Emma's story - breastfeeding and being hospitalised

This week, I’m joined by the brilliant Emma Erskine-Fox, a Bristol-area lawyer, ABM peer supporter, and mother, to talk about breastfeeding her daughter Isabelle to nearly age four, including a gentle self-weaning ending. Emma describes being breastfed herself, antenatal education that helped normalise cluster feeding, an induced birth ending in an emergency caesarean, early latch and weight-loss difficulties resolved with midwife and IBCLC support, and some intense cluster feeding. She also shares navigating planned thyroid surgery while breastfeeding: initially being wrongly told her baby couldn’t stay and that she must pump and dump. Emma postponed surgery when Isabelle wouldn’t take a bottle, then did some research, contacting the trust infant feeding team and PALS, and secured a private room so her husband and baby could stay overnight. Emma continued to breastfeed Isabelle throughout her recovery and return to full time work, until Isabelle  finally weaned herself around 3 years and 10 months.

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, by going to https://bit.ly/JKPbooks and using the code MMPE10 at checkout.

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

Emma is @‌emma.is.milking.it on instagram

Resources mentioned - 

ABM Clinical Protocol #35: Supporting Breastfeeding During Maternal or Child Hospitalization https://www.bfmed.org/assets/ABM%20protocol%2035%20Nov%202021.pdf

Kate Battersby https://www.theperfectstart.org.uk/

Training with the ABM https://abm.me.uk/breastfeeding-training/

Olivia Hinge @‌olivia_lactation_consultant on Instagram

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'm going to be talking to another Emma, Emma Erskine Fox, who's from the Bristol area. I need to ask her exactly where, 'cause I didn't get that detail. Um, she's an A BM peer supporter. She's a mother of Isabelle who's very nearly four. She's a lawyer and we're gonna be talking about her breastfeeding experience with her daughter Isabelle, which includes a self weaning end.

And we're also gonna be talking about the experience of being in hospital overnight when you are breastfeeding a baby, and, and the logistics around that as well. Thank you very much for joining me today, Emma. 

[00:01:17] Emma : Thank you very much for having me on. 

[00:01:19] Emma Pickett: Tell me about Isabelle. Where is she right now and how's life for Isabelle?

[00:01:23] Emma : Life is great for her. She loves life. She's, um, as you said, she's just about to turn four, so she's currently very, very excited for her birthday party, which is, uh, on Sunday this weekend. So six days away she goes to a preschool just down the road from us, which she absolutely loves. Um, having a slightly unsettled time at the moment because there's a bit of a change of personnel there.

Um, somebody who she was very close to has just left, so she's a little bit unsettled by that, but, you know, nothing that we can't manage. Um, she'll be gonna school in September, which again, she's very excited about and I think we we're having to make it very clear at the moment that she's not gonna school the moment she impress.

So, 

[00:02:10] Emma Pickett: yeah, actually when you're four time is very difficult to get your head around, isn't it? The idea of it being months and months away is just completely impossible to, to comprehend. Yeah. So, so good luck with that. Um, yeah, no, I had that experience too, but a few years ago. So as I said, you're a lawyer, you're a fulltime lawyer and also an a BM peer supporter.

How do you manage to wear a peer supporter hat? I'm guessing you haven't, haven't got much time at the moment for groups and things. 

[00:02:35] Emma : Well, so I do still try and get to the, the group that I volunteer at, um, as often as I can. As you say, it's probably not as often as I would like at the moment. Part of that is also that we, we moved house last year, so I'm a bit further away.

I used to be a, probably a 32nd walk away from the children's Center where it was held, and I'm now a sort 15, 20 minute drive. So it's just a, it's a bit more difficult to get to, um. I'm still, I'm still trying to, trying to get there when I can. I'm very lucky that the law for my work at is very flexible and actually we get paid volunteering time, so we get certain number of hours a year that's paid time that we can go and volunteer.

So when I do go to a group, I, I, I use that. So it means I'm not kind of, you know, it's part of my, my working day and, and part of my sort of working life. And then, and then beyond that, you know, it's, it's, it's kind of supporting friends and supporting friends of friends and, and family with their journeys when I can as well.

Um, sometimes, you know, dipping in and outta Facebook groups and things as well when people need support on, on those. So yeah, that's, that's kind of how I'm managing it at, at the moment. And yeah, try trying at least once a month to get to, to get to my group. Um, doesn't always happen quite like that. 

[00:03:39] Emma Pickett: Isn't 

[00:03:39] Emma : it 

[00:03:39] Emma Pickett: brilliant that your work pays for you to volunteer as a breastfeeding peer supporter, I wouldn't that be fantastic if that was everyone's experience.

I've kind of walked past groups of, of lawyers and, and businessy people kind of cleaning gardens and helping schools lay tarmac and all these sorts of things. So I know the, the world of kind of corporate volunteering is out there, but I guess I didn't realize that you could be a corporate volunteer breastfeeding peer supporter.

That's flipping excellent. I love that. That's great. Yeah. Um, how, how did you find your A BM training for anyone who's thinking of training with the A BM? Obviously there are lots of different options in the UK to become a peer supporter and it's worth finding out who's active in your local area. Does a particular organization have a contract, for example?

'cause they're probably gonna want you to train with them. How did you choose the A BM at the beginning and, and how did you find training with them? 

[00:04:25] Emma : It was pretty much the only,

it. It was the one that always just came to my mind when I thought about doing it. I, I, from, from, from when Isabel was probably about six months old, I sort of decided that I wanted to be a, to train, to be a supporter. I started when she had just turned one, I think. And I just, I knew about the abm, I knew about all the amazing work that the ABM does.

I knew that you could train through the bm. And so when I started looking into it, that was the first place I looked and it just seemed really kind of flexible. And, and that's, and it was, I, when you ask how I found it, that was the, the main thing that was really important to me was that it was flexible because I'd just gone back to work, not full time quite then, but I had just gone back to work, which, you know, any returning parents after a long period of leave, um, will know is, is a challenge.

So I needed it to be able to fit around what I was doing work-wise. So I liked that it was kind of. You could do it when you, when you wanted and when suited you. And obviously, you know, you have your time within which you have to complete each, each module, but within that you can kind of structure it how you, how you wanna.

So I liked that. I liked that it was kind of online and I could just, yeah, just do it, do it when suited me, really. And so I, and I really enjoyed it and I found it. Part of the reason I wanted to do it was because I've always been so fascinated by the science of breastfeeding. I remember finding out that it's funny, the facts that stick in your mind, isn't it?

But I remembered when I found out that your breast milk is colder in a heat wave. And I just remember my mind being absolutely blown by that fact, just thinking how incredible this thing is, this substance, and how incredible the female body is. That it, it can do these amazing things. And I, and I just found it all so interesting.

And I loved, I loved doing my training. 

[00:06:05] Emma Pickett: Yeah, so the a BM, that's the Association of Breastfeeding Mothers, um, founded in 1979, I think, um, all around England and, and Wales and Scotland and all over the place. And there's quite a few long-term, um, breastfeeding counselors based in the Bristol area. So you've got Anne Watts, you've got Sandra Tanner, you've got, um, quite a, quite a good crew there.

So, um, I can imagine if you bump into one of those that's, that's fairly inspiring. 

[00:06:31] Emma : Well, Anne comes to our group and volunteers at our group, so I know Anne 

[00:06:34] Emma Pickett: well. Oh, okay. Oh, right, okay. Well, 

[00:06:36] Emma : absolute Queen, queen 

[00:06:37] Emma Pickett: Anne. Yeah. Yeah. Well, that, I think she should, should be called Queen Anne. 'cause she's, she's excellent.

I mean, she's helped so many families. She's fantastic over the, over the years and years and years in the Bristol area. She's a, she's a legend. 

[00:06:48] Emma : She is. 

[00:06:48] Emma Pickett: And then you, as you say, the training's online, you work through modules, you have a mentor. There's also online community. You're not kind of on your own sitting in front of a computer.

You do kind of connect with other people as well. There's chance, there's a chance for face-to-face training. We have our conference. Um, you know, and if you do decide to progress and become a breastfeeding counselor, um, you can end up training and, and volunteering on the national breastfeeding helpline.

And, um, yeah. So yeah, I'm, I've been a member of the A BM for nearly 20 years now, probably about 20 years. Um, and a breastfeeding counselor since 2007 ish, 2006 ish. Um, I don't even remember. But yeah, I have three cheers for the a BM from, from me as well. And, and I'm sure they're very happy to have you and lucky to have you.

I still volunteer as a marker, um, for the National Breastfeeding helpline training. So, so I'm Mark module two on, on that training. So thank you for being part of the A BM. Thank you for making a difference and helping families. 'cause I know how important. It's, let's talk a bit more about your own breastfeeding experience.

So before you had Isabelle, what did you know about breastfeeding? What was your kind of family culture around breastfeeding? Did you have any friends that were breastfeeding? 

[00:07:52] Emma : Yeah, so I, I was breastfed myself until I was about 13 months. Um, so I kind of always knew that that had been the case for, for my mum.

I had lots of friends who had had babies and who had breastfed. And my sort of, I actually remember in pregnancy being very, very anxious about it because I've heard that it was hard. I think in some ways it's, it's almost better to go in with some knowledge that it is gonna be tricky because then at least you know that if things are hard, it's normal for things to be hard.

And I think actually that was ultimately better than sort of going in, thinking it was gonna be really easy, because then I think if you go in thinking it's gonna be a breeze, the minute you run into a problem, you wouldn't think like, oh God, this isn't normal. And then you, you're more inclined to stop.

So I think I sort of had this impression that it was, it would be potentially hard. I don't think I knew anybody who would've said it was an easy thing, um, to, to get to grips with. But I also knew that all of those people had carried on and had managed to get to a point that they were sort of happy with in, in their breastfeeding journeys.

Give or take, you know, that's not always the case for everybody, obviously. So I think I was quite lucky to be sort of surrounded by people who had breastfed and were breastfeeding. And I, it was something I was really, really, really keen to do and really very sort of stubborn and adamant about it, that this was what I was going to do and that I was gonna get whatever support I needed to, to make it work.

You know, I think like, and I, and I think probably in my pregnancy, I probably said like, oh, well, I'll just, I'll see how it goes, and if it doesn't work out, it doesn't work out. But I, I don't think that's ever what I meant. I think, I think I always thought, actually, if it's hard, I'm gonna find a way to make it work as, as, as much as I can.

[00:09:30] Emma Pickett: Yeah. What, what, what was antenatal education like for you? 

[00:09:33] Emma : So I did, yeah. Good. I mean, I did a h birthing course, which was helpful. There was a breastfeeding session on that. And actually, interestingly, interesting twist of fate that my, the, the lady who did my birthing course, Ruth. Now is the group leader of, of my group.

And so she's a bsc, um, now, and so I, I kind of know her now through that and that's been quite a nice full circle moment that she did my hypno birthing course as well. And there breastfeeding session on that. There was a breastfeeding session through the NCT classes that I did as well. And I think both were, I think both were really helpful.

The hyp birthing one, probably more so than the NCT one, I think. But I think, you know, both good in terms of giving you the sort of grounding of the, of, of the knowledge of how things work, et cetera. I think what was more helpful probably about the hypnobirthing one was it covered things like cluster feeding, for example, and it, so it, it taught you that cluster feeding doesn't mean that you don't have enough milk, which is like one of the sort of key things that I hear, you know, as a supporter now.

[00:10:28] Emma Pickett: Yeah. 

[00:10:29] Emma : One of the things that happens, you know, one of the things you hear all the time is, you know, well, my baby just won't stop eating. I must not have enough milk. And actually when you dig into it and you realize that it's, it's, it's cluster feeding and actually it's perfectly normal. So again, kind of having that knowledge going into it was really helpful.

A lot of that knowledge goes outta the window when it's like 3:00 AM and your, and you've got no idea what's going on. So I'm not saying that that meant it was kind of plain sailing and there were never any wobbles, but it did mean that there was always a sort of rational part of my brain in those first few days, weeks, when things are hard that were saying, actually, you know this, you talk, you've covered this, you know that this is probably normal and here's how you can get the, the support that you need.

[00:11:11] Emma Pickett: Yeah. It's funny you, me mentioned cluster feeding. I was literally just messaging somebody 24 hours ago about, no, that sounds like cluster feeding. And, and actually I'm not sure a parent believes you when you say that because everything in their soul thinks, no, no, this is what it looks like. If I don't have enough milk, surely this must mean I don't have enough milk.

And, and you have to really drill down and go, come on, let's talk about nappies. Tell me about weight gain. Tell me about the last 24 hours of nappies. Tell me what's happening when they're on the breast. Tell me what's, you know, I have to, you have to really kind of force them to look at the logical side of things and, and look at all the evidence, because everything in a parent's instinct is, no, this can't be right.

This can't be right. I, I still don't think we talk about cluster video enough. And, and I've been doing this for 20 years. I still don't think it's, it's part of the conversation enough. I, I don't think parents understand, um, why, why it's happening and, and we're so quick to doubt milk supply and I don't think that's gone away.

I think now we're focusing even more on pumping and fancy pumps and catching milk and, and we're, you know, we're externalizing milk so much with all these kind of silicon milk catches that people are, I think, more worried about their milk supply than they've ever been. Um, I dunno whether that's something you notice as well.

[00:12:16] Emma : Yeah, definitely. I think it's, it's, it's just, it's one of the most common things that comes up in the groups, as I say, is, is concerns about supply. And they're very rarely, you know, founded. I, I guess you know, it, it's very rarely an actual issue with supply. Obviously sometimes it does happen and some people do have a challenge with supply, but generally speaking it's, it's to do with normal baby behavior that people have not been taught is normal.

[00:12:40] Emma Pickett: Yeah, as you said, there are definitely some people for whom it is an issue, and I've, I've interviewed some of them on the podcast, but we've, we've, they often get drowned out because so much energy has to go into, to talking about what's normal with everybody else. It's, it's, it's very tricky to meet everybody's needs.

So you were well prepared, you gave birth to Isabel. How did your birth go? How did your early breastfeeding go? 

[00:13:03] Emma : Um, so birth, um, was interesting. I, um, why 

[00:13:07] Emma Pickett: are you laughing? That's an interesting reaction. 

[00:13:09] Emma : Well, I just, because, because I'm never really sure whether to describe my birth experience as traumatic or not, because I think objectively it probably was, but I don't feel particularly traumatized by it.

Um, it was very, um, I was, I was, I was induced. Uh, she was, uh, she was 12 days past her estimated due date. So I had what was supposed to be an outpatient induction, well, it was an outpatient induction. Um, went in at sort of 8:00 PM. I didn't get induced in the end until 2:00 AM was in the hospital until 5:00 AM obviously awake all this time.

Um, went home, had a couple of hours sleep, woke up and I was in hyperstimulation straight away. So kind of battled through that for a while at home, before going in. Ended up, uh, there was, I was being monitored on the triage ward. Um, and her heart rate dropped at one point and back then afterwards told me had been because abruption Right, right time because, very differently.

But because we were there, it was, and, and actually I think both my husband and I think, you know, look at it actually is a very positive experience because we were just very, very lucky. The care we had was exceptional. The team is brilliant. Um, I just, you know, remember the, the whole team. You know, doing the, doing the section where, um, everybody kind of laughing and joking and just keep doing, did a really brilliant job of keeping us calm and keeping us updated.

They didn't know it was potential abruption until afterwards. That's why we didn't, it wasn't that they knew and didn't tell us. They just didn't know until afterwards that that was what caused her heart rate to, to go down. Um, but yeah, it just, it just absolutely amazes me that, you know, they started the operation at 6:02 PM and 6:05 PM she was born.

It's just incredible work that is that quick, um, to be honest. Yeah. 

[00:14:58] Emma Pickett: They don't mess around, do they? I mean, that's lovely to hear that the team made such a difference. I mean, that really shows how much it's about humans, isn't it? But I mean, even as you say on paper, that's a really tough birth that you've just described.

That's, you know, that wasn't what you're expecting. And that was, um, and you are, you know, you are the one who gets to define whether it was dramatic or not, but the fact that you don't feel it was. It sounds like that was down to, to people, to people connecting with you and helping you feel safe and you know, talking to you.

And I mean, that's, that's, that's really special. Um, so Isabel pops out at 6 0 5 and what was her first breastfeeding like? 

[00:15:35] Emma : So she, um, I mean it's, it's hard to remember, isn't it? But I do remember, I felt like in the hospital she actually latched quite well at first. She definitely, um, you know, we did have skin, skin.

She was, she was taken, she was a little bit floy when she came out, so they took her to monitor for a little bit. But, but very quickly she was back with me and, and then skin to skin and then she just stayed there for, um, obviously, um, didn't move all night probably. Um, and yeah, she did, she did latch I think, I think well, um, at first she was, she was quite sleepy and I think looking back on it now, she probably had, you know, very short feeds at first and there was probably a lot of that, which was probably not active feeding.

And so I probably thought that she was kind of taking on more than she was because she was latched and sort of flutter sucking. And I sort of probably, again in my former adult state, didn't quite register that she probably wasn't actually taking on as much milk. So we actually, we, we were only in for one night and we got discharged 9:00 PM the day after.

And I do remember that the midwives had sort of said to us, you know, she has only had kind of quite short feed, sort of five, five minutes here and there. Um, you might wanna consider staying in another night. But actually I think, I think at that point I'd had, which again, I think is very common experience.

I'd had differing advice from different midwives and I think I just at that point wanted to get home and work it out for myself. And I say I knew where I could access the support if I needed to, so I just thought, I just wanna be in my own space. You know, she has been feeding, she has been latching, I know that she has, and I just wanna get home and work this out for ourselves and get the support if we need it.

So. So we did, and I think, you know, had probably a fairly normal first few days. I remember there being one horrendous night where she, you know, was screaming all night and I, I think she, she sort of lost the latch bit. She did latch quite well. And I, I actually remember when my milk came in a few days after.

I remember her having her first sort of full feed that was about 45 minutes long. It felt great. I had no pain. I was like, this is, this is amazing. This has like, clicked already. And then it immediately just went kind of a bit awry and she ended up in a position after a few days where she would latch on my right side.

But it was very painful. She wouldn't latch at all on my left side. I couldn't get her latch at all. So we went to be, went for her to be weighed at day five. And I knew that things weren't going well. I knew that, that something needed to, to, I needed some support and we were very lucky. But I think we, um, we went to a different clinic because it was a Sunday, so our normal clinics closed.

So we went to a different clinic. So we saw different, different people. And I think because it was Sunday it was a bit quieter. And so the midwives we saw had more time to spend with us and she had lost 11.7% of her birth weight, which, you know, normally sort of 10 plus, that's when they start sort of talking about feeding cats and things like that.

We were so lucky that we did not get put on a feeding plan and it didn't even get mentioned. And I think, I think there were two reasons for it. I think one, one was, as I say, I think we were in a different clinic where they had more time to spend with us. So we had this wonderful, wonderful midwife who sat with us for an hour, just helping me get her latched managed to get a pretty good latch on the right side, but wasn't painful.

Didn't quite manage it with the left, but I already had an appointment with an IB CLC booked the day after, so I was like, we can just deal with that tomorrow. The important thing is she can get some milk and that's, that's fine. And I think the second reason was because I went in and I immediately said.

I need help feeding. This is not working. And I think because I knew and sort of immediately went in and advocated for myself, I think that meant that they were sort of more inclined to then say, well, okay, we'll we can help you, help you through this. So we didn't get put on a feeding plan. They did say, come back in 24 hours, we'll weigh her again then If she's putting on weight, then great.

And we won't, we won't worry about the exam. And so that's what we did. So about 24 hours later, and she was gaining weight really well by then, as say I had an appointment with an IBCLC that day as well. And so she came over. Brilliant. Kate Battersby, who's had a shout out on your podcast before, who's, um, amazing, amazing, um, IBCLC.

So she came, came over and helped us and managed to, you know, sort the latch out on, on the left side as well. And so, and then after that it was, can 

[00:19:51] Emma Pickett: I interrupt you for a second then? I just ask Yeah. Sorry, I'm not expecting you. No, no. You're allowed to talk. That's the point. I'm, I don't expect you to remember the details, but I'm gonna try anyway.

Do you remember what you were doing with latching that needed a tweak? What, what were some of the things that were being adjusted? Does, do you have any recollection? Like what was happening, for example, on the side where she wasn't attaching and what made a difference to getting her to attach? 

[00:20:14] Emma : That is such a good question.

I know. Something that did really help me was breast shaping actually. And I know that breast shaping is one of these things that kind of, some works, some people works many times with many things, works with some people, works, doesn't work for some others. And I know some, some supporters are sort of a bit reluctant to recommend it, but breast shaping works really, really well for me.

So the sort of breast sandwich, um 

[00:20:38] Emma Pickett: okay. 

[00:20:38] Emma : Type of technique that works really, really well for me on the left side particularly. I mean, I, you know, I, I probably made similar sort of mistakes to lots of people that, you know, that I remember having lots of cushions around me. I think you were talking on this podcast with somebody else recently as well, having lots of cushions around me.

You know, probably putting me in a bit of an unnatural position. I think I definitely remember like her hands kind of being in the way. And, you know, a big thing for me was, was making sure that her hands were either side of the breast when I was latching her and not in between her body and my body. Okay.

And I remember that making a difference as well. So yeah, those are things I can't, I can't remember, as you say, it's, it's a long time ago now and, and my brain was all over the place, but, um, those are the things that kind of stick out as the things that seem to make a real difference 

[00:21:26] Emma Pickett: to me. 

[00:21:26] Emma : Okay. 

[00:21:26] Emma Pickett: Okay.

Yeah, that hand thing is so important. I think quite often I meet a family where the partner is holding one hand, the mother is holding another hand, and they're sort of wrestling with the baby before the baby's even got close to the breast. And I'm pretty sure, I'm not saying this is necessarily what's happening in your situation, but I bet we say the same things of actually, if a baby can't feel the breast with their chin and their face, their hands are often gonna be like looking for the breast instead.

Mm-hmm. So if you're battling with hands, that's probably the baby saying, can we just try this another way? Please? Can we, can I be a bit closer? Can the chin be touching the breast before we do anything else? And often when the chin touches, the hands immediately relax. When the family are holding their hands really firmly before the baby even gets there, the baby's not in that kind of emotionally regulated, relaxed zone of being able to do all their lovely and, you know, reflexes and, and all the things they need to do.

Um, and I think hands are also often what babies do when they're not feeling anchored. They'll just bring their hands to the breast and try and bring their hands to sort of their midline. So if you are wrestling with baby's hands, it's the solution is not to hold the baby's hands. The solution is to work out why the baby is bringing the hands to the center of their face.

And, and ideally it's that chin contact, which is the most important thing, bringing the chin to the breast. Um, so a little, little side note there. So, so with help from Kate, with help from this lovely midwife, you had the solutions to some of your positioning attachment issues. Weight gain was improving.

Um, what did the next few weeks feel like? 

[00:22:52] Emma : Um, I mean, just she, she clustered, like her life depended on it. She cluster fed basically until she was about 10 weeks old, pretty much every day. So it, it was a, but you know, I I, I always sort of joked about it, you know, she was just making up for that initial, you know, quite a, quite a chunky weight drop.

Um, because yeah, she just, she gained weight like a champ after that. And, and, and after that we kind of didn't really have any sort of significant issues. She, I think, you know, looking back on it, I, I probably had a, I had a slight oversupply probably. Um, you know, she, like her, her, her poos never really went sort of fully or took a long time to go sort of fully yellow.

Um, if that's not TMI for the, the podcast i's TMI on this podcast. But, you know, just, just, just the things that sort of indicated that there was, there was quite a lot of that kind of, um. The sort of lactose heavy milk perhaps that was, that was coming through. I think I had quite a, quite a fast let down as well, which perhaps didn't happen, but it was never, it was never a problem, you know, it was never, it was never sort of something that unsettled her or caused us any issues.

So it was just, that was just kind of our normal for a while really. Um, she was a very, very snappy baby. She, she liked sort of short and frequent feeds. Um, she's now a very snacky 4-year-old, so, you know, that's, uh, that's natural. I was always very keen that we fared out and about as soon as we could, et cetera.

You know, I think the first time I've had her out, she was, maybe she was a couple of weeks olds on a park bench all places. Um, you know, I wanted to get very comfortable doing that quite early on. So I was kind of out and about with her quite early and feeding her in all sorts of places. Uh, and, and yeah, just kind of, we, we didn't, I say we didn't really have any other significant challenges after that.

Um. Hospitalization piece, which I know we'll, we'll come onto. But, um, but yeah, otherwise it was, it was a, it was a very positive journey after that, you know, Kate was always there for sort of ongoing support. I did go to the, the, um, support group that I now volunteer at, just around the corner for me as well.

So I went there quite a lot and had some really good support from the peer support was there too. Um, so yeah, all, all very positive from then on. Really. 

[00:24:58] Emma Pickett: That's what we like to hear. I'd love to tell you about my four most recent books. So we've got the story of Jesse's Milky, which is a picture book from two to six year olds that really tells the story of Little Jesse and how his breastfeeding journey may come to an end in one of three different ways.

Maybe there'll be a new baby sister, maybe his mom will need to practice parenthood weaning. Maybe he will have a self weaning ending. It's a book that helps your little people understand that there are lots of different ways breastfeeding journeys might end, that we are there to support them through all of them.

And also we sometimes have needs to. Also on endings. We have supporting the transition from breastfeeding, which is a guide to weaning that really talks through how to bring breastfeeding to a close in a way that protects your emotional connection with your child. There are also chapters on different individual situations like weaning an older child when there's still a baby, feeding, weaning in an emergency, weaning in a special needs situation.

Then we have supporting breastfeeding past the first six months and beyond. That's really a companion to sit alongside you as you carry on breastfeeding through babyhood and beyond. What are the common challenges and how can we overcome them, and let's hear some stories about other people who've had a natural term breastfeeding journey.

Then we have the breast book, which is a puberty guide for nine to 14 year olds. It talks about how breasts grow. It answers common questions. It talks about what breastfeeding is. I talk about bras. I really want to leave a little person feeling confident and well-informed as breasts enter their lives.

So if you want to buy any of those books, I am eternally grateful. If you want to buy one of the supporting books, you can go to the Jessica Kingsley press website, that's uk.jkp.com. Use the code mm p 10 to get 10% off. And if you have read one of those books and you can take a moment to do an online review, I would be incredibly grateful.

It really, really makes a difference. And as you can tell 

[00:26:58] Emma : from the fact I'm making this advert, 

[00:27:00] Emma Pickett: I 

[00:27:00] Emma : have no publicity 

[00:27:01] Emma Pickett: budget. 

[00:27:01] Emma : Thank you. 

[00:27:04] Emma Pickett: Now let's talk about your hospitalization. So, so you told me before we start a recording that you knew before you had Isabelle, that you were going to need surgery at some point in the beginning of her life.

Tell me a bit more about that. 

[00:27:15] Emma : So when I was about seven weeks pregnant, I noticed I was just getting ready in the morning and noticed that I had a lump on the front of my neck, like the, the, the sort of swelling, um, kind of just looked like I had a massive Adams apple. Um, really, and I, so I did, as most people do, uh, consulted Dr.

Google and, um, found out that something that can happen. It's that there can be a, you can your thyroid as well, and that's called a goer when your thyroid swab. You know, full disclosure, I'm obviously not a medical professional, so if anything that I'm saying is medically incorrect, I apologize that this is just my sort of understanding of, of what, what happened really.

And when you look on the NHS page about goiters, one of the sort of causes of a goiter that's mentioned is pregnancy hormones. So I just thought, oh, probably just, just that, right? Um, but I also then remembered a few weeks ago, funny how these things stick in your mind that I'd seen something on social media about.

Symptoms of thyroid cancer to be aware of. And one of them was a swollen thyroid. And so I just thought probably hormones, but I'll just get it, I'll, I'll get it checked out. I'm very lucky that through my work I've got private health insurance, so I was able to get a private, um, they do sort of video, private video GP appointments, so I was able to get one of those same day, spoke to this gp, he said, worth investigating, so I'm gonna refer you to your NHS gp.

So then I had an NHS GP appointment the next day. They did a kind of physical exam, weren't able to kind of conclude anything. So they sent me to the hospital for some further tests and there were a few different appointments. Um, and it ended up with, they sort of did a kind of ultrasound on it and they said, okay, well this sort of looks, it looks like it's fine, but we're not, we're just not hundred percent sure that it's fine, so we're gonna biopsy it.

Um, and so they did biopsy and actually, interestingly, I was given the choice to not have the biopsy. They, they were that sort of on the, they were like. We could just kind of watch and wait and see what happens and not do the biopsy now because we, we think it's most likely fine or we can go ahead and do it.

So I was like, just, yeah, just do the, do the biopsy. So had the biopsy and the biopsy came back and the biopsy was inconclusive as well. And I now know that it's because there was basically a lump pop cells on my thyroid, um, which spoiler alert now, it was not cancer. So we can get that out the way. It was, it was not, it was a positive outcome, but I obviously didn't notice at the time.

But it's because of the type of cells they couldn't tell from. You can't tell from looking at them if they're cancerous, it depends on how they behave. So that was why they sort of, the biopsy didn't kind of conclude anything. So then they were basically like, look, we're gonna have to take this thing out.

We're gonna have to remove half of your thyroid, but this lump is on and that's, that's what's then gonna tell us if, uh, it's, um, if it's canceled or not. So. 

[00:29:53] Emma Pickett: So you knew it was gonna happen at some point, but you didn't. So just, just to say, for anyone listening who thinks that I keep talking to people with thyroid issues, Laura is an episode that has gone out quite recently with a thyroid cancer journey.

So her lump was cancerous and we discuss Laura's journey. So, so it's good to have the other perspective where it wasn't, um, but obviously surgery still needed. So no question of doing the surgery while you're pregnant. That's not, that's not on the cards. 

[00:30:20] Emma : No, that's the, they and I never thought to kind of question that really.

I was just, they just said, look, obviously you're pregnant. We don't wanna it while you're pregnant. So what I was originally told was that they were gonna, they would do it sort of six to eight weeks after I had the baby. And I remember that being the thing. It was, it was, it was a funny appointment when I was kind of told that they weren't sure if it was cancer or not, because they'd been so kind of relaxed about it all the way through.

And so sort of, you know, that it was all very much like, oh, this is all precautionary. Like sure. It's, it's not. So I went in sort of expecting that that was gonna be the news, and then when it was like, oh, actually we can't tell, and it might be, and, and they said it was kind of a, I think they said a 25 to 30% chance that it was so, you know, not likely, but not as unlikely as you would.

[00:31:05] Emma Pickett: No. As 

[00:31:05] Emma : you would think, 

[00:31:06] Emma Pickett: not as unlikely as you might wish. That's, that's a really tough thing to, to have live over your head. Um, Emma, how, how does it feel to continue the rest of your pregnancy with that uncertainty? I mean, are you somebody that was able to kind of push that to one side or, or how, how, I guess you can't know what life would've been like if you hadn't have had that information hanging over you.

But how did that affect you? 

[00:31:27] Emma : I was never worried about my own health in, in any of this. Like the, my health was not the thing I was worried about because they said to me, they were like, look, because the type of cancer that this could be is very slow growing, doesn't spread. So their view was very much like, look, even if it is the prognosis.

Excellent. So it's not, you know, and that's why obviously if they had been concerned about it, and I do remember saying this to me, that if they had been concerned about it, they would, they would've taken the risk of operating while pregnant, and they would've got it out then, and they would've suggested that that was the, the way forward.

Um, but they, you know, they were very much like that this, this isn't a kind of necessarily a, a health risk for, you know, for you at, at the moment as it stands. So I was never worried about my own health. But the thing that was, the thing that was kind of giving me the anxiety about it was this idea of, as I thought at the time, having to have surgery, inpatient surgery when I had a very small baby.

And I said right from that first appointment when they said I was gonna have to have this surgery, there were, there, there were two things that I asked. I didn't, probably didn't ask any of the right questions that people should ask, but one was, will I still be able to sing because I do not sing, I sing in a choir.

And, uh, your thyroid is very close to your, uh, vocal chord if you laryngeal nerve. So I was bit nervous about that. And uh, the second one was. I wanna breastfeed my baby. Will I be able to have my baby with me in hospital when I go in for surgery? And at the time, and I remember the consultant going to check with the admissions team and while I was there the appointment, he came back and said, check the admission team.

And, and they said, no, you won't be able to have your baby with you. Oh, and by the way, you'll have to. And as well, luckily, I already knew that that was not the case. So luckily I was able to sort that away and say, right, I'm not gonna have that fight because I know I'll not need to pump. And I know that I can feed after having general anesthetic.

But my, the information I had was that I wouldn't be able to have her with me. So I was there sort of thinking, well, she's gonna be six to eight weeks old. How am I gonna. Manage that. 

[00:33:27] Emma Pickett: That's a very, that's a very little baby to not be with you, isn't it? That's, so there was no question of your husband being able to come into hospital with you and care for the baby when you were unable.

That just wasn't on the cards. He just wasn't able to be there at all. You and 

[00:33:40] Emma : baby at wasn't able to 

[00:33:41] Emma Pickett: be there. Okay. Not 

[00:33:42] Emma : at that point. Yeah. That was, that was the information that, that I, that I had. Um, and so, and so that was the main sort of thing that was kind of hanging over me really throughout the pregnancy was, you know, well I'm, I'm gonna have to have this surgery and I, I, I'm not gonna be able to have my daughter, daughter, but I'm not gonna be able to have my baby with me.

And so my, our sort of plan was, well, we'll have to, we'll have to get her used to having a bottle of Express milk as well, and we'll have to, you know, be able to, to do that. And as things got closer, so I was monitored very closely throughout the pregnancy. I had regular kind of scans to check that nothing was growing and all of this and that sort fine.

And I think as we got closer to the end of the pregnancy. Then said, okay, well things are sort of looking, things are looking fine. So we can probably go to like three months post birth before we have the surgery. So I was actually booked in for the May, so she was born in February. I was booked in for the sort of middle of May after she was born.

And we tried everything under the sun to get her to take a bottle, absolutely everything. I kind of wanted to wait until breastfeeding was established before we did start pumping and giving express milk in a bottle, et cetera. And because we now knew we had this little bit more time, kind of felt comfortable doing that.

But from sort of six to eight weeks old, we did start trying a bottle and we just tried, we tried every type of bottle under the sun. We tried, you know, me giving it to her. We tried my husband giving it to her. We tried hungry, we tried not hungry. We tried my mom giving it to her. We obviously were doing, you know, trying like feeding and all this.

And she was not interested in any of this. 

[00:35:20] Emma Pickett: It doesn't, doesn't sound like you were getting support for things like finger feeding or cup feeding. 

[00:35:25] Emma : So we did, we tried, we tried cup feeding, we tried cup feeding as well. So we tried, we tried, um, we tried, uh, some open cup feeding. Um, and I finger feeding, if I'm honest, never really occurred to me.

And I kind of looking back at it now, I'm sort of, I, I did reach out for support about bottles, but I, yeah, I never really, the concept of finger feeding kind of never really came up in the discussions that, that I was having. Um, and we basically, as we got closer and closer to the day, I just made the decision to postpone it.

And I said that I'm not, I can't have, because I'm not in a position where I can leave her overnight at the moment, and another three months in my mind was not gonna increase the risk to my own health. 

[00:36:11] Emma Pickett: Okay. 

[00:36:12] Emma : And so I made that decision. And again, you know, I don't wanna come across like I'm recommending that because that, you know, that was, that was probably against medical advice.

Yeah. But that was the decision that was right for us at that time. And so I postponed it. And so it was booked in then for when she was six months. She, she literally just turned six months on the date. It was six months and two days. 

[00:36:32] Emma Pickett: Okay. 

[00:36:32] Emma : Old. And actually what I then did was alongside, you know, we, we still kept trying to get her to take bottle, but part of the reason I thought I couldn't do it three months was because I didn't have the head space to think about how I could try and persuade the hospital to let have her with me.

[00:36:51] Emma Pickett: Okay. 

[00:36:52] Emma : And actually then I then felt like I had a bit more breathing room then to actually do some research and, and, and try and fight to have her with me because I just thought that was gonna be, that was my preference. That was what I wanted. That was gonna be what was best for everybody all round. And if she never did take a bottle.

Six months could have looked into cups when we did. Um, but that was, that was partly why I made that decision. And that was then what I sort of focused most of the energy that I had on was actually doing the research into how can I make this happen for her to stay with me rather than how can we get take bottle.

So I kind of, okay, 

[00:37:27] Emma Pickett: so this is when your lawyer brain is very useful because you'll, you'll be good at research and you'll be good at advocacy. What did you find out now? I, I sort of vaguely know the answer to this question 'cause I've helped tried to help other people and what I discover is there isn't really a national policy around what happens when a mom goes into hospital.

Is that your understanding as well? I've not missed anything recent. Yeah, 

[00:37:49] Emma : no, that was my understanding. There is an Academy of Breastfeeding medicine protocol on it, which, um. Another incredible IB CLC Olivia, who is just wonderful and so very generous with her time on, on Instagram. Um, she shared that with me and she, she was kind of gracious enough to reply to my, I looked back at message recently in preparation for this podcast to find that protocol.

I back on Thetic message from me that's like. And, you know, bless her, say she shared this, um, protocol with me. And so, can I just 

[00:38:24] Emma Pickett: interrupt for anyone who doesn't know that? So the Academy of Breastfeeding Medicine, which is another A BM, not the Association of Breastfeeding Mothers, but the Academy of Breastfeeding Medicine, it, it's more u it's more America based, isn't it?

It's US based. It's, it is officially international and it certainly governs decisions made around the world. But truthfully, an NHS team are gonna look at that and go, sorry, love. This is a bunch of American doctors. And of course they're lactation focused and yes, okay. It's full of evidence. It's full of research based research.

The protocols are always heavily, heavily evidenced and research based, but I doubt that's gonna sway anybody if, if, if it's that from that organization. 

[00:39:02] Emma : Yeah, absolutely. But it was very helpful to know that there was something, because as I say, there, there's not really anything in the UK that's sort of universal.

Um, and kind of the way I approached it, I, I'm very lucky again that I know lots of people who work in the n. So I spoke to lots of people. I have a friend of mine who was hospitalized on an emergency basis when her daughter was, was breastfeeding, was able to kind of have her daughter with her very similar story.

Um, one of your guests, uh, Iisha, wasn't it recently, who had a very similar story to that as well with an emergency hospitalization. With a breastfeeding baby. And so I kind of, I, I got all this information from all different places and, um, I, and actually the thing that I did that was really game changing and the whole thing was I spoke to the infant feeding team at the, the trust maternity unit.

So the hospital that I was at surgery didn't have a maternity unit itself, but the trust does, um, in one of the different hospitals. And so I called them up and I spoke to, I've managed to speak to a midwife in the intimate feeding team who again, just was absolutely wonderful. She was so brilliant and she was exactly the voice I needed to hear because she made me think that it was gonna be possible.

And actually what she said to me. Her name was, um, I can't, I think her name was Joan. She was just, she was brilliant. She, she's one of these midwives who'd kind of retired and then come back during COVID. And so she was just, she was just, I, I'm so indebted to her because she, she said to me, she was like, we do have a policy, we have a policy at, at this trust that if, and it's written down.

And she sent it to me that if a breastfeeding mother has to have inpatient surgery and the baby can't take a bottle, I think it was like if they're under a year and they can't take a bottle, then the hospital should make arrangements for the breastfeeding mother to have the baby with her and for there to be another responsible adult staying as well.

Okay. And that was brilliant. That was the thing that I was like, this is what I've been looking for all these months. That is 

[00:41:02] Emma Pickett: written down, written down as 

[00:41:04] Emma : a 

[00:41:04] Emma Pickett: policy for your trust and anyone else who goes, oh, what does our trust say? I guarantee you there'll be some trusts that won't have anything like that, I'm sure.

And there'll be, and there'll be other trusts that do, and other trusts that will say six months and other trusts that will say eight months. And it will be so variable. I mean it's interesting they say 12 months, isn't it? 'cause a whole bunch of other people will be like, what if an 11 month old can't take a bottle?

What's the big deal? They'll just eat, you know, they'll eat sandwiches and drink some water. So it just shows you how individualized this is and how it comes down to a group of people in a room saying, we've noticed this is a problem. Let's write a policy or a document. And when documents exist, everybody relaxes.

So the fact you found that is, but, but that you only found that because you happened to get in contact with Joan and you happened to come across that almost accidentally. It wasn't sort of on a website or anything like that. 

[00:41:53] Emma : No, no, it wasn't. And, and I think that was the, that was the sort of the main.

Stress for me. And the main frustration was just that there wasn't the awareness of it. And even sort of after I'd identified that, the next thing I then did, I think I even remember raising it at kind of one of my appointments that like, oh, I found this policy because they didn't know about it. Like, oh, I'm not really sure what, what we can do with this.

So, so actually what I ended up doing was I got in touch with the patient liaison, liaison service, and I, I sent what, um, my husband described as a very loyally email, um, to the patient liaison service, which attached a copy of this policy referred to that I referred to the World Health Organization guidelines that referred to the NHS guidelines on breastfeeding.

I did refer to that. That's an Academy of Breastfeeding Medicine protocol and all of this. And I sent this, you know, let's say quite lengthy email to the patient liaison service. And I was just basically like, somebody help me make this happen. And I remember I then got a call from the matron for that part of the hospital that I was in.

Once I got hold of the right person, it could not have been easier. And she just said to me, she was like, yeah, I've been past your email about this. We can absolutely make this happen. We're gonna have a private cubicle for you. Um, your husband can stay over. He might have to sleep on a mattress on the floor, but you know, he, he can stay over.

Um, you can bring your travel cart, you can have your daughter with you and all this. But this was only, that was, um, six days before the surgery. That was like, how long is took? 

[00:43:22] Emma Pickett: And if you hadn't have been Emma the lawyer, and if you hadn't have written that email, and if you hadn't have pestered, and just think all the people that A, don't have the capacity to do this because they may not have that level of education or confidence, but B, all the people that have to go in for an emergency and have nothing like that, that preparation.

So, I mean, I want to say, I know you did this for, for you and for Isabella and your family, but what a gift you've also given for, for future moms and families that come after you because they will remember these, these conversations and that email will be on record. And that policy has been drawn to the attention of people who weren't aware of it.

So you've done a great service there with your, with your peer supporter hat on. 

[00:44:01] Emma : Well, I hope so. 

[00:44:02] Emma Pickett: It seems to be that in emergencies. People don't think about it as much. Like if you've got mastitis or you've got an abscess, it seems very logical to have your baby with you. Mm-hmm. And, and that's when it seems to happen.

It's when it's not breast related or you happen to bump into the wrong people, um, that things tend to go pear shaped. So the fact that you had, you've met the right people and you had the advance notice and you were able to get organized, it was wool all went into your favor. 

[00:44:28] Emma : Yeah, definitely. 

[00:44:29] Emma Pickett: So, I mean to say bring a travel cart, so you were on a main ward.

Were you with multiple beds in the ward and there was space for you and your, and the travel cart and your husband in that space. So I'm guessing you were kind of on the end. I'm trying to work out physically where everybody was. 

[00:44:44] Emma : We were, we were in a private room, so we, we were very lucky. Had a private, private room and, um, and gosh, and I, I, and I remember I kind of came the, came the surgery and even, you know, this was.

I was away from her for five hours for the, for the surgery. She, you know, she, she and my husband were in the hospital with me until I went in about 2:45 PM They came back to me at 7:45 PM That was the longest I've been away from her ever at that point. You know, I've never been away, I've never been separated from her, from her for that long.

As, say she was a six month old baby who was, as I say, very, very snappy, very frequent leader, very much a koala baby. That was the longest I've been away from her. And I remember being kind of wheeled into the ward and, you know, I, and I sort of checked, made sure all these arrangements were in place when I went in and I sort of said to my consultant when I went in, this is, this is what's happening.

I've arranged all this. And, and the nurse who was sort of wheeling me into the ward actually did originally just wheel me onto the main ward and put me in a bay, like between two other people. And I remember being, I was so groggy still from the surgery and I was feeling really sick and just not, you know, but I remember being like, and I remember saying to her, probably not making any sense.

I was like, I'm not meant to be here. I'm meant to be in a private room because my, my baby's coming. And she was just like, no. That's not what I've been told. And I was like, oh God, is this all gonna come like crashing down? Is this all gonna go wrong? Like last minute? And luckily then one of the other nurses came over, I was like, no, no, no.

Yeah, that, that's right. She's, she's going 

[00:46:04] Emma Pickett: into this group, so, okay. So somebody knew. Gosh, I guess one of the other things with NHS is quite open. You can bump into agency staff, you know, I mean, if someone doesn't know, if someone hasn't read your notes, I'm guessing block capitals on the whiteboard in the entrance to the ward was, this is the one with the baby.

I'm surprised you didn't kind of sharpie on your forehead. I have the baby put me back with the baby. But it 

[00:46:25] Emma : worked out. It worked out. And so I went into this private room and I just, and I remember hearing little bit later on whenever it was that they, they, they came, I remember hearing my daughters screaming from way down the corridor and just knowing that that was her, and again, like all the, you know, all the staff in the ward knew, obviously they saw a baby and they knew immediately where to kind of usher my husband and her.

And I just like seeing her little face. Like, you know, clearly really distraught that like, she'd been away from me for so long, and I think up until then she'd actually been fine. You know, my mom had come down to help as well, and I think she'd been fine. I'd made sure I'd left. She literally just started experimenting with solids.

So I'd left some, you know, really hydrating foods and things for her. I'd left some like breast milk porridge and things like that, but she could, you know, experiment with while I was out. So she, they, they'd all done absolutely fine. Um, but I think she was just, you know, 7:45 PM she was getting really tired, like, where's my mom?

And she, you know, and, and so she, she came in and she, and she said, she, she laughed straight away. I was very, um, the other thing about the surgery was, so I say I went in at 2:45 PM I hadn't been able to eat since before midnight, the night before. And I'd only been able to have sip of, like, I, I, I think every hour I could have 50 of water.

So I was really hungry. I was, you know, very hungry. I hadn't been able to had her stomach any food by that point. So, you know, she was then getting really, I remember her getting very frustrated because my let down worry wasn't coming as fast as it as it normally does. So it wasn't the sort of, you know, serene first feed after that separation that I hoped.

But, you know, she, she was there and she was feeding and it was, it was fine. And um, yeah, that was, it 

[00:48:06] Emma Pickett: worked out. You mentioned that in the early days someone had talked about pumping and dumping, that was just misunderstandings around anesthesia. Was it that whole, that chestnut, which occasionally we still bump into where people are told they can't breastfeed immediately after anesthesia, which is not the case for anyone listening.

If you are awake, you are okay to breastfeed 'cause it leaves your system very quickly. And there were no other medications that weren't compatible with breastfeeding. It was just a misunderstanding around that. No, 

[00:48:30] Emma : yeah, it was just a misunderstanding around that. And actually by the time I got, you know, the, the staff on the clearly were, you know, knew that it was fine and you know, after when, when I actually got the, to the day the event and nobody said anything about it then, so it was all just like, yeah, of course you can breastfeed.

[00:48:45] Emma Pickett: Okay, well, I'm glad that worked. Um, might imagine that a devastating it would've been if you'd been fighting the battle and still hadn't won it by the time you went to hospital. So anyone who's listening to this, who's in this situation, who is having a scheduled surgery and is still fighting this battle, um, Emma's Instagram handle is in the show notes.

She's a busy woman. She's, she's a full-time lawyer, but she might be able to ping you the policy from the hospital where she went, and that could be evidence that, that you would perhaps use in your conversations. Um, it's absolutely possible for your baby to be with you. You just have to find, um, the right people to listen to you.

Um, it doesn't make sense for babies to be separated from breastfeeding moms. There's no reason why that has to happen even in a stretched environment. How long were you actually in hospital? 

[00:49:28] Emma : Uh, just, just the one night, just, just overnight. So it was, it was very short. It was a very short stay and yeah, discharge.

Discharge the following day. Um, all fine. You know, the recovery was kind of as, as smooth as could be expected with a a six month old. And as I say, the results came back and it was all, it was all fine. Um, so I was, I was, I was very, very lucky really in that. Yeah, 

[00:49:48] Emma Pickett: I guess things are a bit more complicated if people are there for an extended period of time.

Yeah, and I guess things are also a bit more complicated if somebody is very, very unwell. Um, and actually talking of Olivia, I remember she did a post not so long ago about expressing for somebody who was not conscious. Um, you know, there, I mean, are ICU nurses that are expressing for women who are unable to, to breastfeed or feed their babies?

So obviously every situation has to be looked at individually. I don't think either you or I would claim that there's a universal answer where every single person is entitled to have their baby by their side for every minute they're in hospital. We're gonna have to balance all these different needs.

But certainly for someone going in for scheduled surgery for one night, it doesn't seem sensible to, to separate you from your baby. 

[00:50:30] Emma : No. One of the things, I think actually, it's actually just helpful to know that, that it can be done. I think, you know, I spoke, this happens, I think, more often than people realize, you know, it sounds like a very niche thing.

And I think that's perhaps why there wasn't, like the awareness of it, because it, it's not something that happens every day that, you know, a, a breastfeeding mother has to be a missive surgery with a very young baby. But it does happen. And, you know, and I have supported women who have been through a similar thing.

And actually there was one woman who I spoke to recently who, who actually just said, you know, it was, it was a completely different situation for her because actually she was, she, she was having it done at a private hospital, so it was completely different again for her. But she said that actually even just knowing that it was possible and that somebody had fought for it before was the thing that gave her kind of the impetus to, to fight for it herself.

And actually she wasn't allowed to have a baby all, all. But her husband and her baby could stay until midnight and then they came back at 5:00 AM So it's kind of, there's, even if it's not the case of, you know, yes, they can be there all night, there will be a way. And it's just knowing the right avenues to explore.

So definitely like, you know, speaking to the infant feeding team and the trust and things like that, just things that I think are really helpful to know about. And, and, you know, I didn't even know there was such thing as a patient liaison service until I spoke to an NHS friend who was like, oh, you should get in touch with PALS about it.

And I was like, who's, what's pals? 

[00:51:50] Emma Pickett: So every hospital, every trust has pals and PALS often deal with complaints, but actually they can also be part of any conversation that's to do with how a patient interacts with the hospital. So you can absolutely talk to them before, um, a procedure as well. And it sounds as though that that was, that was really valuable for you.

And how was your recovery, um, back home? Everything carried on. Okay. Yeah. Obviously they looked at, they looked at what was removed and, and it wasn't cancerous, so you didn't have to have some of the treatment that Laura described in her episode. Um, and I'm gonna skip a little bit here to ask about your ending, 'cause I realize we're coming up to an hour now and it'll be lovely to hear how Isabelle's breastfeeding journey ended.

But before I do that, is there anything else you want to say to anybody who's in this space of worrying about an operation and worrying about their baby being with them in hospital? 

[00:52:39] Emma : Just as you say, I do, I'm very happy for people to reach out to me. I have, I say supported other women going through, I've, I've shared in the past the kind of the email correspondence I had in case it's like a helpful framework for, you know, emails to send as you say.

You know, I, I, there were a combination of things that meant that I was in quite a good position to fight for myself with this, but I appreciate not everybody is in that same position. So I'm really happy and as you say, do put my handle in the show notes, and if people want to send me a message. Um, I might, I might take a few days to get back to you, as, as you say, I, I, I've got a lot going on, but I'm always really happy to do what I can to help because it is, it's not the most usual situation for people to be in.

Um, but you know, it, there, there is, there is support and there are things that you can do. 

[00:53:25] Emma Pickett: Yeah, yeah, for sure. Thank you. That's very generous of you. So, tell us about Isabelle's endings. How did things continue as she drifted into the second year of life? What, what happened with her breastfeeding? Jenny and you went, you were back at work as well, so you're working full time.

What was her breastfeeding like when you were working full time? 

[00:53:43] Emma : So, I mean, you know, typical, typical, I suppose in some ways that, you know, she, um, she, but when I was not there very much outta sight outta mind. Um, you know, we sort of tried sending some expressed milk into her childminder with her as she started off at childminder, sort tried sending some expressed milk in with her.

She was never interested in it, so we stopped very quickly. Um, so I was pumping a bit at first, mostly for my own comfort, um, but a little bit to kind of send her. But I kind, I phase that out quite quickly, really quite quickly. Then on the days that I was with her, she was still a very frequent feeder for, for a long time actually.

Um, and I, uh, around the time she turned two, that was when you and I had a very helpful session, um, to when you helped me kind of try and put some boundaries in place and reduce feeds down because she was still feeding sort of. 10 plus times a day as well as overnight at that point. And at age two, that's just quite, it's quite a lot to, to manage.

So 

[00:54:38] Emma Pickett: can I just pause you for a second there, Emma, and say, it's actually really interesting to hear someone say that you didn't have to express on your working days, despite the fact she was still feeding f frequently when you were with her on overnight. And some people are like, what the, how does that work?

But breasts so clever, aren't they? I mean, did you have problems with engorgement and leaking on your working days? 

[00:54:57] Emma : No. No. And actually it's, again, it's another one of the, the fascinating things that like your body knows, your body knows. And again, just blows my mind because yeah, was feeding all the time on the days that I was with her.

Um, and then very quickly on the days when I wasn't, I stopped having to pump and I was just able to go the full day. Um, and it was fine. So yeah, it's, it's just, it's it's incredible, isn't it? And you know, it's, it's, it's often something that I do talk to women about when I'm supporting people in the transition to work.

Again, it comes up quite a. Uh, groups and things when, you know, mothers are, are sort of approaching the return to work and they often get worried about that. And I say, like, your, your body, your body will adjust it. It'll adjust and it'll know when you're with your, your baby and it'll know when you're not and it'll adjust accordingly.

It's amazing. Yeah. 

[00:55:42] Emma Pickett: Super clever. I mean, I get, I guess a little side note, there will be some people who's their storage capacity and the production means they may need to express perhaps even at the beginning of the week after a weekend. But lots and lots of people don't. Lots of people will just absolutely not need to express at all.

Um, so her, so her daytime feeding calmed down a little bit. Just describe for me, you're working full-time as a lawyer and she's fitting through the night. How did, how did that, how did that go? 

[00:56:08] Emma : Um, well, uh, yeah, that, that was, that was, that was tricky. So she was probably, she was still, she was up probably three or four times a night from to sort of my, my first year back at work.

Really? She didn't sleep through the night until she was. Just over to, I think she was 26 months old the first time she slept through the night. And after that we actually, so I've been back at work kind of just over a year. Um, and after that we had a blissful period a few months where she pretty regularly slept.

She slept through pretty much every night and that it was completely outta the blue the night before that she'd woken up her normal three times, I think, and then suddenly she slept through. And I remember waking up at 5:00 AM and rushing in to check that she was okay because I was, it was so kind of alien to me.

So yeah, it's, it's tough. Like, you know, that kind of being up that much in the night, um, when you are sort of working, I mean, I was, I was part-time then, but still, even then it's, it's, it's hard. I think you just, you adapt and you get used to it. But it was sort of amazing the kind of, when she did start speaking through and I, we then were getting better sleep.

The difference it made to my sort of mental clarity at work, I suppose. Um, and how I felt I was performing was, was remarkable. And, and kind of from then on, we, we, from then on, it's sort of been up and down asleep. She still, I mean, she, she kind of ends up in our bed at some point every night and how well we sleep depends on how still she stays.

Um, you know, she very often ends up sleeping horizontally and one of us gets headbutted and one of us gets kicked, and so often one of us then moves it to, to a different bed. So, so it's, it's not sleep has never been brilliant with her, but we have definitely had, period, it's so much better than it was when I first went back to work.

It's so much more manageable now. Okay. 

[00:57:59] Emma Pickett: And her breastfeeding gradually reduced and then she ended up self weaning. Spoiler alert, just a few months ago. For anyone who's listening, who's thinking, Ooh, self weaning, what was that like? Can you kind of explain how, how that worked for her? What was that process like?

[00:58:12] Emma : Yeah, sure. I mean, it was so, it was really, it was unexpected. I genuinely thought that we would have to. Put in place like some serious like measures to, for her to stop breastfeeding because she was such, she, she was such, such, you know, your, um, your wonderful podcast episode that I recommend for everybody, weaning a boob monster.

She was the definition of a boob monster. She was, you know, loved, it was assessed and I really thought it was gonna be a battle. I thought it was gonna be a battle that we would have to have and that we would have to, you know, really sort of manage some big emotions around it. And actually it just, it happened so gradually and it was so very led by her in the end.

So we, we, with your help, we got down, as I say, to kind of morning and evening, you know, morning bedtime, and then feeds overnight as of when she needed them as well. Um, and so we were kind of like that for a long time. And then she just sort of gradually started losing interest. So she, she started first during the night feed.

She kind of. Just have like a tiny bit and then she'd roll off and just go back to sleep cuddling. Or even sometimes she wouldn't have any at all and she just wanna to cuddle. And then the morning ones were kind of phasing out as well. She just, some mornings she just didn't ask for it. She wasn't fussed.

And I kind of just gotta the point where I was like, I'm gonna offer, if she doesn't ask for it, I'm not gonna, you know, kind of don't offer, don't refuse type thing. Then there was some warnings that she would want it, and then some warnings where she was absolutely fine without it. And then the bedtime feed, which I always thought was gonna be the kind of last one, the one that was gonna be the real struggle to let go of, she just, again, started just not, not really being interested and she wouldn't even really match properly.

But in the, in the last few weeks, she wasn't even matching properly. She'd just kind of stick her mouth off and then just have a couple of sucks and then roll off and just again, cuddle to sleep. And so I remember sort of thinking like, is this, are we kind of approaching the end here? And then I, I went away.

I had to go away with work for a three. November last year, which was, um, the longest I'd been away from her. I'd only ever done a night at a time before then. And it was kind of when I came back from that, she was just even less interested. And so we did then for a week or so after a week or sort of 10 days after that, we were kind of going through the motions, but she pretty much stopped in the morning by then.

She wasn't interested in the night. It was just that bedtime feed, which I think was more just outta habit than anything, but wasn't actually really serving her. And then there was just suddenly one day where I realized it was the first time I'd got a whole day where I'd been with her all day and I hadn't fed her at all.

And that was, that was pretty much that. 

[01:00:44] Emma Pickett: So you, so the bedtime feed, then it was part of the ritual to feed at bedtime. So she, but she, it almost became symbolic that she kind of latch on symbolically without actually feeding. Um, and then when she didn't feed, what, she just moved for a cuddle. She just, yeah.

What, what did it look like when she wasn't feeding at all? 

[01:01:04] Emma : She just, so, yeah, she would just, she would just want a cuddle. Um, and actually she became more attached to, um, cuddly toys and things, which she'd never really had much of an interest in cuddly toys before. And again, I remember it from one of your podcast episodes, um, that, you know, breastfed babies and breastfed toddlers often don't have the same attachment to like a cuddly toy or a, um, a comforter or anything because they get the comfort from the breastfeeding.

And that was really true of her. She was never particularly interested in cuddly toys. But since she stopped, she, she has, that was, that was the kind of thing that she suddenly became really interested in a need. Now she needed the cuddly toy to go to sleep, and Yeah. And it was just a cu lord, or even just kind of lying.

With and singing. Like I've always sung to her. I've always sung her sleep or sung her, sung her to sleep while she's been feeding. I've always fed her to sleep previously, but, um, I've always sung to her as well. And so we have a kind of ritual of bedtime 

[01:01:57] Emma Pickett: songs 

[01:01:57] Emma : that we 

[01:01:58] Emma Pickett: Okay. So you actually had that habit stacking already in place.

Yeah. Even though you weren't actually weaning her. So, so as you said, this was very much led by her And I just to say that, that you are going away, I don't think anyone could say that was the cause of her weaning. She was very clearly, very clearly on the way out before then. You never read any weaning books.

You never talked to her about the end of breastfeeding. It just was very, very organic and natural. And, and how did it feel for you when it ended? Did you feel any kind of, oh gosh, I wasn't quite ready for that. Or did you feel okay? 

[01:02:26] Emma : Yeah. So overall we, I'll just come back. We, we did actually just come back to the point because we, we did actually read some books to her.

So, um, but like, not recently, we sort of read them to her. I actually read them, I realized on them more when I was just reducing those piece down just after she, through, after you and I, so we did, um, you know, we sort of dropped bits in here and there when we talked about, you know, everybody stops at some point and, you know, everybody stops having milk and all of this.

So there was, there was a bit of that, but it wasn't, we hadn't been focusing on that recently at all. Um, yeah, which is why I feel about Blue. Um, in terms of how, how I felt about it. I mean, yeah, overall just massive relief that there was no drama, there were no tears. It was, it felt so gentle and so gradual.

Part of me was kind of hoping that we'd make it to four just because it's a nice round number to make it to four years. We didn't quite make that. She was three years and, and nearly 10 months, um, by the time she stopped. So, you know, kind of hoping to make it to four. But, you know, ultimately I remember feeling very vindicated because.

She got there on her own. And I always knew she would. It was always just a question of when she would, and, you know, all these, all these sort of people who, you know, doubted that the fact that I was still breastfeeding her as a 3-year-old and thought that that was weird or thought that that was abnormal or that, you know, which, you know, sadly there are still those kind of attitudes.

Um, you know, that she did and, you know, thought that it would have some sort of impact on her independence and would mean that she wouldn't be as independent or that, you know, she'd still be breastfeeding when she was a teenager and all this. I just feel very vindicated. But actually, you know, she was three and she just, she did, she, she got her on her own.

And I was a bit, this, the main stuff for me actually was that it was just very unceremonious. I say it just happened that there, it just suddenly was like that, it not suddenly, that's the wrong word to say. It was gradual, but the, the actual end felt quite kind of, there wasn't, I always thought that we would mark the last feed in some way.

I don't have a photo, for example, I don't have a photo for the last feed because I didn't know it was the last feed. And in so many ways that's the best way for it to happen. But I think just sentimentally. I would've liked to have known that that was the last time I was gonna beat her, because it, it was such a big part of our lives for such a long time and such a big thing for me that I'm so proud of.

But I would like to have something to mark that. But I have the, the memories of it, and I, I don't really need more than that. And as I say, overwhelmingly, it was just relief that, because I was definitely ready, I was definitely gonna point where I was ready to stop and ready to feel like I had my body back again.

So it just happened that, you know, we, we were both ready at the same time. Um, which I never thought would be the case. I always thought I'd be ready for her. 

[01:04:55] Emma Pickett: And it sounds as though, unlike lots of little people, she didn't do that thing of asking and then not asking for a week and then asking again, and then not asking for two weeks.

There was one night and then that was it. Yeah. And there was no, no more requests after that. 

[01:05:09] Emma : Pretty much, yeah, she did. There were a few times where she had where, and actually even recently, even like last week at one point she asked, she asked for it. Um. She, but one of the things that happened when I was, when she was kind of reducing down, um, and, and self weaning was, um, she told me that my milk tasted salty, which I know can happen because the balance Yeah.

As as the volume drop. Yep. Yeah. Um, so actually I don't think she liked the taste much anymore. So actually when she, if she did ever ask for it, and there were a few times that say dotted around where she would ask it normally if she was very, very tired or a bit emotional and she'd ask for it. And I would just say, I dunno if this is recommended or, but I just say, okay, salty now remember?

And then she'd go, oh yeah, she'd just be fine. So I was like, well, that's okay. Fine. Don't have to do any, any, any, when you say, is this 

[01:05:55] Emma Pickett: recommended, Hey, there's no international council of weaning in here. I mean, you do whatever feels right. And, and, and it felt right in that moment to respond like that, which I think I totally understand.

Yeah. And, and if she was bothered, she'd have pushed back. Yeah. And she clearly, she clearly wasn't. So, yeah. Sounds like, sounds like you were ready to, thank you so much for your time today, Emma. I really appreciate it. You've been very generous. And, um, thank you for offering to, to, to reach out and help someone, anyone who's really struggling, um, with the hospital issue in particular.

Is there anything we haven't talked about that you, you wanted to make sure we mentioned? 

[01:06:27] Emma : No, I don't think so. I think that's everything. Yeah, it's been great to talk to you. Thank you so much for having me on. It's been quite cathartic to talk about all of that actually with the surgery. It's quite a cathar experience, so thank you.

Yeah, 

[01:06:38] Emma Pickett: no, well thank you for your time and congratulations on your, your very special breastfeeding journey, um, and overcoming the challenges along the way, including working full-time as a lawyer, which is not easy when you are, when you're breastfeeding natural term little people. So well done for good for making all that work as well, and thanks for your time today.

Thank you. 

[01:06:55] Emma : Thanks so much, Emma.

Thank you for joining me 

[01:07:02] Emma Pickett: 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.