that's the other, thank you for saying that. I think for me, parents have always got the right to breastfeeding when they want to. That's crucial.

That's about body autonomy, that's about our rights over our own bodies. But we must always remember that little people have a right to feel sad and they are going through a bereavement. And if we pretend that's not the case, we are not being responsive parents. And, and that's what gentle parenting is.

Gentle parenting is not self-sacrificing and pushing yourself to breastfeed longer than you want to because you're scared of your child feeling sad. Gentle parenting is about modeling self-care and having intelligent, emotionally intelligent conversations with little people. And even if he's sad, you're there to support him through that sadness.

That's, that's gentle parenting. Um, so tell us about your mad plan. What's the mad 

[00:50:10] Gabby: plan aspect? The mad plan is to go and see my consultant who has asked for another MRI to see what my disease kind of progression has been over the last few years and say, tell you what, let's not go back on my biologics.

Let's just pump instead and see how much I need to pump to keep the benefits. 'cause I can donate the milk. Like I say, I can pump quite a lot of milk in a short period of time. And if it works, it has no side effects. Apart from letting me eat more cake, I don't know if it will actually work in practice.

It might be too time consuming. 

[00:50:44] Emma Pickett: Well, if you only have to pump twice to get a full newborn load of milk, it probably isn't gonna be that time consuming and, and obviously your 10 month old is still going. Um, you're just looking to find that sweet spot. So you'll be doing a bit of experimenting and keeping a diary, I'm guessing, to work out what that sweet spot is.

[00:51:01] Gabby: Yeah, I haven't quite thought it fully through, but, 'cause at the moment it's still in the mad idea stage. But it has been nice not being immunosuppressed as this one started now. And I have found I'm able to get over stuff much more quickly and you know how horrendous it is looking after little ones.

When you are poorly, it's just to be avoided as much as possible. So that's kind of my mad plan. I think 

[00:51:23] Emma Pickett: It sounds like a very UNM mad plan. It sounds like you are very clever in working out what's happened to you and, and can you continue those, those values and benefits without having to select it, 

[00:51:32] Gabby: but imagine if breastfeeding could be.

A cure or like a treatment for arthritis. Isn't that crazy? And also, you know, these fancy immunosuppressant drugs that I take, they're great. Like it's been life changing, not being in pain and not having to deal with chronic pain. And essentially, although I still have my conditions, not feeling like I'm disabled anymore, or not having to live with a real life impact of disability, but they cost like over 10 grand a year or something.

Imagine if we could put that money, you know, if we knew that breastfeeding was gonna work for certain types of people and we could put a tiny amount of that money into providing the support to ensure they're able to breastfeed for the number of months that it would save them taking that medication.

Imagine what that could do. Yeah. Um, I mean, we'll never get there because that's not how our system works, but. 

[00:52:21] Emma Pickett: Well, I look forward to seeing the case study in this medical journal where you describe what happened and I all the table of your pumping amounts and, and your pain scores. And I 

[00:52:32] Gabby: think you are drastically overestimating my, uh, attention to detail and my ability to follow through with something that I very much dont think 

[00:52:39] Emma Pickett: that's the case having spoken to you.

And, uh, even if you just jot down some notes, I reckon you can keep that information. Um, yeah, I think that sounds really sensible to just wait and see what happens. Just give yourself that chance. 

[00:52:51] Gabby: But the takeaway, I think is this, I've had a difficult relationship with breastfeeding at times. I never expected to have the journey that I've had and I never expected it to protect me or either of my children in the specific ways that it has.

And I also, having been through a difficult breastfeeding initiation, I really wanna say to all those people for whom it didn't go to plan. It takes so many different things to line up just right. I think sometimes we think that it's in our power, but it really isn't. And, and, and oddly for me it was when I accepted that it wasn't, that things changed.

And I think there's actually so little support. And the other thing that kind of took me aback when I did work with a private lactation consultant is the amount of knowledge she had to, compared to the other healthcare professionals I'd, I'd interacted with. Even the infant feeding advisor on the ward who I asked to see when I was stuck there with an IV in my arm.

Didn't really have the answers, didn't really know what to look out for. And I also experienced some really shoddy feeding advice from midwives, some outdated advice on how to deal with mastitis. Like no idea of what paste feeding means as they pour a bottle down my newborn's throat going, well, you can really have a lot of this, you know?

Um, and I just, yeah. One of my first jobs was actually in breastfeeding policy and. And I was very junior, so I didn't really kind of understand what was going on or what it meant. But I just think it's such a shame that we haven't got this right as part of a kind of healthcare provision and that we don't see it as a, as a kind of core part of healthcare.

Um, and, and I know I'm preaching to the converter a little bit. 

[00:54:32] Emma Pickett: Well, we don't mind. We like to hear it. And it's interesting you're talking about like, like this from someone from Scotland. 'cause we, we look at Scotland as, oh my god, you've got government support, you've got breastfeeding coordinators on a national level, you've got committees.

I don't 

[00:54:44] Gabby: think the problem is government and committees and support. I think the problem is I have to be careful what I say here and you might need to edit this next bit out. 'cause I do work. Can I guess your next, can I guess the 

[00:54:55] Emma Pickett: end of your sentence, are you gonna say health professional training? 

[00:55:00] Gabby: No, I think it's just actually the problem is like we have an overstretch health system and so like with this sort of thing, you'd, you'd want to be able to delegate the autonomy to the people at the bottom who do care about quality of care.

But they don't have the time or the resources or the support or the, 

[00:55:19] Emma Pickett: yeah. On the, on the ward, there should be a lactation consultant, infant feeding specialist. Yeah. Who then freeze up midwives to spend time caring for people who've just had C-sections and not the midwives don't do reading support, but there should be a greater system of, of signposting, and that's what the infant feeding advisors supposed to do.

But, but, and it's not their fault. They were recruited by people who don't understand the value of lactation. So they didn't look for an I-B-C-I-B-C qualification. They didn't, they didn't think. And I've also had other people 

[00:55:49] Gabby: who call themselves breastfeeding experts, tell me that the I-B-C-R-C qualification isn't all it's cracked up to be.

And it's just a online quiz. Yeah. I mean, mean that's not, didn't 

[00:55:58] Emma Pickett: know who to believe when you're, that's not entirely wrong, I have to say, as an I-B-C-L-C myself, the actual exam is not the end of the story by any means. So when you take the exam, that's step one. You're not done, you know, you're at the very beginning of your career, you then have to go on to do, you know, lots of further learning and, and recertify.

And it's, it's, it's a starting point. Um, and, and there are some people who can pass the exam and, you know, without having had an enormous amount of hands-on experiences, certain age groups. But that, I guess that's true of, you know, let's line up all the surgeons in the world. Some are fantastic, some are less experienced, some are not great at being humble.

I also think that's what makes it really hard 

[00:56:36] Gabby: as a new mom to take that jump. So, you know, I told you about how I definitely should have hired a lactational subject. My first, and I didn't. The thing is, when you enter this world as a new mountain, you don't know who's a hack and who's just after your money and whether it will be well spent and you've just had a baby.

You don't wanna spend hundreds of pounds on things you've found off the internet. And I think it makes it really hard to make informed decisions and to get to the point where you realize that actually they can offer something that the NHS can't offer. And. And if you find the right person, it will be transformational and it'll be absolutely worth it.

Yeah, 

[00:57:10] Emma Pickett: I mean that's one of the values of social media is that you can go onto your local Facebook group and say, hi Edinburgh, hi West Edinburgh. I'm looking for lactation consultant and get personal recommendations. If you can get personal recommendations, that's always valuable. Um, 

[00:57:25] Gabby: so I can absolutely give a personal recommendation for Carla Rodriguez if you are in the Edinburgh or Fife area.

She was incredible. Her level of knowledge was fantastic. Her, the support that she gave me was great. Um, the fact that she was able to kind of do a full oral assessment and a full feeding assessment at the same time. 'cause the other thing, there's a lot of people recommend having online consultations.

For a newborn, I find I sort of want someone to be physically there and, and be 

[00:57:51] Emma Pickett: able to see what's going on. I mean, that is the ideal I have to say. But there are, there are some practitioners who have really fine tuned their online skills just because they live in a world where you can't always get that face-to-face support.

So Charlotte Young, who runs Milk Matters out of Yorkshire, she's fine tuned the, the online experience, um, you know, just through years and years and years of doing it. But I agree that it ideally, everyone meets somebody in person. That should be the standard. Yeah. It's not easy to find the right people but you, I'm glad you found Carla.

Thank you for, for mentioning her by name. 'cause I think it's important to shout out the good people. So you are carrying on breastfeeding a little person who's 10 months old and you talked about them finishing where they're for. Is that really what you're thinking or are you just waiting to see how it feels?

[00:58:33] Gabby: It was just kind of the important thing was understand that for the total, to understand that just because he was finished, the baby wouldn't necessarily be finished. I'm just gonna wait and see what happens and, um. He's very different in temperament to the others. So he might self ween earlier. It's hard to tell.

But you don't think his lactation, I think you can't prejudge these things. His lactation's 

[00:58:52] Emma Pickett: not at a level that you think would be protective enough. I'm just curious as to how you're breastfeeding the 10 month old, but you're still thinking only to pump after the eldest is finished. 

[00:59:01] Gabby: Yeah, well, I noticed it's when they're both going at it that the effects are the best.

And I think that's why it's gone on for longer this time than the first time. But I don't know. This'll be, I can report back if it works or not. And I suppose also, we don't know how these diseases evolve through a lifespan. They're affected by all sorts of things. And you know, this is one of my other frustrations is that the NHS can prescribe something that costs 10 grand a year, but can't give me a budget to spend it on physio or other things that are supposed to help instead so I can stay off the medication, you know, so yeah, I'm, I'm not a very disciplined person, so people can tell me you should do physio and gentle exercise and all that sort of stuff, but.

Life gets in the way and it's, and it's hard, um, to fit all these things in. Yeah, 

[00:59:46] Emma Pickett: I'm not sure I used the word disciplined or ill disciplined. I think it's called parenting Two little people and having to squeeze in everyone's needs. It's not easy to, to manage to look after yourself as well. Um, thank you so much Gabby, for your time today.

Is there anything that we haven't touched on that you really wanted to make sure we, we covered? 

[01:00:05] Gabby: No, I think that's been really comprehensive. Okay. Thank you 

[01:00:07] Emma Pickett: for allowing me to. Come to your breastfeeding therapist's couch today. You're very welcome. Thank you. Okay, so in terms of show notes then we'll, we'll mention the book, stretch the Limits, if there's anything else around arthritis, we'll put that in the show notes as well.

Um, and I'll, and I'll look out those studies that I'm, I referenced. But as I said, I'm sure you, you are familiar with them too. And yeah, very good luck with your next stage. And yeah, do let us know how you get on. Sounds good. Thank you, Emma.

Thank you for joining me today. You can find me on Instagram at Emma Pickett Ibclc and on Twitter at Makes milk. It would be lovely if you subscribed because that helps other people to know I exist and leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast.

This podcast is produced by the lovely Emily Crosby Media.