Charlotte's story - a faltering growth journey

In this episode, Charlotte shares her story of her son Noah’s journey with faltering growth and weight gain challenges. Her family struggled with bottle refusal, insufficient NHS support and hospital stays. Thanks partly to the remote support of lactation consultants, Noah is a happy 14 month old today with some great fat rolls, but the journey to get here was not an easy one.

Charlotte is @the.smart.doula on instagram

Charlotte talks about working with the brilliant Lucy Webber IBCLC. You can hear Lucy talking about the fourth trimester in episode 33 of this podcast. Lactation Consultant | Lucy Webber IBCLC | Bristol, England (lmjinfantfeedingsupport.com)

She also talks about Charlotte Young IBCLC from Milk Matters Infant Feeding Solutions – Infant feeding information, support & education

My new book, ‘Supporting the Transition from Breastfeeding: a Guide to Weaning for Professionals, Supporters and Parents’, is out now.

You can get 10% off the book at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

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

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

Transcript

Hi. I'm 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 to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk. 

Emma Pickett  00:47

Thank you very much for joining me for today's episode. I'm sitting with Charlotte, who is a virtual doula. You know you're in 2024 when somebody's a virtual doula. We'll talk to her a little bit more in a minute about what that means. As you will have noticed from the title of this episode, we're talking about faltering growth and Charlotte's journey with her son, Noah. And that phrase faltering growth, I should say is with the consent of Charlotte, that's not me labelling her story, we're going to be talking about a journey, struggling with weight gain issues and trying to resolve those issues. And if that's a difficult story for you to hear, I totally understand but I'm hoping that it will be something that you will will gain something from especially if you're in the world of breastfeeding, support yourself. Thank you very much for joining me today, Charlotte.

Charlotte Young  01:31

No problem. Excited to be here.

Emma Pickett  01:33

Cool. So let's start at the end. So you have no now who is happy, healthy 14 months old? What's your story today when it comes to feeding and and Noah's health?

Charlotte Young  01:45

So Noah has no he's perfectly healthy. In fact, he is a chubby little boy. Now when we've got all the thigh rolls and the cheeks and the chins, which is beautiful to see. We still breastfeed once a day in the morning. And he does even I'm aware we ought to be cutting out a bottle or two. He has about one and a half bottles of cow's milk a day and the rest is just food.

Emma Pickett  02:08

Cool. So he's still breastfeeding. What Where's when's the breastfeeding happening?

Charlotte Young  02:12

In the morning in bed?

Emma Pickett  02:13

Oh, nice. snuggly. Yeah, no. So he was your, your second you have a daughter as well. Mia, who's nearly coming up to five. Before we talk about your story with Noah. What was your breastfeeding experience like with me or your feeding experience like with Mia? 

Charlotte Young  02:29

Yeah, Mia was was tricky. I had quite a traumatic birth. I had done some kind of breastfeeding preparation. I had done NCT class classes. I've had the like, the session that they do on breastfeeding. I really wanted to breastfeed. But then after the birth, me and my husband were just kind of really low on energy. And Mia was rather she was very upset. She was a very cry, colicky baby from kind of day one. And you know, she her latch, she would latch but it wasn't a brilliant latch. I got I was my nipples are really sore. They were kind of the scabby end of sauce. Okay, quite a lot of friction happening. But I was kind of persisting and then on day five, we were told, you know, she'd gone I think it was around 10%. So we were told her weight loss. So we were told, okay, we need to do something. They suggested cook feeding her but with a very cry for Ashley baby. That was absolutely impossible. And just my my mental health was really suffering at that point, I was finding or very difficult and overwhelming. So we we ended up dropping breastfeeding completely and going on to formula. A did kind of toy with doing a little bit of both. But I almost felt because I've made that decision to do formula. I just needed to do all formula, which is not something I believe in now. But yeah, it was just something that felt like the best decision for us at the time. 

Emma Pickett  03:54

Yeah, I understand. And you were pregnant with Noah, Noah came along. And did you have plans in pregnancy for how you were going to feed Noah? What were you thinking about breastfeeding at that point,

Charlotte Young  04:06

I absolutely wanted to try again. And I did a lot more kind of research. I found Lucy Weber's Instagram page and just kind of all of her content just ate it all up, as well as that my little sister had breastfed her first as well. So I'd been around that and had had I've just had a few more people around me that had successfully breastfed. So I was kind of knew a bit more what it looked like. And I felt a little bit more prepared about it. 

Emma Pickett  04:37

Okay, so you were absolutely convinced that breastfeeding was the right thing for you. And you're going into that journey with a really positive outlook. And that really shows how important having role models is and to see absolutely around you and having those positive experiences and how valuable that is. You mentioned that you'd had a difficult birth with me or how was it with Noah?

Charlotte Young  04:55

It was absolutely amazing. We did a lot of I did a lot of kind of evidence based research, I listened to a lot of podcasts and kind of tapped into my clinical research experience. I was really, really informed, as well as knowing all the guidelines that I was going to come up against in the NHS, because I still wanted a hospital birth, I used a midwife led unit. But I just was I was very aware of kind of the time periods that they were up against. So when they were suddenly like, oh, we need to do X, Y, and Zed. I knew why they were asking. So I was able to say, Okay, no, actually happy staying with this now. Yeah, I felt very empowered in that birth. And, yeah, it was, it was pretty straightforward. I still had, I should have mentioned, but I still had a retained placenta with nowhere, so I had one with me as well. So that was a big interruption to kind of the golden hour, and kind of the initial skin to skin. But with Noah, I asked for no and my husband to come with me to theatre. So even though we were separated, they were still there. So I could still see them and talk to them. So that felt a lot better second time around.

Emma Pickett  06:06

tell us a little bit more about retained placenta. So essentially, that means it's not releasing from the wall of your uterus and the way we would, we would hope it to and it wasn't responding to the sort of classic third stage injection that people have it was still hanging on. So you had to have it manually removed, as you said, 

Charlotte Young  06:22

Yeah, moved the first time around. We waited a little bit, we waited a long bit a little bit longer before I had the injection and my percentage and calm. And but because that birth was quite traumatic birth, the lights were on everybody was already in the room. It wasn't that kind of protected golden hour anyway, it was, you know, had been a by the endless lots of people watching me pushing and people coming in seeing if I needed help or like an episiotomy or a drip to help me. So it had kind of all kind of gone awry by that point. So I said yes, the injection eventually, and still nothing. It didn't come out. I said yes, I consented to them trying to remove it by gently tugging on the toad and giving some fundal pressure. But again, that didn't, didn't help. So eventually, as I went to theatre, I had a spinal, and they did a manual removal with nowhere. Again, I really wanted a physiological third stage of nowhere. But again, it didn't come. We didn't wait as long that time. But I think that was mainly me because I knew what if I knew what was coming. I was just like, you know, what, just take me to theatre. I'm not I don't want anyone tugging on the cord. That was not very nice. Last time. I'd rather just get it done and over with so yeah, we went to theatre quite quickly with that one. But like I said, No. And Mark came with me. 

Emma Pickett  07:42

Yeah, you sound like a woman who knows what you need. That word empowered is good. I love that word. Were you already working as a doula at that point?

Charlotte Young  07:48

No, but Well, I think no, not officially. But I'd become obsessed with prepping for birth, basically, because of my first. So yeah, I don't know, I've done so much reading and research and knew my rights. had lovely midwife. Second time around eventually, when I found her, she was really helpful. So yeah, I was very, very prepared and empowered for my second because the birth itself wasn't dramatically different to the first. But I just felt like I'd made the choices myself, which was the absolute key thing. Yeah.

Emma Pickett  08:21

Just give us a couple of lines on what a virtual doula is. I'm going to imagine that you're kind of WhatsApp in clients and doing your video messages. And kind of you're like, you're like the doula in their pocket.

Charlotte Young  08:32

So yeah, I work with all types of women. And, but I can even do kind of one off, which is quite common. I think of a lot of dealers like one off, I call them birth boost calls, but we just chat for an hour about anything you want to talk about. And I kind of talk you through the evidence and guidelines behind that and provide you with kind of the research papers or the evidence based podcasts or whatever, or my full package is, you can start working with me at whatever point in your pregnancy I've had people do it as early as like 11 weeks and as late as like 38 weeks. And yeah, I am just in your pocket. You can send me questions whenever I'll always answer them as quickly as I can. And yeah, it's it's support. It's a little cheerleader, but it's also kind of evidence based support for whatever questions you have that come up in your pregnancy. 

Emma Pickett  09:22

Cool. So you were doing that for yourself. I guess that's not really possible but you're you are definitely informing, being informed and, and showing all evidence with yourself to help you get to that more empowered birth and, and it's really interesting to say actually, the birth probably wasn't that much different on paper, but your feelings about it was so much different. So you were you able to have that first feed How did that correspond with the being in theatre? 

Charlotte Young  09:45

I don't think we fed him before. Yeah, not before I'd been theatre. Second time around though. I had done a lot of colostrum expressing. Just because I was had in the back of my mind that this could be a something that happened again. And I didn't want to worry that if I was in theatre for a long time that no one might be like wanting a feed. So my husband had taken quite a lot of colostrum with him. We've taken it frozen to the hospital. And I don't think they actually needed to use it. It was a bit quicker second time round and theatre. So I had that first feed that was in recovery. And it was tricky, because I at that point had a cannula in I had a spinal. So positioning was, was tricky for that first feat. So I did have a midwife helped me with that. But now I latched beautifully, pretty much straightaway. I had no pain, and he seemed very happy on the boob. So that was a real difference too. With Mia. Mia never really latched herself properly, or really wanted to either. She was always just very flashy. But ya know, we're never seemed really content on the boob.

Emma Pickett  10:56

Thrush is not a good word when it comes to breast. We don't want thrush. Yeah, I'm sorry, you've had that experience with me. But great, your pain free is latching on, you know what you're doing? It seems like, you know, this is gonna be a different kind of experience. When did things start to maybe reveal themselves as not, perhaps as we might hope them to be going. 

Charlotte Young  11:16

And so he was basically he was on the boob constantly, but I was very, I was fine with that. And we'd made quite a specific postpartum plan me and my husband where we decided that for two weeks, I had kind of carte blanche to be in bed feeding baby, and he would take care of everything else. So we were kind of prepared really for, for that. And I knew all about kind of cluster feeding and everything. So I felt things were going well. He was weighing on lots pooing an amazing amount. So we wish we were quite convinced everything was good. But then I think it was day five, the weighing again. My husband actually had taken my daughter out. So I was on my own. And they weighed him. And he dropped quite a lot. I think it was close to 10%. Again, maybe a little bit more. But we kind of discussed it. And we agreed that because we'd had that delay to the start of breastfeeding because of the theatre. And no, it had been quite sleepy in hospital, that maybe that was the cause of the weight loss. And, you know, he was putting a lot it was weighing a lot. You seemed content on the breasts. They watched her breastfeed, it seemed seemed like it was he was latched well. So can we all agreed that? Okay, let's continue as we are, hopefully things will pick up at the next weigh in and they decided to do another weigh in in two days. And then that two days again, put on weight but not very much. It's not losing weight, which I suppose is a good thing. But he hadn't put on is it the 30 grammes a day that's expected roughly roughly so we had put on nowhere near that. So then we were in the kind of cycle of two weekly, no, two days every two days weigh ins, which was very, it was very intense. And quite, it was very, it made me very anxious after say, 

Emma Pickett  13:09

Yeah, I can imagine every two days is is intense. This is the Under midwife care still, you know, the midwife nappies was still okay. Yeah. So we're what sort of ended the first week coming into the second week, still getting the all the pools that we would want. 

Charlotte Young  13:24

Yes. In fact, it was always too much like he started to get really sore. He got quite a bad nappy rash, that we ended up getting a fungal cream for. And that did help clear it up initially. I think we were discharged from the two daily weigh ins when he'd got I think, under like seven potstill had lost 7% of his weight. But we didn't feel like they had to come every two days at that point. Because he was back within kind of the normal range of weight loss. We still wasn't putting on enough really.

Emma Pickett  14:02

And were you getting breastfeeding support like with someone you said that someone who watched you feed is someone saying you know what's happening with Audible swallowing? Can you recognise swallowing? Is someone talking to you about whether to feed from two breasts or one breast or Yeah, tell me about the sort of support conversations you were having? 

Charlotte Young  14:17

Yeah, so I'd had like a midwife and had a like a, like a one of the healthcare support workers as well that was coming just to do the the weigh ins and it was all very much everyone would agree this latch was good. I think looking back that he really wasn't doing a lot of audible swallowing button that didn't really seem to be picked up. And we were kind of thrown into. I think at one point we were doing the feeding where you just switch constantly to keep him going. So you know, from what be able to boob until he absolutely like, conked out

Emma Pickett  14:53

And breast compressions?

Charlotte Young  14:57

It did actually get to the point where with breast compressions, that was really the only way to get him to do audible swallowing. So I was doing a lot of kind of a lot of work. I felt like I was doing a lot of the work in terms of feeding. So a lot of the a lot of breast compressions and he would only really start swallowing when I was doing the breast compressions.

Emma Pickett  15:18

Okay, but still no pain, no no damage, no damage, 

Charlotte Young  15:22

no nothing. Okay. It just kind of went on from there. Really. I think we got to our six week appointment, and he still wasn't backup to his birth weights.

Emma Pickett  15:36

Okay,

Charlotte Young  15:37

I should say as well by this point. Obviously, I wanted him to put on weight. And I wasn't so much like I must breastfeed and won't do anything else. So we had like, tried to syringe feed him. breast pumps, breast milk, we tried cup feeding, and he just really was not interested at all in it. In fact, he would get very upset when we tried to do anything other than breastfeed. I think as well, we'd identified the Fed much better arm my right boob than my left boob. So I'd started and my left boob kind of disapply my left boob I felt it started to dip. So I started pumping the left boob to try and get my supplier to go up in the left boob. It was all very just kind of like guesswork as to what what was going on. So six weeks, we had a midwife appointment. It still wasn't backup to his weight, his birth weight. So she extended we weren't discharged. And I think she gave us another week. I think we were close, but not quite there. She gave us another week. And a week later, we saw her and she had his birth weight. So they discharged us at that point. I'm not looking back. I'm not very happy about that. Because obviously it shouldn't have taken me that long to 

Emma Pickett  16:53

Gosh, it's so hard, isn't it to look back with and look back with different eyes? Yeah, yeah, I mean, a baby that's not back up to birth weight to six weeks. You know, that's a family that needs extra help. That's a family that needs support. For sure. I mean, at this point, was anyone using the term filtering growth? When was the first time that was used? 

Charlotte Young  17:10

No. Ah, so at this point, I should say that we weren't relying on the NHS is weighing so they they reduced the waiting for us. So it wasn't very often but bade I'd found a place on the corner from me, it was like a children's activity barn. They had like some scales in their toilets, like specifically for women to go away their babies. There were like calibrated scales. So I'd started over so often going there and weighing him. So I knew and my husband knew that things were we're not every time he went to work, this is gonna be the time like he's gonna put on loads away. Yeah, but he hadn't.

Emma Pickett  17:51

Gosh, that's just it, I'm just visualising you going to that activity barn. And there's me running around outside and jumping up and down 

Charlotte Young  17:57

It got to the point where I was like, No, we're asking Mark to go and do it. Because I was like, I can't like I can't go and look at the scale again.

Emma Pickett  18:05

I was actually going to say the idea of it being in women's toilets as a bit of a problem, because, you know, we might have a trans dad or dad who's not trans wanting to go away a baby. And so was Mark literally having to go into the women's toilets. I mean, I think it's great. They had scales on one level might

Charlotte Young  18:20

be they might have been unisex. Actually. It was I think it was quite a it's quite a nice place. And yeah, the toilets are unisex and Mark are certainly marked and feel funny about going in. So if there were or it was,

Emma Pickett  18:34

okay, gosh, I'm just imagining you go in the weights, not what you want. And you come back out and there's screaming toddlers running around, it was very stressed. There's no one to have a conversation with, there's no one to talk to.

Charlotte Young  18:45

So before this, I had got in touch with Lucy Weber via her WhatsApp service. And we were talking to her and she kind of confirmed like that his latch looked perfect. Like positioning was really good. The videos that I was sending her you could hear audible swallowing. So it was it was difficult for her to say like what the issue could be. So we decided that I needed someone to look at him in person. And obviously she was nowhere near me. So I was like that I need to go find somebody. So one of the times we went to the playground and it was all kind of doom and gloom again, because he hadn't put on enough weight. I sat there while my daughter was playing and filled in a referral form for milk matters, which is a company. Yeah. So we we filled in a form for them. And they asked us to get a photo I think of his mouth in a particular position. So we did that. And they were pretty convinced he had a tongue tie. And then around that time, I had my eight week GP appointment. So I went to my GP appointment. And I was saying, Look, this is you know, he's not putting on weight. But he's read book chart, because it's so small and it would all happen in such a like as Slow, slow, quite a small time period that we were talking about eight weeks. The line didn't look too bad. But I'd been plotting it digitally. And I knew that he was dropping centre like he was dropping and dropping and dropping his Central's the GP just did not seem concerned about it. It was almost as if I was a mother who was overly concerned about it all. Because as I explained to her, like, I've tried syringe feeding, I've tried bottle feeding. I've tried all of this, and this is and he's still not, he's still not gaining very much weight, even though I'm trying to like, do all these things. But yeah, there was no, there's no urgency or concern that at all at that appointment.

Emma Pickett  20:43

Oh, Sean, I'm sorry, that was your experience. I mean, I would have thought a baby who's not back up to birth weight by six weeks, you should have automatically had a referral to a paediatrician just to sort of check was I mean, I've got I don't want to kind of imagine what you were going through. But were you starting to worry that maybe something was up with no or Yeah,

Charlotte Young  21:00

I mean, we've gone through everything, dairy intolerance, sigh of intolerance, like just in case it was worse things I think I'd caught by that point, I'd cut those things out. Because I was just like, if there's a small chance that it could be anything of that, then I'll just stick our hand totally happy to cut those out on my diet. I mean, we would have given it in formula if we needed to, or 100%. But at that point, like he wasn't even taking breast express breast milk at all. So there was just no point in, in trying formula. 

Emma Pickett  21:29

Did anybody talk to you about using a supplementary nutritional system at the breast feeding at the breast? How did that go?

Charlotte Young  21:35

Milk matters, gave me one and sent me off sent me on my way. I think at that point, they diagnosed him with a tongue tied, but the concern was that his weight was so low. At that point, that if we did his tongue tie in, if I gave it kind of interrupted the feeding, he was doing that point, if we saw it is dumped out that he could, you know, he was taking such a little amount that if he stopped, you know, it would be no thing who could was able to take at that point, because he was down to like, the sixth or seventh centre from like, the 75th when he was born. So he was he looked very skinny as well. He was a very, you know, he looked very skinny, could see all the ridges on his head. And it was it was getting to the point where anyone that looked at him could see wasn't it wasn't thriving MCL again, was supplementary feeding system. And I can see how it would work amazingly for lots of women. But he just anytime he was so used to getting nothing, hardly anything that anytime any amount of milk was in his mouth, it was like he was shocked. And he would like pull back. So no matter how slow, I tried to do the supplementary feeding system, just every time anything went in his mouth, he would you know, unlatch pull back. So it was interrupting the little amount he could get from the breath because he was hating it so much. So we we tried for a while with that, but that just didn't work at all. So I explained all this to the GP and she was looking at me like, you know, I was just being an overanxious mom. Yeah, that wasn't, that wasn't ideal. But that matters had identified a tongue tie to get some osteopath appointments. And then we managed to get a tongue tie appointment on the NHS. So he had his tongue tie cut. And again, I was very much like, oh, the next weigh in. It might be you know, he might put loads of weight on. But he hadn't. Actually, we had a real crisis point. Because he was on me 24/7 Because he must have, you know, that's the only way he could get enough milk to kind of keep putting on those small amounts of weight. So I was absolutely exhausted. And so what we would start doing is my husband would take him for half of the night. And I would try and get a couple of hours sleep. But my husband had him for about four hours in and I and we came and I can't wait to feed him he just wouldn't really wake up. He was really lethargic, really tired, wouldn't really latch properly at all. And me and my husband just looked at each other and we were thought this is this has got to a crisis point now. So we spoke to milk matters. And she said look, I think you need to go to hospital and I think you need to say that. This is what's happening to this baby and you need an NG tube. We need to get some food. We need to get some some nutrients into him. Give him the energy to figure things out and to you know, get a better yeah,

Emma Pickett  24:32

that that that that advice for an NG tube. My brain is going NG tube NG tube NG tube and I'm guessing you spoke to Charlotte at milk matters Yeah,

Charlotte Young  24:40

she was Charlotte matters Yeah, absolutely knows what she's just sent me an email letter to present it as a wave. And also I double checked of Lucy that she felt like that was the way to go because I'd still Lucy had still been like, my little lactation consultant in my pocket as well as Charlotte just kind of chair Going beyond Emma she has like absolutely like exactly what you need to do

Emma Pickett  25:08

A little advert just to say that you can buy my four books online. You've Got It In You, a positive guide to breastfeeding is 99p as an e book, and that's aimed at expectant and new parents. The Breast Book published by Pinter Martin 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 my last two books are 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 MMPE10, Makes Milk Pickett Emma 10. Thanks.  

Charlotte Young  25:56

So I presented at a&e, and at first it was kind of white here. And but once they got his clothes off him, you know he was so skinny. He was a bit mottled. I think he was close to being dehydrated. And he had gone at that point. He passed the two cent tiles, like the two lines. So I think that was kind of like, okay, yes, we do something about this baby. So we were admitted. Went through it quite quickly. Actually, to be fair with a young baby. We were admitted to like the cat unit in the NLGI. They'd look at him, like the ugly is the weight loss was slow. And they were like, can we try and with a bottle? I was like, absolutely. You try and with a bottle. I'll be very crass. If he takes it after all this, 

Emma Pickett  26:46

you literally had had no, you must have had everyone's saying, Come on, you should be triple feeding, you should be pumping giving a bottle. Everyone's saying give everybody 

Charlotte Young  26:54

we've got so many bottles say many it was like a joke, the amount of bottles that we had. And so yeah, they tried to give them a bottle. They actually said to us, or why don't you go for a walk? And we'll try with a bottle. And I was like, You know what? That's fine. Yeah, I don't need to sit there and watch you do it. When we came back. They looked a bit suspicious. And they said, Well, we managed to get him to have some a little bit of milk. He was very upset about it. But we did manage to get some in him. And he was doing a lot of arching of his back. So we gave him some a map puzzle. Okay. And I'm sorry that we didn't ask you about that. But we just felt like it was appropriate. So I was a little bit taken aback because I didn't, you know, I hadn't really consented to them giving him some reflux medication. But I was like, okay, he managed to get a bottle. That's it. That's, that's a good thing, I suppose. And then they want you to stay so they could try again, to make sure it wasn't a one off. And I was saying it's not really that's not really going to help me because if we won't take a bottle from me, what we're going to do stay here. And anyway. So they did say they weren't admitted to keep us under observation. Or they didn't want to give an NG tube because they've managed to get him to take a bit of milk, apparently. And then someone else tried again. And I don't know what he did when they tried it. But she came in and she was like he will absolutely not to say that. I said, I've never seen a baby refuse milk like this. You know, he was, you know, he was a young baby in a environment. When people didn't know you were suddenly trying to force him to have a bottle. I imagine he was extremely crass. But yeah, at that point, they were like, Yeah, we think we need an NG tube, we're not gonna be able to get enough milk in him. And they said he was on the verge of dehydration. So we needed to act. And I was happy with that, I suppose. Because that's why I've gone in, I wanted the end. 

Emma Pickett  28:49

But an NG tube is a friend in this situation. That's what we need. I mean, I'm sure Charlotte and Lucy would explain to you that once. The weight loss is a certain amount, babies lose the umph to breastfeed, so even the breastfeed he was able to do you know, if we don't have those buccal fat pads, we can't create that negative pressure on our mouth. If we don't have the total muscle strength, we're not gonna be able to breastfeed. So what he was doing would have been, you know, less effective over time. Yeah. I'm glad that NG tube happened in the end. And how are you feeling emotionally at this point, you sound very calm when you're talking about going for a walk and, and waiting to see how they get on with the bottles. But I mean, you must have been very worried.

Charlotte Young  29:27

I wasn't, I wasn't really worried. I was still feeling quite strong, to be honest. And I kind of accredit that to what I'd managed in the birth because it was still quite close to the birth. I still had that I was still kind of riding that high of achieving what I wanted to achieve during my birth. Yeah, when we were close, we were worried but I wasn't really make the latest draft and because of my background, and I've worked in hospitals, I've been around hospitals. I didn't I wasn't so kind of scared of being in there. And because it had been my choice to present as well, and to go in so they were doing what I wanted, obviously, it was very stressful with he wasn't obviously my second child, my husband had gone back to work at that point, there was a lot of childcare issues to sort out, it was more of that than actually being worried about Noah because I knew, I kind of knew that he was probably going to be okay, once you get get some milk into him. 

Emma Pickett  30:26

So you're in hospital, he's got the NG tube, or you and you've been discharged, you've been put in a children's ward guess or with a little eight week old little bit more than eight week old, 

Charlotte Young  30:35

we were in our own room, the good thing was actually, it's not good, but it was good. It ended up being quite good for us is that he'd had an incidental finding of flu be on admission. So all of a sudden, it was very much isolation for him, which meant we got our own room with our own bathroom, which actually was exactly what you needed with a young baby in hospital. He didn't want to be in a ward, it would have been very difficult. Yeah. So we were in, and he didn't seem unwell, to be honest. So, you know, it kind of was just incidental. MCI we were we were in the ward. One thing that was quite tricky is they seem to think it would be easier for them if they could calculate exactly what the the feeds that he was getting. So they did kind of suggest that I needed to stop feeding him, or I only needed to offer feed, offer a boob for comfort and not try to actively feed him. And I wasn't happy with that at all. Namely, because at the moment, that was the only way he would or really take anything. So I just didn't want to stop that. Because I couldn't see a way out at that point if our way away from this empty tube if we'd lost that. So yeah, I am. I said that was gonna keep feeding him. I just kind of nodded. And we're like, okay, yeah, sure, but carried on with what I was doing. I also, at that point, I had at home hired a medical grade breast pump. So they got them to bring me a breast pump as well in hospital. And I got my flanges in from home that were the right size. So yeah, I should probably not mentioned but I was literally pumping every opportunity at this point, because I just knew I needed to keep my seat. Even if he wasn't managing to take much milk. I knew I needed my supplier to be there. So yeah, I was managed to this weird like way of feeding him whilst he was in a sling and napping. So I'd spent a lot of spending a lot of time standing in the kitchen attached to this machine whilst he was napping on me and his leg. So I'd kind of started that system out anyway. So I continued that in hospital, so they would give him his feeds. Via ng M, and I would feed him as well, just as much as he wanted,

Emma Pickett  32:53

pumping while you're wearing his baby in a sling. That sounds like the million dollar thing that everyone needs to know about. If you've got any pictures if you pop. Well, yeah, I've got a video about sharing those. But that honestly, so many people are like, so many people are going like, oh, how do you do that? 

Charlotte Young  33:09

I think it was one time, one boob at a time I could do because I had to kind of like shift him in the sling from one side to the other. But yeah, it works. It works. All right, actually. 

Emma Pickett  33:20

And have you seen a paediatrician yet? So you're in the children's ward has he had he been checked and had an assessment and the blood tests are happening? What's happening? 

Charlotte Young  33:28

No blood tests, just the NG tube. I think he said had a blood test a couple of days ago, because we've been in with like a temperature which may have been related to the flu B actually. And he wasn't very ill with it. We're just taking them in because we knew he was a very skinny guy had baby and we didn't even hear temperature. So we're just taking him in. So I think that had some bloods on record. And the time before, but there was no blood test just had NG tube. And it basically just said, this is the amount of milk we need to get into him. We're going to do it for three days. And then we're going to weigh in and see how he's responded to that milk. So yeah, we were just in hospital with this NG tube. 

Emma Pickett  34:08

I just say one little thing, I just the idea of you come and going in a couple of days before for the for the temperature, you must have seen a doctor at that point. 

Charlotte Young  34:17

We saw like a nurse consultant, not should

Emma Pickett  34:21

not have been going home at that point Charlotte

Charlotte Young  34:24

We were referred to the at that point and had a discussion and explained my concerns. And they'd said that they would refer as to the community dietary team. I think it was just missed at every point to be honest, until and then suddenly when we got in hospital and he had the NG tube. It was kind of like it was my fault then, like it felt there was a bit of blame happening, especially because I was still breastfeeding. So I wasn't doing what they wanted me to do. So one of the things that was quite tricky is that they want him to give him the full amounts via NG tube, but I was also wanting to feed him him. So he wasn't really tolerating the full feeds. So he was vomiting quite a lot. And I wanted them to reduce the volume of the feed just by 2030. Mil, because I felt that he was probably getting that from me because he had been putting on slow amounts of weight. So he was getting some milk. But yeah, he, yeah, I was kind of met with a bit of why aren't you doing what you're told? We're trying to help your baby. You need to have handover towards now. But I wouldn't agree to that. So eventually, I did get kind of like did get them to drop the feeds volumes need to tolerate that much better.

Emma Pickett  35:40

And what's going in the NG tube? That's your expressed milk from your pumping on the hospital grade? Or is there some formula happening at this point?

Charlotte Young  35:45

you would hope it was, I was pumping and providing the breast milk. I thought it was my milk. And it was at some points. But then shift change happened, and you lose a query dairy allergy, because I'd cut the dairy out. So he was, so it turned out at some point that just started giving him the the horrible dairy free formula stinks. So yeah, I'd have to question. Every feed is this what is this? Is this my milk? Can you it? Does not enough of my milk available? Can you mix it with the formula? And at one point, I was told, No, we can't do that. It's too difficult. Or he won't you might not tolerate it. It was there was

Emma Pickett  36:27

there's lots of mixed views about putting milk together. I mean, my understanding is that you always want to give breast milk on its own if you can, just because otherwise, if there's milk leftover, it might be wasted breast milk. So with an NG tube, I can't imagine why you couldn't give your milk first. And then any extra milk. Yeah, but I'm not I'm not going to pretend I'm an expert. 

Charlotte Young  36:47

There was no breastfeeding support at all going on. In fact, there was quite a lot of anti breastfeeding happening. There was a lot of maybe your breast milk is low calorie. There was a lot of old chestnut, yeah, there was a lot of actually you pumping a decent amount, have you ever considered considered just pumping?

Emma Pickett  37:06

Like, because because he takes a bottle so well.

Charlotte Young  37:10

Because also, that's really easy.

Emma Pickett  37:14

I can't believe someone says exclusively pumping when they've just spent, you know, X number of times trying to get milk into him in the bottle, you're not going to have a minute with an NG tube, the next three, 

Charlotte Young  37:22

you know, and also here. And also I was kind of at the paediatrician, I did see came in and he was just very much we're going to use the NG tube. And he looked at me and he said, I'm not going to try and tell you how to breastfeed because you were a woman, I amount, I'm not going to try and tell you how to breastfeed, and I was like, someone needs to help be like, I do need some help, because obviously, something's happening. But anyway, there was no help. And actually, at one point, I was in hospital trying to ring like the infant feeding team or the health visitor to try and get some breastfeeding support. But I just couldn't get through to anyone. It was like it was really, really difficult. So I just, I obviously had Lucy and Charlotte, in my pocket talking to me. So I just carried on doing what I knew I needed to be doing. But there was no forthcoming help in the hospital at all.

Emma Pickett  38:09

I love the idea that because I'm a man, I don't need to care about breastfeeding. I think Dr. Jack Newman would have something to say about that. Not to mention all the other paediatricians who were also ibclcs and, and men. Yeah, it got it sounds like you were so isolated from getting the support you need. I can just imagine you in this room pumping, wondering what's going to happen next. So the tongue tie procedure doesn't seem to have made a big difference, necessarily, it really doesn't seem to have changed what was happening at the breast. 

Charlotte Young  38:36

But we sent a video to Charlotte. And she said, Oh, it looks like he's still got his tongue tie. Yeah. So either it healed and reattached, or it wasn't done. As much as they would have done it at all matters. Let's put it that way. But anyway, we were just at that point it was it was all about just getting to put on some weight. And we had the NG tube. So we were in for four days, with the NG tube. On the third day, the way they put on loads away, like it was probably a lot of water weight, and etc, etc. But the good thing was he had put on weight. So obviously, when he was getting enough milk, he would put in weight. So that was good. That meant it was no or suggested there was no underlying conditions associated or whatever. So at that point, though, because he'd gone up is way they suddenly wanted to offer his milk feeds again, which I wasn't happy with because I knew we hadn't been tolerating the higher amounts. And also they started suggesting all we could thicken it to make him keep it down. And that just to me, I didn't, I didn't want him to, you know, be fed the thickened milk to make him keep it down when I felt the reason he wasn't keeping it down was because he's always he was getting milk from me as well. I was absolutely exhausted by this point, though, because I've been on basically my husband had come to visit, but he was also looking after our I have a child. So I was basically like on my own hospital for the four days. And I because he had the NG tube. I was like, You know what, like, you can forgive him for feeds and I can go home and have like a couple of hours or a couple of over overnight have like a decent sleep. So my husband stayed with him. And I went home. I did have to go back and my husband rang. I went to pick my child up from from her nursery. And then when I came home, I had a voicemail, my husband's saying, You need to come back to work, stop crying, like he's been crying for like hours. So you need to come back. So I took my daughter with me and went back to the hospital. But by the time we got there as I walked in, my husband was giving him a bottle. And it was a premature baby teat. Very small, very, very soft. Yeah. And he was taking it was amazing. It was breast milk. My point breast milk. And yeah, that was absolutely great. So I did go home again after that. And my husband did have him for the night. And he started having bottles instead of the NG feeds think. But the problem was, he wouldn't take for the farm and the dairy free formula. He wouldn't take that in a bottle because it didn't taste very nice. 

Emma Pickett  41:22

Yeah, when it goes down your nose, guess what we bypass the tongue? we bypass the taste buds. 

Charlotte Young  41:27

Yeah. It wasn't. That didn't really helped us in a way because I couldn't pump enough milk to give him the full feeds that he needed. So we sat down with the paediatrician and agreed that we would give him dairy formula, because we'd never had the dairy intolerance, intolerance confirmed. So you know, we were in the best place if he was like, he was terribly allergic to it. We're in a hospital. So yeah, we gave him some dairy formula. And he took it. And he didn't have any sort of reaction to it. So it kind of crossed the dairy allergy off, which was nice for me, because it meant that I could start having dairy and soy again. And yeah, he started taking the bottle. So yeah, the NG tube was taken out. I was pumping. And we were topping up with formula. And I think we were agreed that we could go home. I think it was on 870 mil bottles a day, or in 24 hour period. So that's what we were discharged with.

Emma Pickett  42:24

So your home he's who's what his 910 weeks at this point. I'm trying to work out 

Charlotte Young  42:28

Yeah, eight, nine weeks. Yeah, nine weeks.

Emma Pickett  42:32

And what did the next few weeks look like for you? What did you what kind of support were you getting out? You know, under under health visitor care when they don't really get any support? Back at the play barn? 

Charlotte Young  42:39

Yeah, back at the play barn. So we had we had his tongue tied done properly. Again, again, I should say buy milk matters. He was on his bottles. We kept him on the number of bottles that he was having because we had a paediatrician appointment. I think it was like a week later, when we were when we sent home. So we went to that paediatrician appointment and he had kept the weight that you kept gaining weight because we've been giving them all these bottles. And the paediatrician said, Great. What's your goal? And I said, Oh, I want to I want to keep breastfeeding. And he said, All right, cut all the bottles out. And I was like, Really, and it was a call. Yeah. Like, you know, you should, you'll catch it probably will lose a bit of weight. But where that's okay. And you'll it'll catch up and it'll all just even out. So I we kind of, by this point, to be honest, I learned to smile and nod, smiled and nodded. And then left and went home, spoke to Charlotte spoke to Lucy. There were different opinions, though, from Charlotte and Lucy Charlotte wanted him to keep put more weight on before we started reducing the bottles. But he really wasn't he was well, he was having the bottles. He wouldn't take any more milk from a bottle like he wouldn't he would stop. But he was still staying on that seventh percentile. He wasn't going up anymore. So I didn't, I couldn't see a point where he would put on loads more weight. So I spoke to Lucy and Lucy said, Okay, if we staying on seven centile you know, let's drop a bottle. Let's see what happens. So basically the next month with just me dropping one bottle, waiting a week, weighing him at the play bar and seeing what happened to his weight. And just doing it very, very slowly. And there was a couple of times where his weight dipped. So we thought I spoke to Lucy and we said okay, let's just wait another week maybe like he was a bit ill or maybe we'll just wait till it evens out. Maybe you can just apply and it's to kind of adjust a little bit more. So yeah, just weekly, going in. We have an over appointment with the paediatrician who thought we dropped all the bottles and his weight was still brilliant. So again, smiled and nodded and we got discharged and So yeah, that was the end of the hospital support. But yeah, he was still having bottles, and we were just dropping them really slowly.

Emma Pickett  45:07

And how are you timing things with sort of your breastfeeding? Are you pumping still at this point? I only just I only just stopped pumping. Wow, that's so you were triple feeding for a long time? Yeah. If anyone's listening to this, and they're triple feeding and thinking, what on earth? How on earth? Can you manage to triple feed like this? Do you have any sort of tips to make it work? What did your day look like?

Charlotte Young  45:30

It was utilising naps, really. So we had yet three naps day, we managed to get him down in the car. So it had quite a bit of a routine going. So we would just get up in the morning, give him a big feed or a bottle. And regarding if we dropped that bottle or not, I can't really remember the order in which we dropped the bottles. And then he would we always did a bit of a bottle feed before a nap. Just to we found that I helped him sleep a bit longer to be honest. So put him down, give him a bottle, then I would pump and then we'd have milk for the next feed. And when I got to the point where I was pumping enough that we dropped formula completely. And so all the top ups were just breast milk. But I was very relaxed in the fact that if there was a time when I wasn't pumping enough, we were just mixing some formula like I kind of I tried really not to be attached to that even though it felt like a good kind of I liked it when that was completed. He was just getting copied breast milk. I wasn't going to picky and I would just add in the formula. If I needed to be Yeah, it was just it was just utilising the naps and also utilising the evenings. So I'd pump once he went down at night, and then I'd pump again before I went to bed. So my pumping sessions were when he was asleep, basically. 

Emma Pickett  46:44

Okay, and he's still breastfeeding throughout all these bottles of 70 mils, you know, eat lots of 70 milis. He's still happy to be on the breast keen to breastfeed. Did you feel that as he put on weight?

Charlotte Young  46:54

We paced fed, he certainly I did lose the baby magic. I did feel like that he was very aware that he could get milk faster and easier for my bottle. So it would still happily go on the boob but we did lose kind of stopped falling asleep on the boob like he stopped really wanting a boob for comfort. Like he would still take it. But it wasn't as obsessed as I know some some entirely breastfed babies are but yeah, we just we just continued and I think we got down to three bottles a day from the A and actually I felt like that was a good a good point to maybe stop leave it as there's benefits I suppose my husband could feed him you know he settled quite well on the bottle. So yeah, we've got we've got down to that and then I think Nach One of the bottles one of those bottles was in the night. But then he just dropped that himself because he started sleeping through and we didn't really panic about that. So then he was just on the two bottles which is what he kind of is still on now that we've we've reduced reduce the amount he's having in them.

Emma Pickett  48:05

And what how what was happening with his weight as he got closer to sort of six months what was going on with his weight gain,

Charlotte Young  48:10

stayed at seven centile maybe bounced around. I think at one point we got to like 1011 and then went back down. I had to really wean myself off weighing him to be honest. I kind of thought you know if he looks okay, then he's okay. I'll just try and try and stay away from because it was quite a big source of anxiety for me coming and going and doing the weigh ins and it was never that amazing. Wow was put on those away that I kind of was chasing. So I just Yeah, we did. We did slow down with the weighing quite a lot. And every time I'd weigh them message Lucy like, oh, Lucy's. He's gone down to the six deuce. He was like, stop weighing him. Leave him. So yeah, I did. I did stop. And then when he got to six months and started eating his weight shot up, absolutely shutter. And it's continued to shoot up. We did have a blip where he he got a vomiting bug and it went on for a really long time. I lost loads of weight. And it was really traumatic for me and my husband and because he started looking or Ikki did lost his cheeks lost his rolls. Yeah, that was quite triggering for us both but quite quickly once he got better. We picked back up and yeah, I mean, I've never seen him at the moment. I've never seen him as is lovely and healthy looking in his ears right now. 

Emma Pickett  49:36

So that's great. Well, it's lovely to hear. So you had two sessions with the paediatrician and maybe three when you were doing the smile and nod. I don't know if anyone anyone's listen to this has listened to my episode with the amazing Vicki Thomas, who would be wringing her hands at hearing your story and wishing very much that you'd had a different type of support. So really, all those sessions did was wrong. that underlying issue for him, it didn't really give you feeding support or anything particularly realistic in terms of what was best best for now. But after that you didn't, you obviously benefited so much from having Lucy's ongoing support and contact with Charlotte as well. But, but you didn't really have health visitor support that was

Charlotte Young  50:20

going on, I think I did have a phone call from a health visitor, who really just listened to my story, said how terrible it was, and then asked if I needed any support. But at that point, I'd kind of like I said, learn to smile and nod and actually realised that I was better off just following the advice of the people that found privately. 

Emma Pickett  50:44

And when someone used that term faltering growth, how did that feel to have that sort of label put on our

Charlotte Young  50:50

as a relief, actually, at that point, because I'd been, I mean, we'd all known anyone that looked at him, or my family, we've all known that things weren't going well, and that he was struggling. And it had taken such a long time for it to be recognised that when they finally recognised it, I was like, Yeah, he is faltering, his growth is faltering. But it's not like, it's not for lack of us doing anything. So it really, yeah, it was a relief, actually. 

Emma Pickett  51:18

Well, that's good to hear. Because I think the old fashioned language of failure to thrive is really not going to be a term that anyone's going to welcome. But you know, faltering growth, as you say, is is a label that perhaps helps you get the support you need, although necessarily in your case, when you look back on those early weeks, other people were blaming you for the sounds of it, and you were struggling with other people's attitudes. Do you look back and think if only if only this had happened, if only that had happened? Or are you somebody that's pretty good at just saying, you know, it was what it was, and here I am today?

Charlotte Young  51:50

I did the only thing that as an asset, it's a losing asset to Charlotte. And they've both kind of said he could have been in the exact same situation is if I hadn't have wanted to breastfeed. If I had gone straight to a bottle, would he have just taken a bottle and been able to feed effectively? And would we have not been in that place? That was the only thing that I struggled with? But I think Lucy was a no, it was Charlotte said, with this tongue tie that he had, he probably would have struggled to effectively feed from a bottle, and we probably would have had other issues, he probably would have had terrible colic or reflux or because he wouldn't have been feeding effectively that way, either. So

Emma Pickett  52:33

yeah, no, I can understand that you think this would mess

Charlotte Young  52:36

with my thirst we had? No, because she was on formula, and she was on bottles. You know, we just didn't ever think about it. When we went to that eight week check. There was no like, oh, what's a weight? Because we knew she was having all of the bottles. And we could see she was growing? Well, so there was real, there was no real weight conflict, we never really thought about her weight. 

Emma Pickett  52:55

But you had a drive, didn't you to make sure it was your milk going down the NG tube. There was something in you that kept you pumping. 14 months, there's something in you which values breast milk. And yeah, and we're talking about it his whole life in terms of health, health outcomes, we could have another whole hour talking about all the all the value that breast milk will have given him. I can understand wanting to move the anxiety around weight gain, though don't get me wrong at all. But you've given him such a gift with all your hard work and all the feeds that you've done and all the comfort you've given him and all the antibodies and lifestyle and lactoferrin. And let's just talk about all the hormones, and there's just been so much value in there's something there that kept you going with the breast milk.

Charlotte Young  53:37

Yeah. And I did. I did complain, I went through polls. I kind of got it all out on paper. And I did get a response with some, some apologies. And they did said that they had rolled out some breastfeeding support in the ward, the particular ward that I was in. So yeah, I felt like that was a little a little when how effective that's pot was was one we'll never know. But yeah, well,

Emma Pickett  54:06

all you can do is raise the issue and make your complaint and well done for doing that. And yeah, that's I'm sure that will have made a difference on some level, even if we can't fix everything overnight when it comes to NHS training. Thank you very much for sharing your story today. Charlotte, is there anything we we've talked about that you want to clarify, or we haven't mentioned that you wanted to make sure you covered? Now I think we've we've covered most things. It's a story of a determined mother and someone who wanted to get the right support for their baby, but first being let down by services that really weren't listening, not listening to you to the point where they were speaking at you and you stopped listening because the communication was so poor and so on. You know. It's just it's a sad story in lots of ways, but I hope people also hear how strong you were through that and it's great to hear that that nowhere is where he is today. And yay for antenatal expression and colostrum. Yay for Charlotte and Lucy. Yay for NG tubes. Yay for that magic bottle that made the difference.

Charlotte Young  55:07

We did get him off the we caught him off that bottle because they were in one use only.

Emma Pickett  55:13

Okay, so that's not so handy. But yeah, I will. I'm glad that that that's what you needed to be able to go home. Yeah, otherwise, you might still be in hospital today with an NG tube if you hadn't if that hadn't happened. So. So just just I know we're running out of time, but just very briefly at the end, when you describe the tongue time, I mean, Charlotte's the tongue tie expert, not me. But it's a little bit mysterious, in some ways as to what was happening and know when I hear your story. You know, you weren't in pain. He was attaching, you know, Lucy's fantastic. And she was looking to latch and it appeared to be effective. So when you look back, do you kind of you were happy to live with that piece of tongue tie was a factor. But maybe it wasn't the whole story. Or, you know, are you somebody that really still needs answers and looks back with kind of frustration that you don't have 100% answers as to, you know, why was this? Was there lots of polls and wet nappies, that weight gain was still slow is that there's a sort of slightly unknown element to this story

Charlotte Young  56:07

there is for sure. But I think if I dwell on it too much, like I said, I get too frustrated. I think it is certainly, I think certainly the tongue tie had quite a big impact. There was some reason why he wasn't effectively draining the breast and why my supply then dipped, because he wasn't initiating my suppliers he should have been so yeah, I do, you kind of do kind of go with, I think Charlotte felt as well, like it was probably a tongue tie, which then led to my supply being low. And also him not being him getting tired and tired and tired as things getting worse and worse. And worse. I think it was just all of those factors combined, because the fact is, you know, event when he came off the NG tube, that we didn't manage to get down to those two small bottles, and he did manage to maintain his way. So, you know, the energy like him being able to feed more effectively and my supply kind of me pumping to get my supply back up there obviously did did work. 

Emma Pickett  57:09

Yeah, you're just in a little bit of a spiral of him losing energy and losing weight losing energy and your supply dipping? No, I understand. Yep. Okay, thank you, Charlotte. I'm gonna let you go and have your day and speak to your virtual clients and do your work. And in the show notes, we will put your Instagram are there any particular resources that you'd like people to know about that we can put in the show notes? 

Charlotte Young  57:33

It will guess it would just be Lucy and milk matters? Because and they're people that I recommend to all my clients? Yeah, I think yeah, they definitely saved my feed and journey with Noah. 

Emma Pickett  57:46

Yeah, I can hear that for sure. Yep. Yeah, I have lots of respect for milk matters and Lucy as well. So I'm very happy to do that. 

Charlotte Young  57:53

Thank you. 

Emma Pickett  57:53

Thanks, Charlotte. Thank you for joining me today. 

Emma Pickett  58:00

Thank you for joining me today. You can find me on Instagram at Emma Pickett IBCLC and on Twitter @MakesMilk. 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.